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Wang P, Wei C, McFarland W, Raymond HF. The Development and the Assessment of Sampling Methods for Hard-to-Reach Populations in HIV Surveillance. J Urban Health 2024; 101:856-866. [PMID: 38787451 PMCID: PMC11329483 DOI: 10.1007/s11524-024-00880-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
Due to stigma or legal issues, populations with higher HIV risk are often hard to reach, which impedes accurate population estimation of HIV burden. To better sample hard-to-reach populations (HTRPs) for HIV surveillance, various sampling methods have been designed and/or used since HIV epidemic following the first reported AIDS cases in 1981. This paper describes the development and the assessment (i.e., validity and reproducibility) of approximately eight sampling methods (e.g., convenience sampling, snowball sampling, time location sampling, and respondent-driven sampling) for HTRPs in HIV surveillance, with a focus on respondent-driven sampling (RDS). Compared to other methods, RDS has been greatly assessed. However, current evidence is still inadequate for RDS to be considered the best option for sampling HTRPs. The field must continue to assess RDS and to develop new sampling approaches or modifications to existing approaches.
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Affiliation(s)
- Peng Wang
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chongyi Wei
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Willi McFarland
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Henry F Raymond
- School of Public Health, Rutgers University, Piscataway, NJ, USA.
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Singhato A, Booranasuksakul U, Khongkhon S, Rueangsri N. Effectiveness of the Therapeutic Lifestyle Change Diet Intervention to Improve Biochemical Markers of Cardiovascular Diseases in HIV-Infected Patients with Dyslipidemia. ANNALS OF NUTRITION & METABOLISM 2024; 80:202-210. [PMID: 38631311 DOI: 10.1159/000538578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION This randomized controlled trial study aimed to investigate the effectiveness of therapeutic lifestyle change (TLC) diet intervention by the registered dietitians. METHODS Eighty-two people living with HIV (PLHIV) with dyslipidemia were randomly allocated to the intervention group as well as another 82 PLHIV with dyslipidemia to the control group. Participants in the intervention group were instructed to meet the registered dietitians every 2 weeks at weeks 0, 2, 4, 6, and 12 (a totally of 12 weeks) to receive individual medical nutrition therapy according to the TLC diet principles, while the participants in the control group only received routine health care service. RESULTS Triglycerides, total cholesterol, and LDL cholesterol of the intervention group were significantly lower than those of the control group at the endpoint (p < 0.05). In addition, these biomarkers and C-reactive protein of the intervention group were significantly lower when compared with their baseline (p < 0.05). The overall dietary habits of participants in the intervention group were significantly improved at the end of the study (p < 0.05). CONCLUSION The medical nutrition therapy intervention based on the TLC diet is effective in improving blood lipid profiles among PLHIV with dyslipidemia.
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Affiliation(s)
- Alongkote Singhato
- Nutrition and Dietetics Division, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
| | - Uraiporn Booranasuksakul
- Nutrition and Dietetics Division, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
| | - Somjet Khongkhon
- Thai Traditional Medicine Division, Faculty of Thai Traditional and Alternative Medicine, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
| | - Narisa Rueangsri
- Nutrition and Dietetics Division, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
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Chan LS, Chui DLT, Yanagi J. Cultural-Psychological Differences, Social Acceptance of Same-Sex Relationships, and Dating App Use Motives of Young GBMSM: A Comparative Study Across Hong Kong, Taipei, and Osaka. JOURNAL OF SEX RESEARCH 2024:1-11. [PMID: 38412108 DOI: 10.1080/00224499.2024.2317806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Gay-specific mobile dating apps such as Grindr are popular among young gay, bisexual, and other men who have sex with men (GBMSM) worldwide. However, how the use of these apps differs between regions is underexplored. In this study, we drew on the uses and gratifications literature and cross-cultural studies to examine how cultural-psychological differences (sensation seeking and communication apprehension) and social acceptance of same-sex relationships are associated with the motives for using gay dating apps in three East Asian cities. Using a sample of 18-34-year-old GBMSM (217 participants from Hong Kong, 330 from Taipei, and 175 from Osaka), we found that the Taiwanese participants scored higher than their Japanese counterparts on almost all motives. Sensation seeking was positively associated with using gay dating apps for casual sex, self-worth validation, and thrill of excitement in both Taipei and Osaka. Communication apprehension was positively associated with using the apps for ease of communication in all three cities. Social acceptance of same-sex relationships had positive relationships with using the apps for love in Hong Kong and casual sex in Taipei but negative relationships with other motives in Taipei and Osaka. These inconsistent relationships between the variables across the three cities point to the importance of cultural and regional specificity in predicting gay dating app use motives.
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Affiliation(s)
- Lik Sam Chan
- School of Journalism and Communication, The Chinese University of Hong Kong
| | - Don Lok Tung Chui
- School of Journalism and Communication, The Chinese University of Hong Kong
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Araújo TMED, Lulendo E, Brito Magalhães RDL, Valle ARMDC, Borges PDTM, Almeida PD, Almeida MG, Oliveira LBD, Mendes IAC, Sousa AFLD. Sexual exposure to HIV in Angolan men who have sex with men immigrants: A cross-sectional study in Portugal and Brazil. Int J STD AIDS 2023; 34:876-883. [PMID: 37350448 DOI: 10.1177/09564624231185810] [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] [Indexed: 06/24/2023]
Abstract
BACKGROUND In different contexts, international migrants are vulnerable to health disparities that increase the risk of HIV/AIDS exposure and continue to bear a significant burden of new virus infections in developed and developing countries. In this study, we sought to examine sexual practices and factors linked to HIV exposure among a sample of Angolan men who have sex with men (MSM) immigrants. METHODS The study was conducted in two Portuguese-speaking countries, Brazil and Portugal, and involved 250 Angolan MSM immigrants between September 2020 and February 2021, using sampling methods to constitute the sample and the HIV Incidence Risk Index (HIRI) to define virus exposure risk. Odds ratio (OR) and adjusted odds ratio (aOR) were used to calculate the chances of higher HIRI index in the sample. RESULTS Our results showed that 76.8% of participants presented a high HIRI index, influenced by the practice of chemsex (aOR: 4.26), having a known/repeated partner (aOR: 4.59), and engaging in passive sex without a condom in the last 30 days (aOR: 1.29) or 6 months (aOR: 1.98). CONCLUSIONS It is crucial to focus on this vulnerable population and implement sexual health policies that integrate combined HIV prevention measures aimed at immigrant MSM.
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Chan LS, Wu-Ouyang B. Sexting Among Men Who Have Sex with Men in Hong Kong and Taiwan: Roles of Sensation-Seeking, Gay Identity, and Muscularity Ideal. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2373-2384. [PMID: 36849674 PMCID: PMC9970127 DOI: 10.1007/s10508-023-02559-w] [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] [Received: 05/24/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Prior studies found that sexting was associated with risky sexual activities and that men who have sex with men (MSM) engaged in more frequent sexting than their heterosexual counterparts. Therefore, it is pertinent to understand what factors are associated with sexting among MSM. This study explored the relationships between sensation-seeking, gay identity confusion, and muscularity ideal with sexting behaviors. An online survey was administered to 355 and 448 18-34-year-old MSM in Hong Kong and Taiwan, respectively. While the number of sexting partners and the frequency of sexting were similar across the two regions, they had different associations with psychological factors. In Hong Kong, sensation-seeking was positively related to the number of sexting partners, while in Taiwan, it was positively related to the frequency of sending sexts. In Hong Kong, MSM who were more confused about their sexual orientation had fewer sexting partners. In both regions, MSM holding a stronger muscularity ideal also had more sexting partners. Gay identity confusion and muscularity ideal were associated with sexting under pressure in Taiwan; all three psychological factors concerned were associated with sexting under pressure in Hong Kong. Overall, these results showed that some MSM found sexting to be a sensation-fulfilling activity, but some were vulnerable to sexting under pressure. Counseling services to MSM about their sexual identity and concern for muscularity are needed to prevent them from becoming victims of forced sexting. Finally, the inconsistent results for the Hong Kong and Taiwanese samples indicated the importance of considering regional specificity in sexting research.
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Affiliation(s)
- Lik Sam Chan
- School of Journalism and Communication, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Biying Wu-Ouyang
- School of Journalism and Communication, The Chinese University of Hong Kong, Shatin, Hong Kong
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Garrido‐Hernansaiz H. The use of online social media for the recruitment of people living with HIV in Spain and Latin America: Lessons from two studies. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4065-e4073. [PMID: 35318765 PMCID: PMC10078670 DOI: 10.1111/hsc.13799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 02/17/2022] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
Various barriers make recruiting a difficult task for researchers, especially when recruiting people living with HIV (PLWH) or conducting longitudinal studies. Effective recruitment is crucial to the validity of studies, and in this regard, social media can come to aid, although researchers usually rely on paid advertisements. This paper describes the free social media strategies used for participant recruitment in two studies carried out with PLWH in Spain and Latin America. Study 1 was a cross-sectional study on the validation of two stigma scales with a 1-month retest. Study 2 was a longitudinal study exploring the mental health of newly diagnosed PLWH, with a second assessment after 6 months. Facebook posts, Twitter mentions, and discussion forums were used in both studies. Study 2 also recruited participants through a healthcare centre. In Study 1, 5-month recruitment yielded a sample of 458 PLWH, averaging 91.6 surveys/month and a 43% retention rate. In study 2, recruitment took 16 months, yielding a final sample of 145 newly diagnosed PLWH, 92 from the healthcare centre (5.75 surveys/month) and 53 from social media (3.31 surveys/month), with 95% and 60% retention rates, respectively. Participants in Study 2 did not differ in sociodemographic characteristics by recruitment method, except for the region of origin and financial difficulty (more diverse origin and greater difficulty emerged in social media participants). Greater psychological distress and lower personal and social resources were also found in social media participants. These data indicate that free social media recruitment is a feasible and effective tool for the recruitment of Spanish-speaking PLWH, although it is best used in combination with traditional methods for newly diagnosed PLWH and longitudinal studies.
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Meanley S, Sexton Topper P, Listerud L, Bonett SK, Watson D, Choi SK, Teixeira Da Silva D, Flores DD, James R, Bauermeister JA. Leveraging Resilience-supportive Strategies to Enhance Protective Factors in Young Sexual Minority Men: A Scoping Review of HIV Behavioral Interventions Implemented in High-income Countries. JOURNAL OF SEX RESEARCH 2022; 59:957-983. [PMID: 35080999 DOI: 10.1080/00224499.2021.2024789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Behavioral HIV interventions focused on strengthening young sexual minority men's (SMM) internal (assets) and external (resources) protective factors are promising, yet their evaluation as resilience-supportive strategies to minimize or negate HIV-related risks remain understudied. The objective of this scoping review was to describe resilience-supportive intervention strategies that have been used to achieve desired HIV behavioral outcomes and to identify how these strategies have been evaluated using a resilience analytic framework. Our scoping review uncovered 271 peer-reviewed articles, of which 38 were eligible for inclusion based on our review criteria. The majority of interventions relied on social support strategies as their primary resilience-supportive strategy. A third of interventions reviewed analyzed their findings from a deficits-focused model, another third used compensatory resilience models, and the remaining interventions employed a hybrid (i.e., deficit and compensatory model) strategy. None of the interventions evaluated their intervention effects using a risk-protective model. From our synthesis regarding the current state of research around resilience-informed interventions, we propose strategies to inform the design of resilience-supportive approaches and make recommendations to move the field forward on how to develop, implement, and measure young SMM's resiliency processes.
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Affiliation(s)
- Steven Meanley
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Patrina Sexton Topper
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Louis Listerud
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Stephen K Bonett
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- University of Pennsylvania Leonard Davis Institute of Health Economics
| | - Dovie Watson
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- School of Medicine, Division of Infectious Diseases, University of Pennsylvania Perelman
| | - Seul Ki Choi
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | - Daniel Teixeira Da Silva
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
- University of Pennsylvania Leonard Davis Institute of Health Economics
- School of Medicine National Clinician Scholar, University of Pennsylvania Perelman
| | - Dalmacio D Flores
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
| | | | - José A Bauermeister
- School of Nursing, Department of Family and Community Health, University of Pennsylvania
- School of Nursing, Program on Sexuality, Technology, and Action Research, University of Pennsylvania
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Hulstein SH, Zimmermann HM, de la Court F, Matser AA, Schim van der Loeff MF, Hoornenborg E, Davidovich U, Prins M, de Vries HJ. Factors Associated With the Intention to Use HIV Preexposure Prophylaxis for Young and Older Men Who Have Sex With Men. Sex Transm Dis 2022; 49:343-352. [PMID: 35001016 PMCID: PMC8994038 DOI: 10.1097/olq.0000000000001599] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The uptake of preexposure prophylaxis (PrEP) against HIV is low among young men who have sex with men (MSM) in the Netherlands. Studying the intention to use PrEP among non-PrEP using young and older MSM can guide health authorities in developing new prevention campaigns to optimize PrEP uptake. METHODS We investigated the sociodemographic, behavioral, and psychosocial factors associated with a high PrEP use intention in the coming 6 months among 93 young MSM (aged ≤25 years), participating in an online survey, and 290 older MSM (aged ≥26 years), participating in an open, prospective cohort in 2019 to 2020. RESULTS Perceiving PrEP as an important prevention tool was associated with a high PrEP use intention among young and older MSM. Among young MSM, a high level of PrEP knowledge and believing that PrEP users take good care of themselves and others were associated with a high PrEP use intention. Among older MSM, 2 or more anal sex partners, chemsex, high HIV risk perception, and believing PrEP increases sexual pleasure were associated with a high PrEP use intention. Believing PrEP leads to adverse effects was associated with a low intention to use PrEP among older MSM. CONCLUSIONS To conclude, we showed that both behavioral and psychosocial factors were associated with a high PrEP use intention among young and older MSM. In addition to focusing on sexual behavior and HIV risk, future prevention campaigns and counseling on PrEP could incorporate education, endorsing positive beliefs, and disarming negative beliefs to improve the uptake of PrEP in young and older MSM.
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Affiliation(s)
| | | | - Feline de la Court
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
| | - Amy A. Matser
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
- Division of Infectious Diseases, Department of Internal Medicine, Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam
| | - Maarten F. Schim van der Loeff
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
- Division of Infectious Diseases, Department of Internal Medicine, Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam
| | - Elske Hoornenborg
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
| | - Udi Davidovich
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
| | - Maria Prins
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
- Division of Infectious Diseases, Department of Internal Medicine, Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam
| | - Henry J.C. de Vries
- Department of Dermatology, Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
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A Network Approach to Determine Optimization of PrEP Uptake in Athens, Greece. AIDS Behav 2022; 26:2703-2712. [PMID: 35147808 DOI: 10.1007/s10461-022-03581-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 11/01/2022]
Abstract
Although the HIV epidemic in Athens, Greece has reemerged and spread in men who have sex with men (MSM), state-supported PrEP programs have not been instituted. A PrEP intervention was implemented building upon an existing network cohort of MSM (308 participants; 1212 network members). A PrEP intervention cohort of 106 participants was selected based upon sex behaviors. Individual, partner, and network characteristics were compared between the cohorts. The PrEP cohort members were more highly connected and in more influential positions in the network than their peers. Further, their sexual network connections' behaviors increased their vulnerability to HIV infection relative to the rest of the network's sex partners. This included greater stimulant use (24.2% vs 7.0%; χ2 = 28.2; p < 0.001), greater rates of at least weekly condomless sex (OR = 2.7; 95% CI 2.1-3.5; χ2 = 59.2; p < 0.001) and at least weekly use of drugs or alcohol during sex (OR = 3.4; 95% CI 2.6-4.3; χ2 = 89.7; p < 0.001). Finally the PrEP cohort's social networks showed similarly increased vulnerability to seroconversion, including greater rates of injection drug use (4.1% vs 0.5%; χ2 = 3.9; p = 0.04), greater stimulant use (33.6% vs 14.6%; χ2 = 16.9, p < 0.001), and higher rates of recent STIs (21.6% vs 13.1%; χ2 = 4.4; p = 0.04). Thus, this PrEP intervention engaged individuals in vulnerable positions with vulnerable connections within an MSM community.
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Bartels SM, Guzmán Guevara K, Pajarito Rompich Y, Barrington C. Narratives of Change From Gay and Bisexual Men Living With HIV in an Emotional Well-Being Intervention. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:53-68. [PMID: 35192393 PMCID: PMC9164147 DOI: 10.1521/aeap.2022.34.1.53] [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: 06/14/2023]
Abstract
The emotional burden of an HIV diagnosis can impact HIV outcomes and overall well-being. We piloted a four-session individual-level emotional well-being intervention, offered during HIV care visits, for gay and bisexual men living with HIV in Guatemala City who were recently diagnosed or reengaged in care. To assess intervention impact in a contextualized manner, we conducted longitudinal qualitative interviews (n = 3) with study participants (n = 10) over 12 months. Data analysis included thematic coding using NVivo and longitudinal narrative summaries and matrices to identify narratives of change and assess intervention impact. Participants experienced changes in their view of self and diagnosis perceptions, improved physical and mental health, increased interest in sex and relationships, and a clarification of their life goals. The intervention helped participants reach diagnosis acceptance, improve self-esteem, and gain self-efficacy for managing life with HIV. Findings support the importance of integrating emotional well-being into HIV care.
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Affiliation(s)
- Sophia M Bartels
- The University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Karla Guzmán Guevara
- HIV Central America Regional Program, Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Yolanda Pajarito Rompich
- National Program for the Prevention and Control of STIs, HIV, and AIDS, Ministry of Public Health and Social Assistance, Guatemala City, Guatemala
| | - Clare Barrington
- The University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
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Kaniuka AR, Zarwell M, Cramer RJ, Quinn K, Broaddus M, Patton A, Walsh JL. Perceptions of HIV Research Participation Among Gay, Bisexual, and Other Men who Have Sex with Men and Transgender and Nonbinary Adults: Results From a Midwest Pride Event. J Empir Res Hum Res Ethics 2021; 17:15-28. [PMID: 34866467 DOI: 10.1177/15562646211062707] [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: 11/16/2022]
Abstract
Human immunodeficiency virus (HIV) continues to disproportionately affect gay, bisexual, and other men who have sex with men (GBM) and transgender and nonbinary (trans/NB) individuals. This study investigated attitudes toward participation in HIV survey research, guided by Emanuel's framework for ethical clinical research (e.g., risk-benefit ratio, fair participant selection, respect for participants, social value, and collaborative partnership). GBM (n = 294) and trans/NB (n = 86) persons recruited at a Pride event in Milwaukee completed a survey assessing risks and benefits of participation in, and comfort responding to, sexual health surveys. Participants reported few ethical concerns (e.g., privacy and confidentiality), with notable differences by race, sexual orientation and gender identity, and prior research experiences. Implications for HIV research with GBM and trans/NB individuals are discussed.
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Affiliation(s)
- Andrea R Kaniuka
- Department of Public Health Sciences, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Meagan Zarwell
- Department of Public Health Sciences, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Robert J Cramer
- Department of Public Health Sciences, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Katherine Quinn
- Center for AIDS Intervention Research, 356955Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michelle Broaddus
- Center for AIDS Intervention Research, 356955Medical College of Wisconsin, Milwaukee, WI, USA
| | - Alexandra Patton
- Department of Public Health Sciences, 14727University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Jennifer L Walsh
- Center for AIDS Intervention Research, 356955Medical College of Wisconsin, Milwaukee, WI, USA
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El-Khechen HA, Khan MIU, Leenus S, Olaiya O, Durrani Z, Masood Z, Leenus A, Akhter S, Mbuagbaw L. Design, analysis, and reporting of pilot studies in HIV: a systematic review and methodological study. Pilot Feasibility Stud 2021; 7:211. [PMID: 34847957 PMCID: PMC8630899 DOI: 10.1186/s40814-021-00934-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 10/22/2021] [Indexed: 11/12/2022] Open
Abstract
Background Pilot studies are essential in determining if a larger study is feasible. This is especially true when targeting populations that experience stigma and may be difficult to include in research, such as people with HIV. We sought to describe how pilot studies have been used to inform HIV clinical trials. Methods We conducted a methodological study of pilot studies of interventions in people living with HIV published until November 25, 2020, using Medline, Embase, and Cochrane Controlled Register of Trials (CENTRAL). We extracted data on their nomenclature, primary objective, use of progression criteria, sample size, use of qualitative methods, and other contextual information (region, income, level, type of intervention, study design). Results Our search retrieved 10,597 studies, of which 248 were eligible. The number of pilot studies increased steadily over time. We found that 179 studies (72.2%) used the terms “pilot” or “feasibility” in their title, 65.3% tested feasibility as a primary objective, only 2% used progression criteria, 23.9% provided a sample size estimation and only 30.2% used qualitative methods. Conclusions Pilot studies are increasingly being used to inform HIV research. However, the titles and objectives are not always consistent with piloting. The design and reporting of pilot studies in HIV could be improved. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00934-9.
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Affiliation(s)
- Hussein Ali El-Khechen
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada.
| | - Mohammed Inam Ullah Khan
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Selvin Leenus
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Oluwatobi Olaiya
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Zoha Durrani
- Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Zaryan Masood
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Alvin Leenus
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Shakib Akhter
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada.,Center for the Development of Best Practices in Health, Yaoundé, Cameroon
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Ossa-Giraldo AC, Correa JS, Moreno CL, Blanquiceth Y, Flórez-Álvarez L, Contreras-Ramírez K, Higuita-Gutérrez LF, Hernández JC, Zapata W. Sexual Behaviors and Factors Associated with Condomless Sexual Practice in Colombian Men Who Have Sex with Men at High Risk of HIV Transmission. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3175-3190. [PMID: 33829332 DOI: 10.1007/s10508-020-01856-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 06/12/2023]
Abstract
Men who have sex with men (MSM) have a disproportionate burden of HIV infection worldwide. In Colombia, the prevalence of HIV in MSM is ~ 43 times higher than in the general population (17% vs. 0.4%). This study determined the sexual behaviors, HIV serostatus, and associated factors with condomless sexual practice with both regular and casual partners in 92 MSM from Medellín, Colombia. The subjects were recruited through a community-based approach, and the data were collected by a structured survey and in-depth interviews. Participants were classified into three groups according to the number of sexual partners in the last three months, to compare the sociodemographic conditions and sexual behaviors. Univariate analysis was described by absolute and relative frequencies; bivariate analysis and multivariate logistic regression were used to compare the groups and to explore the associated factors with condomless sexual practice. The overall HIV estimated prevalence was 4.3%, while the estimated prevalence for MSM with > 10 sexual partners in the last three months was 14.8%. This last group showed higher average age, higher percentage of subjects who have had sex with people living with HIV, and increased frequency of previous sexually transmitted infections. Having condomless sex with casual partners was associated with the number of sexual partners in the last three months. This study demonstrates that Colombian MSM continue to have a high risk of HIV infection/transmission and reinforce the need to implement adequate prevention programs, PrEP and guarantee access to treatment for people living with HIV.
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Affiliation(s)
- Ana Claudia Ossa-Giraldo
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia.
| | - John Sebastián Correa
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
| | - Cristhian Leonardo Moreno
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
| | - Yurany Blanquiceth
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellín, Colombia
| | - Lizdany Flórez-Álvarez
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellín, Colombia
| | - Katherin Contreras-Ramírez
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellín, Colombia
| | - Luis Felipe Higuita-Gutérrez
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
| | - Juan Carlos Hernández
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellín, Colombia
| | - Wildeman Zapata
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Calle 50 No. 40-74, 050012, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, UdeA, Medellín, Colombia
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14
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Dias S, Gama A, Sherriff N, Gios L, Berghe WV, Folch C, Marcus U, Staneková DV, Pawlęga M, Caplinskas S, Naseva E, Klavs I, Velicko I, Mirandola M, Nöstlinger C. Process evaluation of a bio-behavioural HIV research combined with prevention among GBMSM in 13 European countries. Glob Public Health 2021; 17:672-687. [PMID: 33460361 DOI: 10.1080/17441692.2021.1874469] [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: 10/22/2022]
Abstract
Comparative European data using Second Generation Surveillance System (SGSS) are scarce among gay, bisexual and other men who have sex with men. This study evaluated the implementation of Sialon II, a bio-behavioural HIV research combined with targeted HIV prevention in 13 European cities conducted in collaboration with community partners. A mixed-methods process evaluation assessed the project's coverage, outputs, quality, challenges and opportunities for improvement. Data collected through structured questionnaire from 71 data collectors from community-based organisations and semi-structured interviews with 17 managers of participating gay venues were analysed. Overall implementation was successful, achieving 4901 valid behavioural questionnaires and obtaining 4716 biological samples. Challenges in conducting bio-behavioural research in gay venues related to strict research protocols and unfavourable characteristics of venues. Formative research, collaboration with community gay venues, and offering HIV prevention emerged as facilitators. Community researchers' training was crucial for fidelity to research protocols, increased trust amongst communities and enabled data collectors to effectively address practical problems in the field. Scientifically sound SGSS with community participation is feasible and allows for including 'hard-to-reach' populations. Prevention benefits include awareness raising, capacity building and sexual health promotion in gay venues. The findings are beneficial for epidemiological research among other HIV key populations.
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Affiliation(s)
- Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal.,Comprehensive Health Research Centre (CHRC), Lisboa, Portugal
| | - Ana Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal.,Comprehensive Health Research Centre (CHRC), Lisboa, Portugal
| | - Nigel Sherriff
- School of Health Sciences, University of Brighton, Brighton, UK
| | - Lorenzo Gios
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Cinta Folch
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya/CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Ulrich Marcus
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | | | - Saulius Caplinskas
- Centre for Communicable Diseases and AIDS, Mykolas Romeris University, Vilnius, Lithuania
| | - Emilia Naseva
- Ministry of Health, Program "Prevention and Control of HIV/AIDS", Sofia, Bulgaria
| | - Irena Klavs
- National Institute of Public Health, Ljubljana, Slovenia
| | - Inga Velicko
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Massimo Mirandola
- Epidemiology Unit - UOC Infectious Diseases, Verona University Hospital, Verona, Italy
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- Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
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15
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Arends RM, van den Heuvel TJ, Foeken-Verwoert EGJ, Grintjes KJT, Keizer HJG, Schene AH, van der Ven AJAM, Schellekens AFA. Sex, Drugs, and Impulse Regulation: A Perspective on Reducing Transmission Risk Behavior and Improving Mental Health Among MSM Living With HIV. Front Psychol 2020; 11:1005. [PMID: 32547451 PMCID: PMC7270329 DOI: 10.3389/fpsyg.2020.01005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 04/22/2020] [Indexed: 11/16/2022] Open
Abstract
Unprotected sexual contact continues to be a main cause of HIV transmission and poses certain key populations at increased risk for HIV infection. One of the populations at high risk are men who have sex with men. A subset of MSM engages in chemsex, whereby consumption of illicit drugs is used to facilitate or enhance sexual activity. This practice can have several negative consequences, such as sexually transmitted infections (including HIV) and mental health problems (including compulsive sexual behavior, addiction, and mood disorders). In this article, we provide our perspective on the current situation that medical professionals dealing with MSM living with HIV often feel empty-handed in how to deal with these behavioral and psychological issues. Close collaboration between somatic and mental health professionals is key to address treatment needs of people living with HIV, regarding the negative consequences of chemsex and their overall quality of life. In this article, we discuss possibilities for psychological treatment, including behavioral skills training to improve impulse control and reduce compulsive sexual behaviors among MSM living with HIV who persistently engage in sexual transmission risk behavior, based on our experience with implementing such an intervention. Important barriers and facilitators for further implementation of behavioral interventions will be discussed. Reduction of HIV transmission risk behavior is needed to achieve the WHO aim to end HIV as a public health threat by 2030. We propose that close collaboration between somatic and mental health professionals and implementation of behavioral interventions for risk populations are key to achieve this goal.
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Affiliation(s)
- Rachel M. Arends
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Center for Medical Neuroscience, Donders Institute for Brain, Cognition and Behavior, Nijmegen, Netherlands
- Tactus Addiction Care, Deventer, Netherlands
| | - Thom J. van den Heuvel
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Scelta, GGNet, Nijmegen, Netherlands
| | | | - Karin J. T. Grintjes
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Aart H. Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Center for Medical Neuroscience, Donders Institute for Brain, Cognition and Behavior, Nijmegen, Netherlands
| | | | - Arnt F. A. Schellekens
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Center for Medical Neuroscience, Donders Institute for Brain, Cognition and Behavior, Nijmegen, Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, Netherlands
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16
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Hsiao YH, Lee IK, Lin TY, Liao CH, Lee CH, Ku WW, Huang SS, Yu CH, Liu ZH, Chiu YC, Lin YH, Chen NY. Demographic differences in people living with HIV according to recruitment sources: comparison between health-care systems and social media networks. AIDS Care 2019; 32:901-906. [PMID: 31533457 DOI: 10.1080/09540121.2019.1668524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
With the improvement of internet technology in health applications, the utilization of internet and social media as new survey methodologies and recruitment source for research participants have been encouraged, yet evidence of the feasibility in people living with HIV (PLHIV) study is still lacking. We conducted a cross-sectional survey to determine whether there are differences among PLHIV recruited from social media networks and health-care systems using an HIV stigma and discrimination questionnaire. The result revealed that PLHIV recruited from social media networks were younger, more sexually active, and had higher educational status and awareness of the country's HIV rights protection laws than those recruited from hospitals. By contrast, participants recruited from hospitals were more diverse regarding key population compositions, had lived with HIV for a longer duration, had a higher prevalence of concomitant physical disabilities than those recruited from social media networks, and fit Taiwan PLHIV characteristics described by 2016 census from Taiwan Centres for Disease Control. We conclude that sampling bias exists when utilizing social media networks for PLHIV studies.
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Affiliation(s)
- Yu-Hsiang Hsiao
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou Branch, Chang Gung University College of Medicine, Taoyuan, Taiwan.,Persons with HIV/AIDS Rights Advocacy Association of Taiwan, Taipei, Taiwan
| | - Ing-Kit Lee
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital Kaohsiung Branch, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Te-Yu Lin
- Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | | | - Chen-Hsiang Lee
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital Kaohsiung Branch, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Wei Ku
- Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu, Taiwan
| | - Shie-Shian Huang
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital Keelung Branch, Keelung, Taiwan
| | - Chia-Hui Yu
- Department of medical Quality, Chung Shan Medical University Hospital, Taichung, Taiwan.,College of Nursing, Chung Shan Medical University, Taichung, Taiwan
| | - Zhuo-Hao Liu
- Department of Neurosurgery, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
| | - Yi-Chi Chiu
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou Branch, Chang Gung University College of Medicine, Taoyuan, Taiwan.,Persons with HIV/AIDS Rights Advocacy Association of Taiwan, Taipei, Taiwan
| | - Yi-Hui Lin
- Persons with HIV/AIDS Rights Advocacy Association of Taiwan, Taipei, Taiwan
| | - Nan-Yu Chen
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital Linkou Branch, Chang Gung University College of Medicine, Taoyuan, Taiwan
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17
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Wu ZL, Guan GY, Zhao JH, Ma XM, Wang XM, Yang DZ, Cao M, Rawle DJ. Dynamic Characteristics and HIV Infection of Men who have Sex with Men from 2011 to 2017 in Yinchuan, Ningxia, China. Curr HIV Res 2019; 16:364-373. [PMID: 30659545 PMCID: PMC6446446 DOI: 10.2174/1570162x17666190119094035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/10/2019] [Accepted: 01/13/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Ningxia Hui Autonomous Region, an important area for ethnic Hui settlement in Northwest China, is a low HIV prevalence region. However, HIV infection rates among men who have sex with men (MSM) in Ningxia have increased to an alarming level, despite scale-up of control measures in recent years. This study aimed to understand the demographical and sexual behavior dynamics of MSM and to explore the factors associated with HIV infection. METHODS Annual cross-sectional surveys were carried out among MSM during 2011~2017 in Yinchuan, the capital city of Ningxia. Information regarding social demographics, sexual behavior and HIV prevention knowledge was collected. Blood samples were taken for HIV, HCV serological and genetic analysis, and syphilis serological analysis. The dynamic trend was analyzed with trend χ2 test and factors associated with HIV infection were identified by multivariate logistic regression analysis. RESULTS The study found a decreasing trend for mean age of the MSM population over the study period. MSMs with a college education or higher increased significantly, while the proportions that were in a marriage significantly decreased over the study period. The rate of HIV positive among MSM increased during the study period (p<0.05), however, the rate of recently diagnosed infections decreased from 2012 (p<0.05). Overall, a very high proportion (98%) of MSM had basic knowledge of HIV prevention, however, only approximately 40% of them used condoms consistently during anal sex with male partners. Unprotected anal sex was identified as a risk factor associated with HIV infection, as was syphilis infection. Local residency status and MSM who received intervention and detection services were the factors that decreased HIV infection risk. Sequence analysis identified the HIV-1 CRF55_01B subtype from MSM for the first time in Yinchuan. CONCLUSION The reduction of recent HIV diagnoses is an encouraging sign of successful HIV control measures in MSM in Ningxia. The finding that a high proportion of MSM had knowledge of HIV prevention but still conducted unprotected sex highlights the need for further control measures to change unsafe sexual practices among MSM.
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Affiliation(s)
- Zhong-Lan Wu
- Ningxia Center for Disease Control and Prevention, 470 Shengli St. Yinchuan, Ningxia 750001, China
| | - Guang-Yu Guan
- Ningxia Center for Disease Control and Prevention, 470 Shengli St. Yinchuan, Ningxia 750001, China
| | - Jian-Hua Zhao
- Ningxia Center for Disease Control and Prevention, 470 Shengli St. Yinchuan, Ningxia 750001, China
| | - Xue-Min Ma
- Ningxia Center for Disease Control and Prevention, 470 Shengli St. Yinchuan, Ningxia 750001, China
| | - Xue-Min Wang
- Ningxia Center for Disease Control and Prevention, 470 Shengli St. Yinchuan, Ningxia 750001, China
| | - Dong-Zhi Yang
- Ningxia Center for Disease Control and Prevention, 470 Shengli St. Yinchuan, Ningxia 750001, China
| | - Min Cao
- Ningxia Center for Disease Control and Prevention, 470 Shengli St. Yinchuan, Ningxia 750001, China
| | - Daniel J Rawle
- Department of Cell and Molecular Biology, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
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18
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Tran NK, Welles SL. Four Decades of Epidemiologic Science on HIV Infection and Disease, and Its Impact on Public Health Practice and Policy for Sexual and Gender Minority Persons. Dela J Public Health 2019; 5:64-71. [PMID: 34467031 PMCID: PMC8396754 DOI: 10.32481/djph.2019.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Even at the cusp of the second decade of the new millennia, HIV continues to be a significant public health challenge for sexual and gender minorities (SGM). Men who have sex with men and transgender women, in particular, continue to report higher rates of HIV incidence compared to their heterosexual counterparts, while facing significant barriers to comprehensive sexual healthcare. In Delaware, HIV infection impacts a substantial number of individuals with approximately 14.5 incident cases per 100,000. This ranks Delaware as the 14th highest for HIV incidence among U.S. states. However, the largest healthcare provider in Delaware, Christiana Care Health System, has created many health initiatives to support the health needs of SGM and those living with HIV. The current sustained rate of HIV infection indicates the need for enhanced epidemiologic work to identify HIV cases in subgroups of diverse sexuality and gender identity, collaboration within and across research institution and community organizations, as well as engagement in creative solutions that target the multiple levels of factors contributing to HIV incidence. In addition, it is imperative that local agencies and health organizations continue to support these communities of SGM individuals during the current sociopolitical climate of the national U.S. government.
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Affiliation(s)
- Nguyen K Tran
- Department of Epidemiology & Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA
| | - Seth L Welles
- Department of Epidemiology & Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA
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19
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Li WY, Chen M, Huang SW, Jen IA, Wang SF, Yang JY, Chen YH, Chen YMA. Molecular epidemiology of HIV-1 infection among men who have sex with men in Taiwan from 2013 to 2015. PLoS One 2018; 13:e0202622. [PMID: 30521534 PMCID: PMC6283607 DOI: 10.1371/journal.pone.0202622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/07/2018] [Indexed: 11/24/2022] Open
Abstract
Men who have sex with men (MSM) is the major risk population of HIV-1 infection in Taiwan, and its surveillance has become critical in HIV-1 prevention. We recruited MSM subjects from 17 high-risk venues and 4 community centers in northern and southern Taiwan for anonymous HIV-1 screening during 2013–2015. Blood samples were obtained for genotyping and phylogenetic analysis, and a questionnaire survey covering demographic variables and social behavior was conducted. In total, 4,675 subjects were enrolled, yielding a HIV-1 prevalence rate of 4.3% (201/4675). Eight risk factors including subjects who did not always use condoms (OR = 1.509, p = 0.0123), those who used oil-based lubricants (OR = 1.413, p = 0.0409), and those who used recreational drugs (OR = 2.182, p = < .0001) had a higher risk of HIV-1 infection. The annual prevalence and incidence of HIV-1 showed a downward trend from 2013 to 2015 (6.56%, 5.97 per 100 person-years in 2013; 4.53%, 3.97 per 100 person-years in 2014; 1.84%, 2.08 per 100 person-years in 2015). Factors such as always using condoms, water-based lubricant use, correct knowledge of lubricating substitutes, and recreational drug use were significantly associated with the trend of incidence. Phylogenetic tree analysis showed that the cross-regional and international interaction of the local MSM population may have facilitated transmission of HIV. This survey of high-risk venues showed decreased prevalence and incidence of HIV-1 infection in Taiwan from 2013 to 2015, and this may be related to changes in behavioral patterns. Moreover, cross-regional interaction and recreational drug use need to be considered in future surveillance.
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Affiliation(s)
- Wei-You Li
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Marcelo Chen
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Szu-Wei Huang
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - I-An Jen
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Sheng-Fan Wang
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jyh-Yuan Yang
- Research and Diagnostic Center, Taipei, Centers for Disease Control, Department of Health, Taipei, Taiwan
| | - Yen-Hsu Chen
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Ming Arthur Chen
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
- * E-mail:
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20
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Werner RN, Gaskins M, Nast A, Dressler C. Incidence of sexually transmitted infections in men who have sex with men and who are at substantial risk of HIV infection - A meta-analysis of data from trials and observational studies of HIV pre-exposure prophylaxis. PLoS One 2018; 13:e0208107. [PMID: 30507962 PMCID: PMC6277101 DOI: 10.1371/journal.pone.0208107] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/12/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) and who engage in condomless anal intercourse with casual partners are at high risk of acquiring sexually transmitted infections (STIs), but reliable epidemiological data are scarce. Studies on HIV pre-exposure prophylaxis (PrEP) enrol MSM who indicate that they engage in behaviour that puts them at high risk of acquiring HIV. Because they also screen for STIs at regular intervals, these studies may serve as a valuable source to estimate incidence rates of STIs in this subpopulation of MSM. METHODS We systematically searched for trials and observational studies of PrEP in MSM that reported data on the incidence of STIs during the study period. Incidence rates were calculated as events per 100 person-years (py) with 95% confidence intervals (CI). Data from individual studies were pooled building subgroups along study types and geography. We performed sensitivity analyses, including data only from studies that met pre-defined quality criteria. RESULTS Twenty-four publications on 20 studies were included. The majority of studies reported that sexual behaviour and/or STI incidence remained stable or decreased during the study period. For syphilis, incidence rates ranged from 1.8/100py to 14.9/100py, the pooled estimate was 9.1/100py (95%-CI: 7.7-10.9). Incidence rates for gonorrhoea and chlamydia of any site ranged from 13.3/100py to 43.0/100py and 15.1/100py to 48.5/100py, respectively. Considering only studies that met the criteria for sensitivity analysis yielded pooled estimates of 39.6/100py (95%-CI: 32.9-47.6) and 41.8/100py (95%-CI: 33.9-51.5), respectively. The overall estimate for hepatitis C incidence was 1.3/100py (95%-CI: 1.0-1.8). CONCLUSIONS Despite partly heterogeneous results, the data depict high incidence rates of STIs among MSM who engage in higher-risk sexual behaviours such as condomless sex with casual partners. This subpopulation of MSM requires access to STI screening at close intervals. By offering access to structures that provide regular STI monitoring and prompt treatment, PrEP may not only decrease HIV incidence but also have beneficial effects in decreasing the burden of STIs.
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Affiliation(s)
- Ricardo Niklas Werner
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Department of Dermatology, Venerology and Allergy; Division of Evidence-Based Medicine (dEBM), Berlin, Germany
| | - Matthew Gaskins
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Department of Dermatology, Venerology and Allergy; Division of Evidence-Based Medicine (dEBM), Berlin, Germany
| | - Alexander Nast
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Department of Dermatology, Venerology and Allergy; Division of Evidence-Based Medicine (dEBM), Berlin, Germany
| | - Corinna Dressler
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Department of Dermatology, Venerology and Allergy; Division of Evidence-Based Medicine (dEBM), Berlin, Germany
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21
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Werner RN, Gaskins M, Ahrens J, Jessen H, Kutscha F, Mosdzen R, Osswald W, Sander D, Schellberg S, Schwabe K, Wünsche T, Dressler C, Sammons M, Nast A. Knowledge and use of HIV pre-exposure prophylaxis among men who have sex with men in Berlin - A multicentre, cross-sectional survey. PLoS One 2018; 13:e0204067. [PMID: 30212547 PMCID: PMC6136827 DOI: 10.1371/journal.pone.0204067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 08/31/2018] [Indexed: 12/22/2022] Open
Abstract
Background HIV pre-exposure prophylaxis (PrEP) has likely contributed to large decreases in HIV incidence among men who have sex with men (MSM) in several major cities. Berlin has seen a smaller decline, and affordable PrEP has been accessible through formal channels in Germany only since autumn 2017. We aimed to investigate knowledge and use of PrEP among MSM in Berlin, and factors predictive of a desire to use PrEP and history of PrEP use. Methods Multicentre, paper-based, self-administered survey of adult MSM whose HIV status was negative or unknown at time of participation. Data were collected from 1 October 2017 to 2 April 2018. Results 473 of 875 questionnaires were returned (response rate 54.1%; mean age 37.4 years, range 18–79). 90.0% of participants were aware of PrEP and, of these, 48.2% felt well informed about it. Among the 17.2% of participants reporting PrEP use, 59.3% indicated obtaining some or all of it from informal sources. 23.7% of those with no history of PrEP use reported having condomless anal intercourse (CAI) with two or more partners over the past six months. Worries about side effects, cost, not having a doctor who prescribes it, and a lack of information were the most frequently reported barriers to PrEP use. A desire to use PrEP and history of PrEP use were associated in our multivariable model with having multiple CAI partners. A history of PrEP use was associated with having a university degree, one or two parents born outside Germany, or friends living with HIV. Conclusions We found high awareness of PrEP among MSM in Berlin, but also a strong need for more education on its pros, cons and proper use. The frequency of informal PrEP use was also high, raising urgent individual and public health concerns. Policy makers need to consider recent calls to improve access to PrEP and PrEP education through regular health services.
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Affiliation(s)
- Ricardo Niklas Werner
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Department of Dermatology, Venereology and Allergy; Division of Evidence-Based Medicine (dEBM), Berlin, Germany
- * E-mail:
| | - Matthew Gaskins
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Department of Dermatology, Venereology and Allergy; Division of Evidence-Based Medicine (dEBM), Berlin, Germany
| | | | - Heiko Jessen
- Praxis Jessen + Kollegen, SHC–Sexual Health Center Berlin, Berlin, Germany
| | | | | | | | | | | | - Kai Schwabe
- Schwulenberatung Berlin gGmbH, Berlin, Germany
| | | | - Corinna Dressler
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Department of Dermatology, Venereology and Allergy; Division of Evidence-Based Medicine (dEBM), Berlin, Germany
| | - Mary Sammons
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Department of Dermatology, Venereology and Allergy; Division of Evidence-Based Medicine (dEBM), Berlin, Germany
| | - Alexander Nast
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health; Department of Dermatology, Venereology and Allergy; Division of Evidence-Based Medicine (dEBM), Berlin, Germany
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Wong NS, Kwan TH, Tsang OTY, Lee MP, Yam WC, Lam W, Leung WS, Chan JMC, Ho KM, Lee SS. Pre-exposure prophylaxis (PrEP) for MSM in low HIV incidence places: should high risk individuals be targeted? Sci Rep 2018; 8:11641. [PMID: 30076362 PMCID: PMC6076226 DOI: 10.1038/s41598-018-30101-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 07/24/2018] [Indexed: 01/11/2023] Open
Abstract
Pre-exposure prophylaxis (PrEP) targeting high-risk men who have sex with men (MSM) has been shown to be a cost-effective HIV control measure. However, the approach could be a challenge in low HIV incidence places with a low proportion of high-risk MSM. To examine the impact of PrEP in such setting in Asia, we developed an epidemic model and conducted cost-effectiveness analysis using empirical multicentre clinical and HIV sequence data from HIV-infected MSM in Hong Kong, in conjunction with behavioural data of local MSM. Without PrEP, the HIV incidence (per 100 person-years) would increase from 1.1 to 1.6 between 2011 and 2021. PrEP could avert 3–63% of total new infections in a five-year period (2017–2021), the variability of which depends on the implementation strategies and combination with test-and-treat. However, under current market drug price in 2016, the incremental cost per quality-adjusted life-year gained (QALYG) of PrEP (USD1583136/QALYG) is almost 3 times higher than test-and-treat intervention alone (USD396874/QALYG). Assuming 93% fall of PrEP drug price and in combination with test-and-treat, putting 30% of MSM on non-targeting PrEP would be more feasible, cost-effective (USD268915/QALYG), and could avert more new infections (40%). PrEP could contribute to HIV epidemic control in a low incidence place.
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Affiliation(s)
- Ngai Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Tsz Ho Kwan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Owen T Y Tsang
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Man Po Lee
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Wing Cheong Yam
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Wilson Lam
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Wai Shing Leung
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Jacky M C Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Kai Man Ho
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.
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