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Zheng Y, Ying M, Zhou Y, Lin Y, Ren J, Wu J. Global Burden and Changing Trend of Hepatitis C Virus Infection in HIV-Positive and HIV-Negative MSM: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:774793. [PMID: 34966758 PMCID: PMC8710739 DOI: 10.3389/fmed.2021.774793] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The disease burden of hepatitis C virus (HCV) infection in HIV-positive and HIV-negative men who have sex with men (MSM) is changing. We aim to provide an updated comprehensive estimate of HCV prevalence and incidence among the HIV-positive and HIV-negative MSM population at the country, regional, and global levels and their changing trends over time. Methods: PubMed, Embase, PsycINFO, CINAHL, and conference databases were searched and eligible records on the prevalence and incidence of HCV antibodies were selected and pooled via a random-effects model. Meta-regression was performed to demonstrate the association between the pooled rates and study year. Results: A total of 230 articles reporting 245 records from 51 countries with 445,883 participants and 704,249 follow-up person-years were included. The pooled prevalence of HCV in MSM was 5.9% (95% CI: 5.1-6.8), with substantial differences between countries and regions. Low- and lower-middle-income countries (12.3 and 7.0%) manifested a larger disease burden than high- and upper-middle-income countries (5.8 and 3.8%). HCV prevalence in HIV-positive MSM was substantially higher than in HIV-negative MSM (8.1 vs. 2.8%, p < 0.001). The pooled incidence of HCV was 8.6 (95% CI: 7.2-10.0) per 1,000 person-years, with an increasing trend over time, according to meta-regression (p < 0.05). Conclusion: Global HCV prevalence in MSM varies by region and HIV status. Behavior counseling and regular HCV monitoring are needed in HIV-positive subgroups and high-risk regions. Given the upward trend of HCV incidence and sexual risk behaviors, there is also a continued need to reinforce risk-reduction intervention. Systematic Review Registration: PROSPERO, identifier CRD42020211028; https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Yang Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Meike Ying
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuqing Zhou
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Respiratory Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yushi Lin
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jingjing Ren
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Clatts MC, Goldsamt LA, Giang LM, Quôc Báo L, Yu G, Colby D. Sexually transmissible infection and HIV prevention and treatment for young male sex workers in Vietnam: findings from the SHEATH intervention. Sex Health 2018; 13:575-581. [PMID: 27607764 DOI: 10.1071/sh16051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 07/05/2016] [Indexed: 01/02/2023]
Abstract
Background Urban centres in Vietnam have high rates of HIV infection, especially among men who have sex with men (MSM). A subgroup of MSM, young male sex workers (YMSW), are at especially high risk due to concurrent sex with multiple male and female partners, low levels of knowledge regarding HIV and sexually transmissible infection (STI) transmission, and limited engagement with health services, including STI and HIV screening and treatment. METHODS A targeted intervention (SHEATH) derived from Harm Reduction and Sexual Health Promotion intervention technology was implemented in an out-of-treatment population of YMSW in Hanoi and Ho Chi Minh City (n=919). RESULTS YMSW reported high levels of satisfaction with each of the seven core modules within the intervention and for the intervention as a whole. The intervention conferred significant benefit in relation to improved knowledge of STI and HIV transmission (P<0.001). Although only 36% of participants had seen a healthcare provider in the past year, following the intervention 81% intended to see one in the next 6 months. Similarly, although 71% of participants did not disclose that they were MSM the last time they visited a healthcare provider, following the intervention 71% intended to do so at their next visit. High rates of STIs (>10%) and HIV (9.5%) were also found. CONCLUSION The data show that the SHEATH intervention can be implemented in this population and setting, is met with high rates of acceptability, and positively impacts STI and HIV knowledge and multiple health services outcomes (including knowledge of HIV status and disposition towards habituation of HIV screening).
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Affiliation(s)
- Michael C Clatts
- School of Public Health, PO Box 365067, University of Puerto Rico Medical Science Center, San Juan 00936, Puerto Rico
| | - Lloyd A Goldsamt
- New York University College of Nursing, 433 First Avenue, New York, NY 10010, USA
| | - Lê Minh Giang
- Center for Research and Training on HIV/AIDS, 1 Tôn Thât Tùng Street, Room 601, Building A1, Hanoi Medical University, Hanoi, Vietnam
| | - Lê Quôc Báo
- Center for AIDS Research on Men and Community Health (CARMAH), 51-53 Võ Vãn Tân Street (KM Plaza), Ho Chi Minh City, Vietnam
| | - Gary Yu
- New York University College of Nursing, 433 First Avenue, New York, NY 10010, USA
| | - Donn Colby
- Center for AIDS Research on Men and Community Health (CARMAH), 51-53 Võ Vãn Tân Street (KM Plaza), Ho Chi Minh City, Vietnam
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Biello KB, Thomas BE, Johnson BE, Closson EF, Navakodi P, Dhanalakshmi A, Menon S, Mayer KH, Safren SA, Mimiaga MJ. Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India. AIDS Care 2016; 29:231-238. [PMID: 27397549 DOI: 10.1080/09540121.2016.1204421] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Male sex workers (MSW) are a significant but invisible population in India who are at risk for HIV/sexually transmitted infections (STIs). Few studies from India have documented HIV risk factors and motivations for sex work in this population. Between 2013 and 2014, a community-based convenience sample of 100 MSW in Chennai (south India) completed a baseline risk assessment as part of a behavioral intervention. Participants were ≥18 years, and reported current sex work. We report medians and proportions, and Wilcoxon-Mann-Whitney and chi-square tests are used to examine differences between sex work and sexual behavior measures by income source. Participants were engaged in sex work for 5.0 years (IQR = 2.3-10.0), and earned 3000 (IQR = 2000-8000) Rupees (<50 USD) per month from sex work. Sixty-four percent reported ever testing for HIV and 20.2% for any STI. The most common reasons for starting sex work were money (83.0%) and pleasure (56.0%). Compared to participants with an additional source of income, those whose only source of income was sex work reported more male clients in the past month (10.0 vs. 6.0, p = .017), as well as more condomless anal sex acts with male clients (8.0 vs. 5.0, p = .008). Nearly 70.0% were offered more money not to use a condom during sex with a client, and 74.2% reported accepting more money not to use a condom. Three-quarters reported having experienced difficulty using condoms with clients. MSW in India engage in high levels of sexual risk for HIV/STIs. Money appears to be a driving factor for engaging in sex work and condomless sex with clients. HIV prevention interventions with MSW should focus on facilitating skills that will support their ability to negotiate sexual safety in the context of monetary disincentives.
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Affiliation(s)
- Katie B Biello
- a Institute for Community Health Promotion, Brown University , Providence , RI , USA.,b Departments of Behavioral & Social Sciences and Epidemiology , Brown University School of Public Health , Providence , RI , USA.,c The Fenway Institute, Fenway Health , Boston , MA , USA
| | - Beena E Thomas
- d National Institute for Research in Tuberculosis (NIRT) , Chennai , India
| | - Blake E Johnson
- c The Fenway Institute, Fenway Health , Boston , MA , USA.,e Department of Epidemiology , Harvard T. H. Chan School of Public Health , Boston , MA , USA
| | | | | | - A Dhanalakshmi
- d National Institute for Research in Tuberculosis (NIRT) , Chennai , India
| | | | - Kenneth H Mayer
- c The Fenway Institute, Fenway Health , Boston , MA , USA.,g Division of Infectious Diseases , Harvard Medical School/Beth Israel Deaconess Medical Center , Boston , MA , USA.,h Department of Global Health and Population , Harvard T. H. Chan School of Public Health , Boston , MA , USA
| | - Steven A Safren
- c The Fenway Institute, Fenway Health , Boston , MA , USA.,h Department of Global Health and Population , Harvard T. H. Chan School of Public Health , Boston , MA , USA.,i Department of Psychology , University of Miami , Coral Gables , FL , USA
| | - Matthew J Mimiaga
- a Institute for Community Health Promotion, Brown University , Providence , RI , USA.,b Departments of Behavioral & Social Sciences and Epidemiology , Brown University School of Public Health , Providence , RI , USA.,c The Fenway Institute, Fenway Health , Boston , MA , USA
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Oldenburg CE, Perez-Brumer AG, Reisner SL, Mattie J, Bärnighausen T, Mayer KH, Mimiaga MJ. Global burden of HIV among men who engage in transactional sex: a systematic review and meta-analysis. PLoS One 2014; 9:e103549. [PMID: 25068720 PMCID: PMC4113434 DOI: 10.1371/journal.pone.0103549] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 06/29/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Men who engage in transactional sex, the exchange of sex for money, goods, or other items of value, are thought to be at increased risk of HIV, but there have been no systematic attempts to characterize HIV burden in this population. We undertook a systematic review and meta-analysis to quantify the burden in this population compared with that of men in the general population to better inform future HIV prevention efforts. METHODS We searched seven electronic databases, national surveillance reports, and conference abstracts for studies of men who engage in transactional sex published between 2004-2013. Random effects meta-analysis was used to determine pooled HIV prevalence and prevalence ratios (PR) for the difference in HIV prevalence among men who engage in transactional sex as compared to general population men. FINDINGS Of 66 studies included representing 31,924 men who had engaged in transactional sex in 28 countries, pooled biological assay-confirmed HIV prevalence was 10.5% (95% CI = 9.4 to 11.5%). The highest pooled HIV prevalence was in Sub-Saharan Africa (31.5%, 95% CI = 21.6 to 41.5%), followed by Latin America (19.3%, 95% CI = 15.5 to 23.1%), North America (16.6%, 95% CI = 3.7 to 29.5%), and Europe (12.2%, 95% CI = 6.0 to 17.2%). Men who engaged in transactional sex had an elevated burden of HIV compared to the general male population (PR = 20.7, 95% CI = 16.8 to 25.5). CONCLUSIONS The global burden of HIV is disproportionately high among men who engage in transactional sex compared with the general male population. There is an urgent need to include this population in systematic surveillance as well as to scale-up access to quality HIV prevention programs.
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Affiliation(s)
- Catherine E. Oldenburg
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- The Fenway Institute, Fenway Community Health, Boston, Massachusetts, United States of America
| | - Amaya G. Perez-Brumer
- Department of Sociomedical Sciences, Columbia Mailman School of Public Health, New York, New York, United States of America
| | - Sari L. Reisner
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- The Fenway Institute, Fenway Community Health, Boston, Massachusetts, United States of America
| | - Jason Mattie
- The Fenway Institute, Fenway Community Health, Boston, Massachusetts, United States of America
| | - Till Bärnighausen
- Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Africa Centre for Health and Population Science, Mtubatuba, South Africa
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Community Health, Boston, Massachusetts, United States of America
- Department of Medicine, Beth Israel Deaconess, Boston, Massachusetts, United States of America
| | - Matthew J. Mimiaga
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- The Fenway Institute, Fenway Community Health, Boston, Massachusetts, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
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Oldenburg CE, Biello KB, Colby D, Closson EF, Nguyen T, Trang NN, Lan HX, Mayer KH, Mimiaga MJ. Engagement with peer health educators is associated with willingness to use pre-exposure prophylaxis among male sex workers in Ho Chi Minh City, Vietnam. AIDS Patient Care STDS 2014; 28:109-12. [PMID: 24601733 DOI: 10.1089/apc.2013.0372] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Katie B. Biello
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- The Fenway Institute, Fenway Community Health Boston, Massachusetts
| | - Donn Colby
- Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam
- Center for Applied Research on Men and Health, Ho Chi Minh City, Vietnam
| | | | - Thi Nguyen
- Harvard Medical School AIDS Initiative in Vietnam, Ho Chi Minh City, Vietnam
| | - Nguyen N.N. Trang
- Centre for Promotion of Quality of Life (Life Centre), Ho Chi Minh City, Vietnam
| | - Hang X. Lan
- Centre for Promotion of Quality of Life (Life Centre), Ho Chi Minh City, Vietnam
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Community Health Boston, Massachusetts
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
- Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts
| | - Matthew J. Mimiaga
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- The Fenway Institute, Fenway Community Health Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts
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