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Dean G Cruess, Kaylee E Burnham, David J Finitsis, Brett M Goshe, Lauren Strainge, Moira Kalichman, Tamar Grebler, Chauncey Cherry, Seth C Kalichman
Background: HIV disproportionately affects sexual minority men, and developing strategies to reduce transmission risk is a public health priority. Purpose: The goal was to empirically test a newly developed, Information, Motivation, Behavioral skills (IMB) theoretically derived, online HIV sexual risk reduction intervention (called HINTS) among a sample of sexual minority men living with HIV. Methods: Participants were 167 men randomized to either the four-session online HINTS intervention or to a time-matched, online control condition...
February 5, 2018: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
Stephanie A Grilo, Marina Catallozzi, Craig J Heck, Sanyukta Mathur, Neema Nakyanjo, John S Santelli
Understanding how couples perceive a recent unintended pregnancy in the context of HIV infection and high levels of gender inequality may provide insights for prevention of undesired pregnancy. We used data from 24 in-depth interviews with 8 HIV-serodiscordant and 4 seroconcordant couples living in rural Uganda and interviewed separately; between 15 and 49 years and one or both identified the pregnancy as unintended. A dyadic analysis was performed to understand each partner's perspectives on experiences of a specific pregnancy...
March 14, 2018: Global Public Health
Kiffer G Card, Nathan J Lachowsky, Heather L Armstrong, Zishan Cui, Lu Wang, Paul Sereda, Jody Jollimore, Thomas L Patterson, Trevor Corneil, Robert S Hogg, Eric A Roth, David M Moore
INTRODUCTION: Among gay, bisexual, and other men who have sex with men (GBM), collinearity between polysubstance use and mental health concerns has obscured their combined effects on HIV risk with multivariable results often highlighting only one or the other. METHODS: We used mediation and moderation analyses to examine the effects of polysubstance use and depressive symptoms on high-risk sex (i.e., condomless anal sex with serodiscordant/unknown status partner) in a sample of sexually-active GBM, aged ≥16 years, recruited in Metro Vancouver using respondent driven sampling...
March 6, 2018: Addictive Behaviors
Kerry A Thomson, James Hughes, Jared M Baeten, Grace John-Stewart, Connie Celum, Craig R Cohen, Kenneth Ngure, James Kiarie, Nelly Mugo, Renee Heffron
Background: Understanding the absolute and relative risk of HIV-1 acquisition during pregnancy and postpartum can inform HIV-1 prevention strategies for women. Methods: We used a complementary log-log model and data from 2,751 HIV-1 serodiscordant couples to compare the probability of women's HIV-1 acquisition risk per sex act during early pregnancy, late pregnancy, postpartum, and non-pregnant periods. Results: At total of 686 pregnancies were identified and 82 incident HIV-1 infections occurred...
March 5, 2018: Journal of Infectious Diseases
Clarence S Yah
Background: Despite the shift in antiretroviral therapy (ARVs) eligibility cascade from CD4 ≤ 200 to CD4 ≤ 350 to CD4 ≤ 500 mm3 , HIV related morbidity and mortality continue to escalate annually, as do HIV infections. The new paradigm of treatment for all HIV positives individual irrespective of CD4 count may significantly reduce HIV and related illnesses. The author assumes that all HIV infected partners should be eligible for HIV treatment and care, irrespective of CD4 count...
November 2017: Ethiopian Journal of Health Sciences
Charlene A Flash, Oluwatobi O Adegboyega, Xiaoying Yu, Carmen Avalos, Syundai Johnson, Kenneth H Mayer, Thomas P Giordano
BACKGROUND: Publicly funded HIV-testing sites can identify HIV preexposure prophylaxis (PrEP) candidates and provide PrEP linkage. SETTING: Harris Health System's HIV clinic, HIV-testing program, and HIV-prevention program (HPP) in Houston, TX, a high HIV-incidence city. METHODS: A prospective assessment of individuals aged 18 years and older recruited from walk-in HIV testing from December 2013 to April 2015 included risk assessment, HIV testing, and self-administered survey, with follow-up surveys at 6 and 12 months and medical record review...
April 1, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Pengtao Liu, Zhenzhu Tang, Guanghua Lan, Qiuying Zhu, Huanhuan Chen, Yinghui You, Xiaoyi Yang, Shujia Liang, Yi Chen, Hui Xing, Lingjie Liao, Yi Feng, Zhiyong Shen, Yuhua Ruan, Yiming Shao
Early antiretroviral therapy (ART) initiation is a recommended public health approach for the prevention of HIV-1 transmission. In this cohort study, we included 13132 serodiscordant couples. ART was initiated for patients with CD4+ T cell counts less than 200 cells/uL, 350 cells/uL, and 500 cells/uL respectively. This divided the ART treated couples into three groups. Univariate and multivariate intention-to-treat analyses were performed to examine the association between the study groups. Early-ART initiation was associated with a 45% lower risk of partner infection than was late-ART initiation (AHR 0...
February 21, 2018: Scientific Reports
Hong-Ha M Truong, Robin Fatch, Judy Y Tan, H Fisher Raymond, Willi McFarland
HIV-negative and HIV-positive men believed they both are responsible for preventing HIV. Responsibility beliefs, however, did not always correspond with discussing HIV status or refraining from serodiscordant condomless anal sex. Discrepancies between individuals' HIV prevention responsibility beliefs and their sexual risk behaviors merit further examination, particularly in the PrEP era.
January 18, 2018: Sexually Transmitted Diseases
Pamela Musoke, Abigail Hatcher, Anna Joy Rogers, Lillian Achiro, Elizabeth Bukusi, Lynae Darbes, Zachary Kwena, Patrick Oyaro, Elly Weke, Janet M Turan
Male involvement in antenatal care has been shown to improve health outcomes for women and infants. However, little is known about how best to encourage male partners to support essential perinatal health activities. We explored men's perceptions of facilitators and barriers to involvement in antenatal care and HIV prevention including fears, hopes and challenges. Forty in-depth interviews were conducted with the male partners of HIV-positive and HIV-negative pregnant women in southwest Kenya. Most male partners believed engaging in pregnancy health-related activities was beneficial for keeping families healthy...
February 21, 2018: Culture, Health & Sexuality
Kathy Goggin, Emily A Hurley, Glenn J Wagner, Vincent Staggs, Sarah Finocchario-Kessler, Jolly Beyeza-Kashesya, Deborah Mindry, Josephine Birungi, Rhoda K Wanyenze
High rates of fertility desires, childbearing and serodiscordant partnerships among people living with HIV (PLHIV) in Uganda underscore the need to promote use of safer conception methods (SCM). Effective SCM exist but few PLHIV benefit from provider-led safer conception counseling (SCC) and comprehensive national SCC guidelines are still lacking. Providers' self-efficacy, intentions and attitudes for SCC impact provision and should inform development of services, but there are no longitudinal studies that assess these important constructs...
February 20, 2018: AIDS and Behavior
Karolynn Siegel, Étienne Meunier, Helen-Maria Lekas
Despite treatment advances that have improved the health and life expectancy of HIV-positive people and contribute to the prevention of HIV transmission, HIV stigma is still frequently experienced by HIV-infected individuals and those close to them. This study investigated the types of HIV-related stigma experienced by HIV-negative adults in serodiscordant heterosexual relationships when their partner's HIV-positive status was revealed to family and friends and their strategies to manage such stigma. In-depth interviews were conducted in New York City with 56 men and 44 women who were HIV negative and had been in a relationship for at least six months with an HIV-positive partner of the opposite sex...
February 19, 2018: AIDS Care
Kerry Hancuch, Jared Baeten, Kenneth Ngure, Connie Celum, Nelly Mugo, Edna Tindimwebwa, Renee Heffron
For HIV-1 serodiscordant couples, HIV-1 exposure and risk of transmission is heightened during pregnancy attempts, but safer conception strategies can reduce risk. As safer conception programs are scaled up, understanding couples' preferences and experiences can be useful for programmatic recommendations. We followed 1013 high-risk, heterosexual HIV-1 serodiscordant couples from Kenya and Uganda for two years in an open-label delivery study of integrated pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART), the Partners Demonstration Project...
February 17, 2018: AIDS Care
Ashley A Leech, Pietro Bortoletto, Cindy Christiansen, Mari-Lynn Drainoni, Benjamin P Linas, Cassandra Roeca, Megan Curtis, Meg Sullivan
OBJECTIVE: To understand the barriers that serodiscordant couples with human immunodeficiency virus (HIV) face in accessing services for risk reduction and infertility using assisted reproductive technology (ART). DESIGN: Two-arm cross-sectional telephone "secret shopper" study. SETTING: Infertility clinics designated by the Society for Assisted Reproductive Technology (SART), 140 from 15 American states with the highest prevalence of heterosexual HIV-infected men...
February 7, 2018: Fertility and Sterility
Millicent Atujuna, Peter A Newman, Melissa Wallace, Megan Eluhu, Clara Rubincam, Ben Brown, Linda-Gail Bekker
BACKGROUND: New biomedical prevention technologies (NPTs) may contribute to substantially reducing incident HIV infections globally. We explored acceptability and preferences for NPTs among key and other vulnerable populations in two South African townships. METHODS: We conducted six focus groups and 12 in-depth interviews with adolescents, and adult heterosexual men, women, and men who have sex with men (MSM) (n = 48), and eight in-depth interviews with key informant healthcare workers...
2018: PloS One
R Scott McClelland, Jairam R Lingappa, Sujatha Srinivasan, John Kinuthia, Grace C John-Stewart, Walter Jaoko, Barbra A Richardson, Krista Yuhas, Tina L Fiedler, Kishorchandra N Mandaliya, Matthew M Munch, Nelly R Mugo, Craig R Cohen, Jared M Baeten, Connie Celum, Julie Overbaugh, David N Fredricks
BACKGROUND: Disruptions of vaginal microbiota might increase women's susceptibility to HIV infection. Advances in molecular microbiology have enabled detailed examination of associations between vaginal bacteria and HIV acquisition. Therefore, this study aimed to evaluate the association between the concentrations of specific vaginal bacteria and increased risk of HIV acquisition in African women. METHODS: We did a nested case-control study of participants from eastern and southern Africa...
January 25, 2018: Lancet Infectious Diseases
E L Pufall, M Kall, M Shahmanesh, A Nardone, R Gilson, V Delpech, H Ward
OBJECTIVES: The incidence of sexually transmitted infections (STIs) and HIV infection remains high in gay, bisexual, and other men who have sex with men (MSM) in the UK, and sexualized drug use ("chemsex") and injecting drug use ("slamsex") may play a part in this. We aimed to characterize HIV-positive MSM engaging in chemsex/slamsex and to assess the associations with self-reported STI diagnoses and sexual behaviours. METHODS: Data from a 2014 survey of people attending HIV clinics in England and Wales were linked to clinical data from national HIV surveillance records and weighted to be nationally representative...
January 24, 2018: HIV Medicine
Dvora Leah Joseph Davey, Kristin M Wall, William Kilembe, Naw Htee Khu, Ilene Brill, Bellington Vwalika, Elwyn Chomba, Joseph Mulenga, Amanda Tichacek, Pamina M Gorbach, Susan Allen
INTRODUCTION: Attempts to conceive and pregnancy may increase HIV transmission to sex partners and infants. Our study evaluated the association between fertility intentions and HIV acquisition among Zambian HIV-serodiscordant couples. METHODS: We collected demographic, behavioral, clinical exposures, and data on fertility intentions in a cohort of HIV-serodiscordant couples in Lusaka, Zambia from 2005 to 2012. We evaluated factors associated with fertility intentions stratified by gender using multivariable logistic regression...
2018: PloS One
Renee Heffron, Kenneth Ngure, Josephine Odoyo, Nulu Bulya, Edna Tindimwebwa, Ting Hong, Lara Kidoguchi, Deborah Donnell, Nelly R Mugo, Elizabeth A Bukusi, Elly Katabira, Stephen Asiimwe, Jennifer Morton, Susan Morrison, Harald Haugen, Andrew Mujugira, Jessica E Haberer, Norma C Ware, Monique A Wyatt, Mark A Marzinke, Lisa M Frenkel, Connie Celum, Jared M Baeten
Introduction: Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk, such as individuals with a partner living with HIV.  Demonstration projects of PrEP have been conducted in diverse settings worldwide to illustrate practical examples of how PrEP can be delivered.  Methods: We evaluated delivery of PrEP for HIV-negative partners within heterosexual HIV serodiscordant couples in an open-label demonstration project in East Africa...
November 6, 2017: Gates Open Res
Lisa Haddad, Kristin M Wall, William Kilembe, Bellington Vwailika, Naw Htee, Ilene Brill, Elwyn Chomba, Amanda Tichacek, Susan Allen
OBJECTIVE: To examine BV as an effect modifier for the association between hormonal contraception (HC) and incident HIV infection DESIGN:: Serodiscordant couples enrolled in an open longitudinal cohort in Lusaka, Zambia from 1994-2012. This analysis was restricted to couples with an HIV-positive man enrolled between1994-2002 when a quarterly genital tract examination and HIV testing was performed. METHODS: Multivariate Cox models evaluated the association between contraceptive method and HIV-acquisition, stratified by time-varying BV status...
January 13, 2018: AIDS
H Jonathon Rendina, Jeffrey T Parsons
INTRODUCTION: Recent research has shown high efficacy of HIV treatment for reducing the risk of HIV transmission to sexual partners. As the efficacy of treatment as prevention (TasP) has proliferated, a new messaging campaign, Undetectable = Untransmittable, has been gaining popularity. The purpose of this paper was to assess factors associated with the perceived accuracy of this TasP messaging strategy among a large and diverse sample of gay, bisexual, and other men who have sex with men (GBMSM) in order to inform subsequent efforts at large-scale and implementation of the HIV prevention message...
January 2018: Journal of the International AIDS Society
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