HIV in men who have sex with men in Lebanon: clinical and psychosocial aspects

A concerted global effort to end HIV transmissions is necessary. In the Middle East and North Africa (MENA), men who have sex with men (MSM) constitute a hard-to-reach population, due to the social stigma and criminalisation of homosexuality in most countries.1 When compared with other MENA countries, Lebanon is one of the safest for sexual minority groups. Its capital city, Beirut, is one of the most socially progressive cities in MENA, with a vibrant MSM community and gay bars, clubs and community centres.2 Yet, we know little about HIV prevalence, incidence and risk factors in MSM in Lebanon, a group disproportionately affected by the condition. This editorial sets an agenda for HIV research in this key population

Social identity and attitudes toward HIV pre-exposure prophylaxis: a structural equation model

This study focuses on the role of social identity and prejudice as causal variables in public attitudes toward pre-exposure prophylaxis (PrEP) in a UK sample. In all, 222 participants participated in an experimental vignette study with a 2 × 2 × 2 design with between-participants factors of ethnicity, sexual orientation and gender, and completed measures of attitudes toward gay men, Black Africans, and PrEP. Kruskal–Wallis tests showed significant effects of gender on attitudes toward gay men and Black Africans; of ethnicity on attitudes toward gay men and PrEP; and of religion on attitudes toward gay men. A univariate analysis of variance (ANOVA) revealed more positive attitudes toward PrEP when it was presented as benefitting men (vs. women). Structural equation modeling showed that the relationship between the independent variables of gender, ethnicity, and religion and the dependent variable of attitudes toward PrEP was mediated by attitudes toward gay men and Black Africans. Individuals must perceive the principal beneficiaries of PrEP (i.e., gay men and Black Africans) positively to endorse PrEP for these groups, and sexism may reduce public acceptability of PrEP for women. Future research should use representative samples and alternative experimental manipulations, and include strength of social identification as an independent variable

How can we enhance sexual health outcomes in men who have sex with men in Lebanon?

In Lebanese men who have sex with men (MSM), the prevalence of HIV is 12% and the prevalence of having at least one symptom of a sexually transmitted infection (STI) is 34.9%.1 Low HIV testing rates, unprotected unprotected sexual intercourse, alcohol and substance use contribute to this epidemic.2 Here we present data on the prevalence of STIs in a sample of MSM attending a sexual health clinic in order to identify the correlates of risk-taking behaviour, and of testing behaviour in this population. Addressing these questions is crucial for reducing the incidence of HIV/STIs and, thus, for enhancing sexual health outcomes in this high-risk population in Lebanon

炭水化物水酸基の相対的反応性について (そのII) : ペントースの選択的エステル化反応を中心に

Landfill site of Tangier City is non-engineered low lying open dump. It has neither bottom liner nor leachate collection and treatment system. Therefore, all the leachate generated finds its paths into the surrounding environment Leachate samples of landfill site were collected and analyzed to estimate its pollution potential. The analyzed samples contained a high concentration of organic and inorganic compounds, beyond the permissible limits

Dermoscopy for venereologists: an update on patterns of tumors, inflammatory and infectious diseases of the genitalia, and tips for differential diagnosis

Introduction: Dermoscopy is an integrative part of clinical dermatologic examination. For clinicians mainly dealing with genital dermatoses and other venereal diseases, the differential diagnosis includes a broad spectrum of neoplastic, inflammatory, and infectious entities. Dermoscopy might have a valuable role to enhance the clinical differential diagnosis and help avoid some biopsies done for diagnostic purposes. Although the dermoscopic patterns of most tumors and inflammatory diseases of the trunk/face have been described, their manifestations on genital areas are less elucidated. We aimed to provide a succinct summary of existing data on dermoscopy of dermatologic diseases on genital areas. Methods: A literature search was performed on PubMed using the terms dermoscopy OR dermatoscopy OR videodermoscopy OR video dermoscopy AND genital. All studies reporting on dermoscopic findings of at least one case of a dermatologic disease on genital areas were included in the review. Unless otherwise indicated, 710 was the magnification used in the reported studies. The main outcome was to describe the dermoscopic feature of each disease. Results: A total of 31 articles were identified and analyzed. They included single case reports and case series. The described entities were categorized into anatomical variants, vascular and lymphatic lesions, tumors, inflammatory disorders, and infectious conditions. Conclusion: In diseases of the genital area, dermoscopic findings can be highly diagnostic and might establish a confident diagnosis. Limitation is that most of the criteria are based on case series, and few of them have been validated

Barriers to HIV treatment as prevention (TasP) in men who have sex with men in the Eastern Mediterranean Region

Treatment as prevention (TasP) refers to the use of antiretroviral therapy to reduce HIV viremia to 'undetectable' levels which in turn eliminates the risk of HIV transmission. Significant efforts have been made to increase awareness and understanding of TasP in many countries but not in the Eastern Mediterranean Region (EMR) where HIV remains a highly stigmatized condition especially in men who have sex with men. In this editorial, we discuss the effectiveness of TasP and public understanding of it, with a focus on men who have sex with men living in the EMR. We argue that increasing awareness and understanding of TasP could enable the concentrated epidemic in men who have sex with men in the EMR to move closer towards the UNAIDS target of 90-90-90

Managing HIV prevention in the Eastern Mediterranean Region during the COVID19 outbreak: challenges and opportunities

Coronavirus disease (COVID-19) is a global pandemic and has had a significant impact on society, health and wellbeing in the Eastern Mediterranean Region (EMR). There is limited insight into the potential impact of the pandemic on HIV outcomes. This paper focuses on the challenges and opportunities for HIV management amid the COVID-19 outbreak and provides three key recommendations for the EMR: condom distribution and packaging in light of physical distancing measures through civil organizations; implementation of a special hotline for HIV/sexual health through community testing centers; and most importantly scale-up of the recently implemented HIV self-testing which plays a crucial role in the management of HIV during COVID-19

Psychological distress and self-harm in a religiously diverse sample of Lebanese students

Drawing on identity process theory from social psychology, this study explores the protective and risk factors of psychological distress and self-harm in a religiously diverse sample of heterosexual and non-heterosexual students at an English-speaking university in Lebanon. A convenience sample of 209 undergraduate students participated in a cross-sectional survey and completed measures of religiosity, identity threat, psychological distress and self-harm. Results indicated that non-heterosexual participants exhibited higher levels of psychological distress, were more likely to report self-harm, and reported lower levels of religiosity than their heterosexual counterparts. The multiple regression analyses showed that religiosity is protective against psychological distress, and that sexual orientation distress predicts self-harm. In order to reduce the risk of psychological distress and self-harm, it will be necessary to challenge stigma towards sexual minorities, to promote engagement with a broader range of social identity categories (other than just religion), and to ensure that individuals of all faiths and sexualities in Lebanon are able to access counselling support if they require it

Emerging impact of the COVID-19 outbreak on sexual health in Lebanon

Lebanon registered its first coronavirus-2019 (COVID-19) case on 21 February 2020, which was followed by a nationwide lockdown (15 March to 8 June), resulting in strict curfews, the prohibition of public gatherings and the closure of the international airport in Beirut. The pandemic has had compounding effects on the political and economic crisis with severe economic and health consequences

Self-harm and suicidal ideation during the COVID-19 outbreak in Lebanon: a preliminary study

Purpose: This cross-sectional study focuses on the social psychological correlates of self-harm and suicidal ideation during the COVID-19 outbreak in Lebanon, which is a country characterized by political and economic instability. Design: A convenience sample of 191 Lebanese individuals completed measures of length of being in lockdown, fear of COVID-19, job insecurity, political trust, self-harm and suicidal ideation. Data were analyzed using independent samples t-tests and multiple regression. Findings: Fear of COVID-19 was associated with neither self-harm nor suicidal ideation. Males and people with lower income reported higher suicidal ideation than females and those with higher income, respectively, and religiosity was inversely associated with suicidal ideation. People who reported self-harm generally exhibited lower political trust than those who did not report self-harm. Research implications: Beyond fear of COVID-19, the socio-economic sequelae of COVID-19 (especially the economic fallout and declining political trust), which are accentuated in already economically and politically unstable societies, may precipitate poor mental health and maladaptive coping strategies in Lebanon. There is a need to ensure adequate access to mental health services to the general population amid the COVID-19 outbreak in Lebanon. Originality/value: This study provides novel insight into the risk factors for self-harm and suicidal ideation in Lebanon during the COVID-19 pandemic