HIV Seropositivity & Sexuality: Cessation of Sexual Relations among Men & Women Living with HIV in Five Countries

The sexuality of people living with HIV (PLHIV) is a key issue in the fight against HIV, as it influences both the dynamic of the epidemic and the quality of life of PLHIV. 

The present study examined the factors associated with cessation of sexual relations after HIV diagnosis among men and women in five countries: Mali, Morocco, Democratic Republic of the Congo, Romania and Ecuador. A community-based cross-sectional study was implemented by a mixed consortium [researchers/community-based organizations (CBO)]. Trained CBO members interviewed 1500 PLHIV in contact with CBOs using a 125-item questionnaire. 

A weighted multivariate logistic regression and a separate gender analysis were performed. Among the 1413 participants, 471 (33%) declared that they stopped having sexual relations after their HIV diagnosis, including 318 women (42%) and 153 men (23%) (p < .001). 

Concerning women, variables associated with the cessation of sexual relations in the final multivariate model were mainly related with relational factors and the possibility of getting social support (e.g., needing help to disclose HIV serostatus, feeling lonely every day, not finding support in CBOs, not being in a couple). 

Men's sexual activity was more associated with their representations and their perception of the infection (e.g., thinking they will have their HIV infection for the rest of their life, perceiving the HIV infection as a mystery, perceiving the infection as serious). 

Furthermore, the following variables were associated with both men and women sexual behaviours: being older, having suffered from serious social consequences after serostatus disclosure and not being able to regularly discuss about HIV with their steady partner. 

Results suggested clear differences between men and women regarding cessation of sexual relations and highlighted the importance of implementing gender-based tailored interventions that promote safe and satisfying sexuality, as it is known to have a positive impact on the overall well-being of PLHIV.

Purchase full article at:   http://goo.gl/XgYIvD

By:  Bernier A1, Lefèvre M1, Henry E1, Verdes L2, Acosta ME3, Benmoussa A4, Mukumbi H5, Cissé M6, Otis J7, Préau M8.

• 1 Coalition Internationale Sida , Pantin , France.
• 2 ARAS , Bucharest , Romania.
• 3 Kimirina , Quito , Ecuador.
• 4 ALCS , Casablanca , Morocco.
• 5 ACS/AMO Congo , Kinshasa , Democratic Republic of the Congo.
• 6 ARCAD-SIDA , Bamako , Mali.
• 7 CReCES, Université du Québec à Montréal , Montréal , Canada.
• 8 Social Psychology Research Group , Institute of Psychology, University of Lyon 2 , Bron , France.
• AIDS Care. 2016 Feb 28:1-6.  

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Prevalence of Marijuana Use among University Students in Bolivia, Colombia, Ecuador, and Peru

Young adults 18 to 25 years old show the highest prevalence of marijuana use in Latin America. This study analyzes the changes in prevalence of marijuana use among university students in the Andean Community (Bolivia, Colombia, Ecuador, and Peru) from two studies carried out in 2009 and in 2012. 

Data were collected through representative two-stage samples of universities and students in the Andean Community. An online survey was administered using a standardized questionnaire. Prevalence was calculated for lifetime, past year, and past month. Marijuana was the most widely used illicit substance consumed among university students, in 2009 and in 2012. 

Past month prevalence among university students in 2009 in Colombia was 5.27%, in Peru 1.00%, in Ecuador 1.68%, and in Bolivia 0.76%. Past month prevalence in 2012 in Colombia was 7.14%, in Ecuador 3.67%, in Peru 1.62%, and in Bolivia 1.45% in 2012. Among university students in the Andean Community, past month prevalence increased among both males and females between 2009 and 2012 in most countries. 

Marijuana continues to be the most commonly used illicit drug in Latin American countries. Increases in prevalence among young adults could have important implications for national drug policy.

Below:  Past year incidence of marijuana use in Andean Countries, by country

Full article at:  http://goo.gl/C3Q4wJ

By: Hynes M1, Demarco M2, Araneda JC3, Cumsille F4.

• 1Inter-American Observatory on Drugs, Inter-American Drug Abuse Control Commission (CICAD), Organization of American States (OAS), 1889 F Street NW, Washington, DC 20006, USA. mhynes@oas.org.
• 2Inter-American Observatory on Drugs, Inter-American Drug Abuse Control Commission (CICAD), Organization of American States (OAS), 1889 F Street NW, Washington, DC 20006, USA. mdemarco@oas.org.
• 3Global SMART Programme (Latin America), United Nations Office on Drugs and Crime, 1889 F Street NW, Washington, DC 20006, USA. jaraneda@oas.org.
• 4Inter-American Observatory on Drugs, Inter-American Drug Abuse Control Commission (CICAD), Organization of American States (OAS), 1889 F Street NW, Washington, DC 20006, USA. fcumsille@oas.org. 

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Transactional Sex & Prevalence of STIs: A Cross-Sectional Study of MSM & Transwomen Screened for an HIV Prevention Trial

Few studies have characterised the degree of engagement in transactional sex among men and transgender women who have sex with men and explored its association with sexually transmitted infections and human immunodeficiency virus in Ecuador.

We screened 642 men who have sex with men and transgender women for a pre-exposure prophylaxis clinical trial (iPrEx) in Guayaquil, Ecuador, 2007-2009. We analysed the association of degree of engagement in transactional sex and prevalence of sexually transmitted infections including human immunodeficiency virus using chi-square and analysis of variance tests. 

• Although just 6.2% of those who screened self-identified as sex workers, 52.1% reported having engaged in transactional sex. 
• Compared to those who had never been paid for sex, those who had been paid were more likely to have a sexually transmitted infection (56.6% vs. 45.0%) and trended towards a higher HIV prevalence (16.6% vs. 10.4%) at screening. 
• Transgender women compared to other men who have sex with men were more likely to have STIs diagnosed at screening (75.6% vs. 50.0%).

 Transactional sex is practiced widely but occasionally among the men who have sex with men and transgender women in Guayaquil who screened for the iPrEx study; however, engaging in transactional sex may not lead to a sex worker self-identification. Both transactional sex and being a transgender woman are associated with sexually transmitted infections prevalence.

Via:  http://goo.gl/dKaXRb Purchase full article at: http://goo.gl/pwoXd9

By: Solomon MM1, Nureña CR2, Tanur JM3, Montoya O4, Grant RM5, Jeff McConnell J6.

• 1Department of Medicine, University of California, CA, USA Gladstone Institutes, CA, USA marc.solomon@ucsf.edu.
• 2Escuela de Antropología, Universidad Nacional Mayor de San Marcos, Perú
• 3Department of Sociology, Stony Brook University, Stony Brook, NY, USA.
• 4Fundación Ecuatoriana Equidad, Ecuador.
• 5Department of Medicine, University of California, CA, USA Gladstone Institutes, CA, USA.
• 6Gladstone Institutes, CA, USA. 

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HIV, STI and Behavioral Risk among Men Who have Sex with Men in a Setting of Elevated HIV Prevalence Along Ecuador's Pacific Coast

We assessed HIV and STI prevalence, risk behaviors and factors associated with HIV infection in men who have sex with men (MSM) in Guayaquil, Ecuador. Respondent-driven sampling was used to recruit 400 MSM in 2011-2012. Participants completed a computer-assisted self-interview and provided blood samples. Statistical analysis accounted for differential probability of selection and for recruitment patterns. 

• HIV prevalence was 11.3 %, 
• HSV-2 30.2 %, 
• active syphilis 6.9 % and 
• hepatitis B 1.2 %. 

In the previous 12 months, 

• 84 % of MSM reported casual male sex partners and 
• 25 % sex work. 
• Only 48 % of MSM consistently used condoms with male partners and 
• 54 % had ever been tested for HIV. 
• Of 17 % of MSM reporting a female partner, consistent condom use was 6 %. 
• HIV infection was associated with age 25 or older, active syphilis and homosexual self-identification. 

Findings suggest continuing HIV risk and a need to strengthen prevention and testing among MSM.

Via:  http://goo.gl/68XFz5 Purchase full article at: http://goo.gl/TkFCWF

By: Sánchez-Gómez A1, Jacobson JO, Montoya O, Magallanes D, Bajaña W, Aviles O, Esparza T, Soria E, González MA, Morales-Miranda S, Tobar R, Riera C.

1Pan American Health Organization, Quito, Ecuador,

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A Cross-Sectional Study to Evaluate Factors Related to Condom Use with Commercial Sexual Partners in Workers from Ecuadorian Companies

Below: New HIV infections in Latin America, 2013

Background

Unprotected intercourse with sex workers is one of the major risk factors for HIV infection. Consistent condom use is a prerequisite to lower the incidence of HIV.

Methods

We assessed the prevalence of condom use and its determinants among company workers engaged with commercial sexual partners in Ecuador. The study was based on a random sample of 115 companies and 1,732 workers stratified by province and working sector and utilized the “Behavioral Surveillance Surveys – Adult questionnaire” developed by Family Health International.

Results

Of the 1,561 sexually active workers, 311 (19.9 %) reported having intercourse with sex workers. Among them 25.9 % did not use a condom at the last sexual intercourse. As for condom use frequency over the last 12 months, 29/208 (13.9 %) reported never, 23 (11.1 %) sometimes, 24 (11.5 %) almost every time and 132 (63.5 %) every time. Factors adversely affecting condom use frequency over the last 12 months were female gender (OR = 4.56, 95 % CI: 1.45-14.4), older age (OR = 1.07, 95 % CI: 1.03-1.10), low educational level (OR = 4.69, 95 % CI: 1.95-11.3) and married workers living with spouse (OR = 7.66, 95 % CI: 3.08-19.1). By contrast, factors such as age at first sexual intercourse, job category, HIV transmission and prevention measure knowledge, single workers, previous exposure to HIV intervention programs and having a casual sexual partner were not affecting condom use frequency. When considering condom use during the last sexual intercourse or during the past 12 months with commercial sexual partners, results were similar.

Conclusions

Workers with low education, older age, female gender and those married living with their spouse should be targeted for specific educational interventions.

Read more at: http://ht.ly/RPPQ3 HT https://twitter.com/UniversiteLiege

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Family Planning for Strangers: An Experiment on the Validity of Reported Contraceptive Use

Below:  Scatterplot for Reported Sterilization and TFR in Urban Latin American DHS data, 42 surveys from 15 countries, including OLS Regression Prediction Line (R2 = 0.14; p = 0.015).

Sterilization levels reported in the Dominican Republic appear well above what we would normally expect given prevailing patterns in the region. We suspect that the use of strangers as interviewers—the normative approach in data collection in both developed and developing country settings—may be partly responsible for this result, and may underlie a long history of bias in family planning data. We present findings from a field experiment conducted in a Dominican town in 2010, where interviewer assignment was randomized by level of preexisting level of familiarity between interviewer and respondent. In our data, sterilization use is higher when the interviewer is an outsider, as opposed to someone known to the respondent or from the same community. In addition, high sterilization use is correlated with a propensity of respondents to present themselves in a positive light to interviewers. These results call into question the routine use of strangers and outsiders as interviewers in demographic and health surveys.

Read more at:  http://goo.gl/YdgGZ0 HT https://twitter.com/Hebrewu

Accurate Dosing of Antiretrovirals at Home Using a Foilized, Polyethylene Pouch to Prevent the Transmission of HIV From Mother to Child

Below:  Example of returned pouch analysis. The solid line indicates the measurement from the edge of the tear site to the edge of the pouch. This length was recorded to assess tear length remain. The dashed line indicates the measurement taken from the minimum point of the tear site to the bottom of the pouch. This was taken to assess whether the user's tear site extended into the liquid contents of the pouch.

Mother-to-child HIV transmission rates remain elevated in countries with high home birth rates. This risk can be dramatically reduced if infants receive antiretroviral (ARV) medication within 24 hours after birth. However, many barriers prevent access to these medications immediately after delivery, for example, there is currently no suitable mechanism to preserve predosed ARVs in the home during the months before birth. In response to this, students of the Duke University developed the Pratt pouch, a foilized polyethylene packet designed to preserve predosed ARVs.

This cross-sectional study presents the data from the first clinical trials of the Pratt pouch in Guayaquil, Ecuador.

Fourteen HIV-positive mothers and nurses were observed using the pouch to deliver a dose of ARVs to an infant. Weight measurements, time, and notes on spillage were taken at each observation period. Successful usage was quantitatively assessed through the calculation of dosing accuracy based on the volume of liquid medication emptied from the pouch. Additionally, mothers were surveyed after a month of using the device at home to assess their perception of the accuracy, acceptability, and ease of use of the pouch. Used pouches were collected for physical analysis of tearing.

Observed users delivered accurate doses (M = 101.1%, standard deviation = 8.2%) in an average time of 2.6 minutes. A total of 2869 used pouches were recovered. No seal failures or failed attempts at opening/delivering the pouches were observed or detected. Forty-three mothers were surveyed. All mothers (100%) reported that they were able to follow their physician's treatment plan, all pouches were received in good condition and the pictorial sheets provided clear instructions.

We conclude that the Pratt pouch is a highly accurate and easy-to-use device for delivering liquid oral ARVs to infants and is appropriate for prepackaging ARVs for home use.

Read more at:   http://ht.ly/QOAOA HT @DukeEngineering