Perceived barriers to pre-exposure prophylaxis use and the role of syndemic factors among female sex workers in the Mexico-United States border region: <i>a latent class analysis</i>

Jain, Jennifer; Strathdee, Steffanie A.; Patterson, Thomas L.; Semple, Shirley J.; Vera, Alicia; Magis-Rodríguez, Carlos; Martínez, Gustavo; Pines, Heather A.

doi:10.1080/09540121.2019.1626338

Cited by 19 publications

(32 citation statements)

References 52 publications

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“…Lack of insurance coverage was a concern [81] Race 18.7% of individuals cited perceived financial barriers to PrEP [192] Mixed methods study of young adults experiencing homelessness in Houston and Los Angeles (N = 45)…”

Section: History Of Substance Abusementioning

confidence: 99%

Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

2020

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Antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV transmission was first approved by the US Food and Drug Administration in 2012. Despite correlations of decreases in new HIV infections being greatest where PrEP has been deployed, the uptake of PrEP is lagging, particularly among populations with disproportionate HIV burden. This narrative review seeks to identify individual and systemic barriers to PrEP usage in the USA. A comprehensive search of recent literature uncovered a complex array of structural, social, clinical, and behavioral barriers, including knowledge/awareness of PrEP, perception of HIV risk, stigma from healthcare providers or family/partners/friends, distrust of healthcare providers/systems, access to PrEP, costs of PrEP, and concerns around PrEP side effects/medication interactions. Importantly, these barriers may have different effects on specific populations at risk. The full potential of PrEP for HIV prevention will not be realized until these issues are addressed. Strategies to achieve this goal should include educational interventions, innovative approaches to delivery of HIV care, financial support, and destigmatization of PrEP and PrEP users. Until then, PrEP uptake will continue to be suboptimal, particularly among those who need it most.

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Section: History Of Substance Abusementioning

confidence: 99%

Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

2020

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“…Of the 56 studies, 14 scored as strong quality, 34 scored as moderate, and 8 scored as weak (S3 Text). Sixteen studies (14 moderate; 2 weak) selected participants based on harmful alcohol or drug use (n = 9) [24,26,31,33,34,[37][38][39][40], or positive [32,41] or negative [29,[42][43][44][45] HIV status (n = 5), and were excluded from the meta-analyses (regardless of CEBM score) to avoid biasing the pooled estimates. Analyses used a variety of validated scales and cut-off points to assess mental disorders (Table 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Measures of violence varied by timeframe (recent versus ever), typology (physical, sexual, emotional) and perpetrator (client, intimate partner, etc.). Overall, 13 studies reported associations between depression and violence [34,37,39,43,44,46,49,52,53,59,79,83], with 7 studies included in the meta-analyses (S1 Fig). The pooled unadjusted OR of depression and violence experience (ever or recent) is 2.2 (1.4-3.3), p < 0.001 (n = 7 studies), and the pooled unadjusted OR of depression and recent violence experience is 2.3 (1.3-4.2), p = 0.005 (n = 5 studies).…”

Section: Associations Between Mental Health and Other Factorsmentioning

confidence: 99%

“…measure hazardous, harmful, or dependent drinking [44,73,84] or severe binge drinking [46] ( Table 2). The pooled unadjusted OR for depression and alcohol use is 1.6 (0.8-3.1), p = 0.2 (n = 4 studies) ( S2 Fig); when the outlier study is removed from the analyses, the pooled unadjusted OR is 2.1 (1.4-3.2), p < 0.001 (n = 3 studies) ( S2 Fig).…”

Section: Plos Medicinementioning

confidence: 99%

“…The pooled unadjusted OR of recent suicide ideation and alcohol use is 1.6 (1.0-2.5), p = 0.03 (n = 2 studies) (S2 Fig); one study reported associations between a recent suicide attempt and alcohol use, with an unadjusted OR of 2.8 (1.4-5.5), p = 0.003. Three studies reported on mental health problems and illicit drug use, again with considerable variation in the way illicit drug use was measured (any illicit drug use ever [85,86] versus polydrug use past month [44]). Two studies were included in the meta-analysis (S3 Fig).…”

Section: Plos Medicinementioning

confidence: 99%

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Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis

et al. 2020

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Background The psychological health of female sex workers (FSWs) has emerged as a major public health concern in many low-and middle-income countries (LMICs). Key risk factors include poverty, low education, violence, alcohol and drug use, human immunodeficiency virus (HIV), and stigma and discrimination. This systematic review and meta-analysis aimed to quantify the prevalence of mental health problems among FSWs in LMICs, and to examine associations with common risk factors. Method and findings The review protocol was registered with PROSPERO, number CRD42016049179. We searched 6 electronic databases for peer-reviewed, quantitative studies from inception to 26 April 2020. Study quality was assessed with the Centre for Evidence-Based Management (CEBM) Critical Appraisal Tool. Pooled prevalence estimates were calculated for depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal behaviour. Meta-analyses examined associations between these disorders and violence, alcohol/drug use, condom use, and HIV/sexually transmitted infection (STI). A total of 1,046 studies were identified, and 68 papers reporting on 56 unique studies were eligible for inclusion. These were geographically diverse (26 countries), representing all LMIC regions, and included 24,940 participants. All studies were cross-sectional and used a range of measurement tools; none reported a mental health intervention. Of the 56 studies, 14 scored as strong quality, 34 scored as moderate, and 8 scored as weak. The average age of participants was 28.9 years (age range: 11-64 years), with just under half (46%) having up to primary education or less. The pooled prevalence rates for mental disorders among FSWs in LMICs were as follows: depression 41.8% (95% CI 35.8%-48.0%), anxiety 21.0% (95% CI: 4.8%-58.4%), PTSD 19.7% (95% CI 3.2%-64.6%), psychological distress 40.8% (95% CI 20.7%-64.4%), recent suicide ideation 22.8% (95% CI 13.2%-36.5%), and recent suicide attempt 6.3% (95% CI 3.4%-11.4%). Meta-analyses found significant associations between violence experience

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Estimating HIV transmissions in a large U.S. clinic‐based sample: effects of time and syndemic conditions

Satyanarayana

Safren

Rogers

et al. 2021

J. Intern. AIDS Soc.

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Introduction: Little is known about onward HIV transmissions from people living with HIV (PLWH) in care. Antiretroviral therapy (ART) has increased in potency, and treatment as prevention (TasP) is an important component of ending the epidemic. Syndemic theory has informed modelling of HIV risk but has yet to inform modelling of HIV transmissions. Methods: Data were from 61,198 primary HIV care visits for 14,261 PLWH receiving care through the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) at seven United States (U.S.) sites from 2007 to 2017. Patient-reported outcomes and measures (PROs) of syndemic conditionsdepressive symptoms, anxiety symptoms, drug use (opiates, amphetamines, crack/cocaine) and alcohol usewere collected approximately four to six months apart along with sexual behaviours (mean = 4.3 observations). Counts of syndemic conditions, HIV sexual risk group and time in care were modelled to predict estimated HIV transmissions resulting from sexual behaviour and viral suppression status (HIV RNA < 400/ mL) using hierarchical linear modelling. Results: Patients averaged 0.38 estimated HIV transmissions/100 patients/year for all visits with syndemic conditions measured (down from 0.83, first visit). The final multivariate model showed that per 100 patients, each care visit predicted 0.05 fewer estimated transmissions annually (95% confidence interval (CI): 0.03 to 0.06; p < 0.0005). Cisgender women, cisgender heterosexual men and cisgender men of undisclosed sexual orientation had, respectively, 0.47 (95% CI: 0.35 to 0.59; p < 0.0005), 0.34 (95% CI: 0.20 to 0.49; p < 0.0005) and 0.22 (95% CI: 0.09 to 0.35; p < 0.005) fewer estimated HIV transmissions/100 patients/year than cisgender men who have sex with men (MSM). Each within-patient syndemic condition predicted 0.18 estimated transmissions/100 patients/year (95% CI: 0.12 to 0.24; p < 0.0005). Each between-syndemic condition predicted 0.23 estimated HIV transmissions/100 patients/year (95% CI: 0.17 to 0.28; p < 0.0005). Conclusions: Estimated HIV transmissions among PLWH receiving care in well-resourced U.S. clinical settings varied by HIV sexual risk group and decreased with time in care, highlighting the importance of TasP efforts. Syndemic conditions remained a significant predictor of estimated HIV transmissions notwithstanding the effects of HIV sexual risk group and time in care.

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Perceived barriers to pre-exposure prophylaxis use and the role of syndemic factors among female sex workers in the Mexico-United States border region: a latent class analysis

Cited by 19 publications

References 52 publications

Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis

Estimating HIV transmissions in a large U.S. clinic‐based sample: effects of time and syndemic conditions

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