{"id":15148,"date":"2015-05-07T10:55:13","date_gmt":"2015-05-07T16:55:13","guid":{"rendered":"http:\/\/www.salud.carlosslim.org\/english2\/?p=15148"},"modified":"2015-05-08T04:33:12","modified_gmt":"2015-05-08T10:33:12","slug":"new-models-to-reduce-hiv-among-sex-workers-in-mexico","status":"publish","type":"post","link":"http:\/\/www.salud.carlosslim.org\/english2\/new-models-to-reduce-hiv-among-sex-workers-in-mexico\/","title":{"rendered":"New Models to Reduce HIV among Sex Workers in Mexico"},"content":{"rendered":"

\"VIH-microscopio-electronico-Wikipedia\"To prevent new HIV infections is necessary to direct the strategy towards the sector of men who have sex with male sex workers<\/strong>, because there is a large percentage of new infections in this sector \u00a0in the country<\/strong>, said Omar Galarraga, assistant professor of Public Policy on Health at the School of Public Health of Brown University.<\/p>\n

According to research supported by the US National Institutes of Health (NIH), one of the largest sources of new HIV infections is commercial sex between men<\/strong>.<\/p>\n

This assertion is based on a study that included interviews and screening tests among hundreds of sex workers stationed in different streets of the Mexican capital or attending the Condesa Specialized Clinic (CEC). Results obtained by Galarraga and other researchers showed that the prevalence of HIV in this sector of the population (sex workers and users of their services) could be up to 40 percent.<\/p>\n

Among the factors that propitiate this situation are the inconsistent use of condoms and high rates of infection among sex workers<\/strong>, resulting in an estimated eight percent of new infections per year among their clients or sex partners<\/strong>, a figure that may be underestimated if taking into account that the infection can spread beyond them.<\/p>\n

Despite the bleak panorama, Galarraga considers that there is hope. According to a study published in the journal AIDS and Behavior, headed by Joao Filipe Monteiro and G. Galarraga himself, if the usage of condoms is increased by 10 percent among HIV-positive sex workers new annual infections can be reduced from 8 to 5.2 percent.<\/p>\n

Also, if the number of sex workers taking antiretroviral therapy is increased to around 50 percent, the rate of new infections could be reduced to 4.4 percent. Furthermore, according to the authors, more aggressive interventions could further reduce the numbers.<\/p>\n

Reducing new infections rates to zero is the final goal of the project proposed Galarraga and coauthors, who have studied the trajectory of the epidemic in men who have sex with men in urban communities for years. This, with the purpose of determining how behavior and biology contribute to the spread of the virus, and thus, knowing how to act with intervention strategies.<\/p>\n

One of the studies conducted by this research team included 79 HIV positive sex workers between 18 and 25 years, who agreed to answer questionnaires and interviews, plus undertook medical tests.<\/p>\n

Among the data obtained, participants reported having had 405 unique sexual partners (i.e. they did not repeat sexual encounter with the same person) during week before the interviews. A condom was used in three out of four encounters. Only 40 percent of those interviewed received medication and most (53 percent) had a viral load of around 10 000 copies of the virus per milliliter of blood, a threshold far above average.<\/p>\n

Summarizing, sex workers in Mexico City present serious risks of infection because in many of their sexual encounters a condom is not used, and many of those with HIV have no proper medical control.<\/p>\n

The combination of data collected by the research group with others published in various journals, including estimates of infectivity with different viral loads, allowed Monteiro building a statistical model to predict how effective interventions can be, such as increased condom use or antiretroviral therapies.<\/p>\n

After “running” the model a thousand times in each variant, Monteiro found that an estimated average of eight percent of men who turn to male sex commerce become infected with HIV each year (even considering those who were already infected before the sexual encounter).<\/p>\n

With these parameters, he measured that a 10 percent increase in condom usage reduced rates of new infections to 5.2 percent. In order to reduce the infection rate by half (4.1 percent), it would be required increasing condom use by 20 percent (an average figure of 90 percent of sexual encounters with protection).<\/p>\n

About the effectiveness of antiretroviral treatment, the model took two variants: if viral suppression rate reached 60 percent (possible, real and achievable in the field of sex workers) or the ideal of 100 percent.<\/p>\n

If 60 percent of viral suppression is reached, it would be required that 51 percent of sex workers were under treatment (25 percent more than current figures). With this measure, the number of new infections would fell to five percent. With 61 percent of sex workers in treatment, the rate would drop to 4.4 percent. If each sex worker was treated with a viral suppression of 60 percent, infection rates among its customers would be reduced to 2.5 percent.<\/p>\n

One of the biggest challenges these scientists have to face is how to counter male sex worker\u2019s economic incentive of not using condoms during sexual encounters in exchange for a higher price for their services<\/strong>.<\/p>\n

One answer for this problem, the authors believe, is the implementation of an intervention program that includes an economic stimulus to encourage condom use in this sector, and thus, reducing statistics of new infections among customers, a key fact to reduce HIV rates in Mexico.<\/p>\n

 <\/p>\n

Source:<\/strong> Letra S – La Jornada<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

To prevent new HIV infections is necessary to direct the strategy towards the sector of men who have sex with male sex workers, because there is a large percentage of new infections in this sector \u00a0in the country, said Omar Galarraga, assistant professor of Public Policy on Health at the School of Public Health of …<\/p>\n","protected":false},"author":1,"featured_media":12413,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"footnotes":""},"categories":[3],"tags":[15,11],"class_list":["post-15148","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-actualidad-en-la-salud","tag-casalud","tag-vacunologia","cat-3-id","has_thumb"],"_links":{"self":[{"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/posts\/15148","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/comments?post=15148"}],"version-history":[{"count":6,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/posts\/15148\/revisions"}],"predecessor-version":[{"id":15154,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/posts\/15148\/revisions\/15154"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/media\/12413"}],"wp:attachment":[{"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/media?parent=15148"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/categories?post=15148"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.salud.carlosslim.org\/english2\/wp-json\/wp\/v2\/tags?post=15148"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}