Screening HIV-positive men who have sex with men for hepatitis C re-infection risk: is a single question on condom-use enough? A sensitivity analysis

Abstract Background Hepatitis C virus (HCV) is common in men who have sex with men (MSM) with HIV. The Swiss HCVree Trial targeted a micro-elimination by using a treat and counsel strategy. Self-reported condomless anal intercourse with non-steady partners was used as the selection criterion for participation in a counselling intervention designed to prevent HCV re-infection. The purpose of this study was to assess the ability of this criterion to identify men who engaged in other sexual risk behaviours associated with HCV re-infection. Methods Men who disclosed their sexual and drug- use behaviours during the prior 6 months, at study baseline, were included in the current study. Using a descriptive comparative study design, we explored self-reported sexual and drug-use risk behaviours, compared the odds of reporting each behaviour in men who reported and denied condomless anal intercourse with non-steady partners during the prior year and calculated the sensitivity/specificity (95% CI) of the screening question in relation to the other at-risk behaviours. Results Seventy-two (61%) of the 118 men meeting eligibity criteria reported condomless anal intercourse with non-steady partners during the prior year. Many also engaged in other potential HCV transmission risk behaviours, e.g., 52 (44%) had used drugs. In participants disclosing drug use, 44 (37%) reported sexualised drug use and 17 (14%) injected drugs. Unadjusted odds ratios (95% CI) for two well-known risk behaviours were 2.02 (0.80, 5.62) for fisting and 5.66 (1.49, 37.12) for injecting drug use. The odds ratio for sexualised drug use - a potential mediator for increased sexual risk taking - was 5.90 (2.44, 16.05). Condomless anal intercourse with non-steady partners showed varying sensitivity in relation to the other risk behaviours examined (66.7–88.2%). Conclusions Although condomless anal intercourse with non-steady partners was fairly sensitive in detecting other HCV relevant risk behaviours, using it as the only screening criterion could lead to missing a proportion of HIV-positive men at risk for HCV re-infection due to other behaviours. This work also points to the importance of providing access to behavioral interventions addressing other sexual and drug use practices as part of HCV treatment. Trial registration Clinical Trial Number: NCT02785666, 30.05.2016.

Download Full-text

HIV and syphilis and sexual risk behaviours among men who have sex with men attending university in China: a systematic review and meta-analysis

Sexual Health ◽

10.1071/sh18231 ◽

2019 ◽

Vol 16 (6) ◽

pp. 554 ◽

Cited By ~ 1

Author(s):

Song Fan ◽

Zuyao Yang ◽

Fengsu Hou ◽

Maohe Yu ◽

Zhenzhou Luo ◽

...

Keyword(s):

Hiv Testing ◽

Sexual Risk ◽

Meta Analysis ◽

Male Partner ◽

Anal Intercourse ◽

Hiv Prevalence ◽

Risk Behaviours ◽

Sex With Men ◽

Group Sex ◽

Sexual Risk Behaviours

Background This study was conducted to summarise the HIV epidemic, sexual behaviours and HIV testing among men who have sex with men (MSM) attending university in China. Methods: Five databases were searched for student MSM information in English and Chinese language publications. Meta-analyses were performed to calculate the pooled prevalence of HIV and syphilis, pooled mean age at first anal intercourse (AFAI) and the rate of other HIV-related behaviours among MSM attending university in China. Univariate meta-regression and subgroup analysis were conducted to explore potential sources of heterogeneity. Publication bias was measured using Egger’s test. Results: Thirty-three articles representing 31 studies were included in the analysis. The pooled HIV prevalence was 4.1% (95% CI 3.1–5.0%). The estimated AFAI was 18.7 years, but 37.5% of students had their first anal intercourse before 18 years of age. Most (88.2%) had their first sexual intercourse with a male partner. Of the MSM attending university, 4.2% of MSM engaged in commercial sex (either selling or buying sex), 10.3% had ever engaged in group sex, 13.1% had had sex with a female partner in the past month and 10.1% had ever used drugs. Most (77.7%) sought sex partners via geosocial networking gay apps or the Internet, and 42.9% had ever tested for HIV. There was a tendency for an increase in lifetime HIV testing rate from 32% in 2005–07 to 53% in 2014–16. Conclusions: This review found high HIV prevalence, early AFAI and a high prevalence of sexual risk behaviours among MSM attending university in China. Interventions aimed at increasing HIV testing and reducing sexual risk behaviours are urgently needed among this young population.

Download Full-text

Uptake and willingness to use PrEP among Chinese men who have sex with men with experience of sexualized drug use

10.21203/rs.2.22067/v1 ◽

2020 ◽

Author(s):

Zixin Wang ◽

Phoenix K.H. Mo ◽

Mary Ip ◽

Yuan Fang ◽

Joseph T.F. Lau

Keyword(s):

Drug Use ◽

Hiv Testing ◽

Behavioral Control ◽

Anal Intercourse ◽

Perceived Behavioral Control ◽

Future Health ◽

Cross Sectional ◽

Condomless Anal Intercourse ◽

Sex With Men ◽

Willingness To Use

Abstract Background Sexualized drug use (SDU, use of any psychoactive substance before/during sexual intercourse) is prevalent among men who have sex with men (MSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among MSM with experience of SDU. Methods A total of 580 Hong Kong Chinese speaking MSM self-reported to be HIV negative/unknown sero-status completed a cross-sectional anonymous telephone interview. Results Of the participants, 107 (18.4%) and 56 (9.7%) had experience of SDU and chemsex in their lifetime. The prevalence of PrEP use was 4.0% among all participants and 12.1% among those with experience of SDU. Among MSM with experience of SDU who were not on PrEP (n=94), 59.6% were willing to use daily oral PrEP in the next six months. After adjustment for significant background variables (age group, HIV testing in the past year, and anal intercourse with non-regular male sex partners), having ≥3 episodes of SDU per month (adjusted odds ratios (AOR): 3.87, 95%CI: 1.01, 15.28), presence of condomless anal intercourse during SDU (AOR: 2.96, 95%CI: 1.03, 9.55), positive attitudes toward PrEP (AOR: 2.01, 95%CI: 1.37, 2.95), perceived support from significant others to use PrEP (AOR: 11.63, 95%CI: 3.93, 34.37)), and perceived behavioral control of using PrEP (AOR: 20.82, 95%CI: 6.51, 66.64) were significantly associated with higher willingness to use PrEP. Conclusion MSM with experience of SDU are potential good candidates of PrEP implementation. Effective strategies to increase PrEP coverage are needed even if affordable PrEP became available, future health promotion may make use of HIV testing and counseling settings and modify perception related to PrEP.

Download Full-text

Predictors of Condomless Anal Intercourse in Young HIV-Positive Men Who Have Sex With Men With Detectable Viral Loads

Journal of Adolescent Health ◽

10.1016/j.jadohealth.2019.12.006 ◽

2020 ◽

Vol 66 (6) ◽

pp. 672-683 ◽

Cited By ~ 1

Author(s):

Lisa Hightow-Weidman ◽

Kate Muessig ◽

Joseph R. Egger ◽

Sara LeGrand ◽

Alyssa Platt

Keyword(s):

Anal Intercourse ◽

Hiv Positive ◽

Viral Loads ◽

Condomless Anal Intercourse ◽

Sex With Men ◽

Hiv Positive Men

Download Full-text

Geosocial networking app use associated with sexual risk behavior, but also PrEP use, among gay, bisexual, and other men who have sex with men: Cross-sectional web-based survey (Preprint)

10.2196/preprints.35548 ◽

2021 ◽

Author(s):

Laurel Prescott Gibson ◽

Emily B Kramer ◽

Angela D. Bryan

Keyword(s):

Alcohol Use ◽

Sexual Risk ◽

Anal Intercourse ◽

The United States ◽

Sexual Partners ◽

Cannabis Use ◽

Cross Sectional ◽

Condomless Anal Intercourse ◽

Geosocial Networking ◽

Sex With Men

BACKGROUND In the United States, geosocial networking (GSN) applications (i.e., mobile dating apps) have become central to dating and sexual interactions in recent years. Among gay, bisexual, and other men who have sex with men (GBM), these apps play an important role in reducing barriers and facilitating partner-seeking. However, despite these benefits, there are concerns that these apps may facilitate risky sexual behavior and transmission of sexually transmitted infections (STIs) among GBM. OBJECTIVE The present study examined the association between GSN app use and sexual risk among a U.S. sample of GBM. METHODS Using a cross-sectional design, respondents (N = 223) completed an online survey assessing their use of GSN apps, sexual risk and protective behaviors, HIV serostatus, and previous STI diagnoses. RESULTS Respondents were ages 21-78 (M = 31.90, SD = 10.06), 69.5% Non-Hispanic White, and from 40 States and the District of Columbia. Nearly half (47%; n = 104) of the sample reported using GSN apps. GSN users were more likely to report past year condomless anal intercourse (p < .001), 3+ sexual partners in the previous year (p < .001), and a previous STI diagnosis (p = .001) relative to non-users, and also reported more frequent use of recreational drugs before sex (p = .001), alcohol use before sex (p < .001), and cannabis use before sex (p = .01). Interestingly, GSN users were also more likely to report having ever received an HIV test (p < .001) and using pre-exposure prophylaxis (PrEP; p = .03). Rates of HIV seropositivity did not significantly differ between GSN users and non-users (p = .53). Among the subset of GSN users, 38 participants reported using only GBM-specific GSN apps (e.g., Grindr), while 27 participants reported using only sexuality nonspecific GSN apps (e.g., Tinder). Exclusive users of sexual minority-specific apps reported more frequent recreational drug use before sex (p = .01) and were also more likely to report past year condomless anal intercourse (p < .001), 3+ sexual partners in the previous year (p = .004), a previous STI diagnosis (p = .002), and HIV testing (p = .003). Alcohol use before sex, cannabis use before sex, PrEP use, and HIV rates were similar between both groups (ps > .11). CONCLUSIONS Findings suggest that GSN apps may be a useful pathway for interventions aimed at reducing STI-risk among GBM. Future, prospective studies should examine how risk levels change after initiation of GSN app use.

Download Full-text

Let’s talk about sex: A qualitative study exploring the experiences of HIV nurses when discussing sexual risk behaviours with HIV-positive men who have sex with men

International Journal of Nursing Studies ◽

10.1016/j.ijnurstu.2017.09.002 ◽

2017 ◽

Vol 76 ◽

pp. 55-61 ◽

Cited By ~ 4

Author(s):

S. de Munnik ◽

C. den Daas ◽

H.S.M. Ammerlaan ◽

G. Kok ◽

M.S. Raethke ◽

...

Keyword(s):

Qualitative Study ◽

Sexual Risk ◽

Hiv Positive ◽

Risk Behaviours ◽

Sex With Men ◽

Sexual Risk Behaviours ◽

Hiv Positive Men

Download Full-text

Partner meeting venue typology and sexual risk behaviors among French men who have sex with men

International Journal of STD & AIDS ◽

10.1177/0956462418775524 ◽

2018 ◽

Vol 29 (13) ◽

pp. 1282-1288 ◽

Cited By ~ 3

Author(s):

Yazan A Al-Ajlouni ◽

Su H Park ◽

John A Schneider ◽

William C Goedel ◽

H Rhodes Hambrick ◽

...

Keyword(s):

Hiv Infection ◽

Sexual Risk ◽

Risk Behaviors ◽

Sexual Risk Behaviors ◽

Anal Intercourse ◽

Adjusted Relative Risk ◽

Condomless Anal Intercourse ◽

Geosocial Networking ◽

Sex With Men ◽

Group Sex

Previous research has given considerable attention to venues where men who have sex with men (MSM) meet their sex partners. However, no previous study examined a vast range of sexual risk behaviors. The objective of this study was to examine the association between the types of venues for meeting sexual partners, condomless anal intercourse, engagement in group sex, and HIV and sexually transmitted infection (STI) risk among a sample of MSM. Users of a popular geosocial-networking app in Paris were provided an advertisement with text encouraging them to complete an anonymous web-based survey ( n = 580), which included questions about sex-seeking venues, condomless anal intercourse, HIV status and STI history, and sociodemographic characteristics. A log-binomial model was used to assess association between venues (i.e. public venues [gay clubs, bars, and discos], cruising venues [such as gay saunas, beaches, and parks], and internet-based venues [internet chat sites and geosocial-networking apps]), condomless anal intercourse, engagement in group sex, and HIV infection as well as infection with other STIs, after adjustment for sociodemographics. In multivariable models, attending cruising venues was associated with condomless receptive anal intercourse (adjusted relative risk [aRR] = 1.47; 95% confidence interval [CI] = 1.20–1.81), any kind of condomless anal intercourse (aRR = 1.34; 95% CI = 1.14–1.58), an STI (aRR = 1.50; 95% CI = 1.09–2.05), engagement in group sex (aRR = 1.42; 95% CI = 1.27–1.59), and multiple partners for both condomless insertive (aRR = 2.00; 95% CI = 1.38–2.88), and receptive (aRR = 1.70; 95% CI = 1.23–2.36) anal intercourse, STI infection (aRR = 1.50, 95% CI = 1.09–2.05) and HIV infection (aRR = 1.76; 95% CI = 1.05–2.96). No associations were found with other venue types and sexual risk behaviors, STIs, and HIV infection, except for group sex, which was associated with all venue types. Use of cruising where the primary aim is to have sex was found to be associated with risky sexual behavior. Risky behavior reduction strategies such as preexposure prophylaxis campaigns should be targeted to MSM who frequent cruising venues.

Download Full-text

Sexual risk behaviour and its determinants among men who have sex with men in Catalonia, Spain

Eurosurveillance ◽

10.2807/ese.14.47.19415-en ◽

2009 ◽

Vol 14 (47) ◽

Cited By ~ 29

Author(s):

C Folch ◽

R Muñoz ◽

K Zaragoza ◽

J Casabona

Keyword(s):

Sexual Risk ◽

Latin American ◽

Casual Sex ◽

Hiv Positive ◽

Sexual Risk Behaviour ◽

Risk Behaviours ◽

Convenience Sample ◽

Sti Prevention ◽

Sex With Men ◽

The Impact

To evaluate the prevalence of sexual risk behaviours among men who have sex with men (MSM) in Catalonia and to identify sociodemographic, psychosocial, and behavioural factors associated with unprotected anal intercourse (UAI) with casual partners a convenience sample of 850 MSM was recruited in 2006. An anonymous questionnaire was used to explore risk behaviours during the previous 12 months. Logistic regression models were used to examine the variables associated with UAI. Mean age was 41 years and 20.4% were immigrants. Among those with casual partners (91.7% of all respondents), 31.4% had UAI. The multivariate analysis revealed that the likelihood of UAI was higher in men who were HIV-positive (OR: 1.77), used more than four drugs before sex (OR: 4.90 for +6), were not from Spain (OR: 2.10 for Latin American; OR: 1.86 for other immigrants), had more than 20 sexual partners (OR: 1.56), met casual sex partners on the Internet (OR:1.45) and presented a high level of internalised homophobia (OR: 2.40). HIV/STI prevention programmes for MSM in Catalonia should incorporate activities that strengthen self-esteem, take into account the impact of internalised homophobia, and adapt to the sociocultural reality of immigrants. Furthermore, these programmes should also address substance abuse and alert HIV-positive men about the risk of HIV re-infection and transmission of other STI.

Download Full-text

Hepatitis C Virus Seroconversion among Hiv-Positive Men Who Have Sex with Men with No History of Injection Drug Use: Results from a Clinical Hiv Cohort

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2015/689671 ◽

2015 ◽

Vol 26 (1) ◽

pp. 17-22 ◽

Cited By ~ 18

Author(s):

Ann N Burchell ◽

Sandra L Gardner ◽

Tony Mazzulli ◽

Michael Manno ◽

Janet Raboud ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Drug Use ◽

Injection Drug Use ◽

Injection Drug ◽

Hiv Care ◽

Hiv Positive ◽

History Of ◽

Sex With Men ◽

Hiv Positive Men

BACKGROUND: Internationally, there is a growing recognition that hepatitis C virus (HCV) may be sexually transmitted among HIV-positive men who have sex with men (MSM).OBJECTIVE: To report the first Canadian estimate of HCV seroincidence in 2000 to 2010 and its risk factors among HIV-positive MSM with no known history of injection drug use.METHODS: Data from the Ontario HIV Treatment Network Cohort Study, an ongoing cohort of individuals in HIV care in Ontario, were analyzed. Data were obtained from medical charts, interviews and record linkage with the provincial public health laboratories. The analysis was restricted to 1534 MSM who did not report injection drug use and had undergone ≥2 HCV antibody tests, of which the first was negative (median 6.1 person-years [PY] of follow-up; sum 9987 PY).RESULTS: In 2000 to 2010, 51 HCV seroconversions were observed, an overall incidence of 5.1 per 1000 PY (95% CI 3.9 to 6.7). Annual incidence varied from 1.6 to 8.9 per 1000 PY, with no statistical evidence of a temporal trend. Risk for seroconversion was elevated among men who had ever had syphilis (adjusted HR 2.5 [95% CI 1.1 to 5.5) and men who had acute syphilis infection in the previous 18 months (adjusted HR 2.8 [95% CI 1.0 to 7.9]). Risk was lower for men who had initiated antiretroviral treatment (adjusted HR 0.49 [95% CI 0.25 to 0.95]). There were no statistically significant effects of age, ethnicity, region, CD4 cell count or HIV viral load.CONCLUSIONS: These findings suggest that periodic HCV rescreening may be appropriate in Ontario among HIV-positive MSM. Future research should seek evidence whether syphilis is simply a marker for high-risk sexual behaviour or networks, or whether it potentiates sexual HCV transmission among individuals with HIV.

Download Full-text