Search

Developmental assets are critical to the health and wellbeing of youth. The current study examines the influence of developmental assets on PrEP use and HIV testing among YBMSM ages 18-24. Using a cross-sectional survey of YBMSM (N = 225), this study explored the role of external (e.g., family support, other adult support) and internal (e.g., personal responsibility) assets in explaining HIV prevention behaviors. Participants were recruited from Mechanical Turk (M-Turk) internet-based platform, social media sites, and community-based organizations. A path analysis was conducted to investigate the direct/indirect effects of internal and external assets on PrEP use and HIV testing. Family support (β = 0.40, p

Background: HIV affects 1.2 million Americans, with 20% of new diagnoses being 13 to 24-year-olds. Young adult college students are more likely than the general population of 18 to 24-year-olds in the U.S. to engage in sexual practices that increase their risk of STIs. Objectives: This scoping review explores factors that promote or hinder STD/STI/HIV self-testing among U.S. college students. Search Methods: A scoping review of original, experimental (randomized or nonrandomized), observational (longitudinal and cross-sectional), and qualitative or mixed-methods U.S. research was conducted using OVID Medline, OVID Embase, PubMed, CINAHL, Web of Science Core Collection, and Cochrane CENTRAL. English-language studies measured STD/STI/HIV self-test kits and college student testing. Selection Criteria: Inclusion and exclusion criteria were used to narrow down articles that addressed barriers and facilitators to STD/STI/HIV testing, and self-testing among college students in the U.S. Results: Database searches yielded 8,373 articles. After removing duplicates, 6173 items remained. After independent dual-title/abstract screening, 100 papers were full-text reviewed. Seven retrieved articles were unavailable, and 93 were selected for full-text screening. After reviewing the whole text, 89 papers did not fulfill the inclusion requirements and were deleted, leaving 4 articles in the final analysis. Conclusion: Additional research on self-testing among college students in the U.S. is urgently required. The results should guide university health policies on the need to cater to the unique requirements of college students by increasing the availability of healthcare and embracing STD/STI/HIV self-testing. This can enhance testing rates, diminish stigmas, and ultimately contribute to wider endeavors to reduce the transmission of infections in the U.S. [ABSTRACT FROM AUTHOR]

Background: Apart from HIV acquisition, men who have sex with men are at a higher risk of sexually transmitted infections, especially syphilis. Although the intersection between syphilis and HIV poses a formidable challenge among key populations who are known to be vulnerable to many health threats, there is little known about syphilis infection among MSM living with HIV in Ghana. This study seeks to investigate the burden of syphilis and address the existing knowledge gap by exploring behavioral, healthcare access, and structural factors influencing the syphilis burden within the HIV-positive MSM population. Method: This study was conducted in 2023 as part of the bio-behavioral survey (BBS) among men who have sex with men (MSM) in Ghana. A cross-sectional survey that used a respondent-driven sampling (RDS) approach was conducted in the old ten regions of Ghana. Data was collected on 3,420 participants, however, 857 HIV-positive MSM were included in this study since it focused on syphilis among HIV-positive MSM in Ghana. The study estimated the prevalence of syphilis among MSM living with HIV and provided a 95% confidence interval across different categories of explanatory variables. Bivariate and multivariable logistic regression models were used to identify factors associated with overall syphilis prevalence. All other analyses were weighted due to the complex design of the study. Results: The overall prevalence of syphilis was 23.83% (95% CI: 20.44, 27.58). HIV-positive men who only had sex with men had a 29.77% (95% CI: 23.90, 36.40) prevalence of syphilis compared to a prevalence of 9.50% (95% CI: 2.56, 29.53) recorded by HIV-positive MSM who were attracted to mostly females. Participants who ever had receptive anal sex recorded a higher prevalence 26.79% (95% CI: 22.78, 31.23) than those who never had receptive anal sex 12.86% (95% CI: 8.02, 19.99). The odds of syphilis among HIV-positive MSM who never used condoms with regular sex partners in the last 6 months were 41.08 (aOR: 41.08 at 95% CI 1.24–136.42; p = 0.038). Conclusion: There is a high prevalence of syphilis among HIV-positive men who have sex with men in Ghana, especially among those who engage in unprotected anal sex and have multiple sexual partners. Our findings underscore the dire need for targeted interventions to address the dual brunt of HIV and syphilis among the MSM population in Ghana. [ABSTRACT FROM AUTHOR]

Among adolescents, HIV/AIDs remains a significant cause of death globally [1–4]. Given the unique stages in human development, adolescents have been shown to fall within a sexually active phase. Combined with other social and structural factors in their immediate environments, HIV prevention and care among adolescents can be filled with challenges for intervention. This paper outlines this protocol to systematically review peer-reviewed literature in prevention and care among adolescents 10–19 years. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) will be used to report this scoping review. The review will involve screening and extracting data using covidence as the primary tool. The review will encompass quantitative, qualitative, and mixed methods studies, utilizing a search strategy from electronic databases such as PubMed (NCBI), Web of Science Core Collection (Clarivate), Embase (Elsevier), and Scopus (Elsevier). Additionally, a search will be conducted for grey literature using Global Index Medicus (WHO), MedNar (Deep Web Technologies), and Central Register of Controlled Trials (Cochrane). Duplicate removal and selection of articles that meet the inclusion criteria for the study will be performed using Covidence. Once the screening process is complete, data will be extracted from the full-text screened articles in Covidence. We will pilot the extracted data in Covidence to ensure that all relevant information has been captured, making necessary changes if required. Data extraction will be carried out by at least two authors, with any conflicts resolved by the same authors. If a conflict cannot be resolved between the two, a third author will make a final determination. We aim to analyze data thematically by employing a grounded theory approach to generate codes pertinent to the research question. The team will review and discuss codes to create a cohesive set of codes that will be instrumental in identifying knowledge gaps and constructing themes that summarize the data. The proposed systematic review will be among the pioneering efforts to rigorously assess global data on HIV prevention and care, with a specific focus on adolescents 10–19 years. It will consider the diverse socio-economic factors and experiences shaping these adolescents' lives in HIV prevention and care. We expect this review to yield critical insights into the present landscape of HIV prevention and care for individuals aged 10–19. These findings will also play a pivotal role in shaping the development of a global framework that researchers and stakeholders can readily adopt and implement across socio-economic contexts. This framework will aim to address the unique needs of all adolescents concerning HIV prevention and care. [ABSTRACT FROM AUTHOR]

Introduction: Research has begun to examine human immunodeficiency virus (HIV) prevention strategies within the Ghanaian context. Still, little is known about specific populations such as gay, bisexual, and other cisgender men who have sex with men (GBMSM) living in slum communities. We studied HIV prevention strategies such as condoms and preexposure prophylaxis (PrEP) in slum communities and the awareness and willingness to use these choices among GBMSM. This qualitative study examines HIV prevention strategies, specifically examining PrEP and condom use behaviors among GBMSM in Ghana. Methods: We conducted in-depth face-to-face interviews among 12 GBMSM from slums in Accra and Kumasi cities in Ghana. Data were analyzed through a summative content analysis with multiple reviewers to develop codes. Data were collected from participants in January 2022. Results: We found the fear and perceived risk of infection were motivators for consistent condom use, especially during anal sex. GBMSM living with HIV receiving antiretroviral therapy were more inclined to use condoms. We found motivations for using PrEP were influenced by the type of sexual activity and a history of negative HIV status. Also, the barriers to PrEP for GBMSM included limited access to healthcare facilities and the distance to these facilities. Conclusions: To improve condom and PrEP access and uptake, we recommend addressing structural barriers by increasing the number of health facilities and implementing targeted interventions to address the lack of information on HIV awareness and prevention. Involving peer educators may also effectively promote HIV prevention strategies, especially in communities with limited access to healthcare such as slums. Overcoming these access constraints could significantly enhance awareness and prevention of HIV, leading to improved health outcomes for GBMSM living in slum communities. [ABSTRACT FROM AUTHOR]

Background: This study addresses the gap in the literature on protective factors for preexposure prophylaxis (PrEP) stigma and attitudes among Black men who have sex with men (BMSM) and young adults using the Developmental Assets Framework to examine how external assets (eg, family support, open family communication, and communication with parents about sex and drugs) can help reduce stigma and increase positive attitudes toward PrEP use. Methods: A cross-sectional survey was administered to participants (N = 400, mean age = 23.46, standard deviation = 2.59) using Amazon Mechanical Turk, social media sites, and community-based organization. A path analysis was conducted to examine associations between stigma and positive attitudes toward PrEP among external assets (family support, communication with parents about sex and drugs, and open family communication). Results: Communication with parents about sex and drugs was positive and directly associatedwith PrEP stigma (ß = 0.42, P < 0.001). Family support was negative and indirectly associated with stigma associated with PrEP (ß = -0.20, P < 0.001). Conclusions: This is the first study to use a developmental asset framework to assess positive PrEP attitudes and stigma among young BMSM. Our results underscore that parents have an influence on human immunodeficiency virus prevention behaviors for BMSM. In addition, their influence can be both positive by helping lowering PrEP stigma and negatively lowering PrEP attitudes. It is critical that we develop culturally competent human immunodeficiency virus and sexuality prevention and intervention programs for BMSM and their families. [ABSTRACT FROM AUTHOR]

Background: While GBMSM constitute less than 2% of Ghana's population, their HIV prevalence surpasses the national average by more than eightfold, emphasizing the critical need for targeted interventions to improve detection, care linkage, and reduce community transmission. This study seeks to increase HIV testing, Pre-Exposure Prophylaxis (PrEP), and Antiretroviral Therapy (ART) uptake (HPART) among YGBMSM through the adaptation of an evidence-based intervention (LAFIYA)., Methodology: We will employ the ADAPTT-IT framework to adapt LAFIYA and evaluate its feasibility and effectiveness in addressing intersectional stigma and increasing HPART uptake among YGBMSM residing in Ghanaian slums. In aim 1, we will hold focus groups (n=5) and interviews (n=20) among YGBMSM and two FGDs among GBMSM-led organizations. At the HCF level, we will hold 6 FGDs and interviews (n=20) among nurses. In AIM 2, we will randomly assign 6 healthcare facilities (HCFs) to receive the LAFIYA (n=3) or wait-list control (n=3). Friend groups (cluster) of YGBMSM (N=240) will be assigned to receive LAFIYA (n=120) or a wait-list control (n=120). We will collect 3-, 6-, and 9-months post-intervention data among YGBMSM(n=240) and HCWs(n=300) to measure HPART adherence (primary outcomes), ISD reduction, HIV and status-neutral knowledge (secondary outcomes), and intervention acceptability, appropriateness, and feasibility (implementation outcomes)., Conclusion: The intervention group will observe increased HPART adherence, reduced ISD, and enhanced HPART knowledge and efficacy relative to the wait-list control group. The findings will inform ISD reduction and HIV status-neutral implementation strategies - and place-based interventions that address access to HIV prevention and care among YGBMSM, slum and in different settings., Trail Registration: This study was registered on clinicalTrail.gov, with identifier number NCT06312514 on 03/14/2023. https://classic.clinicaltrials.gov/ct2/show/NCT06312514., Competing Interests: Additional Declarations: The authors declare no competing interests.

Background: Black men who have sex with men (MSM) experience disproportionately high HIV incidence globally. A comprehensive, intersectional approach (race, gender, and sexuality or sexual behavior) in understanding the experiences of Black MSM in Canada along the HIV prevention and care continuums has yet to be explored., Objective: This scoping review aims to examine the available evidence on the access, quality, gaps, facilitators, and barriers of engagement and identify interventions relevant to the HIV prevention and care continuum for Black MSM in Canada., Methods: We conducted a systematic database search, in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, of the available studies on HIV health experience and epidemiology concerning Black MSM living with or without HIV in Canada and were published after 1983 in either English or French. Searched databases include MEDLINE, Excerpta, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, the NHUS Economic Development Database, Global Health, PsycInfo, PubMed, Scopus, and Web of Science. From the 3095 articles identified, 19 met the inclusion criteria and were analyzed., Results: Black MSM in Canada consistently report multiple forms of stigma and lack of community support contributing to an increased HIV burden. They experience discrimination based on their intersectional identities while accessing HIV preventative and treatment interventions. Available data demonstrate that Black MSM have higher HIV incidences than Black men who have sex with women (MSW) and White MSM, and low preexposure prophylaxis knowledge and HIV literacy. Black MSM experience significant disparities in HIV prevention and care knowledge, access, and use. Structural barriers, including anti-Black racism, homophobia, and xenophobia, are responsible for gaps in HIV prevention and care continuums, poor quality of care and linkage to HIV services, as well as a higher incidence of HIV., Conclusions: Considering the lack of targeted interventions, there is a clear need for interventions that reduce HIV diagnoses among Black MSM, increase access and reduce structural barriers that significantly affect the ability of Black MSM to engage with HIV prevention and care, and address provider's capacity for care and the structural barriers. These findings can inform future interventions, programming, and tools that may alleviate this HIV inequity., International Registered Report Identifier (irrid): RR2-10.1136/bmjopen-2020-043055., (©Jemal Demeke, Pascal Djiadeu, Abban Yusuf, Darren Lovell Whitfield, David Lightfoot, Fiqir Worku, Gamji Rabiu Abu-Ba'are, Lawrence Mbuagbaw, Sulaimon Giwa, LaRon E Nelson. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 18.01.2024.)

Despite a disproportionately high burden of HIV, GBMSM in Ghana and sub-Saharan Africa often delay testing until the point of illness. However, limited studies examine factors that affect their participation in testing. We used qualitative in-depth interviews (IDIs) and focus group discussions (FGDs) to collect insights into experiences, motivators, and barriers to HIV testing among GBMSM. Two community-based organizations used snowball and convenience sampling to recruit 10 GBMSM for IDIs and 8 to 12 for FGDs. We transcribed, coded, identified, and analyzed the relationship and commonalities between the participants' responses. Under experiences with testing, 1) fear of HIV infection created a stressful HIV testing experience, and 2) a friendly and supportive healthcare environment facilitated a positive experience in healthcare facilities. Motivators or facilitators of testing include 1) the perception or belief that HIV testing is an HIV prevention strategy; 2) encouragement from friends and peers; 3) understanding risk associated with certain sexual behaviors; 4) education or information on HIV; 5) access to free testing and incentives; 6) early symptoms and provider recommendation. Barriers to HIV testing include 1) negative community perceptions of HIV; 2) individual-level low-risk perception or indifference about HIV infection; 3) health system issues; 5) Perceived stigma at healthcare facilities. The findings point to the need to address critical issues around stigma, education, peer support, and healthcare resources through interventions and research to improve HIV testing among GBMSM in the country., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Abu-Ba’are et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

It can be challenging for sexual minority men (SMM) to decide whether or not to disclose their sexual orientation or behavior. The implications of this decision are significant, especially when considering how their family might react. We interviewed individuals living in slum communities (n = 12) in Accra and Kumasi, Ghana. Our study found that two factors primarily influenced the decision of SMM to disclose their sexual orientation. Firstly, SMM feared facing harm from their families and, secondly, the close ties of SMM families to religious institutions in their communities, which taught against LGBTQ+ activities in the country. These findings contribute to understanding why SMM in Ghanaian slum communities choose to keep their sexual orientation anonymous. While no single intervention is enough to address the challenges associated with coming out, participants in the study agreed that a social support intervention that provides opportunities to educate and inform their families and community on LGBTQ+ activities could help them assimilate comfortably in their communities., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Shamrock et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)