scholarly journals Effect of rectal douching/enema on rectal gonorrhoea and chlamydia among a cohort of men who have sex with men on HIV pre-exposure prophylaxis

2018 ◽  
Vol 94 (7) ◽  
pp. 508-514 ◽  
Author(s):  
Adiba Hassan ◽  
Jill S Blumenthal ◽  
Michael P Dube ◽  
Eric Ellorin ◽  
Katya Corado ◽  
...  
Keyword(s):  
Substance Use ◽  
Sexual Risk ◽  
Mucosal Barrier ◽  
Controlled Study ◽  
Sexual Risk Behaviour ◽  
Male Partners ◽  
Reverse Causality ◽  
Rectal Douching ◽  
Sex With Men ◽  
Exposure Prophylaxis

ObjectivesRectal douching/enema (RD) is a common practice among men who have sex with men (MSM) in preparation for sex. RD can break down the rectal mucosal barrier and potentially affect the rectal microbiome. The objective of this study was to understand if RD is associated with acquiring rectal infections (RI) with rectal gonorrhoea (NG) and/or chlamydia (CT).MethodsFrom 2013 to 2015, 395 adult HIV-uninfected MSM were enrolled in a randomised controlled study for pre-exposure prophylaxis (PrEP) adherence with routine sexual risk survey and testing. Using data from this cohort, baseline differences by RI were assessed using Pearson’s χ² and Wilcoxon-Mann-Whitney test. Association between RD and RI was modelled using multivariable logistic regression adjusted for potential confounders (sexual behaviour, substance use and age) selected a priori. Effect modification by number of male partners and sensitivity analysis to rule out reverse causality were also conducted.ResultsOf 395 participants, 261 (66%) performed RD and 133 (33%) had at least one NG/CT RI over 48 weeks. Number of condomless anal receptive sex (med: 4, p<0.001), male partners (med:6, p<0.001) and substance use (any of methamphetamine/hallucinogens/dissociative/poppers) (p<0.001) were associated with increased odds of RI. Controlling for potential confounders, odds of prevalent RI were 3.59 (p<0.001, 95% CI 1.90 to 6.78) and incident RI 3.87 (p=0.001, 95% CI 1.78 to 8.39) when douching weekly or more compared with not douching. MSM with more than six male partners had 5.34 (p=0.002, 95% CI 1.87 to 15.31) increased odds of RI when douching weekly or more compared with not douching.ConclusionRectal hygiene with RD is a common practice (66%) among HIV-uninfected MSM on PrEP in this study, which increases the odds of acquiring rectal NG and/or CT independent of sexual risk behaviour, substance use and other factors. This suggests interventional approaches targeting rectal hygiene products and practices could reduce sexually transmitted infections.

scholarly journals Influence of Internalised Homonegativity on Sexual Risk Behaviour of Men Who Have Sex with Men in Spain

2021 ◽  
Author(s):  
İbrahim Sönmez ◽  
Cinta Folch ◽  
Nicolas Lorente ◽  
Rigmor C. Berg ◽  
Natalie Thurlby ◽  
...  
Keyword(s):  
Substance Use ◽  
Sexual Risk ◽  
Structural Equation ◽  
Risk Behaviour ◽  
Sexual Risk Behaviour ◽  
Mediating Effects ◽  
Equation Modelling ◽  
Direct Association ◽  
Sex With Men ◽  
The Relationship

AbstractIn a sample of men who have sex with men (MSM) (N = 3436) in Spain who bear intrinsic HIV risk, we investigated how internalised homonegativity (IH) is associated with the number of non-steady male partners with condomless intercourse (as a proxy of sexual risk behaviour). Using structural equation modelling (SEM), we examined the relationship between IH and sexual risk behaviour, and mediating effects of HIV/PrEP knowledge and substance use during sex on this relationship. We found no direct association between IH and sexual risk behaviour, nor did IH influence substance use during sex. In line with our hypothesis, association between IH and sexual risk behaviour was significant when mediated by HIV/PrEP knowledge. We found that as IH increased, sexual risk behaviour decreased, because higher IH was associated with lower HIV/PrEP knowledge while higher HIV/PrEP knowledge was associated with increased non-condom use with non-steady partners. Substance use during sex was significantly associated with sexual risk behaviour. Our results emphasize the continuing importance of prevention strategies focused on behavioural changes and community level interventions, especially targeting substance use.

scholarly journals Theories of change for e-health interventions targeting HIV/STIs and sexual risk, substance use and mental ill health amongst men who have sex with men: systematic review and synthesis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Rebecca Meiksin ◽  
G. J. Melendez-Torres ◽  
Jane Falconer ◽  
T. Charles Witzel ◽  
Peter Weatherburn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Substance Use ◽  
Cognitive Therapy ◽  
Sexual Risk ◽  
Health Interventions ◽  
Theory Of Change ◽  
Sexual Risk Behaviour ◽  
Report Quality ◽  
Sex With Men ◽  
Theories Of Change

Abstract Background Sexual risk, substance use, and mental ill health constitute a syndemic of co-occurring, mutually reinforcing epidemics amongst men who have sex with men (MSM). Developed since 1995, e-health interventions offer accessible, anonymous support and can be effective in addressing these outcomes, suggesting the potential value of developing e-health interventions that address these simultaneously amongst MSM. We conducted a systematic review of e-health interventions addressing one or more of these outcomes amongst MSM and in this paper describe the theories of change underpinning relevant interventions, what these offer and how they might complement each other. Methods We identified eligible reports via expert requests, reference-checking and database and Google searches. Results were screened for reports published in 1995 or later; focused on MSM; reporting on e-health interventions providing ongoing support to prevent HIV/STIs, sexual risk behaviour, substance use, anxiety or depression; and describing intervention theories of change. Reviewers assessed report quality, extracted intervention and theory of change data, and developed a novel method of synthesis using diagrammatic representations of theories of change. Results Thirty-three reports on 22 intervention theories of change were included, largely of low/medium-quality. Inductively grouping these theories according to their core constructs, we identified three distinct groupings of theorised pathways. In the largest, the ‘cognitive/skills’ grouping, interventions provide information and activities which are theorised to influence behaviour via motivation/intention and self-efficacy/perceived control. In the ‘self-monitoring’ grouping, interventions are theorised to trigger reflection, self-reward/critique and self-regulation. In the ‘cognitive therapy’ grouping, the theory of change is rooted in cognitive therapy techniques, aiming to reframe negative emotions to improve mental health. Conclusions The synthesised theories of change provide a framework for developing e-health interventions that might holistically address syndemic health problems amongst MSM. Improving reporting on theories of change in primary studies of e-health interventions would enable a better understanding of how they are intended to work and the evidence supporting this. The novel diagrammatic method of theory of change synthesis used here could be used for future reviews where interventions are driven by existing well-defined behaviour and behaviour change theories. Systematic review registration PROSPERO CRD42018110317

scholarly journals Longitudinal Event-Level Sexual Risk and Substance Use among Gay, Bisexual, and Other Men Who Have Sex with Men

2021 ◽  
Vol 18 (6) ◽  
pp. 3183
Author(s):  
Jordan M. Sang ◽  
Zishan Cui ◽  
Paul Sereda ◽  
Heather L. Armstrong ◽  
Gbolahan Olarewaju ◽  
...  
Keyword(s):  
Substance Use ◽  
Sexual Risk ◽  
Health Study ◽  
Anal Sex ◽  
Study Objective ◽  
Condomless Anal Sex ◽  
Gamma Hydroxybutyrate ◽  
Sex With Men ◽  
Hiv Negative

(1) Background: Condomless anal sex and substance use are associated with STI risk among gay, bisexual, and other men who have sex with men (gbMSM). Our first study objective was to describe event-level sexual risk and substance use trends among gbMSM. Our second study objective was to describe substances associated with event-level sexual risk. (2) Methods: Data come from the Momentum Health Study in Vancouver, British Columbia and participants were recruited from 2012–2015, with follow-up until 2018. Stratified by self-reported HIV status, we used generalized estimating equations to assess trends of sexual event-level substance use and assessed interactions between substance use and time period on event-level higher risk sex defined as condomless anal sex with an HIV serodifferent or unknown status partner. (3) Results: Event-level higher risk anal sex increased across the study period among HIV-negative/unknown (baseline prevalence: 13% vs. study end prevalence: 29%) and HIV-positive gbMSM (baseline prevalence: 16% vs. study end prevalence: 38%). Among HIV-negative/unknown gbMSM, event-level erectile drug use increased, while alcohol use decreased over the study period. Overall, interactions between substance use and time on higher risk anal sex were not statistically significant, regardless of serostatus. However, we found a number of time-specific significant interactions for erectile drugs, poppers, Gamma-hydroxybutyrate (GHB), crystal methamphetamine and ecstasy/MDMA use among HIV-negative/unknown gbMSM. (4) Conclusion: Significant differences in substance use trends and associated risks exist and are varied among gbMSM by serostatus. These findings provide a more comprehensive understanding of the effects of event-level substance use on sexual risk through longitudinal follow-up of nearly six years.

scholarly journals O02.5 Narrating risk: new and traditional methods to understand sexual risk behaviour among hiv-uninfected men who have sex with men in lima, peru

2017 ◽  
Author(s):  
Jesse L Clark ◽  
Ximena Salazar ◽  
Williams Gonzales ◽  
Amaya Perez-Brumer ◽  
Francisco Nanclares ◽  
...  
Keyword(s):  
Sexual Risk ◽  
Risk Behaviour ◽  
Sexual Risk Behaviour ◽  
Traditional Methods ◽  
Sex With Men

scholarly journals The Context of Sexual Risk Behaviour Among Men Who Have Sex with Men Seeking PrEP, and the Impact of PrEP on Sexual Behaviour

2018 ◽  
Vol 23 (7) ◽  
pp. 1708-1720 ◽  
Author(s):  
Mitzy Gafos ◽  
Rob Horne ◽  
Will Nutland ◽  
Gill Bell ◽  
Caroline Rae ◽  
...  
Keyword(s):  
Sexual Risk ◽  
Sexual Behaviour ◽  
Risk Behaviour ◽  
Sexual Risk Behaviour ◽  
Sex With Men ◽  
The Impact
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