Dataset Information

Accuracy of Self-Reported HIV Status Among African Men and Transgender Women Who Have Sex with Men Who were Screened for Participation in a Research Study: HPTN 075.

ABSTRACT: Some HIV-infected individuals in research studies may choose not to disclose knowledge of their HIV status to study staff. We evaluated the accuracy of self-reported HIV status among African men and transgender women who have sex with men and who were screened for a research study. Sixty-seven of 183 HIV-infected participants reported a prior HIV diagnosis. Samples from the remaining 116 participants were tested for antiretroviral (ARV) drugs. Thirty-six of the 116 participants had ARV drugs detected, indicating that they were on antiretroviral treatment; these participants were classified as previously diagnosed based on ARV drug testing. Among participants classified as previously diagnosed, disclosure of a prior HIV diagnosis varied among study sites (p?=?0.006) and was more common among those who reported having sex with men only (p?=?0.002). ARV drug testing in addition to self-report improves the accuracy for identifying individuals with a prior HIV diagnosis.

SUBMITTER: Fogel JM

PROVIDER: S-EPMC6344310 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Accuracy of Self-Reported HIV Status Among African Men and Transgender Women Who Have Sex with Men Who were Screened for Participation in a Research Study: HPTN 075.

Fogel Jessica M JM Sandfort Theodorus T Zhang Yinfeng Y Guo Xu X Clarke William W Breaud Autumn A Cummings Vanessa V Hamilton Erica L EL Ogendo Arthur A Kayange Noel N Panchia Ravindre R Dominguez Karen K Chen Ying Q YQ Eshleman Susan H SH

AIDS and behavior 20190101 1

Some HIV-infected individuals in research studies may choose not to disclose knowledge of their HIV status to study staff. We evaluated the accuracy of self-reported HIV status among African men and transgender women who have sex with men and who were screened for a research study. Sixty-seven of 183 HIV-infected participants reported a prior HIV diagnosis. Samples from the remaining 116 participants were tested for antiretroviral (ARV) drugs. Thirty-six of the 116 participants had ARV drugs det ...[more]

PMID: 30051192

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Project description:Throughout the world, men who have sex with men (MSM) are at increased risk for HIV infection compared to heterosexual men. Little is known about awareness of HIV infection and other gaps in the HIV care continuum for MSM, especially in sub-Saharan Africa (SSA). This information is urgently needed to address the HIV epidemic in this population. This study assessed gaps in the HIV care continuum among persons screened for participation in a multi-country prospective study that evaluated the feasibility of recruiting and retaining MSM for HIV prevention studies in SSA (HIV Prevention Trials Network (HPTN) 075, conducted in four cities in Kenya, Malawi, and South Africa). Participants were recruited using site-specific strategies, that included outreach and informal networks. Transgender women (TW) were eligible to participate. During screening, 601 MSM and TW were tested for HIV infection and asked about prior HIV testing, HIV status, engagement in care, and HIV treatment. Viral load testing and retrospective antiretroviral (ARV) drug testing were performed for HIV-infected participants. Most participants (92.2%) had a prior HIV test; 42.1% were last tested >6 months earlier. HIV prevalence was 30.4%. HIV infection was associated with older age and identifying as female or transgender; 43.7% of the HIV-infected participants were newly diagnosed, especially younger persons and persons with a less recent HIV test. Almost a third of previously-diagnosed participants were not linked to care. Most participants (88.7%) in care were on ARV treatment (ART). Only about one-quarter of all HIV-infected participants were virally suppressed. These findings demonstrate substantial prevalence of undiagnosed HIV infection and sub-optimal HIV care engagement among MSM and TW in SSA. Increased HIV testing frequency and better linkage to care represent critical steps in preventing further HIV transmission in this population. Once in care, gaps in the HIV care continuum appear less critical.

Project description:IntroductionMen who have sex with men (MSM) and transgender women (TGW) in sub-Saharan Africa (SSA) are profoundly affected by HIV with high HIV prevalence and incidence. This population also faces strong social stigma and legal barriers, potentially impeding participation in research. To date, few multi-country longitudinal HIV research studies with MSM/TGW have been conducted in SSA. Primary objective of the HIV Prevention Trials Network (HPTN) 075 study was to assess feasibility of recruiting and retaining a multinational prospective cohort of MSM/TGW in SSA for HIV prevention research.MethodsHPTN 075, conducted from 2015 to 2017, was designed to enroll 400 MSM/TGW at four sites in SSA (100 per site: Kisumu, Kenya; Blantyre, Malawi; Cape Town, South Africa; and Soweto, South Africa). The number of HIV-positive persons was capped at 20 per site; HIV-positive persons already in care were excluded from participation. The one-year study included five biobehavioural assessments. Community-based input and risk mitigation protocols were included in study design and conduct.ResultsOf 624 persons screened, 401 were enrolled. One in five participants was classified as transgender. Main reasons for ineligibility included: (a) being HIV positive after the cap was reached (29.6%); (b) not reporting anal intercourse with a man in the preceding three months (20.6%); and (c) being HIV positive and already in care (17.5%). Five (1.2%) participants died during the study (unrelated to study participation). 92.9% of the eligible participants (368/396) completed the final study visit and 86.1% participated in all visits. The main, overlapping reasons for early termination included being (a) unable to adhere to the visit schedule, predominantly because of relocation (46.4%), and (b) unable to contact the participant (32.1%). Participants reported strong motivation to participate and few participation barriers. Four participants reported social harms (loss of confidentiality and sexual harassment by study staff) that were successfully addressed.ConclusionsHPTN 075 successfully enrolled a multinational sample of MSM/TGW in SSA in a prospective HIV prevention research study with a high retention rate and few documented social harms. This supports the feasibility of conducting large-scale research trials in this population to address its urgent, unmet HIV prevention needs.

Project description:BackgroundFindings from specific countries indicated group sex was common among men who have sex with men (MSM), and men who reported group sex participation were at increased risk of human immunodeficiency virus (HIV)/sexually transmitted infections (STIs). The purpose of the current analysis was to describe the prevalence and correlates of group sex participation among a community-based sample of MSM in Chongqing, southwestern China.MethodsConvenience sampling method was used to recruit participants and data were collected through an anonymous questionnaire. Logistic regression analysis was employed to identify correlates of group sex participation.ResultsOverall, 1151 eligible participants were enrolled in the study. 14.7% of MSM reported participating in group sex in their lifetime, and 5.8% reported group sex participation in the prior 6 months. Factors positively associated with group sex participation in both the prior 6 months and the lifetime included: monthly income ≥3000 Yuan (adjusted odds ratios [aOR] = 3.67, 95% confidence interval [CI] 1.25-10.75; aOR = 2.30, 95% CI 1.21-4.35), initiating anal sex before 18 years old (aOR = 1.86, 95% CI 1.03-3.34; aOR = 2.00, 95% CI 1.31-3.05), using gay apps to seek sex partners (aOR = 7.41, 95% CI 2.57-21.33; aOR = 9.75, 95% CI 4.92-19.33), recreational drug use (aOR = 10.10, 95% CI 5.52-18.49; aOR = 4.75, 95% CI 3.20-7.05) and having condomless internal ejaculation (CIE) (aOR = 3.66, 95% CI 2.01-6.68; aOR = 1.61, 95% CI 1.11-2.35). Factors only associated with group sex participation in the lifetime were older age (age between 26 and 35 years old: aOR = 2.06, 95% CI 1.30-3.26; age > 35 years old: aOR = 1.95, 95% CI 1.10-3.46) and history of STIs (aOR = 2.51, 95% CI 1.37-4.62).ConclusionsThe results of this study suggested that group sex participation was a potentially risky context for acquisition and transmission of HIV/STIs. Close attention should be given to MSM who participated in group sex, and appropriate risk reduction interventions should be developed specific to this subgroup of MSM.

Dataset Information

Accuracy of Self-Reported HIV Status Among African Men and Transgender Women Who Have Sex with Men Who were Screened for Participation in a Research Study: HPTN 075.

Publications

Accuracy of Self-Reported HIV Status Among African Men and Transgender Women Who Have Sex with Men Who were Screened for Participation in a Research Study: HPTN 075.

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