HIV Treatment Cascades that Leak: Correlates of Drop-off from the HIV Care Continuum among Men who have Sex with Men Worldwide

Ayala, George; Makofane, Keletso; Santos, Glenn-Milo; Arreola, Sonya; Hebert, Pato; Thomann, Matthew; Wilson, Patrick A.; Beck, Jack; D., Tri

doi:10.4172/2155-6113.1000331

Cited by 18 publications

(22 citation statements)

References 35 publications

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“…To benefit fully from treatment, however, individuals need to first be aware of their HIV status (Ayala et al, 2014; Bickman & Hoagwood, 2010; Rosenberg, Millett, Sullivan, del Rio, & Curran, 2014; Singh et al, 2014; Zanoni & Mayer, 2014). Early diagnosis allows HIV-infected individuals to take steps to protect their partners from infection, and early treatment can lower viral load and reduce the risk of transmitting HIV (Cohen et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of peer-led interventions to increase HIV testing among men who have sex with men: a systematic review and meta-analysis

et al. 2017

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HIV testing constitutes a key step along the continuum of HIV care. Men who have sex with men (MSM) have low HIV testing rates and delayed diagnosis, especially in low-resource settings. Peer-led interventions offer a strategy to increase testing rates in this population. This systematic review and meta-analysis summarizes evidence on the effectiveness of peer-led interventions to increase the uptake of HIV testing among MSM. Using a systematic review protocol that was developed a priori, we searched PubMed, PsycINFO and CINAHL for articles reporting original results of randomized or non-randomized controlled trials (RCTs), quasi-experimental interventions, and pre- and post-intervention studies. Studies were eligible if they targeted MSM and utilized peers to increase HIV testing. We included studies published in or after 1996 to focus on HIV testing during the era of combination antiretroviral therapy. Seven studies encompassing a total of 6,205 participants met eligibility criteria, including two quasi-experimental studies, four non-randomized pre- and-post intervention studies, and one cluster randomized trial. Four studies were from high-income countries, two were from Asia and only one from sub-Saharan Africa. We assigned four studies a ‘moderate’ methodological rigor rating and three a ‘strong’ rating. Meta-analysis of the seven studies found HIV testing rates were statistically significantly higher in the peer-led intervention groups versus control groups (pooled OR 2.00, 95% CI 1.74–2.31). Among randomized trials, HIV testing rates were significantly higher in the peer-led intervention versus control groups (pooled OR: 2.48, 95% CI 1.99–3.08). Among the non-randomized pre- and post-intervention studies, the overall pooled OR for intervention versus control groups was 1.71 (95% CI 1.42–2.06), with substantial heterogeneity among studies (I2=70 %, p<0.02). Overall, peer-led interventions increased HIV testing among MSM but more data from high-quality studies are needed to evaluate effects of peer-led interventions on HIV testing among MSM in low- and middle-income countries.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of peer-led interventions to increase HIV testing among men who have sex with men: a systematic review and meta-analysis

et al. 2017

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“…Self‐reported HIV prevalence among study participants is troubling given the young median age of this cohort. HIV incidence among gay and bisexual men under the age of 30 is especially high and of concern .…”

Section: Discussionmentioning

confidence: 99%

“…ART utilization and viral suppression rates reported by study participants are higher than previously reported among men who have sex with men in other studies . This may be due to increasing awareness among gay and bisexual men about the health and prevention benefits of UVL because of community education efforts (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Criminalization of homosexuality encourages human rights abuses, violence, discrimination and stigma, which contribute to health disparities for men who have sex with men . Social connectedness with the gay community has been shown to have a protective effect against the often‐devastating effects of homophobia . In policy environments that are hostile to lesbian, gay, bisexual and transgender people, men who have sex with men must find creative and discrete ways to find each other for support and health information.…”

Section: Introductionmentioning

confidence: 99%

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Blue‐Ribbon Boys: factors associated with PrEP use, ART use and undetectable viral load among gay app users across six regions of the world

Ayala¹,

Santos

Arreola³

et al. 2018

J Intern AIDS Soc

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IntroductionGay social networking apps have grown in popularity among men who have sex with men offering opportunities for rapid and confidential collection of vital data as well as social connection. The goal of our study was to explore factors associated with utilization of pre‐exposure prophylaxis (PrEP) and antiretroviral treatment (ART), and self‐reported undetectable viral load (UVL) using data collected by the gay social networking app Hornet.MethodsIn 2016, the Global Forum on MSM & HIV (MSMGF) partnered with Hornet, to support an educational initiative called Blue‐Ribbon Boys. One aspect of the initiative prompts Hornet users to answer a short series of yes‐no questions about their sexual health. Using survey responses, we evaluated factors associated with PrEP and ART use as well as self‐reported UVL by fitting separate multivariable generalized estimating equation models.ResultsIn total, 16,008 unique Hornet users started the survey, of which 12,126 (76%) provided sufficient data for analyses. Of the 10,774 HIV‐negative men, 13% reported PrEP use in the past year. PrEP use was associated with a recent sexually transmitted infection (STI) test or treatment (aOR = 2.19, CI = 1.49 to 3.21); and taking steps to protect oneself from HIV (aOR = 1.41, CI = 1.13 to 1.76). Among HIV‐positive Hornet users (n = 1243), ART use was associated with older age (each year increase aOR = 1.02, CI = 1.01 to 1.04), a recent STI test or treatment (aOR = 4.54, CI = 2.65 to 7.78); and awareness of unlikely HIV transmission with UVL (aOR = 1.53, CI = 1.03 to 2.26). UVL was associated with older age (each year increase aOR = 1.03, CI = 1.01 to 1.04), a recent STI test or treatment (aOR = 4.84, CI = 2.74 to 8.55), and awareness of unlikely HIV transmission with UVL (aOR = 1.98, CI = 1.37 to 2.85).ConclusionsStudy findings underscore the importance of STI testing and treatment as well as information about HIV transmissibility for encouraging PrEP and ART use. Our findings also reveal age disparities, which can undermine incidence reduction among gay men. Gay social networking apps can be effectively used for rapid data collection and sexual health promotion with men who have sex with men. STI testing and treatment programmes offer important opportunities for encouraging PrEP and ART use. Information about HIV transmissibility with consistent ART use should be incorporated into prevention messaging tailored to various age groups.

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“…Delaying or not seeking medical services, or concealing sexual health needs within clinical encounters, increases the likelihood of negative health outcomes for infectious diseases that require medical management, including elevating the risk of transmission to other people (Ayala 2014). For example, in the context of HIV, the likelihood of contracting an opportunistic infection, including tuberculosis, or developing AIDS is greatly increased when antiretroviral therapy (ART) is not initiated at an appropriate time …”

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confidence: 99%

A SWOT analysis of health service access by men who have sex with men in South Africa: lessons for higher education institutions

Scheibe

Daniels

Kutner

et al. 2017

SAJHE

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Few interventions to address heteronormativity in health education and practice exist within South Africa's Higher Education Institutions (HEIs). We conducted a strengths, weaknesses, opportunities and threats (SWOT) analysis of programmes that enhanced the competency of health workers with respect to men who have sex with men (MSM) and the MSM-focused HIV response in South Africa to develop recommendations for similar interventions within HEIs. We found that a combination of political will, MSM community mobilisation, appropriate training approaches, and dedicated funding have enabled the up-scale of HIV-related services for MSM.The implications of our analysis suggest that support from HEI management, student mobilisation, sensitisation training, dedicated financing, and mechanisms to address discrimination would Scheibe, Daniels, Kutner and Lane A SWOT analysis of health service access by men who have sex with men 220 facilitate expansion of practices at HEIs to include the health and wellbeing of sexual minorities.

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HIV Treatment Cascades that Leak: Correlates of Drop-off from the HIV Care Continuum among Men who have Sex with Men Worldwide

Cited by 18 publications

References 35 publications

Effectiveness of peer-led interventions to increase HIV testing among men who have sex with men: a systematic review and meta-analysis

Effectiveness of peer-led interventions to increase HIV testing among men who have sex with men: a systematic review and meta-analysis

Blue‐Ribbon Boys: factors associated with PrEP use, ART use and undetectable viral load among gay app users across six regions of the world

A SWOT analysis of health service access by men who have sex with men in South Africa: lessons for higher education institutions

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