1
|
Watson RJ, Morgan E, Sherman J, Caba A, Wheldon CW, Chan PA, Eaton LA. Pre-exposure prophylaxis (PrEP) use, anticipated PrEP stigma, and bisexual identity among a Black and Hispanic/Latino sexual and gender diverse sample. Behav Med 2022:1-9. [PMID: 35465800 PMCID: PMC9592674 DOI: 10.1080/08964289.2022.2048249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Black and Hispanic/Latino sexual minority men and gender diverse (SMMGD) individuals are disproportionately impacted by the HIV epidemic. Uptake and adherence to pre-exposure prophylaxis (PrEP) is suboptimal among SMMGD Black and Hispanic/Latino individuals, but most research has approached this population as homogenous (e.g., a group operationalized as men who have sex with men). Bisexual men are less likely to disclose their sexual identity and report more mental health problems than their gay counterparts, but there is less attention to the impact of different sexual identities on PrEP use over time. We utilized data from three waves of a national longitudinal study (2020-2021) to characterize Black and Hispanic/Latino SMMGD participants' PrEP use including: 1) PrEP uptake during the study; 2) consistent PrEP use across the study; and 3) discontinuation of PrEP use since study baseline. We found bisexual men were significantly less likely than gay men to be consistent PrEP users and were more likely to discontinue PrEP use over the course of the study. Of the sample who reported PrEP use across surveys, 10% initiated PrEP during the study period, 0% of whom were bisexual. Additionally, bisexual participants reported statistically significantly higher anticipated PrEP stigma relative to gay participants. These findings have implications for HIV prevention interventions. Given the differences in PrEP experiences as a function of sexual identity, researchers and clinicians should consider the disruptive role of stigma (both biphobia and anticipated PrEP stigma) in PrEP care and adherence.
Collapse
Affiliation(s)
- Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, US
| | - Ethan Morgan
- College of Nursing, The Ohio State University, Columbus, OH,Infectious Disease Institute, The Ohio State University, Columbus, OH
| | | | - Antonia Caba
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, US
| | - Christopher W. Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, US
| | - Philip A. Chan
- Department of Medicine, Brown University, Providence, RI, US
| | - Lisa A. Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, US
| |
Collapse
|
2
|
Loosier PS, Haderxhanaj L, Beltran O, Hogben M. Food Insecurity and Risk Indicators for Sexually Transmitted Infection Among Sexually Active Persons Aged 15-44, National Survey of Family Growth, 2011-2017. Public Health Rep 2020; 135:270-281. [PMID: 32031921 DOI: 10.1177/0033354920904063] [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: 11/17/2022] Open
Abstract
OBJECTIVES Food insecurity is linked to poor sexual health outcomes, especially among persons engaged in sexual behaviors that are associated with the risk of acquiring sexually transmitted infections (STIs). We examined this link using nationally representative data. METHODS We used data on adolescents and adults aged 15-44 who reported sexual activity in the past year from 6 years (September 2011-September 2017) of cross-sectional, weighted public-use data from the National Survey of Family Growth. We compared data on persons who did and did not report food insecurity, accounting for demographic characteristics, markers of poverty, and past-year STI risk indicators (ie, engaged in 1 of 4 high-risk activities or diagnosed with chlamydia or gonorrhea). RESULTS Respondents who reported at least 1 past-year STI risk indicator were significantly more likely to report food insecurity (females: adjusted risk ratio [ARR] = 1.63; 95% confidence interval [CI], 1.35-1.97; P < .001; males: ARR = 1.46; 95% CI, 1.16-1.85) than respondents who did not report food insecurity. This finding was independent of the association between food insecurity and markers of poverty (≤100% federal poverty level [females: ARR = 1.46; 95% CI, 1.23-1.72; P < .001; males: ARR = 1.81; 95% CI, 1.49-2.20; P < .001]; if the respondent or someone in the household had received Special Supplemental Nutrition Program for Women, Infants, and Children or Supplemental Nutrition Assistance Program benefits in the past year [females: ARR = 3.37; 95% CI, 2.81-4.02; P < .001; males: ARR = 3.27; 95% CI, 2.76-3.87; P < .001]). Sex with opposite- and same-sex partners in the past year was significantly associated with food insecurity (females: ARR = 1.44; 95% CI, 1.11-1.85; P = .01; males: ARR = 1.99; 95% CI, 1.15-3.42; P = .02). CONCLUSIONS Food insecurity should be considered a social determinant of health independent of poverty, and its effect on persons at highest risk for STIs, including HIV, should be considered when planning interventions designed to decrease engagement in higher-risk sexual behaviors.
Collapse
Affiliation(s)
- Penny S Loosier
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura Haderxhanaj
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Oscar Beltran
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew Hogben
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
3
|
Gaines MT, McCree DH, Gaul Z, Henny KD, Hickson DA, Sutton MY. Comparison of Selected Sociodemographic Characteristics and Sexual Risk Behaviors of Black/African American Men Who Have Sex with Men Only and Men Who Have Sex with Men and Women, Southeastern United States, 2013-2016. J Racial Ethn Health Disparities 2019; 7:84-89. [PMID: 31502106 DOI: 10.1007/s40615-019-00636-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/08/2019] [Accepted: 08/29/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE Compare selected sociodemographic and sexual risk characteristics of black/African American (black) men who have sex with men only (MSMO) and men who have sex with men and women (MSMW) in the southeastern United States (the South). METHODS We conducted bivariate and multivariable analyses to explore the sociodemographic characteristics and sexual risk behaviors of 584 MSMW and MSMO in the South. RESULTS MSMW had lesser odds of having a college or graduate degree (aOR = 0.32; 95% CI = 0.19, 0.54) and having > 2 male oral sex partners (aOR = 0.20; 95% CI = 0.08, 0.48) compared to MSMO. MSMW had greater odds of being homeless (aOR = 3.11; 95% CI = 1.80, 5.38) and selecting "top" sexual position (aOR = 1.70; 95% CI = 1.07, 2.72) compared to MSMO. CONCLUSION MSMW in the South experience social and structural factors that may affect their risk for HIV infection. Strategies to address these factors should be considered in prevention and care efforts for this population.
Collapse
Affiliation(s)
- Malendie T Gaines
- Oak Ridge Institute for Science and Education, 100 ORAU Way, Oak Ridge, TN, 37830, USA.
| | - Donna Hubbard McCree
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30333, Georgia
| | - Zaneta Gaul
- ICF, 3 Corporate Square NE, Suite 370, Atlanta, GA, 30329, Georgia
| | - Kirk D Henny
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30333, Georgia
| | - DeMarc A Hickson
- My Brothers' Keeper, 510 George Street, Suite 100, Jackson, MS, 39202, USA.,Us Helping Us, Inc., 3636 Georgia Avenue NW, Washington, DC, 20010, USA
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30333, Georgia.,Department of Obstetrics and Gynecology, Morehouse School of Medicine, 80 Jesse Hill Jr. Drive SE, Atlanta, GA, 30303, Georgia
| |
Collapse
|
4
|
Clark HA, Oraka E, DiNenno EA, Wesolowski LG, Chavez PR, Pitasi MA, Delaney KP. Men Who Have Sex with Men (MSM) Who Have Not Previously Tested for HIV: Results from the MSM Testing Initiative, United States (2012-2015). AIDS Behav 2019; 23:359-365. [PMID: 30173345 PMCID: PMC6986464 DOI: 10.1007/s10461-018-2266-3] [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: 10/28/2022]
Abstract
The Centers for Disease Control and Prevention recommends annual HIV tests for men who have sex with men (MSM), yet some have never tested. We analyzed data from the MSM Testing Initiative. Of 68,185 HIV tests, 8% were with MSM who never previously tested ("first-time testers"). Among tests with first-time testers, 70.7% were with MSM from racial or ethnic minorities; 66.5% were with MSM younger than 30 years. Tests with MSM who reported female partners only during the past year (compared to male partners only) or were recruited for at-home testing (compared to venue-based recruitment) were 4 times (prevalence ratio [PR] 3.62, 95% CI 3.15-4.15) and 5 times as likely (PR 4.69, 95% CI 4.22-5.21) to be associated with first-time testing. At-home testing and focusing on MSM who have sex with women may be effective methods for reaching MSM who are first-time testers.
Collapse
Affiliation(s)
- Hollie A Clark
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia.
| | | | - Elizabeth A DiNenno
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
| | - Laura G Wesolowski
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
| | - Pollyanna R Chavez
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
| | - Marc A Pitasi
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
| | - Kevin P Delaney
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia
| |
Collapse
|
5
|
Halkitis PN, Bub K, Stults CB, Bates FC, Kapadia F. Latent Growth Curve Modeling of Non-Injection Drug Use and Condomless Sexual Behavior from Ages 18 to 21 in Gay, Bisexual, and Other YMSM: The P18 Cohort Study. Subst Use Misuse 2018; 53:101-113. [PMID: 28820622 PMCID: PMC6085877 DOI: 10.1080/10826084.2017.1334067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND HIV/AIDS continues to be a health disparity faced by sexual minority men, and is exacerbated by non-injection drug use. OBJECTIVES We sought to delineate growth in non-injection drug use and condomless sex in a sample of racially and economically diverse of gay, bisexual, and other young men who have sex with men (YMSM) as they emerged into adulthood between the ages of 18 and 21 and who came of age in the post-HAART era. METHODS Behavioral data on drug use and condomless sex, collected via a calendar based technique over 7 waves of a cohort study of 600 YMSM, were analyzed using latent growth curve modeling to document patterns of growth in these behaviors, their associations, and the extent to which patterns and associations are moderated by race/ethnicity and socioeconomic status. RESULTS Significant growth was noted in the frequencies of condomless oral and anal intercourse, alcohol to intoxication, marijuana use, and inhalant nitrate use. High levels of association were noted between all behaviors across time but associations did not differ by either race/ethnicity or socioeconomic status. The link between drug use and risky sexual behavior continue to be evident in YMSM with significant increases in these behaviors demonstrated as YMSM transition between adolescence and young adulthood. Conclusions/Importance: Healthcare for a new generation of sexual minority males must address the synergy of these behaviors and also nest HIV prevention and care within a larger context of sexual minority health that acknowledges the advances made in the last three decades.
Collapse
Affiliation(s)
- Perry N Halkitis
- a Department of Biostatistics, School of Public Health , Rutgers University , Piscataway Township , New Jersey , USA.,b Department of Social and Behavioral Health Sciences, School of Public Health , Rutgers University , Piscataway Township , New Jersey , USA.,c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA
| | - Kristen Bub
- e College of Education , University of Illinois , Chicago , Illinois , USA
| | - Christopher B Stults
- c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA
| | - Francesca C Bates
- c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA
| | - Farzana Kapadia
- c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA.,d Department of Population Health, School of Medicine , New York University
| |
Collapse
|
6
|
Boyer CB, Greenberg L, Chutuape K, Walker B, Monte D, Kirk J, Ellen JM. Exchange of Sex for Drugs or Money in Adolescents and Young Adults: An Examination of Sociodemographic Factors, HIV-Related Risk, and Community Context. J Community Health 2018; 42:90-100. [PMID: 27498094 DOI: 10.1007/s10900-016-0234-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The goal of this research was to examine associations among sociodemographic factors, HIV risk, and community context (e.g., economic insecurity, job training, housing instability, crime victimization, and perceived community norms) in adolescents and young adults who ever exchanged sex for drugs or money. Anonymous survey data were collected using ACASIs at community venues where adolescents and young adults congregate in resource-challenged, STI prevalent, urban, US neighborhoods. Conventional descriptive statistics, Fisher's exact tests, and generalized estimating equations approaches were used to examine associations. Participants (1818, 95.5 % of those screened eligible) were, on average, aged 21.0 years; 42.2 % were males, and 4.6 % were transgender. Almost one-third (32.1 %) identified as gay or lesbian, 18.1 % identified as bisexual; 66.2 % were Black and 21.0 % were Hispanic; 1.3 % was 'living on the street'. A sizeable proportion reported HIV-related risk: 16.3 % exchanged sex, 12.6 % had sex with someone they knew to be HIV-infected, 7.8 % had sex with someone who injected drugs, and 1.3 % injected drugs. Multivariate comparisons identified a number of variables (e.g., being male or transgender, homelessness, sex with a partner who has HIV, STI history, unemployment, job training access, housing instability, crime victimization, perceived community norms) that were significantly associated with exchange of sex (p < 0.05). This research contributes to the knowledge-base regarding exchange of sex among adolescents and young adults, particularly as it relates to community context. Longitudinal studies to describe the trajectory of social, health, and physical risks and consequences are needed for development of effective evidence-based prevention strategies.
Collapse
Affiliation(s)
- Cherrie B Boyer
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California, San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94118, USA.
| | | | - Kate Chutuape
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - Bendu Walker
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Jonathan M Ellen
- All Children's Hospital Johns Hopkins Medicine, St. Petersburg, FL, USA
| | | |
Collapse
|
7
|
Dyer TV, Khan MR, Sandoval M, Acheampong A, Regan R, Bolyard M, Mateu-Gelabert P, Friedman SR. Drug Use and Sexual HIV Transmission Risk Among Men Who have Sex with Men and Women (MSMW), Men Who have Sex with Men only (MSMO), and Men Who have Sex with Women Only (MSWO) and the Female Partners of MSMW and MSWO: A Network Perspective. AIDS Behav 2017; 21:3590-3598. [PMID: 28229245 DOI: 10.1007/s10461-017-1736-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We described drug use, sex risk, and STI/HIV among men who have sex with men and women (MSMW) and their female partners. We used the Network, Norms and HIV/STI Risk among Youth (NNAHRAY) study to evaluate drug use, sex risk, and biologically-confirmed STI/HIV in (1) MSMW and men who had sex with men only (MSMO) versus men who had sex with women only (MSWO) and (2) female partners of MSMW versus female partners of MSWO (N = 182 men, 152 women). MSMW versus MSWO had 30 to 60% increased odds of substance use, over twice the odds of multiple partnerships, and almost five times the odds of sex trade and HIV infection. Female partners of MSMW versus female partners of MSWO had approximately twice the odds of substance use and 1.5-2 times the odds of multiple partnerships and sex trade. Interventions should address STI/HIV risk among MSMW and their female partners.
Collapse
Affiliation(s)
- Typhanye V Dyer
- Department of Epidemiology and Biostatistics, The University of Maryland, 2234FF School of Public Health, College Park, MD, 20742, USA.
| | - Maria R Khan
- Population Health, New York University School of Medicine, New York, NY, USA
| | - Milagros Sandoval
- National Development and Research Institutes Inc., New York, NY, USA
| | - Abenaa Acheampong
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Rotrease Regan
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Melissa Bolyard
- Office of Institutional Research, Planning and Effectiveness, Emory University, Atlanta, GA, USA
| | | | - Samuel R Friedman
- National Development and Research Institutes Inc., New York, NY, USA
| |
Collapse
|
8
|
Liu Y, Qian HZ, Amico KR, Liu H, Yin L, Ruan Y, Shao Y, Zhang C, Vermund SH. Subsequent Sexual Risks Among Men Who Have Sex with Men May Differ by Sex of First Partner and Age at Sexual Debut: A Cross-Sectional Study in Beijing, China. AIDS Behav 2017; 21:2913-2923. [PMID: 28110474 DOI: 10.1007/s10461-017-1677-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Sexual debut experience may influence HIV/sexual risks among men who have sex with men (MSM). We assessed associations between age of sexual debut and sex of debut partner with recent (past-3-month) sexual/HIV/syphilis risks among 3588 community-based Chinese MSM. Sexual debut with women was associated with more recent (condomless) insertive anal sex with men, more recent (condomless) vaginal sex, and more lifetime female partners. Sexual debut with men was associated with more recent (condomless) receptive anal sex with men and more lifetime male partners. All associations were strongest among those having first sex ≤18 years in both groups. Earlier sexual debut was associated with higher HIV/syphilis risk; HIV risk was higher with first sex with a man, but syphilis was higher with first sex with a woman. Earlier age of sexual debut is associated with greater HIV/syphilis and sexual risks, but MSM risk differs with first sex with women versus men.
Collapse
Affiliation(s)
- Yu Liu
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Suite 750, 2525 West End Avenue, Nashville, TN, 37203, USA
| | - Han-Zhu Qian
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Suite 750, 2525 West End Avenue, Nashville, TN, 37203, USA
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - K Rivet Amico
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Hongjie Liu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Lu Yin
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Suite 750, 2525 West End Avenue, Nashville, TN, 37203, USA
| | - Yuhua Ruan
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yiming Shao
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chen Zhang
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Suite 750, 2525 West End Avenue, Nashville, TN, 37203, USA
| | - Sten H Vermund
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Suite 750, 2525 West End Avenue, Nashville, TN, 37203, USA.
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
| |
Collapse
|
9
|
Oldenburg CE, Biello KB, Perez-Brumer AG, Rosenberger J, Novak DS, Mayer KH, Mimiaga MJ. HIV testing practices and the potential role of HIV self-testing among men who have sex with men in Mexico. Int J STD AIDS 2017; 28:242-249. [PMID: 27020081 PMCID: PMC5039047 DOI: 10.1177/0956462416641556] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The objective of this study was to characterize HIV testing practices among men who have sex with men in Mexico and intention to use HIV self-testing. In 2012, members of one of the largest social/sexual networking websites for men who have sex with men in Latin America completed an anonymous online survey. This analysis was restricted to HIV-uninfected men who have sex with men residing in Mexico. Multivariable logistic regression models were fit to assess factors associated with HIV testing and intention to use a HIV self-test. Of 4537 respondents, 70.9% reported ever having a HIV test, of whom 75.5% reported testing at least yearly. The majority (94.3%) indicated that they would use a HIV home self-test if it were available. Participants identifying as bisexual less often reported ever HIV testing compared to those identifying as gay/homosexual (adjusted odds ratio = 0.52, 95% confidence interval: 0.44-0.62). Having a physical exam in the past year was associated with increased ever HIV testing (adjusted odds ratio = 4.35, 95% confidence interval: 3.73-5.07), but associated with decreased interest in HIV self-testing (adjusted odds ratio = 0.66, 95% confidence interval: 0.48-0.89). The high intention to use HIV home self-testing supports the use of this method as an acceptable alternative to clinic- or hospital-based HIV testing.
Collapse
Affiliation(s)
| | - Katie B. Biello
- The Fenway Institute, Fenway Community Health, Boston, MA
- Departments of Behavioral & Social Health Sciences and Epidemiology and the Institute for Community Health Promotion, Brown University School of Public Health, Providence, RI
| | - Amaya G. Perez-Brumer
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Joshua Rosenberger
- Department of Biobehavioral Health, Penn State University, University Park, PA
| | - David S. Novak
- Online Buddies, Inc, OLB Research Institute, Cambridge, MA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Community Health, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Matthew J. Mimiaga
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- The Fenway Institute, Fenway Community Health, Boston, MA
- Departments of Behavioral & Social Health Sciences and Epidemiology and the Institute for Community Health Promotion, Brown University School of Public Health, Providence, RI
| |
Collapse
|
10
|
Mor Z, Davidovich U. Sexual Orientation and Behavior of Adult Jews in Israel and the Association With Risk Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:1563-1571. [PMID: 26754157 DOI: 10.1007/s10508-015-0631-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 09/05/2015] [Accepted: 09/15/2015] [Indexed: 06/05/2023]
Abstract
Estimating the size of key risk groups susceptible to HIV/sexually transmitted diseases (STI) is necessary for establishment of interventions and budget allocation. This study aimed to identify various dimensions of sexual orientation and practices in Israel, and correlate the findings with sexual risk behavior (SRB). It used a random representative sample of the Jewish population aged 18-44 years who completed online questionnaires regarding their self-identified sexual orientation, attraction and practices, and SRB. Concordant heterosexuals were those who self-reported heterosexual identity, were attracted and had sex only with the opposite gender. National estimates regarding prevalence of gay, lesbian, and bisexual men and women were based on the civil census. The sample included 997 men and 1005 women, of whom 11.3 and 15.2 % were attracted to the same-gender, 10.2 and 8.7 % reported lifetime same-gender encounters, while 8.2 and 4.8 % self-identified as gay or bisexual men and lesbian or bisexual women, respectively. The estimated population of self-identified Jewish gay or bisexual men and lesbian or bisexual women aged 18-44 in Israel was 94,176, and 57,671, respectively. SRB was more common among self-identified gays or bisexual men and among discordant heterosexual men and women. Those who reported same-gender sexual practices reported greater SRB than those who only had opposite-gender encounters. Interestingly, SRB among discordant heterosexuals was associated with same-sex behavior rather than attraction. Health practitioners should increase their awareness of sexual diversity among their clientele, and should recognize that risk for HIV/STI may exist among self-identified heterosexuals, who may not disclose their actual sexual attraction or practices.
Collapse
Affiliation(s)
- Zohar Mor
- Ramla Department of Health, Ministry of Health, 3 Danny Mass St., 72100, Ramla, Israel.
| | - Udi Davidovich
- Geneeskundige en Gezondheidsdienst, Amsterdam, The Netherlands
| |
Collapse
|
11
|
HIV Infection Rates and Risk Behavior among Young Men undergoing community-based Testing in San Diego. Sci Rep 2016; 6:25927. [PMID: 27181715 PMCID: PMC4867437 DOI: 10.1038/srep25927] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/25/2016] [Indexed: 11/26/2022] Open
Abstract
Approximately 80% of new HIV infections in the United States occur in men. Four out of five men diagnosed with HIV infection are men who have sex with men (MSM), with an increasing proportion of young MSM (i.e. ≤24 years of age). We performed a retrospective analysis 11,873 cisgender men participating in a community based HIV screening program in San Diego between 2008 and 2014 to characterize the HIV prevalence and sexual risk behaviors among young men. In young heterosexual men HIV prevalence was lower compared to heterosexual men between 25 and 49 years of age (0.3% vs. 1.4%, p = 0.043). Among young MSM, HIV prevalence was 5.5%, per test positivity rate 3.6%, and HIV incidence 3.4 per 100 person years (95% CI 2.2–5.4). Per test positivity rate (p = 0.008) and incidence (p < 0.001) were significantly higher among young MSM than among MSM above 24-years of age. Young MSM diagnosed with HIV infection reported significantly more serodiscordant condomless anal intercourse, bacterial sexually transmitted infections, and higher rates of methamphetamine and gamma hydroxybutyrate use when compared to young MSM who tested negative. In conclusion, young MSM are particularly vulnerable to HIV infection and may represent ideal candidates for targeted prevention interventions that increase testing uptake and/or decrease the risk of acquiring HIV infection.
Collapse
|
12
|
Ding Y, Yan H, Ning Z, Cai X, Yang Y, Pan R, Zhou Y, Zheng H, Gao M, Rou K, Wu Z, He N. Low willingness and actual uptake of pre-exposure prophylaxis for HIV-1 prevention among men who have sex with men in Shanghai, China. Biosci Trends 2016; 10:113-9. [PMID: 27052151 DOI: 10.5582/bst.2016.01035] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Little is known about the acceptance and actual uptake of pre-exposure prophylaxis (PrEP) and associated factors in men who have sex with men (MSM) in China. This study is the baseline survey of an intervention study designed to evaluate the effectiveness of tenofovirdisoproxil fumarate (TDF) on a daily use for human immunodeficiency virus (HIV) prevention among MSM in Shanghai, China. From October 2012 to December 2013, a total of 1,033 MSM in Shanghai were recruited by local district Centers for Disease Control and Prevention (CDC) and a MSM community-based non-governmental organization (NGO). Among them, 197 (19.1%) participants expressed willingness to use the TDF group at baseline survey, but only 26 (2.5%) participated in the TDF group and took TDF one tablet a day. Higher willingness to use PrEP was associated with being 45 years or older, non-local residents, having more male sex partners in the past 6 months and not using condom at last anal sex with man. Acutal uptake of PrEP was associated with having ≥ 11 male sex partners in lifetime and reporting no female sex partners in lifetime. Reasons for not participating in TDF group among those who expressed willingness to use PrEP at baseline survey included loss of contact, ineligiblity because of abnormal results for liver or renal function tests, change of mind, and HIV seroconversion before uptake of PrEP. Our findings suggest that promotion of PrEP in MSM remains challenging at current circumstancein China. Future research is needed to solicit effective education and intervention programs to promote acceptance of PrEP among Chinese MSM.
Collapse
Affiliation(s)
- Yingying Ding
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Cassell JA. Highlights from this issue. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|