DISCUSSION: Twenty scientists from regions across the world developed this Expert Consensus Statement to address the use of HIV science by the criminal justice system. A detailed analysis of the best available scientific and medical research data on HIV transmission, treatment effectiveness and forensic phylogenetic evidence was performed and described so it may be better understood in criminal law contexts. Description of the possibility of HIV transmission was limited to acts most often at issue in criminal cases. The possibility of HIV transmission during a single, specific act was positioned along a continuum of risk, noting that the possibility of HIV transmission varies according to a range of intersecting factors including viral load, condom use, and other risk reduction practices. Current evidence suggests the possibility of HIV transmission during a single episode of sex, biting or spitting ranges from no possibility to low possibility. Further research considered the positive health impact of modern antiretroviral therapies that have improved the life expectancy of most people living with HIV to a point similar to their HIV-negative counterparts, transforming HIV infection into a chronic, manageable health condition. Lastly, consideration of the use of scientific evidence in court found that phylogenetic analysis alone cannot prove beyond reasonable doubt that one person infected another although it can be used to exonerate a defendant.
CONCLUSIONS: The application of up-to-date scientific evidence in criminal cases has the potential to limit unjust prosecutions and convictions. The authors recommend that caution be exercised when considering prosecution, and encourage governments and those working in legal and judicial systems to pay close attention to the significant advances in HIV science that have occurred over the last three decades to ensure current scientific knowledge informs application of the law in cases related to HIV.
DESIGN: Qualitative study with a quantitative component.
SETTING: Pediatric and adolescent gynecology unit at Universiti Kebangsaan Malaysia Medical Centre, Malaysia.
PARTICIPANTS: Twelve women with MRKH.
INTERVENTIONS: Face-to-face interview and short questionnaire.
MAIN OUTCOME MEASURES: Thematic analysis was used to understand participants' experiences.
RESULTS: There were 7 themes identified: (1) delayed diagnoses; (2) doctors' roles and attitudes; (3) gender identity; (4) family and society's response; (5) reaction toward infertility; (6) managing sexual intimacy; and (7) coping mechanisms. Several participants consulted their physicians regarding their primary amenorrhea at an opportunistic setting. When they were referred to the gynecologists, they were dismayed at the lack of information given. The term, "MRKH" plays an important role to ease information-seeking. Participants felt that the doctors were insensitive toward them. Mental illness is a significant complication of MRKH. All participants acknowledged that infertility was the hardest part of the condition. The importance of blood lineage affects their outlook on childbearing options. Some were afraid of sexual intimacy and worried that they would not be able to satisfy their partners. Participants gained support and bonded with their counterparts in the MRKH support group.
CONCLUSION: A multidisciplinary approach including medical, psychological, and social support is essential for the management of MRKH. Adequate information and sexual education plays the utmost importance in preventing social-related complications of MRKH.
METHODS: We analyzed a cross-sectional survey conducted in 2021 among Thai MSM who attended any private sex parties or circuit parties in the past 3 years ("sexualized parties").
RESULTS: Of the 424 men included in our analysis, 47.6% had been recently tested for HIV in the past 1 year, 30.2% had not recently been tested, and 22.2% had never been tested. In our multivariable analysis, relative to participants who had recently tested for HIV, those who have never tested were more likely to have lower education or to live outside of Bangkok, and to have attended both circuit and private sex parties (vs. private sex party only) but were less likely to report any sexually transmitted infection diagnosis or to have heard of PrEP. Participants who had an HIV test more than a year ago were more likely to have attended both circuit and private sex parties (vs. private sex parties only) but were less likely to have any sexually transmitted infection diagnosis, meet sexual partners online, or have heard of PrEP. Rates of condomless anal sex and willingness to use PrEP were similar across groups.
CONCLUSIONS: Despite the high rates of sexual risk-taking, sexualized party attendees reported suboptimal HIV testing uptake. The joint promotion of HIV testing and PrEP is warranted-especially on-premise HIV testing at circuit parties and outreach at online platforms to reach sexualized party attendees.
METHODS: A cross-sectional study was carried out among 1294 married Malaysian older couples who were randomly selected from all 14 states in Malaysia. The data were collected by trained enumerators using a set of validated questionnaires consisting of eight sections, namely sociodemographic characteristics, chronic diseases, perceived health status, life satisfaction, body mass index, disability status (World Health Organization Disability Assessment Schedule), social support (Lubben Social Network Scale) and sexual intimacy.
RESULTS: Having good social support (AOR 0.57, 95% CI 0.45-0.74) from family and friends were protective determinants against poor sexual intimacy in later life. Meanwhile, those who were aged 70-79 years (AOR 1.81, 95% CI 1.35-2.42), aged >80 years (AOR 35.49, 95% CI 4.80-262.18), women (AOR 1.47, 95% CI 1.13-1.90), non-Malay (AOR 1.93, 95% CI 1.50-2.48), received only informal education (AOR 1.81, 95% CI 1.35-2.42), had gastritis (AOR 2.62, 95% CI 1.58-4.34), had a stroke (AOR 3.83, 95% CI 1.04-14.12), perceived their current health status was satisfactory (AOR 1.52, 95% CI 1.15-2.00) and disabled based on the World Health Organization Disability Assessment Schedule (AOR 3.14, 95% CI 1.34-7.36) were at risk of poor sexual intimacy.
CONCLUSIONS: The majority of older Malaysian couples were having poor sexual intimacy despite being still married and sleeping with their partners, reflecting the presence of underlying barriers towards sexual intimacy in later life among older Malaysians. Geriatr Gerontol Int 2019; 19: 492-496.