Being in the Closet. Correlates of Outness Among MSM in 13 European Cities

Gios, Lorenzo; Mirandola, Massimo; Sherriff, Nigel; Toskin, Igor; Blondeel, Karel; Dias, Sónia; Staneková, Danica; Folch, Cinta; Schink, Susanne; Nöstlinger, C; Berghe, Wim Vanden; Naseva, Emilia; Alexiev, Ivailo

doi:10.1080/00918369.2019.1656033

Cited by 14 publications

(8 citation statements)

References 38 publications

(52 reference statements)

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“…Similar situations have been reported elsewhere in Europe and the US where subtype B predominates [34,35]. Prevention efforts to reduce stigma may help to improve reporting of potential transmission risks and increase acceptability of treatment and care, including PrEP [36,37]. There were nearly equal numbers of MSM and HET members in the clusters composed of only two or three sequences at the 1.5% threshold.…”

Section: Discussionsupporting

confidence: 69%

Molecular Epidemiology of the HIV-1 Subtype B Sub-Epidemic in Bulgaria

Alexiev

Campbell

Knyazev

et al. 2020

Viruses

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HIV-1 subtype B is the predominant strain in Bulgaria, yet little is known about the molecular epidemiology of these infections, including its origin and transmissibility. We used a phylodynamics approach by combining and analyzing 663 HIV-1 polymerase (pol) sequences collected from persons diagnosed with HIV/AIDS between 1988–2018 and associated epidemiologic data to better understand this sub-epidemic in Bulgaria. Using network analyses at a 1.5% genetic distance threshold (d) we found several large phylogenetic clusters composed mostly of men who have sex with men (MSM) and male heterosexuals (HET). However, at d = 0.5%, used to identify more recent transmission, the largest clusters dissociated to become smaller in size. The majority of female HET and persons with other transmission risks were singletons or pairs in the network. Phylogenetic analysis of the Bulgarian pol sequences with publicly available global sequences showed that subtype B was likely introduced into Bulgaria from multiple countries, including Israel and several European countries. Our findings indicate that subtype B was introduced into Bulgaria multiple times since 1988 and then infections rapidly spread among MSM and non-disclosed MSM. These high-risk behaviors continue to spread subtype B infection in Bulgaria as evidenced by the large clusters at d = 0.5%. Relatively low levels of antiretroviral drug resistance were observed in our study. Prevention strategies should continue to include increased testing and linkage to care and treatment, as well as expanded outreach to the MSM communities.

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Section: Discussionsupporting

confidence: 69%

Molecular Epidemiology of the HIV-1 Subtype B Sub-Epidemic in Bulgaria

Alexiev

Campbell

Knyazev

et al. 2020

Viruses

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“…Since its introduction in 1997, the RDS methodology has been widely used in surveys of hidden or hard-to-reach populations using 25 26. Although often efficient, the RDS method has some limitations.…”

Section: Discussionmentioning

confidence: 99%

Evaluating sexual health in sex workers and men who have sex with men: the SMESH cross-sectional protocol study

et al. 2019

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IntroductionHuman papillomavirus (HPV) infection is transmitted through skin-to-skin contact, and vaginal and anal sex are the most common transmission routes. Sex workers and men who have sex with men (MSM) are more exposed to the virus, and therefore, a higher frequency of this infection would be expected. The prevalence of HPV infection types and the forms and factors of transmission must be investigated to control infection-related outcomes. This protocol study will be the first nationwide study with a uniform methodology to evaluate HPV prevalence of and infection types among sex workers and MSM in Brazil.Methods and analysisThis multicentre cross-sectional study will be conducted with a respondent-driven sampling method to recruit 1174 sex workers and 1198 MSM from all regions of Brazil. The study will consist of preliminary interviews to verify the eligibility criteria and characterise the network size as well as a second questionnaire to obtain sociodemographic, behavioural and sexual information. Specimens from the oral cavity and anal and cervical or penile/scrotal sites will be collected. All HPV samples will be processed in a certified central laboratory. Other sexually transmitted infections will be evaluated by interview and by rapid testing for HIV and syphilis. Strict quality control will be conducted using different procedures, including the training and certification of the health professionals responsible for acquiring data and monitoring visits.Ethics and disseminationThe project was approved by the research ethics committee of the main institution and the corresponding ethics committees of the recruitment sites. Due to the literature gap on the sexual health of sex workers and MSM and the intense stigma surrounding these populations, a critical analysis of the study results will contribute to epidemiological knowledge and will be useful for the development of strategies against virus morbidities.

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“… 54 Gios et al have discussed the correlates of outness in this sample elsewhere. 64 Self-reporting of outness might be affected by social desirability. The expected positive association between outness and sexual satisfaction might be reversed by higher external minority stressors.…”

Section: Discussionmentioning

confidence: 99%

Sexual satisfaction, an indicator of sexual health and well-being? Insights from STI/HIV prevention research in European men who have sex with men

Blondeel,

Mirandola,

Gios

et al. 2024

BMJ Glob Health

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IntroductionAlthough sexual health has been holistically defined to include sexual satisfaction, it has been largely absent in health services and sexual and reproductive health and rights programmes in many parts of the world. We propose sexual satisfaction as a useful indicator, as one of the proxy measures for sexual health and well-being and as a component of well-being in general.MethodsThe Sialon II project is a multicentre biological and behavioural cross-sectional community-based survey implemented across 13 European cities during 2013–2014 among men who have sex with men. Sexual satisfaction was explored using one single item: ‘How satisfied are you with your sex life?’ A multivariable multilevel logistic random-intercept model was estimated to identify factors associated with reporting positive sexual satisfaction versus negative sexual satisfaction.ResultsAge, the number of partners and self-reported HIV status were not significantly associated with sexual satisfaction in the multivariate model. Participants reporting an insertive role or reported both an insertive and receptive role during the last anal intercourse were more likely to be sexually satisfied, compared with a receptive role. Participants reporting anal intercourse with a condom were more likely to be satisfied than those declaring no anal intercourse in the last 6 months, but no significant association was found compared with anal intercourse without condom. Knowledge of HIV-serostatus concordance with the last sexual partner was positively correlated with sexual satisfaction. Having had sexual intercourse with non-steady partners only in the last 6 months was negatively correlated. The more positive participants perceived their work/school, parents and friends/acquaintances’ attitudes towards gay or bisexual persons, the higher the odds they were satisfied with their sexual life.ConclusionUsing a single item on sexual satisfaction in a bio-behavioural study, our analysis has shown that it is associated with individual, interpersonal and social/structural factors and has proven its usefulness as a sexual health indicator among men who have sex with men.

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Being in the Closet. Correlates of Outness Among MSM in 13 European Cities

Cited by 14 publications

References 38 publications

Molecular Epidemiology of the HIV-1 Subtype B Sub-Epidemic in Bulgaria

Molecular Epidemiology of the HIV-1 Subtype B Sub-Epidemic in Bulgaria

Evaluating sexual health in sex workers and men who have sex with men: the SMESH cross-sectional protocol study

Sexual satisfaction, an indicator of sexual health and well-being? Insights from STI/HIV prevention research in European men who have sex with men

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