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Krajewski T, LeMasters KH, Oser CB, Brinkley-Rubinstein L. Perceived versus actual HIV risk among PrEP indicated persons with criminal legal involvement. AIDS Care 2024:1-10. [PMID: 39088545 DOI: 10.1080/09540121.2024.2383873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 07/18/2024] [Indexed: 08/03/2024]
Abstract
Individuals involved with community supervision experience multi-level obstacles impacting health outcomes. This is a high-risk period for HIV acquisition due to potential reengagement in unprotected sex and/or unsafe injection drug practices. This study aimed to assess the congruence between actual and perceived HIV risk and the degree to which individual, social, and behavioral factors impact risk perception among individuals on community supervision. While all participants were clinically indicated for PrEP, most participants (81.5%) did not consider themselves at risk for HIV (69.5%) or were not sure of their risk (12.0%). Among those with no or unsure perceived risk, 94% engaged in sexual behaviors that put them at-risk of HIV. Perceived HIV risk was associated with sharing injection equipment (aPR = 1.8, 95% CI [1.02, 3.3]), identifying as a sexual minority (aPR = 2.3, 95% CI [1.3, 3.9]), and having sex with a partner living with HIV (aPR = 2.4, 95% CI [1.3, 4.3]). Having sex with a partner living with HIV was the only sexual risk behavior associated with a perceived risk of HIV. These findings indicate a substantial discrepancy between actual and perceived HIV risk, highlighting the need for targeted interventions to improve risk perception accuracy and enhance risk prevention among individuals on community supervision.
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Affiliation(s)
- Taylor Krajewski
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for AIDS Research, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine H LeMasters
- Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carrie B Oser
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
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Lin Y, Li C, Liao M, Jiao K, Ma J, Yan Y, Li Y, Wu T, Cheng C, Cao Y, Jia W, Zhao Z, Wang L, Hua D, Li R, Guo N, Meng J, Ma W. Associations between perceived and actual risk of HIV infection and HIV prevention services uptake among men who have sex with men in Shandong province, China: a cross-sectional study. BMC Public Health 2024; 24:1470. [PMID: 38822308 PMCID: PMC11143659 DOI: 10.1186/s12889-024-18985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Associations between perceived and actual risk of HIV infection and HIV prevention services uptake are inconclusive. This study aimed to evaluate the discrepancy between the perceived and actual HIV risk, and quantify the associations between perceived and actual risk of HIV infection and three HIV prevention services utilization among men who have sex with men (MSM) in Shandong province, China. METHODS A cross-sectional study was conducted in Shandong province in June 2021. Participants were eligible if they were born biologically male, aged 18 years or older, had negative or unknown HIV status, and had sex with men in the past year. Participants were recruited online. The discrepancy between their perceived and actual risk of HIV infection was evaluated by calculating the Kappa value. Bayesian model averaging was used to assess the associations between perceived and actual risk of HIV infection and HIV prevention services uptake. RESULTS A total of 1136 MSM were recruited, most of them were 30 years old or younger (59.9%), single (79.5%), with at least college education level (74.7%). Most participants (97.4%) perceived that they had low risk of HIV infection, and 14.1% were assessed with high actual risk. The discrepancy between their perceived and actual risk of HIV infection was evaluated with a Kappa value of 0.076 (P < 0.001). HIV testing uptake had a weak association with perceived high HIV prevalence among social networks (aOR = 1.156, post probability = 0.547). The perceived high HIV prevalence among national MSM was positive related to willingness to use PrEP (aOR = 1.903, post probability = 0.943) and PEP (aOR = 1.737, post probability = 0.829). Perceived personal risk (aOR = 4.486, post probability = 0.994) and perceived HIV prevalence among social networks (aOR = 1.280, post probability = 0.572) were related to history of using PrEP. Perceived personal risk (aOR = 3.144, post probability = 0.952), actual risk (aOR = 1.890, post probability = 0.950), and perceived risk among social networks (aOR = 1.502, post probability = 0.786) were related to history of using PEP. CONCLUSIONS There is discordance between perceived and actual personal risk of HIV infection among MSM in China. HIV risk assessment and education on HIV prevalence among MSM should be strengthened to assist high-risk populations aware their risk accurately and hence access HIV prevention services proactively.
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Affiliation(s)
- Yuxi Lin
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chuanxi Li
- Qilu Hospital of Shandong University, Jinan, China
| | - Meizhen Liao
- Institution for AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Kedi Jiao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jing Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yu Yan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yijun Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Taoyu Wu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chunxiao Cheng
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yanwen Cao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wenwen Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhonghui Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lina Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Dongdong Hua
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ruixiao Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ningning Guo
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jing Meng
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
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Chen Y, Chang R, Hu F, Xu C, Yu X, Liu S, Xia D, Chen H, Wang R, Liu Y, Ge X, Ma T, Wang Y, Cai Y. Exploring the long-term sequelae of childhood sexual abuse on risky sexual behavior among Chinese transgender women. Front Psychol 2023; 14:1057225. [PMID: 37123291 PMCID: PMC10140497 DOI: 10.3389/fpsyg.2023.1057225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/13/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Childhood sexual abuse (CSA) is a hidden but serious public health issue that can lead to a series of behavioral consequences and health problems in adulthood. It has been well documented that transgender women (TGW) have a high prevalence of CSA victimization. Moreover, risky sexual behaviors are also widespread among TGW; nevertheless, research investigating the associations between CSA victimization and risky sexual behaviors in TGW represents a gap in the literature. Methods Our research was carried out mainly in Shenyang of China from November 2018 to January 2019. Sociodemographic characteristics, as well as information on participants' HIV awareness and sexual behaviors, were collected through face-to-face interviews. The impact of CSA was examined through hierarchical logistic regression, adjusted for sociodemographic factors and HIV awareness. Results In the sample of 247 adult TGW, 14.2% of them had a CSA history. In the previous 6 months, 30.8% of the participants reported condomless anal intercourse (CAI) and 38.5% of them had multiple sexual partners (MSP). The findings demonstrated that TGW with CSA history were more likely to take part in CAI (p = 0.001, OR = 4.252) or have MSP (p = 0.004, OR = 3.260) in adulthood. Furthermore, HIV knowledge was not a predictor of CAI or MSP, but higher HIV risk perception was associated with a greater probability of CAI. Conclusion Transgender women with a history of CSA were more prone to engage in CAI and have MSP in China.
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Affiliation(s)
- Yingjie Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruijie Chang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Hu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyue Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shangbin Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danni Xia
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongxi Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujie Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Ge
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Liu Y, Fu G, Chen Y, Wu L, Pan M, Yang Y, Chen Z, Cao Y, Li Y, Wang H, Wang B, Lv C, Du R, Xiong Y, Liu W, Xu N, Xia X, Li Q, Ruan F, Wang J. Discordance between perceived risk and actual risky sexual behaviors among undergraduate university students in mainland China: a cross-sectional study. BMC Public Health 2022; 22:729. [PMID: 35413860 PMCID: PMC9006618 DOI: 10.1186/s12889-022-13132-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV prevention, diagnosis, treatment and care services might be hampered by inaccurate risk assessment. This study aimed to investigate the extent of and factors associated with the discordance between perceived risk and actual risky sexual behaviors among undergraduates in mainland China, guided by the Anderson's behavioral model. METHODS This study involved a secondary analysis of cross-sectional data collected during the fall semester of 2018-2019 academic year. The present analysis was restricted to 8808 undergraduates with low risk perception. Those who had low perceived risk but actually engaged in risky sexual behaviors were categorized as risk discordance (RD). Univariate and multivariate Logistic regression analyses were conducted to identify factors associated with RD. RESULTS Overall, the discordance rate between perceived and actual risk was 8.5% (95% CI: 7.9%-9.1%). Multivariate Logistic regression analysis indicated that non-heterosexual women (AOR = 0.41, 95% CI:0.27-0.60), heterosexual men (AOR = 0.45, 95% CI:0.33-0.61) and women (AOR = 0.26, 95% CI:0.19-0.35) were less likely to exhibit RD, when compared with non- heterosexual men. Furthermore, non-freshmen (AOR = 1.57, 95% CI:1.30-1.90), early initiators of sexual intercourse (AOR = 5.82, 95% CI:4.10-8.26), and those who had lower levels of HIV knowledge (AOR = 1.28, 95% CI:1.08-1.51), displayed higher levels of stigma against PLHIV (AOR = 1.50, 95% CI:1.26-1.77) and had ever been tested for HIV (AOR = 1.36, 95% CI:1.04-1.77) were more prone to reporting RD. Those with more enabling resources [i.e., displaying high levels of condom use self-efficacy (AOR = 0.70, 95% CI:0.59-0.84) and being knowledge of local testing center (AOR = 0.71, 95% CI:0.60-0.83)] were less likely to report RD. However, spending more than 2000 Yuan a month on basic needs (AOR = 2.55, 95% CI:2.07-3.14), residing in urban areas (AOR = 1.35, 95% CI:1.15-1.59) and being knowledgeable of the national AIDS policy (AOR = 1.40,95% CI:1.18-1.66) increased the chance of exhibiting RD. CONCLUSIONS Comprehensive interventions, including targeting students with high-risk characteristics, improving the acceptability of PrEP and PEP, conducting health education, enhancing self-efficacy for using condoms and making opt-out HIV testing routine in college campus, should be taken to reduce the discordance between perceived and actual HIV risk and finally to reach the goal of Zero AIDS.
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Affiliation(s)
- Yusi Liu
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Guochen Fu
- National Demonstration Center for Experimental General Medicine Education of Hubei University of Science and Technology, Xianning City, China
| | - Yifan Chen
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Lei Wu
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Mingliang Pan
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Yuli Yang
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Zhuo Chen
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Yu Cao
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Yong Li
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Hao Wang
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Bixiang Wang
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Chengcheng Lv
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Ruyi Du
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Yanting Xiong
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Wei Liu
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Nuo Xu
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Xiaobao Xia
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Qianqian Li
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Fang Ruan
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China
| | - Junfang Wang
- Department of Preventive Medicine, School of Basic Medical Sciences, Hubei University of Science and Technology, No.88 Xianning Avenue, Xianning City, Hubei Province, 437100, China.
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Phanuphak N, Ramautarsing R, Chinbunchorn T, Janamnuaysook R, Pengnonyang S, Termvanich K, Chanlearn P, Linjongrat D, Janyam S, Phanuphak P. Implementing a Status-Neutral Approach to HIV in the Asia-Pacific. Curr HIV/AIDS Rep 2020; 17:422-430. [PMID: 32725317 PMCID: PMC7497381 DOI: 10.1007/s11904-020-00516-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Globally, "undetectable equals untransmittable (U=U)" and "pre-exposure prophylaxis (PrEP)" have become crucial elements in HIV treatment and prevention programs. We reviewed the implementation of U=U and PrEP among countries in the Asia-Pacific region. RECENT FINDINGS U=U and PrEP uptakes were limited and slow in the Asia-Pacific. Inadequate knowledge among health care practitioners and pervasive stigma towards individuals living with HIV and their sexual lives are key barriers for the integration of U=U into clinical practice. Paternalistic and hierarchical health care systems are major obstacles in PrEP implementation and scale-up. Countries with the most advanced PrEP implementation all use community-based, nurse-led, and key population-led service delivery models. To advance U=U and PrEP in the Asia-Pacific, strategies targeting changes to practice norm through wide-scale stakeholders' training and education, making use of online health care professional influencers, and utilizing financial mechanism should be further explored through implementation research.
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Affiliation(s)
- Nittaya Phanuphak
- Institute of HIV Research and Innovation, 319 Phayathai Road, Pathumwan, Bangkok, 10330 Thailand
| | - Reshmie Ramautarsing
- Institute of HIV Research and Innovation, 319 Phayathai Road, Pathumwan, Bangkok, 10330 Thailand
| | - Tanat Chinbunchorn
- Institute of HIV Research and Innovation, 319 Phayathai Road, Pathumwan, Bangkok, 10330 Thailand
| | - Rena Janamnuaysook
- Institute of HIV Research and Innovation, 319 Phayathai Road, Pathumwan, Bangkok, 10330 Thailand
| | - Supabhorn Pengnonyang
- Institute of HIV Research and Innovation, 319 Phayathai Road, Pathumwan, Bangkok, 10330 Thailand
| | - Krittaporn Termvanich
- Institute of HIV Research and Innovation, 319 Phayathai Road, Pathumwan, Bangkok, 10330 Thailand
| | - Pongthorn Chanlearn
- Mplus Foundation, 142 Chiang Mai Hod Road, Muang, Chiang Mai, 50200 Thailand
| | - Danai Linjongrat
- Rainbow Sky Association of Thailand, 1 and 3 Ramkhamhaeng Road, Bangkapi, Bangkok, 10240 Thailand
| | - Surang Janyam
- Service Workers in Group Foundation, Surawong Road, Bangrak, Bangkok, 10500 Thailand
| | - Praphan Phanuphak
- Thai Red Cross AIDS Research Centre, 104 Rajdumri Road, Pathumwan, Bangkok, 10330 Thailand
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