Doing Sexual Responsibility: HIV, Risk Discourses, Trust, and Gay Men Interacting Online

2017 ◽  
Vol 61 (3) ◽  
pp. 383-398 ◽  
Author(s):  
Brandon Andrew Robinson
Keyword(s):  
Gay Men ◽  
Hiv Risk ◽  
Boundary Work ◽  
Unintended Consequences ◽  
Individual Responsibility ◽  
Hiv Positive ◽  
Hiv Status ◽  
Similar Information ◽  
Sexual Responsibility ◽  
Hiv Negative

This study draws from interviews with HIV-negative gay men to show how they are doing sexual responsibility online and how their actions uphold moralizing discourses around HIV. The analysis shows how gay men often engage in boundary work through stating their HIV status and “safe sex” practices on their online profile and through screening other people’s profiles for similar information. The gay men also avoid interactions with HIV-positive people, maintaining the stigmatization of HIV-positive people and constructing an HIV-positive serostatus as a status distinction. However, although the HIV-negative gay men are often invested in doing sexual responsibility, they eschew condom use with people they trust. This study then demonstrates the limitations and unintended consequences of discourses that often focus on risk and individual responsibility. These discourses ignore the relational and emotive components of sexual interactions, and hence fail to capture the complexities of people’s lives.

scholarly journals Primary and secondary supportive partnerships among HIV-positive and HIV-negative middle-aged and older gay men

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245863
Author(s):  
Matthew Statz ◽  
Deanna Ware ◽  
Nicholas Perry ◽  
David Huebner ◽  
Christopher Cox ◽  
...  
Keyword(s):  
Gay Men ◽  
Healthy Aging ◽  
Hiv Positive ◽  
Hiv Status ◽  
Significant Difference ◽  
Partnership Status ◽  
Race Ethnicity ◽  
Sex With Men ◽  
Older Gay Men ◽  
Hiv Negative

This study describes the primary and secondary partnerships of aging gay men participating in the Understanding Patterns of Healthy Aging Among Men Who Have Sex with Men substudy of the Multicenter AIDS Cohort Study and examines differences in the prevalence of these relationship structures by HIV status while adjusting for age, education, and race/ethnicity. Relationships were compared within the following structural categories: “only a primary partnership”, “only a secondary partnership”, “both a primary and secondary relationship”, or “neither a primary nor secondary relationship”. There were 1,054 participants (51.9% HIV negative/48.1% HIV positive) included in the study. Participants had a median age of 62.0 years (interquartile range: 56.0–67.0) and most reported being non-Hispanic white (74.6%) and college educated (88.0%). Of the 1,004 participants with available partnership status data, 384 (38.2%) reported no primary or secondary partnerships, 108 (10.8%) reported secondary-only partnership, 385 (38.3%) reported primary-only partnership, and 127 (12.6%) reported both primary and secondary partnerships. Of participants who reported primary partnerships only, the prevalence rates (PRs) were lower among those 62 years and older, HIV positive, black non-Hispanic and Hispanics. Of participants who reported only having a secondary partnership, the PRs were higher among those 62 years and older and HIV positive. Of participants who did not report having either a primary or secondary partnership, the PRs were higher among those 62 years and older, HIV positive, and black non-Hispanic compared with their respective referent groups. There was no significant difference in PRs of having both primary and secondary partnerships by age category, HIV status, race/ethnicity, and education. This study aimed to fill a knowledge gap in the literature regarding both primary and secondary supportive partnerships among aging HIV-positive and HIV-negative gay men.

scholarly journals The Paradoxes of PrEP: Rejection, Reluctancy, and Novel Gay Identities in Biomedical HIV Prevention in Serbia

2022 ◽  
pp. 34-51
Author(s):  
Zoran Milosavljević
Keyword(s):  
Hiv Prevention ◽  
Gay Men ◽  
Hiv Transmission ◽  
Gay Identity ◽  
Hiv Status ◽  
Social Significance ◽  
Gay Communities ◽  
Hiv Status Disclosure ◽  
Status Disclosure ◽  
Hiv Negative

This article explores the different ways in which gay men in Serbia perceive PrEP as a novel method of HIV prevention. In the article, I draw on data from my research on PrEP use among thirty gay men in Belgrade. The use of PrEP is still very low amongst gay communities in Serbia due to their rejection of PrEP and due to the stigma around PrEP use. In Serbia, the social significance of PrEP relates to HIV status disclosure on gay social/dating media. Paradoxically, on gay dating sites, the signifier "PrEP" blurs the line between HIV positive gay men – who have achieved undetectable HIV status through a potent ARV therapy – and those HIV negative gay men who use PrEP as a preventative tool against HIV transmission. In the article, I will argue that a new form of gay identity has emerged on gay dating apps in Serbia – "undetectable, on PrEP." This new identity emerges from confusion in HIV risk assessment. The use of PrEP has been seen as a marker to denote someone’s HIV negative status and to protect them from HIV transmission. However, some gay men with an undetectable HIV status would like to be regarded as HIV negative even though they are not, and thus they use the signifier "on PrEP" to highlight their desire to claim an HIV negative status. PrEP has many symbolic valences: from HIV status disclosure to assumed promiscuity. As I will argue, while the health paradigm is of utmost importance for Serbian gay men, internalized stigma additionally drives the low uptake of PrEP amongst gay communities in Serbia, thus contributing to the confusion regarding PrEP use and the overall approach to HIV prevention. This article finds that those respondents who accept PrEP without stigma or confusion regarding their HIV status are also more willing and ready to recommend using PrEP to other gay men.

HIV-Related Attitudes and Intentions for High-Risk, Substance-Using Men Who Have Sex With Men: Associations and Clinical Implications for HIV-Positive and HIV-Negative MSM

2010 ◽  
Vol 24 (4) ◽  
pp. 281-293 ◽  
Author(s):  
Gordon Mansergh ◽  
David J. McKirnan ◽  
Stephen A. Flores ◽  
Sharon M. Hudson ◽  
Beryl A. Koblin ◽  
...  
Keyword(s):  
Substance Use ◽  
Risk Behavior ◽  
Self Efficacy ◽  
Safer Sex ◽  
Hiv Positive ◽  
Hiv Status ◽  
Anal Sex ◽  
Sex With Men ◽  
Hiv Negative ◽  
Hiv Positive Men

This study compared HIV-related attitudes and intentions by respondent HIV-status in a large sample of substance-using men who have sex with men (MSM) in the United States. Attitudes and intentions included self-efficacy for safer sex; difficulty communicating with sex partners about safer sex; intent to use condoms consistently and to not use substances before sex in the next 3 months; and less concern for HIV given effective antiviral treatments. Differences were found for behavior during the most recent anal sex encounter by HIV-status, including (a) insertive and (b) receptive anal sex risk behavior, and (c) substance use before or during the encounter. Self-efficacy for safer sex was associated with less risk behavior among HIV-negative men but not among HIV-positive men, suggesting that self-efficacy for safer sex continues to be a relevant issue to address in counseling uninfected MSM. HIV-positive men who reported less concern for HIV given treatments were more likely to report receptive risk behavior, as were HIV-negative men who reported difficulty communicating about safer sex. Implications are discussed for potentially heightened client desire and therapeutic opportunity to reduce future substance use during sex for clients who report recent substance use during sex.

scholarly journals 423. Self-Reported Screening for Rectal Sexually Transmitted Infections Among Men Who Have Sex with Men

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S212-S213
Author(s):  
Timothy William. Menza ◽  
Lauren Lipira ◽  
Amisha Bhattarai ◽  
Joseph Ramirez ◽  
Roberto Orellana
Keyword(s):  
Sexually Transmitted Infections ◽  
Multivariable Analysis ◽  
Prevalence Ratio ◽  
Hiv Positive ◽  
Sexually Active ◽  
Hiv Status ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Hiv Negative ◽  
Hiv Positive Men

Abstract Background Rectal gonorrhea and Chlamydia are common and predict HIV acquisition among men who have sex with men (MSM); however, screening for rectal sexually transmitted infections (STIs) is not routine. Methods In 2017, we recruited sexually-active MSM in the Portland, Oregon metropolitan area through venue-based sampling. Our outcome of interest was self-reported rectal STI screening in the prior 12 months. Stratified by HIV status, we assessed the prevalence and demographic, healthcare, clinical, and behavioral predictors of screening. Results Of 448 participants, 168 (37.5%) reported rectal STI screening. One hundred twenty-seven (35.8%) of 355 HIV-negative men, 41 (58.6%) of 70 HIV-positive men, and none of 23 men who did not know their HIV status reported screening. Among HIV-negative men, having a healthcare provider who offered HIV testing (adjusted prevalence ratio [aPR]=2.09; 95% confidence interval [CI]: 1.43, 3.04), a syphilis diagnosis (aPR=1.32; 95% CI: 1.03, 1.69), use of pre-exposure prophylaxis (aPR=1.57; 95% CI 1.21, 2.04), and condomless anal sex with casual partners in the prior 12 months (aPR=1.74; 95% CI: 1.36, 2.22) independently predicted screening for rectal STI in multivariable analysis. HIV-positive men who reported having a provider who always or often initiates conversations about sex were significantly more likely to report screening compared with men who did not have such a provider (aPR=1.48; 95% CI: 1.06, 2.06). Conclusion Rectal STI screening is not universal in a venue-based sample of sexually-active MSM. Implementing innovative, acceptable, and accessible screening practices and improving provider comfort with talking about sex are paramount to increasing rectal STI screening. Disclosures All authors: No reported disclosures.

Rate of BCG Immunization in HIV-Exposed Infants in a Selected Primary Health Centre in Southern Nigeria: Implications of No Vaccine Policy for HIV-Positive Infants

2020 ◽  
Author(s):  
A M Ekanem ◽  
I P Oloyede ◽  
U E Ekrikpo ◽  
A U Idung ◽  
E Edward
Keyword(s):  
Health Centre ◽  
Primary Health Centre ◽  
Hiv Positive ◽  
Hiv Status ◽  
Hiv Dna ◽  
Primary Health ◽  
Hiv Exposed ◽  
Dna Pcr ◽  
Pcr Test ◽  
Hiv Negative

Abstract Background Maternal and infant HIV status influences the decision of BCG immunization of infants at birth. The objective of this study was to determine the HIV status of HIV-exposed infants (HEIs) by the first HIV DNA PCR test and the rate of BCG uptake among the HEIs who were confirmed HIV negative. Methods This was a retrospective descriptive cross-sectional study involving the review of results of 99 dried blood samples (DBS) for the first HIV DNA PCR test of HEIs whose mothers were diagnosed HIV positive on presentation of the infants at first immunization visit at a Primary Health Centre from January 2018 to January 2019. Results Of the 99 DBS examined, 86; 86.9% (95% CI 80.1–93.6) were HIV negative, 9; 9.1% (95% CI 3.3–14.8) were positive while the results of 4 (4.0%) infants were not in the register. Only 7; 7.1% (95% CI 1.9–12.2) of the 99 HEIs returned for BCG immunization at the centre. BCG immunization status of the HEIs after first PCR results was not significantly associated with sex of the infants or availability of phone number of the guardians (p = 0.70 and 0.12, respectively). Conclusion The majority of HEIs were HIV negative at first HIV DNA PCR test. Few of these HIV negative infants returned for BCG immunization. Hence, all HEIs should be given BCG immunization according to WHO GAVCS committee recommendation on BCG immunization for settings with poor HIV diagnostic and treatment facilities for mothers and infants.

scholarly journals Performance of verbal autopsy methods in estimating HIV-associated mortality among adults in South Africa

2018 ◽  
Vol 3 (4) ◽  
pp. e000833 ◽  
Author(s):  
Aaron S Karat ◽  
Noriah Maraba ◽  
Mpho Tlali ◽  
Salome Charalambous ◽  
Violet N Chihota ◽  
...  
Keyword(s):  
South Africa ◽  
Verbal Autopsy ◽  
Vital Statistics ◽  
Classification Systems ◽  
Hiv Positive ◽  
Hiv Status ◽  
Civil Registration ◽  
Art Initiation ◽  
Better Than ◽  
Hiv Negative

IntroductionVerbal autopsy (VA) can be integrated into civil registration and vital statistics systems, but its accuracy in determining HIV-associated causes of death (CoD) is uncertain. We assessed the sensitivity and specificity of VA questions in determining HIV status and antiretroviral therapy (ART) initiation and compared HIV-associated mortality fractions assigned by different VA interpretation methods.MethodsUsing the WHO 2012 instrument with added ART questions, VA was conducted for deaths among adults with known HIV status (356 HIV positive and 103 HIV negative) in South Africa. CoD were assigned using physician-certified VA (PCVA) and computer-coded VA (CCVA) methods and compared with documented HIV status.ResultsThe sensitivity of VA questions in detecting HIV status and ART initiation was 84.3% (95% CI 80 to 88) and 91.0% (95% CI 86 to 95); 283/356 (79.5%) HIV-positive individuals were assigned HIV-associated CoD by PCVA, 166 (46.6%) by InterVA-4.03, 201 (56.5%) by InterVA-5, and 80 (22.5%) and 289 (81.2%) by SmartVA-Analyze V.1.1.1 and V.1.2.1. Agreement between PCVA and older CCVA methods was poor (chance-corrected concordance [CCC] <0; cause-specific mortality fraction [CSMF] accuracy ≤56%) but better between PCVA and updated methods (CCC 0.21–0.75; CSMF accuracy 65%–98%). All methods were specific (specificity 87% to 96%) in assigning HIV-associated CoD.ConclusionAll CCVA interpretation methods underestimated the HIV-associated mortality fraction compared with PCVA; InterVA-5 and SmartVA-Analyze V.1.2.1 performed better than earlier versions. Changes to VA methods and classification systems are needed to track progress towards targets for reducing HIV-associated mortality,

scholarly journals The Demand for, and Impact of, Learning HIV Status

2008 ◽  
Vol 98 (5) ◽  
pp. 1829-1863 ◽  
Author(s):  
Rebecca L Thornton
Keyword(s):  
Hiv Positive ◽  
Sexually Active ◽  
Monetary Incentives ◽  
Hiv Status ◽  
Hiv Negative

This paper evaluates an experiment in which individuals in rural Malawi were randomly assigned monetary incentives to learn their HIV results after being tested. Distance to the HIV results centers was also randomly assigned. Without any incentive, 34 percent of the participants learned their HIV results. However, even the smallest incentive doubled that share. Using the randomly assigned incentives and distance from results centers as instruments for the knowledge of HIV status, sexually active HIV-positive individuals who learned their results are three times more likely to purchase condoms two months later than sexually active HIV-positive individuals who did not learn their results; however, HIV-positive individuals who learned their results purchase only two additional condoms than those who did not. There is no significant effect of learning HIV-negative status on the purchase of condoms. (JEL I12, O15)

scholarly journals Patterns of sexualised recreational drug use and its association with risk behaviours and sexual health outcomes in men who have sex with men in London, UK: a comparison of cross-sectional studies conducted in 2013 and 2016

2019 ◽  
Vol 96 (3) ◽  
pp. 197-203 ◽  
Author(s):  
Tyrone J Curtis ◽  
Alison J Rodger ◽  
Fiona Burns ◽  
Anthony Nardone ◽  
Andrew Copas ◽  
...  
Keyword(s):  
Sexual Health ◽  
Hiv Positive ◽  
Risk Behaviours ◽  
Hiv Status ◽  
Cross Sectional ◽  
The Past ◽  
Unknown Status ◽  
Sex With Men ◽  
Hiv Negative ◽  
Hiv Positive Men

ObjectiveLondon has one of the highest identified prevalence of chemsex (sexualised recreational drug use) among men who have sex with men (MSM) in Europe. We examine MSM’s patterns of chemsex and its association with HIV/STI risk behaviours, STI diagnoses and sexual healthcare-seeking behaviours, including if HIV testing behaviour met UK national guidelines (three monthly if engaging in chemsex).MethodsCross-sectional survey data from 2013 (n=905) and 2016 (n=739) were collected using anonymous, self-administered questionnaires from MSM recruited in commercial gay venues in London, UK. Descriptive and multivariable analyses, stratified by self-reported HIV status, were conducted. Adjusted prevalence ratios (aPR) with 95% CIs were calculated.ResultsComparing the 2013 and 2016 surveys, chemsex prevalence in the past year remained stable, in both HIV-negative/unknown-status MSM (20.9% in 2013 vs 18.7% in 2016, p=0.301) and HIV-positive MSM (41.6% in 2013 vs 41.7% in 2016, p=0.992). Combined 2013–2016 data showed that compared with other MSM, those reporting chemsex were more likely to report HIV/STI risk behaviours, including condomless anal intercourse with serodifferent HIV-status partners (HIV-negative/unknown-status men: aPR 2.36, 95% CI 1.68 to 3.30; HIV-positive men: aPR 4.19, 95% CI 1.85 to 9.50), and STI diagnoses in the past year (HIV-negative/unknown-status men: aPR 2.10, 95% CI 1.64 to 2.69; HIV-positive men: aPR 2.56, 95% CI 1.57 to 4.20). 68.6% of HIV-negative/unknown-status men reporting chemsex attended sexual health clinics and 47.6% had tested for HIV more than once in the past year.ConclusionsChemsex in London MSM remained stable but high, particularly among HIV-positive men. Irrespective of HIV status, chemsex was associated with engagement in HIV/STI risk behaviours. Frequency of HIV testing in the past year among HIV-negative/unknown-status men was below national recommendations. Promoting combination prevention strategies, including three monthly HIV/STI testing, access to pre-exposure prophylaxis/antiretroviral treatment and behavioural interventions among MSM reporting chemsex, remains vital to address sexual health inequalities in MSM.

scholarly journals PD-L1 protein expression and copy number gains in HIV-positive locally advanced cervical cancer

2020 ◽  
Vol 12 ◽  
pp. 175883592096300
Author(s):  
Kongsak Loharamtaweethong ◽  
Napaporn Puripat ◽  
Niphon Praditphol ◽  
Jidapa Thammasiri ◽  
Siriwan Tangitgamol
Keyword(s):  
Cervical Cancer ◽  
Copy Number ◽  
Locally Advanced ◽  
Hiv Positive ◽  
Hiv Status ◽  
Free Survival ◽  
Parametrial Invasion ◽  
Programmed Death ◽  
Significant Difference ◽  
Hiv Negative

Background: The programmed death-1/programmed death-ligand-1 (PD-1/PD-L1) axis may represent a target for cervical cancer; however, it is poorly understood in human immunodeficiency virus (HIV)-infected patients. Methods: We evaluated HIV-positive ( n = 42) and HIV-negative ( n = 110) women with locally advanced cervical cancer regarding their PD-L1 expression, determined by combined positive score (CPS) ⩾ 1 and tumor proportion score (TPS) ⩾ 25%, and PD-L1 copy number alterations, assessed by fluorescence in situ hybridization. Results: Regardless of HIV status, 84.9% and 44.8% of cases were PD-L1-positive according to CPS ⩾ 1 and TPS ⩾ 25%. Per CPS ⩾ 1, PD-L1 positive rate was similar between HIV-positive and HIV-negative women, whereas a significant difference was seen per TPS ⩾ 25%. Tumor size and parametrial invasion were correlated with PD-L1 positivity in HIV-negative women, whereas anti-retroviral therapy (ART) was correlated with TPS < 25%. Low CD4-positive cell counts were associated with CPS < 1 in HIV-positive women. No significant difference was observed in PD-L1 copy number status between HIV-positive and HIV-negative women. PD-L1 amplification and polysomy were independently associated with TPS ⩾ 25%, whereas the presence of parametrial invasion was independently associated with CPS ⩾ 1. Cancer stage and PD-L1 amplification were identified as independent predictors of recurrence-free survival [hazard ratio (HR) = 2.40 (1.32–4.36) and HR = 5.33 (1.94–14.61)] and cancer-specific survival [HR = 13.62 (5.1–36.38) and HR = 3.53 (1.43–8.69)]. PD-L1 polysomy was an independent predictor of locoregional recurrence-free survival [HR = 3.27 (1.27–8.41)]. HIV status and PD-L1 expression (CPS ⩾ 1 or TPS ⩾ 25%) were not associated with poor patient outcomes. Conclusion: PD-L1 amplification and polysomy are the strongest drivers of PD-L1 expression in cervical cancer, and could represent prognostic biomarkers for anti-PD-1/PD-L1 therapy. Cervical cancer biology may be modulated by HIV infection, CD4-positive cells, and HIV treatments.

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