Spillover of a hepatitis A outbreak among men who have sex with men (MSM) to the general population, the Netherlands, 2017.

Since 2015, outbreaks of hepatitis A among men who have sex with men (MSM) have been reported worldwide. To examine the impact of these MSM outbreaks in the Netherlands, we combined notification and epidemiological data with sequence analysis. Our results show the hazards of outbreaks within risk-groups spilling over into the largely susceptible general population. One third of the outbreak-related hepatitis A virus genotypes were detected in non-MSM cases

The impact of the COVID-19 pandemic on hepatitis B virus vaccination and transmission among men who have sex with men: a mathematical modelling study

Background: During the COVID-19 pandemic, the number of hepatitis B virus (HBV) vaccinations among men who have sex with men (MSM) has been considerably lower than before the pandemic. Moreover, a reduction in numbers of sex partners and less frequent HBV testing have been reported. We assessed the impact of these COVID-19-related changes on HBV transmission among MSM in the Netherlands. Methods: We estimated the changes in sexual activity, HBV testing, and HBV vaccination among MSM during the pandemic from Dutch data. We used a deterministic compartmental model and investigated scenarios with small or large decline in sexual activity, testing, and vaccination in periods when no data were available. Also, we examined the increase in HBV vaccinations needed to prevent further increase in HBV incidence. Results: With a decrease in numbers of sex partners of 15-25% during the first lockdown and 5% in the second lockdown, we found a decline of 6.6% in HBV incidence in 2020, despite a >70% reduction in HBV vaccination and testing during the first lockdown. With numbers of sex partners rebounding close to pre-pandemic level in 2021 and a reduction of 15% in testing and 30% in vaccination in 2021, we found an increase of 1.4% in incidence in 2021 and 3.1% in 2026. With these changes, an increase of at least 60% in HBV vaccinations in 2022 would be needed to bring the HBV incidence in 2023 back to the level that it would have had if the pandemic had not occurred. Conclusions: Despite phases of reduction in sexual activity during the COVID-19 pandemic, the decrease in HBV vaccinations can result in a small increase in HBV incidence after 2021, that may persist for years. Considerable efforts are needed to restore the vaccination level and prevent further increase in HBV transmission among MSM

The psychosocial determinants of the intention to test for HIV among young men in KwaZulu-Natal province, South Africa

: Voluntary counselling and testing is one of the effective prevention strategies against the HIV/AIDS epidemic. This study investigated the psychosocial determinants of the intention to be tested for HIV among young men in South Africa’s KwaZulu-Natal province using the theory of planned behaviour as the guiding framework. A facilitator-administered questionnaire was used to collect data among 350 isiZulu-speaking men between the ages of 18 and 35. Results show that 24% reported ever having tested. Intention to test showed strong positive correlations with subjective norm to test (r = 0.67), intention to use condoms (r = 0.65), intention to reduce alcohol use (r = 0.60), subjective norm to reduce alcohol use (r = 0.54), and subjective norm to use condoms (r = 0.51). For multiple regression, attitude, subjective norm and perceived behavioural control explained 43% of the variance in intention to test, with subjective norm and perceived behavioural control making significant unique contributions. An additional 12% of the variance was explained by intention to reduce alcohol and drug use, and use condoms

Determinants for HIV testing and counselling in Nairobi urban informal settlements

BACKGROUND: Counselling and testing is important in HIV prevention and care. Majority of people in sub-Saharan Africa do not know their HIV status and are therefore unable to take steps to prevent infection or take up life prolonging anti-retroviral drugs in time if infected. This study aimed at exploring determinants of HIV testing and counselling in two Nairobi informal settlements. METHODS: Data are derived from a cross-sectional survey nested in an ongoing demographic surveillance system. A total of 3,162 individuals responded to the interview and out of these, 82% provided a blood sample which was tested using rapid test kits. The outcome of interest in this paper was HIV testing status in the past categorised as "never tested"; "client-initiated testing and counselling (CITC)" and provider-initiated testing and counselling (PITC). Multinomial logistic regression was used to identify determinants of HIV testing. RESULTS: Approximately 31% of all respondents had ever been tested for HIV through CITC, 22% through PITC and 42% had never been tested but indicated willingness to test. Overall, 62% of females and 38% of males had ever been tested for HIV. Males were less likely to have had CITC (OR = 0.47; p value < 0.001) and also less likely to have had PITC (OR = 0.16; p value < 0.001) compared to females. Individuals aged 20-24 years were more likely to have had either CITC or PITC compared to the other age groups. The divorced/separated/widowed were more likely (OR = 1.65; p value < 0.01) to have had CITC than their married counterparts, while the never married were less likely to have had either CITC or PITC. HIV positive individuals (OR = 1.60; p value < 0.01) and those who refused testing in the survey (OR = 1.39; p value < 0.05) were more likely to have had CITC compared to their HIV negative counterparts. CONCLUSION: Although the proportion of individuals ever tested in the informal settlements is similar to the national average, it remains low compared to that of Nairobi province especially among men. Key determinants of HIV testing and counselling include; gender, age, education level, HIV status and marital status. These factors need to be considered in efforts aimed at increasing participation in HIV testing

Pregnancy wastage among HIV infected women in a high HIV prevalence district of India

BACKGROUND: Bagalkot district in Karnataka state is one of the highest HIV prevalence districts in India. A large proportion of the girls also marry at early age in the district and negative pregnancy outcomes among the HIV positive women likely to have large pregnancy wastages. Therefore, this study examined the pregnancy wastages and the associated factors among HIV positive women in a high prevalent district in India. METHODS: We used data from a cross-sectional survey conducted recently among randomly selected currently married HIV positive women, 15–29 years of age, in one of the high HIV prevalence districts in India. The study used the experience of reported pregnancy wastage as an outcome variable, and both bi-variate and multivariate logistic regression analyses were carried out to understand the factors associated with the pregnancy wastage among HIV infected women. RESULTS: Overall, 17 % of the respondents reported pregnancy wastage, of which 81 % were due to spontaneous abortions. Respondents who became pregnant since testing HIV positive reported significantly higher level of pregnancy wastage as compared to those were pregnant before they were tested for HIV. (AOR = 1.9; p = 0.00). While a positive association between duration of marriage and pregnancy wastage was noticed (AOR = 7.4; p = 0.01), there was a negative association between number of living children and pregnancy wastage (AOR = 0.24; p = 0.00). Living in a joint family was associated with increased reporting of pregnancy wastage as compared to those living in nuclear families (AOR = 1.7; p = 0.03). CONCLUSIONS: HIV prevention and care programs need to consider the reproductive health needs of HIV infected married women as a priority area since large proportion of these women reported negative pregnancy outcomes. There is also a need to explore ways to raise the age at marriage in order to stop women getting married before the legal age at marriage