A Latent Class Analysis of Risk Factors for Acquiring HIV Among Men Who Have Sex with Men: Implications for Implementing Pre-Exposure Prophylaxis Programs

Chan, Philip A.; Rose, Jennifer; Maher, Justine; Benben, Stacey; Pfeiffer, Kristen; Almonte, Alexi; Poceta, Joanna; Oldenburg, Catherine E.; Parker, Sharon; Marshall, Brandon D. L.; Lally, Michelle; Mayer, Kenneth H.; Mena, Leandro; Patel, Rupa; Nunn, Amy

doi:10.1089/apc.2015.0113

Cited by 47 publications

(23 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In line with research in other in North and South American populations, 3,4,6,26-28,30 our findings suggest that HIV risk behaviors represent heterogeneous classes within a population. Participants who were younger, reported higher alcohol use, were married, and had low income were at higher risk.…”

Section: Discussionsupporting

confidence: 91%

“…Studies in other countries identified types of HIV risk behaviors in IDU and illegal opioid users, 3,26-29 heroin and cocaine users, 30 men who have sex with men, 4 and in a group of heterosexual and marginalized men in Peru. 6 In line with these studies, the current study provides a person-centered approach, using latent class analysis 31 (LCA), to analyze the spectrum of HIV risk behaviors for identifying groups of individuals who share similar HIV risk characteristics.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies

et al. 2017

View full text Add to dashboard Cite

The number of HIV cases attributed to heterosexual contact and the proportion of women among HIV positive individuals has increased worldwide. Russia is a country with the highest rates of newly diagnosed HIV infections in the region, and the infection spreads beyond traditional risk groups. While young women are affected disproportionately, knowledge of HIV risk behaviors in women in the general population remains limited. The objectives of this study were to identify patterns of behaviors that place women of childbearing age at high risk for HIV transmission and determine whether socio-demographic characteristics and alcohol use are predictive of the risk pattern. A total of 708 non-pregnant women, aged between 18–44 years, who were at risk for an alcohol-exposed pregnancy (AEP) were enrolled in two regions in Russia. Participants completed a structured interview focused on HIV risk behaviors, including risky sexual behavior and alcohol and drug use. Latent class analysis was utilized to examine associations between HIV risk and other demographic and alcohol use characteristics and to identify patterns of risk among women. Three classes were identified. 34.93% of participants were at high risk, combining their risk behaviors, e.g., having multiple sexual partners, with high partner's risk associated with partner's drug use (class I). Despite reporting self-perceived risk for HIV/STI, this class of participants was unlikely to utilize adequate protection (i.e., condom use). The second high risk class included 13.19% of participants who combined their risky sexual behaviors, i.e., multiple sexual partners and having STDs, with partner's risk that included partner's imprisonment and partner's sex with other women (class II). Participants in this class were likely to utilize protection/condoms. Finally, 51.88% of participants were at lower risk, which was associated primarily with their partners' risk, and these participants utilized protection (class III). The odds of being in class I compared with class III were 3.3 (95% CI: [1.06, 10.38]) times higher for those women who had Alcohol Use Disorders Identification Test scores ≥8 than those who had lower scores, and were 3.9 (95% CI: [1.69, 8.97]) times higher for those who used alcohol before sex than those who did not. In addition, women who drank more days per week were 1.36 times more likely to be in class II than in class III. The study informs prevention by identifying specific population groups and targets for interventions. Alcohol use is a significant predictor and an overarching factor of HIV risk in women. Since at-risk drinking is common among young Russian women, alcohol risk reduction should be an essential component of HIV prevention efforts.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies

et al. 2017

View full text Add to dashboard Cite

show abstract

“…21 CDC guidelines recommend considering PrEP in MSM who report condomless anal sex with men. 19 To promote PrEP among MSM, PrEP education and counseling were integrated into standard care at our STD clinic.…”

Section: Discussionmentioning

confidence: 99%

Implementation of Preexposure Prophylaxis for Human Immunodeficiency Virus Prevention Among Men Who Have Sex With Men at a New England Sexually Transmitted Diseases Clinic

Chan¹,

Glynn

Oldenburg

et al. 2016

Sexual Trans Dis

Self Cite

View full text Add to dashboard Cite

Background Pre-exposure prophylaxis (PrEP) is efficacious in preventing HIV among men who have sex with men (MSM). We assessed PrEP uptake among MSM presenting for services at a sexually transmitted diseases (STD) clinic. Methods MSM presenting to the Rhode Island STD Clinic between October 2013 and November 2014 were educated about, and offered, PrEP. We categorized PrEP engagement using an implementation cascade to describe gaps in uptake which described MSM who: 1) were educated about PrEP, 2) indicated interest, 3) successfully received follow-up contact, 4) scheduled an appointment, 5) attended an appointment, and 6) initiated PrEP (i.e., received a prescription). Bivariate and multivariable logistic regression models were used to examine predictors of PrEP initiation. Results A total of 234 MSM were educated about PrEP; of these, 56% expressed interest. Common reasons for lack of interest were low HIV risk perception (37%), wanting more time to consider (10%), concern about side effects (7%), and financial barriers (3%). Among those interested, 53% followed up. Of those, 51% scheduled an appointment. The most common reason patients did not schedule an appointment was low HIV risk perception (38%). Seventy-seven percent of those with an appointment attended the appointment; of those, 93% initiated PrEP. Patients with higher HIV risk perception (aOR=2.17, 95% CI 1.29-3.64) and a history of sex with an HIV-positive partner (aOR=7.08, 95% CI 2.35-21.34) had significantly higher odds of initiating PrEP. Conclusions Low HIV risk perception was the most significant barrier to PrEP uptake among MSM attending a public STD clinic.

show abstract

“…The US-Food and Drug Administration approved Truvada as an oral PrEP treatment for MSM in 2012. 5 PrEP could help reduce HIV incidence among MSM, 6 who account for approximately two-thirds of new HIV infections in the United States. 7 Black MSM (BMSM) have the highest HIV incidence rates in the United States; reduction of such disparities is a vital part of the US National HIV/AIDS strategy.…”

mentioning

confidence: 99%

The Promise of Pre-Exposure Prophylaxis for Black Men Who Have Sex with Men: An Ecological Approach to Attitudes, Beliefs, and Barriers

Philbin

Parker

et al. 2016

AIDS Patient Care and STDs

View full text Add to dashboard Cite

Research has demonstrated the clinical effectiveness of pre-exposure prophylaxis (PrEP) for HIV prevention, but little is known about how factors at the individual-, interpersonal-, community-, and structural levels impact PrEP use for black men who have sex with men (BMSM). We advance existing work by examining how all levels of the ecological framework must be addressed for PrEP to be successfully implemented as an effective HIV prevention approach. We interviewed 31 BMSM three times each and 17 community stakeholders once each; interviews were taped, transcribed, and analyzed using the constant comparative method. Factors that influence how BMSM experienced PrEP emerged across all levels of the ecological framework: At the individual level, respondents were wary of giving medication to healthy people and of the potential side-effects. At the interpersonal level, BMSM believed that PrEP use would discourage condom use and that PrEP should only be one option for HIV prevention, not the main option. At the community level, men described not trusting the pharmaceutical industry and described PrEP as an option for others, not for themselves. At the structural level, BMSM talked about HIV and sexuality-related stigmas and how they must overcome those before PrEP engagement. BMSM are a key population in the US National HIV/AIDS Strategy, yet few individuals believe that PrEP would be personally helpful. Our research indicates the urgent need to raise awareness and address structural stigma and policies that could be substantial barriers to the scale-up and implementation of PrEP-related services.

show abstract

A Latent Class Analysis of Risk Factors for Acquiring HIV Among Men Who Have Sex with Men: Implications for Implementing Pre-Exposure Prophylaxis Programs

Cited by 47 publications

References 44 publications

Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies

Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies

Implementation of Preexposure Prophylaxis for Human Immunodeficiency Virus Prevention Among Men Who Have Sex With Men at a New England Sexually Transmitted Diseases Clinic

The Promise of Pre-Exposure Prophylaxis for Black Men Who Have Sex with Men: An Ecological Approach to Attitudes, Beliefs, and Barriers

Contact Info

Product

Resources

About