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Laughney CI, Lee YG, Mergenova G, Vinogradov V, Zhakupova G, Paine EA, Primbetova S, Terlikbayeva A, Wu E. Earlier sexual debut as a risk factor for substance use among men who have sex with men (MSM) in Kazakhstan. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2024; 11:225-232. [PMID: 39364214 PMCID: PMC11449431 DOI: 10.1007/s40609-023-00298-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 10/05/2024]
Abstract
Background Limited research have examined predictors of illicit use of drugs and binge drinking among gay, bisexual, and other men who have sex with men (MSM) in Kazakhstan and Central Asia. This study examines earlier sexual debut as a risk factor for lifetime and recent substance use behaviors among MSM in Kazakhstan. Methods We conducted a secondary analysis of self-reported data from a NIDA-funded HIV prevention trial including 902 adult cisgender MSM in Kazakhstan who completed structured screening interviews. Logistic regression models were used to estimate associations between earlier sexual debut (ages 16 and older as the reference group) and lifetime and recent substance use, with covariance adjustment for sociodemographic characteristics. Results The majority of MSM in our sample reported lifetime binge drinking behavior (73%) and illicit use of drugs (65%). Participants with an earlier sexual debut before 13 years old had significantly higher odds of lifetime binge drinking and any illicit use of drugs (aOR= 2.3, 95%CI: 1.2-4.5; aOR=3.0, 95%CI: 1.6-5.8). MSM who reported an earlier sexual debut between 13-15 years old had significantly higher odds of lifetime binge drinking and illicit use of any drugs (aOR=1.6, 95%CI: 1.1-2.3; aOR=1.6, 95%CI: 1.1-2.3); as well as recent binge drinking behavior (aOR=1.6, 95%CI: 1.2-2.3). Conclusion Future research should examine pathways between earlier sexual experiences and substance use behaviors among sexually diverse populations. Earlier sexual experiences during childhood and adolescence may be relevant contextual information for interventions aimed at substance use risk prevention, treatment, and recovery among MSM populations.
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Affiliation(s)
| | - Yong Gun Lee
- Social Intervention Group, Columbia School of Social Work, New York, NY, 10027, USA
| | | | | | | | - Emily Allen Paine
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, Columbia University and New York State Psychiatric Institute, New York, NY 10032, USA
| | | | | | - Elwin Wu
- Social Intervention Group, Columbia School of Social Work, New York, NY, 10027, USA
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
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2
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Laughney CI, Lee YG, Mergenova G, Vinogradov V, Zhakupova G, Paine EA, Primbetova S, Terlikbayeva A, Wu E. Earlier Sexual Debut and Exchange Sex among Men Who Have Sex with Men (MSM) in Kazakhstan. JOURNAL OF SEX RESEARCH 2023; 60:919-924. [PMID: 36657067 PMCID: PMC10354213 DOI: 10.1080/00224499.2023.2167064] [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: 05/10/2023]
Abstract
Limited research has examined prevalence rates and associations related to exchange sex behaviors among gay, bisexual, and other men who have sex with men (MSM) in Kazakhstan. This study aimed to examine associations between earlier sexual debuts and lifetime exchange sex behaviors among Kazakhstani MSM. Using data from a National Institute on Drug Abuse-funded Human Immunodeficiency Virus (HIV) prevention trial, we conducted a secondary analysis of self-reported data from 766 adult cisgender MSM in Kazakhstan, who completed structured screening interviews. Earlier sexual debuts were measured as age of sexual onset prior to 16 years old with ages 16 and older as the reference group. Logistic regression models were used to estimate associations between earlier sexual debuts and lifetime reports of buying or selling sex for resources, with covariance adjustment for sociodemographic characteristics. The study findings indicated that, among our sample of MSM in Kazakhstan, 23% had sold sex, and 26% had bought sex in their lifetime. Kazakhstani MSM who reported an earlier sexual debut had significantly higher odds of ever selling or buying sex in their lifetime. Future research should examine how consensual and non-consensual sexual activities during childhood and adolescence relate to exchange sex behaviors and risk among MSM.
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Affiliation(s)
| | - Yong Gun Lee
- Social Intervention Group, Columbia School of Social Work, New York, NY, 10027, USA
| | | | | | | | - Emily Allen Paine
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, Columbia University and New York State Psychiatric Institute, New York, NY 10032, USA
| | | | | | - Elwin Wu
- Social Intervention Group, Columbia School of Social Work, New York, NY, 10027, USA
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
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3
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Wirtz AL, Cooney EE, Stevenson M, Radix A, Poteat T, Wawrzyniak AJ, Cannon CM, Schneider JS, Haw JS, Case J, Althoff KN, Humes E, Mayer KH, Beyrer C, Rodriguez AE, Reisner SL. Digital Epidemiologic Research on Multilevel Risks for HIV Acquisition and Other Health Outcomes Among Transgender Women in Eastern and Southern United States: Protocol for an Online Cohort. JMIR Res Protoc 2021; 10:e29152. [PMID: 33900202 PMCID: PMC8111508 DOI: 10.2196/29152] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 03/31/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The HIV epidemic disproportionately impacts transgender women in the United States. Cohort studies identify unique risks for affected populations, but use of facility-based methods may bias findings towards individuals living in research catchment areas, more engaged in health services, or, in the case of transgender populations, those who are open about their transgender identity. Digital clinical trials and other online research methods are increasingly common, providing opportunity to reach those not commonly engaged in research. Simultaneously, there is a need to understand potential biases associated with digital research, how these methods perform, and whether they are accepted across populations. OBJECTIVE This study aims to assess the feasibility of developing and implementing an online cohort of transgender women to assess risks for HIV acquisition and other health experiences. Further, this study aims to evaluate how an online cohort compares to a site-based, technology-enhanced cohort for epidemiologic research. The overarching goal is to estimate incidence of HIV and other health outcomes among transgender women in eastern and southern United States. METHODS This substudy is part of a larger multisite prospective cohort (LITE) conducted among transgender women, which also includes a site-based, technology-enhanced cohort in 6 eastern and southern US cities. The online cohort was launched to enroll and follow participants across 72 cities in the same region and with similar demographic characteristics as the site-based cohort. Participants are followed for 24 months. Adult transgender women are recruited via convenience sampling (eg, peer referrals, social media, and dating apps). Participants reporting negative or unknown HIV status are enrolled in a baseline study visit, complete a sociobehavioral survey, and provide oral fluid specimens to test for HIV. Participants not living with HIV (lab-confirmed) at baseline are offered enrollment into the cohort; follow-up assessments occur every 6 months. RESULTS Enrollment into the online cohort launched in January 2019. Active recruitment stopped in May 2019, and enrollment officially closed in August 2020. A total of 580 participants enrolled into and are followed in the cohort. A recruitment-enrollment cascade was observed across screening, consent, and completion of study activities. Implementation experiences with HIV test kits highlight the need for heavy staff engagement to support participant engagement, visit completion, and retention, even with automated digital procedures. CONCLUSIONS This study is responsive to increasing research interest in digital observational and intervention research, particularly for populations who are most affected by the HIV epidemic and for those who may otherwise not participate in person. The progression across stages of the recruitment-enrollment cascade provides useful insight for implementation of cohort studies in the online environment. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/29152.
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Affiliation(s)
- Andrea L Wirtz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Erin E Cooney
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Megan Stevenson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Asa Radix
- Callen-Lorde Community Health Center, New York, NY, United States
| | - Tonia Poteat
- Center for Health Equity Research, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Andrew J Wawrzyniak
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Christopher M Cannon
- Research and Evaluation, Whitman-Walker Institute, Washington DC, DC, United States
| | | | - J Sonya Haw
- Emory University School of Medicine, Atlanta, GA, United States
| | - James Case
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Keri N Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Elizabeth Humes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Kenneth H Mayer
- Beth Israel Deaconess Medical Center, Harvard Medical School, Harvard University, Boston, MA, United States.,The Fenway Institute, Fenway Health, Boston, MA, United States
| | - Chris Beyrer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Allan E Rodriguez
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Sari L Reisner
- The Fenway Institute, Fenway Health, Boston, MA, United States.,Division of Endocrinology, Diabetes, and Hypertension, Brigham Women's Hospital, Boston, MA, United States.,Department of Medicine, Harvard Medical School, Harvard University, Boston, MA, United States.,Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, United States
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- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Wirtz AL, Cooney EE, Chaudhry A, Reisner SL. Computer-Mediated Communication to Facilitate Synchronous Online Focus Group Discussions: Feasibility Study for Qualitative HIV Research Among Transgender Women Across the United States. J Med Internet Res 2019; 21:e12569. [PMID: 30924782 PMCID: PMC6460306 DOI: 10.2196/12569] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/20/2018] [Accepted: 12/30/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Novel, technology-based methods are rapidly increasing in popularity across multiple facets of quantitative research. Qualitative research, however, has been slower to integrate technology into research methodology. One method, computer-mediated communication (CMC), has been utilized to a limited extent for focus group discussions. OBJECTIVE This study aimed to assess feasibility of an online video conferencing system to further adapt CMC to facilitate synchronous focus group discussions among transgender women living in six cities in eastern and southern United States. METHODS Between August 2017 and January 2018, focus group discussions with adult transgender women were conducted in English and Spanish by research teams based in Boston, MA, and Baltimore, MD. Participants were sampled from six cities: Baltimore, MD; Boston, MA; New York, NY; Washington, DC; Atlanta, GA; and Miami, FL. This was formative research to inform a technology-enhanced cohort study to assess HIV acquisition among transgender women. This analysis focused on the methodologic use of CMC focus groups conducted synchronously using online software that enabled video or phone discussion. Findings were based on qualitative observations of attendance and study team debriefing on topics of individual, social, technical, and logistical challenges encountered. RESULTS A total of 41 transgender women from all six cities participated in seven online focus group discussions-five English and two Spanish. There was equal racial distribution of black/African American (14/41, 34%) and white (14/41, 34%) attendees, with 29% (12/41) identifying as Hispanic/Latina ethnicity. Overall, 29 of 70 (41%) eligible and scheduled transgender women failed to attend the focus group discussions. The most common reason for nonattendance was forgetting or having a scheduling conflict (16/29, 55%). A total of 14% (4/29) reported technical challenges associated with accessing the CMC focus group discussion. CMC focus group discussions were found to facilitate geographic diversity; allow participants to control anonymity and privacy (eg, use of pseudonyms and option to use video); ease scheduling by eliminating challenges related to travel to a data collection site; and offer flexibility to join via a variety of devices. Challenges encountered were related to overlapping conversations; variable audio quality in cases where Internet or cellular connection was poor; and distribution of incentives (eg, cash versus gift cards). As with all focus group discussions, establishment of ground rules and employing both a skilled facilitator and a notetaker who could troubleshoot technology issues were critical to the success of CMC focus group discussions. CONCLUSIONS Synchronous CMC focus group discussions provide a secure opportunity to convene participants across geographic space with minimal time burden and without losing the standardized approach that is expected of focus group discussions. This method may provide an optimal alternative to engaging hard-to-reach participants in focus group discussions. Participants with limited technological literacy or inconsistent access to a phone and/or cellular data or service, as well as circumstances necessitating immediate cash incentives may, however, require additional support and accommodation when participating in CMC focus group discussions.
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Affiliation(s)
- Andrea L Wirtz
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Erin E Cooney
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Aeysha Chaudhry
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA, United States
| | - Sari L Reisner
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA, United States
- Pediatrics, Harvard Medical School, Boston, MA, United States
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States
- Fenway Health, The Fenway Institute, Boston, MA, United States
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5
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Chen L, Lian D, Wang B. Factors associated with disclosing men who have sex with men (MSM) sexual behaviors and HIV-positive status: A study based on a social network analysis in Nanjing, China. PLoS One 2018; 13:e0196116. [PMID: 29672596 PMCID: PMC5908074 DOI: 10.1371/journal.pone.0196116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 04/08/2018] [Indexed: 11/18/2022] Open
Abstract
Objective We explored the factors associated with disclosure of men who have with sex with men (MSM) behaviors and HIV-positive status among HIV-positive MSM in Nanjing, China. Methods Social network analysis and epidemiological methods were combined in this pilot study. Information about participants’ (egos’) characteristics and behaviors and their social network members (alters) were collected through interview-administered questionnaires. General estimating equation logistic regression analysis was applied in both univariate and multivariate analysis. Results Eighty-seven HIV-positive MSM participated. Their mean age was 35.9 ±13.81years. They were more likely to disclose their MSM behavior to their friends [adjust Odds Ratio (AOR) = 6.43, 95% confidence interval (CI):3.08–13.42] or to the social network members who were not heterosexual [AOR = 4.40, 95%CI: 2.17–8.91]. Being participants’ friends [AOR = 5.16, 95%CI: 2.03–13.10] or family members [AOR = 6.22, 95%CI: 2.52–15.33] was significantly associated with HIV-positive status disclosure. Conclusion HIV-positive MSM tended to disclose their MSM behaviors and HIV positive status to close friends, family members or other individuals who were HIV-positive, engaging in MSM behavior, or both. Consequently, it will be an effective way to implement HIV prevention and intervention strategies in both MSM population and their trusted social networks.
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Affiliation(s)
- Lusi Chen
- Department of Epidemiology and Health statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Dashuai Lian
- Department of Epidemiology and Health statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Bei Wang
- Department of Epidemiology and Health statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
- * E-mail:
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6
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Chard AN, Metheny NS, Sullivan PS, Stephenson R. Social Stressors and Intoxicated Sex Among an Online Sample of Men who have Sex with Men (MSM) Drawn from Seven Countries. Subst Use Misuse 2018; 53:42-50. [PMID: 28792280 DOI: 10.1080/10826084.2017.1322985] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Rates of drug and alcohol use are higher among men who have sex with men (MSM) than the general adult male population, and are often associated with increased sexual risk-taking. OBJECTIVES We aim to examine the prevalence of drunk or high sex and their associations with socio-demographic characteristics, gay social network size, and social stress among an online sample of MSM drawn from seven countries. METHODS Sexually-active MSM aged over 18 residing in Australia, Brazil, Canada, South Africa, Thailand, the United Kingdom, or the United States were recruited through Facebook for a quantitative survey (n = 2,403) in 2012. Two outcomes were examined via logistic regression: reporting being buzzed/drunk at last sex, and reporting being high at last sex. RESULTS Results highlight the role of social stressors in shaping drug use among MSM. Results were context-specific, though commonalities were seen across countries. Being in a male-male sexual relationship was associated with lower odds of being buzzed/drunk at last sex in five countries. Higher scores on measures of external homonegative discrimination and internalized homonegativity were associated with greater odds of reporting being high at last sex in three countries. Conclusions/Importance: Social networks and minority stressors can have significant effects on drug use and sex while drunk or high. This points to the importance of focusing on structural issues when designing interventions for MSM aimed at reducing the transmission of HIV and other STIs.
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Affiliation(s)
- Anna N Chard
- a Department of Environmental Health, Rollins School of Public Health , Emory University ; Clifton Road, Atlanta , Georgia , USA
| | - Nicholas S Metheny
- b Department of Health Behavior and Biological Science, School of Nursing , University of Michigan , Ann Arbor , Michigan , USA.,c The Center for Sexuality and Health Disparities , University of Michigan , Ann Arbor , Michigan , USA
| | - Patrick S Sullivan
- d Department of Epidemiology, Rollins School of Public Health , Emory University , Clifton Road, Atlanta , Georgia , USA
| | - Rob Stephenson
- b Department of Health Behavior and Biological Science, School of Nursing , University of Michigan , Ann Arbor , Michigan , USA.,c The Center for Sexuality and Health Disparities , University of Michigan , Ann Arbor , Michigan , USA
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Chard AN, Metheny N, Stephenson R. Perceptions of HIV Seriousness, Risk, and Threat Among Online Samples of HIV-Negative Men Who Have Sex With Men in Seven Countries. JMIR Public Health Surveill 2017. [PMID: 28634155 PMCID: PMC5497068 DOI: 10.2196/publichealth.7546] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Rates of new HIV infections continue to increase worldwide among men who have sex with men (MSM). Despite effective prevention strategies such as condoms and pre-exposure prophylaxis (PrEP), low usage of both methods in many parts of the world hinder prevention efforts. An individual’s perceptions of the risk of acquiring HIV and the seriousness they afford to seroconversion are important drivers of behavioral risk-taking. Understanding the behavioral factors suppressing the uptake of HIV prevention services is a critical step in informing strategies to improve interventions to combat the ongoing HIV pandemic among MSM. Objective The study aimed to examine cross-national perceptions of HIV/AIDS seriousness, risk, and threat and the association between these perceptions and sociodemographic characteristics, relationships, and high-risk sexual behaviors among MSM. Methods Participants in Australia, Brazil, Canada, Thailand, South Africa, the United Kingdom, and the United States were recruited for a self-administered survey via Facebook (N=1908). Respondents were asked to rate their perceived seriousness from 1 (not at all serious) to 5 (very serious) of contracting HIV, their perceived risk from 1 (no risk) to 10 (very high risk) of contracting HIV based on their current behavior, and their perception of the threat of HIV—measured as their confidence in being able to stay HIV-negative throughout their lifetimes—on a scale from 1 (will not have HIV by the end of his lifetime) to 5 (will have HIV by the end of his lifetime). Covariates included sociodemographic factors, sexual behavior, HIV testing, drug use, and relationship status. Three ordered logistic regression models, one for each outcome variable, were fit for each country. Results Contracting HIV was perceived as serious (mean=4.1-4.6), but perceptions of HIV risk (mean=2.7-3.8) and threat of HIV (mean=1.7-2.2) were relatively low across countries. Older age was associated with significantly lower perceived seriousness of acquiring HIV in five countries (Australia: odds ratio, OR 0.97, 95% CI 0.94-0.99; Brazil: OR 0.95, 95% CI 0.91-0.98; Canada: OR 0.96, 95% CI 0.93-0.98; South Africa: OR 0.96, 95% CI 0.94-0.98; United Kingdom: OR 0.95, 95% CI 0.92-0.98). Being in a male-male sexual relationship was associated with significantly lower perceived risk of HIV in four countries (Australia: OR 0.47, 95% CI 0.30-0.75; Canada: OR: 0.54, 95% CI 0.35-0.86; United Kingdom: OR 0.38, 95% CI 0.24-0.60; United States: OR 0.5, 95% CI 0.31-0.82). Drug use in the previous year was associated with greater threat of contracting HIV in two countries (Canada: OR 1.81, 95% CI 1.13-2.91; United Kingdom: OR 1.7, 95% CI 1.06-2.74). Conclusions Few measures of behavioral or sexual risk-taking were significantly associated with perceived HIV seriousness, risk, or threat across countries. Overall, low levels of reported risk were identified, and results illustrate important gaps in the understanding of risk among MSM across societies that could be addressed through culturally-tailored prevention messaging.
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Affiliation(s)
- Anna N Chard
- Department of Environmental HealthRollins School of Public HealthEmory UniversityAtlanta, GAUnited States
| | - Nicholas Metheny
- Department of Health Behavior and Biological SciencesSchool of NursingUniversity of MichiganAnn Arbor, MIUnited States.,Center for Sexuality and Health DisparitiesSchool of NursingUniversity of MichiganAnn Arbor, MIUnited States
| | - Rob Stephenson
- Department of Health Behavior and Biological SciencesSchool of NursingUniversity of MichiganAnn Arbor, MIUnited States.,Center for Sexuality and Health DisparitiesSchool of NursingUniversity of MichiganAnn Arbor, MIUnited States
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Jin H, Friedman MR, Lim SH, Guadamuz TE, Wei C. Suboptimal HIV Testing Uptake Among Men Who Engage in Commercial Sex Work with Men in Asia. LGBT Health 2016; 3:465-471. [PMID: 26982598 DOI: 10.1089/lgbt.2015.0051] [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] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Men who have sex with men and are sex workers (MSMSW) are disproportionately affected by the growing and emerging HIV epidemic. As sex work and same-sex behavior are heavily stigmatized and often illegal in most Asian countries, HIV research focusing on MSMSW has been limited. The goal of this analysis is to examine HIV testing practices and identify correlates of HIV testing among MSMSW in Asia. METHODS The Asia Internet MSM Sex Survey, an online cross-sectional survey of 10,861 men who have sex with men (MSM), was conducted in 2010. Data on sociodemographic characteristics, HIV testing behaviors, and sexual behaviors were collected. Five hundred and seventy-four HIV-negative/unknown respondents reported receiving payment for sex with men at least once in the past 6 months and were included in this analysis. Multivariable logistic regression was conducted to identify independent correlates of HIV testing in the past year. RESULTS About half (48.6%) of the participants had been tested for HIV at least once within the past year, and 30.5% had never been tested. We also found that MSMSW participants who engaged in risky behaviors were less likely to be tested. CONCLUSION While one might expect a high HIV testing rate among MSMSW due to the risks associated with engaging in sex work, we found that HIV testing uptake is suboptimal among MSMSW in Asia. These results suggest that targeted HIV prevention and testing promotion among MSMSW are needed.
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Affiliation(s)
- Harry Jin
- 1 Center for Public Health Research , San Francisco Department of Public Health, San Francisco, California
| | - Mackey Reuel Friedman
- 2 Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health , Pittsburgh, Pennsylvania
| | - Sin How Lim
- 3 Center of Excellence for Research in AIDS, University of Malaya , Kuala Lumpur, Malaysia
| | - Thomas E Guadamuz
- 4 Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University , Nakorn Pathom, Thailand
| | - Chongyi Wei
- 5 Department of Epidemiology and Biostatistics, University of California , San Francisco, San Francisco, California
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