Risk for HIV acquisition among sub-Saharan African migrant travelers in Belgium and Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Dias ◽  
J Loos ◽  
A Gama ◽  
D Simões ◽  
C Nöstlinger
Keyword(s):  
Host Country ◽  
Hiv Risk ◽  
Sexual Behaviors ◽  
Host Countries ◽  
Cross Sectional ◽  
Condomless Sex ◽  
Prevention Interventions ◽  
African Migrant ◽  
Sub Saharan ◽  
Hiv Acquisition

Abstract Migrants often travel back to the origin countries and to other European states after settling in the residence country. Mobility along with structural vulnerabilities may increase HIV acquisition risk. Knowledge on HIV risk exposure when traveling is limited, yet crucial to inform prevention. This study aims to explore risky sexual behaviors and assess HIV prevalence among sub-Saharan African migrants (SAMs) who travel, residing in two European cities. Two cross-sectional biobehavioral surveys were conducted in Lisbon and Antwerp with a venue-based sample of 1508 SAMs. Descriptive and multivariable logistic regression analyses were performed to examine travel patterns and associated sexual risk behaviors. Overall, 68.4% of participants had traveled to other countries after settling in the residence country; 41% had traveled back to Africa and within Europe, 25.2% only to Africa and 33.8% only to Europe. Among travelers who reported sexual encounters abroad (49.2%), condomless sex at last intercourse was high both abroad (62.5%) and in the host country (70.7%). Odds of condomless sex at the last sexual encounter in the host country were five times higher among those who also reported no condom use abroad [OR: 5.32; 95% CI: 2.98-9.25], controlling for gender, age, educational level, relationship status, survey country, partner type and origin, and number of sexual partners over the last year. Condomless sex was higher with a regular partner and with an African partner, both abroad (79.9% and 67.5%, respectively) and in the host country (81.3% and 74.6%, respectively). Among the 75 participants who tested HIV-positive (around 5%), more than half had travelled to other countries; of these, about half reported condomless sex with their last sexual partner abroad. SAMs are a mobile population and are exposed to sexual HIV risk both while traveling and in host countries. Prevention interventions should address the complex interplay between migrants' mobility and HIV risk. Key messages Migrants often travel to their origin home countries and other destinations after having settled in host countries, and this mobility increases exposure to HIV risk. A transnational perspective on HIV prevention and sexual health promotion is needed for effectively reducing migrants’ HIV risk related to their mobility.

scholarly journals Emotional Violence is Associated with Increased HIV Risk Behavior Among South African Adolescent Girls and Young Women in the HPTN 068 Cohort

2021 ◽  
Author(s):  
Anna M. Leddy ◽  
Amanda Selin ◽  
Sheri A. Lippman ◽  
Linda J. Kimaru ◽  
Rhian Twine ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Young Women ◽  
Hiv Risk ◽  
Partner Violence ◽  
Transactional Sex ◽  
Hiv Risk Behavior ◽  
Future Research ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Condomless Sex

AbstractLimited research has explored how emotional intimate partner violence (IPV) shapes HIV risk behaviors. Using cross-sectional data from the HPTN 068 post-trial visit (N = 1942), we assessed the association between emotional IPV and its sub-domains (verbal abuse and threats) with condomless sex, transactional sex, and frequent alcohol use among young women in South Africa. In adjusted multivariable logistic regression models, any emotional IPV and verbal IPV were associated with increased odds of condomless sex (aOR: 1.47; 95% CI: 1.15, 1.87; and aOR: 1.48; 95% CI: 1.15, 1.89), transactional sex (aOR: 2.32; 95% CI: 1.74, 3.08; and aOR: 2.02; 95% CI: 1.51, 2.71) and alcohol use (aOR: 1.88; 95% CI: 1.39, 2.53; and aOR: 1.87; 95% CI: 1.37, 2.55). Threats were associated with transactional sex (aOR: 3.67; 95% CI: 2.62, 5.14). Future research should examine this relationship over-time and HIV prevention programs should consider and address emotional IPV.

scholarly journals Schistosoma and Other Relevant Helminth Infections in HIV-Positive Individuals—an Overview

2019 ◽  
Vol 4 (2) ◽  
pp. 65 ◽  
Author(s):  
Amrei von Braun ◽  
Henning Trawinski ◽  
Sebastian Wendt ◽  
Christoph Lübbert
Keyword(s):  
Neglected Tropical Diseases ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Treatment And Prevention ◽  
Helminth Infections ◽  
Helminthic Infections ◽  
Sub Saharan ◽  
Health Organization ◽  
Hiv Acquisition

For many years, researchers have postulated that helminthic infections may increase susceptibility to HIV, and that immune activation may have contributed to the extensive spread of HIV in sub-Saharan Africa. In the meantime, immunological studies have provided some evidence in support of this hypothesis, while cross-sectional clinical studies were able to further support the assumed association between HIV infection and selected helminthic co-infections. However, as many of the helminthic infections relevant to HIV-infected patients belong to the group of “neglected tropical diseases”, as defined by the World Health Organization, a certain lack of attention has inhibited progress in fully scaling up treatment and prevention efforts. In addition, despite the fact that the challenges of co-infections have preoccupied clinicians for over two decades, relevant research questions remain unanswered. The following review aims to provide a concise overview of associations between HIV and selected helminthic co-infections concerning aspects of HIV acquisition and transmission, clinical and immunological findings in co-infected individuals, as well as treatment and prevention efforts.

scholarly journals HIV risk and pre-exposure prophylaxis interest among female bar workers in Dar es Salaam: cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e023272 ◽  
Author(s):  
Guy Harling ◽  
Aisa Muya ◽  
Katrina F Ortblad ◽  
Irene Mashasi ◽  
Peter Dambach ◽  
...  
Keyword(s):  
Risk Factors ◽  
East Africa ◽  
Hiv Risk ◽  
Dar Es Salaam ◽  
Hiv Positive ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Long Acting ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

ObjectiveFemale bar workers (FBW) in East Africa often conduct sex work to supplement their incomes, and may be vulnerable to HIV acquisition. Pre-exposure prophylaxis (PrEP) offers protection against HIV acquisition. However, there is little research on FBW’s sexual health. Our objective was to determine HIV risk behaviours and interest in PrEP among FBW in the largest city in East Africa.DesignCross-sectional survey covering respondents’ work and personal lives, including social and behavioural risk factors for HIV. The survey aimed to determine the feasibility of working with FBW and HIV prevalence estimates. Those who did not report being HIV positive were asked about their knowledge of and interest in PrEP. All women were offered free on-site HIV testing and counselling (HTC).SettingEight randomly selected workplaces, that is, bars, in Kinondoni district, Dar es Salaam (DSM).Participants66 FBW (≥18 years) selected at random from all women working in selected bars on the day of visit.ResultsHalf of respondents reported having had sex for money: 20% with bar clients only, 15% with other men only and 15% with both. Almost all (98%) reported ≥1 non-commercial partners in the past 12 months; only 30% reported using condoms with these partners. 85% of respondents had ever been pregnant; 44% had had an unintended pregnancy. Only 5% of respondents had ever heard of PrEP. However, 54% were somewhat/very interested in daily-pill PrEP and 79% were somewhat/very interested in long-acting injectable PrEP. When asked to rank modalities, long-acting injectable PrEP was the most preferred. Seven per cent of the 56 respondents who completed HTC tested HIV positive.ConclusionsFBW in DSM have elevated risk factors for HIV acquisition, and PrEP appears highly acceptable. Studies developing PrEP delivery models and assessing PrEP initiation and adherence in FBW appear warranted.

scholarly journals Depression and HIV Risk Behaviors among Female Sex Workers in Guangdong, China: A Multicenter Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Hongcheng Shen ◽  
Huachun Zou ◽  
Shujie Huang ◽  
Fengying Liu ◽  
Peizhen Zhao ◽  
...  
Keyword(s):  
Risk Behaviors ◽  
Hiv Risk ◽  
Sexual Behaviors ◽  
Sex Workers ◽  
Female Sex Workers ◽  
General Health Questionnaire ◽  
Hiv Risk Behaviors ◽  
Cross Sectional ◽  
Female Sex ◽  
Sex Partner

Background. Our study aimed to assess the burden of depression and evaluate factors associated with depression and status of HIV risk behaviors among female sex workers (FSWs) in Guangdong, China. Method. We recruited FSWs from massage parlors, saunas, restaurants, hotels, hair salons, and streets in Guangdong, China, in 2014. Information on demographic characteristics, HIV testing history, and sexual behaviors was collected using a questionnaire. A blood sample was collected to test for HIV, syphilis, and HCV. A participant was defined as being depressed if she obtained 6 points or above using the 12-item General Health Questionnaire. Results. Among the 653 participants, 41.7% were 21–30 years old and 43.6% married. Overall, 52.4% were found to be depressed. FSWs who had correct syphilis related knowledge [aOR = 1.45; 95% CI: 1.04–2.03] and had primary sex partner (1.63, 1.14–2.33) were more likely to be depressed. FSWs who did not use a condom during their last sex with the primary sex partner were less likely to be depressed (0.47, 0.31–0.71). Conclusion. Our study observed high level of depression and HIV risk behaviors among Chinese FSWs. Future interventions should integrate mental health services in comprehensive interventions to prevent depression among Chinese FSWs.

scholarly journals High prevalence of HIV, HBsAg and anti-HCV positivity among people who injected drugs: results of the first bio-behavioral survey using respondent-driven sampling in two urban areas in Mozambique

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cynthia Semá Baltazar ◽  
Roberta Horth ◽  
Makini Boothe ◽  
Isabel Sathane ◽  
Peter Young ◽  
...  
Keyword(s):  
Sexual Behaviors ◽  
Disease Transmission ◽  
Urban Areas ◽  
Hepatitis B Surface Antigen ◽  
Multivariable Analysis ◽  
Sub Saharan Africa ◽  
Respondent Driven Sampling ◽  
Cross Sectional ◽  
Hbsag Positivity ◽  
Sub Saharan

Abstract Background Few countries in sub-Saharan Africa know the magnitude of their HIV epidemic among people who inject drugs (PWID). This was the first study in Mozambique to measure prevalence of HIV, HBV, and HCV, and to assess demographic characteristics and risk behaviors in this key population. Methods We used respondent-driven sampling (RDS) to conduct a cross-sectional behavioral surveillance survey of PWID in two cities of Mozambique lasting six months. Participants were persons who had ever injected drugs without a prescription. Participants completed a behavioral questionnaire and provided blood specimens for HIV, hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) testing. We performed RDS-adjusted analysis in R 3.2 using RDSAT 7.1 weights. Results We enrolled 353 PWID in Maputo and 139 in Nampula/Nacala; approximately 95% of participants were men. Disease prevalence in Maputo and Nampula/Nacala, respectively, was 50.1 and 19.9% for HIV, 32.1 and 36.4% for HBsAg positivity, and 44.6 and 7.0% for anti-HCV positivity. Additionally, 8% (Maputo) and 28.6% (Nampula/Nacala) of PWID reported having a genital sore or ulcer in the 12 months preceding the survey. Among PWID who injected drugs in the last month, 50.3% (Maputo) and 49.6% (Nampula/Nacala) shared a needle at least once that month. Condomless sex in the last 12 months was reported by 52.4% of PWID in Maputo and 29.1% in Nampula/Nacala. Among PWID, 31.6% (Maputo) and 41.0% (Nampula/Nacala) had never tested for HIV. In multivariable analysis, PWID who used heroin had 4.3 (Maputo; 95% confidence interval [CI]: 1.2, 18.2) and 2.3 (Nampula/Nacala; 95% CI: 1.2, 4.9) greater odds of having HIV. Conclusion Unsafe sexual behaviors and injection practices are frequent among PWID in Mozambique, and likely contribute to the disproportionate burden of disease we found. Intensified efforts in prevention, care, and treatment specific for PWID have the potential to limit disease transmission.

scholarly journals Who falls between the cracks? Identifying eligible PrEP users among people with Sub-Saharan African migration background living in Antwerp, Belgium

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256269
Author(s):  
Veerle Buffel ◽  
Caroline Masquillier ◽  
Thijs Reyniers ◽  
Ella Van Landeghem ◽  
Edwin Wouters ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Population Group ◽  
Demographic Characteristics ◽  
Migration Background ◽  
Equitable Access ◽  
Community Based ◽  
Eligibility Criteria ◽  
Sub Saharan ◽  
Hiv Acquisition ◽  
Hiv Risk Factors

Introduction This study produces an estimate of the proportion of eligible PrEP users among people of Sub-Saharan African background based on the Belgian PrEP eligibility criteria and examines associations with socio-economic and demographic characteristics. Methods We performed logistic regression analysis on data of a representative community-based survey conducted among Sub-Saharan African communities (n = 685) living in Antwerp. Results Almost a third (30.3%) of the respondents were eligible to use PrEP. Those who were male, single, lower educated, undocumented, and had experienced forced sex were more likely to be eligible for PrEP use. The findings highlight the importance of taking intra-, interpersonal and structural HIV risk factors into account. Conclusions The study shows high unmet PrEP needs in this population, especially among those with high vulnerability for HIV acquisition. A better understanding of barriers to PrEP use in this population group is needed to allow for equitable access.

scholarly journals Dynamic Perceived HIV Risk and Sexual Behaviors Among Young Women Enrolled in a PrEP Trial in Kenya: A Qualitative Study

2021 ◽  
Vol 3 ◽  
Author(s):  
Kenneth Ngure ◽  
Nicholas Thuo ◽  
Vallery Ogello ◽  
Catherine Kiptinness ◽  
Kevin Kamolloh ◽  
...  
Keyword(s):  
Risk Perception ◽  
High Risk ◽  
Hiv Prevention ◽  
Qualitative Study ◽  
Young Women ◽  
Hiv Risk ◽  
Sexual Behaviors ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Over Time

Background: In Kenya and elsewhere in sub-Saharan Africa, young women are disproportionately affected by the HIV epidemic compared to young men. The extent to which young women's self-perceptions about risk of HIV acquisition influence their sexual behaviors and use of HIV prevention methods remains unclear. We therefore conducted a qualitative study to explore these issues among young women enrolled in a pre-exposure prophylaxis (PrEP) trial.Methods: From January 2017 to January 2020, we conducted serial semi-structured in-depth interviews 50 purposively selected young women (18–24 years old) who were participating in the MPYA (Monitoring PrEP for Young Adult women) study—a randomized controlled trial in Thika and Kisumu, Kenya, assessing the impact of SMS reminders on PrEP adherence. Interviews were conducted at three time points (~1 week, 3, and 12 months after initiating PrEP). We used an inductive, content analytic approach to identify key themes related to risk perceptions, sexual behavior, and use of HIV prevention tools.Results: Around the time of enrollment, most of the 50 women interviewed reported being at high risk of HIV because of their own sexual behaviors, such as inconsistent condom use, multiple sexual partners, and transactional sex. Additionally, high risk perception was based on the behavior of their partners, such as refusing to use condoms and being unsure of their partner's HIV status. Young women's perceived risk of HIV acquisition was a key motivator for PrEP initiation and continuation. During PrEP use, participants reported feeling protected and at less risk compared to peers who were not taking PrEP. Some reported no longer using condoms because they were confident that PrEP provided enough protection. Over time, many young women reported reducing risky sexual behaviors because of the regular counseling and HIV testing they received as part of their PrEP services. This lowered risk perception was in most cases accompanied by discontinuation of PrEP.Conclusions: HIV risk perception among young women in Kenya was dynamic and influenced their use of PrEP and condoms over time, suggesting an often-deliberate approach to HIV prevention and sexual health.

scholarly journals Gender, peer and partner influences on adolescent HIV risk in rural South Africa

Sexual Health ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. 178 ◽  
Author(s):  
Abigail Harrison ◽  
Jenni Smit ◽  
Susie Hoffman ◽  
Thobile Nzama ◽  
Cheng-Shiun Leu ◽  
...  
Keyword(s):  
South Africa ◽  
Condom Use ◽  
Sexual Activity ◽  
Hiv Risk ◽  
Sexual Communication ◽  
Peer Norms ◽  
Cross Sectional Survey ◽  
Pregnancy Risk ◽  
Cross Sectional ◽  
Prevention Interventions

Background and methods In preparation for a school-based intervention in KwaZulu-Natal, South Africa, a cross-sectional survey of potential HIV risk factors in youth aged 14–17 (n = 983) was conducted. Results: Boys were significantly more likely than girls to report lifetime sexual activity (37.7% v. 13.8%, P < 0.01). Among boys and girls, 46.1% reported condom use at last sex. Discussion of condom use with a partner was the strongest predictor of condom use (boys, odds ratio (OR) = 7.39; girls, OR = 5.58, P < 0.0001). Age was independently associated with sexual activity for boys (OR = 1.49, P < 0.0001) and girls (OR = 1.74, P = 0.02). For boys, perceptions of male peer behaviour were associated with both ever having participated in sexual activity (OR = 1.48, P < 0.01) and condom use at last sex (OR = 1.79, P < 0.01). Girls who equated condom use with having numerous partners were more likely to use them. Among boys, results challenged some expected gender beliefs: support for girls’ initiative in relationship formation and refusal of sex were significant predictors of sexual activity. Among girls, higher pregnancy risk perception (OR = 1.32, P = 0.02) and knowledge (OR = 4.85, P = 0.055) were associated with sexual activity. Conclusions: Creating more gender equitable norms can reduce HIV risk behaviours. HIV prevention interventions should build on existing gender equitable beliefs, and work to promote others, including sexual communication and negotiation skills, and modelling of positive peer norms.

scholarly journals A comparison of two population-based household surveys in Uganda for assessment of violence against youth

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260986
Author(s):  
Dustin W. Currie ◽  
Rose Apondi ◽  
Christine A. West ◽  
Samuel Biraro ◽  
Lydia N. Wasula ◽  
...  
Keyword(s):  
Physical Violence ◽  
Health Risk Behaviors ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Household Surveys ◽  
Cross Sectional ◽  
Sub Saharan ◽  
Interviewer Training ◽  
Hiv Acquisition ◽  
Violence Prevalence

Violence is associated with health-risk behaviors, potentially contributing to gender-related HIV incidence disparities in sub-Saharan Africa. Previous research has demonstrated that violence, gender, and HIV are linked via complex mechanisms that may be direct, such as through forced sex, or indirect, such as an inability to negotiate safe sex. Accurately estimating violence prevalence and its association with HIV is critical in monitoring programmatic efforts to reduce both violence and HIV. We compared prevalence estimates of violence in youth aged 15–24 years from two Ugandan population-based cross-sectional household surveys (Uganda Violence Against Children Survey 2015 [VACS] and Uganda Population-based HIV Impact Assessment 2016–2017 [UPHIA]), stratified by gender. UPHIA violence estimates were consistently lower than VACS estimates, including lifetime physical violence, recent intimate partner physical violence, and lifetime sexual violence, likely reflecting underestimation of violence in UPHIA. Multiple factors likely contributed to these differences, including the survey objectives, interviewer training, and questionnaire structure. VACS may be better suited to estimate distal determinants of HIV acquisition for youth (including experience of violence) than UPHIA, which is crucial for monitoring progress toward HIV epidemic control.

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