Viral suppression among middle-aged and aging MSM living with HIV: Partnership type and quality

Functional support—the availability of material aid, emotional support, or companionship—promotes general well-being. For men who have sex with men (MSM) living with HIV, having a person who supports you associates with viral suppression. This study examines the association between supportive partnerships and HIV viral suppression among middle-aged and aging MSM living with HIV. A total of 423 middle-aged and aging MSM (mean age, 58.2 years) from the Multicenter AIDS Cohort Study provided self-reported data about their partnerships. Separate Poisson regression models assessed how partnership type, support, strain, and duration from April 2017 were associated with repeated viral load measurements up to April 2019. Of the follow-up visits (N = 1289), 90.0% of participants were virally suppressed. Most participants reported being non-Hispanic White (61.0%) and college-educated (83.4%). Participants were asked about their primary partnerships (i.e., “someone they are committed to above anyone else”) and secondary partnerships (i.e., those who can also be intimate or supportive but not necessarily romantic or sexual). The participants reported: no partnerships (45.2%), only primary partnerships (31.0%), only secondary partnerships (11.1%), or both primary and secondary partnerships (12.8%). Primary and secondary partnerships had mean (SD) durations of 15.9 (11.3) and 25.2 (16.5) years, respectively. Participants reporting both primary and secondary partnerships (compared with no partnership) showed significantly higher odds of being virally suppressed (adjusted prevalence ratio [aPR], 1.04; 95% CI, 1.00–1.08; p = 0.043). Albeit not statistically significant, primary-only (aPR, 1.01; 95% CI, 0.97–1.06; p = 0.547) or secondary-only (aPR, 1.03; 95% CI, 0.98–1.08; p = 0.224) partnership types were positively associated with viral suppression. Partner support and strain were not associated with viral suppression in any partnership group. Being older and non-Hispanic Black were positively and negatively associated with viral suppression, respectively. Encouraging partnerships should be considered one of clinicians’ many tools to help middle-aged and aging MSM achieve long-term viral suppression.

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Social Capital, Depressive Symptoms, and HIV Viral Suppression Among Young Black, Gay, Bisexual and Other Men Who Have Sex with Men Living with HIV

AIDS and Behavior ◽

10.1007/s10461-018-2105-6 ◽

2018 ◽

Vol 22 (9) ◽

pp. 3024-3032 ◽

Cited By ~ 14

Author(s):

Sophia A. Hussen ◽

Kirk A. Easley ◽

Justin C. Smith ◽

Neeta Shenvi ◽

Gary W. Harper ◽

...

Keyword(s):

Social Capital ◽

Depressive Symptoms ◽

Viral Suppression ◽

Hiv Viral Suppression ◽

Sex With Men ◽

Living With Hiv

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An urgent need for HIV testing among men who have sex with men and transgender women in Bamako, Mali: Low awareness of HIV infection and viral suppression among those living with HIV

PLoS ONE ◽

10.1371/journal.pone.0207363 ◽

2018 ◽

Vol 13 (11) ◽

pp. e0207363 ◽

Cited By ~ 1

Author(s):

Avi J. Hakim ◽

Kelsey Coy ◽

Padmaja Patnaik ◽

Nouhoum Telly ◽

Tako Ballo ◽

...

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

Viral Suppression ◽

Transgender Women ◽

Sex With Men ◽

Living With Hiv

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ART Adherence, Resistance, and Long-term HIV Viral Suppression in Postpartum Women

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa346 ◽

2020 ◽

Vol 7 (10) ◽

Author(s):

Andrew D Redd ◽

Elton Mukonda ◽

Nai-Chung Hu ◽

Tamsin K Philips ◽

Allison Zerbe ◽

...

Keyword(s):

Viral Load ◽

South African ◽

Viral Suppression ◽

African Women ◽

Load Testing ◽

Resistance Mutations ◽

Hiv Viral Suppression ◽

South African Women ◽

Routine Antenatal Care

Abstract HIV+ South African women who achieved viral suppression during routine antenatal care, but later experienced a viremic episode (viral load >1000 copies/mL), were examined for presence of antiretrovirals and classified as “nonadherers” or “suboptimal adherers.” Women were tested for drug resistance mutations (DRMs) at several time points and underwent viral load testing 36–60 months postpartum. Suboptimal adherers were more likely to have DRM detected during their viremic episode (P = .03) and at a subsequent viremic time point (P = .05). There was no difference in levels of viral suppression 36–60 months later in women with DRM detected vs women who had no evidence of DRM (P = .5).

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1322. A Mobile Technology-Based Intervention Improves HIV Care Continuum for Young People Living with HIV

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1185 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S478-S478

Author(s):

Ping Du ◽

John Zurlo ◽

Tarek Eshak ◽

Tonya Crook ◽

Cynthia Whitener

Keyword(s):

Mobile Technology ◽

Viral Suppression ◽

Retention In Care ◽

Hiv Care ◽

People Living With Hiv ◽

Hiv Care Continuum ◽

Care Continuum ◽

Hiv Viral Suppression ◽

Study Participants ◽

Living With Hiv

Abstract Background Young people living with HIV (YPLWH) have lower rates of retention in care and HIV viral suppression. Multiple barriers exist to engage YPLWH in care. As nearly all YPLWH use their mobile phones to access health information and to communicate with other people, we implemented a mobile technology-based intervention with the goal to improve HIV care continuum in YPLWH. Methods YPLWH were eligible for this study if they were: (1) aged 18–34 years; (2) newly diagnosed with HIV; (3) having a history of being out of care; or (4) not virally suppressed. We recruited YPLWH during January 2017-May 2018 and followed them every 6 months. We developed a HIPAA-compliant mobile application, “OPT-In For Life,” and let participants use this app to manage their HIV care. The app integrated multiple features that enabled users to communicate with the HIV treatment team via a secure messaging function, to access laboratory results and HIV prevention resources, and to set up appointment or medication reminders. We obtained participants’ demographics, app-usage data, and medical records to evaluate if this mobile technology-based intervention would improve HIV care continuum among YPLWH. We used a quasi-experiment study design to compare the rates of retention in care and HIV viral suppression every 6 months between study participants and YPLWH who were eligible but not enrolled in the study. Results 92 YPLWH participated in this study (70% male, 56% Hispanics or Blacks, 54% retained in care, and 66% virally suppressed at baseline). On average study participants used the app 1–2 times/week to discuss various health issues and supportive services with HIV providers, to access HIV-related health information, and to manage their HIV care. At the 6-month evaluation, compared with 88 eligible YPLWH who were not enrolled in this intervention, study participants had increased rates of retention in care (baseline-to-6-month between participants and nonparticipants: 54%–84% vs. 26%–25%) and HIV viral suppression (66%–80% vs. 56%–60%). Conclusion Our study demonstrates using a HIPAA-compliant mobile app as an effective intervention to engage YPLWH in care. This intervention can be adapted by other HIV programs to improve HIV care continuum for YPLWH or broader HIV populations. Disclosures All authors: No reported disclosures.

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Increasing HIV Testing and Viral Suppression via Stigma Reduction in a Social Networking Mobile Health Intervention Among Black and Latinx Young Men and Transgender Women Who Have Sex With Men (HealthMpowerment): Protocol for a Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/24043 ◽

2020 ◽

Vol 9 (12) ◽

pp. e24043

Author(s):

Kathryn Elizabeth Muessig ◽

Jesse M Golinkoff ◽

Lisa B Hightow-Weidman ◽

Aimee E Rochelle ◽

Marta I Mulawa ◽

...

Keyword(s):

Hiv Testing ◽

Viral Suppression ◽

The United States ◽

Hiv Care ◽

Hiv Status ◽

Mhealth Intervention ◽

Sex With Men ◽

The University ◽

Living With Hiv ◽

Hiv Negative

Background Stigma and discrimination related to sexuality, race, ethnicity, and HIV status negatively impact HIV testing, engagement in care, and consistent viral suppression (VS) among young Black and Latinx men who have sex with men and transgender women who have sex with men (YBLMT). Few interventions address the effects of intersectional stigma among youth living with HIV and those at risk for HIV within the same virtual space. Objective Building on the success of the HealthMpowerment (HMP) mobile health (mHealth) intervention (HMP 1.0) and with the input of a youth advisory board, HMP 2.0 is an app-based intervention that promotes user-generated content and social support to reduce intersectional stigma and improve HIV-related outcomes among YBLMT. The primary objective of this study is to test whether participants randomized to HMP 2.0 report improvement in HIV prevention and care continuum outcomes compared with an information-only control arm. We will also explore whether participant engagement, as measured by paradata (data collected as users interact with an mHealth intervention, eg, time spent using the intervention), mediates stigma- and HIV care–related outcomes. Finally, we will assess whether changes in intersectional stigma and improvements in HIV care continuum outcomes vary across different types of social networks formed within the intervention study arms. Methods We will enroll 1050 YBLMT aged 15 to 29 years affected by HIV across the United States. Using an HIV-status stratified, randomized trial design, participants will be randomly assigned to 1 of the 3 app-based conditions (information-only app-based control arm, a researcher-created network arm of HMP 2.0, or a peer-referred network arm of HMP 2.0). Behavioral assessments will occur at baseline, 3, 6, 9, and 12 months. For participants living with HIV, self-collected biomarkers (viral load) are scheduled for baseline, 6, and 12 months. For HIV-negative participants, up to 3 HIV self-testing kits will be available during the study period. Results Research activities began in September 2018 and are ongoing. The University of Pennsylvania is the central institutional review board for this study (protocol #829805) with institutional reliance agreements with the University of North Carolina at Chapel Hill, Duke University, and SUNY Downstate Health Sciences University. Study recruitment began on July 20, 2020. A total of 205 participants have been enrolled as of November 20, 2020. Conclusions Among a large sample of US-based YBLMT, this study will assess whether HMP 2.0, an app-based intervention designed to ameliorate stigma and its negative sequelae, can increase routine HIV testing among HIV-negative participants and consistent VS among participants living with HIV. If efficacious and brought to scale, this intervention has the potential to significantly impact the disproportionate burden of HIV among YBLMT in the United States. Trial Registration ClinicalTrials.gov NCT03678181; https://clinicaltrials.gov/ct2/show/study/NCT03678181. International Registered Report Identifier (IRRID) DERR1-10.2196/24043

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Knowledge and Impact of COVID-19 on Middle-Aged and Older People living with HIV in Lima, Peru

10.1101/2021.04.23.21255998 ◽

2021 ◽

Author(s):

Monica Maria Diaz ◽

Diego M Cabrera ◽

Marcela Gil-Zacarias ◽

Valeria Ramirez ◽

Manuel Saavedra ◽

...

Keyword(s):

Secondary School ◽

Prevalence Ratio ◽

Health Impact ◽

People Living With Hiv ◽

Middle Aged ◽

Cross Sectional ◽

Educational Levels ◽

Informal Workers ◽

Prevention Methods ◽

Living With Hiv

COVID-19 has had an unprecedented worldwide impact, and Peru has had one of the highest COVID-19 case rates despite implementation of an early strict nationwide quarantine. Repercussions on Peru healthcare system may impact vulnerable populations, particularly people with HIV (PWH). We explored the knowledge of COVID-19 and the socioeconomic and health impact of the pandemic among middle-aged and older PWH. A cross-sectional telephone survey was administered to 156 PWH age >=40 years receiving care in one of two large HIV clinics in Lima, Peru. The majority of PWH (age 52+/-7.7 years, 41% female, 65% completed secondary school or less) were knowledgeable regarding COVID-19 symptoms and prevention methods. Nearly half of those employed prior to the pandemic reported job loss. Female sex (unadjusted prevalence ratio [PR] 1.85 [95%CI 1.27-2.69]), low educational level (PR 1.62 [1.06-2.48]) and informal work (PR 1.58 [1.06-2.36]) were risk factors for unemployment but not in adjusted models. Increased anxiety was reported in 64% and stress in 77%. COVID-19 has had a substantial socioeconomic and mental health impact on PWH living in Lima, Peru, particularly those with lower educational levels and informal workers. Efforts are needed to ensure continued medical care and socioeconomic support of PWH in Peru.

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Review of UNAIDS national estimates of men who have sex with men, gay dating application users, and 90-90-90 data

10.1101/186163 ◽

2017 ◽

Cited By ~ 1

Author(s):

Reuben Granich ◽

Somya Gupta ◽

Alex Garner ◽

Sean Howell

Keyword(s):

Quality Data ◽

People Living With Hiv ◽

Emergency Plan ◽

The Public ◽

Left Behind ◽

Hiv Viral Suppression ◽

National Estimates ◽

Nationally Representative ◽

Sex With Men ◽

Living With Hiv

AbstractBackgroundAchieving the 90-90-90 is essential to keep people alive and to end AIDS. Men who have sex with men (MSM) often have the least access to HIV services.PurposeEstimates for key populations are often unavailable, dated or have very wide confidence intervals and more accurate estimates are required.MethodsWe compared registered users from a major gay dating application (2016) from 29 countries with the latest available (2013-2016) UNAIDS estimates by country. We searched the Internet, PubMed, national surveillance reports, UNAIDS country reports, President’s Emergency Plan for AIDS Relief (PEPFAR) 2016 and 2017 operational plans, and conference abstracts for the latest nationally representative continua for MSM.ResultsOf comparison countries, only 18 countries had UNAIDS or other MSM population estimates in the public domain. UNAIDS estimates were larger than the gay dating application users in 9 countries, perhaps reflecting incomplete market penetration for the application. The gay dating application users in 9 countries were above the UNAIDS estimates; 8 were over 30% higher and three more than double the reported estimate. Seven partial or complete nationally representative care continua for MSM were published between 2010 and 2016. Among estimated MSM living with HIV, viral suppression varied between 42% (United States) to 99% (Denmark). The quality of the continua methods varied (quality data not shown).Conclusion“What is not monitored is not done” and social media has significant promise to improve estimates to ensure that MSM and other vulnerable people living with HIV and their communities are not left behind on the way to ending AIDS.

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LOW PSYCHOLOGICAL WELL-BEING AMONG MEN WHO HAVE SEX WITH MEN (MSM) DURING THE SHELTER-IN-PLACE ORDERS TO PREVENT THE COVID-19 SPREAD: RESULTS FROM A NATIONWIDE STUDY

10.1101/2020.09.21.20198929 ◽

2020 ◽

Author(s):

Emerson Lucas Silva Camargo ◽

Bruna Isabela Adolpho de Oliveira ◽

Igor Fessina Siffoni ◽

Anderson Reis de Sousa ◽

Jules Ramon Brito Teixeira ◽

...

Keyword(s):

Social Media ◽

Social Isolation ◽

Prevalence Ratio ◽

Federal District ◽

Well Being ◽

Policy Implications ◽

Cross Sectional ◽

Psychological Well Being ◽

The Social ◽

Sex With Men

ABSTRACTIntroductionLittle is known about how sheltering in place to contain the spread of COVID-19 over extended periods affects individuals’ psychological well-being. This study’s objective was to analyze the factors associated with MSM’s (men who have sex with men) low psychological well-being in the COVID-19 pandemic context.MethodThis cross-sectional study was conducted online in the entire Brazilian territory (26 states and federal district) in April and May 2020. The participants were recruited using an adapted version of Respondent-Driven Sampling (RDS), and Facebook posts. Data were collected using social media and MSM dating apps. We estimated the prevalence, crude prevalence ratio (PR), and respective confidence intervals (CI95%).ResultsThe prevalence of low psychological well-being found in the sample was 7.9%. Associated factors were belonging to the youngest group (PR: 2.76; CI95%: 1.90-4.01), having polyamorous relationships (PR: 2.78; CI95%: 1.51-5.11), not complying with social isolation measures (PR: 6.27; CI95%: 4.42-8.87), not using the social media to find partners (PR: 1.63; CI95%: 1.06-2.53), having multiple sexual partners (PR: 1.80; CI95%: 1.04-3.11), having reduced the number of partners (PR: 2.67; CI95%: 1.44-4.95), and group sex (PR: 1.82; CI95%: 1.23-2.69)ConclusionThe well-being of MSM living in Brazil was negatively affected during the social distancing measures intended to control the spread of COVID-19. The variables that contributed the most to this outcome include social isolation, relationships established with partners, and sexual behavior.Policy ImplicationsPlanning and implementing public policies and actions to promote psychological well-being are needed to improve MSM’s resilience by adopting safe strategies and behavior.

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Understanding How Gay, Bisexual, and Other Men Who Have Sex With Men in China Cope With HIV Care-Related Stressors

AIDS Education and Prevention ◽

10.1521/aeap.2021.33.1.46 ◽

2021 ◽

Vol 33 (1) ◽

pp. 46-61

Author(s):

Chunyan Li ◽

Danielle Giovenco ◽

Willa Dong ◽

M. Kumi Smith ◽

Carol E. Golin ◽

...

Keyword(s):

Social Support ◽

Well Being ◽

Hiv Care ◽

Semistructured Interviews ◽

Stress Coping Strategies ◽

Community Based Organization ◽

Related Stress ◽

Sex With Men ◽

And Coping ◽

Living With Hiv

Understanding how Chinese gay, bisexual, and other men who have sex with men (GBMSM) cope with HIV care-related stressors could improve their care engagement. Qualitative semistructured interviews were conducted with 30 GBMSM living with HIV recruited through clinics and a community-based organization (CBO) in Chengdu, China. Interviews focused on treatment-related stress, coping strategies, social support, and well-being. Half reported symptoms consistent with mild or moderate depression as measured by the PHQ-9 scale. HIV care-related stressors included side effects, difficulty with adherence, and fear of drug resistance. Challenges to coping include navigating contradictory information about HIV and treatment, experiencing stigma and discrimination within medical and nonmedical settings, and managing financial concerns. CBOs, peer groups, and providers were salient sources of social support benefitting coping. To improve sustained HIV care that meets the needs of Chinese GBMSM living with HIV, tailored interventions that address the above-mentioned stressors and coping challenges are likely needed.

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