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      Prevalence and correlates of HIV among men who have sex with men in Tijuana, Mexico

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          Abstract

          Introduction

          Men who have sex with men (MSM) in developing countries such as Mexico have received relatively little research attention. In Tijuana, Mexico, a border city experiencing a dynamic HIV epidemic, data on MSM are over a decade old. Our aims were to estimate the prevalence and examine correlates of HIV infection among MSM in this city.

          Methods

          We conducted a cross-sectional study of 191 MSM recruited through respondent-driven sampling (RDS) in 2012. Biological males over the age of 18 who resided in Tijuana and reported sex with a male in the past year were included. Participants underwent interviewer-administered surveys and rapid tests for HIV and syphilis with confirmation.

          Results

          A total of 33 MSM tested positive for HIV, yielding an RDS-adjusted estimated 20% prevalence. Of those who tested positive, 89% were previously unaware of their HIV status. An estimated 36% (95% CI: 26.4–46.5) had been tested for HIV in the past year, and 30% (95% CI: 19.0–40.0) were estimated to have ever used methamphetamine. Independent correlates of being infected with HIV were methamphetamine use (odds ratio [OR]=2.24, p=0.045, 95% CI: 1.02, 4.92) and active syphilis infection (OR=4.33, p=0.01, 95% CI: 1.42, 13.19).

          Conclusions

          Our data indicate that MSM are a key sub-population in Tijuana at higher risk for HIV. Tijuana would also appear to have the highest proportion among upper-middle-income countries of HIV-positive MSM who are unknowingly infected. More HIV prevention research on MSM is urgently needed in Tijuana.

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          Most cited references34

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          Respondent-Driven Sampling: A New Approach to the Study of Hidden Populations

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            Variance Estimation, Design Effects, and Sample Size Calculations for Respondent-Driven Sampling

            Hidden populations, such as injection drug users and sex workers, are central to a number of public health problems. However, because of the nature of these groups, it is difficult to collect accurate information about them, and this difficulty complicates disease prevention efforts. A recently developed statistical approach called respondent-driven sampling improves our ability to study hidden populations by allowing researchers to make unbiased estimates of the prevalence of certain traits in these populations. Yet, not enough is known about the sample-to-sample variability of these prevalence estimates. In this paper, we present a bootstrap method for constructing confidence intervals around respondent-driven sampling estimates and demonstrate in simulations that it outperforms the naive method currently in use. We also use simulations and real data to estimate the design effects for respondent-driven sampling in a number of situations. We conclude with practical advice about the power calculations that are needed to determine the appropriate sample size for a study using respondent-driven sampling. In general, we recommend a sample size twice as large as would be needed under simple random sampling.
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              The global epidemic of HIV infection among men who have sex with men.

              In the last few years, there have been reports of new, newly identified and resurging epidemics of HIV infection among men who have sex with men (MSM). This article reviews and summarizes the global epidemic of HIV infection among MSM. In the Western world, the increase in notifications of new HIV infections among MSM is continuing. Steep increases in reports of new HIV diagnoses among MSM were also seen in the developed economies of East Asia. In the developing world, epidemiologic studies have now established the presence of MSM populations in Africa, China and Russia and a high HIV prevalence among them. High and increasing HIV prevalence was also reported from South and Southeast Asia, and Latin America and the Caribbean. HIV continues to spread among MSM on a global level. Current prevention efforts have been unable to contain or reduce HIV transmission in this population. Additional behavioral and biomedical interventions are urgently needed.
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                Author and article information

                Journal
                J Int AIDS Soc
                J Int AIDS Soc
                JIAS
                Journal of the International AIDS Society
                International AIDS Society
                1758-2652
                09 February 2015
                2015
                : 18
                : 1
                : 19304
                Affiliations
                [1 ]Division of Global Public Health, Department of Medicine, University of California, San Diego, CA, USA
                [2 ]Department of Psychiatry, University of California, San Diego, CA, USA
                [3 ]Agencia Familiar Binacional, A.C., Tijuana, Mexico
                Author notes
                [§ ] Corresponding author: Thomas L Patterson, Department of Psychiatry, University of California, San Diego, Mail Code 0680, 9500 Gilman Drive, La Jolla, CA 92093-0680, USA. Tel: +1 858 534 3354. Fax: +1 858 534 7723. ( tpatterson@ 123456ucsd.edu )
                [*]

                These authors have contributed equally to this manuscript.

                Some data herein were presented at the 75th Annual Meeting of the College on Problems of Drug Dependence, June 15–20, 2013, in San Diego, California.

                Article
                19304
                10.7448/IAS.18.1.19304
                4323407
                25669423
                50c959c2-d0f4-45b6-834c-40a3a506c122
                © 2015 Pitpitan EV et al; licensee International AIDS Society

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 June 2014
                : 03 November 2014
                : 16 December 2014
                Categories
                Research Article

                Infectious disease & Microbiology
                men who have sex with men,correlates of hiv infection,hiv prevalence,us–mexico border,global public health,respondent-driven sampling

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