scholarly journals Potential interruptions in HIV prevention and treatment services for gay, bisexual, and other men who have sex with men associated with COVID-19

2020 ◽  
Author(s):  
Amrita Rao ◽  
Katherine Rucinski ◽  
Brooke Jarrett ◽  
Benjamin Ackerman ◽  
Sara Wallach ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Population Based ◽  
Mitigation Strategies ◽  
Control Measures ◽  
Morbidity And Mortality ◽  
Treatment Services ◽  
Country Level ◽  
Prevention And Treatment ◽  
Sex With Men ◽  
Living With Hiv

Background Globally, the coronavirus pandemic has necessitated a range of population-based measures in order to stem the spread of infection and reduce COVID-19-related morbidity and mortality. These measures may be associated with disruptions to other health services including for gay, bisexual, and other men who have sex with men (MSM) at risk for or living with HIV. Here, we assess the relationship between stringency of COVID-19 mitigation strategies and interruptions to HIV prevention and treatment services for MSM. Methods Data for this study were collected as part of a COVID-19 Disparities Survey implemented by the gay social networking app Hornet, with data collected between April 16th, 2020 and May 24th, 2020. Data were assessed for countries where at least 50 participants completed the survey, to best evaluate country-level heterogeneity. We used a modified Poisson regression model, with clustering at the country-level, to assess the association between stringency of pandemic control measures and access to HIV services. Pandemic control measures were quantified using the Oxford Government Response Tracker Stringency Index; each country received a score (0-100) based on the number and strictness of nine indicators related to school and workplace closures and travel bans. Results A total of 10,654 MSM across 20 countries were included in these analyses. The mean age was 34.2 (standard deviation: 10.8), and 12% (1264/10540) of participants reported living with HIV. The median stringency score was 82.31 (Range:[19.44, Belarus]-[92.59, Ukraine]). For every ten-point increase in stringency, there was a 3% reduction in the prevalence of access to in-person testing (aPR: 0.97, 95% CI:[0.96, 0.98]), a 6% reduction in the prevalence of access to self-testing (aPR: 0.94, 95% CI:[0.93, 0.95]), and a 5% reduction in access to PrEP (aPR: 0.95, 95% CI:[0.95, 0.97]). Among those living with HIV, close to one in five (n=218/1105) participants reported being unable to access their provider either in-person or via telemedicine during the COVID-19 pandemic, with a greater proportion of interruptions to treatment services reported in Belarus and Mexico. Almost half (n=820/1254) reported being unable to refill their HIV medicine prescription remotely. Conclusions More stringent government responses were associated with decreased access to HIV diagnostic, prevention, and treatment services. To minimize increases in HIV-related morbidity and mortality, innovative strategies are needed to facilitate minimize service interruptions to MSM communities during this and potential future waves of COVID-19.

scholarly journals High levels of mild to moderate depression among men who have sex with men and transgender women in Lima, Peru: implications for integrated depression and HIV care

2020 ◽  
Author(s):  
Jerome T. Galea ◽  
Stephanie Marhefka ◽  
Segundo R. León ◽  
Guitele Rahill ◽  
Elena Cyrus ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Transgender Women ◽  
Hiv Care ◽  
Depression Care ◽  
Care Services ◽  
Treatment Services ◽  
Moderate Depression ◽  
Prevention And Treatment ◽  
Patient Health ◽  
Sex With Men

ABSTRACTDepression disproportionally affects people at risk of acquiring or living with HIV and is associated with worse health outcomes; however, depression care is not routinely integrated with HIV prevention and treatment services. Selection of the best depression intervention(s) for integration depends both on the prevalence and severity of depression among potential users. To inform depression care integration in a community-based setting in Lima, Peru, we retrospectively analyzed routinely collected depression screening data from men who have sex with men and transgender women seeking HIV prevention and care services (N=185). Depression was screened for using the Patient Health Questionnaire-9. Prevalence of any depression (PHQ-9 ≥5) was 42% and was significantly associated with the last sexual partner being “casual” (p=0.01). Most (81%) depressive symptoms were mild to moderate (≥5 PHQ-9 ≤14). Integrating depression care with HIV prevention and treatment services in Peru should begin by implementing interventions targeting mild to moderate depression.

scholarly journals Integration of Gender-Affirming Primary Care and Peer Navigation With HIV Prevention and Treatment Services to Improve the Health of Transgender Women: Protocol for a Prospective Longitudinal Cohort Study (Preprint)

2019 ◽  
Author(s):  
Javier R Lama ◽  
Kenneth H Mayer ◽  
Amaya G Perez-Brumer ◽  
Leyla Huerta ◽  
Hugo Sanchez ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Hiv Prevention ◽  
Hormone Therapy ◽  
Transgender Women ◽  
Treatment Services ◽  
Prevention And Treatment ◽  
Gender Affirmation ◽  
Peer Navigation ◽  
Living With Hiv

BACKGROUND Public health strategies are urgently needed to improve HIV disparities among transgender women, including holistic intervention approaches that address those health needs prioritized by the community. Hormone therapy is the primary method by which many transgender women medically achieve gender affirmation. Peer navigation has been shown to be effective to engage and retain underserved populations living with HIV in stable primary medical care. OBJECTIVE This study aims to assess the feasibility and acceptability of an integrated innovative HIV service delivery model designed to improve HIV prevention and care by combining gender-affirming primary care and peer navigation with HIV prevention and treatment services. METHODS A 12-month, nonrandomized, single-arm cohort study was implemented in Lima, Peru, among adult individuals, assigned a male sex at birth, who identified themselves as transgender women, regardless of initiation or completion of medical gender affirmation, and who were unaware of their HIV serostatus or were living with HIV but not engaged in HIV treatment. HIV-negative participants received quarterly HIV testing and were offered to initiate pre-exposure prophylaxis. HIV-positive participants were offered to initiate antiretroviral treatment and underwent quarterly plasma HIV-1 RNA and peripheral CD4+ lymphocyte cell count monitoring. All participants received feminizing hormone therapy and adherence counseling and education on their use. Peer health navigation facilitated retention in care by visiting participants at home, work, or socialization venues, or by contacting them by social media and phone. RESULTS Patient recruitment started in October 2016 and finished in March 2017. The cohort ended follow-up on March 2018. Data analysis is currently underway. CONCLUSIONS Innovative and culturally sensitive strategies to improve access to HIV prevention and treatment services for transgender women are vital to curb the burden of HIV epidemic for this key population. Findings of this intervention will inform future policies and research, including evaluation of its efficacy in a randomized controlled trial. CLINICALTRIAL ClinicalTrials.gov NCT03757117; https://clinicaltrials.gov/ct2/show/NCT03757117 INTERNATIONAL REGISTERED REPOR DERR1-10.2196/14091

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 Availability of HIV prevention and treatment services for people who inject drugs: findings from 21 countries

2013 ◽  
Vol 10 (1) ◽  
pp. 13 ◽  
Author(s):  
Zaino Petersen ◽  
Bronwyn Myers ◽  
Marie-Claire van Hout ◽  
Andreas Plüddemann ◽  
Charles Parry
Keyword(s):  
Hiv Prevention ◽  
People Who Inject Drugs ◽  
Treatment Services ◽  
Prevention And Treatment

scholarly journals A systematic review of mHealth interventions for HIV prevention and treatment among gay, bisexual, and other men who have sex with men

2020 ◽  
Vol 10 (5) ◽  
pp. 1211-1220
Author(s):  
Kimberly M Nelson ◽  
Nicholas S Perry ◽  
Keith J Horvath ◽  
Laramie R Smith
Keyword(s):  
Systematic Review ◽  
Hiv Prevention ◽  
Text Messaging ◽  
Controlled Trial ◽  
The United States ◽  
Current Evidence ◽  
Future Research ◽  
Targeted Prevention ◽  
Prevention And Treatment ◽  
Sex With Men

Abstract The use of mobile health (mHealth) technologies addressing HIV disparities among gay, bisexual, and other men who have sex with men (GBMSM) has increased. A systematic review of mHealth interventions for HIV prevention and treatment among GBMSM was conducted to summarize the current evidence and provide recommendations for future research. PRISMA guidelines were followed (PROSPERO ID: 148452). Studies identified via PubMed, PsychInfo, or Embase were included that (i) were in English, (ii) were published in a peer-reviewed journal prior to July 1, 2019, (iii) presented primary results, (iv) included only GBMSM, and (v) reported the results of an mHealth intervention (e.g., text message, phone/mobile application [app]) to improve HIV prevention or treatment outcomes. Of 1,636 identified abstracts, 16 published studies met inclusion criteria. Eleven studies were conducted in the United States. One study was a fully powered randomized controlled trial (RCT), seven were single-arm pilots with pre–post assessments, four were pilot RCTs, and four tested public health campaigns with post-assessments. Seven developed study-specific apps, five used text messaging, and four used existing social networking apps. Most (81%) targeted prevention outcomes. Nine cited a specific behavioral theory. All studies found that a mHealth approach was feasible and acceptable. All interventions provided evidence of preliminary efficacy or promising trends on primary outcomes. Although mHealth interventions for HIV prevention and treatment appear feasible and acceptable, most published studies are small pilot trials. Additional research assessing the efficacy and mechanisms of mHealth interventions is needed.

scholarly journals Mental health in 2020 for men who have sex with men in the United States

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 59 ◽  
Author(s):  
Abigail W. Batchelder ◽  
Steven Safren ◽  
Avery D. Mitchell ◽  
Ivan Ivardic ◽  
Conall O'Cleirigh
Keyword(s):  
Mental Health ◽  
Hiv Prevention ◽  
The United States ◽  
Hiv Care ◽  
Hiv Care Cascade ◽  
Age Related ◽  
The Us ◽  
Prevention And Treatment ◽  
Sex With Men ◽  
Hiv Aids

Despite continued advances in HIV prevention and treatment, gay and bisexual men and other men who have sex with men (MSM) remain the population most impacted by HIV/AIDS in the US and many other Western countries. Additionally, MSM are disproportionately affected by various psychological problems, including depression, distress, trauma and substance use. These challenges frequently co-occur, and are associated with higher rates of behaviours related to HIV acquisition and transmission, HIV infection, and, for those living with HIV/AIDS, lower levels of treatment engagement. Moreover, racial disparities exist among MSM in the US; for example, young African American MSM bear a disproportionate burden of the continuing HIV epidemic, likely related to disparate HIV prevalence in partner pools as well as long-standing structural inequities. In this review, the mental health challenges facing MSM primarily in the US, related to HIV and STI prevention and across the HIV care cascade, including HIV diagnosis, engagement and retention in care, and antiretroviral adherence, are illustrated. Disparities among MSM including racial and ethnic, age-related and structural barriers associated with HIV prevention and treatment, as well as current interventions, are also described. Moving forward towards 2020, resources will be needed to assess and implement scalable intervention strategies to address psychological and social barriers to HIV and STI risk reduction and treatment for MSM, with a particular focus on the most vulnerable subpopulations. As access to prevention and treatment strategies expand, and new breakthroughs continue to emerge, behavioural strategies will continue to be needed to reduce risk and increase uptake and engagement among MSM most at risk through 2020 and beyond.

A realist systematic review of stigma reduction interventions for HIV prevention and care continuum outcomes among men who have sex with men

2020 ◽  
Vol 31 (8) ◽  
pp. 712-723
Author(s):  
Willy Dunbar ◽  
Aline Labat ◽  
Christian Raccurt ◽  
Nancy Sohler ◽  
Jean William Pape ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Prevention ◽  
Mitigation Strategies ◽  
Care Providers ◽  
Programme Theory ◽  
Stigma Reduction ◽  
Self Reflection ◽  
Enacted Stigma ◽  
Sex With Men ◽  
Anticipated Stigma

While stigma associated with human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) is well recognized, there remains relatively limited intervention data on effective stigma reduction strategies. This systematic review was conducted to highlight the mechanisms through which sexual and HIV stigma is reduced in relation to HIV prevention and care engagement. Search of PubMed and Scopus resulted in 11 tested interventions to include in our preliminary model constructed from programme frameworks and recommendations. We refined the preliminary programme theory to identify whether, why, or how mitigation strategies produce observed outcomes. Our review showed that the interventions produced stigma reduction through three groups of mechanisms: (1) Self-acceptance, leadership, and motivational activation for behaviour change from intrapersonal strategies, such as education and mobile health strategies, which intervene on internalized and anticipated stigma; (2) socialization, knowledge sharing, and social empowerment from interpersonal strategies, such as peer support and training for care providers; and (3) community introspection, self-reflection, and humanistic activation from structural strategies such as community leaders’ sensitization, which intervene on both anticipated and enacted stigma. Interventions mechanisms act complementarily and can be activated in different contexts in which MSM exposed to and infected with HIV are living.

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