scholarly journals Pilot implementation of a home-care programme with chlamydia, gonorrhoea, hepatitis B, and syphilis self-sampling in HIV-positive men who have sex with men

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
J. Leenen ◽  
C. J. P. A. Hoebe ◽  
R. P. Ackens ◽  
D. Posthouwer ◽  
I. H. M. van Loo ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Home Care ◽  
Hiv Care ◽  
Hiv Positive ◽  
Successful Implementation ◽  
Care Providers ◽  
Care Programme ◽  
Home Setting ◽  
Blood Samples ◽  
Sex With Men

Abstract Background Not all men who have sex with men (MSM) at risk for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) infection currently receive sexual healthcare. To increase the coverage of high-quality HIV/STI care for MSM, we developed a home-care programme, as extended STI clinic care. This programme included home sampling for testing, combined with treatment and sexual health counselling. Here, we pilot implemented the programme in a hospital setting (HIV-positive MSM) to determine the factors for the successful implementation of STI home sampling strategies. Methods Healthcare providers from the HIV hospital treatment centre (Maastricht) were invited to offer free STI sampling kits (syphilis, hepatitis B, [extra]genital chlamydia and gonorrhoea laboratory testing) to their HIV-positive MSM patients (March to May 2018). To evaluate implementation of the program, quantitative and qualitative data were collected to assess adoption (HIV care providers offered sampling kits to MSM), participation (MSM accepted the sampling kits) and sampling-kit return, STI diagnoses, and implementation experiences. Results Adoption was 85.3% (110/129), participation was 58.2% (64/110), and sampling-kit return was 43.8% (28/64). Of the tested MSM, 64.3% (18/28) did not recently (< 3 months) undergo a STI test; during the programme, 17.9% (5/28) were diagnosed with an STI. Of tested MSM, 64.3% (18/28) was vaccinated against hepatitis B. MSM reported that the sampling kits were easily and conveniently used. Care providers (hospital and STI clinic) considered the programme acceptable and feasible, with some logistical challenges. All (100%) self-taken chlamydia and gonorrhoea samples were adequate for testing, and 82.1% (23/28) of MSM provided sufficient self-taken blood samples for syphilis screening. However, full syphilis diagnostic work-up required for MSM with a history of syphilis (18/28) was not possible in 44.4% (8/18) of MSM because of insufficient blood sampled. Conclusion The home sampling programme increased STI test uptake and was acceptable and feasible for MSM and their care providers. Return of sampling kits should be further improved. The home-care programme is a promising extension of regular STI care to deliver comprehensive STI care to the home setting for MSM. Yet, in an HIV-positive population, syphilis diagnosis may be challenging when using self-taken blood samples.

scholarly journals The reporting of the mode of transmission among HIV-positive men who have sex with men in Lviv oblast, Ukraine, 2014-2018

2020 ◽  
Vol 14 (11.1) ◽  
pp. 122S-127S
Author(s):  
Maryana Sluzhynska ◽  
Olga Denisiuk ◽  
Ruzanna Grigoryan ◽  
Yulia Sereda ◽  
Gennadiy Slabkiy ◽  
...  
Keyword(s):  
Urban Areas ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Medical Doctor ◽  
Hiv Care ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Aids Epidemic ◽  
Mode Of Transmission ◽  
Sex With Men

Introduction: Men who have sex with men (MSM) are one of the key populations driving HIV/AIDS epidemic globally. To date, MSM is the only population in Ukraine where the prevalence and incidence of HIV is increasing. As HIV-positive MSM might feel uncomfortable to report homosexual intercourses as a possible mode of transmission (MoT) of HIV, they prefer being registered as patients with heterosexual or non-defined MoT. This study aimed to calculate the proportion of misclassified MoT among HIV-positive MSM registered in Lviv oblast, Ukraine, during 2014-2018. Methodology: Cross-sectional study with 127 HIV-positive MSM patients from Lviv region for the period of 2014-2018. Results: Out of 127 HIV-positive MSM included in the study, 110 (86.6%) were from urban areas. In addition, 52 patients (40.9%) were diagnosed with stage 1 HIV, 16 (12.6%) – stage 2, 19 (15%) – stage 3, and 36 (28.3%) – stage 4. CD4 count < 200 cells/μL was found in 35 (27.6%) patients. Mean time from registration to antiretroviral therapy initiation was 80 days. During the first visit to medical doctor out of those 48 patients who had previously reported “other modes” of HIV transmission, 33 patients (68.7%) disclosed homosexual MoT of HIV. The remaining 15 (31.3%) patients disclosed their homosexual MoT of HIV later – during their regular follow-up visits to the doctor. Conclusion: Special measures are needed to improve the reporting of homosexual MoT which can potentially strengthen the HIV care among MSM.

scholarly journals Do HIV Care Providers Appropriately Manage Hepatitis B in Coinfected Patients Treated with Antiretroviral Therapy?

2007 ◽  
Vol 44 (7) ◽  
pp. 996-1000 ◽  
Author(s):  
M. K. Jain ◽  
C. K. Opio ◽  
C. C. Osuagwu ◽  
R. Pillai ◽  
P. Keiser ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hepatitis B ◽  
Hiv Care ◽  
Care Providers

A qualitative study of Thai HIV-positive young men who have sex with men and transgender women demonstrates the need for eHealth interventions to optimize the HIV care continuum

AIDS Care ◽  
2017 ◽  
Vol 29 (7) ◽  
pp. 870-875 ◽  
Author(s):  
Tarandeep Anand ◽  
Chattiya Nitpolprasert ◽  
Stephen J. Kerr ◽  
Kathryn E. Muessig ◽  
Sangusa Promthong ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Young Men ◽  
Transgender Women ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Sex With Men

Survival of HIV-positive individuals with hepatitis B and C infection in Michigan

2013 ◽  
Vol 142 (10) ◽  
pp. 2131-2139 ◽  
Author(s):  
Z. A. BUTT ◽  
M. J. WILKINS ◽  
E. HAMILTON ◽  
D. TODEM ◽  
J. C. GARDINER ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Drug Users ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Hiv Positive ◽  
Hiv Status ◽  
Proportional Hazards Regression ◽  
Sex With Men

SUMMARYWe sought to estimate mortality and associated factors in HIV-hepatitis co-infected individuals in Michigan using a retrospective cohort study. For the study period of 1 January 2006 to 31 December 2009, all HIV-infected individuals were matched to hepatitis B and C cases. In the final Cox proportional hazards regression model, individuals of other [hazard ratio (HR) 2·2, 95% confidence interval (CI) 1·4–3·2] and black (HR 1·3, 95% CI 1·1–1·6) race had decreased survival compared to white race. Similarly, injecting drug users (IDUs) (HR 2·1, 95% CI 1·6–2·6), men who have sex with men (MSM)/IDUs (HR 1·5, 95% CI 1·1–2·2), individuals with undetermined risk (HR 1·5, 95% CI 1·2–1·9) and heterosexual practices (HR 1·4, 95% CI 1·1–1·8) had decreased survival compared to MSM. Additionally, an interaction was found between current HIV status and co-infection. Mortality in HIV-hepatitis co-infected individuals remains a continuing problem. Our study can help in planning interventions to reduce mortality in HIV-infected individuals.

scholarly journals A Gamified Smartphone App to Support Engagement in Care and Medication Adherence for HIV-Positive Young Men Who Have Sex With Men (AllyQuest): Development and Pilot Study (Preprint)

2017 ◽  
Author(s):  
Lisa Hightow-Weidman ◽  
Kathryn Muessig ◽  
Kelly Knudtson ◽  
Mala Srivatsa ◽  
Ellena Lawrence ◽  
...  
Keyword(s):  
Pilot Trial ◽  
Young Men ◽  
Hiv Care ◽  
Smartphone App ◽  
Hiv Positive ◽  
Art Adherence ◽  
Engagement In Care ◽  
Care Needs ◽  
Advisory Boards ◽  
Sex With Men

BACKGROUND HIV disproportionately impacts young men who have sex with men (YMSM) who experience disparities across the HIV care continuum. Addressing antiretroviral therapy (ART) adherence among YMSM is an urgent public health priority. Technology-based interventions—particularly mobile health platforms—can provide tailored adherence interventions and allow YMSM to engage and connect with others. OBJECTIVE The objective of this study was to describe the development of AllyQuest, a novel, theoretically-based, smartphone app designed to improve engagement in care and ART adherence and social support among HIV-positive YMSM. METHODS AllyQuest was built on an established platform for patient engagement that embeds social networking and fundamental game mechanics, such as challenges, points, and rewards. A medication tracker provides reminders to promote ART adherence via personalized adherence strategies that are user and context specific; a calendar allows for reflection on adherence over time. After iterative development with input from two youth advisory boards, usability testing was conducted to assess app functionality, comprehension of the educational content, use of intervention features, and overall impressions of app relevance and appeal. A 28-day pilot trial was conducted with 20 HIV+ YMSM to evaluate intervention feasibility and acceptability. RESULTS Mean age of participants was 21.8 years (range 19-24), and 95% (19/20) of the participants were nonwhite. The mean time of app use was 158.4 min (SD 114.1), with a range of 13 to 441 min. There was a mean of 21.2 days of use (out of a total possible 28 days). There were 222 posts to the daily discussion social wall. Feasibility and acceptability ratings were high. Overall, participants found the app easy to use and navigate, not intrusive, and had few reported technical issues. Higher levels of app usage were positively correlated with HIV self-management outcomes, and there was a statistically significant (P<.05) positive association between the number of days logged into the app and knowledge and confidence in ability to reliably take HIV medications. CONCLUSIONS AllyQuest represents a new, highly scalable solution that is well-suited to meet the specific prevention and care needs of HIV+ YMSM. The development of this intervention is both timely and vital, given the urgency of the ongoing HIV epidemic among YMSM.

scholarly journals Prescribing of Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis by HIV Medical Providers in the United States, 2013–2014

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
John Weiser ◽  
Shikha Garg ◽  
Linda Beer ◽  
Jacek Skarbinski
Keyword(s):  
Human Immunodeficiency Virus ◽  
Prevalence Ratio ◽  
The United States ◽  
Hiv Care ◽  
Care Providers ◽  
Persons Who Inject Drugs ◽  
Provider Characteristics ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Exposure Prophylaxis

Abstract Background Clinical trials have demonstrated the effectiveness of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) for reducing HIV acquisition. Understanding how HIV care providers are prescribing PrEP is necessary to ensure success of this prevention strategy. Methods During 2013–2014, we surveyed US HIV care providers who also provided care to HIV-negative patients. We estimated percentages who had prescribed PrEP and assessed associations between provider characteristics and PrEP prescribing. Results An estimated 26% (95% confidence interval [CI], 20–31) had ever prescribed PrEP. Of these, 74% (95% CI, 61–87) prescribed for men who have sex with men (MSM), 30% (95% CI, 21–39) for women who have sex with men, 23% (95% CI, 9–37) for men who have sex with women, 23% (95% CI, 15–30) for uninfected partners in HIV-discordant couples trying to conceive, and 1% (95% CI, 0–2) for persons who inject drugs. The following provider characteristics were significantly associated with having prescribed PrEP: male vs female (32% vs 16%; adjusted prevalence ratio [aPR], 1.5; 95% CI, 1.0–2.2), lesbian/gay/bisexual vs heterosexual orientation (50% vs 21%; aPR, 2.0; 95% CI, 1.3–2.9), and HIV caseload (&gt;200, 51–200, and ≤50 patients, 39%, 29%, and 14%, respectively; &gt;200 vs ≤50 patients, aPR 2.4, 95% CI 1.1–5.2, and 51–200 vs ≤50 patients, aPR 2.2, 95% CI 1.2–4.0). Conclusions In 2013–2014, one quarter of HIV care providers reported having prescribed PrEP, most commonly for MSM and rarely for persons who inject drugs. Lesbian/gay/bisexual providers and male providers were more likely than others to have prescribed PrEP. Additional efforts may enable more providers to prescribe PrEP to underserved clients needing the service.

Risk behaviours in HIV-positive men who have sex with men participating in an intervention in a primary care setting

2009 ◽  
Vol 20 (9) ◽  
pp. 607-612 ◽  
Author(s):  
L H Bachmann ◽  
D M Grimley ◽  
H Chen ◽  
I Aban ◽  
J Hu ◽  
...  
Keyword(s):  
Transtheoretical Model ◽  
Readiness To Change ◽  
Risk Behaviour ◽  
Unprotected Sex ◽  
Hiv Care ◽  
Hiv Positive ◽  
Partner Status ◽  
Unknown Status ◽  
Sex With Men ◽  
Hiv Negative

Men who have sex with men receiving HIV care reported their sexual behaviours and their intentions, classified according to the Transtheoretical Model of Change, to modify the following behaviours: (1) condom use by partner type and activity type; (2) reduction of partner number; and (3) disclosure of HIV serostatus to partners. Most participants were white (68.8%) or black (29.5%) and were more likely to report unprotected sex with HIV-positive than with serodiscordant partners for most activities. Whites reported more partners than black patients (mean 4.1 versus 2; P < 0.0001) and black participants reported fewer HIV-negative ( P = 0.0084) and -unknown status partners ( P = 0.00095) than whites. Cocaine/crack use was associated with more sexual partners ( P = 0.001) and more frequent unprotected sex with HIV-negative or -unknown status partners ( P = 0.036). Readiness to change risk behaviour varied by partner status and type of sexual activity. Understanding patients' risks and their readiness to change behaviours may help providers to promote sexual health.

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