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Tang W, Xie Y, Xiong M, Wu D, Ong JJ, Wi TE, Yang B, Tucker JD, Wang C. A Pay-It-Forward Approach to Improve Chlamydia and Gonorrhea Testing Uptake Among Female Sex Workers in China: Venue-Based Superiority Cluster Randomized Controlled Trial. JMIR Public Health Surveill 2023; 9:e43772. [PMID: 36862485 PMCID: PMC10020898 DOI: 10.2196/43772] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Regular chlamydia and gonorrhea testing are essential for key populations, such as female sex workers (FSWs). However, testing cost, stigma, and lack of access prevent FSWs in low- and middle-income countries from receiving chlamydia and gonorrhea testing. A social innovation to address these problems is "pay it forward," where an individual receives a gift (free testing) and then asks whether they would like to give a gift to another person in the community. OBJECTIVE This cluster randomized controlled trial examined the effectiveness and cost of the pay-it-forward strategy in increasing access to chlamydia and gonorrhea testing among FSWs in China. METHODS This trial integrated a pay-it-forward approach into a community-based HIV outreach service. FSWs (aged 18 years or older) were invited by an outreach team from 4 Chinese cities (clusters) to receive free HIV testing. The 4 clusters were randomized into 2 study arms in a 1:1 ratio: a pay-it-forward arm (offered chlamydia and gonorrhea testing as a gift) and a standard-of-care arm (out-of-pocket cost for testing: US $11). The primary outcome was chlamydia and gonorrhea test uptake, as ascertained by administrative records. We conducted an economic evaluation using a microcosting approach from a health provider perspective, reporting our results in US dollars (at 2021 exchange rates). RESULTS Overall, 480 FSWs were recruited from 4 cities (120 per city). Most FSWs were aged ≥30 years (313/480, 65.2%), were married (283/480, 59%), had an annual income CONCLUSIONS The pay-it-forward strategy has the potential to enhance chlamydia and gonorrhea testing for Chinese FSWs and may be useful for scaling up preventive services. Further implementation research is needed to inform the transition of pay-it-forward research into practice. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000037653; https://www.chictr.org.cn/showprojen.aspx?proj=57233.
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Affiliation(s)
- Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
| | - Yewei Xie
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
- Health Service & System Research programme, Duke-NUS Medical School, Singapore, Singapore
| | - Mingzhou Xiong
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
| | - Dan Wu
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Jason J Ong
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia
| | - Teodora Elvira Wi
- Department of Global HIV, Hepatitis and STI Programmes, World Health Organization Headquarters, Geneva, Switzerland
| | - Bin Yang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
| | - Joseph D Tucker
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Cheng Wang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
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Sun HT, Fan XR, Gu YZ, Lu YH, Qiu JL, Yang QL, Li JH, Gu J, Hao C. WeChat-based HIV E-report, A New Manner for HIV Serostatus Request and Disclosure and Their Associated Factors Among Men Who Have Sex with Men: Prospective Subgroup Analysis of Randomized Controlled Trails (Preprint). JMIR Mhealth Uhealth 2022; 11:e44513. [PMID: 37155223 DOI: 10.2196/44513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Requesting and disclosing HIV serostatus is associated with a reduction in HIV transmission among men who have sex with men (MSM). However, the reliability of common methods for HIV serostatus requests and disclosure is unsatisfactory. Validated approaches for requesting and disclosing HIV serostatus are necessary. OBJECTIVE The objective of this study was to investigate the use of the HIV e-report as authentic evidence of HIV serostatus among the MSM community in Guangzhou, China. Additionally, the study aimed to explore its correlates with HIV serostatus requesting and disclosure receiving behavior. METHODS This study is a subgroup analysis of a cluster randomized controlled trial (RCT) that enrolled 357 participants during the first year. Participants in this RCT were recruited from the WeChat-based HIV testing service miniprogram developed by Guangzhou Center for Disease Control and Prevention, China. Participants completed web-based questionnaires at baseline and at the month 3 follow-up, which covered sociodemographic characteristics, HIV-related information, HIV serostatus requests, HIV serostatus disclosure receiving, and HIV e-report usage. Univariate and multivariate logistic regressions were used for data analysis. RESULTS The WeChat-based HIV e-report was available in Guangzhou when the RCT project started. At the month 3 follow-up, 32.2% (115/357) of participants had their own HIV e-reports, and 37.8% (135/357) of them had received others' HIV e-reports. For HIV serostatus requests, 13.1% (27/205) and 10.5% (16/153) of participants started to use HIV e-reports to ask the HIV serostatus of regular and casual male sex partners, respectively. Of the regular and casual male sex partners, 27.3% (42/154) and 16.5% (18/109), respectively, chose HIV e-reports to disclose HIV serostatus. Compared to MSM who did not have HIV e-reports, those who said, "I had had my own HIV e-report(s) but hadn't sent to others" (multivariate odds ratio 2.71, 95% CI 1.19-6.86; P=.02) and "I had had my own HIV e-reports and had sent to others" (multivariate odds ratio 2.67, 95% CI 1.07-7.73; P=.048) were more likely to request HIV serostatus from their partners. Whereas no factor was associated with HIV serostatus disclosure received from partners. CONCLUSIONS The HIV e-report has been accepted by the MSM community in Guangzhou and could be applied as a new optional way for HIV serostatus request and disclosure. This innovative intervention could be effective in promoting infectious disease serostatus disclosure among the related high-risk population. TRIAL REGISTRATION ClinicalTrials.gov NCT03984136; https://clinicaltrials.gov/show/NCT03984136. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12879-021-06484-y.
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Affiliation(s)
- Hai-Tong Sun
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Sun Yat‑Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, China
| | - Xiao-Ru Fan
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Sun Yat‑Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, China
| | - Yu-Zhou Gu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Yong-Heng Lu
- Lingnan Community Support Center, Guangzhou, China
| | - Jia-Ling Qiu
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Sun Yat‑Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, China
| | - Qing-Ling Yang
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Sun Yat‑Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, China
| | - Jing-Hua Li
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Sun Yat‑Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, China
| | - Jing Gu
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Sun Yat‑Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, China
| | - Chun Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Sun Yat‑Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, China
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3
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Xu X, Fairley CK, Chow EPF, Lee D, Aung ET, Zhang L, Ong JJ. Using machine learning approaches to predict timely clinic attendance and the uptake of HIV/STI testing post clinic reminder messages. Sci Rep 2022; 12:8757. [PMID: 35610227 PMCID: PMC9128330 DOI: 10.1038/s41598-022-12033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/07/2022] [Indexed: 11/09/2022] Open
Abstract
Timely and regular testing for HIV and sexually transmitted infections (STI) is important for controlling HIV and STI (HIV/STI) among men who have sex with men (MSM). We established multiple machine learning models (e.g., logistic regression, lasso regression, ridge regression, elastic net regression, support vector machine, k-nearest neighbour, naïve bayes, random forest, gradient boosting machine, XGBoost, and multi-layer perceptron) to predict timely (i.e., within 30 days) clinic attendance and HIV/STI testing uptake after receiving a reminder message via short message service (SMS) or email). Our study used 3044 clinic consultations among MSM within 12 months after receiving an email or SMS reminder at the Melbourne Sexual Health Centre between April 11, 2019, and April 30, 2020. About 29.5% [899/3044] were timely clinic attendance post reminder messages, and 84.6% [761/899] had HIV/STI testing. The XGBoost model performed best in predicting timely clinic attendance [mean [SD] AUC 62.8% (3.2%); F1 score 70.8% (1.2%)]. The elastic net regression model performed best in predicting HIV/STI testing within 30 days [AUC 82.7% (6.3%); F1 score 85.3% (1.8%)]. The machine learning approach is helpful in predicting timely clinic attendance and HIV/STI re-testing. Our predictive models could be incorporated into clinic websites to inform sexual health care or follow-up service.
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Affiliation(s)
- Xianglong Xu
- Central Clinical School, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, The Alfred, Melbourne, 3053, Australia
| | - Christopher K Fairley
- Central Clinical School, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, The Alfred, Melbourne, 3053, Australia
| | - Eric P F Chow
- Central Clinical School, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, The Alfred, Melbourne, 3053, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - David Lee
- Melbourne Sexual Health Centre, The Alfred, Melbourne, 3053, Australia
| | - Ei T Aung
- Central Clinical School, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, The Alfred, Melbourne, 3053, Australia
| | - Lei Zhang
- Central Clinical School, Monash University, Melbourne, Australia. .,Melbourne Sexual Health Centre, The Alfred, Melbourne, 3053, Australia. .,China Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, China. .,Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
| | - Jason J Ong
- Central Clinical School, Monash University, Melbourne, Australia. .,Melbourne Sexual Health Centre, The Alfred, Melbourne, 3053, Australia. .,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
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4
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Otsuki A, Saito J, Yaguchi‐Saito A, Odawara M, Fujimori M, Hayakawa M, Katanoda K, Matsuda T, Matsuoka YJ, Takahashi H, Takahashi M, Inoue M, Yoshimi I, Kreps GL, Uchitomi Y, Shimazu T. A nationally representative cross‐sectional survey on health information access for consumers in Japan: A protocol for the INFORM Study. WORLD MEDICAL & HEALTH POLICY 2022. [DOI: 10.1002/wmh3.506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Aki Otsuki
- Division of Behavioral Sciences, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Junko Saito
- Division of Behavioral Sciences, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Akiko Yaguchi‐Saito
- Division of Behavioral Sciences, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Miyuki Odawara
- Division of Behavioral Sciences, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Maiko Fujimori
- Division of Behavioral Sciences, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Masayo Hayakawa
- Division of Cancer Information Service, Center for Cancer Control and Information Services National Cancer Center Tokyo Japan
| | - Kota Katanoda
- Division of Cancer Statistics Integration, Center for Cancer Control and Information Services National Cancer Center Tokyo Japan
| | - Tomohiro Matsuda
- Center for Cancer Registries, Center for Cancer Control and Information Services National Cancer Center Tokyo Japan
| | - Yutaka J. Matsuoka
- Division of Health Care Research, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Hirokazu Takahashi
- Division of Cancer Screening Assessment and Management, Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Miyako Takahashi
- Division of Cancer Survivorship Research, Center for Cancer Control and Information Services National Cancer Center Tokyo Japan
- Japan Cancer Survivorship Network Tokyo Japan
- School of Medicine Iwate Medical University Iwate Japan
- Faculty of Medicine The Jikei University School of Medicine Tokyo Japan
| | - Manami Inoue
- Division of Prevention, Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Itsuro Yoshimi
- Division of Tabacco Policy Research, Center for Cancer Control and Information Services National Cancer Center Tokyo Japan
| | - Gary L. Kreps
- Department of Communication, Center for Health and Risk Communication George Mason University Fairfax Virginia USA
| | - Yosuke Uchitomi
- Division of Behavioral Sciences, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences National Cancer Center Tokyo Japan
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5
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Xu X, Ge Z, Chow EPF, Yu Z, Lee D, Wu J, Ong JJ, Fairley CK, Zhang L. A Machine-Learning-Based Risk-Prediction Tool for HIV and Sexually Transmitted Infections Acquisition over the Next 12 Months. J Clin Med 2022; 11:jcm11071818. [PMID: 35407428 PMCID: PMC8999359 DOI: 10.3390/jcm11071818] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background: More than one million people acquire sexually transmitted infections (STIs) every day globally. It is possible that predicting an individual’s future risk of HIV/STIs could contribute to behaviour change or improve testing. We developed a series of machine learning models and a subsequent risk-prediction tool for predicting the risk of HIV/STIs over the next 12 months. Methods: Our data included individuals who were re-tested at the clinic for HIV (65,043 consultations), syphilis (56,889 consultations), gonorrhoea (60,598 consultations), and chlamydia (63,529 consultations) after initial consultations at the largest public sexual health centre in Melbourne from 2 March 2015 to 31 December 2019. We used the receiver operating characteristic (AUC) curve to evaluate the model’s performance. The HIV/STI risk-prediction tool was delivered via a web application. Results: Our risk-prediction tool had an acceptable performance on the testing datasets for predicting HIV (AUC = 0.72), syphilis (AUC = 0.75), gonorrhoea (AUC = 0.73), and chlamydia (AUC = 0.67) acquisition. Conclusions: Using machine learning techniques, our risk-prediction tool has acceptable reliability in predicting HIV/STI acquisition over the next 12 months. This tool may be used on clinic websites or digital health platforms to form part of an intervention tool to increase testing or reduce future HIV/STI risk.
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Affiliation(s)
- Xianglong Xu
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3053, Australia; (X.X.); (E.P.F.C.); (D.L.); (J.J.O.); (C.K.F.)
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia;
- China Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an 710061, China
| | - Zongyuan Ge
- Monash e-Research Centre, Faculty of Engineering, Airdoc Research, Nvidia AI Technology Research Centre, Monash University, Melbourne, VIC 3800, Australia;
| | - Eric P. F. Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3053, Australia; (X.X.); (E.P.F.C.); (D.L.); (J.J.O.); (C.K.F.)
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia;
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia
| | - Zhen Yu
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia;
- Monash e-Research Centre, Faculty of Engineering, Airdoc Research, Nvidia AI Technology Research Centre, Monash University, Melbourne, VIC 3800, Australia;
| | - David Lee
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3053, Australia; (X.X.); (E.P.F.C.); (D.L.); (J.J.O.); (C.K.F.)
| | - Jinrong Wu
- Research Centre for Data Analytics and Cognition, La Trobe University, Bundoora, VIC 3086, Australia;
| | - Jason J. Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3053, Australia; (X.X.); (E.P.F.C.); (D.L.); (J.J.O.); (C.K.F.)
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia;
- China Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an 710061, China
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3053, Australia; (X.X.); (E.P.F.C.); (D.L.); (J.J.O.); (C.K.F.)
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia;
- China Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an 710061, China
| | - Lei Zhang
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC 3053, Australia; (X.X.); (E.P.F.C.); (D.L.); (J.J.O.); (C.K.F.)
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia;
- China Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Centre, Xi’an 710061, China
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
- Correspondence:
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6
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Shi Y, Qiu J, Yang Q, Chen T, Lu Y, Chen S, Fan X, Lin Z, Han Z, Lu J, Qian H, Gu J, Xu DR, Gu Y, Hao C. Increasing the HIV testing among MSM through HIV test result exchange mechanism: study protocol for a cluster randomized controlled trial. BMC Infect Dis 2021; 21:764. [PMID: 34362323 PMCID: PMC8343929 DOI: 10.1186/s12879-021-06484-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
Background HIV testing is an essential gateway to HIV prevention and treatment thus controlling the HIV epidemic. More innovative interventions are needed to increase HIV testing among men who have sex with men (MSM) since their testing rate is still low. We proposed an online HIV test results exchange mechanism whereby the one without a certified online HIV report will be asked to test HIV for exchanging HIV report with others. The exchange mechanism is developed as an extension to the existing online HIV testing service system. Through the extended system, MSM can obtain certified online HIV reports and exchange their reports with friends via WeChat. This study aims to assess effectiveness of the exchange mechanism to increase the HIV testing rate among MSM. Methods This study will use a cluster randomized controlled trial (RCT) design. Participants are recruited based on the unit of individual social network, the sender and the receivers of the HIV report. An individual social network is composed of one sender (ego) and one or more receivers (alters). In this study, MSM in an HIV testing clinic are recruited as potential egos and forwarded online reports to their WeChat friends voluntarily. Friends are invited to participate by report links and become alters. Ego and alters serve as a cluster and are randomized to the group using the certified online HIV report with exchange mechanism (intervention group) or without exchange mechanism (control group). Alters are the intervention targeting participants. The primary outcome is HIV testing rate. Other outcomes are sexual transmitted infections, sexual behaviors, HIV testing norms, stigma, risk perception and HIV report delivery. The outcomes will be assessed at baseline and follow-up questionnaires. Analysis will be according to intention to treat approach and using mixed-effect models with networks and individuals as random effects. Discussion This is the first study to evaluate the effectiveness of an HIV test result exchange mechanism to increase the HIV testing among MSM. This assessment of the intervention will also provide scientific evidence on other potential effects. Findings from this study will yield insights for sustainability driven by communities' intrinsic motivation. Trail registration: ClinicalTrials.gov NCT03984136. Registered 12 June 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06484-y.
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Affiliation(s)
- Yuning Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China.,Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China
| | - Jialing Qiu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China.,Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China
| | - Qingling Yang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China.,Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China
| | - Tailin Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China.,Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China
| | - Yongheng Lu
- Kangyuan Community Support Center of Yuexiu District, Guangzhou, 510000, Guangdong, P. R. China
| | - Sha Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China.,Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China
| | - Xiaoru Fan
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China.,Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China
| | - Zhiye Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China.,Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China
| | - Zhigang Han
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, Guangdong, P. R. China
| | - Jie Lu
- Kangyuan Community Support Center of Yuexiu District, Guangzhou, 510000, Guangdong, P. R. China
| | - Haobing Qian
- Department of Health Management and Policy, College of Public Health, The University of Iowa, Iowa, IA, USA
| | - Jing Gu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China.,Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China
| | - Dong Roman Xu
- Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, 510000, Guangdong, P. R. China.,ACACIA Labs, SMU Institute for Global Health and Dermatology Hospital of Southern Medical University, Guangzhou, 510000, Guangdong, P. R. China
| | - Yuzhou Gu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, Guangdong, P. R. China.
| | - Chun Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China. .,Sun Yat-Sen Global Health Institute, Institute of State Governance, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, P. R. China.
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7
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Kaushal A, Bravo C, Duffy S, Lewins D, Möhler R, Raine R, Vlaev I, Waller J, von Wagner C. Development of Reporting Guidelines for Social Media Research (RESOME) using a modified Delphi Method: Study protocol (Preprint). JMIR Res Protoc 2021; 11:e31739. [PMID: 35532999 PMCID: PMC9127642 DOI: 10.2196/31739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions International Registered Report Identifier (IRRID)
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Affiliation(s)
- Aradhna Kaushal
- Research Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Caroline Bravo
- Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
| | - Stephen Duffy
- Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Douglas Lewins
- Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Ralph Möhler
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Rosalind Raine
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Ivo Vlaev
- Behavioural Science Group, Warwick Business School, University of Warwick, Coventry, United Kingdom
| | - Jo Waller
- School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Christian von Wagner
- Research Department of Behavioural Science and Health, University College London, London, United Kingdom
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Aya Pastrana N, Lazo-Porras M, Miranda JJ, Beran D, Suggs LS. Social marketing interventions for the prevention and control of neglected tropical diseases: A systematic review. PLoS Negl Trop Dis 2020; 14:e0008360. [PMID: 32555705 PMCID: PMC7299328 DOI: 10.1371/journal.pntd.0008360] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 05/04/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Social marketing is an approach to behavior change that contributes to disease prevention and control. This study aimed to understand how social marketing interventions have addressed neglected tropical diseases (NTDs). It examined the characteristics, breadth of coverage, and outcomes of social marketing interventions focused on the prevention and control of these diseases. METHODOLOGY/PRINCIPAL FINDINGS Studies published in any language between January 1971 and April 2017, targeting at least one of the 17 NTDs prioritized in the World Health Organization (WHO) NTD Roadmap were considered. Included studies had interventions that applied both, at least one core social marketing concept, "social behavioral influence", and one social marketing technique, "integrated intervention mix", described in the Hierarchical Model of Social Marketing. This review is registered with PROSPERO CRD42017063858. Twenty interventions, addressing eight NTDs, met the inclusion criteria. They focused on behaviors related to four of the five WHO public health strategies for NTDs. Most interventions incorporated the concepts "relationship building" and "public / people orientation focus", and the technique "insight-driven segmentation". All the interventions reported changing behavioral determinants such as knowledge, 19 reported behavior change, and four influenced health outcomes. CONCLUSION/SIGNIFICANCE Evidence from this study shows that social marketing has been successfully used to address behaviors related to most of the five public health strategic interventions for NTDs recommended by the WHO. It is suggested that social marketing interventions for the prevention and control of NTDs be grounded on an understanding of the audience and adapted to the contexts intervened. Building stakeholder relationships as early as possible, and involving the publics could help in reaching NTD outcomes. Elements of the intervention mix should be integrated and mutually supportive. Incorporating health education and capacity building, as well as being culturally appropriate, is also relevant. It is recommended that ongoing discussions to formulate the targets and milestones of the new global Roadmap for NTDs integrate social marketing as an approach to overcome these diseases.
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Affiliation(s)
- Nathaly Aya Pastrana
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
| | - Maria Lazo-Porras
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - J. Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - David Beran
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Swiss School of Public Health+, Zurich, Switzerland
| | - L. Suzanne Suggs
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
- Swiss School of Public Health+, Zurich, Switzerland
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Olusanya OO, Wigfall LT, Rossheim ME, Tomar A, Barry AE. Binge drinking, HIV/HPV co-infection risk, and HIV testing: Factors associated with HPV vaccination among young adults in the United States. Prev Med 2020; 134:106023. [PMID: 32061685 PMCID: PMC7195993 DOI: 10.1016/j.ypmed.2020.106023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/12/2020] [Accepted: 02/10/2020] [Indexed: 12/30/2022]
Abstract
Human papillomavirus (HPV) is a common sexually transmitted infection. Binge drinkers often engage in HIV/HPV co-infection high-risk behaviors. We examined the association between binge drinking, HIV/HPV co-infection risk, HIV testing and HPV vaccination among young adults. Data from the 2017 Behavioral Risk Factor Surveillance System survey were examined. Participants (N = 430/450,016; 0.11%) were HPV vaccine-eligible young adults ages 18-26 years. Multivariable logistic regression examined the association between binge drinking in the past 30 days, HIV/HPV co-infection high-risk risk behaviors, HIV testing, and HPV vaccination (initiated/completed, unvaccinated) among young adults. Respondents were primarily cisgender (99.8%), non-Hispanic White (41.4%), employed (46.2%) or student (35.4%), and insured (68.2%). Most did not binge drink (55.2%). The majority did not engage in HIV/HPV co-infection high-risk risk behaviors (78.2%). More than one-half had never been tested for HIV (59%) nor vaccinated against HPV (60.6%). Although binge drinkers (44.8%) were significantly more likely to engage in HIV/HPV co-infection high-risk behaviors (OR = 2.1; 95% CI: 1.0-4.5), binge drinking was not positively associated with HIV testing (OR = 0.98; 95% CI: 0.63-1.53). After adjusting for demographics and HIV/HPV co-infection high-risk behaviors, one (aOR = 2.71; 95% CI: 1.11-6.65) and two episodes (aOR = 3.05; 95% CI: 1.26-7.41) of binge drinking in the past 30 days were significantly associated with HPV vaccination uptake. Positive associations between HPV vaccination and participants having an HIV test in 2017 (aOR = 3.86; 95% CI: 1.42-10.55) and before 2017 (aOR = 2.62; 95% CI: 1.23-5.56) were also statistically significant. Because young adult binge drinkers are more likely to engage in HIV/HPV co-infection high-risk behaviors, promoting HPV vaccination and HIV testing are important public health objectives.
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Affiliation(s)
- O O Olusanya
- Department of Biology, Texas A&M University, Butler Hall, 3258, 525 Lubbock Street, College Station, TX 77843, United States of America.
| | - L T Wigfall
- Texas A&M University, College of Education and Human Development, Department of Health and Kinesiology, Division of Health Education, United States of America.
| | - M E Rossheim
- Department of Global and Community Health, George Mason University, 4400 University Drive, MS5B7, Peterson Family Health Sciences Hall, Fairfax, VA 22030, United States of America.
| | - A Tomar
- Texas A&M University, College of Education and Human Development, Department of Health and Kinesiology, Division of Health Education, United States of America.
| | - A E Barry
- Texas A&M University, College of Education and Human Development, Department of Health and Kinesiology, Division of Health Education, United States of America.
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Feinstein BA, Dodge B. Meeting the Sexual Health Needs of Bisexual Men in the Age of Biomedical HIV Prevention: Gaps and Priorities. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:217-232. [PMID: 31691076 PMCID: PMC7018582 DOI: 10.1007/s10508-019-01468-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 05/09/2019] [Accepted: 05/14/2019] [Indexed: 05/02/2023]
Abstract
The field of HIV/STI prevention has primarily focused on gay men (or "men who have sex with men" [MSM] as a broad category) with limited attention to bisexual men in particular. Although bisexual men are also at increased risk for HIV and other STI, they are less likely to utilize HIV/STI prevention services than gay men, and very few interventions have been developed to address their unique needs. Further, while biomedical advances are changing the field of HIV prevention, bisexual men are also less likely to use biomedical HIV prevention strategies (e.g., pre-exposure prophylaxis [PrEP]) than gay men. In an effort to advance research on bisexual men and their sexual health needs, the goals of this commentary are: (1) to review the empirical literature on the prevalence of HIV/STI among bisexual men, the few existing HIV/STI prevention interventions developed for bisexual men, and the use of biomedical HIV prevention among bisexual men; (2) to describe the ways in which the field of HIV/STI prevention has largely overlooked bisexual men as a population in need of targeted services; and (3) to discuss how researchers can better address the sexual health needs of bisexual men in the age of biomedical HIV prevention.
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Affiliation(s)
- Brian A Feinstein
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., #14-047, Chicago, IL, 60611, USA.
| | - Brian Dodge
- Indiana University School of Public Health, Bloomington, IN, USA
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11
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The Effectiveness of Social Marketing Interventions to Improve HIV Testing Among Gay, Bisexual and Other Men Who Have Sex with Men: A Systematic Review. AIDS Behav 2019; 23:2273-2303. [PMID: 31006047 PMCID: PMC6766472 DOI: 10.1007/s10461-019-02507-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
HIV testing is central to biomedical HIV prevention, but testing among men who have sex with men remains suboptimal. We evaluated effectiveness of mass media and communication interventions to increase HIV testing and explored patterns between study type, internal validity and intervention effectiveness for the first time. Five databases were searched for articles published between 2009 and 2016 using standard MeSH terms. Eligible studies were quality appraised using standard checklists for risk of bias. Data were extracted and synthesised narratively. Nineteen studies met inclusion criteria; 11 were cross-sectional/non-comparative studies, four were pre/post or interrupted time series, three were randomised controlled trials (RCTs) and one was a case study. Risk of bias was high. Five cross-sectional (two graded as high internal validity, one medium and two low) and one RCT (medium validity) reported increased HIV testing. Further work is required to develop and evaluate interventions to increase frequency and maintenance of HIV testing.
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12
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Flowers P, Riddell J, Boydell N, Teal G, Coia N, McDaid L. What are mass media interventions made of? Exploring the active content of interventions designed to increase HIV testing in gay men within a systematic review. Br J Health Psychol 2019; 24:704-737. [PMID: 31267624 PMCID: PMC7058418 DOI: 10.1111/bjhp.12377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 05/12/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Mass media HIV testing interventions are effective in increasing testing, but there has been no examination of their theory or behaviour change technique (BCT) content. Within a heterogeneous body of studies with weak evaluative designs and differing outcomes, we attempted to gain useful knowledge to shape future interventions. METHODS Within a systematic review, following repeated requests to the authors of included studies for intervention materials, the Theory Coding Scheme, the Theoretical Domains Framework (TDF), and Behaviour Change Technique Taxonomy (BCTT) were used to extract data relating to active intervention content. RESULTS Of 19 studies, five reported an explicit theoretical basis to their intervention. TDF analysis highlighted the key domains employed within the majority of interventions: 'knowledge', 'social roles and identities', and 'beliefs about consequences'. BCT analysis showed three BCT groupings commonly reported within interventions: 'Comparison of outcomes', 'Natural consequences', and 'Shaping knowledge'. Three individual BCTs formed the backbone of most interventions and can be considered 'standard' content: 'Instructions on how to perform behaviour'; 'Credible source'; and 'Information about health consequences'. CONCLUSIONS This is the first study to examine and detail active intervention content in this field. It suggests future interventions should improve knowledge about testing, and use well-branded and trusted sources that endorse testing. Future interventions should also provide clear information about the health benefits of testing. Our analysis also suggests that to improve levels of effectiveness characterizing the current field, it may be useful to elicit commitment, and action plans, relating to how to implement testing intentions. STATEMENT OF CONTRIBUTION What is already known on this subject? Interventions are urgently needed to increase HIV testing among men who have sex with men (MSM) and enable increased access to effective treatment for HIV infection. There is some evidence of the effectiveness of mass media interventions in increasing HIV testing among MSM. Nothing is known about the active components of existing mass media interventions targeting HIV testing. What does this study add? It describes the available literature concerning evaluated mass media interventions to increase HIV testing. It shows few interventions report any explicit theoretical basis although many interventions share common components, including coherently connected causal mechanisms and behaviour change techniques to moderate them. As a minimum, future interventions should improve knowledge about testing; use well-branded and trusted sources that endorse testing; and provide clear information about the health benefits of testing. Our analysis also tentatively suggests it may be useful to elicit commitment and planning of how to implement testing intentions.
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Affiliation(s)
- Paul Flowers
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowUK
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowUK
| | - Nicola Boydell
- Usher Institute of Population Health Sciences and InformaticsUniversity of EdinburghUK
| | - Gemma Teal
- Innovation School, The Glasgow School of ArtUK
| | | | - Lisa McDaid
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowUK
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13
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Abstract
As of 2017, the Centers for Disease Control and Prevention (CDC) HIV testing guidelines recommend that those at increased risk for HIV are tested two to four times per year. Evidence-based interventions that promote frequent and repeated testing remain sparse. We conducted a systematic review to: (1) identify frequent testing interventions; and (2) determine which were successful in increasing frequent testing rates. We searched PubMed, PsycINFO, Web of Science, Embase, and CINAHL for peer-reviewed articles published between January 1, 2010 and September 30, 2017. Ten studies met inclusion criteria. Operationalization of frequent HIV testing varied widely across studies. Four interventions involved text message reminders for HIV testing, three involved community-based testing, two self-testing, and one rapid testing. Text message reminder interventions were most successful in increasing rates of frequent HIV testing. Future research should standardize frequent testing measurement to allow for more robust comparisons of intervention efficacy.
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14
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Tang W, Mao J, Liu C, Mollan K, Zhang Y, Tang S, Hudgens M, Ma W, Kang D, Wei C, Tucker JD. Reimagining Health Communication: A Noninferiority Randomized Controlled Trial of Crowdsourced Intervention in China. Sex Transm Dis 2019; 46:172-178. [PMID: 30741854 PMCID: PMC6380681 DOI: 10.1097/olq.0000000000000930] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Crowdsourcing, the process of shifting individual tasks to a large group, may be useful for health communication, making it more people-centered. We aimed to evaluate whether a crowdsourced video is noninferior to a social marketing video in promoting condom use. METHODS Men who have sex with men (≥16 years old, had condomless sex within 3 months) were recruited and randomly assigned to watch 1 of the 2 videos in 2015. The crowdsourced video was developed through an open contest, and the social marketing video was designed by using social marketing principles. Participants completed a baseline survey and follow-up surveys at 3 weeks and 3 months postintervention. The outcome was compared with a noninferiority margin of +10%. RESULTS Among the 1173 participants, 907 (77%) and 791 (67%) completed the 3-week and 3-month follow-ups. At 3 weeks, condomless sex was reported by 146 (33.6%) of 434 participants and 153 (32.3%) 473 participants in the crowdsourced and social marketing arms, respectively. The crowdsourced intervention achieved noninferiority (estimated difference, +1.3%; 95% confidence interval, -4.8% to 7.4%). At 3 months, 196 (52.1%) of 376 individuals and 206 (49.6%) of 415 individuals reported condomless sex in the crowdsourced and social-marketing arms (estimated difference: +2.5%, 95% confidence interval, -4.5 to 9.5%). The 2 arms also had similar human immunodeficiency virus testing rates and other condom-related secondary outcomes. CONCLUSIONS Our study demonstrates that crowdsourced message is noninferior to a social marketing intervention in promoting condom use among Chinese men who have sex with men. Crowdsourcing contests could have a wider reach than other approaches and create more people-centered intervention tools for human immunodeficiency virus control.
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Affiliation(s)
- Weiming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
- SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
- School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Jessica Mao
- SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
| | - Chuncheng Liu
- SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
| | - Katie Mollan
- School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Ye Zhang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
- SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
| | - Songyuan Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
| | - Michael Hudgens
- Department of Biostatistics of University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Wei Ma
- School of Public Health, Shandong University, Jinan, China
| | - Dianmin Kang
- Shandong Provincial Center for Disease Prevention and Control, Jinan, China
| | | | - Joseph D. Tucker
- University of North Carolina at Chapel Hill Project-China, Guangzhou, China
- SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
- School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - SESH study group
- SESH study group: Terrence Wong, Haochu Li, Yilu Qin, Bin Yang, Meizhen Liao, Lisa Hightow-Weidman, Barry Bayus, Fern Terris-Prestholt, Ligang Yang, Rosanna Peeling, Kevin Fenton, Shuj, ie Huang, Cheng Wang, Heping Zheng, Peter Vickerman, Kate M Mitchell, Zihuang Cheng, John Best, Thitikarn May Tangthanasup, Larry Han, and Ngai Sze Wong, Lai Sze Tso, Wei Zhang
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15
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Gilbert M, Salway T, Haag D, Kwag M, Edward J, Bondyra M, Cox J, Hart TA, Grace D, Grennan T, Ogilvie G, Shoveller J. Assessing the Impact of a Social Marketing Campaign on Program Outcomes for Users of an Internet-Based Testing Service for Sexually Transmitted and Blood-Borne Infections: Observational Study. J Med Internet Res 2019; 21:e11291. [PMID: 30664456 PMCID: PMC6360387 DOI: 10.2196/11291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND While social marketing (SM) campaigns can be effective in increasing testing for sexually transmitted and blood-borne infections (STBBIs), they are seldom rigorously evaluated and often rely on process measures (eg, Web-based ad click-throughs). With Web-based campaigns for internet-based health services, there is a potential to connect campaign process measures to program outcomes, permitting the assessment of venue-specific yield based on health outcomes (eg, click-throughs per test). OBJECTIVE This study aims to evaluate the impact of an SM campaign by the promotional venue on use and diagnostic test results of the internet-based STBBI testing service GetCheckedOnline.com (GCO). METHODS Through GCO, clients create an account using an access code, complete a risk assessment, print a lab form, submit specimens at a lab, and get results online or by phone. From April to August 2015, a campaign promoted GCO to gay, bisexual, and other men who have sex with men in Vancouver, Canada. The campaign highlighted GCO's convenience in 3 types of promotional venues-location advertisements in print or video displayed in gay venues or events, ads on a queer news website, and ads on geosocial websites and apps. Where feasible, individuals were tracked from campaign exposures to account creation and testing using venue-specific GCO access codes. In addition, Web-based ads were linked to alternate versions of the campaign website, which used URLs with embedded access codes to connect ad exposure to account creation. Furthermore, we examined the number of individuals creating GCO accounts, number tested, and cost per account created and test for each venue type. RESULTS Over 6 months, 177 people created a GCO account because of the campaign, where 22.0% (39/177) of these completed testing; the overall cost was Can $118 per account created and Can $533 per test. Ads on geosocial websites and apps accounted for 46.9% (83/177) of all accounts; ads on the news website had the lowest testing rate and highest cost per test. We observed variation between different geosocial websites and apps with some ads having high click-through rates yet low GCO account creation rates, and vice versa. CONCLUSIONS Developing mechanisms to track individuals from Web-based exposure to SM campaigns to outcomes of internet-based health services permits greater evaluation of the yield and cost-effectiveness of different promotional efforts. Web-based ads with high click-through rates may not have a high conversion to service use, the ultimate outcome of SM campaigns.
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Affiliation(s)
- Mark Gilbert
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Travis Salway
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Devon Haag
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Michael Kwag
- Community Based Research Centre for Gay Men's Health, Vancouver, BC, Canada
| | | | - Mark Bondyra
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Joseph Cox
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Trevor A Hart
- Department of Psychology, Ryerson University, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Troy Grennan
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Division of Infectious Diseases, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Gina Ogilvie
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jean Shoveller
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Boudewyns V, Paquin RS, Uhrig JD, Badal H, August E, Stryker JE. An Interrupted Time Series Evaluation of the Testing Makes Us Stronger HIV Campaign for Black Gay and Bisexual Men in the United States. JOURNAL OF HEALTH COMMUNICATION 2018; 23:865-873. [PMID: 30307784 DOI: 10.1080/10810730.2018.1528318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Black gay, bisexual, and other men who have sex with men (BMSM) are the subpopulation most disproportionately affected by HIV in the United States. Testing Makes Us Stronger (TMUS), a communication campaign designed to increase HIV testing rates among BMSM ages 18 to 44, was implemented in the United States from December 2011 through September 2015. We used interrupted time series analysis (ITSA) to compare pre- and post-campaign trends in monthly HIV testing events among the priority audience in six of the implementation cities from January 2011 through December 2014. In the 11 months prior to the launch of TMUS, HIV testing events among BMSM in the six campaign implementation cities decreased by nearly 35 tests per month (p = .021). After the introduction of TMUS, the number of HIV testing events among BMSM in the same cities increased by more than 6 tests per month (p = .002). ITSA represents a quasi-experimental technique for investigating campaign effects beyond underlying time trends when serial outcome data are available. Future evaluations can be further strengthened by incorporating a comparison group to account for the effects of history and maturation on pre- and post-campaign trends.
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Affiliation(s)
- Vanessa Boudewyns
- a Center for Communication Science , RTI International , Minneapolis , MN , USA
| | - Ryan S Paquin
- a Center for Communication Science , RTI International , Minneapolis , MN , USA
| | - Jennifer D Uhrig
- b Center for Communication Science , RTI International , NC , USA
| | - Hannah Badal
- c Division of HIV/AIDS Prevention , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Euna August
- c Division of HIV/AIDS Prevention , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Jo Ellen Stryker
- c Division of HIV/AIDS Prevention , National Center for HIV/AIDS, Viral Hepatitis, STD, and TB, Centers for Disease Control and Prevention , Atlanta , GA , USA
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17
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Tang W, Wei C, Cao B, Wu D, Li KT, Lu H, Ma W, Kang D, Li H, Liao M, Mollan KR, Hudgens MG, Liu C, Huang W, Liu A, Zhang Y, Smith MK, Mitchell KM, Ong JJ, Fu H, Vickerman P, Yang L, Wang C, Zheng H, Yang B, Tucker JD. Crowdsourcing to expand HIV testing among men who have sex with men in China: A closed cohort stepped wedge cluster randomized controlled trial. PLoS Med 2018; 15:e1002645. [PMID: 30153265 PMCID: PMC6112627 DOI: 10.1371/journal.pmed.1002645] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/26/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND HIV testing rates are suboptimal among at-risk men. Crowdsourcing may be a useful tool for designing innovative, community-based HIV testing strategies to increase HIV testing. The purpose of this study was to use a stepped wedge cluster randomized controlled trial (RCT) to evaluate the effect of a crowdsourced HIV intervention on HIV testing uptake among men who have sex with men (MSM) in eight Chinese cities. METHODS AND FINDINGS An HIV testing intervention was developed through a national image contest, a regional strategy designathon, and local message contests. The final intervention included a multimedia HIV testing campaign, an online HIV testing service, and local testing promotion campaigns tailored for MSM. This intervention was evaluated using a closed cohort stepped wedge cluster RCT in eight Chinese cities (Guangzhou, Shenzhen, Zhuhai, and Jiangmen in Guangdong province; Jinan, Qingdao, Yantai, and Jining in Shandong province) from August 2016 to August 2017. MSM were recruited through Blued, a social networking mobile application for MSM, from July 29 to August 21 of 2016. The primary outcome was self-reported HIV testing in the past 3 months. Secondary outcomes included HIV self-testing, facility-based HIV testing, condom use, and syphilis testing. Generalized linear mixed models (GLMMs) were used to analyze primary and secondary outcomes. We enrolled a total of 1,381 MSM. Most were ≤30 years old (82%), unmarried (86%), and had a college degree or higher (65%). The proportion of individuals receiving an HIV test during the intervention periods within a city was 8.9% (95% confidence interval [CI] 2.2-15.5) greater than during the control periods. In addition, the intention-to-treat analysis showed a higher probability of receiving an HIV test during the intervention periods as compared to the control periods (estimated risk ratio [RR] = 1.43, 95% CI 1.19-1.73). The intervention also increased HIV self-testing (RR = 1.89, 95% CI 1.50-2.38). There was no effect on facility-based HIV testing (RR = 1.00, 95% CI 0.79-1.26), condom use (RR = 1.00, 95% CI 0.86-1.17), or syphilis testing (RR = 0.92, 95% CI 0.70-1.21). A total of 48.6% (593/1,219) of participants reported that they received HIV self-testing. Among men who received two HIV tests, 32 individuals seroconverted during the 1-year study period. Study limitations include the use of self-reported HIV testing data among a subset of men and non-completion of the final survey by 23% of participants. Our study population was a young online group in urban China and the relevance of our findings to other populations will require further investigation. CONCLUSIONS In this setting, crowdsourcing was effective for developing and strengthening community-based HIV testing services for MSM. Crowdsourced interventions may be an important tool for the scale-up of HIV testing services among MSM in low- and middle-income countries (LMIC). TRIAL REGISTRATION ClinicalTrials.gov NCT02796963.
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Affiliation(s)
- Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Chongyi Wei
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Social and Behavioral Health Sciences, School of Public Health, Rutgers University, Piscataway, New Jersey, United States of America
| | - Bolin Cao
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Dan Wu
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
| | - Katherine T. Li
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Weill Cornell Medical College, New York, New York, United States of America
| | - Haidong Lu
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Wei Ma
- Shandong University School of Public Health, Jinan, China
| | - Dianmin Kang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Haochu Li
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Shandong University School of Public Health, Jinan, China
| | - Meizhen Liao
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Katie R. Mollan
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Michael G. Hudgens
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Chuncheng Liu
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Department of Sociology, University of California San Diego, La Jolla, California, United States of America
| | - Wenting Huang
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
| | - Aifeng Liu
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
| | - Ye Zhang
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - M. Kumi Smith
- Department of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States of America
| | - Kate M. Mitchell
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Jason J. Ong
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Hongyun Fu
- Division of Community Health and Research, Eastern Virginia Medical School, Norfolk, Virginia, United States of America
| | - Peter Vickerman
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Ligang Yang
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Heping Zheng
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Joseph D. Tucker
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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18
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Merchant RC, Liu T, Clark MA, Carey MP. Facilitating HIV/AIDS and HIV testing literacy for emergency department patients: a randomized, controlled, trial. BMC Emerg Med 2018; 18:21. [PMID: 29986662 PMCID: PMC6038177 DOI: 10.1186/s12873-018-0172-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 06/26/2018] [Indexed: 11/17/2022] Open
Abstract
Background Although this has not been fully studied, videos and pictorial brochures might be equivalent methods of delivering HIV/AIDS and HIV testing information to emergency departments (ED) patients. It also is not known how well or for how long such knowledge is retained, if this information should be tailored according to patient health literacy, and if retention of this knowledge impacts future HIV testing behavior. Methods We will conduct a multi-site, randomized, controlled, longitudinal trial among 600 English- and 600 Spanish-speaking 18–64-year-old ED patients to investigate these questions. We will stratify our sample within language (English vs. Spanish) by health literacy level (lower vs. higher) and randomly assign patients to receive HIV/AIDS and HIV testing information by video or pictorial brochure. All patients will be tested for HIV in the ED. At 12-months post-enrollment, we will invite participants to be tested again for HIV. As primary aims, we will compare the efficacy of pictorial brochures and videos in improving short-term (in ED) HIV/AIDS and HIV testing knowledge and retaining this knowledge over 12 months. We will determine if and how short-term improvement and longer-term retention of knowledge interacts with information delivery mode (pictorial brochure or video), patient health literacy level (lower or higher), and language (English or Spanish). As secondary aims, using the Information-Motivation-Behavioral Skills (IMB) model as a heuristic framework, we will measure constructs from the IMB model relevant to our study, and assess their impact on HIV re-testing behavior; we will also examine the moderating influences of information delivery mode, language, and health literacy level. In addition, we will explore simplified screening strategies to identify ED patients with lower health literacy as ways to implement a tailored approach to HIV/AIDS and HIV testing information delivery in EDs. Discussion Study findings will guide ED-based delivery of HIV/AIDS and HIV testing information; that is, whether delivery modes (video or pictorial brochure) should be selected for patients by language and/or health literacy level. The results also will inform EDs when, how, and for whom information needs to be provided for those undergoing testing again for HIV within a one-year period. Trial registration ClinicalTrials.gov Identifier: NCT02284451. Posted November 6, 2014. Electronic supplementary material The online version of this article (10.1186/s12873-018-0172-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
| | - Tao Liu
- Department of Biostatistics, Center for Statistical Sciences, School of Public Health, Brown University, Providence, RI, 02906, USA
| | - Melissa A Clark
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Ave, Providence, RI, 02906, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, 02906, USA
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19
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Li J, Lau JTF, Ma YL, Lau MMC. Trend and Factors Associated with Condom Use Among Male Clients of Female Sex Workers in Hong Kong: Findings of 13 Serial Behavioural Surveillance Surveys. AIDS Behav 2018; 22:2235-2247. [PMID: 29946808 DOI: 10.1007/s10461-018-2148-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study investigated the trend and associated factors of condom use among male clients of female sex workers (CFSW) in Hong Kong. A total of 25,443 males of the general population were screened to identify 2,330 CFSW via 13 rounds of population-based serial cross-sectional telephone surveys during 1998 through 2015. Over time, there were no significant changes in condom use with various types of female sex partners (p ranged 0. 219-0.837) and prevalence of self-reported STI (p = 0.975) in the past 6 months. Decrease in the prevalence of non-regular sex partners (p < 0.001) and increase in perceived efficacy of condom use for HIV prevention (p = 0.028) were observed. Perceived efficacy of condom use for HIV prevention and self-reported STI experience were significantly associated with condom use with various types of female sex partners in the past 6 months. No evident improvement for condom use was found. Tailored intervention programs are warranted.
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Affiliation(s)
- Jinghua Li
- The School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Joseph T F Lau
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | - Yee Ling Ma
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Mason M C Lau
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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20
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Ong JJ, Fu H, Smith MK, Tucker JD. Expanding syphilis testing: a scoping review of syphilis testing interventions among key populations. Expert Rev Anti Infect Ther 2018; 16:423-432. [PMID: 29633888 PMCID: PMC6046060 DOI: 10.1080/14787210.2018.1463846] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Syphilis is an important sexually transmitted infection (STI). Despite inexpensive and effective treatment, few key populations receive syphilis testing. Innovative strategies are needed to increase syphilis testing among key populations. Areas covered: This scoping review focused on strategies to increase syphilis testing in key populations (men who have sex with men (MSM), sex workers, people who use drugs, transgender people, and incarcerated individuals). Expert commentary: We identified many promising syphilis testing strategies, particularly among MSM. These innovations are separated into diagnostic, clinic-based, and non-clinic based strategies. In terms of diagnostics, self-testing, dried blood spots, and point-of-care testing can decentralize syphilis testing. Effective syphilis self-testing pilots suggest the need for further attention and research. In terms of clinic-based strategies, modifying default clinical procedures can nudge physicians to more frequently recommend syphilis testing. In terms of non-clinic based strategies, venue-based screening (e.g. in correctional facilities, drug rehabilitation centres) and mobile testing units have been successfully implemented in a variety of settings. Integration of syphilis with HIV testing may facilitate implementation in settings where individuals have increased sexual risk. There is a strong need for further syphilis testing research and programs.
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Affiliation(s)
- Jason J. Ong
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Central Clinical School, Monash University, Victoria, Australia
| | - Hongyun Fu
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Eastern Virginia Medical School, Norfolk, USA
| | - M. Kumi Smith
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- University of North Carolina at Chapel Hill, North Carolina, USA
| | - Joseph D. Tucker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- University of North Carolina at Chapel Hill, North Carolina, USA
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21
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Wilton J, Noor SW, Schnubb A, Lawless J, Hart TA, Grennan T, Fowler S, Maxwell J, Tan DHS. High HIV risk and syndemic burden regardless of referral source among MSM screening for a PrEP demonstration project in Toronto, Canada. BMC Public Health 2018; 18:292. [PMID: 29486737 PMCID: PMC5830065 DOI: 10.1186/s12889-018-5180-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/19/2018] [Indexed: 11/24/2022] Open
Abstract
Background To maximize public health impact and cost-effectiveness, HIV pre-exposure prophylaxis (PrEP) must reach individuals at high HIV risk. Referrals for PrEP can be self- or provider-initiated, but there are several challenges to both. We assessed whether HIV risk differed by referral source among gay, bisexual and other men who have sex (gbMSM) screening for an HIV PrEP demonstration project. Methods PREPARATORY-5 was an open-label PrEP demonstration project enrolling gbMSM at high risk of HIV acquisition in Toronto, Canada. Study eligibility criteria related to high risk was defined as scoring ≥10 on the HIV Incidence Risk Index for MSM (HIRI-MSM) and engaging in at least 1 act of condomless receptive anal sex within the past 6 months. Recruitment was promoted through self-referrals (ads in a sexual networking app and gay newspaper/website) and provider-referrals (10 community-based organizations, CBOs). HIV risk score (HIRI-MSM) and syndemic health burden were measured among gbMSM screened for study participation and compared according to referral source. Results Between October 16 and December 30, 2014, online ads generated 1518 click-throughs and CBOs referred 115 individuals. Overall, 165 men inquired about the trial, of which 86 underwent screening. The majority of screened men were self-referrals (60.5%), scored ≥10 on HIRI-MSM (96.5%), and reported condomless receptive anal sex in the past 6 months (74.2%). Self- and provider-referrals had similarly high HIV risk profiles, with a median (IQR) HIRI-MSM score of 26.0 (19.0–32.5) and 28.5 (20.0–34.0) (p = 0.3), and 75.0% and 73.5% reporting condomless receptive anal sex (p = 0.9), respectively. The overall burden of syndemic health problems was also high, with approximately one-third overall identified as having depressive symptoms (39.5%), alcohol-related problems (39.5%), multiple drug use (31.4%), or sexual compulsivity (31.4%). There were no significant differences in syndemic health problems by referral source. Conclusions HIV risk and syndemic burden were high among gbMSM presenting for this PrEP demonstration project regardless of referral source. Self-referral may be a useful and efficient strategy for identifying individuals suitable for PrEP use. Online strategies and CBOs working in gay men’s health may play important roles in connecting individuals at high HIV risk to PrEP services. Trial registration ClinicalTrials.gov NCT02149888. Registered May 12th 2014.
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Affiliation(s)
- James Wilton
- Applied Epidemiology Unit, Ontario HIV Treatment Network, Toronto, Ontario, Canada
| | - Syed W Noor
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Alexandre Schnubb
- Division of Infectious Diseases, St. Michael's Hospital, 30 Bond St, 4CC - Room 4-179, Toronto, ON, M5B 1W8, Canada
| | - James Lawless
- Division of Infectious Diseases, St. Michael's Hospital, 30 Bond St, 4CC - Room 4-179, Toronto, ON, M5B 1W8, Canada
| | - Trevor A Hart
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Troy Grennan
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - John Maxwell
- ACT (AIDS Committee of Toronto), Toronto, Ontario, Canada
| | - Darrell H S Tan
- Division of Infectious Diseases, St. Michael's Hospital, 30 Bond St, 4CC - Room 4-179, Toronto, ON, M5B 1W8, Canada. .,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
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22
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Purnomo J, Coote K, Mao L, Fan L, Gold J, Ahmad R, Zhang L. Using eHealth to engage and retain priority populations in the HIV treatment and care cascade in the Asia-Pacific region: a systematic review of literature. BMC Infect Dis 2018; 18:82. [PMID: 29454322 PMCID: PMC5816561 DOI: 10.1186/s12879-018-2972-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 01/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The exponential growth in the reach and development of new technologies over the past decade means that mobile technologies and social media play an increasingly important role in service delivery models to maximise HIV testing and access to treatment and care. This systematic review examines the impact of electronic and mobile technologies in medical care (eHealth) in the linkage to and retention of priority populations in the HIV treatment and care cascade, focussing on the Asia-Pacific region. METHODS The review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement from the Cochrane Collaboration guidelines. Both grey and published scientific literature from five different databases were searched for all original articles in English published from 2010 to 2017. Studies conducted outside the Asia-Pacific region or not including HIV priority populations were excluded. The methodological quality of studies included in the review was assessed using the Quality Assessment Tool for Quantitative Studies. RESULTS The database search identified 7309 records. Of the 224 peer-reviewed articles identified for full text review, 16 studies from seven countries met inclusion criteria. Six cross sectional studies found evidence to support the use of eHealth, via text messages, instant messaging, social media and health promotion websites, to increase rates of HIV testing and re-testing among men who have sex with men (MSM). Evidence regarding the efficacy of eHealth interventions to improve antiretroviral treatment (ART) adherence was mixed, where one randomised controlled trial (RCT) showed significant benefit of weekly phone call reminders on improving ART adherence. Three further RCTs found that biofeedback eHealth interventions that provided estimated ART plasma concentration levels, showed promising results for ART adherence. CONCLUSIONS This review found encouraging evidence about how eHealth can be used across the HIV treatment and care cascade in the Asia-Pacific region, including increasing HIV testing and re-testing in priority populations as well as ART adherence. eHealth interventions have an important role to play in the movement towards the end of AIDS, particularly to target harder-to-reach HIV priority populations, such as MSM.
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Affiliation(s)
- Julianita Purnomo
- The Albion Centre, South Eastern Sydney Local Health District, 150-154 Albion Street, Sydney, NSW, 2010, Australia.
| | - Katherine Coote
- The Albion Centre, South Eastern Sydney Local Health District, 150-154 Albion Street, Sydney, NSW, 2010, Australia
| | - Limin Mao
- Centre for Social Research in Health, UNSW, Sydney, NSW, 2052, Australia
| | - Ling Fan
- The Albion Centre, South Eastern Sydney Local Health District, 150-154 Albion Street, Sydney, NSW, 2010, Australia
| | - Julian Gold
- The Albion Centre, South Eastern Sydney Local Health District, 150-154 Albion Street, Sydney, NSW, 2010, Australia.,Centre for Neuroscience and Trauma, Blizard Institute, Queen Mary University of London, London, UK
| | - Raghib Ahmad
- The Albion Centre, South Eastern Sydney Local Health District, 150-154 Albion Street, Sydney, NSW, 2010, Australia
| | - Lei Zhang
- Research Center for Public Health, Tsinghua University, Beijing, 100084, China. .,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia. .,Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia. .,School of Public Health and Preventive Medicine, Faculty of Medicine, Monash University, Melbourne, Australia.
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23
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Chen X, Elliott AL, Wang S. Cross-country Association of Press Freedom and LGBT freedom with prevalence of persons living with HIV: implication for global strategy against HIV/AIDS. Glob Health Res Policy 2018; 3:6. [PMID: 29457142 PMCID: PMC5806491 DOI: 10.1186/s41256-018-0061-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/17/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Human behaviors are affected by attitudes and beliefs, which in turn are shaped by higher-level values to which we have ascribed. In this study, we explore the relationship between two higher-level values, press freedom and LGBT freedom, and HIV infection with national data at the population level. METHODS Data were the number of persons living with HIV (PLWH, n = 35,468,911) for 148 countries during 2011-15, press freedom index (PFI) determined by the Reporters Without Borders, and LGBT freedom index (LGBT-FI) based on laws regulating same-sex relationships and expression. PLWH prevalence (1/1000), PFI and LGBT-FI were mapped first. Multiple regression was thus used to associate the logarithm of PLWH prevalence with PFI, LGBT-FI and PFI × LGBT-FI interaction, controlling for per capita GDP and weighted by population size. RESULTS Global prevalence of PLWH during 2011-15 was 0.51 per 1000 population. The prevalence showed a geographic pattern moving from high at the south and west ends of the world map to low at the north and east. Both PFI and LGBT-FI were positively associated with PLWH prevalence with a negative interaction between the two. CONCLUSIONS More people are infected with HIV in countries with higher press freedom and higher LGBT freedom. Furthermore, press freedom can attenuate the positive association between levels of LGBT freedom and risk of HIV infection. This study demonstrated the urgency for and provided data supporting further research to investigate potential cultural and socioecological mechanisms underpinning the complex relationship among press freedom, LGBT freedom and HIV infection, with data collected at the individual level.
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Affiliation(s)
- Xinguang Chen
- College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida USA
| | - Amy L. Elliott
- College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida USA
| | - Shuang Wang
- College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida USA
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24
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Sampogna G, Bakolis I, Evans-Lacko S, Robinson E, Thornicroft G, Henderson C. The impact of social marketing campaigns on reducing mental health stigma: Results from the 2009-2014 Time to Change programme. Eur Psychiatry 2017; 40:116-122. [PMID: 27997875 DOI: 10.1016/j.eurpsy.2016.08.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/22/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND In England, during 2009-2014 the 'Time to Change' anti-stigma programme has included a social marketing campaign (SMC) using mass media channels, social media and social contact events but the efficacy of such approach has not been evaluated yet. METHODS The target population included people aged between mid-twenties/mid-forties, from middle-income groups. Participants were recruited through an online market research panel, before and after each burst of the campaign (with a mean number of unique participants per each burst: 956.9±170.2). Participants completed an online questionnaire evaluating knowledge [Mental Health Knowledge Schedule (MAKS)]; attitudes [Community Attitudes toward Mental Illness (CAMI)]; and behaviours [Reported and Intended Behaviour Scale (RIBS)]. Socio-demographic data and level of awareness of the SMC were also collected. RESULTS A total of 10,526 people were interviewed. An increasing usage of the SMC-media channels as well as of the level of awareness of SMC was found (P<0.001). Being aware of the SMC was found to be associated with higher score at MAKS (OR=0.95, CI=0.68 to 1.21; P<0.001), at 'tolerance and support' CAMI subscale (OR=0.12, CI=0.09 to 0.16; P<0.001), and at RIBS (OR=0.71, CI=0.51 to 0.92; P<0.001), controlling for confounders. CONCLUSION The SMC represents an important way to effectively reduce stigma. Taking into account these positive findings, further population-based campaigns using social media may represent an effective strategy to challenge stigma.
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Affiliation(s)
- G Sampogna
- Department of Psychiatry, University of Naples SUN, Naples, Italy.
| | - I Bakolis
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Biostatistics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Evans-Lacko
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - E Robinson
- Biostatistics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - G Thornicroft
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C Henderson
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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25
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Tucker JD. Crowdsourcing to promote HIV testing among MSM in China: study protocol for a stepped wedge randomized controlled trial. Trials 2017; 18:447. [PMID: 28969702 PMCID: PMC5625620 DOI: 10.1186/s13063-017-2183-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 09/08/2017] [Indexed: 11/13/2022] Open
Abstract
Background HIV testing for marginalized populations is critical to controlling the HIV epidemic. However, the HIV testing rate among men who have sex with men (MSM) in China remains low. Crowdsourcing, the process of shifting individual tasks to a group, has been increasingly adopted in public health programs and may be a useful tool for spurring innovation in HIV testing campaigns. We designed a multi-site study to develop a crowdsourced HIV test promotion campaign and evaluate its effectiveness against conventional campaigns among MSM in China. Methods This study will use an adaptation of the stepped wedge, randomized controlled trial design. A total of eight major metropolitan cities in China will be randomized to sequentially initiate interventions at 3-month intervals. The intervention uses crowdsourcing at multiple steps to sustain crowd contribution. Approximately 1280 MSM, who are 16 years of age or over, live in the intervention city, have not been tested for HIV in the past 3 months, and are not living with HIV, will be recruited. Recruitment will take place through banner advertisements on a large gay dating app along with other social media platforms. Participants will complete one follow-up survey every 3 months for 12 months to evaluate their HIV testing uptake in the past 3 months and secondary outcomes including syphilis testing, sex without condoms, community engagement, testing stigma, and other related outcomes. Discussion MSM HIV testing rates remain poor in China. Innovative methods to promote HIV testing are urgently needed. With a large-scale, stepped wedge, randomized controlled trial our study can improve understanding of crowdsourcing’s long-term effectiveness in public health campaigns, expand HIV testing coverage among a key population, and inform intervention design in related public health fields. Trial Registration ClinicalTrials.gov, NCT02796963. Registered on 23 May 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2183-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Joseph D Tucker
- University of North Carolina Chapel Hill Project-China, No. 2 Lujing Road, Guangzhou, 510095, China.
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26
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Community intervention improves knowledge of HIV status of adolescents in Zambia: findings from HPTN 071-PopART for youth study. AIDS 2017; 31 Suppl 3:S221-S232. [PMID: 28665880 PMCID: PMC5497780 DOI: 10.1097/qad.0000000000001530] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the uptake of home-based HIV counselling and testing (HCT) in four communities of the HPTN 071 (PopART) trial in Zambia among adolescents aged 15-19 years and explore factors associated with HCT uptake. DESIGN The PopART for youth study is a three-arm community-randomized trial in 12 communities in Zambia and nine communities in South Africa which aims to evaluate the acceptability and uptake of a HIV prevention package, including universal HIV testing and treatment, among young people. The study is nested within the HPTN 071 (PopART) trial. METHODS Using a door-to-door approach that includes systematically revisiting households, all adolescents enumerated were offered participation in the intervention and verbal consent was obtained. Data were analysed from October 2015 to September 2016. RESULTS Among 15 456 enumerated adolescents, 11 175 (72.3%) accepted the intervention. HCT uptake was 80.6% (8707/10 809) and was similar by sex. Adolescents that knew their HIV-positive status increased almost three-fold, from 75 to 210. Following visits from community HIV care providers, knowledge of HIV status increased from 27.6% (3007/10 884) to 88.5% (9636/10 884). HCT uptake was associated with community, age, duration since previous HIV test; other household members accepting HCT, having an HIV-positive household member, circumcision, and being symptomatic for STIs. CONCLUSION Through a home-based approach of offering a combination HIV prevention package, the proportion of adolescents who knew their HIV status increased from ∼28 to 89% among those that accepted the intervention. Delivering a community-level door-to-door combination, HIV prevention package is acceptable to many adolescents and can be effective if done in combination with targeted testing.
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27
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Wong NS, Tang W, Han L, Best J, Zhang Y, Huang S, Zheng H, Yang B, Wei C, Pan SW, Tucker JD. MSM HIV testing following an online testing intervention in China. BMC Infect Dis 2017; 17:437. [PMID: 28629439 PMCID: PMC5477382 DOI: 10.1186/s12879-017-2546-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 06/13/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Scaling up HIV testing is the first step in the HIV treatment continuum which is important for controlling the HIV epidemic among men who have sex with men (MSM). Following an online HIV testing intervention among MSM, we aim to examine sociodemographic and spatial factors associated with HIV testing. METHODS We conducted a secondary analysis on data from an online HIV testing intervention among MSM who had never-tested for HIV. The survey was distributed through online networks connected to all provinces and regions of China. Univariate and multivariable analyses were performed to examine factors associated with testing three weeks post-intervention. RESULTS At three weeks after the intervention, 36% of 624 followed-up MSM underwent HIV testing, 69 men reported positive HIV test results. Having money for sex, ever tested for sexually transmitted infections and intimate partner violence experience were significant factors of post-intervention HIV testing. Students were less likely to undergo HIV testing at follow-up compared to others (adjusted odds ratio=0.69, 95% C.I.=0.47-0.99), adjusted by age and type of intervention. Moderate provincial spatial variation of testing was observed. CONCLUSIONS While high risk men generally had higher HIV testing rates, some MSM like students had lower testing rates, suggesting the need for further ways to enhance HIV testing in specific MSM communities.
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Affiliation(s)
- Ngai Sze Wong
- University of North Carolina Project-China, Guangzhou, Guangdong China
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, Guangdong China
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- SESH Global, Guangzhou, Guangdong China
| | - Larry Han
- University of North Carolina Project-China, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - John Best
- University of North Carolina Project-China, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
- School of Medicine, University of California, San Francisco, CA USA
| | - Ye Zhang
- University of North Carolina Project-China, Guangzhou, Guangdong China
- SESH Global, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
| | - Shujie Huang
- SESH Global, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong China
| | - Heping Zheng
- SESH Global, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong China
| | - Bin Yang
- SESH Global, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong China
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA
| | - Stephen W. Pan
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Joseph D. Tucker
- University of North Carolina Project-China, Guangzhou, Guangdong China
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- SESH Global, Guangzhou, Guangdong China
- Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou, Guangdong China
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Mitchell J, Lee JY, Stephenson R. How Best to Obtain Valid, Verifiable Data Online From Male Couples? Lessons Learned From an eHealth HIV Prevention Intervention for HIV-Negative Male Couples. JMIR Public Health Surveill 2016; 2:e152. [PMID: 27649587 PMCID: PMC5050384 DOI: 10.2196/publichealth.6392] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/21/2016] [Accepted: 08/21/2016] [Indexed: 11/23/2022] Open
Abstract
Background As interest increases in the development of eHealth human immunodeficiency virus (HIV)-preventive interventions for gay male couples, Web-based methods must also be developed to help increase the likelihood that couples enrolled and data collected from them represent true unique dyads. Methods to recruit and collect reliable and valid data from both members of a couple are lacking, yet are crucial for uptake of novel sexual health and HIV-prevention eHealth interventions. Methods to describe best practices to recruit male couples using targeted advertisements on Facebook are also lacking in the literature, yet could also help in this uptake. Objective The objective of our study was to describe challenges and lessons learned from experiences from two phases (developmental phase and online randomized controlled trial [RCT]) of an eHealth HIV-prevention intervention for concordant HIV-negative male couples in terms of (1) recruiting male couples using targeted advertisements on Facebook, (2) validating that data came from two partners of the couple, and (3) verifying that the two partners of the couple are in a relationship with each other. Methods The developmental phase refined the intervention via in-person focus groups, whereas the pilot-testing phase included an online RCT. For both phases, couples were recruited via targeted Facebook advertisements. Advertisements directed men to a study webpage and screener; once eligible, participants provided consent electronically. A partner referral system was embedded in the consenting process to recruit the relationship partner of the participant. Both men of the couple had to meet all eligibility criteria—individually and as a couple—before they could enroll in the study. Verification of couples’ relationships was assessed via the concurrence of predetermined screener items from both partners, done manually in the developmental phase and electronically in the pilot-testing phase. A system of decision rules was developed to assess the validity that data came from two unique partners of a couple. Results Several important lessons were learned from these experiences, resulting in recommendations for future eHealth studies involving male couples. Use of certain “interests” and types of images (eg, shirtless) in targeted Facebook advertisements should be avoided or used sparingly because these interests and types of images may generate adverse reactions from a broader audience. Development of a systematic approach with predetermined criteria and parameters to verify male couples’ relationships is strongly recommended. Further, researchers are encouraged to develop a system of decision rules to detect and handle suspicious data (eg, suspicious email addresses/names, multiple entries, same IP address used in multiple entries) to help validate the legitimacy of male couples’ relationships online. Conclusions These lessons learned combined with recommendations for future studies aim to help enhance recruitment efforts and the validity and reliability of collecting dyadic data from male couples for novel eHealth HIV-preventive interventions.
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Affiliation(s)
- Jason Mitchell
- Office of Public Health StudiesUniversity of Hawai'i at ManoaHonolulu, HIUnited States
| | - Ji-Young Lee
- Office of Public Health StudiesUniversity of Hawai'i at ManoaHonolulu, HIUnited States
| | - Rob Stephenson
- Center for Sexuality and Health DisparitiesDepartment of Health Behavior and Biological SciencesUniversity of Michigan School of NursingAnn Arbor, MIUnited States
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Tu Amigo Pepe: Evaluation of a Multi-media Marketing Campaign that Targets Young Latino Immigrant MSM with HIV Testing Messages. AIDS Behav 2016; 20:1973-88. [PMID: 26850101 DOI: 10.1007/s10461-015-1277-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Latino immigrant men who have sex with men (MSM) are at risk for HIV and delayed diagnosis in the United States. This paper describes the evaluation of a pilot of the Tu Amigo Pepe, a multimedia HIV testing campaign aimed at Latino MSM in Seattle, WA particularly targeting immigrants who may not identify as gay, ages 18-30 years old. The 16-week campaign included Spanish-language radio public service announcements (PSAs), a Web site, social media outreach, a reminder system using mobile technology, print materials and a toll-free hotline. In developing the PSAs, the Integrated Behavioral Model was used as a framework to reframe negative attitudes, beliefs and norms towards HIV testing with positive ones as well as to promote self-efficacy towards HIV testing. The campaign had a significant and immediate impact on attitudes, beliefs, norms and self-efficacy towards HIV testing as well as on actual behavior, with HIV testing rates increasing over time.
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Garbers S, Friedman A, Martinez O, Scheinmann R, Bermudez D, Silva M, Silverman J, Chiasson MA. Adapting the Get Yourself Tested Campaign to Reach Black and Latino Sexual-Minority Youth. Health Promot Pract 2016; 17:739-50. [PMID: 27225216 PMCID: PMC4980262 DOI: 10.1177/1524839916647329] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Culturally appropriate efforts are needed to increase sexually transmitted disease (STD) testing and care among Black and Latino sexual-minority youth, who are at high risk for STDs. Get Yourself Tested, a national testing campaign, has demonstrated success among youth, but it has yet to be assessed for relevance or impact among this population. METHOD This effort included (1) formative and materials-testing research through focus groups; (2) adaptation of existing Get Yourself Tested campaign materials to be more inclusive of Black and Latino sexual-minority youth; (3) a 3-month campaign in four venues of New York City, promoting STD testing at events and through mobile testing and online and social media platforms; (4) process evaluation of outreach activities; and (5) an outcome evaluation of testing at select campaign venues, using a preexperimental design. RESULTS During the 3-month campaign period, the number of STD tests conducted at select campaign venues increased from a comparable 3-month baseline period. Although testing uptake through mobile vans remained low in absolute numbers, the van drew a high-prevalence sample, with positivity rates of 26.9% for chlamydia and 11.5% for gonorrhea. This article documents the process and lessons learned from adapting and implementing a local campaign for Black and Latino sexual-minority youth.
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Affiliation(s)
| | | | | | | | | | - Manel Silva
- Callen-Lorde Community Health Center, New York, NY, USA
| | - Jen Silverman
- Callen-Lorde Community Health Center, New York, NY, USA
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Tang W, Han L, Best J, Zhang Y, Mollan K, Kim J, Liu F, Hudgens M, Bayus B, Terris-Prestholt F, Galler S, Yang L, Peeling R, Volberding P, Ma B, Xu H, Yang B, Huang S, Fenton K, Wei C, Tucker JD. Crowdsourcing HIV Test Promotion Videos: A Noninferiority Randomized Controlled Trial in China. Clin Infect Dis 2016; 62:1436-1442. [PMID: 27129465 PMCID: PMC4872295 DOI: 10.1093/cid/ciw171] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 12/04/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Crowdsourcing, the process of shifting individual tasks to a large group, may enhance human immunodeficiency virus (HIV) testing interventions. We conducted a noninferiority, randomized controlled trial to compare first-time HIV testing rates among men who have sex with men (MSM) and transgender individuals who received a crowdsourced or a health marketing HIV test promotion video. METHODS Seven hundred twenty-one MSM and transgender participants (≥16 years old, never before tested for HIV) were recruited through 3 Chinese MSM Web portals and randomly assigned to 1 of 2 videos. The crowdsourced video was developed using an open contest and formal transparent judging while the evidence-based health marketing video was designed by experts. Study objectives were to measure HIV test uptake within 3 weeks of watching either HIV test promotion video and cost per new HIV test and diagnosis. RESULTS Overall, 624 of 721 (87%) participants from 31 provinces in 217 Chinese cities completed the study. HIV test uptake was similar between the crowdsourced arm (37% [114/307]) and the health marketing arm (35% [111/317]). The estimated difference between the interventions was 2.1% (95% confidence interval, -5.4% to 9.7%). Among those tested, 31% (69/225) reported a new HIV diagnosis. The crowdsourced intervention cost substantially less than the health marketing intervention per first-time HIV test (US$131 vs US$238 per person) and per new HIV diagnosis (US$415 vs US$799 per person). CONCLUSIONS Our nationwide study demonstrates that crowdsourcing may be an effective tool for improving HIV testing messaging campaigns and could increase community engagement in health campaigns. CLINICAL TRIALS REGISTRATION NCT02248558.
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Affiliation(s)
- Weiming Tang
- University of North Carolina Project-China
- Guangdong Provincial Center for Skin Diseases and STI Control
- Social Entrepreneurship for Sexual Health (SESH) Global, Guangzhou, China
- School of Medicine
| | - Larry Han
- University of North Carolina Project-China
- Guangdong Provincial Center for Skin Diseases and STI Control
- Department of Biostatistics, University of North Carolina at Chapel Hill
| | - John Best
- University of North Carolina Project-China
- Social Entrepreneurship for Sexual Health (SESH) Global, Guangzhou, China
- School of Medicine, University of California, San Francisco
| | - Ye Zhang
- University of North Carolina Project-China
- Guangdong Provincial Center for Skin Diseases and STI Control
- Social Entrepreneurship for Sexual Health (SESH) Global, Guangzhou, China
| | - Katie Mollan
- Department of Biostatistics, University of North Carolina at Chapel Hill
| | - Julie Kim
- Social Entrepreneurship for Sexual Health (SESH) Global, Guangzhou, China
| | - Fengying Liu
- Guangdong Provincial Center for Skin Diseases and STI Control
- Social Entrepreneurship for Sexual Health (SESH) Global, Guangzhou, China
| | - Michael Hudgens
- Department of Biostatistics, University of North Carolina at Chapel Hill
| | - Barry Bayus
- Business School, University of North Carolina at Chapel Hill
| | - Fern Terris-Prestholt
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine
| | - Sam Galler
- University of North Carolina Project-China
- University of Oxford, United Kingdom
| | - Ligang Yang
- Guangdong Provincial Center for Skin Diseases and STI Control
| | - Rosanna Peeling
- Social Entrepreneurship for Sexual Health (SESH) Global, Guangzhou, China
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine
| | | | | | - Huifang Xu
- Department of HIV/AIDS Prevention and Control, Guangzhou Center for Disease Control and Prevention, Baiyun, China
| | - Bin Yang
- Guangdong Provincial Center for Skin Diseases and STI Control
- Social Entrepreneurship for Sexual Health (SESH) Global, Guangzhou, China
| | - Shujie Huang
- Guangdong Provincial Center for Skin Diseases and STI Control
- Social Entrepreneurship for Sexual Health (SESH) Global, Guangzhou, China
| | | | - Chongyi Wei
- School of Medicine, University of California, San Francisco
| | - Joseph D Tucker
- University of North Carolina Project-China
- Guangdong Provincial Center for Skin Diseases and STI Control
- Social Entrepreneurship for Sexual Health (SESH) Global, Guangzhou, China
- School of Medicine
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Tucker JD, Cao B, Li H, Tang S, Tang W, Wong NS, Wei C. Social Media Interventions to Promote HIV Testing. Clin Infect Dis 2016; 63:282-3. [PMID: 27161778 DOI: 10.1093/cid/ciw297] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
| | - Bolin Cao
- University of North Carolina Project-China SESH Global Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou
| | - Haochu Li
- University of North Carolina Project-China SESH Global Department of Epidemiology, Shandong University School of Public Health, Jinan, China
| | - Songyuan Tang
- University of North Carolina Project-China SESH Global Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou
| | - Weiming Tang
- University of North Carolina Project-China SESH Global Guangdong Provincial Centres for Skin Diseases and STI Control, Guangzhou
| | - Ngai Sze Wong
- University of North Carolina Project-China SESH Global
| | - Chongyi Wei
- School of Medicine, University of California, San Francisco
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Evangeli M, Pady K, Wroe AL. Which Psychological Factors are Related to HIV Testing? A Quantitative Systematic Review of Global Studies. AIDS Behav 2016; 20:880-918. [PMID: 26566783 PMCID: PMC4799267 DOI: 10.1007/s10461-015-1246-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Deciding to test for HIV is necessary for receiving HIV treatment and care among those who are HIV-positive. This article presents a systematic review of quantitative studies on relationships between psychological (cognitive and affective) variables and HIV testing. Sixty two studies were included (fifty six cross sectional). Most measured lifetime testing. HIV knowledge, risk perception and stigma were the most commonly measured psychological variables. Meta-analysis was carried out on the relationships between HIV knowledge and testing, and HIV risk perception and testing. Both relationships were positive and significant, representing small effects (HIV knowledge, d = 0.22, 95 % CI 0.14-0.31, p < 0.001; HIV risk perception, OR 1.47, 95 % CI 1.26-1.67, p < 0.001). Other variables with a majority of studies showing a relationship with HIV testing included: perceived testing benefits, testing fear, perceived behavioural control/self-efficacy, knowledge of testing sites, prejudiced attitudes towards people living with HIV, and knowing someone with HIV. Research and practice implications are outlined.
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Affiliation(s)
- Michael Evangeli
- Department of Psychology, Royal Holloway University of London, Egham, Surrey, TW20 0EX, UK.
| | - Kirsten Pady
- Department of Psychology, Royal Holloway University of London, Egham, Surrey, TW20 0EX, UK
| | - Abigail L Wroe
- Department of Psychology, Royal Holloway University of London, Egham, Surrey, TW20 0EX, UK
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Sexual behaviors and HIV/syphilis testing among transgender individuals in China: implications for expanding HIV testing services. Sex Transm Dis 2015; 42:281-5. [PMID: 25868142 DOI: 10.1097/olq.0000000000000269] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND HIV and syphilis are disproportionately common among transgender individuals globally, yet few studies have investigated transgender HIV/syphilis risk and testing in low- and middle-income nations. We conducted an online survey of men who have sex with men (MSM) and transgender individuals to examine sexual behaviors and HIV/syphilis testing in China. METHODS We recruited MSM and transgender individuals from 2 major Chinese lesbian, gay, bisexual, and transgender Web platforms. χ Test and logistic regression were used to compare risk behaviors, HIV and syphilis testing history, and prevalence between transgender individuals and other MSM. RESULTS Among the 1320 participants, 52 (3.9%) self-identified as transgender. Demographics, including education, employment, and marital status, were similar between both groups, whereas transgender individuals were older. Condomless anal intercourse rate was comparable between the groups. Transgender individuals were less likely to report ever testing for HIV (34.6% vs. 62.0%) and syphilis (15.7% vs. 31.2%) with adjusted odds ratios of 0.36 (95% confidence interval, 0.20-0.65) and 0.42 (95% confidence interval, 0.20-0.91), respectively. We found a trend toward a higher HIV prevalence among transgender individuals (11.1% vs. 5.7%, P = 0.12). CONCLUSIONS Transgender individuals have suboptimal HIV and syphilis testing rates in China. Given the substantial risk behaviors and burden of HIV/STI in the general Chinese MSM population and a lack of knowledge about transgender individuals, enhanced HIV/syphilis testing programs for transgender individuals in China are needed.
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Crabtree-Ramírez B, Vega YNC, Shepherd BE, Turner M, Carriquiry G, Fink V, Luz PM, Cortes CP, Rouzier V, Padgett D, Jayathilake K, McGowan CC, Person AK. Temporal Trends in Age at HIV Diagnosis in Cohorts in the United States, the Caribbean, and Central and South America. AIDS Behav 2015; 19:1599-608. [PMID: 25613592 DOI: 10.1007/s10461-014-0974-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In the United States (USA), the age of those newly diagnosed with HIV is changing, particularly among men who have sex with men (MSM). A retrospective analysis included HIV-infected adults from seven sites in the Caribbean, Central and South America network (CCASAnet) and the Vanderbilt Comprehensive Care Clinic (VCCC-Nashville, Tennessee, USA). We estimated the proportion of patients <25 years at HIV diagnosis by calendar year among the general population and MSM. 19,466 (CCASAnet) and 3,746 (VCCC) patients were included. The proportion <25 years at diagnosis in VCCC increased over time for both the general population and MSM (p < 0.001). Only in the Chilean site for the general population and the Brazilian site for MSM were similar trends seen. Subjects <25 years of age at diagnosis were less likely to be immunocompromised at enrollment at both the VCCC and CCASAnet. Recent trends in the USA of greater numbers of newly diagnosed young patients were not consistently observed in Latin America and the Caribbean. Prevention efforts tailored to young adults should be increased.
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Holloway IW, Pulsipher CA, Gibbs J, Barman-Adhikari A, Rice E. Network Influences on the Sexual Risk Behaviors of Gay, Bisexual and Other Men Who Have Sex with Men Using Geosocial Networking Applications. AIDS Behav 2015; 19 Suppl 2:112-22. [PMID: 25572832 DOI: 10.1007/s10461-014-0989-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Geosocial networking applications (GSN apps) have become increasingly popular among gay, bisexual and other men who have sex with men (MSM). Our study sought to understand whether inclusion of individuals met via GSN apps in participants' social networks was associated with increased HIV risk behaviors among a probability sample of GSN app using MSM (N = 295) recruited in Los Angeles, California. Approximately 20 % of participants included a GSN app-met individual as one of their top five closest social network members. Those with a GSN app-met network member had more recent (past 30-day) sexual partners (B = 1.21, p < 0.05), were nearly twice as likely to have engaged in unprotected anal intercourse (UAI) with their last sexual partner (AOR = 2.02, p < 0.05), and were nearly four times as likely to have engaged in UAI with their last GSN app-met sexual partner (AOR = 3.98, p < 0.001). Network-based interventions delivered via GSN apps may be useful in preventing the spread of HIV among MSM.
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Affiliation(s)
- Ian W Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, 3250 Public Affairs Building, Box 951656, Los Angeles, CA, 90095-1656, USA,
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Stromdahl S, Hickson F, Pharris A, Sabido M, Baral S, Thorson A. A systematic review of evidence to inform HIV prevention interventions among men who have sex with men in Europe. ACTA ACUST UNITED AC 2015; 20. [PMID: 25953133 DOI: 10.2807/1560-7917.es2015.20.15.21096] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An estimated 42% of all newly diagnosed HIV cases in Europe in 2013 were transmitted during sex between men. This review was performed to identify and describe studies evaluating the efficacy and effectiveness of HIV prevention interventions among men who have sex with men (MSM), in relation to implementation data from European settings. A systematic search was performed individually for 24 interventions.Data were extracted from studies including efficacy or implementation data from European settings,appraised for efficacy, implementation and plausibility, and assigned a grade (1-4) according to the Highest Attainable Standard of Evidence (HASTE)framework. Four interventions (condom use, peer outreach,peer-led groups, and using universal coverage of antiretroviral treatment and treatment as prevention)were assigned the highest HASTE grade, 1. Another four interventions were assigned 2a for probable recommendation, including voluntary counseling and testing for HIV, using condom-compatible lubricant,using post-exposure prophylaxis, and individual counselling for MSM living with HIV. In addition, seven interventions were assigned a grade of 2b, for possible recommendation. Encouragingly, 15 interventions were graded to be strongly, probably or possibly recommended.In the relatively resource-rich European setting, there is an opportunity to provide global leadership with regard to the regional scale-up of comprehensive HIV prevention interventions for MSM.
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Affiliation(s)
- S Stromdahl
- Department of Public Health Sciences, Karolinska Institutet, Sweden
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Larsson LS. The Montana Radon Study: social marketing via digital signage technology for reaching families in the waiting room. Am J Public Health 2014; 105:779-85. [PMID: 25121816 DOI: 10.2105/ajph.2014.302060] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES I tested a social marketing intervention delivered in health department waiting rooms via digital signage technology for increasing radon program participation among priority groups. METHODS I conducted a tri-county, community-based study over a 3-year period (2010-2013) in a high-radon state by using a quasi-experimental design. We collected survey data for eligible participants at the time of radon test kit purchase. RESULTS Radon program participation increased at the intervention site (t38 = 3.74; P = .001; 95% confidence interval [CI] = 4.8, 16.0) with an increase in renters (χ(2)1,228 = 4.3; P = .039), Special Supplementary Nutrition Program for Women, Infants, and Children families (χ(2)1,166 = 3.13; P = .077) and first-time testers (χ(2)1,228 = 10.93; P = .001). Approximately one third (30.3%; n = 30) attributed participation in the radon program to viewing the intervention message. The intervention crossover was also successful with increased monthly kit sales (t37 = 2.69; P = .01; 95% CI = 1.20, 8.47) and increased households participating (t23 = 4.76; P < .001; 95% CI = 3.10, 7.88). CONCLUSIONS A social marketing message was an effective population-based intervention for increasing radon program participation. The results prompted policy changes for Montana radon programming and adoption of digital signage technology by 2 health departments.
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Affiliation(s)
- Laura S Larsson
- Laura S. Larsson is with the College of Nursing at Montana State University, Bozeman, MT
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Negin J, Rozea A, Martiniuk ALC. HIV behavioural interventions targeted towards older adults: a systematic review. BMC Public Health 2014; 14:507. [PMID: 24884947 PMCID: PMC4049807 DOI: 10.1186/1471-2458-14-507] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 05/20/2014] [Indexed: 11/14/2022] Open
Abstract
Background The increasing number of people living with HIV aged 50 years and older has been recognised around the world yet non-pharmacologic HIV behavioural and cognitive interventions specifically targeted to older adults are limited. Evidence is needed to guide the response to this affected group. Methods We conducted a systematic review of the available published literature in MEDLINE, Embase and the Education Resources Information Center. A search strategy was defined with high sensitivity but low specificity to identify behavioural interventions with outcomes in the areas of treatment adherence, HIV testing uptake, increased HIV knowledge and uptake of prevention measures. Data from relevant articles were extracted into excel. Results Twelve articles were identified all of which originated from the Americas. Eight of the interventions were conducted among older adults living with HIV and four for HIV-negative older adults. Five studies included control groups. Of the included studies, four focused on general knowledge of HIV, three emphasised mental health and coping, two focused on reduced sexual risk behaviour, two on physical status and one on referral for care. Only four of the studies were randomised controlled trials and seven – including all of the studies among HIV-negative older adults – did not include controls at all. A few of the studies conducted statistical testing on small samples of 16 or 11 older adults making inference based on the results difficult. The most relevant study demonstrated that using telephone-based interventions can reduce risky sexual behaviour among older adults with control reporting 3.24 times (95% CI 1.79-5.85) as many occasions of unprotected sex at follow-up as participants. Overall however, few of the articles are sufficiently rigorous to suggest broad replication or to be considered representative and applicable in other settings. Conclusions More evidence is needed on what interventions work among older adults to support prevention, adherence and testing. More methodological rigourised needed in the studies targeting older adults. Specifically, including control groups in all studies is needed as well as sufficient sample size to allow for statistical testing. Addition of specific bio-marker or validated behavioural or cognitive outcomes would also strengthen the studies.
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Affiliation(s)
- Joel Negin
- Sydney School of Public Health, University of Sydney, Edward Ford Building (A27), Sydney, NSW, Australia.
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Martinez O, Wu E, Shultz AZ, Capote J, López Rios J, Sandfort T, Manusov J, Ovejero H, Carballo-Dieguez A, Chavez Baray S, Moya E, López Matos J, DelaCruz JJ, Remien RH, Rhodes SD. Still a hard-to-reach population? Using social media to recruit Latino gay couples for an HIV intervention adaptation study. J Med Internet Res 2014; 16:e113. [PMID: 24763130 PMCID: PMC4019772 DOI: 10.2196/jmir.3311] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 03/17/2014] [Accepted: 04/13/2014] [Indexed: 11/13/2022] Open
Abstract
Background Online social networking use has increased rapidly among African American and Latino men who have sex with men (MSM), making it important to understand how these technologies can be used to reach, retain, and maintain individuals in care and promote health wellness. In particular, the Internet is increasingly recognized as a platform for health communication and education. However, little is known about how primarily Spanish-speaking populations use and engage with each other through social media platforms. Objective We aimed to recruit eligible couples for a study to adapt “Connect ‘n Unite” (an HIV prevention intervention initially created for black gay couples) for Spanish-speaking Latino gay couples living in New York City. Methods In order to successfully design and implement an effective social media recruitment campaign to reach Spanish-speaking Latino gay couples for our ongoing “Latinos en Pareja” study, our community stakeholders and research team used McGuire’s communication/persuasion matrix. The matrix guided our research, specifically each marketing “channel”, targeted “message”, and target population or “receiver”. We developed a social media recruitment protocol and trained our research staff and stakeholders to conduct social media recruitment. Results As a result, in just 1 month, we recruited all of our subjects (N=14 couples, that is, N=28 participants) and reached more than 35,658 participants through different channels. One of the major successes of our social media recruitment campaign was to build a strong stakeholder base that became involved early on in all aspects of the research process—from pilot study writing and development to recruitment and retention. In addition, the variety of “messages” used across different social media platforms (including Facebook, the “Latinos en Pareja” study website, Craigslist, and various smartphone applications such as Grindr, SCRUFF, and Jack’d) helped recruit Latino gay couples. We also relied on a wide range of community-based organizations across New York City to promote the study and build in the social media components. Conclusions Our findings highlight the importance of incorporating communication technologies into the recruitment and engagement of participants in HIV interventions. Particularly, the success of our social media recruitment strategy with Spanish-speaking Latino MSM shows that this population is not particularly “hard to reach”, as it is often characterized within public health literature.
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Affiliation(s)
- Omar Martinez
- Columbia University, HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, United States.
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HIV Prevention Messages Targeting Young Latino Immigrant MSM. AIDS Res Treat 2014; 2014:353092. [PMID: 24864201 PMCID: PMC4016876 DOI: 10.1155/2014/353092] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 03/30/2014] [Indexed: 11/18/2022] Open
Abstract
Young Latino immigrant men who have sex with men (MSM) are at risk for HIV and for delayed diagnosis. A need exists to raise awareness about HIV prevention in this population, including the benefits of timely HIV testing. This project was developed through collaboration between University of WA researchers and Entre Hermanos, a community-based organization serving Latinos. Building from a community-based participatory research approach, the researchers developed a campaign that was executed by Activate Brands, based in Denver, Colorado. The authors (a) describe the development of HIV prevention messages through the integration of previously collected formative data; (b) describe the process of translating these messages into PSAs, including the application of a marketing strategy; (c) describe testing the PSAs within the Latino MSM community; and (c) determine a set of important factors to consider when developing HIV prevention messages for young Latino MSM who do not identify as gay.
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Arya M, Kallen MA, Street RL, Viswanath K, Giordano TP. African-American patients' preferences for a health center campaign promoting HIV testing: an exploratory study and future directions. J Int Assoc Provid AIDS Care 2014; 13:488-91. [PMID: 24739209 DOI: 10.1177/2325957414529823] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE In 2006, the US Centers for Disease Control and Prevention recommended routine HIV testing in health care settings and called for HIV testing campaigns targeting African Americans. In a 2011 national survey, 63% of African Americans wanted information on HIV testing. METHODS In our study, 176 African Americans were surveyed to determine channels and spokespersons for an HIV testing campaign. RESULTS Among 9 media channels, the top 3 ranked as "very likely" to convince them to get HIV tested were television, poster, and brochure. Among 10 spokespersons, the top 3 were doctor, nurse, and "real person like me." CONCLUSION The media are a cost-effective strategy to promote HIV prevention. Posters and brochures are inexpensive and easy to reproduce for clinical settings. Television campaigns may be feasible in clinics with closed-circuit televisions. Research is needed on campaign messages. An effective health center HIV testing campaign may help mitigate the disproportionate toll HIV is having on African Americans.
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Affiliation(s)
- Monisha Arya
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Health Decision-Making and Communication Program, Houston VA Health Services Research and Development Center of Excellence, Michael E. Debakey VA Medical Center, Houston, TX, USA
| | - Michael A Kallen
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Richard L Street
- Baylor College of Medicine and Houston VA Health Services Research and Development Center of Excellence, Michael E. Debakey VA Medical Center, Houston, TX, USA
| | | | - Thomas P Giordano
- Baylor College of Medicine and Houston VA Health Services Research and Development Center of Excellence, Michael E. Debakey VA Medical Center, Houston, TX, USA
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Goetz MB, Hoang T, Knapp H, Burgess J, Fletcher MD, Gifford AL, Asch SM. Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities. J Gen Intern Med 2013; 28:1311-7. [PMID: 23605307 PMCID: PMC3785651 DOI: 10.1007/s11606-013-2420-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 12/18/2012] [Accepted: 03/06/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown. OBJECTIVE To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support. DESIGN Three arm, quasi-experimental implementation research study. SETTING Veterans Health Administration (VHA) facilities. PATIENTS Persons receiving primary care between June 2009 and September 2011 INTERVENTION: A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no intervention MAIN MEASURES Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II). KEY RESULTS The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). During phase II, the adjusted rate of routine testing increased by 1.1 %, 6.3 % and 9.2 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). At study end, 70-80 % of patients had been offered an HIV test. CONCLUSIONS Use of clinical reminders, provider feedback, education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.
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Affiliation(s)
- Matthew Bidwell Goetz
- Infectious Diseases Section (111-F), VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA, 90073, USA,
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Abstract
BACKGROUND HIV testing is the gateway for prevention and care. We explored factors associated with HIV testing among Chinese men who have sex with men (MSM). METHODS In Chongqing City, we recruited 492 MSM in 2010 using respondent-driven sampling in a cross-sectional study. Computer-assisted self-interviews were conducted to collect information on history of HIV testing. RESULTS Only 58% of participants reported ever having taken an HIV test. Men who have sex with men who had a college degree (adjusted odds ratio [AOR], 1.7; 95% confidence interval (CI), 1.2-2.6; P = 0.008) were more likely to take a test; those who preferred a receptive role in anal sex were less likely to do so than those with insertive sex preference (AOR, 0.6; 95% CI, 0.35-0.94; P = 0.03); and those who used condoms with the recent male partner during the past 6 months were more likely to get tested (AOR, 2.87; 95% CI, 1.25-6.62; P = 0.01). Principal perceived barriers to testing included the following: fear of knowing a positive result, fear of discrimination if tested positive, low perceived risk of HIV infection, and not knowing where to take a test. Factors reported to facilitate testing were sympathetic attitudes from health staff and guaranteed confidentiality. Prevalence was high: 11.7% HIV positive and 4.7% syphilis positive. CONCLUSIONS The HIV testing rate among MSM in Chongqing is still low, although MSM prevalence is high compared with other Chinese cities. Men who have sex with men preferring receptive anal sex are less likely to get testing and perceive having lower HIV risk. Along with expanded education and social marketing, a welcoming and nonjudgmental environment for HIV testing is needed.
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Flowers P, McDaid LM, Knussen C. Exposure and impact of a mass media campaign targeting sexual health amongst Scottish men who have sex with men: an outcome evaluation. BMC Public Health 2013; 13:737. [PMID: 23923977 PMCID: PMC3750620 DOI: 10.1186/1471-2458-13-737] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 07/31/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This paper explores the exposure and impact of a Scottish mass media campaign: Make Your Position Clear. It ran from October 2009 to July 2010, targeted gay men and other men who have sex with men (MSM), and had two key aims: to promote regular sexual health and HIV testing every 6 months, and to promote the use of appropriate condoms and water-based lubricant with each episode of anal intercourse. METHODS A cross-sectional survey (anonymous and self-report) was conducted 10 months after the campaign was launched (July 2010). Men were recruited from commercial venues. Outcome measures included use of lubricant, testing for sexually transmitted infections and HIV, and intentions to seek HIV testing within the following six months. Linear-by-linear chi-square analysis and binary logistic regressions were conducted to explore the associations between the outcome measures and campaign exposure. RESULTS The total sample was 822 men (62.6% response rate). Men self-identifying as HIV positive were excluded from the analysis (n=38). Binary logistic analysis indicated that those with mid or high campaign exposure were more likely to have been tested for HIV in the previous six months when adjusted for age, area of residence and use of the "gay scene" (AOR=1.96, 95% CI=1.26 to 3.06, p=.003), but were not more likely to be tested for STIs (AOR=1.37, 95% CI=0.88 to 2.16, p=.167). When adjusted for previous HIV testing, those with mid or high campaign exposure were not more likely to indicate intention to be tested for HIV in the following six months (AOR=1.30, 95% CI=0.73 to 2.32, p=.367). Those with no campaign exposure were less likely than those with low exposure to have used appropriate lubricant with anal sex partners in the previous year (AOR=0.42, 95% CI=0.23 to 0.77, p=.005). CONCLUSIONS The campaign had demonstrable reach. The analysis showed partial support for the role of mass media campaigns in improving sexual health outcomes. This suggests that a role for mass media campaigns remains within combination HIV prevention.
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Affiliation(s)
- Paul Flowers
- Department of Psychology and Allied Health Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
| | - Lisa M McDaid
- MRC/CSO Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow G12 8RZ, UK
| | - Christina Knussen
- Department of Psychology and Allied Health Sciences, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
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Ko NY, Hsieh CH, Wang MC, Lee C, Chen CL, Chung AC, Hsu ST. Effects of Internet popular opinion leaders (iPOL) among Internet-using men who have sex with men. J Med Internet Res 2013; 15:e40. [PMID: 23439583 PMCID: PMC3636233 DOI: 10.2196/jmir.2264] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 08/29/2012] [Accepted: 10/24/2012] [Indexed: 11/23/2022] Open
Abstract
Background The Internet has become a popular venue for facilitating sex networking for men who have sex with men (MSM). Objective The study aimed to evaluate the effectiveness of Internet popular opinion leaders (iPOL) in disseminating information about the human immunodeficiency virus (HIV), increasing the frequency of HIV testing, and reducing risky behaviors among MSM in Taiwan. Methods A quasi-experimental study with a nonequivalent control website for comparison was used to estimate the effectiveness of iPOL. A community-level intervention, iPOL, was conducted at the Facebook social networking website and at top1069 as a control. The iPOLs actively disseminated HIV-related information via the platform of Internet opinion leaders and AIDS information center, and discussed and responded to questions or replied to Internet-using MSM. Results A total of 369 iPOLs posted 432 articles and 503 replies to others, influencing 959,088 persons on Facebook. A total of 1037 MSM, 552 (53.23%) from an intervention website and 485 (46.76%) from a control website, participated in the follow-up study survey (response rate 96%). At the 6-month follow-up after the intervention was conducted, MSM who visited the intervention website were more likely to receive HIV-related information (25.49% versus 10.47%, P<.001), discuss HIV issues with others (41.88% versus 23.79%, P<.001), review articles about HIV (90.58% versus 79.73%, P<.001), and be asked about or discuss HIV-related questions (51.11% versus 31.78%, P<.001) than those on the control website. In addition, MSM were more likely to have HIV tests within 6 months (43.89% versus 22.31%, P<.001) and consistently use condoms during anal sex with online sex partners than those using the control website (34.15% versus 26.19%, P=.004). Conclusions The study showed the feasibility and effectiveness of the iPOL intervention as an online HIV prevention program. These findings underscore the importance of disseminating HIV information online, as well as the challenges inherent in the efforts of iPOL to reduce HIV-related risky behaviors among Internet-using MSM.
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Affiliation(s)
- Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
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Stekler JD, Baldwin HD, Louella MW, Katz DA, Golden MR. ru2hot?: A public health education campaign for men who have sex with men to increase awareness of symptoms of acute HIV infection. Sex Transm Infect 2013; 89:409-14. [PMID: 23349338 DOI: 10.1136/sextrans-2012-050730] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Teach HIV-negative men who have sex with men (MSM) symptoms of acute HIV infection (AHI) and direct them to nucleic acid amplification testing (NAAT) though Public Health--Seattle & King County (PHSKC). DESIGN Cross-sectional surveys, retrospective database analysis and chart review. METHODS Beginning in June 2009, the ru2hot? campaign described AHI symptoms and NAAT. Two preintervention and two postintervention surveys assessed campaign visibility, symptom knowledge, and healthcare-seeking behaviour. Regression analyses evaluated secular trends in case-finding. RESULTS 366 MSM completed surveys. In survey 4, 23% of 100 men reported seeing the campaign, and 25% knew 'ru2hot?' referred to AHI. From survey 1 to survey 4, the proportion of subjects who knew ≥2 symptoms or that AHI was a 'flu-like' illness was unchanged (61% vs 57%, p=0.6). However, in survey 4, 13 (72%) of 18 subjects who saw the campaign named fever as a symptom of AHI compared with 19 (35%) of 55 subjects who had not seen the campaign (p=0.005). From 9/2003 to 12/2010, 622 (2.2%) of 27 661 MSM tested HIV-positive, and 111 (18%) were identified by the Public Health--Seattle & King County NAAT programme. In terms of the impact of the campaign on case-finding, diagnosis of EIA-negative/NAAT-positive and OraQuick-negative/EIA-positive cases increased from six in 2004 to 20 in 2010 (p=0.01), but postcampaign numbers were unchanged. 23 (51%) of 45 cases identified before and 8 (44%) of 18 cases identified after the campaign reported symptoms at initial testing (p=0.6). CONCLUSIONS Although a quarter of MSM surveyed saw the campaign and knowledge of fever (the symptom of emphasis) was high, case-finding was unchanged. Increasing campaign visibility could have had greater impact.
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Affiliation(s)
- Joanne D Stekler
- Department of Medicine, University of Washington, Seattle, WA, USA.
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McDaid LM, Li J, Knussen C, Flowers P. Sexually transmitted infection testing and self-reported diagnoses among a community sample of men who have sex with men, in Scotland. Sex Transm Infect 2012; 89:223-30. [PMID: 23042901 PMCID: PMC3625820 DOI: 10.1136/sextrans-2012-050605] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction To examine sexually transmitted infection (STI) testing and self-reported diagnoses among men who have sex with men (MSM), in Scotland. Methods Cross-sectional survey of seven Glasgow gay bars in July 2010 (n=822, 62% response rate); 693 are included in the analyses. Results 81.8% reported ever having had an STI test; 37.4% had tested in the previous 6 months; 13.2% reported having an STI in the previous 12 months. The adjusted odds of having ever tested were significantly higher for men who had 6+ sexual partners in the previous 12 months (adjusted OR=2.66), a maximum sexual health knowledge score (2.23), and had talked to an outreach worker/participated in counselling (1.96), and lower for men reporting any high-risk unprotected anal intercourse (UAI) in the previous 12 months (0.51). Adjusted odds of recent testing were higher for men who had 6+ sexual partners (2.10), talked to an outreach worker/participated in counselling (1.66), maximum sexual health knowledge (1.59), and higher condom use knowledge (1.04), and lower for men aged ≥25 years (0.46). Adjusted odds of having had an STI in the previous 12 months were higher for men who had 6+ sexual partners (3.96) and any high-risk UAI in the previous 12 months (2.24) and lower for men aged ≥25 years (0.57). Conclusions STI testing rates were relatively high, yet still below the minimum recommended for MSM at high risk. Consideration should be given to initiating recall systems for men who test positive for STIs, and to developing behavioural interventions which seek to address STI transmission.
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Affiliation(s)
- Lisa M McDaid
- MRC/CSO Social and Public Health Sciences Unit, Medical Research Council, 4 Lilybank Gardens, Glasgow G12 8RZ, UK.
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