Men Having Sex With Men Research Articles

Monkeypox outbreak 2023 in Chengdu, China: an observational study

Monkeypox is a zoonotic viral disease caused by monkeypox virus infection and formerly this disease had been endemic mainly in Africa. Since May 2022, the disease has rapidly spread across the world and some imported case was confirmed sporadically in China. Under these circumstances, data of confirmed cases were collected consecutively in Chengdu, southwest China to investigate clinical and epidemiological characteristics. In this study, 28 male patients were confirmed to have monkeypox infection, with 26 identifying as MSM (men who have sex with men). Typical lesions included papules, pustular papules, vesicles, scabs and ulcerations. The most common sites of skin lesions were anogenital and perineal areas, three patients developed a widespread exanthem. Seven patients reported a history of sexual transmitted diseases, no one was hospitalized and there were no deaths. Three instances of secondary transmission were identified among close contacts, all of them were sexual partners of our participants. Furthermore, this observation provides insights of the public health for surveillance of this emerging disease and raises awareness among people at risk.

Problematic online dating app use and its association with mental and sexual health outcomes in a sample of Men-having-Sex-with-Men.

Online dating applications (ODAs) are gaining popularity, raising concerns about their potential addictive effects on users' health. The main objective of this study was to investigate the association between problematic ODA use and mental health, substance use, and sexual behavior outcomes in men-who-have-sex-with-men (MSM). To achieve this, we first validated a German version of the Problematic ODA Use Scale (PODAUS), which assesses problematic ODA usage patterns. Problematic ODA use was assessed in 226 HIV-negative MSM counseling for HIV pre-exposure prophylaxis at baseline and 6-month follow-up (n = 164, Mage = 42, SD = 11). TheGerman PODAUS was validated using confirmatory factor analyses (CFA) and correlational analysis. Multiple linear regression analyses were performed to investigate associations of PODAUS with mental, sexual health, and substance use outcomes. CFA supported PODAUS' 6-item unidimensional structure, demonstrating excellent fit indices. Reliability analyses indicated good internalconsistency (α = 0.79) and high test-retest reliability (rs = 0.68). Regarding mental health, significant positive associations were found between PODAUS and symptoms of depression, loneliness, anxiety, Attention Deficit Hyperactivity Disorder (ADHD), and impulsivity, with medium to large effect sizes. Regarding sexual health, significant negative associations of small to medium effect sizes werefound between PODAUS and lifetime prevalence of sexually transmitted infections, body acceptance, and sexual fulfillment, while a significant positive association with trait sex motivation occurred. The German version of PODAUS emerges as a valid, reliable tool to assess problematic ODA use. In an MSM sample, problematic ODA use was associated with lower mental and sexual health.

P-38. Connecting the Dots: Unveiling Shared Motivations for Mpox Vaccination

Abstract Background In 2022, a global outbreak of mpox spurred novel efforts for vaccination among previously unvaccinated individuals in the United States. Between 2022-2023, the United States was home to approximately 1/3 of documented global cases (32,063 cases) and suffered 56 deaths. These cases were concentrated in men-who-have-sex-with-men (MSM) and deaths were concentrated in people with HIV (PWH) and other immunocompromised individuals. Tolan Park Clinic in Detroit, Michigan, the largest HIV clinic in the state, began an intensive effort to vaccinate patients at risk of mpox acquisition. Surveys were provided to patients undergoing vaccination to assess motivations of undergoing vaccination. The objective of the study was to assess reasons for vaccination other than HIV status. Methods Surveys were conducted of patients at Tolan Park Clinic who underwent mpox vaccination. During the survey period, 167 surveys were completed. The survey evaluated different motivations to receive vaccination, including exposure to mpox in the last 14 days, attendance at an event with a known case of mpox, MSM or transgender women with greater than two partners in the last year, MSM or transgender women with a partner known to have a STI in the last year, if pt participated in commercial sex work, or plan to attend a ball, sex party, or bath house. Patients could select multiple responses to the survey. Results Analysis of results revealed that 49% (82) of surveys reported participants being MSM with greater than 2 partners in the last year as some motivation for undergoing vaccination. Following that, 24% (41) of surveys reported that participant planned to attend a ball, sex party, or bath house as a motivation for vaccination. The third most reported driver was MSM with a partner known to have an STI in the last year. This made of 14% (25) of all surveys reported. Conclusion Results demonstrated that the two most common drivers of vaccination included MSM with greater than two partners in the last year and those planning to attend a ball, sex party or bath house. Targeting vaccination efforts toward these groups helped to curb the spread of mpox. Our data will be utilized to better target outreach efforts during future epidemics of mpox. Disclosures All Authors: No reported disclosures

Barriers and Facilitators in Accessing HIV Prevention Services for Men Having Sex with Men (MSM): A Comprehensive Analysis

Objectives: This study explores MSM’s perspective on HIV prevention needs, barriers, facilitators, and retention strategies in prevention programs. Method: In-depth interviews, key informant interviews, focus group discussions, and structured questionnaires were used to interview urban and rural Nigerian men having sex with men (MSM) aged 18 and older. Candidates were recruited using snowball referrals. Data analysis used IBM-SPSS 28. Result: Urban residents (67.6%) had more secondary education than rural residents (53.7%) in the 299 MSM research. Drug use was 84.2% in urban and 61.3% in rural MSM. The majority of rural MSM (90.1%) had multiple sexual partners, unlike urban residents (70.1%). Compared to rural people (8.0%), urban MSM reported greater sexual abuse rates (22.0%). Over 80% of MSM used condoms, attended HIV meetings, visited STI clinics, and used lubricant. However, less than 80% would attend a peer-led clinic or have peers assist with drug adherence. MSM attending private healthcare facilities stated that distance to service delivery points was a major barrier (60.6%). However, those attending public health facilities cited lack of information (67.0%), unpleasant facilities (76.1%), stigma (81.8%), and incapacity to handle police harassment (74.4%) as key hurdles to treatment. MSM views on HIV preventive programs are examined in this qualitative study. Despite economic limits, respondents preferred private hospitals due to confidentiality, stigmatisation, and discrimination difficulties at public hospitals, which hinder treatment acceptance. Conclusion: MSM in urban and rural settings have different HIV risk behaviours and access issues, requiring specific interventions.

ASSOCIATION BETWEEN SOCIAL POLICY, STIGMA, SOCIAL ACCEPTANCE, AND MENTAL HEALTH AMONG OLDER MEN WHO HAVE SEX WITH MEN

Abstract Background Older MSM (Men who have Sex with Men) often face discrimination and marginalization due to ageism and homophobia, impacting their psychological well-being. This study investigates the influence of social factors on the psychological well-being of older MSM, considering variations in social policy and cultural contexts across China, Hong Kong, and Taiwan. Methods A comparative approach was utilized, gathering data (N=453) from older MSM in the aforementioned regions. Measures assessing social policy, stigma, social acceptance, and psychological well-being were employed. Control variables, such as age, education level, and income, were included to mitigate potential influences. The data were analyzed using descriptive statistics, ANOVA, and regression analysis. Results The findings demonstrate significant negative effects of stigmatization across all three regions. F-statistics indicate the regression models’ overall significance: China (F = 69.583, p < 0.001), Hong Kong (F = 51.971, p < 0.001), and Taiwan (F = 57.725, p < 0.001). This highlights stigmatization’s strong influence on dependent variables in each region. Additionally, high adjusted R-squared values suggest substantial explained variance: China (Adj R2 = 0.632), Hong Kong (Adj R2 = 0.514), and Taiwan (Adj R2 = 0.565), emphasizing the model’s ability to account for variability in dependent variables. Conclusion The study underscores the need for targeted interventions and policy changes to combat stigma and promote social acceptance, thereby enhancing the psychological well-being of this vulnerable population.

Description of the Quality of Life of MSM HIV Suffering Groups in Surakarta

There has been a significant increase in HIV cases in the MSM (men who have sex with men) group. They have a greater risk of contracting HIV than the adult male group in general, which is 22x more likely to contract HIV. This is caused by risky sexual behavior, changing partners without using a condom. HIV infections in the MSM group have increased, 25.8% from 2012 to 2016. The dual stigma of sexual and status as HIV sufferers has caused them to become a hidden and difficult to reach group. This condition contributes to less than optimal handling and prevention of HIV transmission. Changes in physical, psychological and social conditions influence the productivity of PLHIV (People Living with HIV). Opportunistic infections cause physical problems. Losing their jobs, rejection and the risk of mental disorders due to their status as MSM and HIV. The high level of stigma and discrimination still hampers access to health services, thereby affecting the quality of life for PLHIV. This research aims to provide an overview of the quality of life of the MSM group suffering from HIV in Surakarta. The instrument uses a standardized questionnaire, namely the Indonesian version of WHO Quality of Life-HIV Bref which has been tested for validity and reliability. This research is a type of quantitative research using a descriptive research design with 30 respondents. The research results showed that most respondents were unmarried (86.7%), worked as private employees (66.7%), had a high school education (96.7%) and had been diagnosed with HIV for more than 5 years (63.3%). The majority of respondents' quality of life was in the sufficient category, namely 86.6%. The results of this research can be used as a reference in developing further interventions as an effort to improve the quality of life of MSM HIV in Surakarta.

Sexual behavior factors that influence the incidence of HIV/AIDS in men's groups’ male sex

Introduction: HIV/AIDS remains a significant public health problem in the world, including in Indonesia. The disease is spread through various pathways, but one of the groups most vulnerable to infection is Men Who Have Sex with Men (MSM). This study aims to analyze the influence of sexual behavior on the incidence of HIV/AIDS in the Men Having Sex with Men (MSM) group. Research Methodology: This type of research is quantitative research with a case-control research design. The population in this study consisted of cases and a control population. The population of cases in this study were all groups of Men Who Have Sex with Men (MSM) who had undergone an HIV test with positive (+) HIV test results and had taken ARV treatment at the Kendari City Regional Hospital for the last 6 (six) months and were domiciled as many as 349 people. Result: The results of the study showed that there was an influence of condom use (OR = 7.154), number of sexual partners (OR = 21,000), anal sex (OR = 7.042), and oral sex (OR = 3.367) on the incidence of HIV/AIDS in the Men Sex Men group. Conclusion: The conclusion is that the sexual behavior of using condoms, number of sexual partners, anal sex, and oral sex are risk factors for the occurrence of HIV/AIDS in the group of men having sex with men. Therefore, individuals in this group need to receive education about the risks, as well as effective prevention methods, such as consistent condom use, routine HIV testing, and open communication with sexual partners.

A Mixed Effect Similarity Matrix Regression Model (SMRmix) for Integrating Multiple Microbiome Datasets at Community Level.

Recent studies have highlighted the importance of human microbiota in our health and diseases. However, in many areas of research, individual microbiome studies often offer inconsistent results due to the limited sample sizes and the heterogeneity in study populations and experimental procedures. This inconsistency underscores the necessity for integrative analysis of multiple microbiome datasets. Despite the critical need, statistical methods that incorporate multiple microbiome datasets and account for the study heterogeneity are not available in the literature. In this paper, we develop a mixed effect similarity matrix regression (SMRmix) approach for identifying community level microbiome shifts between outcomes. SMRmix has a close connection with the microbiome kernel association test, one of the most popular approaches for such a task but is only applicable when we have a single study. SMRmix enables researchers to consolidate findings from diverse microbiome studies. Via extensive simulations, we show that SMRmix has well-controlled type I error and higher power than some potential competitors. We applied the SMRmix to two real-world datasets. The first, from the HIV-reanalysis consortium, integrated data from 17 studies on gut dysbiosis in HIV. Our analysis confirmed consistent associations between the gut microbiome and HIV infection as well as MSM (men who have sex with men) status, demonstrating greater power than competing methods. The second dataset involved 11 studies on the gut microbiome in colorectal cancer; analysis with SMRmix confirmed significant dysbiosis in affected individuals compared to healthy controls. The development of SMRmix enables the integration of multiple studies and effectively managing study heterogeneity, and provides a powerful tool for uncovering consistent associations between diseases and community-level microbiome data.

Mediatization of care for MSM living with HIV by government and civil society organizations in the Philippines during the COVID-19 pandemic

In the modern milieu, information and communications technologies (ICT) developments have dominated and been domesticated in almost all aspects of human life. This movement was made more palpable during the recent COVID-19 pandemic when access to regular treatment has been disrupted for people living with the human immunodeficiency virus (PLHIV). The health sector had to cope with the “new normal” by migrating to the online sphere. This phenomenon may be understood as mediatization, where media are viewed as an independent institution with its norms and logics, influencing the health service sector. To understand the reconfigured communicative practices of government and non-government organizations in PLHIV care provision, this study asked: How is care mediatized, and what are its consequences on healthcare service provision for men having sex with men (MSM) living with HIV in the Philippines? Narratives of interviewees from organizations enacting the online care continuum for PLHIVs reveal that, on an individual level, media and technologies have been embedded in the communicative practices of health service providers. On an institutional level, media logics are now part and parcel of the practice of health provision for PLHIVs. Examining the consequences of the mediatization of PLHIV care, theoretical and practical recommendations are made at the end of the study.

Age, sex and sexual orientation effects in the Safetxt trial: secondary data analysis of a randomised controlled trial

BackgroundIncreasing rates of sexually transmitted infections (STIs) and antimicrobial resistance among young people underscore the urgent need for preventative interventions. Interventions should be evidence-based and tailored to the unique risks...

Therapeutic drug monitoring of tenofovir disoproxil and emtricitabine in oral HIV pre-exposure prophylaxis (PrEP) users who have undergone gastrointestinal surgery.

Oral HIV pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV, but its efficacy depends on adequate absorption of drug, which may decrease following gastrointestinal surgery. Clinicians across eight Genito-urinary Medicine clinics in the United Kingdom submitted data on PrEP users with history of gastrointestinal surgery who were referred to a national complex PrEP multi-disciplinary team between June 2021 and April 2023. Anonymised data were submitted on demographics, surgical history, PrEP regimen, and results of therapeutic drug monitoring (TDM) and HIV screening tests. Descriptive analyses were performed in SPSS version 29. Nine cases described cis-gender men-who-have-sex-with-men (MSM) with median age of 47.4 years (IQR = 43 - 56.5) taking tenofovir disoproxil (TDF)/emtricitabine (FTC) daily (n = 8) or event-based (n = 1) as PrEP. Median time between PrEP initiation and TDM was 53 days (IQR = 8.5-1705). The mean (±SD) trough concentration of tenofovir (TFV) and FTC were 90.2 ± 27.7ng/mL and 76.0 ± 45.9ng/mL, respectively. All patients had a negative HIV test at follow-up. Plasma trough concentrations of TFV observed in our cohort taking TDF/FTC were above the expected concentrations associated with PrEP efficacy as previously described in the literature, suggesting that PrEP can be safely given in this population, with TDM used for reassurance.

Nuclear Factor Kappa B p65: A Possible Biomarker for Persistent Inflammation in HIV-1 Infection?

Low-grade inflammation in people living with HIV (PWH) has become a significant contributor to the development of non-communicable diseases (NCDs) such as heart disease, stroke, and renal dysfunction. Though antiretroviral therapy (ART) has dramatically reduced mortality by limiting the emergence of opportunistic infections, it has not been successful in eliminating the remaining chronic, low-grade inflammation and activation that persists in the infected despite viral suppression and better CD4+ T cell count. Nonetheless, this relatively asymptomatic and subclinical chronic inflammation remains poorly understood and has become a major contributor to mortality in PWH. Another important component involved in this step is the Nuclear Factor kappa B (NF-κB) which is a central transcription factor in the immune system to respond to infection. Specifically, the p65/RELA subunit attaches to the HIV LTR (long terminal repeat) gene and consequently initiates the synthesis of genes related to inflammation and immune reactions. Persistent low-level chronic inflammation contributes to the pathophysiology of metabolic-inflammatory NCDs. Therefore, this review aims to assess the complex contextual function of NF-κB p65 during HIV-1 disease, particularly among individuals on ART who achieve viral suppression. As much as ART has helped to arrest the progression of the virus, immune function, and chronic inflammation have not been reversed in most PWH. It is, therefore, pertinent to know how the NF-κB p65 molecule remains involved in those with persistent immune inflammation concerns to enhance strategies on the same. This review will also discuss the possible variation in NF-κB p65 activity in particular population groups such as MSM (men who have sex with men) to acquire additional information that could potentially enhance the treatment.

Viral hepatitis in persons living with HIV in the post-COVID era.

Coinfection with hepatitis viruses A to E is frequent in persons living with HIV (PLWH) and causes significant morbidity and mortality. Oro-fecal transmissible hepatitis A and E mostly produce acute self-limited episodes in poor income regions and in non-vaccinated travelers. In high-income countries, outbreaks of hepatitis A occur in men having sex with men (MSM) and chronic hepatitis E is occasionally reported among PLWH with severe immunodeficiency. Chronic hepatitis B, C, and D are frequent in PLWH in highly endemic regions and globally in persons who inject drugs (PWID) and MSM. Progression to liver cirrhosis and development of hepatocellular carcinoma (HCC) is major clinical complications in coinfected patients. Current estimates for PLWH are of 38 million worldwide. Roughly 12% have chronic viral hepatitis (5 million). Coinfection figures are of 5-10% for HBV (2-4 million), 4% for HCV (1.5 million), and 15% of HBsAg+ for HDV (0.5 million). Oral direct-acting antivirals (DAA) cure almost all treated patients with hepatitis C. However, given that there is no protective HCV immunity, PLWH with high-risk behaviors may experience HCV reinfection episodes. Tenofovir is the drug of choice in PLWH with chronic hepatitis B, given its dual effect on HIV and HBV. Lifelong oral tenofovir suppresses HBV replication and ameliorate liver damage. However, the risk of HCC persists even in the absence of cirrhosis. Finally, HDV causes the worst of viral hepatitis with faster progression to cirrhosis and HCC. An entry inhibitor, bulevirtide, has recently been approved and another drug, lonafarnib, is completing Phase 3 trials. Combination antiviral therapy for hepatitis D could improve dramatically the poor prognosis of HIV-HDV coinfected patients. The resumption of good medical practices in PLWH after the big disruption caused by COVID-19 will reduce the burden of viral hepatitis coinfections. Renewed efforts on HAV and HBV vaccination of susceptible individuals and earlier and wider prescription of antiviral therapy for HBV, HCV, and/or HDV coinfection should be prioritized in PLWH. The benefits of innovative strategies for viral hepatitis, including pre-exposure prophylaxis or use of long-acting antivirals, warrant further consideration in PLWH.

Epidemiological impact of Neisseria gonorrhoeae and Chlamydia trachomatis screening in men having sex with men: a modelling study

ObjectivesThe impact of the systematic screening of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in men having sex with men (MSM) on these pathogens’ epidemiology remains unclear. We conducted a...

Queer Linguistics: Exploring Pragmatic Strategy within Gay’s Language on Online Dating Apps

A play in meanings can be found within an internal interaction of a secretive and concealed community. In Surabaya, queer individuals, particularly gay men, employ secret codes within their language as a defensive measure against conservative societal norms. The primary strategy of this coded language involves the selection of specific vocabulary and the nuanced meanings embedded within it. Many MSMs (men who have sex with men) utilize these vocabularies for communication, primarily through online dating apps. This study aims to uncover the registers within the gay community and explore how their meanings correspond with their literal meanings in the English language. The research employs a case study method of qualitative approach and applies Leech’s seven types of meaning theory (1981) for analysis. The findings reveal that gay registers convey connotative, reflected, social, and collocative meanings. Connotative meaning is the most commonly used, followed by reflected, collocative, and social meaning. Connotative meanings are frequently employed because the gay community assigns codes to various concepts based on their real-world references. The study sheds light on how queer communities, particularly MSMs in Surabaya, use coded language as a tool for navigating conservative societal pressures. This highlights the adaptability of marginalized groups in protecting their identities, emphasizing the importance of language as valid form of expression and resistance. Future research could expand to other regions with similar or differing cultural contexts, allowing for comparative analysis of coded language usage among MSMs in various conservative environments and providing a more comprehensive understanding of the phenomenon.

Observational study of effects of HIV acquisition and antiretroviral treatment on biomarkers of systemic immune activation.

To assess whether biomarkers of systemic inflammation are associated with HIV acquisition or with the timing of ART initiation ("immediate", at diagnosis, versus "deferred", at 24 weeks post-diagnosis) in men-who-have-sex-with-men (MSM) and transgender women, we conducted a retrospective study comparing inflammatory biomarkers in participants' specimens collected before infection and after ≥2 years of effective ART. We measured biomarkers in four longitudinally collected plasma, including two specimens collected from each participant before and two after HIV acquisition and confirmed ART-suppression. Biomarkers were quantified by enzyme-linked immuno-assay or Meso Scale Discovery. When evaluating systematic variation in these markers over time, we found that multiple biomarkers consistently varied across participants' two pre-infection or two post-ART-suppression specimens. Additionally, we compared changes in biomarkers after vs before HIV acquisition. Across 47 participants, the levels of C-reactive protein (CRP), monocyte chemo-attractant protein-1, tumor necrosis factor-α and interferon gamma-induced protein-10 significantly increased while leptin and lipopolysaccharide binding protein (LBP) significantly decreased following HIV infection. Randomization to deferred-ART initiation was associated with greater increases in CRP and no decrease in LBP. Acquisition of HIV appeared to induce systemic inflammation, with elevation of biomarkers previously associated with infections and cardiovascular disease. Initiation of ART during the early weeks of infection tempered the increase in pro-inflammatory biomarkers compared to delaying ART for ~24 weeks after HIV diagnosis. These findings provide insight into potential mediators by which immediate-ART initiation improves health outcomes, perhaps because immediate-ART limits the size of the HIV reservoir or limits immune dysregulation that in turn trigger systemic inflammation.

Quantifying the basic reproduction number and underestimated fraction of Mpox cases worldwide at the onset of the outbreak.

In 2022, there was a global resurgence of mpox, with different clinical-epidemiological features compared with previous outbreaks. Sexual contact was hypothesized as the primary transmission route, and the community of men having sex with men (MSM) was disproportionately affected. Because of the stigma associated with sexually transmitted infections, the real burden of mpox could be masked. We quantified the basic reproduction number (R 0) and the underestimated fraction of mpox cases in 16 countries, from the onset of the outbreak until early September 2022, using Bayesian inference and a compartmentalized, risk-structured (high-/low-risk populations) and two-route (sexual/non-sexual transmission) mathematical model. Machine learning (ML) was harnessed to identify underestimation determinants. Estimated R 0 ranged between 1.37 (Canada) and 3.68 (Germany). The underestimation rates for the high- and low-risk populations varied between 25-93% and 65-85%, respectively. The estimated total number of mpox cases, relative to the reported cases, is highest in Colombia (3.60) and lowest in Canada (1.08). In the ML analysis, two clusters of countries could be identified, differing in terms of attitudes towards the 2SLGBTQIAP+ community and the importance of religion. Given the substantial mpox underestimation, surveillance should be enhanced, and country-specific campaigns against the stigmatization of MSM should be organized, leveraging community-based interventions.

Clinical and Epidemiological Characteristics of Mpox Cases Identified Through Case-based Surveillance in India, July 2022-January 2023.

Of the 43 mpox cases reported by the WHO in South East Asia between January 2022 and March 2023, 24 (56%) were from India. We describe the clinical and epidemiological profile of cases identified through India's hospital case-based surveillance. We identified mpox cases as a positive result for mpox virus polymerase-chain-reaction assay, reported through surveillance from July 1, 2022 to January 7, 2023. Cases and clinicians were interviewed, and data were abstracted from the medical records. We conducted contact tracing among family, close social networks, and healthcare personnel staff for the first 17 cases. We collected the data on sociodemographics, clinical findings, and behavior, and described data using summary statistics. We identified 24 laboratory-confirmed cases (42% females, median age 30 years, range 22-38), including one death (case fatality rate 4.2%). We collected clinical and behavioural data from 21 of 24 cases. All had rashes with vesicles and genital lesions; 7 (33%) reported genital lesions as the first symptom; and 3 (13%) reported complications. Among the 21 cases, all were sexually active, none self-identified as men having sex with men (MSM), and 6 (29%) reported multiple sex partners. We identified 51 contacts of the first 17 reported cases, none reported symptoms suggestive of mpox. The clinical and behavioral characteristics of mpox cases in India are consistent with the global 2022 outbreak, with the exception that no cases in India reported MSM. Most were sexually active young adult economic migrants and developed genital lesions.

Transgender HIV activism in Eastern Europe and Central Asia

Eastern Europe and Central Asia (EECA) is a region with the fastest growing HIV epidemic in the world. Trans people are designated by UNAIDS as one of the key population groups susceptible to HIV. However, in 8 out of 12 EECA countries, they are not recognized as a key group by the state. This article explores HIV-related trans activism in EECA based on interviews with 13 activists. The participants’ goal was the construction of “trans” as a legible category with specific needs and its recognition by the state as a key population group susceptible to HIV distinct from other key groups, especially men having sex with men (MSM). Such recognition was thought to improve accessibility and acceptability of HIV services for trans people, especially trans women. In addition, HIV issues were strategically used to promote gender-affirming healthcare and legal gender recognition. Quantitative research (population size and HIV prevalence estimations) was extensively used to underpin advocacy. While the activists recognized the limitations of these quantification projects, they did not question “trans” as a discoverable and quantifiable category.

Gut resistome linked to sexual preference and HIV infection

BackgroundPeople living with HIV (PLWH) are at increased risk of acquisition of multidrug resistant organisms due to higher rates of predisposing factors. The gut microbiome is the main reservoir of the collection of antimicrobial resistance determinants known as the gut resistome. In PLWH, changes in gut microbiome have been linked to immune activation and HIV-1 associated complications. Specifically, gut dysbiosis defined by low microbial gene richness has been linked to low Nadir CD4 + T-cell counts. Additionally, sexual preference has been shown to strongly influence gut microbiome composition in PLWH resulting in different Prevotella or Bacteroides enriched enterotypes, in MSM (men-who-have–sex-with-men) or no-MSM, respectively. To date, little is known about gut resistome composition in PLWH due to the scarcity of studies using shotgun metagenomics. The present study aimed to detect associations between different microbiome features linked to HIV-1 infection and gut resistome composition.ResultsUsing shotgun metagenomics we characterized the gut resistome composition of 129 HIV-1 infected subjects showing different HIV clinical profiles and 27 HIV-1 negative controls from a cross-sectional observational study conducted in Barcelona, Spain. Most no-MSM showed a Bacteroides-enriched enterotype and low microbial gene richness microbiomes. We did not identify differences in resistome diversity and composition according to HIV-1 infection or immune status. However, gut resistome was more diverse in MSM group, Prevotella-enriched enterotype and gut micorbiomes with high microbial gene richness compared to no-MSM group, Bacteroides-enriched enterotype and gut microbiomes with low microbial gene richness. Additionally, gut resistome beta-diversity was different according to the defined groups and we identified a set of differentially abundant antimicrobial resistance determinants based on the established categories.ConclusionsOur findings reveal a significant correlation between gut resistome composition and various host variables commonly associated with gut microbiome, including microbiome enterotype, microbial gene richness, and sexual preference. These host variables have been previously linked to immune activation and lower Nadir CD4 + T-Cell counts, which are prognostic factors of HIV-related comorbidities. This study provides new insights into the relationship between antibiotic resistance and clinical characteristics of PLWH.