Blood Donation and COVID-19: Reconsidering the 3-Month Deferral Policy for Gay, Bisexual, Transgender, and Other Men Who Have Sex With Men.

Park C ，Gellman C ，O'Brien M ，Eidelberg A ，Subudhi I ，Gorodetsky EF ，Asriel B ，Furlow A ，Mullen M ，Nadkarni G ，Somani S ，Sigel K ，Reich DL ... -  《-》

Attitudes and willingness to donate blood among gay and bisexual men in Australia.

Men who have sex with men in Australia are currently ineligible to donate blood (are "deferred") for 12 months since last oral or anal sexual contact with another man. In Australia and overseas, there has been limited research on attitudes and perceptions related to blood donation in this population. Questions on blood donation histories and attitudes toward the deferral policy were included in the questionnaire of an online prospective cohort of gay and bisexual men (GBM) living in Australia. In 2018, 1595 GBM responded to the survey. In this sample, 28.7% reported previously donating blood. Among the remaining men who had never donated blood, 64.5% expressed an interest in doing so. Nearly all men indicated they were not willing to abstain from sex with another man for 12 months in order to donate, and the vast majority believed the rule was unfair, too strict, and homophobic. Three-quarters (77.7%) said that if the policy changed, they would likely donate blood. Age and openness about one's sexuality were independently associated with one's willingness to donate blood in the absence of the deferral. There was a high level of willingness and desire to donate blood among GBM. However, rather than abstaining from sex in order to donate, many men comply with the deferral policy and do not donate. A less conservative deferral policy may increase donations from GBM.

Clackett S ，Seed CR ，Prestage G ，Hammoud MA ，Hoad V ，Saxton P ，Haire B ，Holt M ，Jin F ，Bourne A ，Maher L ，Kaldor J ... -  《-》

The impact of COVID-19 restrictions on HIV prevention and treatment services for key populations in South Africa: an interrupted time series analysis.

Key populations (KP), including men who have sex with men (MSM), female sex workers (FSW), and transgender women (TGW), experience a disproportionate burden of HIV, even in generalized epidemics like South Africa. Given this disproportionate burden and unique barriers to accessing health services, sustained provision of care is particularly relevant. It is unclear how the COVID-19 pandemic and its associated restrictions may have impacted this delivery. In this study, we aimed to describe patterns of engagement in HIV prevention and treatment services among KP in South Africa and assess the impact of different COVID-19 restriction levels on service delivery. We leveraged programmatic data collected by the US President's Emergency Plan for AIDS Relief (PEPFAR)-supported KP partners in South Africa. We divided data into three discrete time periods based on national COVID-19 restriction periods: (i) Pre-restriction period, (ii) High-level restriction period, and (iii) After-high level restriction period. Primary outcomes included monthly total HIV tests, new HIV cases identified, new initiations of pre-exposure prophylaxis (PrEP), and new enrollments in antiretroviral therapy (ART). We conducted interrupted time series segmented regression analyses to estimate the impact of COVID-19 restrictions on HIV prevention and treatment service utilization. Between January 2018 and June 2022, there were a total of 231,086 HIV tests, 27,051 HIV positive cases, 27,656 pre-exposure prophylaxis (PrEP) initiations, and 15,949 antiretroviral therapy initiations among MSM, FSW and TGW in PEPFAR-supported KP programs in South Africa. We recorded 90,457 total HIV tests during the 'pre-restriction' period, with 13,593 confirmed new HIV diagnoses; 26,134 total HIV tests with 2,771 new diagnoses during the 'high-level restriction' period; and 114,495 HIV tests with 10,687 new diagnoses during the after high-level restriction period. Our Poisson regression model estimates indicate an immediate and significant decrease in service engagement at the onset of COVID-19 restrictions, including declines in HIV testing, treatment, and PrEP use, which persisted. As programs adjusted to the new restrictions, there was a gradual rebound in service engagement, particularly among MSM and FSW. Towards the end of the high-level restriction period, with some aspects of daily life returning to normal but others still restricted, there was more variability. Some indicators continued to improve, while others stagnated or decreased. Service provision rebounded from the initial shock created by pandemic-related restrictions, and HIV services were largely maintained for KP in South Africa. These results suggest that HIV service delivery among programs designed for KP was able to be flexible and resilient to the evolving restrictions. The results of this study can inform plans for future pandemics and large-scale disruptions to the delivery of HIV services.

Yao D ，Hill N ，Brown B ，Gule D ，Chabane M ，Mcingana M ，Willis K ，Shiba V ，Olawore O ，Nel D ，Pienaar J ，Theunissen J ，Rucinski K ，Reichert K ，Parmley L ，Lawrence JJ ，Baral S ，Rao A ... -  《BMC PUBLIC HEALTH》

HIV care cascade and associated factors among men who have sex with men, transgender women, and genderqueer individuals in Zimbabwe: findings from a biobehavioural survey using respondent-driven sampling.

Globally, men who have sex with men (MSM), transgender women, and genderqueer individuals are at greater risk for HIV than the general population although little data are available from these groups in Zimbabwe, a country with a national adult HIV prevalence of 12·9%. We aimed to examine progress towards the UNAIDS 90-90-90 treatment targets and factors associated with meeting the targets among a sample of MSM, transgender women, and genderqueer individuals in Zimbabwe. In this cross-sectional survey in 2019, we used respondent-driven sampling to identify MSM, transgender women, and genderqueer individuals aged at least 18 years to participate in a biobehavioural survey in Harare and Bulawayo, Zimbabwe. Participants were eligible to participate if they were assigned male at birth; had engaged in anal or oral sex with a man in the past 12 months; resided in Harare or Bulawayo for at least 1 month; spoke English, Shona, or Ndebele; provided written informed consent; and were in possession of a valid recruitment coupon if applicable. Enrolled participants completed a questionnaire and underwent HIV testing, and off-site viral load testing was done on all HIV-positive samples. Unweighted bivariate analyses and multivariable logistic regression models were used to evaluate the association of sociodemographic, behavioural, and other factors with HIV-positive status awareness among MSM, transgender women, and genderqueer individuals, and with viral load suppression among MSM. Analyses were done firstly using self-reported information and then by classifying those with a viral load of less than 200 copies per mL as being aware of their status and on treatment (viral load recategorisation). Among MSM, 248 (21%; 95% CI 19-24) of 1176 tested positive for HIV. Of those who tested positive, based on self-report, 119 (48%; 95% CI 42-54) reported knowing their HIV status, of whom 112 (94%; 88-98) reported using antiretroviral therapy (ART), of whom 89 (79%; 71-87) had viral load suppression. Based on viral load recategorisation, 180 (73%; 67-78) of 248 MSM testing HIV positive reported knowing their HIV status, of whom 174 (97%; 93-99) reported using ART, of whom 151 (87%; 81-91) had viral load suppression. 92 (28%; 23-33) of 335 transgender women and genderqueer individuals tested positive for HIV. Based on self-reports from these individuals 34 (37%; 27-48) of 92 participants reported knowing their HIV status, of whom 31 (91%; 76-98) reported using ART, of whom 27 (87%; 70-96%) had viral load suppression. Based on viral load recategorisation of data from transgender women and genderqueer participants, 53 (58%; 47-58) of 92 reported awareness of their HIV status, of whom 50 (94%; 84-99) reported using ART, of whom 46 (92%; 81-98) had viral load suppression. HIV-positive MSM aged 18-24 years had lower odds of being aware of their status than those aged at least 35 years (adjusted odds ratio [aOR] 0·34; 95% CI 0·13-0·92), as did HIV-positive MSM aged 25-34 years (aOR 0·26; 0·12-0·56). HIV-positive MSM aged 18-24 years also had a lower odds of having viral load suppression than those aged 35 years and older (aOR 0·35; 0·16-0·78), as did those aged 25-34 years (aOR 0·36; 0·19-0·67). No factors were significantly associated with awareness among transgender women and genderqueer individuals in multivariable models. Our survey showed that HIV prevalence was high and the largest difference between our results and the 90-90-90 treatment targets was in HIV status awareness, indicating the need for improvements in engaging MSM (especially young MSM), transgender women, and genderqueer individuals in HIV testing services. US President's Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention.

Harris TG ，Wu Y ，Parmley LE ，Musuka G ，Mapingure MP ，Chingombe I ，Mugurungi O ，Hakim A ，Gozhora P ，Miller SS ，Lamb MR ，Samba C ，Rogers JH ... -  《Lancet HIV》

Perspectives of the COVID-19 pandemic and vaccination among racially and ethnically diverse gay, bisexual, and other men who have sex with men with and without HIV in the US South: findings from qualitative individual in-depth interviews.

The impact of COVID-19 on specific populations, including gay, bisexual, and other men who have sex with men (GBMSM), varies based on a range of factors such as access to health care, underlying health behaviors and conditions, and social determinants of health. Our community-based participatory research partnership sought to better understand perspectives about and experiences with the COVID-19 pandemic, COVID-19 vaccination, and related health care among GBMSM. We collected, analyzed, and interpreted qualitative in-depth interview data from a diverse sample of GBMSM (N = 30) in North Carolina, USA. Using purposive sampling, we recruited native English (n = 15) and Spanish (n = 15) speakers and persons with HIV (n = 13) and persons without HIV (n = 17). We analyzed interview data using constant comparison, an approach to grounded theory. Participant mean was 33.4 (SD = 8.5) years. Sixteen themes emerged that were categorized into five domains: trust/mistrust of politicians, healthcare professionals, and the US government (n = 4 themes); engagement in COVID-19 prevention strategies (n = 2 themes); attitudes towards COVID-19 vaccination (n = 3 themes); access to and use of health care (n = 4 themes); and impact of COVID-19 on social determinants of health and mental health (n = 3 themes). This research increases our understanding of the COVID-19 pandemic among particularly minoritized and underserved communities: racially and ethnically diverse, English- and Spanish-speaking GBMSM with and without HIV in the US South. By addressing the unique needs and concerns of these communities, we can promote more equitable public health responses; enhance preventive healthcare delivery; improve preparedness for subsequent outbreaks (e.g., mpox), epidemics, and pandemics; and be better equipped to support delivery and uptake of potential future preventive HIV vaccines among communities impacted by health disparities.

Waldman JS ，Alonzo J ，Mann-Jackson L ，Aguilar-Palma SK ，Garcia M ，Smart BD ，Rhodes SD ... -  《BMC INFECTIOUS DISEASES》