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Zeng W, Luo Y, Liu F, Han Z, Zhan L, Lu Y, Cai Y, Xu H, Gu Y. Impact of Awareness of Sexual Partners' HIV Serostatus on the HIV Acquisition among Men Who Have Sex with Men in Guangzhou, China: A Nested Case-Control Study. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:3655-3662. [PMID: 39152320 DOI: 10.1007/s10508-024-02971-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 05/24/2024] [Accepted: 07/30/2024] [Indexed: 08/19/2024]
Abstract
This study aimed to investigate the impact of sexual partners' HIV serostatus awareness on the HIV acquisition among men who have sex with men (MSM) in Guangzhou, China. A nested case-control study was conducted based on a prospective cohort of MSM in Guangzhou. Within the cohort, individuals who underwent HIV seroconversion were identified as the case group, and each case was matched with four controls from the non-seroconverted participants. Information regarding the awareness of sexual partners' HIV serostatus over the preceding 6 months was gathered. Of the 161 participants, 36.0% were aware of the HIV serostatus of all their sexual partners. The practice of engaging in condomless anal sex with partners of unknown HIV serostatus and being aware of the HIV serostatus of only some casual partners were positively correlated with an elevated risk of acquiring HIV. Conversely, being fully aware of the HIV serostatus of all sexual partners, including regular ones, was associated with a diminished risk of HIV incidence. Regular communication with sexual partners regarding HIV testing outcomes, honest disclosure of one's own HIV serostatus, and refusal of sexual contact with partners of unknown HIV serostatus can potentially mitigate the risk of acquiring HIV among MSM.
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Affiliation(s)
- Wenting Zeng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
- Huangpu District Center for Disease Control and Prevention, Guangzhou, China
| | - Yefei Luo
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Fanghua Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Zhigang Han
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Lishan Zhan
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Yongheng Lu
- Lingnan Partner Community Support Center, Guangzhou, China
| | - Yanshan Cai
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Huifang Xu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
- Guangdong Association of STD and AIDS Prevention and Control, Guangzhou, China
| | - Yuzhou Gu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China.
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Truong HHM, Fatch R, Ogolla D, Otieno B, Amboka S, Kadede K, Cohen CR, Bukusi EA, Guzé MA. Respondent-driven sampling to recruit adolescents in Kenya. Ann Epidemiol 2023; 78:68-73. [PMID: 36509343 PMCID: PMC10789922 DOI: 10.1016/j.annepidem.2022.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 10/21/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Respondent-driven sampling (RDS) uses long-chain referral whereby members of the target population recruit other members. We describe the use of RDS for a mixed-methods sexual and reproductive health (SRH) study in Kisumu, Kenya. METHODS Initial seeds for the cross-sectional surveys were selected from adolescents aged 15-19 residing in urban informal settlements. Participants were provided up to five referral coupons to distribute. RESULTS Across four communities, 18 seeds were selected, 13,489 coupons distributed, and 3381 adolescents referred, yielding a 25% coupon return rate. We enrolled 3061 participants for a 23% survey rate. Median referral lag time was three days (IQR 1, 7). Demographic characteristics reached equilibrium between recruitment waves 5 to 8 in three communities, and waves 7 to 15 in the fourth. CONCLUSIONS Our study demonstrated that RDS is a feasible and efficient approach for recruiting a large sample of adolescents. Though our research focused on SRH, many adolescents residing in the impoverished urban environments where our study was implemented also experience food insecurity, housing instability and violence. RDS can therefore be a valuable recruitment approach for future studies to reach vulnerable adolescents and design interventions that address the variety of health-related challenges that affect this underserved population.
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Affiliation(s)
- Hong-Ha M Truong
- University of California San Francisco, San Francisco, California, USA.
| | - Robin Fatch
- University of California San Francisco, San Francisco, California, USA
| | | | | | - Sayo Amboka
- Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Craig R Cohen
- University of California San Francisco, San Francisco, California, USA
| | | | - Mary A Guzé
- University of California San Francisco, San Francisco, California, USA
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Truong HHM, Fatch R, McFarland W, Grasso M, Raymond HF, Holt M, Steward WT. Destination-Specific and Home Environment Condom Norms Influence Sexual Behavior During Travel. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:245-255. [PMID: 35647868 PMCID: PMC10654111 DOI: 10.1521/aeap.2022.34.3.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Travelers may adapt HIV risk-reduction practices based on perceived destination-specific norms. We examined the association between perceived condom norms and condomless anal sex (CAS) during international and domestic travel and in the home environment among men who have sex with men. Men who traveled internationally in the past 12 months were recruited by respondent-driven sampling (N = 501). Not knowing destination-specific condom norms was significantly associated with less CAS during international travel and in the home environment but not during domestic travel. Perceiving home environment condom norms to expect use of condoms was significantly associated with less CAS during domestic but not international travel. Men were less likely to engage in CAS during international travel when destination-specific condom norms were unknown. Unfamiliarity with the environment and culture may influence some men to refrain from higher-risk behaviors. During domestic travel, some men appeared to apply home environment condom norms, which may be erroneous in some situations and pose an HIV risk.
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Affiliation(s)
| | | | - Willi McFarland
- University of California San Francisco
- California Department of Public Health
| | | | | | - Martin Holt
- University of New South Wales, Sydney, Australia
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Dennermalm N, Scarlett J, Thomsen S, Persson KI, Alvesson HM. Sex, drugs and techno - a qualitative study on finding the balance between risk, safety and pleasure among men who have sex with men engaging in recreational and sexualised drug use. BMC Public Health 2021; 21:863. [PMID: 33952247 PMCID: PMC8097859 DOI: 10.1186/s12889-021-10906-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 04/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recreational and sexual drug use among men who have sex with men may result in increased risk of poor health. The aim of this study was to better understand drug use and harm reduction techniques among Swedish men who have sex with men traveling to Berlin in order to improve the health of this population and inform public health strategies. METHODS A qualitative study based on semi-structured interviews with 15 Swedish men aged 23-44 with experience of drug use were recruited through network sampling. Interviews were conducted in Stockholm and Berlin and analysed using content analysis. The interview guide included questions on drug use, context, health and safety. RESULTS The participants engaged in drug use in both settings and in various contexts. Participants saw themselves as capable of finding a balance between pleasure, safety and risk with the aim to maximize positive effects while minimizing negative ones. The different risks of drug use were known, and participants relied on knowledge, harm reduction strategies and self-defined rules of intake to stay safe and healthy in a broad sense, both short term (i.e. during each session) and long term. Choice of drug and, frequency of intake, multi-use, risk of overdose, risk of HIV, purpose and context of use, how often, etc. were all part of the overall strategy. Knowledge of these methods was spread within the community and on-line rather than from counsellors or other health care providers. However, it did not always translate perfectly into practice and some had experienced overdoses and problematic use. CONCLUSIONS The findings of this study point to the need for increased adoption of harm reduction techniques in this population focusing on mitigating harm and prevention of risk of problematic use or starting injection drugs. Existing traditional services require adaptations to become more accessible and acceptable to sub-groups of drug users, including low-threshold services providing non-judgemental, evidence-based information. This will require funding of alternative providers such as STI/HIV clinics, among others, and health care providers to increase adoption of prevention strategies, specifically pre-exposure prophylaxis for HIV.
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Affiliation(s)
- Nicklas Dennermalm
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden. .,Department of Social Work, Stockholm University, Sveavägen 160, 113 46, Stockholm, Sweden.
| | - Julia Scarlett
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Sarah Thomsen
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
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Truong HHM, Mehrotra ML, Grant RM. Brief Report: Seroadaptive Behaviors Varied Among Geographically Diverse iPrEx Participants. J Acquir Immune Defic Syndr 2021; 86:e43-e47. [PMID: 33093331 DOI: 10.1097/qai.0000000000002551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/14/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Seroadaptive behaviors refer to a wide range of harm reduction practices to decrease HIV transmission risk. Effective implementation of seroadaptive behaviors is dependent on knowledge of one's own serostatus and that of one's sexual partners. Partner-level and environmental-level attributes may affect seroadaptation practices. We assessed factors associated with seroadaptive behaviors. METHODS Men who have sex with men and transgender women were recruited from an HIV pre-exposure prophylaxis clinical trial (iPrEx) with study sites in the US, Peru, Ecuador, Brazil, Thailand, and South Africa. Partnership-level data were collected at the baseline visit for the 3 most recent partners. Participants were considered to have practiced seroadaptive behaviors if: (1) they believed their partner to be HIV-negative, that is, serosorting; or (2) no condomless receptive sex occurred with an HIV-positive or unknown status partner, that is, seropositioning. RESULTS Of 2331 participants, 41% always practiced seroadaptive behaviors, 36% sometimes did, and 23% never did. Participants enrolled at study sites in the US (P < 0.001) and Peru/Ecuador (P < 0.001) were more likely to practice seroadaptive behaviors, whereas transgender women were less likely to do so (P < 0.001). Seroadaptive behaviors were more likely to occur in relationships with steady partners (P = 0.005) and emotionally close relationships (P = 0.013). CONCLUSIONS Seroadaptive behaviors were more frequently observed among iPrEx participants from the US, Peru, and Ecuador study sites and among participants in relationships with partners who they were more committed to and felt emotionally close to. Our findings suggest that seroadaptive behaviors may be influenced by social norms that vary geographically and culturally.
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Affiliation(s)
| | - Megha L Mehrotra
- Epidemiology and Biostatistics, University of California, San Francisco, CA
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Sex Tourism, Condomless Anal Intercourse, and HIV Risk Among Men Who Have Sex With Men. J Assoc Nurses AIDS Care 2020; 30:405-414. [PMID: 31241505 DOI: 10.1097/jnc.0000000000000018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Sex tourism affects the sexual health of tourists and locals with whom they interact. However, a few studies have examined whether sex tourism is a risk factor for the acquisition of HIV and other sexually transmitted infections among men who have sex with men, and no such studies have been conducted in Western Europe. Almost 28% of our respondents reported engaging in sex tourism in their lifetime. Sex tourism was associated with an elevated risk of engagement in condomless receptive anal intercourse, use of alcohol/drugs during sex, participation in group sex, and an elevated risk of diagnosis with any type of sexually transmitted infection over the previous year, specifically gonorrhea and chlamydia. Research with men who have sex with men who engage in sex tourism should explore high-risk sexual behavior during sex tourism and also the feasibility and acceptability of the use of episodic pre-exposure prophylaxis for short periods of participation in elevated risk behaviors by tourists and local sex partners.
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Dennermalm N, Ingemarsdotter Persson K, Thomsen S, Forsberg BC. "You can smell the freedom": a qualitative study on perceptions and experiences of sex among Swedish men who have sex with men in Berlin. BMJ Open 2019; 9:e024459. [PMID: 31201183 PMCID: PMC6576123 DOI: 10.1136/bmjopen-2018-024459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
PURPOSE The purpose of this study was to explore the perceptions and experiences of sex among Swedish Men who have Sex with Men (MSM) in Berlin. BACKGROUND MSM are disproportionally affected by HIV.Berlin is also a key destination when looking into where Swedish MSM sero-convert, while travelling. METHOD A qualitative study with semi-structured interviews using open-ended questions with participants recruited through network sampling. Data were analysed with content analysis. PARTICIPANTS 15 Swedish cis-men (as in non-transgender) who have sex with men aged 25-44 years, who travelled to or were living in Berlin. To be included in the study, the participants had to be cis-MSM, Swedish citizens, spending time in Berlin and having sex in both settings. RESULTS For a majority of the participants, sex was the main reason for going to Berlin but cultural aspects like art and the techno scene were also important. Berlin was perceived as a sex-oriented city providing venues where respondents did not have to care about reputation and status and where social and sexual spaces co-existed side by side. This in sharp contrast to Sweden, which represented a limiting environment both in culture and what was available culturally and sexually. CONCLUSION The men interviewed experienced multiple partners and had a broad sexual repertoire both abroad and at home. However, the behaviour was amplified in Berlin. The men did not alter their safer sex practice depending on if they had sex in Sweden or Berlin. The high mobility and vulnerability for HIV/sexually transmitted infection (STI) among these men highlights the need of increased access to antiretroviral treatment, pre-exposure prophylaxis for HIV and low-threshold HIV/STI testing services in Europe.
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Affiliation(s)
- Nicklas Dennermalm
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Kristina Ingemarsdotter Persson
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
- Department of Communicable Disease Control and Health Protection, Unit for Sexual Health and HIV Prevention, Public Health Agency of Sweden, Solna, Sweden
| | - Sarah Thomsen
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Birger C Forsberg
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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Adedimeji A, Sinayobye JD, Asiimwe-Kateera B, Chaudhry J, Buzinge L, Gitembagara A, Murenzi G, Mugenzi P, Patel VV, Castle PE, Mutesa L, Palefsky J, Anastos KM. Social contexts as mediator of risk behaviors in Rwandan men who have sex with men (MSM): Implications for HIV and STI transmission. PLoS One 2019; 14:e0211099. [PMID: 30657797 PMCID: PMC6338414 DOI: 10.1371/journal.pone.0211099] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/08/2019] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Men who have sex with men (MSM) are disproportionately impacted by HIV/AIDS resulting from risky sexual behaviors. Social and contextual factors are known to mediate risk behaviors, but there is limited information about the prevalence of risky sexual practices of Rwandan MSM and the concomitant socio-contextual determinants making it difficult to assess implications for preventing HIV/STI transmission in this key population. METHODS Using exploratory qualitative design, we obtained socio-contextual information regarding prevalence of risky sexual behavior and assessed implications for HIV/ STIs transmission and preventive measures taken by MSM to improve sexual health and wellbeing. Thirty MSM were recruited to participate in in-depth interviews using respondent-driven sampling from LGBT associations in Kigali. Data were analyzed using standard qualitative data analysis procedures. RESULTS Respondents' were between 18-40 years old; all completed primary education and are mostly low-socioeconomic status. Risky sexual practices were common, but differed by peculiar individual and contextual factors. Older MSM often reported occasional sexual relations with women to avoid suspicion and social stigma. Younger MSM's risky sexual practices are mostly transactional and mediated by the need for social acceptance and support. Knowledge of STIs was poor, but prevalence, especially of HPV was high. The options for improving sexual wellbeing are limited and mostly clandestine. CONCLUSION Risky sexual behavior of Rwandan MSM has major implications for HIV/STI transmission. An environment of intense social stigma and social isolation makes it difficult to obtain information or services to improve sexual health. Effective interventions that address individual and contextual determinants of risk and access to health services are urgently needed to limit the consequence of MSM as a bridge for HIV transmission to the general population.
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Affiliation(s)
- Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
- * E-mail:
| | - Jean d’Amour Sinayobye
- Division of Research and Medical Education, Rwanda Military Hospital, Kanombe, Kigali, Rwanda
| | | | - Junaid Chaudhry
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Lydia Buzinge
- Division of Research and Medical Education, Rwanda Military Hospital, Kanombe, Kigali, Rwanda
| | | | - Gad Murenzi
- Division of Research and Medical Education, Rwanda Military Hospital, Kanombe, Kigali, Rwanda
| | - Pacifique Mugenzi
- Division of Research and Medical Education, Rwanda Military Hospital, Kanombe, Kigali, Rwanda
| | - Viraj V. Patel
- Division of General Internal Medicine, Albert Einstein College of Medicine/Montefiore Health System, Bronx, New York, United States of America
| | - Philip E. Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Leon Mutesa
- College of Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Joel Palefsky
- School of Medicine, University of California, San Francisco, California, United States of America
| | - Kathryn M. Anastos
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Division of General Internal Medicine, Albert Einstein College of Medicine/Montefiore Health System, Bronx, New York, United States of America
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Agüero F, Masuet-Aumatell C, Morchon S, Ramon-Torrell JM. Men who have sex with men: A group of travellers with special needs. Travel Med Infect Dis 2018; 28:74-80. [PMID: 30399444 DOI: 10.1016/j.tmaid.2018.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/08/2018] [Accepted: 10/29/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Fernando Agüero
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain; Medical Sciences Department, School of Medicine, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Cristina Masuet-Aumatell
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain; Medical Sciences Department, School of Medicine, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Sergio Morchon
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain; Medical Sciences Department, School of Medicine, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Maria Ramon-Torrell
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain; Medical Sciences Department, School of Medicine, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.
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Persson KI, Berglund T, Bergström J, Tikkanen R, Thorson A, Forsberg B. Place and practice: Sexual risk behaviour while travelling abroad among Swedish men who have sex with men. Travel Med Infect Dis 2018; 25:58-64. [DOI: 10.1016/j.tmaid.2018.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 01/09/2018] [Accepted: 01/30/2018] [Indexed: 10/17/2022]
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Truong HHM, Fatch R, Do TD, McFarland W. Hepatitis B Vaccination and Infection Prevalence Among Men Who Have Sex With Men Who Travel Internationally. Sex Transm Dis 2018; 45:e25-e28. [PMID: 29465694 PMCID: PMC5908219 DOI: 10.1097/olq.0000000000000743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Among men who have sex with men traveling internationally, self-reported hepatitis B virus (HBV) vaccination prevalence was 77% and less prevalent among older men and those with HBV infection. The HBV infection prevalence was 25% and was associated with older age and HIV infection. Testing for chronic infection, universal vaccination, and treatment for populations with multiple risks is needed.
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Affiliation(s)
- Hong-Ha M. Truong
- University of California, San Francisco, 94158, USA
- Gladstone Institutes, San Francisco, 94158, USA
| | - Robin Fatch
- University of California, San Francisco, 94158, USA
| | - Tri D. Do
- University of California, San Francisco, 94158, USA
- Asian & Pacific Islander Wellness Center, San Francisco, 94109, USA
| | - Willi McFarland
- University of California, San Francisco, 94158, USA
- Department of Public Health, San Francisco, 94102, USA
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Brown G, Prestage G, Down I, Ellard J, Triffitt K. Not so different? Comparison of risk profile of gay men who acquired HIV while travelling with those who acquired HIV in Australia. Health Promot J Austr 2017; 29:58-64. [PMID: 29700942 DOI: 10.1002/hpja.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 02/27/2017] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED Many countries now identify HIV and international mobility as a priority issue within a global and shared epidemic, including Australia. To support health promotion in this complex area, we investigated recent HIV infections that occurred among Australian gay men while travelling and compared to HIV infections that occurred in Australia. METHODS 446 gay men recently diagnosed with HIV completed an on-line survey regarding the high risk event (HRE) where they believed that they acquired HIV. Those who acquired HIV while in their usual place of residence (308 men), those who were travelling within Australia (59 men), and those who were travelling overseas (79 men) were compared. RESULTS Those who acquired HIV while overseas had very similar risk profiles, sexual behaviour, and made similar assumptions about their partners and their own HIV status, as those who acquired HIV in Australia. Only HIV status disclosure at the HRE differed across locations (P = .030). Three quarters (74.7%) of the men who acquired HIV while overseas were not diagnosed until they returned to Australia. CONCLUSIONS Our findings challenge the idea that there are necessarily differences in behaviour and assumptions for HIV transmission in Australia and overseas. However, the men travelling may be in communities where HIV status is less commonly disclosed, and where HIV prevalence is higher. SO WHAT?: A deeper understanding of contextual factors may be required for HIV prevention and health promotion strategies targeting gay men travelling to locations with different cultural, HIV prevalence, and HIV testing considerations. This would also identify opportunities for new tools such as Pre-Exposure Prophylaxis and self-testing.
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Affiliation(s)
- Graham Brown
- The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Garrett Prestage
- The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.,The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia
| | - Ian Down
- The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia
| | - Jeanne Ellard
- The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.,The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia
| | - Kathy Triffitt
- The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia
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Brown MJ, Serovich JM, Kimberly JA. Perceived intentional transmission of HIV infection, sustained viral suppression and psychosocial outcomes among men who have sex with men living with HIV: a cross-sectional assessment. Sex Transm Infect 2017; 94:483-486. [PMID: 29066629 DOI: 10.1136/sextrans-2017-053153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 09/06/2017] [Accepted: 09/23/2017] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE HIV continues to be a global and national public health challenge, and men who have sex with men (MSM) are disproportionately affected in the USA. Transmission of HIV is intentional if the person living with HIV knows about his/her serostatus, acts with the intention to and actually transmits HIV. Research on intentional transmission of HIV infections is lacking, and the relationships between perceived intentional transmission, viral suppression and psychosocial outcomes have not been assessed. The objective of this study was to investigate the association between perceived intentional transmission of HIV, sustained viral suppression and psychosocial outcomes. METHODS Data were obtained from 338 MSM living with HIV who participated in a disclosure intervention study. Logistic and linear regression models were used to assess the associations between perceived intentional transmission and viral suppression, condomless anal intercourse in the past 30 days, being at risk for clinical depression, substance use, self-efficacies for condom use, HIV disclosure and negotiation of safer sex practices, and sexual compulsivity. RESULTS 44% of the study population reported perceiving intentional HIV transmission. After adjusting for sociodemographic characteristics, men who thought that they were infected intentionally had 69% higher odds (adjusted OR: 1.69; 95% CI 1.01 to 2.83) of being at risk for clinical depression, and on average, scored approximately 3 points and 4 points higher on depressive symptoms and sexual compulsivity, respectively (adjusted β: 3.29; 95% CI 0.42 to 6.15; adjusted β: 3.74; 95% CI 1.32 to 6.17) compared with men who did not think that they were intentionally infected. After adjusting for confounders, there was no statistically significant association between perceived intentional transmission and viral suppression. CONCLUSIONS Intervention programmes for MSM living with HIV who thought they were infected intentionally are warranted and should aim to attenuate depressive symptoms and sexual compulsivity.
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Affiliation(s)
- Monique J Brown
- College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Julianne M Serovich
- College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Judy A Kimberly
- College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
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International Sexual Partnerships May Be Shaped by Sexual Histories and Socioeconomic Status. Sex Transm Dis 2017; 44:306-309. [PMID: 28407648 DOI: 10.1097/olq.0000000000000601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Exchange sex and higher education were associated with an increased likelihood of international sexual partnerships (ISPs). Exchange sex and older age were associated with an increased likelihood of condomless sex in ISPs. Educational and socioeconomic factors may create unbalanced power dynamics that influence exchange sex and condomless sex in ISPs.
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Lejelind E, Westerling R, Sjögren Fugl-Meyer K, Larsson K. Condom use among Swedes while traveling internationally: A qualitative descriptive study. Nurs Health Sci 2017; 19:257-263. [PMID: 28371120 DOI: 10.1111/nhs.12341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/15/2016] [Accepted: 01/21/2017] [Indexed: 11/29/2022]
Abstract
This study explores factors influencing condom use among Swedish women and men who visited a sexual health clinic after unprotected sex during international travel. Semi-structured interviews were conducted with 25 women and 25 men. The data were analyzed using conventional content analysis. The informants' narratives were categorized as strategies and barriers. Strategies found were: risk assessment, testing, and treatment for sexually transmitted infections. The barriers were characterized as technical and personal or emotional. The findings indicate that sexual behavior may be different while traveling internationally, and that a release of social constraints and increased alcohol consumption were risk factors for practicing unprotected sex. Some of the strategies may be appropriate for the prevention of sexually transmitted infections, but several strategies and most barriers were used to explain why unprotected sex was practiced. Thus, people need the opportunity to reconsider strategies and strengthen confidence in their ability to use condoms. An individual-based approach employed within routine health care may support the practice of safer sex and prevent further transmission of sexually transmitted infections.
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Affiliation(s)
- Eva Lejelind
- Department of Dermatology and Venereology, Uppsala University Hospital, Uppsala, Sweden
| | - Ragnar Westerling
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Kerstin Sjögren Fugl-Meyer
- Department of Neurology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Department of Social Work, Karolinska University Hospital, Stockholm, Sweden
| | - Kjerstin Larsson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Department of Neurology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Lee VC, Sullivan PS, Baral SD. Global travel and HIV/STI epidemics among MSM: what does the future hold? Sex Health 2017; 14:51-58. [DOI: 10.1071/sh16099] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/27/2016] [Indexed: 11/23/2022]
Abstract
Infectious disease epidemics occur within dynamic systems and environments that shape risk and, ultimately, the spread of infectious diseases. Gay men and other men who have sex with men (MSM) are disproportionately impacted by HIV everywhere in the world. Several emerging trends present risks for sustained or increased HIV acquisition and transmission, and the growth of global travel in the context of emerging online platforms for social/sexual networking is discussed here. Four factors associated with travel that could potentiate HIV transmission are highlighted: different patterns of sexual risk behaviours during travel; the growth of online tools to meet sex partners more efficiently; the global heterogeneity of HIV strains; and the potential for diassortative mixing of men from high- and low-HIV prevalence areas. Prevention tools and services must rise to these challenges, and innovative mobile applications and programs have played, and will continue to play, an important role in supporting MSM at risk for or living with HIV during their periods of travel.
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17
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Pope Z, McFarland W, Raymond HF. San Franciscan MSM have similar types and numbers of partnerships with men inside San Francisco and outside San Francisco, 2011. AIDS Care 2016; 29:782-786. [PMID: 27817201 DOI: 10.1080/09540121.2016.1255706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Sexual networks among men who have sex with men (MSM) across health jurisdictions may play a role in HIV transmission and acquisition. Levels of HIV prevention activities may be different across health jurisdictions leading to differential risk for HIV transmission with partners in and outside of San Francisco (SF). We examined MSM sexual partnerships within and outside SF. Data were collected during the 2011 National HIV Behavioral Surveillance MSM data collection cycle. Participants were asked to report characteristics of and sexual behaviors with up to five most recent sexual partners. Restricting our analysis to sexually active San Franciscans (n = 329 MSM reporting 927 partnerships), we found that SF MSM have similar numbers of partnerships (SF mean = 1.3, non-SF mean = 1.2) and levels of risk behavior with men within and outside SF. With the current intensity of HIV prevention occurring in SF additional strategies may be needed to address the fact that SF MSM have many sexual connections to men in other health jurisdictions where HIV prevention may not be similar to those in SF.
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Affiliation(s)
- Zachary Pope
- a Chicago Medical School, Rosalind Franklin University of Medicine and Science , North Chicago , IL , USA
| | - Willi McFarland
- b SF Department of Public Health , San Francisco , CA , USA.,c Epidemiology and Biostatistics , University of California, SF , San Francisco , CA , USA
| | - H Fisher Raymond
- b SF Department of Public Health , San Francisco , CA , USA.,c Epidemiology and Biostatistics , University of California, SF , San Francisco , CA , USA
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