The success of HIV combination prevention: The Dean Street model

HIV Medicine ◽  
2021 ◽  
Author(s):  
Nicolò Girometti ◽  
Valerie Delpech ◽  
Sheena McCormack ◽  
Jameel Khawam ◽  
Sophie Nash ◽  
...  
Keyword(s):  
Combination Prevention

scholarly journals Sexual behaviour patterns and STI risk: results of a cluster analysis among men who have sex with men in Portugal

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e033290
Author(s):  
Karel Blondeel ◽  
Sonia Dias ◽  
Martina Furegato ◽  
Armando Seuc ◽  
Ana Gama ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Sexual Behaviour ◽  
Hierarchical Cluster ◽  
Risk Behaviour ◽  
Sexual Partners ◽  
Hiv Positive ◽  
Research Approach ◽  
Cross Sectional ◽  
Combination Prevention ◽  
Sex With Men

ObjectivesPortugal has the highest HIV incidence rate in Western Europe. The proportion assigned to sexual contact between men recently increased to more than 30% of all HIV infections. Men who have sex with men (MSM) are vulnerable to the acquisition of other sexually transmitted infections (STIs), increasing the per-contact risk of HIV infection. Building on syndemic theory, the aim of this analysis was to identify patterns of current sexual behaviour in MSM, and explore their relationship with self-reported current, past STI diagnoses and HIV positive serostatus.DesignA cross-sectional behavioural survey was conducted in Portugal among MSM, using a community-based participatory research approach. Hierarchical cluster analysis was used to identify patterns including behavioural and demographic factors.ResultsThe analysis resulted in six clusters. Three clusters showed higher rates of current STI diagnosis (ranging from 11.7% to 17.1%), past STI diagnosis (ranging from 25.5% to 41.5%) and HIV positive serostatus (ranging from 13.0% to 16.7%). From the three clusters scoring lower on current and past STI and HIV diagnoses, one was characterised by a high number of sexual partners (62% had more than 12 partners in the last year), a high proportion (94.6%) of frequent visits to gay venues to meet sexual partners and high alcohol use (46.1%). The other two clusters scored lower on high risk sexual behaviour.ConclusionFactors other than sexual behaviour appear to reinforce the vulnerability to STIs and HIV of some MSM in this study, suggesting a syndemic of STIs, HIV and other adverse conditions. More research is needed to better understand the drivers of the STI/HIV epidemic in Portuguese MSM, using a concept that goes beyond risk behaviour, to develop effective combination prevention interventions.

Transformation of HIV from pandemic to low-endemic levels: a public health approach to combination prevention

The Lancet ◽  
2014 ◽  
Vol 384 (9939) ◽  
pp. 272-279 ◽  
Author(s):  
Alexandra Jones ◽  
Ide Cremin ◽  
Fareed Abdullah ◽  
John Idoko ◽  
Peter Cherutich ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Approach ◽  
Combination Prevention

49. Impact of HIV Combination Prevention on Orphanhood Among Adolescents, Rakai, Uganda, 2001-2018

2021 ◽  
Vol 68 (2) ◽  
pp. S27
Author(s):  
John S. Santelli ◽  
Ivy S. Chen ◽  
Dorean Nabukalu ◽  
Tom Lutalo ◽  
Esther Janaina Spindler ◽  
...  
Keyword(s):  
Combination Prevention

scholarly journals Overlap between harm reduction and HIV service utilisation among PWID in India: Implications for HIV combination prevention

2018 ◽  
Vol 57 ◽  
pp. 111-118 ◽  
Author(s):  
M. Kumi Smith ◽  
Sunil S. Solomon ◽  
Derek A.T. Cummings ◽  
Aylur K. Srikrishnan ◽  
M. Suresh Kumar ◽  
...  
Keyword(s):  
Harm Reduction ◽  
Service Utilisation ◽  
Combination Prevention

scholarly journals Quantitative methods used to evaluate impact of health promotion interventions to prevent HIV infections: a methodological systematic review protocol

2021 ◽  
Author(s):  
Andrainolo Ravalihasy ◽  
Lidia Kardas-Sloma ◽  
Yazdan Yazdanpanah ◽  
Valéry Ridde
Keyword(s):  
Systematic Review ◽  
Health Promotion ◽  
Impact Evaluation ◽  
Quantitative Methods ◽  
Evaluation Studies ◽  
Complex Interventions ◽  
Hiv Infections ◽  
Combination Prevention ◽  
Health Promotion Interventions ◽  
The Impact

Abstract Background Combination prevention is currently considered the best approach to combat HIV epidemic. It is based upon the combination of structural, behavioral and biomedical interventions. Such interventions are frequently implemented in a health promoting manner due to their aims, the approach that was adopted and their complexity. The impact evaluation of these interventions often relies on methods inherited from the biomedical field. However, these methods have limitations and should be adapted to be relevant for these complex interventions. This systematic review aims to map the evidence-based methods used to quantify the impact of these interventions and analyze how these methods are implemented. Methods Three databases (Web of Science, Scopus, PubMed) will be used to identify impact evaluation studies of health promotion interventions that aimed at reducing the incidence or prevalence of HIV infection. Only studies based on quantitative design assessing intervention impact on HIV prevalence or incidence will be included. Two reviewers will independently screen studies based on titles and abstracts and then on the full text. The information about study characteristics will be extracted to understand the context in which the interventions are implemented. The information specific to quantitative methods of impact evaluation will be extracted using items from the Mixed Methods Appraisal Tool (MMAT), the guidelines for reporting Statistical Analyses and Methods in the Published Literature (SAMPL) and the guidelines for Strengthening The Reporting of Empirical Simulation Studies (STRESS). This review will be conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Discussion The impact evaluation of HIV prevention interventions is a matter of substantial importance given the growing need for evidence of the effectiveness of these interventions whereas they are increasingly complex. These evaluations allow to identify the most effective strategies to be implemented to fight the epidemic. It is therefore relevant to map the methods to better implement them and adapt them according to the type of intervention to be evaluated. Systematic review registration: PROSPERO CRD42020210825

Combination Prevention

2015 ◽  
pp. 109-130
Author(s):  
Peter Piot ◽  
Laurence Garey
Keyword(s):  
Combination Prevention

scholarly journals “The Time Has Arrived”: Perceptions of Behavioral Adjustments in the Context of Pre-Exposure Prophylaxis Availability Among Adolescents in South Africa

2018 ◽  
Vol 30 (6) ◽  
pp. 463-473 ◽  
Author(s):  
Danielle Giovenco ◽  
Caroline Kuo ◽  
Kristen Underhill ◽  
Jacqueline Hoare ◽  
Don Operario
Keyword(s):  
South Africa ◽  
Qualitative Methodology ◽  
Service Providers ◽  
Developmentally Appropriate ◽  
Western Cape ◽  
African Countries ◽  
Combination Prevention ◽  
Implementation Challenges ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

Antiretroviral pre-exposure prophylaxis (PrEP) holds enormous potential to reduce HIV acquisition in key populations globally. We conducted an exploratory PrEP acceptability study using qualitative methodology among adolescents and service providers in the Western Cape Province of South Africa to inform future PrEP implementation challenges in South Africa and other high-prevalence African countries. Semistructured focus groups and in-depth individual interviews were conducted among 57 adolescents 16–17 years of age, living with and without HIV, and 25 clinical service providers. Adolescents and service providers expressed concerns that the availability of PrEP would lead to sexual disinhibition and a reduction in condom use among adolescents. Unexpected positive impacts included predictions that PrEP might encourage disclosure in serodiscordant partnerships and help normalize pill-taking in the community. Careful age, gender, and developmentally appropriate messaging will be needed to ensure adolescents understand partial efficacy and view PrEP as a component of combination prevention.

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