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Luo R, Xie Z, Silenzio VMB, Kuang Y, Luo D. Gay App Use, Sexuality Traits, and High-Risk Sexual Behaviors Among Men Who Have Sex With Men in China: Mediation Analysis. J Med Internet Res 2023; 25:e49137. [PMID: 37910154 PMCID: PMC10652192 DOI: 10.2196/49137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Gay geosocial networking apps, also known as "gay apps," have gained increasing popularity in the men who have sex with men (MSM) community. Certain sexuality traits and gay app use are both associated with high-risk sexual behaviors among MSM. However, little is known about the underlying mechanism of such relationships. OBJECTIVE Based on the uses and gratifications theory, this study aimed to test the mediation effect of gay app use on the relationship between sexuality traits (sexual compulsivity and sexual sensation seeking) and high-risk sexual behaviors (multiple sexual partners and unprotected anal intercourse) among MSM. METHODS A cross-sectional, multicenter study was conducted in Wuhan and Changsha, China, from August to October 2020. A representative sample of 402 MSM was recruited through respondent-driven sampling. A self-administered web-based structured questionnaire was used to collect data on sociodemographic information, high-risk sexual behaviors, gay app use, sexual compulsivity, and sexual sensation seeking. Path analysis was conducted to assess the mediation effect. RESULTS Our study revealed that 67.42% (n=271) of MSM used gay apps for seeking potential sexual partners, with 37.06% (n=149) of them engaging in unprotected anal intercourse, and 45.42% (n=218) of them having multiple sexual partners. Of the participants, 17.16% (n=69) reported significant sexual compulsivity, while 29.10% (n=117) reported significant sexual sensation seeking. Notably, gay app usage partially mediated the relationship between sexual compulsivity and multiple sexual partners but fully mediated the relationship between sexual compulsivity and unprotected anal intercourse. Furthermore, gay app usage partially mediated the relationship between sexual sensation seeking and multiple sexual partners but fully mediated the relationship between sexual sensation seeking and unprotected anal intercourse. CONCLUSIONS High-risk sexual behaviors are common among MSM. Most MSM rely on gay apps to find sexual partners, which, when combined with higher levels of sexual compulsivity and sexual sensation seeking, can increase the likelihood of engaging in high-risk sexual behaviors. Therefore, interventions aimed at reducing these behaviors among MSM should focus on addressing the use of gay apps, while also considering the influence of their sexuality traits on gay app use.
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Affiliation(s)
- Rui Luo
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhi Xie
- Changsha Center for Disease Control and Prevention, Changsha, China
| | - Vincent M B Silenzio
- Department of Urban-Global Public Health, Rutgers School of Public Health, Rutgers University, Newark, NJ, United States
| | - Yun Kuang
- Changsha Zonda-sunshine Social Work Center, Changsha, China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Wang Y, Zhang W, Gong X, Ong JJ, Marks M, Zhao P, Tucker JD, Tang W, Wu D, Wang C. Optimizing Peer Distribution of Syphilis Self-Testing Among Men Who Have Sex with Men in China: A Multi-City Pragmatic Randomized Controlled Trial. ARCHIVES OF SEXUAL BEHAVIOR 2023:1-12. [PMID: 36626071 PMCID: PMC9831370 DOI: 10.1007/s10508-022-02507-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Syphilis testing uptake is low among men who have sex with men (MSM) around the world. Syphilis self-testing (SST) may complement facility-based testing; the distribution model is yet to be explored. This study aimed to investigate the effectiveness of peer distribution of syphilis self-testing on promoting syphilis testing. We conducted a three-arm, unblinded, parallel individually randomized controlled trial among MSM in three cities in Guangdong, China. Inclusion criteria were: men who were born biologically male, aged 18 or above, have ever had sex with a man, will refer the interventions to peers, and will take the three-month follow-up survey. Enrolled indexes were randomly assigned in a 1:1:1 ratio into standard-of-care arm (SOC arm), standard SST delivery arm (S-SST arm), and a web-based referral link SST delivery arm (RL-SST arm). The primary outcome was the number of returned photograph-verified syphilis testing results per index. A total number of 300 indexes were enrolled, with 100 indexes in each arm. The number of verified syphilis tests per index conducted by alters was 0.05 in the control arm, 0.51 in the S-SST arm, and 0.31 in the RL-SST arm. The cost per alter tested was $760.60 for SOC, $83.78 for S-SST, and $93.10 for RL-SST. Minimal adverse event was reported among both indexes and alters during the study. This study showed that peer distribution of SST could improve syphilis testing uptake among MSM in China compared to facility-based testing. This approach warrants further consideration as part of expanding syphilis self-testing.
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Affiliation(s)
- Yajie Wang
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, 510091, China
- Southern Medical University Institute for Global Health, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, Guangdong, China
| | - Wei Zhang
- University of North Carolina at Chapel Hill, Project-China, Guangzhou, Guangdong, China
| | - Xiao Gong
- Department of Biostatistics, Guangzhou Jeeyor Medical Research Co., Ltd, Guangzhou, Guangdong, China
| | - Jason J Ong
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Hospital for Tropical Diseases, London, UK
| | - Peizhen Zhao
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, 510091, China
- Southern Medical University Institute for Global Health, Guangzhou, Guangdong, China
- Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, Guangdong, China
| | - Joseph D Tucker
- University of North Carolina at Chapel Hill, Project-China, Guangzhou, Guangdong, China
- Central Clinical School, Monash University, Melbourne, VIC, Australia
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, 510091, China
- University of North Carolina at Chapel Hill, Project-China, Guangzhou, Guangdong, China
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dan Wu
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Cheng Wang
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, 510091, China.
- Southern Medical University Institute for Global Health, Guangzhou, Guangdong, China.
- Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, Guangdong, China.
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Li J, Shan D, Liu P, Liu H, Cai L, Zhang H, Zhang L, Zhang D. Sex-seeking on the internet and mobile-based applications among young people in China: An online survey. Int J STD AIDS 2021; 32:403-410. [PMID: 33612032 DOI: 10.1177/0956462420971940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to investigate young people's risk behaviors in use of social network applications for sexual purposes. Snowball sampling technique was used to recruit participants online. Logistic regressions were performed to examine interrelationships among risk behaviors and sex-seeking platforms (A, B, C, D, and others). The prevalence of online sex-seeking was 22.2% (1156/5199) among people with sexual experience, and the most debut online sex-seeking happened in 15-24 years old in both men and women (79.8%, 590/739 vs 86.1%, 359/417). The risk behaviors varied in different platforms among 730 young people age 15-24 years. Among men, participants seeking sex via B were more likely to engage in concurrent sexual partnership (aOR: 1.64; 95% CI: 1.01-2.66). Participants seeking sex via C were more likely to engage in drug use (aOR: 1.74; 95% CI: 1.01-3.02) and condomless sex (aOR: 1.75; 95% CI: 1.04-2.95). Participants seeking sex via A, C, or D were all less likely to have homosexual behaviors. Among women, participants seeking sex via B were more likely to have condomless sex (aOR: 2.06; 95% CI: 1.10-3.86). The study indicated that emerging of the HIV epidemic in young people might be driven by risk behaviors during online sex-seeking. Effective intervention programs need to target on different social network platforms.
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Affiliation(s)
- Jian Li
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Duo Shan
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Liu
- Chinese Association of STD and AIDS Prevention and Control, Beijing, China
| | - Hui Liu
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lingping Cai
- China HIV/AIDS Information Network, Beijing, China
| | | | - Lei Zhang
- China HIV/AIDS Information Network, Beijing, China
| | - Dapeng Zhang
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
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Lemke R. The association of the availability of offline gay scenes and national tolerance of homosexuality with gay and bisexual men's sexual online dating behavior. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2019.106172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yan X, Lu Z, Zhang B, Li Y, Tang W, Zhang L, Jia Z. Protecting Men Who Have Sex With Men From HIV Infection With an mHealth App for Partner Notification: Observational Study. JMIR Mhealth Uhealth 2020; 8:e14457. [PMID: 32130147 PMCID: PMC7057823 DOI: 10.2196/14457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 11/22/2019] [Accepted: 11/29/2019] [Indexed: 12/01/2022] Open
Abstract
Background Traditional partner notification methods have been implemented for HIV-infected patients, as well as HIV treatment, in order to identify people at risk of HIV infection, especially men who have sex with men (MSM), since they are more likely to have casual sex partners. These traditional methods have some limitations. Objective Our study focused on developing an mHealth app to improve partner notification in practice for MSM; the study then focused on evaluating the effects of the app. Methods We developed an mHealth app with different modules using Java and HTML5 and tested it in an MSM community to prevent HIV transmission. The HIV incidence stratified by different follow-up periods were calculated. Poisson regression and social networks were used to estimate the risk ratios and to identify the connection among MSM, respectively. Results In addition to the partner notification module, which is the kernel of the app, we developed a test result self-query module to enable MSM to get their approved test results in a timely manner, a prompt and warning module to alert users to protect themselves from high-risk conditions, and a health education module to teach users more skills regarding HIV/AIDS prevention. Over a 1-year duration, a total of 3186 MSM used the app, of which 678 had at least two HIV test results since becoming app users; they were included in the final analysis. Among 678 users, a total of 6473 self-queries and 623 partner notifications were recorded, which identified 180 social networks of MSM app users. Those who used the partner notification function were more likely to have self-queries (P<.001). The 678 MSM app users covered 296.47 person-years and contributed to 20 HIV seroconversions; the cumulative HIV infection incidence was estimated as 6.75 per 100 person-years (95% CI 4.38-10.01). We found that the longer the app was used, the lower the HIV incidence (>5 months vs ≤5 months: 2.22 per 100 person-years vs 6.99 per 100 person-years; risk ratio 0.32, 95% CI 0.12- 0.87). Conclusions The app developed in this study is consistent with the World Health Organization’s sensitivity and confidentiality recommendations; it has the potential to reduce the risk of HIV infection among MSM.
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Affiliation(s)
- Xiangyu Yan
- School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Zuhong Lu
- Biomedical Engineering, Southeast University, Jiangsu Province, China
| | - Bo Zhang
- School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Yongjie Li
- School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Wenjun Tang
- School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Lingling Zhang
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Zhongwei Jia
- National Institute on Drug Dependence, Peking University, Beijing, China
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Hu M, Xu C, Wang J. Spatiotemporal Analysis of Men Who Have Sex With Men in Mainland China: Social App Capture-Recapture Method. JMIR Mhealth Uhealth 2020; 8:e14800. [PMID: 32012086 PMCID: PMC7007599 DOI: 10.2196/14800] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 10/31/2019] [Accepted: 11/15/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND In China, the cases of newly diagnosed HIV/AIDS in men who have sex with men (MSM) have increased more than tenfold since 2006. However, the MSM population size, geographical distribution, and migration patterns are largely unknown. OBJECTIVE Our aim is to estimate the number, spatial distribution, and migration of MSM populations in mainland China using big data from social networking. METHODS We collected 85 days of data on online users of a social networking MSM app in mainland China. Daily online MSM users and their migration across the country were investigated during a holiday period and a nonholiday period. Using the capture-mark-recapture model, we designed an experiment consisting of two independent samples to estimate the total provincial MSM population. RESULTS The estimate of MSM in mainland China was 8,288,536 (95% CI 8,274,931-8,302,141), accounting for 1.732% (95% CI 1.729%-1.734%) of adult men aged 18 to 64 years. The average daily number of MSM social networking online across mainland China was 1,198,682 during the nonholiday period. The five provinces (including municipalities) with the highest average number of daily online MSM numbers were Guangdong (n=141,712), Jiangsu (n=90,710), Zhejiang (n=72,212), Shandong (n=68,065), and Beijing (n=66,057). The proportion of daily online MSM among adult men in different cities varied from 0.04% to 0.96%, with a mean of 0.20% (SD 0.14%). Three migrating centers-Guangdong, Beijing, and the Yangtze River Delta (Shanghai-Zhejiang-Jiangsu)-accounted for 57.23% of MSM migrants in the county. CONCLUSIONS The percentage of MSM among adult men in mainland China is at the middle level compared with other Asia and Pacific countries. However, the number of MSM is very large, and the distribution is uneven. Both MSM distribution and migration are highly affected by socioeconomic status.
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Affiliation(s)
- Maogui Hu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
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7
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Yu MH, Guo CM, Gong H, Li Y, Li CP, Liu Y, Guo M, Zhao YQ, Xu J, Li Z, Gao YJ, Yang J, Cui Z. Using latent class analysis to identify money boys at highest risk of HIV infection. Public Health 2019; 177:57-65. [PMID: 31536863 DOI: 10.1016/j.puhe.2019.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 07/04/2019] [Accepted: 07/20/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Limited research has been conducted to investigate the characteristics of money boys (MBs) in China. This study was aimed to identify the subgroups of MBs based on sexual behaviors, Net-based venue sex-seeking, and substance abuse. STUDY DESIGN Cross-sectional study. METHODS Convenience sampling was used to recruit MBs from December 2014 to June 2015 in Tianjin, China. Face-to-face interviews were conducted for 330 MBs, and trained interviewers collected data. RESULTS The laboratory-confirmed human immunodeficiency virus (HIV)-positive rate was 11.52% among 330 MBs. Four classes were identified through latent class analysis (LCA) method: 'relatively safe behavior' group, 'higher sexual risk' group, 'multiple sexual-partners' group, and 'unprotected sex and substance abuse' group, and there is a significant difference based on the HIV status. Significant differences were found in original residence, monthly income, duration in sex trade, employment, history of sexually transmitted infection (STI), HIV testing, knowledge of free antiviral treatment policy, and awareness of free AIDS testing between the four latent classes (P < 0.05). MBs who used Net-based venues to seek sexual partners; who have inconsistent condom use, substance abuse, a longer duration in sex trade, multiple sexual clients, and multiple anal sex; and who were full-time employed had the highest risk of HIV infection. CONCLUSIONS The utility of LCA to identify subgroups based on risky behaviors attributes to formulating targeted intervention strategy.
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Affiliation(s)
- M-H Yu
- Section of STD & AIDS Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - C-M Guo
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Heping District, Tianjin, China
| | - H Gong
- Section of STD & AIDS Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Y Li
- Section of STD & AIDS Control and Prevention, Tianjin Nankai District Center for Disease Control and Prevention, Tianjin, China
| | - C-P Li
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Heping District, Tianjin, China
| | - Y Liu
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Heping District, Tianjin, China
| | - M Guo
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Heping District, Tianjin, China
| | - Y-Q Zhao
- Department of Medical English and Health Communication, Tianjin Medical University, Tianjin, China
| | - J Xu
- National Center for AIDS/STD Control and Prevention, Beijing, China
| | - Z Li
- GAP Program Office of U.S CDC, Atlanta, USA
| | - Y-J Gao
- Section of STD & AIDS Control and Prevention, Tianjin HongQiao District Center for Disease Prevention and Control, Tianjin, China
| | - J Yang
- Tianjin Shen-Lan Public Health Counseling Service Center, Tianjin, China
| | - Z Cui
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Heping District, Tianjin, China.
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A Comparison of Syphilis Partner Notification Outcomes by Reported Use of Internet-based Apps to Meet Sex Partners in North Carolina, 2013-2016. Sex Transm Dis 2019; 45:823-828. [PMID: 29944644 DOI: 10.1097/olq.0000000000000884] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Partner notification services (PNS) remain the backbone of syphilis control. The popularity of Internet-based apps to meet sex partners among early syphilis (ES) patients may hinder the success of PNS if partners cannot be located. METHODS We compared demographic and clinical characteristics between male ES patients indicating sex with men (MSM) and reported in North Carolina between 2013 and 2016 by reported use of an Internet-based app to meet sex partners (app user). We used multivariable log-binomial regression to assess the association between app usage and ES exposure notification of 1 or more sex partner. RESULTS Among 3414 MSM ES patients, 58.6% were app users. App users were more frequently white (33.2% vs 27.3%; P = 0.003), younger (median, 28 years vs 30 years; P = 0.0002) and less frequently human immunodeficiency virus coinfected (54.1% vs 58.2%; P = 0.02) compared to non-app users. Overall, 94.9% of app users and 89.6% of non-app users reported 1 or more sex partner. App users reported 2.5 times more locatable and 2.7 times more unlocatable sex partners than non-app users. Similar proportions of app (23.6%) and non-app users (25.0%) reported only unlocatable partners (P = 0.4). App usage was not associated with ES exposure notification of 1 or more sex partner (adjusted risk ratio, 0.99; 95% confidence interval, 0.87-1.13). CONCLUSIONS We observed no difference in the proportion of locatable partners or likelihood of notifying 1 or more sex partner of exposure among MSM ES patients, by reported use of Internet-based apps to meet sex partners. Partner notification services continues to be an important mechanism to locate and assure treatment for sex partners in this population.
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Guo C, Yu M, Deng X, Gong H, Li Y, Li C, Liu Y, Guo M, Gong X, Feng S, Xu J, Li Z, Gao Y, Yang J, Cui Z, Ma J. The characteristics of internet-based venue sex-seeking and mobility among money boys in Tianjin, China. HIV Med 2019; 20:473-484. [PMID: 31006956 DOI: 10.1111/hiv.12746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Internet-based venue sex-seeking is prevalent among money boys (MBs), as is a high degree of mobility, which is crucial for HIV transmission in key populations with high risks of HIV infection. However, correlation studies in MBs are scarce because of the secretive nature of this hard-to-reach subpopulation. We conducted this project to explore the characteristics of MBs. METHODS This survey was conducted from December 2014 to June 2015 in Tianjin; a total of 330 MBs were recruited by convenience sampling. Demographic and behavioural data were collected for analysis. RESULTS Among the investigated MBs, 38 (11.52%) were HIV positive, 147 (44.55%) reported using internet-based venues to seek sexual partners and 257 (77.88%) had travelled to two or more destinations in the past 6 months. Compared with non-internet-based venue-using MBs, internet-based venue-using MBs were more likely to have part-time employment as MBs, to have a longer duration of working in the sex trade, to engage in finger intercourse and to present a history of substance abuse and sexually transmitted infections. However, internet-based venue-using MBs were less likely to exhibit consistent condom usage and undergo HIV testing. Origin of residence data showed that most MBs were from northern China, with Tianjin, Beijing and Shanghai as the main travel destinations. Mobile MBs were characterized as a group who were fully engaged in the sex trade and frequently took part in sexual activities but had a weak sense of self-protection. CONCLUSIONS Internet-based venue sex-seeking and mobility are prevalent in MBs. Renewed efforts in internet-based health promotion and school-based primary health examination programmes may benefit more mobile and/or internet-based venue sex-seeking MBs.
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Affiliation(s)
- C Guo
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - M Yu
- STD & AIDS Control and Prevention Section, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - X Deng
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - H Gong
- STD & AIDS Control and Prevention Section, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Y Li
- STD & AIDS Control and Prevention Section, Tianjin Nankai District Center for Disease Control and Prevention, Tianjin, China
| | - C Li
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - Y Liu
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - M Guo
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - X Gong
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - S Feng
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - J Xu
- National Center for AIDS/STD Control and Prevention, Beijing, China
| | - Z Li
- GAP Program Office of US CDC, Atlanta, GA, USA
| | - Y Gao
- STD & AIDS Control and Prevention Section, Tianjin HongQiao District Center for Disease Prevention and Control, Tianjin, China
| | - J Yang
- Tianjin ShenLan Public Health Counseling Service Center, Tianjin, China
| | - Z Cui
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
| | - J Ma
- Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China
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Guanghua L, Yi C, Shuai T, Zhiyong S, Zhenzhu T, Yuhua R, Yousuf MA, Wensheng F. HIV, syphilis and behavioral risk factors among men who have sex with men in a drug-using area of southwestern China: Results of 3 cross-sectional surveys from 2013 to 2015. Medicine (Baltimore) 2018; 97:e0404. [PMID: 29668597 PMCID: PMC5916656 DOI: 10.1097/md.0000000000010404] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To assess human immunodeficiency virus (HIV), syphilis, and behavioral risk factors among men who have sex with men (MSM) in southwestern China, where HIV started as a drug-driven epidemic, and shifted to mainly heterosexual transmission.These cross-sectional studies were conducted yearly in 2013, 2014, and 2015 in Guangxi, China. A total of 1,996, 1,965, and 1,697 participants were recruited in 2013, 2014, and 2015, respectively. The data included demographic and sexual behavioral variables. Other variables included individuals who used illegal drugs, and who received HIV counseling, testing, and free condoms, and peer education. Participants were tested for HIV, syphilis, and hepatitis C virus (HCV) with whole blood specimens. Questionnaires and laboratory testing data were double entered, and validated with EpiData software. The data were then transferred into SPSS software (SPSS Inc, Chicago, IL) and Chi-square test performed.The prevalence of HIV was 6.6% in 2013, 8.4% in 2014, and 11.2% in 2015. The prevalence of syphilis was 9.3% in 2013, 9.8% in 2014, and 6.1% in 2015. And HCV prevalence was 0.5% in 2013 and remained stable at 0.4% in 2014, and 2015. HIV infection, and associated factors among MSM in these 3 annual cross-sectional survey showed that HIV-infected MSM were significantly, more likely, to perform unprotected anal intercourse with any commercial male partners in the past 6 months (adjusted odds ratio [AOR] = 1.81, 95% CI: 1.50-2.20), had sex with any female partners in the past 6 months (AOR = 1.31, 95% CI: 1.01-1.71), used drugs in the past (AOR = 2.73, 95% CI: 1.30-5.71), and are syphilis infected (AOR = 3.53, 95% CI: 2.77-4.49).There is an urgent need for intervention strategies like condom distribution, HIV counseling, free testing, and education regarding safe sex, HIV, and other sex-related diseases in Guangxi to curb, and prevent HIV among MSM.
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Affiliation(s)
- Lan Guanghua
- Guangxi Center for Disease Control and Prevention, Nanning
| | - Chen Yi
- Guangxi Center for Disease Control and Prevention, Nanning
| | - Tang Shuai
- Guangxi Center for Disease Control and Prevention, Nanning
| | - Shen Zhiyong
- Guangxi Center for Disease Control and Prevention, Nanning
| | - Tang Zhenzhu
- Guangxi Center for Disease Control and Prevention, Nanning
| | - Ruan Yuhua
- State Key Laboratory for Infectious Disease Prevention and Control (SKLID), Chinese Center for Disease Control and Prevention (China CDC), Beijing
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | | | - Fan Wensheng
- Department of Health Services Administration, Florida International University, Miami, FL
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Liu Y, Ruan Y, Strauss SM, Yin L, Liu H, Amico KR, Zhang C, Shao Y, Qian HZ, Vermund SH. Alcohol misuse, risky sexual behaviors, and HIV or syphilis infections among Chinese men who have sex with men. Drug Alcohol Depend 2016; 168:239-246. [PMID: 27723554 PMCID: PMC5523945 DOI: 10.1016/j.drugalcdep.2016.09.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 09/21/2016] [Accepted: 09/25/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Few studies have employed standardized alcohol misuse measures to assess relationships with sexual risk and HIV/syphilis infections among Chinese men who have sex with men (MSM). METHODS We conducted a cross-sectional study among MSM in Beijing during 2013-2014. An interviewer-administered survey was conducted to collect data on sociodemographics, high-risk behaviors, and alcohol use/misuse patterns (hazardous/binge drinking and risk of alcohol dependence) in the past 3 months using Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). We defined AUDIT-C score ≥4 as recent hazardous drinkers, and drinking ≥6 standard drinks on one occasion as recent binge drinkers. RESULTS Of 3588 participants, 14.4% reported hazardous drinking, 16.8% reported binge drinking. Hazardous and binge drinking are both associated with these factors (p<0.05): older age, being migrants, living longer in Beijing, township/village origin, being employed, higher income, self-perceived low/no HIV risk, and sex-finding via non-Internet venues. Hazardous (vs non-hazardous) or binge (vs. non-binge) drinkers were more likely to use illicit drugs, use alcohol before sex, have multiple partnerships, pay for sex, and have condomless insertive anal intercourse. MSM who reported binge (AOR, 1.34, 95% CI, 1.02-1.77) or hazardous (AOR, 1.36, 95% CI, 1.02-1.82) drinking were more likely to be HIV-infected. MSM at high risk of current alcohol dependence (AUDIT-C ≥8) were more likely to be HIV- (AOR, 2.37, 95% CI, 1.39-4.04) or syphilis-infected (AOR, 1.96, 95% CI, 1.01-3.86). CONCLUSIONS Recent alcohol misuse was associated with increased sexual and HIV/syphilis risks among Chinese MSM, emphasizing the needs of implementing alcohol risk reduction programs in this population.
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Affiliation(s)
- Yu Liu
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee 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
| | - Shiela M. Strauss
- The Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Lu Yin
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee 37203, USA
| | - Hongjie Liu
- The Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - K. Rivet Amico
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, USA
| | - Chen Zhang
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee 37203, USA
| | - 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
| | - Han-Zhu Qian
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee 37203, USA,Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sten H. Vermund
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee 37203, USA,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Liu Y, Wang J, Qian HZ, Liu H, Yin L, Lu H, Zhang C, Ruan Y, Shao Y, Vermund SH. Seeking Male Sexual Partners via Internet and Traditional Venues among Chinese Men Who Have Sex with Men: Implications for HIV Risk Reduction Interventions. AIDS Behav 2016; 20:2222-2230. [PMID: 27000143 DOI: 10.1007/s10461-016-1371-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The dynamic nature of finding male sexual partners (sex-finding) among Chinese men who have sex with men (MSM) may play a substantial role in the HIV epidemic. We compared characteristics and behaviors of MSM who mostly sought sex via the Internet versus traditional venues in a cross-sectional survey among 3588 Chinese MSM. We assessed the sociodemographic predictors and compared high-risk behaviors of using Internet versus traditional venues for sex-finding. Compared to non-Internet MSM, Internet-user MSM were more likely to have been: younger, currently single, better educated, health-insured, with higher income, with Beijing residency ('Hukou'), living longer in the city, HIV-positive, ever using drug and engaging in condomless receptive anal sex. Internet sex-finding users were less likely to be sexually active for longer duration, drink alcohol, drink alcohol before sex, or ever have sex with women. Knowledge of differential characteristics of various sex-finding MSM can help design targeted interventions.
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Affiliation(s)
- Yu Liu
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Suite 725, 2525 West End Avenue, Nashville, TN, 37203, USA
| | - Juan Wang
- Beijing Municipal Center for Disease Control and Prevention, Beijing, China
| | - Han-Zhu Qian
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Suite 725, 2525 West End Avenue, Nashville, TN, 37203, USA
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, 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 School of Medicine, Suite 725, 2525 West End Avenue, Nashville, TN, 37203, USA
| | - Hongyan Lu
- Beijing Municipal Center for Disease Control and Prevention, Beijing, China
| | - Chen Zhang
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Suite 725, 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
| | - Sten H Vermund
- Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Suite 725, 2525 West End Avenue, Nashville, TN, 37203, USA.
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
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13
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Wang AL, Peng RR, Tucker JD, Chakraborty H, Cohen MS, Chen XS. Optimizing Partner Notification Programs for Men Who Have Sex with Men: Factorial Survey Results from South China. PLoS One 2016; 11:e0157749. [PMID: 27462724 PMCID: PMC4963097 DOI: 10.1371/journal.pone.0157749] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/04/2016] [Indexed: 11/24/2022] Open
Abstract
Background Syphilis is prevalent among men who have sex with men (MSM) in China. Syphilis partner notification (PN) programs targeting MSM has been considered as one of effective strategies to prevention and control of the infection in the population. We examined willingness and preferences for PN among MSM to measure feasibility and optimize uptake. Methods Participation in a syphilis PN program was measured using a factorial survey from both the perspective of the index patient and the partner. Respondents were recruited from April-July 2011 using convenience sampling at two sites—a MSM sexually transmitted disease (STD) clinic and a MSM community based organization (CBO). Respondents first evaluated three factorial survey vignettes to measure probability of participation and then an anonymous sociodemographic questionnaire. A two-level mixed linear model was fitted for the factorial survey analysis. Results In 372 respondents with mean age (± SD) 28.5 (± 6.0) years, most were single (82.0%) and closeted gays (66.7%). The Internet was the most frequent place to search for sex. Few (31.2%) had legal names for casual partners, but most had instant messenger (86.5%) and mobile phone numbers (77.7%). The mean probability of participation in a syphilis PN program was 64.5% (± 32.4%) for index patients and 63.7% (± 32.6%) for partners. Referral of the partner to a private clinic or MSM CBO for follow-up decreased participation compared to the local Center for Disease Control and Prevention (CDC) or public STD clinic. Conclusions Enhanced PN services may be feasible among MSM in South China. Internet and mobile phone PN may contact partners untraceable by traditional PN. Referral of partners to the local CDC or public STD clinic may maximize PN participation.
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Affiliation(s)
- Alberta L. Wang
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - Joseph D. Tucker
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Hrishikesh Chakraborty
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, United States of America
| | - Myron S. Cohen
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Xiang-Sheng Chen
- National Center for Sexually Transmitted Disease Control, Chinese Academy of Medical Science and Peking Union Medical College Institute of Dermatology, Nanjing, China
- * E-mail:
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14
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Choi EPH, Wong JYH, Fong DYT. The use of social networking applications of smartphone and associated sexual risks in lesbian, gay, bisexual, and transgender populations: a systematic review. AIDS Care 2016; 29:145-155. [DOI: 10.1080/09540121.2016.1211606] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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15
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DeSilva M, Hedberg K, Robinson B, Toevs K, Neblett-Fanfair R, Petrosky E, Hariri S, Schafer S. A case-control study evaluating the role of internet meet-up sites and mobile telephone applications in influencing a syphilis outbreak: Multnomah County, Oregon, USA 2014. Sex Transm Infect 2016; 92:353-8. [PMID: 27188272 DOI: 10.1136/sextrans-2015-052509] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 04/20/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Early syphilis in Multnomah County, Oregon, USA, increased 16-fold during 2007-2013. Cases predominantly occurred among men who have sex with men (MSM); 55% were HIV coinfected. We conducted a case-control study to evaluate the association between meeting sex partners online and early syphilis. METHODS Cases subjects (cases) were Multnomah County resident, English speaking, MSM, aged ≥18 years with laboratory-confirmed early syphilis reported 1 January to 31 December 2013. We recruited two MSM controls subjects (controls) per case, frequency matched by HIV status and age. Participants completed self-administered questionnaires. We performed multivariable logistic regression. RESULTS Seventy per cent (40/57) of cases and 42% (50/119) of controls met partners online (p<0.001). Cases more frequently met partners online (adjusted OR (aOR)=3.0; 95% CI 1.2 to 6.7), controlling for presumptive confounders. Cases reported more partners than controls (medians 5, 2; p<0.001). When including number of partners, aOR decreased to 1.4 (95% CI 0.5 to 3.9). CONCLUSIONS Early syphilis was associated with meeting partners online. We believe this association may be related to number of sex partners acting as an intermediate variable between use of online resources to meet sex partners and early syphilis. Online meet-up sites might represent areas for public health interventions targeting at-risk individuals.
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Affiliation(s)
- Malini DeSilva
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia, USA
| | | | - Byron Robinson
- Epidemiology Workforce Branch, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia, USA
| | - Kim Toevs
- Adolescent Health Promotion and STD/HIV/HCV Programs, Multnomah County Health Department, Portland, Oregon, USA
| | - Robyn Neblett-Fanfair
- Epidemiology and Surveillance Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, USA
| | - Emiko Petrosky
- Epidemiology and Surveillance Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, USA
| | - Susan Hariri
- Epidemiology and Surveillance Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia, USA
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16
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Lacefield K, Negy C, Schrader RM, Kuhlman C. Comparing Psychosocial Correlates of Condomless Anal Sex in HIV-Diagnosed and HIV-Nondiagnosed Men Who Have Sex with Men: A Series of Meta-Analyses of Studies from 1993-2013. LGBT Health 2015; 2:200-20. [PMID: 26788669 DOI: 10.1089/lgbt.2014.0069] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Men who have sex with men (MSM) continue to be overrepresented in rates of incidence and prevalence of human immunodeficiency virus (HIV). Both HIV-diagnosed (HIV-D) and HIV-nondiagnosed (HIV-N) MSM report a variety of reasons for intentional and unintentional nonuse of condoms. Elucidating and comparing reasons for continued engagement in condomless anal sex specific to both HIV-D and HIV-N MSM likely is important to identifying effective prevention. METHODS This study employed meta-analytic methods to evaluate and compare correlates to condomless anal sex in both HIV-D and HIV-N MSM from primary studies from 1993 to February 2013. RESULTS Of the 19 individual correlates assessed within the subgroup of HIV-D MSM, variables that achieved significant effect were alcohol, mind-altering substance use, sexual-enhancement medication, intentional condom nonuse, self-efficacy, attitudes toward condom use, social support, gay identity, compulsivity, trading sex, and number of sex partners. Those that were statistically non-significant were intention to use a condom, perceived risk, perceived norms, perceived responsibility, HIV medical management, treatment optimism, mental health, and setting. Of the 12 correlates assessed within the subgroup of HIV-N MSM, variables that achieved significant effect were alcohol, mind-altering substance use, intentional condom nonuse, attitudes toward condom use, perceived risk, and setting. Those observed as statistically non-significant were perceived norms, social support, gay identity, mental health, trading sex, and number of sex partners. CONCLUSION Study results have clinical implications that may guide future prevention research and practice by highlighting risk variables shared between HIV-N and HIV-D MSM, as well as variables observed to be unique to each group that may warrant more tailored intervention. Further investigation is recommended to elucidate the relationships among these variables such that optimal intervention can be determined.
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Affiliation(s)
- Katharine Lacefield
- 1 Department of Psychology, VA Maryland Healthcare System , Baltimore, Maryland.,2 Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Charles Negy
- 3 Department of Psychology, University of Central Florida , Orlando, Florida
| | - Ronald M Schrader
- 4 Department of Dialysis, DCI Corporate Quality Management , Albuquerque, New Mexico
| | - Christina Kuhlman
- 3 Department of Psychology, University of Central Florida , Orlando, Florida
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17
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Muessig KE, Bien CH, Wei C, Lo EJ, Yang M, Tucker JD, Yang L, Meng G, Hightow-Weidman LB. A mixed-methods study on the acceptability of using eHealth for HIV prevention and sexual health care among men who have sex with men in China. J Med Internet Res 2015; 17:e100. [PMID: 25900881 PMCID: PMC4420841 DOI: 10.2196/jmir.3370] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 12/19/2014] [Accepted: 02/05/2015] [Indexed: 01/16/2023] Open
Abstract
Background Human immunodeficiency virus (HIV) infection disproportionately affects men who have sex with men (MSM). Over half of all HIV-positive MSM in China may not know their HIV status. Mobile phones and Web interventions (eHealth) are underutilized resources that show promise for supporting HIV education, testing, and linkage to care. Objective This mixed-methods study among MSM in China assessed technology utilization and eHealth acceptability for sexual health care. Methods We conducted in-depth interviews and an online survey. Qualitative analyses informed the development of the Internet survey, which was administered through two popular MSM websites. Bivariate and multivariate analysis assessed characteristics of MSM interested in eHealth for sexual health care. Results The qualitative sample included MSM across a range of ages, education, marital status, sexuality, and HIV testing experience. Qualitative findings included the importance of the Internet as the primary source of information about sexual health, HIV and other sexually transmitted diseases (STDs), use of the Internet to enable HIV testing opportunities by facilitating connections with both the gay community and health care providers, and mixed perceptions regarding the confidentiality of eHealth tools for sexual health. Among the Internet sample (N=1342), the average age was 30.6 years old, 82.81% (1098/1342) were single, and 53.42% (711/1331) had completed college. In the past 3 months, 38.66% (382/988) had condomless sex and 60.53% (805/1330) self-reported having ever tested for HIV. The majority of men owned computers (94.14%, 1220/1296) and mobile phones (92.32%, 1239/1342), which many had used to search for HIV/STD information and testing sites. In multivariate analysis, interest in using computers or mobile phones to support their sexual health care was associated with being a student, prior use of computers or mobile phones to search for general health information, prior use of computers or mobile phones to search for HIV/STD information, and confidentiality concerns. Conclusions MSM in this sample had high utilization of technology and interest in eHealth despite confidentiality concerns. Future eHealth interventions can thoughtfully and creatively address these concerns as a priority for successful implementation.
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Affiliation(s)
- Kathryn E Muessig
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
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18
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Bowring AL, van Gemert C, Vongsaiya K, Hughes C, Sihavong A, Phimphachanh C, Chanlivong N, Agius PA, Toole M, Hellard M. Setting the scene: locations for meeting sex partners among behaviorally bisexual men in Vientiane, Laos, and opportunities for health promotion. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2014; 26:538-553. [PMID: 25490734 DOI: 10.1521/aeap.2014.26.6.538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Behaviorally bisexual men (BBM) in Vientiane, Laos report high-risk sexual behaviors. We explore settings for meeting sex partners and associated risk behaviors among BBM in Laos. BBM and their sexual partners were recruited in Vientiane Capital using modified snowball sampling (2010). Settings for usually meeting sex partners and associations with risk behaviors were assessed. Among 88 BBM, the most common settings for men meeting male, kathoey, and female sex partners were private residences (48%, 37%, 51%, respectively) and hospitality settings (39%, 31%, 40%, respectively). Hospitality settings were more commonly reported by heterosexual-identifying BBM, and private residences more commonly reported by bisexual/homosexual-identifying BBM. Inconsistent condom use was high across partners and settings. Meeting partners in hospitality settings was associated with reporting a high number of female sex partners and frequently drinking alcohol before sex. Our results suggest that targeted health promotion initiatives in bars, clubs, and beer-shops could reach a high proportion of high-risk bisexual men, particularly heterosexual-identifying BBM.
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Estimating the size of key populations at higher risk of HIV infection: a summary of experiences and lessons presented during a technical meeting on size estimation among key populations in Asian countries. Western Pac Surveill Response J 2014; 5:43-9. [PMID: 25320676 DOI: 10.5365/wpsar.2014.5.2.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PROBLEM Size estimates of key populations at higher risk of HIV exposure are recognized as critical for understanding the trajectory of the HIV epidemic and planning and monitoring an effective response, especially for countries with concentrated and low epidemics such as those in Asia. CONTEXT To help countries estimate population sizes of key populations, global guidelines were updated in 2011 to reflect new technical developments and recent field experiences in applying these methods. ACTION In September 2013, a meeting of programme managers and experts experienced with population size estimates (PSE) for key populations was held for 13 Asian countries. This article summarizes the key results presented, shares practical lessons learnt and reviews the methodological approaches from implementing PSE in 13 countries. LESSONS LEARNT It is important to build capacity to collect, analyse and use PSE data; establish a technical review group; and implement a transparent, well documented process. Countries should adapt global PSE guidelines and maintain operational definitions that are more relevant and useable for country programmes. Development of methods for non-venue-based key populations requires more investment and collaborative efforts between countries and among partners.
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20
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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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Wong ML, Koh TT, Tjahjadi S, Govender M. Men seeking sex online practise riskier sexual behaviours than men frequenting brothels: survey findings from Singapore. Sex Transm Infect 2014; 90:401-7. [DOI: 10.1136/sextrans-2013-051366] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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22
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Lehmiller JJ, Ioerger M. Social networking smartphone applications and sexual health outcomes among men who have sex with men. PLoS One 2014; 9:e86603. [PMID: 24466166 PMCID: PMC3900560 DOI: 10.1371/journal.pone.0086603] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 12/12/2013] [Indexed: 11/18/2022] Open
Abstract
Several smartphone applications (apps) designed to help men who have sex with men (MSM) find casual sexual partners have appeared on the market recently. Apps of this nature have the potential to impact sexual health and behavior by providing constant access to a large supply of available partners. In this study, the sexual health history, behavior, and personality of MSM who use these apps was compared to MSM who meet partners in other ways. A sample of 110 adult MSM was recruited online to complete a cross-sectional survey. All participants were either single or involved in a non-exclusive romantic relationship. There were no statistically significant differences between app users and non-users in frequency of insertive or receptive anal sex without a condom. However, app users reported significantly more sexual partners and had a higher prevalence of ever being diagnosed with an STI than did non-users. App users did not differ from non-users on any demographic or personality variables (including erotophilia, sensation seeking, and self-control); however, when adjusting lifetime total sex partners for those met specifically through apps, app users still had significantly more partners. This pattern of results suggests that app users may be more sexually active in general. More work is needed to fully understand the association between this emerging technology and potential sexual health risks.
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Affiliation(s)
- Justin J. Lehmiller
- Department of Psychology, Harvard University, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Michael Ioerger
- Department of Psychology, Syracuse University, Syracuse, New York, United States of America
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23
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Li D, Li S, Liu Y, Gao Y, Yu M, Yang X, Li Q, Jiang S, Zhou Z, Zhang Z, Yan L, Jiang G, Xiao D, Pan SW, Luo F, Ruan Y, Shao Y. HIV incidence among men who have sex with men in Beijing: a prospective cohort study. BMJ Open 2012; 2:bmjopen-2012-001829. [PMID: 23166133 PMCID: PMC3533041 DOI: 10.1136/bmjopen-2012-001829] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES (1) To assess the HIV incidence rate among men who have sex with men (MSM) in a large cohort study in Beijing, China and (2) to identify sociodemographic and behavioural risk factors of HIV seroconversion among MSM in Beijing, China. DESIGN A prospective cohort study. SETTING Baseline and follow-up visits were conducted among MSM in Beijing, China. PARTICIPANTS A cohort of 797 HIV-seronegative MSM was recruited from August to December 2009, with follow-up occurring after 6 and 12 months. PRIMARY AND SECONDARY OUTCOME MEASURES At baseline and follow-up visits, participants reported sociodemographic and sexual behaviour information, and were tested for HIV, herpes simplex virus-2 (HSV-2) and syphilis with whole blood specimens. Cox regression analysis was used to identify factors associated with HIV seroconversion. RESULTS Most study participants (86.8%) were retained by the 12-month follow-up. The HIV, HSV-2 and syphilis incidence rates were 8.09 (95% CI 6.92 to 9.26), 5.92 (95% CI 5.44 to 6.40) and 8.06 (95% CI 7.56 to 8.56) cases per 100 person-years, respectively. HIV seroconversion was significantly associated with being <25 years old, having <12 years of education, having >1 male sex partner in the past 6 months, and being syphilis positive or HSV-2 positive. CONCLUSIONS The HIV incidence among MSM in Beijing is serious. Interventions and treatment of sexually transmitted diseases (STD) should be combined with HIV control and prevention measures among MSM.
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Affiliation(s)
- Dongliang Li
- Chaoyang Center for Disease Control and Prevention, Beijing, PR China
| | - Shuming Li
- Chaoyang Center for Disease Control and Prevention, Beijing, PR China
| | - Yingjie Liu
- Chaoyang Center for Disease Control and Prevention, Beijing, PR China
| | - Yanjie Gao
- Chaoyang Center for Disease Control and Prevention, Beijing, PR China
| | - Mingrun Yu
- Chaoyang Center for Disease Control and Prevention, Beijing, PR China
| | - Xueying Yang
- Chaoyang Center for Disease Control and Prevention, Beijing, PR China
| | - Qingchun Li
- State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, PR China
| | - Shulin Jiang
- Chaoyang Center for Disease Control and Prevention, Beijing, PR China
| | - Zhenhai Zhou
- State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, PR China
| | - Zheng Zhang
- Chaoyang Center for Disease Control and Prevention, Beijing, PR China
| | - Li Yan
- Beijing Jingcheng Skin Diseases Hospital, Beijing, PR China
| | - Guiyan Jiang
- Beijing Jingcheng Skin Diseases Hospital, Beijing, PR China
| | - Dong Xiao
- Chaoyang Chinese AIDS Volunteer Group, Beijing, PR China
| | - Stephen W Pan
- The School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fengji Luo
- Chaoyang Center for Disease Control and Prevention, Beijing, PR China
| | - Yuhua Ruan
- State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, PR China
| | - Yiming Shao
- State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, PR China
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