Community-based HIV testing in The Netherlands: experiences of lay providers and end users at a rapid HIV test checkpoint

Differences in STI/HIV Burden and Sexual Health Care-Seeking Behavior Among First- and Second-Generation Migrant and Western-Born Male Sex Workers Who Have Sex With Men in the Netherlands: A Retrospective Cohort Study

BACKGROUND

Globally, migrant sex workers have a higher burden of sexually transmitted infections (STI)/human immunodeficiency virus (HIV). This large study aimed to assess demographics, STI/HIV burden, and sexual health care-seeking behavior of first-generation migrant and second-generation migrant male sex workers who have sex with men (MSW-MSM) versus Western-born MSW-MSM.

METHODS

Coded STI clinic consultations (n = 6970) from 3116 individual MSW-MSM attending any Dutch STI clinic between 2016 and 2021 were included. First-generation migrant: born outside of northern/central/southern/western Europe/North America/Oceania. Second-generation migrant: ≥1parent born outside of northern/central/southern/western Europe/North America/Oceania. Multivariable logistic regression analysis assessed associations between MSW-MSM groups and STI in first consultation in the data. A Cox proportional hazard regression compared the incidence of a first repeat consultation between migration groups, stratified by STI in first consultation. All analyses were adjusted for age and urbanity of STI clinic region.

RESULTS

First-generation migrant MSW-MSM (n = 1085) were mostly born in Latin America (50%), whereas second-generation migrant MSW-MSM (n = 368) mostly originated from North Africa (30.4%). The proportion of STI diagnoses differed (33.2%, 29.3%, 23.3%; P < 0.001) between the first-generation migrant, second-generation migrant, and Western-born MSW-MSM. First-generation migrant MSW-MSM versus Western-born had an adjusted odds ratio of 1.6 (95% confidence interval, 1.3-1.9) of STI diagnosis in the first consultation. First-generation migrant MSW-MSM versus Western-born had an adjusted hazard ratio of 1.5 (95% confidence interval, 1.3-1.8) of having a first repeat consultation at any time, when stratified for no STI in the first consultation.

CONCLUSIONS

The STI/HIV burden is high among all 3 MSW-MSM groups. First-generation migrants have higher odds of STI, but retention in care seems similar. Results highlight the importance of low-threshold STI testing and care for (migrant) MSW-MSM.

Prevention of HIV in the MSM Population: A Cultural-Historical Comparison of Sweden and the Netherlands

The aim of this article is to compare the cultural-historical events and decisions regarding how to deal with the higher risks of HIV in MSM, and more specifically, gay populations in Sweden and the Netherlands. A narrative literature was used, based on 46 scientific articles and 20 additional semi-scientific resources. The themes of the arrival of HIV and AIDS, blood donations, offender/victim, the balance of risks with respect to the statistical probabilities and the human factor, and finally, prevention were discussed. It is concluded that certain context-specific historical events (the Dutch Bloody Sunday and the Swedish gay sauna ban) and culturally determined processes (trust in others in the Netherlands, and disapproval of casual sex in Sweden) have led to some important differences in how HIV and AIDS and the higher risks for gay men and MSM have been dealt with. In the Netherlands, there is a stronger protective attitude when it comes to the freedom and autonomy of MSM both when it comes to decisions about sexual behavior and to sharing any positive HIV status. In Sweden, on the other hand, there is a stronger tendency to enforce informing others of their HIV status. In both countries, despite efforts to prevent this, HIV has increased stigma for gay men and other MSM.

Quality of Nursing Care Perceived by People With HIV in Brazil: A Cross-Sectional Study

ABSTRACT

We evaluated the quality of care provided by the nursing team within specialized care services (SCS) from the perspective of persons with HIV (PWH). A cross-sectional study was conducted in 25 SCS selected by a single-stage cluster sampling in 21 municipalities in Brazil. Systematic sampling was performed between October 2019 and March 2020 in the reception areas of SCS locations to choose the study population ( N = 377). The adapted and validated Quality of Care Through the Patient's Eyes-HIV (QUOTE-HIV) questionnaire was used to measure the quality of perceived care, and the Mann-Whitney test to compare the scores between men and women. Of the 377 PWH, most were women (57.71%), Black or Brown (85.9%), heterosexual (67.1%), and cisgendered (96.0%); the mean age was ≥30 years (76.1%). Users' evaluation of the care provided by SCS according to scores of importance and performance of the QUOTE-HIV instrument ranged from 5.60 to 8.95 and 0.03 to 0.76, respectively. The perception of PWH about the quality of care provided by the nursing team in SCS suggests that there are opportunities to improve.