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. 

More at:  https://twitter.com/hiv_insight

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,

More at:  https://twitter.com/hiv_insight

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