HIV and STI prevalence and testing history among men who have sex with men in Hanoi, Vietnam

Background HIV and other sexually transmitted infections (STIs) have disproportionately affected communities of men who have sex with men (MSM). We describe HIV and STI prevalence and testing patterns among urban Vietnamese MSM. Methods We conducted a cross-sectional community-based study of MSM in Hanoi, Vietnam in 2016. Participants self-reported experiences of social stigma in healthcare settings and previous HIV and STI testing. STI testing included HIV, herpes simplex virus-2 (HSV-2), syphilis, gonorrhea, and chlamydia. Results 205 MSM participated in the study. STI prevalence was HIV (10%), HSV-2 (4%), syphilis (13%), gonorrhea (34%), and chlamydia (19%). More than half (55%) of participants tested positive for at least one STI. Most participants had been previously tested for HIV or another STI (72%), with 24% previously receiving a positive result. Perceived and enacted social stigma in healthcare contexts was negatively associated with previous HIV or STI testing (adjusted prevalence odds ratio (aPOR): 0.22; 95% confidence interval (CI): 0.10–0.48). Discussion High prevalence of STIs was observed among Vietnamese MSM, and perceived and enacted stigma was related to HIV and STI testing. Our findings reaffirm the importance of regular STI screening among this population as well as additional outreach to promote safe HIV and STI healthcare engagement.

HIV and STI testing among substance-using sexual and gender minority adolescents and young adults (Preprint)

BACKGROUND Gay, bisexual and other men who have sex with men (GBMSM) and transgender individuals are more heavily impacted by HIV and other sexually transmitted infections (STIs) than their cisgender, heterosexual peers. Additionally, sexual and gender minorities who use substances are often at a further increased risk of HIV and other STIs. Increasing testing for HIV and other STIs allows for this hardly reached population allows for early intervention, prevention, and education. OBJECTIVE We explored HIV and STI testing patterns among 414 sexual and gender minority substance-using adolescents and young adults (AYAs) (aged 15-29). METHODS We fit multinomial logistic regression models to two categorical HIV and STI testing variables (lifetime, past 12-months) based on self-report of testing (never, STIs only, HIV only, or both). RESULTS Only 41% of the sample achieved the CDC recommendation of past-year HIV and STI testing. We observed HIV and STI testing disparities across sociodemographic (e.g., sexual identity, education, and income) and health correlates (e.g., substance use). Specifically, cisgender men who have sex with men were more likely to report testing compared to gender minority participants. CONCLUSIONS These results illustrate the need for HIV prevention interventions that leverage structural factors, psychosocial barriers, and substance-use as key drivers of achieving HIV and STI testing rates to meet CDC’s guidelines. CLINICALTRIAL ClinicalTrials.gov NCT02945436; http://clinicaltrials.gov/ct2/show/NCT02945436 INTERNATIONAL REGISTERED REPORT RR2-10.2196/resprot.9414

Learnings from a decade experience of a community-based HIV and STI testing and counseling center in Lisbon – Portugal

Background In the context of an increased number of men who have sex with men (MSM) being diagnosed with HIV infection in many European countries, it became a matter of maximum priority to consider new strategies to monitor and tackle the epidemic. In this scenario, CheckpointLX and a cohort study were projected as a sexual health and research center oriented towards MSM in Portugal. Methods In 2011 CheckpointLX was launched in Lisbon as a community-based center for anonymous and free rapid HIV and other sexually transmitted diseases (STI) testing with a strong component of counseling for sexual health, specially targeted at MSM. In the case of a reactive test, a medical appointment is proposed and scheduled. The Lisbon Cohort of MSM is an ongoing observational prospective study conducted at CheckpointLX. Collected data include sexual behaviors, preventive strategies, and history of STI. Results Until July 2019, 7,351 HIV-negative MSM chose to participate in the Lisbon Cohort of MSM. 3,523 had at least one follow-up visit. The median age was 29 (IQR 25 - 37), and 27% were born in a foreign country, including 15% born in Africa and South America. HIV incidence increased up until 2015, reaching 5 reactive tests per 100 tested annually. There has been a sustained decrease in HIV observed since 2015. The use of HIV prevention tools was provided: 31% used condoms consistently, 3% reported PrEP, and 4% PEP. Conclusions A decade since the beginning of this experience shows positive results, such as increased access and testing. We promoted a stigma-free service that facilitated MSM's and other key population's access to sexual health care. We contribute unique data for assisting in the monitoring of the Dublin Declaration in Portugal.

PrEP Continuation, HIV and STI Testing Rates, and Delivery of Preventive Care in a Clinic-Based Cohort

HIV pre-exposure prophylaxis (PrEP) has been demonstrated to be a safe and effective method of reducing HIV incidence. Questions remain regarding PrEP's efficacy and outcomes in real-world clinical settings. We conducted a retrospective review to assess PrEP outcomes in an academic clinic setting and focused on retention in care, reasons for discontinuation, and receipt of appropriate preventive care (immunizations, HIV testing, and STI testing). One hundred thirty-four patients were seen between 2010 and 2016 over 309 visits. One hundred sixteen patients (87%) started daily PrEP and of those, 88 (76%) attended at least one 6-month follow-up visit. Over 60% of PrEP patients completed all recommended STI screening after starting PrEP. Only 40% of patients had all appropriate immunizations at baseline; 78% had all appropriate immunizations at study completion. This study demonstrated high rates of both retention and of attaining recommended preventive care in a clinical setting outside of the rigors of clinical trials.