This study assessed the feasibility of online recruitment of high-risk Latino men who have sex with men (MSM) for HIV prevention survey research and investigated the relationship between Internet use and unsafe sex. Participants (N= 1,026) were Internet-using Latino MSM living in the U.S. recruited using online banner advertisements. Respondents completed a cross-sectional, online survey in English or Spanish. Sample characteristics reflected national statistics within 5%. Nearly all (99%) reported having used the Internet to seek sex with another man. Two-thirds of respondents reported having unprotected anal sex with ≥ 1 man in the last year, 57% of these with multiple partners. Participants reported engaging in anal sex and unprotected anal sex with nearly twice as many men first met online versus offline, but risk proportions did not differ. Internet-based HIV prevention research is possible even with geographically-dispersed minority populations. Efficiency appears the primary risk associated with meeting partners online. KeywordsHIV prevention; Internet sex; Latino; men who have sex with men; Men who use the Internet to seek Sex with Men; MISM
IntroductionTransgender women are the population most vulnerable to HIV in Latin America, with prevalence between 18 and 38%. Although the region has improved antiretroviral coverage, there is an urgent need to strengthen HIV prevention for key populations to meet regional targets set by governments. We conducted an assessment on the state of HIV prevention among transgender women in Latin America.MethodsWe conducted a desk review of Global AIDS Response Progress Reports, national strategic plans, technical reports and peer-reviewed articles from 17 Latin American countries published through January 2015. The review was preceded by 12 semi-structured interviews with UNAIDS and Pan American Health Organization officers and a discussion group with transgender women regional leaders, to guide the identification of documents. We assessed access to, implementation and coverage of programmes; legal frameworks; community participation; inclusion of new strategies; and alignment with international recommendations.Results and discussionOverall, prevention activities in the region focus on condom distribution, diagnosis of sexually transmitted infections and peer education, mostly delivered at health facilities, with limited community involvement. Argentina and Uruguay have implemented structural interventions to address social inclusion. Argentina, Brazil and Mexico have adopted early initiation of antiretroviral therapy and treatment as prevention strategies. The other countries do not have substantial tailored interventions and consider the trans population a sub-population of men who have sex with men in data collection and programme implementation. Limited coverage of services, discrimination and a deep-seated mistrust of the health system among transgender women are the main barriers to accessing HIV prevention services. Promising interventions include health services adapted to transgender women in Mexico; LGBT-friendly clinics in Argentina that incorporate community and health workers in mixed teams; task-shifting to community-based organizations; mobile HIV testing; and gender identity laws.ConclusionsTransgender women in Latin America continue to have limited access to HIV prevention services, which presents a bottleneck for reaching prevention goals and incorporating new prevention interventions. Prevention programmes should be rights-based; offer tailored, holistic interventions; and involve transgender women in their design and implementation.
ObjectivesSummarize hepatitis C virus (HCV) prevalence in injecting (IDU) and non-injecting drug users (NIDU), men who have sex with men (MSM), sex workers, and prison inmates in Latin America and the Caribbean (LAC).MethodsSystematic review on HCV prevalence in sub-populations in LAC. Databases searched from 1-1-2000 to 10-30-2013. Inclusion criteria: prevalence studies in sub-populations in LAC. HCV-antibody was marker for prevalence of current/past HCV infection and HCV-RNA for prevalence of HCV current infection.ResultsIDU HCV current/past infection presented highest prevalence, from 1.7 % in Colombia to over 95 % in Ciudad Juarez and Tijuana, Mexico and pooled regional anti-HCV prevalence was 49 % (CI 95 % 22.6–76.3 %). NIDU, MSM and sex workers anti-HCV prevalence was below 10 %, and pooled regional prevalence of 4 % (CI 95 % 2.6–4.5 %), 3 % (CI 95 % 1.7–4.5 %) and 2 % (CI 95 % 1.0–3.4 %), respectively. Prison inmates presented higher values, but prevalence decreased over the 15-year time span (p < 0.001). Current HCV infection from three countries showed prevalence under 10 % in prison inmates and 1–46 % among drug users.ConclusionsDisease burden is high and surveillance, prevention and treatment should target these groups in LAC.Electronic supplementary materialThe online version of this article (doi:10.1007/s00038-015-0708-5) contains supplementary material, which is available to authorized users.
Experiences of men who have internet sex with men were studied to determine the level of misrepresentation in real life and on the Internet of physical, relationship, sexual interests, and HIV status. An internet-based questionnaire in English and Spanish ($20 compensation) recruited 1,026 Latino MISM over 3 weeks. Four 'fib' scales were created to measure misrepresentation by the respondent and to the respondent on the Internet and IRL. Overall, respondents rated being misrepresented to on the Internet significantly highest, followed by being misrepresented to IRL and misrepresenting themselves to others on the Internet, and misrepresenting themselves to others IRL lowest. For HIV status there were no differences between Internet and IRL misrepresentation by others and Internet and IRL misrepresentation by self, but a significant difference between HIV status misrepresentation by self and others. Misrepresenters were more likely to have had cybersex before meeting their last partner and to prefer cybersex, to be more sexually compulsive, and to speak and think more in Spanish. Social desirability considerations account for the higher misrepresentation on physical characteristics and sexual interests by others, and higher misrepresentation on the Internet. However, misrepresentation of HIV status was the lowest category and while it was misrepresented more often by others than self, there were no internet/IRL differences. Data suggest that HIV misrepresentation occurred for 20% of men and was lower than other forms of misrepresentation. Implications for HIV prevention are discussed, along with the concept of levels of accuracy in internet communications.
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