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Mitchell JW, Lee JY, Godoy F, Asmar L, Perez G. HIV-discordant and concordant HIV-positive male couples' recommendations for how an eHealth HIV prevention toolkit for concordant HIV-negative male couples could be improved to meet their specific needs. AIDS Care 2018; 30:54-60. [PMID: 29848043 PMCID: PMC6118857 DOI: 10.1080/09540121.2018.1465527] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A number of HIV prevention interventions for male couples are in the pipeline for development as few evidence-based ones exist. Among these projects, none include all three groups of male couples (concordant HIV-negative, HIV-discordant, and concordant HIV-positive) as their target population, and only two are eHealth-based. The present qualitative study sought to assess whether one of the eHealth HIV prevention interventions for concordant HIV-negative male couples - called MCAP - could be adapted to meet the relationship and HIV prevention needs of HIV-discordant and HIV-positive male couples. Data for this study are drawn from in-person, individual-level interviews conducted with a convenience sample of 10 HIV-discordant male couples (n = 20) and 8 HIV-positive male couples (n = 16) from the Miami-Fort Lauderdale metro area in 2016. Thematic analysis was conducted to identify patterns (themes) of partners' thoughts about the toolkit, including how they perceived it could be improved for their own relationship and other couple's relationships. Two themes emerged from analysis of the qualitative data suggesting how the participants wanted the toolkit to be improved to meet their needs. Specifically, participants recommended for the toolkit to include guidance about integrating the use of biomedical HIV prevention strategies into couple's relationships, as well as for how partners can best take care of each other and further protect themselves from HIV and/or other STIs (Prevention Guidance). In addition, participants requested for the concept of sexual agreements to be broadened to include other aspects they deemed to be important in their life (e.g., mental health, exercise and nutrition) (Holistic agreements). Findings from the present study illuminate the ways in which MCAP would need to be adapted for these two groups of male couples in order to meet the needs for all three groups of male couples in the U.S. in a future iteration of this intervention.
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Affiliation(s)
- J W Mitchell
- a Office of Public Health Studies , University of Hawai'i at Mānoa Myron B. Thompson School of Social Work , Honolulu , HI , USA
| | - J-Y Lee
- b University of Miami Miller School of Medicine , Miami , FL , USA
| | - F Godoy
- b University of Miami Miller School of Medicine , Miami , FL , USA
| | - L Asmar
- b University of Miami Miller School of Medicine , Miami , FL , USA
| | - G Perez
- b University of Miami Miller School of Medicine , Miami , FL , USA
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Freeman AE, Sullivan P, Higa D, Sharma A, MacGowan R, Hirshfield S, Greene GJ, Gravens L, Chavez P, McNaghten AD, Johnson WD, Mustanski B. Perceptions of HIV Self-Testing Among Men Who Have Sex With Men in the United States: A Qualitative Analysis. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:47-62. [PMID: 29481298 DOI: 10.1521/aeap.2018.30.1.47] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
HIV testing is the gateway into both prevention and treatment services. It is important to understand how men who have sex with men (MSM) perceive HIV self-tests. We conducted focus groups and individual interviews to collect feedback on two HIV self-tests, and on a dried blood spot (DBS) specimen collection kit. Perceptions and attitudes around HIV self-testing (HIVST), and willingness to distribute HIV self-tests to others were assessed. MSM reported HIVST to be complementary to facility-based testing, and liked this approach because it offers privacy and convenience, does not require counseling, and could lead to linkage to care. However, they also had concerns around the accuracy of HIV self-tests, their cost, and receiving a positive test result without immediate access to follow-up services. Despite these issues, they perceived HIVST as a positive addition to their HIV prevention toolbox.
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Affiliation(s)
- Arin E Freeman
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patrick Sullivan
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Darrel Higa
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Akshay Sharma
- University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Robin MacGowan
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - George J Greene
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Laura Gravens
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Pollyanna Chavez
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - A D McNaghten
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wayne D Johnson
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Mustanski
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Sophus AI, Fujitani L, Vallabhbhai S, Antonio JA, Yang PL, Elliott E, Mitchell JW. Insights in Public Health: In What Ways are Hawaii's HIV Prevention Services Engaging Gay Male Couples and Using Technology? HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2018; 77:38-45. [PMID: 29435390 PMCID: PMC5801528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Partner-oriented services and Health Information and Communication technology (HICT) in the forms of mHealth (eg, smartphone applications), eHealth (eg, interactive websites), telemedicine, and social media play an important and growing role in HIV prevention. Accordingly, the present study sought to describe: (1) the primary and secondary HIV prevention services available in Hawai'i, (2) the prevention services that are available for gay male couples and partners, and (3) the prevention services that use HICT. Information about prevention services and use of HICT were obtained from websites and phone calls made to 19 organizations in the state, including the Hawai'i Department of Health. Overall, partner-oriented services were limited and only 1 couples-based service was currently being offered. Technology, namely social media, was used by 14 organizations, primarily to increase HIV awareness and advertise events. These findings may inform how best to adapt and better leverage the use of innovative technological tools to help expand access to HIV testing and counseling, sexual health education, and case management services for gay male couples and other MSM populations in the state.
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Affiliation(s)
- Amber I Sophus
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI
| | - Loren Fujitani
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI
| | | | - Jo Anna Antonio
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI
| | - Pua Lani Yang
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI
| | - Elyssa Elliott
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI
| | - Jason W Mitchell
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI
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Stephenson R, Metheny N, Sharma A, Sullivan S, Riley E. Providing Home-Based HIV Testing and Counseling for Transgender Youth (Project Moxie): Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e237. [PMID: 29183868 PMCID: PMC5727355 DOI: 10.2196/resprot.8562] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/13/2017] [Accepted: 09/16/2017] [Indexed: 12/29/2022] Open
Abstract
Background Transgender and gender nonconforming people experience some of the highest human immunodeficiency virus (HIV) rates in the United States, and experience many structural and behavioral barriers that may limit their engagement in HIV testing, prevention, and care. Evidence suggests that transgender and gender nonconforming youth (TY) are especially vulnerable to acquiring HIV, yet there is little research on TY and few services are targeted towards HIV testing, prevention, and care for this population. Telehealth presents an opportunity to mitigate some structural barriers that TY experience in accessing HIV testing, allowing TY to engage in HIV testing and counseling in a safe and nonjudgmental space of their choosing. Project Moxie is an HIV prevention intervention that pairs the use of HIV self-testing with remote video-based counseling and support from a trained, gender-affirming counselor. This study aims to offer a more positive HIV testing and counseling experience, with the goal of improving HIV testing frequency. Objective Project Moxie involves a pilot randomized controlled trial (RCT) of 200 TY aged 15-24 years, who are randomized on a 1:1 basis to control or intervention arms. The aim is to examine whether the addition of counseling provided via telehealth, coupled with home-based HIV testing, can create gains in routine HIV testing among TY over a six-month follow-up period. Methods This study implements a prospective pilot RCT of 200 TY recruited online. Participants in the control arm will receive one HIV self-testing kit and will be asked to report their results via the study’s website. Participants in the experimental arm will receive one HIV self-testing kit and will test with a remotely-located counselor during a prescheduled video-counseling session. Participants are assessed at baseline, and at three and six months posttesting. Results Project Moxie was launched in June 2017 and recruitment is ongoing. As of August 21, 2017, the study had enrolled 130 eligible participants. Conclusions Combining home-based HIV testing and video-based counseling allows TY, an often stigmatized and marginalized population, to test for HIV in a safe and nonjudgmental setting of their choosing. This approach creates an opportunity to reduce the high rate of HIV among TY through engagement in care, support, and linkage to the HIV treatment cascade for those who test positive. Trial Registration ClinicalTrials.gov NCT03185975; https://clinicaltrials.gov/ct2/show/NCT03185975 (Archived by WebCite at http://www.webcitation.org/6vIjHJ93s)
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Affiliation(s)
- Rob Stephenson
- School of Nursing, University of Michigan, Ann Arbor, MI, United States.,Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
| | - Nicholas Metheny
- School of Nursing, University of Michigan, Ann Arbor, MI, United States.,Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
| | - Akshay Sharma
- School of Nursing, University of Michigan, Ann Arbor, MI, United States.,Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
| | - Stephen Sullivan
- School of Nursing, University of Michigan, Ann Arbor, MI, United States.,Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
| | - Erin Riley
- School of Nursing, University of Michigan, Ann Arbor, MI, United States.,Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, United States
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