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Yang X, Sun S, Zeng C, Shi F, Qiao S, James T, Brown MJ, Li X. Associations between HIV disclosure and HIV care continuum outcomes among men who have sex with men living with HIV: systematic review and meta-analysis. AIDS Care 2023; 35:1982-1997. [PMID: 36912702 PMCID: PMC10497729 DOI: 10.1080/09540121.2023.2188159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/01/2023] [Indexed: 03/14/2023]
Abstract
ABSTRACTThe objective of this study is to synthesize the existing empirical literature and perform a systematic review and meta-analysis on the relationship between HIV disclosure and engagement in the HIV care continuum among men who have sex with men living with HIV. Twenty-three studies were included, with thirteen quantitative studies and ten qualitative studies. Meta-analytic techniques were used to compute and aggregate effect sizes (odds ratio [OR] and their confidence intervals [95%CI]) for the quantitative studies and a thematic analysis was employed for qualitative studies. Given the small number of eligible studies, meta-analysis was only conducted for the linkage to care outcome, where a positive association was observed from the pooled estimation (OR = 1.51, 95%CI [1.15, 1.99]). Regarding ART initiation, retention in care, and viral suppression outcomes, most of the individual studies revealed a positive association between HIV disclosure and these outcomes. Thematic analysis from qualitative studies complemented the quantitative findings by incorporating the approaching and avoidance motivations underlying the relationship between non-HIV disclosure and the participation in HIV care continuum. The small number of available studies limits the definitive conclusions, and more research is needed to ascertain the magnitude of effect sizes.
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Affiliation(s)
- Xueying Yang
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
| | - Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Chengbo Zeng
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
| | - Fanghui Shi
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
| | - Titilayo James
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
| | - Monique J. Brown
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, 29208
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Bero B, Zidana C, Showa SP. PrEP retention predictors among key populations in urban areas of Zimbabwe - a machine learning approach. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2023; 22:157-164. [PMID: 37905425 DOI: 10.2989/16085906.2023.2237002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 07/01/2023] [Indexed: 11/02/2023]
Abstract
Pre-exposure prophylaxis (PrEP) success depends on adherence and hence retention in care. It is vital to find factors that affect PrEP retention to make this HIV-prevention method successful. The main objectives of this study were to identify the major determinants of PrEP retention at six months from day of initiation and to determine PrEP retention clusters. Data of people who were initiated on PrEP care at Population Services International sites between 2017 and 2019 in Zimbabwe were used. Determinants of PrEP retention were identified using multivariable logistic regression and partitioning around medoids (PAM) cluster analysis to determine the number and composition of PrEP retention clusters. Significant PrEP retention determinants were found to be population type, sex, marital status, employment type, age and education level. Female sex workers were most likely to stay on PrEP compared to other users. We found that PrEP users could be grouped into three risk clusters: cluster 1 consisted of married adult males who are high-risk individuals; cluster 2 consisted of the young single men who have sex with men (MSM); and cluster 3 consisted of adult women who are separated or divorced and employed as sex workers. The retention rates were 32%, 24% and 44% for clusters 1 to 3 respectively. We conclude that adults, female sex workers, high-risk individuals, women, people without or with little education and sex workers stay on PrEP better than youths, MSM, men and educated and employed individuals.
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Affiliation(s)
- Bridgette Bero
- Department of Applied Mathematics, National University of Science and Technology, Bulawayo, Zimbabwe
| | - Chipo Zidana
- Department of Mathematics and Statistical Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - Sarudzai Portia Showa
- Department of Applied Mathematics, National University of Science and Technology, Bulawayo, Zimbabwe
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HIV Status Disclosure and Associated Characteristics Among HIV-Positive MSM Receiving Antiretroviral Therapy in Jinan, China. AIDS Behav 2022; 27:2205-2215. [DOI: 10.1007/s10461-022-03952-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
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Cao W, Li J, Sun S, Sturm C, Peng L, Gu J, Hao C, Hou F, Wei D, You X, Deng Y, Ekström AM. HIV Serostatus Disclosure Among Men Who Have Sex with Men in China in the Era of U=U and PrEP. AIDS Behav 2022; 26:1477-1488. [PMID: 34697704 PMCID: PMC9001537 DOI: 10.1007/s10461-021-03502-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 11/30/2022]
Abstract
Given the recent evidence on "Undetectable = Untransmittable" (U=U) and pre-exposure prophylaxis (PrEP), the present study aimed to investigate HIV disclosure behaviors and their associations with sexual risk behaviors and U=U and PrEP awareness among men who have sex with men (MSM) in China. A cross-sectional survey was conducted among 689 MSM recruited through a gay-friendly non-governmental organization located in Chengdu, China in 2018-2019. Information was collected by a structured self-administrated questionnaire. The enrolled sample included 554 (80.4%) participants who were HIV-negative and 135 (19.6%) participants with an unknown HIV status. In terms of disclosure, 41.4% of participants informed all partners about their HIV status all the time (informing behavior), while 30.4% asked all partners about their HIV status all the time (asking behavior). Only one-fifth knew about U=U, but this was not statistically associated with either informing or asking behavior. Half (50.5%) had heard of PrEP but this was not statistically associated with either informing or asking behavior. Common barriers to informing and asking behaviors were lower risk perception of HIV infection, a history of sexually transmitted infections, engagement in receptive sex, and a history of sex with casual partners. We found that both U=U and PrEP awareness and HIV serostatus disclosure were infrequent and not associated in this study of Chinese MSM. These data indicate huge information gaps among MSM in China.
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Affiliation(s)
- Wangnan Cao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191, China
| | - Jinghua Li
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China.
- Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China.
| | - Shengzhi Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Carla Sturm
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Liping Peng
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
| | - Jing Gu
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
- Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Chun Hao
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
- Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
| | - Fengsu Hou
- Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, China
- Department of Public Mental Health, Kangning Hospital, Shenzhen, Guangdong, China
| | - Dannuo Wei
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
| | - Xinyi You
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
| | - Yang Deng
- School of Public Health, Sun Yat-Sen University, North Campus, 74# Zhongshan 2nd Road, Guangzhou, 510000, China
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Xu JJ, Han MJ, Jiang YJ, Ding HB, Li X, Han XX, Lv F, Chen QF, Zhang ZN, Cui HL, Geng WQ, Zhang J, Wang Q, Kang J, Li XL, Sun H, Fu YJ, An MH, Hu QH, Chu ZX, Liu YJ, Shang H. Prevention and control of HIV/AIDS in China: lessons from the past three decades. Chin Med J (Engl) 2021; 134:2799-2809. [PMID: 34759226 PMCID: PMC8667973 DOI: 10.1097/cm9.0000000000001842] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world most complex co-circulating HIV-1 subtypes, even the prevalence is still low. In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection. China has been providing free antiretroviral therapy (ART) since 2003, which covered >80% of the identified patients and achieved a viral suppression rate of 91%. To bend the curve of increasing the disease burden of HIV and finally end the epidemic, China should consider constraining HIV spread through sexual transmission, narrowing the gaps in identifying HIV cases, and the long-term effectiveness and safety of ART in the future.
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Affiliation(s)
- Jun-Jie Xu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Meng-Jie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yong-Jun Jiang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hai-Bo Ding
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Xi Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiao-Xu Han
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Fan Lv
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Qing-Feng Chen
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Zi-Ning Zhang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hua-Lu Cui
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Wen-Qing Geng
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Jing Zhang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Qi Wang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Jing Kang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Xiao-Lin Li
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hong Sun
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Ya-Jing Fu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Ming-Hui An
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Qing-Hai Hu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Zhen-Xing Chu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Ying-Jie Liu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hong Shang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
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Yang Z, Chen W, Jin M, Chen W, Zhou X, Wang H, Chen L, Jiang T. Analysis of homosexual behavior characteristics and influencing factors of male college students in Zhejiang Province. Medicine (Baltimore) 2021; 100:e26746. [PMID: 34397715 PMCID: PMC8322529 DOI: 10.1097/md.0000000000026746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/29/2021] [Indexed: 01/04/2023] Open
Abstract
The purpose of this study was to understand the homosexual behavior characteristics and influencing factors of male college students and to provide scientific evidence for the prevention of HIV infection in college students.A self-made online questionnaire was used to collect information on demographic characteristics, sexual attitudes, sexual behaviors, and interventions of the respondents. The χ2 test was performed on the constituent ratios of different groups, and whether homosexual behavior occurred was the dependent variable. Logistic regression was subsequently used to analyze the influencing factors of male homosexual behavior.A total of 2665 students were surveyed, including 219 men who have sex with men, accounting for 8.22% of the sample population. Multivariate analysis revealed the following independent influencing factors of homosexual behavior among male college students: the student's household registration was Zhejiang Province, the hometown was in the city, accepted male homosexual sex, had temporary sex in the last year, and awareness that the correct use of condoms can reduce the spread and risk of acquired immunodeficiency syndrome.Various measures should be enacted to promote human immunodeficiency virus/acquired immunodeficiency syndrome education and intervention among college students, especially emphasizing making friends and advocating safe sex to prevent the spread of the disease.
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Affiliation(s)
- Zhongrong Yang
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Weiyong Chen
- Department of HIV/STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Meihua Jin
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Wanjun Chen
- Department of HIV/STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Xin Zhou
- Department of HIV/STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Hui Wang
- Department of HIV/STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Lin Chen
- Department of HIV/STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Tingting Jiang
- Department of HIV/STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
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Correlations between drug use, HIV disclosure and interpersonal communication on sexual risk behaviour of HIV-positive men who have sex with men. BMC Proc 2020; 14:20. [PMID: 33292259 PMCID: PMC7722415 DOI: 10.1186/s12919-020-00200-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background The Human Immunodeficiency Virus (HIV) epidemic is a global health problem whose number of cases are always higher among men who have sex with men (MSM). Most existing MSM have moderate and very high risk behaviour in HIV transmission. This study was designed to identify correlations between drug use, HIV disclosure and interpersonal communication patterns on sexual risk behaviour among HIV-positive MSM. Methods This study used a cross sectional design with a purposive sampling technique for participants who visited the voluntary counselling and testing (VCT) clinic in a referral hospital and snowball sampling technique for participants in the work area of a community health centre in Batam involving 126 HIV-positive MSM. Data were collected by 5 part questionnaire, namely demographic questionnaire, drug screening questionnaire, brief scale for HIV self disclosure, communication pattern questionnaire-short form, and safe sex behaviour questionnaire. Bivariate analysis was applied to determine whether there is a relationship between drug use, HIV disclosure, interpersonal communication and demographic characteristics (ethnicity, educational status) with sexual risk behaviour of MSM. Logistic regression analysis was used to explore the variables that most associated variable to sexual risk behaviour. The results The results showed that there was significant correlation between HIV disclosure and sexual risk behaviour (p = 0.019, α = 0.05, OR = 2.530) and significant correlation between interpersonal communication patterns and sexual risk behaviour (p = 0.016, α = 0.05, OR = 2.589). There is no significant correlation between demographic characteristics, namely: ethnicity and educational status with sexual behaviour at risk of MSM. In multiple logistic regression analysis, educational status was the factor that most associated with sexual risk behaviour among HIV-positive MSM (p = 0.027, α = 0.05, OR = 2.807, 95% CI = 1.125–7.006). Conclusions HIV disclosure and interpersonal communication patterns have a significant negative correlation with sexual risk behaviour among HIV-positive MSM. MSM with low HIV disclosure have high risk sexual behaviour opportunities. MSM with the closed interpersonal communication pattern also has a high risk of sexual behaviour. Education status was the most associated variable to sexual risk behaviour of HIV-positive MSM. Nurses as professional health workers need to improve comprehensive assessment, personal counselling and plan specific learning model by involving HIV-positive MSM in reducing HIV transmission from risky behaviour.
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HIV status disclosure by Nigerian men who have sex with men and transgender women living with HIV: a cross-sectional analysis at enrollment into an observational cohort. BMC Public Health 2020; 20:1282. [PMID: 32842997 PMCID: PMC7448976 DOI: 10.1186/s12889-020-09315-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/29/2020] [Indexed: 11/10/2022] Open
Abstract
Background Men who have sex with men (MSM) and transgender women (TGW) are disproportionately impacted by HIV and may face barriers to HIV status disclosure with negative ramifications for HIV prevention and care. We evaluated HIV status disclosure to sexual partners, HIV treatment outcomes, and stigma patterns of MSM and TGW in Abuja and Lagos, Nigeria. Methods Previously-diagnosed MSM and TGW living with HIV who enrolled in the TRUST/RV368 cohort from March 2013 to August 2018 were asked, “Have you told your (male/female) sexual partners (MSP/FSP) that you are living with HIV?” In separate analyses, robust Poisson regression models were used to estimate risk ratios (RRs) and 95% confidence intervals (95% CIs) for characteristics associated with HIV status disclosure to MSP and FSP. Self-reported stigma indicators were compared between groups. Results Of 493 participants living with HIV, 153 (31.0%) had disclosed their HIV status to some or all MSP since being diagnosed. Among 222 with FSP, 34 (15.3%) had disclosed to some or all FSP. Factors independently associated with disclosure to MSP included living in Lagos (RR 1.58 [95% CI 1.14–2.20]) and having viral load < 50 copies/mL (RR 1.67 [95% CI 1.24–2.25]). Disclosure to FSP was more common among participants who were working in entertainment industries (RR 6.25 [95% CI 1.06–36.84]) or as drivers/laborers (RR 6.66 [95% CI 1.10–40.36], as compared to unemployed) and also among those married/cohabiting (RR 3.95 [95% CI 1.97–7.91], as compared to single) and prescribed ART (RR 2.27 [95% CI 1.07–4.83]). No differences in self-reported stigma indicators were observed by disclosure status to MSP but disclosure to FSP was associated with a lower likelihood of ever having been assaulted (26.5% versus 45.2%, p = 0.042). Conclusions HIV status disclosure to sexual partners was uncommon among Nigerian MSM and TGW living with HIV but was associated with improved HIV care outcomes. Disclosure was not associated with substantially increased experiences of stigma. Strategies to encourage HIV status disclosure may improve HIV management outcomes in these highly-marginalized populations with a high burden of HIV infection.
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Chiou PY, Liao PH, Liu CY, Hsu YT. Effects of mobile health on HIV risk reduction for men who have sex with men. AIDS Care 2019; 32:316-324. [PMID: 31558040 DOI: 10.1080/09540121.2019.1668531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Mobile health (M-Health) has become a novel method for HIV prevention and the effects need to be promoted. The study purpose was to exam how a smartphone application (app) reduces HIV risky behaviour in men who have sex with men (MSM). The Safe Behaviour and Screening (SBS) app was developed, and included five features: record, output, and resources connection; information provision; testing services; interaction; and online statistics. A random assignment was used. The experimental group used the SBS app for six months. The control group did not use any intervention. There were 130 participants in the experimental group, and 135 in the control group. The average age of all subjects was 27.38 (SD = 5.56). Compared to the control group, the experimental group had significantly higher mean score of safe behaviour knowledge, motivation, and skills; percentage of condom use during anal intercourse; frequency of searching for testing resources and getting HIV and syphilis tests. The frequency of anal intercourse and recreational drug usage were significantly lower in the experimental group. The SBS app could decrease the HIV risky behaviour among MSM and be applied to HIV prevention and nursing intervention.
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Affiliation(s)
- Piao-Yi Chiou
- Department of Nursing, Medical College, National Taiwan University, Taipei City, Taiwan (R.O.C)
| | - Pei-Hung Liao
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan (R.O.C.)
| | - Chieh-Yu Liu
- Department of Speech language pathology and audiology, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan (R.O.C.)
| | - Yu-Tz Hsu
- Department of Infection, Mackay Memorial Hospital, Taipei City, Taiwan (R.O.C.)
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10
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Behavioral interventions promoting HIV serostatus disclosure to sex partners among HIV-positive men who have sex with men: a systematic review. Int J Public Health 2019; 64:985-998. [PMID: 31250027 DOI: 10.1007/s00038-019-01275-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 06/15/2019] [Accepted: 06/19/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This review aimed to identify intervention components which were effective to promote disclosure of HIV status among men have sex with men (MSM) living with HIV, particularly from a theoretical perspective. METHODS A systematic review was performed through searching electronic databases, HIV-related conferences websites, and registered ongoing randomized controlled trials. Studies were included if they reported intervention evaluation results related to HIV disclosure and published before December 31, 2017. Two independent reviewers collected studies and extracted data. RESULTS Eight studies met the inclusion criteria and were summarized. Interventions appeared effective in promoting HIV disclosure to their sex partners among MSM living with HIV if they were theory based (e.g., consequence theory and social cognitive theory). Key elements of effective interventions consisted of increasing disclosure self-efficacy, highlighting disclosure benefits, assisting risk assessment, developing disclosure strategy, and using messages under social influence. CONCLUSIONS Findings of this review imply that future interventions are more likely to succeed if they apply consequence theory, social cognitive theory, and trans-theoretical model of behavior change and include multiple key intervention components.
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Cao W, Mo PKH, Lau JTF. Validation of the Outcome Expectancy Scale for HIV Serostatus Disclosure to Female Sex Partners Among Men Who Have Sex with Men and Women Living with HIV in China. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:604-617. [PMID: 30912477 DOI: 10.1080/0092623x.2019.1599090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The study aimed to develop an instrument, Outcome Expectancy Scale (OES), to assess outcome expectancies regarding disclosing HIV-positive status to the regular female sex partner (i.e. girlfriend, wife) based on a cross-sectional survey among 217 men who have sex with men and women living with HIV. We developed the positive OES and negative OES, and five factors were identified for each of them by the Exploratory Factor Analysis, respectively. The psychometric properties were satisfactory. This 30-item OES was valid and reliable in assessing outcome expectancies, and it could be used to inform intervention design and theory development.
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Affiliation(s)
- Wangnan Cao
- Division of Behavioral Health and Health Promotion, JC School of Public Health and Primary Care, The Chinese University of Hong Kong , HKSAR , China
| | - Phoenix Kit-Han Mo
- Division of Behavioral Health and Health Promotion, JC School of Public Health and Primary Care, The Chinese University of Hong Kong , HKSAR , China
| | - Joseph Tak-Fai Lau
- Division of Behavioral Health and Health Promotion, JC School of Public Health and Primary Care, The Chinese University of Hong Kong , HKSAR , China
- Shenzhen Research Institute, The Chinese University of Hong Kong , Shenzhen , China
- School of Public Health, Zhejiang University School of Medicine , Hangzhou , China
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12
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Serovich JM, Laschober TC, Brown MJ, Kimberly JA. Evaluation of HIV Disclosure Behavior Following a Randomized Controlled Disclosure Intervention for Men Who Have Sex with Men Living with HIV. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2051-2059. [PMID: 29143157 PMCID: PMC5953765 DOI: 10.1007/s10508-017-1055-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 05/30/2023]
Abstract
Preventing the transmission of HIV, especially among high-risk populations, is a U.S. public health priority. Interventions aimed at easing the burden of HIV disclosure to casual sexual partners among men who have sex with men (MSM) living with HIV are essential in this endeavor. This randomized controlled study evaluated differences in disclosure behavior between a disclosure intervention (DI) and attention control case management (ACCM) group for MSM living with HIV (N = 315) and determinants (self-efficacy, outcome expectancy) of disclosure. Mixed-effects models results showed no significant differences in disclosure behavior between the DI and ACCM groups. Further, disclosure behavior changed in a curvilinear manner over 12 months and benefited from a booster session. Both disclosure self-efficacy and outcome expectancy predicted disclosure behavior. Interventions targeting HIV disclosure among MSM living with HIV should focus on improving perceptions of disclosure self-efficacy and outcome expectancy and include a booster session to facilitate HIV disclosure.
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Affiliation(s)
- Julianne M Serovich
- College of Behavioral and Community Sciences, University of South Florida, 13301 Bruce B. Downs Blvd., MHC 1110, Tampa, FL, 33612, USA.
| | - Tanja C Laschober
- College of Behavioral and Community Sciences, University of South Florida, 13301 Bruce B. Downs Blvd., MHC 1110, Tampa, FL, 33612, USA
| | - Monique J Brown
- College of Behavioral and Community Sciences, University of South Florida, 13301 Bruce B. Downs Blvd., MHC 1110, Tampa, FL, 33612, USA
| | - Judy A Kimberly
- College of Behavioral and Community Sciences, University of South Florida, 13301 Bruce B. Downs Blvd., MHC 1110, Tampa, FL, 33612, USA
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13
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Factors Affecting Intention to Disclose HIV Status among Adult Population in Sarawak, Malaysia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2018; 2018:2194791. [PMID: 30186334 PMCID: PMC6116389 DOI: 10.1155/2018/2194791] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/16/2018] [Indexed: 11/19/2022]
Abstract
Background Disclosure of HIV-positive status is an essential prerequisite for the prevention and care of person living with HIV/AIDS as well as to tackle hidden epidemic in the society. Objective To determine the intention to disclose the HIV/AIDS status among adult population in Sarawak, Malaysia, and factors affecting thereof. Methods This cross-sectional community-based study was conducted among adult population aged 18 years and above in Sarawak, Malaysia. A gender-stratified multistage cluster sampling technique was adopted to select the participants. A total of 900 respondents were successfully interviewed by face-to-face interview using interview schedule. Stepwise binary logistic regression models were fitted in SPSS version 22.0 to identify the factors associated with the disclosure of HIV/AIDS status. A p value less than 0.05 was considered as statistically significant. Results The mean (SD) age of male and female respondents was 41.57 (13.45) and 38.99 (13.09) years, respectively. A statistically significant difference of intention to disclosure of HIV status was found between males and females (p < 0.05). A stepwise binary logistic regression analysis revealed that age, occupation, knowledge on HIV transmission, and content of discussion about HIV/AIDS appeared to be potential predictors for male respondents to disclose HIV status, while ethnicity and content of discussion on HIV/AIDS were found to be important predictors among the female respondents (p < 0.05). Conclusion and Recommendation Though the study did not depict the national prevalence of disclosure of HIV/AIDS status, the findings of the study would provide an important basic information for programme intervention, policy, and future research agenda.
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Al-Ajlouni YA, Park SH, Schneider JA, Goedel WC, Rhodes Hambrick H, Hickson DA, Cantor MN, Duncan DT. Partner meeting venue typology and sexual risk behaviors among French men who have sex with men. Int J STD AIDS 2018; 29:1282-1288. [PMID: 29973129 DOI: 10.1177/0956462418775524] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Previous research has given considerable attention to venues where men who have sex with men (MSM) meet their sex partners. However, no previous study examined a vast range of sexual risk behaviors. The objective of this study was to examine the association between the types of venues for meeting sexual partners, condomless anal intercourse, engagement in group sex, and HIV and sexually transmitted infection (STI) risk among a sample of MSM. Users of a popular geosocial-networking app in Paris were provided an advertisement with text encouraging them to complete an anonymous web-based survey ( n = 580), which included questions about sex-seeking venues, condomless anal intercourse, HIV status and STI history, and sociodemographic characteristics. A log-binomial model was used to assess association between venues (i.e. public venues [gay clubs, bars, and discos], cruising venues [such as gay saunas, beaches, and parks], and internet-based venues [internet chat sites and geosocial-networking apps]), condomless anal intercourse, engagement in group sex, and HIV infection as well as infection with other STIs, after adjustment for sociodemographics. In multivariable models, attending cruising venues was associated with condomless receptive anal intercourse (adjusted relative risk [aRR] = 1.47; 95% confidence interval [CI] = 1.20-1.81), any kind of condomless anal intercourse (aRR = 1.34; 95% CI = 1.14-1.58), an STI (aRR = 1.50; 95% CI = 1.09-2.05), engagement in group sex (aRR = 1.42; 95% CI = 1.27-1.59), and multiple partners for both condomless insertive (aRR = 2.00; 95% CI = 1.38-2.88), and receptive (aRR = 1.70; 95% CI = 1.23-2.36) anal intercourse, STI infection (aRR = 1.50, 95% CI = 1.09-2.05) and HIV infection (aRR = 1.76; 95% CI = 1.05-2.96). No associations were found with other venue types and sexual risk behaviors, STIs, and HIV infection, except for group sex, which was associated with all venue types. Use of cruising where the primary aim is to have sex was found to be associated with risky sexual behavior. Risky behavior reduction strategies such as preexposure prophylaxis campaigns should be targeted to MSM who frequent cruising venues.
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Affiliation(s)
- Yazan A Al-Ajlouni
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Su H Park
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - John A Schneider
- 2 Departments of Medicine and Public Health Sciences, University of Chicago School of Medicine, Chicago, IL, USA.,3 Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - William C Goedel
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - H Rhodes Hambrick
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | | | - Michael N Cantor
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Dustin T Duncan
- 1 Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
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15
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Chen L, Lian D, Wang B. Factors associated with disclosing men who have sex with men (MSM) sexual behaviors and HIV-positive status: A study based on a social network analysis in Nanjing, China. PLoS One 2018; 13:e0196116. [PMID: 29672596 PMCID: PMC5908074 DOI: 10.1371/journal.pone.0196116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 04/08/2018] [Indexed: 11/18/2022] Open
Abstract
Objective We explored the factors associated with disclosure of men who have with sex with men (MSM) behaviors and HIV-positive status among HIV-positive MSM in Nanjing, China. Methods Social network analysis and epidemiological methods were combined in this pilot study. Information about participants’ (egos’) characteristics and behaviors and their social network members (alters) were collected through interview-administered questionnaires. General estimating equation logistic regression analysis was applied in both univariate and multivariate analysis. Results Eighty-seven HIV-positive MSM participated. Their mean age was 35.9 ±13.81years. They were more likely to disclose their MSM behavior to their friends [adjust Odds Ratio (AOR) = 6.43, 95% confidence interval (CI):3.08–13.42] or to the social network members who were not heterosexual [AOR = 4.40, 95%CI: 2.17–8.91]. Being participants’ friends [AOR = 5.16, 95%CI: 2.03–13.10] or family members [AOR = 6.22, 95%CI: 2.52–15.33] was significantly associated with HIV-positive status disclosure. Conclusion HIV-positive MSM tended to disclose their MSM behaviors and HIV positive status to close friends, family members or other individuals who were HIV-positive, engaging in MSM behavior, or both. Consequently, it will be an effective way to implement HIV prevention and intervention strategies in both MSM population and their trusted social networks.
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Affiliation(s)
- Lusi Chen
- Department of Epidemiology and Health statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Dashuai Lian
- Department of Epidemiology and Health statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Bei Wang
- Department of Epidemiology and Health statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
- * E-mail:
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16
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Uthappa CK, Allam RR, Pant R, Pal S, Dinaker M, Oruganti G, Yeldandi VV. Pre-exposure prophylaxis: awareness, acceptability and risk compensation behaviour among men who have sex with men and the transgender population. HIV Med 2017; 19:243-251. [PMID: 29178158 DOI: 10.1111/hiv.12572] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This exploratory study examined the facilitators of and barriers to acceptance of pre-exposure prophylaxis (PrEP) and potential risk compensation behaviour emerging from its use among men who have sex with men (MSM) and transgender individuals (TGs) in India. METHODS A questionnaire was administered to 400 individuals registered with a targeted intervention programme. Logistic regression models were used to identify facilitators of and barriers to PrEP acceptance. RESULTS The respondents consisted of 68% MSM and 32% TGs. Risk behaviour categorization identified 40% as low risk, 41% as medium risk and, 19% as high risk for HIV infection. About 93% of the respondents were unaware of PrEP, but once informed about it, 99% were willing to use PrEP. The facilitators of PrEP acceptance were some schooling [odds ratio (OR) 2.16; P = 0.51], being married or in a live-in relationship (OR 2.08; P = 0.46), having a high calculated risk (OR 3.12; P = 0.33), and having a high self-perceived risk (OR 1.8; P = 0.35). Increasing age (OR 2.12; P = 0.04) was a significant barrier. TGs had higher odds of acceptance of PrEP under conditions of additional cost (OR 2.12; P = 0.02) and once-daily pill (OR 2.85; P = 0.04). Individuals identified as low risk for HIV infection showed lower odds of potential risk compensation, defined as more sexual partners (OR 0.8; P = 0.35), unsafe sex with new partners (OR 0.71; P = 0.16), and decreased condom use with regular partners (OR 0.95; P = 0.84), as compared with medium-risk individuals. The associations, although not statistically significant, are nevertheless important for public health action given the limited scientific evidence on PrEP use among MSM and TGs in India. CONCLUSIONS With high acceptability and a low likelihood of risk compensation behaviour, PrEP can be considered as an effective prevention strategy for HIV infection among MSM and TGs in India.
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Affiliation(s)
- C K Uthappa
- Department of Health Research, SHARE India, Hyderabad, India
| | - R R Allam
- Department of Health Research, SHARE India, Hyderabad, India
| | - R Pant
- Department of Health Research, SHARE India, Hyderabad, India
| | - S Pal
- Prantakatha, New Delhi, India
| | - M Dinaker
- GYD Diagnostics and Reference Laboratories (P) Ltd, Secunderabad, India
| | - G Oruganti
- Department of Health Research, SHARE India, Hyderabad, India.,GYD Diagnostics and Reference Laboratories (P) Ltd, Secunderabad, India
| | - V V Yeldandi
- Department of Health Research, SHARE India, Hyderabad, India.,GYD Diagnostics and Reference Laboratories (P) Ltd, Secunderabad, India.,College of Medicine, University of Illinois, Chicago, IL, USA
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Hojilla JC, Mehrotra M, Truong HHM, Glidden DV, Amico KR, McMahan V, Vlahov D, Chariyalertsak S, Guanira JV, Grant RM, For The iPrEx Study Team. HIV sero disclosure among men who have sex with men and transgender women on HIV pre-exposure prophylaxis. AIDS Care 2017; 30:466-472. [PMID: 29082776 DOI: 10.1080/09540121.2017.1394437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
HIV pre-exposure prophyalxis (PrEP) might lead individuals to view serodisclosure as unnecessary. We examined the prevalence of non-disclosure and lack of knowledge of partner status in a global cohort of men who have sex with men (MSM) and transgender women (TW) enrolled in the iPrEx Open Label Extension (OLE). We calculated prevalence ratios by fitting a logistic model and estimating predicted probabilities using marginal standardization. Prevalence of non-disclosure and lack of knowledge of partner status were highest in Thailand (73% and 74%, respectively) and lowest in the USA (23% and 37%, respectively). In adjusted analyses, PrEP use was not significantly associated with non-disclosure or lack of knowledge of partner status (p-values>0.05). We found that relationship characteristics were significantly associated with both outcomes. Non-disclosure was higher among casual (adjusted prevalence ratio [aPR] 1.54, [95% confidence interval 1.24-1.84]) and transactional sex partners (aPR 2.03, [1.44-2.62]), and among partners whom participants have known only minutes or hours before their first sexual encounter (aPR 1.62, [1.33-1.92]). Similarly, participants were less likely to know the HIV status of casual partners (aPR 1.50, [1.30-1.71]), transactional sex partners (aPR 1.62, [1.30-1.95]), and those they have known for only days or weeks (aPR 1.13, [0.99-1.27]) or minutes or hours (aPR 1.27, [1.11-1.42]). Our findings underscore the role of dyadic factors in influencing serodisclosure. Comprehensive risk reduction counseling provided in conjunction with PrEP that address relationship characteristics are needed to help patients navigate discussions around HIV status.
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Affiliation(s)
- J Carlo Hojilla
- a School of Nursing , University of California , San Francisco , CA , USA
| | - Megha Mehrotra
- b Department of Epidemiology and Biostatistics , University of California , San Francisco , CA , USA.,c Gladstone Institute of Virology and Immunology , San Francisco , CA , USA
| | - Hong-Ha M Truong
- d Center for AIDS Prevention Studies , University of California , San Francisco , CA , USA
| | - David V Glidden
- b Department of Epidemiology and Biostatistics , University of California , San Francisco , CA , USA
| | - K Rivet Amico
- e School of Public Health , University of Michigan , Ann Arbor , MI , USA
| | - Vanessa McMahan
- c Gladstone Institute of Virology and Immunology , San Francisco , CA , USA
| | - David Vlahov
- f School of Nursing , Yale University , New Haven , CT
| | | | | | - Robert M Grant
- c Gladstone Institute of Virology and Immunology , San Francisco , CA , USA.,i School of Medicine , University of California , San Francisco
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Abstract
The main aim of this review article is to outline the factors linked to vulnerability of women to HIV infection and to understand the challenges and possible management of HIV among women. The review is a theoretical endeavour to understand women’s experiences of living with HIV. This review primarily focuses on studies in the Indian set-up, but to further substantiate the arguments and describe the relevant concepts it also takes into account literature from other cultures. On the basis of studies included in this article, it can be surmised that women are more susceptible to HIV due to cultural barriers, health vulnerabilities and social structures. They show less awareness about the treatment facilities, prevention strategies and perceived risk of infection. Women have to face numerous challenges after the infection, such as lack of social support, a higher level of stigma and discrimination, decreased quality of life, mental health issues and adverse coping. To prevent the spread of HIV among women as well as men, it is necessary to plan strategies which deal with empowerment of women, education and awareness regarding the vulnerabilities and knowledge and challenges of HIV infection. There is also a need to address the management of HIV among the infected and even those at risk. This article describes the possible interventions based on existing literature. The review also attempts to suggest certain future directions for the research.
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Affiliation(s)
- Anu Malik
- Research Scholar in Psychology, Department of Humanities and Social Sciences, Indian Institute of Technology, Kanpur, India
| | - Shikha Dixit
- Professor in Psychology, Department of Humanities and Social Sciences, Indian Institute of Technology, Kanpur, India
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Gama A, Abecasis A, Pingarilho M, Mendão L, Martins MO, Barros H, Dias S. Cruising Venues as a Context for HIV Risky Behavior Among Men Who Have Sex With Men. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1061-1068. [PMID: 26987977 DOI: 10.1007/s10508-016-0707-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/01/2015] [Accepted: 02/05/2016] [Indexed: 06/05/2023]
Abstract
We examined differences in sexual risk behaviors, HIV prevalence, and demographic characteristics between men who have sex with men (MSM) who visit different types of venues to meet sexual partners, and identified correlates of high-risk behaviors. A cross-sectional behavioral survey was conducted with a venue-based sample of 1011 MSM in Portugal. Overall, 36.3 % of MSM usually visit cruising venues to meet sexual partners (63.7 % only visit social gay venues). Cruising venues' visitors reported higher HIV prevalence (14.6 % [95 % CI 11-18 %] vs. 5.5 % [95 % CI 4-7 %]). Visiting cruising venues was more likely among those older, reporting high number of male sexual partners, group sex, and unprotected anal sex with a partner whose HIV status was unknown. Cruising venues play an important role in increasing risk of HIV transmission among MSM who frequent them. Venue-focused behavioral interventions that promote healthy sexual behaviors are needed.
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Affiliation(s)
- Ana Gama
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n. 100, 1349-008, Lisbon, Portugal.
| | - Ana Abecasis
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n. 100, 1349-008, Lisbon, Portugal
| | - Marta Pingarilho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n. 100, 1349-008, Lisbon, Portugal
| | - Luís Mendão
- Grupo Português de Ativistas sobre Tratamentos de VIH/SIDA, Lisbon, Portugal
| | - Maria O Martins
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n. 100, 1349-008, Lisbon, Portugal
| | - Henrique Barros
- Institute of Public Health of University of Porto, University of Porto Medical School, Porto, Portugal
| | - Sónia Dias
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, n. 100, 1349-008, Lisbon, Portugal
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20
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Souleymanov R, Huang YT. 'Men who use the Internet to seek sex with men': Rethinking sexuality in the transnational context of HIV prevention. Glob Public Health 2016; 11:888-901. [PMID: 27142110 DOI: 10.1080/17441692.2016.1180701] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
MISM (i.e. men who use the Internet to seek sex with men) has emerged in public health literature as a population in need of HIV prevention. In this paper, we argue for the importance of rethinking the dominant notions of the MISM category to uncover its ethnocentric and heteronormative bias. To accomplish this, we conducted a historical, epistemological and transnational analysis of social sciences and health research literature (n = 146) published on MISM between 2000 and 2014. We critically unravel the normative underpinnings of 'westernised' knowledge upon which the MISM category is based. We argue that the essentialist approach of Western scholarship can homogenise MISM by narrowly referring to behavioural aspects of sexuality, thereby rendering multiple sexualities/desires invisible. Furthermore, we argue that a Eurocentric bias, which underlies the MISM category, may hinder our awareness of the transnational dynamics of sexual minority communities, identities, histories and cultures. We propose the conceptualisation of MISM as hybrid cultural subjects that go beyond transnational and social boundaries, and generate conclusions about the future of the MISM category for HIV prevention and health promotion.
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Affiliation(s)
- R Souleymanov
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - Y-T Huang
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
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21
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Rönn M, White PJ, Hughes G, Ward H. Developing a conceptual framework of seroadaptive behaviors in HIV-diagnosed men who have sex with men. J Infect Dis 2015; 210 Suppl 2:S586-93. [PMID: 25381379 PMCID: PMC4231642 DOI: 10.1093/infdis/jiu482] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Seroadaptive behaviors are strategies employed by men who have sex with men (MSM) to reduce the transmission risk for human immunodeficiency virus (HIV). It has been suggested that they contribute to the increasing diagnoses of sexually transmitted infections in HIV-diagnosed MSM. To understand the context in which the reemerging sexually transmitted infections appear, we developed a social epidemiological model incorporating the multiple factors influencing seroadaptive behaviors. METHODS A literature review of seroadaptive behaviors in HIV-diagnosed MSM was conducted. The literature was synthesized using a social epidemiological perspective. RESULTS Seroadaptive behaviors are adopted by MSM in high-income countries and are a way for HIV-diagnosed men to manage and enjoy their sexual lives. Influences are apparent at structural, community, interpersonal, and intrapersonal levels. There is little evidence of whether and when the behavior forms part of a premeditated strategy; it seems dependent on the social context and on time since HIV diagnosis. Social rules of HIV disclosure and perception of risk depend on the setting where partners are encountered. CONCLUSIONS Seroadaptive behaviors are strongly context dependent and can reduce or increase transmission risk for different infectious diseases. Further data collection and mathematical modeling can help us explore the specific conditions in more detail.
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Affiliation(s)
- Minttu Rönn
- Department of Infectious Disease Epidemiology
| | - Peter J White
- MRC Centre for Outbreak Analysis and Modelling and NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control
| | - Gwenda Hughes
- STI Section, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
| | - Helen Ward
- Department of Infectious Disease Epidemiology
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22
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Wei C, Muessig KE, Bien C, Yang L, Meng R, Han L, Yang M, Tucker JD. Strategies for promoting HIV testing uptake: willingness to receive couple-based and collective HIV testing among a cross-sectional online sample of men who have sex with men in China. Sex Transm Infect 2014; 90:469-74. [PMID: 24760266 DOI: 10.1136/sextrans-2013-051460] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Low rates of HIV testing drive the rapidly growing HIV epidemic among men who have sex with men (MSM) in China. We examined the potential usefulness of couple-based and collective HIV testing strategies among Chinese MSM. METHODS A cross-sectional online survey was conducted among 1113 MSM in 2013. Multivariable logistic regression analyses were conducted to identify factors associated with willingness to receive couple-based and collective testing. RESULTS Acceptability of couple-based testing was very high among participants (86.1%), with a moderate level of interest in collective testing (43.2%). Being 'out' to others about one's sexual identity (adjusted OR (AOR)=1.48, 95% CI 1.01 to 2.17) and having ever had an HIV test (AOR=3.05, 95% CI 2.10 to 4.33) were associated with willingness to receive couple-based testing. Having multiple male anal sex partners in the past 3 months was associated with willingness to participate in collective testing (AOR=1.43, 95% CI 1.03 to 1.99). DISCUSSION Couple-based and collective HIV testing could help better control the HIV epidemic among Chinese MSM if implemented and promoted in a culturally competent manner.
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Affiliation(s)
- Chongyi Wei
- Department of Epidemiology and Biostatistics & Global Health Sciences, University of California-San Francisco, San Francisco, California, USA
| | - Kathryn E Muessig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA University of North Carolina Project-China, Guangzhou, China
| | - Cedric Bien
- University of North Carolina Project-China, Guangzhou, China Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ligang Yang
- Guangdong Provincial Center for STI Control and Prevention, Guangzhou, China
| | - Roger Meng
- Guangtong-Lingnan MSM Community Support Center, Guangzhou, China
| | - Larry Han
- University of North Carolina Project-China, Guangzhou, China School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Min Yang
- University of North Carolina Project-China, Guangzhou, China School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
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23
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Nguyen H, Nguyen HQ, Colby DJ. HIV knowledge and risks among Vietnamese men who have sex with men travelling abroad. Int J STD AIDS 2013; 25:643-9. [DOI: 10.1177/0956462413516098] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 11/17/2013] [Indexed: 11/17/2022]
Abstract
Rapid economic and social development in Vietnam has resulted in increased opportunities for travel and new potential routes of HIV transmission. We conducted a cross-sectional study examining demographics, knowledge, and sexual risk behaviour amongst 100 Vietnamese men who have sex with men who traveled abroad in the previous 12 months. Men who have sex with men surveyed were mostly university-educated, single, and under 30. Most travel (73%) was within Southeast Asia and was undertaken for tourism (51%) or for work (29%). Casual sex with a foreign partner occurred on 39% of trips. Only four were reported to have involved in unsafe sex with a casual partner. Four reported illicit drug use. Alcohol was widely consumed. Multivariate analysis showed that two variables, travelling alone (OR = 5.26, p < 0.001) and a university education (OR = 4.05, p = 0.004), were significantly associated with casual sex abroad. More HIV prevention education on the risks of sex while travelling abroad is needed for men who have sex with men in Vietnam.
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Affiliation(s)
- Huyen Nguyen
- Center for Applied Research on Men and Health, Ho Chi Minh City, Vietnam
| | - Hoang Quan Nguyen
- Center for Applied Research on Men and Health, Ho Chi Minh City, Vietnam
| | - Donn Joseph Colby
- Center for Applied Research on Men and Health, Ho Chi Minh City, Vietnam
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24
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Huang L, Nehl EJ, Lin L, Meng G, Liu Q, Ross MW, Wong FY. Sociodemographic and sexual behavior characteristics of an online MSM sample in Guangdong, China. AIDS Care 2013; 26:648-52. [PMID: 24124988 DOI: 10.1080/09540121.2013.844760] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Public health research and interventions often assume that men who have sex with men (MSM) who use the Internet in China have similar characteristics to those in Western countries, though with little empirical evidence. This study aimed to describe and examine the sociodemographic and basic sexual behavioral characteristics of an online sample of MSM in Guangdong, China. In 2010, a total of 1100 MSM were recruited from an lesbian, gay, bisexual, and transgender (LGBT)-oriented website and were asked about their sociodemographic and sexual behavior characteristics. The majority of the participants (77.9%) self-identified as homosexual, and the mean age was 30.0 years (SD = 6.7). About 80% of the participants had attained a college degree and only 4.8% were unemployed. About 60% had a monthly salary of more than CNY 3000 (476 USD), and more than 10% were married. The majority (71.7%) had used condoms in the last anal sex. Nearly half of the participants have never been tested for HIV or other sexually transmitted infections (STIs) (47.3% and 47.7%, respectively). More than 80% were willing to be contacted by researchers after the survey. Findings indicate that the sociodemographic characteristics of Chinese MSM who use the Internet are relatively similar to those in the Western countries. However, Chinese MSM are less likely to self-identify as homosexual and be tested for HIV and other STIs than Western MSM. On a positive note, Chinese MSM would be likely to engage in e-technology research showing potential feasibility of an online HIV/STI intervention.
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Affiliation(s)
- L Huang
- a GZTZ.ORG (XQ Solutions) , Guangzhou , PR China
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25
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Chua AC, Chen MIC, Cavailler P, Jiang L, Abdullah MR, Ng OT, Chio M, Koe S, Tay J, Wong ML, Chan R. Challenges of Respondent Driven Sampling to Assess Sexual Behaviour and Estimate the Prevalence of Human Immunodeficiency Virus(HIV) and Syphilis in Men Who Have Sex with Men (MSM) in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2013. [DOI: 10.47102/annals-acadmedsg.v42n7p350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There is a lack of representative samples to provide reliable and accurate seroprevalence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) as well as behavioural information among men who have sex with men (MSM) in Singapore. We used respondent driven sampling (RDS) to recruit MSM. Participants completed a survey used by Asian Internet MSM Sex Survey (AIMSS) and were tested for HIV and syphilis. We compared the characteristics of the RDS participants with STI diagnosis against those who did not have any STI diagnosis in the past 6 months. We compared RDS participants with AIMSS participants. Of 72 MSM recruited, 1 was positive for HIV (1.3%) and 4 (5.5%) tested positive for syphilis. Median age was 30 years and majority was Chinese (69.4%). RDS participants who had any STI diagnosis reported to have more use of recreational drugs (P = 0.006), and lower condom use (P = 0.054). Comparing RDS participants (n = 72) with the AIMSS participants (n = 2075), RDS respondents had ≥1 male partner in the past 6 months (P = 0.003), more casual sex partners (P = 0.012) and more STI symptoms (P = 0.019). There was no difference in terms of HIV testing and recreational drug use. The HIV and syphilis seroprevalence rates from our study are similar to previous reports conducted in high-risk MSM. In contrast to other settings, RDS did not work well among MSM in Singapore. The public health implications of our study highlight the challenges in obtaining data for HIV surveillance in assessing prevalence and risk behaviours among MSM.
Key words: Sexually transmitted infection (STI), Behaviour
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Affiliation(s)
| | | | | | - Lili Jiang
- Communicable Diseases Division, Ministry of Health, Singapore
| | | | | | | | - Stuart Koe
- Asia Pacific Coalition on Male Sexual Health (APCOM), Bangkok, Thailand
| | - Joanne Tay
- Communicable Diseases Division, Ministry of Health, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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26
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Klein H. Involvement in Specific HIV Risk Practices among Men Who Use the Internet to Find Male Partners for Unprotected Sex. JOURNAL OF ADDICTION 2013; 2013:826039. [PMID: 24826369 PMCID: PMC4008398 DOI: 10.1155/2013/826039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 02/21/2013] [Indexed: 11/17/2022]
Abstract
Purpose. Men who have sex with other men (MSM) account for more than one-half of all new HIV infections in the USA. This study reports on the prevalence of a variety of HIV risk behaviors in one specific subpopulation of risk-seeking MSM. Methods. The study was based on a national sample of 332 MSM who use the Internet to find partners for unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Results. Unprotected oral and anal sex was commonplace among study participants. Men engaged in a large number of other risky behaviors as well, including having had multiple recent sex partners (mean number = 11), simultaneous double-penile penetration of the anus (16%), eating semen out of another man's anus (17%), engaging in multiple-partner sexual encounters (47%), engaging in anonymous sex (51%), and having sex while "under the influence" (52%). Conclusions. HIV intervention and prevention programs need to address numerous behaviors that place MSM at risk for contracting/transmitting HIV. Merely focusing on unprotected anal sex does a disservice to members of this community, who typically engage in many types of behavioral risks, each of which requires addressing if HIV transmission rates are to be reduced.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, 401 Schuyler Road, Silver Spring, MD 20910, USA
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27
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Frasca T, Dowsett GW, Carballo-Diéguez A. The ethics of barebacking: Implications of gay men's concepts of right and wrong in the context of HIV. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2013; 25:10.1080/19317611.2013.764375. [PMID: 24416091 PMCID: PMC3886189 DOI: 10.1080/19317611.2013.764375] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Timothy Frasca
- HIV Center for Clinical & Behavioral Studies, New York State Psychiatric Institute/Columbia University, 1051 Riverside Drive, Unit 15, New York NY 10032, Tel (212) 568-4506 Fax (212) 543-6003
| | - Gary W. Dowsett
- Acting Director, Australian Research Centre in Sex, Health & Society, 215 Franklin Street, Latrobe University, Melbourne, Australia 3000
| | - Alex Carballo-Diéguez
- HIV Center for Clinical & Behavioral Studies, New York State Psychiatric Institute/Columbia University, 1051 Riverside Drive, Unit 15, New York NY 10032
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28
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Ng DHL. Into the Shadow: A Reflection on the Stigma of Human Immunodeficiency Virus (HIV) in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2012. [DOI: 10.47102/annals-acadmedsg.v41n12p625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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