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The epidemiology of HIV and other sexually transmitted infections in African, Caribbean and Black men in Toronto, Canada.
BMC Infect Dis 2019; 19(1):294BI

Abstract

BACKGROUND

African, Caribbean, and Black (Black) men account for 16.5% of new HIV diagnoses among men in Ontario. There is substantial evidence that sexually transmitted infections (STIs) are associated with increased likelihood of HIV infection; however, little is known regarding the prevalence of HIV/STI co-infections among Black men in Toronto. Progress has been made in understanding factors contributing to racial/ethnic disparities in HIV between among men who have sex with men (MSM). In this study, we investigate within-racial group patterns of HIV/STI infection between Black MSM and Black men who only have sex with women (MSW).

METHODS

A cross-sectional descriptive epidemiological study was conducted with a non-probability sample of Black men recruited from Toronto, Ontario. Audio Computer Assisted Self-Interviews (ACASI) surveys were used to collect demographic and behavioral data. Biological specimens were collected to screen for HIV and other STIs. Chi-Square tests were used to compare the prevalence of (1) HIV and current STIs between MSM and MSW and (2) current STIs between people living with HIV and people not living with HIV. Logistic regression models were constructed to assess whether or not history of STIs were associated with current HIV infection.

RESULTS

The prevalence of HIV (9.2%), syphilis (7.2%), hepatitis B (2.7%), and high-risk anal HPV (8.4%) and penile HPV (21.3%) infections were high in Black men (N = 487) and were significantly increased in Black MSM compared with MSW; the prevalence of syphilis and high-risk HPV were also increased in men living with HIV. Men with a history of syphilis (OR = 6.48, 95% CI: 2.68,15.71), genital warts (OR = 4.32, 95% CI: 1.79,10.43) or genital ulcers (OR = 21.3, 95% CI: 1.89,239.51) had an increased odds of HIV infection.

CONCLUSIONS

The HIV/STI prevalence was high among this sample of Black men, although the study design may have led to oversampling of men living with HIV. The associations between STIs and current HIV infection highlight the need for integrated of HIV/STI screening and treatment programs for Black men. Public health strategies are also needed to reduce disproportionate HIV/STI burden among Black MSM-including improving HPV vaccine coverage.

Authors+Show Affiliations

School of Nursing, Yale University, 400 West Campus Drive, New Haven, CT, 06477, USA. laron.nelson@yale.edu. Centre for Urban Health Solutions, St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada. laron.nelson@yale.edu.Women's Health in Women's Hands Community Health Centre, 2 Carlton Street, Suite 500, Toronto, ON, M5B 1J3, Canada.Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON, M4T 1X3, Canada.Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.Faculty of Medicine, University of Toronto, 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada.Centre for Urban Health Solutions, St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.Faculty of Medicine, University of Toronto, 1 Kings College Circle, Toronto, ON, M5S 1A8, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30925906

Citation

Nelson, LaRon E., et al. "The Epidemiology of HIV and Other Sexually Transmitted Infections in African, Caribbean and Black Men in Toronto, Canada." BMC Infectious Diseases, vol. 19, no. 1, 2019, p. 294.
Nelson LE, Tharao W, Husbands W, et al. The epidemiology of HIV and other sexually transmitted infections in African, Caribbean and Black men in Toronto, Canada. BMC Infect Dis. 2019;19(1):294.
Nelson, L. E., Tharao, W., Husbands, W., Sa, T., Zhang, N., Kushwaha, S., ... Kaul, R. (2019). The epidemiology of HIV and other sexually transmitted infections in African, Caribbean and Black men in Toronto, Canada. BMC Infectious Diseases, 19(1), p. 294. doi:10.1186/s12879-019-3925-3.
Nelson LE, et al. The Epidemiology of HIV and Other Sexually Transmitted Infections in African, Caribbean and Black Men in Toronto, Canada. BMC Infect Dis. 2019 Mar 29;19(1):294. PubMed PMID: 30925906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The epidemiology of HIV and other sexually transmitted infections in African, Caribbean and Black men in Toronto, Canada. AU - Nelson,LaRon E, AU - Tharao,Wangari, AU - Husbands,Winston, AU - Sa,Ting, AU - Zhang,Nanhua, AU - Kushwaha,Sameer, AU - Absalom,David, AU - Kaul,Rupert, Y1 - 2019/03/29/ PY - 2017/04/19/received PY - 2019/03/20/accepted PY - 2019/3/31/entrez PY - 2019/3/31/pubmed PY - 2019/5/7/medline KW - Black KW - Black Canadian men KW - Black MSM KW - Epidemiology KW - HIV KW - HIV/STI co-infection KW - Health disparities KW - Sexually transmitted infections KW - Syphilis KW - Toronto SP - 294 EP - 294 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 19 IS - 1 N2 - BACKGROUND: African, Caribbean, and Black (Black) men account for 16.5% of new HIV diagnoses among men in Ontario. There is substantial evidence that sexually transmitted infections (STIs) are associated with increased likelihood of HIV infection; however, little is known regarding the prevalence of HIV/STI co-infections among Black men in Toronto. Progress has been made in understanding factors contributing to racial/ethnic disparities in HIV between among men who have sex with men (MSM). In this study, we investigate within-racial group patterns of HIV/STI infection between Black MSM and Black men who only have sex with women (MSW). METHODS: A cross-sectional descriptive epidemiological study was conducted with a non-probability sample of Black men recruited from Toronto, Ontario. Audio Computer Assisted Self-Interviews (ACASI) surveys were used to collect demographic and behavioral data. Biological specimens were collected to screen for HIV and other STIs. Chi-Square tests were used to compare the prevalence of (1) HIV and current STIs between MSM and MSW and (2) current STIs between people living with HIV and people not living with HIV. Logistic regression models were constructed to assess whether or not history of STIs were associated with current HIV infection. RESULTS: The prevalence of HIV (9.2%), syphilis (7.2%), hepatitis B (2.7%), and high-risk anal HPV (8.4%) and penile HPV (21.3%) infections were high in Black men (N = 487) and were significantly increased in Black MSM compared with MSW; the prevalence of syphilis and high-risk HPV were also increased in men living with HIV. Men with a history of syphilis (OR = 6.48, 95% CI: 2.68,15.71), genital warts (OR = 4.32, 95% CI: 1.79,10.43) or genital ulcers (OR = 21.3, 95% CI: 1.89,239.51) had an increased odds of HIV infection. CONCLUSIONS: The HIV/STI prevalence was high among this sample of Black men, although the study design may have led to oversampling of men living with HIV. The associations between STIs and current HIV infection highlight the need for integrated of HIV/STI screening and treatment programs for Black men. Public health strategies are also needed to reduce disproportionate HIV/STI burden among Black MSM-including improving HPV vaccine coverage. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/30925906/The_epidemiology_of_HIV_and_other_sexually_transmitted_infections_in_African_Caribbean_and_Black_men_in_Toronto_Canada_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3925-3 DB - PRIME DP - Unbound Medicine ER -