Relationship between serostatus disclosure and categories of HIV transmission risk in men who have sex with men living with HIV

2018 ◽  
Vol 29 (8) ◽  
pp. 744-750 ◽  
Author(s):  
Julianne M Serovich ◽  
Sandra J Reed ◽  
Ann A O’Connell ◽  
Tanja C Laschober

In prior studies, the relationship between serostatus disclosure and reduced HIV transmission risk has been mixed. The demonstration of a clear connection may be restricted by three main methodological limitations. This study evaluates the relationship between (1) more refined measures of serostatus disclosure and (2) eight categories of HIV transmission risk (lowest to highest risk) among men who have sex with men (MSM) living with HIV, while (3) considering a number of control variables. Results demonstrate that disclosure is more likely in sexual encounters involving no intercourse or involving protected and unprotected anal intercourse with HIV-positive partners than unprotected insertive anal intercourse with HIV-negative/unknown status partners. Additionally, substance use prior to sexual encounters is less likely in lower risk categories than the highest risk category. Results of this study are important to the design of future studies, prevention, and intervention programs for MSM and to the methods used to evaluate their effectiveness.

2021 ◽  
Vol 6 (3) ◽  
pp. 139
Author(s):  
Benjamin R. Bavinton ◽  
I Gusti Agung Agus Mahendra ◽  
John Kaldor ◽  
Matthew Law ◽  
Andrew E. Grulich ◽  
...  

In recent years, prevalence of Human Immunodeficiency Virus (HIV) has increased substantially in Bali, Indonesia, in men who have sex with men (MSM) and transgender women, known locally as ‘waria’. There are limited behavioural data in this population. We conducted a behavioural survey of MSM/waria in Bali in March–April 2018. Respondents were primarily recruited by HIV outreach workers. Respondents reported details about anal intercourse events with their last male/waria romantic partner and/or last male/waria casual partner (respondents could report on both if relevant). Statistical significance was tested with generalised estimating equations. Among 709 participants, median age was 27 (interquartile range = 24–31), and 92.1% were male and 7.9% were waria. One-third were born in Bali. Overall, 85.9% had ever had an HIV test; 55.1% reported being HIV-negative, 15.0% HIV-positive, and 30.0% had unknown serostatus. Most (86.5%) reported sex with men, 9.5% with waria, and 20.0% with women in the previous 6 months. Respondents described 703 anal intercourse events (397/306 with romantic/casual partners, respectively; 191 reported on both). Over half (56.5%) of the events were protected by condoms and 7.3% by biomedical prevention (2.6% by PrEP in either partner, 4.7% by HIV treatments in either partner). Thus, 36.3% of events involved unprotected condomless anal intercourse (40.8%/30.4% in romantic/casual partners, respectively). In multivariate analysis, unprotected condomless anal intercourse events were associated with romantic partners (p < 0.001), being born in Bali (p = 0.002), lower education (p = 0.013), believing that withdrawal before ejaculation is effective (p < 0.001), liking to use withdrawal (p = 0.021), and not liking condoms (p < 0.001). One-quarter of events had potentially reduced HIV transmission risk through non-condom-based risk reduction strategies, while 11.1% had no potential risk reduction. Events presenting the highest potential risk of HIV transmission were more commonly reported by respondents born in Bali.


2018 ◽  
Vol 13 (1) ◽  
pp. 155798831881828
Author(s):  
Jacob J. van den Berg ◽  
Nickolas D. Zaller ◽  
Fizza S. Gillani ◽  
Shira I. Dunsiger ◽  
Brandon D. L. Marshall ◽  
...  

Examining how multiple concomitant factors interact to augment HIV transmission risk is needed to inform more effective primary and secondary HIV prevention programs for men who have sex with men (MSM) in the United States. The development of a “taxonomy” of long-term sexual and drug-related risk behavior profiles may have important implications for resource allocation and targeted HIV prevention programming. A secondary data analysis was conducted to explore longitudinal HIV transmission risk profiles among 423 MSM living with HIV enrolled in the Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN Study). Between March 2004 and February 2012, participants completed semiannual, audio computer-assisted self-interviews that included demographics, employment status, medical information, alcohol use, stimulant use, sexual risk, and depression. Latent class analysis was used to identify patterns of risky behavior over time with respect to sexual risk, heavy drinking, and stimulant (i.e., methamphetamine and cocaine) use taken collectively. Three classes were identified: (a) High Sustained Heavy Drinker Class (33%), (b) High Mostly Stable Sexual Risk Class (17%), and (c) Overall Low Risk Class. (50%). Post hoc comparisons between classes revealed that men in Classes 1 ( p = .03) and 2 ( p = .02) were significantly younger than those in Class 3. In comparison to those in Classes 1 and 3, those in Class 2 were less likely to report being a racial/ethnic minority ( p = .04) and had the highest self-reported sexually transmitted infections ( p < .001). Findings indicate the need to better integrate sexual and substance use risk reduction strategies, including brief interventions and engagement in addiction treatment, for MSM living with HIV in the United States.


2019 ◽  
Vol 30 (5) ◽  
pp. 486-495
Author(s):  
Kara K Osbak ◽  
Conor J Meehan ◽  
Sergio G Ribas ◽  
Leo Heyndrickx ◽  
Kevin K Ariën ◽  
...  

In this study, we assessed if the superimposition of incident sexually transmitted infections (STIs) on HIV phylogenetic analyses could reveal possible sexual behaviour misclassifications in our HIV-infected population. HIV-1 sequences collected between 1997 and 2014 from 1169 individuals attending a HIV clinic in Antwerp, Belgium were analysed to infer a partial HIV transmission network. Individual demographic, clinical and laboratory data collected during routine HIV follow-up were used to compare clustered and non-clustered individuals using logistic regression analyses. In total, 438 (37.5%) individuals were identified in 136 clusters, including 76 transmission pairs and 60 clusters consisting of three or more individuals. Individuals in a cluster were more likely to have a history of syphilis, Chlamydia and/or gonorrhoea (P < 0.05); however, when analyses were stratified by HIV transmission risk groups (heterosexual and men who have sex with men [MSM]), this association only remained significant for heterosexuals with syphilis (P = 0.001). Under closer scrutiny, this association was driven by six heterosexual men who were located in six almost exclusively MSM clusters. A parsimonious conclusion is that these six individuals were potentially misclassified as heterosexual. Improving the accuracy of sexual behaviour reporting could improve care.


2002 ◽  
Vol 13 (10) ◽  
pp. 677-682 ◽  
Author(s):  
Seth C Kalichman ◽  
David Rompa ◽  
Webster Luke ◽  
James Austin

As many as one in three persons living with HIV-AIDS continue to practise unprotected sexual intercourse and these practices often occur with HIV-negative or unknown HIV serostatus (serodiscordant) partners. The current study examined the rates of HIV transmission risk behaviours in non-regular (e.g. casual) and regular (e.g. steady) serodiscordant relationships. HIV positive men ( n = 269) and women ( n = 114) responded to measures of demographic characteristics, health and mental health status, and sexual behaviours assessed in partner-by-partner interviews. 257 (67%) participants were sexually active in the preceding three months and 182 (71%) of the sexually active persons had engaged in vaginal or anal intercourse with serodiscordant partners. Comparisons of persons with non-regular ( n = 97) and regular ( n = 85) serodiscordant partners showed that overall rates of unprotected and protected intercourse were greater with regular partners than non-regular partners. Disclosure of HIV status to regular and non-regular serodiscordant partners did not appear to influence the pattern of results. Mathematical modelling showed that HIV transmission estimates over a one-year horizon were significantly greater for male regular partners of HIV-positive men than non-regular partners and there was a trend toward greater HIV transmission rates from HIV-positive men to their regular serodiscordant female partners compared to non-regular partners. Results suggest an urgent need for HIV transmission risk reduction interventions for HIV serodiscordant couples, particularly for couples in established, regular relationships.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246192
Author(s):  
Marion Fiorentino ◽  
Abdourahmane Sow ◽  
Luis Sagaon-Teyssier ◽  
Marion Mora ◽  
Marie-Thérèse Mengue ◽  
...  

Objectives Intimate partner violence (IPV) against women is frequent in Central Africa and may be a HIV infection risk factor. More data on HIV-positive men (MLHIV) committing IPV are needed to develop perpetrator-focused IPV and HIV prevention interventions. We investigated the relationship between IPV and HIV transmission risk and IPV-associated factors. Methods We used data from the cross-sectional survey EVOLCam which was conducted in Cameroonian outpatient HIV structures in 2014. The study population comprised MLHIV declaring at least one sexual partner in the previous year. Using principal component analysis, we built three variables measuring, respectively, self-reported MLHIV-perpetrated psychological and physical IPV (PPV), severe physical IPV (SPV), and sexual IPV (SV). Ordinal logistic regressions helped investigate: i) the relationship between HIV transmission risk (defined as unstable aviremia and inconsistent condom use) and IPV variables, ii) factors associated with each IPV variable. Results PPV, SPV and SV were self-reported by 28, 15 and 11% of the 406 study participants, respectively. IPV perpetrators had a significantly higher risk of transmitting HIV than non-IPV perpetrators. Factors independently associated with IPV variables were: i) socio-demographic, economic and dyadic factors, including younger age (PPV and SPV), lower income (PPV), not being the household head (SPV and SV), living with a main partner (SPV), and having a younger main partner (SPV); ii) sexual behaviors, including ≥2 partners in the previous year (PPV and SPV), lifetime sex with another man (SPV), inconsistent condom use (SV), and >20 partners during lifetime (SV); iii) HIV-related stigma (PPV and SV). Conclusion IPV perpetrators had a higher risk of transmitting HIV and having lifetime and recent risky sexual behaviors. Perpetrating IPV was more frequent in those with socioeconomic vulnerability and self-perceived HIV-related stigma. These findings highlight the need for interventions to prevent IPV by MLHIV and related HIV transmission to their(s) partner(s).


2019 ◽  
Vol 96 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Weizi Wu ◽  
Xiaochen Yan ◽  
Xiaoxia Zhang ◽  
Lloyd Goldsamt ◽  
Yuanyuan Chi ◽  
...  

ObjectiveThe HIV epidemic in China is shifting from the high-risk groups of men who have sex with men (MSM), injection drug users and sex workers to the general population, and sexual contact among spouses is assumed to be one route of transmission. Our objective was to determine the intention to marry and the expected extramarital male-to-male sex among single Chinese MSM, in order to estimate the potential HIV transmission risk among MSM living with HIV and their female spouses.MethodsWe conducted a web-based, cross-sectional survey between May 2016 and May 2017. A questionnaire covering sociodemographic characteristics, sexual behaviours, HIV-related and homosexuality-related stigma, marriage intention, and expected extramarital sexual behaviours was completed by 556 single MSM in Hunan, China. Descriptive statistics, χ2 test, two-sample t-test and multivariate logistic regression analysis were performed.ResultsCurrently 48.9% of the participants intended to marry a woman in their lifetime, and 91% of them reported that they would continue to have sex with men after getting married. Those who were living with parents (OR=2.26), self-identified as bisexual (OR=2.57), had at least one heterosexual partner in the previous 6 months (OR=0.33) and perceived a higher level of self-homosexual stigma (OR=1.78) had greater intention to marry a woman.ConclusionNearly half of Chinese MSM intend to marry women, which has significantly dropped from the estimated percentage more than 10 years ago for Chinese MSM. However, the expectation of extramarital homosexual behaviours was common in these men. Sexual and gender minority stresses especially from family members, homosexual identity assertiveness and related stigma were the main factors for marriage intention, which should be addressed in future studies and practices.


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