Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

Abstract Background There is limited information about the types of recreational drugs used by men who have sex with men (MSM) in China or the consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods We recruited MSM from seven cities in China between 2012 and 2013 using multiple approaches including advertisements on gay websites, collaborating with local MSM community-based organizations, peer referrals, and venues such as gay bars and bathrooms visited by MSM. We divided participants into four subgroups based on the number of recreational drugs (RDs) used in the previous 6 months. We defined use of multiple RDs as use of ≥2 types of RDs. Demographics and HIV-related high-risk behaviors were collected, and blood samples were tested for recent HIV infection by the HIV-1 subtypes B, E, and D immunoglobulin G capture enzyme immunoassay (BED-CEIA). We used multivariable logistic regression adjusted for sociodemographics to determine the adjusted odds ratios (aORs) and associated 95% confidence intervals (CIs) of the subgroups of RD use for recent or established HIV infection. Results A total of 4496 Chinese MSM participated; 28.4% used RDs, and 5% used multiple types of RDs. The prevalence of each RD use was as follows: poppers (25.9%), ecstasy (2.4%), ketamine (1.2%), amphetamine (0.6%), tramadol (0.4%), methamphetamine (3.8%), and codeine (1.9%). Users of multiple RDs commonly used poppers combined with one or more other types of RDs. Multiple RD users were likely to be aged 26–30 years (vs. 18–25 and > 30 years), live in non-local cities (vs. local cities), never married (vs. married), have a high monthly income (vs. no income and 1–599 USD), use versatile positions during anal intercourse (vs. top or bottom), and have inadequate HIV-related prevention knowledge (vs. adequate). As the number of RDs used in the previous 6 months increased, the prevalence of HIV-related high-risk behaviors increased (P < 0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95% CI: 1.5–3.0) or two types of RD (aOR=2.3, 95% CI: 1.0-5.2) in the previous 6 months compared to the odds among those who did not use RDs. Conclusion The level and pattern of multiple RD use among Chinese MSM were different from high-income countries. MSM who used more RDs are more likely to engage in high-risk sexual behaviors, and these behaviors may be associated with increases in new HIV infections.

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Food Insecurity Partially Mediates the Association Between Drug Use and Depressive Symptoms among Men who have Sex with Men in Los Angeles, California

Public Health Nutrition ◽

10.1017/s1368980021002494 ◽

2021 ◽

pp. 1-26

Author(s):

David A. Wiss ◽

Marjan Javanbakht ◽

Michael J. Li ◽

Michael Prelip ◽

Robert Bolan ◽

...

Keyword(s):

Food Security ◽

Depressive Symptoms ◽

High Risk ◽

Los Angeles ◽

Drug Use ◽

Food Insecurity ◽

Hiv Positive ◽

Sex With Men ◽

The Relationship ◽

Hiv Negative

Abstract Objective: To understand the relationship between drug use, food insecurity (FI), and mental health among men who have sex with men (MSM). Design: Cohort study (2014-2019) with at least one follow-up. Setting: Visits at 6-month intervals included self-assessment for FI and depressive symptoms. Urine testing results confirmed drug use. Factors associated with FI were assessed using multiple logistic regression with random effects for repeated measures. General structural equation modeling tested whether FI mediates the relationship between drug use and depressive symptoms. Participants: Data were from HIV-positive and high-risk HIV negative MSM in Los Angeles, CA (n=431; 1,192 visits). Results: At baseline, FI was reported by 50.8% of participants, depressive symptoms in 36.7%, and 52.7% of urine screening tests were positive for drugs (i.e., marijuana, opioids, methamphetamine, cocaine, ecstasy). A positive drug test was associated with a 96% increase in the odds of being food insecure (95% CI: 1.26-3.07). Compared to those with high food security, individuals with very low food security have a nearly 7-fold increase in the odds of reporting depressive symptoms (95% CI: 3.71-11.92). Findings showed 14.9% of the association between drug use (exposure) and depressive symptoms (outcome) can be explained by FI (mediator). Conclusion: The prevalence of FI among this cohort of HIV-positive and high-risk HIV-negative MSM was high; the association between drug use and depressive symptoms was partially mediated by FI. Findings suggest that enhancing access to food and nutrition may improve mood in the context of drug use, especially among MSM at risk for HIV-transmission.

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Unprotected Anal Intercourse and Substance Use Among Men Who Have Sex With Men With Recent HIV Infection

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/01.qai.0000230530.02212.86 ◽

2006 ◽

Vol 43 (3) ◽

pp. 344-350 ◽

Cited By ~ 75

Author(s):

Lydia N Drumright ◽

Susan J Little ◽

Steffanie A Strathdee ◽

Donald J Slymen ◽

Maria Rosario G Araneta ◽

...

Keyword(s):

Substance Use ◽

Hiv Infection ◽

Anal Intercourse ◽

Unprotected Anal Intercourse ◽

Sex With Men ◽

Recent Hiv Infection

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Sexual behaviours and sexually transmitted infection outcomes in a cohort of HIV-negative men who have sex with men attending sexual health clinics in England

International Journal of STD & AIDS ◽

10.1177/0956462418789333 ◽

2018 ◽

Vol 29 (14) ◽

pp. 1407-1416 ◽

Cited By ~ 1

Author(s):

S Desai ◽

F Burns ◽

G Schembri ◽

D Williams ◽

A Sullivan ◽

...

Keyword(s):

High Risk ◽

Sexual Health ◽

Receptive Anal Intercourse ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Sexual Behaviours ◽

Increased Risk ◽

Sex With Men ◽

Clinical Records ◽

Hiv Negative

Men who have sex with men (MSM) attending sexual health (SH) clinics are at high risk for HIV acquisition and are disproportionately affected by sexually transmitted infections (STIs). We collected standardised behavioural data from MSM attending clinics to characterise sexual behaviours and identify predictors for HIV and STIs. In 2012–2013, HIV-negative MSM attending five SH clinics in England reported sexual behaviours in the previous three months via a self-administered questionnaire. Behaviours were linked to the individual’s clinical records using national surveillance. The prevalence and incidence of bacterial STIs (gonorrhoea, Chlamydia, lymphogranuloma venereum and syphilis) and incidence of HIV were calculated. Adjusted odds ratios and hazard ratios with 95% confidence interval (CI) were reported for significant predictors. Of 1278 HIV-negative MSM, 54% were of white ethnicity and UK-born and 43% were 25–34 years old. Almost all men reported at least one partner in the last three months. Half reported condomless anal sex and 36% condomless receptive anal intercourse (CRAI). Incidence of bacterial STIs was 46/100 (95%CI 39–54) person years (py) and of HIV was 3.1/100 (95%CI 1.7–5.6) py. A STI at baseline and CRAI with increasing numbers of partners were associated with both incident infections. In this cohort of MSM high-risk behaviours and STIs were prevalent. Engagement in CRAI increased the likelihood of subsequent infection, while men diagnosed with a bacterial STI were at increased risk of a future STI. Clinical and behavioural risk assessments to determine an individual’s risk of infection could allow a more nuanced prevention approach that has greater success in reducing transmission.

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Defining the PrEP care continuum among recently incarcerated men at high risk for HIV infection (Preprint)

10.2196/preprints.31928 ◽

2021 ◽

Author(s):

Matthew Murphy ◽

Colette Sosnowy ◽

Brooke Rogers ◽

Siena Napoleon ◽

Drew Galipeau ◽

...

Keyword(s):

Public Health ◽

High Risk ◽

Hiv Infection ◽

Care Continuum ◽

Increased Risk ◽

Biomedical Intervention ◽

Prep Implementation ◽

Hiv Acquisition ◽

Risk Of Hiv Acquisition ◽

Prospective Longitudinal

BACKGROUND HIV disproportionately impacts criminal justice (CJ)-involved individuals, including men who experience incarceration. Men make up the vast majority of those experiencing incarceration as well as those newly diagnosed with HIV infection. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention that significantly reduces the risk of HIV acquisition. However, implementation in CJ-systems is limited. Little is known about effective PrEP implementation and use in this unique public health context. OBJECTIVE This article describes a PrEP care continuum for men experiencing incarceration who are at increased risk of HIV acquisition, which can help conceptualize approaches to evaluating PrEP implementation. METHODS Men incarcerated in the Rhode Island Department of Corrections, a correctional system composed of all of the state's sentenced and awaiting trial population, are screened for HIV acquisition risk during the course of routine clinical care. Those identified at high risk for HIV acquisition are referred for evaluation for PrEP initiation and enrollment in this study. Individuals who express interest in initiating PrEP and consent to the study are then followed in a prospective longitudinal cohort. RESULTS The outlined study will enroll 100 men experiencing incarceration at high risk for HIV acquisition prior to release into the community. The goal is to initiate PrEP prior to incarceration and link individuals to PrEP providers in the community, capturing barriers and facilitators to PrEP use during this uniquely vulnerable time period for HIV acquisition. CONCLUSIONS Based on the proposed care continuum and what is known about HIV risk and prevention efforts in the CJ-context, we outline key future research efforts to better understand effective approaches to preventing HIV infection among this vulnerable population. The described approach presents a powerful public health opportunity to help end the HIV epidemic.

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Prevalence and Genotype distribution of Human Papillomavirus Infection in Different Anatomical Sites among Men Who Have Sex with Men (MSM): A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-17873/v1 ◽

2020 ◽

Author(s):

Mohammad Farahmand ◽

Seyed Hamidreza Monavari ◽

Ahmad Tavakoli

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

High Risk ◽

Sexual Behaviors ◽

Meta Analysis ◽

Hpv Infection ◽

Genotype Distribution ◽

Increased Risk ◽

Pertinent Data ◽

Sex With Men

Abstract Background: Homosexual men or men who have sex with men (MSM) are at increased risk of human papillomavirus (HPV) infection because of their high-risk sexual behaviors. In this large study, a meta-analytic approach was used to systematically analyze the literature to elucidate the prevalence and genotype distribution of anal, penile, oral, and urethral HPV infection among MSM in the world.Methods: To carry out this systematic review, five electronic databases were searched for relevant studies published from January 2012 through to November 2019, and pertinent data were collected from the eligible articles. The pooled HPV prevalences were calculated for each anatomical region using random-effect model weighted by the inverse variance method. Subgroup analyses were performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the “Metaprop” function in the R package Meta.Results: The overall pooled prevalence of anal, penile, oral, and urethral HPV infection among MSM were 78.11 % (95% CI: 75.50%-80.52%), 36.26% (95% CI: 29.13%–44.05%), 17.33% (95% CI: 13.65%–21.75%), and 15.40% (95% CI: 7.86%–27.97%), respectively. Stratified analyses showed that the prevalences of HPV were significantly higher in HIV-positive than HIV-negative MSM. The most frequent HPV high-risk type detected in the anus, penis, and oral cavity was HPV-16 (20.32%, 4.96%, and 3.16%, respectively). Conclusion: HPV infection is on the dramatic rise in MSM because of high-risk sexual behaviors, strongly suggesting the increased risk of developing HPV-related diseases and malignancies in this population. Among different sexual orientations, male homosexuality is associated with the highest risk of acquiring sexually transmitted infections.

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Do men who have sex with men who report alcohol and illicit drug use before/during sex (chemsex) present moderate/high risk for substance use disorders?

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2020.107908 ◽

2020 ◽

Vol 209 ◽

pp. 107908 ◽

Cited By ~ 5

Author(s):

Thiago S. Torres ◽

Leonardo S. Bastos ◽

Luciana Kamel ◽

Daniel R.B. Bezerra ◽

Nilo M. Fernandes ◽

...

Keyword(s):

Substance Use ◽

High Risk ◽

Drug Use ◽

Substance Use Disorders ◽

Illicit Drug ◽

Illicit Drug Use ◽

Sex With Men

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A survey of HIV infection and related high-risk factors among men who have sex with men in Suzhou, Jiangsu, China

Journal of Biomedical Research ◽

10.1016/s1674-8301(11)60002-x ◽

2012 ◽

Vol 25 (1) ◽

pp. 17-24 ◽

Cited By ~ 10

Author(s):

Hongling Bai ◽

Xiping Huan ◽

Weiming Tang ◽

Xin Chen ◽

Hongjing Yan ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Hiv Infection ◽

High Risk Factors ◽

Sex With Men

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Cervicovaginal Levels of Lactoferrin, Secretory Leukocyte Protease Inhibitor, and RANTES and the Effects of Coexisting Vaginoses in Human Immunodeficiency Virus (HIV)-Seronegative Women with a High Risk of Heterosexual Acquisition of HIV Infection

Clinical and Vaccine Immunology ◽

10.1128/cvi.00386-06 ◽

2007 ◽

Vol 14 (9) ◽

pp. 1102-1107 ◽

Cited By ~ 62

Author(s):

Richard M. Novak ◽

Betty A. Donoval ◽

Parrie J. Graham ◽

Lucy A. Boksa ◽

Gregory Spear ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

High Risk ◽

Hiv Infection ◽

Protease Inhibitor ◽

Genital Tract ◽

Secretory Leukocyte Protease Inhibitor ◽

Low Risk ◽

High Risk Women ◽

Increased Risk ◽

Immunodeficiency Virus

ABSTRACT Innate immune factors in mucosal secretions may influence human immunodeficiency virus type 1 (HIV-1) transmission. This study examined the levels of three such factors, genital tract lactoferrin [Lf], secretory leukocyte protease inhibitor [SLPI], and RANTES, in women at risk for acquiring HIV infection, as well as cofactors that may be associated with their presence. Women at high risk for HIV infection meeting established criteria (n = 62) and low-risk controls (n = 33) underwent cervicovaginal lavage (CVL), and the CVL fluid samples were assayed for Lf and SLPI. Subsets of 26 and 10 samples, respectively, were assayed for RANTES. Coexisting sexually transmitted infections and vaginoses were also assessed, and detailed behavioral information was collected. Lf levels were higher in high-risk (mean, 204 ng/ml) versus low-risk (mean, 160 ng/ml, P = 0.007) women, but SLPI levels did not differ, and RANTES levels were higher in only the highest-risk subset. Lf was positively associated only with the presence of leukocytes in the CVL fluid (P < 0.0001). SLPI levels were lower in women with bacterial vaginosis [BV] than in those without BV (P = 0.04). Treatment of BV reduced RANTES levels (P = 0.05). The influence, if any, of these three cofactors on HIV transmission in women cannot be determined from this study. The higher Lf concentrations observed in high-risk women were strongly associated with the presence of leukocytes, suggesting a leukocyte source and consistent with greater genital tract inflammation in the high-risk group. Reduced SLPI levels during BV infection are consistent with an increased risk of HIV infection, which has been associated with BV. However, the increased RANTES levels in a higher-risk subset of high-risk women were reduced after BV treatment.

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1630. Voluntary HIV Testing and Self-Realization of Risk of HIV Infection Among Young Men-Who-Have-Sex-with-Men in the Miami-Dade Area

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1494 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S595-S595

Author(s):

Hampton Ocon ◽

Samir Sabbag

Keyword(s):

Public Health ◽

High Risk ◽

Hiv Infection ◽

Hiv Testing ◽

Hiv Risk ◽

Perceived Risk ◽

Health Initiatives ◽

History Of ◽

Sex With Men ◽

Public Health Initiatives

Abstract Background According to the Centers for Disease Control and Prevention, Miami-Dade County has the highest rate of new HIV diagnoses in the Nation. So far, a large focus of public health initiatives has been spreading awareness of HIV testing locations, but this form of voluntary testing relies on individuals realizing that they are at risk of HIV infection in the first place. Consequently, a major obstacle to encouraging young men-who-have-sex-with-men (YMSM) to test themselves for HIV is their own self-perceived risk of having an undetected infection. Methods In an effort to better understand the discordance between high-risk sexual behavior and HIV testing among this high-risk population, YMSM (18–24) were surveyed through smartphone applications that facilitate sexual encounters in the Miami-Dade area (eg Grindr, Scruff). Users were asked about their history of condomless anal intercourse (CAI), their HIV testing habits, and whether or not they believe it possible that they are currently infected with HIV. An analysis of the relationship between CAI and self-perception of possible HIV infection was performed using Cochran-Mantel–Haenszel testing. Results Of the 843 eligible responses, 667 reported a history of voluntary HIV testing while 176 had never voluntarily tested. 726 respondents reported a history of CAI and 131 of these have never voluntarily tested. Of the 843 total participants, 1.6% were in the highest HIV risk group, which is those who have engaged in CAI with an exchange/casual partner, have never voluntarily tested for HIV, and have no self-perceived risk of being currently infected. According to data analysis, YMSM who have engaged in CAI but have never been tested for HIV were not more likely to have a self-perceived possibility of infection when compared with those who have voluntarily tested (P < 0.595). Conclusion This suggests that many high-risk YMSM are not voluntarily testing themselves for HIV not because they do not have access to testing, but rather because they do not perceive themselves as being possibly infected in the first place. Therefore, in addition to increasing access to HIV testing, new public health initiatives must be designed to facilitate YMSM understanding their own personal HIV risk. Disclosures All authors: No reported disclosures.

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