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Le Brazidec DL, Cormier K, Almonte A, Napoleon S, Chambers LC, Tao J, Bertrand TE, Gummo CL, Beltrami J, Kinsey J, Maguire-Wilkerson A, Chan PA. Pre-Exposure Prophylaxis Care Cascade Among Men Who Have Sex with Men Engaging in Partner Notification Services at a Sexually Transmitted Infections Clinic. AIDS Res Hum Retroviruses 2024; 40:435-438. [PMID: 38497559 PMCID: PMC11251867 DOI: 10.1089/aid.2023.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
Partner notification services (PNS) offers opportunities to discuss HIV pre-exposure prophylaxis (PrEP) and provide referrals. We evaluated the PrEP care cascade among men who have sex with men (MSM) engaging in PNS within a sexually transmitted infections clinic. Among 121 MSM eligible for PrEP during PNS, 21% subsequently initiated PrEP.
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Affiliation(s)
| | - Kevin Cormier
- Brown University Warren Alpert Medical School, Providence, Rhode Island
| | - Alexi Almonte
- Infectious Diseases, Miriam Hospital, Providence, Rhode Island
| | - Siena Napoleon
- Brown University Warren Alpert Medical School, Providence, Rhode Island
| | - Laura C. Chambers
- Brown University Warren Alpert Medical School, Providence, Rhode Island
| | - Jun Tao
- Brown University Warren Alpert Medical School, Providence, Rhode Island
| | | | - Caroline L. Gummo
- State of Rhode Island Department of Health, Providence, Rhode Island
| | - John Beltrami
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennine Kinsey
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Philip A. Chan
- Brown University Warren Alpert Medical School, Providence, Rhode Island
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Nante RW, Muyinda H, Kiweewa JM, Ndagire R, Ssendikwanawa E, Ojiambo KO, Nangendo J, Nakku J, Semitala FC. Acceptance of assisted partner notification among HIV-positive adults with severe mental illness at a national referral hospital in Uganda: a cross-sectional study. BMC Health Serv Res 2024; 24:319. [PMID: 38459486 PMCID: PMC10924341 DOI: 10.1186/s12913-024-10770-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/22/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND HIV mostly affects people with severe mental illnesses (SMIs) than the general population. In 2015, the World Health Organization (WHO) introduced assisted partner notification (APN) as a strategy to increase HIV testing. Although research has demonstrated the effectiveness of APN in the general population, its use among people living with HIV (PLHIV) who have SMI is not well understood. This study sought to determine the acceptance of the APN strategy among PLHIV who had a diagnosis of SMI. METHODS This study used a cross-sectional study design that was retrospective to determine acceptance of APN among PLHIV with a documented diagnosis of SMI. We enrolled participants with a diagnosis of both HIV and SMI from August 2018 to January 2022, attending the HIV clinic at Butabika Hospital. We used pretested questionnaires to extract participants' demographic and clinical data from their existing clinical charts, antiretroviral therapy (ART) registers and APN registers. We defined acceptance of APN as the number of PLHIV with SMI diagnoses who agreed to provide information about their sexual partners. We used modified Poisson regression analysis to assess the factors associated with the acceptance of APN. RESULTS A total of 125 participants were enrolled, of whom 83 (66.4%) were female. The median age was 30 (interquartile range (IQR) (25-34)), and 41 (33%) of them accepted APN (95% CI: 25.05-41.61). Receipt of at least three counselling sessions before enrollment in APN (aPR = 1.8, 95% CI: 1.72-1.98) was the most significant factor associated with increased acceptance of APN. Poor adherence to ART (aPR = 0.62, 95% CI: 0.54-0.80), being escorted to hospital by a distant relative (aPR = 0.55, 95% CI: 0.39-0.80), being married/cohabiting (aPR = 0.65, 95% CI: 0.60-0.81), and being a Seventh Day Adventist (SDA) (aPR = 0.53, 95% CI: 0.45-0.71) or Pentecostal (aPR = 0.44, 95% CI: 0.22-0.98) by faith were associated with reduced acceptance of APN. CONCLUSION AND RECOMMENDATION The acceptance of APN is low among PLHIV with a diagnosis of SMI. More structured counselling would facilitate earlier identification of undiagnosed HIV-positive partners. We recommend a follow-up study to compare acceptance of APN among PLHIV with SMI and those without SMI.
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Affiliation(s)
- Rachel Wangi Nante
- Clinical Epidemiology Unit, Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
- Africa Centre for Systematic Reviews and Knowledge Translation, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Herbert Muyinda
- Child Health and Development Centre (CHDC), College of Health Sciences, Makerere University, Kampala, Uganda
| | - John M Kiweewa
- Education Department, Fairfield University, Fairfield, CT, USA
| | - Regina Ndagire
- Clinical Epidemiology Unit, Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Africa Centre for Systematic Reviews and Knowledge Translation, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Emmanuel Ssendikwanawa
- Clinical Epidemiology Unit, Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Kevin Ouma Ojiambo
- Clinical Epidemiology Unit, Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Africa Centre for Systematic Reviews and Knowledge Translation, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joanita Nangendo
- Clinical Epidemiology Unit, Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Juliet Nakku
- Butabika National Referral Mental Hospital, Kampala, Uganda
| | - Fred C Semitala
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Mulago Immune Suppression Syndrome Clinic, Mulago National Referral Hospital, Kampala, Uganda
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Silva VGFD, Nogueira ILA, Elias TMN, Reis RK, Souza NLD, Menezes RMPD. HIV serodiscordant sexual partners: social representations of health care professionals. Rev Bras Enferm 2022; 75:e20210867. [PMID: 35766755 DOI: 10.1590/0034-7167-2021-0867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 03/21/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to understand the structure of the social representations of health professionals from HIV/AIDS Specialized Care Services about HIV-positive partners. METHODS this is a qualitative study, based on the structural aspect of Social Representations, developed in specialized services of the metropolitan area of a state in the Northeast Region. Fifty-one professionals were interviewed using the technique of free association of words, processed by the software IRaMuTeQ, by means of prototypical and similarity analysis. RESULTS the central nucleus was constituted by the terms "partnership", "love" and "fear", showing appreciation of meanings inherent to their beliefs, values and experiences that bring possibilities of reflections for health practices. FINAL CONSIDERATIONS the findings reinforce the impacts generated in the different segments of the lives of people living with HIV and in their emotional bonds. This highlights the need for the implementation of care strategies contemplating the biopsychosocial care model rather than the biological model.
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Affiliation(s)
| | | | | | | | - Nilba Lima de Souza
- Universidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil
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Silva VGFD, Nogueira ILA, Elias TMN, Reis RK, Souza NLD, Menezes RMPD. Parceiros sexuais sorodiferentes quanto ao HIV: representações sociais dos profissionais de serviços de saúde. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0867pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivos: apreender a estrutura das representações sociais de profissionais de saúde dos Serviços de Assistência Especializada HIV/aids sobre os parceiros que vivem em sorodiferença quanto ao HIV. Métodos: estudo qualitativo, fundamentado na vertente estrutural das Representações Sociais, desenvolvido em serviços especializados da região metropolitana de um estado da Região Nordeste. Entrevistaram-se 51 profissionais com aplicação da técnica de associação livre de palavras, processadas pelo software IRaMuTeQ, mediante análise prototípica e de similitude. Resultados: o núcleo central foi constituído pelos termos “parceria”, “amor” e “medo”, evidenciando valorização de sentidos inerentes às suas crenças, valores e experiências que trazem possibilidades de reflexões para as práticas de saúde. Considerações Finais: os achados reforçam os impactos gerados nos diferentes segmentos da vida das pessoas que vivem com o HIV e em seus vínculos afetivos. Isso ressalta a necessidade da implementação de estratégias assistenciais contemplando o modelo de cuidado biopsicossocial em detrimento do modelo biológico.
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Kimani M, van der Elst EM, Chirro O, Wahome E, Ibrahim F, Mukuria N, de Wit TFR, Graham SM, Operario D, Sanders EJ. "I wish to remain HIV negative": Pre-exposure prophylaxis adherence and persistence in transgender women and men who have sex with men in coastal Kenya. PLoS One 2021; 16:e0244226. [PMID: 33465090 PMCID: PMC7815127 DOI: 10.1371/journal.pone.0244226] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 12/06/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Transgender women (TGW) and men who have sex with men (MSM) in sub-Saharan Africa have high HIV acquisition risks and can benefit from daily pre-exposure prophylaxis (PrEP). We assessed PrEP adherence by measuring tenofovir-diphosphate (TFV-DP) levels and explore motives for PrEP persistence in TGW and MSM. METHODS Participants were enrolled in a one-year PrEP programme and made quarterly visits irrespective of whether they were still using PrEP. At their month 6 visit, participants provided a dried blood spot to test for TFV-DP levels; protective levels were defined as those compatible with ≥4 pills per week (700-1249 fmol/punch). Before TFV-DP levels were available, a sub-set of these participants were invited for an in-depth interview (IDI). Semi-structured IDI topic guides were used to explore motives to uptake, adhere to, and discontinue PrEP. IDI data were analyzed thematically. RESULTS Fifty-three participants (42 MSM and 11 TGW) were enrolled. At month 6, 11 (20.7%) participants (8 MSM and 3 TGW) were lost to follow up or stopped taking PrEP. Any TFV-DP was detected in 62.5% (5/8) of TGW vs. 14.7% of MSM (5/34, p = 0.01). Protective levels were detected in 37.5% of TGW (3/8), but not in any MSM. Nineteen IDI were conducted with 7 TGW and 9 MSM on PrEP, and 1 TGW and 2 MSM off PrEP. Unplanned or frequent risky sexual risk behaviour were the main motives for PrEP uptake. Among participants on PrEP, TGW had a more complete understanding of the benefits of PrEP. Inconsistent PrEP use was attributed to situational factors. Motives to discontinue PrEP included negative reactions from partners and stigmatizing healthcare services. CONCLUSION While MSM evinced greater adherence challenges in this PrEP programme, almost 40% of TGW were protected by PrEP. Given high HIV incidences in TGW these findings hold promise for TGW PrEP programming in the region.
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Affiliation(s)
- Makobu Kimani
- KEMRI-Wellcome Trust Research Program, Kilifi, Kenya
| | | | - Oscar Chirro
- KEMRI-Wellcome Trust Research Program, Kilifi, Kenya
| | | | - Fauz Ibrahim
- Department of Health, Kilifi County, Kilifi, Kenya
| | - Nana Mukuria
- KEMRI-Wellcome Trust Research Program, Kilifi, Kenya
| | - Tobias F Rinke de Wit
- Department of Global Health, Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, Netherlands
| | - Susan M Graham
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Don Operario
- Department of Public Health, Brown University, Providence, Rhode Island, United States of America
| | - Eduard J Sanders
- KEMRI-Wellcome Trust Research Program, Kilifi, Kenya.,Nufield Department of Medicine, Oxford University, Oxford, United Kingdom
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Katz DA, Wong VJ, Medley AM, Johnson CC, Cherutich PK, Green KE, Huong P, Baggaley RC. The power of partners: positively engaging networks of people with HIV in testing, treatment and prevention. J Int AIDS Soc 2019; 22 Suppl 3:e25314. [PMID: 31321909 PMCID: PMC6639670 DOI: 10.1002/jia2.25314] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 05/15/2019] [Indexed: 01/09/2023] Open
Affiliation(s)
- David A Katz
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
| | - Vincent J Wong
- Global Health BureauOffice of HIV/AIDSUnited States Agency for International Development (USAID)WashingtonDCUSA
| | - Amy M Medley
- Division of Global HIV and TBCenter for Global HealthU.S. Centers for Disease Control and Prevention (CDC)AtlantaGAUSA
| | | | - Peter K Cherutich
- National AIDS/Sexually Transmitted Diseases Control ProgrammeMinistry of HealthNairobiKenya
| | | | - Phan Huong
- Vietnam Authority of HIV/AIDS Control, Ministry of HealthHanoiVietnam
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