Awareness and uptake of pre-exposure prophylaxis for HIV among low-income, HIV-negative heterosexuals in San Francisco

2021 ◽  
pp. 095646242098666
Author(s):  
Daphine Namara ◽  
Hui Xie ◽  
Desmond Miller ◽  
Danielle Veloso ◽  
Willi McFarland
Keyword(s):  
San Francisco ◽  
Low Income ◽  
Educational Materials ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Left Behind ◽  
Prep Implementation ◽  
Prep Awareness ◽  
Exposure Prophylaxis ◽  
Hiv Negative

We examined pre-exposure prophylaxis (PrEP) awareness and uptake among low-income heterosexual men and women in San Francisco in 2019. Of 294 HIV-negative survey participants, 42.5% were aware of PrEP. Few women (12.5%) and men (8.9%) had discussed PrEP with a healthcare provider; 3.8% of women and 0% of men had used PrEP in the last year. White participants (adjusted odds ratio (aOR) 5.39, 95% CI 1.02, 28.56), women (aOR 2.19, 95% CI 1.30, 3.70), and age 60 years or above (aOR 4.00, 95% CI 1.12, 14.34) had greater odds of being aware of PrEP. Testing for HIV or sexually transmitted infection in the past year was marginally associated with a greater PrEP awareness. Our findings reveal gaps in PrEP implementation associated with social disparities among low-income heterosexuals. Testing services and targeted promotional and educational materials are needed lest high-risk, low-income populations are left behind in San Francisco’s aggressive “Getting to Zero” efforts.

Conference report: 34th IUSTI Europe Congress

2021 ◽  
pp. 095646242097592
Author(s):  
Anisa Bangura ◽  
Amelia Marriott ◽  
Jessica Shaw ◽  
Rajul Patel
Keyword(s):  
Vaccine Development ◽  
Conference Report ◽  
Asymptomatic Infection ◽  
Surveillance Systems ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Prep Implementation ◽  
Disease Study ◽  
Exposure Prophylaxis ◽  
And Control

The 34th IUSTI European Conference was held from the 3rd to the 5th of October 2020. There were presentations on STIs in Europe, many centred on Romania. A full session was devoted to syphilis, including global efforts in syphilis vaccine development. A workshop on Pre-Exposure Prophylaxis (PrEP) implementation in Europe reviewed the ‘PrEP gap’ and the East/West divide with an additional presentation on upcoming PrEP technologies. The conference featured symposia from WHO: STIs are still increasing and with no Euro universal surveillance systems. Other symposia focused on health inequalities amongst gender and sexual minorities and the recently published changes in IUSTI guidelines on gonorrhoea, syphilis and Lymphogranuloma Venereum. SARS-CoV-2 was a focus for several plenary sessions and its possibly lasting impact on service delivery. New challenges were discussed, particularly the loss of azithromycin as a useful antimicrobial. The symposia covered latest research and work into genomics of STIs. Whole-genome sequencing has revolutionised infectious disease study, particularly infection transmission and control. There was a debate on whether ‘screening and treatment of bacterial Sexually Transmitted Infection is associated with Antimicrobial Resistance and should be reconsidered’, emphasising limited damage of asymptomatic infection and the possibility of emergence of rapid antibiotic resistance. The conference closed with several IUSTI awards.

scholarly journals Trichomonas vaginalis AND HIV INFECTION: RELATION AND PREVALENCE AMONG WOMEN IN SOUTHERN BRAZIL

2019 ◽  
Vol 48 (1) ◽  
pp. 15-24
Author(s):  
Mirian Pinheiro Bruni ◽  
Carolina Caetano dos Santos ◽  
Dulce Stauffert ◽  
Nilton Da Cunha Filho ◽  
Guilherme De Oliveira Bicca ◽  
...  
Keyword(s):  
Viral Load ◽  
Low Income ◽  
Trichomonas Vaginalis ◽  
Hiv Positive ◽  
Hiv Status ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Cell Counts ◽  
Hiv Negative

Trichomoniasis is a curable sexually transmitted infection (STI) that has been reported to be linked to exposure to human immunodeficiency virus (HIV), although few studies have described this association. The purpose of this study was to focus on the incidence of trichomoniasis in low-income women, its relation to HIV status, viral load levels and TCD4+ cell counts, among other risk factors, using an in vitro culture as a diagnostic test. A crosssectional study among 267 women (103 HIV-positive and 164 HIV-negative) was conducted in 2015. The overall prevalence of Trichomonas vaginalis (TV) infection was 6.4%. Among HIVpositive and HIV-negative women, the prevalence was 3.9% and 7.9%, respectively, yet these results were not statistically different (p=0.1878). The factors associated with TV infection were cigarette smoking (OR= 3.52), vaginal itching (OR=4.43) and bacterial vaginosis (BV) (OR= 5.29). HIV status, TCD4+ cell count and viral load were not associated with TV infection in this group. The prevalence rates found, lower than those observed in other studies, may be due to the fact that the women evaluated in the present study are part of a low-risk populationas well as the limited sample size of HIV positive women.

Pre-exposure prophylaxis awareness, use, and intention to use in a regional sample of Latin American geosocial networking application users in 2018–2019

2021 ◽  
pp. 095646242110346
Author(s):  
Kevin J Blair ◽  
Eddy R Segura ◽  
Alex Garner ◽  
Jianchao Lai ◽  
Amy Ritterbusch ◽  
...  
Keyword(s):  
Latin America ◽  
Latin American ◽  
Online Survey ◽  
Policy Adoption ◽  
Intention To Use ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Geosocial Networking ◽  
Prep Awareness ◽  
Exposure Prophylaxis

Pre-exposure prophylaxis (PrEP) access is increasing in Latin America. We explored PrEP use among Spanish-speaking, Hornet geosocial networking application users from Latin American countries with limited PrEP data via an online survey completed between December 2018 and February 2019. A total of 718 Hornet users from 10 countries were included, of whom 72.1% reported PrEP awareness. Few (5.6%) were currently taking PrEP, though 32.1% intended to take PrEP in the subsequent 6 months. PrEP awareness was lower in 18–25 year olds compared to 26+ (62.4% vs. 75.6%, aOR 0.67, [95% CI 0.46–0.97]), and higher among those living in larger versus smaller cities (74.4% vs. 58.8%, aOR 1.96, [95% CI 1.25–3.07]) or countries with at least partial versus no PrEP policy adoption (79.1% vs. 60.8%, aOR 2.20, [95% CI 1.56–3.12]). Intention to use PrEP was higher among PrEP-eligible respondents (51.8% vs. 29.6%, aOR 2.26, [95% CI 1.26–4.07]) and those recently tested for a sexually transmitted infection (35.4% vs. 25.5%, aOR 1.58, [95% CI 1.01–2.48]). Efforts to expand PrEP use in Latin America should focus on national PrEP policy adoption, and research should explore barriers to awareness and use among young men who have sex with men.

scholarly journals Factors Correlated with Pre-Exposure Prophylaxis (PrEP) Awareness and Use among Black Adults in the United States: Implications for Improving PrEP Uptake

2021 ◽  
Author(s):  
Kennethea A. Wilson ◽  
Sarahmona M. Przybyla ◽  
Jacob Bleasdale ◽  
Steven Gabriel ◽  
Natalie Leblanc ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Black Adults ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
History Of ◽  
Nationally Representative ◽  
Prep Awareness ◽  
Exposure Prophylaxis

Abstract In the United States, low rates of pre-exposure prophylaxis (PrEP) awareness and utilization persist among Black adults. To date, few studies have assessed PrEP awareness and use among a nationally representative sample of Black adults. The present study explored factors associated with PrEP awareness and use among Black adults in the United States. Most participants were unaware of PrEP (71%). Those reporting a history of incarceration [aOR 1.73 (1.04, 2.90), p <.05] and lifetime sexually transmitted infection testing [aOR 1.76 (1.19, 2.59), p <.05] had greater odds of awareness. In the sample, only 6% of participants had ever taken PrEP. Those with a history of incarceration [aOR 9.96 (2.82, 35.14), p <.05], concurrent sexual partners [aOR 1.09 (1.00, 1.18), p <.05], and substance use during sex [aOR 4.23 (1.02, 17.48), p <.05] had greater odds of use. Interventions to improve PrEP uptake among Black adults must consider the contextual factors associated with awareness and use.

scholarly journals Improved PrEP Awareness and Use among Trans Women in San Francisco, California

2021 ◽  
Author(s):  
Erin C. Wilson ◽  
Christopher J. Hernandez ◽  
Susan Scheer ◽  
Dillon Trujillo ◽  
Sean Arayasirikul ◽  
...  
Keyword(s):  
San Francisco ◽  
Anal Intercourse ◽  
Receptive Anal Intercourse ◽  
The Past ◽  
National Hiv Behavioral Surveillance ◽  
Trans Women ◽  
Gender Based ◽  
Prep Awareness ◽  
Almost All ◽  
Exposure Prophylaxis

AbstractTransgender women face a serious risk of HIV infection. Despite this, there is limited knowledge and use of Pre-exposure prophylaxis (PrEP). We measured the continuity of prevention across services in the PrEP cascade and correlates of PrEP use among trans women in San Francisco enrolled in the 2019/20 National HIV Behavioral Surveillance Study. Knowledge and use of PrEP among trans women in San Francisco increased in recent years; almost all (94.0%) had heard about PrEP, 64.7% had discussed PrEP with a healthcare provider, and 44.8% had taken PrEP in the past 12 months. PrEP use was associated with participation in a PrEP demonstration project (aOR = 31.44, p = 0.001) and condomless receptive anal intercourse (aOR = 3.63, p = 0.024). Injection drug use was negatively associated (aOR = 0.19, p = 0.014). Efforts are needed to combat the gender-based stigma and discrimination faced by trans women, which can result in avoidance and mistrust of the medical system.

scholarly journals Optimising sexually transmitted infection screening in correctional facilities: San Francisco, 2003 5

2007 ◽  
Vol 83 (5) ◽  
pp. 416-418 ◽  
Author(s):  
P. M Barry ◽  
C. K Kent ◽  
K. C Scott ◽  
A. Snell ◽  
J. Goldenson ◽  
...  
Keyword(s):  
San Francisco ◽  
Sexually Transmitted Infection ◽  
Correctional Facilities ◽  
Transmitted Infection ◽  
Sexually Transmitted

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.

Acceptability of a digital patient notification and linkage-to-care tool for French PrEPers (WeFLASH©): Key stakeholders' perspectives

2019 ◽  
Vol 30 (14) ◽  
pp. 1397-1407
Author(s):  
David Lessard ◽  
Alexandre Aslan ◽  
Jérémy Zeggagh ◽  
Stéphane Morel ◽  
David Michels ◽  
...  
Keyword(s):  
Linkage To Care ◽  
Epidemiological Data ◽  
Management Decision ◽  
Time Data ◽  
Transmitted Infection ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Access To Data ◽  
Exposure Prophylaxis

The objective of this study was to describe stakeholders’ perspectives on the acceptability of WeFLASH© (AADISS, Paris, France), a digital smartphone sexually transmitted infection (STI) patient notification (PN) tool to be launched among French HIV pre-exposure prophylaxis users (PrEPers). In Paris, Lyon, and Nice, we conducted 2-hour focus group discussions with PrEPers (n = 21) and community mediators (n = 10), and one-on-one interviews with PrEP-prescribing physicians (n = 5) and HIV/STI management decision-makers (n = 4). Recordings were transcribed. The analysis focused on perceived benefits and risks. Concerning benefits, participants mentioned that WeFLASH© could provide: improved PN and STI screening, by refining the notification of anonymous partners; customized linkage-to-care, by providing users with tailored information on care; and transferable epidemiological data, by filling a need for real-time data. Participants anticipated risks for: privacy and confidentiality and suggested specific security settings to protect users’ identity; sexual behavior and suggested game-like functions to improve the integration of the tool in sexual contexts; and fairness and emphasized the importance of making WeFLASH© accessible to all men who have sex with men. WeFLASH© could facilitate PN for an increasing proportion of anonymous partners met online, and empower users, including notified partners, on questions of confidentiality and consent, access to STI prevention and screening services, and access to data.

Mechanisms of HIV Transmission

2017 ◽  
Author(s):  
Puja Nambiar ◽  
William R. Short
Keyword(s):  
Hiv Transmission ◽  
Hiv Infections ◽  
The United States ◽  
Antiretroviral Drugs ◽  
Oral Sex ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Mucous Membranes ◽  
Perinatal Treatment ◽  
Hiv Negative

HIV is a sexually transmitted infection. Most new HIV infections in the United States are the result of sex, but it is rare for HIV to be transmitted through oral sex. The risk of HIV transmission to a receptive partner remains higher than that to an insertive one; however, both are at risk. Anything that compromises the integrity of mucous membranes, such as sexually transmitted infections, may increase the risk of transmission. Although not 100% effective, keeping an infected partner’s viral load low reduces the risk of transmission to an HIV-negative partner. Maternal transmission is a larger concern in developing countries due to lack of access to perinatal treatment with antiretroviral drugs.

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