Revitalizing HIV Prevention Programs: Recommendations From Those Most Impacted by the HIV in the Deep South

2021 ◽  
pp. 089011712110410
Author(s):  
Michelle S. Williams ◽  
Tonia Poteat ◽  
Melverta Bender ◽  
Precious Ugwu ◽  
Paul A. Burns
Keyword(s):  
Hiv Prevention ◽  
Hiv Infections ◽  
Target Population ◽  
Health Promotion Program ◽  
Deep South ◽  
Hiv Education ◽  
Community Based ◽  
Prevention Interventions ◽  
Sex With Men ◽  
Black Health

Purpose: The incidence of new HIV infections is disproportionately high among Black men who have sex with men (BMSM) in Mississippi. Community-based organizations received funding through the ACCELERATE! initiative to implement interventions aimed at increasing BMSM’s access to HIV prevention, treatment and care interventions. Approach: We conducted a mixed methods evaluation of the ACCELERATE! initiative to assess its impact. We also explored factors that act as barriers to and facilitators of BMSM’s engagement in HIV prevention interventions. Setting: Interviews were conducted between July 2018 and February 2020. Participants: Thirty-six BMSM and 13 non-grantee key informants who worked in the field of HIV in Mississippi participated. Method: The qualitative data from the interview transcripts was analyzed using an iterative, inductive coding process. Results: We identified 10 key recommendations that were most common across all participants and that were aligned with UNAIDS Global AIDS Strategy strategic priorities. Several recommendations address the reduction of HIV- and LGBT-stigma. Two of the most common recommendations were to increase representation of the target population in health promotion program leadership and to include HIV with other Black health issues in community-based health education programs rather than singling it out. Another recommendation called for programs aimed at addressing underlying factors associated with HIV-risk behaviors, such as mental illness. Conclusion: Our results indicate that HIV education interventions in the Deep South need to be revitalized to enhance their reach and effectiveness.

scholarly journals Combination HIV Prevention Strategy Implementation in El Salvador: Perceived Barriers and Adaptations Reported by Outreach Peer Educators and Supervisors

2017 ◽  
Vol 4 ◽  
pp. 233339361770319 ◽  
Author(s):  
Meredith Buck ◽  
Julia Dickson-Gomez ◽  
Gloria Bodnar
Keyword(s):  
Hiv Prevention ◽  
El Salvador ◽  
Sex Workers ◽  
Target Population ◽  
Peer Educators ◽  
Middle Income ◽  
Hiv Prevention Intervention ◽  
Middle Income Countries ◽  
Prevention Interventions ◽  
Sex With Men

El Salvador was one of three countries to receive funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria to conduct a combination HIV prevention intervention among transwomen (TW), men who have sex with men (MSM), and commercial sex workers (CSW). Program evaluation revealed that prevention activities reached only 50% of the target population. The purpose of this study is to examine the barriers that Salvadoran educators faced in implementing the peer education as designed and adaptations made as a result. Between March and June 2015, 18 in-depth interviews with educators were conducted. Violence was reported as the biggest barrier to intervention implementation. Other barriers differed by subpopulation. The level of violence and discrimination calls into question the feasibility and appropriateness of peer-led interventions in the Salvadoran context and demonstrates the importance of implementation research when translating HIV prevention interventions developed in high-income countries to low- and middle-income countries.

scholarly journals Community Based HIV Prevention Interventions In Africa: A Systematic Review

2021 ◽  
Author(s):  
Sarah Ibrahim
Keyword(s):  
Systematic Review ◽  
Hiv Prevention ◽  
Teaching Method ◽  
Mode Of Delivery ◽  
Risk Behaviour ◽  
Community Based ◽  
Theoretical Underpinning ◽  
Hiv Prevention Intervention ◽  
Prevention Interventions ◽  
Hiv Prevention Interventions

This systematic review is the first to examine the characteristics of community-based HIV prevention interventions, specifically the theoretical underpinning, type and number of components, dose, mode of delivery, and teaching method; and explore the effects of the intervention characteristics on HIV-related knowledge and engagement in risk behaviour among young persons in Africa. A total of 5 studies were included in this review. Conceptual and operational definitions of the intervention characteristics guided the coding and extraction of data from the reports. The overall results of this study showed variability in theoretical underpinning, dose, and mode of delivery of interventions. Multi-component interventions using mixed teaching method produced the desired effect on knowledge and risk behaviour. The examination of community based HIV prevention intervention characteristics provides direction for the development of efficient future interventions to decrease the transmission of HIV among young persons in Africa.

Systematic review of reviews of behavioural HIV prevention interventions among men who have sex with men

AIDS Care ◽  
2012 ◽  
Vol 25 (2) ◽  
pp. 133-150 ◽  
Author(s):  
Karen Lorimer ◽  
Lisa Kidd ◽  
Maggie Lawrence ◽  
Kerri McPherson ◽  
Sandi Cayless ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Prevention ◽  
Prevention Interventions ◽  
Review Of Reviews ◽  
Hiv Prevention Interventions ◽  
Sex With Men

scholarly journals PrEP in Prisons: HIV prevention in incarcerated populations

2019 ◽  
Vol 16 (2) ◽  
pp. 199-206
Author(s):  
Jordan Parsons ◽  
Chelsea Cox
Keyword(s):  
Hiv Prevention ◽  
Harm Reduction ◽  
New Approach ◽  
Content Type ◽  
Harm Reduction Intervention ◽  
Access To Health ◽  
Prevention Interventions ◽  
High Risk Populations ◽  
Sex With Men ◽  
Exposure Prophylaxis

Purpose The purpose of this paper is to discuss the possibility of using pre-exposure prophylaxis (PrEP) as an HIV harm reduction intervention in prisons. PrEP is primarily discussed in relation to men who have sex with men (MSM), meaning other high-risk populations, such as prisoners, are often side-lined. The authors wanted to consider how it could prove beneficial beyond the MSM community. Design/methodology/approach First, the authors discuss whether the common objections to existing HIV harm reduction interventions in prisons, such as needle exchanges, are applicable to PrEP. The authors then apply common objections to the provision of PrEP in the general population to the provision of PrEP in a prison context in order to assess their strength. Finally, the authors discuss what the authors anticipate to be a key objection to PrEP in prisons: post-incarceration access. Findings The authors argue that both sets of common objections considered are easily refuted in the case of PrEP in prisons. The unique setting and nature of the intervention are such that it is without immediately apparent flaws. In addressing post-incarceration access, the authors suggest that a longitudinal consideration of a prisoner’s HIV risk undermines the objection. Originality/value This discussion is of importance due to the significantly heightened risk of HIV infection prisoners are subject to. Not only do effective HIV prevention interventions in prisons contribute to fair access to health for incarcerated individuals, but also to the wider fight against HIV. The authors demonstrate that PrEP has potential as a new approach and call for further research in this area.

scholarly journals ‘Break the Chains 2015’ community-based HIV prevention campaign for men who have sex with men in Switzerland: non-randomised evaluation and cost analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032459
Author(s):  
Kathrin Frey ◽  
Stéphanie Lociciro ◽  
Patricia Blank ◽  
Matthias Schwenkglenks ◽  
Françoise Dubois-Arber ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Cost Analysis ◽  
Hiv Testing ◽  
Community Based ◽  
Prevention Campaign ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Campaign Message

ObjectivesTo study the implementation, effects and costs of Break the Chains, a community-based HIV prevention campaign for men who have sex with men (MSM) in Switzerland, from March to May 2015, which aimed to reduce early HIV transmission by promoting the campaign message to adopt short-term risk reduction followed by HIV testing.DesignNon-randomised evaluation and cost analysis.SettingGay venues in 11 of 26 cantons in Switzerland and national online media campaign.ParticipantsMSM in online surveys (precampaign n=834, postcampaign n=688) or attending HIV testing centres (n=885); campaign managers (n=9); and campaign staff (n=38) or further intermediaries (n=80) in an online survey.Primary and secondary outcome measuresThe primary outcome measure was the proportion of MSM at risk of HIV acquisition or transmission who adhered to the campaign message. Secondary outcomes were postcampaign test uptake, knowledge about HIV primary infection and sense of belonging to the gay community.ResultsCampaign staff estimated that they contacted 17 145 MSM in 11 cantons. Among 688 respondents to the postcampaign survey, 311 (45.2%) were categorised as MSM at risk. Of 402/688 (58.5%) MSM who had heard about Break the Chains 2015, MSM categorised as being at risk were less likely to report adherence to the campaign message than MSM not at risk (adjusted OR 0.24; 95% CI 0.14 to 0.42). Twenty per cent of MSM with a defined risk of HIV acquisition or transmission who adopted risk reduction declared having done so because of the campaign. Costs for one MSM at risk to adhere to the campaign message were estimated at USD purchasing power parity 36–55. The number of HIV tests in the month after the campaign was twice the monthly average.ConclusionBreak the Chains increased HIV testing, implying that community-based campaigns are useful HIV prevention strategies for MSM. Additional interventions are needed to reach MSM at the highest risk of infection more effectively.

scholarly journals The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities: The Neighborhoods and Networks (N2) Cohort Study

2019 ◽  
Vol 16 (11) ◽  
pp. 1922 ◽  
Author(s):  
Dustin T. Duncan ◽  
DeMarc A. Hickson ◽  
William C. Goedel ◽  
Denton Callander ◽  
Brandon Brooks ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hiv Prevention ◽  
New Orleans ◽  
Black Msm ◽  
Deep South ◽  
Network Characteristics ◽  
Sex With Men ◽  
Study Sites ◽  
The U.S

Background: In many parts of the world, stark racial disparities in human immunodeficiency virus (HIV) prevalence, incidence, prevention, and care outcomes persist among gay, bisexual, and other men who have sex with men (MSM), with Black MSM significantly impacted in the United States (U.S.). Individual-level characteristics, including sexual behaviors and socioeconomic status, do not fully account for racial/ethnic disparities in HIV among MSM. We hypothesize that neighborhood contexts and network characteristics influence risk for HIV infection as well as HIV-related prevention and care behaviors. As such, the study design includes the use of real-time geospatial methods and in-depth assessments of multiple network typologies to investigate the impact of neighborhood and network-level factors on HIV prevention and treatment among Black MSM residing in longstanding priority HIV elimination areas in the U.S., namely Chicago, Illinois and in the Deep South (Jackson, Mississippi and New Orleans, Louisiana) (n = 450, n = 50, and n = 100, respectively). We describe the design, sampling methods, data collection, data management methods, and preliminary findings of the ongoing ‘Neighborhoods and Networks (N2) Cohort Study’. Methods/Design: N2 employs a prospective longitudinal design. The sample includes Black MSM participants in Chicago recruited via respondent-driven sampling and assessed every six months over two years of follow-up. Participants enrolled in Jackson and New Orleans are being recruited through existing health and community services and assessed every six months over one year of follow-up. Mobility within and between neighborhoods is being assessed using global positioning system (GPS) technology. Social and sexual networks among Black MSM are being studied through egocentric network inventories as well as newer methods of creating meso-level networks that involve social media (Facebook) and mobile phone contacts. Key HIV prevention outcomes such as pre-exposure prophylaxis (PrEP) care engagement, and HIV/STI (sexually transmitted infections) biomarkers will be examined at baseline and follow-up. Results: As of 31 December 2018, a total of 361 men were enrolled across all study sites: 259 in Chicago and 102 in the Deep South (75 in New Orleans and 27 in Jackson). At baseline, participants ranged in age from 17 to 65 years old (mean = 34.3, standard deviation = 5.1) with 123 men (34.1%) self-reported as HIV positive. While HIV treatment levels were similar between sites, men in the Deep South reported higher rates of adherence than men in Chicago (63.3% versus 49.4%, p = 0.03). Sexual risk profiles were mainly the same between men from different study sites, with 22.9% of men in Chicago and 28.9% in the Deep South reporting consistent condom use during vaginal and anal sex (p = 0.26). Regarding their home neighborhoods, men in the Deep South were more likely than those in Chicago to characterize theirs as having a good reputation (43.1% versus 24.7%, p < 0.001) and as being safe (37.3% versus 21.2%, p = 0.002). Conclusions: The focus on Black MSM in the N2 Study will allow for a nuanced exploration of the attitudes, beliefs, behaviors, and practices of a diverse group of Black MSM. The study is also positioned to provide novel insight about neighborhood and network characteristics that influence HIV-related behaviors. A health equity framework ensures that Black MSM are not explicitly or implicitly deemed as deviant, disordered, or the non-reference group. Findings from N2 will provide guidance for the implementation of more impactful HIV prevention interventions that engage a diverse population of Black MSM as we work toward HIV elimination in the U.S.

scholarly journals HIV Prevention Interventions in Chennai, India: Are Men Who Have Sex with Men Being Reached?

2009 ◽  
Vol 23 (11) ◽  
pp. 981-986 ◽  
Author(s):  
Beena Thomas ◽  
Matthew J. Mimiaga ◽  
Kenneth H. Mayer ◽  
Carey V. Johnson ◽  
Sunil Menon ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Prevention Interventions ◽  
Hiv Prevention Interventions ◽  
Sex With Men
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