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Kazmirak C, Tollefson D, Lankowski A, Sanchez H, Gonzales I, Espinoza D, Duerr A. Practices and preferences for HIV testing and treatment services amongst partners of transgender women in Lima, Peru: An exploratory, mixed methods study. PLoS One 2024; 19:e0306852. [PMID: 38980855 PMCID: PMC11232998 DOI: 10.1371/journal.pone.0306852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 06/25/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND In Peru, one-third of transgender women (TW) are estimated to be living with HIV. While TW are recognized as a priority population, their sexual partners are an at-risk hidden population with unmet needs for HIV services. We conducted a study examining the practices and preferences for HIV services among partners of transgender women (PTW), as compared to TW, to better understand the needs of PTW and inform HIV service delivery for them in Peru. METHODS Between July-October 2022 we conducted a cross-sectional mixed methods study among PTW and TW in Lima, Peru. Using an explanatory sequential design, we administered online surveys to PTW (n = 165) and TW (n = 69), then interviewed a subset of participants (n = 20: 16 PTW, 4 TW). We quantitatively and qualitatively described PTW practices/perspectives on HIV testing and treatment and compared them to TW practices/preferences; we also compared practices/preferences among PTW based on their relationship with TW. RESULTS Overall, PTW and TW shared similar experiences and preferences for HIV testing/treatment, but fewer PTW reported accessing non-traditional HIV testing options and PTW expressed less strong preferences for HIV services. PTW practices/preferences varied by type of relationship with TWs. Surveys and interviews highlighted a need to prioritize efficiency for HIV testing, eliminate gender/sexuality-based discrimination in healthcare settings, increase privacy when delivering HIV services, and increase awareness of pre-exposure prophylaxis. CONCLUSION PTW identified many aspects related to the location, convenience, and privacy of HIV services as important. Next steps could include a discrete choice experiment to further clarify priorities for HIV services for PTW in Peru.
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Affiliation(s)
- Claudia Kazmirak
- University of Illinois College of Medicine, Chicago, IL, United States of America
- Vaccine Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States of America
| | - Deanna Tollefson
- Vaccine Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States of America
| | - Alexander Lankowski
- Vaccine Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States of America
- Department of Global Health, University of Washington, Seattle, WA, United States of America
| | | | | | | | - Ann Duerr
- Vaccine Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, United States of America
- Department of Global Health, University of Washington, Seattle, WA, United States of America
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Brown EE, Patel EU, Poteat TC, Mayer K, Wawrzyniak AJ, Radix AE, Cooney EE, Laeyendecker O, Reisner SL, Wirtz AL. Prevalence of Sexually Transmitted Infections Among Transgender Women With and Without HIV in the Eastern and Southern United States. J Infect Dis 2024; 229:1614-1627. [PMID: 38232978 PMCID: PMC11175699 DOI: 10.1093/infdis/jiad605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/31/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Data on the epidemiology of sexually transmitted infections (STIs) among transgender women (TGW) with and without human immunodeficiency virus (HIV) are limited. METHODS We analyzed baseline data collected from a cohort of adult TGW across 6 eastern and southern US cities between March 2018 and August 2020 (n = 1018). Participants completed oral HIV screening, provided self-collected rectal and urogenital specimens for chlamydia and gonorrhea testing, and provided sera specimens for syphilis testing. We assessed associations with ≥1 prevalent bacterial STI using modified Poisson regression. RESULTS Bacterial STI prevalence was high and differed by HIV status: 32% among TGW with HIV and 11% among those without HIV (demographic-adjusted prevalence ratio = 1.91; 95% confidence interval = 1.39-2.62). Among TGW without HIV, bacterial STI prevalence differed by geographic region, race and ethnicity, and gender identity, and was positively associated with reporting >1 sexual partner, hazardous alcohol use, homelessness, having safety concerns regarding transit to health care, and no prior receipt of gender-affirming health services. Among TGW with HIV, older age was inversely associated with bacterial STI. CONCLUSIONS TGW had a high prevalence of bacterial STIs. The prevalence and correlates of bacterial STI differed by HIV status, highlighting the unique needs and risks of TGW with and without HIV. Tailored interventions may reduce sexual health-related inequities.
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Affiliation(s)
- Erin E Brown
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Baltimore, Maryland, USA
| | - Eshan U Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Tonia C Poteat
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kenneth Mayer
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew J Wawrzyniak
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Asa E Radix
- Callen-Lorde Community Health Center, New York, New York, USA
| | - Erin E Cooney
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Baltimore, Maryland, USA
| | - Sari L Reisner
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Andrea L Wirtz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Bai C, Tan T, Li L, Lu R, Zhang W, Ouyang L, Wu G, Zhou C. Molecular network characteristics and drug resistance analysis of 392 newly reported MSM HIV/AIDS cases in Chongqing, China. Front Public Health 2024; 12:1308784. [PMID: 38903589 PMCID: PMC11187242 DOI: 10.3389/fpubh.2024.1308784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 05/23/2024] [Indexed: 06/22/2024] Open
Abstract
To comprehensively investigate the molecular transmission patterns of HIV-1 genotypes among men who have sex with men (MSM) in Chongqing, we employed 392 pol sequences of MSM to construct a phylogenetic tree and gene transmission network. Among the viral subtypes, CRF07_BC accounted for 73.2% (287/392) and CRF01_AE accounted for 20.7% (81/392), emerging as the predominant subtypes in this investigation. Additionally, we observed the presence of CRF55_01B, subtype B, CRF08_BC and other circulating recombinant forms. The HIV-1 molecular network was constructed with a gene distance threshold of 1.5%, resulting in an entry rate of 61.4% (241/392). Within the network, we identified a total of 23 molecular clusters, with the largest cluster being the CRF07_BC molecular cluster comprising 148 node values. Transmitted drug-resistance (TDR) mutations were found in 4.34% of the cases, with 1.79% associated with protease inhibitors (PIs), 0.51% with nucleoside reverse transcriptase inhibitors (NRTIs), and 2.55% with non-nucleoside reverse transcriptase inhibitors (NNRTIs). Statistical analysis indicated a higher enrollment rate in the HIV-1 molecular network among infected individuals with the CRF07_BC subtype, those identifying with same-sex sexual roles as "vers," and individuals with higher education levels. This suggests the need for strengthened investigation and intervention in this population to prevent the formation of larger transmission clusters. Furthermore, continuous monitoring of the HIV-1 molecular dynamics network is necessary to promptly and accurately track changes in molecular epidemic characteristics.
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Affiliation(s)
| | | | | | | | | | | | - Guohui Wu
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Chao Zhou
- Chongqing Center for Disease Control and Prevention, Chongqing, China
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Lankowski A, Tollefson D, Sánchez H, Cabello R, Hidalgo J, Mathison MN, Molina Y, Duerr A. Acceptability of venue-based HIV testing and prevention interventions for men who have sex with transgender women and transgender women in Lima, Perú: a formative, qualitative study. HIV Res Clin Pract 2024; 25:2331360. [PMID: 38579280 PMCID: PMC11142865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
BACKGROUND Despite being at elevated risk for HIV, men who have sex with transgender women (MSTW) are an overlooked population in the global HIV response. Venue-based HIV interventions have previously had success reaching other HIV priority populations, including transgender women (TW). Similar approaches could be applied for MSTW. OBJECTIVE To evaluate the prospective acceptability of venue-based HIV testing and prevention interventions for MSTW and TW in Lima, Peru. METHODS In this exploratory qualitative study, we conducted in-depth interviews (IDI) and focus group discussions (FGD) with three types of participants: MSTW (7 IDIs, 1 FGD), TW (1 FGD), and owners of social venues frequented by MSTW/TW in Lima (2 IDIs). We elicited participants' attitudes and perceptions related to the following four hypothetical interventions delivered at social venues in Lima: rapid HIV testing; HIV self-test distribution; condom/lubricant distribution; and enrolment in a mobile app supporting HIV prevention. We performed a mixed deductive-inductive thematic analysis using the framework method, then applied the Theoretical Framework of Acceptability to classify the overall acceptability of each intervention. RESULTS Condom/lubricant distribution and app-based HIV prevention information were highly acceptable among all participant types. The two HIV testing interventions had relatively lower acceptability; however, participants suggested this could be overcome if such interventions focused on ensuring discretion, providing access to healthcare professionals, and offering appropriate incentives. CONCLUSIONS Overall, MSTW and TW shared similar favourable attitudes towards venue-based HIV interventions. Venue-based outreach warrants further exploration as a strategy for engaging MSTW and TW in HIV prevention activities.
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Affiliation(s)
- Alexander Lankowski
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, USA
- Department of Global Health, University of Washington, Seattle, USA
| | - Deanna Tollefson
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, USA
| | | | | | | | | | - Yamilé Molina
- School of Public Health, University of Illinois Chicago, Chicago, USA
| | - Ann Duerr
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, USA
- Department of Global Health, University of Washington, Seattle, USA
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Agustí C, Martínez-Riveros H, Hernández-Rodríguez À, Casañ C, Díaz Y, Alonso L, Martró E, Muñoz-Basagoiti J, Gallemí M, Folch C, Sönmez I, Adell H, Villar M, París de León A, Martinez-Puchol S, Pelegrin AC, Perez-Zsolt D, Raïch-Regué D, Mora R, Villegas L, Clotet B, Izquierdo-Useros N, Cardona PJ, Casabona J. Self-sampling monkeypox virus testing in high-risk populations, asymptomatic or with unrecognized Mpox, in Spain. Nat Commun 2023; 14:5998. [PMID: 37783731 PMCID: PMC10545734 DOI: 10.1038/s41467-023-40490-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/31/2023] [Indexed: 10/04/2023] Open
Abstract
The recent monkeypox virus (MPXV) outbreak was of global concern and has mainly affected gay, bisexual and other men who have sex with men (GBMSM). Here we assess prevalence of MPXV in high-risk populations of GBMSM, trans women (TW) and non-binary people without symptoms or with unrecognized monkeypox (Mpox) symptoms, using a self-sampling strategy. Anal and pharyngeal swabs are tested by MPXV real-time PCR and positive samples are tested for cytopathic effect (CPE) in cell culture. 113 individuals participated in the study, 89 (78.76%) were cis men, 17 (15.04%) were TW. The median age was 35.0 years (IQR: 30.0-43.0), 96 (85.02%) individuals were gay or bisexual and 72 (63.72%) were migrants. Seven participants were MPXV positive (6.19% (95% CI: 1.75%-10.64%)). Five tested positive in pharyngeal swabs, one in anal swab and one in both. Six did not present symptoms recognized as MPXV infection. Three samples were positive for CPE, and showed anti-vaccinia pAb staining by FACS and confocal microscopy. This suggests that unrecognized Mpox cases can shed infectious virus. Restricting testing to individuals reporting Mpox symptoms may not be sufficient to contain outbreaks.
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Affiliation(s)
- Cristina Agustí
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT), Department of Health, Government of Catalonia, Badalona, Spain.
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain.
| | - Héctor Martínez-Riveros
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT), Department of Health, Government of Catalonia, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- Doctorate Program in Methodology of Biomedical Research and Public Health, Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Àgueda Hernández-Rodríguez
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, Badalona, Spain
- Departament of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain
| | - Cristina Casañ
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Yesika Díaz
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT), Department of Health, Government of Catalonia, Badalona, Spain
| | - Lucía Alonso
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT), Department of Health, Government of Catalonia, Badalona, Spain
- Fundació Lluita contra las Infeccions, Infectious Diseases Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Elisa Martró
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, Badalona, Spain
- Departament of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain
| | | | - Marçal Gallemí
- IrsiCaixa AIDS Research Institute, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Cinta Folch
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT), Department of Health, Government of Catalonia, Badalona, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
| | - Ibrahim Sönmez
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT), Department of Health, Government of Catalonia, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
| | | | | | - Alexia París de León
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Sandra Martinez-Puchol
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, Badalona, Spain
- Vicerectorat de Recerca, Universitat de Barcelona, Universitat de Barcelona(UB), Barcelona, Spain
| | - A C Pelegrin
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Daniel Perez-Zsolt
- IrsiCaixa AIDS Research Institute, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Dàlia Raïch-Regué
- IrsiCaixa AIDS Research Institute, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | | | - Bonaventura Clotet
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- Fundació Lluita contra las Infeccions, Infectious Diseases Department, Hospital Germans Trias i Pujol, Badalona, Spain
- IrsiCaixa AIDS Research Institute, Hospital Germans Trias i Pujol, Badalona, Spain
- University of Vic-Central University of Catalonia (uVic-UCC), Vic, Spain
- Biomedical Research Center Network for Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Nuria Izquierdo-Useros
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- IrsiCaixa AIDS Research Institute, Hospital Germans Trias i Pujol, Badalona, Spain
- Biomedical Research Center Network for Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Pere-Joan Cardona
- Microbiology Department, Clinical Laboratory North Metropolitan Area, Germans Trias i Pujol University Hospital, Badalona, Spain
- Departament of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain
- Biomedical Research Center Network for Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Casabona
- Centre of epidemiological studies on sexually transmitted infections and AIDS of Catalunya (CEEISCAT), Department of Health, Government of Catalonia, Badalona, Spain
- Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain
- Departament of Genetics and Microbiology, Autonomous University of Barcelona, Badalona, Spain
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