Bundling HIV Prevention with Prenatal Care Reduces Risky Sex Behaviors Among At-risk Mothers

2010 ◽  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Prenatal Care ◽  
Risky Sex ◽  
Sex Behaviors

scholarly journals Impulsivity Dimensions and Risky Sex Behaviors in an At-Risk Young Adult Sample

2017 ◽  
Vol 47 (2) ◽  
pp. 529-536 ◽  
Author(s):  
Inga Curry ◽  
Jeremy W. Luk ◽  
Ryan S. Trim ◽  
Christian J. Hopfer ◽  
John K. Hewitt ◽  
...  
Keyword(s):  
At Risk ◽  
Young Adult ◽  
Risky Sex ◽  
Adult Sample ◽  
Sex Behaviors

Correlates of Medical Mistrust Among Minority Women at Risk for HIV and Their Networks

2021 ◽  
pp. 109019812098678
Author(s):  
Laura M. Johnson ◽  
Harold D. Green ◽  
Brandon Koch ◽  
Robert Harding ◽  
Jamila K. Stockman ◽  
...  
Keyword(s):  
At Risk ◽  
Black Women ◽  
Hiv Prevention ◽  
Risk Groups ◽  
Medical Mistrust ◽  
Individual Level ◽  
Prevention And Treatment ◽  
Egocentric Network ◽  
History Of ◽  
Sex With Men

Background Medical mistrust is a barrier to engaging in HIV prevention and treatment, including testing and adherence to antiretroviral therapy. Research often focuses on how race and experiences of discrimination relate to medical mistrust, overlooking the role that other characteristics may play (e.g., history of physical abuse, diagnosis of mental illness). Furthermore, studies are often restricted to samples of men who have sex with men and findings may not generalize to other at-risk groups. Aims The current study explores a range of demographic, cognitive, behavioral, and social network correlates of medical mistrust. Method This study employed an egocentric network design among a racially diverse sample of at-risk women and women in their social networks ( n = 165). Results Results from multivariable linear regressions stratified by race (Black vs. others) indicate that medical mistrust is associated with both individual-level and network-level characteristics. Across both groups, age and experiences of racial discrimination were associated with higher medical mistrust. Having a regular sex partner and having a higher proportion of network members who are family was significantly associated with medical mistrust among non-Black women. Discussion Individual-level and network-level variables were significantly associated with medical mistrust. Therefore, interventions that attempt to mitigate medical mistrust as a barrier to HIV prevention and treatment should consider how mistrust may be related to characteristics of individuals and broader contexts. Conclusion Health interventions may benefit from conceiving of medical mistrust as a complex, rational response to cumulative discriminatory life experiences and a reflection of the networks within which individuals are embedded.

scholarly journals Expanding the Space: Inclusion of Most-at-Risk Populations in HIV Prevention, Treatment, and Care Services

2011 ◽  
Vol 57 ◽  
pp. S96-S99 ◽  
Author(s):  
Chris Beyrer ◽  
Stefan Baral ◽  
Deanna Kerrigan ◽  
Nabila El-Bassel ◽  
Linda-Gail Bekker ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Care Services ◽  
At Risk Populations ◽  
Most At Risk Populations

scholarly journals Southern African guidelines for the safe use of pre-exposure prophylaxis in men who have sex with men who are at risk for HIV infection

2012 ◽  
Vol 13 (2) ◽  
Author(s):  
Southern African HIV Clinicians Society Consensus Committee
Keyword(s):  
At Risk ◽  
Renal Function ◽  
Hiv Prevention ◽  
Hepatitis B ◽  
Hiv Infection ◽  
Creatinine Clearance ◽  
Fixed Dose ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

Background. The use of oral antiretrovirals to prevent HIV infection among HIV-negative men who have sex with men (MSM) has been shown to be safe and efficacious. A large, randomised, placebo-controlled trial showed a 44% reduction in the incidence of HIV infection among MSM receiving a daily oral fixed-dose combination of tenofovir disoproxil fumarate and emtricitabine (Truvada) in combination with an HIV prevention package. Improved protection was seen with higher levels of adherence. Aim. The purpose of this guideline is to: (i) explain what pre-exposure prophylaxis (PrEP) is; (ii) outline current indications for its use; (iii) outline steps for appropriate client selection; and (iv) provide guidance for monitoring and maintaining clients on PrEP. Method. PrEP is indicated for HIV-negative MSM who are assessed to be at high risk for HIV acquisition and who are willing and motivated to use PrEP as part of a package of HIV prevention services (including condoms, lubrication, sexually transmitted infection (STI) management and risk reduction counselling). Recommendations. HIV testing, estimation of creatinine clearance and STI and hepatitis B screening are recommended as baseline investigations. Daily oral Truvada, along with adherence support, can then be prescribed for eligible MSM. PrEP should not be given to MSM with abnormal renal function, nor to clients who are unmotivated to use PrEP as part of an HIV prevention package; nor should it be commenced during an acute viral illness. Three-monthly follow-up visits to assess tolerance, renal function, adherence and ongoing eligibility is recommended. Six-monthly STI screens and annual creatinine levels to estimate creatinine clearance are recommended. Hepatitis B vaccination should be provided to susceptible clients. Gastro-intestinal symptoms and weight loss are common side-effects, mostly experienced for the first 4 - 8 weeks after initiating PrEP. There is a risk of the development of antiretroviral resistance among those with undiagnosed acute HIV infection during PrEP initiation and among those with sub-optimal adherence who become HIV infected while on PrEP. Risk compensation (increasing sexual behaviours that can result in exposure to HIV) while on PrEP may become a concern, and clinicians should continue to support MSM clients to continue to use condoms, condom-compatible lubrication and practice safer sex. Research is ongoing to assess optimum dosing regimens, potential long-term effects and alternative PrEP medications. Recommendations for the use of PrEP among other at-risk individuals, and the components of these recommendations, will be informed by future evidence. S Afr J HIV Med 2012;13(2):40-55.

scholarly journals Bahamas National Implementation Project: Proposal for Sustainability of an Evidence-based HIV Prevention Intervention in a School Setting

10.2196/14816 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e14816
Author(s):  
Bo Wang ◽  
Lynette Deveaux ◽  
Sonja Lunn ◽  
Veronica Dinaj-Koci ◽  
Samiran Ghosh ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Primary Schools ◽  
Implementation Strategies ◽  
Implementation Fidelity ◽  
Prevention Programs ◽  
Evidence Based ◽  
School Based ◽  
National Implementation ◽  
Over Time

Background Sustained implementation of school-based prevention programs is low. Effective strategies are needed to enhance both high-level implementation fidelity and sustainability of prevention programs. Objective This proposed study aims to determine if the provision of either biweekly monitoring and feedback and site-based assistance and mentorship or both to at-risk and moderate-performing teachers with monitoring through an enhanced decision-making platform by the Ministry of Education (MOE) and Ministry of Health (MOH) based on the real-time implementation data will increase national implementation fidelity and result in sustained implementation over time. Methods This study will target government schools including 200 grade 6 teachers in 80 primary schools and 100 junior/middle high school teachers (and their classes) on 12 Bahamian islands. Teacher and school coordinator training will be conducted by the MOE in year 1, followed by an optimization trial among teachers in the capital island. Informed by these results, an implementation intervention will be conducted to train using different levels of educational intensity all at-risk and moderate-performing teachers. Subsequently selected training and implementation strategies will be evaluated for the national implementation of Focus on Youth in the Caribbean and Caribbean Informed Parents and Children Together in years 2 to 5. Results It is hypothesized that a more intensive training and supervision program for at-risk and moderate-performing teachers will enhance their implementation fidelity to the average level of the high-performing group (85%), an HIV prevention program delivered at the national level can be implemented with fidelity in grade 6 and sustained over time (monitored annually), and student outcomes will continue to be highly correlated with implementation fidelity and be sustained over time (assessed annually through grade 9). The proposed study is funded by the National Institute of Child Health and Human Development from August 1, 2018, through May 31, 2023. Conclusions The study will explore several theory-driven implementation strategies to increase sustained teacher implementation fidelity and thereby increase the general public health impact of evidence-based interventions. The proposed project has potential to make significant contributions to advancing school-based HIV prevention research and implementation science and serve as a global model for the Fast Track strategy. International Registered Report Identifier (IRRID) PRR1-10.2196/14816

scholarly journals ‘Break the Chains 2015’ community-based HIV prevention campaign for men who have sex with men in Switzerland: non-randomised evaluation and cost analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032459
Author(s):  
Kathrin Frey ◽  
Stéphanie Lociciro ◽  
Patricia Blank ◽  
Matthias Schwenkglenks ◽  
Françoise Dubois-Arber ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Cost Analysis ◽  
Hiv Testing ◽  
Community Based ◽  
Prevention Campaign ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Campaign Message

ObjectivesTo study the implementation, effects and costs of Break the Chains, a community-based HIV prevention campaign for men who have sex with men (MSM) in Switzerland, from March to May 2015, which aimed to reduce early HIV transmission by promoting the campaign message to adopt short-term risk reduction followed by HIV testing.DesignNon-randomised evaluation and cost analysis.SettingGay venues in 11 of 26 cantons in Switzerland and national online media campaign.ParticipantsMSM in online surveys (precampaign n=834, postcampaign n=688) or attending HIV testing centres (n=885); campaign managers (n=9); and campaign staff (n=38) or further intermediaries (n=80) in an online survey.Primary and secondary outcome measuresThe primary outcome measure was the proportion of MSM at risk of HIV acquisition or transmission who adhered to the campaign message. Secondary outcomes were postcampaign test uptake, knowledge about HIV primary infection and sense of belonging to the gay community.ResultsCampaign staff estimated that they contacted 17 145 MSM in 11 cantons. Among 688 respondents to the postcampaign survey, 311 (45.2%) were categorised as MSM at risk. Of 402/688 (58.5%) MSM who had heard about Break the Chains 2015, MSM categorised as being at risk were less likely to report adherence to the campaign message than MSM not at risk (adjusted OR 0.24; 95% CI 0.14 to 0.42). Twenty per cent of MSM with a defined risk of HIV acquisition or transmission who adopted risk reduction declared having done so because of the campaign. Costs for one MSM at risk to adhere to the campaign message were estimated at USD purchasing power parity 36–55. The number of HIV tests in the month after the campaign was twice the monthly average.ConclusionBreak the Chains increased HIV testing, implying that community-based campaigns are useful HIV prevention strategies for MSM. Additional interventions are needed to reach MSM at the highest risk of infection more effectively.

scholarly journals Improving communication about HIV prevention among people living with HIV and their at-risk social network members in Dar es Salaam, Tanzania

2019 ◽  
Vol 6 (1) ◽  
pp. 1600230 ◽  
Author(s):  
Hellen Siril ◽  
Anna Kaale ◽  
Anna Minja ◽  
Japheth Kilewo ◽  
Ferdinand Mugusi ◽  
...  
Keyword(s):  
At Risk ◽  
Social Network ◽  
Hiv Prevention ◽  
Dar Es Salaam ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals The Impact of Acculturation on Utilization of HIV Prevention Services and Access to Care Among an At-Risk Hispanic Population

2009 ◽  
Vol 20 (4) ◽  
pp. 996-1011 ◽  
Author(s):  
Janni J. Kinsler ◽  
Sung-Jae Lee ◽  
Jennifer N. Sayles ◽  
Peter A. Newman ◽  
Allison Diamant ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Access To Care ◽  
Hispanic Population ◽  
Prevention Services ◽  
The Impact

scholarly journals Active-Offer Nurse-Led PrEP (PrEP-RN) Referrals: Analysis of Uptake Rates and Reasons for Declining

2019 ◽  
Vol 24 (5) ◽  
pp. 1281-1289 ◽  
Author(s):  
Patrick O’Byrne ◽  
Lauren Orser ◽  
Marlene Haines
Keyword(s):  
Public Health ◽  
At Risk ◽  
Hiv Prevention ◽  
Qualitative Analysis ◽  
Thematic Analysis ◽  
Prevention Strategy ◽  
Perceptions Of Risk ◽  
Uptake Rates ◽  
Exposure Prophylaxis

AbstractWhile pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy, its uptake is limited. To address barriers, we piloted a nurse-led PrEP clinic in an STI clinic and had public health nurses refer patients during STI follow-up. We recorded the number of PrEP offers and declines and clinic uptake. We conducted a thematic analysis of patients’ responses from nursing notes written at the time patients declined PrEP. From August 6, 2018 to August 5, 2019, nurses offered a PrEP referral to 261 patients who met our criteria; only 47.5% accepted. Qualitative analysis identified four themes: (1) perceptions of risk, (2) lack of interest, (3) inability to manage, and (4) concerns about PrEP. Our patients did not feel sufficiently at-risk for HIV to use PrEP and maintained that PrEP was for a reckless “other”. This analysis sheds light on how assumptions about risk affect PrEP uptake, particularly among those at-risk for HIV.

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