scholarly journals Barriers to using HIV pre-exposure prophylaxis (PrEP) and sexual behaviour after stopping PrEP: a cross-sectional study in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Uwe Koppe ◽  
Ulrich Marcus ◽  
Stefan Albrecht ◽  
Klaus Jansen ◽  
Heiko Jessen ◽  
...  
Keyword(s):  
Side Effects ◽  
Condom Use ◽  
Sexual Behaviour ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Chemical Substance ◽  
Inconsistent Condom ◽  
Cross Sectional ◽  
Exposure Prophylaxis ◽  
Inconsistent Condom Use

Abstract Background Persistence of individuals at risk of HIV with Pre-Exposure Prophylaxis (PrEP) is critical for its impact on the HIV epidemic. We analysed factors associated with stopping PrEP, barriers that may deter people from continuing PrEP and investigated sexual behaviour after stopping PrEP. Methods Current and former PrEP users in Germany were recruited to complete an anonymous online survey on PrEP use and sexual behaviour. Participants were recruited through dating apps, a PrEP community website, anonymous testing sites and peers. The results were analysed using descriptive methods and logistic regression. Results We recruited 4848 current and 609 former PrEP users in two study waves (July–October 2018, April–June 2019). Former PrEP users were more likely 18–29 years old than current users (adjusted OR = 1.6, 95% confidence interval (CI) 1.1–2.3). Moreover, they were more often unhappy with their sex life, which was more pronounced in former daily PrEP users (aOR = 4.5, 95% CI 2.9–7.1) compared to former on-demand users (aOR = 1.8, 95% CI 1.1–2.9, pinteraction = 0.005). The most common reason for stopping PrEP was a reduced need for PrEP (49.1%). However, 31.4% of former users identified logistic reasons and 17.5% stopped due to side effects. Former PrEP users using PrEP < 3 months were more likely to stop PrEP due to concerns over long-term side effects (32.0% vs. 22.5%, p = 0.015) and not wanting to take a chemical substance (33.2% vs. 24.0%, p = 0.020) compared to former PrEP users who used PrEP for longer. After stopping PrEP, 18.7% of former PrEP users indicated inconsistent condom use while having ≥4 sex partners within the previous 6 months. Former PrEP users with many partners and inconsistent condom use more often indicated logistic reasons for stopping (46.5% vs. 27.9%, p < 0.001) than did other former PrEP users. Conclusions To maximise persistence with PrEP we need to develop strategies for younger PrEP users, reduce logistic barriers to access PrEP, and to develop effective communication on side-effect management. Moreover, prevention strategies for people stopping PrEP are required, since some remain at high risk for HIV.

scholarly journals Correlates of inconsistent condom use and drug use among men having sex with men in Poland: a cross-sectional study

2020 ◽  
Vol 31 (9) ◽  
pp. 894-902
Author(s):  
Krzysztof Piersiala ◽  
Joanna Krajewski ◽  
Daniela Dadej ◽  
Anna Loroch ◽  
Witold Czerniak ◽  
...  
Keyword(s):  
Drug Use ◽  
Condom Use ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Sexual Partners ◽  
Inconsistent Condom ◽  
Cross Sectional ◽  
Sti Prevention ◽  
Sex With Men ◽  
Inconsistent Condom Use

The number of new human immunodeficiency virus (HIV) diagnoses is rising in many parts of Europe. We sought to evaluate the rising prevalence of new HIV diagnoses in Poland, where the majority of newly-diagnosed HIV cases are men having sex with men (MSM). This study aims to measure the prevalence of condom use and drug use and to identify risk factors for contracting sexually transmitted infections (STIs) among MSM in Poland by distributing an anonymous online survey aimed toward MSM. Among the 1438 participants who completed valid surveys, those with low education level and greater than 100 prior sexual partners showed the highest odds for inconsistent condom use (adjusted odds ratio [aOR] 3.027, 2.044, respectively). Participants who identified themselves as heterosexuals, with multiple sexual partners and living in big cities showed the highest odds for drug use (aOR 4.869, 3.305, 1.720, respectively). This study identifies groups at the highest risk of HIV/STIs and provides valuable information for public health experts to develop targeted STI prevention campaigns.

scholarly journals Sexualized Drug Use Among Female Sex Workers From Eight Cities in China: a Cross-sectional Study

2021 ◽  
Author(s):  
Jason Ong ◽  
Mingzhou Xiong ◽  
Joseph D. Tucker ◽  
Yajie Wang ◽  
M. Kumi Smith ◽  
...  
Keyword(s):  
Drug Use ◽  
Condom Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Inconsistent Condom ◽  
Cross Sectional ◽  
History Of ◽  
Inconsistent Condom Use

Abstract Background There is rich literature on sexualized drug use (i.e. drug use before or during sex) for men who have sex with men but less data from female sex workers (FSW) particularly from low- and middle-income countries. We describe the sexual and reproductive health outcomes in FSW reporting sexualized drug use.Methods We conducted a cross-sectional study in eight cities from seven provinces in China (2019). We recruited FSW through community organizations working with sex workers, and included those who were age 18 years or above; exchanged sex at least once for money or goods in the past three months. Multivariable logistic regression models were used.Results In total, 1287 women participated: average age was 35.1 years (SD 10.3), 52.4% reported a monthly income over 5000 RMB ($USD 707), and 17.4% completed high school or above. Among participants, 284 (22.1%, 95%CI:19.8-24.4) reported a history of sexualized drug use. Compared to FSW who never reported a history of sexualized drug use, FSW who reported a history of sexualized drug use had greater odds of: reporting inconsistent condom use for vaginal sex (AOR 2.67, 95%CI:1.93-3.69), inconsistent condom use for oral sex (AOR 2.33, 95%CI:1.25-4.37), ever had an unintended pregnancy (AOR 1.43, 95%CI:1.04-1.96), and ever diagnosed with STIs (AOR 5.39, 95%CI:3.92-7.40).Conclusion We recommend routinely asking FSW about sexualized drug use as nearly one in five FSW reported a history of sexualized drug use and these women had an elevated risk profile compared with those who reported no sexualized drug use.

scholarly journals Profilaxia Pré-Exposição para o Vírus da Imunodeficiência Humana no Currículo Médico em Portugal: Uma Análise Transversal

2022 ◽  
Vol 35 (13) ◽  
Author(s):  
Francisco Duarte ◽  
Nuno Rua ◽  
David Gomes ◽  
Vasco Ricoca Peixoto ◽  
Daniela Azevedo ◽  
...  
Keyword(s):  
Medical Students ◽  
Online Survey ◽  
Descriptive Analysis ◽  
Medical Schools ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
School Year ◽  
Exposure Prophylaxis

Introduction: Pre-exposure prophylaxis (PrEP) has gained relevance as a method of prevention for HIV in certain people and settings. Following the publication of the guideline on PrEP prescribing in Portugal, we aimed to assess the knowledge of Portuguese Medical Students about PrEP.Material and Methods: An online survey was sent to Medical students of Portuguese Medical Schools. We conducted a descriptive analysis of the results and an analytic cross-sectional study to identify factors associated with “knowing about PrEP”, “having had one class about PrEP” and “identifying eligible groups correctly”.Results: Of the 796 students that responded to the survey, 64.6% were aware of what PrEP is. Of these, 34.44% acquired this knowledge during their training. Out of the total amount of respondents, 4.77% could identify correctly and completely the eligible groups for PrEP. As the training years went by, the probability of being aware of PrEP, having had one class about PrEP, and identifying the eligible groups correctly, increased. Of the sixth-year students, 43.48% had had one class about PrEP and among the students that were aware of PrEP, 28% identified what the eligible groups were. After adjusting for the school year, we found differences between Medical Schools regarding the outcomes. The association between the different ways of learning about PrEP and the ability to correctly identify eligible groups for PrEP was not statistically significant.Conclusion: The differences between Medical Schools could be harmonized through changes in the medical curricula that would allow this topic to be addressed more often.

scholarly journals Applying the Behavioral Model for Vulnerable Populations to Pre-Exposure Prophylaxis Initiation Among Women Who Inject Drugs

2020 ◽  
Vol 32 (6) ◽  
pp. 486-492
Author(s):  
Marisa Felsher ◽  
Scarlett Bellamy ◽  
Brogan Piecara ◽  
Barbara Van Der Pol ◽  
Rose Laurano ◽  
...  
Keyword(s):  
Condom Use ◽  
Vulnerable Populations ◽  
Behavioral Model ◽  
Chi Square ◽  
Inconsistent Condom ◽  
Factors Associated ◽  
Women Who Inject Drugs ◽  
Exposure Prophylaxis ◽  
Gender Specific ◽  
Inconsistent Condom Use

This study used Behavioral Model for Vulnerable Populations (BMVP) to identify factors associated with pre-exposure prophylaxis (PrEP) initiation among women who inject drugs (WWID) when PrEP was offered at a syringe services program (SSP). Participants (n = 89) were WWID, $ge18 years, and eligible for PrEP. Most (69) initiated PrEP. Chi square and t tests were used to identify bivariate relationships between BMVP factors and PrEP initiation. A greater proportion of PrEP initiators (compared to non-initiators) reported sexual assault, frequent SSP attendance, earning $ge$5,000 annually and inconsistent condom use. Findings can inform the development of gender-specific strategies to promote PrEP among WWID.

scholarly journals Knowledge, attitude and practices of medical and health science students on the antiretroviral based HIV post-exposure prophylaxis in an Ethiopian hospital: an institutional based cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Betelhem Anteneh ◽  
Sewunet Admasu Belachew ◽  
Alem Endeshaw ◽  
Zewdu Birhanu Wubneh ◽  
Barun Ranjan Sarkar
Keyword(s):  
Side Effects ◽  
Cross Sectional Study ◽  
Health Science ◽  
Post Exposure Prophylaxis ◽  
Science Students ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Science Students ◽  
Post Exposure ◽  
Exposure Prophylaxis

Abstract Background HIV/AIDS in resource-limited settings poses a high risk of occupational exposure to healthcare workers due to higher number of HIV infected patients. Hence, antiretroviral based post-exposure prophylaxis (PEP) for HIV is very crucial. The aim of the study was to determine the knowledge, attitudes, and practices of medical and Health science students on antiretroviral based HIV PEP in University of Gondar comprehensive specialized hospital (UOGCSH), Northwestern Ethiopia. Methods An institutional-based cross-sectional study was conducted among 220 medical and health science graduating students in UOGCSH from May to July 2015. Data were collected using a self-administered pretested questionnaire. The collected data were analyzed using SPSS software version 22. Results were summarized in frequencies, percentages, and means with standard deviations and presented using tables or figures. Results Among the respondents, only sixty-six (30%) of the 220 study participants has had adequate knowledge about HIV PEP. Furthermore, over 90 % of the students had positive attitude towards HIV PEP f. Out of the total respondents, 37/220 (16.8%) were in need of HIV PEP and of these students only 18/37 (48.6%) took PEP. On the other hand, merely 50% of the study subjects completed the full course of HIV PEP, while the rest 50% failed to finish. As to the respondents self-report, the sole reason for starting but failing to complete the full course of HIV PEP was intolerance to the side effects of antiretroviral. Conclusions Although majority of the respondents had poor knowledge and practice, they owned a good attitude towards HIV PEP. Therefore, a pre-service intensive training for all students regarding HIV PEP prior to their clinical attachments is mandatory. In addition, potential side effects of ARTs and its managements should be priory informed to the students so as to prevent the associated non-adherence to ultimately reduce the incidence of drug resistance. Moreover, the habit of needle stick injury reporting was found to be poor that needs due improvement and there has been also a pressing need to supply sufficient protective barriers to the students while planning and rendering services.

scholarly journals Inconsistent condom use between serodifferent sexual partnerships to the human immunodeficiency virus

2019 ◽  
Vol 27 ◽  
Author(s):  
Renata Karina Reis ◽  
Elizabete Santos Melo ◽  
Nilo Martinez Fernandes ◽  
Marcela Antonini ◽  
Lis Aparecida de Souza Neves ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Condom Use ◽  
Consistent Condom ◽  
Bivariate Analysis ◽  
Treatment As Prevention ◽  
Sexual Partnership ◽  
Inconsistent Condom ◽  
Cross Sectional ◽  
Immunodeficiency Virus ◽  
Inconsistent Condom Use

Objective: to analyze predictors of inconsistent condom use among HIV-positive people with sexual immunodeficiency virus serodifferent sexual partnership. Method: cross-sectional, analytical study with a consecutive non-probabilistic sample consisting of people living with the human immunodeficiency virus with serodifferent sexual partnership and who were in outpatient clinical follow-up. Data were collected through individual interviews guided by a semi-structured questionnaire and subsequently analyzed with bivariate analysis and logistic regression. Results: Seven variables were independently associated with inconsistent condom use. Schooling less than 11 years of schooling (4.9 [2.4-10.1]), having multiple partnerships (5.0 [1.3-19.6]), using alcohol (2.1 [1.1 -4.4]) or other drugs (2.8 [1.2-6.3]), do not receive advice from a healthcare professional (2.0 [1.1-3.9]), have no knowledge of treatment as prevention (3.0 [1,2-6,9]) and not knowing that undetectable viral load reduces the risk of human immunodeficiency virus transmission (3.8 [1,1-13,7]) were predictors for inconsistent condom use. Conclusion: The study showed that psychosocial factors interfere with consistent condom use between serodifferent partnerships. Thus, it is highlighted that there is a need for comprehensive interventions that include the integration of clinical and psychosocial care.

scholarly journals 1282. A Major Hurdle for HIV Elimination: How Do We Promote Pre-Exposure Prophylaxis Persistence among Men Who Have Sex with Men in the Deep South?

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S461-S462
Author(s):  
Ronnie M Gravett ◽  
Andrew O Westfall ◽  
Kachina Kudroff ◽  
Edgar T Overton ◽  
Jeanne Marrazzo
Keyword(s):  
Condom Use ◽  
Deep South ◽  
Initial Visit ◽  
Inconsistent Condom ◽  
Patient Reported ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
Inconsistent Condom Use

Abstract Background Pre-Exposure Prophylaxis (PrEP) effectively prevents HIV acquisition in men who have sex with men (MSM), if taken appropriately. Effective PrEP requires persistence in PrEP care. We defined the PrEP care continuum in a Deep South PrEP clinic and examined factors related to persistence in care among MSM. Methods We reviewed data for MSM at a university-affiliated PrEP clinic in Birmingham, AL from 2014–2018 to define the PrEP continuum at five major steps: screening, initial visit, follow-up visit, current persistence, and self-reported adherence. We defined persistence as attending a PrEP clinic visit in the last 6 months and nonpersistence as prior attendance without a visit in the last 6 months. We compared demographics, insurance status, and patient-reported behaviors from initial and most recent visits between those who persisted (“persisters”) and did not (“non-persisters”) using Wilcoxon rank sum, chi-square, or Fisher’s exact test. Results 226 (100%) MSM were screened, 141 (62%) MSM attended an initial visit, 116 (51%) MSM attended follow-up, 43 (19.0%) persisted in PrEP care, and 29 (13%) MSM self-reported good adherence (figure). Among 139 MSM (46 persisters, 93 nonpersisters), persisters were older than nonpersisters (33 vs. 32 yr, P = 0.03), and were less likely to report inconsistent condom use at their initial visit (48% vs. 73%; P = 0.01) as compared with their last visit (69% vs. 63%, P = 0.13). 23% of persisters and 29% of nonpersisters were black (P = 0.39), and 98% of persisters and 90% of nonpersisters were insured (P = 0.50). 60% of persisters and 74% of nonpersisters had multiple sex partners at initial visit (P = 0.19) as compared with 56% and 60% at their last visit, respectively (P = 0.83). Conclusion At a Deep South PrEP clinic, persistence overall was poor for MSM. More nonpersisters had inconsistent condom use, indicating higher risk despite nonpersistence. Although not statistically significant, nonpersisters were more likely to be black, uninsured, and have multiple sexual partners when compared with persisters. Disparities seen nationally in new HIV diagnoses are reflected in nonpersisters. Nonpersisters may not realize the extent of their risk of HIV acquisition and warrant intensive engagement interventions. Disclosures All authors: No reported disclosures.

Age differences in attitudes toward safer sex practices in heterosexual men using an Australian Internet dating service

Sexual Health ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 223 ◽  
Author(s):  
Yan Cheng ◽  
Kevin McGeechan ◽  
Deborah Bateson ◽  
Todd Ritter ◽  
Edith Weisberg ◽  
...  
Keyword(s):  
Condom Use ◽  
Online Survey ◽  
Safer Sex ◽  
Older Men ◽  
Cross Sectional Study ◽  
Heterosexual Men ◽  
Cross Sectional ◽  
Internet Dating ◽  
Factors Associated ◽  
Younger Men

Background This cross-sectional study investigated sexually transmissible infection (STI) knowledge, safer sex attitudes and behaviours of sexually active, heterosexual men using an Internet dating service, and explored factors associated with protective attitudes. Methods: An anonymous online survey was sent to men who had logged onto an Internet dating service within the previous year. Factors associated with discussing STIs before sex and condom use intention with a new partner were analysed. Results: In total, 2339 responses were analysed. Men had lower STI knowledge scores, lower use of condoms and greater beliefs that condoms reduced interest in sex as age increased. Younger men (aged 18–29 years) were more likely to report intentions of only having sex with a new partner if a condom was used compared with older men aged over 60 years. Predictors of having a discussion about STIs with a new partner were older age, better knowledge of STIs, greater distress at a potential diagnosis of an STI and stronger future condom use intention. Intention to only have sex with a new female partner if a condom was used was associated with higher STI knowledge, discussing STIs with a new partner and distress at a diagnosis of an STI. Men with a higher number of sexual partners in the last year were less likely to have an STI discussion with new partners or intend to use a condom with a new partner. Conclusions: Older Internet-dating, heterosexual men are vulnerable to STIs. Health promotion interventions to increase STI awareness, condom use and STI testing in older men are warranted.

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