1
|
Chapa Montemayor AS, Connolly DJ. Alcohol reduction interventions for transgender and non-binary people: A PRISMA-ScR-adherent scoping review. Addict Behav 2023; 145:107779. [PMID: 37348175 DOI: 10.1016/j.addbeh.2023.107779] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/17/2023] [Accepted: 06/14/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION Transgender and non-binary people use more alcohol and report a greater need for help to reduce their consumption than their cisgender counterparts. They experience anticipated and enacted discrimination when seeking alcohol reduction healthcare. This study aimed to identify any alcohol reduction interventions for trans and non-binary people. METHODS A systematic scoping review was completed according to PRISMA-ScR guidelines. Following an extensive search across five databases, two independent reviewers carried out abstract screening, full-text screening, data extraction and quality assessment. Findings were synthesised narratively. RESULTS The search generated 1399 unique records. Ten texts were reviewed in full, and the final sample comprised six studies of moderate quality. Included records all reported adaptations of various psychosocial interventions including individual therapies, group therapy, a trans-affirmative clinical environment, and a specialist inpatient rehabilitation service. Four interventions resulted in alcohol reduction with modest effect size. However, the change in alcohol consumption was not statistically significant in two studies. Trans women were disproportionately investigated through the lens of HIV risk reduction. CONCLUSION Interventions developed for one population cannot be presumed effective in another, particularly those as heterogeneous as trans and non-binary communities. There is some suggestion that psychosocial interventions adapted for the needs of the trans community are effective in achieving alcohol reduction. However, it is unclear how these will fare with trans men and non-binary people and specialist interventions may be needed.
Collapse
Affiliation(s)
- Ana Sofia Chapa Montemayor
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dean J Connolly
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| |
Collapse
|
2
|
Let's Talk About Sex: The Impact of Partnership Contexts on Communication About HIV Serostatus and Condom Use Among Men Who Have Sex with Men (MSM) and Transgender Women (TW) in Lima, Peru. AIDS Behav 2021; 25:2139-2153. [PMID: 33411208 DOI: 10.1007/s10461-020-03144-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 01/17/2023]
Abstract
Sexual communication with partners informs risk assessment and sexual practices. We evaluated participant, partner, and network factors associated with communication about condom use and HIV serostatus and explored their relationships with condomless anal intercourse (CAI) among 446 men who have sex with men (MSM) and 122 transgender women (TW) in Lima, Peru. Generalized estimating equations assessed contextual influences on communication and practices with recent sexual partners. More frequent HIV communication was reported by MSM who: identified as heterosexual, compared to bisexual or gay; characterized partnerships as stable, compared to casual, anonymous, or commercial; or discussed HIV/STIs with close social contacts (p < 0.05). TW in concurrent partnerships discussed condom use more frequently than those in monogamous relationships (p < 0.05). Condom use discussions and alcohol use among MSM were associated with CAI (p < 0.05). Findings highlight complexity in sexual decision-making and call for further study of conversation content and practices to inform HIV prevention messaging.
Collapse
|
3
|
Ayer A, Segura ER, Perez-Brumer A, Chavez-Gomez S, Fernandez R, Gutierrez J, Suárez K, Lake JE, Clark JL, Cabello R. Sexual health norms and communication patterns within the close social networks of men who have sex with men and transgender women in Lima, Peru: a 2017 cross-sectional study. BMC Public Health 2021; 21:1090. [PMID: 34098916 PMCID: PMC8186208 DOI: 10.1186/s12889-021-11091-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social networks, norms, and discussions about sexual health may inform sexual practices, influencing risk of human immunodeficiency virus (HIV) or sexually transmitted infection (STI) acquisition. To better understand social networks of Peruvian men who have sex with men (MSM) and transgender women (trans women), we examined key social network members (SNMs), participant perceptions of these network members' opinions toward sexual health behaviors, and associations between network member characteristics and condomless anal intercourse (CAI). METHODS In a 2017 cross-sectional study, a convenience sample of 565 MSM and trans women with HIV-negative or unknown serostatus was asked to identify three close SNMs; describe discussions about HIV and STI prevention with each; and report perceived opinions of condom use, HIV/STI testing, and partner notification of STIs. Generalized estimating equations evaluated relationships between SNM characteristics, opinions, and discussions and participant-reported CAI. RESULTS Among participants who identified as MSM, 42.3% of key SNMs were perceived to identify as gay. MSM "never" discussed HIV and STI prevention concerns with 42.4% of heterosexual SNMs, but discussed them "at least once weekly" with 16.9 and 16.6% of gay- and bisexual- identifying SNMs, respectively. Among participants who identified as trans women, 28.2% of key SNMs were perceived as heterosexual; 25.9%, as bisexual; 24.7%, as transgender; and 21.2%, as gay. Trans women discussed HIV/STI prevention least with cis-gender heterosexual network members (40.2% "never") and most with transgender network members (27.1% "at least once weekly"). Participants perceived most of their close social network to be completely in favor of condom use (71.2% MSM SNMs, 61.5% trans women SNMs) and HIV/STI testing (73.1% MSM SNMs, 75.6% trans women SNMs), but described less support for partner STI notification (33.4% MSM SNMs, 37.4% trans women SNMs). Most participants reported CAI with at least one of their past three sexual partners (77.5% MSM, 62.8% trans women). SNM characteristics were not significantly associated with participant-reported frequency of CAI. CONCLUSIONS Findings compare social support, perceived social norms, and discussion patterns of Peruvian MSM and trans women, offering insight into social contexts and sexual behaviors. TRIAL REGISTRATION The parent study from which this analysis was derived was registered at ClinicalTrials.gov (Identifier: NCT03010020 ) on January 4, 2017.
Collapse
Affiliation(s)
- Amrita Ayer
- South American Program in HIV Prevention Research, University of California Los Angeles David Geffen School of Medicine, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA. .,University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
| | - Eddy R Segura
- South American Program in HIV Prevention Research, University of California Los Angeles David Geffen School of Medicine, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA.,Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Amaya Perez-Brumer
- University of Toronto Dalla Lana School of Public Health, Toronto, Canada
| | | | | | | | | | - Jordan E Lake
- South American Program in HIV Prevention Research, University of California Los Angeles David Geffen School of Medicine, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA.,Department of Internal Medicine, Division of Infectious Diseases, McGovern Medical School at UT Health, Houston, USA
| | - Jesse L Clark
- South American Program in HIV Prevention Research, University of California Los Angeles David Geffen School of Medicine, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA.,Department of Internal Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - Robinson Cabello
- South American Program in HIV Prevention Research, University of California Los Angeles David Geffen School of Medicine, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA, 90095, USA.,Asociación Civil Via Libre, Lima, Peru
| |
Collapse
|
4
|
Tiwari R, Wang J, Han H, Kalu N, Sims LB, Katz DA, Burke B, Tsegaye AT, Carter KA, Freije S, Guo B, Albirair M, Barr‐DiChiara M, Baggaley R, Jamil MS, Senya K, Johnson C, Khosropour CM. Sexual behaviour change following HIV testing services: a systematic review and meta-analysis. J Int AIDS Soc 2020; 23:e25635. [PMID: 33161636 PMCID: PMC7649006 DOI: 10.1002/jia2.25635] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/06/2020] [Accepted: 10/12/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Learning one's HIV status through HIV testing services (HTS) is an essential step toward accessing treatment and linking to preventive services for those at high HIV risk. HTS may impact subsequent sexual behaviour, but the degree to which this varies by population or is true in the setting of contemporary HIV prevention activities is largely unknown. As part of the 2019 World Health Organization Consolidated Guidelines on HTS, we undertook a systematic review and meta-analysis to determine the effect of HTS on sexual behaviour. METHODS We searched nine electronic databases for studies published between July 2010 and December 2019. We included studies that reported on at least one outcome (condom use [defined as the frequency of condom use or condom-protected sex], number of sex partners, HIV incidence, STI incidence/prevalence). We included studies that prospectively assessed outcomes and that fit into one of three categories: (1) those evaluating more versus less-intensive HTS, (2) those of populations receiving HTS versus not and (3) those evaluating outcomes after versus before HTS. We conducted meta-analyses using random-effects models. RESULTS AND DISCUSSION Of 29 980 studies screened, 76 studies were included. Thirty-eight studies were randomized controlled trials, 36 were cohort studies, one was quasi-experimental and one was a serial cross-sectional study. There was no significant difference in condom use among individuals receiving more-intensive HTS compared to less-intensive HTS (relative risk [RR]=1.03; 95% CI: 0.99 to 1.07). Condom use was significantly higher after receiving HTS compared to before HTS for individuals newly diagnosed with HIV (RR = 1.65; 95% CI: 1.36 to 1.99) and marginally significantly higher for individuals receiving an HIV-negative diagnosis (RR = 1.63; 95% CI: 1.01 to 2.62). Individuals receiving more-intensive HTS reported fewer sex partners at follow-up than those receiving less-intensive HTS, but the finding was not statistically significant (mean difference = -0.28; 95% CI: -3.66, 3.10). CONCLUSIONS Our findings highlight the importance of using limited resources towards HTS strategies that focus on early HIV diagnosis, treatment and prevention services rather than resources dedicated to supplementing or enhancing HTS with additional counselling or other interventions.
Collapse
Affiliation(s)
- Ruchi Tiwari
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
| | - Jiayu Wang
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
| | - Hannah Han
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
| | - Ngozi Kalu
- Department of Infectious Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
| | - Lee B Sims
- School of Public HealthImperial College LondonLondonUnited Kingdom
| | - David A Katz
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
| | - Barbara Burke
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
| | - Adino T Tsegaye
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
| | - Kayla A Carter
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
| | - Sophie Freije
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
| | - Boya Guo
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
| | | | | | - Rachel Baggaley
- Global HIV, Hepatitis and STIs programmeWorld Health OrganizationGenevaSwitzerland
| | - Muhammad S Jamil
- Global HIV, Hepatitis and STIs programmeWorld Health OrganizationGenevaSwitzerland
| | - Kafui Senya
- Communicable Diseases ClusterWorld Health OrganizationAccraGhana
| | - Cheryl Johnson
- Global HIV, Hepatitis and STIs programmeWorld Health OrganizationGenevaSwitzerland
| | | |
Collapse
|