An Exploratory Study of Resilience, HIV-Related Stigma, and HIV Care Outcomes Among Men who have Sex with Men (MSM) Living with HIV in Louisiana

In Ghana, the HIV prevalence among MSM is more than 10 times greater than the general population of adults, and rates of engagement in HIV medical care are low among MSM diagnosed with HIV. Using structured surveys, we investigated the impact of HIV-related stigma, same-sex behavior stigma, and gender nonconformity stigma on linkage to HIV care (LTC) in MSM ( N = 225) living with HIV in Ghana. Autonomy-supportive healthcare climate ( OR = 1.63, p < .01), vicarious HIV stigma ( OR = 2.73, p < .01), and age ( OR = 1.06, p < .004) predicted LTC. Conversely, felt normative HIV stigma negatively predicted LTC ( OR = 0.65, p < .05). Finally, we identified regional disparities, with MSM from Takoradi being 4 times and 5 times more likely to be LTC compared to Kumasi and Accra, respectively. Our findings highlight the nuanced roles of stigmas in shaping the HIV care continuum among MSM living with HIV, while revealing potential gaps in current measures of HIV-related stigma.

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Salud y Orgullo Mexicano: Development of a Culturally Specific Transnational Linkage and Retention in Care Intervention for Mexican Men Who Have Sex with Men Living with HIV in Chicago

Journal of Immigrant and Minority Health ◽

10.1007/s10903-021-01185-9 ◽

2021 ◽

Author(s):

Amy K. Johnson ◽

Román Buenrostro ◽

Gilberto Soberanis ◽

Banita McCarn ◽

Bridget Magner ◽

...

Keyword(s):

Intervention Mapping ◽

Retention In Care ◽

Hiv Care ◽

Individual Level ◽

Expert Advisory ◽

Mapping Process ◽

Sex With Men ◽

Peer Navigation ◽

Living With Hiv ◽

Mexican Men

AbstractThis manuscript documents the development of an innovative individual-level peer navigation intervention “Salud y Orgullo Mexicano” (SOM) designed to increase linkage and retention to HIV care for Mexican men who have sex with men (MSM) in Chicago, Illinois. The intervention was developed via a modified intervention mapping process. Elements of two existing interventions were combined and refined with input from the Mexican MSM community, including informant interviews, an expert advisory board, and a design team. A manualized transnational intervention was developed via intervention mapping. A peer health navigation intervention “SOM” was created using intervention mapping and input from the focus community. Next steps include implementing and evaluating the intervention to determine acceptability and efficacy.

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Psychosocial Determinants of HIV Stigma among Men Who Have Sex with Men in San Francisco, California

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158031 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8031

Author(s):

Dharma N. Bhatta ◽

Jennifer Hecht ◽

Shelley N. Facente

Keyword(s):

Mental Health ◽

San Francisco ◽

Age Groups ◽

Hiv Stigma ◽

Hiv Care ◽

People Living With Hiv ◽

Cross Sectional ◽

Adjusted Risk ◽

Sex With Men ◽

Living With Hiv

Background: Stigma and discrimination are major challenges faced by people living with HIV (PLWH), and stigma continues to be prevalent among PLWH. We conducted a cross-sectional study of 584 men who have sex with men (MSM) living with HIV between July 2018 and December 2020, designed to better understand which demographic and behavioral characteristics of MSM living with HIV in San Francisco, California are associated with experience of stigma, so that programs and initiatives can be tailored appropriately to minimize HIV stigma’s impacts. Methods: This analysis was conducted with data from San Francisco AIDS Foundation (SFAF) encompassing services from multiple different locations in San Francisco. Data about the level of HIV-related stigma experienced were collected through a single question incorporated into programmatic data collection forms at SFAF as part of the client record stored in SFAF’s electronic health record. We performed linear regression to determine the associations between self-reported experiences of HIV stigma and other characteristics among MSM living with HIV. Results: HIV stigma was low overall among MSM living with HIV who are actively engaged in HIV care in San Francisco; however, it was significantly higher for the age groups of 13–29 years (adjusted risk difference (ARD): 0.251, 95% CI: 0.012, 0.489) and 30–49 years (ARD: 0.205, 95% CI: 0.042, 0.367) when compared to the age group of 50 years and older, as well as people who were homeless (ARD: 0.844, 95% CI: 0.120, 1.568), unstably housed (ARD: 0.326, 95% CI: 0.109, 0.543) and/or having mental health concerns (ARD: 0.309, 95% CI: 0.075, 0.544), controlling for race, injection history, and viral load. Conclusions: These findings highlight an opportunity to develop culturally, socially, and racially appropriate interventions to reduce HIV stigma among MSM living with HIV, particularly for younger men and those struggling with housing stability and/or mental health.

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Perceptions of Strategies and Intervention Approaches for HIV Self-Management among Ugandan Adolescents: A Qualitative Study

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/2325958218823246 ◽

2019 ◽

Vol 18 ◽

pp. 232595821882324 ◽

Cited By ~ 1

Author(s):

Massy Mutumba ◽

Henry Mugerwa ◽

Victor Musiime ◽

Anudeeta Gautam ◽

Hellen Nakyambadde ◽

...

Keyword(s):

Healthcare Providers ◽

Self Care ◽

Hiv Care ◽

Self Management ◽

Care Needs ◽

Behavioral Skills ◽

Social Challenges ◽

Management Intervention ◽

Care Outcomes ◽

Living With Hiv

The heightened vulnerability of adolescents to poor HIV care outcomes underscores the need for interventions that create and promote HIV self-management behavioral skills. Adolescents living with HIV (ALHIV) experience a complex array of physical, emotional, and social challenges that constrain their self-care, but the majority of existing psychosocial programs focus primarily on medication adherence. Understanding adolescents’ self-care needs, challenges, and preferences is necessary for developing effective culturally relevant interventions. The involvement of caregivers and stakeholders is also critical to realizing positive self-care outcomes. This article presents the findings from focus group discussions with ALHIV, caregivers, and healthcare providers on self-care. The data were collected as part of formative research in the development of a self-management intervention for Ugandan ALHIV. Participants’ discussions on self-care strategies and intervention approaches provide valuable insights to guide the development of interventions to promote positive HIV care outcomes among Ugandan ALHIV.

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Increasing HIV Testing and Viral Suppression via Stigma Reduction in a Social Networking Mobile Health Intervention Among Black and Latinx Young Men and Transgender Women Who Have Sex With Men (HealthMpowerment): Protocol for a Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/24043 ◽

2020 ◽

Vol 9 (12) ◽

pp. e24043

Author(s):

Kathryn Elizabeth Muessig ◽

Jesse M Golinkoff ◽

Lisa B Hightow-Weidman ◽

Aimee E Rochelle ◽

Marta I Mulawa ◽

...

Keyword(s):

Hiv Testing ◽

Viral Suppression ◽

The United States ◽

Hiv Care ◽

Hiv Status ◽

Mhealth Intervention ◽

Sex With Men ◽

The University ◽

Living With Hiv ◽

Hiv Negative

Background Stigma and discrimination related to sexuality, race, ethnicity, and HIV status negatively impact HIV testing, engagement in care, and consistent viral suppression (VS) among young Black and Latinx men who have sex with men and transgender women who have sex with men (YBLMT). Few interventions address the effects of intersectional stigma among youth living with HIV and those at risk for HIV within the same virtual space. Objective Building on the success of the HealthMpowerment (HMP) mobile health (mHealth) intervention (HMP 1.0) and with the input of a youth advisory board, HMP 2.0 is an app-based intervention that promotes user-generated content and social support to reduce intersectional stigma and improve HIV-related outcomes among YBLMT. The primary objective of this study is to test whether participants randomized to HMP 2.0 report improvement in HIV prevention and care continuum outcomes compared with an information-only control arm. We will also explore whether participant engagement, as measured by paradata (data collected as users interact with an mHealth intervention, eg, time spent using the intervention), mediates stigma- and HIV care–related outcomes. Finally, we will assess whether changes in intersectional stigma and improvements in HIV care continuum outcomes vary across different types of social networks formed within the intervention study arms. Methods We will enroll 1050 YBLMT aged 15 to 29 years affected by HIV across the United States. Using an HIV-status stratified, randomized trial design, participants will be randomly assigned to 1 of the 3 app-based conditions (information-only app-based control arm, a researcher-created network arm of HMP 2.0, or a peer-referred network arm of HMP 2.0). Behavioral assessments will occur at baseline, 3, 6, 9, and 12 months. For participants living with HIV, self-collected biomarkers (viral load) are scheduled for baseline, 6, and 12 months. For HIV-negative participants, up to 3 HIV self-testing kits will be available during the study period. Results Research activities began in September 2018 and are ongoing. The University of Pennsylvania is the central institutional review board for this study (protocol #829805) with institutional reliance agreements with the University of North Carolina at Chapel Hill, Duke University, and SUNY Downstate Health Sciences University. Study recruitment began on July 20, 2020. A total of 205 participants have been enrolled as of November 20, 2020. Conclusions Among a large sample of US-based YBLMT, this study will assess whether HMP 2.0, an app-based intervention designed to ameliorate stigma and its negative sequelae, can increase routine HIV testing among HIV-negative participants and consistent VS among participants living with HIV. If efficacious and brought to scale, this intervention has the potential to significantly impact the disproportionate burden of HIV among YBLMT in the United States. Trial Registration ClinicalTrials.gov NCT03678181; https://clinicaltrials.gov/ct2/show/study/NCT03678181. International Registered Report Identifier (IRRID) DERR1-10.2196/24043

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Factors influencing HIV care outcomes among adolescents living with HIV in rural South Africa

10.31899/hiv12.1024 ◽

2021 ◽

Author(s):

Lindsey Filiatreau ◽

Audrey Pettifor ◽

Jess Edwards ◽

Nkosinathi Masilela ◽

Rhian Twine ◽

...

Keyword(s):

South Africa ◽

Hiv Care ◽

Rural South ◽

Factors Influencing ◽

Care Outcomes ◽

Living With Hiv ◽

Rural South Africa

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The Engage[men]t Study: Protocol for a prospective cohort study of Black and White men who have sex with men living with HIV in Atlanta, Georgia to examine Black/White disparities in care outcomes (Preprint)

JMIR Research Protocols ◽

10.2196/21985 ◽

2020 ◽

Author(s):

Patrick Sullivan ◽

Jennifer Taussig ◽

Mariah Valentine-Graves ◽

Nicole Luisi ◽

Carlos Del Rio ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Study Protocol ◽

Prospective Cohort ◽

White Men ◽

Black And White ◽

Care Outcomes ◽

Sex With Men ◽

Living With Hiv

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Perceived Need and Acceptability of a Community-Based Peer Navigator Model to Engage Key Populations in HIV Care in Tijuana, Mexico

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/2325958220919276 ◽

2020 ◽

Vol 19 ◽

pp. 232595822091927

Author(s):

Eileen V. Pitpitan ◽

Maria Luisa Mittal ◽

Laramie R. Smith

Keyword(s):

Hiv Care ◽

Key Populations ◽

Community Based ◽

Perceived Need ◽

Community Stakeholders ◽

Key Stakeholders ◽

Community Forum ◽

Care Outcomes ◽

Living With Hiv ◽

Depth Interviews

Introduction: Prior work found <4% of key populations living with HIV (KPLWH) in Tijuana, Mexico, were on antiretroviral therapy (ART). The goal of this pilot study was to examine community stakeholders’ perceived need and acceptability of a peer-navigator program to improve ART coverage. Methods: We held a community forum and measured perspectives of key stakeholders in local organizations that serve KPLWH using online surveys, and in-depth interviews (with select key informants). Results: Univariate descriptive statistics and emergent thematic analysis illustrated that there was general consensus that the program could improve ART coverage for KPLWH by helping to overcome geographic, transportation, and sociostructural barriers to HIV care. Police harassment, mobility, and non-HIV comorbidities were identified as challenges the program would need to navigate. Conclusions: Community stakeholders expressed perceived need and acceptability of a program to improve HIV care outcomes among KPLWH in Tijuana. The program should address the challenges identified by community stakeholders.

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Understanding How Gay, Bisexual, and Other Men Who Have Sex With Men in China Cope With HIV Care-Related Stressors

AIDS Education and Prevention ◽

10.1521/aeap.2021.33.1.46 ◽

2021 ◽

Vol 33 (1) ◽

pp. 46-61

Author(s):

Chunyan Li ◽

Danielle Giovenco ◽

Willa Dong ◽

M. Kumi Smith ◽

Carol E. Golin ◽

...

Keyword(s):

Social Support ◽

Well Being ◽

Hiv Care ◽

Semistructured Interviews ◽

Stress Coping Strategies ◽

Community Based Organization ◽

Related Stress ◽

Sex With Men ◽

And Coping ◽

Living With Hiv

Understanding how Chinese gay, bisexual, and other men who have sex with men (GBMSM) cope with HIV care-related stressors could improve their care engagement. Qualitative semistructured interviews were conducted with 30 GBMSM living with HIV recruited through clinics and a community-based organization (CBO) in Chengdu, China. Interviews focused on treatment-related stress, coping strategies, social support, and well-being. Half reported symptoms consistent with mild or moderate depression as measured by the PHQ-9 scale. HIV care-related stressors included side effects, difficulty with adherence, and fear of drug resistance. Challenges to coping include navigating contradictory information about HIV and treatment, experiencing stigma and discrimination within medical and nonmedical settings, and managing financial concerns. CBOs, peer groups, and providers were salient sources of social support benefitting coping. To improve sustained HIV care that meets the needs of Chinese GBMSM living with HIV, tailored interventions that address the above-mentioned stressors and coping challenges are likely needed.

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Estimating the HIV undiagnosed population in Catalonia, Spain: descriptive and comparative data analysis to identify differences in MSM stratified by migrant and Spanish-born population

BMJ Open ◽

10.1136/bmjopen-2017-018533 ◽

2018 ◽

Vol 8 (2) ◽

pp. e018533 ◽

Cited By ~ 8

Author(s):

Juliana Maria Reyes-Urueña ◽

Colin N J Campbell ◽

Núria Vives ◽

Anna Esteve ◽

Juan Ambrosioni ◽

...

Keyword(s):

Hiv Transmission ◽

Retention In Care ◽

Hiv And Aids ◽

Hiv Care ◽

People Living With Hiv ◽

Hiv Care Cascade ◽

Care Cascade ◽

Undiagnosed Hiv ◽

Sex With Men ◽

Living With Hiv

ObjectiveUndiagnosed HIV continues to be a hindrance to efforts aimed at reducing incidence of HIV. The objective of this study was to provide an estimate of the HIV undiagnosed population in Catalonia and compare the HIV care cascade with this step included between high-risk populations.MethodsTo estimate HIV incidence, time between infection and diagnosis and the undiagnosed population stratified by CD4 count, we used the ECDC HIV Modelling Tool V.1.2.2. This model uses data on new HIV and AIDS diagnoses from the Catalan HIV/AIDS surveillance system from 2001 to 2013. Data used to estimate the proportion of people enrolled, on ART and virally suppressed in the HIV care cascade were derived from the PISCIS cohort.ResultsThe total number of people living with HIV (PLHIV) in Catalonia in 2013 was 34 729 (32 740 to 36 827), with 12.3% (11.8 to 18.1) of whom were undiagnosed. By 2013, there were 8458 (8101 to 9079) Spanish-born men who have sex with men (MSM) and 2538 (2334 to 2918) migrant MSM living with HIV in Catalonia. A greater proportion of migrant MSM than local MSM was undiagnosed (32% vs 22%). In the subsequent steps of the HIV care cascade, migrants MSM experience greater losses than the Spanish-born MSM: in retention in care (74% vs 55%), in the proportion on combination antiretroviral treatment (70% vs 50%) and virally suppressed (65% vs 46%).ConclusionsBy the end of 2013, there were an estimated 34 729 PLHIV in Catalonia, of whom 4271 were still undiagnosed. This study shows that the Catalan epidemic of HIV has continued to expand with the key group sustaining HIV transmission being MSM living with undiagnosed HIV.

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