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Artículo en Alemán | MEDLINE | ID: mdl-33326051


BACKGROUND: In 2016, the World Health Organization (WHO) released a strategy to eliminate hepatitis B, C, and D and defined indicators to monitor the progress. The Robert Koch Institute organized an interdisciplinary working meeting in 2019 to identify data sources and gaps. OBJECTIVES: The objectives were to network, to create an overview of the data sources available in Germany on hepatitis B and C, and to discuss how to construct indicators. MATERIALS AND METHODS: We extracted the WHO indicators relevant for Germany and determined how they can be constructed on the basis of available data. Stakeholders from public health services, clinics, laboratories, health insurance companies, research institutes, data holders, and registries attended a workshop and discussed methods of constructing the indicators for which data are lacking. Data sources and data were evaluated and prioritized with regard to their quality and completeness. RESULTS: Indicators on prevalence, incidence, prevention, testing and diagnosis, treatment, cure, burden of sequelae, and mortality for the general population can be constructed using secondary data such as diagnosis, health service, and registry data, data from laboratories and hospitals as well as population-based studies. Data sources for vulnerable groups are limited to studies among drug users, men who have sex with men, and about HIV coinfected patients. Data for migrants, prisoners, and sex workers are largely lacking as well as data on burden of disease from chronic viral hepatitis in the general population. CONCLUSIONS: We identified data sources, their limitations, and methods for construction for all selected indicators. The next step is to convert the ideas developed into concrete projects with individual stakeholders.

Hepatitis B , Hepatitis C , Hepatitis Viral Humana , Minorías Sexuales y de Género , Alemania/epidemiología , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Hepatitis C/prevención & control , Homosexualidad Masculina , Humanos , Masculino
J Acquir Immune Defic Syndr ; 86(1): 22-30, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33027151


BACKGROUND: In response to the novel coronavirus disease (COVID-19) pandemic, Australia introduced public health and physical distancing restrictions in late March 2020. We investigated the impact of these restrictions on HIV preexposure prophylaxis (PrEP) use among Australian gay and bisexual men (GBM). METHODS: Participants in an ongoing online cohort study previously reported PrEP use from 2014 to 2019. In April 2020, 847 HIV-negative and untested participants completed questionnaires assessing changes in PrEP use as a result of COVID-19 public health measures. Binary logistic multiple regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) to compare changes in PrEP use behaviors. RESULTS: Among 847 men, mean age was 44.1 years (SD: 12.7). PrEP use rose from 4.9% in 2015 to 47.2% in 2020. Among those, 41.8% (n = 167) discontinued PrEP use during COVID-19 restrictions. Discontinuing PrEP during COVID-19 restrictions was independently associated with being less likely to have recently tested for HIV (aOR: 0.17; 95% CI: 0.09 to 0.34; P < 0.001) and less likely to report sex with casual partners (aOR: 0.28; 95% CI: 0.14 to 0.54; P < 0.001). CONCLUSIONS: By April 2020, following the introduction of COVID-19 restrictions, GBM dramatically reduced PrEP use, coinciding with a reduction in sexual activity. Longer-term impacts of COVID-19 restrictions on sexual behaviors among GBM need to be monitored because they may foreshadow fluctuations in prevention coverage and risk of HIV infection. Our findings indicate a potential need for clear, targeted information about resumption of PrEP and on-demand optimal dosing regimens in response to ongoing changes in restrictions.

/prevención & control , Infecciones por VIH/prevención & control , Profilaxis Pre-Exposición/estadística & datos numéricos , Adolescente , Adulto , Australia , Bisexualidad , Homosexualidad Masculina , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Conducta Sexual , Minorías Sexuales y de Género , Adulto Joven
J Clin Psychiatry ; 81(6)2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33264820


OBJECTIVE: To assess the relationships between adverse childhood experiences (ACEs) and comorbid Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) substance use and mental health disorders across 5 sexual orientation subgroups: lesbian/gay, bisexual, unsure, discordant heterosexual (ie, heterosexual-identified with same-sex attraction or behavior), and concordant heterosexual. METHODS: Data were from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional, nationally representative survey of non-institutionalized US adults. Data were collected in households via structured diagnostic face-to-face interviews; the overall response rate was 60.1%. The sample included 36,309 US adults aged 18 years and older. RESULTS: Sexual minorities (gay, lesbian, bisexual), especially bisexual women, reported the highest prevalence of ACEs and comorbid substance use and mental health disorders. Approximately 43.8% of bisexual women reported 4 or more ACEs, and 38.0% of bisexual women reported comorbid substance use and mental health disorders. Multivariable regression analyses indicated a curvilinear relationship between ACEs and comorbid substance use and mental health disorders, and sexual minorities consistently had a higher ACE mean than concordant heterosexual respondents. The majority of sexual minorities with high levels of ACEs had comorbid substance use and mental health disorders. CONCLUSIONS: Sexual minorities are exposed to more ACEs than their heterosexual counterparts in the US. We found evidence that US sexual minorities are at higher risk of comorbid substance use and mental health disorders. These findings reinforce the importance of identifying exposure to ACEs and developing trauma-informed interventions to treat comorbidities in those exposed to multiple ACEs, especially sexual minorities.​.

Experiencias Adversas de la Infancia/estadística & datos numéricos , Trastornos Mentales/epidemiología , Conducta Sexual/estadística & datos numéricos , Minorías Sexuales y de Género/estadística & datos numéricos , Sexualidad/estadística & datos numéricos , Adolescente , Adulto , Anciano , Comorbilidad , Estudios Transversales , Diagnóstico Dual (Psiquiatría) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Relacionados con Sustancias/epidemiología , Estados Unidos/epidemiología , Adulto Joven
PLoS One ; 15(12): e0244420, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33351852


Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new strain of virus in the Coronavirus family that has not been previously identified. Since SARS-CoV-2 is a new virus, everyone is at risk of catching the Coronavirus disease 2019 (Covid-19). No one has immunity to the virus. Despite this, misconceptions about specific groups of people who are immune to Covid-19 emerged with the onset of the pandemic. This paper explores South African communities' misconceptions about who is most vulnerable to Covid-19. A rapid qualitative assessment was conducted remotely in Gauteng, KwaZulu-Natal and the Western Cape provinces of South Africa. Recruitment of study participants took place through established relationships with civil society organizations and contacts made by researchers. In total, 60 key informant interviews and one focus group discussion was conducted. Atlas.ti.8 Windows was used to facilitate qualitative data analysis. The qualitative data was coded, and thematic analysis used to identify themes. The results show a high level of awareness and knowledge of the transmission and prevention of SARS-CoV-2. Qualitative data revealed that there is awareness of elderly people and those with immunocompromised conditions being more vulnerable to catching Covid-19. However, misconceptions of being protected against the virus or having low or no risk were also evident in the data. We found that false information circulated on social media not only instigated confusion, fear and panic, but also contributed to the construction of misconceptions, othering and stigmatizing responses to Covid-19. The study findings bring attention to the importance of developing communication materials adapted to specific communities to help reduce misconceptions, othering and stigmatization around Covid-19.

/epidemiología , Conocimientos, Actitudes y Práctica en Salud , /patogenicidad , Adaptación Fisiológica , Adulto , Anciano , /virología , Agentes Comunitarios de Salud/psicología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/psicología , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Trabajadores Sexuales/psicología , Minorías Sexuales y de Género/psicología , Sudáfrica/epidemiología , Estereotipo
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(12): 1435-1440, 2020 Dec 06.
Artículo en Chino | MEDLINE | ID: mdl-33333663


Objective: To compare the difference of HIV infection risk among student Men who have sex with men (sMSM) attending secondary vocational colleges or high school, sMSM attending universities or above, and non-student men who have sex with men (MSM). Methods: A cross-sectional study was conducted between July and October, 2019. Inclusion criteria of participants include: 15-24 years old, male at birth, had homosexual oral or anal intercourse before survey, self-reported HIV negative or unclear. Demographic information, HIV testing history and social media usage were collected by a self-reporting questionnaire, the HIV risk assessment tool was used for HIV infection risk assessment. We used Logistic regression to analyze the difference of HIV infection risk among student sMSM attending secondary vocational colleges or high school, sMSM attending universities or above, and non-student MSM. Results: Of the 1 707 participants, 45% (771 projects) reported homosexual debut before the age of 19, the proportion of HIV self-testing was 49% (833 projects), and 34% (587 projects) received facility-based testing. Comparing with sMSM attending universities or above, non-student MSM and sMSM attending secondary vocational colleges or high school had higher probability of medium and high HIV infection risk [OR(95%CI): 1.53(1.10-2.12), 1.80(1.06-3.07), respectively], while the probability of medium and high HIV infection risk between sMSM attending secondary vocational colleges and non-student MSM was not statistically different. Conclusion: Non-student MSM and sMSM attending secondary vocational college or high school have higher risk of HIV infection, health staff should allocate more education resources to Non-student MSM and sMSM attending secondary vocational college or high school, in order to alleviate HIV threat to them.

Infecciones por VIH , Minorías Sexuales y de Género , Adolescente , Adulto , Estudios Transversales , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Humanos , Masculino , Factores de Riesgo , Asunción de Riesgos , Conducta Sexual , Estudiantes , Encuestas y Cuestionarios , Adulto Joven
JAMA Netw Open ; 3(12): e2027572, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33270127


Importance: Understanding patterns of e-cigarette use and access during the coronavirus disease 2019 (COVID-19) pandemic is important because e-cigarettes may put users at risk for more severe respiratory effects and other health problems. Objective: To examine whether underage youth and young adults who ever used e-cigarettes self-reported changes in access and use of e-cigarettes since the COVID-19 pandemic began. Design, Setting, and Participants: A national, cross-sectional online survey study was conducted from May 6 to May 14, 2020. This sample of 4351 participants aged 13 to 24 years across the US included 2167 e-cigarette ever-users. Quota sampling was used to balance for age, sex, race/ethnicity, and 50% having ever used e-cigarettes. Main Outcomes and Measures: Change in e-cigarette use (increase, decrease, quit, no change, and switch to another product) and access to e-cigarettes (easier or harder, and change in point-of-purchase) before and after the COVID-19 pandemic began, reasons for change, number of times e-cigarettes were used, nicotine dependence, and sociodemographic data. Results: This study focused on 2167 e-cigarette ever-users among 4351 participants who completed the survey. Among 2167 e-cigarette users, a total of 1442 were younger than 21 years and 725 were aged 21 years or older; 1397 were female (64.5%) and 438 identified as lesbian, gay, bisexual, transgender, queer (20.2%). The survey completion rate was 40%. Since the COVID-19 pandemic began, 1198 of 2125 e-cigarette users (56.4%) changed their use: 388 individuals (32.4%) quit, 422 individuals (35.3%) reduced the amount of nicotine, 211 individuals (17.6%) increased nicotine use, 94 individuals (7.8%) increased cannabis use, and 82 individuals (6.9%) switched to other products. Participants reported that not being able to go to vape shops and product unavailability were the reasons accessing e-cigarettes was difficult after the pandemic began. Since the COVID-19 pandemic began, individuals reported purchasing from alternative retail stores (disposables, 150 of 632 [23.7%]; pod-based, 144 of 797 [18.1%]; and other e-cigarette, 125 of 560 [22.3%], ie, between 18.1% and 23.7%), purchasing online instead of retail (disposables, 115 of 632 [18.2%]; pod-based, 156 of 797 [19.6%]; and other e-cigarette, 111 of 560 [19.8%], ie, between 18.2% to 19.8%), and shifted to retail instead of online (disposables, 11 of 632 [1.7%]; pod-based, 17 of 797 [2.0%]; and other e-cigarette, 13 of 560 [2.3%], ie, between 1.7%-2.3%). Other individuals reported no change: from retail stores (disposables 262 of 632 [41.5%]; pod-based 344 of 797 [43.2%]; and other e-cigarette, 223 of 560 [39.8%], ie, between 39.8% and 43.2%) and online (disposables 94 of 632 [14.9%]; pod-based 136 of 797 [17.1%]; and other e-cigarette, 88 of 560 [15.8%], ie, between 14.9% and 17.1%). Underage youth reported e-cigarette deliveries from vape shops and/or dealers or friends who received such deliveries, and 63 of 229 (27.5%) self-reported accessing e-cigarettes without age verification. e-Cigarette users were 52% less likely to quit or reduce their use if they previously used e-cigarettes between 11 and 99 times (adjusted odds ratio, 0.48; 95% CI, 0.30-0.78), 68% less likely to quit if they previously used e-cigarettes more than 100 times (adjusted odds ratio, 0.32; 95% CI, 0.20-0.51), and 51% were less likely to quit if they were nicotine dependent (adjusted odds ratio, 0.49; 95% CI, 0.35-0.70). Conclusions and Relevance: During the COVID-19 pandemic, youth e-cigarette users reported changes in e-cigarette use, point-of-purchase, and ability to purchase e-cigarettes without age verification. The US Food and Drug Administration and local policy makers may find these data useful to inform policies to prevent e-cigarette sales to underage youth.

Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Cuarentena/estadística & datos numéricos , Tabaquismo/epidemiología , Vapeo/epidemiología , Adolescente , Comportamiento del Consumidor/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Masculino , Minorías Sexuales y de Género/estadística & datos numéricos , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto Joven
BMC Infect Dis ; 20(1): 925, 2020 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-33276727


BACKGROUND: Not all men who have sex with men (MSM) at risk for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) infection currently receive sexual healthcare. To increase the coverage of high-quality HIV/STI care for MSM, we developed a home-care programme, as extended STI clinic care. This programme included home sampling for testing, combined with treatment and sexual health counselling. Here, we pilot implemented the programme in a hospital setting (HIV-positive MSM) to determine the factors for the successful implementation of STI home sampling strategies. METHODS: Healthcare providers from the HIV hospital treatment centre (Maastricht) were invited to offer free STI sampling kits (syphilis, hepatitis B, [extra]genital chlamydia and gonorrhoea laboratory testing) to their HIV-positive MSM patients (March to May 2018). To evaluate implementation of the program, quantitative and qualitative data were collected to assess adoption (HIV care providers offered sampling kits to MSM), participation (MSM accepted the sampling kits) and sampling-kit return, STI diagnoses, and implementation experiences. RESULTS: Adoption was 85.3% (110/129), participation was 58.2% (64/110), and sampling-kit return was 43.8% (28/64). Of the tested MSM, 64.3% (18/28) did not recently (< 3 months) undergo a STI test; during the programme, 17.9% (5/28) were diagnosed with an STI. Of tested MSM, 64.3% (18/28) was vaccinated against hepatitis B. MSM reported that the sampling kits were easily and conveniently used. Care providers (hospital and STI clinic) considered the programme acceptable and feasible, with some logistical challenges. All (100%) self-taken chlamydia and gonorrhoea samples were adequate for testing, and 82.1% (23/28) of MSM provided sufficient self-taken blood samples for syphilis screening. However, full syphilis diagnostic work-up required for MSM with a history of syphilis (18/28) was not possible in 44.4% (8/18) of MSM because of insufficient blood sampled. CONCLUSION: The home sampling programme increased STI test uptake and was acceptable and feasible for MSM and their care providers. Return of sampling kits should be further improved. The home-care programme is a promising extension of regular STI care to deliver comprehensive STI care to the home setting for MSM. Yet, in an HIV-positive population, syphilis diagnosis may be challenging when using self-taken blood samples.

Infecciones por Chlamydia/epidemiología , Chlamydia/genética , Gonorrea/epidemiología , Seropositividad para VIH/epidemiología , VIH , Virus de la Hepatitis B/inmunología , Hepatitis B/epidemiología , Homosexualidad Masculina , Tamizaje Masivo/métodos , Neisseria gonorrhoeae/genética , Minorías Sexuales y de Género , Manejo de Especímenes/métodos , Sífilis/epidemiología , Treponema pallidum/inmunología , Adulto , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/microbiología , Consejo , Gonorrea/diagnóstico , Gonorrea/microbiología , Seropositividad para VIH/virología , Personal de Salud , Hepatitis B/diagnóstico , Hepatitis B/virología , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Parejas Sexuales , Sífilis/diagnóstico , Sífilis/microbiología
RECIIS (Online) ; 14(4): 857-869, out.-dez. 2020.
Artículo en Portugués | LILACS | ID: biblio-1145475


Este artigo trabalha na perspectiva histórica e na revisão bibliográfica de autores que analisam os recursos da linguagem, como a metáfora, para perceber a construção discursiva do HIV/aids na medicina, na mídia, no campo literário, na militância LGBTI e nos relatos em canais no YouTube de pessoas vivendo com HIV. O objetivo é utilizar as análises da terminologia e da história de luta pela significação de termos associados à doença e ao vírus em cada período. Dessa forma, verificamos que as representações iniciais sobre a condição clínica relacionada à culpa e ao julgamento moral de grupos, já vulneráveis antes da epidemia, não foram totalmente superadas no discurso. Observamos ainda os esforços, ao longo desses 40 anos, no campo da ciência para reduzir o estigma e a discriminação a partir da palavra.

This article works in the historical perspective and in the bibliographic review of authors who analyze language resources, such as the metaphor, to understand the discursive construction of HIV/AIDS in medicine, in the media, in the literary field, in LGBTI activism and in reports on YouTube channels of people living with HIV. The objective is to use the analysis of terminology and history of struggle for the meaning of terms associated with the disease and the virus in each period. We found that the initial representations about the clinical condition related to guilt and the moral judgment of groups, already vulnerable before the epidemic, were not completely overcome in the discourse. We also observe the efforts, over these 40 years, in the field of science to reduce stigma and discrimination based on words.

Este artículo trabaja en la perspectiva histórica y en la revisión bibliográfica de autores que analizan recursos del lenguaje, como la metáfora, para comprender la construcción discursiva del VIH/SIDA en la medicina, en los medios de comunicación, en el campo literario, en el activismo LGBTI y en canales de YouTube de personas que viven con el VIH. El objetivo es utilizar el análisis de la terminología y la historia de las luchas por el significado de los términos asociados a la enfermedad y al virus en cada período. Así, encontramos que las representaciones iniciales sobre el cuadro clínico relacionado con la culpa y el juicio moral de grupos, ya vulnerables antes de la epidemia, no fueron superadas por completo en el discurso. También hemos visto esfuerzos, durante estos 40 años, en el campo de la ciencia para reducir el estigma y la discriminación basados en las palabras.

Humanos , VIH , Epidemias , Medios de Comunicación Sociales , Minorías Sexuales y de Género , Conducta Sexual , Síndrome de Inmunodeficiencia Adquirida , Medios de Comunicación , Periodismo , Difusión por la Web , Estigma Social , Narrativa Personal , Historia
Rev. SPAGESP ; 21(2): 41-54, jul.-dez. 2020.
Artículo en Portugués | LILACS, Index Psicología - Revistas técnico-científicas | ID: biblio-1125730


A teoria do estresse de minoria (EM) defende que minorias sociais vivenciam estressores específicos adicionais aos estressores cotidianos. Fatores individuais e do meio podem funcionar como fatores de risco e/ou de proteção no comprometimento da saúde mental de pessoas LGB. O objetivo deste estudo é apresentar e discutir a teoria do EM em indivíduos LGB por meio de uma revisão narrativa. Compreender a ocorrência do EM em pessoas LGB pode auxiliar na elaboração de planos interventivos, de ordem clínica ou social, com o objetivo de minimizar os efeitos do preconceito nestes indivíduos.

The minority stress (MS) theory argues that social minorities experience specific stressors added to everyday stressors. Individual and contextual factors can function as risk and/or protective factors without compromising the mental health of LGB people. This study aims to present and discuss the theory of MS in LGB individuals through a narrative review. Understanding the occurrence of MS in LGB people can assist in the elaboration of intervention plans, of a clinical or social nature to minimize the effects of prejudice in these situations.

La teoría del estrés de minoría (EM) argumenta que las minorías sociales experimentan factores estresantes que se agregan a los factores estresantes cotidianos. Los factores individuales y contextuales pueden funcionar como factores de riesgo o protectores sin comprometer la salud mental de las personas LGB. El objetivo de este estudio es presentar y discutir la teoría de EM en individuos LGB a través de una revisión narrativa. Comprender el EM en personas LGB puede ayudar en la elaboración de planes de intervención, de naturaleza clínica o social, con el objetivo de minimizar los efectos de los prejuicios en estas situaciones.

Prejuicio , Estrés Psicológico , Salud Mental , Riesgo , Vulnerabilidad Social , Narración , Comprensión , Factores Protectores , Minorías Sexuales y de Género , Distrés Psicológico , Grupos Minoritarios
J Med Internet Res ; 22(7): e17087, 2020 07 31.
Artículo en Inglés | MEDLINE | ID: mdl-33137713


BACKGROUND: Discrimination in the health care system contributes to worse health outcomes among lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. OBJECTIVE: The aim of this study is to examine disparities in patient experience among LGBTQ persons using social media data. METHODS: We collected patient experience data from Twitter from February 2013 to February 2017 in the United States. We compared the sentiment of patient experience tweets between Twitter users who self-identified as LGBTQ and non-LGBTQ. The effect of state-level partisan identity on patient experience sentiment and differences between LGBTQ users and non-LGBTQ users were analyzed. RESULTS: We observed lower (more negative) patient experience sentiment among 13,689 LGBTQ users compared to 1,362,395 non-LGBTQ users. Increasing state-level liberal political identification was associated with higher patient experience sentiment among all users but had stronger effects for LGBTQ users. CONCLUSIONS: Our findings highlight that social media data can yield insights about patient experience for LGBTQ persons and suggest that a state-level sociopolitical environment influences patient experience for this group. Efforts are needed to reduce disparities in patient care for LGBTQ persons while taking into context the effect of the political climate on these inequities.

Disparidades en Atención de Salud/normas , Conducta Sexual/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Medios de Comunicación Sociales/normas , Adulto , Femenino , Humanos , Masculino
PLoS One ; 15(11): e0241596, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33206668


We provide nationally representative estimates of sexual minority representation in STEM fields by studying 142,641 men and women in same-sex couples from the 2009-2018 American Community Surveys. These data indicate that men in same-sex couples are 12 percentage points less likely to have completed a bachelor's degree in a STEM field compared to men in different-sex couples. On the other hand, there is no gap observed for women in same-sex couples compared to women in different-sex couples. The STEM degree gap between men in same-sex and different-sex couples is larger than the STEM degree gap between all white and black men but is smaller than the gender gap in STEM degrees. We also document a smaller but statistically significant gap in STEM occupations between men in same-sex and different-sex couples, and we replicate this finding by comparing heterosexual and gay men using independently drawn data from the 2013-2018 National Health Interview Surveys. These differences persist after controlling for demographic characteristics, location, and fertility. Finally, we document that gay male representation in STEM fields (measured using either degrees or occupations) is systematically and positively associated with female representation in those same STEM fields.

Ingeniería/estadística & datos numéricos , Matemática/estadística & datos numéricos , Ciencia/estadística & datos numéricos , Minorías Sexuales y de Género/estadística & datos numéricos , Recursos Humanos/estadística & datos numéricos , Femenino , Humanos , Masculino , Sexismo , Estados Unidos
PLoS One ; 15(11): e0242788, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33216802


Asian-born gay, bisexual and other men who have sex with men (gbMSM) who are newly arrived in Australia are at a higher risk of acquiring HIV than Australian-born gbMSM. We used a social constructionist framework to explore HIV knowledge and prevention strategies used by newly-arrived Asian-born gbMSM. Twenty four Asian-born gbMSM, aged 20-34 years, attending Melbourne Sexual Health Centre, who arrived in Australia in the preceding five years, participated in semi-structured, face-to-face interviews. Interviews were recorded, transcribed verbatim and analysed thematically. Participants described hiding their sexual identities in their country of origin, particularly from family members, due to fear of judgement and discrimination resulting from exposure to sexual identity and HIV related stigma in their countries of origin, although some were open to friends. Despite feeling more sexual freedom and acceptance in Australia, many were still not forthcoming with their sexual identity due to internalised feelings of stigma and shame. Exposure to stigma in their country of origin led many to report anxiety around HIV testing in Australia due to a fear of testing positive. Some described experiencing racism and lack of acceptance in the gay community in Australia, particularly on dating apps. Fear of discrimination and judgement about their sexual identity can have a significant impact on Asian-born gbMSM living in Australia, particularly in terms of social connectedness. Additionally, HIV-related stigma can contribute to anxieties around HIV testing. Our data highlights the potential discrimination Asian-born gbMSM face in Australia, which has implications for social connectedness, particularly with regard to LGBTQI communities and HIV testing practices. Future studies should determine effective strategies to reduce sexual identity and HIV-related stigma in newly-arrived Asian-born gbMSM.

Bisexualidad/psicología , Homosexualidad Masculina/psicología , Conducta Sexual/psicología , Estigma Social , Adolescente , Adulto , Grupo de Ascendencia Continental Asiática/psicología , Australia/epidemiología , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Humanos , Masculino , Tamizaje Masivo , Minorías Sexuales y de Género/psicología , Adulto Joven
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(11): 1220-1226, 2020 Nov 06.
Artículo en Chino | MEDLINE | ID: mdl-33147920


Objective: To understand the knowledge awareness and service acceptance of HIV non-occupational post-exposure prophylaxis (nPEP) men who have sex with men (MSM) among college students in three cities of China. Methods: Male college students in 10 universities of Beijing, Shenzhen and Kunming aged 18 and above who had sex with men in the last 3 months were recruited as research objects by cluster stratified sampling from March 15, 2019 to April 14, 2019.Basic information, sexual behavior characteristics, knowledge, and service acceptance of nPEP were collected through online questionnaire survey. Multivariate dichotomy and unconditioned logistic regression model was used to explore related factors about knowledge awareness and service acceptance of nPEP. Results: A total of 293 MSM were surveyed. The average age was (21.0±0.2) years old, and 91.1% (267) were undergraduates. In the last 3 months before the survey, 54.3%(159) used condom each time of sex; 4.4%(13) had intercourse with the HIV infected men, and 9.2% (27)suffered STDs in the past 6 months. The 29.4% (86) had not received HIV testing in the past year. The nPEP knowledge awareness rate was 47.8% (140). The 21.2% (62) counseled nPEP services, and 9.9% (29) received nPEP services. After multiple logistic regression analysis, compared with those who not received HIV testing in the past year, OR (95%CI) value of those who received HIV testing for more than twice in the past year to aware the nPEP knowledge was 3.15 (1.01-9.86). Compared with those who not received HIV testing in the past year, OR (95%CI) value of those who received HIV testing for more than twice in the past year to counsel the nPEP services was 5.29 (1.51-18.51). Compared with those who never used rush in the last 3 months, OR(95%CI) value of those who ever used rush in the last 3 months to receive the nPEP services was 3.86 (0.99-14.98). Compared with those who not sexed with HIV infected in the last 3 months, OR (95%CI) value of those who sexed with HIV infected in the last 3 months to receive the nPEP services was 14.30 (3.35-61.03). Conclusion: The proportions of awareness of nPEP knowledge and acceptance of nPEP services are low. MSM among college students need further health education of the nPEP knowledge to improve the accessibility of services.

Infecciones por VIH , Minorías Sexuales y de Género , Adulto , Beijing , China , Ciudades , Infecciones por VIH/prevención & control , Homosexualidad Masculina , Humanos , Lactante , Masculino , Profilaxis Posexposición , Conducta Sexual , Estudiantes , Encuestas y Cuestionarios , Adulto Joven
Epidemiol Psychiatr Sci ; 29: e179, 2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33153509


AIMS: Compared to their heterosexual peers, youth who identify as lesbian, gay or bisexual (LGB) tend to suffer higher rates of peer victimisation from bullying. However, studies of LGB adolescents' participation as bullies are scarce. We aimed to examine the possible association of sexual minority identity and the heightened risk of not only being bullied but bullying others as well. We also explored the effect of one's sexual identity on their involvement in bullying through the mediation of coping strategies and mood states. METHODS: A total of 12 218 students were recruited from 18 secondary schools in China. The demographic information, positive and negative coping strategies, mood state (anxiety, depression and hypomania) and information related to bullying and being bullied were collected. Multinomial regression was used to assess the heightened risk of sexual minority groups in comparison to their heterosexual adolescents' counterparts. A structural equation model (SEM) was used to test the mediating role of coping strategy and mood state between one's sex, sexual identity and bullying experience. RESULTS: Two trends could be observed: (1) LGB groups reported heightened risks of being bullied and bullying others at school than heterosexual peers. However, being a sexual-undeveloped girl seemed to have a protective effect on bullying-related problems. (2) Birth-assigned males were more likely to be bullied as well as bullying others at school when compared to birth-assigned females. SEM analysis revealed that being a sexual minority was directly associated with a higher frequency of being bullied (B = 0.16, 95% CI [0.10, 0.22], p < 0.001) but not bullying others (B = 0.02, 95% CI [-0.02, 0.06], p = 0.398) when compared to the heterosexual group. Negative coping, hypomania, anxiety and depression were associated with a higher frequency of being bullied, while positive coping was associated with a lower frequency of being bullied. Moreover, negative coping, hypomania and depression were associated with a higher frequency of bullying others, while positive coping was associated with a reduced likelihood of bullying others. In addition, being bullied and bullying others were significantly correlated in the SEM model. CONCLUSIONS: This novel research investigated the dynamic nature of the interaction between victim and bullying of LGB school adolescents in China, with a specific exploration of the psychological mechanism behind the pattern of being bullied and bullying others. School-level interventions aimed at teaching positive coping strategies to lower psychological distress are recommended to support sexual minority students.

Adaptación Psicológica , Acoso Escolar/psicología , Víctimas de Crimen/psicología , Minorías Sexuales y de Género/psicología , Estudiantes/psicología , Adolescente , Conducta del Adolescente/psicología , Ansiedad/epidemiología , Ansiedad/psicología , Bisexualidad/etnología , Bisexualidad/psicología , Acoso Escolar/estadística & datos numéricos , China/epidemiología , Víctimas de Crimen/estadística & datos numéricos , Depresión/epidemiología , Depresión/psicología , Femenino , Homosexualidad Femenina/etnología , Homosexualidad Femenina/psicología , Homosexualidad Masculina/etnología , Homosexualidad Masculina/psicología , Humanos , Masculino , Grupo Paritario , Prevalencia , Instituciones Académicas
BMC Infect Dis ; 20(1): 851, 2020 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-33198672


BACKGROUND: HIV, HBV and HCV infections continue to represent major health concerns, especially among key at-risk populations such as men who have sex with men (MSM), people who inject drugs (PWIDs), transgender women (TGW) and sex workers (SW). The objective of the ANRS-CUBE study was to evaluate the acceptability of a healthcare, community-based strategy offering a triple rapid HIV-HBV-HCV testing, and HBV vaccination, targeted at three priority groups (MSM, PWIDs and TGW/SWs), in three community centers, in the Paris area. METHODS: This longitudinal multicentric non-randomized study included all adult volunteers attending one of the three specialized community centers in Paris, between July 2014 and December 2015. HIV, HBV and HCV status and acceptability of HBV vaccination were evaluated. RESULTS: A total of 3662, MSM, 80 PWIDs and 72 TGW/SW were recruited in the three centers respectively. Acceptability of rapid tests was 98.5% in MSM and 14.9% in TGW/SWs, but could not be estimated in PWIDs since the number of users attending and the number of proposals were not recorded. User acceptability of HBV vaccination was weak, only 17.9% of the eligible MSM (neither vaccinated, nor infected) agreed to receive the first dose, 12.2% two doses, 5.9% had a complete vaccination. User acceptability of HBV vaccination was greater in PWIDs and TGW/SWs, but decreased for the last doses (66.7 and 53.3% respectively received a first dose, 24.4 and 26.7% a second dose and 6.7 and 0% a third dose). Fifty-three participants (49 MSM and 4 PWIDs) were discovered HIV positive, more than half with a recent infection. All but two HIV positive participants were linked to appropriate care in less than one month. CONCLUSIONS: Rapid HIV-HCV-HBV screening showed a very high level of acceptability among MSM. Efforts need to be made to improve immediate acceptability for HBV vaccination, especially among MSM, and follow-up doses compliance. Our results show the important role of community centers in reaching targets, often fragile, populations, while also suggesting the need to reinforce on-site human support in terms of testing and vaccination, especially when addressing PWIDs.

Infecciones por VIH/diagnóstico , VIH-1/inmunología , VIH-2/inmunología , Hepacivirus/inmunología , Virus de la Hepatitis B/inmunología , Hepatitis B Crónica/diagnóstico , Hepatitis C Crónica/diagnóstico , Vacunación , Vacunas Virales/inmunología , Adolescente , Adulto , Servicios de Salud Comunitaria , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/virología , Hepatitis B Crónica/epidemiología , Hepatitis B Crónica/virología , Hepatitis C Crónica/epidemiología , Hepatitis C Crónica/virología , Homosexualidad Masculina , Humanos , Estudios Longitudinales , Masculino , Tamizaje Masivo/métodos , Paris/epidemiología , Proyectos Piloto , Estudios Prospectivos , Factores de Riesgo , Pruebas Serológicas , Trabajadores Sexuales , Minorías Sexuales y de Género , Abuso de Sustancias por Vía Intravenosa , Personas Transgénero , Adulto Joven