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The HIV-positive man who stopped thousands getting the virus - BBC

Participants stated whether they had been tested for HIV. Those who had been tested reported the result and the date of their last HIV test.

Sexual behavior in the last 6 months. Recreational drug use in the last 6 months. Participants reported whether they had used each of the following recreational drugs in the previous 6 months: We operationally defined club drugs to include cocaine, crystal methamphetamine, ecstasy, Viagra, ketamine, and g-hydroxybutyrate based on our previous work 16, 20, Psychosocial factors. We measured psychological distress, loneliness, and history of suicide attempts using instruments developed by Diaz et al. We used this instrument because it was specifically constructed and validated for use with Hispanic MSM from three cities, including Miami.

Psychological distress. We used a item questionnaire developed by Diaz et al. We used four items to assess loneliness e. History of suicide attempts. Participants reported whether they had ever attempted to take their own life. Cultural orientation. We measured cultural orientation with the " Americanism" and " Hispanicism" subscales from The Behavioral Acculturation Scale Developed and validated in Miami, it has good reliability with Hispanics from diverse subgroups. For this and subsequent measures, we calculated Cronbach alpha coefficients using study data.

Analysis plan. The P values generated from the univariate tests described above compare a given test variable across each of the six groups but do not compare differences between individual groups. Fifteen participants were not included in this analysis because they did not report whether they had engaged in UAI in the previous 6 months. We conducted univariate analysis to determine which factors to include in a logistic regression. Following the recommendations of Hosmer and Lemeshow 26 , we included factors with P values of 0.

Because of collinearity between HIV status and HIV status at immigration, only status at immigration was included in the logistic regression. We selected HIV status at immigration because of its stronger univariate association with unprotected sex. To control for potential age effects, we included age as a control variable. Demographic characteristics of sample by country of origin.

The demographic characteristics of the sample by country of origin are presented in Table 1. Men born in Cuba were significantly older mean age Compared with the rest of the sample, men born in Venezuela had the highest proportion of HIV-positive men Drug use and sexual behaviors of the sample in the previous 6 months by country of origin. The drug use and sexual behaviors of the sample by country of origin are presented in Table 2.

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Regardless of country of origin, a high proportion of the sample engaged in UAI and used club drugs in the previous 6 months. Men born in Colombia were more likely than other men in the sample to have used marijuana Psychosocial characteristics of the sample by country of origin. The psychosocial characteristics of the sample by country of origin are presented in Table 3. Compared with the rest of the sample, men born in Cuba had the highest mean level of Hispanicism mean 4. Factors associated with UAI in the previous 6 months of the sample. The result of the logistic regression is presented in Table 4.

An alarmingly high number of the participants reported having UAI and multiple sex partners in the last 6 months, sexual practices associated with HIV transmission and acquisition Furthermore, it is possible that some of the men also engage in risky behaviors when they travel to their native countries. Early diagnosis and treatment of HIV infection have beneficial effects for both the individual and society To be maximally effective, these efforts must be culturally tailored and take advantage of familiar technologies that have been effective at reaching Hispanic MSM, such as the Internet 17, Even if a small proportion of men were in their window period, this suggests that the remainder of HIV-positive participants became infected after they immigrated to the United States.

If we examine these data separately by country of origin, Because of the limited access to antiretroviral medications in many LAC countries at the time these data were collected, it is possible that some of these men came to the United States seeking better treatment options. As this study did not focus on HIV-positive men, we are not able to ascertain whether this is because we did not include this response option when we asked men for their primary reason for immigrating to the United States.

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The results of our multivariate model echo some of the findings previously reported among general samples of MSM 27, 29 as well as Hispanic MSM As expected, use of club drugs, number of sex partners, psychological distress, and higher level of orientation to American culture were significantly associated with UAI. One of our more interesting findings was the strong association between being HIV positive at the time of immigration and UAI. To rule out the possibility that the association between UAI and HIV-positive status at the time of immigration was being driven by our decision to include HIV status at the time of immigration rather than the more global current HIV status in the logistic regression, we re-ran the model using HIV status instead in a post hoc analysis.

HIV status did not emerge as a significant predictor of UAI, whereas all the other factors that were significant in the original model retained significance in this post hoc analysis. It also suggests that there is something unique about the men who were HIV positive at the time of immigration, over and above their HIV-positive serostatus, that is associated with UAI. Additional work is needed to understand the meaning of this association and its implication on prevention for Hispanic MSM who are recent immigrants.

First, our sample was recruited as part of a larger study designed to compare the effectiveness of using the Internet as a recruitment modality 19 and is not representative of the Hispanic MSM population in Miami-Dade County. Second, we did not set out to recruit men from specific countries of origin; instead, we formed the groupings based on the data provided by the men who enrolled in the parent study.

Thus, the descriptions by country of origin may not be representative of Hispanic MSM who have immigrated from each the six groups we examined. For more information about Positive Connections, contact eddie pridelines.

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