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Besera G, Snead MC, Goodwin M, Smoots A, Bish CL, Ruiz A, Sayyad A, Avripas S, Ubri P, Ahn R, Pineau V, Warren N, Mukangu D, Johnson-Agbakwu CE, Goldberg H, Okoroh E. The women's health needs study among women from countries with high prevalence of female genital mutilation living in the United States: Design, methods, and participant characteristics. PLoS One 2024; 19:e0302820. [PMID: 38820266 PMCID: PMC11142442 DOI: 10.1371/journal.pone.0302820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 04/12/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The Women's Health Needs Study (WHNS) collected information on the health characteristics, needs, and experiences, including female genital mutilation (FGM) experiences, attitudes, and beliefs, of women aged 18 to 49 years who were born, or whose mothers were born, in a country where FGM is prevalent living in the US. The purpose of this paper is to describe the WHNS design, methods, strengths and limitations, as well as select demographic and health-related characteristics of participants. METHODS We conducted a cross-sectional survey from November 2020 -June 2021 in four US metropolitan areas, using a hybrid venue-based sampling (VBS) and respondent-driven sampling (RDS) approach to identify women for recruitment. RESULTS Of 1,132 participants, 395 were recruited via VBS and 737 RDS. Most were born, or their mothers were born, in either a West African country (Burkina Faso, Guinea, Mali, Mauritania, Sierra Leone, The Gambia) (39.0%) or Ethiopia (30.7%). More than a third were aged 30-39 years (37.5%) with a majority who immigrated at ages ≥13 years (86.6%) and had lived in the United States for ≥5 years (68.9%). Medicaid was the top health insurer (52.5%), followed by private health insurance (30.5%); 17% of participants had no insurance. Nearly half of women reported 1-2 healthcare visits within the past 12 months (47.7%). One in seven did not get needed health care due to cost (14.8%). Over half have ever used contraception (52.1%) to delay or avoid pregnancy and 76.9% had their last pelvic and/or Papanicolaou (pap) exam within the past 3 years. More than half experienced FGM (55.0%). Nearly all women believed that FGM should be stopped (92.0%). CONCLUSION The VBS/RDS approach enabled recruitment of a diverse study population. WHNS advances research related to the health characteristics, needs, and experiences of women living in the US from countries where FGM is prevalent.
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Affiliation(s)
- Ghenet Besera
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Margaret Christine Snead
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mary Goodwin
- Independent Consultant, Atlanta, Georgia, United States of America
| | - Ashley Smoots
- Division of Birth Defects and Infant Disorders, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Connie L. Bish
- Independent Consultant, Atlanta, Georgia, United States of America
| | - Alicia Ruiz
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ayeesha Sayyad
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sabrina Avripas
- NORC at the University of Chicago, Chicago, Illinois, United States of America
| | - Petry Ubri
- NORC at the University of Chicago, Chicago, Illinois, United States of America
| | - Roy Ahn
- NORC at the University of Chicago, Chicago, Illinois, United States of America
| | - Vicki Pineau
- NORC at the University of Chicago, Chicago, Illinois, United States of America
| | - Nicole Warren
- Johns Hopkins University School of Nursing, Washington, DC, United States of America
| | - Doris Mukangu
- Amani Women Center, Atlanta, Georgia, United States of America
| | - Crista E. Johnson-Agbakwu
- Collaborative in Health Equity, Office of Health Equity, The University of Massachusetts, Worcester, Massachusetts, United States of America
- Obstetrics & Gynecology, UMass Memorial Health, Worcester, Massachusetts, United States of America
- Division of Preventive and Behavioral Medicine, Population and Quantitative Health Sciences, University of Massachusetts T.H. Chan Medical School, Worcester, Massachusetts, United States of America
| | - Howard Goldberg
- Independent Consultant, Atlanta, Georgia, United States of America
| | - Ekwutosi Okoroh
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Methods for Assessing Spillover in Network-Based Studies of HIV/AIDS Prevention among People Who Use Drugs. Pathogens 2023; 12:pathogens12020326. [PMID: 36839598 PMCID: PMC9967280 DOI: 10.3390/pathogens12020326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
Human Immunodeficiency Virus (HIV) interventions among people who use drugs (PWUD) often have spillover, also known as interference or dissemination, which occurs when one participant's exposure affects another participant's outcome. PWUD are often members of networks defined by social, sexual, and drug-use partnerships and their receipt of interventions can affect other members in their network. For example, HIV interventions with possible spillover include educational training about HIV risk reduction, pre-exposure prophylaxis, or treatment as prevention. In turn, intervention effects frequently depend on the network structure, and intervention coverage levels and spillover can occur even if not measured in a study, possibly resulting in an underestimation of intervention effects. Recent methodological approaches were developed to assess spillover in the context of network-based studies. This tutorial provides an overview of different study designs for network-based studies and related methodological approaches for assessing spillover in each design. We also provide an overview of other important methodological issues in network studies, including causal influence in networks and missing data. Finally, we highlight applications of different designs and methods from studies of PWUD and conclude with an illustrative example from the Transmission Reduction Intervention Project (TRIP) in Athens, Greece.
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Fujimoto K, Paraskevis D, Kuo JC, Hallmark CJ, Zhao J, Hochi A, Kuhns LM, Hwang LY, Hatzakis A, Schneider JA. Integrated molecular and affiliation network analysis: Core-periphery social clustering is associated with HIV transmission patterns. SOCIAL NETWORKS 2022; 68:107-117. [PMID: 34262236 PMCID: PMC8274587 DOI: 10.1016/j.socnet.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This study investigates the two-mode core-periphery structures of venue affiliation networks of younger Black men who have sex with men (YBMSM). We examined the association between these structures and HIV phylogenetic clusters, defined as members who share highly similar HIV strains that are regarded as a proxy for sexual affiliation networks. Using data from 114 YBMSM who are living with HIV in two large U.S. cities, we found that HIV phylogenetic clustering patterns were associated with social clustering patterns whose members share affiliation with core venues that overlap with those of YBMSM. Distinct HIV transmission patterns were found in each city, a finding that can help to inform tailored venue-based and network intervention strategies.
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Affiliation(s)
- Kayo Fujimoto
- Department of Health Promotion, The University of Texas Health Science Center at Houston, 7000 Fannin Street, UCT 2514, Houston, TX 77030
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jacky C. Kuo
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, 7000 Fannin Street, Houston, TX 77030
| | | | - Jing Zhao
- Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030
| | - Andre Hochi
- Department of Health Promotion, The University of Texas Health Science Center at Houston, 7000 Fannin Street, UCT 2514, Houston, TX 77030
| | - Lisa M Kuhns
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children’s Hospital, and Northwestern University, Feinberg School of Medicine, Department of Pediatrics, 225 E. Chicago Avenue, #161, Chicago, IL 60611
| | - Lu-Yu Hwang
- Department of Epidemiology, Human Genetics, and Environmental Science, The University of Texas Health Science Center at Houston, 7000 Fannin Street, Houston, TX 77030
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - John A. Schneider
- Department of Medicine and Public Health Sciences and the Chicago Center for HIV Elimination, University of Chicago, 5837 South Maryland Avenue MC 5065, Chicago, IL 60637
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4
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Prevalence and Risk Factors for HIV Infection Among Heterosexual Men Recruited from Socializing Venues in Rural KwaZulu-Natal, South Africa. AIDS Behav 2021; 25:3528-3537. [PMID: 33575900 DOI: 10.1007/s10461-021-03182-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2021] [Indexed: 02/07/2023]
Abstract
Young heterosexual men have low uptake of HIV prevention and treatment services and represent an important key population that may require novel strategies. We recruited 1271 heterosexual men, 12 years and older from socializing venues such as "shebeens", transport hubs, "spaza" shops, and community centers in rural KwaZulu-Natal, South Africa. Participants completed a questionnaire and were tested for HIV serostatus. Generalized estimating equations (GEE) with exchangeable covariance structure estimated factors independently associated with prevalent HIV infection. Median age was 25 years [Interquartile range (IQR) 21-29]. HIV prevalence was 15.5% [95% confidence interval (CI) 11.0-21.9] and increased significantly by age. Factors associated with higher odds of HIV infection were being 25 years and older [adjusted odds ratio (aOR) 4.82, 95% CI 3.47-6.69; p < 0.001), not completing high school (aOR 1.60, 95% CI 1.39-1.85; p < 0.001), not using condoms at first sex (aOR 1.43, 95% CI 1.20-1.70; p < 0.001), consuming alcohol (aOR 1.63, 95% CI 1.15-2.31; p = 0.006) or substances (aOR 1.37, 95% CI 1.31-1.44; p < 0.001), and absence of medical circumcision (aOR 2.05, 95% CI 1.71-2.44; p < 0.001). Risk was lower among those testing for HIV in last 12 months (aOR 0.54, 95% CI 0.36-0.80; p = 0.002). Greater effort is needed to implement innovative programs within settings that are easily accessible and where heterosexual men are likely to be.
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Moore TR, Foster EN, Mair C, Burke JG, Coulter RWS. Leveraging Complex Systems Science to Advance Sexual and Gender Minority Youth Health Research and Equity. LGBT Health 2021; 8:379-385. [PMID: 34182823 DOI: 10.1089/lgbt.2020.0297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Over the past two decades, sexual and gender minority (SGM) youth health inequities have remained the same or widened, highlighting the need for new approaches to foster health equity. Complex systems science (CSS) techniques must be added to our armamentarium because of the following: CSS techniques can model cyclical feedback loops inherent in the relationships between SGM youth health outcomes and their multilevel causes, thereby enhancing the integration of real-world complexity in scientific models; and CSS can simulate multiple hypothetical interventions, thereby identifying future interventions with great potential impact. We describe four promising CSS techniques for advancing SGM youth health equity.
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Affiliation(s)
- Travis R Moore
- ChildObesity180, Division of Nutrition Interventions, Communication, and Behavior Change, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Elizabeth N Foster
- Department of Library and Information Science, School of Computing and Information, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for Social Dynamics and Community Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christina Mair
- Center for Social Dynamics and Community Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jessica G Burke
- Center for Social Dynamics and Community Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert W S Coulter
- Center for Social Dynamics and Community Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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6
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Young LE, Fujimoto K. The Co-evolution of online social networks and syphilis incidence among young black men who have sex with men. Soc Sci Med 2021; 272:113764. [PMID: 33592396 DOI: 10.1016/j.socscimed.2021.113764] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/04/2021] [Accepted: 02/07/2021] [Indexed: 11/17/2022]
Abstract
Network contexts have been implicated in the facilitation of syphilis transmission, however little is known about the relationship between online social networks, a proxy for physical networks, and rates of syphilis infection and how they co-evolve over time. To these ends, this study explored the interdependent relationship between Facebook friendship network dynamics and rates of syphilis incidence among young Black men who have sex with men (YBMSM). Specifically, we investigated the extent to which syphilis status, as a latent profile of network members, serves as a selection mechanism of Facebook tie formation and the degree to which Facebook friendships influenced dynamics of syphilis seroconversion. Sexual health, behavioral, and social network data were collected from a cohort of YBMSM (N = 286, Mean age = 22.8) at two time points between 2013 and 2015 in Chicago, IL, USA. The interdependencies between Facebook friendship networks and syphilis infection were assessed using stochastic actor-based models for social networks and behavior. Results showed that YBMSM tended to form Facebook friendships with other YBMSM who had similar syphilis and HIV status profiles, and the hazard of contracting syphilis was likewise influenced by their Facebook friendships, albeit subtly, by being connected to infectious network members. Meanwhile, intrinsic characteristics like condomless sex, HIV status, and online partner-seeking were not associated with dynamics in syphilis incidence. These findings show that there is a mutually dependent relationship between the online network dynamics of YBMSM and rates of syphilis incidence. Findings also direct attention to network-based strategies for intervention.
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Affiliation(s)
- Lindsay E Young
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA.
| | - Kayo Fujimoto
- Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center, Houston, TX, USA
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7
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Location inference for hidden population with online text analysis. Int J Health Geogr 2020; 19:57. [PMID: 33298074 PMCID: PMC7724834 DOI: 10.1186/s12942-020-00245-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/09/2020] [Indexed: 11/21/2022] Open
Abstract
Background Understanding the geographic distribution of hidden population, such as men who have sex with men (MSM), sex workers, or injecting drug users, are of great importance for the adequate deployment of intervention strategies and public health decision making. However, due to the hard-to-access properties, e.g., lack of a sampling frame, sensitivity issue, reporting error, etc., traditional survey methods are largely limited when studying such populations. With data extracted from the very active online community of MSM in China, in this study we adopt and develop location inferring methods to achieve a high-resolution mapping of users in this community at national level. Methods We collect a comprehensive dataset from the largest sub-community related to MSM topics in Baidu Tieba, covering 628,360 MSM-related users. Based on users’ publicly available posts, we evaluate and compare the performances of mainstream location inference algorithms on the online locating problem of Chinese MSM population. To improve the inference accuracy, other approaches in natural language processing are introduced into the location extraction, such as context analysis and pattern recognition. In addition, we develop a hybrid voting algorithm (HVA-LI) by allowing different approaches to vote to determine the best inference results, which guarantees a more effective way on location inference for hidden population. Results By comparing the performances of popular inference algorithms, we find that the classic gazetteer-based algorithm has achieved better results. And in the HVA-LI algorithms, the hybrid algorithm consisting of the simple gazetteer-based method and named entity recognition (NER) is proven to be the best to deal with inferring users’ locations disclosed in short texts on online communities, improving the inferring accuracy from 50.3 to 71.3% on the MSM-related dataset. Conclusions In this study, we have explored the possibility of location inferring by analyzing textual content posted by online users. A more effective hybrid algorithm, i.e., the Gazetteer & NER algorithm is proposed, which is conducive to overcoming the sparse location labeling problem in user profiles, and can be extended to the inference of geo-statistics for other hidden populations.
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8
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Kim B, Regan SD, Callander D, Goedel WC, Chaix B, Duncan DT. Associations of spatial mobility with sexual risk behaviors among young men who have sex with men in New York City: A global positioning system (GPS) study. Soc Sci Med 2020; 258:113060. [PMID: 32473485 DOI: 10.1016/j.socscimed.2020.113060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/17/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
Spatial contexts and spatial mobility are important factors of the HIV epidemic and sexually transmitted infections. Using global positioning system (GPS) devices, we examined the associations of objectively measured spatial mobility with sexual risk behaviors among gay, bisexual and other men who have sex with men (MSM) in New York City. This observational study included a subgroup of 253 HIV-negative MSM from the Project 18 Cohort Study, who participated in the GPS monitoring sub-study. Spatial mobility was measured as (1) distance traveled and (2) activity space size defined as daily path area during 2-week of GPS tracking. We examined the associations of these measures with numbers of male sexual partners and condomless anal intercourse (CAI) acts during last six months using quasi-Poisson models, adjusting for socio-demographics. Results demonstrated that spatial mobility was positively associated with sexual risk behaviors, for example, with CAI (incidence rate ratio [IRR] = 1.01 for a 10 km increase in distance traveled and IRR = 1.04 for a 1 km2 increase in 50 m-buffer activity space size). Our findings may enhance the understanding of spatial contexts of HIV risk. Future studies should be conducted to examine the mechanisms for the associations between spatial mobility behaviors with sexual risk behaviors as well as the influence of neighborhood characteristics in various neighborhood contexts, which may guide the place-based HIV prevention services.
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Affiliation(s)
- Byoungjun Kim
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States.
| | - Seann D Regan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Denton Callander
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
| | - William C Goedel
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis Team, F75012, Paris, France
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
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Fujimoto K, Wang P, Li DH, Kuhns LM, Amith M, Schneider JA. Collective Avoidance of Social and Health Venues and HIV Racial Inequities: Network Modeling of Venue Avoidance on Venue Affiliation, Social Networks, and HIV Risk. HEALTH EDUCATION & BEHAVIOR 2020; 47:202-212. [PMID: 32090656 DOI: 10.1177/1090198119876240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many younger Black men who have sex with men (YBMSM) are exposed to homonegativity, societal stigma, and racial discrimination in their social environment. This study uses a social network modeling methodology to identify aspects of the social environment that are not often described, that is, the places and spaces or "venues" where YBMSM socialize or where they receive HIV prevention services. In particular, we identify the structural features of avoidance of these venues as an indicator of negative experiences, using bipartite exponential random graph models. Our study theorizes that YBMSM avoid certain venues en masse through information diffusion among social network members. We specify two social mechanisms of collective venue avoidance-(1) homophily (i.e., ego-alter similarity in venue avoidance) and (2) popular opinion leaders (as early adopters)-and test the corresponding hypotheses that (Hypothesis 1) socially connected individuals avoid venues together and that (Hypothesis 2) popular individuals would be more likely to avoid venues. Based on data collected from YBMSM aged 16 to 29 years between 2014 and 2016 in Houston, Texas (N = 227) and Chicago, Illinois (N = 241), results indicate that Hypothesis 1 was supported in both cities but that Hypothesis 2 was supported only in Chicago. The findings suggest that the structural patterns of venue avoidance are different between cities and may inform dissemination of prevention messages and delivery of venue- and social influence-based HIV interventions.
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Affiliation(s)
- Kayo Fujimoto
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Peng Wang
- Swinburne University of Technology, Hawthorn, Victoria, Australia
| | | | - Lisa M Kuhns
- Northwestern University, Chicago, IL, USA.,Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | - Muhammad Amith
- The University of Texas Health Science Center at Houston, Houston, TX, USA
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10
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Nguyen AC, Young LE, Beymer MR, Suen SC. Developing targeted HIV risk predictors for young black men who have sex with men: a two-city comparative study. Int J STD AIDS 2020; 31:335-344. [PMID: 32089091 DOI: 10.1177/0956462419886472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
HIV burden in the United States is geographically and demographically heterogeneous. While efforts over the last few decades have reduced HIV incidence, young black men who have sex with men (YBMSM) account for a significant portion of new HIV diagnoses compared to any other race and age group. The Centers for Disease Control and Prevention has allocated funding to help reduce HIV in the YBMSM community; however, their recommended screening/treatment criteria do not emphasize demographic specificity. To better guide more applicable screening guidelines specifically for YBMSM, we examine demographic, behavioral, sexual network, and biological predictors of HIV status among YBMSM in two demographically distinct cities with high HIV burden in the United States: Chicago, IL and Los Angeles, CA. We perform multivariable logistic regressions to identify predictors of HIV in these populations. We found that having a history of syphilis was the only statistically significant predictor across both cities despite inclusion of other characteristics previously shown to be associated with HIV among YBMSM. Syphilis history could be a powerful HIV risk indicator for YBMSM and, therefore, should be integrated into clinical screening practices for critical biomedical prevention options like HIV pre-exposure prophylaxis.
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Affiliation(s)
- Anthony C Nguyen
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA, USA
| | - Lindsay E Young
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Matthew R Beymer
- Department of Health and Mental Health Services, Los Angeles LGBT Center, Los Angeles, CA, USA
| | - Sze-Chuan Suen
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA, USA
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11
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Young LE, Fujimoto K, Schneider JA. Facebook group affiliation ties, group topics, and HIV behavioral characteristics among young Black men who have sex with men: Potential for public health intervention. SSM Popul Health 2019; 9:100510. [PMID: 31993491 PMCID: PMC6978475 DOI: 10.1016/j.ssmph.2019.100510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/24/2019] [Accepted: 10/30/2019] [Indexed: 11/24/2022] Open
Abstract
•YBMSM were more likely to belong to personal/professional development groups.•YBMSM clustered around pairs of LGBTQ identity, sex, and nightlife groups.•Regular testers tended to belong to LGBTQ identity and nightlife groups.•Those who engaged in condomless sex tended to affiliate with LGBTQ identity groups.•Those who were aware of PrEP aware tended to affiliate with chat groups.
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Affiliation(s)
- Lindsay E. Young
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination (CCHE), Chicago, IL, USA
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center, Houston, USA
| | - John A. Schneider
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination (CCHE), Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, USA
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12
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Network Evolution of a Large Online MSM Dating Community: 2005-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224322. [PMID: 31698801 PMCID: PMC6888029 DOI: 10.3390/ijerph16224322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 11/02/2019] [Accepted: 11/04/2019] [Indexed: 01/04/2023]
Abstract
Due to multiple sexual partners and low rates of condom use, the HIV infection rate among MSM (men who have sex with men) is much higher than that of the general population. In order to analyze the characteristics of online activities of MSM, and to understand the evolution of their social networks, in this study we collect a comprehensive dataset, covering the period from January 2005 to June 2018, from the largest Chinese online community, Baidu Tieba. We build an online dating network for MSM-related individuals in the gay-bar community, and analyze the network from static and dynamic aspects. It is found that there is a strong homophily regarding the cities where users reside when developing interactions with others, and that most network measurements tend to be stable at the later stages of evolution, while the size of the largest community fluctuates. This is an indication that the network is formed of rapidly flexible interactions which changes quickly. In comparison with studies on heterosexual networks, we find that the MSM dating network shows differences in many aspects, such as the positive degree-degree correlation and high clustering coefficient, suggesting different thinking and measures should be taken in the policy making of public health management towards the MSM population.
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13
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Young LE, Fujimoto K, Alon L, Zhang L, Schneider JA. The multiplex social environments of young Black men who have sex with men: How online and offline social structures impact HIV prevention and sex behavior engagement. JOURNAL OF SOCIAL STRUCTURE : JOSS 2019; 20:70-95. [PMID: 32855626 PMCID: PMC7449318 DOI: 10.21307/joss-2019-007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
In the United States, young Black men who have sex with men (YBMSM) remain disproportionately affected by HIV. The social networks in which YBMSM are embedded are generally understood to be critical factors in understanding their vulnerability. In this study, we acknowledge the relational richness of YBMSMs' social environments (what we define as multiplexity) and their increasing prioritization of online social networking sites (SNS). Specifically, we investigate whether protective and/or risky features of YBMSMs' Facebook friendships and group affiliations are related to their HIV prevention and sex behavior engagement, while also accounting for features of their offline confidant (or support) and sex networks. Using data from a population-based cohort study of YBMSM living in Chicago (N=268), we perform a series of multiple logistic regression analyses to examine associations between features of YBMSMs' Facebook, confidant, and sexual networks with three prevention outcomes and three sex behavior outcomes, while also controlling for factors at the individual and structural levels. Results show that network features play a more significant role in predicting engagement in sex behaviors than prevention behaviors. Specifically, having more confidants, having confidants who are family members, meeting sex partners online, having more YBMSM Facebook friends, belonging to Facebook groups with an LGBTQ focus, and having greater subject diversity in one's Facebook group affiliations were significantly associated with one or more sex behavior outcomes. We conclude with a discussion of the implications of our findings for HIV prevention intervention efforts.
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Affiliation(s)
- Lindsay E Young
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Leigh Alon
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Liang Zhang
- Harris School of Public Policy, University of Chicago, Chicago, IL, USA
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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14
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Salomon T, Gomes I, Ozahata MC, Valente Moreira CH, Lorenzo Oliveira CD, Gonçalez TT, Duarte ME, Miranda C, de Freitas Carneiro Proietti AB, Sabino E, de Almeida Neto C, Custer B. Social and behavioral characteristics of male blood donors and their sexual partners: an analysis to define risk subsets. Transfusion 2019; 59:2584-2592. [PMID: 31158312 PMCID: PMC6679786 DOI: 10.1111/trf.15388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/15/2019] [Accepted: 05/16/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Men who have sex with men in Brazil are deferred from donation for 1 year since their last sexual contact. Legal proceedings in front of the Brazilian Supreme Court could compel blood collection agencies to discontinue use of sexual orientation questions. METHODS Data from male participants in a completed HIV risk factor case-control study were used to evaluate whether it is possible to differentiate donors at lower and higher risk for HIV using two analytical approaches: latent class and random forest analyses. RESULTS Male blood donors were divided into three distinct risk profile classes. Class 1 includes donors who are heterosexual (96.4%), are HIV negative (88.7%), have a main partner (99.4%), and practice unprotected sex (77.8%). Class 2 includes donors who are men who have sex with men /bisexuals' (100.0%), are HIV positive (97.4%), and were not aware of their sexual partners' HIV status (80.3%). Class 3 includes donors who are heterosexual (84.1%), practice unprotected vaginal/anal heterosexual sex (66.8% vs. 40.9%), and were both HIV positive and HIV negative (49.5% vs. 50.5%). We also found that asking donors about their partner(s)' HIV serostatus could replace asking about donors' sexual orientation and types of partners with relatively minor shifts in sensitivity (0.76 vs. 0.58), specificity (0.89 vs. 0.94), and positive predictive value (0.85 vs. 0.88). CONCLUSION Sexual orientation questions on the donor questionnaire could be replaced without great loss in the sensitivity, specificity, and positive predictive value. Social and sexual behaviors of donors and their partners are proxies for HIV risk and can help to develop modified questions that will need controlled trials to be validated.
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Affiliation(s)
- Tassila Salomon
- Hemominas, Minas Gerais – Brazil,Institute of Tropical Medicine, University of São Paulo, Brazil
| | - Isabel Gomes
- Faculdade Ciências Médicas – Belo Horizonte – Minas Gerais – Brazil
| | | | | | | | | | | | | | | | - Ester Sabino
- Institute of Tropical Medicine, University of São Paulo, Brazil
| | - Cesar de Almeida Neto
- Fundação Pró-Sangue - Hemocentro de São Paulo, São Paulo, Brazil,Disciplina de Ciências Médicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Brian Custer
- Vitalant Research Institute and University of California San Francisco
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15
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Young LE, Fujimoto K, Schneider JA. HIV Prevention and Sex Behaviors as Organizing Mechanisms in a Facebook Group Affiliation Network Among Young Black Men Who Have Sex with Men. AIDS Behav 2018. [PMID: 29536285 DOI: 10.1007/s10461-018-2087-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Online social networking sites (SNS)-the Internet-based platforms that enable connection and communication between users-are increasingly salient social environments for young adults and, consequently, offer tremendous opportunity for HIV behavioral research and intervention among vulnerable populations like young men who have sex with men (YMSM). Drawing from a cohort of 525 young Black MSM (YBMSM) living in Chicago, IL, USA April 2014-May 2015, we conducted social network analysis, estimating an exponential random graph model (ERGM) to model YBMSM's group affiliations on Facebook in relation to their sex behaviors and HIV prevention traits. A group's privacy setting-public, closed, or secret-was also modeled as a potential moderator of that relationship. Findings reveal that HIV positive individuals were more likely to affiliate with Facebook groups, while those who engaged in group sex were less likely to do so. When it came to the privacy of groups, we learned that HIV positive individuals tended not to belong to groups with greater privacy (e.g., closed and secret groups), while individuals who engaged in group sex and those who engaged in regular HIV testing were more likely to belong to those groups. Results also showed that individuals who engaged in condomless sex showed significant signs of clustering around the same set of groups. HIV positive individuals, on the other hand, were significantly less likely to demonstrate clustering. Implications for interventions and future research are discussed.
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Affiliation(s)
- Lindsay E Young
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, Chicago, IL, 60637, USA.
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, Chicago, USA.
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center, Houston, USA
| | - John A Schneider
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, Chicago, IL, 60637, USA
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, Chicago, USA
- Department of Public Health Sciences, University of Chicago, Chicago, USA
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16
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Al-Ajlouni YA, Park SH, Schneider JA, Goedel WC, Rhodes Hambrick H, Hickson DA, Cantor MN, Duncan DT. Partner meeting venue typology and sexual risk behaviors among French men who have sex with men. Int J STD AIDS 2018; 29:1282-1288. [PMID: 29973129 DOI: 10.1177/0956462418775524] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Previous research has given considerable attention to venues where men who have sex with men (MSM) meet their sex partners. However, no previous study examined a vast range of sexual risk behaviors. The objective of this study was to examine the association between the types of venues for meeting sexual partners, condomless anal intercourse, engagement in group sex, and HIV and sexually transmitted infection (STI) risk among a sample of MSM. Users of a popular geosocial-networking app in Paris were provided an advertisement with text encouraging them to complete an anonymous web-based survey ( n = 580), which included questions about sex-seeking venues, condomless anal intercourse, HIV status and STI history, and sociodemographic characteristics. A log-binomial model was used to assess association between venues (i.e. public venues [gay clubs, bars, and discos], cruising venues [such as gay saunas, beaches, and parks], and internet-based venues [internet chat sites and geosocial-networking apps]), condomless anal intercourse, engagement in group sex, and HIV infection as well as infection with other STIs, after adjustment for sociodemographics. In multivariable models, attending cruising venues was associated with condomless receptive anal intercourse (adjusted relative risk [aRR] = 1.47; 95% confidence interval [CI] = 1.20-1.81), any kind of condomless anal intercourse (aRR = 1.34; 95% CI = 1.14-1.58), an STI (aRR = 1.50; 95% CI = 1.09-2.05), engagement in group sex (aRR = 1.42; 95% CI = 1.27-1.59), and multiple partners for both condomless insertive (aRR = 2.00; 95% CI = 1.38-2.88), and receptive (aRR = 1.70; 95% CI = 1.23-2.36) anal intercourse, STI infection (aRR = 1.50, 95% CI = 1.09-2.05) and HIV infection (aRR = 1.76; 95% CI = 1.05-2.96). No associations were found with other venue types and sexual risk behaviors, STIs, and HIV infection, except for group sex, which was associated with all venue types. Use of cruising where the primary aim is to have sex was found to be associated with risky sexual behavior. Risky behavior reduction strategies such as preexposure prophylaxis campaigns should be targeted to MSM who frequent cruising venues.
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Affiliation(s)
- Yazan A Al-Ajlouni
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Su H Park
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - John A Schneider
- 2 Departments of Medicine and Public Health Sciences, University of Chicago School of Medicine, Chicago, IL, USA.,3 Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - William C Goedel
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - H Rhodes Hambrick
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | | | - Michael N Cantor
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Dustin T Duncan
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
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