Effective use of pre-exposure prophylaxis (PrEP) Among stimulant users with multiple condomless sex partners: a longitudinal study of men who have sex with men in Los Angeles

ABSTRACT

PrEP's potential benefit for men who have sex with men (MSM) who use stimulants may be limited by adherence or prescriber willingness to recommend PrEP due to concerns of non-compliance. Using data from PATH-PrEP, a 48-week study evaluating PrEP for MSM in Los Angeles, we modeled an interaction between stimulant use and condomless sex with multiple partners (CAS-MP) on prevention-effective dried blood spot tenofovir-diphosphate concentrations. At week 4, participants reporting stimulant use and CAS-MP had a decreased odds of prevention-effective adherence compared to non-stimulant use and non-CAS-MP (AOR 0.15, 95% CI 0.04–0.57). From week 4–48, participants reporting stimulant use and CAS-MP had increased odds of prevention-effective adherence (AOR 1.06 per week, 95%CI 1.01–1.12). Participants reporting CAS-MP without stimulant use had no significant change in prevention-effective adherence (AOR 0.99 per week, 95%CI 0.96–1.02). Stimulant use moderated the association of CAS-MP on prevention-effective PrEP adherence over time.     

HIV testing and HIV knowledge among men who have sex with men in Natal,Northeast Brazil

Background

Men who have sex with men (MSM) account for the highest prevalence of HIV in Brazil. HIV testing allows to implement preventive measures, reduces transmission, morbidity, and mortality.

Factors associated with self-reported unprotected anal intercourse among men who have sex with men in Changsha city of Hunan province,China

Men who have sex with men (MSM) in China are highly susceptible to HIV infection and HIV prevalence among Chinese MSM is rapidly increasing in recent years. Unprotected anal intercourse (UAI) is a major contributing factor of HIV transmission. This study aims to identify factors associated with UAI among MSM in Changsha city, China. A cross-sectional survey was conducted among 642 MSM in Changsha city from July 2009 to June 2011 via a venue-based sampling method. Data on socio-demographic characteristics, sexual behaviours and utilisation of HIV/AIDS services were collected to determine the associates of UAI in MSM. Among the 642 MSM, 184 (28.7%) reported having UAI with male partners at the last sexual episode. UAI was associated with the venues where MSM met other MSM, and having unprotected sex with female partners at last the sexual episode and in the past six months. In addition, UAI was significant associated with not being exposed to HIV interventions, including free condom, lubricant, HIV testing and counselling, and peer education. MSM who have UAI practice are more likely to have unprotected sex with female; hence, potentially bridging HIV to the general female population. Specific harm-reduction programmes are shown to have significant impacts in reducing UAI and should be scaled up among MSM in China.     

深圳地区MSM性伴数量及影响因素分析

目的了解深圳地区男男性行为人群（MSM）性伴数量,分析其影响因素。方法应用同伴推动抽样（RDS）法进行抽样调查,收集MsM人群人口学和性伴数等资料。用SAS软件对数据进行Poisson回归分析。结果共抽样调查351例MSM。最近半年,仅31．4％MSM没有肛交性伴或保持单一性伴,25．9％没有口交性伴或保持单一性伴：28．5％有女性性伴,其中11．4％有多个女性性伴。职业为娱乐场所从业人员和曾做过男男性工作者（MB）,是MSM肛交性伴数和口交性伴数的共同危险因素。除此之外,HIV风险感知越高,艾滋病知识得分越高,MSM口交性伴数越多。结论对该人群有针对性的干预行动已刻不容缓,以有效阻断HIV传播和蔓延。     

北京市男男性行为者HIV感染及影响因素的调查研究

目的 了解北京市男男性行为者(men who have sex with men,MSM)艾滋病病毒(HIV)感染情况及其影响因素.方法 于2006年9月-2007年2月,在北京市招募MSM进行问卷调查,调查内容包括社会人口学和高危行为学特征,采集血样检测HIV抗体.结果 在所调查的541名MSM中,HIV和梅毒感染率分别为4.8%(26/541)和19.8%(107/541).在多因素Logistic回归模型中,梅毒感染(OR=4.23;95%CI 1.88-9.54)、过去男性性伴总人数≥10个(OR=3.80,95%CI 1.49-9.72)与MSM HIV感染的关系有统计学意义.结论 MSM已成为HIV感染的高危人群之一,有必要加强艾滋病/性病防治知识宣传和预防干预,来降低HIV在MSM中的传播.     

2016-2018年德宏傣族景颇族自治州男男性行为者HIV新发感染率研究

目的 对德宏州2016-2018年男男性行为者(MSM)进行描述及艾滋病病毒(HIV)新发感染率分析.方法 利用"德宏州HIV数据库系统"收集纳入监测工作中MSM,进行人口学特征描述,并应用LAg-AvidityEIA法在历年MSM中进行HIV新发感染率的计算.结果 德宏州2016-2018年共1081例MSM被纳入本...     

沈阳市男男性行为人群HIV感染率及其影响因素分析

目的了解沈阳市男男性行为人群（MSM）艾滋病病毒（HIV）感染率及其影响因素,进一步做好MSM的艾滋病防治工作。方法采用同伴推动法（RDS）招募900名MSM,由经过专业培训的调查员进行面对面的问卷调查,主要内容包括社会人口学特征、艾滋病知识知晓水平、性行为状况、接受干预服务情况和HIV/梅毒感染状况,并抽取静脉血检测HIV及梅毒,对影响HIV感染的相关因素进行χ2检验。结果调查了900名MSM,艾滋病知识知晓率达到91.3%。86.9%的调查对象最近6个月有同性肛交性行为,最近6个月与男性发生肛交性行为时每次都使用安全套的比例为57.5%。HIV感染率为9.3%,梅毒感染率为11.0%。分析显示,年龄较大、文化程度在初中及以下、最近6个月与男性发生肛交性行为时未坚持使用安全套、梅毒感染是感染HIV的危险因素。结论 MSM人群高危性行为发生率、HIV和梅毒感染率均高,可能成为当前HIV流行的重要人群和重要因素,应采取积极有效的宣传教育和行为干预活动。     

Community-level norms and condomless anal intercourse among gay,bisexual, and other men who have sex with men who use geosocial-networking smartphone applications in the Deep South

ABSTRACT

Geosocial-networking smartphone applications represent an increasingly common virtual context in which men who have sex with men (MSM) meet their sexual partners. The purpose of the present study is to evaluate community-level sexual behavior norms and their associations with condom use among MSM in Atlanta, Georgia, recruited from a popular smartphone application (n?=?92). Engagement in condomless anal intercourse was more common among participants who agreed that, among MSM in their community, (a) it is difficult to negotiate condom use in partnerships where condomless sex has already occurred and (b) suggesting condom use implies one distrusts their partner. These norms may represent barriers to increasing condom use.     

Implementation and impact of a technology-based HIV risk-reduction intervention among Thai men who have sex with men using “Vialogues”: a randomized controlled trial

ABSTRACT

We conducted a randomized control trial to evaluate the impact of a novel technology-based intervention on HIV risks and condom use behaviors among Thai men who have sex with men (MSM). Between April 2016 and August 2017, participants aged 18 years and above, and having engaged in unprotected sex in past six months were randomly assigned to control and intervention arm, and received HIV testing at baseline, month 6 and 12. Intervention arm participants engaged in 12-monthly HIV/STI prevention educational sessions delivered via Vialogues.com. Of 76 MSM enrolled, 37 were randomized to intervention and 39 to control arm. Median age was 28 (IQR 24–32) years. Thirty-three (89.2%) intervention arm participants completed all 12-monthly Vialogues sessions. At month 12, intervention arm had higher retention rate (p?=?0.029) and higher median percentage of condom use for anal intercourse (p?=?0.023) versus control arm. Over the 12-month period, intervention arm reported significant reduction in self-perceived HIV risk (p?=?0.001), popper usage (p?=?0.002), median number of sexual partners (p?=?0.003), and increased median condom use percentage (p?=?0.006). Our study highlights that “Vialogues” intervention significantly reduced number of sexual partners and condomless anal intercourse rates among Thai MSM, and has positive implications for reducing epidemic among key populations.     

性网络与男男性行为人群的HIV传播

性网络是男男性行为人群(MSM)经性途径传播艾滋病病毒(HIV)的直接通道。网络分析方法可揭示性网络构成与个体感染HIV风险及与群体中HIV传播的动力学关系。为深入探讨MSM HIV传播风险,为预防干预定位提供信息,该文对性网络与MSMHIV传播关系的研究现况做一简要概述。     

Prevalence and associated factors of HIV serostatus disclosure to regular female sex partners among HIV-positive men who have sex with both men and women in China

HIV-positive men who have sex with men and women (MSMW) may transmit HIV to regular female sexual partners (FSPs, including girlfriend and wife) through unprotected sex. FSPs’ awareness of the HIV serostatus of the MSMW promotes them to access services. However, the prevalence of HIV disclosure among MSMW was low, and factors associated with this disclosure are largely unknown. This study aimed to examine factors associated with HIV disclosure to regular FSPs among HIV-positive MSMW. We recruited 432 HIV-positive MSMW from three provinces of China and collected information on participants’ individual characteristics and interpersonal relationships with their FSPs using individualized structured questionnaire. Univariate and multivariate logistic regression were used for data analysis. The prevalence of HIV disclosure to their most recent FSPs was 49.8%. Facilitators of HIV disclosure included the presence of HIV/AIDS symptoms, perceiving this partner’s HIV status as positive, exposure to counseling favoring disclosure, inconsistent condom use, and this partner’s acknowledgment of MSM identity. Barriers against HIV disclosure included unknown HIV serostatus of this partner and an instrumental relationship to hide MSM identity. HIV disclosure to regular FSPs was low. Programs should target priority subgroups. Services in counseling favoring disclosure and partner HIV testing should be enhanced.     

HIV vulnerabilities and coercive sex at same-sex sexual debut among men who have sex with men in Beijing,China

Few studies have examined coercive sex and HIV vulnerabilities among men who have sex with men (MSM) in China. The present study seeks to compare individual characteristics between MSM who did and did not experience coercive sex at their MSM sexual debut and to identify HIV risk factors correlated with coercive sex at MSM sexual debut. In 2007, we recruited 167 MSM in Beijing, China by peer-referred social network sampling. Each participant then completed self-administered questionnaires regarding their sexual experiences and practices. Results show that 14% of participants reported coercive sex at MSM sexual debut, of whom 48% reported recent unprotected anal intercourse (UAI). Coercive sex at MSM sexual debut was significantly associated with UAI [adjusted odds ratio (AOR): 5.38, 95% confidence interval: 1.95–14.87] and lifetime number of male sex partners (AOR: 7.25, 95% CI: 2.39–22.01). Coercive sex is harming MSM in China and should be immediately addressed by researchers, public health officials, and MSM community stakeholders.     

Vengeance,sexual compulsivity and self-efficacy among men who have sex with men living with HIV

Vengeance is defined as a continuum of thoughts and/or actions ranging from harmless thoughts to destruction or death, due to feelings of hurt or anger, as a result of a perceived personal attack. Studies assessing the association between vengeance and HIV risk behavior are extremely lacking. The primary aims of this study were to examine the associations between vengeance and sexual compulsivity (SC), and self-efficacies (SEs) for condom use, HIV disclosure, and negotiation of safer sex practices. Data were obtained from 266 men who have sex with men (MSM) living with HIV. Simple and multiple linear regression were used to explore the associations between vengeance, SC and SE. After adjusting for sociodemographic and HIV-related factors, there was a negative association between vengeance and SE for HIV disclosure: (most vengeful: β?=??1.49; 95% CI: ?2.40, ?0.58; more vengeful: β?=??1.17; 95% CI: ?2.12, ?0.22; vengeance (continuous: β?=??0.03; 95% CI: ?0.05, ?0.01). Intervention programs geared towards improving SE for HIV disclosure among MSM living with HIV should endeavor to reduce vengeful feelings.     

MSM中HIV抗体阳性率及其影响因素分析

目的了解男男性行为人群（MSM）艾滋病病毒（HIV）的阳性检出率,探讨该人群感染HIV的影响因素。方法2012年1—12月,在武汉市动员MSM参加HIV抗体快速检测,并调查收集人口学和行为学信息,HIV抗体筛查阳性者接受确证检测。结果共有7123名符合条件的MSM参加了检测。分析表明,教育水平、现住址、过去3个月及最近1次肛交性行为安全套使用、找寻性伴地点、检测原因以及是否第1次参加HIV抗体检测,为影响MSM动员检测阳性发现的因素,差异均有统计学意义（P〈0．05）。其中,外地、过去3个月有时使用和最近1次没有使用安全套、在浴池找寻性伴、第1次参加检测和感觉不舒服而参加检测的MSM,HIV阳性检出的风险分别是参照组的1．830、3．082、3．530、2．762、1．943和6．141倍。结论需要综合考虑,调整动员检测模式,设计活动及分配资源,注重实际效果,从而最大限度发现地HIV阳性者。     

HIV testing practices among men who have sex with men in Buenos Aires,Argentina

The objective of the study was to explore HIV-testing practices among men who have sex with men (MSM) in Buenos Aires, Argentina, in light of current international health guidelines that recommend frequent HIV testing for MSM who engage in high-risk behavior. Participants, who were recruited using respondent-driven sampling (RDS), were 500 mostly young, nongay-identified MSM of low socioeconomic status, high levels of unemployment, living mainly in the less-affluent areas surrounding Buenos Aires, and lacking health insurance. They provided blood samples for HIV testing and responded to a Computer Assisted Self Interview. Fifty-two percent had never been tested for HIV, and 20% had been tested only once; 17% were found to be HIV infected, of whom almost half were unaware of their status. Main reasons for never having tested previously were: not feeling at risk, fear of finding out results, and not knowing where to get tested. Among those previously tested, men had been tested a median of 2 times with their most recent test having occurred a median of 2.7 years prior to study enrollment. Of those who had not tested positive before entering the study, only 41% returned for their results. HIV testing was infrequent and insufficient for early detection of infection, entry into treatment, and protection of sexual partners. This was particularly the case among nongay-identified MSM. Testing campaigns should aim to help MSM become aware of their risk behavior, decrease fear of testing by explaining available treatment resources and decreasing the stigma associated with HIV, and by publicizing information about free and confidential testing locations. Rapid HIV testing should be made available to eliminate the need for a return visit and make results immediately available to individuals who are tested.     

Psychosociobehavioral characteristics associated with high condomless anal intercourse intention: a comparison of receptive,versatile, and insertive MSM in Taiwan

ABSTRACT

In Taiwan, men who have sex with men (MSM) continue to be disproportionately affected by HIV, and the main route of HIV transmission is condomless anal intercourse (CAI). This study examined the associations between psychosociobehavioral characteristics and CAI intention among MSM in Taiwan who had ever engaged in anal intercourse with men, and compared the differences across three sexual roles (receptive, versatile, and insertive) using online survey data (N?=?563). For all MSM, those that were in a relationship (AOR?=?2.55; 95% CI: 1.61–4.03), had three or more steady partners (AOR?=?2.58; 95% CI: 1.19–5.58), did not use a condom during last anal intercourse (AOR?=?6.81; 95% CI: 4.36–10.63), perceived high HIV risk (AOR?=?2.13; 95% CI: 1.26–3.60), and had high sexual sensation seeking (AOR?=?2.80; 95% CI: 1.82–4.30) were more likely to have high CAI intention. After stratification, the significant characteristics differed depending on sexual role, except for no condom use during last anal intercourse remaining significant in all models (AOR?=?5.09–20.30; 95% CI: 2.49–66.69, depending on sexual role). Tailoring the programs for MSM of different sexual roles may improve the effectiveness of future prevention efforts.     

男男性行为人群不同性伴寻找场所HIV和梅毒感染及相关行为特征

目的了解不同性伴寻找场所男男性行为人群(MSM)艾滋病病毒(HIV)/梅毒感染状况,以及相关的行为特征。方法采用应答推动方法(RDS),在MSM活动场所定时、定点对MSM人群进行招募和询问式匿名调查,采集血样进行血清学检测。结果共调查400人,寻找性伴场所属酒吧型的占21.5%,浴室型占2.5%,公园型占11.3%,网络型占60.0%,其他型占4.5%。不同年龄、文化、职业、婚姻状态、性取向者,性伴寻找场所的差异有统计学意义(P<0.05)。52.3%酒吧型MSM年龄≤22岁,44.4%公园型年龄≥36岁;公园型MSM学历在初中及以下者占43.2%;网络型MSM学历在大专及以上者为44.5%;网络型未婚为90.4%,浴室型在婚及其他婚姻状况为60.0%。近6月性伴数≥6人、无保护性男男性行为均以其他型最高,分别为15.8%、76.5%;酒吧等其他型53.2%有主动肛交,90.8%有无保护性口交;浴室型50.0%有异性性行为,10.3%酒吧等其他型有卖性商业性行为,14.6%酒吧/浴室型有买性商业性伴,43.2%公园型性伴年龄相差≥11岁。不同场所型MSM HIV知识知晓率,是否知道性伴相关健康问题、不知道性伴相关健康状况的差异有统计学意义(P<0.05)。不同场所型MSM的HIV/梅毒累计感染率差异有统计学意义(P<0.05),浴室/其他型MSM的HIV感染率为20.7%,浴室/公园型MSM的梅毒累计感染率为36.4%。结论 MSM人群寻找性伴场所与艾滋病高危行为及HIV/梅毒感染相关,应根据不同场所MSM的人口学及性行为特征,有针对性地开展健康教育和行为干预。     

Associations of unprotected anal intercourse with Grindr-met partners among Grindr-using young men who have sex with men in Los Angeles

Grindr, a geosocial smartphone application, is a networking medium for men who have sex with men. Although three quarters of young men who have sex with men (YMSM) Grindr users report having sex with a Grindr-met partner, the correlates of risky sexual behavior with Grindr-met partners are unknown. A randomly selected sample of 18- to 24-year-old, Grindr-using YMSM completed an anonymous online questionnaire assessing patterns of Grindr use and sexual behavior with their last Grindr-met partners. Of the 146 YMSM who reported having sex with Grindr-met partners, 20% had unprotected anal intercourse (UAI) at last sex with their Grindr-met partner. In the multivariable model, YMSM who used Grindr for at least one year showed naked chest/abs in their profile photo, and reported more past month Grindr-met partners were more likely to report UAI. These findings suggest that familiarity with the app was associated with YMSM's UAI with Grindr-met partners. Moreover, sexualized profile photos (i.e., naked chest/abs) may be associated with sexual risk-taking behaviors. HIV prevention interventions delivered or linked through such apps should target individuals who are longer/frequent users and who present sexualized profiles.