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HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community‐based HIV testing services

INTRODUCTION: In Myanmar, men who have sex with men (MSM) and transgender women (TW) are disproportionately affected by HIV, despite national HIV program scale‐up. However, limited HIV surveillance capacity prevents monitoring of epidemic trends and program impact. This study aimed to estimate HIV p...

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Autores principales: Veronese, Vanessa, Traeger, Michael, Oo, Zaw M, Tun, Thet T, Oo, Nwe N, Maung, Htay, Hughes, Chad, Pedrana, Alisa, Stoové, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048670/
https://www.ncbi.nlm.nih.gov/pubmed/32112538
http://dx.doi.org/10.1002/jia2.25454
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author Veronese, Vanessa
Traeger, Michael
Oo, Zaw M
Tun, Thet T
Oo, Nwe N
Maung, Htay
Hughes, Chad
Pedrana, Alisa
Stoové, Mark
author_facet Veronese, Vanessa
Traeger, Michael
Oo, Zaw M
Tun, Thet T
Oo, Nwe N
Maung, Htay
Hughes, Chad
Pedrana, Alisa
Stoové, Mark
author_sort Veronese, Vanessa
collection PubMed
description INTRODUCTION: In Myanmar, men who have sex with men (MSM) and transgender women (TW) are disproportionately affected by HIV, despite national HIV program scale‐up. However, limited HIV surveillance capacity prevents monitoring of epidemic trends and program impact. This study aimed to estimate HIV prevalence and incidence and explore associated sexual risk behaviours among MSM and TW clients attending HIV testing clinics in Myanmar. METHODS: An electronic data management system was implemented in two community‐based, MSM and TW ‐tailored HIV testing clinics in Myanmar in August 2016. Unique client identifiers enabled prospective monitoring of service engagement, testing frequency and outcomes. We estimated HIV incidence and rate of HIV diagnosis at baseline testing visit among clients over a 15 month period. Correlates of HIV diagnoses were identified using multivariable logistic regression. RESULTS: 2794 MSM and TW were tested for HIV. At their baseline test, 38% of clients reported any previous testing and 93% reported being sexually active over the previous three months, with 74% reporting sex with casual male partners and 28% reporting consistent condom use with casual partners. 291 clients tested positive for HIV for the first time at baseline (10.4%; 95% CI: 9.3 to 11.6). Twelve incident cases were detected among 279 clients receiving ≥2 tests (incidence = 10.1 per 100 person‐years; 95% CI: 5.73 to 17.8). HIV diagnosis at baseline was significantly associated with being a transgender woman or a non‐openly disclosing man who has sex with men, age 26 to 39 years, and reporting no testing history. CONCLUSIONS: High HIV incidence and new diagnoses being associated with reporting no testing history points to undiagnosed HIV driving transmissions in Myanmar. Repeat testing was uncommon. HIV programs in Myanmar must focus on promoting frequent HIV testing alongside adequate coverage of education and primary prevention interventions among MSM and TW.
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spelling pubmed-70486702020-03-05 HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community‐based HIV testing services Veronese, Vanessa Traeger, Michael Oo, Zaw M Tun, Thet T Oo, Nwe N Maung, Htay Hughes, Chad Pedrana, Alisa Stoové, Mark J Int AIDS Soc Research Articles INTRODUCTION: In Myanmar, men who have sex with men (MSM) and transgender women (TW) are disproportionately affected by HIV, despite national HIV program scale‐up. However, limited HIV surveillance capacity prevents monitoring of epidemic trends and program impact. This study aimed to estimate HIV prevalence and incidence and explore associated sexual risk behaviours among MSM and TW clients attending HIV testing clinics in Myanmar. METHODS: An electronic data management system was implemented in two community‐based, MSM and TW ‐tailored HIV testing clinics in Myanmar in August 2016. Unique client identifiers enabled prospective monitoring of service engagement, testing frequency and outcomes. We estimated HIV incidence and rate of HIV diagnosis at baseline testing visit among clients over a 15 month period. Correlates of HIV diagnoses were identified using multivariable logistic regression. RESULTS: 2794 MSM and TW were tested for HIV. At their baseline test, 38% of clients reported any previous testing and 93% reported being sexually active over the previous three months, with 74% reporting sex with casual male partners and 28% reporting consistent condom use with casual partners. 291 clients tested positive for HIV for the first time at baseline (10.4%; 95% CI: 9.3 to 11.6). Twelve incident cases were detected among 279 clients receiving ≥2 tests (incidence = 10.1 per 100 person‐years; 95% CI: 5.73 to 17.8). HIV diagnosis at baseline was significantly associated with being a transgender woman or a non‐openly disclosing man who has sex with men, age 26 to 39 years, and reporting no testing history. CONCLUSIONS: High HIV incidence and new diagnoses being associated with reporting no testing history points to undiagnosed HIV driving transmissions in Myanmar. Repeat testing was uncommon. HIV programs in Myanmar must focus on promoting frequent HIV testing alongside adequate coverage of education and primary prevention interventions among MSM and TW. John Wiley and Sons Inc. 2020-02-28 /pmc/articles/PMC7048670/ /pubmed/32112538 http://dx.doi.org/10.1002/jia2.25454 Text en © 2020 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Veronese, Vanessa
Traeger, Michael
Oo, Zaw M
Tun, Thet T
Oo, Nwe N
Maung, Htay
Hughes, Chad
Pedrana, Alisa
Stoové, Mark
HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community‐based HIV testing services
title HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community‐based HIV testing services
title_full HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community‐based HIV testing services
title_fullStr HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community‐based HIV testing services
title_full_unstemmed HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community‐based HIV testing services
title_short HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community‐based HIV testing services
title_sort hiv incidence and factors associated with testing positive for hiv among men who have sex with men and transgender women in myanmar: data from community‐based hiv testing services
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048670/
https://www.ncbi.nlm.nih.gov/pubmed/32112538
http://dx.doi.org/10.1002/jia2.25454
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