Men Who Have Sex With Men in Peru: Acceptability of Medication-Assisted Therapy for Treating Alcohol Use Disorders

Brown, Shan-Estelle; Vagenas, Panagiotis; Konda, Kelika A.; Clark, Jesse L.; Lama, Javier R.; Gonzáles, Pedro; Sánchez, Jorge; Duerr, Ann; Altice, Frederick L.

doi:10.1177/1557988315576775

Cited by 18 publications

(25 citation statements)

References 55 publications

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“…As previously reported (Brown et al, 2015), participants were mostly young (mean=28.3 years; range=20–40 years). Socioeconomic information was not recorded.…”

Section: Resultssupporting

confidence: 65%

“…The first four themes are discussed herein; the latter three were published recently (Brown et al, 2015). …”

Section: Resultsmentioning

confidence: 96%

“…The recruitment and methods of FG participants have been previously described for an assessment of naltrexone acceptability (Brown et al, 2015). Briefly, following informed consent procedures, all 26 participants met screening criteria (Babor et al, 1992) for having an AUD (score 8 or greater on the AUDIT), were born male (male-to-female TGW were included), reported unprotected anal intercourse (UAI) with another male in the previous year and were 18 years or older (see Table 1).…”

Section: Methodsmentioning

confidence: 99%

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A Qualitative Assessment of Alcohol Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men and Transgender Women in Peru

Vagenas¹,

Brown²,

Clark

et al. 2017

Substance Use & Misuse

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Background Peruvian men who have sex with men (MSM) and transgender women (TGW) experience the double burden of a highly concentrated HIV epidemic with a high prevalence of alcohol use disorders (AUDs). Recent research has associated both with risky sexual behaviors, including unprotected sex, having multiple sexual partners, engaging in sex work, having recent sexually transmitted infections (STIs) and having HIV-infected partners. AUDs have also been associated in MSM/TGW with being unaware of HIV-positive status. Objectives This study aims to further examine issues associated with alcohol consumption, HIV infection and risk behaviors in a qualitative analysis of focus groups conducted with MSM/TGW in Peru. Methods A total of 26 MSM/TGW participants with AUDs participated in three semi-structured focus groups in Lima, Peru. Content analysis was facilitated by software, and specific themes were elucidated. Results Participants described their drinking patterns, including the types of alcoholic drinks they consumed. They depicted drinking frequently and over multiple-day sessions. Problematic drinking behaviors were described, as well as the perceived characteristics of alcohol dependence. Interestingly, HIV-infected participants who were prescribed antiretroviral therapy (ART) did not believe that their drinking affected their medication adherence. These insights can aid in the design of future interventions aiming to reduce problematic drinking, as well as HIV-related risk behaviors and, subsequently, HIV incidence. Conclusion Peruvian MSM/TGW exhibit problematic drinking which may be associated with risky sexual behaviors and HIV transmission. Interest in reducing alcohol consumption was high, suggesting the need for targeted behavioral and pharmacological interventions.

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“…As previously reported (Brown et al, 2015), participants were mostly young (mean=28.3 years; range=20–40 years). Socioeconomic information was not recorded.…”

Section: Resultssupporting

confidence: 65%

“…The first four themes are discussed herein; the latter three were published recently (Brown et al, 2015). …”

Section: Resultsmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

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A Qualitative Assessment of Alcohol Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men and Transgender Women in Peru

Vagenas¹,

Brown²,

Clark

et al. 2017

Substance Use & Misuse

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“…A systematic review and meta-analysis, however, showed no differences between most pharmacological agents in their ability to reduce relapse to any alcohol use but did find a reduction in days of heavy drinking for most approved (i.e., naltrexone and acamprosate) and some off-label medications [102]. The acceptability of pharmacological treatments for AUDs, however, will be crucial for their uptake [103]. The extent to which alcohol reduction, rather than complete elimination of use, will translate to improvements in each step of the HIV treatment cascade remains likely but unknown and needs empiric support from prospective controlled trials.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Alcohol Use and Related Disorders on the HIV Continuum of Care: a Systematic Review

et al. 2015

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Alcohol use is highly prevalent globally with numerous negative consequences to human health, including HIV progression, in people living with HIV (PLH). The HIV continuum of care, or treatment cascade, represents a sequence of targets for intervention that can result in viral suppression, which ultimately benefits individuals and society. The extent to which alcohol impacts each step in the cascade, however, has not been systematically examined. International targets for HIV treatment as prevention aim for 90 % of PLH to be diagnosed, 90 % of them to be prescribed with antiretroviral therapy (ART), and 90 % to achieve viral suppression; currently, only 20 % of PLH are virally suppressed. This systematic review, from 2010 through May 2015, found 53 clinical research papers examining the impact of alcohol use on each step of the HIV treatment cascade. These studies were mostly cross-sectional or cohort studies and from all income settings. Most (77 %) found a negative association between alcohol consumption on one or more stages of the treatment cascade. Lack of consistency in measurement, however, reduced the ability to draw consistent conclusions. Nonetheless, the strong negative correlations suggest that problematic alcohol consumption should be targeted, preferably using evidence-based behavioral and pharmacological interventions, to indirectly increase the proportion of PLH achieving viral suppression, to achieve treatment as prevention mandates, and to reduce HIV transmission.

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“…Interventions that apply across high-risk populations should be pursued. However differing perceptions of alcohol abuse and cultural acceptability of social alcohol use in excess (Brown et al, 2015), may be hindering participation in alcohol abuse treatment programs. Therefore it is of critical importance that community engagement informs how interventions addressing unsafe alcohol use can be better accessed across high-risk populations.…”

Section: Discussionmentioning

confidence: 99%

Impact of alcohol use on sexual behavior among men who have sex with men and transgender women in Lima, Peru

Herrera

Konda

León

et al. 2016

Drug and Alcohol Dependence

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Background Alcohol use disorders (AUDs) may enhance the likelihood of risky sexual behaviors and the acquisition of sexually transmitted infections (STIs). Associations between AUDs with condomless anal intercourse (CAI) and STI/HIV prevalence were assessed among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. Methods MSM and TW were eligible to participate based on a set of inclusion criteria which characterized them as high-risk. Participants completed a bio-behavioral survey. An AUDIT score ≥8 determined AUD presence. Recent STI diagnosis included rectal gonorrhea/chlamydia, syphilis, and/or new HIV infection within 6 months. Prevalence ratios (PR) were calculated using Poisson regression. Results Among 312 MSM and 89 TW, 45% (181/401) had an AUD. Among those with an AUD, 164 (91%) were hazardous/harmful drinkers, and 17 (9%) had alcohol dependence. Higher CAI was reported by participants with an AUD vs. without, (82% vs. 72% albeit not significant). Reporting anal sex in two or more risky venues was associated with screening AUD positive vs. not (24% vs. 15%, p=0.001). There was no difference in recent STI/HIV prevalence by AUD status (32% overall). In multivariable analysis, screening AUD positive was not associated with CAI or recent STI/HIV infection. Conclusions In our sample AUDs were not associated with CAI or new HIV infection/recent STI. However higher prevalence of CAI, alcohol use at last sex, and anal sex in risky venues among those with AUDs suggests that interventions to reduce the harms of alcohol should be aimed toward specific contexts.

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Men Who Have Sex With Men in Peru: Acceptability of Medication-Assisted Therapy for Treating Alcohol Use Disorders

Cited by 18 publications

References 55 publications

A Qualitative Assessment of Alcohol Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men and Transgender Women in Peru

A Qualitative Assessment of Alcohol Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men and Transgender Women in Peru

The Impact of Alcohol Use and Related Disorders on the HIV Continuum of Care: a Systematic Review

Impact of alcohol use on sexual behavior among men who have sex with men and transgender women in Lima, Peru

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