The changing dynamics of HIV/AIDS during the COVID-19 pandemic in the Rohingya refugee camps in Bangladesh -a call for action

The COVID-19 pandemic has affected every country's health service and plunged refugees into the most desperate conditions. The plight of Rohingya refugees is among the harshest. COVID-19 has severely affected their existing HIV/STI prevention and management services and further increased the risk of violence and onward HIV transmission within the camps. In this commentary, we discuss the context and the changing dynamics of HIV/AIDS during COVID-19 pandemic, among the Rohingya refugee community in Bangladesh. What we currently observe is the worst crisis in the Rohingya refugee camps thus far. Because of being displaced, Rohingya refugees have increased vulnerability to HIV, STIs and other poor health outcomes. They have inadequate access to HIV testing, treatment, and care. Their host country has poor capacity to provide services. Complex economic, socio-cultural and behavioural factors exacerbate their poor access to HIV testing, treatment, and care. The unfolding COVID-19 pandemic has changed priorities in the Rohingya refugee camps so that more emphasis is being placed on COVID-19 prevention and treatment rather than other health issues. This exacerbates the already dire situation with HIV detection, management, and prevention among the refugees.Although the government of Bangladesh and different non-governmental organisations provide harm reduction, HIV care, and COVID-19 care to refugees, a comprehensive response is needed to maintain and strengthen health programs for refugees, for both HIV and COVID-19 care. This comprehensive response should include behavioural intervention, community mobilisation, and effective treatment and care. Without addressing the disadvantage of social conditions, it will be challenging to reduce the burden of HIV and COVID-19 among refugees. While the COVID-19 crisis is a global challenge, the international community has an obligation to improve the life, livelihood and health of those who are most vulnerable. Rohingya refugees are among them

Gay community periodic survey: Melbourne 2015

This study finds that HIV testing by gay and bisexual men in Melbourne continues to increase. Executive summary The Melbourne Gay Community Periodic Survey is a cross-sectional survey of gay and homosexually active men recruited at a range of gay community sites in Melbourne. The major aim of the survey is to provide data on sexual, drug use, and testing practices related to the transmission of HIV and other sexually transmissible infections (STIs) among gay men. The most recent survey, the seventeenth in Melbourne, recruited a total of 3,006 men in January 2015. The majority of these men (n=2,429, 81%) were recruited using face-to-face recruitment by trained staff at gay social venues (e.g. bars and community organisations), sex-on-premises venues, sexual health clinics, and the Midsumma Carnival. The remaining 577 men (19%) participated through an online version of the survey. Online recruitment was conducted for the first time in 2015 through the social networking site Facebook. Men were directed to a website with an online version of the GCPS questionnaire (http://gcpsonline.net). The advertisements were targeted to all men aged 16 and above who were located in Victoria and indicated in their Facebook profile that they were ‘interested’ in men. From its start in 1998, the project has been funded by the Victorian Department of Health and supported by the Victorian AIDS Council and Living Positive Victoria. The Centre for Social Research in Health coordinates the survey, with support from the Kirby Institute. The overall response rate for the 2015 survey was 77%. The data presented in this report are from the period 2011 to 2015. Since 2011, there have been significant decreases in the proportions of men recruited at sexual health clinics, social venues, and the Midsumma Carnival. The proportion of men recruited from sex-on-premises venues has remained stable over time. The online sample was analysed before we incorporated it into the survey database. There were a number of differences between men recruited online and men recruited through venues and events. Men in the online sample were younger and were more likely to be born in Australia. Men in the online sample were also less likely to report testing for HIV in the 12 months prior to the survey and were more likely to report that they were HIV-negative. Compared to men recruited through physical venues, men recruited through online survey were more likely to be in a monogamous relationship and have condomless anal intercourse with their regular partner. They were also more likely to report condomless anal intercourse with casual partners and were less likely to know that PEP was available. The online and offline samples reported similar rates of STI testing and drug use. However, despite these differences, when we merged the online and offline samples, the majority of key indicators did not appear to be affected by the change in sampling methods. We have therefore incorporated the online sample into the combined database and the reporting of trends. We will, however, continue to monitor the impact of online recruitment on the sample over time

Sexual and Reproductive Health of Rohingya Refugee People In Bangladesh: A Systematic Review Protocol

Background and Objective: Rohingya refugees are one of the most vulnerable population groups from any perspective, and that certainly includes their sexual and reproductive health and access to appropriate services. This review synthesizes SRH status and needs of Rohingya women of reproductive age, addressing their experiences in accessing services. Methods:Following PRISMA guidelines, this review employs quality assessment tools (Newcastle-Ottawa Scale, MMAT, Cochrane Risk of Bias). The search strategy will be comprehensive, spanning prominent databases such as PubMed, CINAHL, Embase, Web of Science, and Scopus. Additionally, a diligent search will extend to gray literature, reference lists, and citations. Synthesis: Employing a narrative synthesis approach, the data synthesis will encompass three critical domains: the SRH status and needs of Rohingya women, the barriers encountered in accessing SRH services, and the effectiveness of existing SRH interventions.Results:The review seeks to provide valuable insights for policymakers and healthcare practitioners, offering a foundation for evidence-based strategiesaimed at advancing SRH outcomes among Rohingya refugees in Bangladesh and similar Asian contexts. The review is registered in PROSPERO (CRD42023444386) for transparency and efficiency.Conclusion: Have been made to address the health and humanitarian needs of Rohingya refugees in Bangladesh, there is still limited knowledge about their SRH

Gay Community Periodic Survey: Sydney February 2008

Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics

Methodological challenges in collecting social and behavioural data regarding the HIV epidemic among gay and other men who have sex with men in Australia

©2014 Zablotska et al. Background: Behavioural surveillance and research among gay and other men who have sex with men (GMSM) commonly relies on non-random recruitment approaches. Methodological challenges limit their ability to accurately represent the population of adult GMSM. We compared the social and behavioural profiles of GMSM recruited via venue-based, online, and respondent-driven sampling (RDS) and discussed their utility for behavioural surveillance. Methods: Data from four studies were selected to reflect each recruitment method. We compared demographic characteristics and the prevalence of key indicators including sexual and HIV testing practices obtained from samples recruited through different methods, and population estimates from respondent-driven sampling partition analysis. Results: Overall, the socio-demographic profile of GMSM was similar across samples, with some differences observed in age and sexual identification. Men recruited through time-location sampling appeared more connected to the gay community, reported a greater number of sexual partners, but engaged in less unprotected anal intercourse with regular (UAIR) or casual partners (UAIC). The RDS sample overestimated the proportion of HIV-positive men and appeared to recruit men with an overall higher number of sexual partners. A single-website survey recruited a sample with characteristics which differed considerably from the population estimates with regards to age, ethnically diversity and behaviour. Data acquired through time-location sampling underestimated the rates of UAIR and UAIC, while RDS and online sampling both generated samples that underestimated UAIR. Simulated composite samples combining recruits from time-location and multi-website online sampling may produce characteristics more consistent with the population estimates, particularly with regards to sexual practices. Conclusion: Respondent-driven sampling produced the sample that was most consistent to population estimates, but this methodology is complex and logistically demanding. Time-location and online recruitment are more cost-effective and easier to implement; using these approaches in combination may offer the potential to recruit a more representative sample of GMSM

Gay Community Periodic Survey: Sydney February 2011

Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics

Gay Community Periodic Survey: Queensland 2005

Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics

Willingness to act upon beliefs about 'treatment as prevention' among Australian gay and bisexual men

HIV 'treatment as prevention' (TasP) is highly effective in reducing HIV transmission in serodiscordant couples. There has been little examination of gay and bisexual men's attitudes towards TasP, particularly regarding men's willingness to act on beliefs about TasP. We conducted an online cross-sectional survey of Australian men in late 2012 to investigate knowledge and beliefs about new developments in HIV prevention. Amongst 839 men (mean age 39.5 years), men tended to disagree that TasP was sufficiently effective to justify reduced condom use, although HIV-positive men had more favourable attitudes. Only a minority of men were aware of any evidence for TasP; and one-quarter incorrectly believed that evidence for the effectiveness of TasP already existed for the homosexual population. One-fifth (20.5%) of men reported that they would be willing to have condomless anal intercourse with an opposite-status sexual partner when the HIV-positive partner was taking HIV treatments. Factors independently associated with such willingness were: HIV-positive serostatus, reporting any serodiscordant or serononconcordant condomless anal intercourse with a regular male partner in the previous six months, reporting any condomless anal intercourse with a casual male partner in the previous six months, and having greater beliefs in the effectiveness of TasP. This indicated that the men most willing to rely on TasP to prevent transmission were already engaging in higher risk practices. Biomedical HIV prevention represents a rapidly changing environment with new research as well as community and policy responses emerging at a fast pace. For men with serodiscordant sexual partners to successfully apply TasP to reducing transmission risk, more support and education is needed to enable better utilisation of TasP in specific relational and sexual contexts

Genomic characterization of chronic lymphocytic leukemia (CLL) in radiation-exposed Chornobyl cleanup workers

Background Chronic lymphocytic leukemia (CLL) was the predominant leukemia in a recent study of Chornobyl cleanup workers from Ukraine exposed to radiation (UR-CLL). Radiation risks of CLL significantly increased with increasing bone marrow radiation doses. Current analysis aimed to clarify whether the increased risks were due to radiation or to genetic mutations in the Ukrainian population. Methods A detailed characterization of the genomic landscape was performed in a unique sample of 16 UR-CLL patients and age- and sex-matched unexposed general population Ukrainian-CLL (UN-CLL) and Western-CLL (W-CLL) patients (n = 28 and 100, respectively). Results Mutations in telomere-maintenance pathway genes POT1 and ATM were more frequent in UR-CLL compared to UN-CLL and W-CLL (both p < 0.05). No significant enrichment in copy-number abnormalities at del13q14, del11q, del17p or trisomy12 was identified in UR-CLL compared to other groups. Type of work performed in the Chornobyl zone, age at exposure and at diagnosis, calendar time, and Rai stage were significant predictors of total genetic lesions (all p < 0.05). Tumor telomere length was significantly longer in UR-CLL than in UN-CLL (p = 0.009) and was associated with the POT1 mutation and survival. Conclusions No significant enrichment in copy-number abnormalities at CLL-associated genes was identified in UR-CLL compared to other groups. The novel associations between radiation exposure, telomere maintenance and CLL prognosis identified in this unique case series provide suggestive, though limited data and merit further investigation