Examining Factors Associated with Gender Identity Among Individuals Disengaged from HIV Care in Argentina

Radusky, Pablo David; Arístegui, Inés; Mandell, Lissa N.; Dell’Isola, Emanuel; Zalazar, Virginia; Cardozo, Nadir; Alcaide, María L.; Weiss, Stephen M.; Sued, Omar

doi:10.1007/s12529-021-09998-6

Cited by 11 publications

(6 citation statements)

References 40 publications

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“…The prevalence of illicit drug use (DU) in PLWH also varied significantly between and within countries with ranges of 4.5–76.5% in Brazil [ 21 , 22 ], 38% in Ecuador [ 23 ], 6–38% in Peru [ 15 , 24 ], 20.7–59% in Mexico [ 18 , 25 ], 8.4% in Venezuela [ 26 ], 10.5% in Guatemala [ 16 ], 15.9% in Chile [ 27 ], 7–62% in Colombia [ 28 , 29 ], and 46.4% in Uruguay [ 30 ]. Engagement with HIV care affects DU in Argentina, where 19% of PLWH reengaging in care and 76.7% of PLWH disengaged from care reported DU [ 31 , 32 ]. For example, following HIV diagnosis, less individuals reported DU or AU prior to or during sex in Peru and Colombia [ 33 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

HIV and Substance Use in Latin America: A Scoping Review

Huff

Cárcamo

Diaz

et al. 2022

IJERPH

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This scoping review aims to explore the interplay between substance use (SU) and HIV in Latin America (LA). Database searches yielded 3481 references; 196 were included. HIV prevalence among people who used substances (PWUS) ranged from 2.8–15.2%. SU definitions were variable throughout studies, and thus data were not easily comparable. In 2019, only 2% of new HIV infections were attributed to injection drug use (IDU) in LA. Factors associated with HIV among PWUS included being female, IDU and homelessness, and PWUS were likely to engage in risky sexual behaviors, start antiretroviral treatment late, have poor adherence, have treatment failure, be lost to follow-up, have comorbidities, and experience higher mortality rates and lower quality of life, as has been reported in PLWH with SU in other regions. Five intervention studies were identified, and only one was effective at reducing HIV incidence in PWUS. Interventions in other regions have varying success depending on context-specific characteristics, highlighting the need to conduct more research in the LA region. Though progress has been made in establishing SU as a major concern in people living with HIV (PLWH), much more is yet to be done to reduce the burden of HIV and SU in LA.

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Section: Resultsmentioning

confidence: 99%

HIV and Substance Use in Latin America: A Scoping Review

Huff

Cárcamo

Diaz

et al. 2022

IJERPH

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“…In addition to biological factors, stigma, discrimination and structural determinants increase the risks for HIV infection and other sexually transmitted infections and represent barriers to care. In particular, TGW suffer social exclusion at an early age, limiting their access to education and jobs, leading many TGW to engage in sex work 16 , 17 .…”

Section: Introductionmentioning

confidence: 99%

Oral and anal microbiome from HIV-exposed individuals: role of host-associated factors in taxa composition and metabolic pathways

Lacunza

Fink

Salas

et al. 2023

npj Biofilms Microbiomes

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Evidence indicates that the microbiome plays a significant role in HIV immunopathogenesis and associated complications. This study aimed to characterize the oral and anal microbiome of Men who have Sex with Men (MSM) and Transgender Women (TGW), with and without HIV. One hundred and thirty oral and anal DNA-derived samples were obtained from 78 participants and subjected to shotgun metagenomics sequencing for further microbiome analysis. Significant differences in the microbiome composition were found among subjects associated with HIV infection, gender, sex behavior, CD4+ T-cell counts, antiretroviral therapy (ART), and the presence of HPV-associated precancerous anal lesions. Results confirm the occurrence of oncogenic viromes in this high HIV-risk population. The oral microbiome in HIV-associated cases exhibited an enrichment of bacteria associated with periodontal disease pathogenesis. Conversely, anal bacteria showed a significant decrease in HIV-infected subjects (Coprococcus comes, Finegoldia magna, Blautia obeum, Catenibacterium mitsuokai). TGW showed enrichment in species related to sexual transmission, which concurs that most recruited TGW are or have been sex workers. Prevotella bivia and Fusobacterium gonidiaformans were positively associated with anal precancerous lesions among HIV-infected subjects. The enrichment of Holdemanella biformis and C. comes was associated with detectable viral load and ART-untreated patients. Metabolic pathways were distinctly affected by predominant factors linked to sexual behavior or HIV pathogenesis. Gene family analysis identified bacterial gene signatures as potential prognostic and predictive biomarkers for HIV/AIDS-associated malignancies. Conclusions: Identified microbial features at accessible sites are potential biomarkers for predicting precancerous anal lesions and therapeutic targets for HIV immunopathogenesis.

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“…Argentina has a concentrated HIV epidemic among specific groups, with a prevalence estimated at 34% in TGW, compared to 0.4% in the general population [2]. In contrast, this population consistently shows low levels of adherence to antiretroviral treatment (ART) and retention in HIV care, in comparison with cisgender patients, and therefore, TGW are less likely to achieve viral suppression [3][4][5][6]. At the root of this adverse outcome, several factors can be identified, such as experiences of gender identity-related stigma and discrimination, particularly within the healthcare system, and high levels of psychosocial and economic vulnerability (e.g., high prevalence of mental health problems and substance use, barriers to access formal employment, among others) [5,[7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Retention among transgender women treated with dolutegravir associated with tenofovir/lamivudine or emtricitabine in Argentina: TransViiV study

et al. 2023

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In Argentina, transgender women (TGW) have a high HIV prevalence (34%). However, this population shows lower levels of adherence, retention in HIV care and viral suppression than cisgender patients. The World Health Organization (WHO) recommends the transition to dolutegravir (DTG)-based regimens to reduce adverse events and improve adherence and retention. The purpose of this study was to determine retention, adherence and viral suppression in naïve TGW starting a DTG-based first-line antiretroviral treatment (ART) and to identify clinical and psychosocial factors associated with retention. We designed a prospective, open-label, single-arm trial among ART-naïve HIV positive TGW (Clinical Trial Number: NCT03033836). Participants were followed at weeks 4, 8, 12, 24, 36 and 48, in a trans-affirmative HIV care service that included peer navigators, between December, 2015 and May, 2019. Retention was defined as the proportion of TGW retained at week 48 and adherence was self-reported. Viral suppression at <50 copies/mL was evaluated using snapshot algorithm and as per protocol analysis. Of 75 TGW screened, 61 were enrolled. At baseline, median age was 28 y/o., HIV-1-RNA (pVL) 46,908 copies/mL and CD4+ T-cell count 383 cells/mm3. At week 48, 77% were retained and 72% had viral suppression (97% per protocol). The regimen was well tolerated and participants reported high adherence (about 95%). Eleven of the fourteen TGW who discontinued or were lost to follow-up had undetectable pVL at their last visit. Older age was associated with better retention. DTG-based treatment delivered by a trans-competent team in a trans-affirmative service was safe and well tolerated by TGW and associated with high retention, high adherence and high viral suppression at 48 weeks among those being retained.

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Examining Factors Associated with Gender Identity Among Individuals Disengaged from HIV Care in Argentina

Cited by 11 publications

References 40 publications

HIV and Substance Use in Latin America: A Scoping Review

HIV and Substance Use in Latin America: A Scoping Review

Oral and anal microbiome from HIV-exposed individuals: role of host-associated factors in taxa composition and metabolic pathways

Retention among transgender women treated with dolutegravir associated with tenofovir/lamivudine or emtricitabine in Argentina: TransViiV study

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