227 results on '"MEN who have sex with men"'
Search Results
2. Sexually Transmitted Dermatophytes Can Cause Severe Infection Among Men who Have Sex With Men as Tinea Genitalis.
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Chromy, David, Osmers, Anthea-Margaux, Bauer, Wolfgang Michael, Touzeau-Roemer, Veronique, Borst, Carina, Esser, Stefan, Weninger, Wolfgang, Willinger, Birgit, and Grabmeier-Pfistershammer, Katharina
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SEXUALLY transmitted diseases , *HIV seroconversion , *DERMATOPHYTES , *HIV infections , *RINGWORM , *PRE-exposure prophylaxis , *SEXUAL intercourse - Abstract
Very limited data on tinea genitalis, a potentially severe dermatophytosis transmitted during sexual intercourse affecting the genital area, suggest its potential to cause outbreaks. Thus, we investigated genital dermatophyte infections at an HIV/sexually transmitted infection clinic and identified 17 men who have sex with men (all people with HIV or pre-exposure prophylaxis users) diagnosed with tinea genitalis. [ABSTRACT FROM AUTHOR]
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- 2023
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3. Plasma Human Immunodeficiency Virus 1 RNA and CD4+ T-Cell Counts Are Determinants of Virological Nonsuppression Outcomes With Initial Integrase Inhibitor-Based Regimens: A Prospective RESPOND Cohort Study.
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Álvarez, Hortensia, Mocroft, Amanda, Ryom, Lene, Neesgaard, Bastian, Edwards, Simon, Svedhem, Veronica, Günthard, Huldrych F, Zangerle, Robert, Smith, Colette, Castagna, Antonella, Monforte, Antonella d'Arminio, Wit, Ferdinand, Stecher, Melanie, Lehman, Clara, Mussini, Cristina, Fontas, Eric, González, Eva, Wasmuth, Jan-Christian, Sönnerborg, Anders, and Wit, Stéphane De
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HIV infections , *DRUG efficacy , *HIV integrase inhibitors , *CONFIDENCE intervals , *BLOOD plasma , *MULTIVARIATE analysis , *AGE distribution , *RNA , *RACE , *HEPATITIS C , *POPULATION geography , *TREATMENT failure , *SEX distribution , *RISK assessment , *CD4 lymphocyte count , *VIREMIA , *DESCRIPTIVE statistics , *KAPLAN-Meier estimator , *RESEARCH funding , *LOGISTIC regression analysis , *ODDS ratio , *DATA analysis software , *MEN who have sex with men , *LONGITUDINAL method , *PROPORTIONAL hazards models , *AIDS - Abstract
Background There are conflicting data regarding baseline determinants of virological nonsuppression outcomes in persons with human immunodeficiency virus (HIV) starting antiretroviral treatment (ART). We evaluated the impact of different baseline variables in the RESPOND cohort. Methods We included treatment-naive participants aged ≥18 who initiated 3-drug ART, in 2014–2020. We assessed the odds of virological suppression (VS) at weeks 48 and 96 using logistic regression. Viral blips, low-level viremia (LLV), residual viremia (RV), and virological failure (VF) rates were assessed using Cox regression. Results Of 4310 eligible participants, 72% started integrase strand transfer inhibitor (INSTI)-based regimens. At 48 and 96 weeks, 91.0% and 93.3% achieved VS, respectively. At 48 weeks, Kaplan-Meier estimates of rates were 9.6% for viral blips, 2.1% for LLV, 22.2% for RV, and 2.1% for VF. Baseline HIV-1 RNA levels >100 000 copies/mL and CD4+ T-cell counts ≤200/µL were negatively associated with VS at weeks 48 (adjusted odds ratio, 0.51 [95% confidence interval,.39–.68] and.40 [.27–.58], respectively) and 96 and with significantly higher rates of blips, LLV, and RV. CD4+ T-cell counts ≤200/µL were associated with higher risk of VF (adjusted hazard ratio, 3.12 [95% confidence interval, 2.02–4.83]). Results were consistent in those starting INSTIs versus other regimens and those starting dolutegravir versus other INSTIs. Conclusions Initial high HIV-1 RNA and low CD4+ T-cell counts are associated with lower rates of VS at 48 and 96 weeks and higher rates of viral blips, LLV, and RV. Low baseline CD4+ T-cell counts are associated with higher VF rates. These associations remain with INSTI-based and specifically with dolutegravir-based regimens. These findings suggest that the impact of these baseline determinants is independent of the ART regimen initiated. [ABSTRACT FROM AUTHOR]
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- 2023
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4. 'She showed me a new path, a way forward': exploring how navigation influences mental health among Guatemalan gay and bisexual men living with HIV.
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Davis, Dirk A, Muessig, Kathryn E, Matthews, Derrick D, Angeles, Gustavo, McNaughton-Reyes, Luz, Guzmán, Karla, Northbrook, Sanny, and Barrington, Clare
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HIV infection epidemiology , *HIV infections , *HIV-positive persons , *SOCIAL support , *HEALTH services accessibility , *PSYCHOLOGY of LGBTQ+ people , *MOTIVATION (Psychology) , *MENTAL health , *PATIENT-centered care , *INTERVIEWING , *HOPE , *DESCRIPTIVE statistics , *MEN who have sex with men , *THEMATIC analysis , *HEALTH promotion - Abstract
Mental health problems, including anxiety and depression, are a common comorbidity among gay, bisexual and other men who have sex with men (GBMSM) living with HIV. Informed by social support theory, health navigation is a strengths-based intervention that has been demonstrated to improve HIV care outcomes. The purpose of this study was to explore how health navigation influences the mental health of GBMSM living with HIV. We analyzed longitudinal qualitative in-depth interviews conducted with GBMSM (n = 29) in a 12-month multi-component intervention to improve HIV care outcomes, including health navigation. We used narrative and thematic analytic approaches to identify salient themes, including if and how themes changed over time. Participants described that navigator support helped them maintain good mental health, prevent crises and respond to crises. Navigator support included providing motivational messaging, facilitating participants' control over their health and improving access to care, which aided with supporting mental health. Navigators also responded to acute crises by providing guidance for those newly diagnosed with HIV and support for those experiencing critical life events. Participants emphasized the importance of feeling heard and valued by their navigators and gaining hope for the future as key to their wellbeing. In conclusion, health navigation may be an effective intervention for promoting mental health among GBMSM living with HIV. Additional research is needed to examine mediating pathways between navigation and mental health, including informational support, or if navigator support moderates the relationship between stressors and mental health outcomes for GBMSM. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Anorectal Testing for Mpox Virus Infection in Men Who Have Sex With Men With and Without Proctitis.
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Meyerowitz, Eric A, Gendlina, Inessa, Desai, Vimi J, Grossberg, Robert, Nair, Singh R, Pujar, Beendu, Riska, Paul F, Root, Heather B, Toro, Justin, Torres, Julian A, Pirofski, Liise-anne, and Zingman, Barry S
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DNA analysis , *HIV-positive persons , *HIV infections , *RECTAL diseases , *VIRAL load , *MONKEYPOX , *ANTIRETROVIRAL agents , *ANTIVIRAL agents , *PRE-exposure prophylaxis , *SMALLPOX vaccines , *MICROBIOLOGICAL techniques , *DESCRIPTIVE statistics , *MEN who have sex with men , *POLYMERASE chain reaction , *COLLECTION & preservation of biological specimens , *CISGENDER people , *PHARYNGITIS - Abstract
We performed anorectal testing in 18 cis-gender men who have sex with men with symptoms consistent with mpox virus (MPXV) infection. We found rectal MPXV DNA in 9/9 with and 7/9 without proctitis. Future study of anorectal testing is needed and may inform the diagnosis and pathogenesis of MPXV disease. [ABSTRACT FROM AUTHOR]
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- 2023
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6. Low Spontaneous Clearance Rates of Recently Acquired Hepatitis C Virus in Human Immunodeficiency Virus–Positive Men Who Have Sex With Men (PROBE-C Study).
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Monin, Malte B, Ingiliz, Patrick, Lutz, Thomas, Scholten, Stefan, Cordes, Christiane, Martínez-Rebollar, Maria, Spinner, Christoph D, Nelson, Mark, Rausch, Michael, Bhagani, Sanjay, Peters, Lars, Reiberger, Thomas, Mauss, Stefan, Rockstroh, Jürgen K, Boesecke, Christoph, and group, for the PROBE-C study
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HEPATITIS C risk factors , *HEPATITIS C transmission , *HIV infections , *DRUG efficacy , *HIV-positive persons , *SCIENTIFIC observation , *COMBINATION drug therapy , *PREDICTIVE tests , *MICROBIAL genetics , *HEPATITIS C , *ANTIVIRAL agents , *FISHER exact test , *MANN Whitney U Test , *RNA , *RISK assessment , *MIXED infections , *CHI-squared test , *DESCRIPTIVE statistics , *RESEARCH funding , *INFECTIOUS disease transmission , *GENOTYPES , *CD4 lymphocyte count , *MEN who have sex with men , *SENSITIVITY & specificity (Statistics) , *LONGITUDINAL method , *ALANINE aminotransferase , *DISEASE risk factors , *EVALUATION , *THERAPEUTICS - Abstract
Background Using direct-acting antivirals (DAAs) for recently acquired hepatitis C virus (RAHCV) infections, particularly in human immunodeficiency virus (HIV)–positive men who have sex with men (MSM), dramatically reduced the incidence of hepatitis C. However, implementation into clinical practice is challenging. The aim of this study was to analyze spontaneous clearance (SC) rates of RAHCV and to identify predictors of SC. Methods The PROBE-C study is an observational European cohort on RAHCV infections in HIV-positive MSM. Between 2007 and 2017, RAHCV infections were documented with ≥12 months of follow-up. Fisher exact, χ2, and Mann-Whitney U tests were used for statistical analysis. Results A total of 464 RAHCV infections were documented; 457 of 464 patients (98%) were male, and the median age (interquartile range [IQR]) was 41 (38–46) years. The main risk group for hepatitis C virus (HCV) transmission was MSM (98.9%). Most participants were infected with HCV genotype 1 (78.3%). The median baseline HCV RNA level (IQR) was 230 000 (135 000–474 432) IU/mL, and the median CD4+ T-cell count was 574/µL (547–604/µL. Of all cases, 92% received combination antiretroviral therapy, with 91% showing suppressed HIV RNA levels (<200 copies/mL). The median maximum alanine aminotransferase level (IQR) was 445 (402–522) U/L. SC of RAHCV infection occurred in 55 of 464 cases (11.9%). A >2-log decline in HCV RNA levels 4 weeks after diagnosis of RAHCV infection was the strongest predictor of SC (P <.001; sensitivity, 96.4%; specificity, 97.5%; positive predictive value, 84.1%; negative predictive value, 99.5%). Conclusions SC of RAHCV in HIV-positive MSM is found in only 11.9% of cases and a <2-log drop in HCV RNA level at week 4 after diagnosis should prompt early DAA-based treatment. However, immediate DAA treatment for RAHCV infection may also be favored in patients with ongoing transmission risk behavior. [ABSTRACT FROM AUTHOR]
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- 2023
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7. Incidence and Clearance of Anal Human Papillomavirus Infection in 16 164 Individuals, According to Human Immunodeficiency Virus Status, Sex, and Male Sexuality: An International Pooled Analysis of 34 Longitudinal Studies.
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Wei, Feixue, Goodman, Marc T, Xia, Ningshao, Zhang, Jun, Giuliano, Anna R, D'Souza, Gypsyamber, Hessol, Nancy A, Loeff, Maarten F Schim van der, Dai, Jianghong, Neukam, Karin, Pokomandy, Alexandra de, Poynten, I Mary, Geskus, Ronald B, Burgos, Joaquin, Etienney, Isabelle, Moscicki, Anna-Barbara, Donà, Maria Gabriella, Gillison, Maura L, Nyitray, Alan G, and Nowak, Rebecca G
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HIV infections , *IMMUNIZATION , *HUMAN sexuality , *AGE distribution , *HEALTH status indicators , *DISEASE incidence , *EARLY detection of cancer , *SEX distribution , *ANAL tumors , *RISK assessment , *PAPILLOMAVIRUS diseases , *DISEASE prevalence , *HUMAN papillomavirus vaccines , *ANAL diseases , *SEXUAL partners , *MEN who have sex with men , *HIV , *SECONDARY analysis , *DISEASE risk factors , *DISEASE complications - Abstract
Background Understanding the natural history of anal high-risk human papillomavirus (hrHPV) infection is key for designing anal cancer prevention programs but has not been systematically characterized. Methods We reanalyzed data from 34 studies including 16 164 individuals in 6 risk groups defined by human immunodeficiency virus (HIV) status, sex, and male sexuality: men who have sex with men (MSM) and people with HIV (MSMWH), HIV-negative MSM, women with HIV (WWH), HIV-negative women, men who have sex with women (MSW) with HIV (MSWWH), and HIV-negative MSW. We used Markov models to estimate incidence and clearance of 13 hrHPV types and their determinants. Results Human papillomavirus (HPV) 16 had the highest incidence-clearance ratio of the hrHPV types. MSMWH had the highest hrHPV incidence (eg, 15.5% newly HPV-16 infected within 2 years), followed by HIV-negative MSM (7.5%), WWH (6.6%), HIV-negative women (2.9%), MSWWH (1.7%), and HIV-negative MSW (0.7%). Determinants of HPV-16 incidence included HIV status and number of sexual partners for MSM, women, and MSW, and anal sex behavior for MSM only. HPV-16 clearance was lower for people with HIV (PWH) and lower for prevalent than incident infection. Among MSM, increasing age was associated with lower clearance of prevalent, but not incident, HPV-16 infection. Conclusions This robust and unifying analysis of anal hrHPV natural history is essential to designing and predicting the impact of HPV vaccination and HPV-based screening programs on anal cancer prevention, particularly in MSM and PWH. Importantly, it demonstrates the higher carcinogenic potential of longstanding anal prevalent hrHPV infection than more recent incident infection. [ABSTRACT FROM AUTHOR]
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- 2023
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8. Sustained Effect on Hepatitis C Elimination Among Men Who Have Sex With Men in the Swiss HIV Cohort Study: A Systematic Re-Screening for Hepatitis C RNA Two Years Following a Nation-Wide Elimination Program.
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HEPATITIS C prevention , *HEPATITIS C diagnosis , *HIV infections , *EVALUATION of human services programs , *CONFIDENCE intervals , *DISEASE eradication , *BLOOD plasma , *MEDICAL screening , *RNA , *HEPATITIS C , *DESCRIPTIVE statistics , *DISEASE prevalence , *MIXED infections , *MEN who have sex with men , *SWISS , *LONGITUDINAL method - Abstract
Background The Swiss HCVree Trial (NCT 02785666) was conducted in 2015–2017 with the goal of implementing a population-based systematic hepatitis C virus (HCV) micro-elimination program among men who have sex with men (MSM) with human immunodeficiency virus (HIV) enrolled in the Swiss HIV Cohort Study (SHCS). The trial led to a 91% and 77% decline of HCV prevalence and incidence, respectively. The long-term effect of this HCV micro-elimination program is yet to be explored. Methods All MSM enrolled in the SHCS were screened for HCV RNA using stored plasma samples obtained in 2019, termed "Swiss HCVree Post" screen. The incidence of HCV infection over time was assessed using additional information on HCV testing routinely collected in the SHCS. Characteristics of participants with replicating HCV infection were analyzed. Results The point-prevalence of "Swiss HCVree Post" (N = 4641) was 0.6%, reflecting a decline of 48% compared to the end of the Swiss HCVree Trial where the prevalence was 1.2%. Further, the incidence of HCV among MSM in the SHCS declined from 0.31/100 person-years (py) (95% confidence interval [CI] [.17,.55]) in 2017 to 0.19/100 py (95% CI [.09,.39]) in 2019. Conclusions A systematic HCV RNA-based screening among MSM with HIV conducted 2 years after the Swiss HCVree Trial revealed a sustained effect and further decline of the prevalence and incidence of replicating HCV infection. This indicates that the Swiss HCVree Trial was successful in curbing the HCV epidemic among MSM with HIV in Switzerland. Clinical Trials Registration NCT02785666. [ABSTRACT FROM AUTHOR]
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- 2022
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9. Natural History of Rectal Gonococcal and Chlamydial Infections: The ExGen Study.
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Barbee, Lindley A, Khosropour, Christine M, Soge, Olusegun O, Hughes, James P, Haglund, Micaela, Yeung, Winnie, and Golden, Matthew R
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HIV infections , *GONORRHEA , *SCIENTIFIC observation , *CONFIDENCE intervals , *RECTAL diseases , *HUMAN sexuality , *LOG-rank test , *HEALTH status indicators , *SURVEYS , *DISEASE duration , *SEX customs , *KAPLAN-Meier estimator , *DESCRIPTIVE statistics , *MEN who have sex with men , *CHLAMYDIA infections , *LONGITUDINAL method - Abstract
Background The duration of rectal gonococcal and chlamydial infection remains unknown. This basic epidemiologic parameter is needed to understand transmission dynamics. Methods We conducted a prospective, longitudinal, observational cohort study of 140 men who have sex with men (MSM) at risk of gonorrhea and chlamydia acquisition. For 48 weeks, enrolled men collected rectal swabs (Aptima multi-test kit) at home and responded to an electronic survey about sexual behavior and health conditions weekly. Swabs remained untested until participants completed the study. We used Kaplan-Meier estimates to determine the median duration of infection, censoring infections for treatment, loss to follow-up, and end-of-study. We used log-rank test to compare duration of infection by human immunodeficiency virus (HIV) status, history of infection with gonorrhea or chlamydia, and coinfection with the other pathogen. Results 140 enrolled MSM contributed 70.5 person-years of follow-up. Eighteen men had 20 incident rectal gonococcal infections, which persisted for 2–23 weeks; 30% were censored for treatment. The estimated median duration of rectal gonorrhea was 9 weeks (95% confidence interval [CI]: 3–12 weeks). Twenty-four men experienced 32 rectal chlamydial infections, persisting between 2 and 42 weeks; 60% were censored. The estimated duration of rectal chlamydia was 13 weeks (95% CI: 6 weeks–undefined). There were no differences in the duration of rectal gonorrhea or chlamydia by HIV status, history of chlamydia/gonorrhea, or coinfection. Conclusions On average, rectal gonorrhea and chlamydial infections last 2–3 months, although some infections persisted for 6–11 months. Further understanding into predictors of persistence is needed. [ABSTRACT FROM AUTHOR]
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- 2022
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10. Sexuality-based stigma and access to care: intersecting perspectives between healthcare providers and men who have sex with men in HIV care centres in Senegal.
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Ndione, Albert Gautier, Procureur, Fanny, Senne, Jean-Noël, Cornaglia, Francesca, Gueye, Khady, Ndour, Cheikh Tidiane, and Lépine, Aurélia
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MEDICAL personnel ,MEDICAL disclosure ,SOCIAL stigma ,HIV ,PRE-exposure prophylaxis ,MEN who have sex with men ,HIV infections ,HEALTH services accessibility ,HOMOSEXUALITY ,RESEARCH funding - Abstract
Men who have sex with men (MSM) in Senegal face a challenging socio-legal context, marked by homophobia and the illegality of homosexuality. In addition, human immunodeficiency virus (HIV) prevalence among MSM is 27.6%, 46 times greater than the one in the general population (0.5%). Nevertheless, access to healthcare by MSM may be hampered by stigmatizing attitudes from health facility staff (medical and non-medical). This article describes the health facility staff/MSM relationship and analyses its effects on access to healthcare by MSM. The data used were collected through a field survey based on observations and qualitative interviews conducted in 2019 and 2020 with 16 MSM, 1 non-governmental organization (NGO) staff and 9 healthcare providers in Dakar (the capital city) and Mbour (secondary city on the West Coast) hospitals. The data were subject to a thematic analysis assisted by the ATLAS software. The relationship between MSM and healthcare providers is ambiguous. On the one hand, healthcare providers are torn between their professional duty to treat MSM and the cost of being stigmatized by other colleagues. Therefore, they often limit their empathy with MSM within the hospital context. On the other hand, MSM, trusting in the confidentiality of healthcare providers, feel safe in the care pathway. However, we identify the following stigmatizing factors limiting access to care include (1) fear of meeting a relative, (2) difficult relationships with non-medical support staff (mainly security guards), (3) HIV status disclosure and (4) potential conflicts with other MSM. This study is unique as it includes non-medical staff in its respondents. It shows that hospitals are divided into several areas, based on the stigma perceived by MSM. It is important to map out MSM's care trajectories and spaces and to identify all types of staff working within them, including non-medical staff, and enrol them in stigma reduction interventions. [ABSTRACT FROM AUTHOR]
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- 2022
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11. Impact of Racial Categorization on Effect Estimates: An HIV Stigma Analysis.
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Facente, Shelley N, Lam-Hine, Tracy, Bhatta, Dharma N, and Hecht, Jennifer
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HIV infection epidemiology , *HIV infections , *HIV-positive persons , *ATTITUDE (Psychology) , *MULTIPLE regression analysis , *RACE , *GROUP identity , *SOCIAL stigma , *CULTURAL pluralism , *RISK assessment , *PSYCHOSOCIAL factors , *MEN who have sex with men , *ETHNIC groups , *STATISTICAL models , *AFRICAN Americans - Abstract
Suboptimal racial categorization potentially introduces bias in epidemiologic analysis and interpretation, making it difficult to appropriately measure factors leading to racial health disparities. As part of an analysis focused on predictors of experiencing human immunodeficiency status (HIV)-related stigma among men who have sex with men living with HIV in San Francisco, we struggled with the most appropriate ways to categorize people who reported more than 1 racial identity, and we aimed to explore the implications of different methodological choices in this analysis. We fitted 3 different multivariable linear regression models, each utilizing a different approach to racial categorization: the "multiracial," "othering," and "hypodescent" models. We estimated an adjusted risk difference in mean score for reported frequency of experiencing HIV-related stigma on a 4-point scale, adjusting for age, race, gender identity, injection history, housing, mental health concerns, and viral load. Use of a hypodescent model for racial categorization led to a shift in the point estimate through the null for Blacks/African Americans, and it improved precision for that group. However, it obscured the association of increased stigma and race for multiracial people, compared with monoracial counterparts. We conclude that methodological decisions related to racial categorization of participants can dramatically affect race-related study findings in predictor regression models. [ABSTRACT FROM AUTHOR]
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- 2022
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12. Heterogeneity in the Prevalence of High-Risk Human Papillomavirus Infection in Human Immunodeficiency Virus-Negative and Human Immunodeficiency Virus-Positive Men Who Have Sex With Men in West Africa.
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Yaya, Issifou, Boyer, Véronique, Ehlan, Phyllis Amivi, Coulibaly, Alou, Agboyibor, Mawuényégan Kouamivi, Traoré, Issa, Kouamé, Malan Jean-Baptiste, Maiga, Alassane Kader, Kotchi, Ochoh Rachelle, Nyasenu, Yawo Tufa, Maradan, Gwenaëlle, Rojas-Castro, Daniela, Diallo, Fodié, Anoma, Camille, Dah, Ter Tiero Elias, Mensah, Ephrem, Keita, Bintou Dembélé, Spire, Bruno, Dagnra, Claver Anoumou, and Laurent, Christian
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HIV infections , *CONFIDENCE intervals , *CROSS-sectional method , *MULTIVARIATE analysis , *RISK assessment , *HOMOSEXUALITY , *PAPILLOMAVIRUS diseases , *DISEASE prevalence , *HUMAN papillomavirus vaccines , *DESCRIPTIVE statistics , *MEN who have sex with men , *LOGISTIC regression analysis , *ODDS ratio , *ANAL sex , *EDUCATIONAL attainment , *UNSAFE sex , *DISEASE risk factors - Abstract
Background Men who have sex with men (MSM) are at high risk of human papillomavirus (HPV) infection. We assessed (i) the prevalence of high-risk HPV (HR-HPV) infection and associated factors, and (ii) the prevalence of vaccine-preventable HPV infections in MSM in Burkina Faso, Côte d'Ivoire, Mali, and Togo. Methods A cross-sectional study was conducted in 2017–2018 among MSM ≥18 years old followed in community-based clinics. HPV infection was investigated in oral and anal samples using the e-BRID system. Factors associated with HR-HPV infection were identified using multivariate logistic regressions. Results Among 631 participants, 425 were HIV-negative and 206 HIV-positive. HR-HPV prevalence ranged from 9.2% to 34.8% in the former, and 33.3% to 71.0% in the latter, according to the study country. In multivariate analysis, HIV infection (adjusted odds ratio (aOR) 3.61, 95% confidence interval (CI) 2.48–5.27) and study country (4.73, 2.66–8.43 for Mali; 3.12, 1.68–5.80 for Burkina Faso; 3.51, 1.92–6.42 for Togo) were associated with HR-HPV infection. Other associated factors were low educational level, self-defined homosexual identity, and condomless anal sex. The prevalence of infections which can be prevented with bivalent, quadrivalent, and nonavalent vaccines was 5.9, 27.1, and 34.6% in HIV-negative participants, and 18.9, 43.7, and 54.9% in HIV-positive participants, respectively. Conclusions HR-HPV prevalence was very heterogeneous between the study countries in both HIV-negative and HIV-positive MSM. Vaccine-preventable HPV infections predominated. Vaccination should be proposed to young MSM to reduce the burden of HPV infection in this vulnerable population and their female partners in West Africa. [ABSTRACT FROM AUTHOR]
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- 2021
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13. Characterization of Human Immunodeficiency Virus (HIV) Infection in Cisgender Men and Transgender Women Who Have Sex With Men Receiving Injectable Cabotegravir for HIV Prevention: HPTN 083.
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Marzinke, Mark A, Grinsztejn, Beatriz, Fogel, Jessica M, Piwowar-Manning, Estelle, Li, Maoji, Weng, Lei, McCauley, Marybeth, Cummings, Vanessa, Ahmed, Shahnaz, Haines, Casey D, Bushman, Lane R, Petropoulos, Christos, Persaud, Deborah, Adeyeye, Adeola, Kofron, Ryan, Rinehart, Alex, Clair, Marty St, Rooney, James F, Pryluka, Daniel, and Coelho, Lara
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HIV , *TRANSGENDER people , *HIV prevention , *PNEUMOCYSTIS pneumonia , *HIV infections , *MEN who have sex with men - Abstract
Background: The HIV Prevention Trials Network (HPTN) 083 trial demonstrated that long-acting cabotegravir (CAB-LA) was more effective than tenofovir disoproxil fumarate-emtricitabine (TDF/FTC) in preventing human immunodeficiency virus (HIV) in cisgender men and transgender women who have sex with men. We characterized HIV infections that occurred in the blinded phase of HPTN 083.Methods: Retrospective testing included HIV testing, viral load testing, quantification of study drugs, and HIV drug resistance testing.Results: Fifty-eight infections were evaluated, including 51 incident infections (12 in CAB arm and 39 in TDF/FTC arm). In many cases (5 in CAB arm and 37 in TDF/FTC arm), infection was associated with low or unquantifiable study drug concentrations. In 4 cases, infection occurred with on-time CAB-LA injections and expected plasma CAB concentrations. CAB exposure was associated with prolonged viral suppression and delayed antibody expression. In some cases, delayed HIV diagnosis resulted in CAB provision to participants with undetected infection, delayed antiretroviral therapy, and emergence of drug resistance; most of these infections would have been detected earlier with viral load testing.Conclusions: Early detection of HIV infection and prompt antiretroviral therapy initiation could improve clinical outcomes in persons who become infected despite CAB-LA prophylaxis. Further studies are needed to elucidate the correlates of HIV protection in persons receiving CAB-LA. [ABSTRACT FROM AUTHOR]- Published
- 2021
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14. A Treatment-as-Prevention Trial to Eliminate Hepatitis C Among Men Who Have Sex With Men Living With Human Immunodeficiency Virus (HIV) in the Swiss HIV Cohort Study.
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Braun, Dominique L, Hampel, Benjamin, Ledergerber, Bruno, Grube, Christina, Nguyen, Huyen, Künzler-Heule, Patrizia, Shah, Cyril, Salazar-Vizcaya, Luisa, Conen, Anna, Flepp, Markus, Stöckle, Marcel, Béguelin, Charles, Schmid, Patrick, Rougemont, Mathieu, Delaloye, Julie, Bernasconi, Enos, Nicca, Dunja, Böni, Jürg, Rauch, Andri, and Kouyos, Roger D
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RNA analysis , *HEPATITIS C prevention , *HIV infections , *CONFIDENCE intervals , *ANTIVIRAL agents , *MEDICAL screening , *MEN who have sex with men - Abstract
Background In 2016, the World Health Organization (WHO) introduced global targets for the elimination of hepatitis C virus (HCV) by 2030. We conducted a nationwide HCV micro-elimination program among men who have sex with men (MSM) living with human immunodeficiency virus (HIV) from the Swiss HIV Cohort Study (SHCS) to test whether the WHO goals are achievable in this population. Methods During phase A (10/2015–06/2016), we performed a population-based and systematic screening for HCV-RNA among MSM from the SHCS. During phase B (06/2016–02/2017) we offered treatment with HCV direct-acting antiviral (DAA) agents to MSM identified with a replicating HCV infection. During phase C (03/2017–11/2017), we offered rescreening to all MSM for HCV-RNA and initiated DAA treatment in MSM with replicating infections. Results We screened 3715/4640 (80%) MSM and identified 177 with replicating HCV infections (4.8%); 150 (85%) of whom started DAA treatment and 149 (99.3%) were cured. We rescreened 2930/3538 (83%) MSM with a prior negative HCV-RNA and identified 13 (0.4%) with a new HCV infection. At the end of the micro-elimination program, 176/190 MSM (93%) were cured, and the HCV incidence rate declined from.53 per 100 patient-years (95% CI,.35–.83) prior to the intervention to.12 (95% CI,.03–.49) by the end of 2019. Conclusions A systematic, population-based HCV micro-elimination program among MSM living with HIV was feasible and resulted in a strong decline in HCV incidence and prevalence. Our study can serve as a model for other countries aiming to achieve the WHO HCV elimination targets. Clinical Trials Registration NCT02785666. [ABSTRACT FROM AUTHOR]
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- 2021
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15. A Spatial Approach for Ending the Human Immunodeficiency Virus Epidemic for the United States—A DC Model.
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Das, Suparna, Allston, Adam, Opoku, Jenevieve, and Kharfen, Michael
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HIV infection epidemiology , *PREVENTION of epidemics , *DISEASE clusters , *HIV infections , *PUBLIC health surveillance , *CONFIDENCE intervals , *VIRAL load , *REGRESSION analysis , *ANTIVIRAL agents , *TREATMENT effectiveness , *RISK assessment , *DESCRIPTIVE statistics , *MEN who have sex with men - Abstract
Background Mode of transmission–based hotspots is a smart approach to HIV mitigation, yet remains poorly evaluated and implemented in the United States. The primary aim was to identifying mode of transmission–based hotspots and populations at risk of lower viral suppression to assist in targeted planning and implementation of programs. Methods We implemented spatial statistics to identify global-local hotspots and regression analysis to find populations at risk of lower viral suppression within hotspots. Data were obtained from the District of Columbia's (DC's) active surveillance system, which were geocoded based on current residence address. Results The analysis identified 6001 HIV-positive men who have sex with men (MSM) and 6077 HIV-positive non-MSM (N = 12 078) living in DC at the end of 2018. The hotspots for MSM were central DC and non-MSM in south DC. Trends of viral suppression within MSM hotspots showed plateauing and, among non-MSM, showed decline. Regression analysis showed MSM aged 21–25 (RR: 3.199; 95% CI: 1.832–5.586) and not linked to care (8.592; 2.907–25.398) were at higher risk of being virally unsuppressed within the hotspots. For non-MSM we found those aged 12–18 (9.025; 3.314–2.581) and with unknown linkages (6.087; 3.346–13.848) were at higher risk of being virally unsuppressed within the hotspots. Conclusions Our analysis provides a model that may be used by other jurisdictions to identify areas of priority and plan treatment-adherence programs using surveillance data. Attaining viral suppression is crucial in reducing new diagnoses; a spatial approach can be an important tool in Ending the HIV Epidemic. [ABSTRACT FROM AUTHOR]
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- 2021
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16. Transporting Subgroup Analyses of Randomized Controlled Trials for Planning Implementation of New Interventions.
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Mehrotra, Megha L, Westreich, Daniel, Glymour, M Maria, Geng, Elvin, and Glidden, David V
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HIV infections , *EXPERIMENTAL design , *SAMPLE size (Statistics) , *RANDOMIZED controlled trials , *COST effectiveness , *PREVENTIVE medicine , *MEN who have sex with men , *HEALTH care rationing - Abstract
Subgroup analyses of randomized controlled trials guide resource allocation and implementation of new interventions by identifying groups of individuals who are likely to benefit most from the intervention. Unfortunately, trial populations are rarely representative of the target populations of public health or clinical interest. Unless the relevant differences between trial and target populations are accounted for, subgroup results from trials might not reflect which groups in the target population will benefit most from the intervention. Transportability provides a rigorous framework for applying results derived in potentially highly selected study populations to external target populations. The method requires that researchers measure and adjust for all variables that 1) modify the effect of interest and 2) differ between the target and trial populations. To date, applications of transportability have focused on the external validity of overall study results and understanding within-trial heterogeneity; however, this approach has not yet been used for subgroup analyses of trials. Through an example from the Iniciativa Profilaxis Pre-Exposición (iPrEx) study (multiple countries, 2007–2010) of preexposure prophylaxis for human immunodeficiency virus, we illustrate how transporting subgroup analyses can produce target-specific subgroup effect estimates and numbers needed to treat. This approach could lead to more tailored and accurate guidance for resource allocation and cost-effectiveness analyses. [ABSTRACT FROM AUTHOR]
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- 2021
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17. CD4/CD8 Ratio and the Risk of Kaposi Sarcoma or Non-Hodgkin Lymphoma in the Context of Efficiently Treated Human Immunodeficiency Virus (HIV) Infection: A Collaborative Analysis of 20 European Cohort Studies.
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Caby, Fabienne, Guiguet, Marguerite, Weiss, Laurence, Winston, Alan, Miro, Jose M, Konopnicki, Deborah, Moing, Vincent Le, Bonnet, Fabrice, Reiss, Peter, Mussini, Cristina, Poizot-Martin, Isabelle, Taylor, Ninon, Skoutelis, Athanasios, Meyer, Laurence, Goujard, Cécile, Bartmeyer, Barbara, Boesecke, Christoph, Antinori, Andrea, Quiros-Roldan, Eugenia, and Wittkop, Linda
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LYMPHOMA risk factors , *HIV infections , *HIV-positive persons , *CONFIDENCE intervals , *KAPOSI'S sarcoma , *RISK assessment , *CD4 lymphocyte count , *DESCRIPTIVE statistics , *T cells , *MEN who have sex with men , *LONGITUDINAL method , *DISEASE risk factors - Abstract
Background A persistently low CD4/CD8 ratio has been reported to inversely correlate with the risk of non-AIDS defining cancer in people living with human immunodeficiency virus (HIV; PLWH) efficiently treated by combination antiretroviral therapy (cART). We evaluated the impact of the CD4/CD8 ratio on the risk of Kaposi sarcoma (KS) or non-Hodgkin lymphoma (NHL), still among the most frequent cancers in treated PLWH. Methods PLWH from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) were included if they achieved virological control (viral load ≤ 500 copies/mL) within 9 months following cART and without previous KS/LNH diagnosis. Cox models were used to identify factors associated with KS or NHL risk, in all participants and those with CD4 ≥ 500/mm3 at virological control. We analyzed the CD4/CD8 ratio, CD4 count and CD8 count as time-dependent variables, using spline transformations. Results We included 56 708 PLWH, enrolled between 2000 and 2014. At virological control, the median (interquartile range [IQR]) CD4 count, CD8 count, and CD4/CD8 ratio were 414 (296–552)/mm3, 936 (670–1304)/mm3, and 0.43 (0.28–0.65), respectively. Overall, 221 KS and 187 NHL were diagnosed 9 (2–37) and 18 (7–42) months after virological control. Low CD4/CD8 ratios were associated with KS risk (hazard ratio [HR] = 2.02 [95% confidence interval {CI } = 1.23–3.31]) when comparing CD4/CD8 = 0.3 to CD4/CD8 = 1) but not with NHL risk. High CD8 counts were associated with higher NHL risk (HR = 3.14 [95% CI = 1.58–6.22]) when comparing CD8 = 3000/mm3 to CD8 = 1000/mm3). Similar results with increased associations were found in PLWH with CD4 ≥ 500/mm3 at virological control (HR = 3.27 [95% CI = 1.60–6.56] for KS; HR = 5.28 [95% CI = 2.17–12.83] for NHL). Conclusions Low CD4/CD8 ratios and high CD8 counts despite effective cART were associated with increased KS/NHL risks respectively, especially when CD4 ≥ 500/mm3. [ABSTRACT FROM AUTHOR]
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- 2021
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18. Human Immunodeficiency Virus (HIV) Drug Resistance, Phylogenetic Analysis, and Superinfection Among Men Who Have Sex with Men and Transgender Women in Sub-Saharan Africa: HIV Prevention Trials Network (HPTN) 075 Study.
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Sivay, Mariya V, Palumbo, Philip J, Zhang, Yinfeng, Cummings, Vanessa, Guo, Xu, Hamilton, Erica L, McKinstry, Laura, Ogendo, Arthur, Kayange, Noel, Panchia, Ravindre, Dominguez, Karen, Chen, Ying Q, Sandfort, Theodorus G M, and Eshleman, Susan H
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HIV infection transmission , *HIV infections , *PHYLOGENY , *SEQUENCE analysis , *GENETIC mutation , *VIRAL load , *DRUG resistance , *SUPERINFECTION , *DISEASE incidence , *GENE expression , *GENOTYPES , *DISEASE prevalence , *DESCRIPTIVE statistics , *MEN who have sex with men , *LOGISTIC regression analysis , *DATA analysis software , *LONGITUDINAL method - Abstract
Background The HIV Prevention Trials Network (HPTN) 075 study evaluated the feasibility of enrolling and retaining men who have sex with men (MSM) and transgender women (TGW) from Kenya, Malawi, and South Africa. During the study follow-up, 21 participants acquired human immunodeficiency virus (HIV) (seroconverters). We analyzed HIV subtype diversity, drug resistance, transmission dynamics, and HIV superinfection data among MSM and TGW enrolled in HPTN 075. Methods HIV genotyping and drug resistance testing were performed for participants living with HIV who had viral loads >400 copies/mL at screening (prevalent cases, n = 124) and seroconverters (n = 21). HIV pol clusters were identified using Cluster Picker. Superinfection was assessed by a longitudinal analysis of env and pol sequences generated by next-generation sequencing. Results HIV genotyping was successful for 123/124 prevalent cases and all 21 seroconverters. The major HIV subtypes were A1 (Kenya) and C (Malawi and South Africa). Major drug resistance mutations were detected in samples from 21 (14.6%) of 144 participants; the most frequent mutations were K103N and M184V/I. Phylogenetic analyses identified 11 clusters (2–6 individuals). Clusters included seroconverters only (n = 1), prevalent cases and seroconverters (n = 4), and prevalent cases only (n = 6). Superinfections were identified in 1 prevalent case and 2 seroconverters. The annual incidence of superinfection was higher among seroconverters than among prevalent cases, and was higher than the rate of primary HIV infection in the cohort. Conclusions This report provides important insights into HIV genetic diversity, drug resistance, and superinfection among MSM and TGW in sub-Saharan Africa. These findings may help to inform future HIV prevention interventions in these high-risk groups. [ABSTRACT FROM AUTHOR]
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- 2021
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19. Decreased Time to Viral Suppression After Implementation of Targeted Testing and Immediate Initiation of Treatment of Acute Human Immunodeficiency Virus Infection Among Men Who Have Sex With Men in Amsterdam.
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Dijkstra, Maartje, Rooijen, Martijn S van, Hillebregt, Mariska M, Sighem, Ard van, Smit, Colette, Hogewoning, Arjan, Davidovich, Udi, Heijman, Titia, Hoornenborg, Elske, Reiss, Peter, van der Valk, Marc, Prins, Maria, Prins, Jan M, Loeff, Maarten F Schim van der, Bree, Godelieve J de, and Initiative, HIV Transmission Elimination Amsterdam (H-TEAM)
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DIAGNOSIS of HIV infections , *HIV infections , *COMBINATION drug therapy , *VIRAL load , *ANTIRETROVIRAL agents , *CD4 lymphocyte count , *DESCRIPTIVE statistics , *MEN who have sex with men - Abstract
Background Men who have sex with men (MSM) with acute human immunodeficiency virus (HIV) infection (AHI) are a key source of new infections. To curb transmission, we implemented a strategy for rapid AHI diagnosis and immediate initiation of combination antiretroviral therapy (cART) in Amsterdam MSM. We assessed its effectiveness in diagnosing AHI and decreasing the time to viral suppression. Methods We included 63 278 HIV testing visits in 2008–2017, during which 1013 MSM were diagnosed. Standard of care (SOC) included HIV diagnosis confirmation in < 1 week and cART initiation in < 1 month. The AHI strategy comprised same-visit diagnosis confirmation and immediate cART. Time from diagnosis to viral suppression was assessed for 3 cART initiation periods: (1) 2008–2011: cART initiation if CD4 < 500 cells/μL (SOC); (2) January 2012–July 2015: cART initiation if CD4 < 500 cells/μL, or if AHI or early HIV infection (SOC); and (3a) August 2015–June 2017: universal cART initiation (SOC) or (3b) August 2015–June 2017 (the AHI strategy). Results Before implementation of the AHI strategy, the proportion of AHI among HIV diagnoses was 0.6% (5/876); after implementation this was 11.0% (15/137). Median time (in days) to viral suppression during periods 1, 2, 3a, and 3b was 584 (interquartile range [IQR], 267–1065), 230 (IQR, 132–480), 95 (IQR, 63–136), and 55 (IQR, 31–72), respectively (P <.001). Conclusions Implementing the AHI strategy was successful in diagnosing AHI and significantly decreasing the time between HIV diagnosis and viral suppression. [ABSTRACT FROM AUTHOR]
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- 2021
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20. Peer Mobilization and Human Immunodeficiency Virus (HIV) Partner Notification Services Among Gay, Bisexual, and Other Men Who Have Sex With Men and Transgender Women in Coastal Kenya Identified a High Number of Undiagnosed HIV Infections.
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Dijkstra, Maartje, Mohamed, Khamisi, Kigoro, Alex, Mumba, Teresia, Mahmoud, Shally, Wesonga, Abdalla, Mukuria, Nana, Oduor, Tony, Gichuru, Evans, Loeff, Maarten F Schim van der, Palmer, Shaun, Graham, Susan M, Elst, Elise M van der, and Sanders, Eduard J
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HIV-positive men , *SEXUAL partners , *PRE-exposure prophylaxis , *HIV infections , *TRANSGENDER people , *HIV , *MEN who have sex with men , *ANTIBODY titer - Abstract
Background Human immunodeficiency virus (HIV) partner notification services (HPN), peer mobilization with HIV self-testing, and acute and early HIV infection (AEHI) screening among gay, bisexual, and other men who have sex with men (GBMSM) and transgender women (TGW) were assessed for acceptability, feasibility, and linkage to antiretroviral therapy (ART) and preexposure prophylaxis (PrEP) services. Methods Between April and August 2019, peer mobilizers mobilized clients by offering HIV oral self-tests and immediate clinic referral for clients with AEHI symptoms. Mobilized participants received clinic-based rapid antibody testing and point-of-care HIV RNA testing. Newly diagnosed participants including those derived from HIV testing services were offered immediate ART and HPN. Partners were recruited through HPN. Results Of 772 mobilized clients, 452 (58.5%) enrolled in the study as mobilized participants. Of these, 16 (3.5%) were HIV newly diagnosed, including 2 (0.4%) with AEHI. All but 2 (14/16 [87.5%]) initiated ART. Thirty-five GBMSM and TGW were offered HPN and 27 (77.1%) accepted it. Provider referral identified a higher proportion of partners tested (39/64 [60.9%] vs 5/14 [35.7%]) and partners with HIV (27/39 [69.2%] vs 2/5 [40.0%]) than index referral. Of 44 enrolled partners, 10 (22.7%) were newly diagnosed, including 3 (6.8%) with AEHI. All 10 (100%) initiated ART. PrEP was initiated among 24.0% (103/429) mobilized participants and 28.6% (4/14) partners without HIV. Conclusions HPN, combined with a peer mobilization–led self-testing strategy and AEHI screening for GBMSM and TGW, appears to be acceptable and feasible. These strategies, especially HPN provider referral, effectively identified undiagnosed HIV infections and linked individuals to ART and PrEP services. [ABSTRACT FROM AUTHOR]
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- 2021
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21. Clinical and Immunologic Outcomes After Immediate or Deferred Antiretroviral Therapy Initiation During Primary Human Immunodeficiency Virus Infection: The Sabes Randomized Clinical Study.
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Lama, Javier R, Ignacio, Rachel A Bender, Alfaro, Ricardo, Rios, Jessica, Cartagena, Jorge Gallardo, Valdez, Rogelio, Bain, Carolyn, Barbarán, Karin Sosa, Villaran, Manuel V, Pilcher, Christopher D, Gonzales, Pedro, Sanchez, Jorge, and Duerr, Ann
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DIAGNOSIS of HIV infections , *HIV infections , *BIOMARKERS , *CONFIDENCE intervals , *ANTIRETROVIRAL agents , *RNA , *DISEASE incidence , *TREATMENT effectiveness , *RANDOMIZED controlled trials , *COMPARATIVE studies , *PRE-tests & post-tests , *DESCRIPTIVE statistics , *MEN who have sex with men , *VIRAL antibodies , *STATISTICAL sampling , *T cells , *EVALUATION - Abstract
Background In addition to demonstrated public health benefits on reducing transmission, it remains unclear how early antiretroviral therapy (ART) must be started after acquisition of human immunodeficiency virus (HIV) to maximize individual benefits. Methods We conducted an open-label randomized clinical study in Lima, Peru among adult men who have sex with men and transgender women with acute (HIV-antibody negative/HIV-1 RNA positive) or recent (confirmed negative HIV-antibody or RNA test within 3 months) HIV infection, who were randomized to start ART immediately versus defer by 24 weeks. We evaluated outcomes by treatment arm and immunologic markers by days since estimated date of detectible infection (EDDI). Results Of 216 participants, 105 were assigned to immediate arm and 111 to deferred arm (median age 26.8 years, 37% with acute HIV). The incidence of non-ART-related adverse events was lower in immediate versus deferred arm (83 vs 123/100 person-years, IRR 0.67 (95% confidence interval [CI].47,.95; P = .02), the difference dominated by fewer infections in those treated immediately. After 24 weeks of ART, between-group differences in CD4/CD8 cell ratio lessened (P = .09 overall), but differences between those initiating ART ≤ 30 days from EDDI (median 1.03, interquartile range [IQR] 0.84, 1.37), and those initiating > 90 days (0.88, IQR 0.61, 1.11) remained, P = .02. Principal components analysis of 20 immune biomarkers demonstrated distinct patterns between those starting ART > 90 days from EDDI versus those starting within 30 or 90 days (both P < .001). Conclusions To our knowledge, this is the only evaluation of randomized ART initiation during primary HIV and provides evidence to explicitly consider acute HIV in World Health Organization recommendations for universal ART. Clinical Trials Registration NCT01815580. [ABSTRACT FROM AUTHOR]
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- 2021
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22. Human Immunodeficiency Virus Continuum of Care in 11 European Union Countries at the End of 2016 Overall and by Key Population: Have We Made Progress?
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Vourli, Georgia, Noori, Teymur, Pharris, Anastasia, Porter, Kholoud, Axelsson, Maria, Begovac, Josip, Cazein, Francoise, Costagliola, Dominique, Cowan, Susan, Croxford, Sara, Monforte, Antonella d'Arminio, Delpech, Valerie, Díaz, Asunción, Girardi, Enrico, Gunsenheimer-Bartmeyer, Barbara, Hernando, Victoria, Leierer, Gisela, Lot, Florence, Nunez, Olivier, and Obel, Niels
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DIAGNOSIS of HIV infections , *HIV prevention , *COMPARATIVE studies , *CONTINUUM of care , *HIV infections , *HIV-positive persons , *MEN , *HEALTH outcome assessment , *PUBLIC health surveillance , *VIRAL load , *ANTIRETROVIRAL agents , *MEN who have sex with men , *DESCRIPTIVE statistics - Abstract
Background High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control. [ABSTRACT FROM AUTHOR]
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- 2020
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23. Impact of Acute HIV Infection and Early Antiretroviral Therapy on the Human Gut Microbiome.
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Sortino, Ornella, Phanuphak, Nittaya, Schuetz, Alexandra, Ortiz, Alexandra M, Chomchey, Nitiya, Belkaid, Yasmine, Davis, Jacquice, Mystakelis, Harry A, Quiñones, Mariam, Deleage, Claire, Ingram, Brian, Rerknimitr, Rungsun, Pinyakorn, Suteeraporn, Rupert, Adam, Robb, Merlin L, Ananworanich, Jintanat, Brenchley, Jason, Sereti, Irini, and Group, RV254/SEARCH010 Study
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HIV infections , *HUMAN microbiota , *GUT microbiome , *ANTIRETROVIRAL agents , *HIV seroconversion , *MEN who have sex with men - Abstract
Background Intestinal microbial dysbiosis is evident in chronic HIV-infected individuals and may underlie inflammation that persists even during antiretroviral therapy (ART). It remains unclear, however, how early after HIV infection gut dysbiosis emerges and how it is affected by early ART. Methods Fecal microbiota were studied by 16s rDNA sequencing in 52 Thai men who have sex with men (MSM), at diagnosis of acute HIV infection (AHI), Fiebig Stages 1–5 (F1-5), and after 6 months of ART initiation, and in 7 Thai MSM HIV-uninfected controls. Dysbiotic bacterial taxa were associated with relevant inflammatory markers. Results Fecal microbiota profiling of AHI pre-ART vs HIV-uninfected controls showed a mild dysbiosis. Transition from F1-3 of acute infection was characterized by enrichment in pro-inflammatory bacteria. Lower proportions of Bacteroidetes and higher frequencies of Proteobacteria and Fusobacteria members were observed post-ART compared with pre-ART. Fusobacteria members were positively correlated with levels of soluble CD14 in AHI post-ART. Conclusions Evidence of gut dysbiosis was observed during early acute HIV infection and was partially restored upon early ART initiation. The association of dysbiotic bacterial taxa with inflammatory markers suggests that a potential relationship between altered gut microbiota and systemic inflammation may also be established during AHI. [ABSTRACT FROM AUTHOR]
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- 2020
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24. 'I will welcome this one 101%, I will so embrace it': a qualitative exploration of the feasibility and acceptability of HIV self-testing among men who have sex with men (MSM) in Lagos, Nigeria.
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Dirisu, Osasuyi, Sekoni, Adekemi, Vu, Lung, Adebajo, Sylvia, Njab, Jean, Shoyemi, Elizabeth, Ogunsola, Sade, and Tun, Waimar
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HIV infections ,INTERVIEWING ,HEALTH self-care ,MEN who have sex with men - Abstract
Men who have sex with men (MSM) are disproportionately affected by HIV in Nigeria. A key strategy in reducing transmission is to increase HIV testing uptake and linkage to treatment for those who test positive. HIV self-testing (HIVST) is an innovative strategy with the potential to increase uptake of HIV testing among key populations at higher risk for HIV. We conducted 23 in-depth-interviews with MSM and two focus group discussions with key opinion leaders to explore perceptions about the feasibility and acceptability of oral HIVST among MSM in Lagos, Nigeria. HIVST was highly acceptable because it was considered convenient to use, painless, private and addressed concerns about stigma. Concerns cited by participants included comprehensibility of instructions to perform and interpret results correctly, as well as lack of support mechanisms to facilitate post-test follow-up and linkage to care. Provision of adequate pre-test information was considered vital as part of the kit distribution process to ensure seamless use of HIVST kits. One-on-one peer-to-peer distribution strategies and retail outlets that facilitate anonymous pick-up are potential distribution channels identified in this study. Overall, our findings suggest that an HIVST program that incorporates these considerations would improve access to HIV testing among MSM in Nigeria. [ABSTRACT FROM AUTHOR]
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- 2020
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25. Chlamydia and Gonorrhea Incidence and Testing Among Patients in the Human Immunodeficiency Virus Outpatient Study (HOPS), 2007−2017.
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Li, Jun, Armon, Carl, Palella, Frank J, Novak, Richard M, Ward, Douglas, Purinton, Stacey, Durham, Marcus, and Buchacz, Kate
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CHLAMYDIA infection diagnosis , *GONORRHEA diagnosis , *CHLAMYDIA infections , *GONORRHEA , *HISPANIC Americans , *HIV infections , *HIV-positive persons , *REGRESSION analysis , *RISK assessment , *SEXUALLY transmitted diseases , *MEN who have sex with men , *DISEASE risk factors - Abstract
Background Although chlamydia (CT) and gonorrhea (GC) infections are increasing in the United States, there are limited data on their incidence, testing rates, and associated risk factors among persons living with HIV (PLWH), including by anatomic site among men who have sex with men (MSM). Methods We analyzed 2007–2017 medical records data from Human Immunodeficiency Virus (HIV) Outpatient Study (HOPS) participants in care at 9 HIV clinics. We calculated CT (and GC) incidence and testing rates and assessed associations with sociodemographic and clinical factors using log-linear regression. Results Among 4727 PLWH, 397 had 881 CT infections and 331 had 861 GC infections, with an incidence of 2.95 and 2.88 per 100 person-years, respectively. From 2007 to 2017, incidence and testing rates increased by approximately 3.0- and 1.9-fold for CT and GC, respectively. Multivariable factors associated with incident CT (GC) included younger age, MSM, and prior diagnoses of sexually transmitted diseases (STDs). Among 1159 MSM, 583 (50.3%) had 844 CT and 843 GC tests during 2016–2017, and 26.6% of tests were 3-site (urethra, rectum, and pharynx), yielding the highest rates of CT (GC) detection. Multivariable factors associated with CT (GC) testing included younger age, non-Hispanic/Latino black race, and having prior STDs. Conclusions Recent CT and GC incidence and testing increased among PLWH; however, only half of MSM were tested for CT or GC during 2016–2017 and less than a third of tests were 3-site. To promote sexual health and STD prevention among PLWH who are MSM, research regarding the added value of CT and GC testing across 3 anatomic sites is needed. [ABSTRACT FROM AUTHOR]
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- 2020
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26. Gastroenteritis in Men Who Have Sex With Men in Seattle, Washington, 2017–2018.
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Newman, Kira L, Newman, Gretchen Snoeyenbos, Cybulski, Robert J, and Fang, Ferric C
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FECAL analysis , *BACTERIA , *CAMPYLOBACTER , *CELL culture , *DIARRHEA , *DRUG resistance in microorganisms , *ESCHERICHIA coli , *GASTROENTERITIS , *HIV infections , *HIV-positive persons , *LONGITUDINAL method , *MOLECULAR diagnosis , *PARASITES , *POLYMERASE chain reaction , *RISK assessment , *SHIGELLA , *VIRUSES , *RETROSPECTIVE studies , *ACUTE diseases , *MEN who have sex with men , *ELECTRONIC health records , *DESCRIPTIVE statistics , *MIXED infections - Abstract
Background Men who have sex with men (MSM) are at risk for sexual transmission of enteric pathogens. The microbiology of gastroenteritis in MSM has not been examined since the advent of antiretroviral therapy and molecular diagnostics. Our objective was to assess the causes of gastroenteritis among MSM living with and without human immunodeficiency virus (HIV) coinfection in Seattle, Washington. Methods We conducted a retrospective cohort study of 235 MSM who underwent multiplex stool polymerase chain reaction (PCR) testing between 1 January 2017 and 1 June 2018. We abstracted clinical and laboratory data from electronic medical records. Parallel or reflexive culture and susceptibility testing were performed when PCR detected cultivable pathogens. Results Among 235 MSM tested (268 episodes), 131 had 151 episodes with positive test results. 148 (63.0%) individuals were living with HIV. Among positive tests, 88.7% detected a bacterial pathogen, 26% a virus, and 40% a parasite. Diarrheagenic Escherichia coli (enteroaggretative, enteropathogenic), Shigella , and Campylobacter were the most commonly detected bacteria (33.1%, 30.5%, and 17.2% of positive samples, respectively). Forty-three percent of positive specimens had ≥2 pathogens. Etiologies and clinical presentations were similar between men living with and without HIV. Cultured Shigella and Campylobacter isolates were frequently resistant to multiple antibiotics. Conclusions MSM present with gastroenteritis from varied pathogens, including some not detected by conventional stool culture. High levels of antibiotic resistance are consistent with frequent antibiotic exposure in this population and the transmission of multiresistant strains. New approaches are needed to detect, treat, and prevent enteric infections in MSM. [ABSTRACT FROM AUTHOR]
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- 2020
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27. Characterizing Cross-Culturally Relevant Metrics of Stigma Among Men Who Have Sex With Men Across 8 Sub-Saharan African Countries and the United States.
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Augustinavicius, Jura L, Baral, Stefan D, Murray, Sarah M, Jackman, Kevon, Xue, Qian-Li, Sanchez, Travis H, Nowak, Rebecca G, Crowell, Trevor A, Zlotorzynska, Maria, Olawore, Oluwasolape, Lyons, Carrie E, Njindam, Iliassou M, Tamoufe, Ubald, Diouf, Daouda, Drame, Fatou, Kouanda, Seni, Kouame, Abo, Charurat, Man E, Anato, Simplice, and Mothopeng, Tampose
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SUB-Saharan Africans , *CULTURE , *FACTOR analysis , *HIV infections , *PSYCHOMETRICS , *HUMAN sexuality , *SOCIAL stigma , *ETHNOLOGY research , *MEN who have sex with men ,RESEARCH evaluation - Abstract
Overcoming stigma affecting gay, bisexual, and other men who have sex with men (MSM) is a foundational element of an effective response to the human immunodeficiency virus (HIV) pandemic. Quantifying the impact of stigma mitigation interventions necessitates improved measurement of stigma for MSM around the world. In this study, we explored the underlying factor structure and psychometric properties of 13 sexual behavior stigma items among 10,396 MSM across 8 sub-Saharan African countries and the United States using cross-sectional data collected between 2012 and 2016. Exploratory factor analyses were used to examine the number and composition of underlying stigma factors. A 3-factor model was found to be an adequate fit in all countries (root mean square error of approximation = 0.02–0.05; comparative fit index/Tucker-Lewis index = 0.97–1.00/0.94–1.00; standardized root mean square residual = 0.04–0.08), consisting of "stigma from family and friends," "anticipated health-care stigma," and "general social stigma," with internal consistency estimates across countries of α = 0.36–0.80, α = 0.72–0.93, and α = 0.51–0.79, respectively. The 3-factor model of sexual behavior stigma cut across social contexts among MSM in the 9 countries. These findings indicate commonalities in sexual behavior stigma affecting MSM across sub-Saharan Africa and the United States, which can facilitate efforts to track progress on global stigma mitigation interventions. [ABSTRACT FROM AUTHOR]
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- 2020
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28. Anal Squamous Intraepithelial Lesions (SILs) in Human Immunodeficiency Virus-Positive Men Who Have Sex With Men: Incidence and Risk Factors of SIL and of Progression and Clearance of Low-Grade SILs.
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Jongen, V W, Richel, O, Marra, E, Siegenbeek van Heukelom, M L, van Eeden, A, de Vries, H J C, Cairo, I, Prins, J M, and Schim van der Loeff, M F
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SYPHILIS , *SQUAMOUS cell carcinoma , *IMMUNODEFICIENCY , *NATURAL history , *ODDS ratio , *HIV infection epidemiology , *HIV infection complications , *DISEASE progression , *HIV infections , *AGE distribution , *DISEASE incidence , *HIV seroconversion , *HOMOSEXUALITY , *ANAL tumors - Abstract
Background: Human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) are at risk of anal squamous cell carcinoma. Data are limited on the natural history of the precursor to this carcinoma, anal squamous intraepithelial lesions (SILs).Methods: HIV-positive MSM were screened for histopathological SILs by means of high-resolution anoscopy (HRA). For participants without SILs at baseline, we estimated the cumulative incidence and risk factors for SILs. For those with low-grade SILs (LSILs) at baseline, the risk of progression to high-grade SILs (HSILs) and the clearance rate were estimated at the lesion level.Results: Of 807 men without SILs at baseline, 107 underwent follow-up HRA between 1 to 4.5 years later. At the second visit 18 men (16.8%) showed LSIL, and 25 (23.4%) HSIL. Age was associated with incident LSILs (adjusted odds ratio [aOR], 2.10 per 10-year increase in age; P = .01). Of 393 men with LSILs at baseline, 114 underwent follow-up HRA 0.5 to 2.5 years later. Of the 177 LSILs found at baseline, 87 (49.2%) had cleared at the second visit, and 29 (16.4%) had progressed to HSILs.Conclusion: Incident LSILs and HSILs were common during follow-up among HIV-positive MSM without dysplasia at baseline. Among men with LSILs at baseline, nearly half of these lesions cleared, and a small portion progressed. [ABSTRACT FROM AUTHOR]- Published
- 2020
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29. Factors related to condomless anal intercourse between men who have sex with men: results from a European bio-behavioural survey.
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Sherriff, N S, Jones, A M, Mirandola, M, Gios, L, Marcus, U, Llewellyn, C, Rosinska, M, Folch, C, Dias, S, Toskin, I, Alexiev, I, Kühlmann-Berenzon, S, and Network, Sialon II
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AGE distribution ,CHI-squared test ,CONFIDENCE intervals ,HIV infections ,MULTIVARIATE analysis ,QUESTIONNAIRES ,RISK-taking behavior ,SUBSTANCE abuse ,ANAL sex ,MULTIPLE regression analysis ,HARM reduction ,UNSAFE sex ,CROSS-sectional method ,DATA analysis software ,MEN who have sex with men ,SEXUAL partners ,STATISTICAL models ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Background Relationship status is an important factor associated with condomless anal intercourse (CAI) amongst men who have sex with men (MSM). Methods A multi-centre bio-behavioural survey with MSM was conducted in 13 European cities (n = 4901) exploring factors associated with CAI via bivariate and multivariate multilevel logistic regression analyses. Results Likelihood of CAI with casual partners was associated with being 'out' to a majority (AOR = 1.19;95% CI 1,1.42); knowing their HIV status (AOR = 1.86; 95% CI 1.25,2.76); using substances (1–2 AOR = 1.39; 95% CI 1.16,1.63, 2+ AOR = 1.81; 95% CI 1.35,2.42); being older (AOR = 0.98; 95% CI 0.97,0.99); successful sero-communication (AOR = 0.79; 95% CI 0.67,0.94); and, not having a recent HIV test (AOR = 0.78; 95% CI 0.66,0.92). CAI with steady partners was associated with successful sero-communication (AOR = 2.72; 95% CI 2.72,3.66); not having a recent HIV test (AOR = 1.26; 95% CI 1.09,1.46), and; being older (AOR = 0.99; 95% CI 0.98,0.99). Conclusions Understandings of partner type and/or relationship status in relation to CAI amongst MSM can potentially play an important role in the development of culturally appropriate HIV/STI prevention and risk-reduction efforts targeting at-risk MSM. Our results speak to the need to consider segmented and tailored public health and health promotion initiatives for MSM with differing CAI behaviours and relationship profiles. [ABSTRACT FROM AUTHOR]
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- 2020
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30. Multiplier method estimates of the population of men who have sex with men: the effect of privacy protection.
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Jing, Liwei, Cui, Yuehua, Lu, Qing, and Yu, Hongmei
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CONFIDENCE intervals ,HIV infections ,MEDICAL ethics ,MEN'S health ,POPULATION density ,PRIVACY ,SOCIAL stigma ,SAMPLE size (Statistics) ,MEN who have sex with men ,DESCRIPTIVE statistics - Abstract
Objectives The stigmatization of men who have sex with men (MSM) has led to an underestimation of their population size. To address this, the United Nations Programme on HIV/Acquired Immunodeficiency Syndrome and World Health Organization developed a multiplier method. However, nearly all multiplier method estimates of MSM population size in China are far below national estimates. This study explores how privacy protection to address and avoid MSM stigmatization can affect reliable estimates. Methods Data from an MSM website, a bar, and a peer-based HIV testing were used to produce three multiplier method estimates of the MSM population size in Taiyuan, China, in 2014. The effect of privacy protection on stigmatization was explored by comparing the peer-based HIV testing with other estimates. We used a national estimate as a reference to verify potential underestimation. Results The website and bar estimates were 5- to 10-times and 8- to 16-times lower than the Chinese national estimate range, respectively. Conversely, the peer-based HIV testing estimate was within the national estimate range. Conclusions Though the multiplier method was developed to estimate the size of stigmatized populations, it might be affected by privacy protection addressing stigmatization; this should be considered when gathering data. [ABSTRACT FROM AUTHOR]
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- 2020
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31. Trends in Prevalence of Protective Levels of Hepatitis B Surface Antibody Among Adults Aged 18–49 Years With Risk Factors for Hepatitis B Virus Infection—United States, 2003–2014.
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King, Hope, Xing, Jian, Dean, Hazel D, and Holtzman, Deborah
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ANTIGENS , *HEPATITIS B , *HIV infections , *IMMUNITY , *IMMUNIZATION , *INJECTIONS , *RESEARCH , *RISK assessment , *SEROLOGY , *SEXUALLY transmitted diseases , *VIRAL antigens , *DATA analysis , *MULTIPLE regression analysis , *DISEASE prevalence , *MEN who have sex with men , *DISEASE risk factors - Abstract
Background Hepatitis B virus (HBV) infection can be prevented through vaccination. However, previous data show that only about 24%–45% of US adults at high risk of HBV infection are protected. Our aims were to assess prevalence and trends in protective levels of hepatitis B surface antibody (anti-HBs) from 2003 to 2014 and explore factors associated with protection among adults at high risk. Methods Data were taken from the 2003–2014 National Health and Nutrition Examination surveys. Our sample included adults aged 18-49 years who were tested for HBV and reported at least 1 of the following infection risks: history of sexually transmitted disease, sex with men (for men), infection with human immunodeficiency virus, and injection drug use. We calculated the prevalence of anti-HBs (≥10 mIU/mL), indicative of immunity from vaccination, among respondents for three 4-year time intervals (2003–2006, 2007–2010, and 2011–2014) and applied the Cochran-Mantel-Haenszel test to assess trends. Using multivariable logistic regression, we examined factors associated with positive anti-HBs serology. Results The prevalence of positive anti-HBs serology was 23.4%. Prevalence increased from 2003–2006 (16.3%) to 2007–2010 (27.3%), but no change occurred from 2007–2010 (27.3%) to 2011–2014 (28.1%). Among factors predicting positive anti-HBs serology were young age and higher education. Conclusions By 2014, less than one-third of adults aged 18-49 years at risk of infection exhibited protective antibodies ≥10 mIU/mL. Because these adults account for a majority of unprotected adults, targeted intervention strategies are essential to achieve the hepatitis B elimination goal. [ABSTRACT FROM AUTHOR]
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- 2020
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32. Rectal and seminal HIV-1 RNA decay towards virological suppression in infected MSM initiating dolutegravir/abacavir/lamivudine.
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Fernández-González, Marta, García, José A, Padilla, Sergio, García-Abellán, Javier, Agulló, Vanesa, Gutiérrez, Félix, and Masiá, Mar
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RNA , *VIRAL shedding , *VIRAL load , *GENITALIA , *SEMEN , *LONGITUDINAL method , *HIV infections , *ANTI-HIV agents , *BIOCHEMISTRY , *PYRIDINE , *RESEARCH , *DEOXYRIBONUCLEOSIDES , *HETEROCYCLIC compounds , *RESEARCH methodology , *MEDICAL cooperation , *EVALUATION research , *HOMOSEXUALITY , *LAMIVUDINE , *PHENOMENOLOGY , *COMPARATIVE studies , *CD4 lymphocyte count , *HIV - Abstract
Background: The time at which the protective effect of starting ART is achieved in male rectal and genital reservoirs is not clearly established.Objectives: To quantify HIV-1 RNA decay towards virological suppression in rectal mucosa and semen in MSM starting dolutegravir/abacavir/lamivudine (DTG/ABC/3TC).Methods: A longitudinal cohort study of ART-naive HIV-positive MSM was performed. HIV-1 RNA was quantified in rectal mucosa and seminal plasma samples at day 1 of ART initiation (baseline) and every 4 weeks until week 20 (w20; all participants) and week 64 (w64; 6 of 12 participants).Results: Twelve MSM, with median (IQR) age 36 (33-40) years and baseline CD4+ count 449 (411-503) cells/mm3, were included. At baseline, HIV-1 RNA was detectable in all plasma and seminal samples and 10/12 rectal samples. All participants achieved plasma virological suppression by w20, whereas HIV-1 RNA was detectable in 42% and 50% of seminal and rectal samples, respectively. At w64, HIV-1 RNA was detectable in 1/6 seminal and 1/6 rectal samples. A relationship of baseline seminal and rectal HIV-1 RNA levels with viral shedding in reservoirs (HIV-1 RNA >200 copies/mL or copies/swab) was found. In addition, a significant association of baseline plasma viral load with time to rectal HIV-1 RNA <200 copies/swab was found (P=0.025).Conclusions: Viral decay after initiating DTG/ABC/3TC is slower in rectal mucosa and semen than in plasma. Approximately half of patients achieved undetectable HIV-1 RNA levels in rectal and genital secretions at w20 and in some patients viral shedding persisted for up to 1 year. Initial plasma viral load influences time to rectal suppression. [ABSTRACT FROM AUTHOR]- Published
- 2020
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33. The Impact of Human Immunodeficiency Virus Infection on Gut Microbiota α-Diversity: An Individual-level Meta-analysis.
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Tuddenham, Susan A, Koay, Wei Li A, Zhao, Ni, White, James R, Ghanem, Khalil G, Sears, Cynthia L, and Consortium, HIV Microbiome Re-analysis
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CHI-squared test , *FECES , *HIV infections , *HIV-positive persons , *MEDICAL information storage & retrieval systems , *MEDLINE , *META-analysis , *RNA , *SEX distribution , *T-test (Statistics) , *SYSTEMATIC reviews , *GUT microbiome , *MEN who have sex with men , *SEQUENCE analysis - Abstract
Background Whether human immunodeficiency virus (HIV) infection impacts gut microbial α-diversity is controversial. We reanalyzed raw 16S ribosomal RNA (rRNA) gene sequences and metadata from published studies to examine α-diversity measures between HIV-uninfected (HIV–) and HIV-infected (HIV+) individuals. Methods We conducted a systematic review and individual level meta-analysis by searching Embase, Medline, and Scopus for original research studies (inception to 31 December 2017). Included studies reported 16S rRNA gene sequences of fecal samples from HIV+ patients. Raw sequence reads and metadata were obtained from public databases or from study authors. Raw reads were processed through standardized pipelines with use of a high-resolution taxonomic classifier. The χ2 test, paired t tests, and generalized linear mixed models were used to relate α-diversity measures and clinical metadata. Results Twenty-two studies were identified with 17 datasets available for analysis, yielding 1032 samples (311 HIV–, 721 HIV+). HIV status was associated with a decrease in measures of α-diversity (P <.001). However, in stratified analysis, HIV status was associated with decreased α-diversity only in women and in men who have sex with women (MSW) but not in men who have sex with men (MSM). In analyses limited to women and MSW, controlling for HIV status, women displayed increased α-diversity compared with MSW. Conclusions Our study suggests that HIV status, sexual risk category, and gender impact gut microbial community α-diversity. Future studies should consider MSM status in gut microbiome analyses. [ABSTRACT FROM AUTHOR]
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- 2020
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34. Surveillance of HIV-1 primary infections in France from 2014 to 2016: toward stable resistance, but higher diversity, clustering and virulence?
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Visseaux, Benoit, Assoumou, Lambert, Mahjoub, Nadia, Grude, Maxime, Trabaud, Mary-Anne, Raymond, Stéphanie, Wirden, Marc, Morand-Joubert, Laurence, Roussel, Catherine, Montes, Brigitte, Bocket, Laurence, Fafi-Kremer, Samira, Amiel, Corinne, Monte, Anne De, Stefic, Karl, Pallier, Coralie, Tumiotto, Camille, Maillard, Anne, Vallet, Sophie, and Ferre, Virginie
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INFECTION , *HIV , *NON-nucleoside reverse transcriptase inhibitors , *VIRAL load , *NUCLEOSIDE reverse transcriptase inhibitors , *HIV infection epidemiology , *ANTI-HIV agents , *HIV infections , *RESEARCH , *GENETICS , *BIOLOGICAL evolution , *SEQUENCE analysis , *GENETIC mutation , *RESEARCH methodology , *EPIDEMIOLOGY , *MEDICAL cooperation , *EVALUATION research , *COMPARATIVE studies , *GENOTYPES , *DRUG resistance in microorganisms , *MICROBIAL virulence , *PHARMACODYNAMICS - Abstract
Objectives: Patients with primary HIV-1 infection (PHI) are a particular population, giving important insight about ongoing evolution of transmitted drug resistance-associated mutation (TDRAM) prevalence, HIV diversity and clustering patterns. We describe these evolutions of PHI patients diagnosed in France from 2014 to 2016.Methods: A total of 1121 PHI patients were included. TDRAMs were characterized using the 2009 Stanford list and the French ANRS algorithm. Viral subtypes and recent transmission clusters (RTCs) were also determined.Results: Patients were mainly MSM (70%) living in the Paris area (42%). TDRAMs were identified among 10.8% of patients and rose to 18.6% when including etravirine and rilpivirine TDRAMs. Prevalences of PI-, NRTI-, first-generation NNRTI-, second-generation NNRTI- and integrase inhibitor-associated TDRAMs were 2.9%, 5.0%, 4.0%, 9.4% and 5.4%, respectively. In a multivariable analysis, age >40 years and non-R5 tropic viruses were associated with a >2-fold increased risk of TDRAMs. Regarding HIV diversity, subtype B and CRF02_AG (where CRF stands for circulating recombinant form) were the two main lineages (56% and 20%, respectively). CRF02_AG was associated with higher viral load than subtype B (5.83 versus 5.40 log10 copies/mL, P=0.004). We identified 138 RTCs ranging from 2 to 14 patients and including overall 41% from the global population. Patients in RTCs were younger, more frequently born in France and more frequently MSM.Conclusions: Since 2007, the proportion of TDRAMs has been stable among French PHI patients. Non-B lineages are increasing and may be associated with more virulent CRF02_AG strains. The presence of large RTCs highlights the need for real-time cluster identification to trigger specific prevention action to achieve better control of the epidemic. [ABSTRACT FROM AUTHOR]- Published
- 2020
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35. First year of pre-exposure prophylaxis implementation in France with daily or on-demand tenofovir disoproxil fumarate/emtricitabine.
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Siguier, M, Mera, R, Pialoux, G, Ohayon, M, Cotte, L, Valin, N, Ghosn, J, Cua, E, Pintado, C, Chas, J, Barriere, G, Durand, F, and Molina, J M
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PRE-exposure prophylaxis , *SEXUALLY transmitted diseases , *HIV infections , *BISOPROLOL , *HIV seroconversion , *GLYCOPYRROLATE - Abstract
Background: In January 2016, the French Medicine Agency initiated a Temporary Recommendation for Use (TRU) to allow the use of oral intake of tenofovir disoproxil fumarate and emtricitabine for pre-exposure prophylaxis (PrEP) in adults at high risk of HIV. We report the results of the first year of PrEP implementation in France.Methods: Data were collected by physicians using a secured web subject-monitoring interface, with two forms: an initiation form, with patients' baseline characteristics, and an HIV seroconversion form. Univariate and adjusted multivariate analysis using a logistic regression model were performed to identify baseline factors associated with on-demand PrEP regimen prescription.Results: From 4 January 2016 to 28 February 2017, 3405 subjects were enrolled, with 2774 initiation forms completed; 98.1% were male and 96.9% were MSM. An on-demand regimen was prescribed to 57% of subjects. Older age (OR for participants older than 50 years = 1.76, 95% CI 1.35-2.3, P < 0.001) and site of prescription (OR of former IPERGAY sites = 2.28, 95% CI 1.84-2.83, P < 0.001) were associated with on-demand prescription. Those reporting sexually transmitted infection (STI) and condomless anal sex with at least two different partners were less likely to receive on-demand PrEP (OR = 0.68, 95% CI 0.57-0.82 and 0.75, 95% CI 0.57-0.98, respectively; P < 0.05 for all). Four breakthrough HIV infections were reported during the study, in the context of PrEP interruption or acute infection at the time of PrEP initiation.Conclusions: In a real-life setting in France, PrEP was used, either daily or on-demand, mostly by MSM, with breakthrough infections being rare. [ABSTRACT FROM AUTHOR]- Published
- 2019
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36. Changing Trends in International Versus Domestic HCV Transmission in HIV-Positive Men Who Have Sex With Men: A Perspective for the Direct-Acting Antiviral Scale-Up Era.
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Salazar-Vizcaya, Luisa, Kouyos, Roger D, Metzner, Karin J, Cortes, Kamila Caraballo, Böni, Jürg, Shah, Cyril, Fehr, Jan, Braun, Dominique L, Bernasconi, Enos, Mbunkah, Herbert A, Hoffmann, Matthias, Labhardt, Niklaus, Cavassini, Matthias, Rougemont, Mathieu, Günthard, Huldrych F, Keiser, Olivia, Rauch, Andri, Study, the Swiss HIV Cohort, Caraballo Cortes, Kamila, and Swiss HIV Cohort Study
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HEPATITIS C transmission , *ANTIVIRAL agents , *COMPARATIVE studies , *EPIDEMICS , *HEPATITIS C , *HEPATITIS viruses , *HIV infections , *HOMOSEXUALITY , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *EVALUATION research , *DISEASE incidence , *HIV seroconversion , *MIXED infections , *INFECTIOUS disease transmission - Abstract
Background: Scale-up of direct-acting antiviral therapy is expected to abate hepatitis C virus (HCV) incidence among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM). International transmission could influence this process. We classified HCV infections in HIV-positive MSM as either domestically or internationally acquired, and estimated how this classification changed over time.Methods: HCV subtype 1a (the most frequent subtype among MSM) genomes from 99 persons enrolled in the Swiss HIV Cohort Study and diagnosed with replicating HCV infections, were sequenced. Sixty-six of these sequences were from MSM. We inferred maximum-likelihood phylogenetic trees and time trees containing a fragment of the NS5B region of these and 374 circulating strains. We inferred transmission clusters from these trees and used the country composition of such clusters to attribute infections to domestic or international transmission.Results: Of HCV transmissions, 50% to 80% were classified as domestic depending on the classification criterion. Between 2000 and 2007, the fraction attributable to domestic transmission was 54% (range 0-75%). It increased to 85% (range 67%-100%) between 2008 and 2016.Conclusions: International and domestic transmission have played major roles in this epidemic. While international transmission persists, local transmission has established as the main source of infections. [ABSTRACT FROM AUTHOR]- Published
- 2019
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37. Sexually Acquired Hepatitis C Infection in HIV-Uninfected Men Who Have Sex With Men Using Preexposure Prophylaxis Against HIV.
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Price, Jennifer C, McKinney, Jeffrey E, Crouch, Pierre-Cedric, Dillon, Stephen M, Radix, Asa, Stivala, Alicia, Carollo, Jesse R, and Fierer, Daniel S
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BLOODBORNE infections , *HIV infections , *HEPATITIS C , *HEPATITIS C virus , *ALANINE aminotransferase , *PREVENTIVE medicine , *HIV - Abstract
Sexually acquired hepatitis C virus (HCV) infections among human immunodeficiency virus (HIV)-uninfected men who have sex with men (MSM) have been rare. With the introduction of preexposure prophylaxis (PrEP) against HIV, we hypothesized that these infections would increase. Between 2013 and 2018, we diagnosed 15 likely sexually acquired HCV infections among 14 MSM using PrEP. Most (87%) were asymptomatic, detected by routine alanine transaminase (ALT) or HCV monitoring. Half reported increasing sex partners and drug use after starting PrEP; 5 reported injection of methamphetamine. Interventions are needed to prevent sexually acquired HCV infections by MSM using PrEP. Centers for Disease Control and Prevention guidelines for monitoring during PrEP should include regular ALT and HCV testing. [ABSTRACT FROM AUTHOR]
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- 2019
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38. One Size Fits (n)One: The Influence of Sex, Age, and Sexual Human Immunodeficiency Virus (HIV) Acquisition Risk on Racial/Ethnic Disparities in the HIV Care Continuum in the United States.
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Desir, Fidel A, Lesko, Catherine R, Moore, Richard D, Horberg, Michael A, Wong, Cherise, Crane, Heidi M, Silverberg, Michael, Thorne, Jennifer E, Rachlis, Beth, Rabkin, Charles, Mayor, Angel M, Mathews, William C, and Althoff, Keri N
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HIV infection risk factors , *ANTIRETROVIRAL agents , *HEALTH services accessibility , *HEALTH status indicators , *AGE distribution , *BLACK people , *CONFIDENCE intervals , *CONTINUUM of care , *ETHNIC groups , *HISPANIC Americans , *HIV infections , *SEXUAL health , *INTERPROFESSIONAL relations , *PUBLIC health , *RACE , *WHITE people , *VIRAL load , *MEN who have sex with men - Abstract
Background The United States National HIV/AIDS Strategy established goals to reduce disparities in retention in human immunodeficiency virus (HIV) care, antiretroviral therapy (ART) use, and viral suppression. The impact of sex, age, and sexual HIV acquisition risk (ie, heterosexual vs same-sex contact) on the magnitude of HIV-related racial/ethnic disparities is not well understood. Methods We estimated age-stratified racial/ethnic differences in the 5-year restricted mean percentage of person-time spent in care, on ART, and virally suppressed among 19 521 women (21.4%), men who have sex with men (MSM; 59.0%), and men who have sex with women (MSW; 19.6%) entering HIV care in the North American AIDS Cohort Collaboration on Research and Design between 2004 and 2014. Results Among women aged 18–29 years, whites spent 12.0% (95% confidence interval [CI], 1.1%–20.2%), 9.2% (95% CI,.4%–20.4%), and 13.5% (95% CI, 2.7%–22.5%) less person-time in care, on ART, and virally suppressed, respectively, than Hispanics. Black MSM aged ≥50 years spent 6.3% (95% CI, 1.3%–11.7%), 11.0% (95% CI, 4.6%–18.1%), and 9.7% (95% CI, 3.6%–16.8%) less person-time in these stages, respectively, than white MSM ≥50 years of age. Among MSM aged 40–49 years, blacks spent 9.8% (95% CI, 2.4%–16.5%) and 11.9% (95% CI, 3.8%–19.3%) less person-time on ART and virally suppressed, respectively, than whites. Conclusions Racial/ethnic differences in HIV care persist in specific populations defined by sex, age, and sexual HIV acquisition risk. Clinical and public health interventions that jointly target these demographic factors are needed. [ABSTRACT FROM AUTHOR]
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- 2019
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39. Dolutegravir and lamivudine maintenance therapy in HIV-1 virologically suppressed patients: results of the ANRS 167 trial (LAMIDOL).
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Joly, Véronique, Burdet, Charles, Landman, Roland, Vigan, Marie, Charpentier, Charlotte, Katlama, Christine, Cabié, André, Benalycherif, Aida, Peytavin, Gilles, Yeni, Patrick, Mentre, France, Argoud, Anne-Laure, Amri, Imane, Descamps, Diane, Yazdanpanah, Yazdan, and LAMIDOL Study Group
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LAMIVUDINE , *HIV , *VIROLOGY , *VIRAL load , *HIV infections , *COMPARATIVE studies , *DRUG monitoring , *DRUG resistance in cancer cells , *HETEROCYCLIC compounds , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *EVALUATION research , *HIGHLY active antiretroviral therapy , *TREATMENT effectiveness , *CD4 lymphocyte count - Abstract
Objectives: To evaluate the dolutegravir+lamivudine combination in virologically suppressed patients living with HIV.Methods: The ANRS 167 LAMIDOL trial was an open-label, single arm, multicentre trial assessing once-daily dolutegravir (50 mg)+lamivudine (300 mg) in virologically suppressed HIV-1 patients on first-line triple-drug regimens. The main criteria for inclusion in the trial were plasma viral load (pVL) ≤50 copies/mL for ≥2 years, CD4 nadir >200 cells/mm3 and WT HIV prior to treatment initiation. From week -8 (W-8) to day 0 (D0) (Phase 1), the current third agent was switched to dolutegravir. From D0 to W48 (Phase 2), patients received once-daily dolutegravir+lamivudine, except if intolerant or if pVL >50 copies/mL during Phase 1. Virological failure was defined as pVL >50 copies/mL in two consecutive samples. The study was designed to show that the strategy had an efficacy of ≥80%, assuming a 90% success rate with a type I error of 5% and a power of 90%.Results: In total, 104 of 110 patients enrolled in Phase 1 were included in Phase 2. These 104 patients were 86% male, 72% MSM and 87% CDC stage A. Their characteristics were (median): age 45 years, CD4 nadir 339 cells/mm3, baseline CD4 743 cells/mm3 and duration of viral suppression 4.5 years. The overall success rate at W48 was 97% (95% CI: 94%-100%), meeting the design expectation/assumption. Three therapeutic failures occurred: one virological failure at W4, one lost to follow-up at W32 and one interruption of therapeutic strategy at W40 after a blip (pVL 59 copies/mL but control pVL <50 copies/mL). Three viral blips occurred in two additional patients. Neither M184V nor integrase resistance mutations were detected after failure or blips.Conclusions: Dolutegravir+lamivudine is a promising maintenance therapy in HIV-1-infected patients with controlled virological suppression. [ABSTRACT FROM AUTHOR]- Published
- 2019
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40. High Cure Rates With Grazoprevir-Elbasvir With or Without Ribavirin Guided by Genotypic Resistance Testing Among Human Immunodeficiency Virus/Hepatitis C Virus–coinfected Men Who Have Sex With Men.
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Braun, Dominique L, Hampel, Benjamin, Kouyos, Roger, Nguyen, Huyen, Shah, Cyril, Flepp, Markus, Stöckle, Marcel, Conen, Anna, Béguelin, Charles, Künzler-Heule, Patrizia, Nicca, Dunja, Schmid, Patrick, Delaloye, Julie, Rougemont, Mathieu, Bernasconi, Enos, Rauch, Andri, Günthard, Huldrych F, Böni, Jürg, Fehr, Jan S, and Study, Swiss HIV Cohort
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HEPATITIS C diagnosis , *HEPATITIS C prevention , *HEPATITIS C risk factors , *RIBAVIRIN , *ANTIVIRAL agents , *BEHAVIOR therapy , *COMBINATION drug therapy , *COUNSELING , *DRUG resistance in microorganisms , *HEPATITIS C , *HIV infections , *LONGITUDINAL method , *MEDICAL screening , *MICROBIAL sensitivity tests , *RNA , *VIROLOGY , *UNSAFE sex , *TREATMENT effectiveness , *TREATMENT duration , *MEN who have sex with men , *MIXED infections - Abstract
Background This study was performed to investigate the efficacy and safety of grazoprevir-elbasvir guided by baseline resistance-associated substitutions (RASs) in the Swiss HCVree Trial. Methods We performed hepatitis C virus (HCV) RNA screening among all men who have sex with men (MSM) enrolled in the Swiss HIV Cohort Study. Individuals with replicating HCV genotype 1 or 4 infection were eligible for grazoprevir-elbasvir treatment. Genotype 1a–infected individuals with baseline RASs and genotype 4–infected individuals with prior failure of HCV treatment received 16 weeks of grazoprevir-elbasvir combined with ribavirin. All other individuals received 12 weeks of grazoprevir-elbasvir alone. Patients reporting unprotected sex with occasional partners were offered a HCV risk reduction–oriented behavioral intervention. Results We screened 3722 MSM and identified 177 (4.8%) with replicating infection. A total of 122 individuals (3.3%) were eligible for study treatment. Six of 76 patients infected with genotype 1a (7.3%) harbored baseline RASs. Sustained virological response after 12 weeks of follow-up was achieved in 121 patients (99%), including all with genotype 1a infection. Overall, 8 serious adverse events occurred, none of which was related to the study drug. Seventy-five percent of eligible MSM participated in the risk counseling program. Conclusions Grazoprevir-elbasvir for 12 or 16 weeks, with or without ribavirin, achieved high cure rates and had an excellent safety profile. Unique to other studies, the treatment duration was guided by the presence of baseline RASs among genotype 1a–infected individuals, and the treatment phase was accompanied by an HCV risk reduction–oriented behavioral intervention. This successful population-wide treatment approach lays the groundwork to achieve HCV elimination in coinfected MSM. Clinical Trials Registration NCT02785666 [ABSTRACT FROM AUTHOR]
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- 2019
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41. Risk Factors and Incidence of Syphilis in Human Immunodeficiency Virus (HIV)–Infected Persons: The HIV Outpatient Study, 1999–2015.
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Novak, Richard M, Ghanem, Abdelhamid, Hart, Rachel, Ward, Douglas, Armon, Carl, Buchacz, Kate, and Investigators, HIV Outpatient Study
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HIV prevention , *DIAGNOSIS of syphilis , *SYPHILIS prevention , *HIV infection complications , *BLACK people , *CONFIDENCE intervals , *HETEROSEXUALS , *HIV infections , *OUTPATIENT services in hospitals , *LONGITUDINAL method , *MULTIVARIATE analysis , *SYPHILIS , *WHITE people , *DISEASE incidence , *PROPORTIONAL hazards models , *MEN who have sex with men , *ODDS ratio , *DISEASE risk factors - Abstract
Background Since 2000, the incidence of syphilis has been increasing, especially among gay, bisexual, and other men who have sex with men (MSM) in the United States. We assessed temporal trends and associated risk factors for newly diagnosed syphilis infections among human immunodeficiency virus (HIV)–infected patients during a 16-year period. Methods We analyzed data from the HIV Outpatient Study (HOPS) cohort participants at 10 US HIV clinics during 1999–2015. New syphilis cases were defined based on laboratory parameters and clinical diagnoses. We performed Cox proportional hazards regression analyses of sociodemographic, clinical, and behavioral risk factors for new syphilis infections. Results We studied 6888 HIV-infected participants; 641 had 1 or more new syphilis diagnoses during a median follow-up of 5.2 years. Most participants were male (78%), aged 31–50 years, and 57% were MSM. The overall incidence was 1.8 (95% confidence interval [CI], 1.6–1.9) per 100 person-years (PY) and it increased from 0.4 (95% CI,.2–.8) to 2.2 (95% CI, 1.4–3.5) per 100 PY during 1999–2015. In multivariable analyses adjusting for calendar year, risk factors for syphilis included age 18–30 years (hazard ratio [HR], 1.3 [95% CI, 1.1–1.6]) vs 31–40 years, being MSM (HR, 3.1 [95% CI, 2.4–4.1]) vs heterosexual male, and being non-Hispanic black (HR, 1.6 [95% CI, 1.4–1.9]) vs non-Hispanic white. Conclusions The increases in the syphilis incidence rate through 2015 reflect ongoing sexual risk and highlight the need for enhanced prevention interventions among HIV-infected patients in care. [ABSTRACT FROM AUTHOR]
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- 2018
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42. Hepatitis C Guidance 2018 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection.
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Panel, AASLD-IDSA HCV Guidance
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HEPATITIS C prevention , *ANTIVIRAL agents , *INTRAVENOUS drug abuse , *CHRONIC diseases , *CORRECTIONAL institutions , *COUNSELING , *DRUG interactions , *HEPATITIS C , *HIV infections , *INTERFERONS , *INTERNET , *KIDNEY diseases , *CIRRHOSIS of the liver , *MEDICAL protocols , *PROFESSIONAL associations , *RIBAVIRIN , *TIME , *EVIDENCE-based medicine , *PROTEASE inhibitors , *VERTICAL transmission (Communicable diseases) , *MEN who have sex with men , *ANTI-HIV agents , *GENOTYPES , *MIXED infections - Abstract
Recognizing the importance of timely guidance regarding the rapidly evolving field of hepatitis C management, the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) developed a web-based process for the expeditious formulation and dissemination of evidence-based recommendations. Launched in 2014, the hepatitis C virus (HCV) guidance website undergoes periodic updates as necessitated by availability of new therapeutic agents and/or research data. A major update was released electronically in September 2017, prompted primarily by approval of new direct-acting antiviral agents and expansion of the guidance's scope. This update summarizes the latest release of the HCV guidance and focuses on new or amended recommendations since the previous September 2015 print publication. The recommendations herein were developed by volunteer hepatology and infectious disease experts representing AASLD and IDSA and have been peer reviewed and approved by each society's governing board. [ABSTRACT FROM AUTHOR]
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- 2018
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43. Less Severe but Prolonged Course of Acute Hepatitis A in Human Immunodeficiency Virus (HIV)–Infected Patients Compared With HIV-Uninfected Patients During an Outbreak: A Multicenter Observational Study.
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Lee, Yu-Lin, Chen, Guan-Jhou, Chen, Nan-Yu, Liou, Bo-Huang, Wang, Ning-Chi, Lee, Yuan-Ti, Yang, Chia-Jui, Huang, Yu-Shan, Tang, Hung-Jen, and Huang, Shie-Shian
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BLOOD coagulation disorders , *COMPARATIVE studies , *DIAGNOSTIC imaging , *DISEASE outbreaks , *BIOLOGICAL evolution , *HEPATITIS A , *HIV infections , *PSYCHOLOGY of HIV-positive persons , *MEDICAL cooperation , *SCIENTIFIC observation , *RESEARCH , *RNA , *SPLEEN diseases , *VIRAL load , *ALANINE aminotransferase , *HIGHLY active antiretroviral therapy , *TREATMENT effectiveness , *RETROSPECTIVE studies , *SEVERITY of illness index , *ACUTE diseases , *MEN who have sex with men , *DESCRIPTIVE statistics , *HEPATOMEGALY , *SYMPTOMS - Abstract
Background This multicenter retrospective cohort study aimed to compare the clinical presentations and evolution of acute hepatitis A (AHA) between human immunodeficiency virus (HIV)–infected patients and HIV-uninfected counterparts during the AHA outbreak. Methods Clinical and laboratory data were collected from the medical records of the patients with AHA at the 14 hospitals around Taiwan between May 2015 and May 2017. Results A total of 297 adult patients with AHA were included during the study period. Their mean age was 31.4 years (range, 19.0–76.1 years); 93.4% were men and 58.6% were men who have sex with men. Of 265 patients with known HIV serostatus, 166 (62.6%) were HIV infected. Compared with HIV-uninfected patients, HIV-infected patients had a lower peak alanine aminotransferase (ALT) level (median, 1312 vs 2014 IU/L, P =.003), less coagulopathy (6.0% vs 16.2%, P =.007), and less hepatomegaly or splenomegaly on imaging studies, but a higher rate of delayed resolution of hepatitis (38.8% vs 21.3%, P =.009). HIV-infected patients with plasma RNA load <1000 copies/mL while receiving combination antiretroviral therapy (cART) had a higher peak ALT level (median, 1420 vs 978 IU/L, P =.006) and less delay in resolution of hepatitis (30.6% vs 48.8%, P =.047) than patients without cART or with plasma RNA load ≥1000 copies/mL. Conclusions During an AHA outbreak, HIV-infected patients had a lower severity, but delayed resolution, of AHA than HIV-uninfected patients. Better viral suppression by cART alleviated the impact of HIV infection on the disease course of AHA in HIV-infected patients. [ABSTRACT FROM AUTHOR]
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- 2018
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44. Effects of Substance Use and Sex Practices on the Intestinal Microbiome During HIV-1 Infection.
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Fulcher, Jennifer A, Hussain, Shehnaz K, Cook, Ryan, Li, Fan, Tobin, Nicole H, Ragsdale, Amy, Shoptaw, Steven, Gorbach, Pamina M, and Aldrovandi, Grace M
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SUBSTANCE-induced disorders , *HUMAN microbiota , *HIV infections , *COHORT analysis , *RNA sequencing - Abstract
Background: Human immunodeficiency virus type 1 (HIV-1) infection alters the human intestinal microbiome; however, behavioral factors driving these changes remain poorly defined. Here we examine the effects of substance use and sex behavior on the microbiome during HIV-1 infection.Methods: Archival rectal swab specimens, urine drug test results, and responses to substance use and sex behavior questionnaires were obtained from 37 HIV-positive participants at 2 time points, separated by 6 months, in a cohort examining the effects of substance use in men who have sex with men (MSM). Microbiome profiling was performed using 16S ribosomal RNA gene sequencing, and associations with behavioral factors were examined using 0-inflated negative binomial regression. Further analysis of selected variables of interest was performed using propensity scores to account for multiple confounders.Results: Using permutational multivariate analysis of variance, we found that receptive anal intercourse, methamphetamine use, and marijuana use were among the most important drivers of microbiome variation. Propensity score-adjusted analyses revealed that methamphetamine use and marijuana use displayed unique associations; methamphetamine use was associated with an increased abundance of Porphyromonas and Granulicatella organisms and a decreased abundance of Ruminococcus, Collinsella, and Parabacteroides organisms, whereas marijuana use was associated with an increased abundance of Ruminococcus, Clostridium cluster IV, Solobacterium, and Fusobacterium organisms and a decreased abundance of Acidaminococcus, Prevotella, Dialister, Anaerostipes, and Dorea organisms.Conclusions: Drug use and sex behavior are important factors associated with intestinal dysbiosis during chronic HIV-1 infection among young MSM. [ABSTRACT FROM AUTHOR]- Published
- 2018
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45. Parent-Adolescent Communication About Sex and Condom Use Among Young Men Who Have Sex With Men: An Examination of the Theory of Planned Behavior.
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Thoma, Brian C and Huebner, David M
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COMMUNICATION , *PARENT-teenager relationships , *HUMAN sexuality , *CONDOM use , *HIV infections - Abstract
Background: Young men who have sex with men (YMSM) are at disproportionate risk for HIV infection. Parent-adolescent communication about sex, particularly mother-adolescent communication, protects against adolescent sexual risk behavior. However, it is unclear whether these findings generalize to YMSM.Purpose: The current study used the theory of planned behavior as a framework to examine how YMSM perceptions of parent-adolescent communication about condoms are associated with determinants of condom use and condomless anal sex among YMSM.Method: YMSM ages 14-18 (M = 16.55) completed an online survey (n = 838). Associations between several domains of parent-adolescent communication about condoms (i.e., frequency and specificity, quality, and negative emotionality) and condom-related attitudes, norms, perceived behavioral control, and intentions, as well as instances of condomless anal intercourse (CAI), were examined with structural equation modeling.Results: Multiple facets of mother-adolescent communication were associated with attitudes about condoms, subjective norms for condom use, perceived behavioral control, intentions to use condoms, and indirectly, instances of CAI. Father communication was not associated with determinants of condom use behavior.Conclusions: Parent-adolescent communication about condoms is associated with determinants of condom use behavior among YMSM, and mother communication exerted an indirect influence on HIV-related sexual risk behaviors. Interventions designed to enhance parent- adolescent communication about condoms could prove efficacious in reducing HIV infections among YMSM. [ABSTRACT FROM AUTHOR]- Published
- 2018
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46. A socioecological measurement of homophobia for all countries and its public health impact.
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Lamontagne, Erik, d'Elbée, Marc, Ross, Michael W, Carroll, Aengus, Plessis, André du, and Loures, Luiz
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LAW , *HOMOSEXUALITY , *ANTI-LGBTQ+ discrimination laws , *HIV infection complications , *SOCIAL stigma , *CLIMATOLOGY , *CRIME , *PSYCHOLOGY of gay men , *GENDER identity , *HIV infections , *HOMOPHOBIA , *HUMAN rights , *LIFE expectancy , *MEDICAL care costs , *HEALTH policy , *MINORITIES , *POPULATION geography , *MATHEMATICAL models of psychology , *PUBLIC health , *SATISFACTION , *SOCIAL control , *MEN who have sex with men , *MIDDLE-income countries , *LOW-income countries , *ECONOMICS , *PREVENTION ,RESEARCH evaluation - Abstract
Background Measuring homophobia at country level is important to guide public health policy as reductions in stigma are associated with improved health outcomes among gay men and other men who have sex with men. Methods: We developed a Homophobic Climate Index incorporating institutional and social components of homophobia. Institutional homophobia was based on the level of enforcement of laws that criminalise, protect or recognise same-sex relations. Social homophobia was based on the level of acceptance and justifiability of homosexuality. We estimated the Index for 158 countries and assessed its robustness and validity. Results Western Europe is the most inclusive region, followed by Latin America. Africa and the Middle East are home to the most homophobic countries with two exceptions: South Africa and Cabo Verde. We found that a 1% decrease in the level of homophobia is associated with a 10% increase in the gross domestic product per capita. Countries whose citizens face gender inequality, human rights abuses, low health expenditures and low life satisfaction are the ones with a higher homophobic climate. Moreover, a 10% increase in the level of homophobia at country level is associated with a 1.7-year loss in life expectancy for males. A higher level of homophobia is associated with increased AIDS-related death among HIV-positive men. Conclusion The socioecological approach of this index demonstrates the negative social, economic and health consequences of homophobia in low- and middle-income countries. It provides sound evidence for public health policy in favour of the inclusion of sexual minorities. [ABSTRACT FROM AUTHOR]
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- 2018
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47. Barriers to HIV treatment as prevention (TasP) in men who have sex with men in the Eastern Mediterranean Region.
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Maatouk, Ismael and Jaspal, Rusi
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HIV prevention ,HEALTH promotion ,HEALTH services accessibility ,HIV infections ,PUBLIC opinion ,HIGHLY active antiretroviral therapy ,MEN who have sex with men ,ELECTRONIC health records - Abstract
The article offers information on reduction in Human Immunodeficiency Virus (HIV) viremia to ‘undetectable' levels (HIV plasma viral load < 40 copies/ml) in response to effective antiretroviral therapy (ART) removes the risk of HIV transmission. Topic include studies have contributed to the evidence base that people living with HIV (PLHIV) with an undetectable viral load (‘undetectable' defined by HIV viremia levels < 40 copies/ml) cannot transmit HIV sexually.
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- 2020
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48. Cannabis Use and Plasma Human Immunodeficiency Virus (HIV) RNA Levels in Patients Coinfected With HIV and Hepatitis C Virus Receiving Antiretroviral Therapy: Data From the ANRS CO13 HEPAVIH Cohort.
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Marcellin, Fabienne, Miailhes, Patrick, Santos, Melina, Mercié, Patrick, Beo, Vincent Di, Salmon-Céron, Dominique, Barré, Tangui, Wittkop, Linda, Protopopescu, Camelia, Zucman, David, Sogni, Philippe, Carrieri, Patrizia, and Group, ANRS CO13 HEPAVIH Study
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MEDICAL marijuana , *BIOMARKERS , *HEPATITIS C , *HIV infections , *PSYCHIATRIC drugs , *RNA , *VIRAL load , *ANTIRETROVIRAL agents , *MEN who have sex with men - Abstract
The article examines the association between cannabis use and undetectable plasma human immunodeficiency virus (HIV) RNA levels from male patients coinfected with HIV and hepatitis C virus receiving antiretroviral therapy (ART) based on a study by Chaillon et al. The study identified the effect of cannabis use on the HIV reservoir during ART among male patients. Analysis of sociobehavioral and clinical data revealed no link between the frequency of cannabis use and plasma HIV viral load.
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- 2020
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49. Design Strategy of the Sabes Study: Diagnosis and Treatment of Early HIV Infection Among Men Who Have Sex With Men and Transgender Women in Lima, Peru, 2013–2017.
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Lama, Javier R, Brezak, Audrey, Dobbins, James G, Sanchez, Hugo, Cabello, Robinson, Rios, Jessica, Bain, Carolyn, Ulrich, Angela, Grecca, Robert De la, and Sanchez, Jorge
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DIAGNOSIS of HIV infections , *HIV infection risk factors , *HIV infection transmission , *HIV infection epidemiology , *EPIDEMICS , *HIV infections , *MEDICAL care , *MEDICAL screening , *PATIENTS , *HIGHLY active antiretroviral therapy , *MEN who have sex with men , *TRANSGENDER people , *PSYCHOLOGY - Abstract
The Sabes Study evaluated a treatment-as-prevention intervention among cisgender men who have sex with men and transgender women in Lima, Peru—populations disproportionately affected by the human immunodeficiency virus (HIV) epidemic. The intervention was designed to prevent onward transmission of HIV by identifying HIV-negative high-risk individuals, testing them monthly for the presence of HIV, and then rapidly treating those who became HIV-positive. The main outcome of interest was the development of a model predicting the population-level impact of early detection of HIV infection and immediate initiation of antiretroviral therapy in this population. From July 2013 to September 2015, a total of 3,337 subjects were screened for HIV; 2,685 (80.5%) were negative, and 2,109 began monthly testing. We identified 256 individuals shortly after HIV acquisition, 216 of whom were enrolled in the treatment phase of the study. All participants were followed for 48 weeks (follow-up ended in 2017) and were then referred to the Peruvian Ministry of Health to continue receiving free HIV care and treatment. Initial findings from this intervention demonstrate that it is possible to recruit high-risk individuals, screen them for HIV, continue to test those who are initially HIV-negative in order to identify incident cases shortly after acquisition, and then rapidly link them to health care. [ABSTRACT FROM AUTHOR]
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- 2018
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50. A Simple Symptom Score for Acute Human Immunodeficiency Virus Infection in a San Diego Community-Based Screening Program.
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Lin, Timothy C, Gianella, Sara, Tenenbaum, Tara, Little, Susan J, and Hoenigl, Martin
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DIAGNOSIS of HIV infections , *HIV infection risk factors , *CONFIDENCE intervals , *FEVER , *HIV infections , *MEDICAL screening , *MULTIVARIATE analysis , *MYALGIA , *STATISTICS , *WEIGHT loss , *LOGISTIC regression analysis , *DATA analysis , *HUMAN services programs , *RETROSPECTIVE studies , *RECEIVER operating characteristic curves , *MEN who have sex with men , *NUCLEIC acid amplification techniques , *ODDS ratio , *SYMPTOMS - Abstract
Background. Treatment of acute human immunodeficiency virus (HIV) infection (AHI) decreases transmission and preserves immune function, but AHI diagnosis remains resource intensive. Risk-based scores predictive for AHI have been described for high-risk groups; however, symptom-based scores could be more generalizable across populations. Methods. Adults who tested either positive for AHI (antibody-negative, HIV nucleic acid test [NAT] positive) or HIV NAT negative with the community-based San Diego Early Test HIV screening program were retrospectively randomized 2:1 into a derivation and validation set. In the former, symptoms significant for AHI in a multivariate logistic regression model were assigned a score value (the odds ratio [OR] rounded to the nearest integer). The score was assessed in the validation set using receiver operating characteristics and areas under the curve (AUC). An optimal cutoff score was found using the Youden index. Results. Of 998 participants (including 261 non-men who have sex with men [MSM]), 113 had AHI (including 4 non-MSM). Compared to HIV-negative cases, AHI cases reported more symptoms (median, 4 vs 0; P < .01). Fever, myalgia, and weight loss were significantly associated with AHI in the multivariate model and corresponded to 11, 8, and 4 score points, respectively. The summed score yielded an AUC of 0.85 (95% confidence interval [CI], .77--.93). A score of ≥11 was 72% sensitive and 96% specific (diagnostic OR, 70.27). Conclusions. A 3-symptom score accurately predicted AHI in a community-based screening program and may inform allocation of resources in settings that do not routinely screen for AHI. [ABSTRACT FROM AUTHOR]
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- 2018
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