Socioeconomic inequalities in HIV knowledge, HIV testing, and condom use among adolescent and young women in Latin America and the Caribbean

Objective. To appraise the presence and magnitude of inter- and intra-country health inequalities related to HIV in Latin America and the Caribbean (LAC) among young females. Methods. We analyzed household surveys in twenty LAC countries, that included data from female adolescents and young women (ages 15-24) between 2008 and 2018, measuring inequality with the concentration index of 4 indicators: 1) whether individuals have heard of HIV or not, 2) a composite variable of correct knowledge, 3) reported condom use with the last partner, and 4) whether individuals were ever tested for HIV. Results. Participants from households in countries with higher socioeconomic status are more likely to have heard of HIV, have correct knowledge of HIV transmission, and have used condoms during their last sexual intercourse. The inter-country concentration index for those indicators were 0.352, 0.302 and 0.110, respectively. Conclusions. Economically disadvantaged female adolescents and young women in LAC face an increased risk for HIV, as they are less aware of HIV and its actual transmission mechanism and are less likely to use condoms with their sexual partners. There is an urgent need to tailor prevention strategies of sexually transmitted infections and HIV for adolescents and young women that are sensitive to their socioeconomic context.

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1031. Mobility and Structural Barriers Contribute to Loss to Follow up from HIV Care in Rural South Africa

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1217 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S546-S546

Author(s):

Alisse Hannaford ◽

Anthony Moll ◽

Thuthukani Madondo ◽

Bulelani Khoza ◽

Sheela Shenoi

Keyword(s):

South Africa ◽

Hiv Transmission ◽

Hiv Care ◽

Structural Barriers ◽

Hiv Knowledge ◽

Rural South ◽

Increased Risk ◽

Rural Settings ◽

Rural South Africa

Abstract Background Retention in care is critical to achieving and sustaining viral load suppression, and reducing HIV transmission, yet lost to follow-up (LTFU) in South Africa remains substantial. We sought to understand reasons for disengagement and return to care in neglected rural settings. Methods Using convenience sampling, surveys were completed by 102 PLWH who disengaged from ART (minimum 90 days) and subsequently resumed care. A subset (n=60) completed individual in-depth interviews. Questions assessed HIV knowledge, stigma, barriers to health care, and reasons for both disengaging and returning to care. Results Among 102 participants (53% female), median duration of ART discontinuation was 9 months (IQR 4-22). Participants had HIV knowledge gaps regarding HIV transmission and increased risk of tuberculosis. Two thirds were unaware that ART prevents transmission to other sexual partners. The major contributors to LTFU were mobility and structural barriers. PLWH traveled for an urgent family need or employment and were not able to collect ART while away. Structural barriers included inability to access care, due to lack of financial resources to reach distant clinics, HIV stigma, dissatisfaction with being treated at an HIV specific clinic, pill fatigue and lack of social support. Illness was the major precipitant of returning to care. Conclusion Among those returning to HIV care, patient motivation to continue ART was high, but mobility and structural barriers impede longitudinal HIV care in rural South Africa, threatening the gains made from expanded ART access. To achieve 90-90-90, future interventions to improve retention must address barriers relevant to rural settings including emphasis on patient-centered care such as multi-month ART prescriptions, expanding medication distribution sites, including community-based dispensing sites, integrating ART into primary care, and facilitating linkage to remote facilities when away from their home clinic. Healthcare workers should be capacitated to identify patients’ barriers to chronic care and intervene on those at high risk of LTFU. Disclosures All Authors: No reported disclosures

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Sexual Risk Behaviors, HIV Prevalence and Access to Reproductive Health Services Among Young Women Migrant Workers in the Industrial Zones in Vietnam

Frontiers in Reproductive Health ◽

10.3389/frph.2021.775375 ◽

2021 ◽

Vol 3 ◽

Author(s):

Toan Ha ◽

Stephen L. Schensul ◽

Jean J. Schensul ◽

Trang Nguyen ◽

Nam Nguyen

Keyword(s):

Condom Use ◽

Young Women ◽

Migrant Workers ◽

Hiv Prevalence ◽

Reproductive Health Services ◽

Hiv Knowledge ◽

Hiv Services ◽

Sexually Transmitted ◽

Low Levels ◽

Industrial Zones

Background: Young migrant workers working in the industrial zones (IZ) in low and middle-income countries are at risk for HIV and other sexually transmitted diseases. This study examines the sex-related risks of young women migrant workers in the IZ in Vietnam.Materials and Methods: This cross-sectional survey was conducted among 1,061 young migrant women working in the IZ park in Hanoi, Vietnam. Multivariate logistic regression analysis was used to identify factors associated with HIV testing and condom use at last sex.Results: A total of 1,061 young women migrant workers completed the survey in which 652 participants consented to take the initial rapid HIV test. All but one participant tested negative indicating a HIV prevalence of 150 (95% CI: 27–860) per 100,000 population among this population. There were no differences in sexual behavior, use of sexual and reproductive health services, HIV knowledge, perceived HIV risk or alcohol use between those who were HIV tested and those not tested. Single participants reported high rates of first sex while living in the IZ and high rates of condom use during the first-time sex, however, they had low levels of condom use at last sex. While the majority of married participants used the SRH/HIV services, nearly 80% of the single participants who reported having sex never used SRH/HIV services since living in the IZ. However, single participants were over 4 times more likely to use condoms at last sex compared to married participants (OR = 4.67; 95%CI = 2.96–7.85). Participants with vocational school or higher education was more likely to use condom (OR = 2.19; 95%CI = 1.05–4.57). Neither HIV knowledge or alcohol use were associated with condom use.Conclusions: Although HIV prevalence is very low among young women workers in the IZ in Vietnam, a significant number of them engaged in risky sexual behavior and low levels of condom use at last sex as well as low level of using SRH/HIV services highlights a need to develop interventions that provide tailored-made and cultural appropriate SRH education for unmarried female migrant workers to prevent risky sexual behaviors, sexually transmitted diseases and unwanted pregnancy.

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Cervical cancer mortality among young women in Latin America and the Caribbean: trend analysis from 1997 to 2030

BMC Public Health ◽

10.1186/s12889-021-12413-0 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

J. Smith Torres-Roman ◽

Luz Ronceros-Cardenas ◽

Bryan Valcarcel ◽

Janina Bazalar-Palacios ◽

Jorge Ybaseta-Medina ◽

...

Keyword(s):

Cervical Cancer ◽

Latin America ◽

Young Women ◽

Cancer Mortality ◽

Mortality Rates ◽

World Health ◽

Mortality Trends ◽

Cervical Cancer Mortality ◽

The World ◽

The Caribbean

Abstract Background Cervical cancer continues to show a high burden among young women worldwide, particularly in low- and middle-income countries. Limited data is available describing cervical cancer mortality among young women in Latin America and the Caribbean (LAC). The purpose of this study was to examine the mortality trends of cervical cancer among young women in LAC and predict mortality rates to 2030. Methods Deaths from cervical cancer were obtained from the World Health Organization mortality database. Age-standardized mortality rates per 100,000 women-years were estimated in women aged 20–44 years using the world standard population for 16 countries (and territories) in LAC from 1997 to 2017. We estimated the average mortality rates for the last 4 years (2014–2017). Joinpoint regression models were used to identify significant changes in mortality trends. Nordpred method was used for the prediction of the mortality rates to 2030. Results Between 2014 and 2017, Paraguay and Venezuela had the highest mortality rates of cervical cancer, whereas Puerto Rico had the lowest rates. Overall, most of the LAC countries showed downward trends of cervical cancer mortality over the entire period. Significant decreases were observed in Chile (Average annual percent change [AAPC]: − 2.4%), Colombia (AAPC: − 2.0%), Cuba (AAPC: − 3.6%), El Salvador (AAPC: − 3.1%), Mexico (AAPC: − 3.9%), Nicaragua (AAPC: − 1.7%), Panama (AAPC: − 1.7%), and Peru (AAPC: − 2.2%). In contrast, Brazil (AAPC: + 0.8%) and Paraguay (AAPC: + 3.7%) showed significant upward trends. By 2030, mortality rates are not predicted to further decrease in some LAC countries, including Argentina, Paraguay, and Venezuela. Conclusions Mortality trends of cervical cancer among young women have large variability in LAC countries. Cervical cancer screening programs have a high priority for the region. Primary and secondary prevention in the community are necessary to accelerate a reduction of cervical cancer mortality by 2030.

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HIV serosorting among HIV-positive men who have sex with men is associated with increased self-reported incidence of bacterial sexually transmissible infections

Sexual Health ◽

10.1071/sh10053 ◽

2011 ◽

Vol 8 (2) ◽

pp. 184 ◽

Cited By ~ 45

Author(s):

Ulrich Marcus ◽

Axel J. Schmidt ◽

Osamah Hamouda

Keyword(s):

Condom Use ◽

Hiv Transmission ◽

Hiv Positive ◽

Hiv Test ◽

Increased Risk ◽

Sexually Transmissible Infections ◽

Sex With Men ◽

Hiv Serosorting ◽

Hiv Negative ◽

Hiv Positive Men

Background: We aimed to quantify the frequency of HIV serosorting among men who have sex with men (MSM) in Germany, and evaluate the association of serosorting with other sexual risk management approaches (RMA) and with the frequency of bacterial sexually transmissible infections (STI). Methods: An anonymous, self-administered questionnaire was distributed through German online sexual networking sites and medical practices in 2006. The analysis was based on 2985 respondents who reported an HIV test result. Based on two questions on RMA, serosorting was classified as tactical (an event-based decision) or strategic (a premeditated search for a seroconcordant partner). The analysis was stratified by HIV serostatus and seroconcordant partnership status. Results: HIV serosorting patterns were different for HIV-positive and HIV-negative participants. Tactical serosorting ranked second after RMA based on condom use (HIV-positive: 55.1%, HIV-negative: 45.1%; P < 0.001). While the overlap of strategic and tactical HIV serosorting among HIV-positive MSM was substantial (58.0%), HIV-negative strategic and tactical serosorting were more distinct (18.1% overlap). Among HIV-positive and HIV-negative respondents, tactical serosorting was associated with reduced condom use. Compared with respondents using RMA other than serosorting, HIV-positive men reporting serosorting had a three-fold increased risk for bacterial STI (strategic: odds ratio (OR) = 2.62; 95% confidence interval (CI): 1.76–3.89; tactical: OR = 3.19; 95% CI: 2.14–4.75; both for respondents without HIV seroconcordant partners). Conclusions: HIV serosorting has emerged as a common RMA among MSM. For HIV-positive MSM, it may contribute to high rates of bacterial STI that may lead to elevated per-contact risks for HIV transmission.

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