Uptake and Outcomes Associated with Implementation of a Community-Based Voluntary HIV Counseling and Testing Program in Antigua and Barbuda.

OBJECTIVE: To evaluate the implementation of community-based voluntary HIV counseling and testing (CBVCT) in the Eastern Caribbean. METHODS: A total of 9782 unique HIV testing events performed through a national program of CBVCT in Antigua and Barbuda (2009-2012) were analyzed. The authors describe testers' demographic characteristics and assess demographic (education, housing, marital status, nationality, and age) and sexual exposure (partner gender, transactional sex, and multiple partners) factors associated with testing HIV-positivity and with condom use. RESULTS: Older men and men having sex with women and women with higher education, of Antiguan nationality, and having sex with men were less likely to test positive for HIV. Younger, educated, and unmarried men and women with multiple partners were more likely to report using condoms. CONCLUSION: The CBVCT model can be successfully implemented in Eastern Caribbean. Demographic differences persist in HIV testing, risk behavior, and infection among vulnerable populations and should be considered in HIV prevention intervention design.

Risk behaviors and psychosocial stressors in the new york city house ball community: a comparison of men and transgender women who have sex with men.

The New York City House Ball community consists of social networks of racial/ethnic minority gay, lesbian or bisexual men and women, and transgender persons. HIV seroprevalence and interview data were obtained from a sample of community members to identify statistical differences in HIV prevalence, risk behavior, and psychosocial stressors between men who have sex with men (MSM) and transgender women. Of 301 MSM and 60 transgender women, 20% were HIV-infected and 73% were unaware of their infection, but rates did not differ by gender. Risk behavior and stressors were common in both groups, but transgender women were more likely to report exchange sex, stigmatization, and stressful life events. High rates of risk behavior and HIV in this special community warrant relevant HIV testing and prevention services. Transgender women in the community may be at even greater risk for HIV infection due to behaviors compounded by substantial psychosocial stressors.

HIV prevalence and associated risk behaviors in New York City's house ball community.

OBJECTIVES: We measured HIV seroprevalence and associated risk factors among persons in New York City's house ball community. METHODS: In 2004 we conducted a venue-based risk-behavior survey and HIV testing in the house ball community. RESULTS: Of the 504 study participants, 67% were male, 14% female, and 18% transgender. Mean age was 24 years (range=15-52 years); 55% were Black, and 40% were Latino. More than 85% of participants had previously been tested for HIV, although only 60% had been tested in the previous 12 months. Of the 84 (17%) persons who tested positive for HIV in our study, 61 (73%) were unaware of their HIV status. A logistic regression analysis on data from 371 participants who had had a male sexual partner in the previous 12 months showed that HIV-infected participants were more likely than were HIV-negative participants to be Black, to be older than 29 years, and not to have been tested for HIV in the previous 12 months. CONCLUSIONS: Culturally specific community-level prevention efforts are warranted to reduce risk behaviors and increase the frequency of HIV testing in New York City's house ball community.

Self-reported tuberculosis disease and tuberculin skin testing in the New York City House Ballroom community.

OBJECTIVES: We sought to describe the history of tuberculosis disease and tuberculin skin testing among the New York City House Ballroom community--a social network of diverse sexual and gender identities or expressions. METHODS: Members of the House Ballroom community were convenience sampled, surveyed, and tested for HIV in 2004. We identified characteristics associated with history of tuberculosis, tuberculin skin testing, and test positivity and described the timing of skin testing. RESULTS: Of 504 participants, 1.4% (n=7) reported a history of tuberculosis and 81.1% (n=404 of 498) had received a tuberculin skin test. Of those tested, 16 (4%) had positive results, which indicated latent infection, and 68% had received a test in the 2 years prior to the survey. Participants with health insurance were more likely and those with little education were less likely to have received a skin test. HIV-infected participants (16%) were not more likely to have received a tuberculin skin test compared with non-HIV-infected individuals. Foreign-born participants and self-identified heterosexuals and bisexuals were more likely to have had positive skin tests. CONCLUSIONS: Self-reported history of tuberculosis was high among the House Ballroom community. Although many community members had a recent skin test, further efforts should target services to those who are HIV infected, have low education, lack health insurance, or are foreign born.

Attitudes about combination HIV therapies: the next generation of gay men at risk.

This study examined awareness of and attitudes about highly active antiretroviral therapies (HAARTs) among adolescent and young men who have sex with men (MSM). As part of the multisite Young Men's Survey, 813 MSM aged 15-22 years who attended public venues in two cities were questioned about HAART in 1997-1998. Overall, 45.1% had heard of HAART, 61.6% in Seattle, Washington, and 35.0% in New York City. MSM in New York City who were the youngest, men of color, men who were human immunodeficiency virus (HIV) antibody negative, and men who resided in New Jersey were significantly less likely to be aware of HAART. Attitudes about HAART were not associated with sexual risk behaviors. Prevention efforts among young MSM should focus on other determinants of risk, but also include information on the changing nature of HIV therapies.