Undiagnosed HIV infection in a population of MSM from six European cities: results from the Sialon project

Ferrer, Laia; Furegato, Martina; Foschia, Jean-Pierre; Folch, Cinta; González, Victoria; Ramarli, Dunia; Casabona, Jordi; Mirandola, Massimo

doi:10.1093/eurpub/cku139

Cited by 39 publications

(48 citation statements)

References 24 publications

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“…[10][11][12] Stigma-related barriers to healthcare exacerbate sexual orientation-based health disparities, including increasing HIV and sexually transmitted infection (STI) incidence. [4][5][6][7]10,13 Two international sexual health surveys indicate that HIV prevalence among Romanian men who have sex with men (MSM) was 5% in 2008 14 and 18% in 2014, 15 suggesting a potential recent increase in HIV infection. Romanian LGBT individuals report some of the highest rates of health services dissatisfaction, barriers to healthcare, and mental health problems (e.g., depression, anxiety, and suicidality), yet indicate the highest desire to use LGBT-affirmative healthcare, among their European peers.…”

Section: Introductionmentioning

confidence: 99%

“…19,20 Although data on Romanian LGBT individuals' healthcare experiences are limited, reports indicate pervasive discrimination upon identity disclosure. 21 International surveys show low rates of HIV testing, 14,15 attributed to verbal abuse from healthcare staff. 10 Data also reveal frequently reported depression, anxiety, isolation, and identity concealment in healthcare settings (Lelutiu-Weinberger C, Manu M, Lȃscut F, et al: Preliminary efficacy of the first mobile health intervention to reduce HIV risk among MSM in Romania.…”

Section: Introductionmentioning

confidence: 99%

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Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Leluţiu-Weinberger

Pachankis

2017

LGBT Health

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Purpose: Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills. Methods: We conducted a 2-day training for MHPs in Bucharest. Fifty-four attended and 33 provided training evaluation data at baseline and follow-up. Results: The majority of trainees were female (90%) and heterosexual (73%) with a mean age of 36.4 (SD = 7.7). From baseline to follow-up, trainees demonstrated a significant increase in perceived LGBT-relevant clinical skills (P < 0.001) and perceived knowledge (P < 0.05).LGBT-affirmative practice attitudes (P < 0.05) and comfort in addressing the mental health of LGBT individuals (P < 0.01) increased significantly, and homonegative and transnegative attitudes decreased significantly (P < 0.01). Negative attitudes toward LGBT individuals were low at both baseline and follow-up. The majority of trainees reported being highly interested in the training (84%), which they reported had prepared them to interact with and care for LGBT individuals (74%). Conclusion: This pilot training appeared to be effective in increasing perceived LGBT competence among participating MHPs. This type of training model needs to be tested further in a randomized controlled trial with longer follow-up periods to assess intervention durability and implementation of clinical skills. Future trainings can be incorporated into existing curricula. National accreditation bodies might consider encouraging such training as part of standard educational requirements.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Leluţiu-Weinberger

Pachankis

2017

LGBT Health

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“…However, HIV testing is still offered largely at clinical sites, and outreach programmes remain scarce [1]. This situation results in missed HIV prevention opportunities, particularly for most at-risk populations who might not seek testing in traditional facility-based settings [9,10].…”

Section: Introductionmentioning

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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“…[1,2] GBM are a relatively hidden, [3] yet highly vulnerable emerging HIV risk group in Romania, a country with one of the highest number of unrecognized HIV/AIDS cases in that region. [4,5] Currently, HIV transmission is driven by male-to-male sexual contact.…”

Section: Introductionmentioning

confidence: 99%

“…[4,6,[8][9][10][11][12] However, this group faces some of the highest stigma and discrimination in Europe, [12,13] including in healthcare, [3] where GBMspecific expertise is limited. Consequently, Romanian YGBM most often conceal their sexual orientation, [5,14] have low rates of HIV testing, [1,2] and do not disclose their sexual behavior to providers, all of which likely drive their rising HIV epidemic. [15] Additionally, stigma and discrimination are known risk factors for alcohol abuse, depression, and anxiety, which combine to form a syndemic (i.e., synergistic epidemic) that further exacerbates HIV risk.…”

Section: Introductionmentioning

confidence: 99%

An mHealth Intervention to Improve Young Gay and Bisexual Men’s Sexual, Behavioral, and Mental Health in a Structurally Stigmatizing National Context (Preprint)

Leluţiu-Weinberger¹,

Manu²,

Ionescu³

et al. 2017

Preprint

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Background: Young gay and bisexual men (YGBM) in Eastern European countries like Romania face high stigma and discrimination, including in healthcare. Increasing HIV transmission is a concern given inadequate prevention, travel to high-prevalence countries, and popularity of sexual networking technologies. Objective: An efficacious mobile health (mHealth) HIV-prevention intervention created in the United States was adapted and pilot-tested in Romania to reduce YGBM's HIV risk. Methods:After an intervention formative phase, 43 YGBM (M age = 23.2, SD=3.6) who reported condomless sex with a male partner and at least five days of heavy drinking in the past three months were enrolled and completed up to eight 60-minute counseling sessions based on motivational interviewing and cognitive behavioral skills training with trained counselors. Prepost intervention assessments of sexual (e.g., HIV-risk behavior), behavioral (e.g., alcohol use), and mental health (e.g., depression) outcomes were conducted to evaluate intervention impact. Results:From baseline to follow-up, participants reported significant: 1) increases in HIV-related knowledge (M=4.6 vs. M=4.8, P < 0.001) and recent HIV testing (M=2.8 vs. M=3.3, P < 0.05);2) reductions in heavy alcohol consumption (M=12.8 vs. M=6.9, P < 0.01), and 3) increases in self-efficacy of condom use (M=3.3 vs. M=4.0, P < 0.01). Participants also reported significant reductions in depression symptoms (M=1.5 vs. M=1.0, P < 0.01). Conclusions: This first mHealth HIV risk-reduction pilot intervention for YGBM in EasternEurope indicated preliminary efficacy and strong acceptability and feasibility. This mobile prevention tool lends itself to broad dissemination pending future efficacy testing, especially in contexts where stigma keeps GBM out of reach of affirmative health interventions.

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Undiagnosed HIV infection in a population of MSM from six European cities: results from the Sialon project

Cited by 39 publications

References 24 publications

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

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

An mHealth Intervention to Improve Young Gay and Bisexual Men’s Sexual, Behavioral, and Mental Health in a Structurally Stigmatizing National Context (Preprint)

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