248 results on '"Grosso, Ashley"'
Search Results
2. Sexually Transmitted Infection Risks and Symptoms Heightened Among Female Sex Workers who Started Selling Sex Before the Age of 18 in Five Cities in Cameroon
- Author
-
Grosso, Ashley, Bowring, Anna L., Njindam, Iliassou Mfochive, Decker, Michele R., Lyons, Carrie, Rao, Amrita, Tamoufe, Ubald, Fako, Guy H., Fouda, Ghislaine, Levitt, Daniel, Turpin, Gnilane, Billong, Serge C., Zoung-Kanyi Bissek, Anne Cécile, Njoya, Oudou, and Baral, Stefan
- Published
- 2024
- Full Text
- View/download PDF
3. The relationship between underage initiation of selling sex and depression among female sex workers in Eswatini.
- Author
-
Grosso, Ashley, Fielding-Miller, Rebecca, Matse, Sindy, Sithole, Bhekie, and Baral, Stefan
- Subjects
Eswatini ,adolescent ,barriers to care ,depression ,sex workers ,Mental Health ,Behavioral and Social Science ,Clinical Research ,Prevention ,Depression ,Mental health ,Good Health and Well Being ,Clinical Sciences ,Public Health and Health Services ,Psychology - Abstract
BackgroundMinors who sell sex are likely to have complex mental health needs that may persist into adulthood. This topic is understudied in sub-Saharan Africa. This study hypothesized that adult female sex workers in Eswatini who started selling sex as minors have a higher prevalence of depression than those who started as adults. We also examined correlates of depression and underage initiation of selling sex, including stigma and condom-related behaviors.MethodsFrom October-December 2014, women aged 18 or older who sold sex in the past 12 months in Eswatini were recruited through venue-based sampling. Participants completed a survey including the 9-item Patient Health Questionnaire (PHQ-9) and a question about the age at which they first sold sex for money. T-tests, χ2 tests and multivariable logistic regression were used to assess associations.ResultsOverall, 43.1% of participants (332/770) had probable depression, and 16.6% (128/770) started selling sex as minors under the age of 18. Over half (55.5%, 71/128) of those who started selling sex as minors had depression. This was significantly higher than the 40.7% (261/642) prevalence of depression among participants who started selling sex as adults (p = 0.002). After adjusting for confounders, female sex workers who started selling sex as minors had higher odds of depression than those who started as adults (adjusted odds ratio [aOR] 1.70, 95% confidence interval 1.11-2.60).ConclusionResults highlight the need for trauma-informed and adolescent-friendly mental health services in settings free of stigma toward female sex workers in Eswatini.
- Published
- 2023
4. Characteristics of Men Who Have Sex With Men in Southern Africa Who Seek Sex Online: A Cross-Sectional Study
- Author
-
Stahlman, Shauna, Grosso, Ashley, Ketende, Sosthenes, Mothopeng, Tampose, Taruberekera, Noah, Nkonyana, John, Mabuza, Xolile, Sithole, Bhekie, Mnisi, Zandile, and Baral, Stefan
- Subjects
Computer applications to medicine. Medical informatics ,R858-859.7 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundUse of the Internet for finding sexual partners is increasing, particularly among men who have sex with men (MSM). In particular, MSM who seek sex online are an important group to target for human immunodeficiency virus (HIV)/sexually transmitted infection (STI) interventions because they tend to have elevated levels of sexual risk behavior and because the Internet itself may serve as a promising intervention delivery mechanism. However, few studies have examined the correlates of online sexual partner seeking among MSM in sub-Saharan Africa. ObjectiveThese analyses aim to describe the prevalence of using the Internet to find new male sexual partners among MSM in two southern African countries. In addition, these analyses examine the sociodemographic characteristics, experiences of discrimination and stigma, mental health and substance use characteristics, and HIV-related knowledge, attitudes, and behaviors among MSM associated with meeting sex partners online. MethodsMSM were enrolled into a cross-sectional study across two sites in Lesotho (N=530), and one in Swaziland (N=322) using respondent-driven sampling. Participants completed a survey and HIV testing. Data were analyzed using bivariate and multivariable logistic regression models to determine which factors were associated with using the Internet to meet sex partners among MSM. ResultsThe prevalence of online sex-seeking was high, with 39.4% (209/530) of MSM in Lesotho and 43.8% (141/322) of MSM in Swaziland reporting meeting a new male sexual partner online. In the multivariable analysis, younger age (adjusted odds ratio [aOR] 0.37, 95% confidence interval [CI] 0.27-0.50 per 5 years in Lesotho; aOR 0.68, 95% CI 0.49-0.93 in Swaziland), having more than a high school education (aOR 18.2, 95% CI 7.09-46.62 in Lesotho; aOR 4.23, 95% CI 2.07-8.63 in Swaziland), feeling scared to walk around in public places (aOR 1.89, 95% CI 1.00-3.56 in Lesotho; aOR 2.06, 95% CI 1.23-3.46 in Swaziland), and higher numbers of male anal sex partners within the past 12 months (aOR 1.27, 95% CI 1.01-1.59 per 5 partners in Lesotho; aOR 2.98, 95% CI 1.51-5.89 in Swaziland) were significantly associated with meeting sex partners online in both countries. Additional country-specific associations included increasing knowledge about HIV transmission, feeling afraid to seek health care services, thinking that family members gossiped, and having a prevalent HIV infection among MSM in Lesotho. ConclusionsOverall, a high proportion of MSM in Lesotho and Swaziland reported meeting male sex partners online, as in other parts of the world. The information in this study can be used to tailor interventions or to suggest modes of delivery of HIV prevention messaging to these MSM, who represent a young and highly stigmatized group. These data suggest that further research assessing the feasibility and acceptability of online interventions will be increasingly critical to addressing the HIV epidemic among MSM across sub-Saharan Africa.
- Published
- 2015
- Full Text
- View/download PDF
5. Person-centered patterns of substance use during the COVID-19 pandemic and their associations with COVID-related impacts on health and personal finances in young Black and White women
- Author
-
Chung, Tammy, Sartor, Carolyn, Hipwell, Alison E., Grosso, Ashley, and Jiang, Yanping
- Published
- 2022
- Full Text
- View/download PDF
6. “If You Don't Ask, I'm Not Going to Tell You”: Using Community-Based Participatory Research to Inform Pregnancy Intention Screening Processes for Black and Latina Women in Primary Care
- Author
-
Garbers, Samantha, Falletta, Katherine A., Srinivasulu, Silpa, Almonte, Yolyn, Baum, Rachel, Bermudez, Dayana, Coriano, Madeline, Iglehart, Kathryn, Mota, Cathy, Rodriguez, Laura, Taveras, Jecenia, Tobier, Natalie, and Grosso, Ashley
- Published
- 2020
- Full Text
- View/download PDF
7. Sexually Transmitted Infection Risks and Symptoms Heightened Among Female Sex Workers who Started Selling Sex Before the Age of 18 in Five Cities in Cameroon
- Author
-
Grosso, Ashley, primary, Bowring, Anna L., additional, Njindam, Iliassou Mfochive, additional, Decker, Michele R., additional, Lyons, Carrie, additional, Rao, Amrita, additional, Tamoufe, Ubald, additional, Fako, Guy H., additional, Fouda, Ghislaine, additional, Levitt, Daniel, additional, Turpin, Gnilane, additional, Billong, Serge C., additional, Zoung-Kanyi Bissek, Anne Cécile, additional, Njoya, Oudou, additional, and Baral, Stefan, additional
- Published
- 2023
- Full Text
- View/download PDF
8. The relationship between underage initiation of selling sex and depression among female sex workers in Eswatini
- Author
-
Grosso, Ashley, primary, Fielding-Miller, Rebecca, additional, Matse, Sindy, additional, Sithole, Bhekie, additional, and Baral, Stefan, additional
- Published
- 2023
- Full Text
- View/download PDF
9. ‘WTF is PrEP?’ : attitudes towards pre-exposure prophylaxis among men who have sex with men and transgender women in New York City
- Author
-
Thomann, Matthew, Grosso, Ashley, Zapata, Richard, and Chiasson, Mary Ann
- Published
- 2018
10. Stigma as a barrier to health care utilization among female sex workers and men who have sex with men in Burkina Faso
- Author
-
Kim, Hae-Young, Grosso, Ashley, Ky-Zerbo, Odette, Lougue, Marcel, Stahlman, Shauna, Samadoulougou, Cesaire, Ouedraogo, Gautier, Kouanda, Seni, Liestman, Benjamin, and Baral, Stefan
- Published
- 2018
- Full Text
- View/download PDF
11. Human immunodeficiency virus (HIV) among men who have sex with men: results of the first integrated biological and behavioral survey in Burkina Faso, West Africa
- Author
-
Ouedraogo, Henri Gautier, Ky-Zerbo, Odette, Grosso, Ashley, Goodman, Sara, Samadoulougou, Benoît Cesaire, Tarnagda, Grissoum, Baguiya, Adama, Tiendrebeogo, Simon, Lougue, Marcel, Sawadogo, Nongoba, Traore, Yves, Barro, Nicolas, Baral, Stefan, and Kouanda, Seni
- Published
- 2019
- Full Text
- View/download PDF
12. HIV risks and needs related to the Sustainable Development Goals among female sex workers who were commercially sexually exploited as children in Lesotho
- Author
-
Grosso, Ashley, Busch, Shianne, Mothopeng, Tampose, Sweitzer, Stephanie, Nkonyana, John, Mpooa, Nkomile, Taruberekera, Noah, and Baral, Stefan
- Subjects
Sustainable development -- Analysis ,Child sexual abuse -- Social aspects ,HIV infection -- Risk factors -- Prevention ,Health - Abstract
Introduction: Sustainable Development Goals (SDGs) about gender equality; decent work; and peace, justice, and strong institutions include a focus on eradicating trafficking and sexual exploitation of and violence against women and children. In Lesotho, 86% of women have experienced gender-based violence. In addition, overall HIV prevalence is among the highest globally, and higher among adolescent girls than boys. Moreover, nearly three quarters of female sex workers (FSW) are estimated to be living with HIV in Lesotho. In this context, sexually exploited children may be particularly vulnerable to violence and HIV acquisition risks. This study's objective is to examine the prevalence and correlates of experiencing sexual exploitation as a child among FSW in Lesotho. Methods: FSW ([greater than or equal to] 18 years) recruited through respondent-driven sampling in Maseru and Maputsoe from February to September 2014 completed HIV and syphilis testing and an interviewer-administered survey, including a question about the age at which they started providing sex for money. This study examined correlates of experiencing sexual exploitation as a child ( Results: Across both cities, 20.0% (142/710) of participants were sexually exploited as children. Among them, 65.5% (93/142) tested positive for HIV and 31.0% (44/142) for syphilis, which was similar to those who started selling sex as adults, after adjusting for current age. Participants who experienced child sexual exploitation were more likely to have been forced to have sex before age 18 than those who started selling sex as adults (Maseru-adjusted odds ratio (aOR): 3.52, 95% Confidence Interval (CI): 1.61 to 7.66, p = 0.002; Maputsoe-aOR: 4.39, 95% CI: 1.22 to 15.75, p = 0.023). In Maseru, participants who were sexually exploited as children were more likely to avoid carrying condoms to prevent trouble with police (aOR: 3.18, 95% CI: 1.50 to 6.75, p = 0.003). Conclusions: Risk determinants for HIV and violence among sexually exploited children can be studied retrospectively through research with adult FSW. Further research working directly with sexually exploited children will improve understanding of their needs. Preventing commercial sexual exploitation of children and addressing the social and healthcare needs of those who are exploited are necessary to fully achieve SDGs 5, 8 and 16 and an AIDS-Free Generation. Keywords: AIDS; sex trafficking; human trafficking; sexual violence; physical violence; adolescents, 1 | INTRODUCTION Much of the research on the sexual exploitation of children has been conducted in Asia and the Americas, [1] but studies have increasingly explored this topic in [...]
- Published
- 2018
- Full Text
- View/download PDF
13. Depressive symptoms and substance use as mediators of stigma affecting men who have sex with men in Lesotho: a structural equation modeling approach
- Author
-
Wendi, Da, Stahlman, Shauna, Grosso, Ashley, Sweitzer, Stephanie, Ketende, Sosthenes, Taruberekera, Noah, Nkonyana, John, Mothopeng, Tampose, and Baral, Stefan
- Published
- 2016
- Full Text
- View/download PDF
14. Examining the Correlates of Sexually Transmitted Infection Testing Among Men Who Have Sex With Men in Ouagadougou and Bobo-Dioulasso, Burkina Faso
- Author
-
Goodman, Sara H., Grosso, Ashley L., Ketende, Sosthenes C., Ouedraogo, Gautier H., Kouanda, Seni, Ky-Zerbo, Odette, Samadoulougou, Césaire, and Baral, Stefan
- Published
- 2016
15. Public-Private Partnerships in Global Health
- Author
-
Papworth, Erin, primary, Ewing, Whitney, additional, and Grosso, Ashley, additional
- Published
- 2018
- Full Text
- View/download PDF
16. Development and reliability of metrics to characterize types and sources of stigma among men who have sex with men and female sex workers in Togo and Burkina Faso
- Author
-
Grosso, Ashley L., Ketende, Sosthenes C., Stahlman, Shauna, Ky-Zerbo, Odette, Ouedraogo, Henri Gautier, Kouanda, Seni, Samadoulougou, Cesaire, Lougue, Marcel, Tchalla, Jules, Anato, Simplice, Dometo, Sodji, Nadedjo, Felicity D., Pitche, Vincent, and Baral, Stefan D.
- Published
- 2019
- Full Text
- View/download PDF
17. Sexual and Reproductive Health Service Needs Associated with Underage Initiation of Selling Sex among Adult Female Sex Workers in Guinea-Bissau
- Author
-
Grosso, Ashley, primary, Berg, Lindsay, additional, Rucinski, Katherine, additional, Rao, Amrita, additional, Djaló, Mamadú Aliu, additional, Diouf, Daouda, additional, and Baral, Stefan, additional
- Published
- 2022
- Full Text
- View/download PDF
18. Younger age of initiation of selling sex and depressive symptoms among female sex workers in Eswatini
- Author
-
Grosso, Ashley, primary, Fielding-Miller, Rebecca, additional, Matse, Sindy, additional, Sithole, Bhekie, additional, and Baral, Stefan, additional
- Published
- 2022
- Full Text
- View/download PDF
19. Sexually transmitted infection risks and symptoms among women who started selling sex before the age of 18 in five cities in Cameroon
- Author
-
Grosso, Ashley, primary, Bowring, Anna L., additional, Njindam, Iliassou Mfochive, additional, Decker, Michele R., additional, Lyons, Carrie, additional, Rao, Amrita, additional, Tamoufe, Ubald, additional, Fako, Guy H., additional, Fouda, Ghislaine, additional, Levitt, Daniel, additional, Turpin, Gnilane, additional, Billong, Serge C., additional, Bissek, Anne Cécile Zoung-Kanyi, additional, Njoya, Oudou, additional, and Baral, Stefan, additional
- Published
- 2022
- Full Text
- View/download PDF
20. Depression and Social Stigma Among MSM in Lesotho: Implications for HIV and Sexually Transmitted Infection Prevention
- Author
-
Stahlman, Shauna, Grosso, Ashley, Ketende, Sosthenes, Sweitzer, Stephanie, Mothopeng, Tampose, Taruberekera, Noah, Nkonyana, John, and Baral, Stefan
- Published
- 2015
- Full Text
- View/download PDF
21. Day-level associations of craving and anxiety with self-reported attention and concentration problems in young adults who use cannabis: A key role for anxiety
- Author
-
Chung, Tammy, primary, Millar, Brett, additional, Sizemore, Marie, additional, Jiang, Yanping, additional, Grosso, Ashley, additional, and Ahmed, Zeeshan, additional
- Published
- 2022
- Full Text
- View/download PDF
22. HOW CITIZENS VIEW GOVERNMENT PERFORMANCE REPORTING: Results of a National Survey
- Author
-
GROSSO, ASHLEY L. and VAN RYZIN, GREGG G.
- Published
- 2011
23. SOCIAL SUPPORT AS A PREDICTOR OF HIV TESTING IN AT-RISK POPULATIONS: A RESEARCH NOTE
- Author
-
GROSSO, ASHLEY
- Published
- 2010
24. Evidence of an Output Bias in the Judgment of Public Performance: A Replication and Extension
- Author
-
Van Ryzin, Gregg G., primary, Grosso, Ashley, additional, and Charbonneau, Étienne, additional
- Published
- 2020
- Full Text
- View/download PDF
25. Evidence of an Output Bias in the Judgment of Public Performance: A Replication and Extension.
- Author
-
Van Ryzin, Gregg G., Grosso, Ashley, and Charbonneau, Étienne
- Subjects
POLICY sciences ,AIDS prevention ,HIGH school students ,SOCIAL services - Abstract
Despite calls for an evidence-based focus on outcomes as a way to enhance accountability for public performance, findings from a prior study suggest that the public may be more impressed by high frequency (low cost) but ambiguous outputs (such as people served) rather than more meaningful but costly outcomes (causal effects). We attempt to replicate and extend the investigation of this output bias through a pair of survey experiments involving judgments about two evidence-based, highly effective social programs: one, an HIV/AIDS prevention program (adapted from the prior study), the other, a program for special needs high school students (Check and Connect). Our findings confirm that respondents viewed both programs more favorably when given information about mere outputs (people served) in comparison with more rigorous outcomes (causal effects). We then tested an extension of the Check and Connect experiment in which we modified the framing of cost and performance information in ways that reduced the tendency toward an output bias. We speculate on the possible mechanism that may lead to an output bias, and we discuss the implications of our findings for evidence-based public policy and management. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
26. Primary care providers’ responses to pregnancy intention screening challenges: community-based participatory research at an urban community health centre
- Author
-
Srinivasulu, Silpa, primary, Falletta, Katherine A, additional, Bermudez, Dayana, additional, Almonte, Yolyn, additional, Baum, Rachel, additional, Coriano, Madeline, additional, Grosso, Ashley, additional, Iglehart, Kathryn, additional, Mota, Cathy, additional, Rodriguez, Laura, additional, Taveras, Jecenia, additional, Tobier, Natalie, additional, and Garbers, Samantha V, additional
- Published
- 2019
- Full Text
- View/download PDF
27. Characterising the relationship between migration and stigma affecting healthcare engagement among female sex workers in Lomé, Togo
- Author
-
Lasater, Molly E., primary, Grosso, Ashley, additional, Ketende, Sosthenes, additional, Lyons, Carrie, additional, Pitche, Vincent Palokinam, additional, Tchalla, Jules, additional, Anato, Simplice, additional, Sodji, Dométo, additional, Nadedjo, Felicity, additional, and Baral, Stefan, additional
- Published
- 2019
- Full Text
- View/download PDF
28. Healthcare Stigma Measure
- Author
-
Lasater, Molly E., primary, Grosso, Ashley, additional, Ketende, Sosthenes, additional, Lyons, Carrie, additional, Pitche, Vincent Palokinam, additional, Tchalla, Jules, additional, Anato, Simplice, additional, Sodji, Dométo, additional, Nadedjo, Felicity, additional, and Baral, Stefan, additional
- Published
- 2019
- Full Text
- View/download PDF
29. Hepatitis B, C, and D virus and human T-cell leukemia virus types 1 and 2 infections and correlates among men who have sex with men in Ouagadougou, Burkina Faso
- Author
-
Ouedraogo, Henri Gautier, primary, Kouanda, Seni, additional, Grosso, Ashley, additional, Compaoré, Rebecca, additional, Camara, Modibo, additional, Dabire, Charlemagne, additional, Ouedraogo, Rasmata, additional, Traore, Yves, additional, Baral, Stefan, additional, and Barro, Nicolas, additional
- Published
- 2018
- Full Text
- View/download PDF
30. Syphilis among Female Sex Workers: Results of Point-of-Care Screening during a Cross-Sectional Behavioral Survey in Burkina Faso, West Africa
- Author
-
Ouedraogo, Henri Gautier, primary, Meda, Ivlabehire Bertrand, additional, Zongo, Issaka, additional, Ky-Zerbo, Odette, additional, Grosso, Ashley, additional, Samadoulougou, Benoit Cesaire, additional, Tarnagda, Grissoum, additional, Cisse, Kadari, additional, Sondo, Apoline, additional, Sawadogo, Nongoba, additional, Traoré, Yves, additional, Barro, Nicolas, additional, Baral, Stefan, additional, and Kouanda, Seni, additional
- Published
- 2018
- Full Text
- View/download PDF
31. Pros and Cons of 19 Sport-Related Concussion Educational Resources in Canada: Avenues for Better Care and Prevention
- Author
-
Cusimano, Michael D., primary, Zhang, Stanley, additional, Topolovec-Vranic, Jane, additional, Grosso, Ashley, additional, Jing, Rowan, additional, and Ilie, Gabriela, additional
- Published
- 2018
- Full Text
- View/download PDF
32. ‘The only safe way to find a partner’: rethinking sex and risk online in Abidjan, Côte d’Ivoire
- Author
-
Thomann, Matthew, primary, Grosso, Ashley, additional, Wilson, Patrick A., additional, and Chiasson, Mary Ann, additional
- Published
- 2018
- Full Text
- View/download PDF
33. A cross‐sectional assessment of the burden of HIV and associated individual‐ and structural‐level characteristics among men who have sex with men in Swaziland
- Author
-
Baral, Stefan D., Ketende, Sosthenes, Mnisi, Zandile, Mabuza, Xolile, Grosso, Ashley, Sithole, Bhekie, Maziya, Sibusiso, Kerrigan, Deanna L., Green, Jessica L., Kennedy, Caitlin E., and Adams, Darrin
- Subjects
MSM (Men who have sex with men) -- Health aspects ,HIV infection -- Diagnosis -- Care and treatment ,Health - Abstract
Introduction: Similar to other Southern African countries, Swaziland has been severely affected by HIV, with over a quarter of its reproductive‐age adults estimated to be living with the virus, equating to an estimate of 170,000 people living with HIV. The last several years have witnessed an increase in the understanding of the potential vulnerabilities among men who have sex with men (MSM) in neighbouring countries with similarly widespread HIV epidemics. To date, there are no data characterizing the burden of HIV and the HIV prevention, treatment and care needs of MSM in Swaziland. Methods: In 2011, 324 men who reported sex with another man in the last 12 months were accrued using respondent‐driven sampling (RDS). Participants completed HIV testing using Swazi national guidelines as well as structured survey instruments administered by trained staff, including modules on demographics, individual‐level behavioural and biological risk factors, social and structural characteristics and uptake of HIV services. Population and individual weights were computed separately for each variable with a data‐smoothing algorithm. The weights were used to estimate RDS‐adjusted univariate estimates with 95% bootstrapped confidence intervals (BCIs). Crude and RDS‐adjusted bivariate and multivariate analyses were completed with HIV as the dependent variable. Results: Overall, HIV prevalence was 17.6% (n=50/284), although it was strongly correlated with age in bivariate‐ [odds ratio (OR) 1.2, 95% BCI 1.15–1.21] and multivariate‐adjusted analyses (adjusted OR 1.24, 95% BCI 1.14–1.35) for each additional year of age. Nearly, 70.8% (n=34/48) were unaware of their status of living with HIV. Condom use with all sexual partners and condom‐compatible‐lubricant use with men were reported by 1.3% (95% CI 0.0–9.7). Conclusions: Although the epidemic in Swaziland is driven by high‐risk heterosexual transmission, the burden of HIV and the HIV prevention, treatment and care needs of MSM have been understudied. The data presented here suggest that these men have specific HIV acquisition and transmission risks that differ from those of other reproductive‐age adults. The scale‐up in HIV services over the past decade has likely had limited benefit for MSM, potentially resulting in a scenario where epidemics of HIV among MSM expand in the context of slowing epidemics in the general population, a reality observed in most of the world., Introduction Swaziland is a small, land‐locked, lower‐middle‐income country that is surrounded by South Africa and Mozambique; it has a population of approximately 1.1 million people and a life expectancy at [...]
- Published
- 2013
- Full Text
- View/download PDF
34. HIV prevalence and factors associated with HIV infection among men who have sex with men in Cameroon
- Author
-
Park, Ju Nyeong, Papworth, Erin, Kassegne, Sethson, Moukam, Laure, Billong, Serge Clotaire, Macauley, Issac, Yomb, Yves Roger, Nkoume, Nathalie, Mondoleba, Valentin, Eloundou, Jules, Lebreton, Matthew, Tamoufe, Ubald, Grosso, Ashley, and Baral, Stefan D.
- Subjects
Syphilis -- Diagnosis -- Care and treatment ,Comorbidity -- Evaluation ,Prevalence studies (Epidemiology) -- Management ,MSM (Men who have sex with men) -- Health aspects ,HIV infection -- Diagnosis -- Care and treatment ,Company business management ,Health - Abstract
Introduction: Despite men who have sex with men (MSM) being a key population for HIV programming globally, HIV epidemiologic data on MSM in Central Africa are sparse. We measured HIV and syphilis prevalence and the factors associated with HIV infection among MSM in Cameroon. Methods: Two hundred and seventy‐two and 239 MSM aged ≥18 from Douala and Yaoundé, respectively, were recruited using respondent‐driven sampling (RDS) for this cross‐sectional surveillance study in 2011. Participants completed a structured questionnaire and HIV and syphilis testing. Statistical analyses, including RDS‐weighted proportions, bootstrapped confidence intervals and logistic regressions, were used. Results: Crude and RDS‐weighted HIV prevalence were 28.6% (73/255) and 25.5% (95% CI 19.1–31.9) in Douala, and 47.3% (98/207) and 44.4% (95% CI 35.7–53.2) in Yaoundé. Active syphilis prevalence in total was 0.4% (2/511). Overall, median age was 24 years, 62% (317/511) of MSM identified as bisexual and 28.6% (144/511) identified as gay. Inconsistent condom use with regular male partners (64.1%; 273/426) and casual male and female partners (48.5%; 195/402) was common, as was the inconsistent use of condom‐compatible lubricants (CCLs) (26.3%; 124/472). In Douala, preferring a receptive sexual role was associated with prevalent HIV infection [adjusted odds ratio (aOR) 2.33, 95% CI 1.02–5.32]. Compared to MSM without HIV infection, MSM living with HIV were more likely to have ever accessed a health service targeting MSM in Douala (aOR 4.88, 95% CI 1.63–14.63). In Yaoundé, MSM living with HIV were more likely to use CCLs (aOR 2.44, 95% CI 1.19–4.97). Conclusions: High HIV prevalence were observed and condoms and CCLs were used inconsistently indicating that MSM are a priority population for HIV prevention, treatment and care services in Douala and Yaoundé. Building the capacity of MSM community organizations and improving the delivery and scale‐up of multimodal interventions for MSM that are sensitive to concerns about confidentiality and the complex individual, social, community‐level and policy challenges are needed to successfully engage young MSM in the continuum of HIV care. In addition to scaling up condom and CCL access, evaluating the feasibility of novel biomedical interventions, including antiretroviral pre‐exposure prophylaxis and early antiretroviral therapy for MSM living with HIV in Cameroon, is also warranted., Introduction Globally, it has been observed that HIV prevalence among men who have sex with men (MSM) significantly exceeds HIV prevalence in the general population, even in the context of [...]
- Published
- 2013
- Full Text
- View/download PDF
35. Epidemiology of HIV among female sex workers, their clients, men who have sex with men and people who inject drugs in West and Central Africa
- Author
-
Papworth, Erin, Ceesay, Nuha, An, Louis, Thiam-Niangoin, Marguerite, Ky-Zerbo, Odette, Holland, Claire, Drame, Fatou Maria, Grosso, Ashley, Diouf, Daouda, and Baral, Stefan D.
- Subjects
Drug addicts -- Health aspects -- Research ,Prevalence studies (Epidemiology) ,Prostitutes -- Health aspects -- Research ,Gays -- Health aspects -- Research ,HIV infection -- Risk factors -- Demographic aspects -- Research ,Health - Abstract
Introduction: The West and Central Africa (WCA) sub-region is the most populous region of sub-Saharan Africa (SSA), with an estimated population of 356 million living in 24 countries. The HIV epidemic in WCA appears to have distinct dynamics compared to the rest of SSA, being more concentrated among key populations such as female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and clients of FSWs. To explore the epidemiology of HIV in the region, a systematic review of HIV literature among key populations in WCA was conducted since the onset of the HIV epidemic. Methods: We searched the databases PubMed, CINAHL and others for peer-reviewed articles regarding FSWs, MSM and PWID in 24 countries with no date restriction. Inclusion criteria were sensitive and focused on inclusion of any HIV prevalence data among key populations. HIV prevalence was pooled, and in each country key themes were extracted from the literature. Results: The search generated 885 titles, 214 abstracts and 122 full articles, of which 76 met inclusion and exclusion criteria providing HIV prevalence data. There were 60 articles characterizing the burden of disease among FSWs, eight for their clients, one for both, six for MSM and one for PWID. The pooled HIV prevalence among FSWs was 34.9% (n = 14,388/41,270), among their clients was 7.3% (n = 435/5986), among MSM was 17.7% (n = 656/3714) and among PWID from one study in Nigeria was 3.8% (n = 56/1459). Conclusions: The disproportionate burden of HIV among FSWs appears to be consistent from the beginning of the HIV epidemic in WCA. While there are less data for other key populations such as clients of FSWs and MSM, the prevalence of HIV is higher among these men compared to other men in the region. There have been sporadic reports among PWID, but limited research on the burden of HIV among these men and women. These data affirm that the HIV epidemic in WCA appears to be far more concentrated among key populations than the epidemics in Southern and Eastern Africa. Evidence-based HIV prevention, treatment and care programmes in WCA should focus on engaging populations with the greatest burden of disease in the continuum of HIV care. Keywords: men who have sex with men; sex work; people who inject drugs; HIV epidemiology; West Africa; Central Africa; prevalence; risk factors. To access the supplementary material to this article please see Supplementary Files under Article Tools online., Introduction The sub-region of West and Central Africa (WCA) is the most populous of sub-Saharan Africa (SSA), with a combined population of roughly 356 million [1]. The region possesses a [...]
- Published
- 2013
- Full Text
- View/download PDF
36. School-based Nutrition Intervention for Families of Pre-K through First Grade.
- Author
-
Levy, Andrea M., Grosso, Ashley, Nonas, Cathy, Chiasson, Mary Ann, Dyer, Christina L., and Dannefer, Rachel
- Subjects
- *
NUTRITION , *SCHOOL lunchrooms, cafeterias, etc. , *FAMILIES , *NUTRITION education , *FOOD security , *SCHOOLS - Abstract
Objective: In this paper, we describe the implementation of a novel nutrition education intervention "¡Buen Provecho! - Eat Well" that aims to improve nutrition education, reduce food insecurity, increase healthy eating, and foster school engagement for families of pre-kindergarten through first grade students in 5 public schools in a low-income New York City neighborhood over 3 years. Methods: The intervention included free, weekly parent breakfasts with nutrition discussions, complemented by a common core-integrated classroom nutrition curriculum. A process evaluation assessed program uptake and feasibility of implementation, characterized participants, and identified lessons learned. Data sources included parent breakfast attendance records, parent surveys, and teacher interviews. Results: In the program's first year, 24% (169/717) of eligible children's parents attended at least one of the 130 breakfasts held. Parents redeemed 46% of the produce vouchers. We had 173 parents complete surveys. According to survey results, one-third of parents and children ate fruit daily, and 33% of children and 27% of parents ate vegetables daily. Nine of 36 teachers who had received the classroom curriculum were interviewed, and taught an average of 19% of the lessons from the curriculum. Conclusion: ¡Buen Provecho! - Eat Well has promising uptake and implementation. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
37. 'The only safe way to find a partner': rethinking sex and risk online in Abidjan, Côte d'Ivoire.
- Author
-
Thomann, Matthew, Grosso, Ashley, Wilson, Patrick A., and Chiasson, Mary Ann
- Subjects
- *
INTERNET , *INTERVIEWING , *RESEARCH methodology , *RESEARCH funding , *HUMAN sexuality , *VIOLENCE , *ONLINE social networks , *DATA analysis software , *MEN who have sex with men , *SEXUAL partners , *DESCRIPTIVE statistics - Abstract
Despite the Internet's global importance as a sex-seeking venue for men who have sex with men (MSM) and other sexual and gender minorities, little is known about this topic in sub-Saharan Africa. Furthermore, existing public health research offers limited insight into the sociocultural aspects of sexuality and how they articulate with patterns in online sex-seeking behavior. In 2015, we conducted survey and ethnographic research with 105 sexual and gender minorities in Abidjan, Côte d'Ivoire. Nearly half of survey respondents reported finding partners primarily online. Three quarters reported having found at least one partner online. Interviews with 24 of the survey participants revealed that a primary motivation for using online venues was that they allowed for the preservation and management of discretion and anonymity, permitting users to avoid discrimination and violence. While secondary to their strategies for managing such social risk, participants also reported using the profile features of online venues to filter out partners they perceived as presenting a risk to their sexual health. Though interview participants perceived online venues as providing a degree of protection against potential stigma and violence in offline contexts, survey data showed that over one quarter of participants had experienced extortion and/or blackmail by sexual partners they met online. By taking into account the sociocultural context of sexuality and sexual activity in Abidjan, these findings highlight the disjuncture between essentialist notions of MSM who use the Internet to find sex partners as a universal, at-risk group, and the complexity of sexual and gender minorities' experiences. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
38. Age of Onset of Alcohol Consumption and Subsequent Negative Health Outcomes in Gay and Bisexual Men Who Have Sex With Men.
- Author
-
Grosso, Ashley L., Downing, Martin J., Thomann, Matthew, Chiasson, Mary Ann, Schrimshaw, Eric W., and Hirshfield, Sabina
- Subjects
- *
AGE of onset , *ALCOHOL drinking , *MEN who have sex with men , *BISEXUAL people , *UNSAFE sex , *GAY men's sexual behavior - Abstract
The correlation between current alcohol use and sexual risk behaviors among men who have sex with men (MSM) is well documented, but little is known about age of drinking onset and current risks among this population. Data from a 2008 Internet survey of 8,452 MSM in the United States were used to assess factors associated with age of onset of alcohol use. In a multivariable model, drinking onset before age 15 was significantly associated with a higher number of lifetime male anal sex partners and being behaviorally bisexual in the past 12 months. Men who reported depressive symptoms in the past two weeks or who screened positive for alcohol abuse in the past 60 days were more likely to have early age of drinking onset. Findings suggest the need for targeting younger adolescents for alcohol screening, particularly sexual minority youth, to prevent risk behaviors in adulthood. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
39. Age of Onset of Alcohol Consumption and Subsequent Negative Health Outcomes in Gay and Bisexual Men Who Have Sex With Men
- Author
-
Grosso, Ashley L., primary, Downing, Martin J., additional, Thomann, Matthew, additional, Chiasson, Mary Ann, additional, Schrimshaw, Eric W., additional, and Hirshfield, Sabina, additional
- Published
- 2018
- Full Text
- View/download PDF
40. Measuring stigma affecting sex workers (SW) and men who have sex with men (MSM): A systematic review
- Author
-
Fitzgerald-Husek, Alanna, primary, Van Wert, Michael J., additional, Ewing, Whitney F., additional, Grosso, Ashley L., additional, Holland, Claire E., additional, Katterl, Rachel, additional, Rosman, Lori, additional, Agarwal, Arnav, additional, and Baral, Stefan D., additional
- Published
- 2017
- Full Text
- View/download PDF
41. ‘WTF is PrEP?’: attitudes towards pre-exposure prophylaxis among men who have sex with men and transgender women in New York City
- Author
-
Thomann, Matthew, primary, Grosso, Ashley, additional, Zapata, Richard, additional, and Chiasson, Mary Ann, additional
- Published
- 2017
- Full Text
- View/download PDF
42. Physical and Sexual Violence Affecting Female Sex Workers in Abidjan, Côte d'Ivoire: Prevalence, and the Relationship with the Work Environment, HIV, and Access to Health Services
- Author
-
Lyons, Carrie E., primary, Grosso, Ashley, additional, Drame, Fatou M., additional, Ketende, Sosthenes, additional, Diouf, Daouda, additional, Ba, Ibrahima, additional, Shannon, Kate, additional, Ezouatchi, Rebecca, additional, Bamba, Amara, additional, Kouame, Abo, additional, and Baral, Stefan, additional
- Published
- 2017
- Full Text
- View/download PDF
43. Using a social ecological framework to characterize the correlates of HIV among men who have sex with men in Lomé, Togo
- Author
-
Ruiseñor-Escudero, Horacio, primary, Grosso, Ashley, additional, Ketende, Sosthenes, additional, Pitche, Vincent, additional, Simplice, Anato, additional, Tchalla, Jules, additional, Sodji, Dometo, additional, Liestman, Ben, additional, Kapesa, Laurent, additional, and Baral, Stefan, additional
- Published
- 2017
- Full Text
- View/download PDF
44. HIV among Female Sex Workers in Five Cities in Burkina Faso: A Cross-Sectional Baseline Survey to Inform HIV/AIDS Programs
- Author
-
Ouedraogo, Henri Gautier, primary, Ky-Zerbo, Odette, additional, Baguiya, Adama, additional, Grosso, Ashley, additional, Goodman, Sara, additional, Samadoulougou, Benoît Cesaire, additional, Lougue, Marcel, additional, Sawadogo, Nongoba, additional, Traore, Yves, additional, Barro, Nicolas, additional, Baral, Stefan, additional, and Kouanda, Seni, additional
- Published
- 2017
- Full Text
- View/download PDF
45. The Prevalence and Correlates of Physical and Sexual Violence Affecting Female Sex Workers in Swaziland.
- Author
-
Berger, Blair O., Grosso, Ashley, Adams, Darrin, Ketende, Sosthenes, Sithole, Bhekie, Mabuza, Xolile S., Mavimbela, Mpumelelo J., and Baral, Stefan
- Subjects
- *
CHI-squared test , *CONFIDENCE intervals , *HEALTH status indicators , *LONGITUDINAL method , *MULTIVARIATE analysis , *PROBABILITY theory , *SEX work , *QUESTIONNAIRES , *RESEARCH funding , *RISK-taking behavior , *STATISTICAL sampling , *SEX crimes , *T-test (Statistics) , *VIOLENCE , *LOGISTIC regression analysis , *SECONDARY analysis , *CROSS-sectional method , *DATA analysis software , *ODDS ratio - Abstract
Female sex workers (FSW) have a heightened vulnerability to violence and negative sexual/reproductive health outcomes. Limited research has examined how experiencing physical and sexual violence (PSV) mediates risk for poor health outcomes among FSW in Swaziland. The present analyses aim to contribute to literature linking violence with poor health outcomes, high-risk behaviors, and reduced health service-seeking among FSW. Data were analyzed from a cross-sectional study conducted in Swaziland between July and September 2011 with 325 adult women who reported exchanging sex for money, goods, or favors in the last 12 months, recruited through respondent-driven sampling (RDS). Logistic regression was used to assess the relationship between PSV and ancillary violence/abuse exposures, risk behaviors, and sexual/reproductive and mental health outcomes. PSV was conceptualized as either ever having been beaten up as a result of selling sex or ever being forced to have sex since the age of 18, or both. Prevalence of PSV in this sample was 59.0% in crude estimation, and 48.4% (95% confidence interval [CI]:[39.2,57.6]) with RDS weighting. Separate RDS-weighted estimates of being beaten up as a result of sex work and ever being forced to have sex were 32.4% (95%CI=[24.4,40.4]) and 33.1% (95%CI =[25.0,41.2%]), respectively. Experiencing PSV was associated with being blackmailed (adjusted odds ratio [aOR]= 1.93, 95%CI= [1.07,3.52]), non-injection drug use in the last 12 months (aOR= 1.84, 95%CI= [1.02,3.33]), and feeling afraid to seek health services as a result of selling sex (aOR = 1.74, 95%CI= [1.01,2.99]). Given these findings, violence prevention strategies should be prioritized in programs that address Swazi FSW health, empowerment, and safety. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
46. Men who have sex with men sensitivity training reduces homoprejudice and increases knowledge among Kenyan healthcare providers in coastal Kenya
- Author
-
Wolf, R Cameron, Cheng, Alison Surdo, Kapesa, Laurent, van der Elst, Elise M, Gichuru, Evans, Omar, Anisa, Kanungi, Jennifer, Duby, Zoe, Midoun, Miriam, Shangani, Sylvia, Graham, Susan M, Smith, Adrian D, Sanders, Eduard J, Operario, Don, Wirtz, Andrea L, Jumbe, Vincent, Trapence, Gift, Kamba, Dunker, Umar, Eric, Ketende, Sosthenes, Berry, Mark, Strömdahl, Susanne, Beyrer, Chris, Baral, Stefan D, Gichuru, Evanson, Wahome, Elizabeth, Musyoki, Helgar, Muraguri, Nicolas, Fegan, Greg, Bekker, Linda-Gail, Bender, Bonnie, Kennedy, Caitlin E, Fielding-Miller, Rebecca, Adams, Darrin, Dludlu, Phumlile, Sithole, Bheki, Fonner, Virginia A, Mnisi, Zandile, Kerrigan, Deanna, Papworth, Erin, Ceesay, Nuha, An, Louis, Thiam-Niangoin, Marguerite, Ky-Zerbo, Odette, Holland, Claire, Dramé, Fatou Maria, Grosso, Ashley, Diouf, Daouda, Park, Ju Nyeong, Kassegne, Sethson, Moukam, Laure, Billong, Serge Clotaire, Macauley, Issac, Yomb, Yves Roger, Nkoume, Nathalie, Mondoleba, Valentin, Eloundou, Jules, LeBreton, Matthew, Tamoufe, Ubald, Crawford, Emily E, Batist, Elizabeth, Brown, Benjamin, Scheibe, Andrew, Mabuza, Xolile, Sithole, Bhekie, Maziya, Sibusiso, Kerrigan, Deanna L, Green, Jessica L, and Castor, Delivette
- Subjects
Malawi ,men who have sex with men ,people who inject drugs ,behavioural risks ,Review Article ,prevention ,risk factors ,reproductive and urinary physiology ,positive health dignity and prevention ,Central Africa ,Sub-Saharan Africa ,homoprejudice ,public health ,sexual behaviour ,virus diseases ,The epidemiology of HIV and prevention needs among men who have sex with men in Africa ,homosexuality ,Supplement 3 ,Editorial ,HIV epidemiology ,HIV/AIDS ,epidemiology ,social network ,on-line computer facilitated MSM sensitivity programme ,Research Article ,socio-economic status ,education ,prevalence ,African men who have sex with men (MSM) ,healthcare worker ,West Africa ,respondent-driven sampling (RDS) ,community-based ,MSM ,men who have sex with men (MSM) ,outreach ,people living with HIV ,self-esteem ,Homophobia Scale ,MSM behaviour ,healthcare workers ,HIV ,Kenya ,HIV programmes ,sensitivity training ,stigma and discrimination ,stigma ,Africa ,sex work ,Swaziland ,qualitative research - Abstract
Introduction Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients. Methods Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in serving MSM patients and impacts of programme participation on HCWs’ personal attitudes and professional capacities. Results Before participating in the training programme, HCWs described secondary stigma, lack of professional education about MSM, and personal and social prejudices as barriers to serving MSM clients. After completing the programme, HCWs expressed greater acknowledgement of MSM patients in their clinics, endorsed the need to treat MSM patients with high professional standards and demonstrated sophisticated awareness of the social and behavioural risks for HIV among MSM. Conclusions Findings provide support for this approach to improving health services for MSM patients. Further efforts are needed to broaden the reach of this training in other areas, address identified barriers to HCW participation and evaluate programme effects on patient and HCW outcomes using rigorous methodology., Introduction There are limited data characterizing the burden of HIV among men who have sex with men (MSM) in Malawi. Epidemiologic research and access to HIV prevention, treatment and care services have been traditionally limited in Malawi by criminalization and stigmatization of same-sex practices. To inform the development of a comprehensive HIV prevention intervention for Malawian MSM, we conducted a community-led assessment of HIV prevalence and correlates of infection. Methods From April 2011 to March 2012, 338 MSM were enrolled in a cross-sectional study in Blantyre, Malawi. Participants were recruited by respondent-driven sampling methods (RDS), reaching 19 waves. Trained staff administered the socio-behavioural survey and HIV and syphilis voluntary counselling and testing. Results Crude HIV and syphilis prevalence estimates were 15.4% (RDS-weighted 12.5%, 95% confidence interval (CI): 7.3–17.8) and 5.3% (RDS-weighted 4.4%, 95% CI: 3.1–7.6), respectively. Ninety per cent (90.4%, unweighted) of HIV infections were reported as being previously undiagnosed. Participants were predominantly gay-identified (60.8%) or bisexually identified (36.3%); 50.7% reported recent concurrent relationships. Approximately half reported consistent condom use (always or almost always) with casual male partners, and proportions were relatively uniform across partner types and genders. The prevalence of perceived and experienced stigma exceeded 20% for almost all variables, 11.4% ever experienced physical violence and 7% were ever raped. Current age >25 years (RDS-weighted adjusted odds ratio (AOR) 3.9, 95% CI: 1.2–12.7), single marital status (RDS-weighted AOR: 0.3; 95% CI: 0.1–0.8) and age of first sex with a man, Introduction Healthcare workers (HCWs) in Africa typically receive little or no training in the healthcare needs of men who have sex with men (MSM), limiting the effectiveness and reach of population-based HIV control measures among this group. We assessed the effect of a web-based, self-directed sensitivity training on MSM for HCWs (www.marps-africa.org), combined with facilitated group discussions on knowledge and homophobic attitudes among HCWs in four districts of coastal Kenya. Methods We trained four district “AIDS coordinators” to provide a two-day training to local HCWs working at antiretroviral therapy-providing facilities in coastal Kenya. Self-directed learning supported by group discussions focused on MSM sexual risk practices, HIV prevention and healthcare needs. Knowledge was assessed prior to training, immediately after training and three months after training. The Homophobia Scale assessed homophobic attitudes and was measured before and three months after training. Results Seventy-four HCWs (68% female; 74% clinical officers or nurses; 84% working in government facilities) from 49 health facilities were trained, of whom 71 (96%) completed all measures. At baseline, few HCWs reported any prior training on MSM anal sexual practices, and most HCWs had limited knowledge of MSM sexual health needs. Homophobic attitudes were most pronounced among HCWs who were male, under 30 years of age, and working in clinical roles or government facilities. Three months after training, more HCWs had adequate knowledge compared to baseline (49% vs. 13%, McNemar's test p, Introduction Despite the knowledge that men who have sex with men (MSM) are more likely to be infected with HIV across settings, there has been little investigation of the experiences of MSM who are living with HIV in sub-Saharan Africa. Using the framework of positive health, dignity and prevention, we explored the experiences and HIV prevention, care and treatment needs of MSM who are living with HIV in Swaziland. Methods We conducted 40 in-depth interviews with 20 HIV-positive MSM, 16 interviews with key informants and three focus groups with MSM community members. Qualitative analysis was iterative and included debriefing sessions with a study staff, a stakeholders’ workshop and coding for key themes using Atlas.ti. Results The predominant theme was the significant and multiple forms of stigma and discrimination faced by MSM living with HIV in this setting due to both their sexual identity and HIV status. Dual stigma led to selective disclosure or lack of disclosure of both identities, and consequently a lack of social support for care-seeking and medication adherence. Perceived and experienced stigma from healthcare settings, particularly around sexual identity, also led to delayed care-seeking, travel to more distant clinics and missed opportunities for appropriate services. Participants described experiences of violence and lack of police protection as well as mental health challenges. Key informants, however, reflected on their duty to provide non-discriminatory services to all Swazis regardless of personal beliefs. Conclusions Intersectionality provides a framework for understanding the experiences of dual stigma and discrimination faced by MSM living with HIV in Swaziland and highlights how programmes and policies should consider the specific needs of this population when designing HIV prevention, care and treatment services. In Swaziland, the health sector should consider providing specialized training for healthcare providers, distributing condoms and lubricants and engaging MSM as peer outreach workers or expert clients. Interventions to reduce stigma, discrimination and violence against MSM and people living with HIV are also needed for both healthcare workers and the general population. Finally, research on experiences and needs of MSM living with HIV globally can help inform comprehensive HIV services for this population., Introduction The West and Central Africa (WCA) sub-region is the most populous region of sub-Saharan Africa (SSA), with an estimated population of 356 million living in 24 countries. The HIV epidemic in WCA appears to have distinct dynamics compared to the rest of SSA, being more concentrated among key populations such as female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and clients of FSWs. To explore the epidemiology of HIV in the region, a systematic review of HIV literature among key populations in WCA was conducted since the onset of the HIV epidemic. Methods We searched the databases PubMed, CINAHL and others for peer-reviewed articles regarding FSWs, MSM and PWID in 24 countries with no date restriction. Inclusion criteria were sensitive and focused on inclusion of any HIV prevalence data among key populations. HIV prevalence was pooled, and in each country key themes were extracted from the literature. Results The search generated 885 titles, 214 abstracts and 122 full articles, of which 76 met inclusion and exclusion criteria providing HIV prevalence data. There were 60 articles characterizing the burden of disease among FSWs, eight for their clients, one for both, six for MSM and one for PWID. The pooled HIV prevalence among FSWs was 34.9% (n=14,388/41,270), among their clients was 7.3% (n=435/5986), among MSM was 17.7% (n=656/3714) and among PWID from one study in Nigeria was 3.8% (n=56/1459). Conclusions The disproportionate burden of HIV among FSWs appears to be consistent from the beginning of the HIV epidemic in WCA. While there are less data for other key populations such as clients of FSWs and MSM, the prevalence of HIV is higher among these men compared to other men in the region. There have been sporadic reports among PWID, but limited research on the burden of HIV among these men and women. These data affirm that the HIV epidemic in WCA appears to be far more concentrated among key populations than the epidemics in Southern and Eastern Africa. Evidence-based HIV prevention, treatment and care programmes in WCA should focus on engaging populations with the greatest burden of disease in the continuum of HIV care., Introduction Despite men who have sex with men (MSM) being a key population for HIV programming globally, HIV epidemiologic data on MSM in Central Africa are sparse. We measured HIV and syphilis prevalence and the factors associated with HIV infection among MSM in Cameroon. Methods Two hundred and seventy-two and 239 MSM aged ≥18 from Douala and Yaoundé, respectively, were recruited using respondent-driven sampling (RDS) for this cross-sectional surveillance study in 2011. Participants completed a structured questionnaire and HIV and syphilis testing. Statistical analyses, including RDS-weighted proportions, bootstrapped confidence intervals and logistic regressions, were used. Results Crude and RDS-weighted HIV prevalence were 28.6% (73/255) and 25.5% (95% CI 19.1–31.9) in Douala, and 47.3% (98/207) and 44.4% (95% CI 35.7–53.2) in Yaoundé. Active syphilis prevalence in total was 0.4% (2/511). Overall, median age was 24 years, 62% (317/511) of MSM identified as bisexual and 28.6% (144/511) identified as gay. Inconsistent condom use with regular male partners (64.1%; 273/426) and casual male and female partners (48.5%; 195/402) was common, as was the inconsistent use of condom-compatible lubricants (CCLs) (26.3%; 124/472). In Douala, preferring a receptive sexual role was associated with prevalent HIV infection [adjusted odds ratio (aOR) 2.33, 95% CI 1.02–5.32]. Compared to MSM without HIV infection, MSM living with HIV were more likely to have ever accessed a health service targeting MSM in Douala (aOR 4.88, 95% CI 1.63–14.63). In Yaoundé, MSM living with HIV were more likely to use CCLs (aOR 2.44, 95% CI 1.19–4.97). Conclusions High HIV prevalence were observed and condoms and CCLs were used inconsistently indicating that MSM are a priority population for HIV prevention, treatment and care services in Douala and Yaoundé. Building the capacity of MSM community organizations and improving the delivery and scale-up of multimodal interventions for MSM that are sensitive to concerns about confidentiality and the complex individual, social, community-level and policy challenges are needed to successfully engage young MSM in the continuum of HIV care. In addition to scaling up condom and CCL access, evaluating the feasibility of novel biomedical interventions, including antiretroviral pre-exposure prophylaxis and early antiretroviral therapy for MSM living with HIV in Cameroon, is also warranted., Introduction Men who have sex with men (MSM) are disproportionately burdened by HIV in Senegal, across sub-Saharan Africa and throughout the world. This is driven in part by stigma, and limits health achievements and social capital among these populations. To date, there is a limited understanding of the feasibility of prospective HIV prevention studies among MSM in Senegal, including HIV incidence and cohort retention rates. Methods One hundred and nineteen men who reported having anal sex with another man in the past 12 months were randomly selected from a sampling frame of 450 unique members of community groups serving MSM in Dakar. These men were enrolled in a 15-month pilot cohort study implemented by a community-based partner. The study included a structured survey instrument and biological testing for HIV, syphilis and hepatitis B virus at two time points. Results Baseline HIV prevalence was 36.0% (43/114), with cumulative HIV prevalence at study end being 47.2% (51/108). The annualized incidence rate was 16% (8/40 at risk for seroconversion over 15 months of follow-up, 95% confidence interval 4.6–27.4%). Thirty-seven men were lost to follow up, including at least four deaths. Men who were able to confide in someone about health, emotional distress and sex were less likely to be HIV positive (OR 0.36, p < 0.05, 95% CI 0.13, 0.97). Conclusions High HIV prevalence and incidence, as well as mortality in this young population of Senegalese MSM indicate a public health emergency. Moreover, given the high burden of HIV and rate of incident HIV infections, this population appears to be appropriate for the evaluation of novel HIV prevention, treatment and care approaches. Using a study implemented by community-based organizations, there appears to be feasibility in implementing interventions addressing the multiple levels of HIV risk among MSM in this setting. However, low retention across arms of this pilot intervention, and in the cohort, will need to be addressed for larger-scale efficacy trials to be feasible., Introduction Men who have sex with men (MSM) in Cape Town's townships remain in need of targeted HIV-prevention services. In 2012, a pilot community-based HIV-prevention programme was implemented that aimed to reach MSM in five Cape Town townships, disseminate HIV-prevention information and supplies, and promote the use of condoms and HIV services. Methods Convenience sampling was used to recruit self-identified MSM who were 18 years old or older in five Cape Town townships. The six-month pilot programme trained five community leaders who, along with staff, provided HIV-prevention information and supplies to MSM through small-group meetings, community-based social activities and inter-community events. After the completion of the pilot programme, in-depth interviews and focus group discussions (FGDs) were conducted with a subset of conveniently sampled participants and with each of the community leaders. Qualitative data were then analyzed thematically. Results Overall, 98 mostly gay-identified black MSM consented to participate, 57 community-based activities were facilitated and 9 inter-community events were conducted. Following their enrolment, 60% (59/98) of participants attended at least one pilot activity. Of those participants, 47% (28/59) attended at least half of the scheduled activities. A total of 36 participants took part in FGDs, and five in-depth interviews were completed with community leaders. Participants reported gaining access to MSM-specific HIV-prevention information, condoms and water-based lubricant through the small-group meetings. Some participants described how their feelings of loneliness, social isolation, self-esteem and self-efficacy were improved after taking part. Conclusions The social activities and group meetings were viable strategies for disseminating HIV-prevention information, condoms and water-based lubricant to MSM in this setting. Many MSM were also able to receive social support, reduce social isolation and improve their self-esteem. Further research is needed to explore factors affecting attendance and the sustainability of these activities. Perspectives of MSM who did not attend pilot activities regularly were not equally represented in the final qualitative interviews, which could bias the findings. The use of community-based activities and small-group meetings should be explored further as components to ongoing HIV-prevention interventions for MSM in this setting., Introduction Similar to other Southern African countries, Swaziland has been severely affected by HIV, with over a quarter of its reproductive-age adults estimated to be living with the virus, equating to an estimate of 170,000 people living with HIV. The last several years have witnessed an increase in the understanding of the potential vulnerabilities among men who have sex with men (MSM) in neighbouring countries with similarly widespread HIV epidemics. To date, there are no data characterizing the burden of HIV and the HIV prevention, treatment and care needs of MSM in Swaziland. Methods In 2011, 324 men who reported sex with another man in the last 12 months were accrued using respondent-driven sampling (RDS). Participants completed HIV testing using Swazi national guidelines as well as structured survey instruments administered by trained staff, including modules on demographics, individual-level behavioural and biological risk factors, social and structural characteristics and uptake of HIV services. Population and individual weights were computed separately for each variable with a data-smoothing algorithm. The weights were used to estimate RDS-adjusted univariate estimates with 95% bootstrapped confidence intervals (BCIs). Crude and RDS-adjusted bivariate and multivariate analyses were completed with HIV as the dependent variable. Results Overall, HIV prevalence was 17.6% (n=50/284), although it was strongly correlated with age in bivariate- [odds ratio (OR) 1.2, 95% BCI 1.15–1.21] and multivariate-adjusted analyses (adjusted OR 1.24, 95% BCI 1.14–1.35) for each additional year of age. Nearly, 70.8% (n=34/48) were unaware of their status of living with HIV. Condom use with all sexual partners and condom-compatible-lubricant use with men were reported by 1.3% (95% CI 0.0–9.7). Conclusions Although the epidemic in Swaziland is driven by high-risk heterosexual transmission, the burden of HIV and the HIV prevention, treatment and care needs of MSM have been understudied. The data presented here suggest that these men have specific HIV acquisition and transmission risks that differ from those of other reproductive-age adults. The scale-up in HIV services over the past decade has likely had limited benefit for MSM, potentially resulting in a scenario where epidemics of HIV among MSM expand in the context of slowing epidemics in the general population, a reality observed in most of the world., 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 inaction may be explained by ignorance, new data document highly elevated and sustained HIV prevalence that is seemingly isolated from recent overall declines in prevalence. The articles in this series highlight new studies which focus on the stark epidemiologic burden in countries from concentrated, mixed and generalized epidemic settings. The issue includes research from West, Central, East and Southern Africa and explores the pervasive impact of stigma and discrimination as critical barriers to confronting the HIV epidemic among MSM and the intersecting stigma and marginalization found between living with HIV and sexual minority status. Interventions to remove barriers to service access, including those aimed at training providers and mobilizing communities even within stigmatized peri-urban settings, are featured in this issue, which further demonstrates the immediate need for comprehensive action to address HIV among MSM in all countries in the region, regardless of epidemic classification.
- Published
- 2013
47. Public Administration in the Age of AIDS
- Author
-
Grosso, Ashley
- Published
- 2011
- Full Text
- View/download PDF
48. Suicidal ideation among MSM in three West African countries: Associations with stigma and social capital
- Author
-
Stahlman, Shauna, primary, Grosso, Ashley, additional, Ketende, Sosthenes, additional, Pitche, Vincent, additional, Kouanda, Seni, additional, Ceesay, Nuha, additional, Ouedraogo, Henri G, additional, Ky-Zerbo, Odette, additional, Lougue, Marcel, additional, Diouf, Daouda, additional, Anato, Simplice, additional, Tchalla, Jules, additional, and Baral, Stefan, additional
- Published
- 2016
- Full Text
- View/download PDF
49. Gender-based violence against female sex workers in Cameroon: prevalence and associations with sexual HIV risk and access to health services and justice
- Author
-
Decker, Michele R, primary, Lyons, Carrie, additional, Billong, Serge Clotaire, additional, Njindam, Iliassou Mfochive, additional, Grosso, Ashley, additional, Nunez, Gnilane Turpin, additional, Tumasang, Florence, additional, LeBreton, Matthew, additional, Tamoufe, Ubald, additional, and Baral, Stefan, additional
- Published
- 2016
- Full Text
- View/download PDF
50. Characterizing the Individual, Social, and Structural Determinants of Condom Use Among Men Who Have Sex with Men in Swaziland
- Author
-
Brown, Carolyn Adele, primary, Grosso, Ashley Lynn, additional, Adams, Darrin, additional, Sithole, Bhekie, additional, Ketende, Sosthenes, additional, Greene, Jessica, additional, Maziya, Sibusiso, additional, Mnisi, Zandile, additional, Mabuza, Xolile, additional, and Baral, Stefan, additional
- Published
- 2016
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.