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[PMID]:29220710
[Au] Autor:Zhang A; Yan J; Yang G; Tan X; Wang X; Tan S
[Ad] Endereço:The 3rd Xiangya Hospital, Central South University, Tongzipo Road #138, Changsha, Hunan 410013, China.
[Ti] Título:Life satisfaction and its associated factors among money boys in China.
[So] Source:Public Health;154:110-117, 2018 Jan.
[Is] ISSN:1476-5616
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Money Boy (MB) is a unique term used in China referring to a specialized population of men who sell sex to other men. Life satisfaction can influence one's health-related behaviors. The aim of our study was to find out the situation of MBs' life satisfaction and its associated factors. STUDY DESIGN: A cross-sectional study among MBs was conducted between July and December 2013 in Hunan province, China. METHODS: Respondent-driven sampling method was used for recruitment, with the initial seven 'seeds' found from a gay dating website, and 234 participants were enrolled into the study. They were asked to complete a questionnaire about their demographic characteristics, work experience as MB, family environment, health-related behaviors, status of self-esteem, self-stigma, and perceived life satisfaction. Descriptive statistics and multiple linear regression analysis were applied. RESULTS: There were 205 valid questionnaires collected. The results showed that MBs' life satisfaction score was 17.9 ± 6.3. The multiple linear regression model identified five factors correlated with MBs' life satisfaction. Three factors were found to be positively correlated with life satisfaction, consistent condom use with clients (ß = 3.093, P = 0.010), interpersonal relationship (ß = 1.027, P = 0.017), and self-esteem (ß = 0.253, P = 0.005). And two factors were found to be negatively correlated with life satisfaction, seeking for clients through mommy's arrangement (ß = -2.091, P = 0.019) and had ever gotten at least one kind of sexually transmitted disease (STDs) (ß = -1.971, P = 0.034). CONCLUSIONS: The present study contributed to a better understanding of MBs' life satisfaction and behavioral and other psychosocial features. It is suggested that comprehensive interventions involving behavioral and psychosocial health promotion approaches are needed for this population. Those programs will be more acceptable among this group and tend to be sustainable.
[Mh] Termos MeSH primário: Homossexualidade Masculina
Satisfação Pessoal
Profissionais do Sexo/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
China
Estudos Transversais
Seres Humanos
Masculino
Fatores de Risco
Profissionais do Sexo/estatística & dados numéricos
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


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[PMID]:29182634
[Au] Autor:Ortblad K; Kibuuka Musoke D; Ngabirano T; Nakitende A; Magoola J; Kayiira P; Taasi G; Barresi LG; Haberer JE; McConnell MA; Oldenburg CE; Bärnighausen T
[Ad] Endereço:Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
[Ti] Título:Direct provision versus facility collection of HIV self-tests among female sex workers in Uganda: A cluster-randomized controlled health systems trial.
[So] Source:PLoS Med;14(11):e1002458, 2017 Nov.
[Is] ISSN:1549-1676
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: HIV self-testing allows HIV testing at any place and time and without health workers. HIV self-testing may thus be particularly useful for female sex workers (FSWs), who should test frequently but face stigma and financial and time barriers when accessing healthcare facilities. METHODS AND FINDINGS: We conducted a cluster-randomized controlled health systems trial among FSWs in Kampala, Uganda, to measure the effect of 2 HIV self-testing delivery models on HIV testing and linkage to care outcomes. FSW peer educator groups (1 peer educator and 8 participants) were randomized to either (1) direct provision of HIV self-tests, (2) provision of coupons for free collection of HIV self-tests in a healthcare facility, or (3) standard of care HIV testing. We randomized 960 participants in 120 peer educator groups from October 18, 2016, to November 16, 2016. Participants' median age was 28 years (IQR 24-32). Our prespecified primary outcomes were self-report of any HIV testing at 1 month and at 4 months; our prespecified secondary outcomes were self-report of HIV self-test use, seeking HIV-related medical care and ART initiation. In addition, we analyzed 2 secondary outcomes that were not prespecified: self-report of repeat HIV testing-to understand the intervention effects on frequent testing-and self-reported facility-based testing-to quantify substitution effects. Participants in the direct provision arm were significantly more likely to have tested for HIV than those in the standard of care arm, both at 1 month (risk ratio [RR] 1.33, 95% CI 1.17-1.51, p < 0.001) and at 4 months (RR 1.14, 95% CI 1.07-1.22, p < 0.001). Participants in the direct provision arm were also significantly more likely to have tested for HIV than those in the facility collection arm, both at 1 month (RR 1.18, 95% CI 1.07-1.31, p = 0.001) and at 4 months (RR 1.03, 95% CI 1.01-1.05, p = 0.02). At 1 month, fewer participants in the intervention arms had sought medical care for HIV than in the standard of care arm, but these differences were not significant and were reduced in magnitude at 4 months. There were no statistically significant differences in ART initiation across study arms. At 4 months, participants in the direct provision arm were significantly more likely to have tested twice for HIV than those in the standard of care arm (RR 1.51, 95% CI 1.29-1.77, p < 0.001) and those in the facility collection arm (RR 1.22, 95% CI 1.08-1.37, p = 0.001). Participants in the HIV self-testing arms almost completely replaced facility-based testing with self-testing. Two adverse events related to HIV self-testing were reported: interpersonal violence and mental distress. Study limitations included self-reported outcomes and limited generalizability beyond FSWs in similar settings. CONCLUSIONS: In this study, HIV self-testing appeared to be safe and increased recent and repeat HIV testing among FSWs. We found that direct provision of HIV self-tests was significantly more effective in increasing HIV testing among FSWs than passively offering HIV self-tests for collection in healthcare facilities. HIV self-testing could play an important role in supporting HIV interventions that require frequent HIV testing, such as HIV treatment as prevention, behavior change for transmission reduction, and pre-exposure prophylaxis. TRIAL REGISTRATION: ClinicalTrials.gov NCT02846402.
[Mh] Termos MeSH primário: Infecções por HIV/diagnóstico
Autoadministração/métodos
[Mh] Termos MeSH secundário: Adulto
Análise por Conglomerados
Feminino
Infecções por HIV/terapia
Seres Humanos
Programas de Rastreamento/métodos
Testes Sorológicos
Profissionais do Sexo
Estigma Social
Uganda/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pmed.1002458


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[PMID]:28449198
[Au] Autor:Awungafac G; Delvaux T; Vuylsteke B
[Ad] Endereço:African Society for Laboratory Medicine, Addis Ababa, Ethiopia.
[Ti] Título:Systematic review of sex work interventions in sub-Saharan Africa: examining combination prevention approaches.
[So] Source:Trop Med Int Health;22(8):971-993, 2017 08.
[Is] ISSN:1365-3156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The incidence of HIV and sexually transmitted infections is disproportionately high among sex workers (SW). We aimed to update the evidence on the effectiveness of SW interventions in sub-Saharan Africa and to provide more insights into combination prevention. METHODS: The Systematic review followed PRISMA guidelines in a search of PUBMED and POPLINE for peer-reviewed literature published between 1 January 2000 and 22 July 2016 (registration number on PROSPERO: CRD42016042529). We considered cohort interventions, randomised controlled trials and cross-sectional surveys of SW programmes. A framework was used in the description and mapping of intervention to desired outcomes. RESULTS: Twenty-six papers(reporting on 25 studies) were included. A strategy that empowered peer educator leaders to steer community activities showed a twofold increase in coverage of behaviour change communication and utilisation of health facility among SW. Brief alcohol harm reduction effort demonstrated a significant effect on sexual violence and engagement in sex trading. A risk reduction counselling intervention among drug-injecting SW showed an effect on alcohol, substance use and engagement in sex work. No study on a promising intervention like PrEP among SWs was found. We observed that interventions that combined some structural components, biomedical and behavioural strategies tend to accumulate more desired outcomes. CONCLUSION: The evidence base that can be considered in intervention designs to prevent HIV in SW in SSA is vast. The health sector should consider interventions to reduce binge alcohol intake and intravenous drug use among sex workers. Programmes should staunchly consider multicomponent approaches that explore community-based structural approaches.
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Trabalho Sexual
Profissionais do Sexo
Doenças Sexualmente Transmissíveis/prevenção & controle
[Mh] Termos MeSH secundário: África ao Sul do Saara
Fármacos Anti-HIV/uso terapêutico
Aconselhamento
Feminino
Educação em Saúde
Seres Humanos
Comportamento de Redução do Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1111/tmi.12890


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[PMID]:28448903
[Au] Autor:Argento E; Strathdee SA; Goldenberg S; Braschel M; Montaner J; Shannon K
[Ad] Endereço:Gender and Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; Interdisciplinary Studies Graduate Program, University of British Columbia, 2357 Main Mall, Vancouver, BC, V6T 1Z4, Canada.
[Ti] Título:Violence, trauma and living with HIV: Longitudinal predictors of initiating crystal methamphetamine injection among sex workers.
[So] Source:Drug Alcohol Depend;175:198-204, 2017 06 01.
[Is] ISSN:1879-0046
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Despite rapid increases in crystal methamphetamine (CM) use worldwide and established gendered patterns of use, empirical research on CM injection initiation among sex workers is limited. Given the wide range of harms associated with CM, alongside stimulant effects including sexual dis-inhibition and prolonged awake-ness, this study aimed to longitudinally investigate socio-structural predictors of initiating CM injection among sex workers in Vancouver, Canada. METHODS: Data (2010-2014) were drawn from a community-based cohort of women sex workers: AESHA (An Evaluation of Sex Workers Health Access). Participants completed bi-annual interviewer-administered questionnaires and HIV/STI testing. Kaplan Meier methods and Cox proportional hazards regression were used to model predictors of CM injection initiation among CM injection-naïve participants. RESULTS: Of 455 participants eligible at baseline, 14.3% (n=65) injected CM for the first time over follow-up, with an incidence density of 6.79 per 100 person-years (95% Confidence Interval [CI] 5.30-8.69). In multivariable analysis, injection heroin use (Adjusted Hazard Ratio [AHR] 6.11; 95%CI 3.24-11.52), having an intimate partner who injects drugs (AHR 2.93; 95%CI 1.57-5.46), workplace violence (AHR 2.85; 95%CI 1.74-4.67), HIV seropositivity (AHR 2.69; 95%CI 1.45-5.00), and childhood abuse (AHR 1.86; 95%CI 0.99-3.49) were independently associated with initiating CM injection. CONCLUSIONS: Findings underscore the gendered and social risk environment of CM injection initiation among sex workers. The strong influences of historical/workplace violence, coupled with heroin injection (known to be self-medicating for post-traumatic stress) as a primary risk pathway, emphasize the urgency of increasing access to integrated, trauma-informed addiction treatment and HIV care for marginalized women.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Anfetaminas/psicologia
Infecções por HIV/psicologia
Profissionais do Sexo/psicologia
Abuso de Substâncias por Via Intravenosa/psicologia
Violência/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Colúmbia Britânica
Estudos de Coortes
Feminino
Seres Humanos
Incidência
Injeções/psicologia
Estudos Longitudinais
Metanfetamina/administração & dosagem
Modelos de Riscos Proporcionais
Comportamento Sexual/psicologia
Parceiros Sexuais/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
44RAL3456C (Methamphetamine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE


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[PMID]:29190642
[Au] Autor:Fitzgerald-Husek A; Van Wert MJ; Ewing WF; Grosso AL; Holland CE; Katterl R; Rosman L; Agarwal A; Baral SD
[Ad] Endereço:Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:Measuring stigma affecting sex workers (SW) and men who have sex with men (MSM): A systematic review.
[So] Source:PLoS One;12(11):e0188393, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Stigma involves discrediting a person or group based on a perceived attribute, behaviour or reputation associated with them. Sex workers (SW) and men who have sex with men (MSM) are key populations who are often at increased risk for the acquisition and transmission of HIV and who are affected by stigma that can negatively impact their health and well-being. Although stigma was included as an indicator in the US National HIV/AIDS Strategic Plan and there have been consultations focused on adding a stigma indicator within PEPFAR and the Global Fund in relation to potentiating HIV risks among key populations, there remains limited consensus on the appropriate measurement of SW- or MSM-associated stigma. Consequently, this systematic review summarizes studies using quantitative, qualitative, or mixed methods approaches to measure stigma affecting sex workers and men who have sex with men. METHODS AND FINDINGS: This systematic review included English, French, and Spanish peer-reviewed research of any study design measuring SW- or MSM-associated stigma. Articles were published from January 1, 2004 to March 26, 2014 in PsycINFO, PubMed, EMBASE, CINAHL Plus, Global Health, and World Health Organization Global Health Library Regional Indexes. Of the 541 articles reviewed, the majority measured stigma toward MSM (over 97%), were conducted in North America, used quantitative methods, and focused on internalized stigma. CONCLUSIONS: With the inclusion of addressing stigma in several domestic and international HIV strategies, there is a need to ensure the use of validated metrics for stigma. The field to date has completed limited measurement of stigma affecting sex workers, and limited measurement of stigma affecting MSM outside of higher income settings. Moving forward requires a concerted effort integrating validated metrics of stigma into health-related surveys and programs for key populations.
[Mh] Termos MeSH primário: Homossexualidade Masculina
Profissionais do Sexo
Estigma Social
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188393


  6 / 1390 MEDLINE  
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[PMID]:29244809
[Au] Autor:Coetzee J; Hunt G; Jaffer M; Otwombe K; Scott L; Bongwe A; Ledwaba J; Molema S; Jewkes R; Gray GE
[Ad] Endereço:Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
[Ti] Título:HIV-1 viraemia and drug resistance amongst female sex workers in Soweto, South Africa: A cross sectional study.
[So] Source:PLoS One;12(12):e0188606, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: HIV drug resistance (HIVDR) poses a threat to future antiretroviral therapy success. Monitoring HIVDR patterns is of particular importance in populations such as sex workers (SWs), where documented HIV prevalence is between 34-89%, and in countries with limited therapeutic options. Currently in South Africa, there is a dearth in evidence and no ongoing surveillance of HIVDR amongst sex work populations. This study aims to describe the prevalence of HIVDR amongst a sample of female sex workers (FSWs) from Soweto, South Africa. METHODOLOGY: A cross-sectional, respondent driven sampling (RDS) recruitment methodology was used to enrol FSWs based in Soweto. Participants were tested for HIV and undertook a survey that included HIV knowledge and treatment status. Whole blood specimens were collected from HIV positive FSWs to measure for CD4 counts, viral load (VL) and perform HIVDR genotyping. Frequencies were determined for categorical variables and medians and interquartile ranges (IQR) for the continuous. RESULTS: Of the 508 enrolled participants, 55% (n = 280) were HIV positive and of median age 32 (IQR: 20-51) years. Among the HIV positive, 51.8% (132/269) were defined as virologically suppressed (VL < 400 copies/ml). Of the 119 individuals with unsuppressed viral loads who were successfully genotyped for resistance testing 37.8% (45/119) had detectable drug resistance. In this group, HIVDR mutations were found amongst 73.7% (14/19) of individuals on treatment, 27.4% (26/95) of individuals who were treatment naïve, and 100% (5/5) of defaulters. One phylogenetic cluster was found amongst treatment naïve FSWs. The K103N mutation was detected most commonly in 68.9% (31/45) individuals with HIVDR mutations, with 20/26 (76.9%) of treatment naïve FSW with detectable resistance having this mutation. The M184V mutation was found in both FSWs on treatment (12/14, 85.7%) and those defaulting (1/5, 20.0%). DISCUSSION: More than one third (45/119) of the genotyped sample had HIVDR, with resistance to the NNRTI class being the most common. Almost half of HIV positive FSWs had unsuppressed viral loads, increasing the likelihood for onward transmission of HIV. Disturbingly, more than 1:4 treatment naïve women with unsuppressed viral loads had HIVDR suggesting that possible sexual transmission of drug resistance is occurring in this high-risk population. Given the high burden of HIVDR in a population with a high background prevalence of HIV, it is imperative that routine monitoring of HIVDR be implemented. Understanding transmission dynamics of HIVDR in FSW and its impact on treatment success should be urgently elucidated.
[Mh] Termos MeSH primário: Farmacorresistência Viral/genética
Infecções por HIV/epidemiologia
Infecções por HIV/transmissão
HIV-1/genética
Profissionais do Sexo
[Mh] Termos MeSH secundário: Adulto
Fármacos Anti-HIV/uso terapêutico
Contagem de Linfócito CD4
Estudos Transversais
Feminino
Genótipo
Infecções por HIV/tratamento farmacológico
Infecções por HIV/virologia
HIV-1/classificação
HIV-1/isolamento & purificação
Seres Humanos
Meia-Idade
Filogenia
Prevalência
Inibidores da Transcriptase Reversa/uso terapêutico
África do Sul/epidemiologia
Carga Viral
Viremia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents); 0 (Reverse Transcriptase Inhibitors)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188606


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[PMID]:29176849
[Au] Autor:Surie D; Yuhas K; Wilson K; Masese LN; Shafi J; Kinuthia J; Jaoko W; McClelland RS
[Ad] Endereço:Department of Medicine, University of Washington, Seattle, United States of America.
[Ti] Título:Association between non-barrier modern contraceptive use and condomless sex among HIV-positive female sex workers in Mombasa, Kenya: A prospective cohort analysis.
[So] Source:PLoS One;12(11):e0187444, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: As access to antiretroviral therapy in sub-Saharan Africa continues to expand, more women with HIV can expect to survive through their reproductive years. Modern contraceptives can help women choose the timing and spacing of childbearing. However, concerns remain that women with HIV who use non-barrier forms of modern contraception may engage in more condomless sex because of their decreased risk of unintended pregnancy. We examined whether non-barrier modern contraceptive use by HIV-positive female sex workers was associated with increased frequency of recent condomless sex, measured by detection of prostate-specific antigen (PSA) in vaginal secretions. METHODS: Women who were HIV-positive and reported transactional sex were included in this analysis. Pregnant and post-menopausal follow-up time was excluded, as were visits at which women reported trying to get pregnant. At enrollment and quarterly follow-up visits, a pelvic speculum examination with collection of vaginal secretions was conducted for detection of PSA. In addition, women completed a structured face-to-face interview about their current contraceptive methods and sexual risk behavior at enrollment and monthly follow-up visits. Log-binomial generalized estimating equations regression was used to test for associations between non-barrier modern contraceptive use and detection of PSA in vaginal secretions and self-reported condomless sex. Data from October 2012 through September 2014 were included in this analysis. RESULTS: Overall, 314 women contributed 1,583 quarterly examination visits. There was minimal difference in PSA detection at contraceptive-exposed versus contraceptive-unexposed visits (adjusted relative risk [aRR] 1.28, 95% confidence interval [95% CI] 0.93-1.76). There was a higher rate of self-reported condomless sex at visits where women reported using modern contraceptives, but this difference was not statistically significant after adjustment for potential confounding factors (aRR 1.59, 95% CI 0.98-2.58). CONCLUSION: Non-barrier methods of modern contraception were not associated with increased risk of objective evidence of condomless sex.
[Mh] Termos MeSH primário: Preservativos/utilização
Comportamento Contraceptivo/estatística & dados numéricos
Soropositividade para HIV/epidemiologia
Profissionais do Sexo/estatística & dados numéricos
Comportamento Sexual
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Quênia/epidemiologia
Estudos Prospectivos
Antígeno Prostático Específico/análise
Autorrelato
Vagina/secreção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0187444


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[PMID]:28467163
[Au] Autor:Restar AJ; Tocco JU; Mantell JE; Lafort Y; Gichangi P; Masvawure TB; Chabeda SV; Sandfort TGM
[Ad] Endereço:Brown School of Public Health, Brown University, Providence, Rhode Island.
[Ti] Título:Perspectives on HIV Pre- and Post-Exposure Prophylaxes (PrEP and PEP) Among Female and Male Sex Workers in Mombasa, Kenya: Implications for Integrating Biomedical Prevention into Sexual Health Services.
[So] Source:AIDS Educ Prev;29(2):141-153, 2017 Apr.
[Is] ISSN:1943-2755
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pre- and post-exposure prophylaxes (PrEP and PEP) can reduce the risk of HIV acquisition, yet often are inaccessible to and underutilized by most-vulnerable populations, including sex workers in sub-Saharan Africa. Based on in-depth interviews with 21 female and 23 male HIV-negative sex workers in Mombasa, Kenya, we found that awareness and knowledge of PrEP and PEP were low, although willingness to use both was high. Participants felt PrEP would be empowering and give added protection against infection, although some expressed concerns about side effects. Despite PEP's availability, few knew about it and even fewer had used it, but most who had would use it again. Sex workers valued confidentiality, privacy, trustworthiness, and convenient location in health services and wanted thorough HIV/STI assessments. These findings suggest the importance of situating PrEP and PEP within sex worker-friendly health services and conducting outreach to promote these biomedical prevention methods for Kenyan sex workers.
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Profilaxia Pós-Exposição
Profilaxia Pré-Exposição
Serviços Preventivos de Saúde
Profissionais do Sexo
Comportamento Sexual
[Mh] Termos MeSH secundário: Adulto
Feminino
Infecções por HIV/tratamento farmacológico
Infecções por HIV/etnologia
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Entrevistas como Assunto
Quênia
Masculino
Pesquisa Qualitativa
Saúde Reprodutiva
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171130
[Lr] Data última revisão:
171130
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1521/aeap.2017.29.2.141


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[PMID]:28981511
[Au] Autor:Coetzee J; Jewkes R; Gray GE
[Ad] Endereço:Perinatal HIV Research Unit, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
[Ti] Título:Cross-sectional study of female sex workers in Soweto, South Africa: Factors associated with HIV infection.
[So] Source:PLoS One;12(10):e0184775, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: In South Africa, the rate of HIV in the sex worker (SW) population is exceedingly high, but critical gaps exist in our understanding of SWs and the factors that make them vulnerable to HIV. This study aimed to estimate HIV prevalence among female sex workers (FSWs) in Soweto, South Africa, and to describe their sexual behavior and other factors associated with HIV infection. METHODS: A cross-sectional, respondent-driven sampling (RDS) recruitment methodology was used to enroll 508 FSWs based in Soweto. Data were collected using a survey instrument, followed by two HIV rapid tests. Raw and RDS adjusted data were analyzed using a chi-squared test of association and multivariate logistic regression to show factors associated with HIV infection. FINDINGS: HIV prevalence among FSWs was 53.6% (95% CI 47.5-59.9). FSWs were almost exclusively based in taverns (85.6%) and hostels (52.0%). Less than a quarter (24.4%) were under 25 years of age. Non-partner violence was reported by 55.5%, 59.6% of whom were HIV-infected. Advancing age, incomplete secondary schooling, migrancy and multiple clients increased the likelihood of HIV acquisition: >30 years of age was associated with a 4.9 times (95% CI 2.6-9.3) increased likelihood of HIV; incomplete secondary schooling almost tripled the likelihood (AOR 2.8, 95% CI 1.6-5.0); being born outside of the Gauteng province increased the likelihood of HIV 2.3 times (95% CI 1.3-4.0); and having more than five clients per day almost doubled the likelihood (AOR 1.9, 95% CI 1.1-3.2). CONCLUSION: Our findings highlight the extreme vulnerability of FSWs to HIV. Advancing age, limited education and multiple clients were risk factors associated with HIV, strongly driven by a combination of structural, biological and behavioral determinants. Evidence suggests that interventions need to be carefully tailored to the varying profiles of SW populations across South Africa. Soweto could be considered a microcosm of South Africa in terms of the epidemic of violence and HIV experienced by the SW population, which is influenced by factors often beyond an individual level of control. While describing a hitherto largely undocumented population of FSWs, our findings confirm the urgent need to scale up innovative HIV prevention and treatment programs for this population.
[Mh] Termos MeSH primário: Infecções por HIV/epidemiologia
Trabalho Sexual
Profissionais do Sexo/estatística & dados numéricos
Comportamento Sexual
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Estudos Transversais
Escolaridade
Feminino
Infecções por HIV/diagnóstico
Seres Humanos
Meia-Idade
Prevalência
Fatores de Risco
África do Sul
Violência
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171022
[Lr] Data última revisão:
171022
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171006
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184775


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[PMID]:28813527
[Au] Autor:Burke VM; Nakyanjo N; Ddaaki W; Payne C; Hutchinson N; Wawer MJ; Nalugoda F; Kennedy CE
[Ad] Endereço:Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
[Ti] Título:HIV self-testing values and preferences among sex workers, fishermen, and mainland community members in Rakai, Uganda: A qualitative study.
[So] Source:PLoS One;12(8):e0183280, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:HIV self-testing may encourage greater uptake of testing, particularly among key populations and other high-risk groups, but local community perceptions will influence test uptake and use. We conducted 33 in-depth interviews and 6 focus group discussions with healthcare providers and community members in high-risk fishing communities (including sex workers and fishermen) and lower-risk mainland communities in rural Uganda to evaluate values and preferences around HIV self-testing. While most participants were unfamiliar with HIV self-testing, they cited a range of potential benefits, including privacy, convenience, and ability to test before sex. Concerns focused on the absence of a health professional, risks of careless kit disposal and limited linkage to care. Participants also discussed issues of kit distribution strategies and cost, among others. Ultimately, most participants concluded that benefits outweighed risks. Our findings suggest a potential role for HIV self-testing across populations in these settings, particularly among these key populations. Program implementers will need to consider how to balance HIV self-testing accessibility with necessary professional support.
[Mh] Termos MeSH primário: Pesqueiros
Infecções por HIV/epidemiologia
Profissionais do Sexo/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Feminino
Infecções por HIV/diagnóstico
Seres Humanos
Malásia/epidemiologia
Masculino
Programas de Rastreamento/estatística & dados numéricos
Meia-Idade
Fatores Socioeconômicos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170817
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183280



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