scholarly journals Who Falls Between the Cracks? Identifying Eligible PrEP Users Among People With Sub-saharan African Migration Background Living in Antwerp, Belgium

2020 ◽  
Author(s):  
Buffel Veerle ◽  
Caroline Masquillier ◽  
Thijs Reyniers ◽  
Ella Van Landeghem ◽  
Edwin Wouters ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Population Group ◽  
Demographic Characteristics ◽  
Migration Background ◽  
Equitable Access ◽  
Community Based ◽  
Eligibility Criteria ◽  
Sub Saharan ◽  
Hiv Acquisition ◽  
Hiv Risk Factors

Abstract Background: This study estimates the proportion of eligible PrEP users among people of Sub-Saharan African background based on the Belgian PrEP eligibility criteria and examines associations with socio-economic and demographic characteristics.Methods: We performed logistic regression analysis on data of a representative community-based survey conducted among sub-Saharan African communities (n=686) living in Antwerp. Results: Almost a third (30.3%) of the respondents were eligible to use PrEP. Those who were male, single, lower educated, undocumented, and had experienced forced sex were more likely to be eligible for PrEP use. The findings highlight the importance of taking intra-, interpersonal and structural HIV risk factors into account.Conclusions: The study shows high unmet PrEP needs in this population, especially among those with high vulnerability for HIV acquisition. A better understanding of barriers to PrEP use in this population group is needed to allow for equitable access.

scholarly journals Who falls between the cracks? Identifying eligible PrEP users among people with Sub-Saharan African migration background living in Antwerp, Belgium

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256269
Author(s):  
Veerle Buffel ◽  
Caroline Masquillier ◽  
Thijs Reyniers ◽  
Ella Van Landeghem ◽  
Edwin Wouters ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Population Group ◽  
Demographic Characteristics ◽  
Migration Background ◽  
Equitable Access ◽  
Community Based ◽  
Eligibility Criteria ◽  
Sub Saharan ◽  
Hiv Acquisition ◽  
Hiv Risk Factors

Introduction This study produces an estimate of the proportion of eligible PrEP users among people of Sub-Saharan African background based on the Belgian PrEP eligibility criteria and examines associations with socio-economic and demographic characteristics. Methods We performed logistic regression analysis on data of a representative community-based survey conducted among Sub-Saharan African communities (n = 685) living in Antwerp. Results Almost a third (30.3%) of the respondents were eligible to use PrEP. Those who were male, single, lower educated, undocumented, and had experienced forced sex were more likely to be eligible for PrEP use. The findings highlight the importance of taking intra-, interpersonal and structural HIV risk factors into account. Conclusions The study shows high unmet PrEP needs in this population, especially among those with high vulnerability for HIV acquisition. A better understanding of barriers to PrEP use in this population group is needed to allow for equitable access.

scholarly journals Disparities Within the Disparity—Determining HIV Risk Factors Among Latino Gay and Bisexual Men Attending a Community-Based Clinic in Los Angeles, CA

2016 ◽  
Vol 73 (2) ◽  
pp. 237-244 ◽  
Author(s):  
Matthew R. Beymer ◽  
Robert E. Weiss ◽  
Perry N. Halkitis ◽  
Farzana Kapadia ◽  
Danielle C. Ompad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Los Angeles ◽  
Hiv Risk ◽  
Gay And Bisexual Men ◽  
Bisexual Men ◽  
Community Based ◽  
And Bisexual ◽  
Hiv Risk Factors

Risk for HIV acquisition among sub-Saharan African migrant travelers in Belgium and Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Dias ◽  
J Loos ◽  
A Gama ◽  
D Simões ◽  
C Nöstlinger
Keyword(s):  
Host Country ◽  
Hiv Risk ◽  
Sexual Behaviors ◽  
Host Countries ◽  
Cross Sectional ◽  
Condomless Sex ◽  
Prevention Interventions ◽  
African Migrant ◽  
Sub Saharan ◽  
Hiv Acquisition

Abstract Migrants often travel back to the origin countries and to other European states after settling in the residence country. Mobility along with structural vulnerabilities may increase HIV acquisition risk. Knowledge on HIV risk exposure when traveling is limited, yet crucial to inform prevention. This study aims to explore risky sexual behaviors and assess HIV prevalence among sub-Saharan African migrants (SAMs) who travel, residing in two European cities. Two cross-sectional biobehavioral surveys were conducted in Lisbon and Antwerp with a venue-based sample of 1508 SAMs. Descriptive and multivariable logistic regression analyses were performed to examine travel patterns and associated sexual risk behaviors. Overall, 68.4% of participants had traveled to other countries after settling in the residence country; 41% had traveled back to Africa and within Europe, 25.2% only to Africa and 33.8% only to Europe. Among travelers who reported sexual encounters abroad (49.2%), condomless sex at last intercourse was high both abroad (62.5%) and in the host country (70.7%). Odds of condomless sex at the last sexual encounter in the host country were five times higher among those who also reported no condom use abroad [OR: 5.32; 95% CI: 2.98-9.25], controlling for gender, age, educational level, relationship status, survey country, partner type and origin, and number of sexual partners over the last year. Condomless sex was higher with a regular partner and with an African partner, both abroad (79.9% and 67.5%, respectively) and in the host country (81.3% and 74.6%, respectively). Among the 75 participants who tested HIV-positive (around 5%), more than half had travelled to other countries; of these, about half reported condomless sex with their last sexual partner abroad. SAMs are a mobile population and are exposed to sexual HIV risk both while traveling and in host countries. Prevention interventions should address the complex interplay between migrants' mobility and HIV risk. Key messages Migrants often travel to their origin home countries and other destinations after having settled in host countries, and this mobility increases exposure to HIV risk. A transnational perspective on HIV prevention and sexual health promotion is needed for effectively reducing migrants’ HIV risk related to their mobility.

scholarly journals Penile Anaerobic Dysbiosis as a Risk Factor for HIV Infection

mBio ◽  
2017 ◽  
Vol 8 (4) ◽  
Author(s):  
Cindy M. Liu ◽  
Jessica L. Prodger ◽  
Aaron A. R. Tobian ◽  
Alison G. Abraham ◽  
Godfrey Kigozi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Inflammatory Response ◽  
Hiv Infection ◽  
Hiv Risk ◽  
Immune Cells ◽  
Target Cells ◽  
Increased Risk ◽  
Hiv Acquisition ◽  
Hiv Risk Factors

ABSTRACT Sexual transmission of HIV requires exposure to the virus and infection of activated mucosal immune cells, specifically CD4 + T cells or dendritic cells. The foreskin is a major site of viral entry in heterosexual transmission of HIV. Although the probability of acquiring HIV from a sexual encounter is low, the risk varies even after adjusting for known HIV risk factors. The genital microbiome may account for some of the variability in risk by interacting with the host immune system to trigger inflammatory responses that mediate the infection of mucosal immune cells. We conducted a case-control study of uncircumcised participants nested within a randomized-controlled trial of male circumcision in Rakai, Uganda. Using penile (coronal sulcus) swabs collected by study personnel at trial enrollment, we characterized the penile microbiome by sequencing and real-time PCR and cytokine levels by electrochemiluminescence assays. The absolute abundances of penile anaerobes at enrollment were associated with later risk of HIV seroconversion, with a 10-fold increase in Prevotella , Dialister , Finegoldia , and Peptoniphilus increasing the odds of HIV acquisition by 54 to 63%, after controlling for other known HIV risk factors. Increased abundances of anaerobic bacteria were also correlated with increased cytokines, including interleukin-8, which can trigger an inflammatory response that recruits susceptible immune cells, suggesting a mechanism underlying the increased risk. These same anaerobic genera can be shared between heterosexual partners and are associated with increased HIV acquisition in women, pointing to anaerobic dysbiosis in the genital microbiome and an accompanying inflammatory response as a novel, independent, and transmissible risk factor for HIV infection. IMPORTANCE We found that uncircumcised men who became infected by HIV during a 2-year clinical trial had higher levels of penile anaerobes than uncircumcised men who remained HIV negative. We also found that having higher levels of penile anaerobes was also associated with higher production of immune factors that recruit HIV target cells to the foreskin, suggesting that anaerobes may modify HIV risk by triggering inflammation. These anaerobes are known to be shared by heterosexual partners and are associated with HIV risk in women. Therefore, penile anaerobes may be a sexually transmissible risk factor for HIV, and modifying the penile microbiome could potentially reduce HIV acquisition in both men and women.

Gender Differences in HIV Risk-Factors in Main-Partner Relationships

2011 ◽  
Author(s):  
Danielle Uding ◽  
Kanisha Collie ◽  
Kevin Wells ◽  
Zoe Peterson ◽  
Akshay Iyengar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Hiv Risk ◽  
Main Partner ◽  
Partner Relationships ◽  
Hiv Risk Factors

A cholera outbreak among semi-nomadic pastoralists in northeastern Uganda: epidemiology and interventions

2011 ◽  
Vol 140 (8) ◽  
pp. 1376-1385 ◽  
Author(s):  
M. J. CUMMINGS ◽  
J. F. WAMALA ◽  
M. EYURA ◽  
M. MALIMBO ◽  
M. E. OMEKE ◽  
...  
Keyword(s):  
Female Gender ◽  
Sub Saharan Africa ◽  
Cholera Outbreak ◽  
Community Based ◽  
Nomadic Pastoralists ◽  
Sub Saharan ◽  
Water And Sanitation Infrastructure ◽  
Sanitation Infrastructure ◽  
Village Health Teams

SUMMARYIn sub-Saharan Africa, many nomadic pastoralists have begun to settle in permanent communities as a result of long-term water, food, and civil insecurity. Little is known about the epidemiology of cholera in these emerging semi-nomadic populations. We report the results of a case-control study conducted during a cholera outbreak among semi-nomadic pastoralists in the Karamoja sub-region of northeastern Uganda in 2010. Data from 99 cases and 99 controls were analysed. In multivariate analyses, risk factors identified were: residing in the same household as another cholera case [adjusted odds ratio (aOR) 6·67, 95% confidence interval (CI) 2·83–15·70], eating roadside food (aOR 2·91, 95% CI 1·24–6·81), not disposing of children's faeces in a latrine (aOR 15·76, 95% CI 1·54–161·25), not treating drinking water with chlorine (aOR 3·86, 95% CI 1·63–9·14), female gender (aOR 2·43, 95% CI 1·09–5·43), and childhood age (10–17 years) (aOR 7·14, 95% CI 1·97–25·83). This is the first epidemiological study of cholera reported from a setting of semi-nomadic pastoralism in sub-Saharan Africa. Public health interventions among semi-nomadic pastoralists should include a two-faceted approach to cholera prevention: intensive health education programmes to address behaviours inherited from insecure nomadic lifestyles, as well as improvements in water and sanitation infrastructure. The utilization of community-based village health teams provides an important method of implementing such activities.

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