Sexualized drug injection among men who have sex with men in Madrid and Barcelona as the first episode of drug injecting

Abstract Background We estimate the prevalence of drug injection, the variables associated with having ever injected and the proportion of ever injectors whose first drug injection was for having sex; we describe the first drug injection episode, analyze the drugs most frequently injected and estimate the prevalence of risky injecting behaviors. Methods The participants were 3387 MSM without a previous HIV diagnosis attending four HIV/STI diagnosis services in Madrid and Barcelona. Lifetime prevalence and prevalence ratios (PRs) by different factors were calculated using Poisson regression models with robust variance. We compared the characteristics of first drug injection episode, lifetime injection and risky injecting behaviors of those whose first injection was for sex (FIS) with those whose was not (non-FIS). Results Lifetime prevalence of injection was 2.1% (CI 1.7–2.7). In the multivariate analysis, it was strongly associated with having been penetrated by more than five men in the last 12 months (aPR = 10.4; CI 2.5–43.4) and having met most of their partners at private parties (aPR = 7.5; CI 4.5–12.3), and less strongly with other factors. Of those who had ever injected drugs, 81.9% injected for sex the first time they injected drugs (FIS). At first injection, FIS participants had a mean age of 31 years, 62.7% used mephedrone and 32.2% methamphetamine on that occasion. Of this FIS group 39.0% had ever shared drugs or equipment and 82.6% had always shared for sex. Some 30.8% of non-FIS reported having also injected drugs for sex later on. Conclusions Only two out of a hundred had ever injected, most to have sex and with frequent drug or injecting equipment sharing. Injecting for sex is the most common first episode of drug injection and is the most efficient risky behavior for the transmission of HIV, hepatitis B or C and other blood-borne infections. MSM participating in private parties should be considered a priority group for prevention policies.

Download Full-text

Data linkage to evaluate the long-term risk of HIV infection in individuals seeking post-exposure prophylaxis

Nature Communications ◽

10.1038/s41467-021-21485-w ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Frédérique Hovaguimian ◽

◽

Huldrych F. Günthard ◽

Christoph Hauser ◽

Anna Conen ◽

...

Keyword(s):

Hiv Infection ◽

Data Linkage ◽

Tertiary Hospital ◽

First Episode ◽

Post Exposure Prophylaxis ◽

Hiv Diagnosis ◽

Post Exposure ◽

Sex With Men ◽

Exposure Prophylaxis

AbstractEvidence on the long-term risk of HIV infection in individuals taking HIV post-exposure prophylaxis remains limited. In this retrospective data linkage study, we evaluate the occurrence of HIV infection in 975 individuals who sought post-exposure prophylaxis in a tertiary hospital between 2007 and 2013. Using privacy preserving probabilistic linkage, we link these 975 records with two observational databases providing data on HIV events (Zurich Primary HIV Infection study and the Swiss HIV Cohort Study). This enables us to identify 22 HIV infections and to obtain long-term follow-up data, which reveal a median of 4.1 years between consultation for post-exposure prophylaxis and HIV diagnosis. Even though men who have sex with men constitute only 35.8% of those seeking post-exposure prophylaxis, all 22 events occur in this subgroup. These findings should strongly encourage early consideration of pre-exposure prophylaxis in men who have sex with men after a first episode of post-exposure prophylaxis.

Download Full-text

Potential excess of vaginal examinations during the management of labor: frequency and associated factors in 13 Peruvian hospitals

Reproductive Health ◽

10.1186/s12978-019-0811-9 ◽

2019 ◽

Vol 16 (1) ◽

Author(s):

Jessica Hanae Zafra-Tanaka ◽

Renee Montesinos-Segura ◽

Pamela D. Flores-Gonzales ◽

Alvaro Taype-Rondan

Keyword(s):

High Frequency ◽

Regression Models ◽

Associated Factors ◽

Secondary Analysis ◽

Median Number ◽

Disrespect And Abuse ◽

Future Studies ◽

Robust Variance ◽

Rank 2 ◽

Prevalence Ratios

Abstract Background A high number of vaginal examinations (VEs) may lead to a higher risk of infections, as well as discomfort/dissatisfaction with intrapartum care. Objective To determine the frequency of potential excess of vaginal examinations (PEVE) during the management of labor and identify its associated factors, in Peruvian hospitals. Methods Secondary analysis of the data collected in the DisrespEct and abuse during ChIlDbirth in pEru (DECIDE) study, held between April and May 2016. In this study, women hospitalized in Peruvian hospitals right after giving birth were surveyed by trained personnel. PEVE, the main outcome, was considered as five or more vaginal examinations (VEs) performed during the management of labor. Poisson regression models with robust variance were performed to calculate crude and adjusted prevalence ratios (cPR and aPR) as well as their 95% confidence intervals (95% CI). Results One thousand four hundred twenty registries of 13 hospitals from 8 Peruvian cities were evaluated. The number of women studied at each hospital ranged between 100 and 129. The median age was 26 years (interquartile rank: 22–31). The median number of VEs was 3 (interquartile rank: 2–5). The proportion of women who underwent PEVE was 33.9%, this ranged from 0.9 to 69.9% at the studied hospitals. The frequency of PEVE was higher in women who attended > 2 obstetric psychoprophylaxis sessions, compared to those who attended ≤ 2 sessions (aPR: 1.78 95% CI: 1.01–3.12); and among women who gave birth between 18:00 h and 23:59 h, compared to those who did it between 7:00 and 17:59 h (aPR: 1.28 95% CI: 1.04–1.57). Conclusion Around one in three women underwent a PEVE, although this frequency varied widely across the evaluated hospitals. Women with more psychoprophylaxis sessions, and who gave birth between 18:00 h and 23:59 h, had a higher PEVE frequency. Future studies should assess in depth the causes and consequences of this high frequency.

Download Full-text

PrEP awareness among men who have sex with men at higher risk for HIV in Brazil, Mexico, and Peru, 2018

10.21203/rs.2.19705/v1 ◽

2019 ◽

Author(s):

Ryan David Assaf ◽

Kelika A. Konda ◽

Thiago S. Torres ◽

E. Hamid Vega-Ramirez ◽

Oliver A. Elorreaga ◽

...

Keyword(s):

Hiv Infection ◽

Regression Models ◽

Online Survey ◽

Hiv Infections ◽

Increased Risk ◽

Unknown Status ◽

Sex With Men ◽

Prep Awareness ◽

Prevalence Ratios ◽

Hiv Negative

Abstract IntroductionPrEP awareness in Latin America has been poorly characterized, with studies in Brazil, Mexico, and Peru highlighting low awareness. We assessed the association between higher risk of HIV infection, indicative of PrEP eligibility, and PrEP awareness among men who have sex with men (MSM) from these countries. MethodsMSM were recruited to complete an online survey via advertisements on Facebook, Grindr, and Hornet from March-June 2018. Eligible individuals were cisgender MSM, ≥18 years old, HIV negative or of unknown status, lived in these countries, and provided informed consent. Higher risk was defined using a CDC score indicating an increased risk of HIV infection and the suggested cutpoint of 10. We used Poisson regression models to calculate adjusted prevalence ratios (aPR) testing the association between higher risk and PrEP awareness; socio-demographics and other risk variables were considered potential confounders. Separate models were conducted for Brazil, Mexico, and Peru. ResultsAfter exclusion, 19,457 MSM were available for analysis. Overall PrEP awareness was 64.9%, with those from Brazil reporting highest awareness (68.8%), followed by Mexico (64.1%), and Peru (46.6%). In Brazil, 53.8% were classified as higher risk for HIV, 51.9% in Mexico, and 54.2% in Peru. Higher risk for HIV was associated with PrEP awareness among those in Brazil (aPR 1.04, 95% CI 1.01, 1.06), but no association was seen in Mexico or Peru. Additionally, having more than high school education, high income, daily use of gay social networking (GSN) applications, and substance use were associated with PrEP awareness in each country. ConclusionHigher risk of HIV infection was associated with increased PrEP awareness in Brazil. However, this association was weak indicating that MSM at higher risk, who would benefit from PrEP, are often not aware of this prevention strategy. In the remaining countries, there was no association between risk and awareness, highlighting a disconnect between need and knowledge. As PrEP is introduced, awareness should increase, as in Brazil where PrEP has been available longer. Interventions to increase PrEP awareness are paramount to increase PrEP uptake and prevent HIV infections. GSN applications and social media could play an important role to achieve this goal.

Download Full-text

ART initiation and predictive factors among men who have sex with men living with HIV after the implementation of new ART strategy in China: an observational cohort study

10.21203/rs.2.19996/v1 ◽

2020 ◽

Author(s):

Weiyi Chen ◽

Zixin Wang ◽

Xiaoyan Fan ◽

Linghua Li ◽

Huifang Xu ◽

...

Keyword(s):

Cohort Study ◽

Social Status ◽

Regression Models ◽

Cox Regression ◽

People Living With Hiv ◽

Hiv Diagnosis ◽

Art Initiation ◽

Baseline Information ◽

Sex With Men ◽

Living With Hiv

Abstract BackgroundChina started the new antiretroviral therapy (ART) strategy since 2016, after which free ART could be provided for all people living with HIV. We aimed to understand the prevalence of ART initiation among men who have sex with men (MSM) living with HIV and to explore how ART-related perceptions, psycho-social status etc. predict ART initiation under the new strategy.MethodsA cohort study (maximum follow-up period = 578 days) was conducted in Guangzhou, China. A total of 303 ART-naïve MSM were recruited from community. Baseline information collected demographic characteristics, HIV/AIDS-related health status, ART-related perceptions, weighting of pros versus cons and psycho-social status. The outcome was ART initiation. Cox regression models were fitted for data analyses.ResultsThe prevalence of ART initiation was 83.8% of all participants and 92.6% of MSM diagnosed recently (within 30 days). In multivariate Cox regression models, HIV-positive MSM received HIV diagnosis ≤30 days were less likely to initiate ART (HR = 0.37, 95% CI: 0.28-0.49). In adjusted analyses, belief that immediate ART initiation would have more benefit for themselves associated with increased ART initiation (HRa = 1.44, 95% CI: 1.06-1.96). In the final model, weighting of pros versus cons and time since diagnosis of HIV infection remained significant.ConclusionThe prevalence of ART initiation was high among MSM living with HIV in Guangzhou. To reach the second 90% target, measures should be focused on MSM previously diagnosed. Interventions showing HIV-positives the benefits of ART were also needed.

Download Full-text

Impact of immediate initiation of antiretroviral therapy among men who have sex with men infected with HIV in Chengdu, southwest China: trends analysis, 2008–2018

BMC Public Health ◽

10.1186/s12889-021-10580-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chenyao Wu ◽

Baiyang Zhang ◽

Zhen Dai ◽

Qianwen Zheng ◽

Zhenhua Duan ◽

...

Keyword(s):

Southwest China ◽

Temporal Trends ◽

Interrupted Time Series ◽

Health Information Systems ◽

Hiv Diagnosis ◽

Annual Percent Change ◽

Percent Change ◽

Hiv Epidemic ◽

Sex With Men ◽

Treat All

Abstract Background Given the rampant HIV epidemic among men who have sex with men (MSM) in Chengdu, southwest China, Treat All policy, defined as immediate antiretroviral therapy (ART) initiation after HIV diagnosis, was implemented since 2014. Real-world research evaluating impacts of immediate ART on HIV epidemics is needed to optimize policy-making as national and international guidelines have been lowering ART eligibility threshold. The purpose of this study is to: assess temporal trends of the HIV epidemic and impacts of Treat All policy among MSM; and lay foundation for HIV-related policy evaluation using longitudinal routine data from health information systems. Methods Data used in this study were HIV sentinel seroprevalence, annual reported HIV cases and ART coverage rate among MSM in Chengdu from 2008 to 2018, derived from national HIV/AIDS information system. Temporal trends of the HIV epidemic were described using Joinpoint Regression Program. Interrupted time-series method was deployed to evaluate Treat All policy. Results HIV sentinel seroprevalence rose from 11.20% in 2008 to 17.67% in 2013 and Annual Percent Change (APC) was 8.25% (95% CI − 2.40%, 20.07%), then decreased to 5.17% in 2018 (APC = − 19.63%, 95% CI − 27.54%, − 10.86%). Newly reported HIV cases increased from 168 cases in 2008 to 1232 cases in 2015 (APC = 26.99%, 95% CI 21.32%, 32.93%), and reduced to 1014 cases in 2018 (APC = − 8.80%, 95% CI − 18.45%, 2.01%). ART coverage rate has been climbing from 11.11% in 2008 to 92.29% in 2018 and Average Annual Percent Change was 16.09% (95% CI 11.76%, 20.59%). Results of interrupted time-series models showed that compared to an annual increase of 0.87% during pre-policy period, there was a decline of 3.08% (95% CI − 0.0366%, − 0.0250%) per year of HIV sentinel seroprevalence since 2014; and compared to an annual increase of 116 cases before 2014, there was an annual drop of 158 newly reported HIV cases (95% CI − 194.87%, − 121.69%) during the post-policy period. Conclusions Immediate ART after HIV diagnosis could potentially curb HIV transmission at population level among MSM, along with other strategies. Future assessment of HIV prevention and control policy can be carried out using routinely collected longitudinal data from health information systems.

Download Full-text

Identifying subgroups within at-risk populations that drive late HIV diagnosis in a Southern U.S. state

International Journal of STD & AIDS ◽

10.1177/0956462420947567 ◽

2020 ◽

pp. 095646242094756

Author(s):

Sabina O Nduaguba ◽

Kentya H Ford ◽

James P Wilson ◽

Kenneth A Lawson ◽

Robert L Cook

Keyword(s):

At Risk ◽

Older Individuals ◽

Hiv Diagnosis ◽

Interaction Terms ◽

Late Hiv Diagnosis ◽

Increased Risk ◽

At Risk Populations ◽

Sex With Men ◽

Aids Diagnosis ◽

Racial Ethnic

We aimed to identify subgroups within age, racial/ethnic, and transmission categories that drive increased risk for late HIV diagnosis (LHD). A 1996–2013 retrospective study of HIV-diagnosed individuals (N = 77,844) was conducted. The proportion of individuals with LHD (AIDS diagnosis within 365 days of HIV diagnosis) was determined, stratified by age, race/ethnicity, and transmission category. Logistic regression with interaction terms was used to identify groups/subgroups at risk for LHD during 1996–2001, 2002–2007, and 2008–2013. Respectively, 78%, 27%, 38%, and 31% were male, White, Black, and Hispanic. Overall, 39% had LHD with a 6.7% reduction for each year increase (OR = 0.93, 95% CI = 0.93–0.94, p < 0.01). Older age was significantly associated with increased odds of LHD (OR range = 1.90–4.55). Compared to their White counterparts, all Hispanic transmission categories (OR range = 1.31–2.58) and only Black female heterosexuals and men who have sex with men (MSM) (OR range = 1.14–1.33) had significantly higher odds of LHD during 1996–2001 and/or 2002–2007. Significance was limited to Hispanic MSM (all age categories), MSM/IDUs (30–59 years), and heterosexuals (18–29 years) and Black MSM (30–39 years) during 2008–2013. Older individuals and Hispanics (driven by MSM) are at increased risk for LHD. HIV testing interventions directed at seniors and Hispanic MSM can further reduce rates of LHD.

Download Full-text

Developing HIV assisted partner notification services tailored to Mexican key populations: a qualitative approach

BMC Public Health ◽

10.1186/s12889-021-10612-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Heleen Vermandere ◽

Santiago Aguilera-Mijares ◽

Liliane Martínez-Vargas ◽

M. Arantxa Colchero ◽

Sergio Bautista-Arredondo

Keyword(s):

Partner Notification ◽

Key Populations ◽

Structured Interviews ◽

Hiv Diagnosis ◽

Serostatus Disclosure ◽

Hiv Epidemic ◽

Contact Information ◽

Hiv Awareness ◽

Sex With Men ◽

The Individual

Abstract Background Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). This study aimed to explore the awareness of and need for HIV partner notification, as well as to outline potential strategies for APNS based on identified barriers and facilitators. Methods We conducted semi-structured interviews to explore partner notification with MSM, TW, and counselors. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. Results Most participants reported experiences with informal partner notification and serostatus disclosure, but not with APNS. Only one counselor indicated assisting notification systematically. The main barriers for notifying or disclosing mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier to inform a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counselors or peers to mitigate potential rejection or violent reactions. Conclusions While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS could potentially enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

Download Full-text

COVID-19 and the Risk for Increased Intimate Partner Violence Among Gay, Bisexual and Other Men Who Have Sex With Men in the United States

Journal of Interpersonal Violence ◽

10.1177/0886260521997454 ◽

2021 ◽

pp. 088626052199745

Author(s):

Rob Stephenson ◽

Tanaka M.D. Chavanduka ◽

Matthew T. Rosso ◽

Stephen P. Sullivan ◽

Renée A. Pitter ◽

...

Keyword(s):

United States ◽

Intimate Partner Violence ◽

Partner Violence ◽

Social Contact ◽

The United States ◽

Intimate Partner ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Sex With Men ◽

First Time

Stay at home orders–intended to reduce the spread of COVID-19 by limiting social contact–have forced people to remain in their homes. The additional stressors created by the need to stay home and socially isolate may act as triggers to intimate partner violence (IPV). In this article, we present data from a recent online cross-sectional survey with gay, bisexual and other men who have sex with men (GBMSM) in the United States to illustrate changes in IPV risks that have occurred during the U.S. COVID-19 epidemic. The Love and Sex in the Time of COVID-19 survey was conducted online from April to May 2020. GBMSM were recruited through paid banner advertisements featured on social networking platforms, recruiting a sample size of 696 GBMSM. Analysis considers changes in victimization and perpetration of IPV during the 3 months prior to the survey (March-May 2020) that represents the first 3 months of lockdown during the COVID-19 epidemic. During the period March-May 2020, 12.6% of participants reported experiencing any IPV with higher rates of emotional IPV (10.3%) than sexual (2.2%) or physical (1.8%) IPV. Of those who reported IPV victimization during lockdown, for almost half this was their first time experience: 5.3% reported the IPV they experienced happened for the first time during the past 3 months (0.8% physical, 2.13% sexual, and 3.3% emotional). Reporting of perpetration of IPV during lockdown was lower: only 6% reported perpetrating any IPV, with perpetration rates of 1.5% for physical, 0.5% for sexual, and 5.3% for emotional IPV. Of those who reported perpetration of IPV during lockdown, very small percentages reported that this was the first time they had perpetrated IPV: 0.9% for any IPV (0.2% physical, 0.2% sexual, and 0.6% emotional). The results illustrate an increased need for IPV resources for GBMSM during these times of increased stress and uncertainty, and the need to find models of resource and service delivery that can work inside of social distancing guidelines while protecting the confidentiality and safety of those who are experiencing IPV.

Download Full-text

Influence of alloying systems on the properties of single crystal nickel-based superalloys

International Journal of Materials Research (formerly Zeitschrift fuer Metallkunde) ◽

10.1515/ijmr-2021-8328 ◽

2021 ◽

Vol 112 (10) ◽

pp. 794-799

Author(s):

Alexander Glotka ◽

Vadim Ol’shanetskii

Keyword(s):

Single Crystal ◽

Regression Models ◽

Strength Properties ◽

Term Limits ◽

Alloying Elements ◽

Structure Stability ◽

Plastic Properties ◽

Crystal Lattices ◽

Predictive Regression ◽

First Time

Abstract The purpose of the investigation was to obtain the predictive regression models that help correct the calculation of the mechanical properties of single crystal nickel-based superalloys without conducting prior experiments. The paper considers the influence of alloying elements on their tendency to form phases in foundry nickel-based superalloys. Using the elements influence on the phase formation, the coefficient Kc’ of the ratio of alloying elements for this class of alloys was set for the first time. We have revealed the short correlation of the ratio Kc’ with the dimensional misfit of γ and γ’ crystal lattices. Also, a high probability to predict the misfit for multicomponent nickel systems is shown, which significantly affected the strength properties. The regression models of correlation dependencies on the dimensional γ/γ’- misfit were offered to predict the short-term and long-term limits of the strength of alloys. We determined the operating temperature at which the misfit value should decrease to zero. The structure stability should increase because of the structural stresses minimizing. This has a positive effect on strength and plastic properties.

Download Full-text

Comparison of the patterns of chlamydia and gonorrhoea at the oropharynx, anorectum and urethra among men who have sex with men

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054632 ◽

2021 ◽

pp. sextrans-2020-054632

Author(s):

Marjan Tabesh ◽

Christopher K Fairley ◽

Jane S Hocking ◽

Deborah A Williamson ◽

Lei Zhang ◽

...

Keyword(s):

Health Centre ◽

Single Site ◽

Chlamydia Infection ◽

Similar Proportion ◽

Anatomical Site ◽

Site Infection ◽

Site Specific ◽

Sexually Transmitted ◽

Sex With Men ◽

First Time

ObjectiveChlamydia and gonorrhoea are common sexually transmitted infections that infect the oropharynx, anorectum and urethra in men who have sex with men (MSM). This study aimed to examine the pattern of infection at more than one site (multisite) for chlamydia and gonorrhoea among MSM.MethodsThis was a retrospective study of MSM attending the Melbourne Sexual Health Centre for the first time between 2018 and 2019. We included MSM aged ≥16 years who had tested for Neisseria gonorrhoeae and Chlamydia trachomatis at all three sites (oropharynx, anorectum and urethra). We compared infections that occurred at a single site (termed single-site infection) and those that occurred at more than one site (termed multisite infections).ResultsOf the 3938 men who were tested for chlamydia and gonorrhoea, 498/3938 men (12.6%, 95% CI 11.5% to 13.6%) had chlamydia at any site, of whom 400/498 (80.3%, 95% CI 78.9% to 81.2%) had single-site chlamydia infection, and 98/498 (19.7%, 95% CI 16.2% to 23.1%) had multisite infections. A similar proportion of men had gonorrhoea at any site (447/3938, 11.4%, 95% CI 10.3% to 12.2%), but among these 447 men, single-site infection was less common (256/447, 57.3%, 95% CI 52.6% to 61.7%, p<0.001) and multisite infection (191/447, 42.7%, 95% CI 38.2% to 47.3%, p<0.001) was more common than chlamydia. There were also marked differences by anatomical site. Urethral infection commonly occurred as single sites (75/122, 61.5%, 95% CI 52.8% to 70.1%) for chlamydia but uncommonly occurred for gonorrhoea (12/100, 12.0%, 95% CI 5.6% to 18.3%, p<0.001). In contrast, anorectal infection uncommonly occurred as multisite infection for chlamydia (98/394, 24.9%, 95% CI 20.6% to 29.1%) but was common (184/309, 59.5%, 95% CI 54.0% to 64.9%, p<0.001) for gonorrhoea.ConclusionsThe markedly different pattern of site-specific infection for chlamydia and gonorrhoea infections among the same MSM suggests significant differences in the transmissibility between anatomical sites and the duration of each infection at each site.

Download Full-text