Raquel B De Boni1, Iona K Machado2, Mauricio T L De Vasconcellos3, Brenda Hoagland1, Esper G Kallas4, José Valdez Madruga5, Nilo M Fernandes1, Natalia B Cerqueira4, Ronaldo I Moreira1, Silvia P Goulart4, Valdilea G Veloso1, Beatriz Grinsztejn1, Paula M Luz6. 1. National Institute of Infectology Evandro Chagas, Lapclin STD/AIDS, Avenida Brasil 4.365, Fiocruz, Rio de Janeiro, Brazil. 2. Columbia College of Physicians and Surgeons, 630 W. 168 St., New York City, NY, USA. 3. National School of Statistical Sciences, IBGE, Rua Andre Cavalcanti, 106 Centro, Rio de Janeiro, Brazil. 4. Division of Clinical Immunology and Allergy, University of São Paulo, São Paulo, Brazil. 5. Centro de Referencia e Treinamento DST/AIDS, 81 Vila Mariana, São Paulo, Brazil. 6. National Institute of Infectology Evandro Chagas, Lapclin STD/AIDS, Avenida Brasil 4.365, Fiocruz, Rio de Janeiro, Brazil. Electronic address: raqueldeboni@gmail.com.
Abstract
BACKGROUND: Concurrent psychosocial problems may synergistically increase the risk of HIV infection (syndemics), representing a challenge for prevention. We aimed to evaluate the prevalence and associated factors of syndemics among men who have sex with men (MSM) and transgender women (TGW) enrolled in the Brazilian pre-exposure prophylaxis demonstration study (PrEP Brasil Study). METHODS: Secondary cross-sectional analysis of the PrEP Brasil Study was performed. Of 450 HIV-seronegative MSM/TGW enrolled in the PrEP Brasil Study- conducted at Rio de Janeiro and São Paulo, Brazil- 421 participants with complete data were included in the present analysis. Syndemics was defined as occurrence of ≥2 of the following conditions: polysubstance (≥2) use, binge drinking, positive depression screen, compulsive sexual behavior, and intimate partner violence (IPV). RESULTS: The prevalence of recent polysubstance use was 22.8%, binge drinking 51.1%, positive depression screening 5.2%, compulsive sexual behavior 7.1%, and IPV 7.3%. Syndemics prevalence was 24.2%, and associated factors were younger age (adjusted Odds Ratio (aOR) 0.95, 95% Confidence Interval (95% CI) 0.92-0.98 per year increase), TGW vs. MSM (aOR 3.09, 95% CI: 1.2-8.0), some college education or more vs. less than college (aOR 2.49, 95% CI: 1.31-4.75), and multiple male sexual partners in prior 3 months (aOR 1.69, 95% CI: 0.92-3.14). CONCLUSION: Given the high prevalence of syndemics, particularly of polysubstance use and binge drinking, PrEP delivery offers an opportunity to diagnose and intervene in mental and social well-being.
BACKGROUND: Concurrent psychosocial problems may synergistically increase the risk of HIV infection (syndemics), representing a challenge for prevention. We aimed to evaluate the prevalence and associated factors of syndemics among men who have sex with men (MSM) and transgender women (TGW) enrolled in the Brazilian pre-exposure prophylaxis demonstration study (PrEP Brasil Study). METHODS: Secondary cross-sectional analysis of the PrEP Brasil Study was performed. Of 450 HIV-seronegative MSM/TGW enrolled in the PrEP Brasil Study- conducted at Rio de Janeiro and São Paulo, Brazil- 421 participants with complete data were included in the present analysis. Syndemics was defined as occurrence of ≥2 of the following conditions: polysubstance (≥2) use, binge drinking, positive depression screen, compulsive sexual behavior, and intimate partner violence (IPV). RESULTS: The prevalence of recent polysubstance use was 22.8%, binge drinking 51.1%, positive depression screening 5.2%, compulsive sexual behavior 7.1%, and IPV 7.3%. Syndemics prevalence was 24.2%, and associated factors were younger age (adjusted Odds Ratio (aOR) 0.95, 95% Confidence Interval (95% CI) 0.92-0.98 per year increase), TGW vs. MSM (aOR 3.09, 95% CI: 1.2-8.0), some college education or more vs. less than college (aOR 2.49, 95% CI: 1.31-4.75), and multiple male sexual partners in prior 3 months (aOR 1.69, 95% CI: 0.92-3.14). CONCLUSION: Given the high prevalence of syndemics, particularly of polysubstance use and binge drinking, PrEP delivery offers an opportunity to diagnose and intervene in mental and social well-being.
Authors: Sarah M Peitzmeier; Mannat Malik; Shanna K Kattari; Elliot Marrow; Rob Stephenson; Madina Agénor; Sari L Reisner Journal: Am J Public Health Date: 2020-07-16 Impact factor: 11.561
Authors: Paul A Shuper; Narges Joharchi; Isaac I Bogoch; Mona Loutfy; Frederic Crouzat; Philippe El-Helou; David C Knox; Kevin Woodward; Jürgen Rehm Journal: BMC Public Health Date: 2020-11-25 Impact factor: 3.295
Authors: Ada Miltz; Fiona Lampe; Sheena McCormack; David Dunn; Ellen White; Alison Rodger; Andrew Phillips; Lorraine Sherr; Ann K Sullivan; Iain Reeves; Amanda Clarke; Mitzy Gafos Journal: BMJ Open Date: 2019-12-10 Impact factor: 2.692