scholarly journals Post-Exposure Prophylaxis and Methamphetamine Use among Young Sexual Minority Men: The P18 Cohort Study

2022 ◽  
Vol 19 (2) ◽  
pp. 712
Author(s):  
Elizabeth Kaplun ◽  
Richard J. Martino ◽  
Kristen D. Krause ◽  
Michael Briganti ◽  
Paul A. D’Avanzo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hiv Infection ◽  
Sexual Minority ◽  
Post Exposure Prophylaxis ◽  
Sexual Minority Men ◽  
Methamphetamine Use ◽  
Post Exposure ◽  
Increased Risk ◽  
Minority Men ◽  
Exposure Prophylaxis

Methamphetamine use is associated with increased risk of HIV infection among young sexual minority men (SMM). Post-exposure prophylaxis (PEP) is an effective strategy for individuals who are exposed to HIV, but there is limited research about PEP use among young SMM and its relationship with methamphetamine use. This study analyzes the association between ever PEP use and recent methamphetamine use among young SMM in New York City, using cross-sectional data from the P18 Cohort Study (n = 429). Multivariable logistic regression models were used to assess the association between methamphetamine use and ever PEP use. Compared with those who had not used methamphetamine in the last 6 months, young SMM who did use methamphetamine were significantly more likely to have ever used PEP (AOR = 6.07, 95% CI: 2.10–16.86). Young SMM who had ever used PrEP had 16 times higher odds of ever using PEP (AOR = 16, 95% CI: 7.41–35.95). Those who completed bachelor’s degrees were 61% less likely to have ever used PEP (AOR = 0.39, 95% CI: 0.17–0.88). These data suggest that methamphetamine use could increase the risk of HIV infection, highlighting the critical need to target interventions for young SMM who use methamphetamine and are more likely to engage in unprotected intercourse.

scholarly journals Structural Barriers to Pre-exposure Prophylaxis Use Among Young Sexual Minority Men: The P18 Cohort Study

2018 ◽  
Vol 16 (3) ◽  
pp. 237-249 ◽  
Author(s):  
Jessica Jaiswal ◽  
Marybec Griffin ◽  
Stuart N. Singer ◽  
Richard E. Greene ◽  
Ingrid Lizette Zambrano Acosta ◽  
...  
Keyword(s):  
Health Care ◽  
Cohort Study ◽  
Hiv Prevention ◽  
Sexual Behaviors ◽  
Sexual Minority ◽  
Structural Level ◽  
Sexual Minority Men ◽  
Hiv Prevention Strategies ◽  
Minority Men ◽  
Exposure Prophylaxis

Background: Despite decreasing rates of HIV among many populations, HIV-related health disparities among gay, bisexual and other men who have sex with men persist, with disproportional percentages of new HIV diagnoses among racial and ethnic minority men. Despite increasing awareness of HIV pre-exposure prophylaxis (PrEP), PrEP use remains low. In addition to exploring individual-level factors for this slow uptake, structural drivers of PrEP use must also be identified in order to maximize the effectiveness of biomedical HIV prevention strategies. Method: Using cross-sectional data from an ongoing cohort study of young sexual minority men (N=492), we examine the extent to which structural-level barriers, including access to health care, medication logistics, counseling support, and stigma are related to PrEP use. Results: While almost all participants indicated awareness of PrEP, only 14% had ever used PrEP. PrEP use was associated with lower concerns about health care access, particularly paying for PrEP. Those with greater concerns talking with their provider about their sexual behaviors were less likely to use PrEP. Conclusion: Paying for PrEP and talking to one’s provider about sexual behaviors are concerns for young sexual minority men. In particular, stigma from healthcare providers poses a significant barrier to PrEP use in this population. Providers need not only to increase their own awareness of and advocacy for PrEP as an effective risk-management strategy for HIV prevention, but also must work to create open and non-judgmental spaces in which patients can discuss sexual behaviors without the fear of stigma.

scholarly journals Countering the rise of syphilis: A role for doxycycline post-exposure prophylaxis?

2021 ◽  
pp. 095646242110424
Author(s):  
Nguyen K Tran ◽  
Neal D Goldstein ◽  
Seth L Welles
Keyword(s):  
Cumulative Incidence ◽  
Population Level ◽  
Limited Attention ◽  
Post Exposure Prophylaxis ◽  
Adherence Level ◽  
Sexual Minority Men ◽  
Post Exposure ◽  
Syphilis Screening ◽  
Minority Men ◽  
Exposure Prophylaxis

Doxycycline post-exposure prophylaxis (PEP) holds the potential to mitigate increasing rates of syphilis among sexual minority men (SMM) in the US yet has received limited attention. Since evaluation of this intervention in actual populations is not currently feasible, we used agent-based models (ABM) to assess the population-level impact of this strategy. We adapted ABM of HIV and HPV transmission, representing a population of 10,230 SMM in Philadelphia, Pennsylvania, US. Parameter inputs were derived from the literature, and ABM outputs during the pre-intervention period were calibrated to local surveillance data. Intervention scenarios varied doxycycline uptake by 20, 40, 60, 80 and 100%, while assuming continued condom use and syphilis screening and treatment. Under each intervention scenario, we incorporated treatment adherence at the following levels: 0, 20, 40, 60, 80 and 100%. Long-term population impact of prophylactic doxycycline was measured using the cumulative incidence over the 10-year period and the percentage of infections prevented attributable to doxycycline at year 10. An uptake scenario of 20% with an adherence level of 80% would reduce the cumulative incidence of infections by 10% over the next decade, translating to 57 fewer cases per 1000 SMM. At year 10, under the same uptake and adherence level, 22% of infections would be prevented due to doxycycline PEP in the instances where condoms were not used or failed. Findings suggest that doxycycline PEP will have a modest impact on syphilis incidence when assuming a reasonable level of uptake and adherence. Doxycycline PEP may be most appropriate as a secondary prevention measure to condoms and enhanced syphilis screening for reducing infections among SMM.

scholarly journals Examining inequities in rates of undiagnosed HIV and rectal STIs in a large nationwide cohort study of sexual minority men

2021 ◽  
pp. sextrans-2021-055047
Author(s):  
H Jonathon Rendina ◽  
Ali Talan ◽  
K Marie Sizemore ◽  
Nicola F Tavella ◽  
Brian Salfas ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hiv Infection ◽  
Ethnic Groups ◽  
Sexual Minority ◽  
Race And Ethnicity ◽  
Sexual Minority Men ◽  
Undiagnosed Hiv ◽  
Incarceration History ◽  
Minority Men ◽  
Black And Latino

ObjectiveSexual minority men (SMM) of colour are disproportionately impacted by HIV and bacterial STIs (bSTIs). To better understand within-group heterogeneity and differential risk factors by race and ethnicity, we sought to examine rates of undiagnosed HIV and rectal bSTI at the intersection of racial and ethnic identity with other sociodemographic factors.MethodsWe examined data from 8105 SMM conducting home-based self-testing at enrolment in a nationwide cohort study collected from November 2017 to August 2018. We conducted analyses stratified by racial and ethnic groups to examine within-group (ie, subgroup) unadjusted rates of HIV and rectal bSTI infection across a range of characteristics.ResultsRates of undiagnosed HIV were highest among Black (4.3%, n=39) and Latino (2.4%, n=38) SMM, with lower rates among those identified as multiracial (1.6%, n=15), white (1.3%, n=56) and other races (1.3%, n=6). Across the stratified analyses of HIV infection, 15 significant associations emerged showing that age, region, insurance type, sexual positioning and incarceration history had differential impacts across racial and ethnic groups. In particular, private and public insurance were protective against HIV for white but not Black and Latino SMM, and incarceration was associated with substantially higher rates of HIV infection for Black and Latino SMM relative to white SMM. We found significant co-occurrence of HIV and bSTI rates for participants who identified as Latino (OR=7.5, 95% CI 2.12 to 26.54), white (OR=3.19, 95% CI 1.14 to 8.98) and multiracial (OR=5.5, 95% CI 1.08 to 27.90), but not those who identified as Black (OR=0.82, 95% CI 0.10 to 6.56) or other races (OR=3.56 95% CI 0.31 to 40.80).ConclusionsStratified analyses showed differential rates of HIV infection at the intersection of racial and ethnic groups with other characteristics, particularly insurance status and incarceration history, pointing to structural inequities rather than individual behaviours underlying disproportionately high rates of HIV for Black and Latino SMM.

scholarly journals Characterisation of social support following incarceration among black sexual minority men and transgender women in the HPTN 061 cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053334
Author(s):  
Joy D Scheidell ◽  
Typhanye V Dyer ◽  
Christopher Hucks-Ortiz ◽  
Jasmyn Abrams ◽  
Medha Mazumdar ◽  
...  
Keyword(s):  
Social Support ◽  
Cohort Study ◽  
Sexual Minority ◽  
Transgender Women ◽  
Sexual Minority Men ◽  
The Past ◽  
Increased Risk ◽  
Tangible Support ◽  
Minority Men

ObjectiveTo examine longitudinal associations between recent incarceration and subsequent social support among black sexual minority men and transgender women, and whether associations differed between those who did and did not have support prior to incarceration.DesignA secondary analysis in 2020 of data from the HIV Prevention Trials Network 061, a cohort study of black sexual minority men and transgender women recruited in 2009–2010 and followed for 12 months.SettingSix US cities (Atlanta, Boston, Los Angeles, New York City, San Francisco and Washington DC).ParticipantsIndividuals ≥18 years of age who identified as black, reported being male or assigned male at birth, reported ≥1 unprotected anal intercourse event with a male partner in the past 6 months, and reported on incarceration at the 6-month follow-up visit.ExposureHaving spent ≥1 night in jail/prison in the past 6 months reported at the 6-month follow-up visit.OutcomeSocial support measured using a six-item scale assessing frequency of emotional/informational, affectionate and tangible support (range 6–30); and dichotomous indicators of low support for each item (ie, receiving that form of support none/little of the time).ResultsAmong participants who returned for the 6-month visit (N=1169), 14% had experienced incarceration in the past 6 months. Mean support score was 20.9; 18.9 among those with recent incarceration versus 21.2 among those without. Recent incarceration predicted lower support (adjusted β −2.40, 95% CI −3.94 to –0.85). Those recently incarcerated had increased risk of lacking emotional/informational (eg, no one to talk to adjusted risk ratio (aRR) 1.55, 95% CI 1.13 to 2.13) and affectionate (aRR 1.51, 95% CI 1.11 to 2.04) but not tangible support. Effects appeared somewhat stronger among those who had support at baseline.ConclusionsIncarceration may reduce support on re-entry among black sexual minority men and transgender women, populations unequally targeted for incarceration and at risk for low support.

Study of sharp injuries and blood splash exposures among healthcare workers in a tertiary hospital in Bangalore

2016 ◽  
Vol 12 (3) ◽  
Author(s):  
Shalini Sivananjiah Pradeep ◽  
Suman Gadicherla Raghu ◽  
Prathab A G ◽  
Banashankari G Rudresh ◽  
Radhika Kunnavil
Keyword(s):  
Healthcare Workers ◽  
Tertiary Hospital ◽  
Post Exposure Prophylaxis ◽  
Care Hospital ◽  
Post Exposure ◽  
Increased Risk ◽  
Management Procedures ◽  
Exposure Prophylaxis ◽  
Sharps Injury ◽  
Sharps Injuries

The working environment of healthcare workers (HCW) exposes them to sharp injuries. This communication attempts to examine the injury registers, incidence of sharps injuries and blood splash exposures, and the post-exposure prophylaxis status of employees in a tertiary care hospital. Analysis included records form 54 locations of two units of a tertiary hospital attached to a Medical College. Maintenance of the injury register overall was highly satisfactory in both units. Two hundred and nine injuries were recorded from both units of the hospital. The majority of injuries (60.5%) occurred in the age group of 20-30 years with 70% among females. Waste handlers were at increased risk during waste management procedures. Thirty two percent of sharps injury injuries occurred in wards. Of the ward nursing staff, 25.3% received sharps injuries. Post-exposure prophylaxis for Hepatitis B (primary dose) was given to 25 HCWs; 11 received booster doses. The basic regimen for HIV post-exposure prophylaxis was given to 4 HCWs. Awareness about records maintenance, regular documentation, awareness and training, and implementation of appropriate preventive measures can reduce the incidence of injuries. Key words: Sharps, injury register, Health care workers (HCW),Post exposure prophylaxis (PEP)

PEP as a potential antecedent to PrEP among an online sample of HIV-negative and unknown status cis- and transgender sexual minority men: A cross-sectional study (Preprint)

2021 ◽  
Author(s):  
Steven A. John ◽  
K. Marie Sizemore ◽  
Ruben H. Jimenez ◽  
S. Scott Jones ◽  
Andrew E. Petroll ◽  
...  
Keyword(s):  
Drug Use ◽  
Sexual Minority ◽  
Multivariable Analysis ◽  
Sexual Minority Men ◽  
Club Drug Use ◽  
Unknown Status ◽  
Minority Men ◽  
Exposure Prophylaxis ◽  
Club Drug ◽  
Hiv Negative

BACKGROUND HIV disproportionately affects sexual minority men (SMM) in the U.S. OBJECTIVE We sought to determine past HIV post-exposure prophylaxis (PEP) use and current pre-exposure prophylaxis (PrEP) use among an online sample of cisgender and transgender men who have sex with men. METHODS In 2019, HIV-negative and unknown status SMM (n=63,015) were recruited via geosocial networking apps, social media, and other online venues to participate in a brief eligibility screening survey. Individuals were asked about past PEP and current PrEP use. We examined associations of demographics, socioeconomic indicators, recent club drug use, and current PrEP use on past PEP use using fully-adjusted logistic regression. RESULTS Prior PEP use was relatively uncommon (11.3%), with 2.66 times more men reporting current PrEP use (30.1%). Most (85.9%) past PEP users were current PrEP users, representing 32.2% of all current PrEP users. In multivariable analysis, current PrEP users had 20.1 times higher odds (95%CI: 18.6-21.6) of past PEP use compared to non-PrEP users. Other factors significantly (p<0.001) associated with past PEP use but with smaller effect sizes included: older age (>24 years old) compared to younger age (AOR=1.15); bisexual identity compared to gay (AOR=0.86); Latino, Black, and other/multiracial race/ethnicity compared to white, individually (AORs=1.37-1.52); having health insurance (AOR=0.80); and recent club drug use (AOR=1.19). CONCLUSIONS Prior PEP use was relatively uncommon in our online sample of SMM, but our findings indicate PEP could potentially be a gateway to PrEP. Advertising and prescribing PEP could support efforts to increase PrEP.

Age of Sexual Debut among Young Gay-identified Sexual Minority Men: The P18 Cohort Study

2020 ◽  
pp. 1-8
Author(s):  
Perry N. Halkitis ◽  
Caleb LoSchiavo ◽  
Richard J. Martino ◽  
Blas Martin De La Cruz ◽  
Christopher B. Stults ◽  
...  
Keyword(s):  
Cohort Study ◽  
Sexual Minority ◽  
Sexual Debut ◽  
Sexual Minority Men ◽  
Minority Men
Sign in / Sign up

Export Citation Format

Share Document