Browsing by Subject "Homosexuality, Male"
Now showing 1 - 7 of 7
Results Per Page
Sort Options
Item Open Access Awareness and acceptability of HIV pre-exposure prophylaxis (PrEP) among students at two historically Black universities (HBCU): a cross-sectional survey.(BMC public health, 2021-05-19) Okeke, Nwora Lance; McLaurin, Tony; Gilliam-Phillips, Ruth; Wagner, David H; Barnwell, Valerie J; Johnson, Yolanda M; James, Osaffo; Webb, Padonda B; Parker, Sharon D; Hill, Bendu; McKellar, Mehri S; Mitchell, John TBackground
Despite young African American adults (ages 18-24) being among the highest risk groups for HIV infection, little is known about their awareness of HIV pre-exposure prophylaxis (PrEP) - a once daily pill shown to be > 90% effective in preventing HIV. To explore awareness and acceptability of PrEP among college students in this demographic, we conducted a survey of attendees at two large historically Black universities (HBCU) in North Carolina.Methods
We administered a 14-item questionnaire to students at two HBCUs in North Carolina between February and April 2018. Questions were formatted in a yes/no or multiple choice format. Questionnaire items specifically addressed PrEP awareness and acceptability. Surveys were administered to students at a campus health fair and while transiting the campus student union via iPad. Response to all questions was optional. We fit a logistic regression model to determine association of key demographic determinants with PrEP acceptability and awareness. Statistical analyses were conducted using SAS 9.4 (SAS, Cary, NC).Results
Overall, 210 students participated in the survey, of which 60 completed all survey items as presented. The survey cohort was 75% female, 89% heterosexual and 39% freshmen. The mean age of respondents was 19.8 years (SD: 1.8). Fifty-two percent of survey respondents reported that they were aware of PrEP prior to the time of survey administration. Only 3% of respondents reported that they were on PrEP. The most common sources of information on PrEP were campus health services (24%) and non-social media advertising (15%). Of respondents who were aware of PrEP, 61% reported that they had heard about in the 6 months prior to survey administration, while only 19% say they were aware of it for more than a year. Regarding acceptability of PrEP, 58% of respondents reported that they would take a once a day pill for HIV if they were at risk. Our logistic regression analysis found no statistically significant associations between key demographic factors and PrEP awareness. However, persons who perceived themselves to be at risk for HIV acquisition were more likely to find once daily oral PrEP (relative risk 2.66 (95% CI 1.31-5.42)) as an acceptable prevention strategy than the rest of the survey cohort.Conclusions
African American HBCU students are becoming aware of PrEP, and generally perceive the intervention as acceptable and worth consideration.Item Open Access Development and validation of the San Diego Early Test Score to predict acute and early HIV infection risk in men who have sex with men.(Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015-08) Hoenigl, Martin; Weibel, Nadir; Mehta, Sanjay R; Anderson, Christy M; Jenks, Jeffrey; Green, Nella; Gianella, Sara; Smith, Davey M; Little, Susan JBackground
Although men who have sex with men (MSM) represent a dominant risk group for human immunodeficiency virus (HIV), the risk of HIV infection within this population is not uniform. The objective of this study was to develop and validate a score to estimate incident HIV infection risk.Methods
Adult MSM who were tested for acute and early HIV (AEH) between 2008 and 2014 were retrospectively randomized 2:1 to a derivation and validation dataset, respectively. Using the derivation dataset, each predictor associated with an AEH outcome in the multivariate prediction model was assigned a point value that corresponded to its odds ratio. The score was validated on the validation dataset using C-statistics.Results
Data collected at a single HIV testing encounter from 8326 unique MSM were analyzed, including 200 with AEH (2.4%). Four risk behavior variables were significantly associated with an AEH diagnosis (ie, incident infection) in multivariable analysis and were used to derive the San Diego Early Test (SDET) score: condomless receptive anal intercourse (CRAI) with an HIV-positive MSM (3 points), the combination of CRAI plus ≥5 male partners (3 points), ≥10 male partners (2 points), and diagnosis of bacterial sexually transmitted infection (2 points)-all as reported for the prior 12 months. The C-statistic for this risk score was >0.7 in both data sets.Conclusions
The SDET risk score may help to prioritize resources and target interventions, such as preexposure prophylaxis, to MSM at greatest risk of acquiring HIV infection. The SDET risk score is deployed as a freely available tool at http://sdet.ucsd.edu.Item Open Access Enhanced immune activation linked to endotoxemia in HIV-1 seronegative MSM.(AIDS (London, England), 2014-09) Palmer, Christine D; Tomassilli, Julia; Sirignano, Michael; Romero-Tejeda, Marisol; Arnold, Kelly B; Che, Denise; Lauffenburger, Douglas A; Jost, Stephanie; Allen, Todd; Mayer, Kenneth H; Altfeld, MarcusThis study assessed cellular and soluble markers of immune activation in HIV-1 seronegative MSM. MSM immune profiles were characterized by an increased expression of CD57 on T cells and endotoxemia. Endotoxin presence was linked to recent high-risk exposure and associated with elevated cytokine levels and decreased CD4+/CD8+ T cell ratios. Taken together, these data show elevated levels of inflammation linked to periods of endotoxemia resulting in a significantly different immune phenotype in a subset of MSM at a high risk of HIV-1 acquisition.Item Open Access HIV/AIDS-related institutional mistrust among multiethnic men who have sex with men: effects on HIV testing and risk behaviors.(Health Psychol, 2012-05) Hoyt, Michael A; Rubin, Lisa R; Nemeroff, Carol J; Lee, Joyce; Huebner, David M; Proeschold-Bell, Rae JeanOBJECTIVE: To investigate relationships between institutional mistrust (systematic discrimination, organizational suspicion, and conspiracy beliefs), HIV risk behaviors, and HIV testing in a multiethnic sample of men who have sex with men (MSM), and to test whether perceived susceptibility to HIV mediates these relationships for White and ethnic minority MSM. METHOD: Participants were 394 MSM residing in Central Arizona (M age = 37 years). Three dimensions of mistrust were examined, including organizational suspicion, conspiracy beliefs, and systematic discrimination. Assessments of sexual risk behavior, HIV testing, and perceived susceptibility to HIV were made at study entry (T1) and again 6 months later (T2). RESULTS: There were no main effects of institutional mistrust dimensions or ethnic minority status on T2 risk behavior, but the interaction of systematic discrimination and conspiracy beliefs with minority status was significant such that higher levels of systematic discrimination and more conspiracy beliefs were associated with increased risk only among ethnic minority MSM. Higher levels of systematic discrimination were significantly related to lower likelihood for HIV testing, and the interaction of organizational suspicion with minority status was significant such that greater levels of organizational suspicion were related to less likelihood of having been tested for HIV among ethnic minority MSM. Perceived susceptibility did not mediate these relationships. CONCLUSION: Findings suggest that it is important to look further into the differential effects of institutional mistrust across marginalized groups, including sexual and ethnic minorities. Aspects of mistrust should be addressed in HIV prevention and counseling efforts.Item Open Access Optimizing Partner Notification Programs for Men Who Have Sex with Men: Factorial Survey Results from South China.(PloS one, 2016-01) Wang, Alberta L; Peng, Rui-Rui; Tucker, Joseph D; Chakraborty, Hrishikesh; Cohen, Myron S; Chen, Xiang-ShengBackground
Syphilis is prevalent among men who have sex with men (MSM) in China. Syphilis partner notification (PN) programs targeting MSM has been considered as one of effective strategies to prevention and control of the infection in the population. We examined willingness and preferences for PN among MSM to measure feasibility and optimize uptake.Methods
Participation in a syphilis PN program was measured using a factorial survey from both the perspective of the index patient and the partner. Respondents were recruited from April-July 2011 using convenience sampling at two sites-a MSM sexually transmitted disease (STD) clinic and a MSM community based organization (CBO). Respondents first evaluated three factorial survey vignettes to measure probability of participation and then an anonymous sociodemographic questionnaire. A two-level mixed linear model was fitted for the factorial survey analysis.Results
In 372 respondents with mean age (± SD) 28.5 (± 6.0) years, most were single (82.0%) and closeted gays (66.7%). The Internet was the most frequent place to search for sex. Few (31.2%) had legal names for casual partners, but most had instant messenger (86.5%) and mobile phone numbers (77.7%). The mean probability of participation in a syphilis PN program was 64.5% (± 32.4%) for index patients and 63.7% (± 32.6%) for partners. Referral of the partner to a private clinic or MSM CBO for follow-up decreased participation compared to the local Center for Disease Control and Prevention (CDC) or public STD clinic.Conclusions
Enhanced PN services may be feasible among MSM in South China. Internet and mobile phone PN may contact partners untraceable by traditional PN. Referral of partners to the local CDC or public STD clinic may maximize PN participation.Item Open Access Severe Monkeypox in Hospitalized Patients - United States, August 10-October 10, 2022.(MMWR. Morbidity and mortality weekly report, 2022-11) Miller, Maureen J; Cash-Goldwasser, Shama; Marx, Grace E; Schrodt, Caroline A; Kimball, Anne; Padgett, Kia; Noe, Rebecca S; McCormick, David W; Wong, Joshua M; Labuda, Sarah M; Borah, Brian F; Zulu, Isaac; Asif, Amimah; Kaur, Gurpreet; McNicholl, Janet M; Kourtis, Athena; Tadros, Andrew; Reagan-Steiner, Sarah; Ritter, Jana M; Yu, Yon; Yu, Patricia; Clinton, Rachel; Parker, Corrine; Click, Eleanor S; Salzer, Johanna S; McCollum, Andrea M; Petersen, Brett; Minhaj, Faisal S; Brown, Ericka; Fischer, Michael P; Atmar, Robert L; DiNardo, Andrew R; Xu, Ya; Brown, Cameron; Goodman, Jerry Clay; Holloman, Ashley; Gallardo, Julia; Siatecka, Hanna; Huffman, Georgia; Powell, John; Alapat, Philip; Sarkar, Pralay; Hanania, Nicola A; Bruck, Or; Brass, Steven D; Mehta, Aneesh; Dretler, Alexandra W; Feldpausch, Amanda; Pavlick, Jessica; Spencer, Hillary; Ghinai, Isaac; Black, Stephanie R; Hernandez-Guarin, Laura N; Won, Sarah Y; Shankaran, Shivanjali; Simms, Andrew T; Alarcón, Jemma; O'Shea, Jesse G; Brooks, John T; McQuiston, Jennifer; Honein, Margaret A; O'Connor, Siobhán M; Chatham-Stephens, Kevin; O'Laughlin, Kevin; Rao, Agam K; Raizes, Elliot; Gold, Jeremy AW; Morris, Sapna Bamrah; CDC Severe Monkeypox Investigations TeamAs of October 21, 2022, a total of 27,884 monkeypox cases (confirmed and probable) have been reported in the United States.§ Gay, bisexual, and other men who have sex with men have constituted a majority of cases, and persons with HIV infection and those from racial and ethnic minority groups have been disproportionately affected (1,2). During previous monkeypox outbreaks, severe manifestations of disease and poor outcomes have been reported among persons with HIV infection, particularly those with AIDS (3-5). This report summarizes findings from CDC clinical consultations provided for 57 patients aged ≥18 years who were hospitalized with severe manifestations of monkeypox¶ during August 10-October 10, 2022, and highlights three clinically representative cases. Overall, 47 (82%) patients had HIV infection, four (9%) of whom were receiving antiretroviral therapy (ART) before monkeypox diagnosis. Most patients were male (95%) and 68% were non-Hispanic Black (Black). Overall, 17 (30%) patients received intensive care unit (ICU)-level care, and 12 (21%) have died. As of this report, monkeypox was a cause of death or contributing factor in five of these deaths; six deaths remain under investigation to determine whether monkeypox was a causal or contributing factor; and in one death, monkeypox was not a cause or contributing factor.** Health care providers and public health professionals should be aware that severe morbidity and mortality associated with monkeypox have been observed during the current outbreak in the United States (6,7), particularly among highly immunocompromised persons. Providers should test all sexually active patients with suspected monkeypox for HIV at the time of monkeypox testing unless a patient is already known to have HIV infection. Providers should consider early commencement and extended duration of monkeypox-directed therapy†† in highly immunocompromised patients with suspected or laboratory-diagnosed monkeypox.§§ Engaging all persons with HIV in sustained care remains a critical public health priority.Item Open Access Test-of-Cure After Treatment of Pharyngeal Gonorrhea in Durham, North Carolina, 2021-2022.(Sexually transmitted diseases, 2022-10) Jenks, Jeffrey D; Hester, Lizeth; Ryan, Emily; Stancil, Candy; Hauser, Quinn; Zitta, John-Paul; Mortiboy, Marissa; Rayner, Malkia; Stevens, Elizabeth; Carrico, Savannah; Jenkins, RodneyBackground
In December 2020, the Centers for Disease Control and Prevention updated its treatment guidelines for gonococcal infection and, for the first time, recommended universal test-of-cure for all individuals treated for pharyngeal gonorrhea. After the release of these guidelines, data are lacking on rates of return for the test-of-cure, particularly in populations other than men who have sex with men.Methods
We analyzed the demographic characteristics, clinical characteristics, rate of return for the recommended test-of-cure, and percent positivity for Neisseria gonorrhoeae on repeat pharyngeal specimens at a local public health department in Durham, NC.Results
Of 101 individuals treated for pharyngeal gonorrhea between March 2021 and April 2022, 54.5% were men, 71.2% Black or African American, and 58.4% between the ages of 20 and 29 years. Most identified as either women who have sex with men (38.6%), men who have sex with men (24.8%), or men who have sex with women (22.8%). Of these individuals, 41 (40.6%) returned for a test-of-cure, with LGBTQ+ individuals more likely to return than men who have sex with women and women who have sex with men. Of those who returned for the test-of-cure, 4.9% of pharyngeal samples were equivocal and 2.4% positive for N. gonorrhoeae by nucleic acid amplification testing, likely reflecting false-positive tests.Conclusion
Despite recommendations to perform a test-of-cure 7 to 14 days after treatment of pharyngeal gonorrhea, rates of return continue to be low. Alternative strategies should be investigated to increase test-of-cure rates.