Successes and challenges of HIV prevention in men who have sex with men

Sullivan, Patrick S.; Carballo‐Diéguez, Alex; Coates, Thomas J.; Goodreau, Steven M.; McGowan, Ian; Sanders, Eduard J.; Smith, Adrian D.; Goswami, Prabuddhagopal; Sánchez, Jorge

doi:10.1016/s0140-6736(12)60955-6

Cited by 352 publications

(315 citation statements)

References 80 publications

(99 reference statements)

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“…We note that as HIV prevention efforts shift towards combination prevention where behavioral efforts are combined with biomedical approaches to HIV prevention, understanding resiliencies will also be an essential tool to translating efficacious biomedical strategies into real world effectiveness [23][24][25]. The impressive strides that have been made recently in the effort to prevent HIV through pre-exposure prophylaxis (PrEP) [26,27], post-exposure prophylaxis (PEP) [28,29], and treatment as prevention [30,31] will be useless if there is not uptake by those most at risk.…”

Section: Incorporating a Resilience Framework Into Research Among Gaymentioning

confidence: 99%

Resilience as a Research Framework and as a Cornerstone of Prevention Research for Gay and Bisexual Men: Theory and Evidence

et al. 2013

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This commentary presents the content and results of a recent symposium held to discuss how resiliencies among gay and bisexual men, and other men who have sex with men, could inform HIV prevention interventions. We outline the argument for including resiliencies in prevention work and present a critique of the deficitbased approached to public health research as it applies to this line of inquiry. The commentary makes the case that HIV prevention work would be more efficacious if it were designed to incorporate naturally occurring resiliencies that manifest among gay male communities rather than primarily using interventions that address vulnerabilities among men who continue to reside in high risk contexts. The commentary concludes by listing a set of resiliency variables and constructs proposed at the meeting that could be tested in theoretically-based investigations to raise resiliencies among gay and bisexual men thereby lowering HIV risks in this population.Keywords Resilience Á MSM health Á Gay and bisexual men Á TheoryIn the summer of 2011, The Fenway Institute of Boston and the University of Pittsburgh Center for Lesbian, Gay, Bisexual and Transgender (LGBT) Health Research convened a meeting of many of the thought leaders in the field of Gay and Bisexual men's health to discuss how resilience among gay and bisexual men, and other men who have sex with men (henceforth referred to simply as gay and bisexual men), could inform HIV prevention interventions. The idea behind the meeting was to outline ways in which resiliencies could be used to move the field forward towards the abatement or elimination of health disparities within this population. The primary goals of this meeting were to raise interest in the study of resilience as a way to improve health outcomes among gay and bisexual men, to learn from community-based programs that were already using resilience-based approaches in their work, and to begin conceptualizing how researchers could adapt and use a resilience-based framework in their study of HIV and other health disparities in gay and bisexual men. We also critically reviewed deficit-based approach to health, focusing on assumptions underlying these methods.Relative to the field of prevention research, communitybased organizations for gay and bisexual men have better recognized that focusing on strengths, resilience, and other protective factors can bring about positive individual and community-level results. However, few community programs have had the resources to test or evaluate their work. To begin to bridge this divide, the meeting organizers brought together leaders in research as well as key informants from resilience-based community programs including Manifest Love, the Harlem United Community AIDS Center (www.harlemunited.org), Easton Mountain (www. eastonmountain.com), Life Lube (www.lifelube.org), and others who have already been using strength-based approaches to promote health among gay and bisexual men. After a day of sharing methods, challenges, questions and results f...

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Section: Incorporating a Resilience Framework Into Research Among Gaymentioning

confidence: 99%

Resilience as a Research Framework and as a Cornerstone of Prevention Research for Gay and Bisexual Men: Theory and Evidence

et al. 2013

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“…Except for heterosexual men, individuals who sold sex regardless of drug use reported high condom use during last sexual intercourse (>70%). Consistent condom use with appropriate lubricants is an essential prevention method for anyone engaging in anal sex [28]. In Brazil, only 55% of subjects aged 15-64 years consistently used condoms during the last 12 months [29].…”

Section: Discussionmentioning

confidence: 99%

Community-Based Rapid HIV Testing in Brazil for Vulnerable Populations: Whom are We Reaching?

Barros¹,

Sabidó²,

Mir³

et al. 2017

J AIDS Clin Res

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Objective: Rapid HIV testing and counselling in community settings delivered by trained peers can allow easier access to and uptake of HIV testing and care. The programme 'Live Better Knowing' offers rapid HIV testing to key populations across Brazil. This cross-sectional study aims at describing the HIV prevalence in population subgroups and at assessing the association of sex work (SW) and/or drug use with a positive HIV result. Methods:Between January 2013 and April 2016, key populations were invited for HIV rapid oral fluid tests (DPP HIV-1/2 Bio-Manguinhos/Fiocruz, Rio de Janeiro, Brazil) by peers. HIV testing was offered in identified venues and areas where these populations socialize. Participants were interviewed using a brief questionnaire about their socio-demographic and risk behaviour. Multivariable logistic regression was used to assess the effect of SW and/or drug use on the risk of HIV.Results: Among the 43,358 participants, 42.9% were ciswomen, 2.9% were transvestites, 2.7% were transgender, 19.8% were men who have sex with men (MSM) and 31.9% were heterosexual men. Overall, 52.1% were first-time HIV testers. The HIV prevalence among the ciswomen, transvestites, transgender people, MSM and heterosexual men was 0.9%, 7.2%, 4%, 3.4% and 1%, respectively. Individuals who performed SW and used drugs had the highest HIV prevalence within each population group (ciswomen 1.7%, transvestites 8.1%, transgender 7.4%, MSM 5.9% and heterosexual men 2.6%). The adjusted odds ratios with 95% confidence intervals for selling sex combined with drug use were 2.90 (1.21-6.96) in ciswomen, 25.01 (2.67-234.57) in transgender people and 2.42 (1.31-4.48) in MSM. Conclusion:This outreach programme attracted persons with high risk practices who had never been tested. Our findings suggest that transvestites and transgender people (particularly those who sell sex) constitute a high risk population for HIV in urgent need of enhanced prevention, treatment and care services.

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“…For instance, while research advances have suggested that to achieve an AIDS-free generation, inclusion of MSM in HIV research interventions is imperative, the unmet health needs of MSM in this region are currently being heightened by discriminatory laws prohibiting these men from attaining a rights-defined health status [3,48]. Also, despite evidence suggesting that great strides have been made in HIV prevention among behaviorally heterosexual populations, the rates of HIV continue to increase disproportionately among MSM [55]. For example, in Kenya, the HIV prevalence among the general population ranged from 6.70% in 2003 to 5.60% in 2012 (Kenya AIDS response progress report 2014) while that of MSM was 24.60% during the same period [21,51].…”

Section: Hiv Disparities and Syndemic Conditions Among Msm In Ssa: Pamentioning

confidence: 99%

Resilience Factors as a Buffer against the Effects of Syndemic Conditions on HIV Risk and Infection among Tanzanian MSM

Adeboye¹,

Ross²,

Wilkerson³

et al. 2017

J Health Edu Res Dev

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Background: In the extremely homophobic conditions in Tanzania and other countries in sub-Saharan Africa (SSA), men who have sex with men (MSM) experience disproportionate amounts of both HIV infection and psychosocial health problems, but no research has been conducted to examine the synergistic or additive effects of these adversities on their experiences. While the predominantly deficit-based research approach has identified various HIV risks and vulnerabilities, any naturally occurring protective and resilience factors that these men naturally employ to these health-related adversities remain undetermined.

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Successes and challenges of HIV prevention in men who have sex with men

Cited by 352 publications

References 80 publications

Resilience as a Research Framework and as a Cornerstone of Prevention Research for Gay and Bisexual Men: Theory and Evidence

Resilience as a Research Framework and as a Cornerstone of Prevention Research for Gay and Bisexual Men: Theory and Evidence

Community-Based Rapid HIV Testing in Brazil for Vulnerable Populations: Whom are We Reaching?

Resilience Factors as a Buffer against the Effects of Syndemic Conditions on HIV Risk and Infection among Tanzanian MSM

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