ABSTRACT
Community-based organizations (CBOs) are critical to delivery of effective HIV prevention because of their reach to key populations. This online survey of a national sample of CBOs assessed their awareness of, interest in, and resources needed to provide nonoccupational postexposure prophylaxis (nPEP), preexposure prophylaxis (PrEP), and HIV treatment as prevention (TasP). One hundred seventy-five CBOs participated: 87 clinical and 88 nonclinical CBOs. For nPEP, PrEP, and TasP, program managers reported that awareness was high (94%, 90%, 85%), meeting current client need was low (20%, 13%, 18%), and the likelihood of increasing their current provision with additional resources was somewhat high (62%, 64%, 62%). Clinical CBOs were more prepared to support expansion of these biomedical interventions than nonclinical CBOs. Meeting the information, training, and resource needs of CBOs is critical for effective collaboration to reduce the number of new HIV infections through expanded delivery of PrEP, nPEP, and TasP.
Subject(s)
Anti-HIV Agents/therapeutic use , HIV Infections/prevention & control , Intention , Organizations, Nonprofit , Post-Exposure Prophylaxis/methods , Pre-Exposure Prophylaxis/methods , Acquired Immunodeficiency Syndrome , Community Health Services , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Surveys and QuestionnairesABSTRACT
Bathhouses and sex clubs were identified as primary venues for HIV transmission during the original HIV epidemic. Because HIV incidence is increasing in some high-risk groups, their potential role in HIV transmission is being examined again. We present an extension of the Bernoulli process model of HIV transmission to incorporate subpopulations with different behaviors in sex acts, condom use, and choice of partners in a single period of time. With this model, we study the role that bathhouses and sex clubs play in HIV transmission using data from the 1997 Urban Men's Health Study. If sexual activity remains the same, we find that bathhouse closures would likely lead to a small increase in HIV transmission in the period examined by this study, although this impact is less than that which would be achieved through a 1% change in current condom use rates. If, conversely, bathhouse closure leads to a reduction of the sexual activity that was in the bathhouse by at least 2%, HIV transmission would be lowered.
