scholarly journals Knowledge, Attitudes and Practices Regarding Pre-Exposure Prophylaxis (PrEP) in a Sample of Italian Men Who Have SEX with MEN (MSM)

Author(s):  
Gianluca Voglino ◽  
Maria Rosaria Gualano ◽  
Stefano Rousset ◽  
Pietro Forghieri ◽  
Isabella Fraire ◽  
...  

Background: Pre-exposure prophylaxis (PrEP) is suitable for high human immunodeficiency virus (HIV)-infection risk people, foremost among whom are males who have sex with other males (MSM). This study evaluated knowledge, attitudes and practices regarding PrEP in a sample of Italian MSM, in order to hypothesize strategies to implement PrEP awareness and use. No previous study has assessed this issue; Methods: An online survey was given to an opportunistic sample of Italian MSM. The questionnaire investigated sexual behaviour and habits, HIV/acquired immune deficiency syndrome (AIDS) knowledge and PrEP awareness, attitudes and practices. Univariable and multivariable logistic regressions were conducted to identify factors associated with PrEP knowledge; Results: A total of 196 MSM participated in this survey. Overall data showed that 87.2% of participants knew what PrEP is, but only 7.5% have ever used it. The main reason for not using PrEP was the cost of the therapy (26.9%). The principal source of PrEP information was the Internet (68.4%). Being regularly tested for HIV was significantly associated with PrEP knowledge (adjusted odds ratio (AdjOR) = 3.16; confidence interval (CI) = 1.06–9.29); Conclusions: Knowledge regarding PrEP was well established, but PrEP use was not equally widespread. It is necessary to improve research on PrEP usage in order to PrEP access to be granted.

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
G Voglino ◽  
MR Gualano ◽  
S Rousset ◽  
F Bert ◽  
R Siliquini ◽  
...  

Abstract Background Pre-exposure prophylaxis (PrEP) is suitable for human immunodeficiency virus (HIV)high-infection-risk people, foremost amongst males who have sex with other males (MSM). This study evaluated knowledge, attitudes and practices regarding PrEP in a sample of Italian MSM, in order to hypothesize strategies to implement PrEP awareness and use. Methods An online survey was given to an opportunistic sample of Italian MSM. The questionnaire investigated sexual behaviour, knowledge on HIV and PrEP awareness, attitudes and practices. Univariable and multivariable logistic regressions were conducted to identify possible associations with PrEP knowledge. Results A total of 196 MSM completed the survey. Overall data showed very good HIV and safe sexual behaviour knowledge (94.4% of correct answers). Nevertheless, our sample rarely used PrEP because of existing barriers: high therapy price (26.9%)and fear of side effects (23.8%). Only 10.3% of partecipants were informed on HIV and PReP by institutional channels, even less (7.5%) from specialized physicians and general practitioners. The most significant association with PrEP knowledge was having regular HIV-tests (adjusted odds ratio (AdjOR) = 3.16; confidence interval (CI) = 1.06-9.29); Conclusions PreP's Knowledge was well established, but PrEP use was not widespread. It is necessary to improve communication on PrEP and to lower existing barriers in order to grant access to PrEP access. Key messages Barriers to access PrEP have to be lowered. Healthcare personnel has to be involved in PrEP's benefits communication.


2019 ◽  
Author(s):  
Thiago Silva Torres ◽  
Kelika Konda ◽  
E. Hamid Vega-Ramirez ◽  
Oliver Antonio Elorreaga Reyes ◽  
Dulce Diaz-Sosa ◽  
...  

BACKGROUND HIV epidemics disproportionally affect key populations including men who have sex with men (MSM). HIV prevalence among MSM varies from 17% in Brazil and Mexico to 13% in Peru, while it is below 0.5% for the general population. Pre-exposure prophylaxis (PrEP) with daily oral emtricitabine/tenofovir is being implemented in the context of combination HIV prevention. Reports on PrEP awareness, willingness to use, and acceptability among MSM have started to emerge over the last few years. Previously reported factors associated with willingness to use PrEP include: awareness, low cost, higher sexual risk behavior, prior sexually transmitted infection, and unwillingness to use condoms. OBJECTIVE This study aims to evaluate the factors associated with willingness to use daily oral PrEP among MSM in three Latin American, middle-income countries (Brazil, Mexico and Peru). METHODS This online cross-sectional survey was advertised in two gay social network apps (Grindr and Hornet) used by MSM to find sex partners and on Facebook during two months in 2018. Inclusion criteria were ≥18 years of age, cisgender men, and HIV-negative by self-report. Eligible individuals answered questions on: demographics, behavior, and PrEP (awareness, willingness to use, barriers and facilitators). Multivariable logistic regression modeling was performed to assess the factors associated with willingness to use daily oral PrEP in each country. RESULTS From a total sample of 43,687 individuals, 19,457 (45%) MSM were eligible and completed the online survey (Brazil: 58%, Mexico: 31%, Peru: 11%); median age was 28 years (IQR: 24-34), almost half lived in large urban cities and 89% self-defined as homosexual. Most of the participants were recruited on Grindr (69%). Almost 20% had never tested for HIV and condomless receptive anal sex was reported by 46% in the previous 6 months. A total of 13,110 (67%) would be eligible for PrEP (adapted from WHO risk criteria), but only 10% of participants had high HIV risk perception. PrEP awareness was reported by 65%, this was lower in Peru (46%). Overall, willingness to use PrEP was reported by 64%, highest in Mexico (70%) and lowest in Peru (58%). In multivariate regression models adjusted for age, schooling, and income: in each country willingness to use PrEP was positively associated with PrEP awareness and PrEP facilitators (e.g. free PrEP and HIV testing), and negatively associated with behavioral (e.g., concerned by daily pill regimen) and belief barriers (e.g., sex partners may expect condomless anal sex). CONCLUSIONS In this first cross-country online survey in Latin America, willingness to use PrEP was found to be high and directly related to PrEP awareness. Interventions to increase awareness and PrEP knowledge about safety and efficacy are crucial to increase PrEP demand. This study provides important information to support the implementation of PrEP in Brazil, Mexico and Peru.


2020 ◽  
Vol 7 (1) ◽  
pp. 10-17
Author(s):  
Oluwatosin Olateju ◽  
◽  
Deb Dunn ◽  
Patricia McLaine ◽  
Sharon Barrett ◽  
...  

Objectives To date, only few United States (US) states have explicit regulations that allow minors to independently give consent for human immunodeficiency virus infection (HIV) prevention treatments. This manuscript will reflect upon key advocacy efforts leading to the revision of the Maryland Minor Consent Law, evaluate current human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) prevention laws for minors in U.S. states, and highlight resources for health advocacy. Methods Between 2018-2019, public health professionals in Baltimore, Maryland reviewed the Maryland Minor Consent Law and other adolescent consent laws within the U.S. The professionals advocated for a legal review of the gap by the State Senate and the Office of Attorney General. Results In May 2019, the public health advocates were successful in their effort for a revision of the Maryland Minor Consent Law to include Treatment for the Prevention of HIV-Consent by minors. Upon their review of all adolescent consent laws within the U.S., they found that only eleven states currently have explicit language indicative of an adolescent’s ability to give consent for pre-exposure prophylaxis (PrEP). Conclusion This inquiry can change upstream factors such as laws, regulations, policies and institutional practices.


2018 ◽  
Vol 30 (4) ◽  
pp. 371-377
Author(s):  
J Gini ◽  
A Amara ◽  
Sujan D Penchala ◽  
David J Back ◽  
L Else ◽  
...  

Herbal medication use amongst people living with human immunodeficiency virus (PLWH) is widespread and understudied. This study aimed to evaluate the prevalence of herbal medicine use amongst PLWH and possible contamination with antiretrovirals (ARVs). Countrywide collection of herbal samples sold by street vendors in Nigeria for the following indications: human immunodeficiency virus (HIV), acquired immune deficiency syndrome, fever and general weakness. Samples were screened using a validated liquid chromatography-mass spectrometry/mass spectrometry method for the presence of the following ARVs: efavirenz, nevirapine, lopinavir, darunavir, ritonavir, atazanavir, emtricitabine, tenofovir and lamivudine. A survey was conducted among 742 PLWH attending four HIV clinics in Nigeria. Data were collected using a structured questionnaire and analysed using IBM SPSS statistics version 22.0 (IBM Corp., 2013, Armond, NY). Of the 138 herbal medicines sampled, three (2%) contained detectable levels of tenofovir, emtricitabine and/or lamivudine. Additionally, of the 742 PLWH surveyed, 310 (41.8%) reported herbal medicine use. Among the users, 191 (61.6%) started taking herbals after commencing HIV therapy while herbal medicine use preceded ARVs treatment in 119 (38.4%) PLWH. We found herbal use to be widespread among PLWH in Nigeria, with increasing use after commencing ARV. Three herbal preparations were also found to contain detectable levels of ARVs. This is a concern and should be studied widely across the region and countries where herbal medicine use is prevalent and poorly regulated.


BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Eddy Lincango-Naranjo ◽  
Paola Solis-Pazmino ◽  
Eddy Lincango-Naranjo

Abstract Introduction As new coronavirus has spread globally, economic instability in healthcare systems has been significant. This reality is especially accentuated in Ecuador where, the shortage of healthcare workers combined with cultural and macroeconomic factors have led it to face the most aggressive outbreak in Latin America. In this context, the participation of medical students on the front line is indispensable. Appropriate training on COVID-19 is an urgent need that universities and health systems must guarantee. We aimed to describe the knowledge, attitudes and practices in Ecuadorian final year medical students in order to identify the knowledge gaps, perceptions and behavior patterns which could guide the desig3n of better medical education curricula regarding COVID-19. Methods This descriptive 33-item online survey conducted between April 6 to April 20 sent by email and by Facebook and WhatsApp. Results 309 students responded to the survey. 88% scored high (≥ 70% correct) for knowledge of the disease. The majority of students were pessimistic about possible government actions, which is reflected in the negative attitude towards the control of COVID19 in Ecuador and volunteering during the outbreak (77%, and 58% of the students, respectively). Moreover, 91% of students said they did not have adequate protective equipment or training in their health facilities. Conclusions Ecuador has a capable upcoming workforce that could benefit from an opportunity to strengthen, improve and advance their training in preparation for COVID-19. Creating a national curriculum may be one of the most effective ways for all students to be trained, while simultaneously focusing on the students’ most pressing concerns.


2001 ◽  
Vol 356 (1410) ◽  
pp. 877-887 ◽  
Author(s):  
Tom Burr ◽  
J. M. Hyman ◽  
Gerald Myers

The subtypes of human immunodeficiency virus type 1 (HIV–1) group M exhibit a remarkable similarity in their between–subtype distances, which we refer to as high synchrony. The shape of the phylogenetic tree of these subtypes is referred to as a sunburst to distinguish it from a simple star phylogeny. Neither a sunburst pattern nor a comparable degree of symmetry is seen in a natural process such as in feline immunodeficiency virus evolution. We therefore have undertaken forward–process simulation studies employing coalescent theory to investigate whether such highly synchronized subtypes could be readily produced by natural Darwinian evolution. The forward model includes both classical (macro) and molecular (micro) epidemiological components. HIV–1 group M subtype synchrony is quantified using the standard deviation of the between–subtype distances and the average of the within–subtype distances. Highly synchronized subtypes and a sunburst phylogeny are not observed in our simulated data, leading to the conclusion that a quasi–Lamarckian, punctuated event occurred. The natural transfer theory for the origin of human acquired immune deficiency syndrome (AIDS) cannot easily be reconciled with these findings and it is as if a recent non–Darwinian process took place coincident with the rise of AIDS in Africa.


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