HIV,syphilis and heterosexual bridging among Peruvian men who have sex with men

OBJECTIVES: To determine prevalence of and risk factors associated with HIV and syphilis seropositivity and estimate incidence of HIV infection among Peruvian men who have sex with men (MSM) and characterize behaviors of men who report sex with both men and women ('bridgers'). DESIGN: Cross-sectional study of MSM in Lima, Peru. METHODS: Four-hundred and fifty-one MSM (of whom 442 responded to the question regarding sexual orientation) recruited through street outreach. Each was interviewed and underwent serologic testing for syphilis and HIV, including the less sensitive enzyme immunoassay test to estimate HIV incidence. RESULTS: Overall, HIV and syphilis prevalence were 18.5% and 16.0%, respectively, with highest prevalence among cross-dressers (33.3% and 51.1%, respectively). The estimated overall HIV seroincidence was 11.2% per year (95% confidence interval, 4.8-23.6). Overall, 47.1% of men reported ever having sex with a woman: 78.6% of men self-identifying as heterosexuals, 85.1% of bisexuals, 35.5% of homosexuals, and 12.5% of cross-dressers. Of these, 26.5% were 'bridgers', of whom 55% reported two or more female partners during the last year. 'Bridgers' were less likely to have always used condoms during the past year for vaginal sex (17%) than for insertive anal sex with men (25.5%). CONCLUSIONS: Among MSM in Peru, HIV and syphilis prevalence and HIV incidence were high, especially among cross-dressers. The high prevalence of bisexuality and low rates of consistent condom use, especially with female sexual partners indicates potential HIV transmission into the heterosexual population.     

深圳市男男性行为人群HIV／梅毒发病密度研究

目的了解深圳市男男性行为人群（MSM）的艾滋病病毒（HIV）/梅毒发病密度,探索防治性病对预防控制艾滋病的作用。方法知情同意原则下,招募符合纳入标准的MSM;建立并保持队列,收集社会人口学、性行为和安全套使用等资料;抽血检测HIV/梅毒,随访观察HIV/梅毒转归结局。结果 609例入选队列,HIV阴转阳19例,观察总人年数249.7人年,发病密度7.6[95%可信区间（CI）：4.6～11.9]/100人年;梅毒酶联免疫吸附试验（ELISA）阴转阳18例,观察总人年数134.9人年,发病密度13.3（95%CI：7.9～21.1）/100人年;梅毒ELISA阳性队列HIV发病密度是梅毒ELISA阴性队列HIV发病密度的2.2倍。结论梅毒对HIV传播具有协同作用,有必要在该人群中实施有效的性病预防措施以控制HIV传播     

Syphilis epidemiology in Norway, 1992-2008: resurgence among men who have sex with men

Background  

In recent years, the number of syphilis cases has stabilised in many countries of Western Europe, however several countries have reported increases among men who have sex with men (MSM). The aim of this article was to describe the epidemiology of early syphilis in Norway in 1992-2008.     

The spread of Mycoplasma genitalium among men who have sex with men

We report two instances of urethral-to-rectal transmission of Mycoplasma genitalium (MG) in men who have sex with men (MSM) couples. Such clear epidemiological correlation has to our knowledge not been published before. The urethral infections led to clinical symptoms, but the rectal infections did not. The rectum might serve as a reservoir for MG in MSM, but there is also some evidence from the literature that MG can cause proctitis. Our finding raises important questions about the role of MG as a pathogen among MSM. Any correlation with HIV transmission risk is currently unknown and needs further research.     

Risk factors of syphilis co-infection among HIV-infected men who have sex with men in Tel-Aviv,Israel

Syphilis incidence in Israel and other industrialized countries has increased in the past decade, mainly among men who have sex with men (MSM) who were co-infected with HIV. This study aimed to assess the demographic characteristics and behavioral risk factors for syphilis infection among HIV-infected MSM in the Tel-Aviv region, Israel. This cross-sectional study compared HIV-infected MSM who were co-infected with syphilis since 2005 with HIV-infected MSM without syphilis, using an anonymous self-administered questionnaire distributed at the AIDS treatment clinic in central Israel in 2016. This study included 75 HIV-infected MSM who were diagnosed with syphilis after their HIV diagnosis and 99 HIV-infected MSM without syphilis. Variables associated with syphilis infection included inadequate adherence to antiretroviral therapy (ART) (OR?=?1.8 [1.2–2.4]), frequent unprotected receptive anal intercourse (UAI) with casual sex partners (OR?=?2.2 [1.5–8.2]), especially with HIV-infected partner (OR?=?3.2 [1.1–7.9]).

In conclusion, HIV and syphilis co-infection were associated with frequent UAI with casual sex partners, inadequate adherence to ART and limited partner notification. In order to minimize syphilis transmission among HIV-infected MSM, AIDS clinics should encourage HIV-infected MSM to use condoms, ensure that patients perform periodic syphilis serology testing and improve partner notifications.     

Depression and anxiety among HIV-positive men who have sex with men and men who have sex with women in China

ABSTRACT

China is experiencing an emerging HIV epidemic among men who have sex with men (MSM). Minority stress theory posits that marginalized populations experience additional stress, which influences experiences of psychological distress and health outcomes. This study aimed to understand psychological distress of MSM relative to men who have sex with women (MSW) in an urban Chinese setting. Cross-sectional survey data were collected from 162 HIV-positive Chinese men receiving HIV treatment at Beijing’s Ditan Hospital. Multiple linear regression with imputation was used to identify correlates of psychological distress. Relative to MSW, MSM were younger, more educated, and less likely to be in a relationship or have children. While both groups reported clinically elevated levels of depression and anxiety, sexual behavior was not associated with either outcome. Higher endorsement of depression symptomology was associated with worse reported physical health (β?=??1.37, p?<?.05) and greater endorsement of maladaptive coping (β?=?2.39, p?<?.05), whereas higher endorsement of anxiety symptomology was associated with greater endorsement of adaptive coping (β?=?0.78, p?<?.05), diminished physical health (β?=??0.86, p?<?.05), and a high school or greater level of education (β?=?4.13, p?<?.05). These findings suggest that interventions targeting coping strategies may address psychological distress among HIV-positive Chinese men.     

Pre-exposure prophylaxis sorting among men who have sex with men

Factors such as race, masculinity, and sexually transmitted infections have been documented to influence partner selection in men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) has received mixed evaluations as a responsible step in HIV prevention and as an enabler of risker sexual practices. PrEP may consequently serve as an additional factor in partner choice. We examine the role that PrEP use and “promiscuity” play in affiliation and dating decisions by men who have sex with men with different HIV and PrEP stati. We invited 450 MSM across the United States from a smartphone geo-locating sex application to complete a survey of which 339 successfully finished the task. The survey contained vignettes of fictional men who were promiscuous or monogamous and either taking PrEP or not. Participants provided responses on whether to affiliate with these characters in three social domains: as friends, dates, or sex partners. Neither PrEP nor promiscuity influenced friendship choices. There was a preference for dating monogamous characters. Critically, PrEP influenced sexual affiliations for HIV negative individuals who showed a preference for PrEP-using characters. The pattern of results provides quantitative evidence for PrEP-based sexual sorting aimed at reducing risk of HIV transmission.     

204例MSM人群HIV／梅毒感染状况及行为学特征分析

目的了解天津市部分男男同性性行为人群（MSM）艾滋病相关危险行为,以及艾滋病病毒（HIV）、梅毒（SP）感染状况,为预防性病、艾滋病传播提供依据。方法采用横断面调查,对进入酒吧的男同性恋者进行问卷调查,同时抽取血样进行梅毒和HIV的实验室检测。结果调查的204人中,HIV感染率为5．9％,梅毒感染率为18．7％。艾滋病知识知晓率为81．4％,近6个月每次性行为均使用安全套的比例为47．9％,HIv感染者安全套使用率低,仅为11．1％,71．4％的HIV感染者最近6个月存在多性伴现象。结论天津市MSM人群危险性行为普遍存在,安全套使用率低,HIV、梅毒感染率较高,应加强对该人群艾滋病性病相关的宣传教育及干预工作,控制HIv的传播。     

Heterogeneity of risk among African-American men who have sex with men

The objective of this study was to examine the social mixing and sexual risk taking of African-American men who have sex with men (AAMSM). The design was a cross-sectional survey with targeted, ethnographically informed recruitment of respondents (n = 95), and subsequent recruitment of their network partners (n = 63). We ascertained current demographics, occupation, peer norms for sexual activity, community involvement, and information about members of their social and sexual network. Risk level was categorized by the frequency of anal sex and the consistency of condom use for anal sex. Twenty-nine of 158 (18.4%) persons were classified as being at high risk (any anal intercourse in the past three months with less than 100% condom use); 79 of 158 (50%) were at medium risk (any anal intercourse in the past three months with 100% condom use reported), and 50 (31.7%) were at low risk (no reported anal intercourse). The risk groups were similar with regard to perception of behavioural and community norms. White-collar workers associated predominantly with each other and other groups mixing preferentially with white-collar workers. Clustering within contact networks (the extent to which partners to a respondent know each other) was high for all risk groups (approximately 0.4-0.5), indicating dense, interactive networks. In conclusion, this study group demonstrates a greater degree of social mixing and heterogeneity than is commonly assumed for AAMSM. At least some portion of AAMSM has internalized public health messages about safer sexual activity. Intervention programmes should avoid the pitfalls of assumed homogeneity.     

长沙市男男性行为者HIV和梅毒感染现状及影响因素分析

目的 了解长沙地区男男性行为者(MSM)艾滋病病毒(HIV)和梅毒感染状况及其影响因素.方法 2018年10月至2019年6月期间,委托非政府组织(NGOs)应用滚雪球的方法招募MSM,开展问卷调查和HIV及梅毒检测.采用多因素Logistic回归模型分析HIV和梅毒感染的影响因素.结果 共招募1 220名MSM,其中...     

Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men

We examined HIV infection and estimated the population-attributable risk percentage (PAR%) for HIV associated fellatio among men who have sex with other men (MSM). Among 239 MSM who practised exclusively fellatio in the past 6 months, 50% had three partners, 98% unprotected; and 28% had an HIV-positive partner; no HIV was detected. PAR%, based on the number of fellatio partners, ranges from 0.10% for one partner to 0.31% for three partners. The risk of HIV attributable to fellatio is extremely low.     

Investigating partner abuse among HIV-positive men who have sex with men

High rates of partner abuse (PA) of all types—physical, sexual, and psychological—have been identified in studies of HIV-positive individuals. We examined both the prevalence and correlates of same-sex PA in HIV-positive men who have sex with men (MSM). Participants recruited from public outpatient HIV clinics (N = 168) completed CASI surveys about PA and current physical and mental health. Electronic medical record data were obtained for HIV biomarkers. Results indicate high rates of past year PA (physical, 19%; sexual, 17%; psychological, 51%; any, 54%), with rates comparable to, or higher than, those reported in recent studies of HIV-positive women and older studies of HIV-positive MSM. Overall, participants endorsing past year PA reported poorer mental but not physical health. Participants who endorsed past year physical PA, specifically, reported the largest number of mental health problems. HIV care providers should routinely assess PA, especially physical PA, in all MSM patients.     

男男性行为人群队列保持的影响因素研究

目的探讨男男性行为人群(MSM)艾滋病病毒(HIV)血清学阳转的前瞻性队列保持影响因素。方法 2009年3-10月,在重庆市采用分类滚雪球的方法,招募HIV抗体检测阴性的MSM,2010年3月和9月分别进行两次随访调查,随访联系以移动电话和网络聊天工具通知为主,并在随访联系中逐一调查研究对象的失访情况。分析研究对象的社会人口学和行为学特征,以及对队列保持的影响。结果基线进入队列的453名MSM,有299人至少参加了一次随访,随访率为66.0%。单因素和多因素分析显示,年龄>25岁、本市居住时间>1年、近1年做过艾滋病检测与近6个月发生无保护男男肛交性行为和较高的保持率密切相关(P<0.05)。结论低年龄段、本地居住时间较短、近1年未做过艾滋病检测、近6个月未发生无保护男男肛交性行为的MSM,相比之下更不易保持在队列中,需要在MSM队列研究时引起注意。     

Determinants of condom use among HIV-positive men who have sex with men

The main objectives of this study were to identify the determinants of condom use among HIV-positive men having anal sex with HIV-negative men or men of unknown HIV status and moderators of the intention-behaviour relationship. A cohort of 237 sexually active HIV-positive men having sex with men was followed over a period of six months. The cognitive variables measured were guided by an extended version of the theory of planned behaviour. Results indicated that past behaviour (odds ratio [OR] = 9.75; 95% confidence interval [CI]: 4.48-21.26), intention (OR = 3.13; 95% CI: 1.25-7.81), self-efficacy (OR = 3.62; 95% CI: 1.40-9.37) and use of sex drugs (OR = 0.16; 95% CI: 0.06-0.45) contributed to the prediction of 100% condom use. Self-efficacy also interacted with intention as a significant moderator of the intention-behaviour relationship (OR = 20.96; 95% CI: 2.90-151.51). Interventions promoting condom use should increase self-efficacy to use condoms and target users of sex drugs.     

Rectal use of nonoxynol-9 among men who have sex with men

OBJECTIVES: To assess recent rectal use of nonoxynol-9 (N-9), intent to use the product, and factors associated with N-9 use among men who have sex with men (MSM). DESIGN: Cross-sectional survey of a diverse sample of MSM in the San Francisco Bay Area. METHODS: Recruitment conducted at multiple street locations on various days/times or through referral during the Fall of 2001. RESULTS: Sixty-one percent (349/573) had heard of N-9, of which 55% (192/349) reported hearing in the prior year that N-9 may not be protective against HIV. Of men aware of N-9, 83% (289/349) knowingly used it in their lifetime, of which 67% (193/289) used it during anal intercourse in the previous year. Forty-one percent (79/193) of those who used N-9 during anal intercourse in the past year did so without a condom because they thought it may protect against HIV. Older men were more likely than younger men to have used N-9 for protection. Men who heard that N-9 may not protect were less likely, and African-Americans (versus Caucasians) were more likely, to say they would definitely use N-9 during anal intercourse in the future. Latinos (versus Caucasians), those with unknown HIV serostatus (versus HIV-negative), and those with lower education were less likely to know about N-9 at all, and thus were at risk for unknowingly using N-9. CONCLUSIONS: Many MSM used N-9 during or following public health warnings about the product. Actions (e.g., information campaigns, warning labels specific to rectal use) should be considered by communities to reduce rectal use of N-9.     

Violence and HIV-related risk among young men who have sex with men

Limited research has been conducted on threats or violence by family members and sexual partners against young men who have sex with men (MSM). Young MSM, aged 15-22 years, who attended public venues in New York City were enrolled in an anonymous, cross-sectional HIV seroprevalence and risk-behavior study. About two-thirds (68%) of the young MSM reported ever experiencing threats or violence from either family or partners and 25% reported threats or violence by both family and partners. In multivariate analysis, threats or violence by partners was significantly associated with older age, a history of forced sex and a history of running away from home. Recent unprotected anal sex and club drug use were significantly associated with a history of threats or violence by both family and partners. HIV prevention interventions need to include multiple factors that may have an impact on risk, including substance use and abuse, anti-violence and other mental-health issues.