scholarly journals Individual and Partner Characteristics Associated With Intentions to Use PrEP Among Partnered Men, Trans Men, and Trans Women in Sero-Concordant and -Discordant Relationships in the United States

2020 ◽  
Vol 32 (5) ◽  
pp. 367-377
Author(s):  
Drew A. Westmoreland ◽  
Alexa D'Angelo ◽  
Denis Nash ◽  
Christian Grov
Keyword(s):  
Hiv Transmission ◽  
The United States ◽  
Hiv Positive ◽  
Main Partner ◽  
Trans Men ◽  
Prevention Interventions ◽  
Partner Characteristics ◽  
National Cohort ◽  
Sex With Men ◽  
Exposure Prophylaxis

Despite proven effectiveness in reducing HIV transmission, pre-exposure prophylaxis (PrEP) use remains low among those who meet the recommended CDC guidance for PrEP use. Data are from a U.S. national cohort of men and trans persons who have sex with men (2017–2018). Logistic regression analyses were used to determine individual and partner factors associated with intentions to use PrEP among non-PrEP-using participants reporting a main partner (n = 1,671). Prior PrEP use among participants (14.2%) and their partners (7.7%) was low. Participants’ prior PrEP use and main partner's HIV-positive status were both positively associated with intentions to use PrEP. HIV prevention interventions incorporating main partners may be effective in increasing PrEP use.

scholarly journals Sociocultural Influences on Attitudes Toward Pre-exposure Prophylaxis (PrEP), History of PrEP Use, and Future PrEP Use in HIV-Vulnerable Cisgender Men Who Have Sex With Men Across the United States

2020 ◽  
Vol 1 (2) ◽  
pp. 128-158
Author(s):  
Drew A. Westmoreland ◽  
Viraj V. Patel ◽  
Alexa B. D'Angelo ◽  
Denis Nash ◽  
Christian Grov
Keyword(s):  
Social Media ◽  
Hiv Transmission ◽  
Social Influences ◽  
The United States ◽  
Social Connections ◽  
Sources Of Information ◽  
National Cohort ◽  
History Of ◽  
Sex With Men ◽  
Exposure Prophylaxis

Despite its proven effectiveness in reducing HIV transmission, pre-exposure prophylaxis (PrEP) use remains low. This study used data from a 2017–2018 U.S. national cohort to investigate social influences on PrEP experience and future PrEP use among cisgender men who have sex with men. We used descriptive statistics and multivariable logistic analyses to examine social influences (e.g., how participants heard about PrEP and number of persons they knew taking PrEP) associated with each previous PrEP use and intentions to use PrEP. Among participants who knew of PrEP, commonly reported ways of first hearing about PrEP were through social media (27.4%) and friends (26.8%). These were also cited top influences on participants' current attitudes toward PrEP (friends 23.5%, social media 22.1%). Multivariable logistic regression analyses found that knowing more people taking PrEP was associated with increased odds of previously using PrEP and intending to use PrEP. Friends and social media were common and influential sources of information regarding PrEP. Results suggest that tapping into these social connections may effectively disseminate public health messaging about PrEP and encourage use among key populations to reduce HIV burden.

scholarly journals Statewide Evaluation of New HIV Diagnoses in Rhode Island: Implications for Prevention

2018 ◽  
Vol 133 (4) ◽  
pp. 489-496
Author(s):  
Philip A. Chan ◽  
Madeline C. Montgomery ◽  
Jennifer Rose ◽  
Alec Tributino ◽  
Christina Crowley ◽  
...  
Keyword(s):  
United States ◽  
Rhode Island ◽  
Latent Class ◽  
Hiv Transmission ◽  
The United States ◽  
Newly Diagnosed ◽  
Foreign Born ◽  
Class 1 ◽  
Sex With Men ◽  
Exposure Prophylaxis

Objectives: Patterns of HIV transmission vary widely across demographic groups. Identifying and engaging these groups are necessary to prevent new infections and diagnose disease among people who are unaware of their infection. The objective of this study was to determine characteristics of newly diagnosed individuals across an entire state to determine patterns of HIV transmission. Methods: We evaluated data on people with new HIV diagnoses in Rhode Island from 2013 through 2015. We performed a latent class analysis (LCA) to identify underlying demographic and behavioral characteristics of people with newly diagnosed HIV. Results: Of 167 people with new HIV diagnoses interviewed in Rhode Island from 2013 through 2015, 132 (79%) were male, 84 (50%) were nonwhite, 112 (67%) were men who have sex with men (MSM), 112 (67%) were born in the United States, and 61 (37%) were born in Rhode Island. LCA revealed 2 major classes. Of the 98 people in class 1, 96% were male, 85% were MSM, 80% were white, 94% were born in the United States, and 80% believed they acquired HIV in Rhode Island. Class 2 was 63% male and 69% Hispanic/Latino; 29% were born in the United States, and 61% believed they acquired HIV in Rhode Island. Conclusions: Most new HIV diagnoses in Rhode Island were among MSM born in the United States, and a substantial number were likely infected in-state. People with newly diagnosed HIV who were foreign-born, including Hispanic/Latino and heterosexual groups, were less likely to have acquired HIV in Rhode Island than were MSM. HIV prevention approaches, including pre-exposure prophylaxis, should be adapted to the needs of specific groups. Rhode Island offers lessons for other states focused on eliminating HIV transmission.

Prior HIV testing behaviour is associated with HIV testing results among men, trans women and trans men who have sex with men in the United States

2020 ◽  
pp. jech-2019-213493
Author(s):  
Christian Grov ◽  
Drew Westmoreland ◽  
Sarit A Golub ◽  
Denis Nash
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
The United States ◽  
Hiv Positive ◽  
Methamphetamine Use ◽  
Trans Men ◽  
Negative Results ◽  
Sex With Men ◽  
Positive Results ◽  
Hiv Negative

BackgroundAmong those at high risk for HIV, it is important to examine the ways in which someone who has recently tested for HIV might differ from someone who has not.MethodsIn 2017–2018, a total of 5001 men, trans women and trans men who have sex with men from across the United States completed an online survey about their recent testing behaviour as well as self-collected oral samples for HIV testing.ResultsIn total, 3.8% tested HIV-positive and—among those with positive results—35% were recent HIV infections (ie, self-reported an HIV-negative test result within the 12 months prior to enrollment). Those with HIV-positive results—regardless of how recent their HIV test was prior to enrollment—differed from those with negative results in ways that are known to be associated with HIV risk: racial and income disparities, housing instability, recent transactional sex and recent methamphetamine use. Among those with HIV-positive results at enrollment, only having a primary care physician distinguished those who recently tested negative prior to enrollment versus not. Among those with HIV-negative results, there were numerous differences between those who had recently tested for HIV prior to enrollment, versus not, such that those who had not recently tested were significantly more likely to report being at higher risk for HIV.ConclusionStrategies aimed at improving more frequent HIV testing among HIV-negative persons at high risk for HIV should address other needs including stable housing, transactional sex, access to a primary care provider and methamphetamine use.

scholarly journals Engagement in group sex among geosocial networking mobile application-using men who have sex with men

Sexual Health ◽  
2015 ◽  
Vol 12 (6) ◽  
pp. 495 ◽  
Author(s):  
Gregory Phillips ◽  
Christian Grov ◽  
Brian Mustanski
Keyword(s):  
Drug Use ◽  
Hiv Transmission ◽  
Significant Risk ◽  
The United States ◽  
Hiv Positive ◽  
Multivariable Logistic Regression Analysis ◽  
Mobile Phone Application ◽  
Geosocial Networking ◽  
Sex With Men ◽  
Group Sex

Background: Men who have sex with men (MSM) remain the group most affected by the HIV epidemic in the United States. At least one-quarter of MSM report engagement in group sex events (GSEs), which can pose a risk for HIV transmission and acquisition. In this study, identification of event-level correlates of sexual and drug use behaviours at GSEs was sought to better inform prevention activities. Methods: For this study, participants were recruited via banner and pop-up advertisements placed on a geosocial networking mobile phone application that MSM use to meet men. Results: Of the 1997 individuals who completed the study screener, 36.0% reported participating in at least one GSE in the prior year. In multivariable logistic regression analysis, attendance at a GSE in the past year was significantly associated with older age, full/part time employment and being HIV positive. Of the men who attended a GSE, more than half reported condomless anal sex (CAS) with at least one of their partners (insertive: 57.7%; receptive: 56.3%). MSM who indicated drug use had significantly higher odds of having insertive CAS [odds ratio (OR) = 2.45; 95% confidence interval (CI): 1.37–4.39] and receptive CAS (OR = 3.60; 95% CI: 1.96–6.63) at their last GSE. Conclusions: The high prevalence of HIV-positive MSM engaging in group sex, coupled with their greater odds of CAS, poses a significant risk for HIV/STI transmission within the group sex setting. More research is needed to determine patterns of condom use at these events and whether seroadaptive behaviours are driving CAS.

scholarly journals Implementation of a Rapid Entry Program Decreases Time to Viral Suppression Among Vulnerable Persons Living With HIV in the Southern United States

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Jonathan Colasanti ◽  
Jeri Sumitani ◽  
C Christina Mehta ◽  
Yiran Zhang ◽  
Minh Ly Nguyen ◽  
...  
Keyword(s):  
United States ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
Positive Impact ◽  
Population Level ◽  
The United States ◽  
Clinic Visit ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Sex With Men

Abstract Background Rapid entry programs (REPs) improve time to antiretroviral therapy (ART) initiation (TAI) and time to viral suppression (TVS). We assessed the feasibility and effectiveness of a REP in a large HIV clinic in Atlanta, Georgia, serving a predominately un- or underinsured population. Methods The Rapid Entry and ART in Clinic for HIV (REACH) program was implemented on May 16, 2016. We performed a retrospective cohort study with the main independent variable being period of enrollment: January 1, 2016, through May 15, 2016 (pre-REACH); May 16, 2016, through July 31, 2016 (post-REACH). Included individuals were HIV-infected and new to the clinic with detectable HIV-1 RNA. Six-month follow-up data were collected for each participant. Survival analyses were conducted for TVS. Logistic and linear regression analyses were used to evaluate secondary outcomes: attendance at first clinic visit, viral suppression, TAI, and time to first attended provider visit. Results There were 117 pre-REACH and 90 post-REACH individuals. Median age (interquartile range [IQR]) was 35 (25–45) years, 80% were male, 91% black, 60% men who have sex with men, 57% uninsured, and 44% active substance users. TVS decreased from 77 (62–96) to 57 (41–70) days (P < .0022). Time to first attended provider visit decreased from 17 to 5 days, and TAI from 21 to 7 days (P < .0001), each remaining significant in adjusted models. Conclusions This is the largest rapid entry cohort described in the United States and suggests that rapid entry is feasible and could have a positive impact on HIV transmission at the population level.

scholarly journals Birth Cohort Variations Across Functional Knowledge of HIV Prevention Strategies, Perceived Risk, and HIV-Associated Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States

2018 ◽  
Vol 12 (6) ◽  
pp. 1824-1834 ◽  
Author(s):  
Akshay Sharma ◽  
Erin M. Kahle ◽  
Stephen P. Sullivan ◽  
Rob Stephenson
Keyword(s):  
Hiv Prevention ◽  
Birth Cohort ◽  
Perceived Risk ◽  
The United States ◽  
Prevention Strategies ◽  
The Past ◽  
Hiv Prevention Strategies ◽  
Functional Knowledge ◽  
Sex With Men ◽  
Exposure Prophylaxis

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain heavily impacted by HIV. The purpose of this study was to describe intergenerational differences in functional knowledge of HIV prevention strategies, perceived risk, recent condomless anal sex (CAS), and HIV testing behavior. Eight hundred sexually active GBMSM were recruited via Facebook from August to September 2015, and administered a Web-based survey which included 12 multiple-choice questions to elicit data regarding functional knowledge of different HIV prevention approaches (e.g., condom use, pre-exposure prophylaxis post-exposure prophylaxis, treatment as prevention, circumcision). Cumulative logit and multivariable logistic models were formulated to examine birth cohort variations across four analytic outcomes. Younger generations were significantly more knowledgeable, as were GBMSM with higher education. Non-Hispanic non-White GBMSM and those reporting a bisexual/other sexual orientation had lower functional knowledge. Younger generations were equally concerned about contracting HIV as their older counterparts. Perceived risk was significantly higher among non-Hispanic non-White and Hispanic GBMSM, but lower among those with higher education and those in a relationship. Finally, birth cohort variations with respect to engaging in CAS with ≥2 men in the past 3 months and testing for HIV in the past year were not markedly pronounced. Younger GBMSM might be more knowledgeable about HIV prevention strategies compared to their predecessors, but are equally concerned about contracting HIV. Researchers and practitioners should consider intergenerational and other demographic differences while designing multifaceted HIV prevention programs for GBMSM.

scholarly journals The reporting of the mode of transmission among HIV-positive men who have sex with men in Lviv oblast, Ukraine, 2014-2018

2020 ◽  
Vol 14 (11.1) ◽  
pp. 122S-127S
Author(s):  
Maryana Sluzhynska ◽  
Olga Denisiuk ◽  
Ruzanna Grigoryan ◽  
Yulia Sereda ◽  
Gennadiy Slabkiy ◽  
...  
Keyword(s):  
Urban Areas ◽  
Hiv Transmission ◽  
Cross Sectional Study ◽  
Medical Doctor ◽  
Hiv Care ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Aids Epidemic ◽  
Mode Of Transmission ◽  
Sex With Men

Introduction: Men who have sex with men (MSM) are one of the key populations driving HIV/AIDS epidemic globally. To date, MSM is the only population in Ukraine where the prevalence and incidence of HIV is increasing. As HIV-positive MSM might feel uncomfortable to report homosexual intercourses as a possible mode of transmission (MoT) of HIV, they prefer being registered as patients with heterosexual or non-defined MoT. This study aimed to calculate the proportion of misclassified MoT among HIV-positive MSM registered in Lviv oblast, Ukraine, during 2014-2018. Methodology: Cross-sectional study with 127 HIV-positive MSM patients from Lviv region for the period of 2014-2018. Results: Out of 127 HIV-positive MSM included in the study, 110 (86.6%) were from urban areas. In addition, 52 patients (40.9%) were diagnosed with stage 1 HIV, 16 (12.6%) – stage 2, 19 (15%) – stage 3, and 36 (28.3%) – stage 4. CD4 count < 200 cells/μL was found in 35 (27.6%) patients. Mean time from registration to antiretroviral therapy initiation was 80 days. During the first visit to medical doctor out of those 48 patients who had previously reported “other modes” of HIV transmission, 33 patients (68.7%) disclosed homosexual MoT of HIV. The remaining 15 (31.3%) patients disclosed their homosexual MoT of HIV later – during their regular follow-up visits to the doctor. Conclusion: Special measures are needed to improve the reporting of homosexual MoT which can potentially strengthen the HIV care among MSM.

scholarly journals 1701. Added Benefits of Pre-exposure Prophylaxis Use on HIV Incidence with Minimal Changes in Efficiency in the Context of High Treatment Engagement among Men Who Have Sex with Men

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S833-S833
Author(s):  
Alyson L Singleton ◽  
Brandon D Marshall ◽  
Xiao Zang ◽  
Amy S Nunn ◽  
William C Goedel
Keyword(s):  
African American ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Treatment Engagement ◽  
Hiv Incidence ◽  
Black African ◽  
African American Msm ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
High Treatment

Abstract Background Although there is ongoing debate over the need for substantial increases in PrEP use when antiretroviral treatment confers the dual benefits of reducing HIV-related morbidity and mortality and the risk of HIV transmission, no studies to date have quantified the potential added benefits of PrEP use in settings with high treatment engagement across variable sub-epidemics in the United States. Methods We used a previously published agent-based network model to simulate HIV transmission in a dynamic network of 17,440 Black/African American and White MSM in Atlanta, Georgia from 2015 to 2024 to understand how the magnitude of reductions in HIV incidence attributable to varying levels of PrEP use (0–90%) changes in potential futures where high levels of treatment engagement (i.e. the UNAIDS ‘90-90-90’ goals and eventual ‘95-95-95’ goals) are achieved and maintained, as compared to current levels of treatment engagement in Atlanta (Figure 1). Model inputs related to HIV treatment engagement among Black/African American and White men who have sex with men in Atlanta. A comparison of current levels of treatment engagement (Panel A) to treatment engagement at ‘90-90-90’ (Panel B) and ‘95-95-95’ goals (Panel C). Results Even at achievement and maintenance of ‘90-90-90’ goals, 75% PrEP coverage reduced incidence rates by an additional 67.9% and 74.2% to 1.53 (SI: 1.39, 1.70) and 0.355 (SI: 0.316, 0.391) per 100 person-years for Black/African American and White MSM, respectively (Figure 2), compared to the same scenario with no PrEP use. Additionally, an increase from 15% PrEP coverage to 75% under ‘90-90-90’ goals only increased person-years of PrEP use per HIV infection averted, a measure of efficiency of PrEP, by 8.1% and 10.5% to 26.7 (SI: 25.6, 28.0) and 73.3 (SI: 70.6, 75.7) among Black/African American MSM and White MSM, respectively (Figure 3). Overall (Panel A) and race-stratified (Panel B and Panel C) marginal changes in HIV incidence over ten years among Black/African American and White men who have sex with men in Atlanta across scenarios of varied levels of treatment engagement among agents living with HIV infection and levels of pre-exposure prophylaxis use among HIV-uninfected agents. Note: All changes are calculated within each set of treatment scenarios relative to a scenario where no agents use pre-exposure prophylaxis. Person-years of pre-exposure prophylaxis use per HIV infection averted among Black/African American (Panel A) and White (Panel B) men who have sex with men in Atlanta across scenarios of varied levels of treatment engagement among agents living with HIV infection and levels of pre-exposure prophylaxis use among HIV-uninfected agents. Note: The number of HIV infections averted is calculated within each set of treatment scenarios relative to a scenario where no agents use pre-exposure prophylaxis. Conclusion Even in the context of high treatment engagement, substantial expansion of PrEP use still contributes to meaningful decreases in HIV incidence among MSM with minimal changes in person-years of PrEP use per HIV infection averted, particularly for Black/African American MSM. Disclosures All Authors: No reported disclosures

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