HIV testing practices among men who have sex with men in Buenos Aires, Argentina

The objective of the study was to explore HIV-testing practices among men who have sex with men (MSM) in Buenos Aires, Argentina, in light of current international health guidelines that recommend frequent HIV testing for MSM who engage in high-risk behavior. Participants, who were recruited using respondent-driven sampling (RDS), were 500 mostly young, nongay-identified MSM of low socioeconomic status, high levels of unemployment, living mainly in the less-affluent areas surrounding Buenos Aires, and lacking health insurance. They provided blood samples for HIV testing and responded to a Computer Assisted Self Interview. Fifty-two percent had never been tested for HIV, and 20% had been tested only once; 17% were found to be HIV infected, of whom almost half were unaware of their status. Main reasons for never having tested previously were: not feeling at risk, fear of finding out results, and not knowing where to get tested. Among those previously tested, men had been tested a median of 2 times with their most recent test having occurred a median of 2.7 years prior to study enrollment. Of those who had not tested positive before entering the study, only 41% returned for their results. HIV testing was infrequent and insufficient for early detection of infection, entry into treatment, and protection of sexual partners. This was particularly the case among nongay-identified MSM. Testing campaigns should aim to help MSM become aware of their risk behavior, decrease fear of testing by explaining available treatment resources and decreasing the stigma associated with HIV, and by publicizing information about free and confidential testing locations. Rapid HIV testing should be made available to eliminate the need for a return visit and make results immediately available to individuals who are tested.Fil: Carballo Diéguez, Alex. Columbia University; Estados UnidosFil: Balán, Iván C.. Columbia University; Estados UnidosFil: Dolezal, Curtis. Columbia University; Estados UnidosFil: Pando, María de los Ángeles. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia para el Sida; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; ArgentinaFil: Marone, Ruben. Nexo Asociación Civil; ArgentinaFil: Barreda, Victoria. Nexo Asociación Civil; ArgentinaFil: Ávila, María Mercedes. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia para el Sida; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentin

Childhood sexual experiences with an older partner among men who have sex with men in Buenos Aires, Argentina

This study sought to describe childhood sexual experiences with older partners (CSEOP) among men who have sex with men (MSM) in Buenos Aires, Argentina. MSM were recruited through respondent driven sampling. They responded to a computer administered self-interview with questions on CSEOP, operationalized as manual, oral, genital, or anal contact prior to age 13 with a partner at least 4 years older. Of the 500 respondents, only 25% identified as gay. Eighteen percent of the respondents reported CSEOP, the majority of whom did not feel they were hurt by the experience and did not consider it to be childhood sexual abuse (CSA). Over two-thirds of MSM who reported CSEOP said that their older partner was a female. Only 4% of those with a female partner felt their experience was CSA compared to 44% of those who had a male partner. Among all men reporting CSEOP, those who felt sexually abused were more likely to have been physically forced or threatened, physically hurt, and emotionally hurt than those who did not feel sexually abused. Having CSEOP, being hurt by the experiences, and perceiving the experiences as sexual abuse were not associated with current HIV sexual risk or substance use behavior. In this sample of MSM in Argentina, a substantial minority reported CSEOP. Those who felt they had been sexually abused were much more likely to have had an older male partner than an older female partner, and were more likely to report having been physically forced and threatened by their older partner.Fil: Dolezal, Curtis. Columbia University; Estados UnidosFil: Carballo Diéguez, A.. Columbia University; Estados UnidosFil: Balán, Iván C.. Columbia University; Estados UnidosFil: Pando, María de los Ángeles. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; ArgentinaFil: Mabragaña, Marina. Columbia University; Estados UnidosFil: Marone, Ruben. Nexo Asociación Civil; ArgentinaFil: Barreda, Victoria. Nexo Asociación Civil; ArgentinaFil: Ávila, María Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentin

HIV status disclosure among infected men who have sex with men (MSM) in Buenos Aires, Argentina

Five hundred men who have sex with men were recruited in Buenos Aires using respondent driven sampling. Of them, 46 respondents (24 of them not gay identified) who were HIV infected were asked questions on serodisclosure. The sample was characterized by indicators of low socioeconomic status. Most of the respondents reported being in good to excellent health despite 42% of them having been diagnosed with AIDS. Only 10% of respondents had not disclosed their serostatus to at least one person. Coworkers and lovers or main sexual partners were those most likely to know the respondents' serostatus. Reactions to disclosure were for the most part supportive. Those who had not disclosed anticipated less favorable reactions than those who had disclosed. No significant differences were observed between gay and non-gay identified respondents. The progressive social environment of Argentina that includes federal laws recognizing gay marriage may contribute to create a climate favorable for serostatus disclosure.Fil: Carballo Diéguez, Alex. HIV Center for Clinical and Behavioral Studies; Estados UnidosFil: Balan, Iván C.. HIV Center for Clinical and Behavioral Studies; Estados UnidosFil: Dolezal, Curtis. HIV Center for Clinical and Behavioral Studies; Estados UnidosFil: Ibitoye, Mobolaji. HIV Center for Clinical and Behavioral Studies; Estados UnidosFil: Pando, Maria de Los Angeles. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia del Sida; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Marone, Ruben. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia del Sida; Argentina. Nexo Asociación Civil; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Barreda, Victoria. Nexo Asociación Civil; ArgentinaFil: Avila, Maria Mercedes. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia del Sida; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentin

High Substance Use and HIV Risk Behavior Among Young Argentine Men Who Have Sex with Men

In the United States young men who have sex with men have higher rates of substance use, higher HIV incidence, and less frequent HIV testing than their heterosexual counterparts and older MSM. Less is known about comparable populations in Latin America. As part of an epidemiological study, MSM were recruited through Respondent Driven Sampling in the metropolitan area of Buenos Aires, Argentina and answered a computerized behavioral survey. From the total of 500 MSM enrolled, a sub-sample of 233 aged 18?25 was analyzed. The sample was concentrated among lower socioeconomic strata, and only 16% identified as gay. Nearly half reported male, female, and transvestite sexual partners. Reported substance use was widespread ranging from 61% for marijuana to 20% for pasta base (cocaine sulfate). Seventy percent of the sample had never been tested for HIV infection; 3% tested positive for HIV and 8% for syphilis during the study.En los Estados Unidos, los hombres jóvenes que tienen sexo con hombres (JHSH) tienen tasas de uso de sustancias más altas de los HSH de mayor edad y de sus pares heterosexuales, además de una mayor incidencia del VIH y menor frecuencia de hacerse el examen del VIH. De las poblaciones comparables en América Latina, se conoce menos. Como parte de un estudio epidemiológico, 500 HSH fueron reclutados a través del método de Muestreo Dirigido por los Participantes (en inglés RDS) en el área metropolitano de Buenos Aires, Argentina y contestaron una encuesta conductual computarizada. Una submuestra de 233 hombres de 18 a 25 años de edad fue analisada. Se concentró en estratos socioeconómicos más bajos y sólo el 16% se identificaron como gay. Casi la mitad de la submuestra reportó haber tenido parejas sexuales masculinas, femeninas y travestíes. El uso de sustancias fue común, desde 61% consumidores de marihuana hasta 20% sulfato de cocaína (pasta base). El 70% de la muestra nunca se había hecho una prueba para el VIH: 3% resultaron positivos para VIH y 8% para sífilis en el transcurso del estudio.Fil: Balán, Iván C.. New York State Psychiatric Institute; Estados Unidos. Columbia University; Estados UnidosFil: Frasca, Timothy. New York State Psychiatric Institute; Estados UnidosFil: Pando, María de los Ángeles. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; ArgentinaFil: Marone, Ruben. Nexo Asociación Civil; ArgentinaFil: Barreda, Victoria. Nexo Asociación Civil; ArgentinaFil: Dolezal, Curtis. New York State Psychiatric Institute; Estados Unidos. Columbia University; Estados UnidosFil: Carballo Diéguez, Alex. New York State Psychiatric Institute; Estados Unidos. Columbia University; Estados UnidosFil: Ávila, María Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentin

Sexual Practices, Drug Use Behaviors, and Prevalence of HIV, Syphilis, Hepatitis B and C, and HTLV-1/2 in Immigrant and Non-immigrant Female Sex Workers in Argentina

Objective To study socio-demographics, sexual practices, drug use behaviors, and prevalences of HIV, syphilis, hepatitis B and C, HTLV-1 and HTLV-2 in immigrant (foreigner) and non-immigrant (local/native) female sex workers (FSW). Design This was a cross-sectional study in immigrant and non-immigrant FSW living in Buenos Aires, Argentina. Participants were interviewed using a standardized questionnaire. Results A total of 625 FSW were enrolled, of whom 169 (27%) were immigrant FSW from Paraguay, the Dominican Republic, Brazil, Peru, and Uruguay. The prevalence of syphilis and hepatitis C was significantly higher among Argentinean FSW than among immigrant FSW. However, hepatitis B prevalence was higher among immigrant FSW. Adjusted risk factor analysis comparing immigrant FSW with Argentinean FSW indicated that marital status (single), occupation (none), fee per sex act (≤US$7), workplace (bar and cabaret), and anal sex with clients were significantly associated with immigrant FSW status. Conclusions Effective HIV/STI prevention and medical care programs need to be tailored to the specific needs of both FSW groups in Argentina.Fil: Bautista, Christian T.. Walter Reed Army Institute of Research; Estados Unidos. US Naval Medical Research Center Detachment; Estados UnidosFil: Pando, María de los Ángeles. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia para el Sida; Argentina. University of Maryland; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Reynaga, Elena. Asociación de Mujeres Meretrices de Argentina; ArgentinaFil: Marone, Ruben. NEXO; ArgentinaFil: Sateren, Warren B.. Walter Reed Army Institute of Research; Estados UnidosFil: Montano, Silvia M.. US Naval Medical Research Center Detachment; Estados UnidosFil: Sanchez, Jose L.. US Naval Medical Research Center Detachment; Estados Unidos. Walter Reed Army Institute of Research; Estados UnidosFil: Ávila, María Mercedes. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia para el Sida; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentin

Low frequency of male circumcision and unwillingness to be circumcised among MSM in Buenos Aires, Argentina: association with sexually transmitted infections

Abstract Objective: The aims of this study were to investigate the frequency of male circumcision among men who have sex with men (MSM) in Buenos Aires, Argentina; the association between circumcision and sexually transmitted infections (STIs); and, among those uncircumcised, the willingness to be circumcised. Methods: A cross-sectional study was conducted among 500 MSM recruited through the respondent-driven sampling (RDS) technique. Participants underwent a consent process, responded to a Web-based survey that included questions on demographic information, sexual behaviour, and circumcision and provided biological samples. HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum, and human papiloma virus (HPV) diagnoses were performed using standard methodologies. For all analyses, data were weighted based on participants' network size. Results: Only 64 (13%) of the 500 MSM in our study reported being circumcised. Among uncircumcised men (n 0418), 302 (70.4%) said that they would not be willing to get circumcised even if the procedure could reduce the risk of HIV infection. When considering all participants, circumcision status was not significantly associated with HIV, HBV, HCV, T. pallidum or HPV infections. However, when we restricted the sample to men who do not practice receptive anal intercourse (RAI) and compared circumcised to uncircumcised men, the former (N033) had no cases of HIV infection, while 34 of 231 (14.8%) uncircumcised men were HIV positive (p 00.020). Regarding HPV, uncircumcised men had a significantly larger number of different HPV types compared with circumcised men (mean 1.83 vs. 1.09, pB0.001) and a higher frequency of high-risk-HPV genotypes (47.6% vs. 12.5%, p 00.012). Conclusions: Consistent with international evidence, male circumcision appears to have a partial protective effect among MSM. The efficacy of circumcision in reducing risk of HIV infection among MSM appears to be correlated with sexual practices. Given the lack of motivation among MSM with regard to circumcision, proper awareness on the risks and benefits of circumcision needs to be created, if circumcision has to be introduced as a prevention strategy

Learning Beyond the Game: A Multimodal Analysis of Rocksmith Users’ Interactions

In the context of games for learning, rich multimodal conversations online can contribute to extending the educational potential of digital games. In this study, we analyzed the multimodal features of user interactions in an online affinity space dedicated to the Rocksmith digital game. This game allows users to connect a traditional electric guitar to a Sony PlayStation 4 console and interact with the game while improving their guitar playing skills. Findings show that users include several multimodal elements in their online conversations in order to support guitar learning beyond the digital walls of the game. Emoticons, emoji, pictures, YouTube videos, and user-generated videos are all part of a constellation of audiovisual modes that support social learning practices in an interestdriven online space. By understanding how users incorporate these modes in their interactions, game designers, game developers, and educators can make informed decisions on how to design and improve these features within the games themselves and in online communities of learning dedicated to such games. The findings of this study can also help these stakeholders and decision-makers create more engaging and more effective connections between games and online platforms

Parâmetros da fiscalização do Programa de Alimentação do Trabalhador (PAT) : incentivos fiscais : competência : princípio da razoabilidade

Discorre sobre a necessária obediência ao princípio da razoabilidade na fiscalização do Programa de Alimentação do Trabalhador (PAT), bem como sobre a competência da fiscalização previdenciária sobre a matéria

Da injuridicidade de determinação do TCU, para que o Tribunal Regional Eleitoral proceda a recolhimentos de imposto de renda e contribuição previdenciária das diferenças de remuneração de seus servidores, relativas aos exercícios de 1994 a 1997

Trata- se de parecer.Trata- se de parecer sobre justificativa tributária para a incidência do imposto de renda retido na fonte e da contribuição previdenciária, sobre valores pagos aos servidores beneficiários em razão do diferencial de remuneração ocorrido quando da implantação do Plano Real

Integration of an Electronic Screening, Brief Intervention, and Referral to Treatment Program Into an HIV Testing Program to Reduce Substance Use and HIV Risk Behavior Among Men Who Have Sex With Men: Protocol for Intervention Development and a Pilot Randomized Controlled Trial

BackgroundMen who have sex with men (MSM) are disproportionally affected by HIV and drug and alcohol use; however, few effective HIV prevention interventions for MSM who use substances exist. Screening, Brief Intervention, and Referral to Treatment is an early intervention for non–treatment-seeking individuals with problematic substance use and for timely referral to treatment for those with substance use disorders. Electronic screening and brief interventions (e-SBIs) reduce implementation challenges. An e-SBI tailored for MSM at the time of HIV testing might be particularly opportune to strengthen their motivation to reduce substance use and HIV risk behavior. ObjectiveThis study aims to develop a tailored e-SBI program to reduce substance use and HIV risk behavior among MSM seeking HIV testing at Nexo Asociación Civil, our community partners in Argentina (primary); assess the feasibility and acceptability of integrating the e-SBI into the Nexo HIV testing program (primary); assess the feasibility and acceptability of implementing an adapted Men’s Health Project (MHP) at Nexo (secondary); and finally, explore preliminary findings on substance use and sexual risk reduction outcomes (exploratory). MethodsThis mixed methods study has 2 stages. During stage 1 (development), we will use the User Centered Rapid App Design process consisting of focus groups (n=16), individual interviews (n=24), and a pilot deployment of the e-SBI (n=50) to iteratively develop the e-SBI. Quantitative and qualitative assessments at each step will inform the revision of the e-SBI. Furthermore, we will use the assessment, decision, administration, production, topic experts, integration, training, testing framework to adapt MHP. During stage 2 (pilot randomized controlled trial [RCT]), we will randomize 200 MSM coming to Nexo for HIV testing. They will complete a baseline assessment and then their assigned intervention (e-SBI vs screening only) and will be followed-up for 6 months. We will also conduct in-depth interviews with up to 45 participants: 15 participants from either study condition who entered or completed MHP or other substance abuse treatment and 15 from each arm who met the criteria for MHP but did not request it. ResultsThe study began recruitment in October 2022, and the stage-1 pilot study is near completion. Preliminary findings from stage 1 show high e-SBI acceptability. Data analysis of the stage-1 pilot is now beginning. The stage-2 pilot RCT will be launched in March 2024, with all data collection completed by May 2025. ConclusionsThis study will allow us to assess the acceptability and feasibility of e-SBI implementation during HIV testing encounters. We will also build the necessary research infrastructure for a subsequent RCT to assess the efficacy of e-SBIs in reducing substance use and HIV sexual risk behavior among MSM in this setting. Trial RegistrationClinicalTrials.gov NCT05542914; https://tinyurl.com/yyjj64dm. International Registered Report Identifier (IRRID)DERR1-10.2196/5668