1
|
Laughney CI, Lee YG, Mergenova G, Vinogradov V, Zhakupova G, Paine EA, Primbetova S, Terlikbayeva A, Wu E. Earlier Sexual Debut and Exchange Sex among Men Who Have Sex with Men (MSM) in Kazakhstan. JOURNAL OF SEX RESEARCH 2023; 60:919-924. [PMID: 36657067 PMCID: PMC10354213 DOI: 10.1080/00224499.2023.2167064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Limited research has examined prevalence rates and associations related to exchange sex behaviors among gay, bisexual, and other men who have sex with men (MSM) in Kazakhstan. This study aimed to examine associations between earlier sexual debuts and lifetime exchange sex behaviors among Kazakhstani MSM. Using data from a National Institute on Drug Abuse-funded Human Immunodeficiency Virus (HIV) prevention trial, we conducted a secondary analysis of self-reported data from 766 adult cisgender MSM in Kazakhstan, who completed structured screening interviews. Earlier sexual debuts were measured as age of sexual onset prior to 16 years old with ages 16 and older as the reference group. Logistic regression models were used to estimate associations between earlier sexual debuts and lifetime reports of buying or selling sex for resources, with covariance adjustment for sociodemographic characteristics. The study findings indicated that, among our sample of MSM in Kazakhstan, 23% had sold sex, and 26% had bought sex in their lifetime. Kazakhstani MSM who reported an earlier sexual debut had significantly higher odds of ever selling or buying sex in their lifetime. Future research should examine how consensual and non-consensual sexual activities during childhood and adolescence relate to exchange sex behaviors and risk among MSM.
Collapse
Affiliation(s)
| | - Yong Gun Lee
- Social Intervention Group, Columbia School of Social Work, New York, NY, 10027, USA
| | | | | | | | - Emily Allen Paine
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, Columbia University and New York State Psychiatric Institute, New York, NY 10032, USA
| | | | | | - Elwin Wu
- Social Intervention Group, Columbia School of Social Work, New York, NY, 10027, USA
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
| |
Collapse
|
2
|
Beksinska A, Karlsen O, Gafos M, Beattie TS. Alcohol use and associated risk factors among female sex workers in low- and middle-income countries: A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001216. [PMID: 37310993 DOI: 10.1371/journal.pgph.0001216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/08/2022] [Indexed: 06/15/2023]
Abstract
Due to its widespread use in the sex work industry, female sex workers (FSWs) in low- and middle-income countries (LMICs) are at high risk of harmful alcohol use and associated adverse health outcomes. Factors associated with harmful alcohol use include violence, mental health problems, drug use, sexual risk behaviors and HIV/STIs. To our knowledge, there has been no quantitative synthesis of FSW alcohol use data to date. This systematic review and meta-analysis aims to provide an estimate of the prevalence of harmful alcohol use among FSWs in LMICs and to examine associations with common health and social concerns. The review protocol was registered with PROSPERO, number CRD42021237438. We searched three electronic databases for peer-reviewed, quantitative studies from inception to 24th February 2021. Studies were selected for inclusion that reported any measure of prevalence or incidence of alcohol use among FSWs aged 18 or older from countries defined as LMIC in accordance with the World Bank income groups 2019. The following study designs were included: cross-sectional survey, case-control study, cohort study, case series analysis, or experimental study with baseline measures for alcohol use. Study quality was assessed with the Center for Evidence-Based Management (CEBMa) Critical Appraisal Tool. Pooled prevalence estimates were calculated for (i) any hazardous/harmful/dependent alcohol use, (ii) harmful/dependent alcohol use only, both overall and by region and (iii) daily alcohol use. Meta-analyses examined associations between harmful alcohol use and violence, condom use, HIV/STIs, mental health problems and other drug use. In total, 435 papers were identified. After screening, 99 papers reporting on 87 unique studies with 51,904 participants from 32 LMICs met the inclusion criteria. Study designs included cross-sectional (n = 89), cohort (n = 6) and experimental (n = 4). Overall, 5 scored as high quality, 79 studies scored as moderate and 15 scored as weak quality. Twenty-nine papers reporting on 22 unique studies used validated alcohol use tools including AUDIT, CAGE and WHO CIDI. The pooled prevalence of any hazardous/harmful/dependent alcohol use was 41% (95% CI: 31-51%), and of daily alcohol use was 26% (95% CI: 17-36%). There was variation in harmful alcohol use by global region (Sub-Saharan Africa: 38%; South Asia/Central Asia/ East Asia and Pacific: 47% and Latin America and the Caribbean:44%). Harmful alcohol use was significantly associated with inconsistent condom use (pooled unadjusted RR: 1.65; 95% CI: 1.01-2.67), STIs (pooled unadjusted OR: 1.29; 95% CI 1.15-1.46); and other drug use (pooled unadjusted OR of 2.44; 95% CI 1.24-4.80), but not with HIV, violence or mental health problems. We found a high prevalence of problem alcohol use and daily alcohol use among FSWs in LMICs. Harmful drinking was associated with important HIV risk factors such as inconsistent condom use, STIs and other drug use. Major limitations included heterogeneity in tools and cut-off scores to measure alcohol use and other common risk factors, and a paucity of longitudinal studies. There is an urgent need for tailored interventions for FSWs in LMICs that address alcohol use as well as the associated sex work risk environment.
Collapse
Affiliation(s)
- Alicja Beksinska
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Oda Karlsen
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mitzy Gafos
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tara S Beattie
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
3
|
Goddard-Eckrich D, Gilbert L, Richer A, Chang M, Hunt T, Henderson A, Marotta P, Wu E, Johnson K, Moses H, Liu Y, El-Bassel N. Moderation Analysis of a couple-based HIV/STI Intervention Among Heterosexual Couples in the Criminal Legal System Experiencing Intimate Partner Violence: Results from a Randomized Controlled Trial. AIDS Behav 2023; 27:1653-1665. [PMID: 36322218 PMCID: PMC9629199 DOI: 10.1007/s10461-022-03897-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
Since the COVID-19 pandemic, intimate partner violence (IPV) rates have increased in the United States. Although accumulating research has documented the effectiveness of couple-based interventions in reducing HIV/STIs, it remains unclear whether they are effective and safe for couples experiencing IPV. We used moderation analysis from a randomized clinical trial to evaluate whether a couples-based HIV/STI intervention may have differential effectiveness in reducing HIV/STI risks among couples where one or both partners reported experiencing IPV compared to couples without such IPV among a sample of 230 men at risk for HIV/STIs who reported using drugs and were mandated to community supervision settings in New York City and their main female sexual partners. The findings of this study suggest that the effectiveness of this evidence-based couple HIV intervention in reducing condomless sex and other HIV/STI risks did not differ between couples with IPV compared to couples without IPV. Intimate partners who use drugs and are involved in the criminal legal system are disproportionately impacted by both HIV/STIs and IPV, underscoring the importance of couple-level interventions that may be scaled up to address the dyadic HIV risks and IPV together in community supervision settings.
Collapse
Affiliation(s)
- Dawn Goddard-Eckrich
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 801, New York, NY, 10027, USA.
| | - Louisa Gilbert
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 801, New York, NY, 10027, USA
| | - Ariel Richer
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 801, New York, NY, 10027, USA
| | - Mingway Chang
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 801, New York, NY, 10027, USA
| | - Timothy Hunt
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 801, New York, NY, 10027, USA
| | - Ambuir Henderson
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 801, New York, NY, 10027, USA
| | - Phillip Marotta
- Brown School, Washington University, 1 Brookings Dr, 63130, St Louis, MO, 63130, USA
| | - Elwin Wu
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 801, New York, NY, 10027, USA
| | - Karen Johnson
- University of Alabama, School of Social Work, Little Hall, 670 Judy Bonner Drive, Tuscaloosa, AL, 35401, USA
| | - Hermione Moses
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 801, New York, NY, 10027, USA
| | - Yifan Liu
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 801, New York, NY, 10027, USA
| | - Nabila El-Bassel
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 801, New York, NY, 10027, USA
| |
Collapse
|
4
|
Shikhansari S, Khalesi ZB, Rad EH. Factors associated with the reproductive health of women living with HIV in Iran. Eur J Obstet Gynecol Reprod Biol X 2022; 13:100136. [PMID: 35118370 PMCID: PMC8792468 DOI: 10.1016/j.eurox.2021.100136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/16/2021] [Accepted: 10/22/2021] [Indexed: 11/26/2022] Open
Abstract
Background Insight on reproductive health status in women living with HIV is associated with improved psychological well-being, health behaviors, and physical wellness. The overall aim of this paper is to gain insight into the reproductive health of women living with HIV and related factors. Method An analytical cross-sectional study was carried on women living with HIV (N = 112) attending high-risk behavior consultation centers in Rasht and Tehran, Iran. The sampling of respondents was in the form of consecutive and available. The data gathering including questionnaires that were divided into three parts: sociodemographic and health characteristics, reproductive behaviors information, and reproductive health assessment tool for women living with HIV. Result The sub-dimension of responsible behavior received the highest total mean score (54.27 ± 22.18). The mean scores in the sub-dimension of coping with the diagnosis, life instability, disease disclosure, disease-related concerns, and support needs for self-care were 50.14, 49.23, 44.27, 40.08, 38.25, and 33.25 respectively. Conclusion The results clearly showed that the reproductive health situation of women living with HIV needs particular attention. Strategic planning and context-specific interventions are needed to improve women’s access and utilization of reproductive health services.
Collapse
Affiliation(s)
| | - Zahra Bostani Khalesi
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Corresponding author.
| | - Enayatollah Homaei Rad
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
5
|
Valencia J, Alvaro-Meca A, Troya J, Gutiérrez J, Ramón C, Rodríguez A, Vázquez-Morón S, Resino S, Moreno S, Ryan P. Gender-based vulnerability in women who inject drugs in a harm reduction setting. PLoS One 2020; 15:e0230886. [PMID: 32226042 PMCID: PMC7105126 DOI: 10.1371/journal.pone.0230886] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/10/2020] [Indexed: 11/19/2022] Open
Abstract
Background and aims In comparison with men, women who use drugs (WWUD) have considerably more frequent and intense experiences with interpersonal violence, sexual abuse and trauma. The aim of this study was to identify issues related to gender-based vulnerability in a group of WWUD attended in a harm reduction facility in Madrid, Spain. Material and methods A cross-sectional study was conducted during a screening of blood borne infections. We included WWUD (smoked or injected heroin/cocaine) who were actively screened for HIV, HBV and HCV in a harm reduction setting in Madrid (Spain) from January to December 2017. WWUD were interviewed for gender-based abuse or violence using a face-to-face questionnaire by a trained interviewer. Aspects related to their social-epidemiological condition and gender-based vulnerability were collected. Results We included 109 women who were actively using drugs. The median age was 39 (IQR 35–47) years, 84.4% were Spanish born, 22.9% were homeless, 43 (41.7%) had ever used injected drugs, 29 (26.6%) were currently using injected drugs, and 27.1% had mental health disorders. Aspects related to gender-based vulnerability were collected. Among those surveyed, they reported having ever suffered emotional or psychological damage (88%), having experienced at least one incident of serious physical injury by a male partner (71%), and having ever suffered sexual abuse (49%). In addition, 28% had ever exchanged sex for money/drugs. When compared to women that did not use injecting drugs, those who injected drugs had more frequently exchanged sex for money/drugs (55% vs 21%, p = 0.003). Conclusions A high proportion of WWUD suffer psychological or physical violence by partners denoting gender-based vulnerability. Interventions in harm reduction settings with a multidisciplinary and gender-based approach should be implemented.
Collapse
Affiliation(s)
- Jorge Valencia
- Harm Reduction Unit “SMASD”; Subdirección General de Adicciones; SERMAS, Madrid, Spain
- Non-Governmental Organization “Madrid Positivo”, Madrid, Spain
- * E-mail:
| | - Alejandro Alvaro-Meca
- Unit of Preventive Medicine and Public Health, Rey Juan Carlos University, Alcorcon, Madrid, Spain
| | - Jesús Troya
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Jorge Gutiérrez
- Non-Governmental Organization “Madrid Positivo”, Madrid, Spain
| | - Cristina Ramón
- Non-Governmental Organization “Madrid Positivo”, Madrid, Spain
| | | | - Sonia Vázquez-Morón
- Fundación Estatal, Salud, Infancia y Bienestar Social (FCSAI), Madrid, Spain
- Unit of Viral Infection and Immunity, National Center for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain
| | - Salvador Resino
- Unit of Viral Infection and Immunity, National Center for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain
| | - Santiago Moreno
- Department of Infectious Diseases, Ramón y Cajal Hospital, IRYCIS, University of Alcalá de Henares, Madrid, Spain
| | - Pablo Ryan
- Hospital Universitario Infanta Leonor, Madrid, Spain
- Complutense de Madrid University (UCM), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| |
Collapse
|
6
|
Juliastuti D, Dean J, Fitzgerald L. Sexual and reproductive health of women living with HIV in Muslim-majority countries: a systematic mixed studies review. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2020; 20:5. [PMID: 32160885 PMCID: PMC7066758 DOI: 10.1186/s12914-020-00225-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 02/28/2020] [Indexed: 01/07/2023]
Abstract
Background The number of women living with the human immunodeficiency virus (WLHIV) in Muslim-majority countries has increased significantly in the last decade. These women are often marginalized and face insecure sexual and reproductive health (SRH) needs and rights. However, little is known about the multi-faceted factors influencing these women’s fertility, contraceptive, and perinatal decisions and sexual life. This systematic mixed studies review aimed to synthesize the empirical evidence on social, cultural, and structural factors influencing the SRH of WLHIV in Muslim-majority countries. Methods This review provides a synthesis of quantitative, qualitative and mixed-method research findings searched from PubMed, EMBASE, Scopus, CINAHL and Cochrane databases. We screened 3452 SRH studies involving WLHIV. The studies, published in English between 2008 and 2017, were from 20 Muslim-majority countries with increased numbers of WLHIV. The quality of eligible studies was appraised using a mixed-methods appraisal tool (MMAT) version 2011. Findings were thematically analysed by a hybrid deductive-inductive approach. Two independent reviewers were involved in the study selection, data extraction, quality appraisal, and data synthesis. Results We included 13 SRH-related studies involving 1748 WLHIV in eight Muslim-majority countries. Most of these studies explored fertility desire and sexual health, while only a small proportion related to contraceptive use and the perinatal-care experience. We identified that WLHIV faced neglect of their SRH rights. These rights were predominantly affected by the socio-cultural, religious and health-services context of the women’s lives, which directed them to unsafe sex practices and stressful perinatal experiences. Conclusions This study points to the need for SRH laws, policies, and interventions which stop WLHIV experiencing SRH discrimination violence and achieving their SRH rights.
Collapse
Affiliation(s)
- Dyah Juliastuti
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia. .,Ichsan Medical Centre Bintaro Health College, South Tangerang, Indonesia. .,School of Public Health room 111, Faculty of Medicine, The University of Queensland, 288 Herston, Road, QLD 4006, Brisbane, Australia.
| | - Judith Dean
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia.,School of Public Health room 025, Faculty of Medicine, The University of Queensland, 288 Herston, Road, QLD 4006, Brisbane, Australia
| | - Lisa Fitzgerald
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia.,School of Public Health room 021, Faculty of Medicine, The University of Queensland, 288 Herston, Road, QLD 4006, Brisbane, Australia
| |
Collapse
|