Responsive Medical Providers and Recent HIV Medical Services Engagement Among Transgender Women and Cisgender Men Who Have Sex With Men in the Philippines

2021 ◽  
Vol 33 (6) ◽  
pp. 495-510
Author(s):  
John Guigayoma ◽  
Amiel Nazer Bermudez ◽  
Maylin Palatino ◽  
Jennifer Nazareno ◽  
Susan Cu-Uvin ◽  
...  
Keyword(s):  
Hiv Infections ◽  
The Philippines ◽  
Transgender Women ◽  
Medical Services ◽  
Medical Providers ◽  
Medical Provider ◽  
The Past ◽  
Service Engagement ◽  
Sex With Men ◽  
The Relationship

Transgender women and cisgender men who have sex with men (trans-WSM and cis-MSM) comprise the majority of new HIV infections in the Philippines. There is limited research in the Philippines on the relationship between having a provider responsive to the needs of these populations and recent engagement in HIV medical services such as HIV testing and treatment. We used multivariate logistic regression to examine the relationship between having a responsive medical provider and engagement in HIV medical services in the past 12 months among an online sample of 318 trans-WSM and cis-MSM in the Philippines. Participants without a responsive medical provider had lower adjusted odds of recent HIV medical service engagement than those who did (aOR = 0.32, 95% CI [0.16, 0.62], p = .00). In stratified analyses, this relationship was significant for trans-WSM but not cis-MSM. Increasing access to responsive providers in the Philippines could bolster recent engagement with HIV medical services.

scholarly journals Using structural equation modelling to characterise multilevel socioecological predictors and mediators of condom use among transgender women and cisgender men who have sex with men in the Philippines

2020 ◽  
Vol 5 (7) ◽  
pp. e002463
Author(s):  
Arjee Restar ◽  
Adedotun Ogunbajo ◽  
Alexander Adia ◽  
Jennifer Nazareno ◽  
Laufred Hernandez ◽  
...  
Keyword(s):  
Social Capital ◽  
Condom Use ◽  
Self Efficacy ◽  
Latent Variables ◽  
Structural Equation ◽  
The Philippines ◽  
Transgender Women ◽  
Health Crisis ◽  
Hiv Services ◽  
Sex With Men

BackgroundRisks for condomless sex among transgender women and cisgender men who have sex with men (trans-WSM and cis-MSM, respectively) in the Philippines, where HIV recently became a national public health crisis, are shaped and exacerbated by various risk factors across multiple levels.MethodsBetween June 2018 and August 2019, we conducted a cross-sectional online study with 318 trans-WSM and cis-MSM respondents from Manila and Cebu cities. Structural equational modelling procedures were performed to determine direct, indirect and overall effects between condom use and latent variables across multiple socioecological levels: personal (ie, condom self-efficacy), social (ie, social capital), environmental (ie, barriers to condom and HIV services) and structural (ie, structural violence, antidiscrimination policies).ResultsAdjusted for gender, age, location and income, our model showed that: (1) all latent variables at the structural and environmental levels were significantly positively associated with each other (all ps<0.05); (2) barriers to condom and HIV services were significantly negatively associated with social capital (p<0.001) as well as condom self-efficacy (p<0.001); and (3) there were significantly positive associations between social capital and condom self-efficacy (p<0.001), and between condom self-efficacy and condom use (p<0.001). Moreover, social capital and condom self-efficacy fully mediated and buffered the negative effects between environmental and structural barriers and condom use.ConclusionThis is the first known study pointing to multiple relationships and pathways across multiple socioecological levels that can potentially be leveraged for future interventions aimed at improving condom use among Filipinx trans-WSM and cis-MSM. Such interventions should be multicomponent and build and/or strengthen social capital and condom self-efficacy, as well as intentionally target prominent structural and environmental barriers to condom use.

scholarly journals The Dawn of State Medicine in Britain

1967 ◽  
Vol 60 (5) ◽  
pp. 483-487
Author(s):  
R M S McConaghey
Keyword(s):  
General Practitioner ◽  
Medical Association ◽  
British Medical Association ◽  
Medical Services ◽  
State Medicine ◽  
State Control ◽  
The Past ◽  
History Of ◽  
The Government ◽  
The Relationship

Dr R M S McConaghey traces the development of State control in the provision of medical services and also describes the rise in status of the general practitioner, from the early apothecary-surgeons. Mr Paul Vaughan describes the history of the British Medical Association and its development from the Provincial Medical and Surgical Association, founded by Sir Charles Hastings. He considers the relationship between the BMA and the Government, both in the past and present.

The influence of COVID-19 on healthcare seeking behaviors among students attending a minority-serving institution: A cross-sectional study (Preprint)

2021 ◽  
Author(s):  
Neal Malik ◽  
Kassandra Harding ◽  
Andres Garcia
Keyword(s):  
University Students ◽  
Online Survey ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Medical Providers ◽  
Medical Provider ◽  
Cross Sectional ◽  
Healthcare Seeking ◽  
Signed Rank ◽  
The Relationship

BACKGROUND COVID-19 may influence healthcare seeking behaviors among university students due to their beliefs about the virus, disruptions in access to care, or both. This has not been studied among university students, particularly those attending a minority-serving institution (MSI). OBJECTIVE To examine the effects of COVID-19 on healthcare seeking behaviors among students attending an MSI. METHODS An online survey was sent to all registered students at a public MSI between February and March 2021. Frequency of in-person and virtual contacts with a healthcare professional across a sample of months in 2019 and 2020 were compared using Wilcoxon Signed Rank Tests. RESULTS Approximately 52.5% reported no in-person visits during the pandemic compared to 47.8% pre-pandemic (Z = -1.800, P = .07). Approximately 47.7% reported no virtual contact during the pandemic compared to 77.5% reporting no virtual contact with a medical provider pre-pandemic (Z = 11.011, P < .001). When in-person and virtual contacts were combined, 43.5% of respondents reported no virtual or in-person contact with medical providers pre-pandemic compared with 34.1% during the pandemic (Z = 3.918, P <.001). CONCLUSIONS Among university students attending a public MSI, in-person visits and contact with their respective healthcare providers decreased during the current COVID-19 pandemic. These results are of particular importance given the relationship between seeking healthcare and the maintenance of health behaviors.

HIV incidence trends vary between jurisdictions in Australia: an extended back-projection analysis of men who have sex with men

Sexual Health ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. 138 ◽  
Author(s):  
Kylie-Ann Mallitt ◽  
David P. Wilson ◽  
Ann McDonald ◽  
Handan Wand
Keyword(s):  
South Australia ◽  
Hiv Infections ◽  
Surveillance Data ◽  
Hiv Incidence ◽  
Back Projection ◽  
Hiv Diagnosis ◽  
Incidence Trends ◽  
The Past ◽  
Sex With Men ◽  
Incident Cases

Background Trends in HIV diagnoses differ across Australia and are primarily driven by men who have sex with men (MSM). We use national population surveillance data to estimate the incidence of HIV infections among MSM by jurisdiction and infer the proportion of undiagnosed infections. Methods: Annual surveillance data for AIDS diagnoses, HIV diagnoses and recently acquired HIV infections were obtained from 1980 to 2009. A modified statistical back-projection method was used to reconstruct HIV incidence by jurisdiction. Results: HIV incidence among MSM peaked for all jurisdictions in the early 1980s and then declined into the early 1990s, after which incidence increased. Trends then differ between jurisdictions. In New South Wales (NSW) and South Australia, estimated HIV incidence peaked at 371 and 50 cases respectively in 2003, and has since decreased to 258 and 24 cases respectively in 2009. HIV infections in Queensland (Qld) have more than doubled over the past decade, from 84 cases in 2000 to 192 cases in 2009. Victoria and Western Australia have seen a rise in HIV incidence from 2000 to 2006 (to a peak of 250 and 38 incident cases respectively), followed by a plateau to 2009. HIV incidence in the Northern Territory, Tasmania and Australian Capital Territory have increased since 2000; however, case numbers remain small (<20 per year). The estimated proportion of HIV infections not yet diagnosed to 2009 ranges from 10% (NSW) to 18% (Qld), with an average of 12% across Australia. Conclusions: HIV diagnosis trends among MSM in Australia reflect changes in estimated incidence to 2009, and reveal the largest increase in the past 10 years in Qld.

scholarly journals Preventive HIV Vaccines-Leveraging on Lessons from the Past to Pave the Way Forward

Vaccines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1001
Author(s):  
Parveen Sobia ◽  
Derseree Archary
Keyword(s):  
Immune Responses ◽  
Female Genital Tract ◽  
Hiv Infections ◽  
Hiv Vaccine ◽  
Effective Vaccine ◽  
Hiv Vaccines ◽  
The Past ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Female Genital

Almost four decades on, since the 1980’s, with hundreds of HIV vaccine candidates tested in both non-human primates and humans, and several HIV vaccines trials later, an efficacious HIV vaccine continues to evade us. The enormous worldwide genetic diversity of HIV, combined with HIV’s inherent recombination and high mutation rates, has hampered the development of an effective vaccine. Despite the advent of antiretrovirals as pre-exposure prophylaxis and preventative treatment, which have shown to be effective, HIV infections continue to proliferate, highlighting the great need for a vaccine. Here, we provide a brief history for the HIV vaccine field, with the most recent disappointments and advancements. We also provide an update on current passive immunity trials, testing proof of the concept of the most clinically advanced broadly neutralizing monoclonal antibodies for HIV prevention. Finally, we include mucosal immunity, the importance of vaccine-elicited immune responses and the challenges thereof in the most vulnerable environment–the female genital tract and the rectal surfaces of the gastrointestinal tract for heterosexual and men who have sex with men transmissions, respectively.

scholarly journals The Relationship Between Risk Perception and Frequency of HIV Testing Among Men Who Have Sex with Men and Transgender Women, Lima, Peru

2018 ◽  
Vol 22 (S1) ◽  
pp. 26-34 ◽  
Author(s):  
S. K. Vargas ◽  
K. A. Konda ◽  
S. R. Leon ◽  
B. Brown ◽  
J. D. Klausner ◽  
...  
Keyword(s):  
Risk Perception ◽  
Hiv Testing ◽  
Transgender Women ◽  
Sex With Men ◽  
The Relationship

scholarly journals Polydrug use is associated with new HIV infections among men who have sex with men in China: a multicenter cross-sectional survey

2019 ◽  
Author(s):  
Xiang Mao ◽  
Sequoia I. Leuba ◽  
Qinghai Hu ◽  
Hongjing Yan ◽  
Zhe Wang ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Infections ◽  
Developed Countries ◽  
Dose Effect ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Polydrug Use ◽  
The Past ◽  
Sex With Men ◽  
Recent Hiv Infection

Abstract Background Recreational drug use is popular among men who have sex with men (MSM), while there is limited information about polydrug use and its consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods MSM were recruited from a multicenter cross-sectional survey conducted in seven Chinese cities. Participants were divided into four subgroups based on the number of recreational drugs (RDs) used in the past 6 months. “Polydrug use” was defined as simultaneous use of ≥2 types of RDs. Information on demographics and HIV high-risk behaviors (HIV-HRBs) was collected, and blood samples were tested for recent HIV infection by the BED capture enzyme immunoassay. Results A total of 4,496 Chinese MSM participated, of which 28.4% used RDs, and 5% were polydrug users. Polydrug users commonly took poppers with one or more types of other RDs (e.g. methamphetamine). Polydrug users were likely to be aged 26–30 years, have low educational attainment, be internal migrants, have a high monthly income, use versatile positions during anal intercourse, and have inadequate knowledge about prevention of HIV infection (P<0.05 for all). As the number of RDs used in the past 6 months increased, the prevalence of HIV-HRBs 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 RDs (2.3, 1.0–5.2) in the past 6 months compared with those who did not use RDs. The population-attributable fractions of most HIV-HRBs for recent HIV infection were higher among polydrug users compared with those who used only one type of RD or used no RD in the past 6 months. Conclusion The level and pattern of polydrug use among Chinese MSM were different from developed countries. Polydrug use had a dose-effect relationship with HIV-HRBs. Polydrug users who have greater levels of RDs use are more likely to engage in various sexual risks, thus may associated with new HIV infections.

Could sexually transmissible infections be contributing to the increase in HIV infections among men who have sex with men in Australia?

Sexual Health ◽  
2008 ◽  
Vol 5 (2) ◽  
pp. 131 ◽  
Author(s):  
Melanie G. Middleton ◽  
Andrew E. Grulich ◽  
Ann M. McDonald ◽  
Basil Donovan ◽  
Jane S. Hocking ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Hiv Infections ◽  
Surveillance Data ◽  
Multiple Sources ◽  
The Past ◽  
Sti Testing ◽  
Urban Men ◽  
Sexually Transmissible Infections ◽  
Laboratory Surveillance ◽  
Sex With Men

Background: To review existing data on sexually transmissible infections (STI) in men who have sex with men in Australia in order to determine the possible contribution of STI to diverging trends in HIV notifications in different states. Methods: We reviewed data from multiple sources, including routine national surveillance data, laboratory surveillance data, self-reported information on STI testing in men who have sex with men and ad hoc reports of STI prevalence. Results: We found increasing rates of gonorrhoea and infectious syphilis notifications in urban men in Australia between 1997 and 2006, and increasing rates of chlamydia notifications in men aged 30–49 years. There was little difference in these trends by state. Differences in the population groups sampled meant we were unable to gain further information on trends in men who have sex with men from these studies. Data on STI testing showed an increase in anal STI testing between 2003 and 2006, which may have increased the number of diagnoses of chlamydia and gonorrhoea for men who have sex with men during this period. Conclusions: Over the past 10 years, there has been a substantial increase in diagnoses of gonorrhoea and infectious syphilis, and probably chlamydia, in men who have sex with men in Australia. However, it is unlikely that changes in the pattern of STI transmission are responsible for the recent divergence in HIV rates between Australian states because there is little evidence that trends in STI also differ by state.

scholarly journals Why we need pre-exposure prophylaxis: incident HIV and syphilis among men, and transgender women, who have sex with men, Bangkok, Thailand, 2005–2015

2019 ◽  
Vol 30 (5) ◽  
pp. 430-439 ◽  
Author(s):  
TH Holtz ◽  
W Wimonsate ◽  
PA Mock ◽  
S Pattanasin ◽  
W Chonwattana ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Treponema Pallidum ◽  
Hiv Infections ◽  
Transgender Women ◽  
Hiv Incidence ◽  
Syphilis Infection ◽  
Transmitted Infection ◽  
Sti Prevention ◽  
Voluntary Counseling And Testing ◽  
Sex With Men

We describe incident human immunodeficiency virus (HIV) and syphilis trends in men who have sex with men (MSM) and transgender women (TGW) presenting for HIV voluntary counseling and testing (VCT) services and sexually transmitted infection (STI) management at the Silom Community Clinic, Bangkok, Thailand. Clients underwent rapid HIV testing and syphilis rapid plasma reagin (RPR) testing. For incidence analysis, we included clients with >1 follow-up visit. Initial negative HIV with subsequent positive HIV defined incident HIV infection; incident syphilis infection was defined as negative RPR followed by positive RPR (titer ≥1:8) and confirmatory anti- Treponema pallidum antibodies. Calculation of incidence using Poisson regression assumed a uniform probability distribution throughout the seroconversion interval. From 15 September 2005 to 31 December 2015, we tested 10,158 clients for HIV and 10,324 for syphilis. Overall, 7109 clients tested HIV-seronegative and contributed 7157 person-years (PY). Three-hundred forty-seven incident HIV infections resulted in an incidence rate of 4.8 per 100 PY (95% confidence interval [CI] 4.4–5.4). We found an inverted U-shape trend of HIV incidence over time with a peak of 6.4 per 100 PY in quarter 2/2011 ( p < 0.01) (Poisson with RCS function, p = 0.001). Overall, 8713 clients tested seronegative for syphilis and contributed 8623 PY. The incidence of syphilis infection was 4.4 per 100 PY (95% CI 3.9–4.8). Despite an apparent decline in HIV incidence among MSM and TGW attending VCT services, syphilis incidence rose and remained high. Evaluating temporal trends of HIV and syphilis incidence provides an opportunity to evaluate epidemic trajectories and target limited program funding. We recommend focused HIV and STI prevention interventions for MSM in Bangkok.

Factors associated with unprotected anal intercourse and age among men who have sex with men who are gay bar customers in Osaka, Japan

Sexual Health ◽  
2012 ◽  
Vol 9 (4) ◽  
pp. 328 ◽  
Author(s):  
Jane Koerner ◽  
Satoshi Shiono ◽  
Seiichi Ichikawa ◽  
Noriyo Kaneko ◽  
Hiroyuki Tsuji ◽  
...  
Keyword(s):  
Drug Use ◽  
Age Groups ◽  
Hiv Infections ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Age Group ◽  
Sex With Men ◽  
Bisexual Identity ◽  
Older Msm ◽  
The Relationship

Background HIV infections among men who have sex with men (MSM) are increasing in Japan. Method: An anonymous self-administered questionnaire among clients of a gay bar in Osaka was used to analyse the relationship between age and unprotected anal sex (UAI). Results: The highest rate of UAI was reported among those aged ≥45 (73.3%), followed by the ≤24 (60.7%), 25–34 (56.3%) and 35–44 (54.0%) age groups (P = 0.01). In multivariate analysis, UAI was related to sex with six or more sexual partners among those aged ≤24 (adjusted odds ratio (AOR), 4.88; confidence interval (CI), 1.21–19.74), bisexual identity (AOR, 2.47; CI, 1.06–5.76) and drug use (AOR, 0.49; CI, 0.26–0.93 for no drug use) in the 25–34 age group, and no lifetime HIV testing in the 35–44 age group (AOR, 2.57; CI, 1.40–4.74). Condom purchasing and condom carrying were protective of UAI in 25–34, 35–44 and ≥45 age groups. Conclusion: Programs promoting condom use are needed for younger and older MSM.

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