Getting pre-exposure prophylaxis to high-risk transgender women: lessons from Detroit, USA

Sexual Health ◽  
2018 ◽  
Vol 15 (6) ◽  
pp. 562 ◽  
Author(s):  
Julia E. Hood ◽  
Tony Eljallad ◽  
Julisa Abad ◽  
Maureen Connolly ◽  
Christine Heumann ◽  
...  
Keyword(s):  
High Risk ◽  
Hormone Replacement ◽  
Risk Behaviour ◽  
Transgender Women ◽  
High Risk Population ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Survey Responses ◽  
Exposure Prophylaxis

Background Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy, but it is unclear how best to deliver PrEP to key populations. Drawing upon a cross-sectional survey of transgender women (TW) in Detroit, USA, and experience of a PrEP clinic that serves this population, this manuscript describes the following: (1) the risk profile of Detroit TW; (2) the proportion of TW with at least one PrEP indication; and (3) perceptions of and experiences with PrEP among TW in Detroit. Methods: Between August 2017 and March 2018, 126 TW completed an online PrEP survey. Survey responses were summarised using descriptive statistics and multivariable relative risk regression. Results: Among participants who reported a negative or unknown HIV status (76% of all participants), 56% reported risk behaviour(s) consistent with PrEP indication guidelines, 17% reported currently taking PrEP and another 4% reported discontinued PrEP use. Among participants who met an indication for PrEP but were not currently taking PrEP, 64% indicated that they were not interested in taking PrEP. Approximately 60% of participants who were not currently taking PrEP reported that they would be more likely to take PrEP if it were provided at a clinic that also provided hormone replacement therapy. Conclusions: Although a substantial proportion of TW in our survey were on PrEP, interest in PrEP among high-risk TW who were not taking it was low. Specialised clinical infrastructure that is responsive to the specific needs of TW may be needed to expand PrEP to this oftentimes marginalised and high-risk population.

Perceptions of people who inject drugs towards HIV pre-exposure prophylaxis in Australia

Sexual Health ◽  
2019 ◽  
Vol 16 (4) ◽  
pp. 383
Author(s):  
Phillip Read ◽  
Karen J. Chronister ◽  
Catherine Kostovski ◽  
Mary Ellen Harrod ◽  
Allison Salmon ◽  
...  
Keyword(s):  
Perceived Risk ◽  
Policy Development ◽  
People Who Inject Drugs ◽  
Hiv Status ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Willingness To Use ◽  
Exposure Prophylaxis ◽  
Current Guidelines ◽  
Hiv Negative

Background People who inject drugs (PWID) are a priority for HIV prevention. This study aimed to determine perceptions, potential eligibility and willingness to use PrEP among PWID in Sydney. Methods: Clients completed a cross-sectional survey to collect data on demographics, perceived risk of HIV and willingness to use PrEP, which were then analysed. Results: Twelve (7%) of 172 HIV-negative participants were eligible for PrEP under current guidelines for injecting reasons, of whom three would also be eligible for sexual risk, leaving nine (5%) eligible for injecting reasons alone. Half had heard of PrEP and, of these, 65% would consider taking it. Most (88%) thought they would continue using needle syringe program services. A minority (8%) indicated they may be likely to share needles and syringes or be less concerned about injecting partners’ HIV status (26%). Conclusions: Although PrEP will benefit a small proportion of PWID, this may equate to a significant number nationally. Policy development around PrEP incorporating affected populations will best support the community of people currently injecting to keep rates of HIV low.

scholarly journals Sexual health of homeless youth: prevalence and correlates of sexually transmissible infections

Sexual Health ◽  
2007 ◽  
Vol 4 (1) ◽  
pp. 57 ◽  
Author(s):  
Kimberly A. Tyler ◽  
Les B. Whitbeck ◽  
Xiaojin Chen ◽  
Kurt Johnson
Keyword(s):  
High Risk ◽  
Homeless Youth ◽  
Sexual Practices ◽  
High Risk Population ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Midwestern Usa ◽  
Sexually Transmissible Infections ◽  
Unit Increase ◽  
Sexual Histories

Background: The study examined risk factors for having ever contracted sexually transmissible infections (STI) among a high-risk sample in midwestern USA. Methods: A cross sectional survey was conducted among 428 homeless youth aged 16–19 years. Assessed correlates included child maltreatment, street exposure, sexual histories, street experiences and substance use. Results: Multivariate analyses revealed that males were 86% less likely to have had STI compared with females (adjusted odds ratio [AOR] = 0.14; 95% confidence interval [CI] = 0.06–0.31). Blacks were almost four times more likely (AOR = 3.71; 95% CI = 1.80–7.63) and other races were over two times more likely (AOR = 2.25; 95% CI = 1.08–4.67) to have had STI compared with whites. For every one unit increase in the number of times youth ran away, there was a 3% increase in the likelihood of ever having had an STI (AOR = 1.03; 95% CI = 1.01–1.06). For every one unit increase in frequency of condom use there was a 61% decrease in the likelihood of an STI (AOR = 1.39; 95% CI = 1.10–1.76). Finally, youth who traded sex were approximately 2.5 times more likely to have had STI compared with youth who did not trade sex (AOR = 2.36; 95% CI = 1.04–5.34). None of the remaining correlates approached multivariate significance. Conclusions: The amount of time youth spend on the street, their sexual practices, and their subsistence strategies are important correlates of STI and females and non-whites are particularly vulnerable among this high-risk population.

scholarly journals Differences in Socio-demographics Status, Risk Behaviours, Healthcare Uptake and HIV/STIs Between Brothel-based and Street-based Female Sex Workers in Yunnan, China

2021 ◽  
Author(s):  
Guoxi Cai ◽  
Yufen Liu ◽  
Jinman Zhuang ◽  
Yixiao Lu ◽  
Jiwen Wu ◽  
...  
Keyword(s):  
High Risk ◽  
Sex Workers ◽  
Healthcare Services ◽  
Consistent Condom ◽  
High Risk Population ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Population ◽  
Sti Prevention ◽  
Female Sex

Abstract Background Heterosexual contact is the primary mode of HIV transmission in China and commercial sex is thought to play a crucial role in China’s epidemic. Female sex works (FSWs) in China tend to be either brothel-based (BSWs) or street-based (SSWs), but few studies have investigated the differences between these important segments of this difficult-to-reach, high-risk population. Our aim was to explore these differences. Methods A cross-sectional survey was conducted in Yunnan Province of China in partnership with a local FSW-friendly non-governmental organization. Face-to-face interviews using a structured questionnaire were conducted to collect data on socio-demographic characteristics, sex work history, sexual behaviours, HIV/STI-related knowledge, HIV testing history, and healthcare services uptake. Blood samples were taken for HIV and syphilis testing, and urine samples for gonorrhea and chlamydia testing. Descriptive statistics were used to evaluate differences between SSWs and BSWs. Results A total of 185 BSWs and 129 SSWs were included in the study. SSWs were older and less educated, had more dependents and more clients, accessed fewer healthcare services, and had higher prevalence of HIV/STIs. SSWs also had similar but higher rates of consistent condom use with clients.Conclusions Our study provides evidence that confirms the disproportionately high vulnerability of SSWs to HIV and other STIs, underscoring the urgent need for the Chinese health and public health sectors to prioritize outreach to SSWs. Awareness and educational programs, condom distribution, testing and health check-ups should be included in a comprehensive strategy for HIV/STI prevention in this high-risk population.

scholarly journals Nepali Migrant Labourers are Highly Exposed to Unsafe Sexual Behaviour

2013 ◽  
Vol 1 (2) ◽  
pp. 20-23
Author(s):  
Madhusudan Ghimire ◽  
Anand Pratap Singh ◽  
Moushami Ghimire
Keyword(s):  
High Risk ◽  
Sexual Behaviour ◽  
Migrant Workers ◽  
Formal Education ◽  
Risk Behaviour ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physical Relation ◽  
High Risk Sexual Behaviour ◽  
Risk Sexual Behaviour

INTRODUCTION: Unsafe sexual behavior between two partners may lead to incidence of STDs/HIV/ AIDS and can create serious problems in society. Both biological and behavioural variables are playing significant role to determine sexual activities of humans and result may end the probability that infection will occur after unsafe sexual contact between a susceptible and infected partner. OBJECTIVES : To study high risk sexual behaviour among the Nepali migrant labourers in India. METHODS: A cross-sectional survey of 240 Nepali migrant labourers temporarily residing in India was carried out. A brief interview schedule was used tocollect information. RESULTS : Most of the Nepali migrant workers (below 30 years) were involved in high risk sexual behaviour. 74.58 percent were exposure to unsafe physical relation. CONCLUSION: Migrants labourers below 30 years with no formal education were involved in high risk behaviour and they could be exposed to STDs/HIV/AIDS.DOI: http://dx.doi.org/10.3126/jucms.v1i2.8405 Journal of Universal College of Medical Sciences Vol.1(2) 2013: 20-23

Uterine Transplantation in Male to Female Transgender Women; A Cross-Sectional Survey Assessing Perceptions, Acceptability and Demand

2020 ◽  
Author(s):  
Benjamin Jones ◽  
Abirami Rajamanoharan ◽  
Saaliha Vali ◽  
Nicola Jane Williams ◽  
Srdjan Saso ◽  
...  
Keyword(s):  
Transgender Women ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Uterine Transplantation ◽  
Male To Female

scholarly journals Determining the perception of a lung cancer screening programme among high-risk patients in a tertiary referral centre, Kuala Lumpur

2019 ◽  
Vol 29 (1) ◽  
pp. 19-24
Author(s):  
Wei Hao Kok ◽  
Andrea Ban Yu-Lin ◽  
Shamsul Azhar Shah ◽  
Faisal Abdul Hamid
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Screening Programme ◽  
Lung Cancer Screening ◽  
High Risk Population ◽  
Willingness To Participate ◽  
Tertiary Referral Centre ◽  
Cross Sectional ◽  
Cancer Screening Programme

Background: Lung cancer is the second most common cause of cancer-related death and the third most common cancer in Malaysia. The rising prevalence of lung cancer suggests the need to consider disease screening for early detection, especially in the high-risk population, as it offers the best chance of cure. Objectives: The study aims to determine the willingness of high-risk respondents to participate in a lung cancer screening programme if made available to them, and to determine their attitude towards lung cancer screening and explore factors that might affect participation in a screening programme. Method: This is a cross-sectional, descriptive study over 6 months conducted in adult patients attending medical clinics in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using face-to-face administered questionnaires. Results: In total 180 respondents were analysed. There were 177 (98.3%) males. Mean age was 59.8 ± 9.1 years. Of the respondents, 138 (76.7%) had poor knowledge about cancer screening. Former smokers comprised 119 (66.1%) of the participants, and 61 (33.9%) were current smokers. In total, 141 (78.3%) respondents indicated willingness to participate in a lung cancer screening programme. Out of this group, 68 (48.2%) respondents were unwilling to pay for the procedure. Only 18 (12.8%) were unwilling to undergo lung cancer treatment if detected early. Conclusions: Awareness about general cancer screening is low. Our study showed that when informed of their high-risk status, respondents were willing to participate in lung cancer screening. There should be more health programmes to promote and raise awareness about lung cancer.

scholarly journals Pre-Exposure Prophylaxis Training among Medical Schools in the United States

2021 ◽  
Vol 12 ◽  
pp. 215013272110287
Author(s):  
Robert L. Cooper ◽  
Mohammad Tabatabai ◽  
Paul D. Juarez ◽  
Aramandla Ramesh ◽  
Matthew C. Morris ◽  
...  
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Injection Drug Users ◽  
Drug Users ◽  
Healthcare Providers ◽  
Medical Schools ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared.

Ambulatory Care: Medication Use Characteristics in an Ambulatory Elderly Population in Taiwan

1997 ◽  
Vol 31 (3) ◽  
pp. 308-314 ◽  
Author(s):  
Rou-Yee Chen Hsu ◽  
Min-Shung Lin ◽  
Mei-Huei Chou ◽  
Ming-Fang Lin
Keyword(s):  
Hormone Replacement ◽  
The Elderly ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Prescribing Patterns ◽  
Cross Sectional Survey ◽  
Antiinflammatory Drugs ◽  
Cross Sectional ◽  
Therapeutic Category ◽  
Prescribing Trends ◽  
Drug Expenditures

Objective To compare prescribing patterns between the elderly and nonelderly in 1994, to disclose prescribing trends in the elderly between 1992 and 1994, to explore whether drug utilization is in agreement with disease prevalence, and to identify suboptimal prescribing by drug category for ambulatory elderly patients. Design Cross-sectional survey at two separate time intervals. Setting All public group practice centers (GPCs) in Taiwan. Patients Ambulatory adults who visited GPCs during 1 random week. Those 65 years or over were classified as the elderly group, and those 20-64 years were the nonelderly group. Main Outcome Measures Mean diagnosis, drug use, and expenditure; frequency of diagnosis; and prescribing by therapeutic category. Results Data on 30 777 elderly and 38 184 nonelderly patients were collected in 1994. There was widespread use of antacids. Compared with nonelderly adults, the elderly were diagnosed with more diseases (1.3 vs. 1.2, respectively; p < 0.01), received more medications (4.7 vs. 4.1, respectively; p < 0.01), and had higher drug expenditures (5.4 vs. 4.6, respectively; p < 0.01). Chronic illness was more prevalent in the elderly, which accounted for the extensive use of cardiovascular drugs (32.1%), nonsteroidal antiinflammatory drugs (25.9%), and anxiolytics (15.9%). The upward trend in the elderly from 1992 to 1994 with hypertension (18.6% vs. 20.0%) or diabetes (9.2% vs. 10.9%) did not result in more cases of cerebrovascular disease (7.1% vs. 4.9%). There was a substantial increase in use of antispasmodic and gastroprokinetic agents (4.5% to 10.7%); the use of antacids decreased (73.6% to 63.4%) in the elderly. Conclusions Compared with the prevalence of disease, there was extensive nonspecific use of anxiolytics and antacids. However, lessened use of antidepressants and postmenopausal hormone replacement may have an impact on morbidity and mortality and deserves particular attention.

scholarly journals Prevalence and Correlates of Pregnancy Self-Testing Among Pregnant Women Attending Antenatal Care in Western Kenya

2020 ◽  
Author(s):  
Nina Njeri Nganga ◽  
Julia Dettinger ◽  
John Kinuthia ◽  
Jared Baeten ◽  
Grace John-Stewart ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Western Kenya ◽  
Self Testing ◽  
Sub Saharan ◽  
Exposure Prophylaxis

Abstract In sub-Saharan Africa little is known about how often women use pregnancy self-tests or characteristics of these women despite evidence that pregnancy self-testing is associated with early antenatal care (ANC) attendance. Understanding the characteristics of women who use pregnancy self-tests may facilitate early access to ANC and preventive interventions in pregnancy. We conducted a cross-sectional survey on an ongoing pre-exposure prophylaxis (PrEP) implementation study which enrolled pregnant women to determine the prevalence and factors associated with pregnancy self-testing among women in western Kenya. Overall in our study population, the prevalence of pregnancy self-testing was 22% and higher among women who were employed, currently in school, had previous pregnancy complications, received services from urban health facilities, and had partners who had at least attended secondary school. The most reported reasons for non-use of pregnancy self-tests included not thinking it was necessary, lack of knowledge, and lack of money to pay for the test. Future research should focus on understanding the knowledge and attitudes of women toward pregnancy self-testing.

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