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Background and Objectives Materials and Methods Results Conclusion In 2016, France allowed men who have sex with men (MSM) to donate blood if they had not had sex with men in the previous 12 months. In April 2020, this restriction was relaxed to 4 months due to the lack of negative impact observed on blood safety. This study assesses the impact of reducing this deferral period on epidemiological surveillance indicators.This study compares infection surveillance indicators between two 30‐month periods before (P1) and after (P2) this second deferral change.Overall, 79 donations tested positive for human immunodeficiency virus (HIV) (49 in P1 and 30 in P2), 322 for hepatitis C virus (HCV) (185 and 137), 622 for hepatitis B virus (HBV) (355 and 267) and 1684 for syphilis (799 and 885). Positive donation rates decreased between P1 and P2, except for syphilis: HIV (0.07/10,000 donations vs. 0.04; p > 0.5), HCV (0.25 vs. 0.20; p < 0.05), HBV (0.49 vs. 0.39; p < 0.01) and syphilis (1.10 vs. 1.29; p < 0.001). For all three viruses, residual risks of transmission by transfusion did not increase: HIV (1/7,800,000 donations vs. 1/10,500,000), HCV (1/25,200,000 vs. 1/47,300,000) and HBV (1/6,400,000 vs. 1/6,000,000).Reducing the deferral period for MSM in April 2020 did not negatively impact residual risks, which remained very low, or the rate of positive donations, except for syphilis, which requires careful monitoring. To ensure equal access to blood donation, MSM have been allowed to donate blood under the same conditions as other donors since March 2022 (i.e., no more than one sexual partner in the last 4 months). [ABSTRACT FROM AUTHOR]

Objectives: Chemsex is a term used to describe sex acts using psychoactive substances to enhance the sexual experience/arousal and predominates among men who have sex with men (MSM). Chemsex drugs predominantly include γ‐hydroxybutyric acid (GHB) and analogues, methamphetamine, mephedrone and erectile dysfunction agents (e.g., Sildenafil). Mindfulness‐basedcognitive therapy (MBCT) combines cognitive therapy and mindfulness and has been shown to help support both sexual functioning and methamphetamine use. However, limited clinical trials have evaluated the use of cognitive mindfulness for chemsex in MSM. The present study assessed the effectiveness of an online mindfulness‐based cognitive intervention (MBCI) among 29 MSM aged 18–30 years engaged in chemsex. Design and Setting: A mixed methods approach consisted of a randomised waitlist‐controlled trial and a content analysis reviewing participants' feedback on MBCI. The design of the intervention was based on a behavioural taxonomy mapped to selected behaviour change techniques (BCTs) to support the reliability of MBCI in its delivery. Main Outcome Measures: Participants completed assessments measuring levels of chemsex, mindfulness, sexual self‐efficacy and well‐being, taken at Weeks 0, 8 and 12 (follow‐up). Results: Participants reported lower levels of chemsex and higher levels of cognitive mindfulness, sexual self‐efficacy and well‐being postintervention and at the 12‐week follow‐up. The content analysis feedback responses yielded favourable outcomes, suggesting that participants developed a sense of self‐compassion, confidence and positive identity. Conclusions: The MBCI effectively reduced chemsex; however, this study warrants replication with a larger, more diverse group of participants. [ABSTRACT FROM AUTHOR]

Introduction Materials and Methods Results Conclusions The population of men who have sex with men (MSM) in India is vulnerable to HIV/AIDS. India instituted a targeted intervention (TI) programme to reduce this vulnerability. We aimed to measure the assessment of the TI programme for MSM.The national Integrated Biological and Behavioural Survey (IBBS) was carried out in 2014–2015. We analysed MSM data from the IBBS and used bivariate and multivariate logistic regression to calculate the unadjusted and adjusted odds ratios with 95% confidence intervals. The use of a condom during their last sexual intercourse and consistent condom use during the previous month were considered indicators of programme effectiveness. The propensity score matching method was used to assess the effectiveness of the TI programme.The matched‐samples estimate (i.e., average treatment effect on treated) for the use of condoms during their last sexual intercourse increased by 10.0% (0.10; 95% confidence interval [CI] 0.08–0.12), and consistent condom use during the previous month increased by 9.0% (0.09; 95% CI 0.07–0.10) among those who had received condoms from the peer educator/outreach worker compared with those who had not received condoms.The TI programme intervention among MSM was effective in reducing HIV risk behaviours, as evidenced by an increase in the use of condoms during their last sexual intercourse and consistent condom use during the last month. [ABSTRACT FROM AUTHOR]

Background Study Design and Methods Results Conclusions Combining pathogen reduction technology (PRT) with blood screening may alleviate concerns over the risk of transfusion‐transmitted infections (TTI) and support changes in blood donor selection to potentially increase blood availability. This study aimed to estimate the residual risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) transfusion‐transmission in Canada after implementing PRT, while eliminating deferrals for sexual risk behaviors.A probabilistic approach that combined Bayesian networks with Monte Carlo simulations was used to estimate the risk of transfusing HIV‐, HBV‐, or HCV‐contaminated blood components. Different scenarios were considered to compare the current residual risk after PRT implementation, with and without donor deferral criteria for sexual risk behaviors. Donor profiles and blood component outcomes were simulated based on a literature review including the prevalence and incidence of HIV, HBV, and HCV in the Canadian blood donor population; the use of current blood screening assays; and HIV, HBV, and HCV blood donor viral loads.In the universal PRT scenario (i.e., with PRT/without deferral criteria), the estimated risks of HIV, HBV, and HCV transmission were significantly lower than those in the currently observed scenario (i.e., without PRT/with deferral criteria).This risk model suggests that PRT for platelets and plasma (and eventually for RBCs when available) significantly reduces the residual risks of HIV, HBV and HCV transfusion‐transmission and could enable the removal of blood donor deferral criteria for sexual risk behaviors. [ABSTRACT FROM AUTHOR]

Background: Young men who have sex with men (YMSM) may experience high levels of sexual minority stigma (SMS) and depressive symptoms (DS) over the world and in China. However, there is a lack of studies investigating the longitudinal effects of SMS on DS of YMSM, especially focusing on YMSM and separating the between‐person and within‐person effects. This study aimed to fill the said gaps. Methods: Study data were derived from a prospective cohort of 349 YMSM from central China (Wuhan, Changsha, Nanchang), the baseline survey was started in 2017 with one follow‐up visit every year. SMS and DS were measured three times using valid and reliable instruments. The cross‐lagged panel model (CLPM) and the random intercept CLPM (RI‐CLPM) were used to examine the between‐person and within‐person concurrent and lagged effects, respectively. Results: Findings of CLPM revealed bidirectional associations between SMS and DS over time. RI‐CLPM suggested that at the between‐person level, SMS was significantly associated with DS, echoing the results of CLPM. However, this reciprocal relationship has not been found at the within‐person level. Conclusion: The associations between SMS and DS among YMSM at the population level is more significant than that at the individual level. We suggest that interventions should be against the adverse effects of cultural marginalization and systemic change the social concepts to reduce the amount of SMS in society. [ABSTRACT FROM AUTHOR]

Objectives: To identify sexual/sex‐associated risk factors for hepatitis C transmission among men who have sex with men (MSM) and visualise behavioural trajectories from 2019 to 2021. Methods: We linked a behavioural survey to a hepatitis C cohort study (NoCo), established in 2019 across six German HIV/hepatitis C virus (HCV) treatment centres, and performed a case–control analysis. Cases were MSM with recent HCV infection, and controls were matched for HIV status (model 1) or proportions of sexual partners with HIV (model 2). We conducted conditional univariable and multivariable regression analyses. Results: In all, 197 cases and 314 controls completed the baseline questionnaire and could be matched with clinical data. For regression models, we restricted cases to those with HCV diagnosed since 2018 (N = 100). Factors independently associated with case status included sex‐associated rectal bleeding, shared fisting lubricant, anal douching, chemsex, intravenous and intracavernosal injections, with population‐attributable fractions of 88% (model 1) and 85% (model 2). These factors remained stable over time among cases, while sexual partner numbers and group sex decreased during COVID‐19 measures. Conclusions: Sexual/sex‐associated practices leading to blood exposure are key factors in HCV transmission in MSM. Public health interventions should emphasize the importance of blood safety in sexual encounters. Micro‐elimination efforts were temporarily aided by reduced opportunities for sexual encounters during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Direct‐acting antivirals (DAAs) are key to eliminating hepatitis C virus (HCV). In men who have sex with men (MSM) with HIV co‐infection, recently acquired HCV infection is common. Sexual practices and reinfection rates may hamper micro‐elimination despite high treatment rates. Methods: The cohort included MSM with recently acquired HCV infection from 2014 to 2021. The patients' demographic, clinical, behavioural, and laboratory data and treatment and reinfection outcomes were documented. Results: A total of 237 men with recently acquired HCV infection were included: 216 (91%) had HIV. The median age was 46 years (interquartile range [IQR] 39–52), and the median CD4 count was 660/mm3 (IQR 527–835). The annual incidence of recently acquired HCV remained between 0.28% and 0.43% but dropped to 0.02% in 2021 during the COVID pandemic, almost reaching micro‐elimination. The reinfection incidence was 15.5 per 100 patient‐years (95% confidence interval 12.6–18.8), and reinfection was associated with the use of crystal methamphetamine (p = 0.032) and ketamine (p = 0.042). In total, 31.3% had multiple reinfections, and four reinfections occurred in users of pre‐exposure prophylaxis. Conclusions: High treatment and cure rates did not lead to HCV elimination. A change in sexual behaviour, potentially imposed by COVID‐19 restrictions, led to micro‐elimination in the NoCo cohort. As recently acquired HCV is prevalent in MSM with and without HIV, surveillance is necessary to consolidate elimination goals. [ABSTRACT FROM AUTHOR]

Background: In May 2023, the Food and Drug Administration (FDA) released final guidance for blood donor eligibility that recommended the elimination of 3‐month deferral for men who have sex with men (MSM) and the related deferral for women who have sex with MSM. In its place, FDA introduced an individual risk assessment policy of asking all presenting blood donors, regardless of sex or gender, if they have had a new partner or more than one sexual partner in the last 3 months and deferring those who also report anal sex (penile–anal intercourse) during this period. We modeled the possible impact of this policy on the US blood donor base. Study Design and Methods: We developed a computational model to estimate the percentage of blood donors who would be deferred under a policy of individual HIV risk assessment. The model incorporated demographic information about donors and national survey data on HIV risk behaviors and included age and sex distributions and dependencies. Results: Our model estimates that approximately 1.2% of US blood donors would be deferred under the individual HIV risk assessment paradigm. Discussion: The model predicts a relatively minor effect of replacing the time‐based deferral for MSM with individual risk‐based deferral for sexual behavior. As US blood centers implement this new policy, the effect may be mitigated by donor gains, which warrant further study. The new policy is unlikely to adversely affect the availability of blood and blood components. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusion The HIV/AIDS epidemic has disproportionately affected men who have sex with men (MSM) since its onset. Despite important medical advancements in treatment, the enduring effects of living with HIV continue to adversely impact the health and well‐being of this population. This cross‐sectional nationwide study examined psychosocial and sexual health among MSM in Denmark, comparing those living with and without HIV.Data from MSM living with HIV were collected from the SHARE study, a Danish nationwide survey that investigated psychosocial, sexual and reproductive health among people with HIV, and compared with data from MSM without HIV, retrieved from the nationally representative cohort study, Project SEXUS. Associations between HIV status and psychosocial and sexual health outcomes were examined using logistic regression models while controlling for potentially confounding variables.Among 369 MSM with HIV and 1002 MSM without HIV, logistic regression analyses revealed that living with HIV was significantly associated with having current symptoms of anxiety and depression and greater dissatisfaction with one's body. Additionally, MSM with HIV significantly more often than MSM without HIV reported low sexual desire, sexual inactivity, a lack of sexual needs in the last year and erectile dysfunction. Having received payment for sex was more frequently reported by MSM with HIV, as was sexualised drug use, including chemsex drugs.Compared with MSM without HIV, MSM with HIV in Denmark report a higher burden of mental health and sex life challenges. [ABSTRACT FROM AUTHOR]

Background Study Design and Methods Results Discussion Less discriminatory donor selection policies for men who have sex with men (MSM) may impact transfusion safety in terms of higher residual risks for known transfusion‐transmitted infections (TTIs), increased vulnerability toward new TTIs that are also transmitted via sex, and HIV infections masked by pre‐exposure prophylaxis (PrEP).TTI trends in Dutch donors were studied over a 13‐year period (2011–2023), characterized by successive relaxations of MSM deferral criteria. Structured posttest counseling was performed to determine risk factors in TTI‐positive donors. PrEP drug levels were measured in 9977 donations from male donors living in urban areas and in 67 donors with active or resolved syphilis.HIV incidence (from 5.8 to 1.5 per 1,000,000 donor years (DY)) and HBV incidence (from 12.4 to 4.5 per 1,000,000 DY) in Dutch donors decreased with less stringent MSM deferral criteria, while syphilis prevalence (from 26.4 to 44.1 per 100,000 new donors) and syphilis incidence (from 18.3 to 46.3 per 1,000,000 DY) increased over time. The proportion of MSM‐related syphilis rose from 2% to 32% in new donors and from 12% to 27% in repeat donors. PrEP was detected in 2 of 9977 (0.02%) donations from male donors living in urban areas, and in 1 of 39 (2.6%) male donors with syphilis.To date, phasing out donor deferral for MSM had no significant impact on transfusion safety in the Netherlands. However, rising syphilis rates and (recent) PrEP use in the blood donor population, albeit rare, suggest an influx of donors with higher sexual risk profiles and requires intensified TTI surveillance in donors. [ABSTRACT FROM AUTHOR]

Introduction: Removing legal barriers to HIV services is crucial for the global 2030 goal of ending the HIV and AIDS epidemic, particularly in eastern Europe, the Caucasus and central Asia. Despite state commitments to uphold human rights, gay, bisexual and other men who have sex with men (gbMSM), along with transgender people (TP) still face stigma and discrimination. This article presents an analysis of rights violations based on sexual orientation and gender identity (SOGI) and HIV reported in 2022 across six countries, highlighting features and their links to legislation and law enforcement practices. Methods: We examined documented cases of rights violations among gbMSM and TP in Armenia, Kazakhstan, Kyrgyzstan, Tajikistan, Uzbekistan and Ukraine in 2022 using the REAct system, a tool for documenting and responding to rights violations against key populations. Initially, we employed directed content analysis based on Yogyakarta Principles to analyse narratives of violations. A codebook was developed through contextual, manifest and latent coding, with themes, categories and codes converted into quantitative variables for statistical analysis. Descriptive statistics were used to identify the characteristics of violations. Results: A total of 456 cases of rights violations related to SOGI and HIV were documented, ranging from 22 cases in Tajikistan to 217 in Ukraine. Most violations concerned gbMSM (76.5%), with one‐fifth involving TP, predominantly transgender women. Complex violations with multiple perpetrators or infringements were documented in Armenia and central Asia. Privacy rights were commonly violated, often through outing. Cases of violations of the right to the highest attainable standard of health (13.6%) and protection from medical abuses (2.6%) were also documented. Other rights violations were sporadic, with each country exhibiting distinct patterns of violated rights and types of violations. In Ukraine, the full‐scale war in 2022 influenced the nature of documented cases, reflecting the challenges faced by gbMSM and TP. Conclusions: Monitoring rights violations proved effective for assessing the situation of gbMSM and TP, particularly in the insufficiently studied and diverse eastern Europe, Caucasus and central Asia regions. As rights violations are linked to both legislation and law enforcement practices, comprehensive interventions to minimize structural and interpersonal stigma are essential. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion and Conclusions It is broadly recognised that chemsex is more prevalent among men who have sex with men, but little is known about chemsex in the context of commercial sexual encounters between men. This study investigates sex worker advertising characteristics and their advertised willingness to engage in chemsex with clients.Data were web scraped from the profiles of US‐based male sex workers (N = 3773) advertising services on an internet advertising platform in February 2021. This study describes the association between chemsex advertising and advertised age, race/ethnicity, sexual orientation, encounter type and COVID‐19 acknowledgement.28.5% of sex workers (n = 1077) advertised chemsex, 64.7% of whom were 25–34 years‐old (n = 697). The odds of chemsex advertising increased between ages 21–24 (aOR = 1.20, 95% CI 1.09–1.32) and declined among sex workers over 35 years‐old (aOR = 0.97, 95% CI 0.95–1.00). Sex workers advertising as bisexual were more likely to advertise chemsex than those identifying as gay (aOR = 1.38, 95% CI 1.18–1.63). Sex workers acknowledging COVID‐19 were less likely to advertise chemsex compared to those who did not (aOR = 0.65, 95% CI 0.48–0.89). Encounter type was associated with chemsex advertising among sex workers in this sample; sex workers not offering the “boyfriend experience” were more than 50% less likely to advertise chemsex than those who did offer the boyfriend experience (aOR = 0.47, 95% CI 0.36–0.61).Chemsex advertising in this population is likely influenced by multiple sociodemographic and occupational characteristics. Identifying sex workers likely to engage in chemsex based on advertising data could inform targeted education and harm‐reduction campaigns in this population. [ABSTRACT FROM AUTHOR]

Introduction: Measuring the coverage of HIV prevention services for key populations (KPs) has consistently been a challenge for national HIV programmes. The current frameworks and measurement methods lack emphasis on effective coverage, occur infrequently, lack timeliness and limit the participation of KPs. The Effective Programme Coverage framework, which utilizes a programme science approach, provides an opportunity to assess gaps in various coverage domains and explore the underlying reasons for these gaps, in order to develop targeted solutions. We have demonstrated the application of this framework in partnership with the KP community in Nairobi, Kenya, using an expanded Polling Booth Survey (ePBS) method. Methods: Data were collected between April and May 2023 among female sex workers (FSWs) and men who have sex with men (MSM) using (a) PBS, (b) bio‐behavioural survey and (c) focus group discussions. Data collection and analysis involved both KP community and non‐community researchers. Descriptive analysis was performed, and proportions were used to assess the programme coverage gaps. The data were weighted to account for the sampling design and unequal selection probabilities. Thematic analysis was conducted on the qualitative data. Results: The condom programme for FSW and MSM had low availability (60.2% and 50.9%), contact (68.8% and 65.9%) and utilization (52.1% and 43.9%) coverages. The pre‐exposure prophylaxis (PrEP) programme had very low utilization coverage for FSW and MSM (4.4% and 2.8%), while antiretroviral therapy utilization coverage was higher (86.6% and 87.7%). Reasons for coverage gaps included a low peer educator‐to‐peer ratio, longer distance to the clinics, shortage of free condoms supplied by the government, experienced and anticipated side effects related to PrEP, and stigma and discrimination experienced in the facilities. Conclusions: The Effective Programme Coverage framework allows programmes to assess coverage gaps and develop solutions and a research agenda targeted at specific domains of coverage with large gaps. The ePBS method works well in collecting data to understand coverage gaps rapidly and allows for the engagement of the KP community. [ABSTRACT FROM AUTHOR]

Introduction: Effective HIV prevention programme coverage is necessary to achieve Nigeria's goal of ending the epidemic by 2030. Recent evidence highlights gaps in service coverage and utilization across the country. The Effective Programme Coverage framework is a Programme Science tool to optimize a programme's population‐level impact by examining gaps in programme coverage using data generated through programme‐embedded research and learning. We apply the framework using Integrated Biological and Behavioural Surveillance Survey (IBBSS) data from Nigeria to examine coverage of four prevention interventions—condoms, HIV testing, and needle and syringe programmes (NSP)—among four key population groups—female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID) and transgender people. Methods: Data from Nigeria's 2020 IBBSS, implemented in 12 states, were analysed to examine HIV prevention programme coverage among key populations. For each key population group and prevention intervention of interest, weighted IBBSS data were used to retrospectively generate coverage cascades that identify and quantify coverage gaps. Required coverage targets were informed by targets articulated in Nigeria's National HIV/AIDS Strategic Framework or, in their absence, by guidelines from policy normative bodies. Availability‐, outreach‐ and utilization coverage proxy indicators were defined using variables from IBBSS data collection tools. Sankey diagrams are presented to visualize pathways followed by participants between coverage cascade steps. Results: Required coverage targets were missed for HIV testing and NSP among all key population groups. Condom availability coverage surpassed required coverage targets among FSW and MSM, while utilization coverage only among FSW exceeded the 90% required coverage target. Outreach coverage was low for all key population groups, falling below all required coverage targets. Conclusions: Our findings identify critical gaps in HIV prevention programme coverage for key populations in Nigeria and demonstrate non‐linear movement across coverage cascades, signalling the need for innovative solutions to optimize coverage of prevention services. Programme‐embedded research is required to better understand how key population groups in Nigeria access and use different HIV prevention services so that programmes, policies and resource allocation decisions can be optimized to achieve effective programme coverage and population‐level impact. [ABSTRACT FROM AUTHOR]

Introduction: Optimizing uptake of pre‐exposure prophylaxis (PrEP) for individuals at risk of HIV acquisition has been challenging despite clear scientific evidence and normative guidelines, particularly for key populations (KPs) such as men who have sex with men (MSM), female sex workers (FSWs), transgender (TG) people and persons who inject drugs (PWID). Applying an iterative Programme Science cycle, building on the effective programme coverage framework, we describe the approach used by the Centre for Infectious Disease Research in Zambia (CIDRZ) to scale up PrEP delivery and address inequities in PrEP access for KP in Lusaka, Zambia. Methods: In 2019, CIDRZ partnered with 10 local KP civil society organizations (CSOs) and the Ministry of Health (MOH) to offer HIV services within KP‐designated community safe spaces. KP CSO partners led KP mobilization, managed safe spaces and delivered peer support; MOH organized clinicians and clinical commodities; and CIDRZ provided technical oversight. In December 2021, we introduced a community‐based intervention focused on PrEP delivery in venues where KP socialize. We collected routine programme data from September 2019 to June 2023 using programme‐specific tools and the national electronic health record. We estimated the before‐after effects of our intervention on PrEP uptake, continuation and equity for KP using descriptive statistics and interrupted time series regression, and used mixed‐effects regression to estimate marginal probabilities of PrEP continuity. Results: Most (25,658) of the 38,307 (67.0%) Key Population Investment Fund beneficiaries were reached with HIV prevention services at community‐based venues. In total, 23,527 (61.4%) received HIV testing services, with 15,508 (65.9%) testing HIV negative and found PrEP eligible, and 15,241 (98.3%) initiating PrEP. Across all programme quarters and KP types, PrEP uptake was >90%. After introducing venue‐based PrEP delivery, PrEP uptake (98.7% after vs. 96.5% before, p < 0.001) and the number of initiations (p = 0.014) increased significantly. The proportion of KP with ≥1 PrEP continuation visit within 6 months of initiation was unchanged post‐intervention (46.7%, 95% confidence interval [CI]: 45.7%, 47.6%) versus pre‐intervention (47.2%, 95% CI: 45.4%, 49.1%). Conclusions: Applying Programme Science principles, we demonstrate how decentralizing HIV prevention services to KP venues and safe spaces in partnership with KP CSOs enabled successful community‐based PrEP delivery beyond the reach of traditional facility‐based services. [ABSTRACT FROM AUTHOR]

Introduction: Improving the delivery of existing evidence‐based interventions to prevent and diagnose HIV is key to Ending the HIV Epidemic in the United States. Structural barriers in the access and delivery of related health services require municipal or state‐level policy changes; however, suboptimal implementation can be addressed directly through interventions designed to improve the reach, effectiveness, adoption or maintenance of available interventions. Our objective was to estimate the cost‐effectiveness and potential epidemiological impact of six real‐world implementation interventions designed to address these barriers and increase the scale of delivery of interventions for HIV testing and pre‐exposure prophylaxis (PrEP) in three US metropolitan areas. Methods: We used a dynamic HIV transmission model calibrated to replicate HIV microepidemics in Atlanta, Los Angeles (LA) and Miami. We identified six implementation interventions designed to improve HIV testing uptake ("Academic detailing for HIV testing," "CyBER/testing," "All About Me") and PrEP uptake/persistence ("Project SLIP," "PrEPmate," "PrEP patient navigation"). Our comparator scenario reflected a scale‐up of interventions with no additional efforts to mitigate implementation and structural barriers. We accounted for potential heterogeneity in population‐level effectiveness across jurisdictions. We sustained implementation interventions over a 10‐year period and evaluated HIV acquisitions averted, costs, quality‐adjusted life years and incremental cost‐effectiveness ratios over a 20‐year time horizon (2023–2042). Results: Across jurisdictions, implementation interventions to improve the scale of HIV testing were most cost‐effective in Atlanta and LA (CyBER/testing cost‐saving and All About Me cost‐effective), while interventions for PrEP were most cost‐effective in Miami (two of three were cost‐saving). We estimated that the most impactful HIV testing intervention, CyBER/testing, was projected to avert 111 (95% credible interval: 110–111), 230 (228–233) and 101 (101–103) acquisitions over 20 years in Atlanta, LA and Miami, respectively. The most impactful implementation intervention to improve PrEP engagement, PrEPmate, averted an estimated 936 (929–943), 860 (853–867) and 2152 (2127–2178) acquisitions over 20 years, in Atlanta, LA and Miami, respectively. Conclusions: Our results highlight the potential impact of interventions to enhance the implementation of existing evidence‐based interventions for the prevention and diagnosis of HIV. [ABSTRACT FROM AUTHOR]

Introduction: HIV self‐testing (HIVST) is a promising strategy to improve diagnosis coverage among key populations (KP). The ATLAS (Auto Test VIH, Libre d'Accéder à la connaissance de son Statut) programme implemented HIVST in three West African countries, distributing over 380,000 kits up between 2019 and 2021, focussing on community‐led distribution by KP to their peers and subsequent secondary distribution to their partners and clients. We aim to evaluate the cost‐effectiveness of community‐led HIVST in Côte d'Ivoire, Mali and Senegal. Methods: An HIV transmission dynamics model was adapted and calibrated to country‐specific epidemiological data and used to predict the impact of HIVST. We considered the distribution of HIVST among two KP—female sex workers (FSW), and men who have sex with men (MSM)—and their sexual partners and clients. We compared the cost‐effectiveness of two scenarios against a counterfactual without HIVST over a 20‐year horizon (2019–2039). The ATLAS‐only scenario mimicked the 2‐year implemented ATLAS programme, whereas the ATLAS‐scale‐up scenario achieved 95% coverage of HIVST distribution among FSW and MSM by 2025 onwards. The primary outcome is the number of disability‐adjusted life‐years (DALY) averted. Scenarios were compared using incremental cost‐effectiveness ratios (ICERs). Costing was performed using a healthcare provider's perspective. Costs were discounted at 4%, converted to $USD 2022 and estimated using a cost‐function to accommodate economies of scale. Results: The ATLAS‐only scenario was highly cost‐effective over 20 years, even at low willingness‐to‐pay thresholds. The median ICERs were $126 ($88–$210) per DALY averted in Côte d'Ivoire, $92 ($88–$210) in Mali and 27$ ($88–$210) in Senegal. Scaling‐up the ATLAS programme would also be cost‐effective, and substantial epidemiological impacts would be achieved. The ICERs for the scale‐up scenario were $199 ($122–$338) per DALY averted in Côte d'Ivoire, $224 ($118–$415) in Mali and $61 ($18–$128) in Senegal. Conclusions: Both the implemented and the potential scale‐up of community‐led HIVST programmes in West Africa, where KP are important to overall transmission dynamics, have the potential to be highly cost‐effective, as compared to a scenario without HIVST. These findings support the scale‐up of community‐led HIVST to reach populations that otherwise may not access conventional testing services. [ABSTRACT FROM AUTHOR]

Introduction: Chemsex, the use of psychotropic drugs before or during sexual intercourse, is associated with various HIV risk factors, including condomless sex and reduced adherence to pre‐exposure prophylaxis or antiretroviral therapy (ART). In the Philippines, there are still limited studies exploring the associations between chemsex, HIV status and ART adherence. This study aims to compare recent and lifetime chemsex engagement in association with self‐reported HIV status among Filipino men who have sex with men (MSM). We further explored the association between chemsex and ART adherence among people living with HIV engaged in chemsex. Methods: A cross‐sectional online survey of 479 Filipino MSM was conducted from 3 August to 1 December 2019. Demographic profiles, sexual behaviours, drug use, history of sexually transmitted infections (STIs), chemsex engagement and HIV status were collected and analysed. Bivariable and multivariable logistic regression were employed to assess the association between self‐reported HIV status and chemsex engagement. Results: Among the 479 respondents, Filipino MSM engaged in drug use and chemsex were generally older compared to those not engaged in drug use and chemsex (average age 31−33 vs. 29 years old; p<0.05). Methamphetamine was the most common drug for people who reported using drugs. An HIV‐positive status was associated with recent chemsex engagement (aOR = 5.18, p<0.05) and a history of STIs (aOR = 2.09, p<0.05). The subgroup analysis showed that 79% (166/200) of persons living with HIV were adherent to ART. There was no significant association found between chemsex and ART adherence in the logistic regression analyses. Conclusions: Chemsex behaviour, particularly recent chemsex engagement, is significantly associated with self‐reported HIV status. The emerging data on MSM engaged in chemsex require integration of a more person‐centred, comprehensive and robust harm reduction programmes into the existing combination prevention strategies in the country. Health education for Filipino MSM engaged in chemsex should prioritize raising awareness about methamphetamine effects and overdose risks, alongside proper medical management. [ABSTRACT FROM AUTHOR]

Introduction: Past research shows that HIV self‐testing (HIVST) can increase testing and facilitate more HIV diagnoses relative to clinic testing. However, in the United States, the use of HIVSTs is limited due to concerns that those who use HIVST could be less likely to be linked to care. Methods: From January 2019 to April 2022, we recruited 811 men who have sex with men (MSM) in the United States who tested infrequently using an online marketing campaign and randomized them 1:1:1 to receive one of the following every 3 months for a year: (1) text message reminders to get tested at a local clinic (control); (2) mailed HIVST kits with access to a free helpline (standard HIVST); and (3) mailed HIVST kits with counselling provided within 24 hours of opening a kit (eTest). Quarterly follow‐up surveys assessed HIV testing, sexually transmitted infection (STI) testing, pre‐exposure prophylaxis (PrEP) use and sexual risk behaviour. Findings: Eight participants were diagnosed with HIV, and all but one were through HIVST. Participants in either HIVST condition, standard or eTest, had significantly higher odds of any testing (OR = 7.9, 95% CI = 4.9−12.9 and OR = 6.6, 95% CI = 4.2−10.5) and repeat testing (>1 test; OR = 8.5, 95% CI = 5.7−12.6; OR = 8.9, 95% CI = 6.1−13.4) over 12 months relative to the control group. Rates of STI testing and PrEP uptake did not differ across study condition, but those in the eTest condition reported 27% fewer sexual risk events across the study period relative to other groups. Conclusions: HIVST vastly increased testing, encouraged more regular testing among MSM, and identified nearly all new cases, suggesting that HIVST could diagnose HIV acquisition earlier. Providing timely follow‐up counselling after HIVST did not increase rates of STI testing or PrEP use, but some evidence suggested that counselling may have reduced sexual risk behaviour. To encourage more optimal testing, programmes should incorporate HIVST and ship kits directly to recipients at regular intervals. [ABSTRACT FROM AUTHOR]

Introduction: New South Wales (NSW) has one of the world's highest uptake rates of HIV pre‐exposure prophylaxis (PrEP). This uptake has been credited with sharp declines in HIV transmission, particularly among Australian‐born gay and bisexual men. Concerns have been raised around the potential for the emergence of tenofovir (TFV) and XTC (lamivudine/emtricitabine) resistance in settings of high PrEP use. Such an emergence could also increase treatment failure and associated clinical outcomes among people living with HIV (PLHIV). Despite low levels of nucleoside reverse‐transcriptase inhibitor (NRTI) resistance relating to PrEP use in clinical settings, there are few published studies describing the prevalence of NRTI resistance among people newly diagnosed with HIV in a setting of high PrEP use. Methods: Using HIV antiretroviral drug resistance data linked to NSW HIV notifications records of people diagnosed from 1 January 2015 to 31 December 2021 and with HIV attributed to male‐to‐male sex, we described trends in TFV and XTC resistance. Resistance was identified using the Stanford HIV Drug Resistance genotypic resistance interpretation system. To focus on transmitted drug resistance, resistance prevalence estimates were generated using sequences taken less than 3 months post‐HIV diagnosis. These estimates were stratified by timing of sequencing relative to the date of diagnosis, year of sequencing, birthplace, likely place of HIV acquisition, and stage of HIV at diagnosis. Results: Among 1119 diagnoses linked to HIV genomes sequenced less than 3 months following diagnosis, overall XTC resistance prevalence was 1.3%. Between 2015 and 2021, XTC resistance fluctuated between 0.5% to 2.9% and was 1.0% in 2021. No TFV resistance was found over the study period in any of the sequences analysed. Higher XTC resistance prevalence was observed among people with newly acquired HIV (evidence of HIV acquisition in the 12 months prior to diagnosis; 2.9%, p = 0.008). Conclusions: In this Australian setting, TFV and XTC resistance prevalence in new HIV diagnoses remained low. Our findings offer further evidence for the safe scale‐up of PrEP in high‐income settings, without jeopardizing the treatment of those living with HIV. [ABSTRACT FROM AUTHOR]

Introduction: In China, young men who have sex with men (YMSM) are one of the groups most at risk of HIV/AIDS. The uptake of pre‐exposure prophylaxis (PrEP) among YMSM has not been well documented. A cascade analysis of awareness, willingness, use and adherence with regard to PrEP was conducted separately among YMSM students and non‐students. Methods: From 20 October to 30 December 2021, all adolescents aged 16–24 years were selected for the study from among MSM recruited from 31 provincial administrative regions in mainland China. Participants were included in a cross‐sectional study of awareness, willingness, use and adherence with regard to PrEP among YMSM. Logistic regression modelling was used to identify factors associated with the four outcomes. Results: Among 1014 student and 866 non‐student YMSMs, respectively, 88.07% and 81.64% had heard of PrEP; 58.16% and 50.35% were willing to use PrEP; 7.59% and 7.62% had used PrEP; and 3.16% and 3.58% had adhered to PrEP. Among students, those living in high‐risk areas and pilot cities and those who had engaged in commercial sex and group sex had a positive effect on PrEP use, and the same trends were found among non‐students living in high‐risk areas and pilot cities and those who had engaged in group sex. 'Daily oral' and 'flexible' PrEP use positively influenced adherence among both groups. Conclusions: A differentiation strategy of PrEP promotion should be implemented among YMSM. Material support for students, such as financial resources, should increase, while non‐students should increase their level of perception of HIV risk. [ABSTRACT FROM AUTHOR]

Background and Objectives: An increasing number of blood operators around the world, including those in Canada, have removed time‐based deferral periods for gay, bisexual and other men who have sex with men and replaced them with sexual behaviour‐based questions for all donors. While this marks a significant shift in screening approach, what remains unclear is how members of two‐spirit, lesbian, gay, bisexual, transgender and queer (2S/LGBTQ+) communities view blood operators' initiatives to be more inclusive. As such, this study was conducted to assess the awareness of donor screening changes and other initiatives among members of 2S/LGBTQ+ communities and to explore their recommendations for blood operators' work with these communities. Materials and Methods: Semi‐structured qualitative interviews (n = 15) were conducted with 2S/LGBTQ+ people across Canada. Data were analysed using open inductive coding methods. Results: Reported here are the key results on recommendations for blood operators. Three themes were identified from the data: (1) the need for increased communications with 2S/LGBTQ+ communities surrounding changes to donor policies and guidelines; (2) the need for trans‐inclusive policy and procedures; and (3) the need for culturally responsive and equity‐informed staff training at donor centres. Conclusion: Results suggest that blood operators should consider 2S/LGTBQ+ communities when developing blood and plasma donation policies, screening procedures and staff training. Increased consultation with these communities is desired, and further research specific to the experiences of transgender blood donors is needed. [ABSTRACT FROM AUTHOR]

Objectives: This qualitative sub‐study aimed to explore how cisgender gay, bisexual, and other men who have sex with men (cis‐GBMSM) and transgender people who reported non‐consensual sex (NCS) accessed health care services, what barriers they faced, and how this experience influenced subsequent HIV testing. Methods: SELPHI is an online randomized controlled trial evaluating both acceptability and efficiency of HIV‐self testing among cis‐GBMSM and transgender people. Semi‐structured interviews were conducted, audio‐recorded, transcribed, and analysed through a framework analysis, as a qualitative sub‐study. We identified narratives of NCS from interviews and investigated experiences of cis‐GBMSM and transgender people accessing health care services following sexual assault. Results: Of 95 participants, 15 (16%) spontaneously reported NCS. Participants reported a broad range of NCS, including partner's coercive behaviours, non‐consensual removal of condoms, and rapes. All feared HIV transmission, leading them to test for HIV, underlining a marked lack of awareness of post‐exposure prophylaxis (PEP). Most had negative experiences in communicating with reception staff in sexual health clinics following these incidents. A lack of confidentiality and empathy was described in these situations of psychological distress. Clinic visits were primarily focused on testing for HIV and sexually transmitted infection, and generally no specific psychological support was offered. Getting a negative HIV result was a key step in regaining control for people who experienced NCS. Conclusions: Sexual health care providers should take care to more fully address the issue of NCS with cis‐GBMSM and transgender people when it arises. Recognizing and managing the emotional impact of NCS on affected patients would prevent negative experiences and increase confidence in care. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus (HIV) infection is highly prevalent and often coexists with other infectious diseases, especially Hepatitis B virus (HBV) and Hepatitis C virus (HCV). Men who have sex with men (MSM) represent a vulnerable population in terms of HIV infection. We aimed to determine the prevalence of HCV, HBV among HIV‐infected MSM. Methods: This systematic review and meta‐analysis searched PubMed, Cochrane, Scopus, Web of Science, and ProQuest up‐to 2023/04/22. All studies reporting the prevalence of HBV or HCV infection in MSM PLHIV were included. Meta‐analysis used random effect model for synthesis and I2 along with prediction interval for heterogeneity. Subgroup analysis based on continent and meta‐regression for study size, average age and year of publication were used to explore heterogeneity. Modified Newcastle‐Ottawa Scale was used to evaluate the quality of studies according to the protocol (PROSPERO: CRD42023428764). Results: Fifty‐six of 5948 studies are included. In 53 studies with 3,07,589 participants, a pooled prevalence of 7% (95% confidence interval [CI]: 5–10) was found for HCV among MSM PLHIV, while a 9% (95% CI: 4–18) prevalence was found for HBV infection from five studies which included 5641 MSM PLHIV. Asia reported the lowest pooled prevalence at 5.84% (95% CI: 2.98–11.13) for HCV while Europe reported the highest pooled prevalence at 7.76% (95% CI: 4.35–13.45). Baujat plot and influence diagnostic identified contributors to influence and between‐study heterogeneity. Sensitivity analyses omitting these studies result in considerably more precise estimates. Another sensitivity analysis as leave‐one‐out meta‐analysis did not change any pooled estimate significantly. Conclusion: There is a significant burden of HCV and HBV among MSM PLHIV worldwide, with varying prevalence rates. Future studies should focus on these multimorbidity clusters and investigate factors influencing disease burden, long‐term outcomes, optimal testing strategies, and tailored interventions. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusions The 2022 mpox outbreak continues, and while progress has been made in prevention strategies and potential treatment options, data on late sequelae following mpox are scarce.This analysis aimed to assess the incidence of scar formation in individuals affected by the 2022 mpox outbreak.All individuals diagnosed with mpox at the Department of Dermatology at the Medical University of Vienna in 2022 were included in this analysis. Follow‐up data were collected throughout November 2023. ‘Scar formation’ was defined as having at least one scar at the former active mpox lesions.At our clinic, 28 cases of mpox presented between June 2022 and October 2022 and exclusively occurred in men who have sex with men (100%, 28/28), of whom 46% (13/28) were living with HIV, and 32% (9/28) were using pre‐exposure prophylaxis (PrEP). Secondary bacterial infection of mpox lesions was suspected in six individuals, and all received systemic antibiotics. Overall, 26 were followed up in November 2023 after a median time of 15 months, and scar formations were found in 43% of cases.Our data provide insights into the late yet cumulating disease burden caused by the 2022 mpox outbreak. Highly effective prevention strategies are warranted to overcome the mpox epidemic and its potential late sequelae. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions The objective of this study was to gain insight into the barriers hindering the use of pre‐exposure prophylaxis (PrEP) among men who have sex with men (MSM) in five cities in China.MSM were recruited via community‐based organizations in an online “snowball” manner. Participants completed the questionnaire anonymously and shared it with key MSM peers (seeds) in five cities in China. Based on the results of univariate analysis, we used a structural equation model to analyse the role of PrEP knowledge awareness, PrEP counselling, and other behavioural variables on PrEP use.The study collected a total of 4223 valid questionnaires, and 18.2% of participants reported PrEP use. The results of the standardized total effects showed that the following paths were statistically significant (p < 0.05): from the age of first sex with men to PrEP knowledge awareness (β = −0.113) and PrEP use (β = 0.042); from high‐risk sexual behaviour scores to PrEP counselling (β = 0.039) and PrEP use (β = 0.103); from the number of HIV tests in the last year to PrEP knowledge awareness (β = 0.034), PrEP counselling (β = 0.170), and PrEP use (β = 0.197); from the level of self‐perceived risk of HIV infection to PrEP counselling (β = −0.115); from PrEP knowledge awareness to PrEP use (β = −0.049); and from PrEP counselling to PrEP use (β = 0.420).The proportion of PrEP use among MSM was relatively low. Age at first sex with men, number of HIV tests, high‐risk sexual behaviour, and PrEP counselling had a positive effect on PrEP use, whereas PrEP knowledge awareness had an inverse effect on PrEP use. [ABSTRACT FROM AUTHOR]

Objective: To understand the factors associated with the practice of chemsex among MSM in Brazil, especially during the Mpox health crisis, and to design effective prevention and intervention strategies specifically for this population. Design: A cross‐sectional and analytical study using an electronic survey, conducted from September to December 2022, during the peak of the Mpox outbreak in Brazil. Sample: A total of 1452 MSM aged 18 and older. Measurements: Data were collected via the REDCap platform through a survey with 46 questions. These addressed demographic data, sexual affiliations, practices, experiences with Mpox, healthcare service usage, and stigma or fear related to Mpox. Results: The prevalence of chemsex was 19.42% (n = 282). Multivariate Poisson modeling indicated a high incidence of chemsex among those diagnosed with Mpox and those involved in high‐risk behaviors. The practice of chemsex was six times higher among those diagnosed with Mpox (95% CI: 4.73–9.10). MSM who engage in bugchasing had a prevalence twice that of the main outcome (95% CI: 1.31–3.16). Conclusion: There is a significant need for targeted interventions for MSM in Brazil, especially given the Mpox outbreak. This study highlights the strong relationships between chemsex, experiences with Mpox, and various sexual behaviors, underscoring the importance of effective public health initiatives. [ABSTRACT FROM AUTHOR]

Introduction: Men who have sex with men (MSM), especially those living with HIV, are at an increased risk of anal cancer. The prevalence and incidence of its precursor, anal high‐grade squamous intraepithelial lesions (HSILs), among MSM who started antiretroviral therapy during acute HIV acquisition are yet to be explored. Methods: Participants in an acute HIV acquisition cohort in Bangkok, Thailand, who agreed to take part in this study, were enrolled. All participants were diagnosed and started antiretroviral therapy during acute HIV acquisition. Human papillomavirus (HPV) genotyping and high‐resolution anoscopy, followed by anal biopsy as indicated, were done at baseline and 6‐monthly visits. Results: A total of 89 MSM and four transgender women were included in the analyses. Median age at enrolment was 26 years. Baseline prevalence of histologic anal HSIL was 11.8%. With a total of 147.0 person‐years of follow‐up, the incidence of initial histologic anal HSIL was 19.7 per 100 person‐years. Factors associated with incident anal HSIL were anal HPV 16 (adjusted hazards ratio [aHR] 4.33, 95% CI 1.03–18.18), anal HPV 18/45 (aHR 6.82, 95% CI 1.57–29.51), other anal high‐risk HPV (aHR 4.23, 95% CI 1.27–14.14), syphilis infection (aHR 4.67, 95% CI 1.10–19.90) and CD4 count <350 cells/mm3 (aHR 3.09, 95% CI 1.28–7.48). Conclusions: With antiretroviral therapy initiation during acute HIV acquisition, we found the prevalence of anal HSIL among cisgender men and transgender women who have sex with men to be similar to those without HIV. Subsequent anal HSIL incidence, although lower than that of those with chronic HIV acquisition, was still higher than that of those without HIV. Screening for and management of anal HSIL should be a crucial part of long‐term HIV care for all MSM. [ABSTRACT FROM AUTHOR]

Introduction: HPTN 083 demonstrated the superiority of long‐acting cabotegravir (CAB‐LA) versus daily oral emtricitabine/tenofovir disoproxil fumarate (TDF/FTC) as pre‐exposure prophylaxis (PrEP) among cisgender men and transgender women who have sex with men (MSM/TGW). HPTN 083 provided the first opportunity to understand experiences with injectable PrEP in a clinical trial. Methods: Participants from two US sites (Chicago, IL and Atlanta, GA) and one international site (Rio de Janeiro, Brazil) were purposively sampled for individual qualitative interviews (N = 40), between November 2019 and March 2020, to explore trial experiences, barriers to adherence and other factors that may have impacted study implementation or outcomes. The blinded phase ended early due to efficacy; this analysis includes interviews conducted prior to unblinding with three groups defined by adherence (i.e. injection visit attendance): adherent (n = 27), non‐adherent (n = 12) and early discontinuers (n = 1). Data were organized using NVivo software and analysed using content analysis. Results: Participants (mean age: 27) were primarily cisgender MSM (90%) and Black/African American (60%). Reasons for trial enrolment and PrEP use included a preference for using HIV prevention medication versus treatment in the event of HIV acquisition; the ability to enhance health via study‐related education and services; access to a novel, convenient HIV prevention product at no cost; and contributing to MSM/TGW communities through research. Participants contrasted positive experiences with study staff with their routine clinical care, and emphasized increased scheduling flexibility, thorough communication, non‐judgemental counselling and open, affirming environments (e.g. compassion, less stigma) as adherence facilitators. Injection experiences were positive overall; some described early injection‐related anxiety, which abated with time and when given some measure of control (e.g. pre‐injection countdown), and minimal injection site discomfort. Some concerns and misperceptions about injectable PrEP were reported. Barriers to adherence, across all adherence categories, included structural factors (e.g. financial constraints, travel) and competing demands (e.g. work schedules). Conclusions: Respondents viewed injectable PrEP trial participation as a positive experience and a means of enhancing wellbeing. Study site flexibility and affirming clinic environments, inclusive of non‐judgemental counselling, were key facilitators of adherence. To support injection persistence, interventions that address structural barriers and promote flexible means of injection delivery may be most effective. [ABSTRACT FROM AUTHOR]

Introduction: Simplified hepatitis C virus (HCV) diagnostic strategies have the potential to improve HCV diagnoses and treatment. We aimed to investigate the impact of simplified HCV diagnostic strategies on HCV incidence and its effect on HCV diagnosis and treatment among men who have sex with men (MSM) regardless of HIV status and use of HIV pre‐exposure prophylaxis (PrEP) in Taiwan. Methods: A compartmental deterministic model was developed to describe the natural history of HCV disease progression, the HCV care cascade and the HIV status and PrEP using among MSM. The model was calibrated to available data for HCV and HIV epidemiology and population demographics in Taiwan. We simulated the epidemic from 2004 and projected the impact of simplified testing strategies on the HCV epidemic among MSM over 2022–2030. Results: Under the current testing approach in Taiwan, total HCV incidence would increase to 12.6 per 1000 person‐years among MSM by 2030. Single‐visit point‐of‐care RNA testing had the largest impact on reducing the number of new HCV infections over 2022–2030, with a 31.1% reduction (interquartile range: 24.9%−32.8%). By 2030, single‐visit point‐of‐care HCV testing improved HCV diagnosis to 90.9%, HCV treatment to 87.7% and HCV cure to 81.5% among MSM living with HCV. Compared to status quo, prioritized simplified HCV testing for PrEP users and MSM living with diagnosed HIV had considerable impact on the broader HCV epidemic among MSM. A sensitivity analysis suggests that reinfection risk would have a large impact on the effectiveness of each point‐of‐care testing scenario. Conclusions: Simplified HCV diagnostic strategies could control the ongoing HCV epidemic and improve HCV testing and treatment among Taiwanese MSM. Single‐visit point‐of‐care RNA testing would result in large reductions in HCV incidence and prevalence among MSM. Efficient risk‐reduction strategies will need to be implemented alongside point‐of‐care testing to achieve HCV elimination among MSM in Taiwan. [ABSTRACT FROM AUTHOR]

People living with HIV (PWH) have been shown to bear a higher burden of hepatitis B virus (HBV) due to shared routes and risk factors for transmission. Populations such as men who have sex with men (MSM) are at an increased risk of both being infected with HBV and HIV, that places them at higher risk of hepatocellular carcinoma. Using weighted and adjusted multilevel logistic regression, we characterized the prevalence and correlates of hepatitis B surface antigen (HBsAg) among MSM living with HIV across 12 Indian cities from 2012 to 2013. Overall, the prevalence of HBsAg was 8% (range across cities: 0.5%–19%). Being between the ages of 25–34, and 35–44 increased the odds of having chronic HBV infection compared to MSM 24 years or younger. Daily or seasonal employment and being unemployed increased the odds of HBsAg prevalence compared to those with monthly or weekly wages. Sexual risk behaviours such as having had sex with both men and women in the prior 6 months and history of sex work increased the odds of having HBV. Ever having insertive sex with a man or hijra (assigned male at birth, currently identifies as female/nonbinary) was negatively associated with HBV. Despite the existence of efficacious vaccines, HBV continues to have high prevalence among PWHs. Programmes to increase early screening, vaccinations and HBV literacy are urgently needed. Integrating HBV and HIV programmes for MSM populations could be critical in addressing this dual burden and improving outcomes for both infections. [ABSTRACT FROM AUTHOR]

Introduction: We assessed the impact of a nationwide screening programme to reduce the risk of anal cancer in a large cohort of high‐risk patients with HIV. Methods: From a large database from one referral centre, all high‐risk patients with HIV (men who have sex with men, history of anal or genital warts, or previous cervix human papillomavirus‐related lesions) who were eligible to enter the French anal cancer screening programme (2011–2020) were retrospectively included. Adherence to the screening programme was defined as no interval >18 months between two visits. Standardized management included perianal visualization and standard anoscopy with biopsies of macroscopic abnormalities. Results: Overall, 700 patients with HIV were included (median follow‐up 8.4 years [interquartile range 4.3–9.2] and 1491.6 patient‐years), and 336 had one or more proctology visit. A total of 13 patients were diagnosed with anal squamous cell carcinomas. The risk of anal cancer was higher with anal intra‐epithelial neoplasia grade 3 (AIN3; hazard ratio [HR] 44.5 [95% confidence interval {CI} 11.2–176.6], p < 0.001), AIN2 (HR 11.9 [95% CI 2.1–66.9], p = 0.005), or high‐grade dysplasia (HR 23.4 [95% CI 7.9–69.1], p < 0.001) than with low‐grade dysplasia or no lesion. Among the patients who were strictly adherent to the screening programme (4.6% [32/700]), we did not report any AIN or anal cancer, but we also did not observe any significant reduction in the risk of anal cancer (p = 0.51), AIN3 (p = 0.28), high‐grade dysplasia (p = 0.19), or any AIN lesions (p = 0.10) compared with non‐adherent patients. In contrast, screened patients were more likely to be diagnosed with anal warts (HR 3.71 [95% CI 2.14–6.42], p < 0.001). Conclusion: Macroscopic high‐grade dysplasia lesions are associated with a higher risk of developing anal cancer. Despite finding no cases of cancer during the screening programme, we also did not demonstrate a clear benefit from our screening programme for the prevention of anal cancer in high‐risk patients with HIV. [ABSTRACT FROM AUTHOR]

This article discusses the emergence of doxycycline-induced fixed drug eruption (FDE), a common adverse reaction characterized by red patches on the skin or mucosa. FDE is typically associated with drugs like paracetamol, antibiotics, and non-steroidal anti-inflammatory drugs. However, recent cases have shown that doxycycline, commonly used for post-exposure prophylaxis (PeP) against sexually transmitted infections (STIs), can also induce FDE. The article presents 15 cases of doxycycline-induced FDE, with most cases occurring within the past 6 months. The authors recommend in situ repeated open application tests (ROAT) to confirm the diagnosis and avoid oral provocation tests (OPT), which can carry risks. They also suggest that all cyclin antibiotics, including doxycycline, be contraindicated for safety reasons. The article emphasizes the importance of recognizing doxycycline-induced FDE, particularly in cases of genital lesions that could be misdiagnosed as STIs. [Extracted from the article]

Introduction: End‐user perspectives are vital to the design of new biomedical HIV prevention products. Conjoint analysis can support the integration of end‐user perspectives by examining their preferences of potential pre‐exposure prophylaxis (PrEP) products. The Microbicides Trial Network (MTN) 035 protocol examined three placebo rectal dosage forms (insert, enema and suppository) that could deliver PrEP prior to receptive anal sex (RAS). Methods: Between April 2019 and July 2020, we enrolled 217 HIV‐negative, cisgender men who have sex with men (MSM; n = 172; 79.3%) and transgender people (n = 47; 20.7%) ages 18–35 into a randomized cross‐over trial across Malawi, Peru, South Africa, Thailand and the United States. Participants used each product prior to RAS over 4‐week periods. Participants completed a conjoint experiment where they selected between random profiles using seven features (dosage form, timing of use before sex, side effects, duration of protection, effectiveness, frequency of use and need for a prescription). Results: Effectiveness was the strongest determinant of choice (30.4%), followed by modality (18.0%), potential side effects (17.2%), frequency of use (10.8%), duration of protection (10.4%), timing of use before sex (7.4%) and need for a prescription (5.9%). Relative utility scores indicated that the most desirable combination of attributes was a product with 95% efficacy, used 30 minutes before sex, offering a 3‐ to 5‐day protection window, used weekly, having no side effects, in the form of an enema and available over‐the‐counter. Conclusions: Choice in next‐generation PrEP products is highly desired by MSM and transgender people, as no one‐size‐fits‐all approach satisfies all the preferences. MTN‐035 participants weighed product features differently, recognizing the need for diverse, behaviourally congruent biomedical options that fit the needs of intended end‐users. [ABSTRACT FROM AUTHOR]

Objectives: We conducted a survey to evaluate HIV pre‐exposure prophylaxis (PrEP) practices in a European clinical research network on HIV, hepatitis, and global infectious diseases (NEAT ID). Methods: An online survey comprising 22 questions was sent via a secure electronic tool to the investigating physician of each of the 342 NEAT ID study centres across 15 European countries in November 2020. Results: In total, 50 sites from 12 countries responded (15% response rate). Most sites were in Western Europe, two were in Poland, and one was in Hungary. Of the responding sites, 45 provided PrEP services for a total of 27 416 PrEP users, with 1361 new PrEP initiators each month. These centres supplied PrEP for men who have sex with men (100%), people who inject drugs (84%), sex workers (84%), women (62%), and transgender women (31%). PrEP persistence after 1 year was >90%, 75%–90%, and 40%–75% in 17, 24, and 4 centres, respectively. In total, 32/45 (71%) centres reported strong community‐based organization commitment at their site, and 15/45 (33%) centres developed task‐shifting processes to deliver PrEP through nurses (11/15), pharmacists (5/15), and key‐population peers (2/15). The biggest barriers to implementation of PrEP were low awareness of and knowledge about PrEP (47%), unwillingness to disclose sexual identity or at‐risk behaviour (36%), and lack of administrative support (29%). Of the 45 centres, 32 (71%) have already been involved in PrEP research and 43 (96%) were interested in participating in such studies. Conclusions: The few NEAT ID centres that responded to the survey showed disparities in PrEP deployment and practices despite a common interest in participating in research in this field. [ABSTRACT FROM AUTHOR]

Background: In Australia, a man cannot donate blood if he has had sex with another man within the past 3 months. However, this policy has been criticized as being discriminatory as it does not consider lower risk subgroups, and led to calls for modifications to the policy that more accurately distinguish risk among gay, bisexual, and other men who have sex with men (GBM). Study Design and Methods: We used data from a nationally representative survey to estimate the proportion of GBM aged 18–74 years old who would be eligible to donate under current criteria and other scenarios. Results: Among the 5178 survey participants, 155 (3.0%) were classified as GBM based on survey responses, Among the GBM, 40.2% (95% CI 28.0%–53.7%) were eligible to donate based on current criteria, and 21.0% (95% CI 14.5%–29.5%) were ineligible due to the 3 months deferral alone. Eligibility among GBM, all men, and the population increased as criteria were removed. Under the new Australian plasma donation criteria, 73.6% (95% CI 64.4%–81.1%) of GBM, 68.4% (95% CI 65.5%–71.2%) of all men, and 60.8% (95% CI 58.8%–62.8%) of the full population were estimated to be eligible. Only 16.1% (95% CI 8.6%–28.1%) of GBM knew that the male‐to‐male sex deferral period is 3 months. Discussion: Changing the deferral criteria and sexual risk evaluation would lead to a higher proportion of GBM being eligible to donate blood. Knowledge of the current GBM deferral period is very low. Improved education about the current criteria and any future changes are required to improve blood donation rates. [ABSTRACT FROM AUTHOR]

The Lubricant Investigation in Men to Inhibit Transmission of human papillomavirus (HPV) Infection randomized control trial in gay, bisexual, and other men who have sex with men (gbMSM) found that carrageenan use neither reduced acquisition of anal HPV infections nor influenced infection clearance. To investigate carrageenan's lack of protective effect, we compared the change in anal HPV16 and HPV18 viral loads following carrageenan use against placebo. We restricted our analysis to participants who completed the first four study visits and had a valid baseline sample (n = 161, 54 HIV‐positive). Samples were tested for HPV detection using the linear array PCR assay. HPV16‐ and/or HPV18‐positive samples were tested for viral load using real‐time PCR. For participants who tested HPV16‐ (n = 29) or HPV18‐positive (n = 10) at least once across visits 1−4, we compared the change in type‐specific viral load between study arms using the Mann−Whitney U test. Although the median net change in HPV16 and HPV18 viral loads across visits 1‐4 was higher in the treatment than placebo arm (HPV16: 0.68 vs. 0.18 copies/cell, p = 0.60; HPV18: 18.32 vs. 10.12 copies/cell, p = 0.52), these differences were not statistically significant. Results were similar by HIV status. Carrageenan use did not impact anal HPV16 or HPV18 viral loads, which may further explain its lack of protective effect in gbMSM. [ABSTRACT FROM AUTHOR]

Objectives: Viral hepatitis co‐infection among people living with HIV is known to accelerate the progression of liver disease and AIDS. An increased prevalence and incidence of hepatitis B virus (HBV) infection among people living with HIV demands continuous monitoring to adapt targeted prevention strategies to reach the global goals of eliminating viral hepatitis as a public health threat. Methods: We determined the prevalence and incidence of HBV for the years 1996–2019 from yearly blood sample testing and questionnaire reports among people living with HIV belonging to a nationwide, multicentre observational, prospective cohort study. Results: Among this study population of 3479 participants, the majority (87%) indicated that being men who have sex with men (MSM) was their likely HIV transmission route; 51% were recruited from Berlin. HBV prevalence for acute/chronic and resolved infections decreased from 4.1% and 45% in 1996–1999 to 1.3% and 16% in 2019, respectively. Simultaneously, participants with a serological status indicating HBV vaccination increased from 25% in 1996–1999 to 69% in 2019. Among vaccinated participants with relevant information (n = 1135), 38% received their first HBV vaccination after HIV infection. The HBV incidence rate in 565 eligible participants decreased from 6.9/100 person‐years in 2004–2007 to 0.45/100 person‐years in 2015. Conclusion: Increasing vaccination coverage because of a general HBV vaccination recommendation and catch‐up vaccination efforts among risk groups decreased HBV infection prevalence over time among this study population of people living with HIV, primarily MSM and from Berlin. Despite this success, the prevalence and incidence of HBV remains higher than in the general population in Germany. This emphasizes the need for continued HBV prevention by promoting HBV vaccination and HBV screening at regular intervals based on the individual risk behaviour. [ABSTRACT FROM AUTHOR]

Introduction: Overseas‐born gay and bisexual men (GBM) are overrepresented in HIV diagnoses in Australia. We assessed social and sexual behaviours, and the use of HIV prevention and testing, by region of birth and length of residence in Australia. We sought to identify similarities and differences between recently arrived and non‐recently arrived GBM from non‐English‐speaking countries to improve targeting and engagement with HIV testing and prevention. Methods: Data were collected in national repeated, behavioural surveillance surveys conducted across Australia during 2019–2021. Logistic regression was used to identify factors that differentiated between recently arrived (<2 years) and non‐recently arrived (≥2 years in Australia) GBM from non‐English‐speaking countries. Results: Among 24,707 participants in 2019–21, 2811 (11.4%) were from high‐income English‐speaking countries, 714 (2.9%) were recently arrived overseas‐born GBM and 3833 (15.5%) were non‐recently arrived migrants. Recently arrived GBM were most likely to be born in Asia (36.1%) and Europe (21.1%). Compared with non‐recently arrived GBM, recently arrived GBM from non‐English‐speaking countries were younger (aOR = 0.95, 95% CI = 0.94–0.96, p<0.001), more likely to be students (aOR = 1.43, 95% CI = 1.11–1.85, p = 0.005), less likely to be in full‐time employment (aOR = 0.56, 95% CI = 0.46–0.69, p <0.001), more likely to report consistent condom use (aOR = 1.30, 95% CI = 1.01–1.66, p = 0.039), but had lower awareness (aOR = 0.62, 95% CI = 0.48–0.80, p<0.001) and use of pre‐exposure prophylaxis (PrEP) (22.8%, vs. 32.3%, χ2(1, 4185) = 23.78, p<0.001), and similar levels of casual sex with a risk of HIV acquisition or transmission (aOR = 1.29, 95% CI = 0.98–1.69, p = 0.066). Recently arrived GBM reported similar levels of lifetime HIV testing (aOR = 0.97, 95% CI = 0.54–1.74, p = 0.915) and recent HIV testing (OR = 1.03, 95% CI = 0.86–1.22, p = 0.779), but were much less likely to have tested at general practitioners (aOR = 0.53, 95% CI = 0.41–0.68, p<0.001) and more likely to report testing at hospitals (aOR = 3.35, 95% CI = 2.53–4.43, p<0.001), at home (aOR = 2.85, 95% CI = 1.63–4.99, p<0.001), or community‐based services (aOR = 1.36, 95% CI = 1.01–1.84, p = 0.043). Conclusions: Recently arrived GBM from non‐English‐speaking countries reported similar levels of risk of HIV acquisition to longer‐term residents in Australia, but lower levels of PrEP awareness and use, and more reliance on HIV testing services which are free or low cost. It is necessary to enhance access to HIV testing and prevention among recently arrived GBM in Australia. [ABSTRACT FROM AUTHOR]

Objectives: Our objective was to obtain long‐term data on the incidence of sexually transmitted infections (STIs) and their association with behavioural factors after widespread pre‐exposure prophylaxis (PrEP) implementation. Methods: This was a time‐to‐event analysis of a national PrEP cohort in Switzerland (SwissPrEPared study). Participants were people without HIV interested in taking PrEP with at least two STI screening visits. Primary outcomes were incidence rate of gonorrhoea, chlamydia, and syphilis. The association between behavioural factors and STI diagnosis was expressed using hazard ratios. We adjusted for testing frequency and calendar year. Results: This analysis included 3907 participants enrolled between April 2019 and April 2022, yielding 3815.7 person‐years of follow‐up for gonorrhoea (15 134 screenings), 3802.5 for chlamydia (15 141 screenings), and 3858.6 for syphilis (15 001 screenings). The median age was 39 years (interquartile range [IQR] 32–47), 93.8% (n = 3664) identified as men who have sex with men (MSM). The incidence was 22.8 (95% confidence interval [CI] 21.3–24.4) per 100 person‐years for gonorrhoea, 26.3 (95% CI 24.7–28.0) for chlamydia, and 4.4 (95% CI 3.8–5.1) for syphilis. Yearly incidence rates decreased between 2019 (all bacterial STIs: 81.6; 95% CI 59.1–109.9) and 2022 (all bacterial STIs: 49.8; 95% CI 44.6–55.3). Participants reporting chemsex substance use were at higher risk of incident STIs, as were those reporting multiple sexual partners. Younger age was associated with a higher risk of gonorrhoea and chlamydia. Conclusions: Incidence rates of bacterial STIs decreased over time. Young MSM, those with multiple partners, and those using chemsex substances were at increased risk of STIs. [ABSTRACT FROM AUTHOR]

Background: The 2022 outbreak of monkeypox virus (MPXV) revealed new transmission routes. Incidence declined sharply in September 2022, and it remains unclear whether MPXV is circulating in asymptomatic individuals because of increased immunity. Objectives: Our study aimed to assesss the number of asymtomatic MPXV carriers in individuals at high risk for STI. Methods: We analysed anal samples from asymptomatic highly sexually active men who have sex with men for the presence of MPXV. Results: We detected a high number of concomitant sexually transmitted infections but did not find a single sample with MPXV. Conclusions: Our results indicate that the general recommendation to implement screening for MPXV is not currently justified. [ABSTRACT FROM AUTHOR]

Assessment of risks and benefits of study participation is standard practice preceding the initiation of human subjects research. Although tracking adverse events during research participation is routine, collecting information from participants about what they perceive as benefits is less common. We longitudinally tracked social risks and benefits of participation among a cohort of 241 men who have sex with men participating in a sexual health study to improve participants' experiences and enhance understanding of participant motivations to enroll and attend follow‐up. Of the participants who returned for at least one follow‐up visit (n = 217, 90%), most (n = 185, 85%) reported positive consequences resulting from participation. Reporting of negative social consequences was rare, and all concerned a stigmatized reaction from someone learning about the participant's involvement in a sexual health study. Better identification of both positive and negative consequences resulting from research participation may improve how researchers design, recruit, and conduct research. [ABSTRACT FROM AUTHOR]

Men who have sex with men living with HIV (MSM LWH) are at highest risk for human papillomavirus (HPV)‐associated anal cancer. There is no consensus on the optimal screening initiation age. This study aimed to assess the prevalence and severity of anal HPV disease among MSM LWH under the age of 35, which is a currently proposed screening age threshold. Between 2014 and 2020, 1255 18‐to‐34‐year‐old MSM LWH underwent anal cytology screening. 916 were co‐tested for high‐risk HPV (HR‐HPV). 467 underwent high‐resolution anoscopy (HRA) and biopsy. Cancer registry data were queried. Predictors of abnormal cytology (ie, ≥ASCUS) and histological high‐grade squamous intraepithelial lesions (HSIL) were evaluated using unadjusted logistic regression models. Median age was 28 years (range, 18‐34). 19% received at least one dose of HPV vaccine. Abnormal cytology rate was 65%. HR‐HPV and HPV16 prevalence were 87% and 30%. Biopsy results were benign (10%), LSIL (43%) and HSIL (47%). No cases of prevalent or incident anal cancers were detected. Findings were similar between age subgroups (18‐24, 25‐29 and 30‐34) except for a higher prevalence of AIN 3 in the 30‐34 group (19%). Abnormal cytology was significantly associated with HR‐HPV infection. Histological HSIL was associated with HR‐HPV infection and cytological LSIL or worse. The absence of anal cancer in a large cohort of MSM LWH under the age of 35, despite high prevalence of anal HR‐HPV infection and precancer, supports an age‐based anal cancer screening strategy for MSM LWH. [ABSTRACT FROM AUTHOR]

This article discusses the loss of seroprotective antibody after a full series of hepatitis A virus (HAV) vaccination in people with HIV (PWH). The study found that PWH who are men who have sex with men (MSM) had a seroreversion rate of 10% over a 3-year follow-up period. Factors associated with seroreversion included lower B cell count and lower anti-HAV IgG titers. The study suggests that regular follow-up of anti-HAV IgG titer may be warranted for PWH who fail to mount higher serologic responses after vaccination. [Extracted from the article]

Study investigating mpox infection and its association with sexual behavior among men who have sex with men (MSM) in China was lacking. This observational survey aimed to provide evidence on detail characteristics of mpox cases and sexual behavior, then analyze their relationship among MSM in China to help formulate prevention and control policies. An anonymous cross‐sectional study was conducted in 27 MSM social organizations across 21 provinces, municipalities, and autonomous regions from July 31 to August 4, 2023. A safe sexual behavior index was constructed based on three risky sexual behaviors in the last month, including condomless anal intercourse, commercial sex and group sex. High safe sexual behavior indicated that the participant engaged in none of the three, and low safe sexual behavior indicated that they engaged in all three behaviors; otherwise, moderate safe sexual behavior was indicated. Among 7538 MSM, the prevalence of mpox was 0.73% (55/7538). The proportion of high safe sexual behavior was 79.64% (6003/7538). The crude prevalence of mpox was lower in the high safe sexual behavior group (0.35%, 21/6003), compared with the low (12.12%, 8/66) and moderate safe (1.78%, 26/1469) sexual behavior group. In the multivariable‐adjusted analysis, after adjusting for all covariates, compared with low safe sexual behavior group, moderate safe sexual behavior group (aOR = 0.21; 95% CI = 0.08, 0.54) and high safe sexual behavior group (aOR = 0.04; 95% CI = 0.02, 0.12) both had lower risk of mpox. Of three sexual behaviors, MSM who reported no commercial sex had the lowest risk of mpox (aOR = 0.23; 95% CI = 0.13, 0.41), compared with those who reported commercial sex in the last month. The other two safe sexual behaviors both were associated with lower risk of mpox (no group sex vs. group sex: aOR = 0.15; 95% CI = 0.08, 0.28; no condomless anal intercourse vs. condomless anal intercourse: aOR = 0.23; 95% CI = 0.13, 0.41). The prevalence of mpox virus infection was nearly 1% among MSM in China. Strengthening mpox surveillance, emphasizing safe sexual behavior in health education are essential for the control of mpox among MSM in China. [ABSTRACT FROM AUTHOR]

Sexual intercourse is a well‐established way of transmission of mpox infection. However, it is still uncertain whether semen may represent a viral reservoir. The aim of the study was to evaluate the clearance of viral DNA in semen samples from individuals diagnosed with mpox infection over 6‐month follow‐up. This prospective, observational, single‐center study was conducted at IRCCS San Raffaele Scientific Institute, Milan, Italy, between May and October 2022 in 140 individuals who attended Sexual Health Clinic and diagnosed with mpox infection. Semen samples were collected and analyzed by real‐time polymerase chain reaction assays. The baseline collection was performed in 64 (46%) of 140 men diagnosed with mpox infection. The viral DNA was detected in 43 (67%) with median cycle threshold (Ct) 34 (interquartile range [IQR] 31–36). The research was repeated in 32 (74%) and viral DNA clearance was observed in all within 6 months in a median time of 10.5 days (IQR 7–33). Viral clearance occurred in all tested individuals, mostly within 2 weeks since the first positive test. These findings suggest a transient presence of viral DNA in semen and do not support the hypothesis of reservoir. More studies on mpox DNA detection in semen with viral culture and extended follow‐up are needed. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prevalence of non‐testing for HIV among immigrant men who have sex with men (MSM) residing in Brazil and identify associated factors. Design: An analytical web‐survey study was conducted across all Brazilian states from January 2020 to May 2021. Sample: The study included 804 MSM immigrants from Portuguese‐speaking countries. Measurements: Odds ratio (OR) and adjusted Odds Ratio (AOR) were utilized to determine the strength of the association between non‐HIV testing and associated factors. Results: Among the participants, 63.7% had never undergone HIV testing. Multivariate analysis revealed several factors associated with a higher likelihood of not being tested for HIV: having a steady/monogamus partner (AOR: 1.5; 95%CI: 1.1‐2.3) or both casual and steady partners (AOR: 1.8; 95%CI: 1.2‐3.4), not engaging in bareback sex (AOR: 1.91; 95%CI: 3‐3.5), being an immigrant in the country for less than 12 months (AOR: 3.7; 95%CI: 2.5‐9.7), and having a preference for insertive (AOR: 1.5; 95%CI: 1.1‐2.5) or receptive (AOR: 2.9; 95%CI: 1.4‐5.7) roles. However, practicing chemsex was found to be a protective factor for testing (AOR: 4). Conclusion: To enhance HIV prevention strategies, it is crucial to implement specific measures that ensure accessibility, confidentiality, and a reduction in stigma associated with HIV testing. [ABSTRACT FROM AUTHOR]

Introduction: More than 70% of new HIV diagnoses in the United States were among men who have sex with men (MSM) in 2019. Pre‐exposure prophylaxis (PrEP) is a transformative innovation for reducing human immunodeficiency virus (HIV) infections. Structural stigma against sexual minorities, including in the form of state‐level policies, may affect PrEP implementation. We evaluated whether lower structural stigma reflected by earlier year of state same‐sex marriage legalization was associated with increased male PrEP prescriptions and male PrEP‐to‐need ratio (PnR), a ratio of PrEP prescriptions to new HIV diagnoses. Methods: We used 2012−2019 AIDSVu data on male PrEP prescriptions and male PnR in each US state and year. We used generalized estimating equations to evaluate the relationship between the timing of implementing state same‐sex marriage policies and the outcomes of male PrEP prescriptions per 100,000 people and the male PnR. We adjusted for calendar year, Medicaid expansion and the political party of the governor in each state. Results: State implementation of same‐sex marriage policies in earlier, relative to later, periods was associated with increases in the rate of male PrEP prescriptions and in the male PnR. Specifically, implementing state same‐sex marriage policies between 2004 and 2011 and between 2012 and 2013 were each associated with greater rates of male PrEP prescriptions relative to implementing same‐sex marriage policies between 2014 and 2015. Implementing state same‐sex marriage policies between 2004 and 2011 as well as between 2012 and 2013 were both significantly associated with a greater male PnR relative to implementing same‐sex marriage policies between 2014 and 2015. By 2019, the difference in male PrEP prescriptions was 137.9 (97.3−175.5) per 100,000 in states that implemented same‐sex marriage in 2004−2011 and 27.2 (23.3−30.5) per 100,000 in states that implemented same‐sex marriage from 2012 to 2013, relative to states that implemented same‐sex marriage in 2014−2015. Conclusions: Earlier implementation of state same‐sex marriage policies was associated with greater rates of male PrEP prescriptions. Reducing state‐level structural stigma may improve HIV prevention among MSM in the United States. [ABSTRACT FROM AUTHOR]

The 2022 monkeypox (MPX) outbreak was a source of consternation and stress among men who have sex with men (MSM)—the population disproportionately affected by the recent MPX outbreak. Individuals at high‐risk for MPX (e.g., MSM, sex workers) were prioritized for vaccination during early state and city health department vaccine initiatives across the U.S., but little is known about how the MSM sex work market was affected by the MPX outbreak in U.S. cities where MPX incidence was particularly high. To better characterize the potential relationship between MPX incidence and MSM sex worker advertising at the height of the U.S. MPX outbreak, we monitored advertising volume on an Internet advertising platform popular among MSM sex workers and compared these data to city and county health department MPX case reporting data during a 13‐week period (July 2nd, 2022‐ September 24th, 2022) in three U.S. cities with peak MPX incidence: Chicago, New York City, and San Francisco. In each of these cities, we observed a decline in advertising during or immediately following study week(s) with the highest number of weekly MPX cases during the study period, recognizing that observed decreases in advertising could be attributed to transient increase(s) in advertising during large‐scale LGBT festivals occurring during the study period. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) report childhood sexual abuse (CSA) at higher rates than heterosexual men. The literature has established a clear association between CSA and sexual risk taking. Biomedical HIV preventative approaches are effective tools for reducing HIV acquisition. Since many studies are conducted on MSM broadly, the objective of this review was to examine outcomes of studies on MSM with CSA histories and HIV biomedical approaches. The PRISMA checklist was used to extract data from the included studies. Of 124 studies retrieved, seven articles (n = 7) met the inclusion criteria. Studies included in the review were predominately correlational. Four themes were identified which were sexual behaviour, mental health, drug use/polydrug abuse and intimate partner violence. All identified variables impacted biomedical adherence either directly or indirectly. However, negative childhood experiences were not the dominant priority in the studies reviewed. In addition, there were confusion over how some variables were operationalized. This systematic review highlights the need for further research and intervention development based on past experiences and trauma, especially among MSM of colour. Approaches that incorporate past trauma should be the future focus of HIV prevention and management. [ABSTRACT FROM AUTHOR]