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Itaki M, Endo M, Asakura H, Nagashima M, Somura Y, Takahashi A, Kayebeta A, Takahashi I, Yahata Y. Hepatitis A outbreak among men who have sex with men, Shinjuku, Japan, 2018. Western Pac Surveill Response J 2025; 16:1-10. [PMID: 40129598 PMCID: PMC11931282 DOI: 10.5365/wpsar.2025.16.1.1088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2025] Open
Abstract
Objective In 2018, the Shinjuku City Department of Health detected excess cases of hepatitis A virus (HAV) infection. The objectives of this investigation were to characterize the outbreak, identify transmission routes among inpatient cases and make recommendations to control and prevent HAV infection among men who have sex with men. Methods Information about cases of HAV infection was collected from the National Epidemiological Surveillance for Infectious Diseases system and inpatient interviews conducted by public health nurses in 2018. Results There were 131 HAV cases in 2018. Of these, 98% (129/131) were male, of whom 81% (105/129) were men who have sex with men. Hospitalization was required for 40 cases (31%). The age groups with the highest proportion of cases were 30-39 and 40-49 years (each 34%; 44/131). Two cases (2%) had received the second dose of the HAV vaccine, but only 10 days before symptom onset; all others had received no doses. The sequence type subgroup 13, an RIVM-HAV-16-090-like strain, was seen in 51 cases (39%). Of the 40 hospitalized cases, 21 (53%) participated in an interview conducted using a semistructured questionnaire. Altogether, of 21 cases, 12 (57%) had coinfection with HIV, 13 (62%) had casual sexual contact within the preceding 2 months and 10 (48%) had used social networking services (SNS) to find a sexual partner. Discussion In Shinjuku, this outbreak almost exclusively affected the population of men who have sex with men. The detected outbreak strain has previously been reported in outbreaks among men who have sex with men in China, Taiwan (China) and Europe. For HAV prevention, the most important measures are raising awareness of the risk of HAV as a sexually transmitted infection via SNS and promoting immunization at the appropriate time.
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Affiliation(s)
- Mariya Itaki
- Department of Health, Shinjuku City Office, Tokyo, Japan
| | - Masayuki Endo
- Department of Health, Shinjuku City Office, Tokyo, Japan
| | - Hiroyuki Asakura
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Mami Nagashima
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Yoshiko Somura
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Aki Takahashi
- Department of Health, Shinjuku City Office, Tokyo, Japan
| | - Aya Kayebeta
- Department of Health, Shinjuku City Office, Tokyo, Japan
| | | | - Yuichiro Yahata
- Infectious Diseases Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
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Woerner J, Chadwick SB, Antebi-Gruszka N, Siegel K, Schrimshaw EW. Negative Sexual Experiences Among Gay, Bisexual, and Other Men Who Have Sex with Men Using GPS-Enabled Hook-Up Apps and Websites. JOURNAL OF SEX RESEARCH 2024; 61:1142-1157. [PMID: 38016029 PMCID: PMC11130079 DOI: 10.1080/00224499.2023.2269930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Gay, bisexual, and other men who have sex with men (GBMSM) often use GPS-enabled dating apps and websites to facilitate in-person sexual encounters. Many of these encounters are positive and enjoyable. However, there is limited research on GBMSM's negative experiences with partners from hookup and dating apps/websites, especially those characterized by threats to GBMSM's sexual, physical, and/or psychological safety. In this report, we investigated this matter. We analyzed data from interviews with GBMSM (N = 60) and identified four categories of negative sexual experiences, each of which were comprised by sub-categories: 1) sexual violence (physical sexual assault, verbal sexual coercion, intoxicated assault/coercion), 2) sexual health risk behaviors (condom use resistance and coercion, deception related to HIV/STI status), 3) non-negotiated behaviors (undiscussed/unexpected sex acts, rough sex, sexualized racism, undesired substance use by the partner), and 4) threats to physical safety beyond sexual violence (being blocked from leaving, stalked, robbed, drugged). These results can inform future research and interventions that aim to promote safety on dating apps/websites within the GBMSM community.
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Affiliation(s)
- Jacqueline Woerner
- Departments of Sociology and Psychology, University of Central Florida, Orlando, FL
| | - Sara B. Chadwick
- Department of Gender & Women’s Studies, University of Wisconsin-Madison, Madison, WI
| | | | - Karolynn Siegel
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Eric W. Schrimshaw
- Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, FL
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Owens C, Hurtado M, Moskowitz DA, Mustanski B, Macapagal K. Rural-Urban Differences in HIV Sexual Risk Behaviors and HIV Service Utilization Among Adolescent Sexual Minority Males in the United States. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2765-2775. [PMID: 38528296 PMCID: PMC11526804 DOI: 10.1007/s10508-024-02840-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/27/2024]
Abstract
In the United States, HIV prevalence is increasing in rural areas, specifically among rural adolescent sexual minority males (ASMM). However, it is unclear what HIV sexual risk behaviors rural ASMM engage in and what HIV preventative services they utilize. This study aimed to (1) document the lifetime HIV sexual risk behaviors and service utilization of rural ASMM and (2) compare rural-urban differences in the prevalence of HIV sexual risk behaviors and service utilization. We analyzed data collected from 1615 ASMM who participated in a baseline survey for an online HIV prevention program from April 2018 to June 2020. We compared the prevalence of lifetime HIV sexual risk behaviors and HIV healthcare utilization among rural and urban participants via descriptive statistics, chi-square tests, linear and logistic regressions, and zero-inflated Poisson regressions. These analyses indicated that rural ASMM were more likely than urban ASMM to engage in condomless sex when they had anal sex. Rural ASMM could benefit from offline and online evidence-based HIV prevention interventions, especially interventions that increase condom use.
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Affiliation(s)
- Christopher Owens
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Manuel Hurtado
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
| | - David A Moskowitz
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave., Suite 1400, Chicago, IL, 60611, USA.
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Abstract
Dermatologists are familiar with the classic aspects of syphilis. Our objective in this update is to display novel features of sexually acquired syphilis, its pathophysiology, natural history, atypical clinical variants, skin of color, clinical pearls, and prospects. Textbook knowledge, congenital syphilis, epidemiology, and historical data are excluded.
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Affiliation(s)
- Jorge Navarrete
- Department of Dermatology, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Department of Dermatology and Sexually Transmitted Infections Clinic, Hospital Padre Hurtado, Santiago, Chile.
| | - Stephanie Saavedra-Portales
- Department of Dermatology and Sexually Transmitted Infections Clinic, Hospital San Juan de Dios, Santiago, Chile
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Ross MW, Rosser BRS, Polter EJ, Bates AJ, Wheldon CW, Haggart R, West W, Kohli N, Konety BR, Mitteldorf D, Talley GKMC, Wright M. Discrimination of Sexual and Gender Minority Patients in Prostate Cancer Treatment: Results from the Restore-1 Study. STIGMA AND HEALTH 2023; 8:85-92. [PMID: 36779009 PMCID: PMC9917961 DOI: 10.1037/sah0000356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study is the first to quantify experiences of discrimination in treatment undertaken by sexual and gender minority prostate cancer patients. Participants were 192 gay and bisexual and one transgender prostate cancer patients living in the US recruited from North America's largest online cancer support group. In this online survey, discrimination in treatment was measured using the Everyday Discrimination Scale (EDS), adapted for medical settings. Almost half (46%) endorsed at least one item, including 43% that the provider did not listen, 25% that they were talked down to, 20% that they received poorer care than other patients, 19% that the provider acted as superior, and 10% that the provider appeared afraid of them. While most (26.3%) rated the discrimination as "rare" or "sometimes" (EDS=1-3), 20% reported it as more common (EDS≥4). Most attributed the discrimination to their sexual orientation, or to providers being arrogant or too pushed for time. Discrimination was significantly associated with poorer urinary, bowel, and hormonal (but not sexual) EPIC function and bother scores, and with poorer mental health (SF-12). Those who had systemic/combined treatment (versus either radiation only or surgery only) were more likely to report discrimination. This study provides the first evidence that discrimination in prostate cancer treatment, including micro-aggressions, appear a common experience for gay and bisexual patients, and may result in poorer health outcomes.
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Affiliation(s)
- Michael W Ross
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Elizabeth J Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Alex J Bates
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ryan Haggart
- Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | - G Kristine M C Talley
- Adult and Gerontological Health, University of Minnesota School of Nursing School, Minneapolis, Minnesota, USA
| | - Morgan Wright
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Pravosud V, Ballard AM, Holloway IW, Young AM. Online Partner Seeking and Sexual Behaviors Among Men Who Have Sex With Men From Small and Midsized Towns: Cross-sectional Study. JMIR Form Res 2022; 6:e35056. [PMID: 35687395 PMCID: PMC9233248 DOI: 10.2196/35056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Men who have sex with men (MSM) residing outside of large urban areas are underrepresented in research on online partner seeking and sexual behaviors related to transmission of HIV. OBJECTIVE We aimed to determine associations between the use of the internet or social networking apps (online tools) to meet partners for sex, dating, or for both purposes (online partner seeking) and sexual behaviors among MSM residing in small and midsized towns in Kentucky, United States. METHODS Using peer-referral sampling and online self-administered questionnaires, data were collected from 252 men, aged 18 to 34 years, who had recently (past 6 months) engaged in anal sex with another man and resided in Central Kentucky. Using multivariable logistic regression models, we assessed associations of online partner seeking and HIV-related sexual behaviors. RESULTS Most (181/252, 71.8%) of the participants reported using online tools for partner seeking. Of these 181 respondents, 166 (91.7%) had used online tools to meet partners for sex (n=45, 27.1% for sex only; and n=121, 72.9% for sex and dating) and 136 (75.1%) had used online tools to meet partners for dating (n=15, 11% for dating only; and n=121, 89% for sex and dating). Adjusted analyses revealed that MSM who had engaged in condomless insertive and receptive anal intercourse were less likely to report online partner seeking (adjusted odds ratio [aOR] 0.22, 95% CI 0.07-0.68; P=.009 and aOR 0.25, 95% CI 0.10-0.66; P=.005, respectively). Increased number of insertive and receptive anal sex partners and substance use before or during sex were associated with higher odds of online partner seeking (aOR 1.31, 95% CI 1.11-1.55; P=.001; aOR 1.20, 95% CI 1.05-1.39; P=.008; and aOR 2.50, 95% CI 1.41-4.44; P=.002, respectively). CONCLUSIONS Among MSM who reside outside of large urban areas and practice online partner seeking, HIV risk-reduction interventions should address safer sex practices, including the risks for HIV transmission associated with alcohol or drug use before or during sex. MSM who do not practice online partner seeking are in need of continued outreach to reduce condomless anal sex.
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Affiliation(s)
- Vira Pravosud
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, United States
| | - April M Ballard
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Ian W Holloway
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - April M Young
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, United States
- Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
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Simon Rosser BR, Wright M, Hoefer CJ, Polter EJ, Kohli N, Wheldon CW, Haggart R, Talley KM, Mitteldorf D, Kilian G, Konety BR, Ross MW, West W. Recruiting an underserved, difficult to reach population into a cancer trial: Strategies from the Restore-2 Rehabilitation Trial for gay and bisexual prostate cancer patients. Clin Trials 2022; 19:239-250. [PMID: 35232299 PMCID: PMC9232867 DOI: 10.1177/17407745221077678] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND/AIMS Sexual minorities are small and under-researched populations that are at disproportionate risk for cancer and poor cancer outcomes. Described as a "hidden population," the principal research challenge has been to develop effective methods to identify and recruit such cancer patients into cancer studies. Online recruitment strategies, as well as targeted clinic recruitment using patient-entered sexual orientation and gender identity data from electronic medical records have potential to transform recruitment, but studies testing the effects of how to recruit using these have not been published. METHODS In 2019, we conducted a naturalistic, three-arm, stratified prospective study to compare three recruitment strategies: (a) clinic based recruitment of prostate cancer patients from gay health and urology clinics; (b) directly from the gay community; and (c) online recruitment (through cancer support, sex/dating, and social sites). For each strategy, we estimated time, workload, and direct costs involved. To study how recruitment strategy may affect sampling, we tested for retention rates, demographic and outcome differences across sites. Using these methods, we successfully recruited 401 gay and bisexual prostate cancer patients into a randomized, controlled, 24-month trial testing an online sexual and urinary rehabilitation curriculum tailored for this population. RESULTS There were seven key results. First, it is possible to recruit substantial numbers of sexual minority men into prostate cancer studies provided online recruitment methods are used. Second, we observed big differences in dropout during study onboarding by recruitment source. Third, within online recruitment, the online sex/dating application (app) was the most successful and efficient, followed by the cancer support site, and then the social networking site. Fourth, while clinics were the cheapest source of recruitment, they were time intensive and low in yield. Fifth, the cancer support site and sex/dating app recruits differed by several characteristics, with the former being more rehabilitation-focused while the latter were younger and more sexually active. Sixth, we found almost no differences in outcomes across the three online recruitment sites. Seventh, because retention in online studies has been a concern, we confirm very low attrition at 3- and 6 months into the trial. CONCLUSION For sexual minority cancer research, more research on how to use sexual orientation and gender identity electronic medical record data for clinic-based recruitment is needed. For other small or hard-to-reach populations, researchers should compare and publish online versus offline recruitment strategies.
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Affiliation(s)
- B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Morgan Wright
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Chris J Hoefer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Elizabeth J Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ryan Haggart
- Department of Urology, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Kristine Mc Talley
- Adult and Gerontological Health Cooperative, School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | | | - Gunna Kilian
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Michael W Ross
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, USA
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Ren M, Dashwood T, Walmsley S. The Intersection of HIV and Syphilis: Update on the Key Considerations in Testing and Management. Curr HIV/AIDS Rep 2021; 18:280-288. [PMID: 34091858 PMCID: PMC8180186 DOI: 10.1007/s11904-021-00564-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To highlight recent trends in the epidemiology of HIV and syphilis, the impact of the COVID epidemic, our approach to care of co-infected patients, and our views on important next steps in advancing the field. RECENT FINDINGS HIV and syphilis co-infection has been on the rise in recent years although since the COVID pandemic there is a decrease in new diagnoses-it remains unclear if this represents a true decline or inadequate testing or under-reporting. Standard HIV care should include regular syphilis serology .Treatment and serological follow-up of syphilis in HIV positive and negative patients can be conducted similarly. Challenges remain in the diagnosis and management of neurosyphilis. New models for testing and prevention will be crucial next steps in controlling co-infection. The intersection of HIV and syphilis infections continues to pose new and unique challenges in diagnosis, treatment, and prevention.
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Affiliation(s)
- Melody Ren
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Thomas Dashwood
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sharon Walmsley
- Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.
- Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, Room 13EN214, Toronto, ON, M5G2C4, Canada.
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Macapagal K, Moran K, Newcomb ME, Moskowitz DA, Owens C, Mustanski B. Patterns of Online and Offline Partnering, Partnership Characteristics, and Condomless Sex Among Adolescent Sexual Minority Males in the USA. AIDS Behav 2021; 25:2033-2045. [PMID: 33385277 PMCID: PMC9355016 DOI: 10.1007/s10461-020-03133-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 01/25/2023]
Abstract
Online partner-seeking among adolescent sexual minority males (ASMM) has been associated with condomless anal sex. Two hypotheses may explain this association: that online venues facilitate HIV transmission risk behavior more than offline venues (accentuation), or that individuals who tend to engage in these behaviors are more likely to seek partners online (self-selection). We examined these hypotheses in 700 13-18 year-old ASMM who completed the baseline survey of an effectiveness trial of an HIV prevention program in 2018-2020. The survey assessed demographic, sexual, and venue characteristics of male anal sex partnerships in the past 3 months. Many participants (83%) reported ≥ 1 online-met partner; most were met via sexual networking applications and were older than offline-met partners. Having met partners online, but not whether a particular partner was met online, was associated with greater odds of receptive condomless sex. Findings support the self-selection hypothesis, which has implications for HIV prevention in ASMM.
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Affiliation(s)
- Kathryn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.
| | - Kevin Moran
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - David A Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Christopher Owens
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
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Choi KWY, Choi EPH, Chow EPF, Wan EYF, Wong WCW, Wong JYH, Fong DYT. The Experience of Using Dating Applications for Sexual Hook-Ups: A Qualitative Exploration among HIV-Negative Men Who Have Sex With Men in Hong Kong. JOURNAL OF SEX RESEARCH 2021; 58:785-794. [PMID: 33656408 DOI: 10.1080/00224499.2021.1886227] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Men who have sex with men (MSM) use dating applications (apps) to explore various romantic and sexual relationships. This qualitative study aimed to describe HIV-negative MSM's experiences with app usage, the sexual activities arranged accordingly and their experiences in using dating apps to arrange sexual encounters. Thirty-one MSM who were sexually active and who used dating apps were recruited. Individual semi-structured interviews were conducted. Qualitative data were thematically analyzed to outline significant phenomena and perceptions. The factors associated with matching on apps included sex roles, human immunodeficiency virus serostatus and availability of a venue for meetup. Facilitated by these apps, diverse types of sexual encounters were arranged. Condoms were typically used for safer intercourse, except by people who were younger and inexperienced or when drugs were consumed before or during sex (chemsex). Extensive interest in non-penetrative sexual behaviors was expressed by our sample. Searching for post-exposure prophylaxis methods and/or sexual health screenings was common after exposure to risk of infections. Sexually abusive encounters were followed by changes in sex-searching habits and lowered trust in relationship formation. The results of this study are important for the development of appropriate interventions to promote safer sexual practices among HIV-negative MSM dating app users.
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Affiliation(s)
- Kitty W Y Choi
- School of Nursing, University of Hong Kong
- Sticky Rice Love
| | | | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health
- Central Clinical School, Monash University
| | - Eric Y F Wan
- Department of Family Medicine and Primary Care, University of Hong Kong
- Department of Pharmacology and Pharmacy, University of Hong Kong
| | - William C W Wong
- Department of Family Medicine and Primary Care, University of Hong Kong
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11
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Jakob L, Steeb T, Fiocco Z, Pumnea T, Jakob SN, Wessely A, Rothenberger CC, Brinker TJ, French LE, Berking C, Heppt MV. Patient Perception of Mobile Phone Apps for the Care and Prevention of Sexually Transmitted Diseases: Cross-Sectional Study. JMIR Mhealth Uhealth 2020; 8:e16517. [PMID: 33170133 PMCID: PMC7685917 DOI: 10.2196/16517] [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: 10/06/2019] [Revised: 08/08/2020] [Accepted: 09/04/2020] [Indexed: 01/06/2023] Open
Abstract
Background In the emerging era of digitalization and electronic health, various health-related apps have been launched, including apps for sexually transmitted diseases. Until now, little has been known about how patients perceive the value of such apps. Objective To investigate patient’s attitudes and awareness toward sexually transmitted disease–related apps in an outpatient sexually transmitted disease clinic setting. Methods A cross-sectional study was conducted at a dermatovenereological outpatient unit between April and July 2019. Patients completed a self-administered questionnaire on their perceptions of the popularity and usefulness of sexually transmitted disease–related apps. Descriptive analysis was performed with expression of categorical variables as frequencies and percentages. For continuous variables, the median, range, and interquartile range were indicated. Contingency tables and chi-square tests were used to investigate associations between sociodemographic data and items of the questionnaire. Results A total of 226 patients were surveyed (heterosexual: 137/193, 71.0%; homosexual: 44/193, 22.8%; bisexual: 12/193, 6.2%); 11.9% (27/225) had previously used health-related apps. Nearly half of the patients (97/214, 45.3%) specifically considered sexually transmitted disease–related apps useful, 47.8% (100/209) voted that they could supplement or support the consultation of a physician. Interestingly, only 35.1% (74/211) preferred a printed patient brochure on sexually transmitted diseases over downloading and using an app, but 64.0% (134/209) would download a sexually transmitted disease–related app recommended by their physician. General information regarding sexually transmitted diseases (93/167, 55.7%), evaluation of skin diseases based on photos or videos (78/167, 53.3%), information on the prevention of sexually transmitted diseases (76/167, 45.5%), mediation of nearby contact points or test sites (74/167, 44.3%), anonymous medical advice (69/167, 41.3%), and calculation of the risk of having a sexually transmitted disease (63/167, 37.3%) were rated as the most important features. Men were more likely than women to find sexually transmitted disease–related apps useful in general (P=.04; χ2=6.28) and to pay for such apps (P=.01; χ2=9.19). Patients aged <40 years would rather download an app recommended by their physician (P=.03; χ2=7.23), whereas patients aged >40 years preferred reading a patient brochure on sexually transmitted diseases (P=.02; χ2=8.14). Conclusions This study demonstrated high general interest in the use of sexually transmitted disease–related apps in this sample of dermatovenereological outpatients. In particular, young age and male sex were significantly associated with a positive perception, underlining the high potential of apps in the prevention and early recognition of sexually transmitted diseases in this group. Future studies are warranted to validate these findings in other populations.
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Affiliation(s)
- Lena Jakob
- Department of Dermatology and Allergy, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
| | - Theresa Steeb
- Department of Dermatology and Allergy, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany.,Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Zeno Fiocco
- Department of Dermatology and Allergy, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
| | - Teodora Pumnea
- Department of Dermatology and Allergy, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
| | - Sophia Nomi Jakob
- Arbeitsstelle für Diagnostik und Evaluation, Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany
| | - Anja Wessely
- Department of Dermatology and Allergy, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany.,Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | | | - Titus Josef Brinker
- National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany.,Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Lars Einar French
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Carola Berking
- Department of Dermatology and Allergy, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany.,Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Markus Vincent Heppt
- Department of Dermatology and Allergy, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany.,Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
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12
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Bragard E, Fisher CB, Curtis BL. "They know what they are getting into:" Researchers confront the benefits and challenges of online recruitment for HIV research. ETHICS & BEHAVIOR 2020; 30:481-495. [PMID: 33041608 DOI: 10.1080/10508422.2019.1692663] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Online research has become a critical recruitment modality for understanding and reducing health disparities among hidden populations most at risk for HIV infection. There is a lack of consensus and guidelines for the responsible conduct of online recruitment for HIV risk populations. Using semi-structured phone interviews, this study drew on the experiences of principal investigators (PIs) engaged in online HIV research to illuminate scientific and ethical benefits and challenges of social media recruitment. Using Thematic Analysis five major themes emerged: sampling advantages and disadvantages; challenges of data integrity; control of privacy protections; researcher competence and responsibility; and resources.
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Affiliation(s)
- Elise Bragard
- Department of Psychology, Fordham University, Bronx, NY
| | - Celia B Fisher
- Center for Ethics Education and Department of Psychology, Fordham University, Bronx, NY
| | - Brenda L Curtis
- Technology and Translational Research Unit, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD
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13
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Rosser BRS, Kohli N, Polter EJ, Lesher L, Capistrant BD, Konety BR, Mitteldorf D, West W, Dewitt J, Kilian G. The Sexual Functioning of Gay and Bisexual Men Following Prostate Cancer Treatment: Results from the Restore Study. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1589-1600. [PMID: 31016492 PMCID: PMC8559526 DOI: 10.1007/s10508-018-1360-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 05/19/2023]
Abstract
Prostate cancer is the second most common cancer in gay, bisexual, and other men who have sex with men (GBM). Few studies have assessed the effects of treatment on GBM's sexual behavior. For an online survey, 193 gay and bisexual men with prostate cancer were recruited from the North American's largest online cancer support group. Sexual functioning was measured using the Expanded Prostate Cancer Index Composite (EPIC) and a tailored Gay Sexual Functioning Inventory (GSFI). GBM have worse EPIC urinary and hormonal function and worse hormonal bother, but better sexual function and bother scores than published norms. In the GSFI, two-thirds of participants described their sexual functioning, post-treatment, as fair to poor. Only 22% reported erections sufficient for insertive anal sex. For receptive anal sex, one-third met criteria for anodyspareunia. Over half reported urination problems during sex or at orgasm. Erectile difficulties were common, severe, and a reason cited for not using condoms. Three men HIV seroconverted post-prostate cancer treatment. Differences in function and bother scores were observed by type of treatment, age, race/ethnicity, sexual orientation, but not relationship status. Sexual functioning significantly predicted long-term mental and physical health. GBM scored significantly worse on mental health and better on physical health than published norms. Sexual recovery after prostate cancer treatment is problematic for most GBM. Research to develop more effective sexual recovery, tailored to the needs of GBM treated for prostate cancer, is needed. Six implications for clinicians treating GBM with prostate cancer are identified.
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Affiliation(s)
- B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA.
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Elizabeth J Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA
| | - Lindsey Lesher
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA
| | | | | | | | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, USA
| | - James Dewitt
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA
| | - Gunna Kilian
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., #300, Minneapolis, MN, 55454, USA
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14
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Nemoto T, Xie H, Iwamoto M, Sakata M. HIV Risk Behaviors in Relation to Psychosocial Factors and Internet Usage Among Asian and Pacific Islander (API) Men Who Had Sex With Men (MSM) in California. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:117-136. [PMID: 32539477 DOI: 10.1521/aeap.2020.32.2.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Very few studies have been conducted to investigate HIV risk and protective behaviors in relation to psychosocial factors among Asian and Pacific Islander (API) MSM whose HIV/AIDS prevalence is lower than those of other racial/ethnic groups. This study, based on an online survey targeting API MSM in California revealed that API MSM often met sex partners online and that psychosocial factors (e.g., homophobia and identity with API gay community) were correlated with condomless receptive anal sex (RAS) with casual partners. In particular, an Asian cultural construct, interdependency, was correlated with condom use for RAS; that is, those who consider sex partners' health and value harmony tend to engage in safe sex. This finding sheds light on re-thinking the current over-emphasis on assertiveness and self-responsibility to keep free from HIV/STIs during negotiation with partners. Future STI prevention programs for API MSM should incorporate Asian cultural constructs and target specific risk groups.
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15
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The Influence of Companion Animals on Quality of Life of Gay and Bisexual Men Diagnosed with Prostate Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224457. [PMID: 31766206 PMCID: PMC6888196 DOI: 10.3390/ijerph16224457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/05/2019] [Accepted: 11/11/2019] [Indexed: 01/05/2023]
Abstract
There has been almost no research on associations of companion animals with quality of life in sexual minorities. Because gay and bisexual men have less social support than their heterosexual peers, some have argued that pet companionship could provide emotional support, while others have argued the opposite, that having a pet is another stressor. This analysis examines the association between having dogs, cats, both animals, or no animals and quality of life using the 12-item Short Form (SF-12) mental and physical composite quality of life scores for gay and bisexual prostate cancer survivors, post-treatment. Participants were 189 gay, bisexual, or other men who have sex with men, who completed online surveys in 2015. Linear regression analysis found that participants with cats and participants with dogs had lower mental quality of life scores than participants without pets. After adjustment for covariates, mental health scores remained significantly lower for cat owners, dog owners, and owners of both animals compared to those of participants who did not have pets. No differences were seen for physical quality of life scores after adjustment. We conclude that pet companionship may be a net stressor for gay and bisexual men following prostate cancer treatment. As this is the first study of pet companionship in sexual minorities, further research is needed to confirm the reliability of these findings, generalizability, and temporality of the association.
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16
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Polter EJ, Wheldon CW, Rosser BRS, Kohli N, Capistrant BD, Kapoor A, Konety B, Mitteldorf D, Ross M, Talley KMC, Terveen L, West W, Wright MM. Health-related quality of life by human immunodeficiency virus status in a cross-sectional survey of gay and bisexual prostate cancer survivors. Psychooncology 2019; 28:2351-2357. [PMID: 31518042 DOI: 10.1002/pon.5228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 09/04/2019] [Accepted: 09/07/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Prostate cancer is the most common invasive cancer in gay and bisexual men (GBM). Despite the unique sexual and urinary concerns of this group, studies of prostate cancer rehabilitation have primarily focused on heterosexual men. GBM also have high prevalence of human immunodeficiency virus (HIV), which may be associated with lower health-related quality of life (HRQOL). We examined the association between HIV status and HRQOL in a cohort of GBM with prostate cancer. METHODS Data from the Restore study, a cross-sectional online survey of GBM treated for prostate cancer, were used to examine this association. The Expanded Prostate Cancer Index Composite (EPIC) assessed function, bother, and summary measures in four domains: urinary, sexual, bowel, and hormone. Overall physical and mental HRQOL was assessed using the Short-Form Health Survey (SF-12). Multivariate analysis of variance and linear regression were used to evaluate the association between HIV status and HRQOL scores after adjustment for demographic and sexual characteristics. RESULTS Of 192 participants, 24 (12.4%) reported an HIV diagnosis. After adjustment for covariates, HIV-positive status was associated with lower scores on the EPIC urinary (mean difference [MD]: -13.0, 95% CI, -21.4 to -4.6), sexual (MD: -12.5, 95% CI, -21.9 to -3.2), and bowel (MD: -5.9, 95% CI, -11.7 to -0.2) domains. No significant associations were observed between HIV status and other outcomes. CONCLUSIONS HIV status may be associated with poorer urinary, sexual, and bowel HRQOL in GBM prostate cancer survivors.
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Affiliation(s)
- Elizabeth J Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Christopher W Wheldon
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.,Department of Public Health, Temple University, Philadelphia, Pennsylvania
| | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota
| | | | - Aditya Kapoor
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Badrinath Konety
- Department of Urology, University of Minnesota, Minneapolis, Minnesota
| | - Darryl Mitteldorf
- Malecare Cancer Support, 85 Delancey Street (The Yard), New York, New York
| | - Michael Ross
- Department of Family Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota
| | | | - Loren Terveen
- Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, Minnesota
| | - Morgan M Wright
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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17
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Cheng W, Xu H, Tang W, Zhong F, Meng G, Han Z, Zhao J. Online HIV prevention intervention on condomless sex among men who have sex with men: a web-based randomized controlled trial. BMC Infect Dis 2019; 19:644. [PMID: 31324233 PMCID: PMC6642590 DOI: 10.1186/s12879-019-4251-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 07/03/2019] [Indexed: 11/13/2022] Open
Abstract
Background Given the widespread use of the Internet among men who have sex with men (MSM) and high risk of Internet-facilitated sexual behaviors, Internet-based interventions to reduce sexual risk are urgently needed. Methods We recruited 1,100 participants from online and randomly assigned to two groups. One group received online HIV intervention services. Online HIV intervention was developed through mix-method formative research, measures included scenarios experiencing intervention and HIV information dissemination. Self-reported condomless anal sex with a male in the past three months was measured to evaluate the intervention effect. Result Of the 1,100 participants, the majority were aged between 21 and 30 years old (62%), had a college degree or higher (80%), were single (88%), and self-identified as homosexual (78%). The estimated risk difference of condomless sex with a male in the past three months between groups was 9.3% (95% confidence interval (CI): 1.1, 17.5%). Using multiple imputations intention-to-treat, the estimated risk difference was 8.9% (95%CI: 1.2, 16.6%). Modification effects were found between intervention and characteristics including: educational attainment (p = 0.012), marital status (p = 0.005) and awareness of AIDS-related knowledge (p = 0.010). Conclusion Internet appears to be a promising approach to disseminate HIV prevention amongst MSM. Interactive online intervention appeals to MSM and poses a great potential for reducing HIV risky behavior. Trial registration ChiCTR1800014260 (retrospectively registered 2 Jan, 2018). Electronic supplementary material The online version of this article (10.1186/s12879-019-4251-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Weibin Cheng
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Baiyun District, Guangzhou, 510440, Guangdong, China. .,Dermatology Hospital of Southern Medical University, No.2 Lujing Road, Yuexiu District, Guangzhou, 510095, Guangdong, China.
| | - Huifang Xu
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Baiyun District, Guangzhou, 510440, Guangdong, China.
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, No.2 Lujing Road, Yuexiu District, Guangzhou, 510095, Guangdong, China.,University of North Carolina Project-China, No.2 Lujing Road, Yuexiu District, Guangzhou, 510095, Guangdong, China
| | - Fei Zhong
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Baiyun District, Guangzhou, 510440, Guangdong, China
| | - Gang Meng
- Lingnan Partners Community Support Center A2-Tianwenyuan, Tiyuxi road, Guangzhou, 510000, Guangdong, China
| | - Zhigang Han
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, No.1, Qide Road, Baiyun District, Guangzhou, 510440, Guangdong, China
| | - Jinkou Zhao
- The Global Fund to fight AIDS, Tuberculosis and Malaria, Chemin de Blandonnet 8
- 1214 Vernier, Geneva, Switzerland
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18
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Sharma A, Stephenson R, Sallabank G, Merrill L, Sullivan S, Gandhi M. Acceptability and Feasibility of Self-Collecting Biological Specimens for HIV, Sexually Transmitted Infection, and Adherence Testing Among High-Risk Populations (Project Caboodle!): Protocol for an Exploratory Mixed-Methods Study. JMIR Res Protoc 2019; 8:e13647. [PMID: 31045502 PMCID: PMC6521211 DOI: 10.2196/13647] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/28/2019] [Accepted: 03/29/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Men who have sex with men (MSM) in the United States experience a disproportionate burden of HIV and bacterial sexually transmitted infections (STIs), such as gonorrhea and chlamydia. Screening levels among MSM remain inadequate owing to barriers to testing such as stigma, privacy and confidentiality concerns, transportation issues, insufficient clinic time, and limited access to health care. Self-collection of specimens at home and their return by mail for HIV and bacterial STI testing, as well as pre-exposure prophylaxis (PrEP) adherence monitoring, could be a resource-efficient option that might mitigate some of these barriers. OBJECTIVE Project Caboodle! is a mixed-methods study that explores the acceptability and feasibility of self-collecting and returning a bundle of 5 different specimens for HIV and bacterial STI testing, as well as PrEP adherence monitoring, among sexually active HIV-negative or unknown status MSM in the United States aged 18 to 34 years. METHODS Participants will be recruited using age, race, and ethnicity varied advertising on social networking websites and mobile gay dating apps. In Phase 1, we will send 100 participants a box containing materials for self-collecting and potentially returning a finger-stick blood sample (for HIV testing), pharyngeal swab, rectal swab, and urine specimen (for gonorrhea and chlamydia testing), and hair sample (to assess adequacy for potential PrEP adherence monitoring). Specimen return will not be incentivized, and participants can choose to mail back all, some, or none of the specimens. Test results will be delivered back to participants by trained counselors over the phone. In Phase 2, we will conduct individual in-depth interviews using a video-based teleconferencing software (VSee) with 32 participants from Phase 1 (half who returned all specimens and half who returned some or no specimens) to examine attitudes toward and barriers to completing various study activities. RESULTS Project Caboodle! was funded in May 2018, and participant recruitment began in March 2019. The processes of designing a study logo, creating advertisements, programming Web-based surveys, and finalizing step-by-step written instructions accompanied by color images for specimen self-collection have been completed. The boxes containing 5 self-collection kits affixed with unique identification stickers are being assembled, and shipping procedures (for mailing out boxes to participants and for specimen return by participants using prepaid shipping envelopes) and payment procedures for completing the surveys and in-depth interviews are being finalized. CONCLUSIONS Self-collection of biological specimens at home and their return by mail for HIV and bacterial STI testing, as well as PrEP adherence monitoring, might offer a practical and convenient solution to improve comprehensive prevention efforts for high-risk MSM. The potentially reduced time, expense, and travel associated with this approach could facilitate a wider implementation of screening algorithms and remote monitoring strategies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/13647.
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Affiliation(s)
- Akshay Sharma
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States.,Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Rob Stephenson
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States.,Department of Systems, Population and Leadership, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Gregory Sallabank
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Leland Merrill
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Stephen Sullivan
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Monica Gandhi
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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19
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Ignacio M, Garofalo R, Pearson C, Kuhns LM, Bruce J, Scott Batey D, Radix A, Belkind U, Hidalgo MA, Hirshfield S, Schnall R. Pilot feasibility trial of the MyPEEPS mobile app to reduce sexual risk among young men in 4 cities. JAMIA Open 2019; 2:272-279. [PMID: 31294422 PMCID: PMC6603441 DOI: 10.1093/jamiaopen/ooz008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/14/2019] [Accepted: 03/12/2019] [Indexed: 11/20/2022] Open
Abstract
Objectives Our study team adapted the MyPEEPS (Male Youth Pursuing Empowerment, Education, and Prevention around Sexuality) curriculum, an evidence-based human immunodeficiency virus (HIV) prevention intervention, from a face-to-face, group-based intervention to an individual-level mobile responsive web-based intervention to improve HIV risk behaviors in very young men, aged 13–18 years. Materials and methods In adapting the MyPEEPS intervention to mobile app, we used a series of methodologies, including expert panel reviews, weekly team meetings with the software development company, and conducted in-depth interviews with very young men. Following the iterative process, we conducted a 6-week pre–post feasibility pilot trial with 40 young men in Birmingham, AL; Chicago, IL; New York City, NY; and Seattle, WA. Primary outcomes of interest were uptake of the app, accessibility and satisfaction. Results Across all 4 sites, 62.5% (25/40) of participants completed all modules in the app in an average of 28.85 (SD 21.69) days. Participants who did not attend to the follow-up visit did not complete any of the app modules. Overall participants reported that the app was easy to use, useful and has the potential to improve their sexual health knowledge and behavior and awareness in risky contexts. Participants also highly rated the app, information and interface quality of the app. Discussion Lessons learned from the pilot included the need for reminder systems and providing anticipatory guidance about Internet connectivity when using the app. These changes will be incorporated into study procedures for our multisite trial. Conclusion Overall, participants found the app to be highly usable and have the potential to positively improve their sexual risk behavior.
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Affiliation(s)
- Matt Ignacio
- School of Social Work, Indigenous Wellness Research Institute, University of Washington, Seattle, Washington, USA
| | - Robert Garofalo
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital, Northwestern University, Chicago, Illinois, USA
| | - Cynthia Pearson
- School of Social Work, Indigenous Wellness Research Institute, University of Washington, Seattle, Washington, USA
| | - Lisa M Kuhns
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital, Northwestern University, Chicago, Illinois, USA
| | - Josh Bruce
- Birmingham AIDS Outreach, Birmingham, Alabama, USA
| | - D Scott Batey
- Department of Social Work, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Asa Radix
- Callen-Lorde Community Health Center, New York, New York, USA
| | - Uri Belkind
- Callen-Lorde Community Health Center, New York, New York, USA
| | - Marco A Hidalgo
- Children's Hospital of Los Angeles, Los Angeles, California, USA
| | - Sabina Hirshfield
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Rebecca Schnall
- School of Nursing, Columbia University, New York, New York, USA
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20
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Saberi P, Neilands TB, Lally MA, Hosek SG, Hightow-Weidman L. The Association between Use of Online Social Networks to Find Sex Partners and Sexually Transmitted Infection Diagnosis among Young Men Who Have Sex with Men and Transgender Women Living with HIV. J Int Assoc Provid AIDS Care 2019; 18:2325958219867324. [PMID: 31389285 PMCID: PMC6900576 DOI: 10.1177/2325958219867324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/23/2019] [Accepted: 07/02/2019] [Indexed: 11/17/2022] Open
Abstract
We conducted a cross-sectional analysis of baseline data from the Adolescent Trials Network for HIV/AIDS Interventions to examine the association between the use of social media sites to find sex partners and recent diagnosis of sexually transmitted infections (STIs) among 13- to 24-year-old men who have sex with men and transgender women living with HIV. We used linear regression to determine the relationship between the number of STIs and the number of social media sites used to find sex partners with each type of sex act included in the analysis. Secondary analyses substituted frequency of social media site use for number of social media sites. Among 741 participants, for every 1 social media account used to find sex partners, there was a 2.53% (95% confidence interval: 0.28-5.54) increase in STIs. This association was mediated through condomless receptive anal intercourse or condomless insertive anal intercourse but not barrierless oral intercourse. Similar but attenuated associations were found when frequency of social media site use was substituted for number of social media sites. Future research should examine innovative interventions on these social media sites with respect for its users.
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Affiliation(s)
- Parya Saberi
- Department of Medicine, University of California San Francisco, San
Francisco, CA, USA
| | - Torsten B. Neilands
- Department of Medicine, University of California San Francisco, San
Francisco, CA, USA
| | - Michelle A. Lally
- Department of Medicine, Alpert Medical School of Brown University and
Lifespan Hospital System, Providence, RI, USA
| | - Sybil G. Hosek
- Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL,
USA
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21
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Schnall R, Kuhns LM, Hidalgo MA, Powell D, Thai J, Hirshfield S, Pearson C, Ignacio M, Bruce J, Batey DS, Radix A, Belkind U, Garofalo R. Adaptation of a Group-Based HIV RISK Reduction Intervention to a Mobile App for Young Sexual Minority Men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:449-462. [PMID: 30966769 PMCID: PMC7019210 DOI: 10.1521/aeap.2018.30.6.449] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
There is a dearth of evidence-based HIV prevention interventions for very young men who have sex with men (YMSM) ages 13-18 years, at high risk for HIV. We adapted the MyPEEPS intervention-an evidence-based, group-level intervention-to individual-level delivery by a mobile application. We used an expert panel review, in-depth interviews with YMSM (n = 40), and weekly meetings with the investigative team and the software development company to develop the mobile app. The expert panel recommended changes to the intervention in the following areas: (1) biomedical interventions, (2) salience of intervention content, (3) age group relevance, (4) technical components, and (5) stigma content. Interview findings reflected current areas of focus for the intervention and recommendations of the expert panel for new content. In regular meetings with the software development firm, guiding principles included development of dynamic content, while maintaining fidelity of the original curriculum and shortening intervention content for mobile delivery.
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Affiliation(s)
| | - Lisa M. Kuhns
- Ann & Robert H. Lurie Children’s Hospital, Division of Adolescent Medicine
| | | | | | - Jennie Thai
- Ann & Robert H. Lurie Children’s Hospital, Division of Adolescent Medicine
| | | | - Cynthia Pearson
- Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, WA
| | - Matt Ignacio
- Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, WA
| | - Josh Bruce
- Birmingham AIDS Outreach, Birmingham, AL
| | - D. Scott Batey
- Department of Social Work, University of Alabama at Birmingham, Birmingham, AL
| | - Asa Radix
- Callen-Lorde Community Health Center, New York
| | - Uri Belkind
- Callen-Lorde Community Health Center, New York
| | - Robert Garofalo
- Ann & Robert H. Lurie Children’s Hospital, Division of Adolescent Medicine
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22
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Jeffries WL, Greene KM, Paz-Bailey G, McCree DH, Scales L, Dunville R, Whitmore S. Determinants of HIV Incidence Disparities Among Young and Older Men Who Have Sex with Men in the United States. AIDS Behav 2018; 22:2199-2213. [PMID: 29633094 DOI: 10.1007/s10461-018-2088-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This study sought to determine why young men who have sex with men (MSM) have higher HIV incidence rates than older MSM in the United States. We developed hypotheses that may explain this disparity. Data came from peer-reviewed studies published during 1996-2016. We compared young and older MSM with respect to behavioral, clinical, psychosocial, and structural factors that promote HIV vulnerability. Compared with older MSM, young MSM were more likely to have HIV-discordant condomless receptive intercourse. Young MSM also were more likely to have "any" sexually transmitted infection and gonorrhea. Among HIV-positive MSM, young MSM were less likely to be virally suppressed, use antiretroviral therapy, and be aware of their infection. Moreover, young MSM were more likely than older MSM to experience depression, polysubstance use, low income, decreased health care access, and early ages of sexual expression. These factors likely converge to exacerbate age-associated HIV incidence disparities among MSM.
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Affiliation(s)
- William L Jeffries
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA.
- Centers for Disease Control and Prevention, 1600 Clifton Road, MS E40, Atlanta, GA, 30333, USA.
| | - Kevin M Greene
- Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Gabriela Paz-Bailey
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Donna Hubbard McCree
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Lamont Scales
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Richard Dunville
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Suzanne Whitmore
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
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Mutchler MG, McDavitt BW, Tran TN, El Khoury C, Ballan E, Tohme J, Kegeles SM, Wagner G. This is who we are: building community for HIV prevention with young gay and bisexual men in Beirut, Lebanon. CULTURE, HEALTH & SEXUALITY 2018; 20:690-703. [PMID: 28922101 PMCID: PMC5857392 DOI: 10.1080/13691058.2017.1371334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Young gay men in Beirut are at significantly elevated risk of HIV infection compared with the general Lebanese population. Despite nascent HIV prevention efforts in the region, there is a need for effective community-level HIV prevention interventions tailored for young gay men. This qualitative study examined internal dynamics within Beirut's gay community as a basis for developing community-level interventions. Peer ethnographers were trained to collect field notes on conversations between young gay men in public spaces in Beirut, and conducted follow-up focus groups with young gay men. Analyses revealed three major themes: (1) the need for safe spaces in which to socialise, (2) the importance of being able to locate and connect with other young gay men, and (3) ambivalence regarding a gay community that was supportive in some ways but also fragmented and often judgemental. Study findings also confirm the existence of external threats to community such as stigma, cultural and familial norms regarding heterosexuality and criminalisation of refugee status. Understanding such community dynamics and the environmental context is central to designing effective community-based HIV prevention programmes.
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Affiliation(s)
- Matt G. Mutchler
- Department of Sociology, California State University Dominguez Hills, Carson, CA, USA
| | | | - Tu N. Tran
- Community Based Research, AIDS Project Los Angeles, Los Angeles, CA, USA
| | | | - Ellie Ballan
- The Arab Foundation for Freedoms and Equality, Beirut, Lebanon
| | | | - Susan M. Kegeles
- Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
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24
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Algarin AB, Ward PJ, Christian WJ, Rudolph AE, Holloway IW, Young AM. Spatial Distribution of Partner-Seeking Men Who Have Sex With Men Using Geosocial Networking Apps: Epidemiologic Study. J Med Internet Res 2018; 20:e173. [PMID: 29853441 PMCID: PMC6002670 DOI: 10.2196/jmir.9919] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/07/2018] [Accepted: 03/09/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Geosocial networking apps have made sexual partner-seeking easier for men who have sex with men, raising both challenges and opportunities for human immunodeficiency virus and sexually transmitted infection prevention and research. Most studies on men who have sex with men geosocial networking app use have been conducted in large urban areas, despite research indicating similar patterns of online- and app-based sex-seeking among men who have sex with men in rural and midsize cities. OBJECTIVE The goal of our research was to examine the spatial distribution of geosocial networking app usage and characterize areas with increasing numbers of partner-seeking men who have sex with men in a midsize city in the South. METHODS Data collection points (n=62) were spaced in 2-mile increments along 9 routes (112 miles) covering the county encompassing the city. At each point, staff logged into 3 different geosocial networking apps to record the number of geosocial networking app users within a 1-mile radius. Data were collected separately during weekday daytime (9:00 AM to 4:00 PM) and weekend nighttime (8:00 PM to 12:00 AM) hours. Empirical Bayesian kriging was used to create a raster estimating the number of app users throughout the county. Raster values were summarized for each of the county's 208 Census block groups and used as the outcome measure (ie, geosocial networking app usage). Negative binomial regression and Wilcoxon signed rank sum tests were used to examine Census block group variables (eg, median income, median age) associated with geosocial networking app usage and temporal differences in app usage, respectively. RESULTS The number of geosocial networking app users within a 1-mile radius of the data collection points ranged from 0 to 36 during weekday daytime hours and 0 to 39 during weekend nighttime hours. In adjusted analyses, Census block group median income and percent Hispanic ethnicity were negatively associated with geosocial networking app usage for all 3 geosocial networking apps during weekday daytime and weekend nighttime hours. Population density and the presence of businesses were positively associated with geosocial networking app usage for all 3 geosocial networking apps during both times. CONCLUSIONS In this midsize city, geosocial networking app usage was highest in areas that were more population-dense, were lower income, and had more businesses. This research is an example of how geosocial networking apps' geospatial capabilities can be used to better understand patterns of virtual partner-seeking among men who have sex with men.
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Affiliation(s)
- Angel B Algarin
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Patrick J Ward
- Department of Epidemiology, University of Kentucky, Lexington, KY, United States
| | - W Jay Christian
- Department of Epidemiology, University of Kentucky, Lexington, KY, United States
| | - Abby E Rudolph
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Ian W Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA, United States
| | - April M Young
- Department of Epidemiology, University of Kentucky, Lexington, KY, United States
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, United States
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25
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Weiss KM, Jonas KJ, Guadamuz TE. Playing and Never Testing: Human Immunodeficiency Virus and Sexually Transmitted Infection Testing Among App-Using MSM in Southeast Asia. Sex Transm Dis 2018; 44:406-411. [PMID: 28608790 DOI: 10.1097/olq.0000000000000624] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Little is known about mobile application (app)-based behavior of men who have sex with men (MSM) in Thailand. A cross-sectional online assessment of app users in Bangkok found that more than a quarter have never tested for human immunodeficiency virus (HIV) and 1 in 3 never tested for sexually transmitted infections (STI). STI testing patterns and HIV testing frequency were highly associated with each other in multinomial logistic regression. In the midst of an escalating epidemic where HIV incidence among MSM is highest in Asia, apps can serve to engage those least likely to be reached by traditional methods of recruitment and outreach in Thailand.
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Affiliation(s)
- Kevin M Weiss
- From the *Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, †Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands; ‡Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; and §Department of Society and Health and the Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
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26
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Cruess DG, Burnham KE, Finitsis DJ, Goshe BM, Strainge L, Kalichman M, Grebler T, Cherry C, Kalichman SC. A Randomized Clinical Trial of a Brief Internet-based Group Intervention to Reduce Sexual Transmission Risk Behavior Among HIV-Positive Gay and Bisexual Men. Ann Behav Med 2018; 52:116-129. [PMID: 29538626 PMCID: PMC6361295 DOI: 10.1093/abm/kax031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background HIV disproportionately affects sexual minority men, and developing strategies to reduce transmission risk is a public health priority. Purpose The goal was to empirically test a newly developed, Information, Motivation, Behavioral skills (IMB) theoretically derived, online HIV sexual risk reduction intervention (called HINTS) among a sample of sexual minority men living with HIV. Methods Participants were 167 men randomized to either the four-session online HINTS intervention or to a time-matched, online control condition. Participants were assessed at baseline and at 6-month follow-up for demographic, medical and psychosocial factors, and sexual risk behavior. Analyses examined group differences in incidence rates of condomless anal sex (CAS) at follow-up with all male sex partners and by partner serostatus, either seroconcordant or serodiscordant for HIV infection. Results Men assigned to the HINTS intervention reported decreased CAS with serodiscordant partners, a behavior that confers high risk of HIV transmission, compared to the control group. Men assigned to the HINTS intervention also reported increased CAS with seroconcordant partners, a behavior indicative of serosorting. Although the IMB model did not appear to mediate these intervention effects, some IMB components were associated with behavioral outcomes at 6-month follow-up. Conclusions A new group-based sexual risk reduction intervention conducted exclusively online was successful in reducing HIV transmission risk behavior in a sample of gay and bisexual men living with HIV. Future work should consider utilizing this intervention with other groups living with HIV, perhaps in combination with biomedical HIV prevention strategies.
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Affiliation(s)
- Dean G Cruess
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT
| | - Kaylee E Burnham
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT
| | - David J Finitsis
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT
| | - Brett M Goshe
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT
| | - Lauren Strainge
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Moira Kalichman
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT
| | - Tamar Grebler
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT
| | - Chauncey Cherry
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT
| | - Seth C Kalichman
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, CT
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27
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Pines HA, Karris MY, Little SJ. Sexual Partner Concurrency Among Partners Reported by MSM with Recent HIV Infection. AIDS Behav 2017; 21:3026-3034. [PMID: 28702851 PMCID: PMC5983362 DOI: 10.1007/s10461-017-1855-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We examined concurrency among sexual partners reported by men who have sex with men (MSM) with recent (acute or early) HIV infection in San Diego, California (2002-2015). Partners overlapping in time in the past 3 months were considered concurrent. Logistic generalized linear mixed models were used to identify factors associated with concurrency at the partner-level. 56% (388/699) of partners were concurrent to ≥1 other partner. The odds of concurrency were higher among partners >10 years younger than the participant (vs. within 10 years of age) [adjusted odds ratio (AOR) = 2.22, 95% confidence interval (CI) 1.09-4.52], longer term partners (AOR per month = 1.02, 95% CI 1.01-1.03), and partners met online (AOR = 1.56, 95% CI 0.98-2.48). Concurrency is common among partners of recently HIV-infected MSM. Tailored HIV prevention strategies for MSM with older partners, longer term partners, and partners met online may help minimize the potential impact of concurrency on HIV transmission.
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Affiliation(s)
- Heather A Pines
- Department of Medicine, University of California, San Diego, 9500 Gilman Dr, MC 0507, La Jolla, CA, 92093-0507, USA.
| | - Maile Y Karris
- Department of Medicine, University of California, San Diego, 9500 Gilman Dr, MC 0507, La Jolla, CA, 92093-0507, USA
| | - Susan J Little
- Department of Medicine, University of California, San Diego, 9500 Gilman Dr, MC 0507, La Jolla, CA, 92093-0507, USA
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28
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Allen JE, Mansergh G, Mimiaga MJ, Holman J, Herbst JH. Mobile Phone and Internet Use Mostly for Sex-Seeking and Associations With Sexually Transmitted Infections and Sample Characteristics Among Black/African American and Hispanic/Latino Men Who Have Sex With Men in 3 US Cities. Sex Transm Dis 2017; 44:284-289. [PMID: 28407644 DOI: 10.1097/olq.0000000000000590] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Men who have sex with men (MSM) have a relatively high prevalence of sexually transmitted infections (STIs). This study examines the association of self-reported STIs and use of mobile phones and/or computer-based Internet to meet sexual partners among black and Hispanic/Latino MSM in the United States. METHODS Black and Hispanic/Latino MSM (N = 853) were recruited from 3 US cities (Chicago, IL; Kansas City, MO; and Fort Lauderdale, FL) via online and community outreach. Men completed a computer-assisted, self-interview assessment on demographics, use of mobile phones and computer-based Internet for sex-seeking, sexual risk behavior, and self-reported bacterial STIs in the past year. Multivariable logistic regression was used to model independent associations of STIs and use of these technologies to meet sexual partners. RESULTS Twenty-three percent of the sample reported having an STI in the past year; 29% reported using a mobile phone and 28% a computer-based Internet mostly for sex-seeking; and 22% reported using both. Number of male sexual partners (past year) was associated with any STI (adjusted odds ratio, 1.03; 95% confidence interval, 1.01-1.06). Adjusting for human immunodeficiency virus status, number of male sexual partners (past year), and demographic variables, men who reported use of both mobile phones and computer-based Internet for sex-seeking had increased odds of reporting an STI (adjusted odds ratio, 2.59; 95% confidence interval, 1.75-3.83), as well as with separate reports of chlamydia, gonorrhea, and syphilis (P's < 0.05). CONCLUSIONS Enhanced community education regarding STI prevention, testing, and treatment options are necessary among this subpopulation of MSM who may benefit from messaging via Internet and mobile phone application sites.
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Affiliation(s)
- Jacob E Allen
- From the *Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA; †Brown University, Providence, RI; and ‡Health Resources in Action, Boston, MA
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29
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Cruess DG, Burnham KE, Finitsis DJ, Cherry C, Grebler T, Goshe BM, Strainge L, Kalichman MO, Kalichman SC. Online Partner Seeking and Sexual Risk Among HIV+ Gay and Bisexual Men: A Dialectical Perspective. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1079-1087. [PMID: 27671781 DOI: 10.1007/s10508-016-0833-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/09/2016] [Accepted: 08/08/2016] [Indexed: 06/06/2023]
Abstract
For almost two decades, researchers have explored the relationship between online partner seeking (OPS) and HIV/STI transmission risk behavior among men who have sex with men (MSM), including gay- and bisexual-identified men. A dichotomy has emerged with some findings that OPS is associated with greater sexual risk behavior, and a sparser but emerging literature that men may use OPS for sexual risk reduction. This study examined the association between proportion of partners met online and sexual risk behavior in a sample of 170 HIV-positive gay- and bisexual-identified men. Participants completed assessments including psychosocial factors and a comprehensive assessment of sexual behavior, including total number of male partners, and condomless insertive and receptive anal sex with HIV-negative/unknown serostatus partners or HIV-positive male partners. Our findings support taking a dialectical stance and indicate that OPS may impact risk differently given different individual and contextual circumstances.
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Affiliation(s)
- Dean G Cruess
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd., Unit 1020, Storrs, CT, 06269, USA.
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA.
| | - Kaylee E Burnham
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd., Unit 1020, Storrs, CT, 06269, USA
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA
| | - David J Finitsis
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd., Unit 1020, Storrs, CT, 06269, USA
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA
| | - Chauncey Cherry
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA
| | - Tamar Grebler
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA
| | - Brett M Goshe
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd., Unit 1020, Storrs, CT, 06269, USA
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA
| | - Lauren Strainge
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd., Unit 1020, Storrs, CT, 06269, USA
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA
| | - Moira O Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA
| | - Seth C Kalichman
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Rd., Unit 1020, Storrs, CT, 06269, USA
- Institute for Collaboration on Health, Intervention, and Policy, Storrs, CT, USA
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Siegel K, Lekas HM, Onaga M, Verni R, Gunn H. The Strategies of Heterosexuals from Large Metropolitan Areas for Assessing the Risks of Exposure to HIV or Other Sexually Transmitted Infections from Partners Met Online. AIDS Patient Care STDS 2017; 31:182-195. [PMID: 28338338 DOI: 10.1089/apc.2016.0299] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Heterosexuals' use of the Internet for meeting romantic or sexual partners is rapidly increasing, raising concerns about the Internet's potential to facilitate encounters that place individuals at risk for acquiring HIV or other sexually transmitted infections (STIs). For example, online sharing of personal information and self-revelations can foster virtual intimacy, promoting a false sense of familiarity that might accelerate progression to unprotected sex. Therefore, it is critical to understand how those who meet sexual partners online attempt to assess the possible risk of acquiring HIV or STIs posed by having unprotected sex with a new partner and decide whether to use a condom. To investigate this issue, in-depth interviews were conducted with a diverse sample of heterosexual male and female participants from large metropolitan cities who had had unprotected vaginal or anal sex with at least two partners met online in the past 3 months. With few exceptions, participants relied on faulty strategies and heuristics to estimate these risks; yet, most engaged in unprotected sex at their first meeting or very soon afterward. While some seemed to try to make a genuine effort to arrive at a reliable assessment of the HIV risk posed, most appeared to be looking for a way to justify their desire and intention to have unprotected sex. The findings suggest the need for more HIV and sexual health education targeted at heterosexuals, especially for those who go online to meet partners.
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Affiliation(s)
- Karolynn Siegel
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Helen-Maria Lekas
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York
- Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
| | - Marie Onaga
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Rachel Verni
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Hamish Gunn
- Department of Psychology, University of Massachusetts, Boston, Massachusetts
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31
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Sharma A, Sullivan SP, Stephenson RB. Detailed Knowledge About HIV Epidemiology and Transmission Dynamics and Their Associations With Preventive and Risk Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States. JMIR Public Health Surveill 2017; 3:e11. [PMID: 28264795 PMCID: PMC5359415 DOI: 10.2196/publichealth.7255] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain disproportionately affected by human immunodeficiency virus (HIV). Yet their testing frequency is suboptimal and condomless anal sex (CAS) is increasing. Behavioral theories posit that information about HIV is a pivotal construct in individual risk reduction. However, measurements of knowledge have traditionally focused on ever hearing about HIV and being aware of the most common routes of spread. OBJECTIVE Using a national Web-based sample of sexually active GBMSM, we sought to (1) quantify levels of detailed knowledge about HIV epidemiology and transmission dynamics, (2) describe variations in detailed knowledge levels across demographic strata, and (3) evaluate potential associations of increasing levels of detailed knowledge with HIV testing in the past year and engaging in CAS with a male partner in the past 3 months. METHODS GBMSM were recruited through a social networking website (Facebook) from August to September 2015 and asked 17 knowledge-based questions pertaining to the following 2 domains using a Web-based survey: HIV epidemiology (9 questions including statistics on incidence, prevalence, and distribution) and HIV transmission dynamics (8 questions including modes of spread and per-act transmission probabilities). Ordinal domain-specific indices of detailed knowledge were created for each respondent by summing their number of correct responses. Separate cumulative logit models were used to identify factors independently associated with each index, and multivariable logistic regression models were used to characterize associations with HIV testing history and recently engaging in CAS. RESULTS Of the 1064 participants in our study, only half (49.62%, 528/1064) had been tested for HIV in the past year, and almost half (47.84%, 509/1064) had engaged in CAS with a male partner in the past 3 months. Majority scored 3 of 9 epidemiology questions correct (26.88%, 286/1064) and 5 of 8 transmission dynamics questions correct (25.00%, 266/1064). Participants younger than 35 years, of non-Hispanic non-white or Hispanic race and ethnicity, with lower educational levels, and who reported a sexual orientation other than homosexual or gay were significantly less knowledgeable about HIV transmission dynamics. Increasing levels of knowledge about this domain were independently associated with testing in the past year (adjusted odds ratio for each additional correct response: 1.10, 95% CI 1.01-1.20) but not with recent CAS. Increasing knowledge about HIV epidemiology was not associated with either outcome. CONCLUSIONS Increasing detailed knowledge about HIV epidemiology might not be as important as educating sexually active GBMSM regarding transmission dynamics. Researchers and practitioners designing prevention messages targeting GBMSM should bear in mind that not all knowledge is equal and that some aspects might have a greater positive impact than others. Future research to identify influential content and contemporary modes of delivery is needed.
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Affiliation(s)
- Akshay Sharma
- Center for Sexuality and Health Disparities, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Stephen P Sullivan
- Center for Sexuality and Health Disparities, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States
| | - Rob B Stephenson
- Center for Sexuality and Health Disparities, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, United States
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Morgan E, Oster AM, Townsell S, Peace D, Benbow N, Schneider JA. HIV-1 Infection and Transmission Networks of Younger People in Chicago, Illinois, 2005-2011. Public Health Rep 2017; 132:48-55. [PMID: 28005480 PMCID: PMC5298503 DOI: 10.1177/0033354916679988] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Analysis of HIV nucleotide sequences can be used to identify people with highly similar HIV strains and understand transmission patterns. The objective of this study was to identify groups of people highly connected by HIV transmission and the extent to which transmission occurred within and between geographic areas in Chicago, Illinois. METHODS We analyzed genetic sequences in the HIV-1 pol region in samples collected from people participating in the VARHS program in Chicago during 2005-2011. We determined pairwise genetic distance, inferred potential transmission events between HIV-infected people whose sequences were ≤1.5% genetically distant, and identified clusters of connected people. We used multivariable analysis to determine demographic characteristics and risk attributes associated with degree of connectivity. RESULTS Of 1154 sequences, 177 (15.3%) were tied to at least 1 other sequence. We determined that younger people, men, non-Hispanic black people, and men who have sex with men were more highly connected than other HIV-infected people. We also identified a high degree of geographic heterogeneity-48 of 67 clusters (71.6%) contained people from >1 Chicago region (north, south, or west sides). CONCLUSION Our results indicate a need to address HIV transmission through the networks of younger non-Hispanic black men who have sex with men. The high level of geographic heterogeneity observed suggests that HIV prevention programs should be targeted toward networks of younger people rather than geographic areas of high incidence. This study could also guide prevention efforts in other diverse metropolitan regions with characteristics similar to those of Chicago.
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Affiliation(s)
- Ethan Morgan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - Alexandra M. Oster
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Donna Peace
- Chicago Department of Public Health, Chicago, IL, USA
| | | | - John A. Schneider
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
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Rhoton J, Wilkerson JM, Mengle S, Patankar P, Rosser BRS, Ekstrand ML. Sexual Preferences and Presentation on Geosocial Networking Apps by Indian Men Who Have Sex With Men in Maharashtra. JMIR Mhealth Uhealth 2016; 4:e120. [PMID: 27799139 PMCID: PMC5108933 DOI: 10.2196/mhealth.5600] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 07/13/2016] [Accepted: 09/17/2016] [Indexed: 11/13/2022] Open
Abstract
Background The affordability of smartphones and improved mobile networks globally has increased the popularity of geosocial networking (GSN) apps (eg, Grindr, Scruff, Planetromeo) as a method for men who have sex with men (MSM) to seek causal sex partners and engage with the queer community. As mobile penetration continues to grow in India, it is important to understand how self-presentation on GSN app is relevant because it offers insight into a population that has not been largely studied. There is very little information about how Indian MSM discuss their sexual preferences and condom preferences and disclose their human immunodeficiency virus (HIV) status with potential sex partners on Web-based platforms. Objective The objective of this study was to describe how self-presentation by Indian MSM on GSN apps contributes to sexual preferences, HIV or sexually transmitted infection (STI) disclosure, and if the presentation differs due to proximity to the Greater Mumbai or Thane region. Methods Between September 2013 and May 2014, participants were recruited through banner advertisements on gay websites, social media advertisements and posts, and distribution of print materials at outreach events hosted by lesbian, gay, bisexual, transgender (LGBT) and HIV service organizations in Maharashtra, India. Eligible participants self-identified as being MSM or hijra (transgender) women, living in Maharashtra, aged above 18 years, having regular Internet access, and having at least one male sex partner in the previous 90 days. Results Indian MSM living inside and outside the Greater Mumbai or Thane region reported an average of 6.7 (SD 11.8) male sex partners in the last 3 months; on average HIV status of the sex partners was disclosed to 2.9 (SD 8.9). The most commonly used websites and GSN apps by MSM living inside Greater Mumbai or Thane region were Planetromeo, Grindr, and Gaydar. Results demonstrated that MSM used smartphones to access GSN apps and stated a preference for both condomless and protected anal sex but did not disclose their HIV status. This low level of HIV disclosure potentially increases risk of HIV or STI transmission; therefore, trends in use should be monitored. Conclusions Our data helps to fill the gap in understanding how Indian MSM use technology to find casual sex partners, disclose their sexual preference, and their HIV status on Web-based platforms. As mobile penetration in India continues to grow and smartphone use increases, the use of GSN sex-seeking apps by MSM should also increase, potentially increasing the risk of HIV or STI transmission within the app’s closed sexual networks.
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Affiliation(s)
- Jayson Rhoton
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Sceince Center Houston, Houston, TX, United States
| | - J Michael Wilkerson
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Sceince Center Houston, Houston, TX, United States
| | | | | | - B R Simon Rosser
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Maria L Ekstrand
- Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States
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Sex Partner Meeting Places Over Time Among Newly HIV-Diagnosed Men Who Have Sex With Men in Baltimore, Maryland. Sex Transm Dis 2016; 42:549-53. [PMID: 26372926 DOI: 10.1097/olq.0000000000000337] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sex partner meeting places may be important locales to access men who have sex with men (MSM) and implement targeted HIV control strategies. These locales may change over time, but temporal evaluations have not been performed. METHODS The objectives of this study were to describe the frequency of report of MSM sex partner meeting places over time and to compare frequently reported meeting places in the past 5 years and past year among newly HIV-diagnosed MSM in Baltimore City, Maryland. Public health HIV surveillance data including partner services information were obtained for this study from the Baltimore City Health Department from May 2009 to June 2014. RESULTS A total of 869 sex partner meeting places were reported, including 306 unique places. Bars/clubs (31%) and Internet-based sites (38%) were the most frequently reported meeting place types. Over the 5-year period, the percentage of bars/clubs decreased over time and the percentage of Internet-based sites increased over time. Among bars/clubs, 4 of 5 of those most frequently reported in the past 5 years were also most frequently reported in the most recent year. Among Internet-based sites, 3 of 5 of those most frequently reported in the past 5 years were also in the top 5 most frequently reported in the past year. CONCLUSION This study provides a richer understanding of sex partner meeting places reported by MSM over time and information to health departments on types of places to access a population at high risk for HIV transmission.
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Hirshfield S, Downing MJ, Parsons JT, Grov C, Gordon RJ, Houang ST, Scheinmann R, Sullivan PS, Yoon IS, Anderson I, Chiasson MA. Developing a Video-Based eHealth Intervention for HIV-Positive Gay, Bisexual, and Other Men Who Have Sex with Men: Study Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2016; 5:e125. [PMID: 27315764 PMCID: PMC4930529 DOI: 10.2196/resprot.5554] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/26/2016] [Accepted: 03/28/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Gay, bisexual, and other men who have sex with men (GBMSM) accounted for 67% of new US human immunodeficiency virus (HIV) infections in 2012; however, less than 40% of HIV-positive GBMSM are virally suppressed. Preventing transmission from virally unsuppressed men who have condomless anal sex (CAS) with serodiscordant partners is a public health imperative. New HIV infections in GBMSM are attributed in part to online access to sex partners; therefore, low-cost eHealth interventions are a unique opportunity to reach men where they meet partners. OBJECTIVE To describe the protocol of a randomized controlled trial evaluating whether video-based messaging delivered online may lead to reductions in serodiscordant CAS and increased HIV disclosure. METHODS Sex Positive!([+]) is a two-arm, phase III, video-based randomized controlled trial delivered online to GBMSM living with HIV. Participants in the intervention arm receive 10 video vignettes grounded in social learning and social cognitive theories that are designed to elicit critical thinking around issues of HIV transmission and disclosure. Participants in the attention control arm receive 10 video vignettes that focus on healthy living. All videos are optimized for mobile viewing. The study protocol includes five online assessments conducted over a 1-year period among 1500 US white, black, or Hispanic/Latino GBMSM living with HIV who report suboptimal antiretroviral therapy (ART) adherence or a detectable viral load in the past 12 months and recent CAS (past 6 months) with HIV-negative or unknown status male partners. Compared to the control arm, we hypothesize that men who watch the intervention videos will report at 12-month follow-up significantly fewer serodiscordant CAS partners, increased HIV disclosure, and improved social cognition (eg, condom use self-efficacy, perceived responsibility). RESULTS Participant recruitment began in June 2015 and ended in December 2015. CONCLUSIONS This protocol describes the underlying theoretical framework and measures, study design, recruitment challenges, and antifraud measures for an online, video-based randomized controlled trial that has the potential to decrease HIV transmission risk behaviors among HIV-positive GBMSM who struggle with ART adherence. The Sex Positive!([+]) intervention allows for participation through multiple Internet-based mediums and has the potential to reach and engage a broader population of HIV-positive GBMSM who are virally unsuppressed. CLINICALTRIAL ClinicalTrials.gov NCT02023580; https://clinicaltrials.gov/ct2/show/NCT02023580 (Archived by WebCite at http://www.webcitation.org/6iHzA8wRG).
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Affiliation(s)
- Sabina Hirshfield
- Public Health Solutions, Research and Evaluation, New York, NY, United States.
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Heijman T, Stolte I, Geskus R, Matser A, Davidovich U, Xiridou M, Schim van der Loeff M. Does online dating lead to higher sexual risk behaviour? A cross-sectional study among MSM in Amsterdam, the Netherlands. BMC Infect Dis 2016; 16:288. [PMID: 27295949 PMCID: PMC4907249 DOI: 10.1186/s12879-016-1637-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/07/2016] [Indexed: 11/29/2022] Open
Abstract
Background Men having sex with men (MSM) frequently use the Internet to find sex partners. We examined the association between unprotected anal intercourse (UAI) with partners dated online and with partners dated offline (met elsewhere), and examined whether differences can be explained by self-perceived HIV status of the index and knowledge of partnership characteristics. Methods MSM were recruited at the Sexually Transmitted Infections Clinic in Amsterdam, in 2008–2009. Participants completed a questionnaire concerning sexual behaviour. Only men reporting both online and offline casual sex partners were included. We assessed the association between online/offline partner dating and UAI, using random-effects logistic regression analysis. Results Five hundred seventy-seven men (351 HIV-negative, 153 HIV-positive, and 73 HIV-unaware) reported UAI in 26 % of 878 online, and 23 % of 903 offline casual partnerships. The crude OR of online dating for UAI was 1.36 (95 % CI 1.03–1.81). HIV-positive men were more likely to report UAI than HIV-negative men (49 % vs. 28 % of partnerships). Adjusted for demographic characteristics, online dating had no significant effect on UAI among HIV-negative and HIV status-unaware men, but HIV-positive men were more likely to have UAI with online partners (aOR = 1.65 [95 % CI 1.05–2.57]). After correction for partner and partnership characteristics the effect of online/offline dating on UAI among HIV-positive MSM was reduced and no longer significant. Conclusions Online dating was not significantly associated with UAI among HIV-negative MSM. HIV-positive MSM were more likely to practise UAI with partners dated online; however, after correction for partner and partnership characteristics, online partnership acquisition was not associated with a significantly increased risk of UAI. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1637-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Titia Heijman
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.
| | - Ineke Stolte
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.,Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Ronald Geskus
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Amy Matser
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.,Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Udi Davidovich
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.,Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Maria Xiridou
- National Institute of Public Health and the Environment, Centre for Infectious Disease Control (RIVM), Bilthoven, The Netherlands
| | - Maarten Schim van der Loeff
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.,Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
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Affiliation(s)
- Meredith E Clement
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
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Benotsch EG, Zimmerman RS, Cathers L, Heck T, McNulty S, Pierce J, Perrin PB, Snipes DJ. Use of the Internet to Meet Sexual Partners, Sexual Risk Behavior, and Mental Health in Transgender Adults. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:597-605. [PMID: 25428577 DOI: 10.1007/s10508-014-0432-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 10/25/2014] [Accepted: 10/31/2014] [Indexed: 06/04/2023]
Abstract
The purpose of this study was to examine the use of the internet to meet sexual partners among transgender individuals and examine correlates of this use, including sexual risk behavior, discrimination experiences, and mental health. A sample of 166 transgender adults (112 male-to-female transgender women and 54 female-to-male transgender men) were recruited in community venues and anonymously completed measures assessing these variables. Most participants (64.5 %) were HIV-negative, 25.2 % were HIV-positive, and 10.3 % did not know their HIV status. Overall, 33.7 % of participants reported having met a sexual partner over the internet, which did not differ significantly between transgender women and men. Among these individuals, transgender women reported significantly more lifetime internet sexual partners (median = 3) than transgender men (median = 1). Use of the internet to meet sexual partners was associated with lower self-esteem but not with depression, anxiety, somatic distress or discrimination experiences. Among transgender women, use of the internet to meet sexual partners was associated with each of the 11 sexual risk behaviors examined, including having multiple partners, sex under the influence of drugs, number of unprotected anal or vaginal sex acts, and history of commercial sex work. The use of the internet to meet partners was not associated with sexual risk behavior among transgender men (0/11 variables assessed). Although the internet is a common mode of meeting sexual partners among some transgender adults, it may also be a potential venue for prevention interventions targeting transgender individuals at particularly high risk for HIV acquisition.
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Affiliation(s)
- Eric G Benotsch
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284, USA.
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA.
- Institute for Women's Health, Virginia Commonwealth University, Richmond, VA, USA.
| | - Rick S Zimmerman
- College of Nursing, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Laurie Cathers
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA
- Institute for Women's Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Ted Heck
- Virginia Department of Health, Richmond, VA, USA
| | | | - Juan Pierce
- Minority Health Consortium, Richmond, VA, USA
| | - Paul B Perrin
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284, USA
| | - Daniel J Snipes
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284, USA
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Grov C, Cain D, Whitfield THF, Rendina HJ, Pawson M, Ventuneac A, Parsons JT. Recruiting a U.S. national sample of HIV-negative gay and bisexual men to complete at-home self-administered HIV/STI testing and surveys: Challenges and Opportunities. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2016; 13:1-21. [PMID: 26858776 PMCID: PMC4743043 DOI: 10.1007/s13178-015-0212-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We describe enrollment for the One Thousand Strong panel, present characteristics of the panel relative to other large U.S. national studies of gay and bisexual men (GBM), and examine demographic and behavioral characteristics that were associated with passing enrollment milestones. A U.S. national sample of HIV-negative men were enrolled via an established online panel of over 22,000 GBM. Participants (n = 1071) passed three milestones to join our panel. Milestone 1 was screening eligible and providing informed consent. Milestone 2 involved completing an hour-long at-home computer-assisted self-interview (CASI) survey. Milestone 3 involved completing at-home self-administered rapid HIV testing and collecting/returning urine and rectal samples for gonorrhea and chlamydia testing. Compared to those who completed milestones: those not passing milestone 1 were more likely to be non-White and older; those not passing milestone 2 were less likely to have insurance or a primary care physician; and those not passing milestone 3 were less educated, more likely to be bisexual as opposed to gay, more likely to live in the Midwest, had fewer male partners in the past year, and less likely to have tested for HIV in the past year. Effect sizes for significant findings were small. We successfully enrolled a national sample of HIV-negative GBM who completed at-home CASI assessments and at-home self-administered HIV and urine and rectal STI testing. This indicates high feasibility and acceptability of incorporating self-administered biological assays into otherwise fully online studies. Differences in completion of study milestones indicate a need for further investigation into the reasons for lower engagement by certain groups.
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Goldenberg T, Vansia D, Stephenson R. Intragroup Stigma Among Men Who Have Sex with Men: Data Extraction from Craigslist Ads in 11 Cities in the United States. JMIR Public Health Surveill 2016; 2:e4. [PMID: 27227158 PMCID: PMC4869222 DOI: 10.2196/publichealth.4742] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/13/2015] [Accepted: 10/14/2015] [Indexed: 11/13/2022] Open
Abstract
Background Gay, bisexual, and other men who have sex with men (MSM) regularly experience homophobic discrimination and stigma. While previous research has examined homophobic and HIV-related intergroup stigma originating from non-MSM directed at MSM, less is known about intragroup stigma originating from within MSM communities. While some research has examined intragroup stigma, this research has focused mostly on HIV-related stigma. Intragroup stigma may have a unique influence on sexual risk-taking behaviors as it occurs between sexual partners. Online sexual networking venues provide a unique opportunity to examine this type of stigma. Objective The purpose of this study is to examine the presence and patterns of various types of intragroup stigma represented in Men Seeking Men Craigslist sex ads. Methods Data were collected from ads on Craigslist sites from 11 of the 12 US metropolitan statistical areas with the highest HIV/AIDS prevalence. Two categories of data were collected: self-reported characteristics of the authors and reported biases in the ads. Chi-square tests were used to examine patterns of biases across cities and author characteristics. Results Biases were rarely reported in the ads. The most commonly reported biases were against men who were not “disease and drug free (DDF),” representing stigma against men living with HIV or a sexually transmitted infection. Patterns in bias reporting occurred across cities and author characteristics. There were no variations based on race, but ageism (mostly against older men) varied based on the ad author’s age and self-reported DDF status; bias against feminine gender expression varied based on self-reported sexual orientation; bias against “fat” men varied by self-reported DDF status; bias against “ugly” men varied by a self-report of being good-looking; and bias against people who do not have a DDF status varied based on self-reported HIV status and self-reported DDF status. Conclusions Despite an overall low reporting of biases in ads, these findings suggest that there is a need to address intragroup stigma within MSM communities. The representation of biases and intragroup stigma on Craigslist may result from internalized stigma among MSM while also perpetuating further internalization of stigma for men who read the sex ads. Understanding patterns in the perpetuation of intragroup stigma can help to better target messages aimed at making cultural and behavioral shifts in the perpetration of intragroup stigma within MSM communities.
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Affiliation(s)
- Tamar Goldenberg
- School of Nursing Department of Health Behavior and Biological Sciences and the Center for Sexuality and Health Disparities University of Michigan Ann Arbor, MI United States
| | - Dhrutika Vansia
- Rollins School of Public Health Hubert Department of Global Health Emory University Atlanta, GA United States
| | - Rob Stephenson
- School of Nursing Department of Health Behavior and Biological Sciences and the Center for Sexuality and Health Disparities University of Michigan Ann Arbor, MI United States
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Stack C, Oldenburg C, Mimiaga M, Elsesser SA, Krakower D, Novak DS, Egan JE, Stall R, Safren S, Mayer KH. Sexual Behavior Patterns and PrEP Dosing Preferences in a Large Sample of North American Men Who Have Sex With Men. J Acquir Immune Defic Syndr 2016; 71:94-101. [PMID: 26371786 PMCID: PMC4713279 DOI: 10.1097/qai.0000000000000816] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Pre-exposure prophylaxis (PrEP), taken as a single daily coformulated pill containing tenofovir -emtricitabine, is a promising intervention to reduce the likelihood of HIV acquisition in at-risk individuals, including men who have sex with men. Little is known about the acceptability of less than daily, intermittent PrEP regimens. METHODS We conducted an online survey of North American men who have sex with men to characterize their sexual frequency and planning behaviors and correlate these with PrEP dosing preferences. RESULTS Of the 3217 respondents who completed the survey, 46% reported engaging in unplanned condomless anal intercourse (CAI) at least once in previous 3 months and 8% reported engaging in CAI more than once per week. In multivariable analysis, reporting unplanned CAI was associated with lower educational level, identifying as homosexual/gay as compared with bisexual, being in a monogamous relationship, having a higher self-perceived risk of HIV acquisition, reporting higher income, engaging in CAI more than five times in the last 3 months, and not having visited a health care provider in the previous year. Frequent CAI (>1 time per week) was associated with being younger, identifying as homosexual/gay as compared with bisexual, being in a monogamous relationship, and having a higher self-perceived risk of HIV. Having only planned sex over the last 3 months was associated with a preference for event-based PrEP, whereas having frequent or unplanned CAI was associated with a preference for daily or time-driven PrEP regimens, respectively. CONCLUSION Our findings suggest that preferences for different PrEP regimens are associated with the sexual frequency and planning behaviors of potential users.
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Affiliation(s)
- Conor Stack
- *Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA;†Department of Epidemiology, Harvard School of Public Health, Boston, MA;‡Institute for Community Health Promotion, Brown University School of Public Health, Providence, RI;§The Fenway Institute, Fenway Health, Boston, MA;¶Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA;#On-Line Buddies, Cambridge, MA;**Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA; and††Department of Psychology, University of Miami, Coral Gables, FL
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Examining Delay Discounting of Condom-Protected Sex Among Men Who Have Sex with Men Using Crowdsourcing Technology. AIDS Behav 2015; 19:1655-65. [PMID: 26066395 DOI: 10.1007/s10461-015-1107-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Some men who have sex with men (MSM) have unprotected anal intercourse (UAI) in situations that put them at risk for HIV infection despite having the knowledge and skills to avoid these risks. The present study examined the potential role of delay discounting in sexual HIV risk behavior among MSM. Participants (n = 108) completed the Sexual Discounting Task and a questionnaire regarding UAI and other variables associated with HIV risk (e.g., age, socioeconomic status, substance use, psychiatric problems). MSM discounted the value of condom-protected anal intercourse in a manner that was orderly, hyperbolic, and sensitive to partner characteristics that likely influence realworld decisions about using condoms. Steeper discounting was associated with UAI, and other factors related to sexual HIV risk among MSM, including young age, socioeconomic disadvantage, substance use, sex under the influence of substances, and depression). Delay discounting is likely a critical, but underappreciated facet of HIV risk among MSM.
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Sun CJ, Reboussin B, Mann L, Garcia M, Rhodes SD. The HIV Risk Profiles of Latino Sexual Minorities and Transgender Persons Who Use Websites or Apps Designed for Social and Sexual Networking. HEALTH EDUCATION & BEHAVIOR 2015; 43:86-93. [PMID: 26272786 DOI: 10.1177/1090198115596735] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The use of websites and GPS-based mobile applications ("apps") designed for social and sexual networking has been associated with increased HIV risk; however, little is known about Latino sexual minorities' and transgender persons' use of these websites and apps and the risk profiles of those who use them compared with those who do not. Data from 167 participants who completed the baseline survey of a community-level HIV prevention intervention, which harnesses the social networks of Latino sexual minorities and transgender persons, were analyzed. One quarter of participants (28.74%, n = 48) reported using websites or apps designed for social and sexual networking, and 119 (71.26%) reported not using websites or apps designed for social and sexual networking. Those who used websites or apps were younger and reported more male sex partners, a sexually transmitted disease diagnosis, and illicit drug use other than marijuana. HIV prevention interventions for those who use websites or apps should consider addressing these risks for HIV.
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Affiliation(s)
| | | | - Lilli Mann
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Manuel Garcia
- Wake Forest School of Medicine, Winston-Salem, NC, USA
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Lacefield K, Negy C, Schrader RM, Kuhlman C. Comparing Psychosocial Correlates of Condomless Anal Sex in HIV-Diagnosed and HIV-Nondiagnosed Men Who Have Sex with Men: A Series of Meta-Analyses of Studies from 1993-2013. LGBT Health 2015; 2:200-20. [PMID: 26788669 DOI: 10.1089/lgbt.2014.0069] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Men who have sex with men (MSM) continue to be overrepresented in rates of incidence and prevalence of human immunodeficiency virus (HIV). Both HIV-diagnosed (HIV-D) and HIV-nondiagnosed (HIV-N) MSM report a variety of reasons for intentional and unintentional nonuse of condoms. Elucidating and comparing reasons for continued engagement in condomless anal sex specific to both HIV-D and HIV-N MSM likely is important to identifying effective prevention. METHODS This study employed meta-analytic methods to evaluate and compare correlates to condomless anal sex in both HIV-D and HIV-N MSM from primary studies from 1993 to February 2013. RESULTS Of the 19 individual correlates assessed within the subgroup of HIV-D MSM, variables that achieved significant effect were alcohol, mind-altering substance use, sexual-enhancement medication, intentional condom nonuse, self-efficacy, attitudes toward condom use, social support, gay identity, compulsivity, trading sex, and number of sex partners. Those that were statistically non-significant were intention to use a condom, perceived risk, perceived norms, perceived responsibility, HIV medical management, treatment optimism, mental health, and setting. Of the 12 correlates assessed within the subgroup of HIV-N MSM, variables that achieved significant effect were alcohol, mind-altering substance use, intentional condom nonuse, attitudes toward condom use, perceived risk, and setting. Those observed as statistically non-significant were perceived norms, social support, gay identity, mental health, trading sex, and number of sex partners. CONCLUSION Study results have clinical implications that may guide future prevention research and practice by highlighting risk variables shared between HIV-N and HIV-D MSM, as well as variables observed to be unique to each group that may warrant more tailored intervention. Further investigation is recommended to elucidate the relationships among these variables such that optimal intervention can be determined.
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Affiliation(s)
- Katharine Lacefield
- 1 Department of Psychology, VA Maryland Healthcare System , Baltimore, Maryland.,2 Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Charles Negy
- 3 Department of Psychology, University of Central Florida , Orlando, Florida
| | - Ronald M Schrader
- 4 Department of Dialysis, DCI Corporate Quality Management , Albuquerque, New Mexico
| | - Christina Kuhlman
- 3 Department of Psychology, University of Central Florida , Orlando, Florida
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Evaluating the Internet as a sexually transmitted disease risk environment for teens: findings from the communication, health, and teens study. Sex Transm Dis 2015; 40:528-33. [PMID: 23965765 DOI: 10.1097/olq.0b013e31829413f7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few studies have examined the association between sexual health risks and online sex-seeking among teenagers. The purpose of this study was to assess the associations between meeting sex partners online and a range of sexual risk behaviors and outcomes among adolescents. METHODS Participants aged 13 to 19 years were recruited from a publicly funded teen clinic in Florida. After obtaining informed consent/assent, 273 participants completed an audio computer-assisted self-interview that included questions on demographics, sexual behavior, sexually transmitted disease (STD) history, and online sex-seeking behaviors and experiences. Participants also provided urine samples for chlamydia and gonorrhea testing. Data were analyzed using logistic regression to identify the association between having an online sex partner and sexual behaviors/outcomes. RESULTS After adjusting for significant bivariate correlates, teens reporting online sex partners were more likely to be male, be multiracial, have a history of same-sex sexual activity, report a higher number of vaginal sex partners, and report a lower age at first vaginal sex. However, teens with online sex partners were no more likely to have ever had an STD or a current biological STD. CONCLUSIONS This study is one of the first to correlate biological STD results to online sexual partnering data in a youth population. Although meeting a sex partner online was not associated with past or current STDs, it was associated with other sexual risk behaviors. Future research is needed to examine the complex nature of online sexual partnering among adolescents and to develop intervention approaches.
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Tensions between the epidemiology and psychology of HIV risk: implications for pre-exposure prophylaxis. AIDS Behav 2014; 18:1686-93. [PMID: 24719201 DOI: 10.1007/s10461-014-0770-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study focuses on psychological differences in risk-taking patterns and their association with risk compensation motivations in the context of pre-exposure prophylaxis (PrEP). Participants were 257 HIV-negative MSM and transgender women recruited in New York City. The majority of participants (89.5 %, n = 230), could be classified as either: Intimates (40 %), who report unprotected anal intercourse (UAI) only with a main partner believed to be HIV-negative; Trusters (34 %), who engaged in UAI only with casual partners believed to be HIV-negative; and Gamblers (26 %) who report UAI with partners of unknown serostatus. Partner-based classifications were better predictors of HIV risk perception and other traditional correlates of risk-taking (e.g. impulsivity, sexual compulsivity) than rates of UAI. The three groups differed significantly in PrEP-related risk compensation motivations: sexual pleasure (Gamblers), intimacy (Trusters) and partner pressure (Intimates). These data underscore the importance of focusing the psychological dynamics of risk perception and sexual decision-making.
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Hernandez-Romieu AC, Sullivan PS, Sanchez TH, Kelley CF, Peterson JL, Del Rio C, Salazar LF, Frew PM, Rosenberg ES. The comparability of men who have sex with men recruited from venue-time-space sampling and facebook: a cohort study. JMIR Res Protoc 2014; 3:e37. [PMID: 25048694 PMCID: PMC4129125 DOI: 10.2196/resprot.3342] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/14/2014] [Accepted: 05/31/2014] [Indexed: 11/18/2022] Open
Abstract
Background Recruiting valid samples of men who have sex with men (MSM) is a key component of the US human immunodeficiency virus (HIV) surveillance and of research studies seeking to improve HIV prevention for MSM. Social media, such as Facebook, may present an opportunity to reach broad samples of MSM, but the extent to which those samples are comparable with men recruited from venue-based, time-space sampling (VBTS) is unknown. Objective The objective of this study was to assess the comparability of MSM recruited via VBTS and Facebook. Methods HIV-negative and HIV-positive black and white MSM were recruited from June 2010 to December 2012 using VBTS and Facebook in Atlanta, GA. We compared the self-reported venue attendance, demographic characteristics, sexual and risk behaviors, history of HIV-testing, and HIV and sexually transmitted infection (STI) prevalence between Facebook- and VTBS-recruited MSM overall and by race. Multivariate logistic and negative binomial models estimated age/race adjusted ratios. The Kaplan-Meier method was used to assess 24-month retention. Results We recruited 803 MSM, of whom 110 (34/110, 30.9% black MSM, 76/110, 69.1% white MSM) were recruited via Facebook and 693 (420/693, 60.6% black MSM, 273/693, 39.4% white MSM) were recruited through VTBS. Facebook recruits had high rates of venue attendance in the previous month (26/34, 77% among black and 71/76, 93% among white MSM; between-race P=.01). MSM recruited on Facebook were generally older, with significant age differences among black MSM (P=.02), but not white MSM (P=.14). In adjusted multivariate models, VBTS-recruited MSM had fewer total partners (risk ratio [RR]=0.78, 95% CI 0.64-0.95; P=.01) and unprotected anal intercourse (UAI) partners (RR=0.54, 95% CI 0.40-0.72; P<.001) in the previous 12 months. No significant differences were observed in HIV testing or HIV/STI prevalence. Retention to the 24-month visit varied from 81% for black and 70% for white MSM recruited via Facebook, to 77% for black and 78% for white MSM recruited at venues. There was no statistically significant differences in retention between the four groups (log-rank P=.64). Conclusions VBTS and Facebook recruitment methods yielded similar samples of MSM in terms of HIV-testing patterns, and prevalence of HIV/STI, with no differences in study retention. Most Facebook-recruited men also attended venues where VTBS recruitment was conducted. Surveillance and research studies may recruit via Facebook with little evidence of bias, relative to VBTS.
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Affiliation(s)
- Alfonso C Hernandez-Romieu
- Rollins School of Public Health, Department of Epidemiology, Emory University, Atlanta, GA, United States.
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Holloway IW, Dunlap S, Del Pino HE, Hermanstyne K, Pulsipher C, Landovitz RJ. Online Social Networking, Sexual Risk and Protective Behaviors: Considerations for Clinicians and Researchers. CURRENT ADDICTION REPORTS 2014; 1:220-228. [PMID: 25642408 DOI: 10.1007/s40429-014-0029-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Online social networking refers to the use of internet-based technologies that facilitate connection and communication between users. These platforms may be accessed via computer or mobile device (e.g., tablet, smartphone); communication between users may include linking of profiles, posting of text, photo and video content, instant messaging and email. This review provides an overview of recent research on the relationship between online social networking and sexual risk and protective behaviors with a focus on use of social networking sites (SNS) among young people and populations at high risk for sexually transmitted infections (STIs). While findings are mixed, the widespread use of SNS for sexual communication and partner seeking presents opportunities for the delivery and evaluation of public health interventions. Results of SNS-based interventions to reduce sexual risk are synthesized in order to offer hands-on advice for clinicians and researchers interested in engaging patients and study participants via online social networking.
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Affiliation(s)
- Ian W Holloway
- Assistant Professor, Department of Social Welfare, UCLA Luskin School of Public Affairs, 3250 Charles Young Drive, Los Angeles, CA 90095,
| | - Shannon Dunlap
- Graduate Student Researcher, UCLA Luskin School of Public Affairs, 3250 Charles Young Drive,
| | - Homero E Del Pino
- Assistant Professor, Psychiatry and Human Behaviors, Charles R. Drew University of Medicine and Science, 1731 E. 120 St., Building N, Los Angeles, CA 90059,
| | - Keith Hermanstyne
- Robert Wood Johnson Foundation Clinical Scholars Program, University of California, Los Angeles, 10920 Wilshire Boulevard, Suite 710, Los Angeles, CA 90024,
| | - Craig Pulsipher
- Graduate Student Researcher, UCLA Luskin School of Public Affairs, 3250 Charles Young Drive,
| | - Raphael J Landovitz
- Associate Professor of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, Los Angeles, CA 90095, 10833 Le Conte Ave, Los Angeles,
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Beymer MR, Weiss RE, Bolan RK, Rudy ET, Bourque LB, Rodriguez JP, Morisky DE. Sex on demand: geosocial networking phone apps and risk of sexually transmitted infections among a cross-sectional sample of men who have sex with men in Los Angeles County. Sex Transm Infect 2014; 90:567-72. [PMID: 24926041 DOI: 10.1136/sextrans-2013-051494] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Geosocial networking applications (GSN apps) used for meeting sexual partners have become increasingly popular with men who have sex with men (MSM) since 2009. The current study aimed to determine if self-identified HIV-negative, MSM clinic attendees who used GSN apps have an increased incidence of sexually transmitted infections (STI) compared to self-identified HIV-negative, MSM attendees who met sexual partners via in-person venues, such as bars or clubs or through MSM-specific hook-up websites. METHODS Data were collected between August 2011 and January 2013 on all self-identified HIV-negative, MSM clients visiting the L.A. Gay & Lesbian Center for STI screening. A total of 7184 individuals tested for STIs and self-reported behaviours on drug use and social networking methods to meet sexual partners. Multivariate logistic regression models were used to analyse the results. RESULTS Individuals who used GSN apps for meeting sexual partners had greater odds of testing positive for gonorrhoea (OR: 1.25; 95% CI 1.06 to 1.48) and for chlamydia (OR: 1.37; 95% CI 1.13 to 1.65) compared to individuals who met partners through in-person methods only. There were no significant differences in syphilis and HIV incidence between those who met partners via in-person venues only, on the internet or through GSN apps. CONCLUSIONS The present study concludes that sexual health clinic MSM attendees who are meeting on GSN apps are at greater risk for gonorrhoea and chlamydia than MSM attendees who meet in-person or on the internet. Future interventions should explore the use of these novel technologies for testing promotion, prevention and education.
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Affiliation(s)
- Matthew R Beymer
- L.A. Gay & Lesbian Center, Los Angeles, California, USA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Robert E Weiss
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | | | - Ellen T Rudy
- County of Los Angeles Department of Public Health, Sexually Transmitted Disease Program, Los Angeles, California, USA
| | - Linda B Bourque
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | | | - Donald E Morisky
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
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Nelson KM, Simoni JM, Morrison DM, George WH, Leickly E, Lengua LJ, Hawes SE. Sexually explicit online media and sexual risk among men who have sex with men in the United States. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:833-843. [PMID: 24464547 PMCID: PMC4011997 DOI: 10.1007/s10508-013-0238-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 08/17/2013] [Accepted: 09/10/2013] [Indexed: 05/31/2023]
Abstract
This study aimed to describe sexually explicit online media (SEOM) consumption among men who have sex with men (MSM) in the United States and examine associations between exposure to unprotected anal intercourse (UAI) in SEOM and engagement in both UAI and serodiscordant UAI. MSM in the U.S. who accessed a men-seeking-men website in the past year (N = 1,170) were recruited online for a cross-sectional, Internet-based survey of sexual risk and SEOM consumption. In the 3 months prior to interview, more than half (57 %) of the men reported viewing SEOM one or more times per day and almost half (45 %) reported that at least half of the SEOM they viewed portrayed UAI. Compared to participants who reported that 0-24 % of the SEOM they viewed showed UAI, participants who reported that 25-49, 50-74, or 75-100 % of the SEOM they viewed portrayed UAI had progressively increasing odds of engaging in UAI and serodiscordant UAI in the past 3 months. As SEOM has become more ubiquitous and accessible, research should examine causal relations between SEOM consumption and sexual risk-taking among MSM as well as ways to use SEOM for HIV prevention.
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Affiliation(s)
- Kimberly M Nelson
- Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195-1525, USA,
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