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1.
BMC Infect Dis ; 23(1): 599, 2023 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-37704973

RESUMO

BACKGROUND: Men who have sex with men (MSM) are at high risk of hepatitis C virus (HCV) infection, especially for those living with human immunodeficiency virus (HIV). Learning about knowledge of and attitudes towards HCV is essential to inform health promotion interventions development. This is one of very limited studies to examine the level of knowledge and attitudes towards HCV and their determinants among HIV-negative MSM and MSM living with HIV in China. METHODS: A cross-sectional survey was conducted across seven provinces in China from December 2021 to January 2022. All the MSM living with HIV were recruited offline, whereas the recruitment ratio for HIV-negative MSM was half online and half offline. Data on socio-demographic characteristics, sexual behaviors, knowledge about HCV, and attitude towards HCV from participants were collected through the online survey. Univariate and multivariable logistic regressions were used to determine the associated factors. RESULTS: Only 39.3% (33/84) of HIV-negative men and 44.0% (37/84) of men living with HIV had a good level knowledge about HCV. Nearly one-third (32.1%, 27/84) of HIV-negative men and 41.7% (35/84) of men living with HIV reported a positive attitude towards HCV. For HIV-negative men, positive attitude towards HCV was associated with the multiple sexual partners (aOR: 5.8, 95%CI:1.9-18.1) and the use of recreational substances (aOR: 3.1, 95%CI: 1.0-9.4). For men living with HIV, knowledge about HCV was associated with disclosing sexual orientation to healthcare providers, family or friends (aOR: 7.0, 1.9-26.0), the multiple sexual partners (aOR: 0.2, 0.1-1.0), the use of recreational substances (aOR: 3.7, 95%CI: 1.1-13.1) and the HBV testing history (aOR: 7.3, 95%CI: 1.6-32.7); positive attitude towards HCV was associated with the use of recreational substances (aOR: 3.1, 95%CI: 1.1-9.0). CONCLUSIONS: The majority of Chinese MSM showed an inadequate knowledge of and negative attitude towards HCV irrespective of HIV infection status. More tailored education campaigns and multicomponent interventions are required to be targeted on MSM, and more researches are also needed to inform how best to address the negative attitudes of this population towards HCV.


Assuntos
Infecções por HIV , Hepatite C , Minorias Sexuais e de Gênero , Feminino , Humanos , Masculino , Hepacivirus , Estudos Transversais , Homossexualidade Masculina , HIV , Infecções por HIV/epidemiologia , Hepatite C/epidemiologia , China/epidemiologia , Atitude
2.
J Int AIDS Soc ; 26(9): e26163, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37675767

RESUMO

INTRODUCTION: While various antiretrovirals have been studied as potential candidates for long-acting pre-exposure prophylaxis (PrEP), the bimonthly injectable cabotegravir-the first long-acting form of PrEP-was approved in 2021. Event-driven (ED) PrEP has been the most prevalent dosing regimen among gay, bisexual and other men who have sex with men (GBMSM) in Taiwan, providing a unique setting to observe the preferences for long-acting PrEP in a community where the daily regimen is not the mainstream method. This study aimed to determine the preferences for the different forms and dosing intervals of long-acting PrEP that are currently in the development pipeline. METHODS: We conducted a survey in 2021 by convenience sampling the users of social networking applications for GBMSM in Taiwan. Our survey included questions on sexual behaviours, current PrEP regimens and the preferences for potential candidates of long-acting PrEP, such as implants, intramuscular and subcutaneous injections. We compared the Likert-scale preference ratings for potential long-acting options, and conducted logistic regression analysis to examine the factors associated with a preference for bimonthly intramuscular injections (2M IM) over ED and daily PrEP regimens, respectively. RESULTS: A total of 1728 responses were eligible for analysis. Three percent of respondents (n = 52) were daily PrEP users; 11.5% (n = 198) were ED PrEP users. When not considering cost, current PrEP users-regardless of their original dosing regimen-were most likely to express preferences for monthly oral PrEP, followed by a 6-month subcutaneous injectable (6M SC) and 2M IM. However, among non-current PrEP users, monthly oral PrEP was the most preferred form, followed by ED, daily oral and 6M SC injectable. Multivariable logistic regression revealed that current daily users, those willing to take PrEP in the next 6 months and those with more sex partners in the last 12 months had a significant correlation with preferences for the 2M IM injectable over the ED PrEP. CONCLUSIONS: The monthly oral form was the most preferable long-acting PrEP among GBMSM in Taiwan. Current daily PrEP users preferred the 2M IM injectable over the ED PrEP, which made the 2M IM injectable a potential alternative. Further studies should focus on how the cost and delivery affect PrEP preferences and their actual uptake.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Masculino , Humanos , Taiwan , Homossexualidade Masculina , Infecções por HIV/prevenção & controle
3.
J Med Internet Res ; 25: e45262, 2023 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-37656500

RESUMO

BACKGROUND: Men who have sex with men (MSM) in China hold a low-risk perception of acquiring HIV. This has resulted in an inadequate HIV testing rate. OBJECTIVE: This study aims to investigate whether administering HIV risk self-assessments with tailored feedback on a gay geosocial networking (GSN) app could improve HIV testing rates and reduce sexual risk behaviors in Chinese MSM. METHODS: We recruited MSM from Beijing, China, who used the GSN platform Blued in October 2017 in this 12-month double-blinded randomized controlled trial. From October 2017 to September 2018, eligible participants were randomly assigned to use a self-reported HIV risk assessment tool that provided tailored feedback according to transmission risk (group 1), access to the same HIV risk assessment without feedback (group 2), or government-recommended HIV education materials (control). All interventions were remotely delivered through the mobile phone-based app Blued, and participants were followed up at 1, 3, 6, and 12 months from baseline. The number of HIV tests over the 12-month study was the primary outcome and was assessed using an intention-to-treat analysis with an incident rate ratio (IRR). Unprotected anal intercourse (UAI) over 6 months was assessed by a modified intention-to-treat analysis and was the secondary outcome. All statistical analyses were conducted in SAS 9.3 (SAS Institute, Inc.), and a P value <.05 was considered statistically significant. RESULTS: In total, 9280 MSM were recruited from baseline and were randomly assigned to group 1 (n=3028), group 2 (n=3065), or controls (n=3187). After follow-up, 1034 (34.1%), 993 (32.4%), and 1103 (34.6%) remained in each group, respectively. Over 12 months, group 1 took 391 tests (mean of 2.51 tests per person), group 2 took 352 tests (mean of 2.01 tests per person), and controls took 295 tests (mean of 1.72 tests per person). Group 1 had significantly more HIV testing than the control group (IRR 1.32, 95% CI 1.09-4.58; P=.01), while group 2 did not differ significantly from the controls (IRR 1.06, 95% CI 0.86-1.30; P=.60). The proportion of UAI was not statistically different among different groups, but all 3 groups had UAI, which declined from baseline. CONCLUSIONS: Repeated HIV risk assessments coupled with tailored feedback through GSN apps improved HIV testing. Such interventions should be considered a simple way of improving HIV testing among MSM in China and increasing awareness of HIV status. TRIAL REGISTRATION: ClinicalTrials.gov NCT03320239; https://clinicaltrials.gov/study/NCT03320239.


Assuntos
Infecções por HIV , Aplicativos Móveis , Minorias Sexuais e de Gênero , Masculino , Humanos , Pequim , Homossexualidade Masculina , Autoavaliação (Psicologia) , China , Teste de HIV , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle
5.
PLoS One ; 18(9): e0291657, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37725628

RESUMO

BACKGROUND: Long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP) was approved by the U.S. Food and Drug Administration in December 2021. This initial phase of implementation represents a prime opportunity to ensure equitable LAI-PrEP provision to communities often underrepresented in PrEP care before disparities in access and uptake emerge. Herein, we describe the EquiPrEP Project which utilizes an equity-oriented implementation science framework to optimize LAI-PrEP rollout in an urban safety-net clinic in New York City. METHODS: The primary objectives of this project are to: (1) increase LAI-PrEP initiation overall; (2) increase uptake among groups disproportionately impacted by the HIV epidemic; (3) preserve high PrEP retention while expanding use; and (4) identify barriers and facilitators to LAI-PrEP use. EquiPrEP will enroll 210 PrEP-eligible participants into LAI-PrEP care with planned follow-up for one year. We will recruit from the following priority populations: Black and/or Latine men who have sex with men, Black and/or Latine cisgender women, and transgender women and nonbinary individuals. To evaluate implementation of LAI-PrEP, we will utilize equity-focused iterations of the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and the Consolidated Framework for Implementation Research (CFIR), in addition to longitudinal surveys and qualitative interviews. DISCUSSION: Novel LAI-PrEP formulations carry tremendous potential to revolutionize the field of HIV prevention. Implementation strategies rooted in equity are needed to ensure that marginalized populations have access to LAI-PrEP and to address the structural factors that hinder initiation and retention in care.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Estados Unidos , Masculino , Feminino , Humanos , HIV , Homossexualidade Masculina , Ciência da Implementação , Infecções por HIV/prevenção & controle
6.
J Infect Dis ; 228(Suppl 3): S168-S179, 2023 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-37703340

RESUMO

The World Health Organization has set tremendous goals to eliminate viral hepatitis by 2030. However, most countries are currently off the track for achieving these goals. Microelimination is a more effective and practical approach that breaks down national elimination targets into goals for smaller and more manageable key populations. These key populations share the characteristics of being highly prevalent for and vulnerable to hepatitis C virus (HCV) infection. Microelimination allows for identifying HCV-infected people and linking them to care more cost-effectively and efficiently. In this review, we discuss the current obstacles to and progress in HCV microelimination in special populations, including uremic patients undergoing hemodialysis, people who inject drugs, incarcerated people, people living in hyperendemic areas, men who have sex with men with or without human immunodeficiency virus (HIV) infection, transgender and gender-diverse populations, and sex workers. Scaling up testing and treatment uptake to achieve HCV microelimination may facilitate global HCV elimination by 2030.


Assuntos
Hepatite C , Minorias Sexuais e de Gênero , Masculino , Humanos , Hepacivirus , Homossexualidade Masculina , Hepatite C/epidemiologia , Hepatite C/prevenção & controle , Transporte Biológico
7.
Emerg Infect Dis ; 29(10): 2083-2092, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37703891

RESUMO

We investigated Treponema pallidum PCR positivity at mucosal sites (oral, anal, and vaginal sites) among adults who had sexual contact with a person with syphilis (syphilis contacts). All syphilis contacts had oral rinse and swab samples collected for testing. Men who have sex with men had anal swab and women had vaginal swab samples collected for testing, regardless of the presence of lesions. Of 407 persons tested, 42 (10%) had early syphilis diagnosed; of those, 19 (45%) tested positive by PCR from any anatomic site and had a positive serologic test. T. pallidum was positive from vaginal samples in 3 women, anal samples in 3 men, and oral cavity samples in 2 women and 3 men, without symptoms at those sites. Three women had no prior syphilis serologic test. T. pallidum detection at asymptomatic mucosal sites suggests early syphilis infections, particularly in cases that would conventionally be staged as latent syphilis of unknown duration.


Assuntos
Minorias Sexuais e de Gênero , Sífilis , Masculino , Adulto , Feminino , Humanos , Treponema pallidum , Sífilis/diagnóstico , Sífilis/epidemiologia , Homossexualidade Masculina , Vagina
8.
Virol J ; 20(1): 214, 2023 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-37723564

RESUMO

BACKGROUND: In May 2022, a new case of Monkeypox Virus (MPX) was reported in a non-endemic area, the United Kingdom, and since then, the number of confirmed cases in Europe has been increasing until WHO, on May 10 2023, declared that MPOX is no longer a public health emergency of international concern. We aimed to describe the clinical and microbiological characteristics of sixteen patients with a confirmed diagnosis of MPX followed by a single Italian clinical centre, the Fondazione Policlinico Universitario Agostino Gemelli, between May 20 and August 30. MATERIALS AND METHODS: A prospective observational study has been conducted, collecting microbiological samples during the time of the infection, as well as epidemiological and clinical data of the patients. All patients provided written informed consent. RESULTS: During clinical practice, 16 individuals presenting with consistent symptoms tested positive for MPX on a polymerase chain reaction. All patients were men having sex with men (MSM). The most frequent clinical presentation was a vesicular erythematous cutaneous rash, mainly distributed on the genital and perianal area, but also regarding limbs, face, neck, chest and back in some of the patients. Systemic symptoms, such as fever or lymphadenopathy, involved eight patients. The symptom most frequently reported by patients was pruritus in the area of the vesicles. Thirteen patients also reported pain. Nine patients were HIV-1 coinfected, but no significant differences have been observed compared to other cohort patients. The median time between the onset of symptoms and the healing was 19.5 days (IQR 14.0-20.3). CONCLUSIONS: Our cohort of patients presented a mild manifestation of the disease with no complications and no need for antiviral therapy nor hospitalization. This population seems different from the ones reported in the literature during the previous outbreaks in endemic areas in epidemiological data and clinical manifestations but also from a cohort of patients described in the literature from the 2022 outbreak, suggesting the importance for healthcare workers to keep in mind the possibility of an MPX infection in the differential diagnosis of patients presenting with consistent symptoms, even in non-endemic areas, to ensure efficient isolation of the patient for infection control purposes and effective management of the infection preventing the development of MPOX-related complications.


Assuntos
Varíola dos Macacos , Minorias Sexuais e de Gênero , Masculino , Humanos , Feminino , Varíola dos Macacos/diagnóstico , Varíola dos Macacos/epidemiologia , Vírus da Varíola dos Macacos/genética , Homossexualidade Masculina , Hospitais , Surtos de Doenças
9.
PLoS One ; 18(9): e0291550, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37729385

RESUMO

Gay, bisexual and other men who have sex with men (GBMSM) college students in China have unique sexual health challenges, including a higher risk of HIV infection, stigma and discrimination against LGBTQ (lesbian, gay, bisexual, transgender, and queer) population, and limited access to LGBTQ-affirmative sexual health support. Nonetheless, previous research or policymaking has rarely addressed the students' needs for sexual health support from their perspectives. This study aims to explore GBMSM college students' perceptions and attitudes to current sexual health resources, the challenges they encounter, and their expectations to acquiring LGBTQ-affirmative sexual health information and services. The exploration was carried out through field visits and in-depth interviews with 26 GBMSM college students and eight relevant stakeholders in five cities in China. Qualitative thematic analysis was applied to the interview transcripts and fieldwork memos. Four themes emerged around the preference and needs of GBMSM students in dealing with their sexual health challenges: the association between tackling sexual health challenges and entering LGBTQ communities, the roles of emotional attachment in shaping the preference for HIV-related care and support, the desired modes of acquiring sexual health support, and the current unmet service needs. We discovered that the information-and-care-seeking behaviors of GBMSM college students are highly influenced by and connected to their participation in online and in-person LGBTQ communities. Due to the overall stigmatizing sociocultural environment of LGBTQ in China, GBMSM college students tend to rely on LGBTQ communities, seeking trust and a sense of belongingness for tackling their sexual health challenges. Conventional school-based sexual health educational programs, which often apply top-down, stigma-and-fear-based, and non-LGBTQ-inclusive teaching strategies, rarely help GBMSM college students to solve sexual health problems in real life. GBMSM college students are eager to have LGBTQ-affirmative "health managers" who can understand their emotional experiences and interpersonal contexts and assist them with sexual health issues. However, such support is generally perceived as limited by the students. Our study highlights these unmet needs of the GBMSM students and emphasizes the importance of developing future LGBTQ-affirmative sexual health programs among Chinese GBMSM college students and young GBMSM in general.


Assuntos
Infecções por HIV , Saúde Sexual , Minorias Sexuais e de Gênero , Feminino , Masculino , Humanos , População do Leste Asiático , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Estudantes
10.
BMJ Open ; 13(9): e070542, 2023 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-37730414

RESUMO

OBJECTIVES: The effectiveness of HIV index testing (IT) in Eastern Europe has not been described. This study reports the performance of a scaled IT programme in Ukraine. DESIGN: This observational study included clients enrolled in IT services in 2020, and used routinely collected data from programme registers and the national electronic health record system. SETTING: The study covered 39 public-sector health facilities where IT services were integrated into medical visits for persons living with HIV (PLHIV) already enrolled in HIV care. PARTICIPANTS: Participants included PLHIV with both recent (<6 months) and previously established (≥6 months) HIV diagnoses. INTERVENTION: Ukraine's physician-led IT model involves a cascade of steps including voluntary informed consent, partner elicitation, selection of partner notification method and follow-up with clients to ensure partners are notified, tested for HIV and linked to HIV prevention and treatment services, as needed. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcomes included contact index, testing, index and HIV case-finding index disaggregated by index client (IC) subgroups, including people with current or past injection drug use (PWID) and men who have sex with men (MSM). RESULTS: Of 14 525 ICs offered index testing, 51.9% accepted, of whom 98.3% named at least one sexual, injection or biological child partner. In total, 14.9% of ICs were PWID and 3.5% were MSM. Clients named 8448 unique partners (contact index=1.14). HIV case finding averaged 0.14 cases per client, and was highest among clients with recent HIV diagnosis (0.29) and among PWID (0.23), and lower among clients with established HIV diagnosis (0.07). More than 90% of all partners with new HIV diagnoses were linked to care. CONCLUSIONS: There was a high case-finding index among ICs with recent HIV and high linkage to care for all partners, demonstrating the effectiveness of this integrated, physician-led model implemented in 39 health facilities in Ukraine.


Assuntos
Infecções por HIV , Médicos , Minorias Sexuais e de Gênero , Abuso de Substâncias por Via Intravenosa , Criança , Masculino , Humanos , Ucrânia/epidemiologia , Homossexualidade Masculina , Europa Oriental/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia
11.
Front Public Health ; 11: 1198339, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37663850

RESUMO

Introduction: Investigating the use and adherence to pre-exposure prophylaxis (PrEP) in MSM is a global health priority in the fight against HIV. Strategies must be capable of increasing usage and reaching not only the population living in the country but also those who immigrate, who face additional vulnerabilities. Based on this, in this observational, cross-sectional, and analytical study, our aim is to analyze the use of PrEP among Brazilian men who have sex with men, whether they are migrants or not. We aim to highlight preventive opportunities and strategies for the global health scenario. Methods: We utilized a sample of Brazilians living in the country and Brazilian immigrants residing in Portugal, one of the main destinations for Brazilians in recent years. To estimate the prevalence ratio (PR) of PrEP use, we employed the Poisson regression model with robust variance estimation using a covariance matrix. Results: A total of 1,117 Brazilian MSM PrEP users participated in this study, with 788 residing in Brazil and 328 in Portugal. Multivariate analysis was conducted in three stages: overall, and for subgroups of residents in Brazil and immigrants in Portugal. We identified four convergent factors that increased the prevalence of PrEP use in Brazilians regardless of migration status: having two or more casual sexual partners per month, engaging in challenging sexual practices as the receptive partner, disclosing serological status on apps, and being single. Among native Brazilians, four unique factors stood out: being in a polyamorous relationship, having sexual relations with unknown casual partners, and having higher levels of education. Discussion: This study highlights the need to implement strategies to strengthen PrEP adherence in Brazil and create international programs that facilitate its usage among populations migrating between these two countries.


Assuntos
Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Masculino , Humanos , Brasil/epidemiologia , Homossexualidade Masculina , Estudos Transversais
12.
J Coll Physicians Surg Pak ; 33(9): 983-989, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37691358

RESUMO

OBJECTIVE: To assess the level of acceptability of oral pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) and transwomen (TW) in Pakistan. STUDY DESIGN: Cross-sectional study. Place and Duration of the Study: Online study portal from September to November 2021. METHODOLOGY: The study participants were recruited through snowball sampling. Consenting individuals who were >13 years and were identified as MSM or TW were included in the study. Data were analysed using SPSS version 25. Frequencies, percentages and correlation coefficients were computed. RESULTS: A total of 347 participants were recruited. The mean age of all participants was 29.8 ± 6.7 years. Fifty-eight (19.7%) of the participants had chemsex with amphetamine-type stimulants (ATS) at least once in preceding six months of the study, and 58 (19.7%) had a sexually transmitted infection (STI) in preceding six months whereas 10 (3.4%) participants had used drugs via injection. Two hundred and thirty-eight (72%) of the participants were aware of PrEP, 30 (11.7%) had used PrEP in the past, and 3.88% were currently using PrEP. The willingness to use PrEP, free of cost, was shown by 300 participants (86.45%) and by 180 (54.5%), if available at a low cost. CONCLUSION: There was a high prevalence of risk factors posing them at considerable risk of human immunodeficiency virus (HIV). The majority was aware of PrEP for HIV prevention. The willingness to use PrEP was high when PrEP was offered free of cost but dropped down when participants were asked to pay for PrEP. Based on this finding, PrEP should be available free of cost at the community preferred outlets. KEY WORDS: Gay, Men who have sex with men, HIV, Pre-exposure prophylaxis Pakistan, Transwomen, Chemsex, People living with HIV.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Pessoas Transgênero , Masculino , Humanos , Adulto Jovem , Adulto , HIV , Homossexualidade Masculina , Estudos Transversais , Paquistão , Infecções por HIV/prevenção & controle
13.
PLoS One ; 18(9): e0289681, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37683036

RESUMO

Black men who have sex with men (MSM) continue to have the highest incidence of new human immunodeficiency virus (HIV) diagnoses in the United States but are least likely to be engaged in care or to be virally suppressed. Many Black MSM face multiple stigmas, but some have found refuge in the House Ball Community (HBC)-a national network of Black lesbian, gay, bisexual, and transgender kinship commitments that provide care-giving, affirmation, and survival skills-building for its members. We propose to modify a skills-building and HIV prevention best-evidence, group-level intervention for HIV- negative Black MSM (Many Men Many Voices) into a family-based intervention to focus on asset-building for both HIV-negative and HIV-positive Black MSM within HBC families. The adapted intervention will be re-branded as Our Family Our Voices (OFOV). We proposed a mixed-methods study to test the feasibility and preliminary efficacy of OFOV adapted for HIV status-neutral use with HBC families. First, we will develop the intervention protocol using the ADAPT-ITT model for modifying behavioral interventions. Then, we will conduct a cluster randomized controlled trial with six HBC families in New York City. Families will be randomized to the OFOV intervention or waitlist control arm. Primary outcomes will be HIV testing, HIV pre-exposure prophylaxis use, currently in HIV care and on HIV treatment. Secondary outcomes will be the number of family-based assets, resilience, number of sexual partners, and relative frequency of condomless anal intercourse. The results of the formative research, including the pilot trial, will contribute to the evidence-base regarding the development of HIV status-neutral interventions that respond to the diversity and complexities of HBC families and that recognize the importance of asset-building for facilitating HBC resilience to stigma as a part of the United States' domestic policy objective of ending the HIV epidemic by 2030.


Assuntos
Soropositividade para HIV , Minorias Sexuais e de Gênero , Humanos , Masculino , Terapia Comportamental , Homossexualidade Masculina , Ensaios Clínicos Controlados Aleatórios como Assunto , Negro ou Afro-Americano
14.
PLoS One ; 18(9): e0281793, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37683033

RESUMO

BACKGROUND: High rates of sexually transmitted infections (STIs) among men who have sex with men (MSM) have been reported, but there is little research on their STI knowledge. Our study sought to determine participants' characteristics that contribute to either high or low STI knowledge among MSM in Nairobi, Kenya. METHODS: We mobilized MSM aged ≥18 years from Nairobi into a cross-sectional study. To determine their understanding of STIs, a pre-tested structured questionnaire was administered. Knowledge score was generated by summing up the number of responses answered correctly by a participant. We dichotomized scores as "low" and "high", by splitting the group at <12 and ≥12 which was the mean. RESULTS: A total of 404 participants were interviewed between March and August 2020. The mean age was 25.2 (SD = 6.4) years. Majority were single (80.4%) and Christians (84.2%). All participants had some formal education ranging from primary to tertiary; the majority (92.3%) had secondary education or more. Most (64.0%) were employed and their monthly income ranged from <50->150 USD. Almost all (98.5%) were Kenyans. Of the 404 (90.6%) self-identified as male and (47.5%) reported to be exclusively top partners. Many (39.9%) reported being versatile, while those reporting to be bottom partners were, (12.6%). The last 12 months, (55.4%) of the participants reported having sex with men only and (88.6%) reported to have had multiple sexual partners. Participants scored an average of 12.2, SD 4.5. Multivariable backward elimination logistic regression revealed that participants who had tertiary education (aOR = 0.50, 95% CI 0.32-0.77), a higher income (aOR = 0.40, 95% CI 0.22-0.75) and were engaging in vaginal sex (aOR = 1.86, 95% CI 1.25-2.78) predicted significantly higher odds of high knowledge in the final multivariable model. CONCLUSION: Participant's knowledge level regarding STIs was low. We recommend health care workers to continue educating patients about STIs.


Assuntos
Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Feminino , Humanos , Masculino , Adolescente , Adulto , Quênia/epidemiologia , Homossexualidade Masculina , Estudos Transversais , Infecções Sexualmente Transmissíveis/epidemiologia
15.
BMC Public Health ; 23(1): 1748, 2023 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-37679765

RESUMO

Culture is an important determinant of HIV risk and protective behaviors; yet, we know little about how it is integrated in HIV interventions. This scoping review characterizes the integration of culture in HIV prevention and treatment interventions focused on Black/African Americans. We searched MEDLINE, PsycINFO, CINAHL, and Google Scholar for peer-reviewed manuscripts published between July 1, 2011, and June 28, 2021. Twenty-five interventions were identified, with 96% focused on prevention. Most (40%) targeted men who have sex with men or transgender women. Only three were grounded in cultural theory. Although all interventions were labeled "culturally based," only two explicitly defined culture. Moreover, there was much diversity regarding the ways in which interventions integrated cultural elements, with some conflating race/ethnicity with culture. To improve uptake and HIV-related outcomes, interventions integrating culture are greatly needed. Additionally, HIV interventions purporting to be "culturally based" must include basic information to support rigor and reproducibility.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Masculino , Humanos , Feminino , Negro ou Afro-Americano , Homossexualidade Masculina , Reprodutibilidade dos Testes , Infecções por HIV/prevenção & controle
16.
PLoS One ; 18(9): e0291001, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37682827

RESUMO

BACKGROUND: Understanding the dynamics of an infectious disease outbreak linked to sexual activity requires valid expectations of likely counts of unique sex partners during the infectious period. Typically, age is the key demographic trait linked to expected partner count, with many transmission models removing adults from the sexually active pool abruptly at a pre-specified age threshold. Modelling the rate of decline in partner counts with age would benefit from a better description of empirical evidence. METHODS: During the 2022 mpox epidemic in the UK, we asked individuals about their partner counts in the preceding three weeks, which is about the same as usual infectious period for persons with active mpox. We used negative binomial regression (all responses) and Weibull regression (non-zero responses) to analyse the relationship between age and partner counts, adjusted for other demographic data (such as education level and occupation), sub-dividing by three types of respondent: men who have sex with men (MSM), men who have sex with women, and women who have sex with men. RESULTS: Most respondents had zero or one recent partner, all distributions were skewed. There was a relatively linear declining relationship between age and partner counts for heterosexual partnership groups, but a peak in partner counts and concurrency for MSMs in middle age years (age 35-54), especially for MSM who seemed to be in a highly sexually active subgroup. CONCLUSION: Useful data were collected that can be used to describe sex partner counts during the British mpox epidemic and that show distinctive partner count relationships with age, dependent on partnership type.


Assuntos
Varíola dos Macacos , Minorias Sexuais e de Gênero , Adulto , Masculino , Pessoa de Meia-Idade , Feminino , Humanos , Parceiros Sexuais , Homossexualidade Masculina , Surtos de Doenças , Reino Unido/epidemiologia
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 44(8): 1264-1269, 2023 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-37661619

RESUMO

Objective: To examine the willingness of HIV non-occupational post-exposure prophylaxis (nPEP) among MSM and factors related were also assessed. Methods: The respondent-driven sampling method was used to recruit MSM for a face-to-face interview with a structured questionnaire,the sample size was estimated at 600 subjects. Demographic data, sexual behavior, awareness, and willingness regarding nPEP were collected. The factors related to willingness to nPEP were assessed using complex logistic regression. Results: A total of 14 rounds were recruited and 608 MSM subjects were included in the study. The average age was (41.6±11.0) years. 55.4% (95%CI: 49.4%-59.4%) were aware of nPEP, and 4.5% (95%CI: 2.9%-6.2%) have used its. 35.9% (95%CI: 31.1%-40.7%) expressed interest in taking nPEP if needed. Among the reasons for not being willing to take nPEP, 68.9% (244/354) were never heard of nPEP, and 24.6% (87/354) were a fluke mentality. The multivariate logistic analysis results showed that the willingness of nPEP awareness of MSM was related to the group aged 25-39 years old (aOR=1.80, 95%CI: 1.01-3.20), knowing a group of HIV prevention knowledge (aOR=2.43, 95%CI: 1.52-3.90), group of consistent condom use in anal sex in the past half of year (aOR=1.76, 95%CI: 1.11-2.79). Conclusions: The use rate of nPEP among MSM in Beijing was low, and the willingness to use in the future also needs to be improved. The training of social organizations should be strengthened to improve the role of peer education in promoting nPEP.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Masculino , Humanos , Adulto , Pessoa de Meia-Idade , Pequim , Homossexualidade Masculina , Profilaxia Pós-Exposição , Comportamento Sexual , Infecções por HIV/prevenção & controle
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 44(8): 1276-1282, 2023 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-37661621

RESUMO

Objective: To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months. Methods: MSM were recruited in nine cities of Shandong Province from April to July 2021, and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics, high-risk behaviors, and HIV testing of MSM. Blood samples were taken for serological tests of HIV and syphilis antibodies. Results: A total of 3 008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months: the fixed sexual partner group (36.83%, 1 108/3 008), the commercial sexual partner group (3.06%, 92/3 008), and casual sexual partner group (60.11%, 1 808/3 008). There were statistically significant differences in the distribution of age, local residence time, education level, the primary place to find male sexual partners, use of new-type drugs in the last six months, consistent condom use every time during same-sex anal sex in the last six months, group sex in the last six months, no HIV testing in the last six months, having had a sexually transmitted disease in the last year, receiving peer education in the last year, and frequency of syphilis testing in the last year among different groups (P<0.05). Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old (aOR=1.39, 95%CI: 1.06-1.83), married/cohabiting (aOR=1.74, 95%CI: 1.39-2.16), high school education or less (aOR=1.39, 95%CI: 1.15-1.67), had not used new-type drugs in the last six months (aOR=2.27, 95%CI: 1.89-2.71), had not received peer education in the last year (aOR=1.59, 95%CI: 1.28-1.98), had never been tested for syphilis (aOR=11.30, 95%CI: 8.15-15.66), had not been tested in the last year but had been previously tested for syphilis (aOR=5.65, 95%CI: 4.19-7.62), the type of primary sexual partner in the last six months being a commercial sexual partner (aOR=1.80, 95%CI: 1.01-3.20), and the type of primary sexual partner in the last six months being a casual sexual partner (aOR=1.50, 95%CI: 1.26-1.80). Conclusions: The characteristics of MSM with different types of primary sexual partners are different, and the proportion of HIV testing still needs to be improved. In the future, we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM, targeting the characteristics of MSM with different types of primary sexual partners.


Assuntos
Minorias Sexuais e de Gênero , Sífilis , Humanos , Masculino , Lactente , Adulto , Parceiros Sexuais , Homossexualidade Masculina , Sífilis/diagnóstico , Sífilis/epidemiologia , Cidades
19.
Zhonghua Liu Xing Bing Xue Za Zhi ; 44(8): 1290-1295, 2023 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-37661623

RESUMO

Objectives: To investigate the potential classification of quality of life in HIV-infected men who have sex with men (HIV-infected MSM) and to analyze possible influencing factors of different categories. Methods: A questionnaire survey was conducted among HIV-infected MSM who received antiretroviral treatment (ART) in an infectious disease hospital in Ji'nan, Shandong Province from October to December 2020. The quality of life scores in six domains were analyzed by latent profile analysis (LPA), and possible related factors of potential classification were explored by ordinal logistic regression analysis. Results: A total of 584 HIV-infected MSM were included in this study. LPA divided their quality of life into three categories, named low score, medium score and high score groups, accounting for 34.4% (201/584), 49.8% (291/584), and 15.8% (92/584), respectively. Multivariate ordinal logistic regression analysis showed that age above 40 years (aOR=1.77, 95%CI:1.11-2.80), monthly average income of 3 000 Yuan and below (aOR=3.15, 95%CI:1.72-5.76), monthly average income of 3 001-5 000 Yuan (aOR=2.26, 95%CI:1.41-3.62), distance to the hospital to receive drugs farer than 40 kms (aOR=1.76, 95%CI:1.07-2.89), and adverse reactions after taking drugs (aOR=2.31, 95%CI:1.65-3.23) were factors associated with low level of quality of life. Conclusions: The qualities of life of HIV-infected MSM showed group heterogeneity and were at high levels. Attention should be focused on HIV-infected MSM who are at older age, with low income, and long distance to access the health facilities. The measures should be taken to reduce the adverse reactions of ART drugs and improve the quality of life.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Masculino , Humanos , Adulto , Qualidade de Vida , Homossexualidade Masculina , Antirretrovirais , Infecções por HIV/tratamento farmacológico
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 44(8): 1321-1326, 2023 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-37661628

RESUMO

MSM are a high-risk population for HPV infection and related diseases. MSM can be effectively protected by quadrivalent and nine-valent HPV vaccines. This paper outlines the significance of providing HPV vaccination to MSM, summarizes the basis of HPV vaccination in MSM, and puts forward the following recommendations. First, China should expedite the development and approval of the HPV vaccine for male use. Second, HIV-positive MSM should vaccinate against HPV as soon as possible. Third, prioritize HPV vaccination for MSM individuals aged 26 or less. Fourth, for MSM aged over 26, catch-up vaccination or opportunistic vaccination should be provided when HPV vaccine resources are sufficient. Implementing this vaccination strategy can provide protection for the MSM and control the spread of sexually transmitted diseases.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Minorias Sexuais e de Gênero , Masculino , Humanos , Infecções por Papillomavirus/prevenção & controle , Homossexualidade Masculina , Papillomavirus Humano , Vacinação , China
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