Is Involvement in Sex Work Associated with Engagement in HIV-Related Medical Care in Latin American Men Who Have Sex with Men? Results of a Large, Multinational Internet Survey

Biello, Katie B.; Oldenburg, Catherine E.; Rosenberger, Joshua G.; Mayer, Kenneth H.; Novak, David S.; Mimiaga, Matthew J.

doi:10.1089/lgbt.2015.0006

Cited by 7 publications

(7 citation statements)

References 26 publications

(27 reference statements)

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“…The flow diagram of study selection is shown in Figure . Fifty‐three studies, composed of 22,603 participants in ART from 25 LAC countries, met eligibility criteria for the systematic review (Table ) . The median number of participants in ART per study was 201 [range: 13 – 3343; interquartile range (IQR): 394 – 125].…”

Section: Resultsmentioning

confidence: 99%

“…Some factors positively associated with adherence to ART were: high social support , good relationship with the physician ; satisfaction with the healthcare service ; and use of counselling services . Some factors negatively associated with adherence to ART were: alcohol use or alcohol use disorders ; substance use ; high pill burden ; depression symptoms ; unemployment or irregular employment ; and high or detectable HIV viral load .…”

Section: Resultsmentioning

confidence: 99%

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Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: Systematic review and meta‐analysis

et al. 2018

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IntroductionOptimal adherence to antiretroviral therapy is closely related with suppression of the HIV viral load in plasma, slowing disease progression and decreasing HIV transmission rates. Despite its importance, the estimated proportion of people living with HIV in Latin America and the Caribbean with optimal adherence has not yet been reported in a meta‐analysis. Moreover, little is known of the factors leading to poor adherence which may be setting‐specific. We present a pooled estimate of adherence to antiretroviral therapy (ART) of people living with HIV in Latin America and Caribbean, report the methods used to measure adherence and describe the factors associated with poor adherence among the selected studies.MethodsWe electronically searched published studies up to July 2016 on the PubMed, Web of Science and Virtual Health Library (Latin America and the Caribbean Regional Portal); considering the following databases: MEDLINE, LILACS, PAHO and IBECS. Two independent reviewers selected and extracted data on ART adherence and study characteristics. Pooled estimate of adherence was derived using a random‐effects model. Risk of bias in individual studies was assessed independently by two investigators using the Risk of Bias Assessment tool for Non‐randomized Studies (RoBANS).Results and discussionThe meta‐analysis included 53 studies published between 2005 and 2016, which analysed 22,603 people living with HIV in 25 Latin America and Caribbean countries. Overall adherence in Latin America and Caribbean was 70% (95% CI: 63–76; I 2 = 98%), similar to levels identified by studies conducted in high‐income regions. Self‐report was the most frequently used method to measure adherence. Subgroup analysis showed that adherence was higher for the shortest recall time frame used, as well as in countries with lower income level, Gross National Income (GNI) per capita and Human Development Index (HDI). Studies reported diverse adherence barriers, such as alcohol and substance misuse, depression, unemployment and pill burden.ConclusionsOur study suggests that adherence to ART in Latin America and Caribbean may be below the sufficient levels required for a successful long‐term viral load suppression.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: Systematic review and meta‐analysis

et al. 2018

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“…The risk may be lessened by available HIV prevention, treatment, and care services at the community level if barriers to the uptake of those services are removed. Previous research has reported that MSM face sexual stigma on multiple levels including anticipated discrimination from health care providers for disclosure of their HIV status, sexual orientation, or behaviors (Biello et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Transactional Sex, Substance Use, and Sexual Risk: Comparing Pay Direction for an Internet-Based U.S. Sample of Men Who Have Sex with Men

et al. 2019

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Demographic, behavioral, and structural factors among four mutually exclusive transactional sex categories were assessed in an online sample of 7217 sexually active US men who have sex with men (MSM): (1) No Trade Sex group (87%); (2) Sellers, accepting money or drugs for sex (5%); (3) Buyers, giving money or drugs for sex (6%); and (4) Sellers and Buyers, accepting and giving money or drugs for sex (2%). Separate multivariable logistic regressions compared men who did not report past 60-day transactional sex with men in the three transactional sex groups. Sellers were more likely to report being black or Asian (versus white), low income, a recent STI diagnosis, six or more recent male anal sex partners, and polydrug use. Buyers were more likely to report being older, higher income, urban residence, incarceration history, a recent STI diagnosis, and having non-main sex partners. Sellers and Buyers were more likely to report a higher income, incarceration history, six or more recent male anal sex partners, and polydrug use. Findings suggest that public health policy and HIV prevention harm reduction strategies should address the distinct sexual and behavioral risk patterns among MSM who engage in transactional sex based on payment direction.

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“…MSM who sell sex may actively avoid healthcare, as well as HIV testing, due to anticipated stigma: a survey with 332 staff of healthcare and social service agencies in Jamaica and the Bahamas found that while most respondents said they believed that people living with HIV, MSM, and sex workers deserved quality care, they expressed a high level of blame and negative moral judgments towards MSM [50]. A study with MSM (n = 2035) in Latin America [67] reported that transactional sex was associated with reduced engagement in HIV medical care, underscoring the importance of addressing intersectional stigma targeting MSM, sex workers, and people living with HIV. A recent qualitative study [18] exploring HIV testing experiences with young MSM (n = 20) and community-based key informants (n = 13) in Kingston, Jamaica found that experiences of perceived and enacted stigma in healthcare settings due to sexual stigma and HIV-related stigma presented barriers to accessing HIV testing and sexual healthcare.…”

Section: Discussionmentioning

confidence: 99%

Social-ecological factors associated with selling sex among men who have sex with men in Jamaica: results from a cross-sectional tablet-based survey

Logie

Lacombe‐Duncan

Kenny

et al. 2018

Global Health Action

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Background: Globally, men who have sex with men (MSM) experience social marginalization and criminalization that increase HIV vulnerability by constraining access to HIV prevention and care. People who sell sex also experience criminalization, rights violations, and violence, which elevate HIV exposure. MSM who sell sex may experience intersectional stigma and intensified social marginalization, yet have largely been overlooked in epidemiological and social HIV research. In Jamaica, where same sex practices and sex work are criminalized, scant research has investigated sex selling among MSM, including associations with HIV vulnerability. Objective: We aimed to examine social ecological factors associated with selling sex among MSM in Jamaica, including exchanging sex for money, shelter, food, transportation, or drugs/alcohol (past 12 months). Methods: We conducted a cross-sectional survey with a peer-driven sample of MSM in Kingston, Ocho Rios, and Montego Bay. Multivariable logistic regression analyses were conducted to estimate intrapersonal/individual, interpersonal/social, and structural factors associated with selling sex. Results: Among 556 MSM, one-third (n = 182; 32.7%) reported selling sex. In the final multivariable model, correlates of selling sex included: individual/intrapersonal (lower safer sex self-efficacy [AOR: 0.85, 95% CI: 0.77, 0.94]), interpersonal/social (concurrent partnerships [AOR: 5.52, 95% CI: 1.56, 19.53], a higher need for social support [AOR: 1.08, 95% CI: 1.03, 1.12], lifetime forced sex [AOR: 2.74, 95% 1.65, 4.55]) and structural-level factors (sexual stigma [AOR: 1.09, 95% CI: 1.04, 1.15], food insecurity [AOR: 2.38, 95% CI: 1.41, 4.02], housing insecurity [AOR: 1.94, 95% CI: 1.16, 3.26], no regular healthcare provider [AOR: 2.72, 95% CI: 1.60, 4.64]). Conclusions: This study highlights social ecological correlates of selling sex among MSM in Jamaica, in particular elevated stigma and economic insecurity. Findings suggest that MSM in Jamaica who sell sex experience intensified social and structural HIV vulnerabilities that should be addressed in multi-level interventions to promote health and human rights.

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Is Involvement in Sex Work Associated with Engagement in HIV-Related Medical Care in Latin American Men Who Have Sex with Men? Results of a Large, Multinational Internet Survey

Cited by 7 publications

References 26 publications

Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: Systematic review and meta‐analysis

Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: Systematic review and meta‐analysis

Transactional Sex, Substance Use, and Sexual Risk: Comparing Pay Direction for an Internet-Based U.S. Sample of Men Who Have Sex with Men

Social-ecological factors associated with selling sex among men who have sex with men in Jamaica: results from a cross-sectional tablet-based survey

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