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Nguyen PT, Hori M, Matsuda T, Katanoda K. Cancer Prevalence Projections in Japan and Decomposition Analysis of Changes in Cancer Burden, 2020-2050: A Statistical Modeling Study. Cancer Epidemiol Biomarkers Prev 2023; 32:1756-1770. [PMID: 37756571 PMCID: PMC10690142 DOI: 10.1158/1055-9965.epi-23-0754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/02/2023] [Accepted: 09/25/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND We provide comprehensive sex-stratified projections of cancer prevalence for 22 cancer sites in Japan from 2020 to 2050. METHODS Using a scenario-based approach, we projected cancer prevalence by combining projected incidence cases and survival probabilities. Age-specific incidences were forecasted using age-period-cohort models, while survival rates were estimated using a period-analysis approach and multiple parametric survival models. To understand changes in cancer prevalence, decomposition analysis was conducted, assessing the contributions of incidence, survival, and population demographics. RESULTS By 2050, cancer prevalence in Japan is projected to reach 3,665,900 (3,210,200 to 4,201,400) thousand cases, representing a 13.1% increase from 2020. This rise is primarily due to a significant increase in female survivors (+27.6%) compared with a modest increase in males (+0.8%), resulting in females overtaking males in prevalence counts from 2040 onward. In 2050, the projected most prevalent cancer sites in Japan include colorectal, female breast, prostate, lung, and stomach cancers, accounting for 66.4% of all survivors. Among males, the highest absolute increases in prevalence are projected for prostate, lung, and malignant lymphoma cancers, while among females, the highest absolute increases are expected for female breast, colorectal, and corpus uteri cancers. CONCLUSIONS These findings emphasize the evolving cancer prevalence, influenced by aging populations, changes in cancer incidence rates, and improved survival. Effective prevention, detection, and treatment strategies are crucial to address the growing cancer burden. IMPACT This study contributes to comprehensive cancer control strategies and ensures sufficient support for cancer survivors in Japan.
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Affiliation(s)
- Phuong The Nguyen
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Megumi Hori
- School of Nursing, University of Shizuoka, Shizuoka, Japan
| | - Tomohiro Matsuda
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kota Katanoda
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
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Yang X, Li L, Zhang N, Hao L, Zhu X, Yu H, Wang G, Kang D. Analysis on epidemiological characters and HIV care continuum of HIV-infected students: a retrospective cohort study in Shandong province, China. BMC Infect Dis 2023; 23:496. [PMID: 37501181 PMCID: PMC10373422 DOI: 10.1186/s12879-023-08476-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUD The proportion of HIV-infected students in China showed an increasing trend. This study aimed to identify the epidemiological characteristics and the HIV care continuum for HIV-infected students in Shandong Province, China. METHODS Case report and follow-up data of HIV-infected students were obtained from the National HIV/AIDS comprehensive response information management system. Logistic regression analyses were used to analyze the associating factors of HIV-infected students accepting CD4 + T cells (CD4) test and antiviral therapy (ART) in 30 days, and ArcGIS software was used for the spatial anlysis. RESULTS From 2017 to 2019, 403 HIV-infected students were reported in Shandong Province. The majority of them were male (99.5%) and transmitted through homosexual sexual activity(92.1%). Most of them lived in Jinan city and Qingdao city. 68.5% (276 cases) accepted CD4 test in 30 days, and 48.6% (196 cases) started ART in 30 days. The heterosexual transmitted cases (AOR = 0.458, 95%CI: 0.210-0.998), patients accepting HIV care in western area (AOR = 0.266,95%CI: 0.147-0.481) were less likely to test CD4 within 30 days; patients aged 23-25 (AOR = 2.316, 95%CI: 1.009-5.316) and patients who had tested CD4 within 30 days (AOR = 4.377; 95%CI: 2.572-7.447) prefered to receive ART within 30 days; patients accepted HIV care in central area (AOR = 0.407; 95%CI: 0.251-0.657) and western area (AOR = 0.508; 95%CI: 0.261-0.989) and patients diagnosed by voluntary blood donation (AOR = 0.352; 95%CI: 0.144-0.864) were less willing to receive ART in 30 days. CONCLUSIONS The HIV care continuum of HIV-infected students in Shandong Province still needed strenghthing. More health education and case management should be done for cases transmitted through heterosexual behavior, accepted HIV care in central and western area, and diagnosed by voluntary blood donation.
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Affiliation(s)
- Xingguang Yang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Ling Li
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Na Zhang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Lianzheng Hao
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Xiaoyan Zhu
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Haiying Yu
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Guoyong Wang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
| | - Dianmin Kang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
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Nguyen PT, Saito E, Katanoda K. Long-Term Projections of Cancer Incidence and Mortality in Japan and Decomposition Analysis of Changes in Cancer Burden, 2020-2054: An Empirical Validation Approach. Cancers (Basel) 2022; 14:cancers14246076. [PMID: 36551562 PMCID: PMC9775633 DOI: 10.3390/cancers14246076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The aim of this study was to project new cancer cases/deaths forward to 2054, and decompose changes in cancer cases/deaths to assess the impact of demographic transitions on cancer burden. METHODS We collected data on cancer cases/deaths up to 2019, empirically validated the projection performance of multiple statistical models, and selected optimal models by applying time series cross-validation. RESULTS We showed an increasing number of new cancer cases but decreasing number of cancer deaths in both genders, with a large burden attributed to population aging. We observed the increasing incidence rates in most cancer sites but reducing rates in some infection-associated cancers, including stomach and liver cancers. Colorectal and lung cancers were projected to remain as leading cancer burdens of both incidence and mortality in Japan over 2020-2054, while prostate and female breast cancers would be the leading incidence burdens among men and women, respectively. CONCLUSIONS Findings from decomposition analysis require more supportive interventions for reducing mortality and improving the quality of life of Japanese elders. We emphasize the important role of governments and policymakers in reforming policies for controlling cancer risk factors, including oncogenic infections. The rapid increase and continued presence of those cancer burdens associated with modifiable risk factors warrant greater efforts in cancer control programs, specifically in enhancing cancer screening and controlling cancer risk factors in Japan.
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Affiliation(s)
- Phuong The Nguyen
- Graduate School of Public Health, St. Luke’s International University, Tokyo 104-0045, Japan
- Division of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo 104-0045, Japan
- Correspondence: or
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Kota Katanoda
- Division of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo 104-0045, Japan
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Nguyen PT, Gilmour S, Le PM, Nguyen HL, Dao TMA, Tran BQ, Hoang MV, Nguyen HV. Trends in, projections of, and inequalities in non-communicable disease management indicators in Vietnam 2010-2030 and progress toward universal health coverage: A Bayesian analysis at national and sub-national levels. EClinicalMedicine 2022; 51:101550. [PMID: 35856038 PMCID: PMC9287489 DOI: 10.1016/j.eclinm.2022.101550] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/31/2022] [Accepted: 06/20/2022] [Indexed: 11/20/2022] Open
Abstract
Background Movement towards Universal Health Coverage (UHC) can improve health services, risk factor management, and inequality in non-communicable diseases (NCD); conversely, prioritizing and monitoring NCD management can support pathways to UHC in resource-limited settings. We aimed to estimate trends in NCD management indicators in Vietnam from 2010, and projections to 2030 at national and sub-national levels; compute the probability of reaching UHC targets; and measure inequalities in NCD management indicators at demographic, geographic, and socio-economic levels. Methods We included data of 37,595 households from four nationally representative surveys from 2010. We selected and estimated the coverage of NCD health service and risk management indicators nationally and by six sub-national groups. Using Bayesian models, we provided trends and projections and calculated the probability of reaching UHC targets of 80% coverage by 2030. We estimated multiple inequality indices including the relative index of inequality, slope index of inequality, and concentration index of inequality, and provided an assessment of improvement in inequalities over the study period. Findings Nationally, all indicators showed a low probability of achieving 2030 targets except sufficient use of fruit and vegetables (SUFV) and non-use of tobacco (NUT). We observed declining trends in national coverage of non-harmful use of alcohol (NHUA), sufficient physical activity (SPA), non-overweight (NOW), and treatment of diabetes (TOD). Except for SPA, no indicator showed the likelihood of achieving 2030 targets at any regional level. Our model suggested a non-achievement of 2030 targets for all indicators in any wealth quintile and educational level, except for SUFV and NUT. There were diversities in tendency and magnitude of inequalities with widening gaps between genders (SPA, TOD), ethnic groups (SUFV), urban-rural areas (TOH), wealth quintiles, and educational levels (TOD, NUT, NHUA). Interpretation Our study suggested slow progress in NCD management at the national level and among key sub-populations in Vietnam, together with existing and increasing inequalities between genders, ethnicities, geographic areas, and socioeconomic groups. We emphasised the necessity of continuously improving the healthcare system and facilities, distributing resources between geographic areas, and simultaneously integrating economic, education, and gender intervention and programs. Funding None.
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Affiliation(s)
- Phuong The Nguyen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Division of Surveillance and Policy Evaluation, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Phuong Mai Le
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Hoa L. Nguyen
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Massachusetts, USA
| | - Thi Minh An Dao
- School of Public Health, The University of Queensland, Queensland, Australia
- Institution for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Bao Quoc Tran
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | | | - Huy Van Nguyen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Health Innovation and Transformation Centre, Federation University, Victoria, Australia
- School of Medicine and Dentistry, Griffith University, Queensland, Australia
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Qin P, He J, Yang X, Chen S, Chen X, Jiang H, Fung AWT, Wang Z, Lau JTF. The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e32968. [PMID: 35984684 PMCID: PMC9440416 DOI: 10.2196/32968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 06/13/2022] [Accepted: 06/26/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Neurocognitive impairments are prevalent among older people in China. It is more problematic among older people living with HIV. OBJECTIVE This study aims to compare neurocognitive performance between older people living with HIV and HIV-negative controls, and to explore whether the association between HIV status and neurocognitive performance was mediated by depressive symptoms and level of physical activity. METHODS A cross-sectional study was conducted in Yongzhou, China. All people living with HIV aged ≥50 years listed in the registry were invited. Frequency matching was used to sample HIV-negative controls from the general population according to the distribution of age, sex, and years of formal education of older people living with HIV. A total of 315 older people living with HIV and 350 HIV-negative controls completed the face-to-face interview and comprehensive neuropsychological assessment of seven domains (learning, memory, working memory, verbal fluency, processing speed, executive function, and motor skills). RESULTS As compared to HIV-negative controls, older people living with HIV performed worse in global score and all seven domains (P<.05). HIV infection was associated with higher depressive symptoms (P<.001) and lower level of physical activity (P<.001). Depressive symptoms and physical activity were negatively correlated (P<.001). Depressive symptoms and level of physical activity mediated the association between HIV status and global z-score and four domain z-scores of neurocognitive performance (learning, memory, verbal fluency, and processing speed). CONCLUSIONS Change in mental health and physical activity after HIV infection may partially explain why older people living with HIV are more susceptible to neurocognitive impairment. Promoting mental health and physical activity are potential entry points to slow down the progress of neurocognitive impairment among older people living with HIV.
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Affiliation(s)
- Pei Qin
- Shenzhen Qianhai Shekou Free Zone Hospital, Shenzhen, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jianmei He
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Xue Yang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Siyu Chen
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Xi Chen
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Hui Jiang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ada Wai Tung Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Joseph Tak Fai Lau
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Affilliated Kangning Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
- School of Mental Health, Wenzhou Medical University, Wen Zhou, China
- School of Public Health, Zhejiang University, Zhejiang, China
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Yang Z, Wei L, Xie W, Chen L, Yang Z, Zhang Y, Liu S, Tan W, Zheng C, Gan Y, Li D, Zou H, Chen W, Ma L, Ju N, Sun Y, Lv F, Zhao J. Estimating Changes in Population Size and Behavioral Characteristics in Men Who Have Sex With Men Between 2014 and 2019: Longitudinal Study. JMIR Public Health Surveill 2022; 8:e34150. [PMID: 35972779 PMCID: PMC9428784 DOI: 10.2196/34150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 05/18/2022] [Accepted: 06/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background Men who have sex with men (MSM) are at high risk for HIV infection. Accurate estimation of the population size and monitoring the risk sexual behavioral change of MSM is of great importance to develop targeted HIV prevention and interventions. Objective The goal of the research was accurate estimation of the population size and monitoring the risk sexual behavioral change of MSM. Methods Street interception investigation methods were conducted among males aged 16 years and older in selected sites in Shenzhen in 2014 and 2019. A population survey was used to estimate the population size of MSM. Logistic regression analysis was applied to evaluate the difference in behavioral characteristics in MSM from 2014 to 2019. Results In this study, we surveyed 10,170 participants in 2014, of whom 448 (4.41%, 95% CI 4.01%-4.80%) participants were men who have ever had sex with another man (MSMe) and 229 (2.25%, 95% CI 1.96%-2.54%) were men who had sex with another man in the previous 6 months (MSMa). A total of 10,226 participants were surveyed in 2019, of which 500 (4.90%, 95% CI 4.47%-5.31%) and 208 (2.03%, 95% CI 1.76%-2.31%) participants were MSMe and MSMa, respectively. The results showed that the population size of MSM who are active (MSMa) in Shenzhen was 155,469 (2.29%, 95% CI 2.28%-2.30%) in 2014 and 167,337 (2.05%, 95% CI 2.04%-2.06%) in 2019. It was estimated that there were about 12,005,445 (2.04%, 95% CI 2.04%-2.04%) MSMa in China in 2019. Compared with 2014, the MSMa in 2019 were more likely to seek sex partners through mobile phone apps and less likely to have male and female sex partners in addition to having inconsistent condom use and more than 6 sex partners in the previous 6 months. Conclusions In Shenzhen, the proportion of MSMa among the general male population was lower in 2019 than in 2014, and the prevalence of HIV risk behavior was reduced in 2019. Although the preferred platform to find male sex partners among MSM has changed, intervention with high–HIV risk MSM could still help to reduce HIV risk behaviors among the whole MSM group. Because MSM prefer to seek sex partners through mobile phone apps, further study is needed to strengthen internet interventions with high–HIV risk MSM to curb the spread of HIV.
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Affiliation(s)
- Zijie Yang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China.,School of Public Health, Peking Unversity, Beijing, China.,School of Public Health, Shantou Unversity, Shantou, China
| | - Lan Wei
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wei Xie
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Lin Chen
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhengrong Yang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yan Zhang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shaochu Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wei Tan
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Chenli Zheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yongxia Gan
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Dongmin Li
- National Center for AIDS/Sexually Transmitted Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huachun Zou
- School of Public Health, Sun Yat-sen University, Shenzhen, China
| | - Wanying Chen
- National Center for AIDS/Sexually Transmitted Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ling Ma
- Binhu District Centers for Disease Control and Prevention, Wuxi, China
| | - Niu Ju
- School of Public Health, Sun Yat-sen University, Shenzhen, China
| | - Yinghui Sun
- School of Public Health, Sun Yat-sen University, Shenzhen, China
| | - Fan Lv
- National Center for AIDS/Sexually Transmitted Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jin Zhao
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China.,School of Public Health, Shantou Unversity, Shantou, China
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Ayala G, Arreola S, Howell S, Hoffmann TJ, Santos GM. Enablers and Barriers to HIV Services for Gay and Bisexual Men in the COVID-19 Era: Fusing Data Sets from Two Global Online Surveys Via File Concatenation With Adjusted Weights. JMIR Public Health Surveill 2022; 8:e33538. [PMID: 35377321 PMCID: PMC9239571 DOI: 10.2196/33538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 03/23/2022] [Accepted: 04/01/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Gay and bisexual men are 26 times more likely to acquire HIV than other adult men and represent nearly 1 in 4 new HIV infections worldwide. There is concern that the COVID-19 pandemic may be complicating efforts to prevent new HIV infections, reduce AIDS-related deaths, and expand access to HIV services. The impact of the COVID-19 pandemic on gay and bisexual men's ability to access services is not fully understood. OBJECTIVE The aim of this study was to understand access to HIV services at the start of the COVID-19 pandemic. METHODS Our study used data collected from two independent global online surveys conducted with convenience samples of gay and bisexual men. Both data sets had common demographic measurements; however, only the COVID-19 Disparities Survey (n=13,562) collected the outcomes of interest (HIV services access at the height of the first COVID-19 wave) and only the Global Men's Health and Rights Survey 4 (GMHR-4; n=6188) gathered pre-COVID-19 pandemic exposures/covariates of interest (social/structural enablers of and barriers to HIV services access). We used data fusion methods to combine these data sets utilizing overlapping demographic variables and assessed relationships between exposures and outcomes. We hypothesized that engagement with the gay community and comfort with one's health care provider would be positively associated with HIV services access and negatively associated with poorer mental health and economic instability as the COVID-19 outbreaks took hold. Conversely, we hypothesized that sexual stigma and experiences of discrimination by a health care provider would be negatively associated with HIV services access and positively associated with poorer mental health and economic instability. RESULTS With 19,643 observations after combining data sets, our study confirmed hypothesized associations between enablers of and barriers to HIV prevention, care, and treatment. For example, community engagement was positively associated with access to an HIV provider (regression coefficient=0.81, 95% CI 0.75 to 0.86; P<.001), while sexual stigma was negatively associated with access to HIV treatment (coefficient=-1.39, 95% CI -1.42 to -1.36; P<.001). CONCLUSIONS HIV services access for gay and bisexual men remained obstructed and perhaps became worse during the first wave of the COVID-19 pandemic. Community-led research that utilizes novel methodological approaches can be helpful in times of crisis to inform urgently needed tailored responses that can be delivered in real time. More research is needed to understand the full impact COVID-19 is having on gay and bisexual men worldwide.
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Affiliation(s)
- George Ayala
- Alameda County Public Health Department, San Leandro, CA, United States
| | | | | | - Thomas J Hoffmann
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - Glenn-Milo Santos
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
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Rosenberg NE, Tembo TA, Simon KR, Mollan K, Rutstein SE, Mwapasa V, Masiano S, Huffstetler HE, Go V, Kim MH. Development of a Blended Learning Approach to Delivering HIV-Assisted Contact Tracing in Malawi: Applied Theory and Formative Research. JMIR Form Res 2022; 6:e32899. [PMID: 35438644 PMCID: PMC9066333 DOI: 10.2196/32899] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/29/2022] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite progress toward the Joint United Nations Programme on HIV/AIDS "95-95-95" targets (95% of HIV-positive persons tested, 95% of tested persons on treatment, and 95% of treated persons virally suppressed), a gap remains in achieving the first 95% target. Assisted contact tracing (ACT), in which health workers support HIV-positive index clients to recruit their contacts (sexual partners and children) for HIV testing, efficiently identifies HIV-positive persons in need of treatment. Although many countries, including Malawi, began implementing ACT, testing outcomes in routine settings have been worse than those in trial settings. OBJECTIVE The aim of this paper is to use formative research and frameworks to develop and digitize an implementation package to bridge the gap between ACT research and practice. METHODS Semistructured qualitative research was conducted in 2019 in Malawi with key informants. Barriers and facilitators to intervention delivery were identified using the Consolidated Framework for Implementation Research. Approaches to digitization were examined using human-centered design principles. RESULTS Limited clinic coordination and health worker capacity to address the complexities of ACT were identified as barriers. Ongoing individual training consisting of learning, observing, practicing, and receiving feedback, as well as group problem-solving were identified as facilitators. Important features of digitization included (1) culturally relevant visual content, (2) capability of offline use, and (3) simple designs and basic editing to keep costs low. CONCLUSIONS Formative research and frameworks played a key role in designing and digitizing an implementation package for ACT delivery in a low-income setting such as Malawi.
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Affiliation(s)
| | - Tapiwa A Tembo
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - Katherine R Simon
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
- Baylor College of Medicine International Pediatric AIDS Initiative, Houston, TX, United States
| | - Katie Mollan
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Sarah E Rutstein
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Steven Masiano
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | | | - Vivian Go
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Maria H Kim
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
- Baylor College of Medicine International Pediatric AIDS Initiative, Houston, TX, United States
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Witkovic YD, Kim HC, Bright DJ, Tan JY. Recruiting Black Men Who Have Sex With Men (MSM) Couples via Dating Apps: Pilot Study on Challenges and Successes. JMIR Form Res 2022; 6:e31901. [PMID: 35394432 PMCID: PMC9034429 DOI: 10.2196/31901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/06/2021] [Accepted: 12/09/2021] [Indexed: 01/30/2023] Open
Abstract
Background HIV disproportionately impacts Black men who have sex with men (MSM), and targeting the primary relationship (ie, couples) using mobile technology for health holds promise for HIV prevention. Web-based recruitment of MSM is commonly employed in HIV prevention and intervention research. However, little known about recruiting Black MSM couples on the internet in the United States. Objective This study describes the process of recruiting Black MSM couples over social networking and dating apps frequented by MSM. We describe the activities for recruiting, screening, and enrolling participants as part of a randomized trial employing a multipronged recruitment approach. Methods Black MSM in couples were recruited via three apps (ie, Jack’d, Adam4Adam, and Growlr) between May 2020 and March 2021 during the COVID-19 pandemic in the United States. Black MSM couples were eligible if one or both partners are Black, MSM, and living with HIV, and if both partners were 18 years or older, and have been together for at least 2 months in what they both consider a primary relationship (ie, one in which both partners reported feeling most committed to over any other partner or relationship). Results A total of 10 Black MSM couples (n=20) were enrolled via social networking apps. App recruitment activities were a combination of passive (eg, in-app advertisements) and active (eg, direct messaging of users) engagement. Recruitment approaches varied by the social networking app owing to differences in app features. A full-time recruiter experienced challenges such as bugs (ie, technical errors in computer program or system), navigating technical requirements specific to each app, and web-based harassment. Conclusions Despite challenges, it was possible to recruit Black MSM couples virtually into research as part of a multipronged recruitment strategy. We identify tips for using web-based dating and other social networking apps as part of a recruitment strategy in future research with Black MSM couples.
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Affiliation(s)
- Yong Darin Witkovic
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
| | - Hyunjin Cindy Kim
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States
| | - Darius Jovon Bright
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States
| | - Judy Y Tan
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States
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Chiou PY, Hung CC, Chen CY. Sexual Partner Referral for HIV Testing Through Social Networking Platforms: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e32156. [PMID: 35380540 PMCID: PMC9019628 DOI: 10.2196/32156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/29/2021] [Accepted: 12/18/2021] [Indexed: 11/19/2022] Open
Abstract
Background Men who have sex with men (MSM) who undergo voluntary HIV counseling and testing (VCT) often report condomless anal sexual intercourse, having many sexual partners, and being exposed to risky sexual networks. Limited research has discussed the application of motivational interviewing and convenience referral platforms to facilitate the referral of sexual partners for HIV testing among MSM. Objective This study aimed to evaluate the effects of VCT referral by sexual partners through social networking platforms and the test results after elicited interviews with MSM; compare the characteristics and risk behaviors among MSM tested without referral, index subjects, and referred sexual partners; and explore unknown sexual affiliations through visualizing and quantifying the social network graph. Methods This was a cross-sectional study. Purposeful sampling was used to recruit index subjects from a community HIV screening station frequented by MSM in Taipei City on Friday and Saturday nights. Respondent-driven sampling was used to recruit sexual partners. Partner-elicited interviews were conducted by trained staff before VCT to motivate MSM to become index subjects and refer sexual partners via the Line app, or to disclose the accounts and profiles of sexual partners on relevant social networking platforms. Referred sexual partners received rapid HIV testing, and the recruitment process was repeated until leads were exhausted. Results After the interviews, 28.2% (75/266) of MSM were successfully persuaded to become index subjects in the first wave, referring 127 sexual partners via the Line app for rapid HIV testing and disclosing 40 sexual partners. The index subjects and tested sexual partners had more sexual partners (F2=3.83, P=.02), more frequent anal intercourse (F2=10.10, P<.001), and higher percentages of those who had not previously received HIV testing (χ21=6.1, P=.047) compared with MSM tested without referrals. The new HIV-seropositivity rate among tested sexual partners was 2.4%, which was higher than the rate in the other 2 groups. The social network analysis revealed the following 4 types of sexual affiliation: chain, Y, star, and complicated. Among the HIV-negative sexual partners, 26.9% (43/160) had sexual affiliations with HIV-positive nodes, and 40% (10/25) were untested sexual partners with a direct sexual affiliation with an HIV-positive node. Four transmission bridges were found in the network graph. Conclusions Partner-elicited interviews can effectively promote referral for HIV testing and case identification via Line, and can clarify unknown sexual affiliations of MSM to facilitate the development of a tailored prevention program. Social network analysis is needed for an insightful understanding of the different network structures.
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Affiliation(s)
- Piao-Yi Chiou
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chien-Yu Chen
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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11
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Xu Q, Nali MC, McMann T, Godinez H, Li J, He Y, Cai M, Lee C, Merenda C, Araojo R, Mackey TK. Unsupervised Machine Learning to Detect and Characterize Barriers to Pre-exposure Prophylaxis Therapy: Multiplatform Social Media Study. JMIR INFODEMIOLOGY 2022; 2:e35446. [PMID: 37113799 PMCID: PMC10014091 DOI: 10.2196/35446] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/18/2022] [Accepted: 03/07/2022] [Indexed: 04/29/2023]
Abstract
Background Among racial and ethnic minority groups, the risk of HIV infection is an ongoing public health challenge. Pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV when taken as prescribed. However, there is a need to understand the experiences, attitudes, and barriers of PrEP for racial and ethnic minority populations and sexual minority groups. Objective This infodemiology study aimed to leverage big data and unsupervised machine learning to identify, characterize, and elucidate experiences and attitudes regarding perceived barriers associated with the uptake and adherence to PrEP therapy. This study also specifically examined shared experiences from racial or ethnic populations and sexual minority groups. Methods The study used data mining approaches to collect posts from popular social media platforms such as Twitter, YouTube, Tumblr, Instagram, and Reddit. Posts were selected by filtering for keywords associated with PrEP, HIV, and approved PrEP therapies. We analyzed data using unsupervised machine learning, followed by manual annotation using a deductive coding approach to characterize PrEP and other HIV prevention-related themes discussed by users. Results We collected 522,430 posts over a 60-day period, including 408,637 (78.22%) tweets, 13,768 (2.63%) YouTube comments, 8728 (1.67%) Tumblr posts, 88,177 (16.88%) Instagram posts, and 3120 (0.6%) Reddit posts. After applying unsupervised machine learning and content analysis, 785 posts were identified that specifically related to barriers to PrEP, and they were grouped into three major thematic domains: provider level (13/785, 1.7%), patient level (570/785, 72.6%), and community level (166/785, 21.1%). The main barriers identified in these categories included those associated with knowledge (lack of knowledge about PrEP), access issues (lack of insurance coverage, no prescription, and impact of COVID-19 pandemic), and adherence (subjective reasons for why users terminated PrEP or decided not to start PrEP, such as side effects, alternative HIV prevention measures, and social stigma). Among the 785 PrEP posts, we identified 320 (40.8%) posts where users self-identified as racial or ethnic minority or as a sexual minority group with their specific PrEP barriers and concerns. Conclusions Both objective and subjective reasons were identified as barriers reported by social media users when initiating, accessing, and adhering to PrEP. Though ample evidence supports PrEP as an effective HIV prevention strategy, user-generated posts nevertheless provide insights into what barriers are preventing people from broader adoption of PrEP, including topics that are specific to 2 different groups of sexual minority groups and racial and ethnic minority populations. Results have the potential to inform future health promotion and regulatory science approaches that can reach these HIV and AIDS communities that may benefit from PrEP.
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Affiliation(s)
- Qing Xu
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
| | - Matthew C Nali
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
- Global Health Program, Department of Anthropology University of California La Jolla, CA United States
| | - Tiana McMann
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
- Global Health Program, Department of Anthropology University of California La Jolla, CA United States
| | | | - Jiawei Li
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
| | - Yifan He
- S-3 Research San Diego, CA United States
| | - Mingxiang Cai
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
| | - Christine Lee
- Office of Minority Health and Health Equity, U.S. Food and Drug Administration Silver Spring, MD United States
| | - Christine Merenda
- Office of Minority Health and Health Equity, U.S. Food and Drug Administration Silver Spring, MD United States
| | - Richardae Araojo
- Office of Minority Health and Health Equity, U.S. Food and Drug Administration Silver Spring, MD United States
| | - Tim Ken Mackey
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
- Global Health Program, Department of Anthropology University of California La Jolla, CA United States
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12
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Baluku JB. INTEREST 2021 conference: is Africa still hoping against hope in the fight against HIV? Ther Adv Infect Dis 2021; 8:20499361211061293. [PMID: 34881022 PMCID: PMC8646192 DOI: 10.1177/20499361211061293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Joseph Baruch Baluku
- Directorate of Programs, Mildmay Uganda, Wakiso, PO Box 26343, Kampala, Uganda.,Division of Pulmonology, Kiruddu National Referral Hospital, Kampala, Uganda
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13
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Tang J, Zheng Y, Yu Z, Zhang D, Yu X, Ren J, Li M, Luo Y, Tian M, Chen Y. Evaluation of an AIDS educational mobile game (AIDS Fighter · Health Defense) for young students to improve AIDS-related knowledge, stigma and attitude of high-risk behaviors in China: A Randomized Controlled Trial. JMIR Serious Games 2021; 10:e32400. [PMID: 34870603 PMCID: PMC8822421 DOI: 10.2196/32400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The AIDS epidemic among young students is serious, and effective preventive interventions are urgently needed. Game-based intervention has become an innovative way to change healthy behaviors, and we have developed an AIDS educational game called AIDS Fighter · Health Defense. In this study we tested the effect of an AIDS Fighter · Health Defense for young students to improve AIDS-related knowledge, stigma and attitude of high-risk behaviors in Southwest China. OBJECTIVE To test the effect of an AIDS educational game (AIDS Fighter · Health Defense) for young students to improve AIDS-related knowledge, stigma and attitude of high-risk behaviors in Southwest China. METHODS A randomized controlled trial was conducted from September 14 to September 27, 2020. Ninety-six students from two classes in a middle school were selected by stratified cluster sampling in Luzhou City, China. The two classes were randomly divided into the intervention group (n=50) and the control group (n=46). The intervention group received AIDS educational game (AIDS Fighter · Health Defense); the control group learned AIDS-related knowledge through independent learning on the QQ chat group. The AIDS-related knowledge questionnaire, the stigma scale, the attitude questionnaire on AIDS-related high-risk behaviors were used to measure the effect of an AIDS educational game by face-to-face. The user's experience of the game was assessed by the Educational Game User Experience Evaluation Scale. The difference was statistically significant with P≤0.05. RESULTS After the intervention, the AIDS knowledge awareness rate (±S, %) of the intervention group and the control group were 70.09±11.58 and 57.49±16.58(t=4.282, P<0.001). The stigma scores of the two groups were 2.44±0.57 and 2.48±0.47(t=0.373, P =0.710), The positive rate (±S, %) of attitudes of high-risk AIDS behaviors of the two groups were 82.00±23.44 and 79.62±17.94(t=0.555, P =0.580. The mean percentage of the game evaluation as excellent was 54.73%, and 31.45% of good, 13.09% of medium, 0.73% of poor. CONCLUSIONS AIDS Fighter · Health Defense could increase the AIDS-related knowledge among young students, but the effect of the game in reducing AIDS-related stigma and improving the attitudes of high-risk AIDS behaviors has not appeared. Long-term effects and large-scale studies are needed to assess the efficacy of game-based intervention. CLINICALTRIAL Chinese Clinical Trial Registry: ChiCTR2000038230. Registered 14 September 2020.
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Affiliation(s)
- Jian Tang
- Department of Operating Room, The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Yu Zheng
- Department of Rheumatology and Immunology, The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Zhaolan Yu
- Department of Nephrology,The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Daiying Zhang
- Department of Operating Room, The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Xingli Yu
- Department of Operating Room, The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Jianlan Ren
- Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Mei Li
- Southwest Medical University, School of Nursing, Luzhou, CN
| | - Yue Luo
- Southwest Medical University, School of Nursing, Luzhou, CN
| | - Min Tian
- Southwest Medical University, School of Nursing, Luzhou, CN
| | - Yanhua Chen
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiangyang District, Luzhou, CN.,Southwest Medical University, School of Nursing, Luzhou, CN
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14
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Majam M, Phatsoane M, Hanna K, Faul C, Arora L, Makthal S, Kumar A, Jois K, Lalla-Edward ST. Utility of a Machine-Guided Tool for Assessing Risk Behavior Associated With Contracting HIV in Three Sites in South Africa: Protocol for an In-Field Evaluation. JMIR Res Protoc 2021; 10:e30304. [PMID: 34860679 PMCID: PMC8686409 DOI: 10.2196/30304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/25/2021] [Accepted: 09/10/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Mobile technology has helped to advance health programs, and studies have shown that an automated risk prediction model can successfully be used to identify patients who exhibit a high probable risk of contracting human immunodeficiency virus (HIV). A machine-guided tool is an algorithm that takes a set of subjective and objective answers from a simple questionnaire and computes an HIV risk assessment score. OBJECTIVE The primary objective of this study is to establish that machine learning can be used to develop machine-guided tools and give us a deeper statistical understanding of the correlation between certain behavioral patterns and HIV. METHODS In total, 200 HIV-negative adult individuals across three South African study sites each (two semirural and one urban) will be recruited. Study processes will include (1) completing a series of questions (demographic, sexual behavior and history, personal, lifestyle, and symptoms) on an application system, unaided (assistance will only be provided upon user request); (2) two HIV tests (one per study visit) being performed by a nurse/counselor according to South African national guidelines (to evaluate the prediction accuracy of the tool); and (3) communicating test results and completing a user experience survey questionnaire. The output metrics for this study will be computed by using the participants' risk assessment scores as "predictions" and the test results as the "ground truth." Analyses will be completed after visit 1 and then again after visit 2. All risk assessment scores will be used to calculate the reliability of the machine-guided tool. RESULTS Ethical approval was received from the University of Witwatersrand Human Research Ethics Committee (HREC; ethics reference no. 200312) on August 20, 2020. This study is ongoing. Data collection has commenced and is expected to be completed in the second half of 2021. We will report on the machine-guided tool's performance and usability, together with user satisfaction and recommendations for improvement. CONCLUSIONS Machine-guided risk assessment tools can provide a cost-effective alternative to large-scale HIV screening and help in providing targeted counseling and testing to prevent the spread of HIV. TRIAL REGISTRATION South African National Clinical Trial Registry DOH-27-042021-679; https://sanctr.samrc.ac.za/TrialDisplay.aspx?TrialID=5545. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/30304.
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Affiliation(s)
- Mohammed Majam
- Ezintsha, Faculty of Health Sciences, University of Witswatersrand, Johannesburg, South Africa
| | - Mothepane Phatsoane
- Ezintsha, Faculty of Health Sciences, University of Witswatersrand, Johannesburg, South Africa
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15
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Matthews LT, Psaros C, Mathenjwa M, Mosery N, Greener LR, Khidir H, Hovey JR, Pratt MC, Harrison A, Bennett K, Bangsberg DR, Smit JA, Safren SA. Demonstration and acceptability of a safer conception intervention for men with HIV in South Africa (Preprint). JMIR Form Res 2021; 6:e34262. [PMID: 35507406 PMCID: PMC9118009 DOI: 10.2196/34262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/24/2022] [Accepted: 03/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background Many men with HIV (MWH) want to have children. HIV viral suppression minimizes sexual HIV transmission risks while allowing for conception and optimization of the health of men, their partners, and their infants. Objective This study developed and evaluated the feasibility and acceptability of an intervention to promote serostatus disclosure, antiretroviral therapy (ART) uptake and adherence, and viral suppression among MWH who want to have children in South Africa. Methods We developed a safer conception intervention (Sinikithemba Kwabesilisa or We give hope to men) to promote viral suppression via ART uptake and adherence, HIV serostatus disclosure, and other safer conception strategies for MWH in South Africa. Through 3 counseling and 2 booster sessions over 12 weeks, we offered education on safer conception strategies and aided participants in developing a safer conception plan. We recruited MWH (HIV diagnosis known for >1 month), not yet accessing ART or accessing ART for <3 months, in a stable partnership with an HIV-negative or unknown-serostatus woman, and wanting to have a child in the following year. We conducted an open pilot study to evaluate acceptability based on patient participation and exit interviews and feasibility based on recruitment and retention. In-depth exit interviews were conducted with men to explore intervention acceptability. Questionnaires collected at baseline and exit assessed disclosure outcomes; CD4 and HIV-RNA data were used to evaluate preliminary impacts on clinical outcomes of interest. Results Among 31 eligible men, 16 (52%) enrolled in the study with a median age of 29 (range 27-44) years and a median time-since-diagnosis of 7 months (range 1 month to 9 years). All identified as Black South African, with 56% (9/16) reporting secondary school completion and 44% (7/16) reporting full-time employment. Approximately 44% (7/16) of participants reported an HIV-negative (vs unknown-serostatus) partner. Approximately 88% (14/16) of men completed the 3 primary counseling sessions. In 11 exit interviews, men reported personal satisfaction with session content and structure while also suggesting that they would refer their peers to the program. They also described the perceived effectiveness of the intervention and self-efficacy to benefit. Although significance testing was not conducted, 81% (13/16) of men were taking ART at the exit, and 100% (13/13) of those on ART were virally suppressed at 12 weeks. Of the 16 men, 12 (75%) reported disclosure to pregnancy partners. Conclusions These preliminary data suggest that safer conception care is acceptable to men and has the potential to reduce HIV incidence among women and their children while supporting men’s health. Approximately half of the men who met the screening eligibility criteria were enrolled. Accordingly, refinement to optimize uptake is needed. Providing safer conception care and peer support at the community level may help reach men. Trial Registration ClinicalTrials.gov NCT03818984; https://clinicaltrials.gov/ct2/show/NCT03818984 International Registered Report Identifier (IRRID) RR2-https://doi.org/10.1007/s10461-017-1719-4
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Affiliation(s)
- Lynn T Matthews
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Christina Psaros
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Mxolisi Mathenjwa
- MatCH Research Unit, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, South Africa
| | - Nzwakie Mosery
- MatCH Research Unit, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, South Africa
| | - Letitia Rambally Greener
- MatCH Research Unit, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, South Africa
- Population Services International, Johannesburg, South Africa
| | - Hazar Khidir
- Harvard Combined Residency Program in Emergency Medicine, Boston, MA, United States
| | - Jacquelyn R Hovey
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Madeline C Pratt
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Abigail Harrison
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, United States
| | - Kara Bennett
- Bennett Statistical Consulting, Ballston Lake, NY, United States
| | - David R Bangsberg
- School of Public Health, Oregon Health Sciences University - Portland State University, Portland, OR, United States
| | - Jennifer A Smit
- MatCH Research Unit, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, South Africa
| | - Steven A Safren
- Department of Psychology, University of Miami, Miami, FL, United States
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16
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Nguyen PT, Rahman MS, Le PM, Nguyen HV, Vu KD, Nguyen HL, Dao ATM, Khuong LQ, Hoang MV, Gilmour S. Trends in, projections of, and inequalities in reproductive, maternal, newborn and child health service coverage in Vietnam 2000-2030: A Bayesian analysis at national and sub-national levels. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 15:100230. [PMID: 34528011 PMCID: PMC8342952 DOI: 10.1016/j.lanwpc.2021.100230] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/25/2021] [Accepted: 07/06/2021] [Indexed: 12/14/2022]
Abstract
Background To assess the reproductive, maternal, newborn and child health (RMNCH) service coverage in Vietnam with trends in 2000−2014, projections and probability of achieving targets in 2030 at national and sub-national levels; and to analyze the socioeconomic, regional and urban-rural inequalities in RMNCH service indicators. Methods We used national population-based datasets of 44,624 households in Vietnam from 2000 to 2014. We applied Bayesian regression models to estimate the trends in and projections of RMNCH indicators and the probabilities of achieving the 2030 targets. Using the relative index, slope index, and concentration index of inequality, we examined the patterns and trends in RMNCH coverage inequality. Findings We projected that 9 out of 17 health service indicators (53%) would likely achieve the 2030 targets at the national level, including at least one and four ANC visits, BCG immunization, access to improved water and adequate sanitation, institutional delivery, skilled birth attendance, care-seeking for pneumonia, and ARI treatment. We observed very low coverages and zero chance of achieving the 2030 targets at national and sub-national levels in early initiation and exclusive breastfeeding, family planning needs satisfied, and oral rehydration therapy. The most deprived households living in rural areas and the Northwest, Northeast, North Central, Central Highlands, and Mekong River Delta regions would not reach the 80% immunization coverage of DPT3, Polio3, Measles and full immunization. We found socioeconomic, regional, and urban-rural inequalities in all RMNCH indicators in 2014 and no change in inequalities over 15 years in the lowest-coverage indicators. Interpretation Vietnam has made substantial progress toward UHC. By improving the government's health system reform efforts, re-allocating resources focusing on people in the most impoverished rural regions, and restructuring and enhancing current health programs, Vietnam can achieve the UHC targets and other health-related SDGs. Funding The authors did not receive any funds for conducting this study.
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Affiliation(s)
- Phuong T Nguyen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.,Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Md Shafiur Rahman
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Phuong Mai Le
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Huy Van Nguyen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.,Innovation Health and Transformation Centre, Federation University, Australia.,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA
| | - Kien Duy Vu
- OnCare Medical Technology Company Limited, Hanoi, Vietnam
| | - Hoa L Nguyen
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA
| | - An Thi Minh Dao
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA.,School of Public Health, The University of Queensland, Queensland, Australia.,Institution for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | | | | | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
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17
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Xu J, Luo Y, Dong H, Zhao G. Effects of internet exposure on sexual partners and sexual risk behavior among sexually experienced college males in China: evidence from an institutional-based cross-sectional study (Preprint). JMIR Public Health Surveill 2021; 8:e31847. [PMID: 35499864 PMCID: PMC9112083 DOI: 10.2196/31847] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/24/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background As a young subgroup, college students have become the main users of mobile social networks. Considering that people can indiscriminately access explicit sexual content on the internet, coupled with the increase of HIV infections in male college students, the role of the internet in meeting sexual partners and its correlation to risky sexual behavior has become an important topic. Objective The aim of this study is to explore the effects of internet exposure on sexual partners and sexual risk behavior among sexually experienced male college students. Methods An institution-based cross-sectional study design was used to collect data through a paper-based questionnaire administered to male college students recruited from colleges and gay organizations in Hangzhou, Zhejiang Province, China. A total of 1045 sexually experienced male students were incorporated in our analysis, with the following information collected: sociodemographic characteristics, sexual intercourse–related behaviors, and sexually transmitted disease (STD) knowledge. Mann-Whitney U and Kruskal-Wallis tests were used to examine differences regarding basic characteristics and sexual risk behaviors between male college students who meet sexual partners via the internet and those who do not. Sequential logistic regression models were employed to examine the influence of meeting sexual partners via the internet on risky sexual behaviors after controlling for other factors. Results The mean age of the sexually experienced male students was 21.6 (SD 2.0) years. The likelihood of risky sexual behavior was varied, yet it was the highest for those who aim to meet paid sexual partners (145/192, 75.5% to 19/22, 86.4%), followed by those seeking partners for love or romance (258/435, 59.3%). Compared to non-internet partner seekers, internet partner seekers tended to have more casual intercourse (292/542, 53.9% versus 51/503, 10.1%), paid intercourse (32/542, 5.9% versus 12/503, 2.4%), and intercourse with same-sex partners (349/542, 64.4% versus 41/503, 8.2%); they were also more likely to use psychoactive drugs (125/349, 35.8% versus 5/41, 12.2%) and have more than 2 partners. With the increase of HIV and STD knowledge, the probability of having unprotected intercourse decreased for non-internet partner seekers. However, it increased for internet partner seekers with a rising HIV knowledge score. Sequential logistic regression showed that meeting sexual partners on the internet was statistically associated with sexual risk behaviors with multiple sexual partners (odds ratio 4.434; P<.001). Conclusions Meeting sexual partners via the internet is a common behavior among sexually experienced male college students, and those who meet partners on the internet exhibited higher levels of risky sexual behaviors although they had sufficient HIV and STD knowledge; this is especially true for students who aimed to find partners for sexual intercourse. Thus, more attention should be paid to young adults to address the risky sexual behaviors that may contribute to STD spread among this population.
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Affiliation(s)
- Junfang Xu
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Luo
- Shenzhen Pingshan District Center for Disease Control and Prevention, Hangzhou, China
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Hengjin Dong
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Gang Zhao
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
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