The COVID-19 pandemic has exacerbated prevalence of alcohol use and violence, including gender-based violence (GBV); however, little is understood about the pandemic's impact on the relationship between the two. Data were collected from January 2021-April 2023 with adults who drink alcohol (N = 565) in the San Francisco Bay Area. Questions assessed prevalence of heavy alcohol use (≥4 drinks on one occasion ≥4 times a month) in the past 3 months and violence/GBV exposure before and during the pandemic.
View Article and Find Full Text PDFBackground Men who have sex with men (MSM) represent a disproportionate total of incident HIV cases. Oral pre-exposure prophylaxis (PrEP) has contributed to significant declines in total HIV incidence. Barriers to PrEP include individual and structural factors that can prevent PrEP adherence and persistence.
View Article and Find Full Text PDFDuring the COVID-19 pandemic, the sampling method for the National HIV Behavioral Surveillance (NHBS) in San Francisco changed from physical venue time-location sampling (TLS) to online or virtual venue TLS for men who have sex with men (MSM). We present differences in the samples of MSM recruited using physical venue TLS in 2017 and virtual venue TLS in 2021. We further assess changes in preventive and risk behaviors from 2017 to 2021 after controlling for differences in the sample compositions with multivariable Poisson models using GLM with robust standard errors.
View Article and Find Full Text PDFEpidemiol Serv Saude
December 2024
Objective: To assess the previous history of syphilis in transgender women and travestis (TWTs) and identify factors associated with treatment incompleteness.
Methods: : This was a multicenter cross-sectional study conducted between 2019 and 2021, with participants recruited through respondent-driven sampling, in five Brazilian capitals. Dependent variable: "reported syphilis treatment in the last year", "no/incomplete" or "complete".
Young men who have sex with men in Brazil face vulnerability to HIV and display lower PrEP uptake and adherence. Understanding their engagement with digital technologies can better inform mobile health (mHealth) strategies for HIV prevention and care. As part of the Conectad@s study, a HIV status-neutral prevention and care intervention for young men who have sex with men, we conducted semi-structured interviews and focus group discussions with 38 participants between January-February 2021.
View Article and Find Full Text PDFBackground: Drug overdose deaths increased by 50 % between 2017 and 2021 in San Francisco. Little is known about non-fatal overdose, which heralds future risk for morbidity and overdose death. We assessed non-fatal overdose, access to drug treatment, and overdose prevention service utilization among people who inject drugs (PWID) in San Francisco in 2022.
View Article and Find Full Text PDFBackground: Transgender women (hereafter "trans women") face social marginalization, stigma, and discrimination and experience a high burden of HIV. More recently, trans women have been identified as having a high risk for hepatitis C (HCV) infection. The interaction between these two diseases and the risks for HIV/HCV co-infection among trans women are understudied.
View Article and Find Full Text PDFBackground: The transition to the "test-and-treat" policy in Nepal in 2017, coupled with the rapid initiation of antiretroviral therapy (ART) in 2020, necessitates an in-depth understanding of factors influencing ART initiation and retention. This study investigates these factors from the perspectives of healthcare providers, families/communities, and people living with HIV (PLHIV).
Methods: Employing a qualitative design, in-depth interviews were conducted with 24 ART clients and 26 healthcare providers across different provinces of Nepal.
Background: Young gay, bisexual, and other men who have sex with men (YMSM) in Latin America experience disproportionately high rates of HIV. While new case numbers have stabilised in other demographics, the incidence of HIV in this particular group continues to rise. We estimated the prevalence of HIV and sexually transmitted infections (STI) and identified correlates of new HIV diagnoses among YMSM in Brazil.
View Article and Find Full Text PDFIntroduction: Little is known about differences in HIV risk for trans women by partner gender, particularly with respect to social determinants and partner-level circumstances that affect behavior. We examined differences in demographic, social determinants, and HIV-related risk behaviors for trans women with cis men and trans women sexual partners.
Materials And Methods: Data are from a cross-sectional survey of trans women and their sexual partners conducted between April 2020 and January 2021.
Background: Young adult (18-30 years) people who inject drugs (PWID) face high hepatitis C virus (HCV) prevalence. In San Francisco, where >60% of PWID lack stable housing, barriers hinder HCV treatment access. We assessed progress towards the World Health Organization's (WHO) HCV elimination goal of an 80% reduction in incidence over 2015-2030, focusing on young (YPWID) and unstably housed PWID in San Francisco.
View Article and Find Full Text PDFWe aimed to estimate the proportions of childhood parental neglect, abuse, and rejection and to evaluate the co-occurrence of these experiences among transgender women in Rio de Janeiro, Brazil. This was a cross-sectional study with a convenience sample enrolled between July 2019 and March 2020, using an adapted version of the Childhood Trauma Questionnaire. Proportions and corresponding confidence intervals (CI) were calculated.
View Article and Find Full Text PDFHIV disproportionately affects Black/African Americans (AA), while PrEP is under-utilized by Black/AA, women, and people who inject drugs (PWID). In San Francisco, California's National HIV Behavioral Surveillance among PWID in 2022, Black/AA women were the least likely to be tested for HIV among all groups by sex and race/ethnicity and the least likely to be aware of PrEP among women. Yet, Black/AA women were no less likely to see a healthcare provider in the last year.
View Article and Find Full Text PDFClinical trials provide evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition including through sharing of injection equipment among people who inject drugs (PWID). However, uptake among many populations at risk for HIV has been slow, particularly among PWID. We examined data from the National HIV Behavioral Surveillance (NHBS) from San Francisco in 2022 to measure PrEP uptake and identify factors associated with PrEP awareness among PWID.
View Article and Find Full Text PDFBackground: Many adolescents and young adults (AYAs; 10-24 years old) are excluded from HIV research because of social, ethical, and legal challenges with informed consent, resulting in limited AYA-focused data. We use a participatory approach to identify strategies for improving AYA consent processes in HIV research in low- and middle-income countries (LMICs).
Methods: We conducted a digital crowdsourcing open call for ideas to improve AYA consent to HIV research in LMICs.
Background: Substance use and mental distress are known barriers to HIV care engagement among trans women. Less is known about access and utilization of mental health and substance use care among trans women and the relationship between unmet behavioral health needs and HIV viral suppression. We examined the relationship between mental health and substance use on HIV viral load among trans women living with HIV.
View Article and Find Full Text PDFIntroduction: Young transgender women (trans women) experience poor health in part due to discrimination. Factors that promote resilience may help young trans women positively adapt to discrimination, resulting in attenuation of poor health outcomes. While religion is sometimes a source of stigma and transphobia, qualitative studies have identified religiosity as an important resilience resource for young trans women.
View Article and Find Full Text PDFPurpose: Sex work is a common form of work among young trans women (YTW).
Methods: Using an occupational health frame, we measured associations between demographics, sex work, and vocational outcomes in 18-month visit data from the SHINE study (=263, San Francisco).
Results: Overall, 41.
Stigma towards trans women in Nepal creates individual and system-level risks for HIV. A critical protective factor is access to HIV prevention. Research is needed to determine the impact of stigma on HIV testing among trans women in Nepal.
View Article and Find Full Text PDFPurpose: Few studies have examined the importance of improving the sexual health delivery system beyond HIV among trans women. We assessed survey data from the National HIV Behavioral Surveillance Transgender Woman (NHBS-Trans) Study in San Francisco to characterize the utilization of sexual health services among HIV-negative trans women and to explore opportunities to improve sexual health services for trans women.
Methods: Trans women were recruited through respondent-driven sampling from July 2019 to February 2020.
Background: The novel coronavirus (COVID-19) is negatively impacting vulnerable and marginalized communities. Growing research among sexual and gender minority communities shows increased COVID-19 risk and burden due to underlying social structure factors, however, not as much is known about the impact on trans women. Our team gathered data on COVID-19 risk, self-reported prevalence, and testing behaviors as part of an ongoing study of trans women's HIV risk and partnerships to fill this gap in data.
View Article and Find Full Text PDFBackground: Trans women face tremendous social inequities as well as disproportionate rates of HIV and substance use, yet disaggregated substance use data specific to trans women remain limited.
Methods: We conducted a secondary analysis of baseline data from the Trans*National Study (2016-2017) surveying trans women in the San Francisco Bay Area (n = 629). Multivariable logistic regression was used to analyze socio-demographic and environmental correlates of substance use, and bivariate associations between substance use and HIV-associated outcomes are presented alongside prevalence data.
The purpose of our study was to examine the effects of mental distress (depression, anxiety, and post-traumatic stress disorder [PTSD]), incarceration, and hate crime on stimulant use (methamphetamine, crack, and cocaine) among transgender women. We conducted a secondary analysis of longitudinal data collected from 2016 to 2018 with 429 transgender women in the San Francisco Bay Area. Generalized estimating equation log-binomial regressions were used to calculate relative risks of stimulant use associated with mental distress, incarceration, and hate crime.
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