scholarly journals Novel Platforms for Biomedical HIV Prevention Delivery to Key Populations — Community Mobile Clinics, Peer-Supported, Pharmacy-Led PrEP Delivery, and the Use of Telemedicine

2021 ◽  
Author(s):  
E. Rousseau ◽  
R. F. Julies ◽  
N. Madubela ◽  
S. Kassim
Keyword(s):  
Hiv Prevention ◽  
Key Populations ◽  
Biomedical Hiv Prevention ◽  
Mobile Clinics

scholarly journals Contexts of vulnerability and the acceptability of new biomedical HIV prevention technologies among key populations in South Africa: A qualitative study

PLoS ONE ◽  
2018 ◽  
Vol 13 (2) ◽  
pp. e0191251 ◽  
Author(s):  
Millicent Atujuna ◽  
Peter A. Newman ◽  
Melissa Wallace ◽  
Megan Eluhu ◽  
Clara Rubincam ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Qualitative Study ◽  
Key Populations ◽  
Biomedical Hiv Prevention

Epidemiology of HIV in Iran

2020 ◽  
Vol 18 (4) ◽  
pp. 228-236
Author(s):  
Zeinab Najafi ◽  
Leila Taj ◽  
Omid Dadras ◽  
Fatemeh Ghadimi ◽  
Banafsheh Moradmand ◽  
...  
Keyword(s):  
Middle East ◽  
Hiv Prevention ◽  
Prevention And Control ◽  
Hiv Transmission ◽  
Health Management ◽  
Key Populations ◽  
Mena Region ◽  
First Case ◽  
And Control ◽  
Hiv Aids

: Iran has been one of the active countries fighting against HIV/AIDS in the Middle East during the last decades. Moreover, there is a strong push to strengthen the national health management system concerning HIV prevention and control. In Iran, HIV disease has its unique features, from changes in modes of transmission to improvement in treatment and care programs, which can make it a good case for closer scrutiny. The present review describes the HIV epidemic in Iran from the first case diagnosed until prevention among different groups at risk and co-infections. Not only we addressed the key populations and community-based attempts to overcome HIV-related issues in clinics, but we also elaborated on the efforts and trends in society and the actual behaviors related to HIV/AIDS. Being located in the Middle East and North Africa (MENA) region, given the countryspecific characteristics, and despite all the national efforts along with other countries in this region, Iran still needs to take extra measures to reduce HIV transmission, especially in health education. Although Iran is one of the pioneers in implementing applicable and appropriate policies in the MENA region, including harm reduction services to reduce HIV incidence, people with substance use disorder continue to be the majority of those living with HIV in the country. Similar to other countries in this region, the HIV prevention and control programs aim at 90-90-90 targets to eliminate HIV infection and reduce the transmission, especially the mother-to-child transmission and among other key populations.

scholarly journals Integrating syphilis screening in a large-scale HIV prevention program for key populations: the Avahan experience from India

2013 ◽  
Vol 7 (06) ◽  
pp. 484-488 ◽  
Author(s):  
Mugundu Ramien Parthasarathy ◽  
Prakash Narayanan ◽  
Anjana Das ◽  
Anup Gurung ◽  
Parimi Prabhakar ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Prevention Program ◽  
Large Scale ◽  
Point Of Care ◽  
Key Populations ◽  
Immunochromatographic Strip ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Syphilis Screening ◽  
Strip Test

Introduction: Documented experiences from India on the implementation of syphilis screening in large-scale HIV prevention programs for “key populations at higher risk’ (KPs) are limited. Avahan is a large-scale HIV prevention program providing services to more than 300,000 KPs in six high HIV prevalence states of India since 2004. Avahan clinics provide a sexually transmitted infection service package which includes bi-annual syphilis screening. The trends in the coverage of syphilis screening among Avahan clinic attendees were studied retrospectively. Methodology: Screening was performed using either the Rapid Plasma Reagin (RPR) test or point-of-care immunochromatographic strip test (ICST). Clinic records from 2005 to 2009 were collated in an individual tracking database and analyzed with STATA-10. Results: Initially the coverage of syphilis screening (2.6% in 2005) was constrained by the availability and operational complexity of the RPR test. After its introduction in 2007, the use of ICST for screening increased from 7.4% to 77.0% and the proportion of clinic attendees screened increased from 9.0% to 21.6% during 2007-2009. The RPR reactivity rates declined from 6.6% (2006) to 4.4% (2009). Conclusion: The data showed improved rates of screening of clinic attendees and declining trends in sero-reactivity over time. The introduction of point-of-care syphilis tests may have contributed to the improved coverage of syphilis screening. The ICST may be considered for initial syphilis screening at other resource-constrained primary care sites in India such as ante-natal clinics and other KP interventions.

scholarly journals Innovative Approaches to Obtain Minors’ Consent for Biomedical HIV Prevention Trials: Multi-Site Quasi-Experimental Study of Adolescent and Parent Perspectives

10.2196/16509 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e16509 ◽  
Author(s):  
Amelia Knopf ◽  
Mary A Ott ◽  
Claire Burke Draucker ◽  
J Dennis Fortenberry ◽  
Daniel H Reirden ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Parental Involvement ◽  
Human Subjects ◽  
Consent Process ◽  
Parental Consent ◽  
Open Label ◽  
Open Label Study ◽  
Biomedical Hiv Prevention ◽  
Quasi Experimental ◽  
Prevention Trials

Background Despite the high burden of new HIV infections in minor adolescents, they are often excluded from biomedical HIV prevention trials, largely owing to the ethical complexities of obtaining consent for enrollment. Researchers and ethics regulators have a duty to protect adolescents—as a special category of human subjects, they must have protection that extends beyond those afforded to all human subjects. Typically, additional protection includes parental consent for enrollment. However, parental consent can present a risk of harm for minor adolescents. Research involving minor adolescents indicate that they are unwilling to join biomedical trials for stigmatized health problems, such as HIV, when parental consent is required. This presents a significant barrier to progress in adolescent HIV prevention by creating delays in research and the translation of new scientific evidence generated in biomedical trials in adult populations. Objective This protocol aims to examine how parental involvement in the consent process affects the acceptability of hypothetical participation in biomedical HIV prevention trials from the perspectives of minor adolescents and parents of minor adolescents. Methods In this protocol, we use a quasi-experimental design that involves a simulated consent process for 2 different HIV prevention trials. The first trial is modeled after an open-label study of the use of tenofovir disoproxil fumarate and emtricitabine as preexposure prophylaxis for HIV. The second trial is modeled after a phase IIa trial of an injectable HIV integrase inhibitor. There are 2 groups in the study—minor adolescents aged 14 to 17 years, inclusive, and parents of minor adolescents in the same age range. The adolescent participants are randomized to 1 of 3 consent conditions with varying degrees of parental involvement. After undergoing a simulated consent process, they rate their willingness to participate (WTP) in each of the 2 trials if offered the opportunity. The primary outcome is WTP, given the consent condition. Parents undergo a similar process but are asked to rate the acceptability of each of the 3 consent conditions. The primary outcome is acceptability of the consent method for enrollment. The secondary outcomes include the following: capacity to consent among both participant groups, the prevalence of medical mistrust, and the effects of the study phase (eg, phase IIa vs the open-label study) and drug administration route (eg, oral vs injection) on WTP (adolescents) and acceptability (parents) of the consent method. Results Enrollment began in April 2018 and ended mid-September 2019. Data are being analyzed and dissemination is expected in April 2020. Conclusions The study will provide the needed empirical data about minor adolescents’ and parents’ perspectives on consent methods for minors. The evidence generated can be used to guide investigators and ethics regulators in the design of consent processes for biomedical HIV prevention trials. International Registered Report Identifier (IRRID) DERR1-10.2196/16509

scholarly journals Prevalence and Correlates of Transactional Sex Among Women of Low Socioeconomic Status in Portland, Oregon

2020 ◽  
Author(s):  
Timothy W Menza ◽  
Lauren Lipira ◽  
Amisha Bhattarai ◽  
Victoria Cali-DeLeon ◽  
Roberto Orellana
Keyword(s):  
Socioeconomic Status ◽  
Hiv Prevention ◽  
Sexual Violence ◽  
Childhood Trauma ◽  
Low Socioeconomic Status ◽  
Transactional Sex ◽  
Hiv Screening ◽  
Low Socioeconomic ◽  
Biomedical Hiv Prevention ◽  
Exposure Prophylaxis

Abstract Background: Women who report transactional sex are at increased risk for HIV and other sexually transmitted infections (STIs). However,in the United States, social, behavioral, and trauma-related vulnerabilities associated with transactional sex are understudied and data on access to biomedical HIV prevention among women who report transactional sex is limited. Methods: In 2016, we conducted a population-based, cross-sectional survey of women of low socioeconomic status recruited via respondent-driven sampling in Portland, Oregon. We calculated the prevalence and,assessed the correlates of, transactional sex using generalized linear models accounting for sampling design. We also compared health outcomes,HIV screening, and knowledge and uptake of HIV pre-exposure prophylaxis (PrEP) between women who did and did not report transactional sex.Results: Of 334 women, 13.6% reported transactional sex (95% confidence interval [CI]: 6.8%, 20.5%). Women who reported transactional sex were older, more likely to identify as black, to identify as lesbian or bisexual, to experience childhood trauma and recent sexual violence, and to have been homeless. Six percent(95%CI: 1.8%, 10.5%) of women with no adverse childhood experiences (ACEs) reported transactional sex compared to 23.8%(95%CI: 13.0%, 34.6%)of women who reported eleven ACEs (P<0.001). Transactional sex was strongly associated withcombination methamphetamine and opiate use as well ascondomless sex. Women who reported transactional sex were more likely to report being diagnosed with a bacterial STI and hepatitis C; however, HIV screening and pre-exposure prophylaxis knowledge and use were low. Conclusions:In a sample ofwomen of low socioeconomic status in Portland, Oregon, transactional sex was characterized by marginalized identities, homelessness, childhood trauma, sexual violence, substance use, and sexual vulnerability to HIV/STI. Multi-level interventions that address these social, behavioral, and trauma-related factors and increase access to biomedical HIV prevention are critical to the sexual health of women who engage in transactional sex.

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