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1.
Artigo em Inglês | MEDLINE | ID: mdl-31738869

RESUMO

Aim: To describe the epidemiology of lymphogranuloma venereum (LGV) in New South Wales (NSW) from 2006 to 2015. Methods: LGV notification data between 2006 and 2015 from New South Wales were analysed to describe time trends in counts and rates by gender, age group and area of residence, as well as anatomical sites of infection. A positivity ratio was calculated using the number of LGV notifications per 100 anorectal chlamydia notifications per year. Data linkage was used to ascertain the proportion of LGV cases that were co-infected with HIV. Results: There were 208 notifications of LGV in NSW from 2006 to 2015; all were among men, with a median age of 42 years, and half were residents of inner-city Sydney. Annual notifications peaked at 57 (1.6 per 100,000 males) in 2010, declined to 16 (0.4 per 100,000 males) in 2014, and then increased to 34 (0.9 per 100,000 males) in 2015. Just under half (47.4%) of LGV cases were determined to be co-infected with HIV. Conclusion: The number of LGV notifications each year has not returned to the low levels seen prior to the peak in 2010. Continued public health surveillance is important for the management and control of LGV.


Assuntos
Chlamydia trachomatis/isolamento & purificação , Monitoramento Epidemiológico , Linfogranuloma Venéreo/epidemiologia , Adolescente , Adulto , Idoso , Notificação de Doenças , Homossexualidade Masculina , Humanos , Linfogranuloma Venéreo/microbiologia , Masculino , Pessoa de Meia-Idade , New South Wales/epidemiologia , Doenças Retais , Minorias Sexuais e de Gênero , Adulto Jovem
2.
Cent Eur J Public Health ; 27(3): 223-228, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31580558

RESUMO

OBJECTIVE: Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities co-infect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases. METHODS: A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases. RESULTS: Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+ ≤ 350 mm3 reached 46%, 17% of the patients received antiretroviral therapy and neurosyphilis association reached 9%. CONCLUSION: Although HIV/AIDS-syphilis co-infection status appeared high in heterosexuals, MSM had a moderate level increase in cases. Our results suggested syphilis co-infection in HIV/AIDS cases should be integral part of monitoring in a national sexual transmitted diseases surveillance system. However, our data may provide base for HIV/syphilis prevention and treatment efforts in the future.


Assuntos
Coinfecção , Infecções por HIV , Minorias Sexuais e de Gênero , Sífilis , HIV , Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Prevalência , Estudos Retrospectivos , Comportamento Sexual/estatística & dados numéricos , Sífilis/epidemiologia , Turquia
3.
Rev Bras Epidemiol ; 22Suppl 1(Suppl 1): e190003, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576979

RESUMO

INTRODUCTION: Discrimination based on sexual orientation can influence vulnerability to HIV, increasing exposure to risky sexual behavior among men who have sex with men (MSM). OBJECTIVES: To analyze data using latent class analysis (LCA) to identify groups of individuals with specific patterns of discrimination based on sexual orientation (DSO). METHODS: Cross-sectional study using respondent-driven sampling in 12 Brazilian cities in 2016. LCA was used to characterize discrimination among MSM based on 13 variables in the survey questionnaire. The proportions of men reporting DSO and other variables of interest were estimated using Gile's Successive Sampling estimator. RESULTS: Most MSM were young, single, had a religion, had a high school or college degree, black or brown skin color, and socioeconomic status classified as average. More than half of the participants reported that they had been discriminated against during the last 12 months due to their sexual orientation (65%), more than a third said they had felt afraid of walking in public places during the past 12 months, and about one-fifth of participants reported having been victims of physical or sexual assault due to DSO. DSO was classified into four latent classes: "very high", "high", "moderate" and "low", with estimates of 2.2%, 16.4%, 35.1%, and 46.19%, respectively. CONCLUSION: We observed a high proportion of discrimination against MSM in this study. The use of LCA differentiated parsimoniously classes of discrimination.


Assuntos
Homossexualidade Masculina/estatística & dados numéricos , Sexismo/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Estudos Transversais , Discriminação (Psicologia) , Homossexualidade Masculina/etnologia , Humanos , Análise de Classes Latentes , Masculino , Autorrelato , Sexismo/etnologia , Fatores Socioeconômicos
4.
Rev Bras Epidemiol ; 22Suppl 1(Suppl 1): e190005, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576981

RESUMO

INTRODUCTION: High level of HIV/AIDS knowledge is required for an effective adoption of preventive strategies. OBJECTIVE: To assess HIV/AIDS knowledge among men who have sex with men (MSM) in 12 Brazilian cities. METHODS: Respondent-Driven Sampling method was used for recruitment. HIV/AIDS knowledge was assessed by Item Response Theory. Difficulty and discrimination parameters were estimated, and the knowledge score was categorized in three levels: high, medium, and low. Logistic regression was used for analysis. RESULTS: Among 4,176 MSM, the proportion of high level of knowledge was 23.7%. The following variables were positively associated with high knowledge (p < 0.05): age 25+ years old, 12+ years of schooling, white skin color, having health insurance, having suffered discrimination due to sexual orientation, having had a syphilis test, and having received educational material in the previous 12 months. Exchanging sex for money was negatively associated. CONCLUSIONS: The proportion of only 23.7% of high HIV/AIDS knowledge was low. We should note that the only potential source of knowledge acquisition associated with high level of knowledge was receiving educational materials. Our study indicates the need for expansion of public prevention policies focused on MSM and with more effective communication strategies, including the development of knowledge that involves motivation and abilities for a safer behavior.


Assuntos
Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Infecções por HIV/prevenção & controle , Comportamentos de Risco à Saúde , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Fatores Socioeconômicos , Inquéritos e Questionários
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1106-1110, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594154

RESUMO

Objective: To understand the HIV infection status and related factors in men who have sex with men (MSM) in Tianjin during 2016-2018. Methods: According to the sentinel surveillance protocol, continuous cross-sectional studies were conducted to collect the information about the awareness of AIDS, related behaviors, HIV infection, syphilis prevalence and HCV infection in the MSM in Tianjin with the annual sample seize of 400 between April and June during 2016-2018. Results: From 2016 to 2018, a total of 1 200 MSM were surveyed. The condom use rate in anal sex was 45.4% (544/1 198) in the past 6 months. The HIV test rate in MSM recruited through network declined with year (trend χ(2)=42.742, P<0.001). The overall HIV infection rate was 3.3% (40/1 200). The HIV-1 infection rate was 2.6% (95%CI: 1.7%-3.5%). The overall prevalence rate of syphilis was 6.7% (80/1 200). The overall HCV infection rate was 0.8% (9/1 200). Results from multivariate logistic regression analysis showed that the risk factors associated with HIV infection in the MSM included divorced or widowed (compared with unmarried, aOR=7.137, 95%CI: 1.621-31.419) and syphilis positive group (compared with syphilis negative group, aOR=3.684, 95%CI: 1.520-8.932). The protective factors for HIV infection in the MSM included consistent use of condom in the past 6 months (compared with occasional use of condom, aOR=0.343, 95%CI: 0.126-0.932) and HIV test (compared with receiving no HIV test, aOR=0.314, 95%CI: 0.123-0.801). Conclusions: The HIV infection rate in the MSM in Tianjin was high from 2016 to 2018. Syphilis prevalence status in MSM should not be neglected. The rate of consistent condom use in anal sex was low in the MSM. It is necessary to take effective measures to promote condom use and strengthen HIV test in MSM.


Assuntos
Infecções por HIV/epidemiologia , Minorias Sexuais e de Gênero , China/epidemiologia , Estudos Transversais , Homossexualidade Masculina , Humanos , Masculino , Prevalência , Fatores de Risco , Vigilância de Evento Sentinela , Comportamento Sexual , Sífilis/epidemiologia
6.
Wei Sheng Yan Jiu ; 48(4): 567-572, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31601337

RESUMO

OBJECTIVE: To understand the plasma selenium level of student men who have sex with men(MSM) in Changzhou and its influencing factors. METHODS: A total of 251 male students with previous male sexual history, 15-25 years of age who had been consulted by VCT clinics in Changzhou were included in this study from January 1, 2014 to December 31, 2017. Questionnaires referred to AIDS sentinel surveillance were conducted to provide information about demographic characteristics and behaviors. Blood samples were collected for syphilis and HIV antibody detection. Selenium in plasma was detected by inductively coupled plasma mass spectrometry. The influencing factors of plasma selenium level among student MSM were screened by classification tree model. RESULTS: The average age of objects was(20. 74±1. 94)years and the average plasma selenium level was(82. 30+12. 05) ng/mL. Educational attainment was mainly college or above, 77. 69%, and HIV antibody positive rate was 29. 48%. Plasma selenium was(87. 39±11. 37) ng/mL among student MSM with college or above, not infected with HIV and older than 20. 5 years, but was(78. 19±13. 48) ng/mL among those who were high school and below. Three related factors were screened out by the classification tree model, including education level, HIV infection status and age. The most important factor was education level. The estimate of substitution and cross-validation of the classification tree model were 131. 87 and 135. 11, and the standard error were 10. 50 and 10. 89, respectively. CONCLUSION: The related factors of plasma selenium level among student MSM are education level, HIV infection status and age.


Assuntos
Homossexualidade Masculina , Selênio/sangue , Adolescente , Adulto , China , Cidades , Infecções por HIV , Humanos , Masculino , Fatores de Risco , Comportamento Sexual , Minorias Sexuais e de Gênero , Estudantes , Inquéritos e Questionários , Adulto Jovem
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1197-1202, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658516

RESUMO

Being a double-edged sword, Internet Plus not only increases the risk of HIV transmission, but also plays an positive role in programs regarding the control and prevention of HIV. Here, we introduced a special issue- "HIV Prevention among MSM in the Internet Era" , synthesizing both domestic and international evidence, and discussed the history and progress, strengths and effectiveness, problems and countermeasures, as well as the directions of the Internet Plus regarding the prevention programs of HIV/AIDS among MSM.


Assuntos
Infecções por HIV/prevenção & controle , Internet , Minorias Sexuais e de Gênero , Homossexualidade Masculina , Humanos , Masculino , Assunção de Riscos , Comportamento Sexual
8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1206-1211, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658518

RESUMO

Objective: To analyze the characteristics of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM who frequently using the Internet in Guangzhou. Methods: An online survey was conducted among MSM who were recruited through gay-website portals between August and September, 2018 in Guangzhou, to collect information regarding the use of and attitudes on the "Interner Plus-based AIDS Comprehensive Prevention Service System" . Logistic regression was used to explore the association between the use of Internet intervention tools and related behavioral characteristics. Information on the awareness of AIDS, HIV testing, and condomless anal sex behavior were compared between the core or non-core services users. Results: A total of 777 Internet-based MSM were recruited as participants including 638 men (82.1%) as core service users. MSM were satisfied in using the the "Interner Plus-based AIDS Comprehensive Prevention Service System" while more than 80.0% of the users felt that the tools were helpful in: increasing the HIV awareness, promoting test uptake, and reducing those related risk behavior. Comparing with those who did not use the tools, the users showed higher rates in practising condomless anal intercourse (1.50-1.86 times), commercial sex with men (11.60-21.21 times), and unprotected vaginal intercourse (13.62-20.67 times), in the last 6 months. Proportions of core service users appeared as: [96.6% vs. 74.8%, aOR (95%CI): 8.80 (4.85-15.97)] on HIV testing, [56.4% vs. 22.3%, aOR (95%CI): 4.54 (2.94-7.02)] on regular HIV testing and [86.2% vs. 80.6%, aOR (95%CI): 1.75 (1.06-2.89)] on awareness of HIV knowledge respectively, which were all significantly higher than the non-core service users. Conclusions: The frequent Internet using MSM in Guangzhou claimed to have had high acceptance and satisfaction on the local Internet HIV intervention service tools. The "Internet Plus-based AIDS Comprehensive Prevention Service System" had effectively reached the high-risk subgroups of MSM, increasing the awareness on related risk and promoting testing on HIV.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Infecções por HIV/prevenção & controle , Internet , Minorias Sexuais e de Gênero , China , Feminino , Homossexualidade Masculina , Humanos , Masculino , Assunção de Riscos , Trabalho Sexual , Comportamento Sexual
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1212-1216, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658519

RESUMO

Objective: This article was to evaluate the applicability and feasibility of "Lingnanzhun" -an "Internet Plus-based HIV Self-testing Tool" targeting MSM in Guangzhou. Hopefully, the results could be used to improve the existing HIV testing services and to support the implementation and scale-up of HIV self-testing programs. Methods: Data were collected from a survey on HIV testing preferences among the Internet-using MSM in April to June, 2015. Univariate and multivariate logistic regression analysis were applied to identify factors associated with the use of HIV self-testing service provided by Lingnanzhun. Information related to the users of Lingnanzhun during September 2014 and December 2018 was also collected. Results: 769 MSM were recruited as participants. Of them, age distribution was 16-77(28.6±6.8) years old, 88.3%(679/769) were unmarried, 42.2%(325/769) were registered residents of Guangzhou, 82.1%(631/769) had university or college education. Among them, 195 (25.4%) used the HIV self- testing program of Lingnanzhun while 574 (74.6%) using the clinic service. Compared with the clinic service users, the Lingnanzhun users showed the following characteristics: longer experience in the MSM community ≥10 years (32.8% vs. 20.9%, 64/195 vs. 120/574); having male casual sexual partners ≥2 (42.1% vs. 29.6%, 82/195 vs. 170/574); having group sex (6.2% vs. 2.6%, 12/195 vs. 15/574) and having commercial sex with men (13.8% vs. 3.0%, 27/195 vs. 17/574). Data from the Lingnanzhun users showed that a total of 3 000 users had practised 5 038 times of self HIV-testings. 11.4% (343/3 000) of the Lingnanzhun users had never been tested. Conclusions: It was applicable and feasible to provide Internet-based HIV self-testing service to MSM as a significant complement to the traditional facility-based HIV testing services. It was also useful in accessing those who were having higher risk or had never received HIV testing so as to increase the testing uptake and the frequency.


Assuntos
Infecções por HIV/diagnóstico , Internet , Minorias Sexuais e de Gênero , Adolescente , Adulto , Idoso , China , Estudos de Viabilidade , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Trabalho Sexual , Comportamento Sexual , Adulto Jovem
10.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1217-1221, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658520

RESUMO

Objective: To analyze the characteristics of levels related to the risk through self-evaluation system, among MSM users in Guangzhou, between 2015 and 2017. Methods: Between 2015 and 2017, data was collected from the users of a self-evaluation system network related to HIV infection, based on the previous 'HIV health risk appraisal model'. Information on risk factors was collected to calculate the scores and levels of risks and to estimate the incidence of HIV. Taking the reference of R value on risks as (R=0.9-1.1) in general population. The ones with very low risk, with low risk, moderate risk, high risk and very high risk were set as R≤0.5, 0.52.0, respectively. The scores of modifiable risk factors were compared with different subgroups of MSM. Results: A total of 4 601 MSM were involved in this study, with the following features presented as: aged 16-64 (28.38±7.11) years, proportions of residence from Guangzhou, Guangdong province or other provinces as 38.6%(1 776/4 601)、35.4%(1 629/4 601) and 26.0%(1 197/4 601), 59.6%(2 742/4 601) received bachelor or above degrees. 81.3%(3 741/4 601) of them claimed as having homosexual orientation. R values of risk level on very low risk, low risk level, moderate risk, high risk and very high risk appeared as 12.9%(594/4 601), 50.9%(2 342/4 601), 17.0%(783/4 601), 14.8%(682/4 601) and 4.3%(200/4 601), respectively. Scores of modifiable risk factors decreased year by year (P<0.05), among MSM in this study. In either of the groups that experiencing insertive or receptive sex, the ones with heterosexual orientation presented the highest scores of modifiable risk factors (P<0.05). Conclusions: The risk levels on HIV infections called for special attention among the users of the self-evaluation network system. Among the MSM that carrying either insertive or receptive sex role, the ones with heterosexual orientation had the highest risk levels and scores of modifiable risk factors in Guangzhou. Further study should be explored to better understand the causes of related risks.


Assuntos
Infecções por HIV/epidemiologia , Medição de Risco , Minorias Sexuais e de Gênero , Adolescente , Adulto , China/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Comportamento Sexual , Adulto Jovem
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1222-1226, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658521

RESUMO

Objective: To evaluate the effectiveness of the "Internet Plus-based AIDS Comprehensive Prevention Service System" among men who have sex with men in Guangzhou. Methods: Data through case-reporting and follow-up programs on MSM HIV/AIDS in Guangzhou was collected from the China Information System for Disease Control and Prevention, which including those from the referral and follow-up treatment compliance programs in 2008-2014 (pre-treatment) and 2017-2018 (post-treatment). According to the types of care services, three groups were set as: with "Internet Plus" service, with 'HIV counseling/testing service' or with 'routine medical service'. General Estimating Equation (GEE) was used to analyze the follow up situation of HIV/AIDS cases, annually. Cox proportional hazard regression model was used to analyze the proportions of treatment referral, within the 30 days of diagnosis. Results: Before the implementation of immediate treatment after HIV diagnosis, 90.6% (707/780) of the HIV/AIDS cases received the first follow up program including the CD(4)(+) T cells counts (CD(4)) test service within 90 days of diagnosis, in the "Internet Plus-based HIV/AIDS care service" group presented 1.19 times (95%CI: 1.14-1.25) of the routine medical service group. The implementation of immediate treatment after HIV diagnosis, compared with the routine medical service group, the "Internet Plus" service group presented 1.71 times (95%CI: 1.03- 2.83) more treatment referrals within the 30 days of diagnosis, when the first testing CD(4) was ≤200 cells/µl. Compared with the routine medical service group, the HIV counseling and testing service group showed 1.37 times (95%CI: 1.20-1.56) more of the treatment referrals within the 30 days of HIV diagnosis, after the first testing CD(4) counts as >200 cells/µl. Conclusion: Standardized care and follow-up service should be promoted as soon as the referral and treatment programs were set after the diagnosis was made, under the "Internet Plus-based AIDS Comprehensive Prevention Service System" for the MSM population, in Guangzhou.


Assuntos
Síndrome de Imunodeficiência Adquirida/diagnóstico , Infecções por HIV/diagnóstico , Serviços Preventivos de Saúde , Minorias Sexuais e de Gênero , Síndrome de Imunodeficiência Adquirida/prevenção & controle , China , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Internet , Masculino
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1227-1233, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658522

RESUMO

Objective: To evaluate the effect of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM in Guangzhou, during 2010-2017, using a dynamic compartmental model. Methods: A dynamic compartmental model was developed to describe the HIV situation among MSM in Guangzhou. This model was parameterized on data from published literature or surveillance programs from the Guangzhou CDC. The Matlab 7.0 software was used for coding and analysis on collected data. HIV prevalence was analyzed among MSM under the status quo data and estimated the impact by the "Internet Plus" AIDS prevention services project. Results: HIV prevalence would have increased to 22.75% in 2017, and the total number of new HIV infections would have been 11 038, from 2010 to 2017, using the data status quo. Under the Guangzhou "Internet Plus" AIDS prevention services project, the prevalence of HIV among MSM from 2010 to 2017 was estimated to be 8.44%, 9.68%, 10.65%, 11.34%, 11.73%, 11.83%, 11.71% and 11.43% in Guangzhou, which were similar to the surveillance data. The total number of new infections in the past 8 years under the "Internet Plus" scenario was estimated to be 4 009. The "Internet Plus" program would have prevented 7 029 (63.68%) new infections during 2010-2017 as compared to the number, status quo. Conclusions: The fitting result of dynamic compartmental model seemed more reasonable, which was applicable to predict HIV epidemic among MSM in Guangzhou, suggesting that the increase of HIV prevalence had been curbed since the "Internet Plus" project which was launched in 2010, and the "Interner Plus-based AIDS Comprehensive Prevention Service System" had achieved the purpose as planned, epidemiologically.


Assuntos
Síndrome de Imunodeficiência Adquirida/diagnóstico , Infecções por HIV/diagnóstico , Internet , Serviços Preventivos de Saúde , Minorias Sexuais e de Gênero , Síndrome de Imunodeficiência Adquirida/prevenção & controle , China , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Modelos Teóricos , Assunção de Riscos
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1279-1284, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658531

RESUMO

Objective: To analyze the influence of the confidence to pre-exposure prophylaxis (PrEP) on the willingness to use PrEP in men who have sex with men (MSM) by using the path analysis model based on structural equation model approach. Methods: A total of 550 MSM were recruited in Urumqi by snowball method and a questionnaire survey was conducted among them. According to the professional knowledge and analysis results of the confidence and willingness to use PrEP, structural equation model (SEM) analysis method was used to construct a path analysis model. Results: A total of 513 MSM participated in the survey. The modified path equation model was well fitted, with the modified fitting index as: GFI=0.993, RMSEA<0.001, and AGFI=0.984. The confidence to PrEP had direct influence on the willingness; the degree of influence from sex partners, the attitude of sex partner to PrEP and the positive emotions not only had direct effects on willingness of PrEP use, but also had indirect effects on willingness of PrEP use by affecting the confidence to it; the role in sexual behavior, AIDS severity, HIV prevention behavior had direct effects on willingness of PrEP use. The proportion of HIV infection in the population had no direct effects on willingness of PrEP use, but had indirect effects on willingness of PrEP use by affecting the confidence to it. Conclusions: The confidence to PrEP had influence on willingness of PrEP use in MSM, therefore targeted activities can be conducted to improve the confidence and willingness of MSM in taking the PrEP and reducing the risk of HIV infection in MSM. Compared with the traditional multiple regression analysis, the path analysis using the structural equation model could better reveal the mediating effect between the independent variables and dependent variables.


Assuntos
Infecções por HIV/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Homossexualidade Masculina , Humanos , Masculino
14.
Medicine (Baltimore) ; 98(40): e17419, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577756

RESUMO

Prospective cohort studies have been conducted to estimate HIV incidence among men who have sex with men (MSM) in first-line megacities cities (>10 million residents) in China, but few in the second-line large- or middle-size cities. This study was to investigate HIV incidence and cohort retention among MSM in a second-line city Hangzhou in eastern China.A total of 523 HIV-seronegative MSM were recruited during September 2014 to September 2015, and were followed up prospectively at 3, 6, 9, and 12 months. Questionnaire interviews were conducted, and laboratory tests were performed to evaluate baseline syphilis infection and HIV seroconversions. Chi-square test and logistic regression model were used to identify factors associated with cohort retention rate and syphilis prevalence.Of 523 participants, 137 (26.2%) completed 6-month follow-up, and use of Internet for recruiting study participants (vs other recruitments: adjusted odds ratio [AOR] = 0.5; 95% confidence interval [CI]: 0.3-0.8) and being homosexual (vs heterosexual or bisexual: AOR = 0.6; 95% CI: 0.4-0.9) were associated with lower cohort retention. The overall HIV incidence during 12 months of follow-up was 6.6 per 100 person-years (95% CI: 3.4-9.8/100 PY). The prevalence of syphilis at baseline was 6.5% (95% CI: 4.4%-8.6%), and disclosing sexual orientation (AOR = 0.4, 95% CI: 0.2-0.9) was associated with lower risk of syphilis infection.HIV is spreading rapidly among MSM in the second-line Chinese city. Effective interventions are needed to target this population in both first-line megacities and second-line large and middle-size cities.


Assuntos
Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Cidades/epidemiologia , Estudos de Coortes , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Retenção nos Cuidados , Sífilis/epidemiologia , Adulto Jovem
15.
MMWR Morb Mortal Wkly Rep ; 68(40): 873-879, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31600183

RESUMO

Correct and consistent condom use and human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) are protective against sexual transmission of HIV (1,2). The incidence of HIV infection among Hispanic/Latino men who have sex with men (MSM) in the United States is increasing (3). HIV risk among Hispanic/Latino MSM differs based on their place of birth and years of U.S. residence (4). Data from CDC's National HIV Behavioral Surveillance (NHBS)* for 2011-2017 were analyzed to assess changes in sexual risk behaviors among Hispanic/Latino MSM by place of birth and years of U.S. residence. Overall, condomless anal sex during the previous 12 months increased from 63% in 2011 to 74% in 2017, and PrEP use during the previous 12 months increased from 3% in 2014 to 24% in 2017. Regardless of place of birth, nearly 75% of Hispanic/Latino MSM reported condomless anal sex during 2017. However, because of PrEP use, <60% of non-U.S.-born Hispanic/Latino MSM and <50% of U.S.-born Hispanic/Latino MSM reported unprotected anal sex (condomless anal sex and no PrEP use) during 2017. Results indicate that PrEP can be a vital tool for reducing HIV transmission among Hispanic/Latino MSM, especially those who have condomless anal sex. Interventions to prevent HIV acquisition, including increasing PrEP uptake, could address cultural and linguistic needs of Hispanic/Latino MSM, as well as other barriers to prevention of HIV infection typically faced by all MSM.


Assuntos
Hispano-Americanos/psicologia , Homossexualidade Masculina/etnologia , Assunção de Riscos , Sexo sem Proteção/etnologia , Adolescente , Adulto , Infecções por HIV/etnologia , Hispano-Americanos/estatística & dados numéricos , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos , Adulto Jovem
17.
Medicine (Baltimore) ; 98(43): e17585, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651864

RESUMO

This study sought to examine the human immunodeficiency virus type 1 (HIV-1) genetic diversity on drug resistance among men who have sex with men (MSM) with virologic failure in antiretroviral therapy (ART), and investigate linking-associated factors for genetic transmission networks.Seven hundred and thirty-four HIV-positive MSM with virologic failure in ART were recruited into our study from 2011 to 2017. HIV-1 pol gene sequences were used for phylogenetic and genotypic drug resistance analyses. The drug resistance mutations were determined using the Stanford University HIV Drug Resistance Database. The genetic transmission networks were analyzed for CRF01_AE and CRF07_BC sequences by the genetic distance-based method.Of 734 subjects, 372 (50.68%) showed drug resistance, in which CRF01_AE and CRF07_BC were the predominating subtypes. Drug resistance more frequently occurred in non-nucleoside reverse transcriptase inhibitors (NNRTIs) treatment (48.64%), and followed by nucleoside reverse transcriptase inhibitors (NRTIs) (36.51%) and PIs (4.03%). The most common drug resistance-associated mutations in protease inhibitors (PIs), NRTIs and NNRTIs were K20I/R, M184V/I and K103N/KN, respectively. For 283CRF01_AE sequences, 64 (22.61%) fell into clusters at a genetic distance of 0.011, resulting in 17 clusters ranging in size from 2 to 16 individuals. For 230 CRF07_BC sequences, 66 (28.69%) were connected to at least one other sequence with 0.005 genetic distances, resulting in 8 clusters ranging in size from 2 to 52 individuals. Individuals who showed drug resistance to ART were less likely to fall into clusters than those who did not. The genetic linkage was robust by the exclusion of sites associated with drug resistance.CRF01_AE and CRF07_BC were the main strains among MSM with virologic failure in ART, and the drug resistance more frequently occurred in NNRTIs, followed by NRTIs and PIs. Genetic transmission networks revealed a complexity of transmission pattern, suggesting early-diagnosis and in-time intervention among MSM.


Assuntos
Fármacos Anti-HIV/efeitos adversos , Farmacorresistência Viral/genética , Infecções por HIV/tratamento farmacológico , HIV-1/genética , Inibidores da Transcriptase Reversa/efeitos adversos , Adolescente , Adulto , China , Homossexualidade Masculina , Humanos , Masculino , Minorias Sexuais e de Gênero/estatística & dados numéricos , Falha de Tratamento , Adulto Jovem
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 941-946, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484258

RESUMO

Objective: This study aimed to examine the demographic characteristics, HIV related knowledge and behavior, correlates of bisexual behavior and status of HIV infection among men who have sex with men only (MSMO) and men who have sex with both men and women (MSMW) in Shandong province. Methods: According to the requirements from "National HIV/AIDS sentinel surveillance program" , a cross-sectional survey was conducted to collect information on demographics, sexual and drug use behaviors, and HIV-related services among MSM in nine sentinel surveillance sites from April to July in 2018. Blood samples were drawn for serological tests on both HIV and syphilis antibodies. Results: A total of 3 474 participants were included in this study. Related information on these participants would include: average age as (31.66±9.01) years; 35.06% (1 218) married or cohabiting with a woman, 50.52% (1 755) had college or higher education, 80.11% (2 783) self-identified as gays and 14.22% (494) self-identified as bisexual men,16.87% (586) ever having sex with woman in the past 6 months, 10.51% (365) ever using drugs. HIV and syphilis prevalence rates were 2.99% (104/3 474) and 2.76%(96/3 474). Through multivariable logistic models, MSMW were more likely to be ≥35 years of age, local residents, self-identified as heterosexual/bisexual/uncertain, ever having commercial sex with man but less likely to consistently use condoms in the past 6 months, less using internet/dating software to find male sex partners and less using drugs. There was no significant differences noticed in the following areas: number of sexual partners in the last week, condom use in the last six months with commercial sex partners, with HIV or syphilis infection and self-reported history of STD in the past year between MSMO and MSMW (P>0.05). HIV-infected MSM were more likely to have the following features, ≥45 years of age, non-local residents, finding male sex partners from the bothhouses, park/toilets or from the internet/dating software, also less likely to consistently use condoms in the past 6 months, using drugs or with syphilis infection. Conclusions: High prevalence of bisexual behavior as well as higher risk of HIV infection were noticed among MSM in Shandong province. It is important to strengthen related surveillance and effective intervention programs for MSM with different characteristics in Shandong province.


Assuntos
Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/estatística & dados numéricos , Trabalho Sexual/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto , China/epidemiologia , Preservativos , Estudos Transversais , Feminino , Infecções por HIV/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Comportamento Sexual , Parceiros Sexuais , Sífilis/epidemiologia , Adulto Jovem
19.
J Environ Manage ; 251: 109565, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31557669

RESUMO

Low cost whey salt medium (WSM) and molasses salt medium (MSM) have been constructed utilizing food processing byproduct whey and molasses for the production of bio-polysaccharide chitosan from Rhizopus oryzae and subsequently comprehensive physico-chemical characterization of the fungal chitosan has been carried out using various analytical tools to apprehend its biochemical utility. Same has been repeated with chitosan from conventional potato dextrose broth (PDB) for comparison purpose. The yields of chitosan in three different media were 0.62 (WSM), 0.39 (MSM) and 0.63 (PDB) g/L respectively. Molecular weights of the chitosans were in the range of 100-300 kDa. WSM-chitosan and MSM-chitosan were less polydispersed, possessed more hydrated polymorph and loose crystal packing than PDB-chitosan. This indicate that WSM-chitosan and MSM-chitosan are highly exposed to the external reagent hence more reactive to the external reagents with compare to PDB-chitosan. Literature suggest isolated chitosans are useful for specific drug delivery applications.


Assuntos
Quitosana , Minorias Sexuais e de Gênero , Manipulação de Alimentos , Homossexualidade Masculina , Humanos , Masculino , Melaço , Rhizopus , Soro do Leite
20.
BMC Infect Dis ; 19(1): 821, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533734

RESUMO

BACKGROUND: Hepatitis C virus (HCV) is common in men who have sex with men (MSM) with HIV. The Swiss HCVree Trial targeted a micro-elimination by using a treat and counsel strategy. Self-reported condomless anal intercourse with non-steady partners was used as the selection criterion for participation in a counselling intervention designed to prevent HCV re-infection. The purpose of this study was to assess the ability of this criterion to identify men who engaged in other sexual risk behaviours associated with HCV re-infection. METHODS: Men who disclosed their sexual and drug- use behaviours during the prior 6 months, at study baseline, were included in the current study. Using a descriptive comparative study design, we explored self-reported sexual and drug-use risk behaviours, compared the odds of reporting each behaviour in men who reported and denied condomless anal intercourse with non-steady partners during the prior year and calculated the sensitivity/specificity (95% CI) of the screening question in relation to the other at-risk behaviours. RESULTS: Seventy-two (61%) of the 118 men meeting eligibity criteria reported condomless anal intercourse with non-steady partners during the prior year. Many also engaged in other potential HCV transmission risk behaviours, e.g., 52 (44%) had used drugs. In participants disclosing drug use, 44 (37%) reported sexualised drug use and 17 (14%) injected drugs. Unadjusted odds ratios (95% CI) for two well-known risk behaviours were 2.02 (0.80, 5.62) for fisting and 5.66 (1.49, 37.12) for injecting drug use. The odds ratio for sexualised drug use - a potential mediator for increased sexual risk taking - was 5.90 (2.44, 16.05). Condomless anal intercourse with non-steady partners showed varying sensitivity in relation to the other risk behaviours examined (66.7-88.2%). CONCLUSIONS: Although condomless anal intercourse with non-steady partners was fairly sensitive in detecting other HCV relevant risk behaviours, using it as the only screening criterion could lead to missing a proportion of HIV-positive men at risk for HCV re-infection due to other behaviours. This work also points to the importance of providing access to behavioral interventions addressing other sexual and drug use practices as part of HCV treatment. TRIAL REGISTRATION: Clinical Trial Number: NCT02785666 , 30.05.2016.


Assuntos
Infecções por HIV/patologia , Hepatite C/diagnóstico , Adulto , Infecções por HIV/complicações , Hepatite C/complicações , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Assunção de Riscos , Autorrelato , Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias/patologia
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