Learnings from a decade experience of a community-based HIV and STI testing and counseling center in Lisbon – Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Fernandes ◽  
P Meireles ◽  
M Rocha ◽  
M Duque ◽  
H Barros

Abstract Background In the context of an increased number of men who have sex with men (MSM) being diagnosed with HIV infection in many European countries, it became a matter of maximum priority to consider new strategies to monitor and tackle the epidemic. In this scenario, CheckpointLX and a cohort study were projected as a sexual health and research center oriented towards MSM in Portugal. Methods In 2011 CheckpointLX was launched in Lisbon as a community-based center for anonymous and free rapid HIV and other sexually transmitted diseases (STI) testing with a strong component of counseling for sexual health, specially targeted at MSM. In the case of a reactive test, a medical appointment is proposed and scheduled. The Lisbon Cohort of MSM is an ongoing observational prospective study conducted at CheckpointLX. Collected data include sexual behaviors, preventive strategies, and history of STI. Results Until July 2019, 7,351 HIV-negative MSM chose to participate in the Lisbon Cohort of MSM. 3,523 had at least one follow-up visit. The median age was 29 (IQR 25 - 37), and 27% were born in a foreign country, including 15% born in Africa and South America. HIV incidence increased up until 2015, reaching 5 reactive tests per 100 tested annually. There has been a sustained decrease in HIV observed since 2015. The use of HIV prevention tools was provided: 31% used condoms consistently, 3% reported PrEP, and 4% PEP. Conclusions A decade since the beginning of this experience shows positive results, such as increased access and testing. We promoted a stigma-free service that facilitated MSM's and other key population's access to sexual health care. We contribute unique data for assisting in the monitoring of the Dublin Declaration in Portugal.

2021 ◽  
pp. 095646242110601
Author(s):  
Jane S Chen ◽  
Sara N Levintow ◽  
Ha V Tran ◽  
Teerada Sripaipan ◽  
Minh X Nguyen ◽  
...  

Background HIV and other sexually transmitted infections (STIs) have disproportionately affected communities of men who have sex with men (MSM). We describe HIV and STI prevalence and testing patterns among urban Vietnamese MSM. Methods We conducted a cross-sectional community-based study of MSM in Hanoi, Vietnam in 2016. Participants self-reported experiences of social stigma in healthcare settings and previous HIV and STI testing. STI testing included HIV, herpes simplex virus-2 (HSV-2), syphilis, gonorrhea, and chlamydia. Results 205 MSM participated in the study. STI prevalence was HIV (10%), HSV-2 (4%), syphilis (13%), gonorrhea (34%), and chlamydia (19%). More than half (55%) of participants tested positive for at least one STI. Most participants had been previously tested for HIV or another STI (72%), with 24% previously receiving a positive result. Perceived and enacted social stigma in healthcare contexts was negatively associated with previous HIV or STI testing (adjusted prevalence odds ratio (aPOR): 0.22; 95% confidence interval (CI): 0.10–0.48). Discussion High prevalence of STIs was observed among Vietnamese MSM, and perceived and enacted stigma was related to HIV and STI testing. Our findings reaffirm the importance of regular STI screening among this population as well as additional outreach to promote safe HIV and STI healthcare engagement.


Author(s):  
Trevor A. Hart ◽  
David M. Moore ◽  
Syed W. Noor ◽  
Nathan Lachowsky ◽  
Daniel Grace ◽  
...  

Abstract Objectives The last Canadian biobehavioural surveillance study of HIV and other sexually transmitted and blood-borne infections (STBBI) among gay, bisexual and other men who have sex with men (GBM) was conducted in 2010. We designed a study to measure STBBI prevalence among GBM in metropolitan Montreal, Toronto and Vancouver and to document related preventive and risk behaviours. Methods The Engage Cohort Study used respondent-driven sampling (RDS) to recruit GBM who reported sex with another man in the past 6 months. At baseline, we examined recruitment characteristics of the samples, and the RDS-II-adjusted distributions of socio-demographics, laboratory-confirmed HIV and other STBBI prevalence, and related behaviours, with a focus on univariate differences among cities. Results A total of 2449 GBM were recruited from February 2017 to August 2019. HIV prevalence was lower in Montreal (14.2%) than in Toronto (22.2%) or Vancouver (20.4%). History of syphilis infection was similar across cities (14–16%). Vancouver had more HIV-negative/unknown participants who reported never being HIV tested (18.6%) than Toronto (12.9%) or Montreal (11.5%). Both Montreal (74.9%) and Vancouver (78.8%) had higher proportions of men who tested for another STBBI in the past 6 months than Toronto (67.4%). Vancouver had a higher proportion of men who used pre-exposure prophylaxis (PrEP) in the past 6 months (18.9%) than Toronto (11.1%) or Montreal (9.6%). Conclusion The three largest cities of Canada differed in HIV prevalence, STBBI testing and PrEP use among GBM. Our findings also suggest the need for scale-up of both PrEP and STI testing among GBM in Canada.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253589
Author(s):  
Shoshana Rosenberg ◽  
Denton Callander ◽  
Martin Holt ◽  
Liz Duck-Chong ◽  
Mish Pony ◽  
...  

Transgender and gender diverse people have unique risks and needs in the context of sexual health, but little is known about sexual health care for this population. In 2018, a national, online survey of sexual health and well-being was conducted with trans and gender diverse people in Australia (n = 1,613). Data from this survey were analysed to describe uptake of sexual health care and experiences of interpersonal and structural cisgenderism and transphobia. Experiences of cisgenderism and transphobia in sexual health care were assessed using a new, four-item scale of ‘gender insensitivity’, which produced scores ranging from 0 (highly gender sensitive) to 4 (highly gender insensitive). Logistic and linear regression analyses were conducted to determine if experiences of gender insensitivity in sexual health care were associated with uptake and frequency of HIV/STI testing in the 12 months prior to participation. Trans and gender diverse participants primarily accessed sexual health care from general practice clinics (86.8%), followed by publicly funded sexual health clinics (45.6%), community-based services (22.3%), and general hospitals (14.9%). Experiences of gender insensitivity were common overall (73.2% of participants reported ≥2 negative experiences) but most common in hospitals (M = 2.9, SD = 1.3) and least common in community-based services (M = 1.3, SD = 1.4; p<0.001). When controlling for sociodemographic factors, social networks, general access to health care, and sexual practices, higher levels of gender insensitivity in previous sexual health care encounters were associated with a lower likelihood of recent HIV/STI testing (adjusted prevalence ratio = 0.92, 95% confidence interval [CI]:091,0.96, p<0.001) and less-frequent HIV/STI testing (B = -0.07, 95%CI:-0.10,-0.03, p = 0.007). Given the high rates of HIV and other STIs among trans and gender diverse people in Australia and overseas, eliminating cisgenderism and transphobia in sexual health care may help improve access to diagnostic testing to reduce infection rates and support the overall sexual health and well-being of these populations.


2005 ◽  
Vol 10 (27) ◽  
Author(s):  
H Blystad ◽  
E Klouman

Recommendations for annual testing for HIV and other sexually transmitted infections (STIs) in men who have sex with men (MSM) have been produced by the Norwegian Folkehelseinstituttet in cooperation with Gay and Lesbian Health Norway and Olafiaklinikken in Oslo


Sexual Health ◽  
2007 ◽  
Vol 4 (3) ◽  
pp. 201 ◽  
Author(s):  
Christine J. Sturrock ◽  
Marian J. Currie ◽  
Hassan Vally ◽  
Elissa J. O'Keefe ◽  
Ruth Primrose ◽  
...  

Background: Men who have sex with men, sex workers, youth and university students are at increased risk for sexually transmissible infections (STI) and blood-borne viruses (BBV) and are therefore targets for sexual health services. In recognition of this, a collaborative project offering sexual health care in various outreach settings frequented by these groups was developed. Methods: Data collected by clinicians during consultations in five outreach venues (a sex-on-premises venue, a community AIDS organisation, a university campus, brothels and a youth centre) between 2002 and 2005 were analysed. Results: During 119 clinics (~547 clinician hours), 313 individuals (205 males and 108 females) received education and/or testing. Of those screened, 6.0% (15/249) were positive for chlamydia and 12.7% (9/71) tested positive for hepatitis C (HCV) antibodies. No new cases of hepatitis B (HBV) or HIV were identified and 37.2% (71/191) of patients reported never having been previously tested for HIV. Seroprevalence of hepatitis A and HBV antibodies were 53.8% (91/169) and 52.1% (135/259), respectively. More than half of all four groups reported inconsistent use of condoms and 8.6% reported intravenous drug use. Conclusions: Collaborations between agencies to provide outreach services facilitate community-based sexual health education and screening for groups at higher risk of STI and BBV. The database audit showed that through these outreach services cases of chlamydia and HCV that may have remained undetected were identified. The results also highlight the need for continuing hepatitis vaccination, testing, health promotion and education in these populations.


2021 ◽  
Author(s):  
Rayner Kay Jin Tan ◽  
Wee Ling Koh ◽  
Daniel Le ◽  
Sumita Banerjee ◽  
Martin Tze-Wei Chio ◽  
...  

BACKGROUND Gay, bisexual and other men who have sex with men (GBMSM) are at disproportionately higher risk of acquiring HIV and other sexually transmitted infections (STI). While HIV/STI testing rates among GBMSM are increasing worldwide, they remain suboptimal in a variety of settings. While many studies have attempted to evaluate the efficacy of a variety of community-based campaigns, including peer and reminder-based interventions on HIV/STI testing, however few have attempted to do so for a web drama series. OBJECTIVE This study evaluates the effectiveness of a popular web drama video series developed by a community-based organization in Singapore for GBMSM on HIV and other STI testing behaviors. METHODS The study is a pragmatic, randomized controlled trial to evaluate a popular web drama video series developed by a community-based organization in Singapore for GBMSM. A total of 300 HIV-negative, GBMSM men in Singapore aged 18 to 29 years old were recruited and block-randomized into the intervention (n=150) and control arms (n=150). Primary outcomes included changes in self-reported intention to test for, actual testing for, and regularity of testing for HIV, Syphilis, Chlamydia or Gonorrhoea, while secondary outcomes include changes in a variety of other knowledge-based and psychosocial measures at the end of the study period. RESULTS Overall, 125 out of 150 participants (83.3%) in the intervention arm completed the proof of completion survey, compared to 133 out of 150 participants (88.7%) in the control arm. We found statistically significant differences in self-reporting as a regular (at least yearly) tester for HIV (15.9% difference, 95%CI [3.2%, 28.6%]), as well as chlamydia or gonorrhoea (15.5% difference, 95%CI [4.2%, 26.9%]), indicating that the intervention had positively impacted these outcomes compared to the control condition. We also found statistically significant differences in participants’ intentions to test for HIV (16.6% difference, 95%CI [4.3%, 28.9%]), syphilis (14.8% difference, 95%CI [3.2%, 26.4%]), as well as chlamydia or gonorrhoea (15.4% difference, 95%CI [4.2%, 26.6%]), in the next three months, indicating that the intervention was effective in positively impacting intention for HIV and other STI testing among participants. CONCLUSIONS There are clear benefits for promoting intentions to test regularly and prospectively on a broad scale through this intervention. This intervention also has potential to reach GBMSM who may not have access to conventional HIV and other STI prevention messaging, which have typically been implemented at sex-on-premises venues, bars, clubs, and in sexual health settings frequented by GBMSM. When coupled with community or population-wide structural interventions, the overall impact on testing will likely be significant. CLINICALTRIAL Clinicaltrials.gov, NCT04021953 INTERNATIONAL REGISTERED REPORT RR2-http://dx.doi.org/10.1136/bmjopen-2019-033855


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jin Chen ◽  
Hui Fan ◽  
Huailiang Chen ◽  
Feifei Yao

Abstract Background Findings from specific countries indicated group sex was common among men who have sex with men (MSM), and men who reported group sex participation were at increased risk of human immunodeficiency virus (HIV)/sexually transmitted infections (STIs). The purpose of the current analysis was to describe the prevalence and correlates of group sex participation among a community-based sample of MSM in Chongqing, southwestern China. Methods Convenience sampling method was used to recruit participants and data were collected through an anonymous questionnaire. Logistic regression analysis was employed to identify correlates of group sex participation. Results Overall, 1151 eligible participants were enrolled in the study. 14.7% of MSM reported participating in group sex in their lifetime, and 5.8% reported group sex participation in the prior 6 months. Factors positively associated with group sex participation in both the prior 6 months and the lifetime included: monthly income ≥3000 Yuan (adjusted odds ratios [aOR] = 3.67, 95% confidence interval [CI] 1.25–10.75; aOR = 2.30, 95% CI 1.21–4.35), initiating anal sex before 18 years old (aOR = 1.86, 95% CI 1.03–3.34; aOR = 2.00, 95% CI 1.31–3.05), using gay apps to seek sex partners (aOR = 7.41, 95% CI 2.57–21.33; aOR = 9.75, 95% CI 4.92–19.33), recreational drug use (aOR = 10.10, 95% CI 5.52–18.49; aOR = 4.75, 95% CI 3.20–7.05) and having condomless internal ejaculation (CIE) (aOR = 3.66, 95% CI 2.01–6.68; aOR = 1.61, 95% CI 1.11–2.35). Factors only associated with group sex participation in the lifetime were older age (age between 26 and 35 years old: aOR = 2.06, 95% CI 1.30–3.26; age > 35 years old: aOR = 1.95, 95% CI 1.10–3.46) and history of STIs (aOR = 2.51, 95% CI 1.37–4.62). Conclusions The results of this study suggested that group sex participation was a potentially risky context for acquisition and transmission of HIV/STIs. Close attention should be given to MSM who participated in group sex, and appropriate risk reduction interventions should be developed specific to this subgroup of MSM.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amrita Ayer ◽  
Eddy R. Segura ◽  
Amaya Perez-Brumer ◽  
Susan Chavez-Gomez ◽  
Rosario Fernandez ◽  
...  

Abstract Background Social networks, norms, and discussions about sexual health may inform sexual practices, influencing risk of human immunodeficiency virus (HIV) or sexually transmitted infection (STI) acquisition. To better understand social networks of Peruvian men who have sex with men (MSM) and transgender women (trans women), we examined key social network members (SNMs), participant perceptions of these network members’ opinions toward sexual health behaviors, and associations between network member characteristics and condomless anal intercourse (CAI). Methods In a 2017 cross-sectional study, a convenience sample of 565 MSM and trans women with HIV-negative or unknown serostatus was asked to identify three close SNMs; describe discussions about HIV and STI prevention with each; and report perceived opinions of condom use, HIV/STI testing, and partner notification of STIs. Generalized estimating equations evaluated relationships between SNM characteristics, opinions, and discussions and participant-reported CAI. Results Among participants who identified as MSM, 42.3% of key SNMs were perceived to identify as gay. MSM “never” discussed HIV and STI prevention concerns with 42.4% of heterosexual SNMs, but discussed them “at least once weekly” with 16.9 and 16.6% of gay- and bisexual- identifying SNMs, respectively. Among participants who identified as trans women, 28.2% of key SNMs were perceived as heterosexual; 25.9%, as bisexual; 24.7%, as transgender; and 21.2%, as gay. Trans women discussed HIV/STI prevention least with cis-gender heterosexual network members (40.2% “never”) and most with transgender network members (27.1% “at least once weekly”). Participants perceived most of their close social network to be completely in favor of condom use (71.2% MSM SNMs, 61.5% trans women SNMs) and HIV/STI testing (73.1% MSM SNMs, 75.6% trans women SNMs), but described less support for partner STI notification (33.4% MSM SNMs, 37.4% trans women SNMs). Most participants reported CAI with at least one of their past three sexual partners (77.5% MSM, 62.8% trans women). SNM characteristics were not significantly associated with participant-reported frequency of CAI. Conclusions Findings compare social support, perceived social norms, and discussion patterns of Peruvian MSM and trans women, offering insight into social contexts and sexual behaviors. Trial registration The parent study from which this analysis was derived was registered at ClinicalTrials.gov (Identifier: NCT03010020) on January 4, 2017.


2008 ◽  
Vol 19 (10) ◽  
pp. 713-714 ◽  
Author(s):  
K M Forbes ◽  
N Rahman ◽  
S Mccrae ◽  
I Reeves

Community-based sexual health services (SHS) are intended to improve access for people who may have difficulty attending traditional genitourinary medicine clinics. The objective of this study was to review uptake of sexually transmitted infection (STI) testing in an outreach clinic for those under 25 in an area where Black and minority ethnic groups comprise the majority of the local population. A retrospective case-notes review was undertaken of those attending. Standards were that Fraser guidelines should be completed in all under 16-year-old and all clients should be offered STI testing, HIV testing and contraception (if applicable) in accordance with local standards. One hundred and seventeen clients attended. Ten percent self-reported ethnicity was Asian. Thirty-six (31%) clients tested for chlamydia. Thirty (26%) had an HIV test. Five (14% of those tested) had a positive nucleic acid amplification test for chlamydia. Five (13%) of those requesting long term contraception had STI testing. This service has successfully improved access to STI screening. However, there may have been missed opportunities to offer tests in those requesting contraception. Under-representation of those of non-white ethnicity suggests access to SHS may be a particular problem and further work is required to improve the sexual health of the local community.


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