Men who have Sex with Men

Background Globally, the HIV epidemic is representing a pressing public health issue in Europe and elsewhere. There is an emerging and progressively urgent need to harmonise HIV and STI behavioural surveillance among MSM across European countries through the adoption of common indicators, as well as the development of trend analysis in order to monitor the HIV-STI epidemic over time. The Sialon II project protocols have been elaborated for the purpose of implementing a large-scale bio-behavioural survey among MSM in Europe in line with a Second Generation Surveillance System (SGSS) approach. Methods/Design Sialon II is a multi-centre biological and behavioural cross-sectional survey carried out across 13 European countries (and the UK) in community settings. A total of 4.966 MSM were enrolled in the study (3.661 participants in the TLS survey, 1.305 participants in the RDS survey). Three distinct components are foreseen in the study protocols: first, a preliminary formative research in each participating country. Second, collection of primary data using two sampling methods designed specifically for 'hard-to-reach' populations, namely Time Location Sampling (TLS) and Respondent Driven Sampling (RDS). Third, implementation of a targeted HIV/STI prevention campaign in the broader context of the data collection. Discussion Through the implementation of combined and targeted prevention complemented by meaningful surveillance among MSM, Sialon II represents a unique opportunity to pilot a bio-behavioural survey in community settings in line with the SGSS approach in a large number of EU countries. Data generated through this survey will not only provide a valuable snapshot of the HIV epidemic in MSM but will also offer an important trend analysis of the epidemiology of HIV and other STIs over time across Europe. Therefore, the Sialon II protocol and findings are likely to contribute significantly to increasing the comparability of data in EU countries through the use of common indicators and in contributing to the development of effective public health strategies and policies in areas of high need.

Background: Recreational drug use and associated harms continue to be of significant concern in men who have sex with men (MSM) particularly in the context of HIV and STI transmission. Methods: Data from 1484 HIV-negative or undiagnosed MSM included in the AURAH study, a cross-sectional, self-completed questionnaire study of 2630 individuals from 20 sexual health clinics in the United Kingdom in 2013–2014, was analysed. Two measures of recreational drug use in the previous three months were defined; (i) polydrug use (use of 3 or more recreational drugs) and (ii) chemsex drug use (use of mephedrone, crystal methamphetamine or GHB/GBL). Associations of socio-demographic, health and lifestyle factors with drug use, and associations of drug use with sexual behaviour, were investigated. Results: Of the 1484 MSM, 350 (23.6%) reported polydrug use and 324 (21.8%) reported chemsex drug use in the past three months. Overall 852 (57.5%) men reported condomless sex in the past three months; 430 (29.0%) had CLS with 2 partners, 474 (31.9%) had CLS with unknown/HIV+ partner(s); 187 (12.6%) had receptive CLS with an unknown status partner. For polydrug use, prevalence ratios (95% confidence interval) for association with CLS measures, adjusted for socio-demographic factors were: 1.38 (1.26, 1.51) for CLS; 2.11 (1.80, 2.47) for CLS with 2 partners; 1.89 (1.63, 2.19) for CLS with unknown/HIV+ partner(s); 1.36 (1.00, 1.83) for receptive CLS with an unknown status partner. Corresponding adjusted prevalence ratios for chemsex drug use were: 1.38 (1.26, 1.52); 2.07 (1.76, 2.43); 1.88 (1.62, 2.19); 1.49 (1.10, 2.02). Polydrug and chemsex drug use were also strongly associated with previous STI, PEP use, group sex and high number of new sexual partners. Associations remained with little attenuation after further adjustment for depressive symptoms and alcohol intake. Conclusion: There was a high prevalence of polydrug use and chemsex drug use among HIV negative MSM attending UK sexual health clinics. Drug use was strongly associated with sexual behaviours linked to risk of acquisition of STIs and HIV.

Recent research suggests that viewing sexually
explicit media (SEM), i.e., adult videos, may influence sexual
risk taking among men who have sex with men. Despite this
evidence,very little isknownaboutthecontent ofgaymaleSEM
onthe Internet, includingtheprevalenceof sexual riskbehaviors
and their relation to video- and performer-characteristics, viewing
frequency, and favorability. The current study content analyzed
302 sexually explicit videos featuring male same-sex
performers that were posted to five highly trafficked adult-oriented
websites. Findings revealed that gay male SEM on the
Internet features a variety of conventional and nonconventional
sexual behaviors. There was a substantial prevalence of unprotected
anal intercourse (UAI) (34 %) andwas virtually the same
as the prevalence of anal sex with a condom (36 %). The presence
of UAI was not associated with video length, amateur
production, number of video views, favorability, or website
source. However, the presence of other potentially high-risk
behaviors (e.g., ejaculation in the mouth, and ejaculation on/in/
rubbed into the anus) was associated with longer videos, more
views, and group sex videos (three or more performers). The
findings of high levels of sexual risk behavior and the fact that
there was virtually no difference in the prevalence of anal sex
with and without a condom in gay male SEM have important
implications for HIV prevention efforts, future research on the
role of SEM on sexual risk taking, and public health policy.

Background: Poor mental health contributes to poor HIV prevention, treatment and care outcomes. This paper documents factors associated with psychological distress among men who have sex with men (MSM) in Cambodia and discusses potential ways in which routine mental health management could be integrated into HIV services.

Methods: A cross-sectional study was conducted in 2014 among 394 MSM randomly selected from two provinces using a two-stage cluster sampling method. A structured questionnaire was used to assess psychological distress, sexual behaviors, substance use, adverse childhood experiences and family dysfunction. Multivariate logistic
regression analysis was performed to explore factors associated with levels of psychological distress.

Results: In total, 10.7 % of the respondents reported having suicidal thoughts and 6.6 % reported having attempted to commit suicide in the past three months, while 38.8 % had a higher level of psychological distress (GHQ-12 > 3), which indicates poor mental health. Higher levels of psychological distress were independently associated with older age
(AOR = 1.09, 95 % CI 1.03–1.14), alcohol use (AOR = 3.3, 95 % CI 1.36–7.83), illicit drug use (AOR = 3.53, 95 % CI 1.12–11.18), poor self-reported quality of life (AOR = 7.45, 95 % CI 1.79–3.04), and reduced condom use at last sex (AOR = 0.40, 95 % CI 0.21–0.73). MSM with higher levels of psychological distress were significantly more likely to report that a family member said hurtful things to them (AOR = 1.80, 95 % CI 1.10–2.97), a parent or guardian had been physically abused (AOR = 3.51, 95 % CI 1.86–6.62), and a family member had been mentally ill (AOR = 4.01, 95 % CI 2.06–7.81) when they were growing up.

Conclusions: In order to mitigate psychological distress among MSM in Cambodia, integration of mental health interventions within HIV programmes should be strengthened. To achieve optimal impact, these
interventions should also address alcohol and other substance use, and low condom use among distressed MSM. In addition, training of clinical and non-clinical HIV service providers to screen for mental health
symptoms, and subsequent provision of peer-based outreach and social support for MSM identified with psychological distress is required.

The Kenyan government offers free HIV self-testing kits to men who have sex with men. The value of self-testing is based on the imaginary of an autonomous technosubject empowered to independently control testing services, thereby “freed,” through technology, from the social conditions that might inhibit health services utilization. Following a community-centered collaborative approach, community researchers interviewed their peers who examined and reacted to the technology. Participants reframed the technosubject as intertwined with the social world and the testing kit itself as an object that exerts agency and possesses affective potential. Attending to these socio-material relationalities offers insights into program planning.

Rojas-Solís, J. L., Rojas-Alonso, I., Meza-Marín, R. N., Villalobos-Raygoza, A. (2021). Violencia de pareja en gays y hombres que tienen sexo con hombres: Una revisión sistemática (Violence between Gay couples and Men who have sex with other men: A Systematic exploratory review). Revista Criminalidad, 63(1), 173-186. Disponible en https://www.policia.gov.co/revista/revista-criminalidad-volumen-63-no-1
=RESUMEN=
La violencia en parejas de gays y hombres que tienen sexo con otros hombres es un problema grave que ha ido captando la atención de la comunidad científica internacional, por ello esta revisión sistemática explora las conceptualizaciones de la violencia en estas parejas, así como la prevalencia de los tipos de violencia y factores asociados en diversos estudios. Siguiendo un protocolo PRISMA se realizó una búsqueda en bases de datos como Scopus, Clarivate, EBSCO, Science Direct, Scielo y La Referencia. Del total de 292 referencias iniciales, se analizaron, mediante un proceso de depuración dividida en cuatro fases, 19 artículos que cumplieron con los criterios de inclusión (publicaciones realizadas entre 2000 y 2019, con acceso abierto y texto completo). Entre los principales resultados destacó la falta de homogeneidad en la definición de la violencia, así como sus subtipos, la mayor representación de muestras estadounidenses, que la violencia psicológica fue la más estudiada y que el análisis y detección de factores protectores fue prácticamente inexistente. Se discuten los resultados e implicaciones priorizando la necesidad de mayores estudios en la región latinoamericana.
-PALABRAS CLAVE- Violencia, homosexualidad, relación (fuente: Tesauro de Política Criminal Latinoamericana - ILANUD). Violencia doméstica, hombres gays, revisión sistemática (fuente: autor).
=ABSTRACT=
Violence between gay couples and men who have sex with other men is a serious problem that has captured the international scientific community’s attention. For this reason, this systematic exploratory review explores these couples’ conceptualization of violence, as well as the prevalence of types of violence and associated factors in various studies. Databases, such as Scopus, Clarivate, EBSCO, Science Direct, Scielo and La Referencia, were searched following a PRISMA protocol. Of 292 total initial references, 19 articles, which complied with inclusion criteria (publications between 2000 and 2019 with open access and full text), were analyzed by means of a debugging process divided into four phases. Among the main results, the lack of homogeneity in definitions of violence, as well as their subtypes, higher representation of samples from the United States, the fact that psychological violence was studied most, and that protective factor analysis and detection were practically nonexistent stood out. The results and implications are discussed, prioritizing the need for more studies in Latin America.
-KEYWORDS- Violence, homosexuality, relationship (source: Latin American Criminal Policy Thesaurus - ILANUD). Domestic violence, gay men, systematic review (source: author).
=RESUMO=
A violência entre casais gays e homens que fazem sexo com homens é um problema grave que vem chamando a atenção da comunidade científica internacional, portanto esta revisão sistemática explora as conceituações da violência nesses casais, bem como a prevalência de tipos de violência e fatores associados em vários estudos. Seguindo um protocolo PRISMA, foi realizada uma busca em bases de dados como Scopus, Clarivate, EBSCO, Science Direct, Scielo e La Referencia. Do total de 292 referências iniciais, foram analisados19 artigos que atenderam aos critérios de inclusão (publicações realizadas entre 2000 e 2019, comacesso aberto e texto completo), após um processo de depuração dividida em quatro fases. Dentre os principais resultados, destacou-se a falta de homogeneidade na definicão da violência e seus subtipos, a maior representatividade de amostras americanas, a violênciapsicológica como o tipo mais estudado e a inexistência de análise e detecção de fatores de proteção. Os resultados e implicações são discutidos, priorizando a necessidade de novos estudos na região da América Latina.
-PALAVRAS-CHAVE- Violência, homossexualidade, relacionamento (fonte: Tesauro de Política Criminal Latino-americana - ILANUD). Violência doméstica, homens gays, revisão sistemática (fonte: autor).

Introduction Crowdsourcing has been used to spur innovation and increase community engagement in public health programmes. Crowdsourcing is the process of giving individual tasks to a large group, often involving open contests and enabled through multisectoral partnerships. Here we describe one crowdsourced video intervention in which a video promoting condom use is produced through an open contest. The aim of this study is to determine whether a crowdsourced intervention is as effective as a social marketing intervention in promoting condom use among high-risk men who have sex with men (MSM) and transgender male-to-female (TG) in China.

Method We evaluate videos developed by crowdsourcing and social marketing. The crowdsourcing contest involved an open call for videos. Entries were judged on capacity to promote condom use, to be shareable or ‘go viral’ and to give value to the individual. 1170 participants will be recruited for the randomised controlled trial. Participants need to be MSM age 16 and over who have had condomless anal sex in the last 3 months. Recruitment will be through an online banner ad on a popular MSM web page and other social media platforms. After completing an initial survey, participants will be randomly assigned to view either the social marketing video or the crowdsourcing video. Follow-up surveys will be completed at 3 weeks and 3 months after initial intervention to evaluate condomless sex and related secondary outcomes. Secondary outcomes include condom social norms, condom negotiation, condom self-efficacy, HIV/syphilis testing, frequency of sex acts and incremental cost.

Ethics and dissemination Approval was obtained from the ethical review boards of the Guangdong Provincial Center for Skin Diseases and STI Control, UNC and UCSF. The results of this trial will be made available through publication in peer-reviewed journals.

Background: Nigeria with an HIV prevalence of 1.4% has a mixed epidemic, a general epidemic affecting the general population and concentrated epidemic affecting key and vulnerable populations.. In Nigeria, FSW, MSM and PWID, who constitute an estimated 1% of the adult Nigerian population, contribute nearly 23% of new HIV infections. About 20% of infections may be attributed to female sex workers, their clients and client partners alone, of which three-fourths may be attributable to brothel-based FSWs. People who inject drugs (PWID), MSM and their partners respectively contribute about 9% and 10% of the annual new infections. These KPs and their partners together, who constitute an estimated 3.4% of the adult population, contribute as much as 40% of new infections (1). Drivers of HIV epidemic among the KP include stigma, discrimination, limited KP-friendly services, and other structural barriers like unfavorable legal environment for MSM in Nigeria through the introduction of the Same Sex Prohibition Act. Also the HIV prevention, treatment, and care continuum remains inaccessible for many KP (Baral et al., 2009, Schwartz, 2015). As a result, progress toward ensuring universal access to HIV services for KP, and achieving HIV epidemic control, has been sub-optimal in many SSA countries (WHO, 2016). In a bid to improve access to HIV services among MSM, staffs in selected public and private hospitals were trained to provide key population friendly services and drop-in centres known as OSS were set up to provide comprehensive HIV services under one roof.
Objective: To evaluate differences in rates of HIV infection, ART initiation, viral  suppression and retention among MSM referred to OSS and KP friendly centers.
Methods: This was a retrospective analysis of the programmatic data of an HIV intervention projects among the MSM populations  in  Oyo and Lagos  states,  Nigeria, between October 2018 and June 2019.The project in Oyo state was centered around  OSS while Lagos engaged  KP friendly public health centers
Findings:  HIV Treatment Cascade
S/N Cascade Levels One Stop Shop(OSS) KP friendly centers P value
1 HIV Testing 3,248 2,707
2 HIV Positive 204 (6.3%) 260(9.6%)
3 ART Linkage 185(90.7%) 250(96.2%)
4 Viral Load Suppression 19/20 (95%)              20/50(40%)
5 Retention 177(95.7%) 229 (91.6%)

Discussion: At the OSS, a total of3, 248 MSM were tested for HIV infection and 204 confirmed HIV infected, giving a positivity rate of 6.3% while on the KP friendly centers project a total of 2,707 were screened for HIV and 260 were confirmed HIV positive giving an infection rate of 9.6%.The difference in number tested for HIV was as a result of the difference in the program targets given to the two states. The HIV infection rate among MSM in Lagos state where the KP friendly centers was engaged can thus be said to be higher than the infection rate among MSM in Oyo state where the OSS center used.  ART Linkage and initiation of ART among the positive MSM was higher at 96% with the KP friendly centers compared with the 91% ART initiation rate at the OSS. Viral suppression rate of 95% among MSM enrolled at the OSS was higher than the 40% suppression rate among the infected MSM in care at the KP friendly centers in Lagos.  About 96% and 92% of those on ART were still active in care at the OSS and the KP friendly centers respectively 6 months after enrolment. 
Conclusions: HIV prevalence among MSM who patronised KP friendly hospitals in Lagos  is higher than those who accessed care at the OSS in Oyo state. Linkage to ART for initiation was also higher among MSM referred to KP friendly centers compared to those referred to OSS. However,  viral suppression and retention in care at 6months were higher among MSM receiving care at OSS.
Recommendations Therefore a project that combine the benefits  of the two modes of interventions will be most ideal for the MSM community.