scholarly journals Factors associated with testing for HIV and hepatitis C among behaviorally vulnerable men in Germany: a cross-sectional analysis upon enrollment into an observational cohort

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Trevor A. Crowell ◽  
Haoyu Qian ◽  
Carsten Tiemann ◽  
Clara Lehmann ◽  
Christoph Boesecke ◽  
...  

Abstract Background HIV and hepatitis C virus (HCV) have shared routes of transmission among men who have sex with men (MSM). Routine testing facilitates early diagnosis and treatment, thereby preventing morbidity and onward transmission. We evaluated factors associated with HIV and HCV testing in a behaviorally vulnerable cohort of predominantly MSM. Methods From June 2018 through June 2019, the BRAHMS study enrolled adults at ten German outpatient clinics that serve gender and sexual minority populations. Participants completed behavioral questionnaires that captured prior experience with HIV and HCV testing. Multivariable robust Poisson regression was used to evaluate factors potentially associated with testing in the previous 6 months. Results Among 1017 participants with median age 33 (interquartile range 28–39) years, 1001 (98.4%) reported any lifetime history of HIV testing and 787 (77.4%) reported any HCV testing, including 16 (1.6%) known to be living with HCV. Testing within the last 6 months was reported by 921 (90.6%) and 513 (50.4%) for HIV and HCV, respectively. Recent HIV testing was more common among participants with higher education level and recent HCV testing. Recent HCV testing was more common among participants with non-cisgender identity, lifetime history of illicit drug use, hepatitis B immunity or infection, and recent HIV testing. Conclusion Prior testing for HIV was common in this cohort, but interventions are needed to improve HCV risk stratification and access to testing. HIV testing infrastructure can be successfully leveraged to support HCV testing, but differentiated preventive care delivery is needed for some vulnerable populations.

2020 ◽  
Author(s):  
Charlotte Laniece Delaunay ◽  
Joseph Cox ◽  
Marina B. Klein ◽  
Gilles Lambert ◽  
Daniel Grace ◽  
...  

AbstractIntroductionTo eliminate the hepatitis C virus (HCV) by 2030, Canada must adopt a micro-elimination approach targeting priority populations, including gay, bisexual, and other men who have sex with men (MSM). HCV prevalence and risk factors among MSM populations are context-dependent, and accurately describing these indicators at the local level is essential if we want to design appropriate, targeted prevention and treatment interventions. We aimed first to estimate and investigate temporal trends in HCV seroprevalence between 2005-2018 among Montréal MSM, and then to identify the socio-economic, behavioural, and biological factors associated with HCV exposure among this population.MethodsWe used data from three bio-behavioural cross-sectional surveys conducted among Montréal MSM in 2005 (n=1,795), 2009 (n=1,258), and 2018 (n=1,086). To ensure comparability of seroprevalence estimates across time, we standardized the 2005 and 2009 time-location samples to the 2018 respondent-driven sample. Time trends overall and stratified by HIV status, history of injection drug use (IDU), and age were examined. Modified Poisson regression analyses with generalized estimating equations were used to identify factors associated with HCV seropositivity pooling all surveys. We used multiple imputation by chained equations for all missing values.ResultsStandardized HCV seroprevalence among all MSM remained stable from 7% (95% confidence interval (CI): 3-10%) in 2005, to 8% (95%CI: 1-9%) in 2009, and 8% (95%CI: 4-11%) in 2018. This apparent stability hides diverging temporal trends in seroprevalence between age groups, with a decrease among MSM <30 years old, and an increase among MSM aged ≥45 years. History of IDU was the strongest predictor for HCV seropositivity (adjusted prevalence ratio: 8.0; 95%CI: 5.5-11.5), and no association was found between HCV seroprevalence and the sexual risk factors studied (condomless anal sex with men of serodiscordant/unknown HIV status, number of sexual partners, and group sex), nor with biological markers of syphilis.ConclusionsHCV seroprevalence remained stable among Montréal MSM between 2005-2018. Unlike other settings where HCV infection was strongly associated with sexual risk factors among MSM subgroups, IDU was the preeminent risk factor for HCV seropositivity. Understanding the intersection of IDU contexts, practices, and populations is essential to prevent HCV transmission among MSM.


2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Siyan Yi ◽  
Sovannary Tuot ◽  
Pheak Chhoun ◽  
Carinne Brody ◽  
Khuondyla Pal ◽  
...  

2020 ◽  
Author(s):  
Hang Hong ◽  
Hong-bo Shi ◽  
Hai-bo Jiang ◽  
Hong-jun Dong ◽  
Yun-liang Shen

Abstract BackgroundHIV testing and early linkage to care are critical for reducing the risk of HIV transmission. HIV self-testing (HIVST) is an useful tool for increasing HIV testing frequency.This study aimed to investigate HIVST rates among men who have sex with men (MSM), the characteristics of MSM who had HIVST, and factors associated with HIVST uptake among MSM in Ningbo, China. MethodsA cross-sectional study was conducted from April to October 2019 in Ningbo,China. Participants were aged at least 18 years and having had sexual contact with men in the past year. Proportions were used for categorical variables. Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) for characteristics associated with HIVST uptake was processed by multiple logistic regression models.ResultsAmong a sample of 699 MSM recruited, 38.2% had reported previous use of an HIV self-test kit. A greater proportion of HIVST Users had a higher frequency of HIV testing(≥2 times: 70.0% versus 41.2%, p<0.001) in the past one year. Factor associated with HIVST uptake was gay apps use(AOR=1.86,CI=1.13-3.05), multiple male sex partners (AOR=1.90,CI=1.29-2.80), frequency of male-male sexual contact ≥1 times per week(AOR=1.86, CI=1.30-2.66), syphilis infection(AOR=5.48, CI=2.53-11.88).ConclusionsFurther HIVST education should be strengthened for school-aged children and teenagers, and free HIVST kits may be provided to low-income high-risk MSM through gay apps and NGOs to achieve the increased HIV testing frequency.


2020 ◽  
pp. sextrans-2020-054464
Author(s):  
Charlotte Lanièce Delaunay ◽  
Joseph Cox ◽  
Marina Klein ◽  
Gilles Lambert ◽  
Daniel Grace ◽  
...  

ObjectivesTo eliminate the hepatitis C virus (HCV) by 2030, Canada must adopt a microelimination approach targeting priority populations, including gay, bisexual and other men who have sex with men (MSM). Accurately describing HCV prevalence and risk factors locally is essential to design appropriate prevention and treatment interventions. We aimed to estimate temporal trends in HCV seroprevalence between 2005 and 2018 among Montréal MSM, and to identify socioeconomic, behavioural and biological factors associated with HCV exposure among this population.MethodsWe used data from three cross-sectional surveys conducted among Montréal MSM in 2005 (n=1795), 2009 (n=1258) and 2018 (n=1086). To ensure comparability of seroprevalence estimates across time, we standardised the 2005 and 2009 time-location samples to the 2018 respondent-driven sample. Time trends overall and stratified by HIV status, history of injection drug use (IDU) and age were examined. Modified Poisson regression analyses with generalised estimating equations were used to identify factors associated with HCV seropositivity pooling all surveys.ResultsStandardised HCV seroprevalence among all MSM remained stable from 7% (95% CI 3% to 10%) in 2005, to 8% (95% CI 1% to 9%) in 2009 and 8% (95% CI 4% to 11%) in 2018. This apparent stability hides diverging temporal trends in seroprevalence between age groups, with a decrease among MSM <30 years old and an increase among MSM aged ≥45 years old. Lifetime IDU was the strongest predictor of HCV seropositivity, and no association was found between HCV seroprevalence and sexual risk factors studied (condomless anal sex with men of serodiscordant/unknown HIV status, number of sexual partners, group sex).ConclusionsHCV seroprevalence remained stable among Montréal MSM between 2005 and 2018. Unlike other settings where HCV infection was strongly associated with sexual risk factors among MSM, IDU was the pre-eminent risk factor for HCV seropositivity. Understanding the intersection of IDU contexts, practices and populations is essential to prevent HCV transmission among MSM.


2021 ◽  
Author(s):  
Ke Chun Zhang ◽  
Yuan Fang ◽  
He Cao ◽  
Hongbiao Chen ◽  
Tian Hu ◽  
...  

BACKGROUND The COVID-19 pandemic creates disruptions on HIV prevention and sexual health services for men who have sex with men (MSM). OBJECTIVE This study compared HIV testing utilization in three different reference periods (i.e., before COVID-19 outbreak, after the outbreak, and after the pandemic was under initial control). Factors associated with HIV testing utilization after COVID-19 outbreak were also investigated. METHODS Participants were Chinese-speaking MSM aged ≥18 years living in Shenzhen, China. Those self-reported as HIV positive were excluded. A total of 595 participants recruited through multiple sources completed a self-administered online survey during August to September 2020. HIV testing uptake between February and July 2020 was the dependent variable, and multivariate logistic regression models were fitted. RESULTS About half of the participants reported any HIV testing uptake between February and July 2020 (n=331, 55.6%). As compared to the time before COVID-19 outbreak (November 2019 to January 2020), HIV testing uptake was significantly lower during February and April 2020 (44.0% versus 61.0%, p<.001). However, HIV testing uptake did not increase significantly after the pandemic was under initial control (May to July 2020) (46.6% versus 44.0%, p=.21). After adjusting for significant background characteristics, factors associated with higher HIV testing uptake between February and July 2020 included: 1) HIV testing uptake prior to COVID-19 outbreak (AOR: 10.75, 95%CI: 7.22, 16.02, p<.001), 2) use of sexually transmitted infections (STI) testing (AOR: 7.02, 95%CI: 4.10, 12.02, p<.001), other HIV/STI prevention (AOR: 3.15, 95%CI: 2.16, 4.60, p<.001) and PrEP (AOR: 3.58, 95%CI: 1.54, 8.34, p=.002) between February and July 2020, 3) CAI with RP (AOR: 2.05, 95%CI: 1.34, 3.13, p=.001) and NRP (AOR: 2.49, 95%CI: 1.39, 4.47, p=.002), and SDU (AOR: 2.72, 95%CI: 1.50, 4.94, p=.001) between February and July 2020, 4) perceived risk of HIV infection at present was higher than the time before COVID-19 outbreak (AOR: 1.15, 95%CI: 1.01, 1.30, p=.03), 5) perceived COVID-19 preventive measures taken up by HIV testing service providers to be effective (AOR: 1.52, 95%CI: 1.29, 1.78, p<.001), and 6) perceived higher behavioral control to take up HIV testing after COVID-19 outbreak (AOR: 1.18, 95%CI: 1.00, 1.40, p=.048). Concerns about COVID-19 infection during HIV testing (AOR: 0.78, 95%CI: 0.68, 0.89, p<.001), avoiding crowed places (AOR: 0.68, 95%CI: 0.48, 0.98, p=0.04) and HIV testing service providers reduced their working hours (AOR: 0.59, 95%CI: 0.48, 0.98, p=0.046) were negatively associated with the dependent variable. CONCLUSIONS HIV testing utilization among Chinese MSM declined after COVID-19 outbreak and did not increase after the pandemic received initial control. Removing structural barriers to access HIV testing caused by COVID-19, modifying perceptions related to HIV testing, and making use of HIV self-testing might be useful strategies to improve HIV testing among MSM during the pandemic.


2020 ◽  
Vol 96 (4) ◽  
pp. 258-264 ◽  
Author(s):  
Zixin Wang ◽  
Phoenix K H Mo ◽  
Yuan Fang ◽  
Mary Ip ◽  
Joseph T F Lau

ObjectivesMen who have sex with men (MSM) are at high risk of hepatitis C virus (HCV). This study investigated predictors of first-time HCV testing uptake during a 6-month period among a sample of MSM in Hong Kong.MethodsParticipants were 351 Chinese-speaking MSM who had never received HCV testing. Participants completed two telephone surveys 6 months apart. At baseline, participants reported on sociodemographics, sexual behaviours, risk perception, depressive symptoms and anxiety symptoms. Illness representations, which refers to how people think about HCV, was measured by the Brief Illness Perception Questionnaire (BIPQ) at baseline. The BIPQ assessed identity (identifying symptoms of HCV), timeline (whether HCV is acute/chronic), consequences (severity of HCV), personal control and treatment control (whether HCV is under volitional control), concern, emotions (anger, guilt or shame) and coherence (overall comprehensibility of HCV). Six months later, participants reported on HCV testing uptake. Logistic regression was used to analyse the associations between baseline predictors and HCV testing uptake.ResultsMost participants were aged ≤30 years (55.0%) and had attained college education or above (85.2%). Among 242 participants (68.9%) who completed the month 6 follow-up, 12.4% had tested for HCV during the follow-up period. After adjustment for HIV testing and chemsex in the last year, participants who perceived more severe consequences of HCV reported higher HCV testing uptake (adjusted ORs (AOR): 2.22, 95% CI: 1.65 to 3.00). Belief that treatment can control HCV (AOR: 1.75, 95% CI: 1.35 to 2.26) and having negative emotions related to HCV (AOR: 1.59, 95% CI: 1.25 to 2.03) were also positively associated with HCV testing uptake.ConclusionsTargeted health promotion efforts are needed to increase HCV testing among MSM in Hong Kong. Healthcare workers engaged in HCV-related programming should consider modifying the illness representations of HCV. Integrating HCV and HIV testing services may also be beneficial.


Sexual Health ◽  
2015 ◽  
Vol 12 (6) ◽  
pp. 565 ◽  
Author(s):  
Rui Cai ◽  
Wende Cai ◽  
Jin Zhao ◽  
Lin Chen ◽  
Zhengrong Yang ◽  
...  

We recruited 510 male sex workers (also referred as ‘money boys’ (MBs) and 533 other men who have sex with men (MSM) to investigate determinants of recent (last year) HIV testing in Shenzhen, China. Overall, 43% of MBs and 48% of other MSM reported having been tested for HIV in the last year. The most important determinant of testing among MBs was having multiple anal sex partners; among other MSM, the most important determinants were having a homosexual orientation and having a history of sexually transmissible infection. For MBs, education programs are needed to increase their awareness of actual HIV risk. For other MSM, destigmatising programs are needed.


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