Connor Volpi, Ruxton Adebiyi, John Chama, Uche Ononaku, Abayomi Aka, Andrew Mitchell, Ashley Shutt, Afoke Kokogho, Abdulwasiu B Tiamiyu, Stefan D Baral, Man Charurat, Sylvia Adebajo, Trevor A Crowell, Rebecca G Nowak
{"title":"Impact of Age of Sexual Debut on HIV Care Engagement among Sexual and Gender Minorities in Nigeria.","authors":"Connor Volpi, Ruxton Adebiyi, John Chama, Uche Ononaku, Abayomi Aka, Andrew Mitchell, Ashley Shutt, Afoke Kokogho, Abdulwasiu B Tiamiyu, Stefan D Baral, Man Charurat, Sylvia Adebajo, Trevor A Crowell, Rebecca G Nowak","doi":"10.1097/QAI.0000000000003574","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sexual and gender minorities (SGM) bear a high burden of HIV. The age of anal sexual debut may influence HIV care engagement. Our objective was to evaluate this relationship to help healthcare providers promote and anticipate future HIV care engagement among at-risk SGM.</p><p><strong>Methods: </strong>The TRUST/RV368 study provided HIV testing and treatment at SGM-friendly clinics in Abuja and Lagos, Nigeria. Self-reported age of sexual debut was dichotomized as <16 or ≥16 years. Multivariable logistic models estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association of sexual debut with 1) prior HIV testing history, 2) HIV testing at the clinics, 3) initiation of antiretroviral therapy (ART) within 6 months of a clinic diagnosis, 4) viral suppression within 12 months of ART initiation.</p><p><strong>Results: </strong>Of the 2,680 participants, 30% (n=805) reported a sexual debut <16 years. Those with an <16-year debut had significantly more receptive sex partners, condomless sex, and transactional sex (all p<0.01) and were 24% less likely to have tested for HIV before enrollment (aOR: 0.76; CI: 0.62-0.93). However, <16-year debut was not associated with HIV testing, receiving ART or achieving viral suppression once engaged with TRUST/RV368 (all p>0.05).</p><p><strong>Conclusions: </strong>SGM with <16-year debut engaged in behaviors that could increase HIV risk and were less likely to have a history of HIV testing. However, once enrolled in SGM-friendly clinics, uptake of HIV care was not associated with <16-year debut, suggesting that SGM-friendly care models may promote HIV care engagement.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAIDS Journal of Acquired Immune Deficiency Syndromes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAI.0000000000003574","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Sexual and gender minorities (SGM) bear a high burden of HIV. The age of anal sexual debut may influence HIV care engagement. Our objective was to evaluate this relationship to help healthcare providers promote and anticipate future HIV care engagement among at-risk SGM.
Methods: The TRUST/RV368 study provided HIV testing and treatment at SGM-friendly clinics in Abuja and Lagos, Nigeria. Self-reported age of sexual debut was dichotomized as <16 or ≥16 years. Multivariable logistic models estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association of sexual debut with 1) prior HIV testing history, 2) HIV testing at the clinics, 3) initiation of antiretroviral therapy (ART) within 6 months of a clinic diagnosis, 4) viral suppression within 12 months of ART initiation.
Results: Of the 2,680 participants, 30% (n=805) reported a sexual debut <16 years. Those with an <16-year debut had significantly more receptive sex partners, condomless sex, and transactional sex (all p<0.01) and were 24% less likely to have tested for HIV before enrollment (aOR: 0.76; CI: 0.62-0.93). However, <16-year debut was not associated with HIV testing, receiving ART or achieving viral suppression once engaged with TRUST/RV368 (all p>0.05).
Conclusions: SGM with <16-year debut engaged in behaviors that could increase HIV risk and were less likely to have a history of HIV testing. However, once enrolled in SGM-friendly clinics, uptake of HIV care was not associated with <16-year debut, suggesting that SGM-friendly care models may promote HIV care engagement.
期刊介绍：
JAIDS: Journal of Acquired Immune Deficiency Syndromes seeks to end the HIV epidemic by presenting important new science across all disciplines that advance our understanding of the biology, treatment and prevention of HIV infection worldwide.
JAIDS: Journal of Acquired Immune Deficiency Syndromes is the trusted, interdisciplinary resource for HIV- and AIDS-related information with a strong focus on basic and translational science, clinical science, and epidemiology and prevention. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world.
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