scholarly journals Are men who have sex with men at higher risk for HIV in Latin America more aware of PrEP?

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255557
Author(s):  
Ryan D. Assaf ◽  
Kelika A. Konda ◽  
Thiago S. Torres ◽  
E. Hamid Vega-Ramirez ◽  
Oliver A. Elorreaga ◽  
...  
Keyword(s):  
Social Media ◽  
Latin America ◽  
Hiv Infection ◽  
Risk Index ◽  
Secondary Analysis ◽  
Hiv Infections ◽  
Social Media Platforms ◽  
Unknown Status ◽  
Sex With Men ◽  
Prep Awareness

Introduction PrEP awareness in Latin America has been poorly characterized, with studies in Brazil, Mexico, and Peru highlighting awareness of 65% among gay, bisexual and other men who have sex with men (MSM). We assessed the association between higher risk of HIV infection, indicative of PrEP eligibility, and PrEP awareness among MSM from these countries. Methods This was a secondary analysis of a web-based survey advertised on social media platforms from March-June 2018 in Brazil, Mexico and Peru. Eligible individuals were cisgender MSM, ≥18 years old, HIV negative or of unknown status, who lived in these countries, and provided informed consent. Higher risk of HIV infection was defined as having 10 or more points in the HIV Risk Index for MSM (HIRI-MSM). We used multivariable Poisson regression models to calculate adjusted prevalence ratios (aPR) testing the association between higher risk for HIV and PrEP awareness. Results After exclusions, 19,457 MSM were included in this analysis. 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 minimally associated with PrEP awareness among those in Brazil (aPR 1.04, 95% CI 1.01, 1.06), but no such association was observed in Mexico or Peru. Having more than a high school education, high income, daily use of geosocial networking (GSN) applications, and substance use were associated with PrEP awareness. Conclusion Higher risk of HIV infection was associated with increased PrEP awareness in Brazil. However, this association was weak indicating that PrEP awareness could be strengthened with further prevention efforts. In the remaining countries, results were non-conclusive between risk and awareness. Interventions to increase PrEP awareness are paramount to increase PrEP willingness and uptake and in turn prevent new HIV infections. Social media platforms could play an important role to achieve this goal.

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

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.

scholarly journals Use of multiple recreational drugs is associated with new HIV infections among men who have sex with men in China: a multicenter cross-sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiang Mao ◽  
Sequoia I. Leuba ◽  
Qinghai Hu ◽  
Hongjing Yan ◽  
Zhe Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Risk Behaviors ◽  
Sexual Behaviors ◽  
Hiv Infections ◽  
Recreational Drugs ◽  
Limited Information ◽  
High Risk Behaviors ◽  
Sex With Men ◽  
Recent Hiv Infection

Abstract Background There is limited information about the types of recreational drugs used by men who have sex with men (MSM) in China or the consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods We recruited MSM from seven cities in China between 2012 and 2013 using multiple approaches including advertisements on gay websites, collaborating with local MSM community-based organizations, peer referrals, and venues such as gay bars and bathrooms visited by MSM. We divided participants into four subgroups based on the number of recreational drugs (RDs) used in the previous 6 months. We defined use of multiple RDs as use of ≥2 types of RDs. Demographics and HIV-related high-risk behaviors were collected, and blood samples were tested for recent HIV infection by the HIV-1 subtypes B, E, and D immunoglobulin G capture enzyme immunoassay (BED-CEIA). We used multivariable logistic regression adjusted for sociodemographics to determine the adjusted odds ratios (aORs) and associated 95% confidence intervals (CIs) of the subgroups of RD use for recent or established HIV infection. Results A total of 4496 Chinese MSM participated; 28.4% used RDs, and 5% used multiple types of RDs. The prevalence of each RD use was as follows: poppers (25.9%), ecstasy (2.4%), ketamine (1.2%), amphetamine (0.6%), tramadol (0.4%), methamphetamine (3.8%), and codeine (1.9%). Users of multiple RDs commonly used poppers combined with one or more other types of RDs. Multiple RD users were likely to be aged 26–30 years (vs. 18–25 and > 30 years), live in non-local cities (vs. local cities), never married (vs. married), have a high monthly income (vs. no income and 1–599 USD), use versatile positions during anal intercourse (vs. top or bottom), and have inadequate HIV-related prevention knowledge (vs. adequate). As the number of RDs used in the previous 6 months increased, the prevalence of HIV-related high-risk behaviors increased (P < 0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95% CI: 1.5–3.0) or two types of RD (aOR=2.3, 95% CI: 1.0-5.2) in the previous 6 months compared to the odds among those who did not use RDs. Conclusion The level and pattern of multiple RD use among Chinese MSM were different from high-income countries. MSM who used more RDs are more likely to engage in high-risk sexual behaviors, and these behaviors may be associated with increases in new HIV infections.

The role of sexual risk behaviors on PrEP awareness and interest among men who have sex with men in Latin America

2019 ◽  
Vol 30 (6) ◽  
pp. 542-549 ◽  
Author(s):  
Alberto Edeza ◽  
Omar Galarraga ◽  
David Novak ◽  
Kenneth Mayer ◽  
Joshua Rosenberger ◽  
...  
Keyword(s):  
Latin America ◽  
Latin American ◽  
Online Survey ◽  
The United States ◽  
Sexual Compulsivity ◽  
Transactional Sex ◽  
Behavioral Risk ◽  
Hazardous Alcohol Use ◽  
Sex With Men ◽  
Prep Awareness

In Latin America, men who have sex with men (MSM) remain disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention tool and has been FDA approved in the United States since 2012, but no Latin American state, with the recent exception of Brazil, has implemented PrEP guidelines. We carried out a multinational online survey of MSM in Latin America (n = 22698) in 2012 to assess whether MSM at highest risk of HIV acquisition (i.e., those engaging in condomless anal sex [CAS; n = 2606] and transactional sex [n = 1488]) had higher levels of awareness of PrEP, PrEP use and interest in participating in a PrEP trial. After adjusting for demographic and psychosocial characteristics including depressive symptoms, hazardous alcohol use, childhood sexual abuse, and sexual compulsivity, transactional sex and CAS were associated with increased PrEP awareness (aOR = 1.29, 95% CI: 1.05–1.59, p < .001 and aOR = 1.22, 95% CI: 1.11–1.34, p < .001, respectively) and PrEP trial interest (aOR = 1.45, 95% CI: 1.25–1.71, p < .001 and aOR = 1.74, 95% CI: 1.57–1.95, p < .001, respectively). Findings demonstrate substantial awareness of and interest in PrEP among MSM with behavioral risk factors for HIV in Latin America, suggesting that this region is primed for PrEP implementation, which has been slow.

scholarly journals Association Between HIV-Related Tweets and HIV Incidence in the United States: Infodemiology Study

10.2196/17196 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e17196 ◽  
Author(s):  
Robin Stevens ◽  
Stephen Bonett ◽  
Jacqueline Bannon ◽  
Deepti Chittamuru ◽  
Barry Slaff ◽  
...  
Keyword(s):  
United States ◽  
Social Media ◽  
Hiv Infection ◽  
Language Processing ◽  
Hiv Risk ◽  
Intraclass Correlation ◽  
Hiv Infections ◽  
The United States ◽  
Infection Rates ◽  
Age Range

Background Adolescents and young adults in the age range of 13-24 years are at the highest risk of developing HIV infections. As social media platforms are extremely popular among youths, researchers can utilize these platforms to curb the HIV epidemic by investigating the associations between the discourses on HIV infections and the epidemiological data of HIV infections. Objective The goal of this study was to examine how Twitter activity among young men is related to the incidence of HIV infection in the population. Methods We used integrated human-computer techniques to characterize the HIV-related tweets by male adolescents and young male adults (age range: 13-24 years). We identified tweets related to HIV risk and prevention by using natural language processing (NLP). Our NLP algorithm identified 89.1% (2243/2517) relevant tweets, which were manually coded by expert coders. We coded 1577 HIV-prevention tweets and 17.5% (940/5372) of general sex-related tweets (including emojis, gifs, and images), and we achieved reliability with intraclass correlation at 0.80 or higher on key constructs. Bivariate and multivariate analyses were performed to identify the spatial patterns in posting HIV-related tweets as well as the relationships between the tweets and local HIV infection rates. Results We analyzed 2517 tweets that were identified as relevant to HIV risk and prevention tags; these tweets were geolocated in 109 counties throughout the United States. After adjusting for region, HIV prevalence, and social disadvantage index, our findings indicated that every 100-tweet increase in HIV-specific tweets per capita from noninstitutional accounts was associated with a multiplicative effect of 0.97 (95% CI [0.94-1.00]; P=.04) on the incidence of HIV infections in the following year in a given county. Conclusions Twitter may serve as a proxy of public behavior related to HIV infections, and the association between the number of HIV-related tweets and HIV infection rates further supports the use of social media for HIV disease prevention.

scholarly journals Association Between HIV-Related Tweets and HIV Incidence in the United States: Infodemiology Study (Preprint)

2019 ◽  
Author(s):  
Robin Stevens ◽  
Stephen Bonett ◽  
Jacqueline Bannon ◽  
Deepti Chittamuru ◽  
Barry Slaff ◽  
...  
Keyword(s):  
United States ◽  
Social Media ◽  
Hiv Infection ◽  
Language Processing ◽  
Hiv Risk ◽  
Intraclass Correlation ◽  
Hiv Infections ◽  
The United States ◽  
Infection Rates ◽  
Age Range

BACKGROUND Adolescents and young adults in the age range of 13-24 years are at the highest risk of developing HIV infections. As social media platforms are extremely popular among youths, researchers can utilize these platforms to curb the HIV epidemic by investigating the associations between the discourses on HIV infections and the epidemiological data of HIV infections. OBJECTIVE The goal of this study was to examine how Twitter activity among young men is related to the incidence of HIV infection in the population. METHODS We used integrated human-computer techniques to characterize the HIV-related tweets by male adolescents and young male adults (age range: 13-24 years). We identified tweets related to HIV risk and prevention by using natural language processing (NLP). Our NLP algorithm identified 89.1% (2243/2517) relevant tweets, which were manually coded by expert coders. We coded 1577 HIV-prevention tweets and 17.5% (940/5372) of general sex-related tweets (including emojis, gifs, and images), and we achieved reliability with intraclass correlation at 0.80 or higher on key constructs. Bivariate and multivariate analyses were performed to identify the spatial patterns in posting HIV-related tweets as well as the relationships between the tweets and local HIV infection rates. RESULTS We analyzed 2517 tweets that were identified as relevant to HIV risk and prevention tags; these tweets were geolocated in 109 counties throughout the United States. After adjusting for region, HIV prevalence, and social disadvantage index, our findings indicated that every 100-tweet increase in HIV-specific tweets per capita from noninstitutional accounts was associated with a multiplicative effect of 0.97 (95% CI [0.94-1.00]; <i>P</i>=.04) on the incidence of HIV infections in the following year in a given county. CONCLUSIONS Twitter may serve as a proxy of public behavior related to HIV infections, and the association between the number of HIV-related tweets and HIV infection rates further supports the use of social media for HIV disease prevention.

scholarly journals Predictive factors for HIV infection among men who have sex with men and who are seeking PrEP: a secondary analysis of the PROUD trial

2019 ◽  
Vol 95 (6) ◽  
pp. 449-454 ◽  
Author(s):  
Ellen White ◽  
David T Dunn ◽  
Monica Desai ◽  
Mitzy Gafos ◽  
Peter Kirwan ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Incidence Rate ◽  
Secondary Analysis ◽  
Anal Intercourse ◽  
Receptive Anal Intercourse ◽  
Hiv Incidence ◽  
Open Label ◽  
Eligibility Criteria ◽  
Sex With Men ◽  
Hiv Acquisition

ObjectivesPre-exposure prophylaxis (PrEP) is a highly effective method of HIV prevention for men who have sex with men (MSM). However, uncertainty remains around the optimal eligibility criteria for PrEP, specifically whether there are subgroups at low risk of HIV for whom PrEP might not be warranted.MethodsPROUD was an open-label waitlist trial design that randomised MSM attending participating sexual health centres in England to receive PrEP immediately (IMM) or after a deferral period of 1 year (DEF). This analysis is based on participants who were randomised to the deferred arm, when they did not have access to PrEP. HIV incidence was compared between subgroups defined by baseline characteristics.ResultsOverall, 21 participants acquired HIV infection over 239.3 person-years (PY) follow-up, yielding an incidence rate of 8.8/100 PY (95% CI 5.4 to 13.4). Two highly significant predictors for HIV acquisition were identified. Men with a self-reported diagnosis of syphilis, rectal chlamydia (CT) or rectal gonorrhoea (GC) in the previous 12 months had an incidence of 17.2/100 PY (95% CI 9.7 to 28.5); those reporting receptive anal intercourse without a condom (ncRAI) with two or more partners in the previous 3 months had an incidence of 13.6/100 PY (95% CI 7.9 to 21.7). The incidence rate among participants lacking both of these risk factors was 1.1/100 PY (1/87.6, 95% CI 0.03 to 6.4).ConclusionsThe high HIV incidence in PROUD suggests that most participants appropriately judged their need for PrEP. Eligibility criteria for a PrEP programme can therefore be broad, as in the current guidelines. However, a recent history of syphilis or rectal CT/GC, or multiple ncRAI partners indicates a high imminent risk of HIV infection. MSM with any of these characteristics should be offered PrEP as a matter of urgency.

scholarly journals A qualitative study exploring the social and environmental context of recently acquired HIV infection among men who have sex with men in South-East England

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016494 ◽  
Author(s):  
Annabelle Gourlay ◽  
Julie Fox ◽  
Mitzy Gafos ◽  
Sarah Fidler ◽  
Nneka Nwokolo ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Antibody Test ◽  
Hiv Infections ◽  
Environmental Context ◽  
The Social ◽  
Hiv Seroconversion ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
The Uk ◽  
Different Levels

ObjectivesA key UK public health priority is to reduce HIV incidence among gay and other men who have sex with men (MSM). This study aimed to explore the social and environmental context in which new HIV infections occurred among MSM in London and Brighton in 2015.DesignA qualitative descriptive study, comprising in-depth interviews, was carried out as a substudy to the UK Register of HIV Seroconverters cohort: an observational cohort of individuals whose date of HIV seroconversion was well estimated. An inductive thematic analysis was conducted in NVivo, guided by a socio-ecological framework.SettingParticipants were recruited from six HIV clinics in London and Brighton. Fieldwork was conducted between January and April 2015.ParticipantsAll MSM eligible for the UK Register Seroconverter cohort (an HIV-positive antibody test result within 12 months of their last documented HIV-negative test or other laboratory evidence of HIV seroconversion) diagnosed within the past 12 months and aged ≥18 were eligible for the qualitative substudy. 21 MSM participated, aged 22–61 years and predominantly white.ResultsA complex interplay of factors, operating at different levels, influenced risk behaviours and HIV acquisition. Participants saw risk as multi-factorial, but the relative importance of factors varied for each person. Individual psycho-social factors, including personal history, recent life stressors and mental health, enhanced vulnerability towards higher risk situations, while features of the social environment, such as chemsex and social media, and prevalent community beliefs regarding treatment and HIV normalisation, encouraged risk taking.ConclusionsRecently acquired HIV infection among MSM reflects a complex web of factors operating at different levels. These findings point to the need for multi-level interventions to reduce the risk of HIV acquisition among high-risk MSM in the UK and similar settings.

Engagement of Latino immigrant men who have sex with men for HIV prevention through eHealth: preferences across social media platforms

2021 ◽  
pp. 1-14
Author(s):  
Jane J. Lee ◽  
Joel Aguirre ◽  
Lesster Munguia ◽  
Gabriel Robles ◽  
Kenia Ramirez Hernandez ◽  
...  
Keyword(s):  
Social Media ◽  
Hiv Prevention ◽  
Latino Immigrant ◽  
Social Media Platforms ◽  
Sex With Men ◽  
Immigrant Men
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