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The expanding epidemics of HIV type 1 among men who have sex with men in low- and middle-income countries: diversity and consistency.

https://arctichealth.org/en/permalink/ahliterature96574
Source
Epidemiol Rev. 2010 Apr;32(1):137-51
Publication Type
Article
Date
Apr-2010
Author
Chris Beyrer
Stefan D Baral
Damian Walker
Andrea L Wirtz
Benjamin Johns
Frangiscos Sifakis
Author Affiliation
Center for Public Health and Human Rights, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 20205, USA.
Source
Epidemiol Rev. 2010 Apr;32(1):137-51
Date
Apr-2010
Language
English
Publication Type
Article
Abstract
Men who have sex with men (MSM) have borne a disproportionate burden of human immunodeficiency virus (HIV) infection and remain a markedly underresourced population globally. To better describe HIV epidemics among MSM in low- and middle-income countries, the authors conducted a systematic review of published and unpublished literature available after January 1, 2000 (2000-2009). A total of 133 HIV prevalence studies from 50 countries met the search criteria. Data were used to develop an algorithmic approach to categorize these epidemics. The authors found that the HIV epidemic in low- and middle-income countries may be described using the following 4 scenarios: 1) settings where MSM are the predominant contributor to HIV cases; 2) settings where HIV transmission among MSM occurs in the context of epidemics driven by injection drug users; 3) settings where HIV transmission among MSM occurs in the context of well-established HIV transmission among heterosexuals; and 4) settings where both sexual and parenteral modes contribute significantly to HIV transmission. The authors focused on Peru, Ukraine, Kenya, and Thailand to describe the diversity across and similarities between proposed epidemic scenarios. This scenario-based categorization of HIV epidemics among MSM may assist public health agencies and civil societies to develop and implement better-targeted HIV prevention programs and interventions.
PubMed ID
20573756 View in PubMed
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The global response to HIV in men who have sex with men.

https://arctichealth.org/en/permalink/ahliterature274917
Source
Lancet. 2016 Jul 9;388(10040):198-206
Publication Type
Article
Date
Jul-9-2016
Author
Chris Beyrer
Stefan D Baral
Chris Collins
Eugene T Richardson
Patrick S Sullivan
Jorge Sanchez
Gift Trapence
Elly Katabira
Michel Kazatchkine
Owen Ryan
Andrea L Wirtz
Kenneth H Mayer
Source
Lancet. 2016 Jul 9;388(10040):198-206
Date
Jul-9-2016
Language
English
Publication Type
Article
Keywords
Anti-HIV Agents - therapeutic use
Antiretroviral Therapy, Highly Active - methods
Bisexuality
China - epidemiology
Epidemics
Gambia - epidemiology
Global health
Great Britain - epidemiology
HIV Infections - drug therapy - epidemiology - prevention & control
Homosexuality, Male
Human Rights
Humans
Incidence
Kenya - epidemiology
Legislation as Topic
Male
Minority Groups
Nigeria - epidemiology
Pre-Exposure Prophylaxis - methods
Russia - epidemiology
Sexual Behavior
Thailand - epidemiology
United States - epidemiology
Abstract
Gay, bisexual, and other men who have sex with men (MSM) continue to have disproportionately high burdens of HIV infection in countries of low, middle, and high income in 2016. 4 years after publication of a Lancet Series on MSM and HIV, progress on reducing HIV incidence, expanding sustained access to treatment, and realising human rights gains for MSM remains markedly uneven and fraught with challenges. Incidence densities in MSM are unacceptably high in countries as diverse as China, Kenya, Thailand, the UK, and the USA, with substantial disparities observed in specific communities of MSM including young and minority populations. Although some settings have achieved sufficient coverage of treatment, pre-exposure prophylaxis (PrEP), and human rights protections for sexual and gender minorities to change the trajectory of the HIV epidemic in MSM, these are exceptions. The roll-out of PrEP has been notably slow and coverage nowhere near what will be required for full use of this new preventive approach. Despite progress on issues such as marriage equality and decriminalisation of same-sex behaviour in some countries, there has been a marked increase in anti-gay legislation in many countries, including Nigeria, Russia, and The Gambia. The global epidemic of HIV in MSM is ongoing, and global efforts to address it remain insufficient. This must change if we are ever to truly achieve an AIDS-free generation.
PubMed ID
27411880 View in PubMed
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Induced abortion, contraceptive use, and dual protection among female sex workers in Moscow, Russia.

https://arctichealth.org/en/permalink/ahliterature119641
Source
Int J Gynaecol Obstet. 2013 Jan;120(1):27-31
Publication Type
Article
Date
Jan-2013
Author
Michele R Decker
Eileen A Yam
Andrea L Wirtz
Stefan D Baral
Alena Peryshkina
Vladmir Mogilnyi
Chris Beyrer
Author Affiliation
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. mdecker@jhsph.edu
Source
Int J Gynaecol Obstet. 2013 Jan;120(1):27-31
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Abortion, Induced - statistics & numerical data
Adolescent
Adult
Condoms - utilization
Contraception - methods - statistics & numerical data
Contraception Behavior - statistics & numerical data
Contraceptive Agents - administration & dosage
Cross-Sectional Studies
Data Collection
Female
Humans
Moscow
Pregnancy
Pregnancy, Unplanned
Prostitution - statistics & numerical data
Young Adult
Abstract
To describe abortion history and current contraceptive use among female sex workers (FSWs) in Moscow, Russia.
A clinic-based survey was conducted among 147 FSWs in Moscow during an 8-month period in 2005.
In total, 83 of 143 (58.0%) FSWs reported a history of abortion, with 45 of 143 (31.5%) indicating multiple abortions. Condoms were the primary form of contraception (145/146 [99.3%]); just 17 of 142 (12.0%) FSWs reported using non-barrier modern contraception. All women who reported using a non-barrier modern method also indicated condom use (i.e. dual protection). Non-barrier contraceptive use was associated with inconsistent condom use (odds ratio [OR] 3.10; 95% confidence interval [CI], 1.07-9.02) and multiple abortions (OR 4.71; 95% CI, 1.19-18.62).
The results illustrate substantial risk for unintended pregnancy among FSWs. Further research is needed regarding the dynamics of non-barrier contraception and condom use. Efforts to improve the health and wellbeing of FSWs should include access to safe and effective contraception, in addition to HIV prevention.
Notes
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PubMed ID
23083495 View in PubMed
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Injection drug use, sexual risk, violence and STI/HIV among Moscow female sex workers.

https://arctichealth.org/en/permalink/ahliterature127511
Source
Sex Transm Infect. 2012 Jun;88(4):278-83
Publication Type
Article
Date
Jun-2012
Author
Michele R Decker
Andrea L Wirtz
Stefan D Baral
Alena Peryshkina
Vladmir Mogilnyi
Rachel A Weber
Julie Stachowiak
Vivian Go
Chris Beyrer
Author Affiliation
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., E4142, Baltimore, MD 21212, USA. mdecker@jhsph.edu
Source
Sex Transm Infect. 2012 Jun;88(4):278-83
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cross-Sectional Studies
Female
HIV Infections - epidemiology
Humans
Moscow - epidemiology
Prevalence
Prostitution - statistics & numerical data
Sex Workers - statistics & numerical data
Sexually Transmitted Diseases - epidemiology
Substance Abuse, Intravenous - epidemiology
Unsafe Sex - statistics & numerical data
Violence - statistics & numerical data
Young Adult
Abstract
The HIV prevalence in Eastern Europe and Central Asia continues to increase. While injection drug use (IDU) is leading factor, heterosexual transmission is on the rise. Little is known about female sex workers (FSWs) in the region despite the central role of commercial sex in heterosexual sexually transmitted infection (STI)/HIV transmission globally. The authors evaluated the prevalence of STI/HIV among Moscow-based FSWs and potential risk factors including IDU, sexual risks and violence victimisation.
Moscow-based FSWs (n=147) completed a clinic-based survey and STI/HIV testing over an 8-month period in 2005.
HIV prevalence was 4.8%, and 31.3% were infected with at least one STI including HIV. Sexual behaviours significantly associated with STI/HIV included anal sex (adjusted odds ratio (AOR) 3.48), high client volume (three or more clients daily, AOR 2.71), recent subbotnik (sex demanded by police; AOR 2.50) and regularly being presented with more clients than initially agreed to (AOR 2.45). Past year experiences of physical violence from clients and threats of violence from pimps were associated with STI/HIV (AOR 3.14 and AOR 3.65, respectively). IDU was not significantly associated with STI/HIV. Anal sex and high client volume partially mediated the associations of abuse with STI/HIV.
Findings illustrate substantial potential for heterosexual STI/HIV transmission in a setting better known for IDU-related risk. Many of the STI/HIV risks observed are not modifiable by FSWs alone. STI/HIV prevention efforts for this vulnerable population will benefit from reducing coercion and abuse perpetrated by pimps and clients.
Notes
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Cites: Sociol Health Illn. 2009 Jan;31(1):1-1619144087
PubMed ID
22287530 View in PubMed
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