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We review the history and evolution of blood donor criteria for men who have sex with men (MSM). Deferral policies in many jurisdictions, including Australia, New Zealand, Canada, the United States, Brazil and many western European countries are based on a period of abstinence from MSM, often of 12 months duration. Several countries (Italy, Spain and Portugal) defer donors based on sexual behaviours considered to be at high risk, regardless of whether the partner is same sex or opposite sex. Compliance is a key determinant in the efficacy of any deferral policy. We summarize research themes and strategies discussed at a January 2017 meeting held in Toronto, Canada, to provide an evidence basis for future policy changes. 相似文献
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Dr. Wendy Levinson MD Patrick M. Dunn MD Thomas G. Cooney MD James H. Sampson MD 《Journal of general internal medicine》1986,1(3):150-154
The purpose of this study was to develop a cost-effective strategy for screening for enteric protozoan infections in homosexual
men without gastrointestinal symptoms suggesting infection. One hundred and one homosexual men in Portland, Oregon, each submitted
at least one unpurged stool sample: 91% submitted three samples each. Of these, 27% had Entamoeba histolytica, 61% had nonpathogenic
protozoa with or without E. histolytica, 36% had a nonpathogen alone, and 3% had Giardia lamblia. Protozoan infection was
highly associated with the practice of anilingus (p<0.05). Infection with E. histolytica correlated significantly with the
presence of nonpathogenic protozoa (p<0.005). The following screening strategy was judged to be the most cost-effective: examine
one sample first; if E. histolytica is found or if the sample is negative, no further investigation is required; if a nonpathogen
is found, one additional sample should be obtained. This strategy had a sensitivity for E. histolytica of 85% and a cost of
$136 per case detected.
Supported by the Oregon AIDS Task Force and NIH BRSG grant no. S07RR05593-17. 相似文献
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Sexualized drug use (‘chemsex’) and high‐risk sexual behaviours in HIV‐positive men who have sex with men 下载免费PDF全文
EL Pufall M Kall M Shahmanesh A Nardone R Gilson V Delpech H Ward The Positive Voices study group 《HIV medicine》2018,19(4):261-270
Objectives
The incidence of sexually transmitted infections (STIs) and HIV infection remains high in gay, bisexual, and other men who have sex with men (MSM) in the UK, and sexualized drug use (“chemsex”) and injecting drug use (“slamsex”) may play a part in this. We aimed to characterize HIV‐positive MSM engaging in chemsex/slamsex and to assess the associations with self‐reported STI diagnoses and sexual behaviours.Methods
Data from a 2014 survey of people attending HIV clinics in England and Wales were linked to clinical data from national HIV surveillance records and weighted to be nationally representative. Multivariable logistic regression assessed the associations of chemsex and slamsex with self‐reported unprotected anal intercourse (UAI), serodiscordant UAI (sdUAI) (i.e. UAI with an HIV‐negative or unknown HIV status partner), sdUAI with a detectable viral load (>50 HIV‐1 RNA copies/mL), hepatitis C, and bacterial STIs.Results
In the previous year, 29.5% of 392 sexually active participants engaged in chemsex, and 10.1% in slamsex. Chemsex was significantly associated with increased odds of UAI [adjusted odds ratio (AOR) 5.73; P < 0.001], sdUAI (AOR 2.34; P < 0.05), sdUAI with a detectable viral load (AOR 3.86; P < 0.01), hepatitis C (AOR 6.58; P < 0.01), and bacterial STI diagnosis (AOR 2.65; P < 0.01). Slamsex was associated with increased odds of UAI (AOR 6.11; P < 0.05), hepatitis C (AOR 9.39; P < 0.001), and bacterial STI diagnosis (AOR 6.11; P < 0.001).Conclusions
Three in ten sexually active HIV‐positive MSM engaged in chemsex in the past year, which was positively associated with self‐reported depression/anxiety, smoking, nonsexual drug use, risky sexual behaviours, STIs, and hepatitis C. Chemsex may therefore play a role in the ongoing HIV and STI epidemics in the UK. 相似文献6.
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Juan Acevedo 《World journal of hepatology》2015,7(7):916-921
Recently, important changes have been reported regarding the epidemiology of bacterial infections in liver cirrhosis. There is an emergence of multiresistant bacteria in many European countries and also worldwide, including the United States and South Korea. The classic empirical antibiotic treatment(third-generation cephalosporins, e.g., ceftriaxone, cefotaxime or amoxicillin-clavulanic acid) is still effective in infections acquired in the community, but its failure rate in hospital acquired infections and in some health-care associated infections is high enough to ban its use in these settings. The current editorial focuses on the different epidemiology of bacterial infections in cirrhosis across countries and on its therapeutic implications. 相似文献
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Artur Acelino Francisco L.N. Queiroz Alvaro Francisco Lopes de Sousa Sandra Brignol Telma Maria Evangelista Araújo Renata K. Reis 《The Brazilian journal of infectious diseases》2019,23(5):298-306
IntroductionThe elderly population is increasingly benefiting from recent technological advances. In this scenario, geolocation-based dating applications provide a viable alternative for finding partners in a practical and timely manner, but may be accompanied by certain risk behaviors for HIV infection. Although there are considerable number of users over 50 on these applications, no studies have addressed this problem. The aim of the present study was to analyze factors of vulnerability to HIV/Aids among the population of men who have sex with men (MSM) age 50 years or older who use dating apps.MethodsThis was a cross-sectional, population-survey-based, analytical study, conducted exclusively online with a sample of 412 MSM. The data was collected from the following apps: Grindr®, Hornet®, Scruff® and Daddy Hunter®.ResultsFactors associated with a higher chance of having HIV were: sexual relations with an HIV-infected partner (ORa = 5.53; 95%CI = 2.23–13.73); chemsex (ORa = 3.97; 95%CI = 1.72–8.92); and, above all, having an HIV-infected partner (ORa = 8.02; 95%CI = 2.01–32.01). The belief that apps increase protection against sexually transmitted infections (ORa = 0.43; 95%CI = 0.19–0.95) and not being familiar with post-exposure prophylaxis (ORa = 0.43; 95%CI = 0.19–0.95) were associated with decreased chances of having HIV.ConclusionsWe highlight some important factors that structure the vulnerability of the MSM surveyed in relation to HIV infection. The findings should be used to customize care for this population, which could bring them in more for health care services. 相似文献
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Men who have Sex with Men (MSM) who find partners on the Internet tend to be sexually risky. A “cognitive escape” perspective
maintains that feeling overwhelmed by rigorous sexual norms may lead one to cognitively disengage from these demands as a
coping strategy. We thus proposed that the Internet might facilitate less restrained behavior among men whose psychological
characteristics make them vulnerable to “escape”-based risk. We tested this in a socio-economically and ethnically diverse
cross sectional survey sample of MSM, n=817. Men who sought sex on-line reported more unprotected sex and sexually transmitted infections, controlling for demographics
and overall number of sex partners. Consistent with an escape perspective, partner choice and sexual context, alcohol and
drug use, and “burnout” or fatigue over sexual safety mediated the relationship between Internet use and sexual risk. The
Internet is not an isolated source of risk; interventions must address the psychosocial aspects of this venue. 相似文献
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Neal A. Carnes James W. Carey Deborah J. Gelaude Damian J. Denson Patricia A. Bessler 《AIDS care》2021,33(1):63-69
ABSTRACT Expeditious linkage and consistent engagement in medical care is important for people with HIV’s (PWH) health. One theory on fostering linkage and engagement involves HIV status disclosure to mobilize social support. To assess disclosure and social support’s association with linkage and engagement, we conducted a qualitative study sampling black and Latino men who have sex with men (MSM of color) in the U.S. Participants' narratives presented mixed results. For instance, several participants who reported delaying, inconsistent access, or detachment from care also reported disclosing for support purposes, yet sporadic engagement suggests that their disclosure or any subsequent social support have not assisted. The findings contribute to the literature that questions disclosure and social support’s influence on care engagement, especially when decontextualized from circumstances and intentions. Our findings suggest the mechanics of disclosure and social support require planned implementation if intending to affect outcomes, especially among MSM of color. From the findings, we explore steps that may bolster interventions seeking to anchor medical care engagement. 相似文献
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Graziella H. Pereira Doroti de Oliveira Garcia Cely Saad Abboud Vera Lucia de Barros Barbosa Paulo Sérgio Lucas da Silva 《The Brazilian journal of infectious diseases》2013,17(5):606-609
We hereby describe the clinical and epidemiological features and, outcomes of nine patients with Elizabethkingia meningoseptica infections in two hospitals over a 2-year period. All infections caused by this pathogen were nosocomial, or healthcare associated infections, in hemodialysis settings whereas none was correlated with hospital outbreaks. 相似文献
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Maria R. Khan Kathleen A. McGinnis Christian Grov Joy D. Scheidell Laura Hawks E. Jennifer Edelman 《AIDS care》2019,31(3):349-356
Three quarters of new HIV infections in the US are among men who have sex with men (MSM). In other populations, incarceration is a social determinant of elevations in viral load and HIV-related substance use and sex risk behavior. There has been limited research on incarceration and these HIV transmission risk determinants in HIV-positive MSM. We used the Veterans Aging Cohort Study (VACS) 2011-2012 follow-up survey to measure associations between past year and prior (more than one year ago) incarceration and HIV viral load and substance use and sex risk behavior among HIV-positive MSM (N?=?532). Approximately 40% had ever been incarcerated, including 9% in the past year. In analyses adjusting for sociodemographic factors, past year and prior incarceration were strongly associated with detectable viral load (HIV-1 RNA >500 copies/mL) (past year adjusted odds ratio (AOR): 3.50 95% confidence interval (CI): 1.59, 7.71; prior AOR: 2.48 95% CI: 1.44, 4.29) and past 12 month injection drug use (AORs?>?6), multiple sex partnerships (AORs?>?1.8), and condomless sex in the context of substance use (AORs?>?3). Past year incarceration also was strongly associated with alcohol and non-injection drug use (AOR > 2.5). Less than one in five HIV-positive MSM recently released from incarceration took advantage of a jail/prison re-entry health care program available to veterans. We need to reach HIV-positive MSM leaving jails and prisons to improve linkage to care and clinical outcomes and reduce transmission risk upon release. 相似文献
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ABSTRACTEmerging data from Europe have documented increases in diagnoses of acute hepatitis C virus (HCV) infection among HIV-negative men who have sex with men. We investigated risk factors for HCV and their correlates in the Together 5000 study, a U.S. national cohort study of HIV-negative men (n?=?6089), transgender women (n?=?40), and transgender men (n?=?42) who have sex with men. We used bivariate and multivariable analyses to determine demographic and behavioral factors associated with high risk for acute HCV infection (using the HCV-MOSAIC risk indicator with a score?≥?2.0). Mean HCV risk score was 1.38 (SD?=?1.09) and 27.3% of participants had HCV risk scores?≥?2.0. In multivariable modeling, being cisgender male (vs. not) was associated with having a lower HCV-MOSAIC risk score. Meanwhile, being white, having been incarcerated, prior use of HIV pre- or post-exposure prophylaxis, having ever been tested for HIV, and recent methamphetamine use were associated with high risk for HCV. More than one-in-four participants exceeded the threshold score for HCV risk. Those with high HCV-MOSAIC risk scores were more likely to have been in settings where they could be tested for acute HCV (i.e., HIV testing, PrEP care, PEP care, incarceration), suggesting opportunities to engage them in HCV screening, prevention, and treatment. 相似文献
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Pando M Coloccini R Schvachsa N Pippo M Alfie L Marone R Gomez-Carrillo M Avila M Salomón H 《HIV medicine》2012,13(9):564-567