Dataset Information

Temporal Trends and Characteristics of Community-Based HIV Testing: First Community-Based Testing Program Results of Men Who Had Sex with Men and Female Sex Workers in Haiti, 2015-2018.

ABSTRACT: To increase HIV status awareness among men who have sex with men (MSM) and female sex workers (FSWs), a community-based HIV testing program was implemented for the first time in Haiti. We aimed to assess 1) the effectiveness of the program to reach HIV-exposed populations over time and 2) the characteristics, HIV exposure, and testing profile of program participants. Rapid diagnostic HIV testing (RDT) was offered to all individuals present in several community-based settings across Haiti. Trends in the number of tested individuals, first-time tested, and HIV positive tested per intervention were described using linear regression. Characteristics and factors related to the first-time test were described. Between July 2015 and April 2018, 445 interventions in 91 community-based venues resulted in 3,998 rapid tests performed. A median of eight individuals was tested per intervention, with 18% first-time testers and 6% with HIV-positive results. The overall numbers of tests and positive test results increased over the intervention program period. Within 1,572 first-time RDT testers (1,216 MSM, 235 FSWs, and 121 nonkey population), 31% (n = 489) were first-time HIV testers. First-time tested individuals reported HIV exposure, such as lack of condom use at last intercourse (33%), transactional sex (35%), and recent (≤12 months) sexually transmitted infection (12%). The community-based HIV testing program effectively reached HIV-positive and previously untested individuals over a 3-year period. Continued community-based testing in conjunction with other HIV testing services is recommended for Haiti.

SUBMITTER: Alain T

PROVIDER: S-EPMC12410271 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature

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Temporal Trends and Characteristics of Community-Based HIV Testing: First Community-Based Testing Program Results of Men Who Had Sex with Men and Female Sex Workers in Haiti, 2015-2018.

Alain Tristan T Inghels Maxime M Mérisier Jean-Mary JM Dimanche Vialli V Quatremère Guillemette G Audemard Candice C Lustin Sabine S Jeudy Charlot C Descardes Arnoux A Rojas Castro Daniela D Michels David D

The American journal of tropical medicine and hygiene 20250708 3

To increase HIV status awareness among men who have sex with men (MSM) and female sex workers (FSWs), a community-based HIV testing program was implemented for the first time in Haiti. We aimed to assess 1) the effectiveness of the program to reach HIV-exposed populations over time and 2) the characteristics, HIV exposure, and testing profile of program participants. Rapid diagnostic HIV testing (RDT) was offered to all individuals present in several community-based settings across Haiti. Trends ...[more]

PMID: 40628240

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Project description:Highly Exposed-Seronegatives (HESN) individuals do not contract HIV-1 infection despite long-term exposure; few comprehensive studies examining behavior, mucosal tissue, and peripheral immune parameters in sexually-exposed HESN have been completed. To this end, we assessed rate of condomless vaginal sex, the immune activation status (peripheral blood) and gene expression (ectocervical biopsies) in female cohort of high-risk female sex workers [FSW] (n=50) and non-sex worker women [CG] (n=32) in San Juan, Puerto Rico, USA. Of the 50 FSWs examined only 5 had detectable anti-HIV responses by either HIV gag-specific CD8+ T-Cell responses or mucosal anti-HIV envelope IgG/IgA. FSW had a uniform lower CD38 expression on circulating CD4+ or CD8+ T-Cells (both: p<0.0001:Wilcoxon Rank Sum). Cervical tissue from FSWs had greater levels of CD4+ T-Cell (p=0.040), CD123+ plasmacytoid Dendritic Cells (p=0.013) and CD68+ macrophage infiltrates (p=0.038). Cervical gene expression by RNA microarray indicated that FSW had a gene signature characterized by lower expression of genes associated with leukocyte homing and chemotaxis; partial interferon regulated gene signature; and lower gene expression of genes required for HIV infection such as CD4 and NUP153 indicating a lower mucosal immune activation state and reduced susceptibility to HIV-1 infection within mucosal tissue. Notably, Interferon (IFN)-ε expression was higher in FSW than CG women, as detected by RNA (microarray) and protein (IHC) expression in cervical epithelium. The observed levels of IFNε were associated with the reported frequency of unprotected intercourse. Finally, IFNε was induced by treatment of the ECT1 cell line with seminal fluid, suggesting that semen exposure may contribute to long-term protection. Decreased levels of immune activation and gene expression required for HIV infection along with semen-induced epithelial Interferon ε production within the reproductive tract of FSWs highlight distinct host intrinsic resistance mechanisms that may contribute to long-term HIV seronegative status in spite of high-risk condomless sex.

Dataset Information

Temporal Trends and Characteristics of Community-Based HIV Testing: First Community-Based Testing Program Results of Men Who Had Sex with Men and Female Sex Workers in Haiti, 2015-2018.

Publications

Temporal Trends and Characteristics of Community-Based HIV Testing: First Community-Based Testing Program Results of Men Who Had Sex with Men and Female Sex Workers in Haiti, 2015-2018.

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