scholarly journals Are Opportunities Being Missed? Burden of HIV, STI and TB, and Unawareness of HIV among African Migrants

2019 ◽  
Vol 16 (15) ◽  
pp. 2710
Author(s):  
Sónia Dias ◽  
Ana Gama ◽  
Ana Maria Tavares ◽  
Vera Reigado ◽  
Daniel Simões ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Hiv Testing ◽  
Low Socioeconomic Status ◽  
Rapid Test ◽  
Sexual Practices ◽  
Hiv Positive ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
The Past ◽  
African Migrants

Sub-Saharan African migrants (SSAMs) have been disproportionately affected by infectious disease burden. We aimed to identify correlates of HIV, past sexually transmitted infection (STI) and past Tuberculosis infection (TB), as well as examine HIV seropositivity unawareness and testing history among SSAMs. A venue-based sample of 790 SSAMs completed a cross-sectional biobehavioral survey on sexual practices, HIV testing and self-reported infectious diseases; an HIV rapid test was offered. Overall, 5.4% of participants were HIV-positive and 16.7% reported a past STI. Odds of being HIV positive or having a past STI were higher among participants with low socioeconomic status and who experienced violence from a partner. Increased odds of having a past STI were also found among long-term migrants and those who reported sexual risk behaviors. In total, 4.1% of participants had TB in the past; these were more likely male and HIV positive. Unawareness of HIV-positive status was notably high (35%). Half of the participants had never been tested for HIV before, including over a third of those who had STI or TB in the past. Efforts are needed to reduce missed opportunities for HIV/STIs prevention and uptake of HIV testing among SSAMs through more integrated care, while addressing social determinants of infectious diseases.

scholarly journals Correlates of HIV, STI and TB among sub-Saharan African migrants in Lisbon: a biobehavioral study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Dias ◽  
A Gama ◽  
D Simões ◽  
E Carreiras ◽  
C Mora ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Hiv Testing ◽  
Social Determinants ◽  
Low Income ◽  
Social Inequalities ◽  
Rapid Test ◽  
Hiv Positive ◽  
The Past ◽  
African Migrants ◽  
Sub Saharan

Abstract Sub-Saharan African migrants (SAMs) have been disproportionately affected by infectious diseases such as HIV, other sexually transmitted infections (STIs) and Tuberculosis infection (TB). Research on infectious diseases and related factors among migrant populations is critical to further understand these populations' health needs and inform prevention strategies. However, migrants are often underrepresented in national statistics and research. This study aimed to examine correlates of HIV, past STI and past TB among SAMs. A venue-based sample of 790 SSAMs completed a cross-sectional biobehavioral survey on sexual practices, HIV testing and self-reported infectious diseases; an HIV rapid test was offered. Uni- and multivariable logistic regression analyses were performed to examine factors associated with HIV, past STI and past TB. Overall, 5.4% of participants were HIV-positive and 16.7% reported a past STI. Odds of being HIV positive increased by age (OR 1.07, 95%CI 1.03-1.11) and were higher among those who experienced violence from a partner (OR 2.77, 95%CI 1.08-7.10). Increased odds of having a past STI were found among migrants with low income (OR 2.86, 95%CI 1.48-5.56), long-term migrants (>25 years residing in Portugal: OR 2.16, 95%CI 1.06-4.38) and those who reported sexual risk behaviors (≥3 sexual partners: OR 2.06, 95%CI 1.14-3.70; inconsistent condom use: OR 2.61, 95%CI 1.32-5.17). In total, 4.1% of participants had TB in the past; these were more likely male (OR 3.42, 95%CI 1.29-9.06) and HIV positive (OR 11.48, 95%CI 4.55-28.94). Half of the participants had never been tested for HIV before, including over a third of those who had STI or TB in the past. Efforts are needed to reduce missed opportunities for HIV/STIs prevention and uptake of HIV testing among SSAMs through more integrated care, while addressing social determinants of infectious diseases. Key messages High levels of HIV, STI and TB infection among SAMs were found to be strongly associated with socioeconomic disadvantage and poor living conditions in the host country. Social inequalities are persistently a major factor affecting risk for HIV, STIs and TB, and thus addressing social determinants of infectious diseases must remain a public health priority.

scholarly journals Combination prevention and HIV: a cross-sectional community survey of gay and bisexual men in London, October to December 2016

2019 ◽  
Vol 24 (25) ◽  
Author(s):  
Louise Logan ◽  
Ibidun Fakoya ◽  
Alison Howarth ◽  
Gary Murphy ◽  
Anne M Johnson ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Gay And Bisexual Men ◽  
Bisexual Men ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Combination Prevention ◽  
Factors Associated ◽  
The Past ◽  
Increased Risk ◽  
And Bisexual

Background Men who have sex with men (MSM) are at risk of HIV and are an important population to monitor and ameliorate combination prevention efforts. Aim To estimate HIV prevalence and identify factors associated with frequent HIV testing (≥ 2 HIV tests in the last year) and pre-exposure prophylaxis (PrEP) use among MSM in London. Methods For this cross-sectional study, MSM recruited from 22 social venues provided oral-fluid samples for anonymous HIV antibody (Ab) testing and completed a questionnaire. Factors associated with frequent HIV testing and PrEP use were identified through logistic regression. Results Of 767 men recruited, 545 provided an eligible oral specimen. Among these, 38 MSM (7.0%) were anti-HIV positive including five (13.2%; 5/38) who reported their status as negative. Condomless anal sex within the previous 3 months was reported by 60.1% (412/685) men. Frequent HIV testing was associated with, in the past year, a reported sexually transmitted infection (adjusted odds ratio (AOR): 5.05; 95% confidence interval (CI): 2.66–9.58) or ≥ 2 casual condomless partners (AOR 2–4 partners: 3.65 (95% CI: 1.87–7.10); AOR 5–10 partners: 3.34 (95% CI: 1.32–8.49). Age ≥ 35 years was related to less frequent HIV testing (AOR 35–44 years: 0.34 (95% CI: 0.16–0.72); AOR ≥ 45 years: 0.29 (95% CI: 0.12–0.69). PrEP use in the past year was reported by 6.2% (46/744) of MSM and associated with ≥ 2 casual condomless sex partners (AOR: 2.86; 95% CI: 1.17–6.98) or chemsex (AOR: 2.31; 95% CI: 1.09–4.91). Conclusion This bio-behavioural study of MSM found high rates of behaviours associated with increased risk of HIV transmission. Combination prevention, including frequent HIV testing and use of PrEP, remains crucial in London.

scholarly journals Hepatitis and tuberculosis testing are much less common than HIV testing among adults in Kisumu, Kenya: results from a cross-sectional assessment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joshua Tunnage ◽  
Adam Yates ◽  
Chiaka Nwoga ◽  
Valentine Sing’oei ◽  
John Owuoth ◽  
...  
Keyword(s):  
Secondary Education ◽  
Viral Hepatitis ◽  
Hiv Testing ◽  
Spatial Location ◽  
Tuberculosis Screening ◽  
Cross Sectional ◽  
The Past ◽  
Prior Testing ◽  
Testing Uptake ◽  
One Year

Abstract Background Kenya has a high burden of HIV, viral hepatitis, and tuberculosis. Screening is necessary for early diagnosis and treatment, which reduces morbidity and mortality across all three illnesses. We evaluated testing uptake for HIV, viral hepatitis, and tuberculosis in Kisumu, Kenya. Methods Cross-sectional data from adults aged 18–35 years who enrolled in a prospective HIV incidence cohort study from February 2017 to May 2018 were analyzed. A questionnaire was administered to each participant at screening for study eligibility to collect behavioral characteristics and to assess prior testing practices. Among participants without a history of previously-diagnosed HIV, multivariable robust Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV testing in the 12 months prior to enrollment. A hierarchical model was used to test for differential access to testing due to spatial location. Results Of 671 participants, 52 (7.7%) were living with HIV, 308 (45.9%) were female, and the median age was 24 (interquartile range 21–28) years. Among 651 (97.0%) who had ever been tested for HIV, 400 (61.2%) reported HIV testing in the past 6 months, 129 (19.7%) in the past 6–12 months, and 125 (19.1%) more than one year prior to enrollment. Any prior testing for viral hepatitis was reported by 8 (1.2%) participants and for tuberculosis by 51 (7.6%). In unadjusted models, HIV testing in the past year was more common among females (PR 1.08 [95% CI 1.01, 1.17]) and participants with secondary education or higher (PR 1.10 [95% CI 1.02, 1.19]). In the multivariable model, only secondary education or higher was associated with recent HIV testing (adjusted PR 1.10 [95% CI 1.02, 1.20]). Hierarchical models showed no geographic differences in HIV testing across Kisumu subcounties. Conclusions Prior HIV testing was common among study participants and most had been tested within the past year but testing for tuberculosis and viral hepatitis was far less common. HIV testing gaps exist for males and those with lower levels of education. HIV testing infrastructure could be leveraged to increase access to testing for other endemic infectious diseases.

scholarly journals Factors associated with HIV testing among traditional healers and their clients in rural Uganda: Results from a cross-sectional study

2021 ◽  
pp. 095646242110150
Author(s):  
Doreen Nabukalu ◽  
Matthew Ponticiello ◽  
Thomas Bennett ◽  
Sunday Clark ◽  
Rachel King ◽  
...  
Keyword(s):  
Rural Communities ◽  
Hiv Testing ◽  
Cross Sectional Study ◽  
Traditional Healers ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Past ◽  
Male Clients ◽  
Hiv Test ◽  
Testing Uptake

Uptake of HIV testing is suboptimal in Uganda, particularly in rural communities. Reaching UNAIDS 95-95-95 goals requires strategies to increase HIV testing among hard-to-reach populations. This cross-sectional study sought to characterize engagement with HIV testing among traditional healers and their clients in rural Uganda. We enrolled 175 traditional healers and 392 adult clients of healers in Mbarara District. The primary outcome for this study was having received an HIV test in the prior 12 months. Most clients ( n = 236, 65.9%) had received an HIV test within 12 months, compared to less than half of healers ( n = 75, 46.3%) who had not. In multivariate regression models, male clients of healers were half as likely to have tested in the past year, compared with female (adjusted odds ratios (AORs) = 0.43, 95% CI = 0.26–0.70). Increasing age negatively predicted testing within the past year (AOR = 0.95, 95% CI = 0.93–0.97) for clients. Among healers, more sexual partners predicted knowing ones serostatus (AOR = 1.6, 95% CI 1.03–2.48). Healers (AOR = 1.16, 95% CI 1.07–1.26) and clients (AOR = 1.28, 95% CI 1.13–1.34 for clients) with greater numbers of lifetime HIV tests were more likely to have tested in the past year. Traditional healers and their clients lag behind UNAIDS benchmarks and would benefit from programs to increase HIV testing uptake.

scholarly journals Coinfection of Sexually Transmitted Infections among HIV-Positive Individuals: Cross-Sectional Results of a Community-Based Positive Living with HIV (POLH) Study in Nepal

2015 ◽  
Vol 16 (4) ◽  
pp. 338-346 ◽  
Author(s):  
Krishna C. Poudel ◽  
Kalpana Poudel-Tandukar ◽  
Paula H. Palmer ◽  
Tetsuya Mizoue ◽  
Masamine Jimba ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Sexual Practices ◽  
Hiv Positive ◽  
Community Based ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Neisseria Gonorrhea ◽  
Living With Hiv

In Asian concentrated HIV epidemics, data on coinfection of sexually transmitted infections (STIs) among HIV-positive individuals are limited. The authors measured the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), and syphilis, and their correlates among 319 HIV-positive individuals in Kathmandu, Nepal. The authors tested blood samples for syphilis and urine samples for CT and NG. Overall, 17 (5.3%) participants had at least 1 STI (CT: 1.3%, NG: 2.8%, and syphilis: 1.2%). Of 226 participants who had sex in past 6 months, 51.3% did not always use condoms. Older (aged 35-60 years) participants were more likely (adjusted odds ratio [AOR] = 3.83; 95% confidence interval [CI] = 1.19-12.33; P = .024) and those who were currently married (AOR = 0.30; 95% CI = 0.09-0.97; P = .046) or on antiretroviral therapy (AOR = 0.21; 95% CI = 0.06-0.71; P = .012) were less likely to have at least 1 STI. Our results suggest the need to strengthen the efforts to screen and treat STIs and to promote safer sexual practices among Nepalese HIV-positive individuals.

scholarly journals What is the level of uptake of Partner Notification Services in HIV testing  in Selected Health Facilities in Muranga County – Kenya; a retrospective Study

2020 ◽  
Author(s):  
Rewel Kariuki ◽  
Gilbert Koome Rithaa ◽  
Oyugi Elvis ◽  
Daniel Gachathi
Keyword(s):  
Hiv Testing ◽  
Partner Notification ◽  
Sexual Partners ◽  
Health Facilities ◽  
World Health ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Case Identification ◽  
Health Organization

Abstract Background: Identification of people living with HIV is key in HIV prevention and control. Partner Notification service is a World Health Organization backed strategy of reaching out to sexual partners of people diagnosed with HIV for HIV testing. However, its adoption and success rate in Kenya remains unknown.Methods: A cross sectional facility based study was undertaken in five purposively selected health facilities in Muranga County, Kenya. A retrospective review of patient medical records data for HIV positive index clients and their Sexual Partners conducted. Census approach applied to extract data for study subjects from Partner Notification Service registers for the period covering January 2017 to August 2018. Epi Info software was used for data analysis.Results: A total of 183 index clients offered Partner notification services. The mean age of the indexed clients studied was 39(SD ±13.1). Females comprised 64 % of clients studied. Of the 183 indexed clients, 89% accepted the services and elicited 216 sexual partners for tracing. The ratio of elicited sexual partners to index client was 1.3:1. Out of the 216 sexual partners, 77% were reached and tested. A total of 46 [32%] of the sexual partners elicited and traced, tested HIV positive. The most preferred approaches were provider referral (51%) and contract referral (45%). Dual referral (4%) was the least preferred approach. Conclusions: Partner notification services is acceptable and an effective strategy of increasing HIV case identification and raising awareness to exposed sexual partners in low resource countries.

Identifying risk factors for HIV-positive test results in walk-in and hospitalized patients in a Mexico City HIV clinic: a descriptive study

2019 ◽  
Vol 30 (6) ◽  
pp. 569-576
Author(s):  
Ester Gutiérrez-Velilla ◽  
Francisco J Quezada-Juárez ◽  
Ivonne N Pérez-Sánchez ◽  
Maria C Iglesias ◽  
Gustavo Reyes-Terán ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Testing ◽  
Mexico City ◽  
Hiv Risk ◽  
Hospitalized Patients ◽  
Hiv Positive ◽  
City Hospital ◽  
Cross Sectional ◽  
Hiv Test ◽  
Hiv Risk Factors

The objective of this study was to analyze risk factors for HIV-positive tests in walk-in users and in hospitalized patients in a Mexico City hospital. We undertook a cross-sectional study based on routine HIV testing and counseling service data in adults undergoing an HIV test from January 2015 to July 2017. Multivariate analysis was performed to determine risk factors for walk-in and hospitalized patients. The results showed that 2040 people tested during the period; hospitalized patients were more likely to test HIV-positive than walk-in users (18 versus 15%; p < 0.05). HIV risk factors for hospitalized patients included being men who have sex with men (MSM) (adjusted odds ratio [aOR] 7.2, 95% CI 2.0–26.5), divorced (aOR 4.4, 95% CI 1.3–14.4), having 3–5 lifetime sexual partners (aOR 2.7, 95% CI 1.0–7.4), and being in the emergency room (aOR 3.6, 95% CI 1.1–11.3), intensive care (aOR 27.2, 95% CI 3.4–217.2), or clinical pneumology wards (aOR 33.4, 95% CI 9.7–115.2). In the walk-in group, HIV risk factors included being male (aOR 2.8, 95% CI 1.3–5.9), being MSM (aOR 4.3, 95% CI 2.0–9.5), having sex while using drugs (aOR 2.3, 95% CI 1.3–4.0), being referred by a physician for testing (aOR 3.2, 95% CI 1.6–6.3), and perceiving oneself at risk (aOR 3.8, 95% CI 2.3–6.3). Differential risk factors found among hospitalized patients and walk-in testers can be helpful in designing better HIV testing strategies to increase early diagnosis and linkage to care.

scholarly journals Patterns of sexualised recreational drug use and its association with risk behaviours and sexual health outcomes in men who have sex with men in London, UK: a comparison of cross-sectional studies conducted in 2013 and 2016

2019 ◽  
Vol 96 (3) ◽  
pp. 197-203 ◽  
Author(s):  
Tyrone J Curtis ◽  
Alison J Rodger ◽  
Fiona Burns ◽  
Anthony Nardone ◽  
Andrew Copas ◽  
...  
Keyword(s):  
Sexual Health ◽  
Hiv Positive ◽  
Risk Behaviours ◽  
Hiv Status ◽  
Cross Sectional ◽  
The Past ◽  
Unknown Status ◽  
Sex With Men ◽  
Hiv Negative ◽  
Hiv Positive Men

ObjectiveLondon has one of the highest identified prevalence of chemsex (sexualised recreational drug use) among men who have sex with men (MSM) in Europe. We examine MSM’s patterns of chemsex and its association with HIV/STI risk behaviours, STI diagnoses and sexual healthcare-seeking behaviours, including if HIV testing behaviour met UK national guidelines (three monthly if engaging in chemsex).MethodsCross-sectional survey data from 2013 (n=905) and 2016 (n=739) were collected using anonymous, self-administered questionnaires from MSM recruited in commercial gay venues in London, UK. Descriptive and multivariable analyses, stratified by self-reported HIV status, were conducted. Adjusted prevalence ratios (aPR) with 95% CIs were calculated.ResultsComparing the 2013 and 2016 surveys, chemsex prevalence in the past year remained stable, in both HIV-negative/unknown-status MSM (20.9% in 2013 vs 18.7% in 2016, p=0.301) and HIV-positive MSM (41.6% in 2013 vs 41.7% in 2016, p=0.992). Combined 2013–2016 data showed that compared with other MSM, those reporting chemsex were more likely to report HIV/STI risk behaviours, including condomless anal intercourse with serodifferent HIV-status partners (HIV-negative/unknown-status men: aPR 2.36, 95% CI 1.68 to 3.30; HIV-positive men: aPR 4.19, 95% CI 1.85 to 9.50), and STI diagnoses in the past year (HIV-negative/unknown-status men: aPR 2.10, 95% CI 1.64 to 2.69; HIV-positive men: aPR 2.56, 95% CI 1.57 to 4.20). 68.6% of HIV-negative/unknown-status men reporting chemsex attended sexual health clinics and 47.6% had tested for HIV more than once in the past year.ConclusionsChemsex in London MSM remained stable but high, particularly among HIV-positive men. Irrespective of HIV status, chemsex was associated with engagement in HIV/STI risk behaviours. Frequency of HIV testing in the past year among HIV-negative/unknown-status men was below national recommendations. Promoting combination prevention strategies, including three monthly HIV/STI testing, access to pre-exposure prophylaxis/antiretroviral treatment and behavioural interventions among MSM reporting chemsex, remains vital to address sexual health inequalities in MSM.

scholarly journals Trends in HIV prevalence and risk behaviours among men who have sex with men from 2013 to 2017 in Nanjing, China: a consecutive cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e021955 ◽  
Author(s):  
Zhengping Zhu ◽  
Hongjing Yan ◽  
Sushu Wu ◽  
Yuanyuan Xu ◽  
Wenjiong Xu ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Protective Factor ◽  
Hiv Prevalence ◽  
Secondary Outcome ◽  
Risk Behaviours ◽  
Cross Sectional ◽  
The Past ◽  
Testing Rate ◽  
Sex With Men

ObjectiveTo examine the trends of HIV prevalence, risk behaviours and HIV testing among men who have sex with men (MSM) in Nanjing.DesignFive consecutive cross-sectional surveys.SettingNanjing, China.Primary and secondary outcome measuresHIV and syphilis prevalence, HIV testing rate and factors associated with HIV infection; demographic characteristics and behaviours.Results649, 669, 577, 633, 503 MSM were recruited from 2013 to 2017. HIV prevalence was 9.9%, 12.3%, 12.5%, 9.8% and 10.1%, respectively. Syphilis prevalence decreased with a range from 10.6% to 5.6%. Risk behaviours like unprotected anal intercourse (UAI) and unprotected virginal sex in the past 6 months decreased, but multiple sex partners and ever used rush popper rose significantly. MSM tested for HIV in the previous year remained stable from 57.0% to 64.1% (P=0.633). Multivariate analysis showed that tested for HIV in the past year was protective factor against HIV infection. MSM who had UAI in the past 6 months, sex role as receptive and dual, diagnosed with sexually transmitted diseases (STDs) in the past year and currently syphilis infected were risk factors for HIV infection.ConclusionsWe observed stable high HIV prevalence, a steady HIV testing rate, decreasing syphilis prevalence and UAI among MSM in Nanjing. However, rush popper use rose dramatically. The HIV preventive strategies for MSM including condom promotion, HIV testing expansion and reduction of rush popper use, STDs screening and standardised treatment should be strengthened.

Continued high-risk sexual behaviour among HIV-positive people in Wales

2003 ◽  
Vol 14 (11) ◽  
pp. 737-739 ◽  
Author(s):  
Mary R Browning ◽  
Meirion R Evans ◽  
Clive M Rees
Keyword(s):  
High Risk ◽  
Sexual Behaviour ◽  
Postal Questionnaire ◽  
Unprotected Sex ◽  
Sexual Practices ◽  
Hiv Positive ◽  
Sexually Active ◽  
Bisexual Men ◽  
Cross Sectional ◽  
Study Objective

The study objective was to investigate self-reported sexual practices among HIV-positive people in Wales in order to estimate the extent of unprotected sex and to develop services that assist positive people reduce the risk of sexual spread of HIV. A cross-sectional postal questionnaire survey was conducted between February and July 1999 at all open-access HIV outpatient facilities in Wales. All HIV-positive people attending during the study period were invited to enrol in the study. Data were obtained on 104/141 (74%) enrolled patients including 70 (67%) homo/bisexual men. Most (79/104, 76%) were sexually active and 42% (33/79) had casual partners. One in six (13/79, 16.5%) sexually active people reported unprotected high-risk sex with HIVnegative or unknown status partners, the majority (9/13, 69%) of whom were male homosexuals. It is important that health professionals specifically address issues of sexual behaviour with HIV positive people during consultation. A renewed safer sex campaign targeting men who have sex with men is urgently needed.

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