scholarly journals Adherence to quarterly HIV prevention services and its impact on HIV incidence in men who have sex with men in West Africa (CohMSM ANRS 12324 – Expertise France)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ter Tiero Elias Dah ◽  
◽  
Issifou Yaya ◽  
Luis Sagaon-Teyssier ◽  
Alou Coulibaly ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
West Africa ◽  
Hiv Infections ◽  
Estimating Equation ◽  
Hiv Incidence ◽  
Sexually Transmitted ◽  
Prevention Services ◽  
Medical Visits ◽  
Sex With Men

Abstract Background Access to tailored HIV prevention services remains limited for West African MSM. We assessed adherence to quarterly HIV prevention services and its impact on HIV incidence in MSM followed up in four cities in Burkina Faso, Côte d’Ivoire, Mali, and Togo. Methods We performed a prospective cohort study between 2015 and 2018. HIV-negative MSM aged over 18 benefited from quarterly medical visits which included a clinical examination, HIV testing, screening and treatment for other sexually transmitted infections, peer-led counselling and support, and the provision of condoms and lubricants. Determinants of adherence to quarterly follow-up visits and incident HIV infections were identified using generalized estimating equation models and Cox proportional hazard models, respectively. Results 618 MSM were followed up for a median time of 20.0 months (interquartile range 15.2–26.3). Overall adherence to quarterly follow-up visits was 76.5% (95% confidence interval [CI] 75.1–77.8), ranging from 66.8% in Abidjan to 87.3% in Lomé (p < 0.001). 78 incident HIV infections occurred during a total follow-up time of 780.8 person-years, giving an overall incidence of 10.0 per 100 person-years (95% CI 8.0–12.5). Adherence to quarterly follow-up visits was not associated with the risk of incident HIV infection (adjusted hazard ratio 0.80, 95% CI 0.44–1.44, p = 0.545). Conclusions Strengthening HIV prevention services among MSM in West Africa, including the use of PrEP, will be critical for controlling the epidemic, not only in this key population but also in the general population. Quarterly follow-up of MSM, which is essential for PrEP delivery, appears feasible. Trial registration ClinicalTrials.gov, number NCT02626286 (December 10, 2015).

scholarly journals Adherence to quarterly HIV prevention services and its impact on HIV incidence in men who have sex with men in West Africa (CohMSM ANRS 12324 – Expertise France)

2020 ◽  
Author(s):  
Ter Tiero Elias DAH ◽  
Issifou Yaya ◽  
Luis Sagaon-Teyssier ◽  
Alou Coulibaly ◽  
Malan Jean-Baptiste Kouamé ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
West Africa ◽  
Hiv Infections ◽  
Estimating Equation ◽  
Hiv Incidence ◽  
Sexually Transmitted ◽  
Prevention Services ◽  
Medical Visits ◽  
Sex With Men

Abstract BackgroundAccess to tailored HIV prevention services remains limited for West African MSM. We assessed adherence to quarterly HIV prevention services and its impact on HIV incidence in MSM followed up in four cities in Burkina Faso, Côte d’Ivoire, Mali, and Togo.MethodsWe performed a prospective cohort study between 2015 and 2018. HIV-negative MSM aged over 18 benefited from quarterly medical visits which included a clinical examination, HIV testing, screening and treatment for other sexually transmitted infections, peer-led counselling and support, and the provision of condoms and lubricants. Determinants of adherence to quarterly follow-up visits and incident HIV infections were identified using generalized estimating equation models and Cox proportional hazard models, respectively.Results618 MSM were followed up for a median time of 20.0 months (interquartile range 15.2–26.3). Overall adherence to quarterly follow-up visits was 76.5% (95% confidence interval [CI] 75.1–77.8), ranging from 66.8% in Abidjan to 87.3% in Lomé (p < 0.001). 78 incident HIV infections occurred during a total follow-up time of 780.8 person-years, giving an overall incidence of 10.0 per 100 person-years (95% CI 8.0-12.5). Adherence to quarterly follow-up visits was not associated with the risk of incident HIV infection (adjusted hazard ratio 0.92, 95% CI 0.51–1.67, p = 0.791).ConclusionsStrengthening HIV prevention services among MSM in West Africa, including the use of PrEP, will be critical for controlling the epidemic, not only in this key population but also in the general population. Quarterly follow-up of MSM, which is essential for PrEP delivery, appears feasible.ClinicalTrials.gov, number NCT02626286 (December 10, 2015)https://clinicaltrials.gov/ct2/results?term=NCT02626286

scholarly journals 1965. PrEP On the Go! Implementation Mobile PrEP, STI, and HIV Prevention Services in South Florida

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S65-S65 ◽  
Author(s):  
Susanne Doblecki-Lewis ◽  
Erin Kobetz ◽  
John Byrne2; Stefani Butts ◽  
Marco Torrealba ◽  
Katie Klose ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
South Florida ◽  
Foreign Born ◽  
Medical Provider ◽  
Latino Men ◽  
Sexually Transmitted ◽  
Prevention Services ◽  
Early Retention ◽  
Cancer Educator

Abstract Background Pre-Exposure Prophylaxis (PrEP) can reduce HIV incidence when implemented effectively for people who are at highest risk of HIV infection. However, access to and uptake of PrEP remains suboptimal among priority populations such as black and Hispanic/Latino men who have sex with men (MSM). We established mobile HIV prevention/PrEP services delivered with cancer screening services through the Sylvester Gamechanger vehicle. We describe demographics, utilization, and early retention in PrEP care delivered through this model. Methods We selected four local HIV high-incidence areas where PrEP services were lacking, to locate the clinic. The vehicle, staffed by a medical provider, HIV/PrEP counselor, and cancer educator, returned to each site regularly. In addition to self-referrals, Prevention305, a community-based organization, developed focused patient recruitment through social media. Services were provided at no cost. Normative demographics, risk behavior, sexually transmitted infections (STIs), and early-maintenance-in-care data were collected. Descriptive statistics were compiled using SPSS. Results From October 2018 to April 2019 services were provided to 229 clients. Of these, 168 (73.7%) sought PrEP. Of PrEP clients, 125 (74.4%) identified as White/Hispanic, 6 (3.5%) as Black/Hispanic, 6 (3.5%) as White/non-Hispanic, 11 (6.5%) as Black/non-Hispanic, and 19 (11.3%) as other; 124 (73.8%) were foreign-born; 159 (94.9%) of PrEP clients identified as MSM. Six (3.5%) PrEP-seeking clients were HIV positive at baseline. Of these, 2 were identified as acute/early infections. An initial PrEP prescription was filled by 166 (98.8%). Of the 77 clients seen within the initial 3 months of operation and due for follow-up assessment, 55 (71.4%) completed a follow-up visit. Overall, 45 (26.6%) PrEP clients had positive STI results (gonorrhea, chlamydia, or syphilis) at baseline. Nine (16.3%) clients returned positive STI results at their follow-up visit. Conclusion Implementation of mobile HIV prevention services including PrEP is feasible and is effective in engaging Hispanic/Latino immigrant MSM. High demand for services is noted and plans are underway to increase capacity and outreach to other highly affected groups. Disclosures All Authors: No reported Disclosures.

Decrease in incidence of sexually transmitted infections symptoms in men who have sex with men enrolled in a quarterly HIV prevention and care programme in West Africa (CohMSM ANRS 12324—Expertise France)

2021 ◽  
pp. sextrans-2020-054755
Author(s):  
Issifou Yaya ◽  
Fodié Diallo ◽  
Malan Jean-Baptiste Kouamé ◽  
Mawuényégan Kouamivi Agboyibor ◽  
Issa Traoré ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
West Africa ◽  
Total Duration ◽  
Diagnosis And Treatment ◽  
Trend Test ◽  
Mixed Effect ◽  
Care Programme ◽  
Sex With Men ◽  
Over Time

ObjectiveAlthough men who have sex with men (MSM) are at high risk of STI, their access to tailored healthcare services remains limited in West Africa. We assessed the change in STI symptoms incidence over time among MSM enrolled in a quarterly HIV prevention and care programme in four cities in Burkina Faso, Côte d’Ivoire, Mali and Togo.MethodsWe performed a prospective cohort study in MSM followed up between 2015 and 2019. Men aged over 18 who reported anal sex with another man within the previous 3 months were offered quarterly syndromic diagnosis and treatment for STI, as well as HIV testing, peer-led counselling and support. Condoms and lubricants were also provided. The change in STI symptoms incidence during follow-up was investigated using a non-parametric trend test and mixed-effect Poisson regression models.Results816 participants were followed for a total duration of 1479 person-years. 198 participants (24.3%) had at least one STI symptom during follow-up. Overall, STI symptoms incidence was 20.4 per 100 person-years (95% CI 18.4 to 22.6), ranging from 15.3 in Abidjan to 33.1 in Ouagadougou (adjusted incidence rate ratio (aIRR) 2.39, 95% CI 1.55 to 3.69, p<0.001). STI symptoms incidence was 16.8 and 23.0 per 100 person-years in HIV-positive and HIV-negative participants, respectively (aIRR 0.77, 95% CI 0.57 to 1.04, p=0.087). STI symptoms incidence decreased significantly from 29.9 per 100 person-years in the first 6 months to 8.6 at 30–35 months of follow-up (aIRR per 6-month increase 0.84, 95% CI 0.77 to 0.92, p<0.001).ConclusionSTI symptoms incidence decreased over time but the overall burden of STI appeared to be very high in MSM followed up in West Africa. STI services including counselling, diagnosis and treatment should be reinforced. Laboratory tests that allow accurate diagnosis of STI are required. Strengthening STI services will be critical for controlling the HIV and STI epidemics in this vulnerable population and in the general population.Trial registration numberNCT02626286.

scholarly journals Cohort profile: l’Actuel Pre-Exposure Prophylaxis (PrEP) Cohort study in Montreal, Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028768 ◽  
Author(s):  
Zoë R Greenwald ◽  
Mathieu Maheu-Giroux ◽  
Jason Szabo ◽  
Judith Alexia B Robin ◽  
Michel Boissonnault ◽  
...  
Keyword(s):  
Population Level ◽  
Hiv Infections ◽  
Health Clinic ◽  
Moderate Increase ◽  
Hiv Incidence ◽  
Sexually Transmitted ◽  
Before And After ◽  
Exposure Prophylaxis ◽  
The Impact

PurposeThel’Actuel PrEP Cohortwas established to monitor the uptake, effectiveness, safety and changes in sexual risk behaviours among individuals receiving pre-exposure prophylaxis (PrEP) for the prevention of HIV. This prospective dynamic cohort is based at Clinique médicale l’Actuel, a large sexual health clinic located in Montreal, Canada.ParticipantsSince the cohort inception in January of 2013 through June 2018, 2156 individuals consulted for PrEP as participants in the l’Actuel PrEP Cohort. Median age was 35 years (IQR: 29–44 years) and the majority (96%) were men who have sex with men. Among 1551 individuals who initiated PrEP care, the median duration of follow-up was 9.2 months (IQR: 3.7–19.6), with substantial variation based on year of cohort entry. Thel’Actuel PrEP Cohortcontains both daily and intermittent ‘on-demand’ PrEP users and has the largest reported population of intermittent PrEP users (n=406) in North America.Findings to dateNo incident HIV infections have occurred among individuals using PrEP over 1637 person-years of follow-up. However, retention in PrEP care is essential as three individuals who discontinued PrEP subsequently acquired HIV, translating to an HIV incidence of 3.9 cases per 100 person-years (95% CI: 1.3 to 12.1). Among a sample of participants with 1 year of follow-up before and after PrEP initiation (n=109), a moderate increase in sexually transmitted infections was observed following PrEP start.Future plansThel’Actuel PrEP Cohortcontinues to grow with new participants starting PrEP monthly and extended follow-up for existing users. The cohort data will be used for ongoing monitoring of PrEP and for population-level modelling of the impact of PrEP on HIV incidence in Montreal.

scholarly journals Estimation of HIV incidence in two Brazilian municipalities, 2013

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Célia Landmann Szwarcwald ◽  
Orlando da Costa Ferreira Júnior ◽  
Ana Maria de Brito ◽  
Karin Regina Luhm ◽  
Clea Elisa Lopes Ribeiro ◽  
...  
Keyword(s):  
Total Population ◽  
Hiv Infections ◽  
Incidence Rates ◽  
Hiv Incidence ◽  
Female Ratio ◽  
Exposure Category ◽  
Two Cities ◽  
Population Subgroup ◽  
Sex With Men ◽  
Male To Female

ABSTRACT OBJECTIVE To estimate HIV incidence in two Brazilian municipalities, Recife and Curitiba, in the year of 2013. METHODS The method for estimating incidence was based on primary information, resulting from the Lag-Avidity laboratory test for detection of recent HIV infections, applied in a sample of the cases diagnosed in the two cities in 2013. For the estimation of the HIV incidence for the total population of the cities, the recent infections detected in the research were annualized and weighted by the inverse of the probability of HIV testing in 2013 among the infected and not diagnosed cases. After estimating HIV incidence for the total population, the incidence rates were estimated by sex, age group, and exposure category. RESULTS In Recife, 902 individuals aged 13 years and older were diagnosed with HIV infection. From these, 528 were included in the study, and the estimated proportion of recent infections was 13.1%. In Curitiba, 1,013 people aged 13 years and older were diagnosed, 497 participated in the study, and the proportion of recent infections was 10.5%. In Recife, the estimated incidence rate was 53.1/100,000 inhabitants of 13 years and older, while in Curitiba, it was 41.1/100,000, with male-to-female ratio of 3.5 and 2.4, respectively. We observed high rates of HIV incidence among men who have sex with men, of 1.47% in Recife and 0.92% in Curitiba. CONCLUSIONS The results obtained in the two cities showed that the group of men who have sex with men are disproportionately subject to a greater risk of new infections, and indicate that strategies to control the spread of the epidemic in this population subgroup are essential and urgent.

scholarly journals Inequities in access to HIV prevention services for transgender men: results of a global survey of men who have sex with men

2016 ◽  
Vol 19 ◽  
pp. 20779 ◽  
Author(s):  
Ayden I Scheim ◽  
Glenn-Milo Santos ◽  
Sonya Arreola ◽  
Keletso Makofane ◽  
Tri D Do ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Global Survey ◽  
Prevention Services ◽  
Sex With Men ◽  
Transgender Men

scholarly journals Men treated for syphilis in Białystok, Poland, 2014-2018

2019 ◽  
pp. 329-335
Author(s):  
Agnieszka Beata Serwin ◽  
Adriana Grochowska ◽  
Iwona Flisiak
Keyword(s):  
Urban Areas ◽  
Partner Notification ◽  
Secondary Syphilis ◽  
Contact Tracing ◽  
Professional Activity ◽  
Symptomatic Infection ◽  
Sexually Transmitted ◽  
Sexual Contacts ◽  
Sex With Men

INTRODUCTION. Incidence of syphilis is increasing in Europe in recent years, mainly due to high incidence in men, especially men who have sex with men (MSM). AIM. To analyse sociodemographic, epidemiological and clinical characteristics of men treated for syphilis in Bialystok in 2014 – 2018, to compare these of MSM and men who have sex with women (MSW). MATERIAL AND METHODS. Analysis of age, residency, professional activity, type of sexual contacts (steady vs. casual), marital status, stage of syphilis diagnosed, concomitant sexually transmitted infections (STIs), treatment, partner notification and follow-up attendance. RESULTS. Of 49 male patients with syphilis 26 (53.06%) were MSM and 23 (46.94%) – MSW. The average age was 33.67 and 35.87 years in MSM and MSW patients, respectively. Majority of patients in both groups were residents of urban areas. Tradesmen and those unemployed constituted the highest proportion in MSM and MSW group, respectively. MSM were in majority single and had only casual contacts while MSW, mostly married or engaged in steady relationship, had also casual contacts. Secondary syphilis was most frequently diagnosed in MSM and late latent syphilis - in MSW. Eight patients (16.32%) had concomitant HIV infection, in all diagnosed before syphilis. Contact tracing was successful in 26.92% of MSM and 39.13% of MSW. Follow-up was not done or not completed in half of MSM and more than half of MSW. CONCLUSIONS. Results confirm that MSM play a crucial role in the current epidemics of syphilis. They have mainly casual sexual contacts and have symptomatic infection. In both MSM and MSW contact tracing and follow-up attendance is suboptimal.

scholarly journals What happens after HIV self-testing? Results from a longitudinal cohort of Chinese men who have sex with men

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weiming Tang ◽  
Wenting Huang ◽  
Haidong Lu ◽  
Bolin Cao ◽  
Dan Wu ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Condom Use ◽  
Hiv Testing ◽  
Consistent Condom ◽  
Consistent Condom Use ◽  
Longitudinal Cohort ◽  
Prevention Services ◽  
Self Testing ◽  
Hiv Test ◽  
Sex With Men

Abstract Background HIV self-testing (HIVST) is a promising approach to expand HIV testing. HIVST is a process in which a person performs an HIV test and interprets the result. Negative HIVST results may encourage men who have sex with men (MSM) to use HIV prevention services. The objective of this study was to examine behaviors (e.g., facility-based HIV testing, condom use) after a negative HIVST test result among Chinese MSM. Methods We collected data from MSM in eight Chinese cities over a 12-month period. This is a secondary analysis of longitudinal cohort data collected as part of an intervention trial to increase HIV testing. Men completed a survey that described sociodemographic information, sexual behaviors, HIV self-testing, and facility-based HIV testing. Men who completed at least one follow-up survey were included in this analysis. Generalized linear mixed models were used to evaluate whether HIVST increased subsequent facility-based HIV testing and consistent condom use. Results We included 1219 men. Most men (78.7%) were under 30 years old and had never been married (87.0%). 755 (61.9%) men tested for HIV and 593 (49.3%) men self-tested during the study period. At baseline, among men who had never been tested for HIV, 44.9% (314/699) initiated HIVST during the study period. HIVST was associated with subsequent facility-based testing (aOR of 1.87, 95% CI: 1.47–2.37). HIVST was also associated with subsequent consistent condom use (aOR = 1.53, 95% CI: 1.13–2.06). Conclusion HIVST was associated with subsequent facility-based HIV testing and consistent condom use. HIVST may enhance uptake of related HIV prevention services at facilities, suggesting the need for more implementation research.

scholarly journals The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities: The Neighborhoods and Networks (N2) Cohort Study

2019 ◽  
Vol 16 (11) ◽  
pp. 1922 ◽  
Author(s):  
Dustin T. Duncan ◽  
DeMarc A. Hickson ◽  
William C. Goedel ◽  
Denton Callander ◽  
Brandon Brooks ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hiv Prevention ◽  
New Orleans ◽  
Black Msm ◽  
Deep South ◽  
Network Characteristics ◽  
Sex With Men ◽  
Study Sites ◽  
The U.S

Background: In many parts of the world, stark racial disparities in human immunodeficiency virus (HIV) prevalence, incidence, prevention, and care outcomes persist among gay, bisexual, and other men who have sex with men (MSM), with Black MSM significantly impacted in the United States (U.S.). Individual-level characteristics, including sexual behaviors and socioeconomic status, do not fully account for racial/ethnic disparities in HIV among MSM. We hypothesize that neighborhood contexts and network characteristics influence risk for HIV infection as well as HIV-related prevention and care behaviors. As such, the study design includes the use of real-time geospatial methods and in-depth assessments of multiple network typologies to investigate the impact of neighborhood and network-level factors on HIV prevention and treatment among Black MSM residing in longstanding priority HIV elimination areas in the U.S., namely Chicago, Illinois and in the Deep South (Jackson, Mississippi and New Orleans, Louisiana) (n = 450, n = 50, and n = 100, respectively). We describe the design, sampling methods, data collection, data management methods, and preliminary findings of the ongoing ‘Neighborhoods and Networks (N2) Cohort Study’. Methods/Design: N2 employs a prospective longitudinal design. The sample includes Black MSM participants in Chicago recruited via respondent-driven sampling and assessed every six months over two years of follow-up. Participants enrolled in Jackson and New Orleans are being recruited through existing health and community services and assessed every six months over one year of follow-up. Mobility within and between neighborhoods is being assessed using global positioning system (GPS) technology. Social and sexual networks among Black MSM are being studied through egocentric network inventories as well as newer methods of creating meso-level networks that involve social media (Facebook) and mobile phone contacts. Key HIV prevention outcomes such as pre-exposure prophylaxis (PrEP) care engagement, and HIV/STI (sexually transmitted infections) biomarkers will be examined at baseline and follow-up. Results: As of 31 December 2018, a total of 361 men were enrolled across all study sites: 259 in Chicago and 102 in the Deep South (75 in New Orleans and 27 in Jackson). At baseline, participants ranged in age from 17 to 65 years old (mean = 34.3, standard deviation = 5.1) with 123 men (34.1%) self-reported as HIV positive. While HIV treatment levels were similar between sites, men in the Deep South reported higher rates of adherence than men in Chicago (63.3% versus 49.4%, p = 0.03). Sexual risk profiles were mainly the same between men from different study sites, with 22.9% of men in Chicago and 28.9% in the Deep South reporting consistent condom use during vaginal and anal sex (p = 0.26). Regarding their home neighborhoods, men in the Deep South were more likely than those in Chicago to characterize theirs as having a good reputation (43.1% versus 24.7%, p < 0.001) and as being safe (37.3% versus 21.2%, p = 0.002). Conclusions: The focus on Black MSM in the N2 Study will allow for a nuanced exploration of the attitudes, beliefs, behaviors, and practices of a diverse group of Black MSM. The study is also positioned to provide novel insight about neighborhood and network characteristics that influence HIV-related behaviors. A health equity framework ensures that Black MSM are not explicitly or implicitly deemed as deviant, disordered, or the non-reference group. Findings from N2 will provide guidance for the implementation of more impactful HIV prevention interventions that engage a diverse population of Black MSM as we work toward HIV elimination in the U.S.

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