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Reyes-Díaz M, Celly A, Folch C, Lorente N, Stuardo V, Veras MA, Barros H, Meireles P, Ramírez D, Jonas KJ, Marcus U, Schmidt AJ, Caceres CF, Casabona J. Latin American Internet Survey for Men who have Sex with Men (LAMIS-2018): Design, methods and implementation. PLoS One 2022; 17:e0277518. [PMID: 36395121 PMCID: PMC9671301 DOI: 10.1371/journal.pone.0277518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 10/28/2022] [Indexed: 11/19/2022] Open
Abstract
Despite men-who-have-sex-with-men (MSM) from Latin America (LA) are still a vulnerable population for known health-related conditions and social problems, availability of comparable data across LA countries for assessment and monitoring purposes is limited. The objective of this article is to present the study design and the questionnaire of LAMIS-2018 (Latin America MSM Internet Survey), its recruitment strategy, rates and sources by country, and the lessons learned from its implementation. LAMIS-2018 was a cross-sectional, internet-based survey targeting MSM living in 18 LA countries (Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Suriname, Uruguay, and Venezuela) that gathered data about sexual behaviors, HIV/STI and viral hepatitis knowledge, prophylactic use of antiretrovirals, psychosocial health, and access to sexual health services. The survey went online for four months and was available in three languages (Spanish, Portuguese, and Dutch). Promotion was carried out using dating apps, websites, social networks, and by community-based and academic organizations of each participating country directly in gay venues and in their own premises. Overall, 64,655 MSM participated in LAMIS-2018. Dating apps and websites were the most important recruitment source in most countries, except for Honduras, Nicaragua, and Suriname, where community-based organizations recruited most of the participants. Beyond the LAMIS-2018 implementation description, we highlight the feasibility of such a study in this context, based on the collaboration between community-based and academic organizations to obtain a large sample of MSM in the region. LAMIS-2018 data will contribute to identify determinants of risk behaviors and prevention needs of vulnerable MSM populations in each country of the region.
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Affiliation(s)
- Michael Reyes-Díaz
- Centro de Investigación Interdisciplinaria en Sexualidad, Sida y Sociedad (CIISSS), Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru
| | - Ana Celly
- Universidad Autónoma de Barcelona, Barcelona, Spain
- Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Madrid, Spain
| | - Cinta Folch
- Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- * E-mail:
| | - Nicolas Lorente
- Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Madrid, Spain
- Coalition PLUS
| | - Valeria Stuardo
- Instituto de Salud Pública, Universidad Andrés Bello, Santiago, Chile
| | - Maria Amelia Veras
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
| | - Henrique Barros
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, Porto, Portugal
| | - Paula Meireles
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, Porto, Portugal
| | | | - Kai J. Jonas
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | | | - Axel J. Schmidt
- Sigma Research, Department of Public Health, Environments & Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Carlos F. Caceres
- Centro de Investigación Interdisciplinaria en Sexualidad, Sida y Sociedad (CIISSS), Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru
| | - Jordi Casabona
- Universidad Autónoma de Barcelona, Barcelona, Spain
- Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Mann LM, Le Guillou A, Goodreau SM, Marcus JL, Sanchez T, Weiss KM, Jenness SM. Correlations between community-level HIV preexposure prophylaxis coverage and individual-level sexual behaviors among United States MSM. AIDS 2022; 36:2015-2023. [PMID: 35876641 PMCID: PMC9617766 DOI: 10.1097/qad.0000000000003343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To evaluate if community-level HIV PrEP coverage is correlated with individual sexual behaviors. DESIGN We used demographic, behavioral, and sexual network data from ARTnet, a 2017-2019 study of United States MSM. METHODS Multivariable regression models with a Bayesian modeling framework were used to estimate associations between area-level PrEP coverage and seven sexual behavior outcomes [number of total, main, and casual male partners (network degree); count of one-time partnerships; consistent condom use in one-time partnerships; and frequency of casual partnership anal sex (total and condomless)], controlling for individual PrEP use. RESULTS PrEP coverage ranged from 10.3% (Philadelphia) to 38.9% (San Francisco). Total degree was highest in Miami (1.35) and lowest in Denver (0.78), while the count of one-time partners was highest in San Francisco (11.7/year) and lowest in Detroit (1.5/year). Adjusting for individual PrEP use and demographics, community PrEP coverage correlated with total degree [adjusted incidence rate ratio (aIRR) = 1.73; 95% credible interval (CrI), 0.92-3.44], casual degree (aIRR = 2.05; 95% CrI, 0.90-5.07), and count of one-time partnerships (aIRR = 1.90; 95% CrI, 0.46-8.54). Without adjustment for individual PrEP use, these associations strengthened. There were weaker or no associations with consistent condom use in one-time partnerships (aIRR = 1.68; 95% CrI, 0.86-3.35), main degree (aIRR = 1.21; 95% CrI, 0.48-3.20), and frequency of casual partnership condomless anal sex (aIRR = 0.23; 95% CrI, 0.01-3.60). CONCLUSION Most correlations between community PrEP coverage and sexual behavior were explained by individual PrEP use. However, some residual associations remained after controlling for individual PrEP use, suggesting that PrEP coverage may partially drive community-level differences in sexual behaviors.
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Affiliation(s)
- Laura M Mann
- Department of Epidemiology, Emory University, Atlanta, Georgia
| | - Adrien Le Guillou
- Department of Epidemiology, Emory University, Atlanta, Georgia
- Department of Research and Public Health, Reims Teaching Hospitals, Robert Debré Hospital, Reims, France
| | - Steven M Goodreau
- Department of Anthropology and Center for Studies in Demography and Ecology, University of Washington, Seattle, WA
| | - Julia L Marcus
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Travis Sanchez
- Department of Epidemiology, Emory University, Atlanta, Georgia
| | - Kevin M Weiss
- Department of Epidemiology, Emory University, Atlanta, Georgia
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Mann LM, Kelley CF, Siegler AJ, Stephenson R, Sullivan PS. Seroadaptive Strategy Patterns of Young Black Gay, Bisexual, and Other Men Who Have Sex With Men in Atlanta, Georgia. J Acquir Immune Defic Syndr 2022; 89:40-48. [PMID: 34878433 PMCID: PMC8711639 DOI: 10.1097/qai.0000000000002816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/15/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Young Black gay, bisexual, and other men who have sex with men (YBMSM) are disproportionally affected by HIV. Seroadaptive strategies-modification of sexual behavior based on an individual's perceived serostatus, the perceived status of the partner, and/or HIV transmission risk by the type of sex act-are often used to reduce the risk of HIV transmission or acquisition. METHODS We used demographic, behavioral, and clinical data from Ele[MEN]t, a prospective cohort study of YBMSM aged 18-29 years in Atlanta, GA, conducted during 2015-2019. The prevalence of seroadaptive strategies at baseline was reported, and latent class analysis was used to identify the latent classes of strategies for both YBMSM known and not known to be living with HIV. Latent classes were compared by key behavioral and clinical characteristics to validate our findings. RESULTS In a 4-class model, the most common latent class of YBMSM not known to be living with HIV (32.4%) was characterized by all individuals reporting only having sex with men not perceived to be living with HIV. The most common latent class of YBMSM known to be living with HIV (48.2%) was characterized by a combination of serosorting strategies, including using condoms for anal sex with partners not known to be living with HIV and avoiding sex with men not known to be living with HIV. CONCLUSIONS YBMSM use various patterns of strategies to reduce their HIV transmission or acquisition risk. Our study highlights the need for targeted HIV prevention recommendations based on individual behaviors.
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Affiliation(s)
- Laura M. Mann
- Department of Epidemiology, Emory University, Atlanta, GA
| | - Colleen F. Kelley
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA
| | | | - Rob Stephenson
- Department of Systems, Populations and Leadership, School of Nursing and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI
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Guest JL, Adam E, Lucas IL, Chandler CJ, Filipowicz R, Luisi N, Gravens L, Leung K, Chavanduka T, Bonar EE, Bauermeister JA, Stephenson R, Sullivan PS. Methods for Authenticating Participants in Fully Web-Based Mobile App Trials from the iReach Project: Cross-sectional Study. JMIR Mhealth Uhealth 2021; 9:e28232. [PMID: 34463631 PMCID: PMC8441600 DOI: 10.2196/28232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/09/2021] [Accepted: 06/17/2021] [Indexed: 02/02/2023] Open
Abstract
Background Mobile health apps are important interventions that increase the scale and reach of prevention services, including HIV testing and prevention counseling, pre-exposure prophylaxis, condom distribution, and education, of which all are required to decrease HIV incidence rates. The use of these web-based apps as well as fully web-based intervention trials can be challenged by the need to remove fraudulent or duplicate entries and authenticate unique trial participants before randomization to protect the integrity of the sample and trial results. It is critical to ensure that the data collected through this modality are valid and reliable. Objective The aim of this study is to discuss the electronic and manual authentication strategies for the iReach randomized controlled trial that were used to monitor and prevent fraudulent enrollment. Methods iReach is a randomized controlled trial that focused on same-sex attracted, cisgender males (people assigned male at birth who identify as men) aged 13-18 years in the United States and on enrolling people of color and those in rural communities. The data were evaluated by identifying possible duplications in enrollment, identifying potentially fraudulent or ineligible participants through inconsistencies in the data collected at screening and survey data, and reviewing baseline completion times to avoid enrolling bots and those who did not complete the baseline questionnaire. Electronic systems flagged questionable enrollment. Additional manual reviews included the verification of age, IP addresses, email addresses, social media accounts, and completion times for surveys. Results The electronic and manual strategies, including the integration of social media profiles, resulted in the identification and prevention of 624 cases of potential fraudulent, duplicative, or ineligible enrollment. A total of 79% (493/624) of the potentially fraudulent or ineligible cases were identified through electronic strategies, thereby reducing the burden of manual authentication for most cases. A case study with a scenario, resolution, and authentication strategy response was included. Conclusions As web-based trials are becoming more common, methods for handling suspicious enrollments that compromise data quality have become increasingly important for inclusion in protocols. International Registered Report Identifier (IRRID) RR2-10.2196/10174
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Affiliation(s)
- Jodie L Guest
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.,School of Medicine, Emory University, Atlanta, GA, United States
| | - Elizabeth Adam
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Iaah L Lucas
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Cristian J Chandler
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Rebecca Filipowicz
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Nicole Luisi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Laura Gravens
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Kingsley Leung
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Tanaka Chavanduka
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
| | - Erin E Bonar
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor, MI, United States.,Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
| | - Jose A Bauermeister
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Rob Stephenson
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States.,Department of Systems, Population and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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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: 1.5] [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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6
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White C, Wray J, Whitfield C. 'A fifty mile round trip to change a lightbulb': An exploratory study of carers' experiences of providing help, care and support to families and friends from a distance. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1632-1642. [PMID: 32227545 DOI: 10.1111/hsc.12988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 02/21/2020] [Accepted: 03/11/2020] [Indexed: 06/10/2023]
Abstract
While the role of carers has been widely investigated, the experiences of those who care from a distance have been little explored, especially in the United Kingdom. However, contemporary patterns of family life suggest that this may be a significant experience for many. This exploratory study employed an anonymous online survey, conducted April-November 2017, to collect data about specific issues (experiences, challenges and satisfactions) faced by carers living at a distance requiring at least 1 hr travel time (each way) from the person they support. One hundred and twenty-eight participant responses were analysed. Qualitative (thematic) analysis identified that 'distance carers' carry out multiple care tasks, both when with, and apart from, the person they care for. Distance creates specific challenges for carers who have to work to 'bridge the distance gap' and who cannot 'just drop in' and see the person they support. Distance further exposes carers to emotional, financial and temporal demands. The use of technologies or the availability of a wider support network may support distance carers, and some explore the viability of relocation. However, these potential support strategies were identified as 'fragile' and at risk of breaking down. Despite the challenges identified, distance carers also reported satisfactions derived from supporting their relative/friend. While the numbers of those providing distance care are unknown, this research suggests that this is a significant carer group, whose needs should be recognised in health and social care policy, practice and research.
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Affiliation(s)
- Caroline White
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Jane Wray
- Faculty of Health Sciences, University of Hull, Hull, UK
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Fisher CB, Bragard E, Bloom R. Ethical Considerations in HIV eHealth Intervention Research: Implications for Informational Risk in Recruitment, Data Maintenance, and Consent Procedures. Curr HIV/AIDS Rep 2020; 17:180-189. [PMID: 32358768 PMCID: PMC7263316 DOI: 10.1007/s11904-020-00489-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Along with the benefits of eHealth HIV interventions are challenges to participant privacy and confidentiality inherent in the use of online strategies. This paper reviews current guidelines and recent publications to identify ethical issues and suggested solutions in recruitment, data management, and informed consent. RECENT FINDINGS Across eHealth HIV research, recruitment, data collection, and storage efforts to protect informational risk highlight the tension between the investigators' ability to protect participant confidentiality and the evolving informational risk posed by the online platforms on which they are operating. Adequately addressing these challenges requires updating technical competencies and educating participants on their own responsibilities to guard against privacy violations. Additional protections are required when interventions involve peer or community support, especially with minors. The rapid progression of technology presents challenges in solidifying best practices for future interventions. This article draws on published works describing investigator experiences to contribute to the ongoing development of guidance in this area.
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Affiliation(s)
- Celia B Fisher
- Center for Ethics Education and Department of Psychology, Fordham University, 117 Dealy Hall, Rose Hill Campus, 441 E. Fordham Road, Bronx, NY, 10458, USA.
| | - Elise Bragard
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Rachel Bloom
- Department of Psychology, Fordham University, Bronx, NY, USA
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Grov C, Stief M, Westmoreland DA, MacCrate C, Mirzayi C, Nash D. Maximizing Response Rates to Ads for Free At-Home HIV Testing on a Men-for-Men Geosocial Sexual Networking App: Lessons Learned and Implications for Researchers and Providers. HEALTH EDUCATION & BEHAVIOR 2020; 47:5-13. [PMID: 31896287 DOI: 10.1177/1090198119893692] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Internet-based recruitment can be effective in reaching large numbers of geographically diverse individuals. Geosocial sexual networking apps on smartphones have emerged as the modal way in which men who have sex with men (MSM) meet sex partners, and as venues for sexual health research. We report on the performance of three types of ads-text-only, text with male figure (no face), and text with male figure (with face)-used on a geosocial sexual networking app to advertise free at-home HIV testing and to enroll in an online study. We ran five 2-week-long ads on a popular MSM geosocial app between fall 2017 and spring 2018 (~2.19 million impressions). Ads were evaluated in terms of the click-through rate (CTR = advertisement clicks/advertisement impressions), conversion rates (CR = number of enrolled participants/ad-generated clicks), cost per enrolled participant, and demographic composition of survey respondents. We enrolled n = 4,023 individuals, n = 2,430 of whom completed HIV testing-$6.21 spent on advertising per participant enrolled and $10.29 spent for everyone who completed HIV testing. Cost per enrolled participant was associated with the content of the ad used-ads featuring male figures (with or without a face shown) were more cost efficient than ads featuring text alone. These ads also outperformed text-only ads across a range of metrics, including responsiveness among younger MSM as well as MSM of color. Advertising materials that combine text with images may have greater appeal among priority populations.
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Affiliation(s)
| | | | | | | | | | - Denis Nash
- The City University of New York New York, NY, USA
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Grov C, Westmoreland D, Rendina HJ, Nash D. Seeing Is Believing? Unique Capabilities of Internet-Only Studies as a Tool for Implementation Research on HIV Prevention for Men Who Have Sex With Men: A Review of Studies and Methodological Considerations. J Acquir Immune Defic Syndr 2019; 82 Suppl 3:S253-S260. [PMID: 31764261 PMCID: PMC6880799 DOI: 10.1097/qai.0000000000002217] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In 2014, Grov et al published a comprehensive review cataloguing both men who have sex with men's (MSM's) sexual behavior transitions in online environments from the 1990s through 2013, as well as researchers' efforts in tandem to use the internet to engage MSM into research, treatment, and prevention. METHODS In this article, we discuss historical events and research having occurred in the half decade since the Grov et al publication. RESULTS Notable transitions include MSM's expanded use of geosocial networking apps, as well as other forms of social media accessed primarily through mobile devices, as well as the addition of biomedical prevention strategies (eg, pre-exposure prophylaxis and undetectable = untransmittable) to the proverbial HIV prevention toolkit. In tandem, researchers have rapidly expanded their employment of internet-mediated methods for the recruitment and engagement of key populations for HIV research, treatment, and prevention. In this article, we discuss methodological considerations for using the internet to conduct HIV prevention research with MSM: (1) sources of recruitment (eg, geosocial apps, Facebook, crowdsourced online panels); (2) design (eg, cross sectional, longitudinal, diaries); (3) incentives (including disincentivizing fraudulent participants and/or spam bots); (4) confidentiality; and (5) representativeness. CONCLUSION We conclude by discussing future directions in HIV prevention research in light of forthcoming technologies such as fifth generation (5G) mobile networks, combined use of self-collected biological data alongside self-report, and the utility of metadata and metaresearch to document, evaluate, and inform best practices.
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Affiliation(s)
- Christian Grov
- CUNY Graduate School of Public Health and Health Policy, New York, NY
- CUNY Institute for Implementation Science in Population Health, New York, NY
| | - Drew Westmoreland
- CUNY Institute for Implementation Science in Population Health, New York, NY
| | | | - Denis Nash
- CUNY Graduate School of Public Health and Health Policy, New York, NY
- CUNY Institute for Implementation Science in Population Health, New York, NY
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Samuel G, Derrick GE, van Leeuwen T. The Ethics Ecosystem: Personal Ethics, Network Governance and Regulating Actors Governing the Use of Social Media Research Data. MINERVA 2019; 57:317-343. [PMID: 31501635 PMCID: PMC6728283 DOI: 10.1007/s11024-019-09368-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This paper examines the consequences of a culture of "personal ethics" when using new methodologies, such as the use of social media (SM) sites as a source of data for research. Using SM research as an example, this paper explores the practices of a number of actors and researchers within the "Ethics Ecosystem" which as a network governs ethically responsible research behaviour. In the case of SM research, the ethical use of this data is currently in dispute, as even though it is seemingly publically available, concerns relating to privacy, vulnerability, potential harm and consent blur the lines of responsible ethical research behaviour. The findings point to the dominance of a personal, bottom-up, researcher-led, 'ethical barometer' for making decisions regarding the permissibility of using SM data. We show that the use of different barometers by different researchers can lead to wide disparities in ethical practice - disparities which are compounded by the lack of firm guidelines for responsible practice of SM research. This has widespread consequences on the development of shared norms and understandings at all levels, and by all actors within the Ethics Ecosystem, and risks inconsistencies in their approaches to ethical decision-making. This paper argues that this governance of ethical behaviour by individual researchers perpetuates a negative cycle of academic practice that is dependent on subjective judgements by researchers themselves, rather than governed by more formalised academic institutions such as the research ethics committee and funding council guidelines.
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Affiliation(s)
- Gabrielle Samuel
- Educational Research, Centre for Higher Education Research and Evaluation (HERE), Lancaster University, Lancaster, LA1 4YD UK
- Department of Global Health and Social Medicine, Strand Campus, King’s College London, Strand, London, WC2R 2LS UK
| | - Gemma E. Derrick
- Educational Research, Centre for Higher Education Research and Evaluation (HERE), Lancaster University, Lancaster, LA1 4YD UK
| | - Thed van Leeuwen
- Centre for Science and Technology Studies, Leiden University, 2300 Leiden, The Netherlands
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Recruiting vulnerable populations to participate in HIV prevention research: findings from the Together 5000 cohort study. Ann Epidemiol 2019; 35:4-11. [PMID: 31182379 DOI: 10.1016/j.annepidem.2019.05.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/12/2019] [Accepted: 05/08/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE The aim of the article was to examine factors associated with completing enrollment milestones in the Together 5000 cohort of at-risk men (n = 8661), transmen (n = 53), and transwomen (n = 63) who have sex with men. METHODS Between 2017 and 2018, participants completed an online enrollment survey and were offered opportunities to complete an incentivized secondary online survey as well as self-administered at-home HIV testing (OraSure). We explored factors associated with completing each study component. RESULTS In total, 8777 individuals completed our enrollment survey, 6166 (70.3%) completed the secondary survey, and 5010 returned the at-home HIV test kit that was mailed to them (81.3% of those mailed a kit). In our multivariable models, those who were White, with more years of education, were more likely to complete study components, although the magnitude of these associations was small. For example, 50.9% of those enrolled, 47.9% of those completing the secondary survey, and 46.8% of those completing HIV testing were persons of color-a statistically significant, but meaningfully insignificant decline. CONCLUSIONS These findings highlight the need for researchers to identify barriers that may prevent persons of color and younger individuals from participating in research studies.
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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: 2.0] [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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Smith MK, Stein G, Cheng W, Miller WC, Tucker JD. Identifying high risk subgroups of MSM: a latent class analysis using two samples. BMC Infect Dis 2019; 19:213. [PMID: 30832592 PMCID: PMC6399860 DOI: 10.1186/s12879-019-3700-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 01/09/2019] [Indexed: 01/08/2023] Open
Abstract
Background Latent class analyses (LCA) are increasingly being used to target specialized HIV interventions, but generalizability of emergent population structures across settings has yet to be considered. We compare LCA performed on two online samples of HIV negative Chinese men who have sex with men (MSM) to detect more generalizable latent class structures and to assess the extent to which sampling considerations impact the validity of LCA results. Methods LCAs were performed on an 1) nationwide online survey which involved no in-person contact with study staff and a 2) sentinel surveillance survey in which participants underwent HIV and syphilis testing in the city of Guangzhou, both conducted in 2014. Models for each sample were informed by risk factors for HIV acquisition in MSM that were common to both datasets. Results An LCA of the Guangzhou sentinel surveillance data indicated the presence of two relatively similar classes, differing only by the greater tendency of one to report group sex. In contrast an LCA of the nationwide survey identified three classes, two of which shared many of the same features as those identified in the Guangzhou survey, including the fact that they were mainly distinguished by group sex behaviors. The final latent class in the nationwide survey was composed of members with notably few risk behaviors. Conclusions Comparisons of the latent class structures of each sample lead us to conclude that the nationwide online sample captured a larger, possibly more representative group of Chinese MSM comprised of a larger, higher risk group and a small yet distinct lower group with few reported behaviors. The absence of a lower risk group in the Guangzhou sentinel surveillance dataset suggests that MSM recruited into studies involving free HIV/STI testing may oversample MSM with higher risk behaviors and therefore greater risk perception. Lastly, two types of higher risk MSM were emergent across both samples distinguished largely by their recent group sex behaviors. Higher odds not only of self-reported HIV infection but also of closeted tendencies and gender fluid identities in this highest risk group suggest that interacting factors drive individual and structural facets of HIV risk.
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Affiliation(s)
- M Kumi Smith
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota Twin Cities, 1300 South 2nd Street, Minneapolis, MN, 55454, USA.
| | - Gabriella Stein
- Department of Biostatistics, University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenberg Hall, CB #7420, Chapel Hill, NC, 27599, USA
| | - Weibin Cheng
- Guangzhou Center for Disease Control and Prevention, Department of AIDS/STD Control and Prevention, 1 Jiaochang E Rd, Guangzhou Shi, 510000, Guangdong Sheng, China
| | - William C Miller
- Division of Epidemiology, The Ohio State University, College of Public Health, 1841 Neal Ave., 302 Cunz Hall, Columbus, OH, 43210, USA
| | - Joseph D Tucker
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Road, 2nd Floor, Chapel Hill, NC, 27599, USA
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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: 1.3] [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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Rendina HJ, Mustanski B. Privacy, Trust, and Data Sharing in Web-Based and Mobile Research: Participant Perspectives in a Large Nationwide Sample of Men Who Have Sex With Men in the United States. J Med Internet Res 2018; 20:e233. [PMID: 29973332 PMCID: PMC6053617 DOI: 10.2196/jmir.9019] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 04/05/2018] [Accepted: 05/12/2018] [Indexed: 11/13/2022] Open
Abstract
Background Modern research is heavily reliant on online and mobile technologies, which is particularly true among historically hard-to-reach populations such as gay, bisexual, and other men who have sex with men (GBMSM). Despite this, very little empirical research has been published on participant perspectives about issues such as privacy, trust, and data sharing. Objective The objective of our study was to analyze data from an online sample of 11,032 GBMSM in the United States to examine their trust in and perspectives on privacy and data sharing within online and mobile research. Methods Participants were recruited via a social networking site or sexual networking app to complete an anonymous online survey. We conducted a series of repeated measures analyses adjusted for between-person factors to examine within-person differences in the following: (1) trust for guarding personal information across different venues (eg, online research conducted by a university vs. an online search engine); (2) privacy concerns about 12 different types of data for three distinct data activities (ie, collection by app owners, anonymous selling to third parties, and anonymous sharing with researchers); and (3) willingness to share those 12 different types of data with researchers. Due to the large sample size, we primarily reported measures of effect size as evidence of clinical significance. Results Online research was rated as most trusted and was more trusted than online and mobile technology companies, such as app owners and search engines, by magnitudes of effect that were moderate-to-large (ηpartial2=0.06-0.11). Responding about 12 different types of data, participants expressed more concerns about data being anonymously sold to third-party partners (mean 7.6, median 10.0) and fewer concerns about data being collected by the app owners (mean 5.8, median 5.0) or shared anonymously with researchers (mean 4.6, median 3.0); differences were small-to-moderate in size (ηpartial2=0.01-0.03). Furthermore, participants were most willing to share their public profile information (eg, age) with researchers but least willing to share device usage information (eg, other apps installed); the comparisons were small-to-moderate in size (ηpartial2=0.03). Conclusions Participants reported high levels of trust in online and mobile research, which is noteworthy given recent high-profile cases of corporate and government data security breaches and privacy violations. Researchers and ethical boards should keep up with technological shifts to maintain the ability to guard privacy and confidentiality and maintain trust. There was substantial variability in privacy concerns about and willingness to share different types of data, suggesting the need to gain consent for data sharing on a specific rather than broad basis. Finally, we saw evidence of a privacy paradox, whereby participants expressed privacy concerns about the very types of data-related activities they have likely already permitted through the terms of the apps and sites they use regularly.
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Affiliation(s)
- H Jonathon Rendina
- Department of Psychology, Hunter College, The City University of New York, New York, NY, United States.,Doctoral Program in Health Psychology and Clinical Science, The Graduate Center, The City University of New York, New York, NY, United States
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Gama A, Martins MO, Dias S. HIV Research with Men who Have Sex with Men (MSM): Advantages and Challenges of Different Methods for Most Appropriately Targeting a Key Population. AIMS Public Health 2017; 4:221-239. [PMID: 29546214 PMCID: PMC5690451 DOI: 10.3934/publichealth.2017.3.221] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 05/16/2017] [Indexed: 12/27/2022] Open
Abstract
The difficulty in accessing hard-to-reach populations as men who have sex with men presents a dilemma for HIV surveillance as their omission from surveillance systems leaves significant gaps in our understanding of HIV/AIDS epidemics. Several methods for recruiting difficult-to-access populations and collecting data on trends of HIV prevalence and behavioural factors for surveillance and research purposes have emerged. This paper aims to critically review different sampling approaches, from chain-referral and venue-based to respondent-driven, time-location and internet sampling methods, focusing on its main advantages and challenges for conducting HIV research among key populations, such as men who have sex with men. The benefits of using these approaches to recruit participants must be weighed against privacy concerns inherent in any social situation or health condition. Nevertheless, the methods discussed in this paper represent some of the best efforts to effectively reach most-at-risk subgroups of men who have sex with men, contributing to obtain unbiased trends of HIV prevalence and HIV-related risk behaviours among this population group.
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Affiliation(s)
- Ana Gama
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisboa, Portugal
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Buckingham L, Becher J, Voytek CD, Fiore D, Dunbar D, Davis-Vogel A, Metzger DS, Frank I. Going social: Success in online recruitment of men who have sex with men for prevention HIV vaccine research. Vaccine 2017; 35:3498-3505. [PMID: 28526330 DOI: 10.1016/j.vaccine.2017.05.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 04/29/2017] [Accepted: 05/02/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the use of four different social media sites to recruit men who have sex with men (MSM) and transgender women to a phase 2b HIV prevention vaccine trial, HVTN 505. DESIGN Retrospective, observational study. METHODS The University of Pennsylvania HIV Vaccine Trials Unit (Penn HVTU) employed street outreach and online recruitment methods to recruit participants for HVTN 505 using a combination of national recruitment images/messages with Philadelphia-specific language and imagery. We compared the efficiency (number of enrolled participants per number of completed phone screens) and effectiveness (number of enrolled participants per time interval employed) of each strategy, as well as the demographics and risk behaviors of the populations. RESULTS Online recruitment strategies populated 37% (71/191) of trial participants at our site. Among the four social media strategies employed, 45.1% (32/71) were enrolled through Facebook, 16.9% (12/71) through Craigslist, 15.5% (11/71) through a web-based marketing company (WBMC), and 22.5% (16/71) via GRINDR. The number of participants enrolled per month of strategy and the months the strategy was employed were Facebook - 32(33months), Craigslist - 12(33months), WBMC - 11(6months), and GRINDR - 16(0.56months). In-person and online recruitment strategies yielded participants of similar demographics and levels of risk behavior. CONCLUSION Use of several social media recruitment modalities produced large numbers of MSM engaging in high risk behavior and willing to participate in an HIV prevention vaccine trial. In comparison to other social media and online strategies, recruitment via GRINDR was the most effective.
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Affiliation(s)
- Lindsey Buckingham
- HIV Prevention Research Division, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Julie Becher
- HIV Prevention Research Division, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chelsea D Voytek
- HIV Prevention Research Division, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Danielle Fiore
- HIV Prevention Research Division, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Debora Dunbar
- HIV Prevention Research Division, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Annet Davis-Vogel
- HIV Prevention Research Division, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David S Metzger
- HIV Prevention Research Division, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ian Frank
- HIV Prevention Research Division, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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18
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Hall EW, Sanchez TH, Stein AD, Stephenson R, Zlotorzynska M, Sineath RC, Sullivan PS. Use of Videos Improves Informed Consent Comprehension in Web-Based Surveys Among Internet-Using Men Who Have Sex With Men: A Randomized Controlled Trial. J Med Internet Res 2017; 19:e64. [PMID: 28264794 PMCID: PMC5359419 DOI: 10.2196/jmir.6710] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/07/2016] [Accepted: 02/08/2017] [Indexed: 11/23/2022] Open
Abstract
Background Web-based surveys are increasingly used to capture data essential for human immunodeficiency virus (HIV) prevention research. However, there are challenges in ensuring the informed consent of Web-based research participants. Objective The aim of our study was to develop and assess the efficacy of alternative methods of administering informed consent in Web-based HIV research with men who have sex with men (MSM). Methods From July to September 2014, paid advertisements on Facebook were used to recruit adult MSM living in the United States for a Web-based survey about risk and preventive behaviors. Participants were randomized to one of the 4 methods of delivering informed consent: a professionally produced video, a study staff-produced video, a frequently asked questions (FAQs) text page, and a standard informed consent text page. Following the behavior survey, participants answered 15 questions about comprehension of consent information. Correct responses to each question were given a score of 1, for a total possible scale score of 15. General linear regression and post-hoc Tukey comparisons were used to assess difference (P<.001) in mean consent comprehension scores. A mediation analysis was used to examine the relationship between time spent on consent page and consent comprehension. Results Of the 665 MSM participants who completed the comprehension questions, 24.2% (161/665) received the standard consent, 27.1% (180/665) received the FAQ consent, 26.8% (178/665) received the professional consent video, and 22.0% (146/665) received the staff video. The overall average consent comprehension score was 6.28 (SD=2.89). The average consent comprehension score differed significantly across consent type (P<.001), age (P=.04), race or ethnicity (P<.001), and highest level of education (P=.001). Compared with those who received the standard consent, comprehension was significantly higher for participants who received the professional video consent (score increase=1.79; 95% CI 1.02-2.55) and participants who received the staff video consent (score increase=1.79; 95% CI 0.99-2.59). There was no significant difference in comprehension for those who received the FAQ consent. Participants spent more time on the 2 video consents (staff video median time=117 seconds; professional video median time=115 seconds) than the FAQ (median=21 seconds) and standard consents (median=37 seconds). Mediation analysis showed that though time spent on the consent page was partially responsible for some of the differences in comprehension, the direct effects of the professional video (score increase=0.93; 95% CI 0.39-1.48) and the staff-produced video (score increase=0.99; 95% CI 0.42-1.56) were still significant. Conclusions Video-based consent methods improve consent comprehension of MSM participating in a Web-based HIV behavioral survey. This effect may be partially mediated through increased time spent reviewing the consent material; however, the video consent may still be superior to standard consent in improving participant comprehension of key study facts. Trail Registration Clinicaltrials.gov NCT02139566; https://clinicaltrials.gov/ct2/show/NCT02139566 (Archived by WebCite at http://www.webcitation.org/6oRnL261N).
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Affiliation(s)
- Eric William Hall
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Travis H Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Rob Stephenson
- Department of Health Behavior and Biological Sciences, School of Nursing and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, GA, United States
| | - Maria Zlotorzynska
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Robert Craig Sineath
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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Metzger IW, Cooper SM, Ritchwood TD, Onyeuku C, Griffin CB. Profiles of African American College Students' Alcohol Use and Sexual Behaviors: Associations With Stress, Racial Discrimination, and Social Support. JOURNAL OF SEX RESEARCH 2017; 54:374-385. [PMID: 27215314 PMCID: PMC5373031 DOI: 10.1080/00224499.2016.1179709] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Though studies show that alcohol use and sexual activity increase during emerging adulthood, few studies examine within-ethnic group differences, particularly among African American college students. This investigation utilized a latent class analytic methodology to identify risk behavior profiles of alcohol use (frequency and amount of alcohol consumed), sexual activity (number of intimate partners), and co-occurring risk behaviors (drinking before sexual intercourse) among 228 African American college students. This investigation also examined whether identified risk behavior profiles were associated with stress (interpersonal, intrapersonal, academic, and environmental), experiences of racial discrimination, and social support (from family, friends, and the college community). Results identified five distinct profiles within this sample: (a) High Sexual Risk-above-average sexual activity; (b) Abstainers-below-average alcohol use and sexual activity; (c) Low Risk-average alcohol use and sexual activity; (d) Alcohol Risk-above-average alcohol use and below-average sexual activity; and (e) Co-Occurring Risk-above-average alcohol use and sexual activity. Identified profiles differed across interpersonal and environmental stress, and self-reported frequency of experiences with racial discrimination. Implications for prevention programs and interventions aimed at reducing alcohol and sexual activity for African American college students are discussed.
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Affiliation(s)
- Isha W. Metzger
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
| | | | - Tiarney D. Ritchwood
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina; and Department of Public Health Sciences, Medical University of South Carolina
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20
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Choi EPH, Wong JYH, Lo HHM, Wong W, Chio JHM, Fong DYT. The Impacts of Using Smartphone Dating Applications on Sexual Risk Behaviours in College Students in Hong Kong. PLoS One 2016; 11:e0165394. [PMID: 27828997 PMCID: PMC5102411 DOI: 10.1371/journal.pone.0165394] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 10/11/2016] [Indexed: 11/30/2022] Open
Abstract
Dating applications (apps) on smartphones have become increasingly popular. The aim of this study was to explore the association between the use of dating apps and risky sexual behaviours. Data were collected in four university campuses in Hong Kong. Subjects completed a structured questionnaire asking about the use of dating apps, sexual behaviours, and sociodemographics. Multiple linear and logistics regressions were used to explore factors associated with sexual risk behaviours. Six hundred sixty-six subjects were included in the data analysis. Factors associated with having unprotected sexual intercourse with more lifetime sexual partners included use of dating apps (β = 0.93, p<0.01), having one’s first sexual intercourse before 16 years of age (β = 1.74, p<0.01), being older (β = 0.4, p<0.01), currently being in a relationship (= 0.69, p<0.05), having a monthly income at least HKD$5,000 (β = 1.34, p<0.01), being a current smoker (β = 1.52, p<0.01), and being a current drinker (β = 0.7, p<0.01). The results of a multiple logistic regression analysis found that users of dating apps (adjust odds ratio: 0.52, p<0.05) and current drinkers (adjust odds ratio: 0.40, p<0.01) were less likely to have consistent condom use. Users of dating apps (adjust odds ratio: 1.93, p<0.05), bisexual/homosexual subjects (adjust odds ratio: 2.57, p<0.01) and female subjects (adjust odds ratio: 2.00, p<0.05) were more likely not to have used condoms the last time they had sexual intercourse. The present study found a robust association between using dating apps and sexual risk behaviours, suggesting that app users had greater sexual risks. Interventions that can target app users so that they can stay safe when seeking sexual partners through dating apps should be developed.
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Affiliation(s)
- Edmond Pui-Hang Choi
- School of Nursing, the University of Hong Kong, Hong Kong S.A.R., People’s Republic of China
| | - Janet Yuen-Ha Wong
- School of Nursing, the University of Hong Kong, Hong Kong S.A.R., People’s Republic of China
- * E-mail:
| | - Herman Hay-Ming Lo
- Department of Applied Social Sciences, The Polytechnic University of Hong Kong, Hong Kong S.A.R., People’s Republic of China
| | - Wendy Wong
- Hong Kong Institute of Integrative Medicine and School of Chinese Medicine, the Chinese University of Hong Kong, Hong Kong S.A.R., People’s Republic of China
| | - Jasmine Hin-Man Chio
- Department of Counselling & Psychology, Hong Kong Shue Yan University, Hong Kong S.A.R., People’s Republic of China
| | - Daniel Yee-Tak Fong
- School of Nursing, the University of Hong Kong, Hong Kong S.A.R., People’s Republic of China
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Grov C, Cain D, Rendina HJ, Ventuneac A, Parsons JT. Characteristics Associated With Urethral and Rectal Gonorrhea and Chlamydia Diagnoses in a US National Sample of Gay and Bisexual Men: Results From the One Thousand Strong Panel. Sex Transm Dis 2016; 43:165-71. [PMID: 26859803 DOI: 10.1097/olq.0000000000000410] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Gay and bisexual men are at elevated risk for Neisseria gonorrhoeae and Chlamydia trachomatis (GC/CT). Rectal GC/CT symptoms may be less obvious than urethral, increasing opportunities for undiagnosed rectal GC/CT. METHODS A US national sample of 1071 gay and bisexual men completed urethral and rectal GC/CT testing and an online survey. RESULTS In total, 6.2% were GC/CT positive (5.3% rectal, 1.7% urethral). We calculated adjusted (for education, race, age, relationship status, having health insurance, and income) odds ratios for factors associated with rectal and urethral GC/CT diagnoses. Age was inversely associated with urethral and rectal GC/CT. Compared with white men, Latinos had significantly greater odds of rectal GC/CT. Among men who reported anal sex, those reporting only insertive sex had lower odds of rectal GC/CT than did men who reported both insertive and receptive. There was a positive association between rectal GC/CT and number of male partners (<12 months), the number of anal receptive acts, receptive condomless anal sex (CAS) acts, and insertive CAS acts. Compared with those who had engaged in both insertive and receptive anal sex, those who engaged in only receptive anal sex had lower odds of urethral GC/CT. The number of male partners (<12 months) was associated with increased odds of urethral GC/CT. CONCLUSIONS Rectal GC/CT was more common than urethral and associated with some demographic and behavioral characteristics. Our finding that insertive CAS acts was associated with rectal GC/CT highlights that providers should screen patients for GC/CT via a full range of transmission routes, lest GC/CT go undiagnosed.
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Affiliation(s)
- Christian Grov
- From the Center for HIV/AIDS Educational Studies and Training, New York, NY
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Jozkowski KN, Sanders SA, Rhoads K, Milhausen RR, Graham CA. Examining the Psychometric Properties of the Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) in a Sample of Lesbian and Bisexual Women. JOURNAL OF SEX RESEARCH 2016; 53:836-848. [PMID: 26479215 DOI: 10.1080/00224499.2015.1066743] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) assesses propensities for sexual excitation (SE) and inhibition (SI). Previous research utilizing the SESII-W included samples comprised exclusively or almost entirely of heterosexual women. The purpose of this study was to examine the psychometric properties of the SESII-W and assess its relation to aspects of sexual function within a sample of lesbian and bisexual women. The sample included 974 self-identified bisexual (n = 733) or lesbian/homosexual (n = 241) women who completed an online survey including items assessing women's sexual behaviors, feelings, and functioning, sociodemographics, and the SESII-W. The sample was split; exploratory factor analyses were conducted on the first half, yielding eight lower-order factors with two higher-order factors. Confirmatory factor analysis was conducted on the second half and suggested reasonable model fit. SI was positively correlated with sexual problems and negatively correlated with sexual pleasure; the correlations were significant but small. Hierarchical regression analyses were conducted to examine the relationships between SESII-W scores and sexual problems/sexual pleasure, controlling for age, relationship duration, and relationship status. Four lower-order factors predicted reports of sexual problems. Findings indicated the SESII-W has similar psychometric properties among sexual minority women as it does among heterosexual women.
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Affiliation(s)
- Kristen N Jozkowski
- a Department of Health, Human Performance, and Recreation , University of Arkansas
- b The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University
| | - Stephanie A Sanders
- b The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University
- c Rural Center for AIDS/STD Prevention , Indiana University
- d Department of Gender Studies , Indiana University
| | - Kelley Rhoads
- a Department of Health, Human Performance, and Recreation , University of Arkansas
| | - Robin R Milhausen
- b The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University
- c Rural Center for AIDS/STD Prevention , Indiana University
- e Department of Family Relations and Applied Nutrition , University of Guelph
| | - Cynthia A Graham
- b The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University
- c Rural Center for AIDS/STD Prevention , Indiana University
- f Department of Psychology , University of Southampton
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Schonnesson LN, Bowen AM, Williams ML. Project SMART: Preliminary Results From a Test of the Efficacy of a Swedish Internet-Based HIV Risk-Reduction Intervention for Men Who Have Sex With Men. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:1501-1511. [PMID: 26545912 DOI: 10.1007/s10508-015-0608-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/30/2015] [Accepted: 08/17/2015] [Indexed: 06/05/2023]
Abstract
In Sweden, 57 % of HIV transmission occurs among MSM, and other sexually transmitted infections are increasing, supporting the need for innovative interventions. The Internet is a potentially useful HIV-prevention platform, but there is a lack of such programs in Sweden. The purpose of this exploratory study was to test the efficacy of the Internet-based SMART intervention to decrease HIV sexual risks in Swedish MSM. The intervention was adapted from the Wyoming Rural AIDS Prevention Project to the Swedish context, which was guided by the Information-Motivation-Behavioral (IMB) skills model and consisted of six sessions. A total of 112 men responded to a pretest questionnaire and were randomly assigned to the SMART intervention or to a waitlist group. Fifty-four men dropped out, leaving a final sample of 58 participants. Twenty-five were assigned to the SMART intervention and 33 to a waitlist group. One month post intervention, the number of casual anal sex partners significantly decreased (t = 2.19, p = .04). Compared with the waitlist group, men in the intervention group increased their HIV knowledge (β = 0.70, p = .01), their belief of condom use as an act of responsibility (β = 1.19, p = .04), their willingness to use a condom with every new partner all the time (β = 1.39, p = .03), and their confidence in using condoms in challenging situations (β = 1.65, p = .02). Condom use was not analyzed due to the small sample size. Despite the small sample, high drop-out, and short follow-up, the study provides support for the efficacy of the Internet interventions, the SMART intervention specifically, for reducing the proportion of casual anal sex partners and improving the three cognitive components of the IMB model for Swedish MSM.
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Affiliation(s)
- Lena Nilsson Schonnesson
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset AB, 118 83, Stockholm, Sweden.
| | - Anne M Bowen
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Mark L Williams
- Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Rodriguez VJ, Spence A, Monda M, Potter J, Jones D. Couples Living with HIV. J Int Assoc Provid AIDS Care 2016; 16:133-139. [PMID: 26467783 DOI: 10.1177/2325957415612127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Desires to have children are not lessened by a woman's HIV status. Couples may lack information to conceive safely, and men may be especially uninformed. This study examined reproductive intentions, practices, and attitudes among men in HIV-infected couples, including attitudes regarding the perceived risk of vertical and horizontal transmission, safer conception, and preconception planning. METHODS Men ( n = 12) in HIV-infected couples were interviewed regarding reproductive intentions, attitudes, and knowledge and qualitative assessments were coded for dominant themes. RESULTS Themes primarily addressed concerns about the health of the baby, men's involvement in pregnancy, safer conception, concerns about HIV transmission and antiretroviral therapy, and HIV infection. Men lacked information on safer conception and newer HIV prevention strategies, such as pre-exposure prophylaxis (PrEP). DISCUSSION Gaps in knowledge regarding preconception practices among men in HIV-infected couples were identified. Results highlight men's desire for involvement in preconception planning, and opportunities for providers to facilitate this practice and to increase patient education and the use of PrEP are discussed.
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Affiliation(s)
- Violeta J Rodriguez
- 1 Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrew Spence
- 1 Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mallory Monda
- 1 Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - JoNell Potter
- 2 Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Deborah Jones
- 1 Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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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: 3.5] [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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Grov C, Rodríguez-Díaz CE, Jovet-Toledo GG. Male Escorts' and Male Clients' Sexual Behavior During Their Last Commercial Sexual Encounter: Comparing and Contrasting Findings from Two Online Studies. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:965-73. [PMID: 25953422 DOI: 10.1007/s10508-015-0531-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 03/09/2015] [Accepted: 03/13/2015] [Indexed: 05/10/2023]
Abstract
Much of what is known about commercial sexual encounters between men is based on data gathered from escorts. With few exceptions, studies have not compared male clients' reports of behavior during commercial sexual encounters with male escorts'. The present study draws from two datasets, a 2012 survey of clients (n = 495) and a 2013 survey of escorts (n = 387)--both used virtually identical measures of sexual behavior during the most recent commercial sexual encounter. For clients and escorts, the majority eschewed having sex without a condom, and kissing and oral sex were among the most common behaviors reported. Using logistic regression, both samples were compared across 15 sexual behaviors, finding significant differences in six--the escort sample had greater odds of reporting their last commercial sexual encounter involved watching the client masturbate, viewing porn, role play (dad/son, dominant/submissive), and having prior sexual experience with their commercial partner. The escort sample had lower odds of reporting that the client watched the escort masturbate, and being told partner's HIV status. In multivariable modeling, both samples did not significantly differ in reports of condomless anal sex. Male-male commercial sexual encounters appear to be involved in a wide range of sexual behaviors, many of which convey low-to-no risk of HIV transmission.
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Affiliation(s)
- Christian Grov
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York (CUNY), 2900 Bedford Avenue, Brooklyn, NY, 11210, USA.
- Doctoral Program in Public Health, The Graduate Center of CUNY, New York, USA.
- Center for HIV/AIDS Educational Studies and Training (CHEST), New York, USA.
| | - Carlos E Rodríguez-Díaz
- Department of Social Sciences, School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
- Center for Sexual Health Promotion and Health Equity, School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - Gerardo G Jovet-Toledo
- Center for Sexual Health Promotion and Health Equity, School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
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Holtzman S, Landis L, Walsh Z, Puterman E, Roberts D, Saya-Moore K. Predictors of HIV testing among men who have sex with men: a focus on men living outside major urban centres in Canada. AIDS Care 2016; 28:705-11. [PMID: 27043184 DOI: 10.1080/09540121.2016.1164288] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Men who have sex with men (MSM) represent almost half of new HIV infections in Canada each year. However, the vast majority of research on HIV testing among MSM has been conducted in major urban centres. The present study addressed this gap by investigating HIV testing behaviour and predictors of HIV testing among MSM living outside major urban centres, in the Interior of British Columbia. An anonymous online survey of 153 MSM assessed HIV testing behaviour and psychosocial factors that may impact HIV testing (internalized homophobia, disclosure to healthcare providers (HCPs) of same sex attraction, and gay community involvement). Almost one-quarter (24%) had never been tested and over one-third (35%) had not disclosed same sex attraction to HCPs. Internalized homophobia was associated with a lower likelihood of HIV testing, and this relationship was partially explained by the fact that those high in internalized homophobia were less likely to disclose same sex attraction to their HCPs. Neither formal nor informal involvement in the gay community was related to HIV testing, and both types of involvement were relatively low in our sample. Further research is needed to better understand the distinctive health issues facing MSM living outside major urban centres.
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Affiliation(s)
- Susan Holtzman
- a Department of Psychology , University of British Columbia , Kelowna , BC , Canada
| | | | - Zachary Walsh
- a Department of Psychology , University of British Columbia , Kelowna , BC , Canada
| | - Eli Puterman
- c School of Kinesiology , University of British Columbia , Vancouver , BC , Canada
| | - Daryle Roberts
- d Kelowna Community Development Society , Kelowna , BC , Canada
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28
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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: 5.9] [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: 0.8] [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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Choi EPH, Wong JYH, Lo HHM, Wong W, Chio JHM, Fong DYT. The Impacts of Using Smartphone Dating Applications on Sexual Risk Behaviours in College Students in Hong Kong. PLoS One 2016. [PMID: 27828997 DOI: 10.1371/journal.pone.0165394[] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Abstract
Dating applications (apps) on smartphones have become increasingly popular. The aim of this study was to explore the association between the use of dating apps and risky sexual behaviours. Data were collected in four university campuses in Hong Kong. Subjects completed a structured questionnaire asking about the use of dating apps, sexual behaviours, and sociodemographics. Multiple linear and logistics regressions were used to explore factors associated with sexual risk behaviours. Six hundred sixty-six subjects were included in the data analysis. Factors associated with having unprotected sexual intercourse with more lifetime sexual partners included use of dating apps (β = 0.93, p<0.01), having one's first sexual intercourse before 16 years of age (β = 1.74, p<0.01), being older (β = 0.4, p<0.01), currently being in a relationship (= 0.69, p<0.05), having a monthly income at least HKD$5,000 (β = 1.34, p<0.01), being a current smoker (β = 1.52, p<0.01), and being a current drinker (β = 0.7, p<0.01). The results of a multiple logistic regression analysis found that users of dating apps (adjust odds ratio: 0.52, p<0.05) and current drinkers (adjust odds ratio: 0.40, p<0.01) were less likely to have consistent condom use. Users of dating apps (adjust odds ratio: 1.93, p<0.05), bisexual/homosexual subjects (adjust odds ratio: 2.57, p<0.01) and female subjects (adjust odds ratio: 2.00, p<0.05) were more likely not to have used condoms the last time they had sexual intercourse. The present study found a robust association between using dating apps and sexual risk behaviours, suggesting that app users had greater sexual risks. Interventions that can target app users so that they can stay safe when seeking sexual partners through dating apps should be developed.
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Affiliation(s)
- Edmond Pui-Hang Choi
- School of Nursing, the University of Hong Kong, Hong Kong S.A.R., People's Republic of China
| | - Janet Yuen-Ha Wong
- School of Nursing, the University of Hong Kong, Hong Kong S.A.R., People's Republic of China
| | - Herman Hay-Ming Lo
- Department of Applied Social Sciences, The Polytechnic University of Hong Kong, Hong Kong S.A.R., People's Republic of China
| | - Wendy Wong
- Hong Kong Institute of Integrative Medicine and School of Chinese Medicine, the Chinese University of Hong Kong, Hong Kong S.A.R., People's Republic of China
| | - Jasmine Hin-Man Chio
- Department of Counselling & Psychology, Hong Kong Shue Yan University, Hong Kong S.A.R., People's Republic of China
| | - Daniel Yee-Tak Fong
- School of Nursing, the University of Hong Kong, Hong Kong S.A.R., People's Republic of China
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iTunes song-gifting is a low-cost, efficient recruitment tool to engage high-risk MSM in internet research. AIDS Behav 2015; 19:1914-8. [PMID: 26174208 DOI: 10.1007/s10461-015-1130-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This brief report describes methodology and results of a novel, efficient, and low-cost recruitment tool to engage high-risk MSM in online research. We developed an incentivization protocol using iTunes song-gifting to encourage participation of high-risk MSM in an Internet-based survey of HIV status, childhood sexual abuse, and adult behavior and functioning. Our recruitment methodology yielded 489 participants in 4.5 months at a total incentive cost of $1.43USD per participant. The sample comprised a critically high-risk group of MSM, including 71.0 % who reported recent condomless anal intercourse. We offer a "how-to" guide to aid future investigators in using iTunes song-gifting incentives.
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Mimiaga MJ, Biello KB, Robertson AM, Oldenburg CE, Rosenberger JG, O'Cleirigh C, Novak DS, Mayer KH, Safren SA. High prevalence of multiple syndemic conditions associated with sexual risk behavior and HIV infection among a large sample of Spanish- and Portuguese-speaking men who have sex with men in Latin America. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1869-78. [PMID: 26159862 DOI: 10.1007/s10508-015-0488-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 01/13/2015] [Accepted: 01/16/2015] [Indexed: 05/08/2023]
Abstract
The HIV epidemic in Latin America is highly concentrated in men who have sex with men (MSM). In the United States, multiple co-occurring psychosocial conditions have been shown to act as intertwined epidemics to potentiate HIV transmission among MSM. To date, no study has examined the role of syndemics and condomless sex among MSM in Latin America. In 2012, an online survey was conducted among members of the largest social/sexual networking website for MSM in Latin America. Participants were asked about demographics, sexual behaviors, HIV/STI diagnoses, and psychosocial well-being, including depression, suicidal ideation, hazardous alcohol use, hard drug use during sex, history of childhood/adolescent sexual abuse, intimate partner violence, and sexual compulsivity. Multivariable logistic generalized estimation equations were used to assess the relationship of syndemic factors and (1) engagement in higher risk condomless anal sex and (2) self-report of prior HIV diagnosis. Among 24,274 survey respondents, 74.6 % of the sample had at least one syndemic factor. In an additive model, syndemics were associated with increased odds of higher risk condomless anal sex, ranging from adjusted odds ratio of 1.31 (95 % CI 1.20, 1.43) for one syndemic factor to 4.06 (95 % CI 3.25, 5.09) for 6/7 syndemic factors. Similarly, syndemics were associated with increased odds of HIV infection (p < .0001). This study provides initial evidence that intertwined syndemics increase HIV risk behavior and HIV infection among MSM in Latin America. In the Latin American context, comprehensive HIV prevention interventions for MSM should be developed and tested that simultaneously address co-occurring psychosocial conditions and HIV risk.
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Affiliation(s)
- Matthew J Mimiaga
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital Behavioral Medicine, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA,
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Hirshfield S, Grov C, Parsons JT, Anderson I, Chiasson MA. Social media use and HIV transmission risk behavior among ethnically diverse HIV-positive gay men: results of an online study in three U.S. states. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1969-1978. [PMID: 26179596 DOI: 10.1007/s10508-015-0513-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 02/16/2015] [Accepted: 02/21/2015] [Indexed: 06/04/2023]
Abstract
Though Black and Hispanic men who have sex with men (MSM) are at an increased risk for HIV, few HIV risk reduction interventions that target HIV-positive MSM, and even fewer that use technology, have been designed to target these groups. Despite similar rates of social media and technology use across racial/ethnic groups, online engagement of minority MSM for HIV prevention efforts is low. Since minority MSM tend to have less representation in online HIV prevention studies, the goals of this online anonymous study of HIV-positive gay-identified men were to test the feasibility of conducting targeted recruitment by race/ethnicity and sexual orientation, to assess technology and social media use, and to assess global HIV transmission risk. In 2011, an anonymous online survey was conducted among 463 members of an HIV-positive personals website. Emails were sent to a subset of HIV-positive male members who self-identified as gay. While 57 % were White, substantial proportions of participants were Black (20 %) or Hispanic (18 %). Median age was 46 (range 18-79). Men who reported using 3 or more websites or apps to meet sex partners were significantly more likely to report anal intercourse (AOR 4.43, p < .001) and condomless anal sex (CAS) (AOR 2.70, p < .05) in the past 3 months. The only predictor of CAS with HIV-negative or unknown status partners was being under age 30 (AOR 3.38, p < .01). This study helped to inform online targeted recruitment techniques, access to technology and social media use, and sexual risk among a diverse sample of HIV-positive gay men. Efficacy trials of technology-based HIV prevention interventions targeting high-risk minority HIV-positive MSM are warranted.
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Affiliation(s)
- Sabina Hirshfield
- Research and Evaluation Unit, Public Health Solutions, 40 Worth Street, 5th Floor, New York, NY, 10013, USA,
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Grey JA, Konstan J, Iantaffi A, Wilkerson JM, Galos D, Rosser BRS. An updated protocol to detect invalid entries in an online survey of men who have sex with men (MSM): how do valid and invalid submissions compare? AIDS Behav 2015; 19:1928-37. [PMID: 25805443 DOI: 10.1007/s10461-015-1033-y] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Researchers use protocols to screen for suspicious survey submissions in online studies. We evaluated how well a de-duplication and cross-validation process detected invalid entries. Data were from the Sexually Explicit Media Study, an Internet-based HIV prevention survey of men who have sex with men. Using our protocol, 146 (11.6 %) of 1254 entries were identified as invalid. Most indicated changes to the screening questionnaire to gain entry (n = 109, 74.7 %), matched other submissions' payment profiles (n = 56, 41.8 %), or featured an IP address that was recorded previously (n = 43, 29.5 %). We found few demographic or behavioral differences between valid and invalid samples, however. Invalid submissions had lower odds of reporting HIV testing in the past year (OR 0.63), and higher odds of requesting no payment compared to check payments (OR 2.75). Thus, rates of HIV testing would have been underestimated if invalid submissions had not been removed, and payment may not be the only incentive for invalid participation.
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Affiliation(s)
- Jeremy A Grey
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA.
| | - Joseph Konstan
- Department of Computer Science & Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Alex Iantaffi
- Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Michael Wilkerson
- Division of Health Promotion & Behavioral Sciences, The University of Texas Health Sciences Center (UTHealth) at Houston, Houston, TX, USA
| | - Dylan Galos
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - B R Simon Rosser
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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Anal intercourse without condoms among HIV-positive men who have sex with men recruited from a sexual networking web site, United States. Sex Transm Dis 2015; 41:749-55. [PMID: 25581813 DOI: 10.1097/olq.0000000000000206] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The changing landscape of HIV prevention in the United States underscores the need to improve our ability to efficiently reach HIV-positive men who have sex with men (MSM) who engage in behaviors that could transmit HIV. METHODS We examined the prevalence of anal intercourse (AI) without condoms with HIV-negative or unknown serostatus partners ("at-risk partners") among 1319 HIV-positive adult male members of a sexual networking Web site for MSM. Sexual behaviors and substance use were measured over a 60-day recall period. Logistic regression was used to identify correlates of insertive and receptive AI without condoms with at-risk partners. RESULTS Approximately 25% of the men had been diagnosed as having HIV 12 months or less before study enrollment. Overall, 32% of men engaged in AI without condoms with at-risk partners. Multiple logistic regression identified behavioral predictors of insertive AI without condoms with at-risk partners, including HIV diagnosis within the last 12 months, sex with multiple male partners, substance use in conjunction with sex, and use of phosphodiesterase type 5 inhibitors. Receptive AI without condoms with at-risk partners was associated with younger age (19-24 years), residing outside metropolitan cities, substance use in conjunction with sex, and having multiple male partners. CONCLUSIONS High levels of sexual risk were found among these MSM. Increased Internet-based HIV prevention marketing efforts and prevention strategies should be considered to efficiently reach HIV-positive MSM who engage in serodiscordant AI without condoms.
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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: 29] [Impact Index Per Article: 3.2] [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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The influence of biological and personality traits on gratifications obtained through online dating websites. COMPUTERS IN HUMAN BEHAVIOR 2015. [DOI: 10.1016/j.chb.2014.12.058] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lelutiu-Weinberger C, Pachankis JE, Gamarel KE, Surace A, Golub SA, Parsons JT. Feasibility, Acceptability, and Preliminary Efficacy of a Live-Chat Social Media Intervention to Reduce HIV Risk Among Young Men Who Have Sex With Men. AIDS Behav 2015; 19:1214-27. [PMID: 25256808 PMCID: PMC4375068 DOI: 10.1007/s10461-014-0911-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Given the popularity of social media among young men who have sex with men (YMSM), and in light of YMSM's elevated and increasing HIV rates, we tested the feasibility, acceptability and preliminary efficacy of a live chat intervention delivered on Facebook in reducing condomless anal sex and substance use within a group of high risk YMSM in a pre-post design with no control group. Participants (N = 41; 18-29 years old) completed up to eight one-hour motivational interviewing and cognitive behavioral skills-based online live chat intervention sessions, and reported on demographic, psychosocial, and behavioral characteristics at baseline and immediately post-intervention. Analyses indicated that participation in the intervention (n = 31) was associated with reductions of days of drug and alcohol use in the past month and instances of anal sex without a condom (including under the influence of substances), as well as increases in knowledge of HIV-related risks at 3-month follow-up. This pilot study argues for the potential of this social media-delivered intervention to reduce HIV risk among a most vulnerable group in the United States, in a manner that was highly acceptable to receive and feasible to execute. A future randomized controlled trial could generate an intervention blueprint for providers to support YMSM's wellbeing by reaching them regardless of their geographical location, at a low cost.
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Affiliation(s)
- Corina Lelutiu-Weinberger
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA, URL: http://cunyhart.org/
| | - John E. Pachankis
- Chronic Disease Epidemiology, Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
| | - Kristi E. Gamarel
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
- Alpert Medical School of Brown University, 167 Point Street, Providence, RI 023093, USA
| | - Anthony Surace
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
| | - Sarit A. Golub
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
- Health Psychology and Basic and Applied Social Psychology Doctoral Programs, the Graduate Center, CUNY, 365 Fifth Avenue, New York, NY 10016, USA
| | - Jeffrey T. Parsons
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
- Health Psychology and Basic and Applied Social Psychology Doctoral Programs, the Graduate Center, CUNY, 365 Fifth Avenue, New York, NY 10016, USA
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36th Street, 9th Floor, New York, NY 10018, USA
- CUNY School of Public Health at Hunter College, 2180 Third Avenue, New York, NY 10035, USA
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Downing MJ, Chiasson MA, Hirshfield S. Recent anxiety symptoms and drug use associated with sexually transmitted infection diagnosis among an online US sample of men who have sex with men. J Health Psychol 2015; 21:2799-2812. [PMID: 26063210 DOI: 10.1177/1359105315587135] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The extent to which mental health problems, including current anxiety and depressive symptoms, may co-occur, or are associated, with the acquisition of sexually transmitted infections other than HIV remains largely unexplored among men who have sex with men. In a cross-sectional survey of 8,381 US men who have sex with men recruited from a sexual networking website, 15 percent reported a past 60-day sexually transmitted infection diagnosis. Among HIV-negative men, increased odds of reporting a sexually transmitted infection were associated with current anxiety symptoms and past 60-day drug use. Findings underscore the need to better understand causal pathways among anxiety, drug use, and sexually transmitted infection acquisition and transmission among men who have sex with men.
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Korchmaros JD, Ybarra ML, Mitchell KJ. Adolescent online romantic relationship initiation: differences by sexual and gender identification. J Adolesc 2015; 40:54-64. [PMID: 25625753 PMCID: PMC4348219 DOI: 10.1016/j.adolescence.2015.01.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 01/06/2015] [Accepted: 01/07/2015] [Indexed: 10/24/2022]
Abstract
Data from the national Teen Health and Technology Study of adolescents 13-18 years old (N = 5091) were used to examine online formation of romantic relationships. Results show that lesbian, gay, bisexual, transgender, and queer (LGBTQ) and non-LGBTQ adolescents similarly were most likely to have met their most recent boy/girlfriend in the past 12 months at school. However, they differed on many characteristics of romantic relationship initiation, including the extent to which they initiated romantic relationships online. LGBTQ and non-LGBTQ adolescents also differed on level of offline access to potential partners, offline popularity, and numerous other factors possibly related to online relationship initiation (e.g., Internet use and demographic factors). Even after adjusting for differences in these factors, LGBTQ adolescents were more likely than non-LGBTQ adolescents to find boy/girlfriends online in the past 12 months. The results support the rich-get-richer hypothesis as well as the social compensation hypothesis.
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Affiliation(s)
- Josephine D Korchmaros
- University of Arizona-Southwest Institute for Research on Women, 181 S. Tucson Blvd., Ste. 101, Tucson, AZ 85716, USA; Center for Innovative Public Health Research, Inc., 555 N. El Camino Real #A347, San Clemente, CA 92672-6745, USA.
| | - Michele L Ybarra
- Center for Innovative Public Health Research, Inc., 555 N. El Camino Real #A347, San Clemente, CA 92672-6745, USA.
| | - Kimberly J Mitchell
- Crimes Against Children Research Center, Family Research Lab, University of New Hampshire, 10 West Edge Drive, Ste. 106, Durham, NH, USA.
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Harding R, Lampe F, Molloy T, Sherr L. Do Web-based and clinic samples of gay men living with HIV differ on self-reported physical and psychological symptoms? A comparative analysis. J Med Internet Res 2015; 17:e57. [PMID: 25793749 PMCID: PMC4383834 DOI: 10.2196/jmir.3800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 12/04/2014] [Accepted: 01/21/2015] [Indexed: 11/23/2022] Open
Abstract
Background Although the Internet is commonly used to recruit samples in studies of human immunodeficiency virus (HIV)-related risk behaviors, it has not been used to measure patient-reported well-being. As the burden of long-term chronic HIV infection rises, the Internet may offer enormous potential for recruitment to research and interventions. Objective This study aimed to compare two samples of gay men living with HIV, one recruited via the Web and the other recruited in outpatient settings, in terms of self-reported physical and psychological symptom burden. Methods The Internet sample was recruited from a UK-wide Web-based survey of gay men with diagnosed HIV. Of these, 154 respondents identified themselves as resident in London and were included in this analysis. The HIV clinic sample was recruited from five HIV outpatient clinics. Of these participants, 400 gay men recruited in London clinics were included in this analysis. Results The Web-based sample was younger than the clinic sample (37.3 years, SD 7.0 vs 40.9 years, SD 8.3), more likely to be in paid employment (72.8%, 99/136 vs 60.1%, 227/378), less likely to be on antiretroviral therapy (ART) (58.4%, 90/154 vs 68.0%, 266/391), and had worse mean psychological symptom burden compared to the clinic sample (mean scores: 1.61, SD 1.09 vs 1.36, SD 0.96) but similar physical symptom burden (mean scores: 0.78, SD 0.65 vs 0.70, SD 0.74). In multivariable logistic regression, for the physical symptom burden model, adjusted for age, ethnicity, employment status, and ART use, the recruitment setting (ie, Web-based vs clinic) was not significantly associated with high physical symptom score. The only variable that remained significantly associated with high physical symptom score was employment status, with those in employment being less likely to report being in the upper (worst) physical symptom tertile versus the other two tertiles (adjusted OR 0.41, 95% CI 0.28-0.62, P<.001). For the psychological symptom burden model, those recruited via the Web were significantly more likely to report being in the upper (worst) tertile (adjusted OR 2.20, 95% CI 1.41-3.44, P=.001). In addition, those in employment were less likely to report being in the upper (worst) psychological symptom tertile compared to those not in employment (adjusted OR 0.32, 95% CI 0.21-0.49, P<.001). Conclusions Our data have revealed a number of differences. Compared to the clinic sample, the Web-based sample had worse psychological symptom burden, younger average age, higher prevalence of employment, and a lower proportion on ART. For future research, we recommend that Web-based data collection should include the demographic variables that we note differed between samples. In addition, we recognize that each recruitment method may bring inherent sampling bias, with clinic populations differing by geographical location and reflecting those accessing regular medical care, and Web-based sampling recruiting those with greater Internet access and identifying survey materials through specific searches and contact with specific websites.
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Affiliation(s)
- Richard Harding
- Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, King's College London, London, United Kingdom.
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Hirshfield S, Schrimshaw EW, Stall RD, Margolis AD, Downing MJ, Chiasson MA. Drug Use, Sexual Risk, and Syndemic Production Among Men Who Have Sex With Men Who Engage in Group Sexual Encounters. Am J Public Health 2015; 105:1849-58. [PMID: 25713951 DOI: 10.2105/ajph.2014.302346] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We surveyed men who have sex with men (MSM) to determine whether sexual risk behaviors, recent drug use, and other psychosocial problems differed between men who engaged in one-on-one and group sexual encounters. METHODS We conducted an Internet-based cross-sectional survey of 7158 MSM aged 18 years or older in the United States recruited from a gay-oriented sexual networking Web site in 2008. Among MSM who engaged in group sexual encounters, we compared their past-60-day sexual behaviors in one-on-one encounters and group sexual encounters. We also compared risk profiles and syndemic production between men who did and did not participate in group sex. RESULTS Men reporting a group-sex encounter had significantly higher polydrug use and sexual risk than did the men not reporting group sex in the past 60 days. The odds of engaging in group sex with 4 or more sexual partners significantly increased with the number of psychosocial problems, supporting evidence of syndemic production. CONCLUSIONS We identified a particularly high-risk subgroup in the MSM population with considerable psychosocial problems that may be reached online. Research is needed on how to engage these high-risk men in combination prevention interventions.
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Affiliation(s)
- Sabina Hirshfield
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
| | - Eric W Schrimshaw
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
| | - Ronald D Stall
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
| | - Andrew D Margolis
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
| | - Martin J Downing
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
| | - Mary Ann Chiasson
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
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Grov C, Rodríguez-Díaz CE, Jovet-Toledo GG, Parsons JT. Comparing male escorts' sexual behaviour with their last male client versus non-commercial male partner. CULTURE, HEALTH & SEXUALITY 2015; 17:194-207. [PMID: 25277601 DOI: 10.1080/13691058.2014.961035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Apart from research suggesting that male escorts are less likely to have condomless anal sex (CAS) with their male clients compared with male non-clients, little is known about how male escorts' behaviour differs between their clients and non-clients. In spring 2013, 387 Internet-based male escorts completed an online survey that included identical questions about their sexual behaviour with their last male client and male non-client. Encounters with non-commercial partners were significantly more likely to involve a greater range of sexual behaviours, including giving oral sex to partner, kissing, anal receptive sex and sex without condoms. These findings suggest that escorts may display a greater sexual repertoire with non-commercial partners compared to their clients. Encounters with non-commercial partners were also rated as more satisfying than with clients. Condomless anal sex was less common with clients, suggesting that escorts and clients may take active roles in mitigating risks for HIV and STI transmission with each other. Although the modal response for CAS was to abstain, more than half of participants reported CAS during at least one of the two encounters assessed. Behavioural and/or biomedical HIV-prevention strategies would be appropriate for some male escorts to reduce HIV transmission risk.
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Affiliation(s)
- Christian Grov
- a Department of Health and Nutrition Sciences , Brooklyn College of the City University of New York , Brooklyn , USA
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Harris S, Nikulina V, Gelpí-Acosta C, Morton C, Newsome V, Gunn A, Hoefinger H, Aikins R, Smith V, Barry V, Downing MJ. Prescription Drug Diversion: Predictors of Illicit Acquisition and Redistribution in Three U.S. Metropolitan Areas. AIMS Public Health 2015; 2:762-783. [PMID: 26690813 PMCID: PMC4683601 DOI: 10.3934/publichealth.2015.4.762] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Prescription drug diversion, the transfer of prescription drugs from lawful to unlawful channels for distribution or use, is a problem in the United States. Despite the pervasiveness of diversion, there are gaps in the literature regarding characteristics of individuals who participate in the illicit trade of prescription drugs. This study examines a range of predictors (e.g., demographics, prescription insurance coverage, perceived risk associated with prescription drug diversion) of membership in three distinct diverter groups: individuals who illicitly acquire prescription drugs, those who redistribute them, and those who engage in both behaviors. METHODS Data were drawn from a cross-sectional Internet study (N = 846) of prescription drug use and diversion patterns in New York City, South Florida, and Washington, D.C.. Participants were classified into diversion categories based on their self-reported involvement in the trade of prescription drugs. Group differences in background characteristics of diverter groups were assessed by Chi-Square tests and followed up with multivariate logistic regressions. RESULTS While individuals in all diversion groups were more likely to be younger and have a licit prescription for any of the assessed drugs in the past year than those who did not divert, individuals who both acquire and redistribute are more likely to live in New York City, not have prescription insurance coverage, and perceive fewer legal risks of prescription drug diversion. CONCLUSION Findings suggest that predictive characteristics vary according to diverter group.
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Affiliation(s)
- Shana Harris
- Department of Anthropology, University of Central Florida, 4000 Central Florida Boulevard, Howard Phillips Hall 309, Orlando, FL 32816-1361, USA
| | - Valentina Nikulina
- Psychology Department, Queens College, City University of New York, 6530 Kissena Boulevard, SB A344, Queens, NY 11367-1597, USA
| | - Camila Gelpí-Acosta
- Social Science Department, LaGuardia Community College, City University of New York, 31-10 Thomson Avenue, Long Island City, NY 11101, USA
| | - Cory Morton
- School of Social Work, Rutgers University, 536 George Street, New Brunswick, NJ 08901, USA
| | - Valerie Newsome
- National Development and Research Institutes, 71 West 23rd Street, 4th Floor, New York, NY 10010, USA
| | - Alana Gunn
- Department of Social Work, Binghamton University, P.O. Box 6000, Binghamton, NY 13902-6000
| | - Heidi Hoefinger
- Science Department, Berkeley College, 3 East 43 Street New York, NY 10017, USA
| | - Ross Aikins
- Graduate School of Education, University of Pennsylvania, 3700 Walnut Street Philadelphia, PA 19104, USA
| | - Vivian Smith
- Sociology and Criminology Department, Cabrini College, 610 King of Prussia Road, Radnor, PA 19087-3698, USA
| | - Victoria Barry
- Department of Pediatrics, Harlem Hospital Center, 506 Malcolm X Boulevard, New York, NY 10037, USA
| | - Martin J Downing
- Public Health Solutions, 40 Worth Street, 5th Floor, New York, NY 10013, USA
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Grov C, Rendina HJ, Ventuneac A, Parsons JT. Partners met via sex parties present significantly greater odds for condomless anal sex among MSM: an event-level analysis of venues where male partners are met. J Acquir Immune Defic Syndr 2014; 67:564-8. [PMID: 25226209 PMCID: PMC4229438 DOI: 10.1097/qai.0000000000000343] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
One hundred forty-seven men who have sex with men completed time-line follow-back interviews about the venues where they met their male partners (n = 1180 sexual events with first-time partners, <30 days). We ran multivariate models to determine the association between venues and condomless anal sex (CAS). After adjusting for known correlates of CAS, partners met at sex parties presented significantly greater odds for CAS compared with meeting a partner at a gay bar/club (adjusted odds ratio = 0.44), online (adjusted odds ratio = 0.42), bathhouse (adjusted odds ratio = 0.35), or via "other" venues (adjusted odds ratio = 0.35), all P < 0.01. These findings highlight the need to develop innovative HIV/sexually transmitted infection prevention initiatives for men who attend sex parties.
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Affiliation(s)
- Christian Grov
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York (CUNY). 2900 Bedford Avenue, Brooklyn, NY. 11210
- Doctoral Program in Public Health, The Graduate Center of CUNY
- Center for HIV/AIDS Educational Studies and Training (CHEST)
| | - H. Jonathon Rendina
- Center for HIV/AIDS Educational Studies and Training (CHEST)
- Doctoral Program in Basic and Applied Social Psychology, The Graduate Center of CUNY
| | - Ana Ventuneac
- Center for HIV/AIDS Educational Studies and Training (CHEST)
| | - Jeffrey T. Parsons
- Doctoral Program in Public Health, The Graduate Center of CUNY
- Center for HIV/AIDS Educational Studies and Training (CHEST)
- Doctoral Program in Basic and Applied Social Psychology, The Graduate Center of CUNY
- Doctoral Program in Health Psychology, The Graduate Center of CUNY
- Department of Psychology, Hunter College of CUNY
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Rodriguez‐Diaz CE, Collazo E, Dodge B, Roman‐Rivera A, Candelaria‐Rosa E, Colon‐Colon M, Herbenick D. “Sexplorando”: Sexual Practices and Condom Use among an Internet‐Based Sample of Men and Women in Puerto Rico. J Sex Med 2014; 11:2385-95. [DOI: 10.1111/jsm.12642] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Virtual versus physical spaces: which facilitates greater HIV risk taking among men who have sex with men in East and South-East Asia? AIDS Behav 2014; 18:1428-35. [PMID: 24077974 DOI: 10.1007/s10461-013-0628-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Increasing use of the Internet to seek sex partners is accompanied by rising HIV infections among men who have sex with men (MSM) in East and South-East Asia. We examined whether the Internet facilitates greater HIV risk taking among MSM in the region. A cross-sectional sample of 9,367 MSM was recruited via the Internet in 2010. We compared socio-demographic and HIV-related behavioral characteristics among MSM who met sex partners on the Internet only, who met sex partners offline only, and who met sex partners through both. Multinomial logistic regression was used to identify independent correlates that were associated with differences in where participants met their male sex partners. Compared to MSM who met partners offline only, those who met partners online only were less likely to have multiple male sex partners, have paid for sex, have consumed recreational drugs, and have used alcohol before sex. MSM who met partners both online and offline appeared to be the riskiest group that they were more likely to have multiple male sex partners, have engaged in UIAI, and have consumed alcohol before sex. These findings suggest that social networking websites alone do not facilitate greater HIV risk taking among MSM. Rather, they provide additional venues for MSM who already engage in HIV-related high risk behaviors to seek sex partners. The Internet offers incredible opportunities to reach large numbers of MSM in East and South-East Asia for HIV prevention and research. Web-based outreach and prevention activities are needed to reach these men. In addition, mobile and application-based interventions should also be developed and disseminated.
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Grov C, Rendina HJ, Parsons JT. Comparing three cohorts of MSM sampled via sex parties, bars/clubs, and Craigslist.org: implications for researchers and providers. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2014; 26:362-82. [PMID: 25068182 PMCID: PMC4116634 DOI: 10.1521/aeap.2014.26.4.362] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
With limited exceptions, few studies have systematically reported on psychosocial and demographic characteristic differences in samples of men who have sex with men (MSM) based on where they were recruited. This study compared three sexually active cohorts of MSM recruited via Craigslist.org (recruited via modified time-space sampling), gay bars and clubs (recruited via time-space sampling), and private sex parties (identified via passive recruitment and listserves), finding mixed results with regard to differences in demographic characteristics, STI history, and psychosocial measures. Men recruited from sex parties were significantly older, reported more symptoms of sexual compulsivity, more likely to be HIV-positive, more likely to report a history of STIs, and more likely to self-identify as a barebacker, than men recruited from the other two venues. In contrast, men from Craigslist.org reported the lowest levels of attachment to the gay and bisexual community and were the least likely to self-identify as gay. Men from bars and clubs were significantly younger, and were more likely to report use of hallucinogens and crack or cocaine. Our findings highlight that the venues in which MSM are recruited have meaningful consequences in terms of the types of individuals who are reached.
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Affiliation(s)
- Christian Grov
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York (CUNY). 2900 Bedford Avenue, Brooklyn, NY. 11210
- Doctoral Program in Public Health, The Graduate Center of CUNY
- Center for HIV/AIDS Educational Studies and Training (CHEST)
| | - H. Jonathon Rendina
- Center for HIV/AIDS Educational Studies and Training (CHEST)
- Doctoral Program in Basic and Applied Social Psychology, The Graduate Center of CUNY
| | - Jeffrey T. Parsons
- Doctoral Program in Public Health, The Graduate Center of CUNY
- Center for HIV/AIDS Educational Studies and Training (CHEST)
- Doctoral Program in Basic and Applied Social Psychology, The Graduate Center of CUNY
- Doctoral Program in Health Psychology, The Graduate Center of CUNY
- Department of Psychology, Hunter College of CUNY
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Yuan P, Bare MG, Johnson MO, Saberi P. Using online social media for recruitment of human immunodeficiency virus-positive participants: a cross-sectional survey. J Med Internet Res 2014; 16:e117. [PMID: 24784982 PMCID: PMC4026571 DOI: 10.2196/jmir.3229] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 03/11/2014] [Accepted: 03/30/2014] [Indexed: 11/13/2022] Open
Abstract
Background There are many challenges in recruiting and engaging participants when conducting research, especially with HIV-positive individuals. Some of these challenges include geographical barriers, insufficient time and financial resources, and perceived HIV-related stigma. Objective This paper describes the methodology of a recruitment approach that capitalized on existing online social media venues and other Internet resources in an attempt to overcome some of these barriers to research recruitment and retention. Methods From May through August 2013, a campaign approach using a combination of online social media, non-financial incentives, and Web-based survey software was implemented to advertise, recruit, and retain participants, and collect data for a survey study with a limited budget. Results Approximately US $5,000 was spent with a research staff designated at 20% of full-time effort, yielding 2034 survey clicks, 1404 of which met the inclusion criteria and initiated the survey, for an average cost of US $3.56 per survey initiation. A total of 1221 individuals completed the survey, yielding 86.97% retention. Conclusions These data indicate that online recruitment is a feasible and efficient tool that can be further enhanced by sophisticated online data collection software and the addition of non-financial incentives.
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Affiliation(s)
- Patrick Yuan
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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O'Brien KK, Solomon P, Worthington C, Ibáñez-Carrasco F, Baxter L, Nixon SA, Baltzer-Turje R, Robinson G, Zack E. Considerations for conducting Web-based survey research with people living with human immunodeficiency virus using a community-based participatory approach. J Med Internet Res 2014; 16:e81. [PMID: 24642066 PMCID: PMC3971118 DOI: 10.2196/jmir.3064] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 01/27/2014] [Accepted: 02/11/2014] [Indexed: 12/03/2022] Open
Abstract
Background Web or Internet-based surveys are increasingly popular in health survey research. However, the strengths and challenges of Web-based surveys with people living with human immunodeficiency virus (HIV) are unclear. Objective The aim of this article is to describe our experience piloting a cross-sectional, Web-based, self-administered survey with adults living with HIV using a community-based participatory research approach. Methods We piloted a Web-based survey that investigated disability and rehabilitation services use with a sample of adults living with HIV in Canada. Community organizations in five provinces emailed invitations to clients, followed by a thank you/reminder one week later. We obtained survey feedback in a structured phone interview with respondents. Participant responses were transcribed verbatim and analyzed using directed content analysis. Results Of 30 people living with HIV who accessed the survey link, 24/30 (80%) initiated and 16/30 (53%) completed the survey instrument. A total of 17 respondents participated in post-survey interviews. Participants described the survey instrument as comprehensive, suggesting content validity. The majority (13/17, 76%) felt instruction and item wording were clear and easy to understand, and found the software easy to navigate. Participants felt having a pop-up reminder directing them to missed items would be useful. Conclusions Strengths of implementing the Web-based survey included: our community-based participatory approach, ease of software use, ability for respondents to complete the questionnaire on one’s own time at one’s own pace, opportunity to obtain geographic variation, and potential for respondent anonymity. Considerations for future survey implementation included: respondent burden and fatigue, the potentially sensitive nature of HIV Web-based research, data management and storage, challenges verifying informed consent, varying computer skills among respondents, and the burden on community organizations. Overall, results provide considerations for researchers conducting community-based participatory Web-based survey research with people living with HIV.
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