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While still an understudied area, there is a growing body of studies highlighting epidemiologic data on men who have sex with men (MSM) in sub-Saharan Africa (SSA) which challenge the attitudes of complacency and irrelevancy among donors and country governments that are uncomfortable in addressing key populations (KPs). While some of the past inact...
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... and economically multifarious, the region has not been immune to the HIV epidemic. The first reported cases of HIV emerged in the mid-1980s, and national surveillance bodies such as National AIDS Committees (NACs) were established over the subsequent decade [3]. Early phyloge- netic subtyping revealed unique regional dynamics, with both HIV-1 and HIV-2 circulating, and the majority of global cases of HIV-2 found in West Africa. Concurrently, the origins and greatest subtype diversity of HIV-1 were reported in Central Africa [4] (Figure ...
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... the country with the highest HIV prevalence in the world, this study describes the burden of HIV and associated characteristics among MSM who were accrued using RDS. Interpreting the prevalence of HIV among MSM and its relationship with the widespread and generalized female- predominant epidemic in Swaziland is challenging on a Baral SD et al. Journal of the International AIDS Society 2013, 16(Suppl 3):18768 http://www.jiasociety.org/index.php/jias/article/view/18768 | http://dx.doi.org/10.7448/IAS.16.4.18768 While the participants in our study were relatively young, the HIV prevalence was consistent with that of general reproductive-age men until age 24Á26, when the prevalence of HIV among age-matched MSM appears to be higher than that of other men sampled as part of the Swazi DHS study ( Figure 1) [2]. Given that relatively few men in our sample reported female sexual partners, their HIV acquisition and transmission risks are likely different from those of other men in Swaziland and potentially more related to anal intercourse. Conversely, Swaziland may be among a small number of countries where even the low acquisition risks associated with insertive penile-vaginal intercourse is counterbalanced by the significantly higher HIV prevalence among women, resulting in significant acquisition risks as- sociated with sex with women. However, the idea that acquisition risk for MSM primarily related to sex with other men is reinforced by the results that condom use was lower with male sexual partners than with female sexual partners. Condoms being used more frequently during sex with women as compared to sex with other men have been ob- served in other studies of MSM across Sub-Saharan Africa and provide an argument against MSM being a population that bridges the HIV epidemic from within their sexual networks to lower risk heterosexual networks ...
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... presented in Table 3, crude and RDS-weighted HIV prevalence were 28.6% (73/255) and 25.5% (95% CI 19.1Á 31.9) in Douala and 47.3% (98/207) and 44.4% (95% CI 35.7Á 53.2) in Yaoundé. Age-stratified prevalence is presented in Figure 1. In Douala, only 17 (6.3%) MSM refused to be tested; in Yaoundé, this number was higher (13.4%, n032). An association between having a history of VCT and refusing testing in the study was observed in Yaoundé, although it did not reach statistical significance (15.2% vs. 4.9%, p ...
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... . . You are able to, you know, be yourself and the sense of getting to be yourself and also giving the feeling that you are not alone . . .. (FGD 1) . . . It's nice when we had events, especially in our communities, because there's nothing happening so Many participants shared how their self-esteem and self-efficacy improved during the meeting groups and community-based activities. For example, participants in multiple townships noted that they were able to explore and understand their sexuality, some for the first ...
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... total of 338 MSM (including original seeds) were recruited via RDS and enrolled into the study, reaching 19 waves of recruitment. Out of 10 seeds, five recruited participants; one recruitment chain was responsible for the recruitment of 70% of the study population. Three recruitment chains are reflective of later seed initiation. A total of 706 coupons were distributed with a return rate of 48%. The majority of participants reported recruitment by a friend (60.5%) or sex partner (32.3%). Median MSM network size was 8 (range 1 to 800). Figure 1 displays the RDS recruitment diagram, high- lighted by HIV diagnosis. We used this method to monitor recruitment and to assess whether HIV diagnosis inhibited recruitment, which appeared not to be the ...
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... majority of HCWs reported lower HS scores three months post-training (80.3%, 57/71) compared to their baseline HS score; in four (5.6%), HS scores were unchanged; and in 14.1% (10/71), HS scores were higher after training than before. Overall, the median decrease in individual HS score after training was 8 points (IQR 2Á15), which was statistically significant. These findings did not change in a sensitivity analysis omitting the three HS questions that were culturally adapted (data not shown). Individual pre-training and post-training HS scores were negatively correlated (Spearman's rho 0( 0.71, pB0.001), reflecting the ten- dency for HCWs with high pre-training HS scores to exhibit greater decreases in this measure as a result of training (Figure ...
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Healthcare workers (HCW) face the risk of occupational exposure to infectious diseases, especially in countries with high burdens of tuberculosis (TB) and human immunodeficiency virus (HIV). Disclosure of TB and/or HIV status is needed to ensure prompt action and treatment, and, in the case of TB, prevent transmission to co-workers and patients. Tr...
Citations
... Similar findings were reported in a study in Kenya, where fear of abnormal screening results (22.1%) and lack of financial support (11.4%) were the most common barriers to cervical cancer screening. 16,17 Another study in China showed that anxious feelings of diagnosis (47.6%) and lack of awareness of screening benefits (13.4%) were significant factors influencing cervical cancer screening. 18 Association between level of knowledge and demographic variables: This study found significant associations between knowledge levels and demographic variables such as area of living, number of pregnancies, number of sexual partners, and previous history of screening. ...
Introduction Cervical cancer manifests in the cervix cells, the lower part of the uterus connecting to the vagina. Similar to other cancers, the exact cause of cervical cancer remains uncertain and idiopathic. However, it is established that the human papilloma virus plays a significant role in initiating cellular changes in the cervix. In India, the lack of cancer awareness and screening facilities results in many women presenting at an advanced and deadly stage of the disease, negatively impacting their prognosis and clinical outcomes.
Methods A total of 255 women aged between 18 and 45 years, who were either patients or accompanying bystanders at a tertiary care hospital, were selected using purposive sampling technique.
Statistical Analysis Descriptive statistics were used to represent the sociodemographic characteristics levels. Association of sociodemographic variables levels is determined using chi-squared test.
Results The mean age of the participants was 31.83 ± 6.83 years, majority (162 [63.5%]) were living in a rural area, most (175 [68.6%]) of the participants were married, majority (254 [99.6%]) of the subjects were not having any family history of cervical cancer, most (202 [79.2%]) of the participants were having a single sexual partner, majority (108 [42.4%]) were not having any information on cervical cancer, most (134 [52.5%]) of the participants were unaware of cervical cancer screening, 39 (15.3%) were aware but delaying, 26 (10.2%) were aware, 17 (6.7%) were aware but not decided to do, 16 (6.3%) were aware but undecided, and 21 (8.2%) were in “others” category.
Conclusion Although women are having good knowledge and positive attitude toward cervical cancer screening and prevention, still there is a gap to transform it into practice. There is a need for more educational programs to connect identified knowledge slits and uplift regular practice of cervical cancer screening.
... 22 There have been demonstrated improvements in health service provision for MSM through sensitization of healthcare workers in sub-Saharan Africa. [42][43][44] There are several limitations with the approaches used to collect these data. One limitation with research involving hidden populations such as MSM is unbiased recruitment of participants; while recruitment is still biased with RDS, analytic approaches can be used to overcome some of this. ...
Liver disease is the leading cause of death not related to AIDS in persons infected with human immunodeficiency virus (HIV). As patients with HIV live longer, hepatic steatosis has become a growing problem. We prospectively evaluated 59 treatment naïve HIV-infected persons in Argentina before and during ART. We found that 66% of cohort participants had evidence of hepatic steatosis by the Ultrasound Steatosis Score. Seventeen percent had evidence of liver fibrosis based on their AST to platelet ratio index (APRI) score. AST and ALT blood levels significantly decreased 6 and 12 weeks post ART and decreases in ALT directly correlated with increases in CD4 counts (p=0.005). In summary, in our cohort the prevalence of fatty liver in Hispanics was higher than reported before. ART led to decreased liver enzyme levels and decreases in ALT correlated with CD4 recovery.
... 9,10 In addition, this type of stigma may thwart retention in care, or in the case of MSM, treatment to achieve viral suppression with improved health outcomes and minimised chances of onward HIV transmission. 11,12 Although the West and Central Africa (WCA)'s HIV epidemic is not as broadly generalised as the one observed in Southern Africa, 13,14 WCA MSM are disproportionately affected by HIV. 13,14 Additionally, despite the relatively high prevalence of HIV among MSM in urban areas in Cameroon (35%), 15 there is inconsistent uptake of the MSMoriented HIV/STIs prevention and treatment services. ...
... 11,12 Although the West and Central Africa (WCA)'s HIV epidemic is not as broadly generalised as the one observed in Southern Africa, 13,14 WCA MSM are disproportionately affected by HIV. 13,14 Additionally, despite the relatively high prevalence of HIV among MSM in urban areas in Cameroon (35%), 15 there is inconsistent uptake of the MSMoriented HIV/STIs prevention and treatment services. 15 The relationship between stigma, homophobia and HIV services uptake have been previously studied in West Africa. ...
Background
Men who have sex with men (MSM) in Cameroon consistently face significant stigma and discrimination. The urban HIV prevalence in MSM is estimated at 35%. This study investigates the effect of stigma, discrimination and alienation on Cameroonian MSM’s engagement of the HIV treatment cascade. Methods: Qualitative interviews were semi-structured using a guide. Participants in Douala, Ngaoundere, Bamenda, Bertoua and Yaoundé were asked to describe the MSM social and structural context, MSM knowledge of existing HIV-related services in public and MSM-focussed non-governmental organisation (NGO) clinics. Using a codebook, coded text was extracted from 40 transcripts with Microsoft Word Macros. These texts were analysed for recurring themes that were developed into results. Results: There were three main themes that emerged. First, among those MSM participants seeking HIV services, many commonly reported experiences of discrimination and physical violence outside the healthcare setting. Second, a few respondents used services provided by the Ministry of Health and local NGOs. However, most participants observed limited clinical and cultural competency of public clinic staff. Third, MSM declared that lack of social support and healthcare access caused them much stress. Several individuals recounted their alienation greatly discouraged them from seeking HIV prevention, treatment and care services. Conclusions: Community-level and public healthcare-related stigma impacts the mental wellbeing of Cameroonian MSM. Alienation among MSM also represents a common obstacle to the uptake of MSM-oriented HIV/AIDS services. Improving provider cultural and clinical competency among Cameroonian health care workers combined with a broader stigma-reduction intervention for Cameroonian healthcare may increase the uptake of HIV prevention, treatment and care among MSM.
Within the broadly generalized HIV epidemic in Swaziland, men who have sex with men (MSM) have specific HIV acquisition and transmission risks. In the current era of expanding antiretroviral therapy-based prevention and treatment approaches, condom use remains a core component of mitigating these risks. A cross-sectional study characterizing the vulnerabilities for HIV among MSM in Swaziland was analyzed to describe factors associated with condom use at last sex with a male partner. Bivariate and multivariate logistic regression were conducted to assess correlates of condom use at last sex with both casual and regular male partners. Disclosure of sexual practices to a healthcare provider and being able to count on other MSM to support condom use were significantly associated with condom use at last sex with a causal and a regular partner respectively. Reporting difficulty insisting on condom use was inversely associated with condom use at last sex with both regular and casual partners. In addition, having faced legal discrimination was similarly inversely associated with condom use at last sex with a regular partner. Condom use among MSM in Swaziland may increase with improved partner communication, provider sensitization to encourage sexual disclosure, and the promotion of safer sex norms within MSM communities. These approaches, in combination with existing and emerging evidence-informed and human rights affirming prevention and HIV treatment approaches may reduce the incidence of HIV among MSM in Swaziland and all those in their sexual networks.