Differences in HIV treatment experiences, perceptions, and behaviors by gender and sexual orientation in 25 middle-income and high-income countries: Findings from the 2019 Positive Perspectives Survey

Okoli, Chinyere; Velde, Nicolas Van de; Brough, Garry; Hardy, William; Corbelli, Giulio Maria; Allan, Brent; Muchenje, Marvelous; Castellanos, Erika; Young, Benjamin E.; Eremin, Anton; Ramothwala, Pholokgolo

doi:10.18332/popmed/128600

Cited by 3 publications

(6 citation statements)

References 26 publications

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“…Another key difference identified in the case reports presented in this paper was the greater health literacy of the gay male as compared to the heterosexual female and male. This finding is mirrored by other studies that report MSM can demonstrate greater understanding of their medications, greater perceived comfort in discussing their challenges with medical professionals and greater overall involvement in their care [7].…”

Section: Access To Medical Servicessupporting

confidence: 65%

“…In Australia, the focus on HIV as predominately affecting MSM has meant heterosexual females and heterosexual males may fall outside the routine screening, be less likely to share their HIV status with healthcare providers outside of their main HIV medical service, and, therefore, miss the opportunity for timely and regular interventions [7,15]. A longitudinal study conducted in middle-income and high-income countries identified higher rates of non-retention in care among heterosexual males, opening the door for poorer virus control and potentially poorer overall health [7]. Findings from this international study also identified more differences existed between heterosexual males and MSM than between heterosexual males and women in a number of health-related outcomes.…”

Section: Access To Medical Servicesmentioning

confidence: 99%

“…Australia's early response to the HIV crisis in the 1980s and 1990s has been described as so successful because the gay community mobilized and developed their own strategies to reduce HIV transmission and care for those affected [16]. It therefore remains a priority to continue working towards minimizing any perceived disparities between the overlapping but unique needs of heterosexual females and males in this ongoing pandemic [7].…”

Section: Access To Medical Servicesmentioning

confidence: 99%

“…Global research suggests that women may have a different lived experience of HIV due to their unequal social and economic status in society [2], while MSM may have a different lived experience depending on the laws and social norms of their geographic location [7]. As the physical challenges of living with HIV have been mitigated for the approximately two-thirds of people with access to antiretroviral therapies [1], other difficulties reported by people with HIV can be socially mediated and perceived differently by MSM, men who have sex with women and women [7]. Therefore, an understanding of gendered experiences in areas such as stigma, access to services and mental health can be important when responding to the challenges of supporting people living with HIV.…”

Section: Introductionmentioning

confidence: 99%

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Gendered Experiences of Living with HIV in Australia

Hutton

2021

Sexes

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Globally, women represent more than half the people living with HIV. This proportion varies by country, with an over-representation of HIV among men who have sex with men (MSM) in some regions. For example, in Australia, MSM account for over 60% of transmissions, with heterosexual sex accounting for almost a quarter of transmissions. Irrespective of geographic region, there is evidence that women can have a different lived experience of HIV due to their unequal social and economic status in society, while MSM can have a different lived experience depending on the laws and customs of their geographic location. Gender differences related to risk factors, stigma, access to services, mental health, health-related quality of life and economic consequences have been consistently reported globally. This paper explores the subjective lived experience of gender and sexuality disparities among three individuals living with HIV in Australia: a male who identified as gay, and a male and female who each identified as heterosexual. Analysis of themes from these three case reports indicated discernible differences by gender and sexuality in four areas: access to medical services, social support, stigma and mental health. It is argued that knowledge and understanding of potential gender and sexuality disparities must be factored into supportive interventions for people living with HIV in Australia.

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Section: Access To Medical Servicessupporting

confidence: 65%

Section: Access To Medical Servicesmentioning

confidence: 99%

Section: Access To Medical Servicesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gendered Experiences of Living with HIV in Australia

Hutton

2021

Sexes

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“…The 2019 Positive Perspectives Study was conducted in 25 countries among 2389 PLHIV aged 18–84 years [ 7 – 9 , 13 – 16 ]. All participants were on ART at the time of the survey and provided informed consent.…”

Section: Methodsmentioning

confidence: 99%

Factors Associated with Treatment Satisfaction Among People Living with HIV in Japan and Other Selected Countries: Examination of the Intertwined Roles of Medication, Patient, and Provider Characteristics

Koga¹,

Wakatabe²,

Okamoto³

et al. 2021

AIDS Behav

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We examined satisfaction and perceived challenges with antiretroviral therapy (ART) among people living with HIV (PLHIV) in Japan vs three other Asian countries (China, Taiwan, South Korea), and 21 non-Asian countries, using data from the 2019 Positive Perspectives Study (pooled sample size from all 25 countries = 2389). Participants in other Asian countries were more likely than those in Japan to report they missed ART ≥ 1 time in the past month because they were depressed/overwhelmed (57.4%[89/155] vs 32.0%[24/75]), had privacy concerns (56.8%[88/155] vs 30.7%[23/75]), were concerned about the potential long-term negative impacts of ART (46.5%[72/155] vs 26.7%[20/75]), or just wanted to forget about HIV (45.8%[71/155] vs 22.7%[17/75]). ART satisfaction however did not differ significantly between surveyed PLHIV in Japan (54.7%[41/75]) vs those in other Asian countries (47.7%[74/155]). The percentage who felt that daily ART dosing limited their lives was 36.0%[27/75] among participants from Japan, 48.4%[75/155] among participants from other Asian countries, and 27.3%[589/2159] among those from non-Asian countries. Within a structural equation model using pooled data from all 25 countries, positive correlations were seen between ART satisfaction and “provider engagement” (β = 0.35), high perceived control over ART dosing schedule (β = 0.28), and the belief that ART prevents HIV transmission (β = 0.16). Conversely, negative correlations were seen between ART satisfaction and experience of ART side-effects (β = − 0.24), high “ART anxiety” (β = − 0.20); and being on multi-tablet regimens (β = − 0.13). Those ART-satisfied reported higher self-rated health and greater ART adherence. These findings underscore the need for patient-centered care to enhance treatment satisfaction and improve ART adherence.

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Efficacy and safety of dolutegravir/lamivudine in virologically suppressed female participants: week 48 data from the pooled TANGO and SALSA studies

Katlama,

Bisshop,

Bogner

et al. 2024

HIV Medicine

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ObjectivesWomen represent >50% of people with HIV globally but have historically been underrepresented in clinical trials. We evaluated the efficacy and safety of switching to dolutegravir/lamivudine (DTG/3TC) vs continuing their current antiretroviral regimen (CAR) by sex assigned at birth (female and male) in virologically suppressed adults with HIV‐1 without prior virological failure in a pooled analysis of two randomized controlled trials.MethodsThis analysis included 48‐week data from the phase 3 TANGO and SALSA studies. Primary and key secondary endpoints included proportions of participants with HIV‐1 RNA ≥50 and <50 copies/mL at week 48, respectively. Safety was also assessed.ResultsOf 1234 participants, 250 (DTG/3TC, n = 133; CAR, n = 117) were female at birth. Week 48 proportions of participants with Snapshot HIV‐1 RNA ≥50 copies/mL were similar regardless of sex at birth (DTG/3TC vs CAR: female, <1% [1/133] vs 2% [2/117]; male, <1% [1/482] vs <1% [3/502]). Proportions with HIV‐1 RNA <50 copies/mL were high across sexes and treatment groups (DTG/3TC vs CAR: female, 91% [121/133] vs 89% [104/117]; male, 94% [455/482] vs 94% [471/502]). Immunological response with DTG/3TC was slightly higher in female participants. Incidences of adverse events leading to withdrawal and serious adverse events were low and comparable between treatment groups and across sexes. Weight gain was higher with DTG/3TC than with CAR among female participants aged ≥50 years (treatment difference 2.08 kg [95% confidence interval 0.40–3.75]).ConclusionsResults confirm the robustness of DTG/3TC as a switch option in virologically suppressed females with HIV‐1, with outcomes similar to those in males.

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Differences in HIV treatment experiences, perceptions, and behaviors by gender and sexual orientation in 25 middle-income and high-income countries: Findings from the 2019 Positive Perspectives Survey

Cited by 3 publications

References 26 publications

Gendered Experiences of Living with HIV in Australia

Gendered Experiences of Living with HIV in Australia

Factors Associated with Treatment Satisfaction Among People Living with HIV in Japan and Other Selected Countries: Examination of the Intertwined Roles of Medication, Patient, and Provider Characteristics

Efficacy and safety of dolutegravir/lamivudine in virologically suppressed female participants: week 48 data from the pooled TANGO and SALSA studies

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