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In the United States, immigrant Latino men who have sex with men (ILMSM) are, compared to white MSM, disproportionately burdened by HIV and lack access to highly effective HIV prevention strategies, such as pre-exposure prophylaxis (PrEP). Qualitative research centered on exploring barriers that ILMSM experience in accessing PrEP and other sexual services is extremely limited, despite a high prevalence of HIV in this population. In this study, a purposive sample of ILMSM (n = 25) was recruited to participate in a semi-structured in-depth interview to identify the distinct barriers and facilitators ILMSM experience in accessing sexual health services given their complex intersectional identities of being an immigrant, Latino, and a sexual minority man. Using a thematic analysis approach, nine themes were generated from the data representing barriers and facilitators. Barriers included: (1) cost and a lack of health insurance, (2) complexity of PrEP assistance programs; (3) challenges related to the immigrant experience; (4) impact of gay stigma; and (5) communication challenges. Facilitators included: (1) improving affordability and accessibility of PrEP services; (2) receiving services from LGBT- or Latine LGBT-centered clinics; (3) receiving services from medical providers who are gay and/or Latino; and (4) providing targeted community outreach, education, and promotion of PrEP to ILMSM. While many of the barriers illuminated in the study were structural (e.g., cost and lack of health insurance), and not easy to overcome, the findings highlight a range of facilitators that can support access to PrEP and other sexual health services for ILMSM. Considering these findings, we suggest strategies that may enhance access to needed sexual health services among ILMSM.

Mobile technology growth in Nepal offers promising opportunities for using mobile health (mHealth) interventions to facilitate HIV prevention efforts. However, little is known about access and utilization of communication technology and their willingness to use mHealth for HIV prevention services in Nepal. We conducted a cross-sectional respondent-driven sampling survey of 250 MSM in Kathmandu Valley of Nepal from October to December 2022. We collected information on participant characteristics, HIV risk-related behaviors, ownership, or access to and frequency of use of communication technology (phones, tablets, laptops, and computers), and willingness to use mHealth to access HIV prevention services. Descriptive, bivariate, and multivariate linear regression analyses were performed. Almost all participants had smartphones with the internet (231/250, 92.4%) and accessed the internet daily (219/250, 87.6%) on the smartphone (236/250, 94.4%). The median score for willingness to use mHealth for HIV prevention was 10 (IQR: 3 to 17). Willingness to use mHealth was higher among those participants with a high school or above education (β = 0.223, p = < 0.001), had experienced violence (β = 0.231, p = 0.006), and had moderate to severe depressive symptoms (β = 0.223, p = < 0.001). However, monthly income above NPR 20,000 (USD 150) (β= -0.153, p = 0.008), disclosure of their sexual orientation to anyone (β= -0.159, p = < 0.007), and worry about being negatively judged by health care workers (β= -0.136, p = 0.023) were less willing to use mHealth strategies. The findings from this study suggest that there is a high willingness for utilizing mHealth interventions for HIV prevention in MSM population who are at higher risk of HIV acquisition.

Mycoplasma genitalium causes a sexually transmitted infection and is also emerging as an important antimicrobial resistant pathogen. Data on M. genitalium infections among men who have sex with men (MSM) in low-resource settings are sparse.From January to December 2022, participants in an HIV pre-exposure prophylaxis (PrEP) program in Hanoi, Vietnam were enrolled into the study. Demographic, behavioral, and clinical characteristics were collected. Self-collected urine, rectal, and pharyngeal specimens were tested for M. genitalium using the Alinity m STI Assay (Abbott Molecular, USA). Univariate and multivariate logistic regression were performed to assess for factors associated with infections.Among 477 participants, the median age was 25.3 years (21.7-29.6) and 92.2% (n = 440) identified as MSM; 48.6% had ≥2 sex partners and 38.1% reported condomless anal sex in the prior month. The overall prevalence of M. genitalium infection was 10.9% (52/477); 7.3% (34/464) rectal, 3.2% (15/476) urethral, and 1.9% (9/476) pharyngeal. Infections were asymptomatic in 71.2% (37/52). Among those with M. genitalium, 30.7% (16/52) were co-infected with either N. gonorrhoeae or C. trachomatis. Among those reporting rectal (n = 51) or urethral (n = 35) symptoms, but without C. trachomatis or N. gonorrhoeae co-infections, five (9.8%) had rectal infections and one (2.9%) had urethral infection. Participants with M. genitalium were more likely to be asymptomatic than participants without M. genitalium (aOR 1.93; 95% CI 1.01-3.71).M. genitalium infections were common among primarily MSM engaged in an HIV PrEP program in Vietnam. The prevalence was highest in rectal specimens and nearly three quarters of M. genitalium infections were asymptomatic. Testing for M. genitalium infections among those with symptoms is important to enable pathogen-directed therapy. Additional research on antimicrobial resistance and treatment strategies for M. genitalium in low-resource settings is needed.

IntroductionHPTN 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.MethodsParticipants 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.ResultsParticipants (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).ConclusionsRespondents 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.

BackgroundDespite high rates of HIV transmission among men who have sex with men (MSM) in Lima, Peru, limited data exist on the sexual network characteristics or risk factors for secondary HIV transmission among MSM with uncontrolled HIV infection. We report the frequency of serodiscordant, condomless anal intercourse (CAI) and associated sexual network characteristics among MSM in Lima with detectable HIV viremia and compare to those with undetectable viremia.MethodsThis cross-sectional analysis includes MSM who tested positive for HIV-1 during screening for a trial of partner management and STI control (June 2022-January 2023). Participants were tested for HIV, gonorrhoea, chlamydia, and syphilis, and completed questionnaires on their demographic characteristics, sexual identity and behaviour, sexual network structures and engagement in HIV care.FindingsOf 665 MSM, 153 (23%) had detectable (>200 copies/mL) viremia. 75% (499/662) of men living with HIV were previously diagnosed, with 94% (n = 469/499) reporting that they were on ART, and 93% (n = 436/469) virally suppressed. 96% (n = 147/153) of men with detectable viremia reported serodiscordant CAI with at least one of their last three sexual partners, and 74% (n = 106/144) reported the same with all three of their recent partners. In contrast, 62% (n = 302/489) of men with undetectable viral load reported serodiscordant CAI with all of their last three partners (p

IntroductionMethamphetamine use is highly prevalent among men who have sex with men (MSM), but knowledge of the long-term dynamics, and how they are affected by substance use treatment, is limited. This study aimed to describe trajectories of methamphetamine use among MSM, and to evaluate the impact of treatment for any kind of substance use on frequency of methamphetamine use.MethodsThis analysis used data from a cohort of MSM in Los Angeles, CA, who participated in semi-annual study visits from 2014 to 2022. The study characterized trajectories of methamphetamine use using a continuous time multistate Markov model with three states. States were defined using self-reported frequency of methamphetamine use in the past six months: frequent (daily), occasional (weekly or less), and never. The model estimated the association between receiving treatment for any kind of substance use and changes in state of frequency of methamphetamine use.ResultsThis analysis included 2348 study visits among 285 individuals who were followed-up for an average of 4.4 years. Among participants who were in the frequent use state, 65 % (n = 26) of those who were receiving any kind of substance use treatment at a study visit had reduced their methamphetamine use at their next visit, compared to 33 % (n = 95) of those who were not receiving treatment. Controlling for age, race/ethnicity, and HIV-status, those who reported receiving current treatment for substance use were more likely to transition from occasional to no use (HR: 1.63, 95 % CI: 1.10-2.42) and frequent to occasional use (HR: 4.25, 95 % CI: 2.11-8.59) in comparison to those who did not report receiving current treatment for substance use.ConclusionsFindings from this dynamic modeling study provide a new method for assessing longitudinal methamphetamine use outcomes and add important evidence outside of clinical trials that substance use treatment may reduce methamphetamine use.

Homoprejudiced violence is a type of aggression against an individual or a community based on their actual or perceived sexual orientation. It may be linked to risks of acquiring HIV/STI via psychosocial variables. This study explored the association between homoprejudiced violence experiences and high-risk sexual behaviors, and potential psychosocial mediators. Using cross-sectional survey data collected in China through Blued among men who have sex with men (MSM) in January 2021, this study conducted multiple mediation analyses. Standard instruments were used to collect data on depressive symptoms in the last two weeks (PHQ-9), recreational drug usage in the last three months, and ever experiencing homoprejudiced violence (12-item survey instrument). Dependent variables were having condomless anal sex and having three or more sexual partners in the last three months. Among 1828 MSM, nearly half (847, 46%) had experienced homoprejudiced violence. Twenty-three percent (427) reached a score that suggested moderate or severe depression and 35% (644) had used recreational drugs. In the last three months, 40% (731) had condomless anal sex and 34% (626) had three or more sexual partners. The indirect mediational coefficients through depression on condomless anal sex and multiple sexual partners were 0.04 (95% CI: [0.02, 0.07]) and 0.02 (95% CI: [0.001, 0.05]), respectively. The indirect mediational coefficient of homoprejudiced violence experience on multiple sexual partners through recreational drug use was 0.05 (95% CI: [0.03, 0.08]). These findings suggest that more comprehensive interventions are needed to address the syndemic of homoprejudiced violence, mental health issues, and HIV/STI-related risks.

Background: Rates of cocaine use disorder (CUD) among men who have sex with men (MSM) are high and rising. Among MSM, cocaine use is associated with negative socioeconomic, medical, and psychological outcomes. There are no FDA-approved pharmacotherapy options to treat CUD, and psychosocial interventions demonstrate limited efficacy. While there have been numerous trials evaluating possible medications for CUD, there is a scarcity of qualitative data on the barriers and facilitators of medication-assisted treatment. Methods: Semi-structured interviews were conducted with 16 participants enrolled in a phase II randomized control trial evaluating extended-release lorcaserin among MSM with CUD. Participants were asked about their motivations for enrolling in the study, attitudes towards taking a medication for CUD, barriers and facilitators of study pill adherence, and their general study experience. Interviews were analyzed using an inductive and exploratory approach to thematic analysis. Results: Participants were highly motivated to reduce cocaine use and viewed pharmacotherapy as a viable and desirable treatment option. Pharmacotherapy was seen as having fewer access and adherence structural barriers compared to existing psychosocial therapies. Medication reminders facilitated pill taking, while side effects, travel, and active substance use presented barriers to study pill adherence. Disclosure of study participation within social networks was variable pointing to anticipated substance use and treatment stigma. Conclusions: Our study highlights important factors affecting the acceptability and uptake of medication-assisted treatment for CUD among a diverse sample of MSM. These findings can help guide the development and implementation of future pharmacotherapy options for CUD and other substance use disorders in this key population. [ABSTRACT FROM AUTHOR]

Background: Men who have sex with men (MSM) are disproportionately affected by sexually transmitted infections (STI) including Neisseria gonorrhoeae (Ng) and Chlamydia trachomatis (Ct). The lack of robust data on STIs among African MSM has limited the development of evidence-based screening strategies. This study aimed at documenting the pooled prevalence of Ng/Ct among MSM in sub-Saharan Africa (SSA). Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) 2020 guidelines. Relevant articles from the following databases were searched: PubMed, Scopus, ISI Web of Science, and the Directory of Open Access Journals (DOAJ). Eligible studies reported on the prevalence of Ng/Ct among the MSM population in SSA. Publication bias was assessed using the Hoy tool, Doi plot, and LFK ratio. Due to heterogeneity among studies, subgroup analyses were performed using the MetaXL add-on tool for Microsoft Excel. Results: Of 525 articles screened, 20 were selected for inclusion. Six were cross-sectional, four had a prospective cohort study design, and one was an epidemiological study. The pooled prevalence of Ng/Ct in MSM was 27% (95% CI, 19–39%), with an I2 of 98% signifying heterogeneity among the studies. Subgroup analysis by country revealed South Africa had the highest prevalence (38%). Discussion: Interpretation The high prevalence of Ng/Ct infection among MSM in SSA is of concern. Limitations Due to limited data available on Ng/Ct prevalence, the true prevalence of SSA and its associated risk factors is uncertain. Conclusion: As the first study to systematically review the available literature on STI prevalence among the MSM population in SSA, it showed the burden of Ng/Ct is higher than in other regions, warranting the strengthening of health systems to improve education, testing, and treatment in MSM population. Systematic review registration: PROSPERO CRD42022327095. [ABSTRACT FROM AUTHOR]

The surging rates of STIs necessitate medical practitioners in the appropriate specialties to focus on rapid recognition, treatment and prevention of these conditions. Through both pre‐ and post‐exposure prophylaxis with doxycycline, dermatologists can provide up‐to‐date treatment in the field of venereology. Herein, we review the results of clinical trials in the available literature that investigate doxycycline prophylaxis in the prevention of bacterial STIs. A search was performed using the PubMED and Scopus databases which yielded six clinical trials for our review. Based on the results of these clinical trials, doxycycline prophylaxis offers significant reductions in bacterial STIs, specifically in men who have sex with men (MSM). Additional research is needed in other high‐risk groups, including females. Moreover, additional research is needed to determine the effects of doxycycline prophylaxis on tetracycline resistance in STI‐causing bacteria. As the utilization of doxycycline prophylaxis for STIs becomes more common, it is important that dermatologists become familiar with the data surrounding this prevention regimen and patient populations who may seek to know more about it. More research is needed to determine benefits in other subpopulations, antimicrobial resistance and cost effectiveness. [ABSTRACT FROM AUTHOR]

Background: Men who have sex with men studying in universities (MSM-US) frequently face multiple sexual minority stressors that potentially lead to maladaptive emotional regulations and mental problems. This study compared the prevalence of depression/insomnia between MSM-US and non-MSM male university students (NUS) and hypothesized that the potential differences would be mediated via emotional dysregulation styles (rumination and catastrophizing). Methods: The study design was a cross-sectional study. NUS were recruited from a university-based survey using cluster sampling in three universities in China from June to October 2018, while MSM-US from the same university-based survey and the other community-based survey using convenience sampling. The effective samples size was 2,531 (292 MSM-US and 2,239 NUS). Structural equation modeling (SEM) was performed. Results: MSM-US had significantly higher prevalence of both probable depression (55.1% versus 35.7%; OR = 4.85, 95% CI: 3.38–6.94) and moderate-to-severe clinical insomnia (17.3% versus 4.1%; OR = 2.21, 95% CI: 1.73–2.83) than NUS. MSM-US were also more likely than NUS to use emotional dysregulation styles (rumination/catastrophizing), which were correlated with probable depression/insomnia (r = 0.17 to 0.31). In the SEM, the differences in depression/insomnia between MSM-US and NUS were partially mediated by the latent variable of emotional dysregulation (rumination and catastrophizing), with effect sizes of 55.0% for probable depression and 33.6% for insomnia, respectively. Conclusions: Depression and insomnia were prevalent among male university students in Sichuan, China. Furthermore, MSM-US were at increased risk than NUS for both mental problems; emotional dysregulation partially explained such differences. Future studies are warranted to confirm the findings, develop tailored interventions to address general and MSM-specific stressors and reduce rumination and catastrophizing, and examine whether similar patterns exist in other sexual minority groups. [ABSTRACT FROM AUTHOR]

To identify differences in human immunodeficiency virus (HIV) risky behavior and healthy practices between rural and urban men who have sex with men (MSM) in Southeast China, a cross-sectional study was conducted on MSM aged ≥ 18 years recruited from four community-based organizations (CBOs) in seven cities in Zhejiang Province between October 2022 and March 2023. An electronic survey questionnaire was completed by the study participants to collect HIV risky behavior and healthy practices. The chi-square test and multiple logistic regression were used for analysis. Among the 1,993 MSM participants, 21.1% (420) were rural MSM. Compared with urban MSM, rural MSM was more likely to have a low level of education (high school and below; 46.2% vs. 40.2%, p = 0.028) and a low annual income (≤ 90,000 RMB; 71.2% vs. 64.7%, p = 0.013). Multiple logistic regression showed that, compared with urban MSM in the past 6 months behaviors, rural MSM had lower odds of finding casual sex partners on the Internet (adjusted odds ratio [aOR]: 0.790, 95% confidence interval [CI]: 0.633–0.986), using stimulants with online casual sex partners (aOR: 0.688, 95% CI: 0.506–0.936), and high odds of ever having sex with a female (aOR: 1.460, 95% CI:1.036–2.058). Rural MSM reported lower odds of an HIV knowledge score of 2–3 (aOR: 0.586, 95% CI: 0.454–0.756), HIV testing more than twice (aOR: 0.583, 95% CI: 0.455–0.748), and obtaining four to five types of HIV information (aOR: 0.661, 95% CI: 0.529–0.826), as well as higher odds of high/very high awareness of HIV infection risk (aOR: 2.312, 95% CI: 1.638–3.263), compared to urban MSM. Rural MSM and urban MSM reported discrepancies in HIV risky behavior, HIV knowledge and HIV-related healthy practices. Paying more attention to HIV risky behavior and improving healthy practices in rural areas may help to prevent HIV transmission. [ABSTRACT FROM AUTHOR]

Background: In Taiwan, the human immunodeficiency virus (HIV) is primarily transmitted among men who have sex with men (MSM). We believe that the primary source of heterogeneity influencing transmission is from whether the infected individuals engage in behaviors that promote transmission. Therefore, we differentiated and modeled the statuses of infected individuals, estimated parameters, and predicted future infection trends to better understand HIV transmission dynamics among MSM. Methods: We devised a computational approach to accurately estimate the number of infectious individuals during early surveillance years in Taiwan using monthly data of newly diagnosed patients with HIV from January 2005 to December 2006. Subsequently, using annual incident cases from 2005 to 2019, we estimated the susceptibility rate, transmission rates, and duration of risk and conducted short-term forecasts of HIV infection among MSM through mathematical modeling based on the susceptible-infected-removed model. Parameters and their values, such as HIV and acquired immunodeficiency syndrome (AIDS) transmission rates and removal rates, were also estimated. Results: A total of 850 infectious individuals with HIV were identified in 2005. From 2005 to 2019, approximately 0.68% (95% confidence interval: 0.64–0.71%) of Taiwan's male population were estimated to be susceptible to HIV infection via MSM. The transmission rate did not significantly differ between individuals with HIV and AIDS (0.0110 and 0.107 per 10,000 individuals, respectively). The average infection duration between infection and AIDS onset was 4.5 years and between AIDS onset and death was 2.1 years. In 2019, the proportion of infectious infected individuals continuously decreased. By 2026, only 11.85% and 10.21% of individuals with HIV and AIDS, respectively, will be infectious. Conclusions: Our study presents a new dynamic mathematical model for estimating infectious HIV cases among MSM in Taiwan. By accounting for the heterogeneity of infectious HIV/AIDS within the MSM population, we effectively estimated the number of infections during early surveillance years and implement concentrated measures, thereby reducing infectious HIV/AIDS cases, which contributes to the overall reduction in HIV/AIDS cases. With these estimations, identifying target populations and implementing effective intervention measures at appropriate times can be improved. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) who use dating applications (apps) have higher rates of engaging in condomless anal sex than those who do not. Therefore, we conducted a two-arm randomized controlled trial to evaluate the effectiveness of an interactive web-based intervention in promoting safer sex among this population. The intervention was guided by the Theory of Planned Behavior and co-designed by researchers, healthcare providers, and MSM participants. The primary outcome was the frequency of condomless anal sex in past three months. Secondary outcomes included five other behavioral outcomes and two psychological outcomes. This trial was registered on ISRCTN (ISRCTN16681863) on 2020/04/28. A total of 480 MSM were enrolled and randomly assigned to the intervention or control group. Our findings indicate that the intervention significantly reduced condomless anal sex behaviors by enhancing self-efficacy and attitudes toward condom use among MSM dating app users, with the effects sustained at both three and six months. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion In Japan, despite low nationwide hepatitis C (HCV) incidence, new infections among people who inject drugs (PWID) and men who have sex with men (MSM) hinder HCV elimination. We explored HCV transmission dynamics and screened HCV recombination within these populations.This cross‐sectional study recruited HCV‐infected patients from Osaka National Hospital, Osaka, Japan, from January 2010 to September 2023. Data from questionnaires and medical records were analyzed. Serum samples collected before anti‐HCV treatment underwent HCV RNA extraction, and sequencing of full core (576 bp) and NS5B (267 bp) regions using the Sanger method. Genotype distribution was determined by phylogenetic analysis, and recombinant screening was conducted.A total of 115 patients were categorized into non‐MSM PWID (31), MSM PWID (15), MSM non‐PWID (25), and non‐MSM non‐PWID (44). Positive amplification rates were 99.1% (114/115) for the full‐core region, and 96.5% (111/115) for NS5B. No intergenotypic recombination was detected. The predominant genotype in non‐MSM PWID was 2a (58%), whereas genotype 1b was most common in MSM PWID, MSM non‐PWID, and non‐MSM non‐PWID groups (79%, 64%, and 68%, respectively). Nucleotide sequence similarity of 94.75%–100% was found in HCV strains from MSM PWID and MSM non‐PWID in both full‐core and NS5B regions, whereas strains from non‐MSM PWID and non‐MSM non‐PWID were distinct.The findings suggest that the transmission route in PWID is determined by MSM status, whereas MSM groups showed the same transmission route regardless of PWID. HCV control measures should be focused not only on PWID, but also on MSM to achieve HCV elimination in Japan. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Assessing the potential increased risk of viral rebound (VR) in migrants requires adequate control for sex and acquisition risk groups.People living with HIV1, enrolled in the ANRS CO4‐French Hospital Database on HIV, who achieved virological suppression with antiretroviral therapy (ART) initiated between 2006 and 2016 were included. We first compared the risk of VR, with loss to follow‐up and death considered as competing events, across origin among the HIV acquisition groups, then across acquisition groups among the different origins, and finally across modality of a variable combining sex, acquisition group, and origin. Models were adjusted for clinical and biological confounding factors.We included 21 571 French natives (FRA), 10 148 migrants from sub‐Saharan Africa (SSA), 1137 migrants from the non‐French West Indies (NFWI), and 4205 other migrants (OTHER). The 5‐year probability of VR was 19% (95% confidence interval [CI] 19–20) overall, 15% in FRA, 21% in OTHER, 26% in SSA, and 34% in NFWI (p < 0.0001). It was 14% in men who have sex with men (MSM), 23% in heterosexual men, and 23% in women (p < 0.0001). After adjustment, all acquisition groups had a higher risk of VR than MSM from FRA, with men and women from NFWI having the highest risk (adjusted hazard ratio [aHR] 2.46; 95% CI 2.12–2.86 and aHR 2.59; 95% CI 2.20–3.04, respectively). Within each acquisition group, all groups of origin had a higher risk of VR than FRA. Within each region of origin, except the NFWI, heterosexual men had a higher risk of VR than MSM.After accounting for sex and acquisition group, migration, especially from NFWI, remains prognostic of VR. [ABSTRACT FROM AUTHOR]

Background and Objectives: 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. Materials and Methods: This study compares infection surveillance indicators between two 30‐month periods before (P1) and after (P2) this second deferral change. Results: 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). Conclusion: 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]

Introduction: Men who have Sex with Men (MSM) are at highrisk for acquiring Sexually Transmitted Infections (STIs). The high prevalence of STIs, such as syphilis, Human Immunodeficiency Virus (HIV), genital herpes, genital warts, gonorrhea, and hepatitis B, necessitates regular screening in the MSM group. Furthermore, the presence of these STIs increases the transmission of HIV. Unfortunately, limited data are available regarding STI prevalence among MSM in India. Understanding the prevalence in this high-risk group aids in rapid diagnosis and effective control of infections, thereby reducing their transmission. Aim: To analyse the prevalence of STIs in the MSM group in Venereology Outpatient Department (OPD) in a Tertiary care centre, Chennai, Tamil Nadu, India. Materials and Methods: A record-based cross-sectional study was conducted at a tertiary care centre in Chennai, Tamil Nadu, India over a period of one year (January 2023 - December 2023). The study included 110 men who were brought in by voluntary organisations or who walked in directly to the Venereology department and identified themselves as homosexuals. Their socio-demographic data, detailed contact history, chief complaints, relevant investigations, and treatments provided were recorded and analysed. All data were analysed using Statistical Package for the Social Sciences (SPSS) software. Results: Out of the 110 men enrolled in this study, most were in the 18 to 29 years age group, and a predominant 58 (52.72%) reported engaging in unprotected sexual practices. Specifically, 67 (60.91%) of the men identified themselves as strictly homosexuals, while 43 (39.1%) identified as bisexuals. Further inquiry about their partners revealed that 24 (21.82%) had contact with known partners, while 86 (78.18%) had contact with unknown partners, primarily through dating apps and social media platforms. Among the 42 patients diagnosed with STIs, syphilis was the most common, affecting 15 (13.63%) individuals. The second most common STI was HIV, seen in 10 (9.09%) of which 4 had co-infection with syphilis. The next most common STIs diagnosed were genital herpes in 7 (6.36%), gonorrhea in 6 (5.45%), genital warts in 3 (2.73%), hepatitis B in 3 (2.73%), and genital scabies in 2 (1.81%). Conclusion: The prevalence of STIs in this study was found to be 38.18%. This study underscores the importance of understanding the prevalence of STIs, which may aid in targeted interventions to address STI transmission, particularly among young adults and MSM populations. Efforts should focus on promoting safer sexual practices, increasing access to testing and treatment, and providing education and support to both individuals and their partners. [ABSTRACT FROM AUTHOR]

Objectives: 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. Methods: 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. Results: 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. Conclusion: Compared with MSM without HIV, MSM with HIV in Denmark report a higher burden of mental health and sex life challenges. [ABSTRACT FROM AUTHOR]

In China, HIV transmission increasingly affected men who have sex with men (MSM) and those in heterosexual marriages. This study addressed a critical gap in understanding HIV and sexual orientation disclosure within conventional heterosexual marriages, framed within a family-oriented cultural context. Heterosexually married MSM living with HIV (HIV+ MMSM) faced complex identity dynamics and interactions between "gay circles" and marital life. Such disclosure was fraught with potential repercussions, including accusations of "marriage fraud", HIV-related stigma, and divorce. This descriptive qualitative study, conducted in 2022, aimed to explore the common factors influencing HIV status disclosure to wives among Chinese HIV+ MMSM. Sixteen semi-structured interviews were conducted to analyze the factors related to the disclosure process model. Four key themes emerged: (a) concern for wives' well-being, (b) perceived marriage strength, (c) the degree of social support they had, and (d) a desire to maintain their status in a heterosexual society. The decision to (non)disclose was shaped by both approach-focused and avoidant-focused goals related to these four themes. The findings underscored the need for culturally sensitive strategies that balance family dynamics, stigma reduction, and HIV care management, emphasizing tailored approaches to effectively support this population. [ABSTRACT FROM AUTHOR]

Introduction: 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. Methods: 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. Results: 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). Discussion and Conclusions: 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]

Background: The social distancing measures associated with the COVID-19 pandemic had far reaching effects on sexual behavior worldwide. However, it remains unclear whether sexual contact with non-steady partners was a contributor to the spread of SARS-CoV-2. The aim of this study was to (i) describe risk factors for SARS-CoV-2 seropositivity after the first pandemic wave among people using HIV Pre-Exposure Prophylaxis (PrEP) in Zurich, Switzerland, including sexual contact with non-steady partners, and (ii) assess whether the SARS-CoV-2 seropositivity among PrEP users in this time period differed from that of a demographic matched population level comparison group. Methods: The study was conducted between July 2020 and October 2020 as a nested cross-sectional study within two ongoing cohort studies, SwissPrEPared (all eligible PrEP users in Switzerland ≥ 18 years old) and Corona Immunitas (a series of cross-sectional and longitudinal studies measuring the SARS-CoV-2 seroprevalence across Switzerland, beginning in April 2020). All SwissPrEPared participants were recruited from Checkpoint Zurich (the main PrEP clinic in Zurich) and were men having sex with men or transgender women. Data were collected on participants' SARS-CoV-2 antibody status, social characteristics and behavioral data after the first wave of the pandemic in Switzerland, and seroprevalence was compared with a propensity score-matched sample from the general Zurich population. Results: Of the 218 participants enrolled, 8.7% (n = 19, 95% CI: 5.5–13.5%) were seropositive for SARS-CoV-2 during the first pandemic wave, higher than that of the general male population in Zurich aged 20–65 (5.5%, 95% CI: 3.8–8.2%). Participants on average reduced their social outings, but the seronegative were more socially active before, during, and after the first lockdown period. In a logistic model, increasing mean sexual partner count was not associated with seropositivity (OR: 1.02, 95% CI: 0.95, 1.07). The estimated risk ratio for seropositivity for the participants compared to the general Zurich population after propensity score matching was 1.46 (95% CI: 0.53, 3.99). Conclusions: Our study suggests that SARS-CoV-2 seropositivity was slightly elevated among people taking PrEP in Zurich during the first wave of the pandemic, but that socializing and sexual activity were less important than other factors in contributing to risk. [ABSTRACT FROM AUTHOR]

Objective: Linkage to HIV medical care is important in the continuum of HIV care and health outcomes for people with HIV. The objective of this analysis was to identify how the community-based organization (CBO) program contributes to linkage to HIV medical care among people with newly diagnosed HIV in the Centers for Disease Control and Prevention's (CDC's) HIV testing program. Methods: We analyzed HIV linkage-to-care data submitted to CDC from 2019 through 2021. Linkage was defined as confirmation that an individual attended their first HIV medical care appointment within 30 days of their HIV test date. We included in the analysis data submitted from the health department (HD) program that included 61 state and local HDs in the United States, Puerto Rico, and the US Virgin Islands and the CBO program that included 150 CBOs. Results: The CBO program linked a higher proportion of people to HIV medical care within 30 days of diagnosis (86.7%) than the HD program (73.7%). By population group, the proportion linked in the CBO program was higher than the proportion linked in the HD program among men who have sex with men (prevalence ratio [PR] = 1.13; P <.001), men who have sex with men/people who inject drugs (PR = 1.29; P <.001), transgender people (PR = 1.28; P <.001), and those reporting no sexual contact or injection drug use (PR = 1.34; P <.001). In the Cox proportional hazards model, time to linkage in the CBO program was significantly shorter than in the HD program (hazard ratio = 0.63; P <.001). Conclusion: This analysis shows that the CBO program fills a vital need in linking newly diagnosed HIV-positive people to HIV medical care, which is important in the HIV care continuum and for viral suppression. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) adherence remains a challenge among young men who have sex with men (MSM). We developed and tested a smartphone application ("app"), "DOT Diary", which combines automated directly observed therapy (DOT) with information about PrEP protection levels, pill-taking reminders, a sexual behavior diary, and a PrEP dosing calendar. To contextualize trial results, we qualitatively explored participants' app experiences. The trial enrolled 100 young MSM in San Francisco and Atlanta. Participants were randomized 2:1 to DOT Diary versus standard-of-care and followed for 24 weeks. Interviews were conducted with 24 intervention participants. Data were analyzed using a memo-writing approach. Most expressed overall satisfaction with the app ("it was good for its purpose"), despite concerns about technical glitches. The most popular app features were the monthly calendar showing days PrEP was taken and information about level of protection based on pills taken. The DOT component helped participants establish PrEP routines. The reminders were "annoying but effective" at motivating dosing. Opinions about the sexual behavior diary varied. Overall, DOT Diary was acceptable; participants were willing to use it daily to record pill-taking. Critical components included the information about PrEP protection levels and calendar, while others may be modified to improve future success. Trial registration: ClinicalTrials.gov identifier: NCT03771638. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the interest in event-driven PrEP (ED-PrEP) among men who have sex with men (MSM) using daily PrEP in Mexico's PrEP demonstration project between 2019 and 2020. We compared participants interested or not in ED-PrEP during their first-month visit and identified associated factors. Of 1,021 MSM attending their first-month visit, 7% had previous knowledge of ED-PrEP, but 40% were interested in ED-PrEP. However, over 50% perceived the scheme as less protective than daily PrEP. Having doubts about ED-PrEP's level of protection was related to less interest in the scheme (aOR = 0.11; CI = 0.07–0.18), just like reporting perceived barriers such as having frequent sex (aOR = 0.06; CI = 0.03–0.14), unplanned sex (aOR = 0.17; CI = 0.11–0.27), forgetting the medicine (aOR = 0.06; CI = 0.03–0.12), or difficulty carrying the medicine (aOR = 0.13; CI = 0.07–0.25). Finally, reporting not taking PrEP for >20 days in the last month (aOR = 0.05; CI = 0.01–0.27) diminished interest in ED-PrEP. In conclusion, few MSM daily PrEP users knew about ED-PrEP yet many were interested in it, suggesting the importance of awareness campaigns regarding ED-PrEP's effectiveness. The lack of interest in ED-PrEP among participants with poor adherence to daily PrEP indicates that they might prefer long-acting PrEP or HIV prevention strategies without medication. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) and are engaged in transactional sex (MSM-TS) experience complex social and structural vulnerabilities that increase their HIV risk. This study aimed to estimate the prevalence of TS and associations between TS and sexually transmitted infection (STI) outcomes among cisgender MSM in the U.S. Using 2017–2021 data from an online survey of U.S. MSM, characteristics of MSM-TS were summarized, and adjusted prevalence ratios (aPRs) calculated for the associations between past-year TS and bacterial STI diagnosis, HIV status, and either antiretroviral or pre-exposure prophylaxis use. Analyses were conducted in 2023. TS prevalence was 3.7% (n =1,848/49,539). Compared to other MSM, MSM-TS more commonly reported homelessness, being uninsured, condomless anal sex with partners of any HIV status and condomless anal sex with serodifferent partners, and illicit drug use. TS was associated with increased HIV (aPR 1.44, 95% CI 1.25–1.66) and bacterial STI prevalence (aPR 2.40, 95% CI=2.09–2.52) and lower antiretroviral therapy use (among MSM living with HIV; PR 0.92, 95% CI=0.87–0.97). Structural and behavioral risks converged among U.S. MSM engaging in TS leading to greater HIV and bacterial STI prevalence in this group. HIV interventions for U.S. MSM-TS should address individual as well as structural risks, including poverty and housing instability. [ABSTRACT FROM AUTHOR]

HIV transmission remains a significant health concern for men who have sex with men (MSM) in the United States. Heavy episodic drinking (HED) is related to increased rates of condomless anal intercourse (CAI) among MSM, though evidence suggests that this association may vary by individual difference factors. The present secondary analysis tested whether sexual alcohol expectancies (SAEs) moderate the associations between frequency of HED and anal intercourse (AI) with and without a condom among moderate-to-heavy drinking HIV- MSM. Two hundred and forty-eight moderate-to-heavy drinking MSM completed self-report questionnaires including the Sexual Behavior Questionnaire, the Modified Daily Drinking Questionnaire, and the Sexual Alcohol Expectancies Questionnaire. Negative binomial regressions indicated that SAEs moderated the association between frequency of HED and AI with a condom, but not between the frequency of HED and condomless AI (CAI). These results suggest that stronger SAEs play a role in alcohol-related sexual behavior among MSM, but do not provide evidence that SAEs are associated with increased risk for HIV transmission through CAI. • Expectancies moderate the drinking-frequency and anal-sex frequency relation. • Expectancies do not moderate relation of drinking frequency and condomless anal sex. • Expectancies related to increased riskiness are the strongest moderators. [ABSTRACT FROM AUTHOR]

• There is no established treatment for problematic chemsex. • Problematic chemsex can be comorbid with sexual addiction. • Results of this exploratory study using ACT with MSM engaging in chemsex are promising. • Preliminary results suggest the efficacy of ACT towards associated psychological inflexibility, anxiety, depression, and sexual addiction. • Further research on ACT for chemsex in MSM is needed. Chemsex, a phenomenon involving the use of psychoactive substances in sexual contexts to facilitate or enhance sexual experiences, is substantially increasing among men who have sex with men (MSM), and has been described as a significant risk factor for mental and physical illness. However, no specialized treatment approach has yet been established. Acceptance and commitment therapy (ACT) could potentially be an appropriate psychotherapeutic framework, especially considering the MSM and sexual minority unique challenges and the role of psychological flexibility in this context. The present paper describes the assessment and ACT interventions, reports and discusses the results, of 10 adult MSM who self-referred to an outpatient psychiatry and addiction department in France for self-reported problematic chemsex that interfered with their quality of life. They completed symptom- and process-based measures at three different timepoints. Results were quantitatively analyzed, and the clinician's session notes and patients' experiences/accounts, recorded verbatim, served as a support for evaluating the global effects of ACT interventions. Results on outcome measures showed clinically notable and statistically significative improvements in psychological flexibility, anxiety and depression symptoms, as well as sexual addiction intensity between pre- and posttreatment, which were all persistent at 3- to 4-month follow-up. Process measure results indicated a high and consistent therapeutic alliance throughout therapy. This exploratory study, directly derived from clinical practice, suggests promising preliminary results. It can provide clinicians with a useful resource for using ACT as a potentially effective approach for problematic chemsex and comorbidities, and may guide future investigation to inform treatment development efforts, especially for MSM and sexual minority communities. [ABSTRACT FROM AUTHOR]

Introduction: Homelessness is associated with an increased risk of syphilis, HIV, and other STIs and disproportionately impacts sexual and gender minorities. Method: Data for this analysis came from a longitudinal cohort study of 285 urban gay, bisexual, and other men who have sex with men (MSM). The study aimed to (1) describe the prevalence of homelessness over time (2) identify characteristics associated with homelessness, and (3) measure associations between recent homelessness and substance use and STI/HIV risk behaviors three months later. Participants were recruited from clinical and non-clinical settings and attended a baseline visit and study visits every three months for up to 18-months. Data was collected between July 2018 and September 2020. Descriptive analyses and mixed-effects logistic regression models were utilized. Results: One-third of participants (94) reported experiencing homelessness throughout the study. Homelessness was significantly and independently associated with increased risk for future drug/alcohol use before/during sex (aOR: 3.8, 95% CI: 1.7, 8.6), methamphetamine use (aOR: 6.3 95% CI: 2.6, 15.2), injection drug use (adjusted odds ratio (aOR): 3.7, 95% CI: 1.0, 13.1), and sex exchange (aOR: 12.7; 95% CI: 5.5, 29.4). Conclusion: Interventions to reduce homelessness are necessary to lower risk of substance use and STI/HIV risk behaviors. [ABSTRACT FROM AUTHOR]

In Jamaica, stigma experiences of sex workers (SW), gay men and other men who have sex with men (MSM), and transgender women living with HIV remain understudied. To address this gap, we explored experiences of stigma and linkages with the HIV care cascade among key populations living with HIV in Jamaica, including cisgender women SW, MSM, and transgender women. This qualitative study involved n = 9 focus groups (FG), n = 1 FG per population living with HIV (SW, MSM, transgender women) in each of three sites (Kingston, St. Ann, Montego Bay). We also conducted key informant (KI) interviews. We applied thematic analysis informed by the Health Stigma and Discrimination (HSD) Framework. FG participants (n = 67) included SW (n = 18), MSM (n = 28), and trans women (n = 21); we interviewed n = 10 KI (n = 5 cisgender women, n = 5 cisgender men). Participant discussions revealed that stigma drivers included low HIV treatment literacy, notably misinformation about antiretroviral therapy (ART) benefits and HIV acquisition risks, and a lack of legal protection from discrimination. Stigma targets health (HIV) and intersecting social identities (sex work, LGBTQ identities, gender non-conformity, low socio-economic status). Stigma manifestations included enacted stigma in communities and families, and internalized stigma—including lateral violence. HIV care cascade impacts included reduced and/or delayed HIV care engagement and ART adherence challenges/disruptions. Participants discussed strategies to live positively with HIV, including ART adherence as stigma resistance; social support and solidarity; and accessing affirming institutional support. In addition to addressing intersecting stigma, future research and programing should bolster multi-level stigma-resistance strategies to live positively with HIV. [ABSTRACT FROM AUTHOR]

To end the HIV epidemic, there is need for targeted strategies to reduce HIV incidence for those most vulnerable, including an HIV vaccine. This study seeks to understand the perceptions that non-PrEP using gay and bisexual men and other men who have sex with men (GBMSM) have about a potential HIV vaccine, while contextualizing their perspectives within the context of heightened vaccine hesitancy that has emerged since the COVID-19 pandemic. Between March and May of 2022, GBMSM (N = 20) participated in in-depth interviews, which assessed their perceptions about an HIV vaccine. Interviews were analysed using a codebook approach to thematic analysis. We oversampled for those unvaccinated against COVID-19 as a proxy for vaccine hesitation. Participants expressed a range of enthusiastic support, cautious optimism and skepticism when presented with the possibility of an HIV vaccine. Factors that drove willingness to receive an HIV vaccine included community-oriented altruism, individualized risk-benefit assessment, and/or the perception that a vaccine could provide a beneficial shift in sexual experiences. Participants also expressed hesitations about receiving an HIV vaccine, including concerns about potential side-effects and efficacy, as well as mistrust in the vaccine development process. Notably, participants often evaluated the vaccine in comparison to PrEP and condoms. Participants offered specific insights into information they would like to receive about an HIV and where/how they would like to receive it. Our findings can help inform future HIV vaccine implementation efforts by offering insights into the factors that motivate and deter GBMSM to receive an HIV vaccine. [ABSTRACT FROM AUTHOR]

Condoms continue to be used by many gay, bisexual, and other men who have sex with men (GBM) to reduce the risk of HIV transmission. However this is impacted by condom failure events, defined here as condom breakage and slippage. In a prospective, observational cohort study of 343 HIV serodiscordant male couples recruited through high HIV caseload clinics and hospitals between 2012 and 2016 in Australia, Brazil, and Thailand, condom failure rates and associated factors were analysed, including with the study partner versus other sexual partners. There were 717 reported instances of condom failure from an estimated total of 25,831 sex acts with condoms, from over 588.4 participant years of follow up. Of the HIV-negative partners (n = 343) in the study, more than a third (n = 117, 36.7%) reported at least one instance of condom failure with any partner type during study follow-up. Condom failure with their study partner was reported by 91/343 (26.5%) HIV-negative partners, compared with 43/343 (12.5%) who reported condom failure with other partners. In total, there were 86 events where the HIV-negative partner experienced ano-receptive condom failure with ejaculation, representing 12.0% of all failure events. In multivariable analysis, compared to Australia, HIV-negative men in Brazil reported a higher incidence risk rate of condom failure (IRR = 1.64, 95%CI 1.01–2.68, p = 0.046) and HIV-negative men who reported anal sex with other partners reported an increased risk of condom failure compared with men who only had sex with their study partner (IRR = 1.89, 95%CI 1.08–3.33, p = 0.025). Although at least one event of condom failure was reported by a significant proportion of participants, overall condom failure events represented a small proportion of the total condom protected sex acts. [ABSTRACT FROM AUTHOR]

Background: Five distinct forms of violence - Physical, Verbal, Sexual, Cyber, and Relational - persistently afflict sexual minorities worldwide. The presence of feminine attributes in Men who have Sex with Men is inherently linked to a heightened susceptibility to various manifestations of violence, thereby exerting detrimental repercussions on both the physical and mental well-being of these individuals. This correlation stands as a principal contributor to the alarmingly elevated rates of suicide attempts among Men who have Sex with Men, particularly during their early years. Data and Methods: This cross-sectional study investigates the risk factors for violence against Men who have Sex with Men in six metropolitan cities across India. Quantitative data were gathered from 300 self-identified Men who have Sex with Men, with 240 providing only quantitative data, while both quantitative and qualitative data were collected from a subset of 60 respondents, ranging in age from 18 to 70 years. Quantitative analysis was conducted using descriptive statistics, chi-square tests, and binary logistic regression to explore the likelihood of different types of violence. Qualitative data collected through in-depth interviews, were analyzed thematically to provide contextual depth and validate the quantitative findings, focusing on specific incidents and key themes associated with violence among Men who have Sex with Men. Results: More than 60 per cent of the respondents encountered at least one type of violence due to their sexuality. More than half of the respondents who engaged in the receptive role during sexual activity reported experiencing sexual violence. The likelihood of encountering verbal violence was found to be nearly six times higher among respondents who were receptive than penetrative sexual partners. Respondents of Muslim religion exhibited a 2.6-fold increase in the likelihood of experiencing sexual violence compared to their Hindu counterparts. Conclusion: Violence against Men who have Sex with Men is a pervasive issue in the six metropolitan cities studied in India, particularly affecting individuals with lower education and low income. These findings resonate with global research, which identifies similar risk factors for violence against sexual minorities, especially in regions with deep-rooted homophobia and socio-economic inequalities. Insights from this study underscore the urgent need for targeted policies and interventions to create a safer, more inclusive environment for this population in India and other parts of the Global South. [ABSTRACT FROM AUTHOR]

Introduction: During the mpox outbreak in 2022, the highest number of cases in Germany were registered in Berlin, almost all of them in men who have sex with men (MSM). However, the frequency of clinically undiagnosed infections is unknown. Methods: A cross-sectional study was conducted among MSM in Berlin, Germany. Participants were recruited from private practices and community-based checkpoints specialised in HIV and STI care for MSM. They were asked to complete an online questionnaire on socio-demographic data, mpox diagnosis, vaccination history and sexual behaviour, and to provide a blood sample for serological analysis. The samples were tested for antibodies against a range of antigens to distinguish between antibodies induced by mpox infection and MVA vaccination, with pre-immune sera from childhood smallpox vaccination as a confounding factor. Associations of behavioural variables with reported and suspected mpox diagnosis as the outcome were tested using univariable and multivariable logistic regression models. Results: Between the 11th April and 1st July 2023, 1,119 participants were recruited in eight private practices and two community-based checkpoints in Berlin. All participants provided a blood sample for serological testing. Information for the online questionnaire was provided by 728 participants; core data on age and mpox history for participants who did not provide questionnaire data were provided by the practices for an additional 218 participants. A previous diagnosis of mpox was reported for/by 70 participants (7.4%). Using a conservative and strict case definition, we serologically identified an additional 91 individuals with suspected undiagnosed mpox infection. Individuals with reported or suspected mpox infections reported more condomless anal sex partners in the past 3 months (OR = 5.93; 95% CI 2.10-18.35 for 5–10 partners; OR = 9.53; 95% CI 2.72–37.54 for > 10 partners) and were more likely to report sexual contact with partners diagnosed with mpox (OR = 2.87; 95% CI 1.39–5.84). Conclusion: A substantial proportion of mpox infections were clinically undiagnosed. The number of condomless anal sex partners was strongly associated with both confirmed and suspected undiagnosed mpox infection. Therefore, mpox control measures based on clinical diagnosis of mpox are likely to have limited effectiveness in preventing mpox transmission in outbreak situations because many infections remain unrecognised and undiagnosed. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Data Sources Results Conclusion Implications for the Profession and/or Patient Care Reporting Method Patient or Public Contribution The aim of this study is to provide conceptual clarity on psychosocial distress among African American and Latine men who have sex with men living with human immunodeficiency virus.Concept analysis.The 8‐step Walker and Avant framework guided the concept analysis of psychosocial distress tailored to this patient population.A literature review was conducted using the research databases PubMed/Medline, PsycINFO, the Cumulated Index of Nursing and Allied Health Literature and Scopus with the selected search terms.A total of 7 articles were retrieved and analysed to explicate the antecedents, attributes, and consequences of psychosocial distress in this population. Four cases were developed to further clarify the concept of psychosocial distress; a model case, borderline case, related case and contrary case.As experienced by African American and Latine men who have sex with men living with human immunodeficiency virus, psychosocial distress is defined as a state of suffering due to uncontrollable structural and/or social factors that threaten the individual's existence and/or livelihood based on their social identity as a racial/ethnic, sexual minority.The concept analysis of psychosocial distress can be useful to guide future theory and measurement development to enhance disease‐specific and general health outcomes for sexual and racial/ethnic minoritised men who have sex with men.Not applicable.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Papua New Guinea lacks data characterising the sexual health needs of younger key populations (KP): female sex workers (FSW) and commercially and sexually exploited girls (CSE), men who have sex with men (MSM), and transgender women (TGW). Biobehavioural surveys among KP were conducted in three cities. We conducted unweighted and weighted analysis for sample and population proportions, respectively. Variables associated with younger versus older age (15–24 versus ≥25 years) were included in the multivariable analysis. Younger FSW/CSEG had greater odds of having both Neisseria gonorrhoea and Chlamydia trachomatis (aOR:3.2, 95%CI 2.0–5.0), or having either infection (aOR:2.2, 95%CI 1.2–4.1) than older peers. They also had lower odds of having tested for HIV (aOR: 0.6, 95%CI 0.4–0.8). Younger MSM/TGW had greater odds of paying for sex in the <6 months (aOR:2.2, 95%CI: 1.5–3.1) and of having been paid for sex (aOR:1.6, 95%CI 1.1–2.4) than their older peers (≥25 years). Younger MSM/TGW had lower odds of having contact with a peer educator ≤12 months (aOR:0.6, 95%CI 0.4–0.9) and having tested for HIV (aOR:0.6, 95%CI: 0.4–0.9). All key populations have substantial sexual health needs, but those of younger members are greatest. Younger key populations would likely benefit from health services designed specifically for them. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) bear a disproportionate burden of HIV in China and are particularly vulnerable to mental health challenges. This study is phase one of a multi-phase project that aimed to identify unmet needs of MSM living with HIV to inform the development of a multi-level intervention. We interviewed 24 stakeholders through videoconferencing, including 15 MSM living with HIV, five staff from a community-based organization serving gender and sexual minority individuals, and four staff from the Centers for Disease Control and Prevention in Shanghai, China. We conducted content analysis using inductive and deductive coding and identified the following themes: 1) Navigating Turbulent Waters: multi-level stress currents; 2) Mapping Anchors: multifaceted support network; 3) Staying Afloat: Daily strategies and functioning; and 4) Charting New Courses: paths for intervention. Examining the stress and coping process among MSM living with HIV from a socio-ecological lens is especially important in the collective cultural context. The interactive nature of the stress from multiple socio-ecological levels, lack of individual coping skills, and scarcity of psychosocial services highlighted the importance of community-based, multi-level interventions to meet the needs of MSM living with HIV in China. [ABSTRACT FROM AUTHOR]

Background Men and women with a migration background comprise an increasing proportion of incident human immunodeficiency virus (HIV) cases across Western Europe. Methods To characterize sources of transmission in local transmission chains, we used partial HIV consensus sequences with linked demographic and clinical data from the opt-out AIDS Therapy Evaluation in the Netherlands (ATHENA) cohort of people with HIV in the Netherlands and identified phylogenetically and epidemiologically possible HIV transmission pairs in Amsterdam. We interpreted these in the context of estimated infection dates, and quantified population-level sources of transmission to foreign-born and Dutch-born Amsterdam men who have sex with men (MSM) within Amsterdam transmission chains. Results We estimate that Dutch-born MSM were the predominant sources of infections among all Amsterdam MSM who acquired their infection locally in 2010–2021, and among almost all foreign-born Amsterdam MSM subpopulations. Stratifying by 2-year intervals indicated time trends in transmission dynamics, with a majority of infections originating from foreign-born MSM since 2016, although uncertainty ranges remained wide. Conclusions Native-born MSM have predominantly driven HIV transmissions in Amsterdam in 2010–2021. However, in the context of rapidly declining incidence in Amsterdam, the contribution from foreign-born MSM living in Amsterdam is increasing, with some evidence that most local transmissions have been from foreign-born Amsterdam MSM since 2016. [ABSTRACT FROM AUTHOR]

Background Little is known about penile high-risk human papillomavirus (hrHPV) among men who have sex with men (MSM) in low- and middle-income countries. We aimed to determine the incidence, clearance, and persistence of penile hrHPV among Rwandan MSM. Methods We enrolled 350 MSM (345 with valid human papillomavirus [HPV] results) aged ≥18 years. At each visit (6–12 months apart), we collected penile PreservCyt specimens and blood for HPV and HIV testing, as well as sociodemographic and behavioral variables. HPV testing was performed with the Ampfire assay. Penile hrHPV incidence and clearance per 1000 person-months of follow-up, as well as prevalent and incident persistence, were computed and compared by HIV status. Results The mean (SD) age was 27.7 (6.7) years and 19.4% were living with HIV. Penile hrHPV incidence was 34.8 (95% CI, 29.1–41.8) per 1000 person-months of follow-up. HPV-16 (11.7; 95% CI, 9.26–14.9) and HPV-59 (6.1; 95% CI, 4.52–8.39) had the highest incidence rates. Prevalent and incident persistence was 47.5% and 46.6%, respectively. HPV-66 (33.3%), HPV-52 (30.8%), and HPV-16 (29.2%) had the highest prevalent persistence and HPV-33 (53.8%), HPV-31 (46.7%), and HPV-16 (42.6%) the highest incident persistence. No differences were found by HIV status except for HPV-45 (higher in MSM with HIV). Conclusions We found high incidence and prevalent/incident persistence of penile hrHPV among Rwandan MSM. This highlights the importance of preventive strategies for HPV-associated anogenital cancers. [ABSTRACT FROM AUTHOR]

Background: The challenges in culturing Treponema pallidum have hindered molecular-biological analysis. This study aims to establish a molecular epidemiological analysis of syphilis among Japanese men who have sex with men (MSM) and to investigate the relationship between bacteremia and associated pathophysiology. Methods: We used whole blood specimens from syphilis-diagnosed individuals in Tokyo, collected between February 2019 and June 2022. All individuals were MSM, and most were people with HIV (97.2%). We used a multi-locus sequence typing (MLST) scheme for epidemiological analysis. Sequences for MLST (TP0136, TP0548, and TP0705) were obtained. Results: Out of 71 whole blood samples, 26 samples (36.6%) were positive for TP0136, and we sequenced three loci for MLST in 22 samples (31.0%). The most frequently detected sequence type (ST) was ST3 (n = 9), followed by ST6 (n = 6). Phylogenetic analysis revealed that 12 samples belonged to the SS14-like group (60%), and 8 samples belonged to the Nichols-like group (40%). Treponema pallidum subsp. endemicum (TEN), the cause of bejel was detected in three samples (12%). There was a significant association between TP0136 detection rate and C- reactive protein (CRP) (77.0% at a cut-off:0.5 mg/dL). Conclusion: Both SS14-like and Nichols-like strains were circulating concurrently, and TEN could have been sexually transmitted among MSM with HIV. Elevated CRP may indicate the presence of the pathogen in the blood. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has significantly impacted the mental health of human beings since 2020, especially the young people and the pre-existing marginalized groups such as men who have sex with men (MSM). During the COVID-19 pandemic, the multi-country outbreak of mpox in 2022 additionally posed a significant stress on the most-affected communities (i.e., MSM). This study investigated the level of depressive symptoms and its multifaceted associated factors among Chinese young men who have sex with men (YMSM) in this unique period. In September 2022, a large-scale cross-sectional survey was conducted among YMSM aged 18–29 years across six representative provinces in China. Hierarchical regression analysis was performed to test the various types of associated factors of depressive symptoms. Among the 2493 participants, 65.6 % (n = 1638) reported mild to severe depressive symptoms. The hierarchical regression analysis identified that depressive symptoms was significantly positively associated with unemployment, having substance use in the past 6 months, a higher level of MSM self-stigma, incompletion of COVID-19 vaccination, greater mpox risk perception, and presence of mpox related-like symptoms. This study used the facility-based sampling method to recruit the participants, which may lead to selection bias. Chinese YMSM faced significant mental health challenges during the concurrent epidemics of COVID-19 and mpox, which was associated with their socio-economic status, risk behaviors, stigma, and multiple diseases-related variables. Proactive measures may hold promise as effective strategies for mitigating mental distress among marginalized groups during public health crises. • YMSM experienced severe depressive symptoms in dual-threat context in China. • Identifies key influencing factors across demographic and psychosocial realms. • Urges tailored mental health support for YMSM during health emergencies. • Recommends proactive mental health measures like campaigns and counseling. [ABSTRACT FROM AUTHOR]

A global outbreak of clade II mpox associated with sexual contact, disproportionately affecting gay, bisexual, and other men who have sex with men (MSM), has been ongoing since May 2022. Information on types of contact most associated with transmission is limited. This report used data from a multijurisdictional vaccine effectiveness case-control study of sexually active persons aged 18-49 years who identified as MSM or transgender, collected during August 2022--July 2023. Odds of mpox associated with selected types of intimate and nonintimate close contact with a person with mpox were estimated. Among 457 case-patients and 1,030 control patients who met minimum data requirements, 150 (32.8%) case-patients and 57 (5.5%) control patients reported close contact with a person with mpox and were included in this analysis. Adjusted odds of mpox were 5.4 times as high among those who reported having condomless receptive anal sex with a person with mpox, compared with participants who reported close contact with a person with mpox and no condomless receptive anal sex with that person (OR = 5.4; p = 0.031). Although the mpox vaccine is highly effective, vaccination coverage remains low; a multifaceted approach to prevention remains important and should include vaccination promotion, safer sex practices, and increasing awareness that mpox continues to circulate. [ABSTRACT FROM AUTHOR]

Intimacy and relationships are important to sexual minority men, yet traditional sex and relationship education from sources such as schools and families may lack perceived usefulness. Consequently, sexual minority men may seek information from alternative sources, but little research has explored the usefulness of these alternatives. A national survey of sexual minority men in Australia (n = 936, Mage = 38.9) evaluated the usefulness of seven sources of information: school programmes, family, peers and friends, social media and the Internet, popular culture, pornography, and official information sources. Five topics were examined for each source: sexual and reproductive physiology, HIV/STI prevention, relationship skills, consent and needs negotiation, and sexual and intimate behaviours. Participants rated the sources as minimally to moderately useful. Official information sources were rated most useful, followed by peers and friends, social media and the Internet, popular culture, pornography, school, and family. Older men found most sources less useful than younger participants. Perceived usefulness varied across topics (e.g. popular culture and peers and friends rated most useful for relationship skills). These findings underscore the limited relevance of conventional sex and relationship education for sexual minority men and highlight the need for enhanced education programmes. [ABSTRACT FROM AUTHOR]

Background The 2022 monkeypox (mpox) outbreak in Los Angeles County (LAC) emphasized the need to prepare for emergent infectious disease outbreaks. Vaccination and promotion of sexual risk reduction practices appeared successful in LAC, as mpox cases declined starting in August. Nonetheless, questions persisted regarding the effectiveness of targeting vaccinations and the role of sexual risk reduction in reducing mpox cases. Methods We collaborated with the LAC Department of Public Health to develop a microsimulation for men who have sex with men (MSM). This model tracked mpox dynamics by age, race/ethnicity, and HIV status and was calibrated and validated against surveillance data. We simulated counterfactual scenarios to understand the effects of variation in vaccination rates, timing of vaccination rollout, vaccine allocation, and sexual contact rates. Results In the simulation, doubling the vaccination rate reduced cumulative cases over a 40-week time horizon by 13% but would necessitate 88 995 additional doses. Initiating vaccination 2 weeks earlier decreased cases by 11%, while an 8-week delay yielded a 20% increase in cases. A 3-week earlier decrease in sexual contact rates reduced cumulative cases by 60%, while a 3-week delay resulted in a 95% increase. Prioritizing people with HIV (PWH) for vaccination reduced cumulative cases, while allocating vaccines to a single racial/ethnic group was not effective. Conclusions Our study highlights the significance of policies to support timely vaccination and sexual partnership reduction to address mpox outbreaks among MSM. These findings also underscore the need to target vulnerable risk groups, such as PWH. [ABSTRACT FROM AUTHOR]

In the United States, Black men who have sex with men (BMSM) represent the most vulnerable population for HIV infection. A potential vaccine could ultimately be the most effective HIV prevention strategy. Understanding the factors that may adversely affect HIV vaccine acceptance among BMSM is critical. We conducted two online surveys with BMSM; one recruited 432 respondents, and another recruited 204. Respondents completed a demographic assessment and questions derived from health behavior change theories and the relevant empirical literature. The two surveys yielded similar results. The findings indicate that vaccine uptake self-efficacy, perceived likelihood of important others receiving the vaccine, and susceptibility to HIV were related to intentions to receive a future HIV vaccine. Other potentially important variables include perceived HIV stigma, response efficacy, how much one conceals one's sexual orientation, and perceived HIV discrimination. Future research and health communication campaigns should consider these factors in potential HIV vaccine programs. [ABSTRACT FROM AUTHOR]

This study explored the feasibility and acceptability of Entre Herman@s, a novel sibling-based intervention designed to engage siblings to increase PrEP utilization among Latino men who have sex with men (LMSM). Siblings were trained in rudimentary motivational interviewing skills to uncover, evoke, and strengthen their brother's motivation to use PrEP, using the constructs of the Information-Motivation-Behavioral Skills (IMB) model for health behavior change. This pilot demonstrated high feasibility, meeting recruitment, retention, and intervention completion targets. Of the 23 LMSM enrolled, 16 (70%) commenced PrEP, with 12 (75%) continuing at the 3-month follow-up. Initially, 15 participants (65%) were open to PrEP, with 9 (39%) ready to start within the next month. Those who began PrEP use reported a significantly higher degree of closeness to their siblings (p =.019) than those who did not. All LMSMs affirmed that their decision to use PrEP was influenced to some degree by their sibling. [ABSTRACT FROM AUTHOR]

Objective To understand the changes in spatial aggregation of HIV cases among men who have sex with men (MSM) in Chengdu from 2010 to 2021, providing a scientific basis for the regional prevention and control of MSM cases. Methods Data were collected from the Chinese Disease Prevention and Control Information System. Spatial-temporal auto-correlation and aggregation analyses were conducted using ArcGIS 10.6 software, while StatsCan software was utilized for spatial-temporal scanning analysis. Results The average annual growth rate of homosexual transmission cases in Chengdu was 27.41% from 2010 to 2015 and -5.03% from 2015 to 2021. The HIV epidemic affected 370 towns/street areas, demonstrating spatial aggregation, with the epidemic concentrated in the central urban area. Over time, the northeastern region spread southeast, the southwestern area expanded southwest and south, and the northwestern region spread northward. The hotspot areas exhibited similar aggregation patterns. Spatial-temporal scanning analysis indicated that from 2013 to 2018, the primary aggregation areas comprised 40 streets in the central urban area. Conclusion During the period from 2010 to 2021, the trend of the HIV epidemic among MSM in Chengdu showed a rapid increase followed by a slow decline. The spatial distribution exhibited significant imbalances, with the epidemic spreading from the central urban area to the suburban areas. Increased efforts are needed to enhance HIV awareness in schools and areas with concentrated mobile populations. [ABSTRACT FROM AUTHOR]

Literature is sparse regarding men's attitudes towards male sexual assault and the role that the sexuality of those involved may have. Despite the high prevalence of chemsex and GHB (gamma-hydroxybutyrate) participation among men who have sex with men, no study has yet investigated attitudes towards such. Utilising a community sample of 141 UK men, participants were randomly assigned into one of six conditions based on victim sexuality (heterosexual or homosexual) and the drug used present during the sexual assault (chemsex, chemical submission, or no drugs). All participants completed the Male Rape Victim and Perpetrator Blaming Scale and Victim-Blaming Empathy Scale to measure victim-blame and empathy attributions. Results of a two-way MANOVA revealed a significant difference between participant gender and empathic ratings, with heterosexual participants significantly less likely to empathise than their homosexual counterparts. A non-significant difference was observed between the conditions alongside a non-significant interaction. Nevertheless, results indicate that victims in the chemsex condition, along with heterosexual victims, encountered the greatest victim-blaming attributions and the lowest rates of participant empathy overall. Findings overall appear to indicate a general decline in victim-blame attitudes towards men who have sex with men, though a level of uncertainty was apparent among the sample. Implications and limitations of the work are discussed alongside the importance of future research and psychoeducation interventions. [ABSTRACT FROM AUTHOR]

Background: HIV Pre‐Exposure Prophylaxis (PrEP) has been available in Wales since 2017. The coronavirus disease (COVID‐19) pandemic impacted UK sexual health services, leading to a reduction in service provision. There is a lack of research on the experiences of PrEP users during this time. Objective: We aimed to explore the experiences of PrEP users in Wales following the introduction of COVID‐19 pandemic measures. Methods: We conducted a secondary data analysis of two prior interview studies (DO‐PrEP and UPrEP). Data collection was undertaken between May 2020 and February 2021 using remote interviewing. Semi‐structured interviews were conducted. Participants were ≥18 years of age, residents of Wales, current or previous PrEP users, and men who have sex with men (MSM). Reflexive thematic analysis was conducted. Results: A total of 32 interviews were included in the analysis. Themes include the following: (1) PrEP use during COVID‐19, (2) sexual behaviour and relationship changes following COVID‐19 restrictions, (3) NHS service provision during the COVID‐19 pandemic, and (4) wider contextual effects of the pandemic. Participants reported a change in PrEP use (pausing or switching to event‐based PrEP). Participants reported reduced access to clinics and appointments. Support for changing to event‐based PrEP was varied. Social isolation resulted in varied responses to lockdown rules, especially in later lockdowns. Conclusion: This study provides patient perspectives on the challenges the COVID‐19 pandemic posed to PrEP use and access. It offers insights into the broader support needs around PrEP use when an individual's circumstances change. Flexible models of PrEP provision, which can be adapted to the patient's needs, will be essential as PrEP delivery extends into the wider community. Patient and Public Contribution: Both the DO‐PrEP and UPrEP studies received input from various stakeholders in the design of the topic guides for the study; these included public lay members, PrEP users, PrEP providers, and individuals involved with HIV advocacy and policy. [ABSTRACT FROM AUTHOR]

Introduction: We evaluated internet platforms for distributing HIV self-tests (HIVSTs) to Black or African American (Black) and Hispanic or Latino men who have sex with men (MSM) and transgender women (TGW). Methods: We recruited MSM and TGW from general interest, dating, and lesbian, gay, bisexual, and transgender platforms. Two HIVSTs were mailed to all MSM and TGW. Surveys (screening, baseline, 4-month, and results reporting) were completed online. After 4 months, participants were mailed another HIVST and a dried blood spot card. All HIVST interpretations and images of HIVST devices were reported online. Results: Of 2093 MSM and 102 TGW, most were recruited through general interest and dating platforms. Over 50% were 18– 29 years old, most identified as gay or bisexual. Overall, 45% had not tested for HIV in the past 12 months, and 9.1% of MSM reported a positive (reactive for HIV antibodies) HIVST result, with the highest percentage among Black MSM (11.5%). Dating platforms recruited higher percentages of MSM who recorded positive results compared with MSM from general interest platforms during the intervention period (11.9% vs 5.5% (P, 0.0001)), and MSM who had never tested for HIV reported a greater percentage of positive HIVST results compared with MSM who had been tested for HIV before enrollment (16.1% vs. 7.1%; P, 0.0001). MSM were able to correctly interpret and report HIVST results. Of TGW, 7% reported a positive HIVST result. Conclusions: Internet dating and general interest platforms can be key to increasing awareness of infection among BMSM, HMSM, and TGW persons, including those who do not use existing HIV services. [ABSTRACT FROM AUTHOR]