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Su R, Liu Y, Li P, Ge L, Liao M, Fu Y, Song X, Tang H, Li D. Utilization of post-exposure prophylaxis potentially contributed to the changes of risk behaviors among men who have sex with men in China. Front Public Health 2024; 12:1364913. [PMID: 38651127 PMCID: PMC11033407 DOI: 10.3389/fpubh.2024.1364913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/26/2024] [Indexed: 04/25/2024] Open
Abstract
Background The HIV infection status among men who have sex with men (MSM) in China is a cause for concern. Post-exposure prophylaxis (PEP) serves as a highly effective biomedical preventive measure against HIV infection. Substantial evidence has established an association between PEP utilization and risk behaviors among MSM, but whether the utilization of PEP has an impact on risk behaviors remains unknown. This study sought to elucidate the impact of PEP usage on risk behaviors among MSM and provide recommendations for developing targeted HIV prevention programs. Methods A cohort study was conducted in Qingdao, China, from April 2021 to January 2022. Participants were enlisted by volunteers from community-based organizations through a snowball sampling method. Face-to-face interviews were conducted to collect sociodemographic and behavioral information of participants. The study encompassed a retrospective investigation, baseline survey, and follow-up survey, representing periods before, during, and after PEP usage, respectively. Generalized estimating equations, fitting a Poisson regression model, were applied to scrutinize changes in risk behaviors of MSM during and after PEP usage, in comparison to before PEP usage. Results A total of 341 MSM were recruited in the cohort study, with 179 individuals completing the follow-up survey. In comparison to before PEP usage, there was a significant increase in the proportion of Rush Popper usage (17.6% vs. 23.8% vs. 29.6%) and commercial sexual partners (10.9% vs. 17.6% vs. 21.8%) among MSM during and after PEP usage. Before PEP usage, 88.7% of MSM reported having ≥3 temporary sexual partners in the last 6 months. This proportion exhibited no significant change during PEP usage (91.8%), but it significantly increased to 97.8% after PEP usage (P < 0.05). Notably, there was a significant decrease in group sex during and after PEP usage compared to before PEP usage (30.8% vs. 21.4% vs. 21.2%). Conclusion The utilization of PEP may impact risk behaviors among MSM, potentially leading to increased Rush Popper usage, temporary sexual partners, and commercial sexual partners after PEP usage, accompanied by a decrease in group sex. Further research is imperative to elucidate the impact of PEP utilization on MSM and develop targeted HIV prevention programs.
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Affiliation(s)
- Rong Su
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Liu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peilong Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lin Ge
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meizhen Liao
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
| | - Yong Fu
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Xin Song
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongmin Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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V. Totala Y, M. Kasbe A. Addiction/Drug Use and Usage of Condoms Among Homosexual Males: A Cross-sectional Study. ADDICTION & HEALTH 2024; 16:28-34. [PMID: 38651029 PMCID: PMC11032612 DOI: 10.34172/ahj.2024.1472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/26/2023] [Indexed: 04/25/2024]
Abstract
Background Despite the legal acceptance of homosexuality in India, it remains a social taboo, resulting in various challenges being faced by homosexual males. These challenges mainly include issues such as addiction/drug use and inconsistent and/ or incorrect condom usage which increase the risk of acquiring sexually transmitted infections (STIs) and HIV among them. This study was thus conducted with the objective of studying the patterns of addiction/drug use and condom usage among homosexual males. Methods The study was conducted at outreach sites of a non-governmental organization (NGO). A total of 240 participants, consisting of homosexual and bisexual males aged 18-24 years who were residing in the metropolitan city of Mumbai for at least 1 year, were enrolled. Data about addiction/drug use and patterns of condom usage was collected, compiled, entered into Microsoft Excel, and subsequently analyzed using SPSS. Findings Out of the total participants, 171 (71.2%) reported engaging in addiction/drug use, Among those participants, 105 (61.4%) engaged in alcohol consumption prior to sexual contact to enhance pleasure or delay climax. Cigarette smoking was the most common type of addiction. Statistically significant association was found between habitual addiction/drug use (P=0.0023), use of ecstasy/aphrodisiac drugs (P=0.00654) and, inconsistent and/or incorrect condom use among the participants. However, planned addiction/drug use only before sexual contact did not show a significant association (P=0.066). Conclusion Habitual addiction/drug use among homosexual males increases the likelihood of engaging in inconsistent and/ or incorrect condom use, thereby elevating the risk of acquiring STIs and HIV. To mitigate this risk, interventions targeting addiction/ drug use prevention should be initiated during adolescence to address this issue at an earlier stage of life.
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Affiliation(s)
- Yashowardhan V. Totala
- Department of Community Medicine, Dr. Vasantrao Pawar Medical College, Hospital & Research Centre, Nashik – 422003, India
| | - Abhiram M. Kasbe
- Department of Community Medicine, Topiwala National Medical College & B.Y.L Nair Charitable Hospital, Mumbai 400008, India
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Ahinkorah BO, Hagan JE, Seidu AA, Budu E, Mensah GY, Adu C, Schack T. Understanding the association between exposure to family planning messages and consistent condom use among never married men in Ghana. PLoS One 2021; 16:e0255325. [PMID: 34428211 PMCID: PMC8384178 DOI: 10.1371/journal.pone.0255325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 07/14/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Despite considerable efforts to promote condom use, sexually active people in sub-Sahara Africa still engage in risky sexual behaviours, with condom use relatively low. With this high vulnerability of these persons to HIV and sexually transmitted infections, research related to exposure to family planning messages to help curb this trend remains sparse. This study examined how exposure to family planning messages in the midst of some socio-demographic factors is associated with consistent condom use among sexually active never married men in Ghana. METHODS Data were obtained from the 2014 Demographic and Health Survey (DHS) of Ghana. Only never married men (15-64 years) who have had sexual experience in the last 12 months were included in the analysis (N = 971). Frequencies, percentages, chi-square tests and binary logistic regression analyses were carried out. Results of the binary logistic regression analysis were presented using crude odds ratios (cOR) and adjusted odds ratios (aOR). RESULTS The results showed that only 26.15% of sexually active never married men in Ghana consistently used condom during sex. Men who were exposed to family planning messages were 51% more likely use condom consistently compared to those who are not exposed [aOR = 1.51, CI = 1.04-2.18]. In terms of the covariates, the likelihood of consistent condom use among men in Ghana was lower among those aged 35 years and above compared to those aged 15-24 [aOR = 0.46 CI = 0.21-0.99]. The odds of consistent condom use among men increased with level of education, with men with higher level of education having the highest odds of consistent condom use compared to those with no formal education [aOR = 9.98, CI = 2.05-48.46]. Men of the richest wealth quintile were more likely to use condom consistently compared to those of the poorest wealth quintile [aOR = 2.62, CI = 1.30-5.27]. Higher odds of consistent condom use was found among men who dwelled in the Central, Northern, and Upper East regions compared to those of the Western region. CONCLUSION Our findings have established a strong association between exposure to family planning messages alongside age, educational level, wealth, and region of residence and consistent condom use. Men exposed to family planning messages were more likely to use condoms consistently. Designed programs should use intervention strategies that focus on interactive and participatory educational activities to improve sexually active men's interpersonal communication on family planning messages, especially on consistent condom use with their sexual partners.
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Affiliation(s)
- Bright Opoku Ahinkorah
- Faculty of Health, School of Public Health, University of Technology Sydney, Sydney, Australia
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Faculty of Psychology and Sport Sciences, Neurocognition and Action-Biomechanics-Research Group, Bielefeld University, Bielefeld, Germany
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Australia
- Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Georgina Yaa Mensah
- Faculty of Health, Department of Communication Studies, University of Cape Coast, Cape Coast, Ghana
| | - Collins Adu
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Thomas Schack
- Faculty of Psychology and Sport Sciences, Neurocognition and Action-Biomechanics-Research Group, Bielefeld University, Bielefeld, Germany
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Wang H, Yu S, Cross W, Lam L, Banik B, Zhang K. Condom Use Consistency and Associated Factors Among College Student Men Who Have Sex with Men from Seven Colleges in Changsha City: A Cross-Sectional Survey. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2021; 13:557-569. [PMID: 34040452 PMCID: PMC8140883 DOI: 10.2147/hiv.s305932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/28/2021] [Indexed: 12/03/2022]
Abstract
Background College student men who have sex with men (MSM) are at high risk for HIV infection due to multiple social and behavioral factors. Consistent condom use is nationally advocated for HIV prevention. This study explored the sexual behaviors and factors associated with condom use consistency in the past six months among college student MSM from seven colleges in Hunan Province, China. Methods A cross-sectional survey was conducted from September 2017 to March 2018. Condom use consistency, sexual behaviors, HIV testing performance, substance use, and alcohol consumption were examined using researcher-created questionnaires. Condom use self-efficacy and HIV-related knowledge were assessed using the Condom Use Self-Efficacy Scale and the unified National AIDS Sentinel Surveillance Questionnaire. Univariate and multivariate logistic regressions were used. P <0.05 was considered significant. Results In the 214 respondents, the rate of consistent condom use was 56% (n = 119) during the past six months. Participants who were studying at first-tier universities (odds ratio [OR]: 2.522, 95% confidence interval [CI]: 1.255–5.067) and had higher scores for condom use self-efficacy (OR: 2.617, 95% CI: 1.462–4.685) were more likely to report consistent condom use than the others. The risk factor was having suspicious symptoms of sexually transmitted diseases (OR: 0.357, 95% CI: 0.163–0.780). Conclusion Numerous students were at high risk of HIV infection with inconsistent condom use. Comprehensive and specific topics about safe sex education from parents and peers should be offered on campuses in China.
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Affiliation(s)
- Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha City, 410000, Hunan Province, People's Republic of China
| | - Simin Yu
- Xiangya School of Nursing, Central South University, Changsha City, 410000, Hunan Province, People's Republic of China
| | - Wendy Cross
- School of Health, Federation University, Berwick, 3806, Victoria, Australia
| | - Louisa Lam
- School of Health, Federation University, Berwick, 3806, Victoria, Australia
| | - Biswajit Banik
- School of Health, Federation University, Berwick, 3806, Victoria, Australia
| | - Kaili Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou City, 221004, Jiangsu Province, People's Republic of China
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Hu L, Luo Y, Zhong X, Lu R, Wang Y, Sharma M, Ye M. Condom Use and Related Factors among Rural and Urban Men Who Have Sex With Men in Western China: Based on Information-Motivation-Behavioral Skills Model. Am J Mens Health 2021; 14:1557988319899799. [PMID: 32028826 PMCID: PMC7008563 DOI: 10.1177/1557988319899799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
This study aimed to determine the differences in condom use and related factors among rural–urban men who have sex with men (MSM) in Western China. A cross-sectional survey was conducted in Chongqing, Sichuan, and Guangxi, which recruited MSM by non-probability sampling. Data were collected through an anonymous, standardized, and self-reported questionnaire guided by an information–motivation–behavioral skills model. Structural equation model was applied to analyze the related factors. Out of the 1141 MSM included in this analysis, 856 (75%) and 285 (25%) were from urban and rural areas, respectively. The median age was 27 years for both groups. Self-reported consistent condom use for anal sex in the past 6 months was 57.58%. The rate of consistent condom use was lower in rural MSM than in urban MSM (50.88% vs. 59.81%, p = .008). Behavioral skills, HIV/AIDS intervention services, and response costs had direct positive and negative influences on condom use, respectively. By contrast, motivation and information exhibited indirect influence. All the factors were mediated by behavioral skills in rural and urban MSM, except for the information that had no effect among urban MSM but had an indirect effect among rural MSM. These findings suggest that service providers should pay attention to substantial rural–urban differences and design different AIDS prevention and intervention strategies targeting rural and urban MSM.
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Affiliation(s)
- Ling Hu
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yetao Luo
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Xiaoni Zhong
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Rongrong Lu
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Yang Wang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Manoj Sharma
- Department of Behavioral and Environmental Health, Jackson State University, Jackson, MS, USA.,School of Health Sciences, Walden University, Minneapolis, MN, USA
| | - Mengliang Ye
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
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Reza MM, Rana AKMM, Azim T, Chowdhury EI, Gourab G, Imran MSA, Islam MA, Khan SI. Changes in condom use among males who have sex with males (MSM): Measuring the effect of HIV prevention programme in Dhaka city. PLoS One 2020; 15:e0236557. [PMID: 32706840 PMCID: PMC7380615 DOI: 10.1371/journal.pone.0236557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 07/08/2020] [Indexed: 11/22/2022] Open
Abstract
Background A systematic assessment was done to examine the effect of HIV interventions among MSM in Dhaka, Bangladesh. MSM were defined as males having sex with males but did not sell sex in the last year. MSM are hidden, marginalized and stigmatized population groups not only in Bangladesh but also globally. In 2010, HIV interventions for MSM were expanded in 40 districts of Bangladesh through 65 drop-in-centres (DICs) and peer outreach workers. Methods Data from two surveys on MSM in Dhaka in 2010 (baseline) and 2013 (midline) were used to analyse the effect of ongoing HIV prevention services. Both surveys used time location sampling to randomly select MSM for risk behaviour interviews. Two outcome variables were considered; condom use in the last anal sex act and consistent condom use during anal sex in the last month. Univariate and multivariate logistic regression methods were used to determine factors associated with condom use. Results Condom use significantly increased at the midline than baseline (p<0.001 for both). Multivariate analysis showed that having comprehensive knowledge of HIV and participation in HIV prevention programme were positively associated with both last time and consistent condom use. MSM who had comprehensive knowledge of HIV were 1.9 times (95% CI: 1.3–2.8, p = 0.002) and 2.1 times (95% CI: 1.4–3.2, p<0.001) more likely to use condoms than those who did not have comprehensive knowledge of HIV. The likelihood of using condoms among MSM was more than double at the midline than the baseline (p<0.01 for both). However, odds of condom use was significantly lower among those who perceived themselves to be at risk or were not able to assess their own risk of HIV. Conclusion To sustain positive changes in HIV risk behaviours, HIV prevention programmes for MSM need to be continued and strengthened.
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Affiliation(s)
- Md. Masud Reza
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - AKM Masud Rana
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tasnim Azim
- Regional Advisor for Research Policy and Cooperation (RPC), Department of Communicable Diseases, WHO South-East Asia Regional Office, Delhi, India
| | | | - Gorkey Gourab
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md. Sha Al Imran
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md. Aminul Islam
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sharful Islam Khan
- Programme for HIV and AIDS, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- * E-mail:
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Wang Y, Jia M, Yuan D, Liang A, Zhang Z, Jiang X, Chen Y, Zhu H, Luo M, Wang Z, Cai Y. Assessing consistent condom use among migrant men who have sex with men in Shanghai, China: validation of an information-motivation-behavioural skills model. BMC Infect Dis 2019; 19:462. [PMID: 31122201 PMCID: PMC6533705 DOI: 10.1186/s12879-019-4090-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In China, high prevalence of risky sexual behaviours and inequity in health services lead to situations in which migrant men who have sex with men face higher risk of contracting the human immunodeficiency virus. Consistent condom use is a primary means of preventing HIV infection during anal sex among MSM. This study aimed to apply the information-motivation-behavioural skills model to examine the predictors of consistent condom use among migrant MSM in Shanghai, and tested the associations between model constructs. METHODS A cross-sectional study was conducted among 412 migrant MSM in Shanghai. Data on HIV-related information, motivation, behavioural skills, and behaviours were collected via structured questionnaires. A structural equation model was used to assess the IMB model. RESULTS Of the 412 participants, 4.4% reported HIV-positive status, and prevalence of consistent condom use in the previous 6 months was 44.9%. A restricted IMB model provided an acceptable fit to the data. Behavioural skills were found to directly predict consistent condom use (β = 0.629, P < 0.01). Neither information nor motivation could directly predict consistent condom use (P > 0.05), but motivation predicted it indirectly and was mediated by behavioural skills. CONCLUSION The prevalence of consistent condom use was found to be relatively low among migrant MSM in Shanghai. The restricted IMB model was found to be a good predictor of consistent condom use among them. The results of this study indicate that intervention strategies for safer sexual behaviour should not only include information dissemination, but also emphasize motivation and behavioural skills among this population.
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Affiliation(s)
- Ying Wang
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
| | - Mengmeng Jia
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021 China
| | - Dong Yuan
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Ajuan Liang
- Renji Hospital, affiliated with the School of Medicine Shanghai Jiao Tong University, Shanghai, 200127 China
| | - Zhiruo Zhang
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
| | - Xueqin Jiang
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
| | - Yi Chen
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Huiyao Zhu
- Changning District Center for Disease Control and Prevention, Shanghai, 200051 China
| | - Mengyun Luo
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
| | - Zezhou Wang
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
| | - Yong Cai
- School of Public Health, affiliated with the School of Medicine, Shanghai Jiao Tong University, No.227, South Chongqing Road, Shanghai, 200025 PR China
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[Data on the sexual health of providers and clients of sexual services for men who have sex with men in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 60:958-970. [PMID: 28741190 DOI: 10.1007/s00103-017-2589-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Little is known about the sexual health of male providers and clients of transactional sex. The data of participants of the European MSM Internet Survey (EMIS-DE; N = 50,086) who live in Germany were analysed. The outcomes were testing for and diagnoses of HIV and other sexually transmitted infections (STIs), partner numbers, illicit drug use, and sexual happiness in two populations: (1) men who offered and (2) men who paid for transactional sex in the past 12 months.In the age group of under 30 years (n = 19,138), providers of sexual services (escorts) were compared with non-providers; in the age group of 30 years and above (n = 30,948), we compared men who paid for sexual services with those who did not. We applied univariable and multinomial, multivariable logistic regression analyses in both age groups.Of those under the age of 30, 8% (n = 1529) had been paid for sex in the last 12 months, of which 49% were only paid once or twice. Escorts had lower educational achievements, lived more commonly in large cities, were more often born abroad, self-defined less frequently as gay, and were more frequently single. They reported higher numbers of sex partners, more drug use, and more sexual happiness. Escorts were more frequently tested for HIV and STIs, and among the tested, more diagnoses of HIV and STIs were reported, but those with HIV were less likely to be treated.Among those over 30 years, 11% (n = 3334) had paid for sex, the majority (58%) only once or twice. Payers were older, lived more commonly in large cities, and were more likely to be single, bisexual, or living with a woman. Clients used more illicit drugs, sexual enhancement drugs, and sedatives, but reported less sexual happiness. They were less likely to be tested for HIV and STIs.
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Yang Z, Li J, Dong Z, Wu N, Jin M. Correlates of recent HIV infection among men who have sex with men recruited through the internet in Huzhou City, Eastern China. J Int Med Res 2018; 46:5052-5061. [PMID: 30099921 PMCID: PMC6300933 DOI: 10.1177/0300060518789813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To identify factors associated with recent HIV infection among men who have sex with men (MSM) in Huzhou City, Eastern China, who seek sexual partners via the internet. METHODS Adult members of Tencent QQ instant messaging software, who completed a face-to-face interview questionnaire and serological HIV testing at baseline, were enrolled into this prospective cohort study. Questionnaires and serological testing were also completed at 6 and 12 months. Cox proportional hazards was used for initial bivariate analyses of differences between participants with or without recent HIV infection, and for subsequent forward stepwise multiple regression of statistically significant variables. RESULTS Out of 415 baseline participants, 283 completed the 12-month follow-up (25 with recent HIV infection and 258 without; recent HIV infection rate, 8.20 per 100 person-years). Recent HIV infection was shown to be significantly associated with ≤ high school education (versus college/university), registered residence outside Huzhou City (versus within Huzhou City), having ≥ two male sexual partners, and syphilis infection. CONCLUSIONS Improving education levels, treating syphilis promptly, and reducing the number of male sexual partners may reduce HIV transmission among MSM in Eastern China.
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Affiliation(s)
- Zhongrong Yang
- 1 Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, China
| | - Jing Li
- 1 Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, China
| | - Zhengquan Dong
- 1 Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, China
| | - Nanping Wu
- 2 State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Meihua Jin
- 1 Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, China
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Chen X, Elliott AL, Wang S. Cross-country Association of Press Freedom and LGBT freedom with prevalence of persons living with HIV: implication for global strategy against HIV/AIDS. Glob Health Res Policy 2018; 3:6. [PMID: 29457142 PMCID: PMC5806491 DOI: 10.1186/s41256-018-0061-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/17/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Human behaviors are affected by attitudes and beliefs, which in turn are shaped by higher-level values to which we have ascribed. In this study, we explore the relationship between two higher-level values, press freedom and LGBT freedom, and HIV infection with national data at the population level. METHODS Data were the number of persons living with HIV (PLWH, n = 35,468,911) for 148 countries during 2011-15, press freedom index (PFI) determined by the Reporters Without Borders, and LGBT freedom index (LGBT-FI) based on laws regulating same-sex relationships and expression. PLWH prevalence (1/1000), PFI and LGBT-FI were mapped first. Multiple regression was thus used to associate the logarithm of PLWH prevalence with PFI, LGBT-FI and PFI × LGBT-FI interaction, controlling for per capita GDP and weighted by population size. RESULTS Global prevalence of PLWH during 2011-15 was 0.51 per 1000 population. The prevalence showed a geographic pattern moving from high at the south and west ends of the world map to low at the north and east. Both PFI and LGBT-FI were positively associated with PLWH prevalence with a negative interaction between the two. CONCLUSIONS More people are infected with HIV in countries with higher press freedom and higher LGBT freedom. Furthermore, press freedom can attenuate the positive association between levels of LGBT freedom and risk of HIV infection. This study demonstrated the urgency for and provided data supporting further research to investigate potential cultural and socioecological mechanisms underpinning the complex relationship among press freedom, LGBT freedom and HIV infection, with data collected at the individual level.
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Affiliation(s)
- Xinguang Chen
- College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida USA
| | - Amy L. Elliott
- College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida USA
| | - Shuang Wang
- College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida USA
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Dai W, Luo Z, Xu R, Zhao G, Tu D, Yang L, Wang F, Cai Y, Lan L, Hong F, Yang T, Feng T. Prevalence of HIV and syphilis co-infection and associated factors among non-commercial men who have sex with men attending a sexually transmitted disease clinic in Shenzhen, China. BMC Infect Dis 2017; 17:86. [PMID: 28100187 PMCID: PMC5241916 DOI: 10.1186/s12879-017-2187-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/05/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although HIV and syphilis co-infection has been frequently observed in men who have sex with men (MSM), only few studies have focused on it. Different subgroups of MSM might exhibit heterogeneous HIV and syphilis risk profiles, indicating that interventions for HIV and HIV-related co-infections may vary with different subgroups of MSM. However, no previous study has investigated HIV and syphilis co-infection among non-commercial MSM (ncMSM) attending a sexually transmitted disease (STD) clinic. Therefore, this study aimed to explore the prevalence of HIV and syphilis co-infection and associated factors among ncMSM attending an STD clinic in Shenzhen, China. METHODS NcMSM attending the STD clinic of Shenzhen Center for Chronic Disease Control were recruited in this cross-sectional study every Monday between March 2013 and August 2015 using a site based convenience sampling method. An anonymous questionnaire was used to collect data regarding socio-demographic characteristics, risky sexual behaviors and HIV-related knowledge. Blood samples were collected to perform HIV and syphilis tests. RESULTS Totally 533 participants were enrolled in this study and the prevalence of HIV and syphilis co-infection among them was 13.13%. Multivariable analyses indicated that having lived in Shenzhen for less than one year (aOR = 2.80, 95% CI = 1.30-6.05), having first anal sexual intercourse before the age of 18 (aOR = 2.78, 95% CI = 1.29-5.89), having 3 to 5 anal sexual partners in the past six months (aOR = 2.54, 95% CI = 1.19-5.40), playing exclusively receptive (aOR = 6.87, 95% CI = 3.02-15.61) or both insertive and receptive (aOR = 3.65, 95% CI = 1.64-8.09) roles in anal sexual intercourse and not always using condom in anal sexual intercourse (aOR = 2.13, 95% CI = 1.08-4.19) were associated risk factors for HIV and syphilis co-infection, relative to the non-infected ncMSM. Compared with the mono-infected ncMSM, associated risk factors for the co-infection were being unmarried (aOR = 2.47, 95% CI = 1.03-5.89) and playing exclusively receptive role (aOR = 2.44, 95% CI = 1.04-5.73) in anal sexual intercourse. CONCLUSIONS HIV and syphilis co-infection is quite prevalent among the study participants in Shenzhen. Integrated and intensified intervention strategies, specifically targeting at the non-infected and mono-infected ncMSM attending the STD clinic, are needed to reduce HIV and syphilis co-infection. Most importantly, non-infected and mono-infected ncMSM attending the STD clinic with the aforementioned associated risk factors should be given special concern.
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Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Zhenzhou Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Ruiwei Xu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Guanglu Zhao
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Dan Tu
- Graduate School, Shenzhen University, Shenzhen, Guangdong China
| | - Lin Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Feng Wang
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Yumao Cai
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Lina Lan
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Fuchang Hong
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Tiejian Feng
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong China
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Yang Z, Huang Z, Dong Z, Li J, Zhang S, Wu N, Jin M. Risk Factors for HIV Diagnosis Among Men Who Have Sex with Men: Results of a Case-Control Study in One Sample of Eastern China. AIDS Res Hum Retroviruses 2016; 32:1163-1168. [PMID: 27329367 DOI: 10.1089/aid.2016.0031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Substantial increases in human immunodeficiency virus (HIV) have been reported worldwide in recent years, particularly among men who have sex with men (MSM). We conducted a matched case-control study to examine the factors associated with HIV diagnosis among MSM in one sample of eastern China. Between February 2012 and December 2014, we used surveillance records to identify MSM diagnosed with HIV (case participants); we also recruited MSM who did not have HIV (controls) and then matched them (2:1) with control cases in terms of age (±3 years). Multivariate logistic regression models were used to assess the factors associated with HIV diagnosis. According to a multivariate analysis using logistic regression model involving 101 cases and 202 matched controls, a lack of comprehensive knowledge of HIV (adjusted odds ratio [OR] = 0.40; 95% confidence interval [CI] = 0.18, 0.89), a monthly income of ≥4,000 RMB (adjusted OR = 2.99; 95% CI = 1.45, 6.16), having at least two male sexual partners in the past 6 months (adjusted OR = 2.85; 95% CI = 1.28, 6.31), participating in at least four anal sex experiences with a man in the past month (adjusted OR = 3.56; 95% CI = 1.64, 7.73), and having a current syphilis infection (adjusted OR = 3.30; 95% CI = 1.06, 10.25) were associated with an increased risk for HIV diagnosis. MSM with a comprehensive knowledge of HIV were at reduced risk of HIV diagnosis, whereas those with more male sexual partners, more male anal sexual experiences (including receptive or/and insertive anal intercourse, rimming, and fisting), and a current syphilis infection were at increased risk of HIV diagnosis. Focus on protection and safer sex behaviors during male sexual activity (i.e., consistent condom use, pre-exposure prophylaxis, closed sexual networks among MSM) would likely be effective for reducing the HIV transmission rate.
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Affiliation(s)
- Zhongrong Yang
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, People's Republic of China
| | - Zhaohui Huang
- Anhui Provincial Family Planning Institute of Science and Technology, Hefei, Anhui Province, People's Republic of China
| | - Zhengquan Dong
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, People's Republic of China
| | - Jing Li
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, People's Republic of China
| | - Sichao Zhang
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, People's Republic of China
| | - Nanping Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, People's Republic of China
| | - Meihua Jin
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, People's Republic of China
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13
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Early Sexual Debut and HIV Infection among Men Who Have Sex with Men in Shenzhen, China. BIOMED RESEARCH INTERNATIONAL 2016; 2016:2987472. [PMID: 28004003 PMCID: PMC5149598 DOI: 10.1155/2016/2987472] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/12/2016] [Accepted: 11/06/2016] [Indexed: 11/17/2022]
Abstract
Studies investigating the association between early sexual debut and human immunodeficiency virus (HIV) infection have mainly focused on Africans or females but rarely on men who have sex with men (MSM) in China. This study, therefore, mainly aimed at exploring the association between early sexual debut and HIV infection among MSM in Shenzhen, China. A total of 533 MSM were enrolled in this study using a convenience sampling method. Information about sociodemographic characteristics and risky sexual behaviors was collected. It was found that the prevalence of HIV infection was 24.2% among this study population and 66.4% of the MSM reported having had vaginal sexual intercourse with females. The mean ages at first vaginal sexual intercourse, first anal sexual intercourse, and first sexual intercourse were 21.38, 22.43, and 19.87 years, respectively. Multivariable logistic regression analyses showed that the MSM who experienced early anal sexual debut were more likely to be infected with HIV than those who did not. The results indicate that HIV infection is quite prevalent among MSM in Shenzhen. Early and efficient intervention strategies should be taken, and the MSM experiencing early anal sexual debut should be given special attention.
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14
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Liu Y, Wang J, Qian HZ, Liu H, Yin L, Lu H, Zhang C, Ruan Y, Shao Y, Vermund SH. Seeking Male Sexual Partners via Internet and Traditional Venues among Chinese Men Who Have Sex with Men: Implications for HIV Risk Reduction Interventions. AIDS Behav 2016; 20:2222-2230. [PMID: 27000143 DOI: 10.1007/s10461-016-1371-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The dynamic nature of finding male sexual partners (sex-finding) among Chinese men who have sex with men (MSM) may play a substantial role in the HIV epidemic. We compared characteristics and behaviors of MSM who mostly sought sex via the Internet versus traditional venues in a cross-sectional survey among 3588 Chinese MSM. We assessed the sociodemographic predictors and compared high-risk behaviors of using Internet versus traditional venues for sex-finding. Compared to non-Internet MSM, Internet-user MSM were more likely to have been: younger, currently single, better educated, health-insured, with higher income, with Beijing residency ('Hukou'), living longer in the city, HIV-positive, ever using drug and engaging in condomless receptive anal sex. Internet sex-finding users were less likely to be sexually active for longer duration, drink alcohol, drink alcohol before sex, or ever have sex with women. Knowledge of differential characteristics of various sex-finding MSM can help design targeted interventions.
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Affiliation(s)
- Yu Liu
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Suite 725, 2525 West End Avenue, Nashville, TN, 37203, USA
| | - Juan Wang
- Beijing Municipal Center for Disease Control and Prevention, Beijing, China
| | - Han-Zhu Qian
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Suite 725, 2525 West End Avenue, Nashville, TN, 37203, USA
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Hongjie Liu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Lu Yin
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Suite 725, 2525 West End Avenue, Nashville, TN, 37203, USA
| | - Hongyan Lu
- Beijing Municipal Center for Disease Control and Prevention, Beijing, China
| | - Chen Zhang
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Suite 725, 2525 West End Avenue, Nashville, TN, 37203, USA
| | - Yuhua Ruan
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yiming Shao
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sten H Vermund
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Suite 725, 2525 West End Avenue, Nashville, TN, 37203, USA.
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
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15
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Passaro RC, Haley CA, Sanchez H, Vermund SH, Kipp AM. High HIV prevalence and the internet as a source of HIV-related service information at a community-based organization in Peru: a cross-sectional study of men who have sex with men. BMC Public Health 2016; 16:871. [PMID: 27557857 PMCID: PMC4997688 DOI: 10.1186/s12889-016-3561-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 08/19/2016] [Indexed: 11/23/2022] Open
Abstract
Background The HIV prevalence among men who have sex with men (MSM) in Peru (12.4 %) is 30 times higher than in the general adult population (0.4 %). It is critical for community-based organizations to understand how to provide HIV services to MSM while maximizing limited resources. This study describes the HIV prevalence and risk profiles of MSM seeking HIV services at a community-based organization in Lima, Peru. It then compares HIV prevalence between those who found out about the HIV services through different sources. Methods A cross-sectional study of MSM seeking HIV services at Epicentro Salud in Lima, Peru for the first time between April 2012 and October 2013. We compared HIV prevalence among MSM who found out about Epicentro via online sources of information (N = 419), those using in-person sources (friends, partners) (N = 907), and sex workers (N = 140) using multivariable logistic regression models. Results HIV prevalence was 18.3 % overall: 23.2 % among MSM using online sources, 19.3 % among sex workers, and 15.9 % among MSM using in-person sources. However, when compared to the in-person group, sexual risk behaviors were not statistically higher among MSM using online sources. For the sex worker group, some behaviors were more common, while others were less. After adjusting for confounders, the odds of having HIV was higher for the online group (Odds Ratio = 1.61; 95 % Confidence Interval: 1.19–2.18), but not for the sex worker group (OR = 1.12; 95 % CI: 0.68–1.86), compared to the in-person group. Conclusion Internet-based promotion appears to successfully reach MSM at high risk of HIV in Peru. Outreach via this medium can facilitate HIV diagnosis, which is the critical first step in getting infected individuals into HIV care. For community-based organizations working in resource-limited settings, this may be an effective strategy for engaging a subset of high-risk persons in HIV care.
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Affiliation(s)
- R Colby Passaro
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA
| | - Connie A Haley
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA.,Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Sten H Vermund
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Aaron M Kipp
- Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA. .,Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. .,Institute for Medicine and Public Health, 2525 West End Ave., Suite 614, Nashville, TN, USA.
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16
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Dysfunction of the frontolimbic region during swear word processing in young adolescents with Internet gaming disorder. Transl Psychiatry 2015; 5:e624. [PMID: 26305475 PMCID: PMC4564561 DOI: 10.1038/tp.2015.106] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 05/13/2015] [Accepted: 06/14/2015] [Indexed: 01/07/2023] Open
Abstract
Although the Internet is an important tool in our daily life, the control of Internet use is necessary to address difficult problems. This study set out with the aim of assessing the cognitive control of affective events in Internet gaming disorder (IGD) and has examined the influence of IGD on neural activities with regard to swear words in young adolescents. We demonstrated the differences between adolescents with IGD and healthy control adolescents (HC) with respect to swear, negative and neutral word conditions. Swear words induced more activation in regions related to social interaction and emotional processing such as the superior temporal sulcus, right temporoparietal junction and orbitofrontal cortex (OFC) when compared with negative words. In this study, adolescents with IGD exhibited reduced activation in the right OFC related to cognitive control and in the dorsal anterior cingulate cortex (dACC) related to social rejection during the swear word condition. In addition, adolescents with IGD were negatively correlated with activity in the right amygdala toward swear words, indicating the important role of the amygdala in the control of aggression in adolescents with IGD. These findings enhance our understanding of social-emotional perception in adolescents with IGD.
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17
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Kramer SC, Drewes J, Kruspe M, Marcus U. Factors associated with sexual risk behaviors with non-steady partners and lack of recent HIV testing among German men who have sex with men in steady relationships: results from a cross-sectional internet survey. BMC Public Health 2015. [PMID: 26205833 PMCID: PMC4513622 DOI: 10.1186/s12889-015-1987-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Recent evidence suggests that the majority of HIV transmissions among men who have sex with men (MSM) occur between steady partners. We sought to determine factors associated with HIV transmission risks in steady partnerships. Methods Data is from the German cross-sectional 2013 Gay Men and AIDS survey. The study population was HIV-negative or untested men reporting a steady partnership and at least one non-steady anal sex partner in the previous year. Bivariate and multivariate logistic regression was used to determine which of several independent variables best predicted both unprotected anal intercourse (UAI) with a non-steady partner and lack of HIV testing in the past year (high-risk outcome group). Results The study population consisted of 1731 men. Among individuals in the outcome group (n = 271), 67 % reported UAI with a non-steady partner of unknown status and 9 % reported UAI with a non-steady HIV-positive partner in the past 12 months; 55 % considered themselves to be at low risk for HIV acquisition. In multivariate analyses (n = 1304), participants were statistically more likely to belong to the outcome group if they reported UAI with their steady partner in the past year (OR = 2.21), did not know their steady partner’s HIV status (OR = 1.98), or agreed that condoms were disruptive during sex (OR = 3.82 (strongly agree), OR = 2.19 (agree)). Participants were less likely to belong to the outcome group if they were out to their primary doctor (OR = 0.54), were well-educated about post-exposure prophylaxis (OR = 0.46), had sought information on HIV in the past year and kept condoms in an accessible place (OR = 0.20), or believed that insisting on condoms would lead partners to assume they were HIV-negative (OR = 0.20). Participants in the outcome group were more likely to say they would use HIV home tests (OR = 1.58) or pre-exposure prophylaxis (OR = 2.11). Conclusions Based on our results, we reflect on HIV prevention measures that should be improved in order to better target behaviors that may lead to HIV transmission between MSM in steady relationships. In particular, we highlight the need for multifaceted interventions focusing not only on members of the at-risk community themselves, but on communities as a whole. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1987-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarah C Kramer
- Department for Infectious Disease Epidemiology, HIV/AIDS, STI and Blood-borne Infections Unit, Robert Koch Institute, Berlin, Germany.
| | - Jochen Drewes
- Public Health: Prevention and Psychological Health Research, Freie Universität Berlin, Berlin, Germany.
| | - Martin Kruspe
- Public Health: Prevention and Psychological Health Research, Freie Universität Berlin, Berlin, Germany.
| | - Ulrich Marcus
- Department for Infectious Disease Epidemiology, HIV/AIDS, STI and Blood-borne Infections Unit, Robert Koch Institute, Berlin, Germany.
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Chen JP, Han MM, Liao ZJ, Dai ZZ, Liu L, Chen H, Wen XY, Hu S, Que P, Wen W, Peng B. HIV-related behaviors, social support and health-related quality of life among men who have sex with men and women (MSMW): a cross-sectional study in Chongqing, China. PLoS One 2015; 10:e0118651. [PMID: 25700107 PMCID: PMC4336282 DOI: 10.1371/journal.pone.0118651] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/11/2015] [Indexed: 11/25/2022] Open
Abstract
Background Health-related quality of life (HRQOL) has become commonly used both as a concept and as a field of research. However, little is known about the HRQOL of men who have sex with men and women (MSMW). The aim of this study was to examine HIV-related behaviors, social support, and HRQOL status and explore its predictors among MSMW. Methods An anonymous cross-sectional study was conducted by snowball sampling method in 2013. A total of 563 Chinese MSM completed a structured questionnaire. The HRQOL and social support were measured with the Chinese version of the World Health Organization Quality of Life Scale (WHOQOL-BRFE) and the Social Support Rating Scale (SSRS), respectively. Results Of the 563 MSM analyzed, 77 (13.68%) were MSMW who had a higher proportion of in-marriage and preference for an insertive role as compared with the men who have sex with men only (MSMO) (P<0.05). As high as 70.13% of MSMW had no regular sex partners and 72.73% of MSMW reported engaging in unprotected anal sex in the last six months. 36.36% had tested for HIV, while only 12.99% had accepted HIV voluntary counseling and testing (VCT) services. The scores of objective support and subjective support in MSMW were significantly higher than that of MSMO (P<0.05). No statistically significant difference was found in scores of all the four domains of the HRQOL between MSMW and MSMO. When comparing the HRQOL scores of MSMW with the Chinese general population reference group, the scores of MSMW were significantly lower in physical health domain. In a multivariate regression model, age, monthly income, sexual role, VCT acceptability, subjective support were associated with variability in HRQOL. Conclusions To improve the HRQOL among MSMW, more attention needs to be paid to those with low social support, low-income, the old and those prefer a receptive role during anal sex populations.
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Affiliation(s)
- Jiang-Peng Chen
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Ming-Ming Han
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Zi-Jun Liao
- Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing, China
| | - Zhen-Zhen Dai
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Liang Liu
- Beichuan Center for Disease Control and Prevention, Mianyang, Sichuan Province, China
| | - Hua Chen
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiao-Yan Wen
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Shan Hu
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Ping Que
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Wen Wen
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Bin Peng
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
- * E-mail:
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Mozalevskis A, Manzanares-Laya S, García de Olalla P, Moreno A, Jacques-Aviñó C, Caylà JA. Can we rely on the antiretroviral treatment as the only means for human immunodeficiency virusprevention? A Public Health perspective. Enferm Infecc Microbiol Clin 2014; 33:e63-8. [PMID: 25444036 DOI: 10.1016/j.eimc.2014.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/25/2014] [Accepted: 07/31/2014] [Indexed: 11/29/2022]
Abstract
The evidence that supports the preventive effect of combination antiretroviral treatment (cART) in HIV sexual transmission suggested the so-called 'treatment as prevention' (TAP) strategy as a promising tool for slowing down HIV transmission. As the messages and attitudes towards condom use in the context of TAP appear to be somehow confusing, the aim here is to assess whether relying on cART alone to prevent HIV transmission can currently be recommended from the Public Health perspective. A review is made of the literature on the effects of TAP strategy on HIV transmission and the epidemiology of other sexual transmitted infections (STIs) in the cART era, and recommendations from Public Health institutions on the TAP as of February 2014. The evolution of HIV and other STIs in Barcelona from 2007 to 2012 has also been analysed. Given that the widespread use of cART has coincided with an increasing incidence of HIV and other STIs, mainly amongst men who have sex with men, a combination and diversified prevention methods should always be considered and recommended in counselling. An informed decision on whether to stop using condoms should only be made by partners within stable couples, and after receiving all the up-to-date information regarding TAP. From the public health perspective, primary prevention should be a priority; therefore relying on cART alone is not a sufficient strategy to prevent new HIV and other STIs.
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Affiliation(s)
- Antons Mozalevskis
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain; National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | | | - Patricia García de Olalla
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Antonio Moreno
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Joan A Caylà
- Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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