scholarly journals Pre-exposure prophylaxis use among men who have sex with men who have experienced problematic chemsex

2020 ◽  
Vol 31 (5) ◽  
pp. 474-480
Author(s):  
Steven Maxwell ◽  
Mitzy Gafos ◽  
Monty Moncrieff ◽  
Maryam Shahmanesh ◽  
Oliver Stirrup
Keyword(s):  
High Risk ◽  
High Risk Group ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Crystal Methamphetamine ◽  
Cross Sectional ◽  
Sexual Behaviours ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

Men who have sex with men (MSM) who experience problematic chemsex are at high risk of acquiring HIV due to combined drug use and sexual behaviours. Pre-exposure prophylaxis (PrEP) could substantially reduce the risk of HIV transmission in this group of men. The aim of this study was to examine the biopsychosocial characteristics associated with PrEP use among HIV-negative MSM who have experienced problematic chemsex. This was a cross-sectional analysis of secondary data collected during client assessments at a specialist alcohol and drug service based within the United Kingdom. We compared the socio-demographics, substance use, sexual behaviours and mental health of MSM who reported ever using PrEP to those who reported never using PrEP. Statistical analysis was conducted using the Mann–Whitney U-test for continuous variables and Fisher’s exact test for categorical variables. Between August 2016 and July 2018, 165 HIV-negative MSM who engaged in chemsex had an assessment completed. Thirty-four per cent (n = 50/145) had ever used PrEP. The median age was 36 years (IQR: 30–42), 92% identified as gay (n = 152/165) and 79% were of white ethnicity (n = 130/164). The use of crystal methamphetamine was associated with higher levels of men ever using PrEP (40% versus 21%) (p= 0.047). Men who had ever used PrEP had a higher median number of sexual partners in the previous three months (20 versus 10) (p= 0.004) and had lower level of condom use in their sex lives (median reported 5% versus 50%) (p= 0.010) in comparison to men who had never used PrEP. It is encouraging that men having higher-risk sex had been accessing PrEP. However, further research is required to explore PrEP uptake, retention and adherence in this high-risk group.

scholarly journals Knowledge of and willingness to take pre-exposure prophylaxis among men who have sex with men in Israel

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Mor Zohar ◽  
Shilo Guy ◽  
Levy Itzchak
Keyword(s):  
High Risk ◽  
Sexual Behaviors ◽  
Post Exposure Prophylaxis ◽  
Structural Barriers ◽  
Cross Sectional ◽  
Academic Degree ◽  
Prior Use ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

Abstract Background Oral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) has been found to reduce viral acquisition among HIV-negative MSM. This cross-sectional study was conducted before pre-exposure prophylaxis (PrEP) licensure in Israel, and aimed to compare men who have sex with men (MSM) who had heard of PrEP with those who had not, as well as MSM willing to take PrEP with those who were hesitant or not willing to take PrEP. Methods HIV-negative MSM responded anonymously to questionnaires in 2017 regarding their knowledge of and willingness to take PrEP, prior use of PrEP and post-exposure prophylaxis (PEP), and their sexual behaviors. Results Among 1705 participants, 1431 (83.9%) had heard about PrEP. They were older and more often reported being Jewish, having an academic degree, self-identifying as gay/bisexual, being tested for HIV in the last year, participating in group sex, using alcohol or drugs before or during sex, and having prior use of PrEP/PEP compared with MSM who had not heard about PrEP. A total of 760 (44.8%) participants indicated that they would consider taking PrEP, 567 (33.5%) maybe would consider taking PrEP, and 367 (21.7%) would not take PrEP. Those who were willing to take PrEP had a lower level of education, were involved in high-risk sexual behaviors, used alcohol or drugs before or during sex, and had previously used PrEP/PEP compared with participants who maybe would consider taking or would not take PrEP. When participants were asked to indicate if they were willing to take PrEP at different potential efficacies and costs, the willingness to using PrEP increased with the potential efficacy of the drug and adversely related to its cost. Conclusions PrEP awareness was high, and 44.8% indicated willingness to take PrEP, especially those who reported high-risk sexual behaviors. This supports the current policy in Israel to allow PrEP to MSM who are at high-risk. In order to maintain a high level of PrEP-adherence, physicians should consider structural barriers, such as negative stigma of being promiscuous, lack of perceived HIV-risk, difficulties in accessing clinics or paying for PrEP, inability to follow-up or low tolerability of the medication.

scholarly journals COVID-19 restrictions and changing sexual behaviours in HIV-negative MSM at high risk of HIV infection in London, UK

2021 ◽  
pp. sextrans-2020-054768
Author(s):  
Iain Hyndman ◽  
Diarmuid Nugent ◽  
Gary George Whitlock ◽  
Alan McOwan ◽  
Nicolò Girometti
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Sexual Activity ◽  
Sexual Behaviour ◽  
Well Being ◽  
Categorical Variables ◽  
Cross Sectional ◽  
The Impact ◽  
Mental Well Being ◽  
Hiv Negative

ObjectivesThe COVID-19 pandemic and its related restrictions have affected attendance to and delivery of UK sexual healthcare services (SHS). We surveyed the impact on sexual behaviour of men having sex with men (MSM) to inform future SHS provision.MethodsWe conducted a cross-sectional, anonymous, web-based survey among HIV-negative MSM at high risk of HIV infection who attended 56 Dean Street, a sexual health and HIV clinic. The survey was conducted over a 7-day period in August 2020. Data on sociodemographic characteristics, sexual behaviour and related mental well-being experienced during lockdown (defined as 23 March–30 June 2020) were extracted. Categorical and non-categorical variables were compared according to HIV pre-exposure prophylaxis (PrEP) use.Results814 MSM completed the questionnaire: 75% were PrEP users; 76% reported they have been sexually active, of which 76% reported sex outside their household. 75% reported fewer partners than prior to lockdown. Isolation/loneliness (48%) and anxiety/stress (27%) triggered sexual activity, and 73% had discussed COVID-19 transmission risks with their sexual partners. While 46% reported no change to emotions ordinarily experienced following sex, 20% reported guilt for breaching COVID-19 restrictions. 76% implemented one or more changes to their sexual behaviour, while 58% applied one or more steps to reduce COVID-19 transmission during sex. 36% accessed SHS and 30% reported difficulties in accessing testing/treatment. Of those who accessed SHS, 28% reported an STI diagnosis. PrEP users reported higher partner number, engagement in ‘chemsex’ and use of SHS than non-PrEP users.ConclusionsCOVID-19 restrictions had a considerable impact on sexual behaviour and mental well-being in our survey respondents. High rates of sexual activity and STI diagnoses were reported during lockdown. Changes to SHS provision for MSM must respond to high rates of psychological and STI-related morbidity and the challenges faced by this population in accessing services.

scholarly journals HPV genotyping and risk factors for anal high-risk HPV infection in men who have sex with men from Toronto, Canada

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoojin Choi ◽  
Mona Loutfy ◽  
Robert S. Remis ◽  
Juan Liu ◽  
Anuradha Rebbapragada ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Hpv Vaccine ◽  
Hpv Infection ◽  
Categorical Variables ◽  
Genotype Distribution ◽  
Continuous Variables ◽  
Chi Square ◽  
Hpv Genotypes ◽  
Sex With Men

AbstractMen who have sex with men (MSM) are disproportionately affected by anal cancer, predominantly caused by high-risk (HR) human papillomavirus (HPV) infection. Currently, the nonavalent HPV vaccine provides coverage against nine HPV genotypes, including seven HR-HPV genotypes. Here, we characterize anal HR-HPV genotype distribution and associated risk factors in MSM from Toronto, Canada recruited between September 2010 and June 2012. Wilcoxon–Mann–Whitney test was used for continuous variables, Chi-square test was performed for categorical variables, and a multivariable model using logistic regression was created to assess for correlates of anal HR-HPV infection. A total of 442 MSM were recruited, with a median age of 45 (IQR 38–50) and an overall HPV prevalence of 82%. The prevalence of any HR-HPV infection was 65.3% and 50.7% in the HIV-positive and HIV-negative MSM, respectively. No participant tested positive for all genotypes covered by the nonavalent vaccine. HIV status (aOR 1.806; 95% CI 1.159–2.816), smoking (aOR 2.176; 95% CI 1.285–3.685) and the number of lifetime sexual partners (aOR 2.466; 95% CI 1.092–5.567) were independent risk factors for anal HR-HPV infection. Our findings will be useful to inform HPV vaccine rollout and HPV prevention strategies in Canadian MSM.

scholarly journals Sexual behaviours and sexually transmitted infection outcomes in a cohort of HIV-negative men who have sex with men attending sexual health clinics in England

2018 ◽  
Vol 29 (14) ◽  
pp. 1407-1416 ◽  
Author(s):  
S Desai ◽  
F Burns ◽  
G Schembri ◽  
D Williams ◽  
A Sullivan ◽  
...  
Keyword(s):  
High Risk ◽  
Sexual Health ◽  
Receptive Anal Intercourse ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Behaviours ◽  
Increased Risk ◽  
Sex With Men ◽  
Clinical Records ◽  
Hiv Negative

Men who have sex with men (MSM) attending sexual health (SH) clinics are at high risk for HIV acquisition and are disproportionately affected by sexually transmitted infections (STIs). We collected standardised behavioural data from MSM attending clinics to characterise sexual behaviours and identify predictors for HIV and STIs. In 2012–2013, HIV-negative MSM attending five SH clinics in England reported sexual behaviours in the previous three months via a self-administered questionnaire. Behaviours were linked to the individual’s clinical records using national surveillance. The prevalence and incidence of bacterial STIs (gonorrhoea, Chlamydia, lymphogranuloma venereum and syphilis) and incidence of HIV were calculated. Adjusted odds ratios and hazard ratios with 95% confidence interval (CI) were reported for significant predictors. Of 1278 HIV-negative MSM, 54% were of white ethnicity and UK-born and 43% were 25–34 years old. Almost all men reported at least one partner in the last three months. Half reported condomless anal sex and 36% condomless receptive anal intercourse (CRAI). Incidence of bacterial STIs was 46/100 (95%CI 39–54) person years (py) and of HIV was 3.1/100 (95%CI 1.7–5.6) py. A STI at baseline and CRAI with increasing numbers of partners were associated with both incident infections. In this cohort of MSM high-risk behaviours and STIs were prevalent. Engagement in CRAI increased the likelihood of subsequent infection, while men diagnosed with a bacterial STI were at increased risk of a future STI. Clinical and behavioural risk assessments to determine an individual’s risk of infection could allow a more nuanced prevention approach that has greater success in reducing transmission.

scholarly journals PrEP users among Lisbon MSM Cohort participants – A first look after PrEP implementation in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
F Fernandes ◽  
P Meireles ◽  
M Rocha ◽  
J Rojas ◽  
H Barros
Keyword(s):  
Foreign Country ◽  
Diverse Group ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Before And After ◽  
Sex With Men ◽  
Reported Data ◽  
Exposure Prophylaxis ◽  
Hiv Negative

Abstract Background Pre-exposure prophylaxis (PrEP) with tenofovir/emtricitabine has shown to be effective in preventing HIV among high-risk HIV-negative men who have sex with men (MSM). Portugal made PrEP available in February 2018, but few MSM reported PrEP use before. We aimed to compare the sociodemographic characteristics of MSM using PrEP and those knowing PrEP but not using and to compare MSM who started PrEP before and after its implementation in Portugal. Methods We performed a cross-sectional analysis, using Lisbon MSM Cohort data - an open prospective cohort of HIV-negative MSM testing at a community-based center in Lisbon - regarding the first time PrEP use was reported. Data from March 2015 to April 2019 was used. In this period 2142 MSM participated in the cohort and reported to know PrEP of whom 160 (7.5%) reported to use it. 83 PrEP-users answered a subset of questions about PrEP. Comparisons were performed using t-test, Chi-square or Fisher’s exact test. Results Comparing with non-users, PrEP users were significantly older (Mean: 35.7, SD 9.4 vs. 30.8, SD 9.2, p < 0.001), had more frequently a Master or PhD degree (37.2% vs. 27.4%, p = 0.017), and were more frequently born in a foreign country (42.2% vs. 31.8%, p < 0.001). Groups were similar in terms sexual orientation. Among the 83 PrEP users answering more questions about PrEP, 28 (33.7%) reported to have ordered their PrEP medication online, 24 (28.9%) obtained it in a medical appointment in Portugal, 15 (18.1%) in a foreign country, 4 in a clinical trial or demonstration project. Of all PrEP users, 30 (19.4%) started PrEP only after February 2018, and no sociodemographic differences were found comparing with those who started before. Conclusions MSM reporting PrEP use were more educated, older and more frequently born in a foreign country than non-PrEP users. MSM starting PrEP before and after February 2018 were similar, which may indicate that making PrEP available did not yet reach a more diverse group of MSM. Key messages MSM reporting PrEP use were more educated, older and more frequently born in a foreign country than non-PrEP users. MSM starting PrEP before and after February 2018 were similar, which may indicate that making PrEP available did not yet reach a more diverse group of MSM.

scholarly journals A Web-Based Study of HIV Prevention in the Era of Pre-Exposure Prophylaxis Among Vulnerable HIV-Negative Gay and Bisexual Men, Transmen, and Transwomen Who Have Sex With Men: Protocol for an Observational Cohort Study (Preprint)

2019 ◽  
Author(s):  
Denis Nash ◽  
Matthew Stief ◽  
Caitlin MacCrate ◽  
Chloe Mirzayi ◽  
Viraj V Patel ◽  
...  
Keyword(s):  
High Risk ◽  
Hiv Prevention ◽  
Hiv Testing ◽  
The United States ◽  
Racially Diverse ◽  
Web Based ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
Hiv Negative

BACKGROUND Gay, bisexual, and other men who have sex with men continue to bear a large burden of the HIV epidemic in the United States and are among the only populations with increasing incidence in recent years. OBJECTIVE The Together 5000 (T5K) Study aimed to enroll a US-based, racially diverse sample of HIV-negative men, transmen, and transwomen who are not on pre-exposure prophylaxis (PrEP) into an observational cohort to inform the design, implementation, scale-up, and evaluation of HIV prevention programs. METHODS We used internet-based strategies to enroll a large, racially diverse national sample of HIV-negative men, transmen, and transwomen aged 16 to 49 years at high risk of HIV acquisition via sexual networking apps. Study participants are contacted every 6 months (in between annual surveys) for a brief survey on HIV testing, HIV diagnosis, and PrEP use (ie, attempts to access, PrEP initiation, and PrEP discontinuation). Participants complete annual self-administered at-home HIV testing and Web-based surveys. Using baseline serologic data and self-reported HIV testing history, we reconstructed a cohort of persons who were HIV negative at 12 months before baseline to estimate HIV incidence leading up to cohort enrollment. RESULTS The study sample included 8777 participants from all 50 US states, Puerto Rico, and Guam; 50.91% (4468/8777) were persons of color and 25.30% (2221/8777) were young individuals aged 16 to 24 years. Per eligibility criteria, all T5K participants reported having sex with >2 male partners in the 90 days before enrollment, self-reported not having been diagnosed with HIV, and were not actively taking PrEP. In addition, 79.39% (6968/8777) reported >2 insertive condomless anal sex (CAS) acts, 61.02% (5356/8777) reported >1 receptive CAS acts in the past 90 days. Furthermore, most (7525/8777, 85.74%) reported never having taken PrEP. In total, 70.25% (6166/8777) were sent a self-administered at-home HIV test kit and 82.29% (5074/6166) of those sent a kit returned a sample for testing. The HIV incidence rate during the 12-month period leading up to enrollment was estimated to be 2.41 (95% CI 2.02-2.90) per 100 person-years. CONCLUSIONS A large, national, and racially diverse fully Web-based cohort of HIV-negative men, transmen, and transwomen at high risk for HIV seroconversion has successfully been recruited into longitudinal follow-up. This cohort is at high risk for HIV acquisition and can provide important insights related to the real-world uptake, impact, and equity of HIV prevention interventions in the United States. Participants can be invited to participate in trials aimed at testing strategies to improve the uptake of and engagement in these interventions. INTERNATIONAL REGISTERED REPORT RR1-10.2196/13715

HIV PREVALENCE AND SOME CHARACTERISTICS OF MAN WHO HAVE SEX WITH MAN (MSM) IN KHANH HOA PROVINCE 2010

2012 ◽  
pp. 114-121
Author(s):  
That Toan Ton ◽  
Xuan Chuong Tran
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Risk Group ◽  
Cross Sectional Study ◽  
Hiv Prevalence ◽  
High Risk Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Men And Women ◽  
Sex With Men

Man who have sex with man (MSM) group is a high risk group of HIV infection. There are very rare studies about HIV infection in this group. Objectives: 1. Determine the rate of HIV infection in MSM in Khanh Hoa province 2010. 2. Study some characteristics of MSM in Khanh Hoa province. Materials and Methods: MSM over 16 yrs. live in Khanh Hoa. Cross-sectional study from June 2010 to June 2011. Results: 1. HIV infection in MSM group in Khanh Hoa 2010: 1.3% (rural 0.6%, urban: 3.7%). Marriaged: 3.9%, single: 0.8%; MSM have sex only with men: 0.3%, MSM have sex with men and women: 3.7%. 2. 83.3% of MSM are single (urban more common than rural). The first sex partner: male 82.2%, female 14.9%. Having sex for pay: urban 29.9%, rural 19.3%. Having sex for enjoying: urban 49.5%, rural 71.8%. Conclusions: HIV infection in MSM group in Khanh Hoa 2010: 1.3% (rural 0.6%, urban: 3.7%). Marriaged: 3.9%, single: 0.8%. 83.3% of MSM are single (urban more common than rural). Having sex for enjoying: urban 49.5%, rural 71.8%.

scholarly journals Changes in recreational drug use, drug use associated with chemsex, and HIV-related behaviours, among HIV-negative men who have sex with men in London and Brighton, 2013–2016

2018 ◽  
Vol 94 (7) ◽  
pp. 494-501 ◽  
Author(s):  
Janey Sewell ◽  
Valentina Cambiano ◽  
Ada Miltz ◽  
Andrew Speakman ◽  
Fiona C Lampe ◽  
...  
Keyword(s):  
Drug Use ◽  
Sexual Health ◽  
Sociodemographic Factors ◽  
Post Exposure Prophylaxis ◽  
Specific Drug ◽  
Cross Sectional ◽  
Polydrug Use ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

ObjectivesThe objective of this study was to compare the prevalence of polydrug use, use of drugs associated with chemsex, specific drug use, and HIV-related behaviours, between two time periods, using two groups of HIV-negative men who have sex with men (MSM) attending the same sexual health clinics in London and Brighton, in two consecutive periods of time from 2013 to 2016.MethodsData from MSM in the cross-sectional Attitudes to and Understanding Risk of Acquisition of HIV (AURAH) study (June 2013 to September 2014) were compared with baseline data from different MSM in the prospective cohort study Attitudes to and Understanding Risk of Acquisition of HIV over Time (AURAH2) (November 2014 to April 2016). Prevalence of polydrug use, drug use associated with chemsex and specific drug use, and 10 measures of HIV-related behaviours including condomless sex, post-exposure prophylaxis (PEP) use, pre-exposure prophylaxis (PrEP) use, and HIV testing, were compared. Prevalence ratios (PRs) for the association of the study (time period) with drug use and HIV-related behaviour measures were estimated using modified Poisson regression analysis, unadjusted and adjusted for sociodemographic factors.ResultsIn total, 991 MSM were included from AURAH and 1031 MSM from AURAH2. After adjustment for sociodemographic factors, use of drugs associated with chemsex had increased (adjusted PR (aPR) 1.30, 95% CI 1.11 to 1.53) and there were prominent increases in specific drug use; in particular, mephedrone (aPR 1.32, 95% CI 1.10 to 1.57), γ-hydroxybutyric/γ-butryolactone (aPR 1.47, 95% CI 1.15 to 1.87) and methamphetamine (aPR 1.42, 95% CI 1.01 to 2.01). Use of ketamine had decreased (aPR 0.54, 95% CI 0.38 to 0.78). Certain measures of HIV-related behaviours had also increased, most notably PEP use (aPR 1.50, 95% CI 1.21 to 1.88) and number of self-reported bacterial STI diagnoses (aPR 1.24, 95% CI 1.08 to 1.43).ConclusionsThere have been significant increases in drug use associated with chemsex and some measures of HIV-related behaviours among HIV-negative MSM in the last few years. Changing patterns of drug use and associated behaviours should be monitored to enable sexual health services to plan for the increasingly complex needs of some clients.

scholarly journals Examining potential effects of non-occupational post-exposure prophylaxis (nPEP) on sexual behaviors of Chinese men who have sex with men: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haochu Li ◽  
Ran Wei ◽  
Jason J. Ong ◽  
Eunsook Kim ◽  
Traci L. Weinstein ◽  
...  
Keyword(s):  
High Risk ◽  
Condom Use ◽  
Behavioral Change ◽  
Sexual Partners ◽  
Post Exposure Prophylaxis ◽  
Cross Sectional ◽  
Chinese Men ◽  
Number Of Sexual Partners ◽  
Sex With Men ◽  
Exposure Prophylaxis

Abstract Background In China, non-occupational post-exposure prophylaxis (nPEP) is not a conventional service yet and nPEP related studies are very few. Recently, China’s 13th Five Year Action Plan for HIV/AIDS Containment and Prevention examines the feasibility of including nPEP as one of the national strategies for HIV prevention. However, there is a concern that nPEP use might exacerbate high-risk sexual activities. In order to facilitate a research-based policy making of routinizing nPEP services, the current study examined potential effects of nPEP use on condom use and number of sexual partners among Chinese men who have sex with men (MSM) . Methods A cross-sectional survey was conducted in two cities of China in November and December 2018. Descriptive analyses of participants’ sociodemographic and behavioral characteristics were conducted using SPSS 24.0. Mplus 7.4 was used to conduct confirmatory factor analysis and structural equation modeling. Results The sample included 419 Chinese MSM with a mean age of 28.04 (SD = 9.71). Participants reported more positive anticipation of their own behaviors than other MSM’s behaviors regarding condom use and number of sexual partners if nPEP were to be routinized in China. About 60% of participants reported discrepancies between anticipated individual and population behaviors as a potential result of routinization of nPEP services. Anticipated individual behavioral change was positively related to age and duration of residence in the current city, and negatively related to education. Anticipated population behavioral change was positively related to age. Anticipated behavioral discrepancy was positively related to being ethnic minority and never married. Conclusions These findings identify a high-risk subgroup of MSM, who reported they would use condoms less and/or have more sexual partners when nPEP becomes available. This subgroup of MSM might benefit from targeted health interventions. Moreover, there is a clear discrepancy between anticipated individual and population behavioral changes regarding future routinization of nPEP services, suggesting incorporating nPEP services as a means of community development for MSM.

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