1
|
Crowell TA, Nitayaphan S, Sirisopana N, Wansom T, Kitsiripornchai S, Francisco L, Li Q, Dear N, O'Connell RJ, Pitisuttithum P, Vasan S. Factors associated with testing for HIV and other sexually transmitted infections in men who have sex with men and transgender women in Bangkok, Thailand. AIDS Res Ther 2022; 19:25. [PMID: 35729561 PMCID: PMC9210729 DOI: 10.1186/s12981-022-00449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Routine screening for HIV and other sexually transmitted infections (STIs) facilitates early diagnosis and treatment, thereby preventing morbidity and onward transmission. We estimated the prevalence of prior HIV/STI testing among men who have sex with men (MSM) and transgender women (TGW) in Bangkok, Thailand, and identified factors associated with prior testing. Methods Cross-sectional analyses were performed using data collected at enrollment into an HIV incidence cohort. From April to October 2017, MSM and TGW were enrolled if they were aged 18–35 years, reported anal intercourse with a male or TGW partner, and reported behavioral vulnerability to HIV. Participants answered questions about demographics, sexual behaviors, and lifetime HIV/STI testing history. Multivariable robust Poisson regression was used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for factors potentially associated with prior testing. Results Among 1,014 participants, 348 (34.3%) were TGW and the median age was 21.6 (interquartile range 20.0-24.8) years. Prior testing for HIV was reported by 421 (41.5%) and for other STIs by 268 (26.4%). HIV testing was more common among participants aged ≥ 22 years (RR 1.37 [95% CI 1.13–1.67]), with college education as compared to secondary or less (RR 1.37 [95% CI 1.08–1.72]), and who met male sexual partners online (RR 1.52 [95% CI 1.24–1.85]), but lower among participants attracted to both men and women as compared to men only (RR 0.64 [95% CI 0.51–0.81]) and who met male sexual partners in bars (RR 0.83 [95% CI 0.72–0.97]). Similar associations were observed with prior testing for other STIs, including increased testing among participants with college education (RR 1.52 [95% CI 1.11–2.09]) and who met male sexual partners online (RR 1.73 [95% CI 1.30–2.31]), but lower among participants attracted to both men and women (RR 0.70 [95% CI 0.51–0.96]) and who met male sexual partners in bars (RR 0.67 [95% CI 0.54–0.83]). Conclusions Despite behavioral vulnerability, prior testing for HIV and other STIs was uncommon. Online engagement strategies may be effectively reaching Thai MSM and TGW who meet sexual partners online, but new interventions are needed to encourage testing among younger, less educated, and bisexual MSM and TGW.
Collapse
Affiliation(s)
- Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA. .,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
| | | | | | - Tanyaporn Wansom
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.,Dreamlopments Social Enterprise and Foundation, Bangkok, Thailand
| | | | - Leilani Francisco
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Qun Li
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Nicole Dear
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Robert J O'Connell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | - Sandhya Vasan
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | | |
Collapse
|
2
|
Mapping and size estimation of men who have sex with men in virtual platforms in Delhi, India. PLoS One 2022; 17:e0262094. [PMID: 35051213 PMCID: PMC8775339 DOI: 10.1371/journal.pone.0262094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 12/16/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction In India, the HIV epidemic is concentrated among Key Populations (KPs), such as men who have sex with men (MSM), who bear a disproportionate burden of HIV disease. Conventional targeted interventions (TI) mitigate HIV transmission among MSM by focusing on physical hotspots. As increasingly, there is a shift within India’s MSM community to connect with sex partners online, novel approaches are needed to map virtual platforms where sexual networks are formed. The objective of this study was to estimate the number of MSM in Delhi using virtual platforms to connect for sex and to describe patterns of their use. Methods The study was conducted in the state of Delhi among MSM over 18 years of age who used virtual platforms to look for sexual partners. Virtual platforms were identified through community consultations. Size estimation was carried out by enumerating the number of online users, accounting for duplication across sites and time and based on interviews with 565 MSM. Results 28,058 MSM (95% CI: range 26,455–29,817) use virtual sites to find sexual partners. We listed 14 MSM specific virtual sites, 14 general virtual sites, 19 social networking pages and 112 messenger groups, all used by MSM. Five virtual sites met feasibility criteria to be included in the virtual mapping. Of the MSM on these sites, 81% used them at night and 94% used them on Sundays, making these the peak time and day of use. Only 16% of users were aware of organizations providing HIV services and 7% were contacted by peer educators in the preceding three months. Two-fifths (42%) also visited a physical location to connect with sexual partners in the month prior to the study. Discussion TI programs that focus on physical hotspots do not reach the majority of MSM who use virtual sites. MSM active on virtual sites have a low awareness of HIV services. Virtual mapping and programmatic interventions to include them must be incorporated into current public health interventions to reach MSM at risk of HIV.
Collapse
|
3
|
Promoting Sexual Health Knowledge through a Social Workers' Mentorship Programme: A Study of Gay Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115619. [PMID: 34070264 PMCID: PMC8197366 DOI: 10.3390/ijerph18115619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 11/16/2022]
Abstract
Mentorship of counselling for men who have sex with other men and gay youths is understudied. The purpose of this study was to explore the effectiveness of how the Mentor Modelling Programme may increase the sexual health knowledge and practices of gay youths. As an expansion of a previous study with the application of the conceptual framework, this study mapped a sexual health promotion plan and the six-month-long Mentor Modelling Programme with the coordination of eight health and social care professionals and 40 gay youths. The researcher found positive and supportive feedback of how the Mentor Modelling Programme could increase sexual health knowledge, promote long-term relationships, and encourage referral of other vulnerable people. The results indicated two directions. The first solicited the perspectives of health and social care professionals and gay youths on how they would describe the relationship, application to, and experience of the Mentor Modelling Programme and second, assessed how this Mentor Modelling Programme influenced and changed the ideas and senses about counselling services and mentorship. This study reflected the current limited sexual promotion between traditional and inclusive sexual health materials. It further indicated the necessary concerns and areas of attention needed to upgrade the materials and host inclusive sexual health materials for both youths and adults in the communities.
Collapse
|
4
|
Emmanuel F, Kioko J, Musyoki H, Kaosa S, Ongaro MK, Kuria S, Olango K, Musimbi J, Walimbwa J, Blanchard J, Isac S, Bhattacharjee P. Mapping virtual platforms to estimate the population size of men who have sex with men (MSM) who use internet to find sexual partners: implications to enhance HIV prevention among MSM in Kenya. Gates Open Res 2020; 4:131. [PMID: 33089073 PMCID: PMC7550793 DOI: 10.12688/gatesopenres.13158.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction: Men who have sex with men (MSM) in Kenya face a disproportionate HIV disease burden. Over the last few years, the use of virtual platforms and internet sites to seek male sexual partners has increased manyfold in Kenya. New approaches are required to map, estimate and profile MSM who operate through virtual platforms to design interventions for them. Methods: This study was conducted in three counties in Kenya: Kiambu, Kisumu and Mombasa with MSM who use virtual platforms such as geosocial networking (GSN) and social networking applications to find and connect with male sex partners. The platforms were profiled through a multi-stage approach and the number of MSM associated with these platforms were estimated. In the final stage, 435 respondents randomly selected from the virtual platforms were interviewed in a secure location after informed consent. Data analysis focused on calculating an estimate of MSM for each virtual platform in each site, adjusting for duplicate profiles and multiple registrations. Results: We identified 24 GSN apps, 18 Facebook accounts/pages and 18 WhatsApp groups across the three counties, with Facebook being the preferred platform. Kiambu had the highest number of estimated MSM at 3,635 (95%CI = 3,335 to 3,990) followed by Kisumu at 1,567 (95%CI = 1,480 to 1,665) and Mombasa at 1,469 (95%CI = 1,335 to 1,604) who used virtual platforms to find other male sexual partners. On average, each MSM had 3.7 profiles on multiple platforms, with an average of 2.1 profiles used in the past month. Conclusions: The use of conventional population size estimation approaches that focus on physical sites alone may underestimate the total number of MSM in a geography. Virtual mapping should be used in conjunction with conventional hot spot based size estimation methodologies to estimate numbers of MSM to set programmatic targets.
Collapse
Affiliation(s)
- Faran Emmanuel
- Institute of Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Japheth Kioko
- Partners for Health and Development in Africa, Nairobi, Kenya
| | - Helgar Musyoki
- National AIDS and STI Control Programme, Ministry of Health, Nairobi, Kenya
| | - Shem Kaosa
- Partners for Health and Development in Africa, Nairobi, Kenya
| | | | | | | | - Janet Musimbi
- Partners for Health and Development in Africa, Nairobi, Kenya
| | | | - James Blanchard
- Institute of Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Shajy Isac
- Institute of Global Public Health, University of Manitoba, Winnipeg, Canada
- India Health Action Trust, Delhi, India
| | - Parinita Bhattacharjee
- Institute of Global Public Health, University of Manitoba, Winnipeg, Canada
- Partners for Health and Development in Africa, Nairobi, Kenya
| |
Collapse
|
5
|
Chong SCS, Hollingshead BM, Lim SH, Bourne A. A scoping review of sexual transmission related HIV research among key populations in Malaysia: Implications for interventions across the HIV care cascade. Glob Public Health 2020; 16:1014-1027. [PMID: 32985388 DOI: 10.1080/17441692.2020.1822901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The Malaysian government has committed to 'Fast Tracking the HIV Response' to achieve UNAIDS 2030 targets to end AIDS. The epidemic is concentrated among key populations and has shifted from people who inject drugs to HIV infection through sexual transmission among men who have sex with men, sex workers and transgender people. The aim of this scoping review was to examine social and behavioural research published since 2005 that can inform understanding of each stage of the 90:90:90 treatment cascade (as proposed by UNAIDS), including HIV risk behaviours and testing practices that precede entry. We found a concentration of studies related to predictors or correlates of HIV infections (mostly among men who have sex with men) and a shortfall in literature pertaining to sex workers or transgender people. While several studies examined factors associated with HIV testing, only one examined uptake of antiretroviral therapy and two explored issues of treatment adherence. No study examined broader care and support of people living with HIV. To scale-up effective programmes and apprise investment to achieve the ambitious targets set-out in the Malaysian National HIV/AIDS Strategic Plan, a combination of comprehensive strategic information and evidence generated through primary research is critical.
Collapse
Affiliation(s)
- S C S Chong
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia.,Department of Public Health, La Trobe University, Melbourne, Australia
| | - B M Hollingshead
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
| | - S H Lim
- Centre of Excellence for Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia
| | - A Bourne
- Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia.,Sigma Research, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, UK
| |
Collapse
|
6
|
Emmanuel F, Kioko J, Musyoki H, Kaosa S, Ongaro MK, Kuria S, Olango K, Musimbi J, Walimbwa J, Blanchard J, Isac S, Bhattacharjee P. Mapping virtual platforms to estimate the population size of men who have sex with men (MSM) who use internet to find sexual partners: implications to enhance HIV prevention among MSM in Kenya. Gates Open Res 2020; 4:131. [PMID: 33089073 PMCID: PMC7550793 DOI: 10.12688/gatesopenres.13158.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2020] [Indexed: 03/31/2024] Open
Abstract
Introduction: Men who have sex with men (MSM) in Kenya face a disproportionate HIV disease burden. Over the last few years, the use of virtual platforms and internet sites to seek male sexual partners has increased manyfold in Kenya. New approaches are required to map, estimate and profile MSM who operate through virtual platforms to design interventions for them. Methods: This study was conducted in three counties in Kenya: Kiambu, Kisumu and Mombasa with MSM who use virtual platforms such as geosocial networking (GSN) and social networking applications to find and connect with male sex partners. The platforms were profiled through a multi-stage approach and the number of MSM associated with these platforms were estimated. In the final stage, 435 respondents randomly selected from the virtual platforms were interviewed in a secure location after informed consent. Data analysis focused on calculating an estimate of MSM for each virtual platform in each site, adjusting for duplicate profiles and multiple registrations. Results: We identified 24 GSN apps, 18 Facebook accounts/pages and 18 WhatsApp groups across the three counties, with Facebook being the preferred platform. Kiambu had the highest number of estimated MSM at 3,635 (95%CI = 3,335 to 3,990) followed by Kisumu at 1,567 (95%CI = 1,480 to 1,665) and Mombasa at 1,469 (95%CI = 1,335 to 1,604) who used virtual platforms to find other male sexual partners. On average, each MSM had 3.7 profiles on multiple platforms, with an average of 2.1 profiles used in the past month. Conclusions: The use of conventional population size estimation approaches that focus on physical sites alone may underestimate the total number of MSM in a geography. Virtual mapping should be used in conjunction with conventional hot spot based size estimation methodologies to estimate numbers of MSM to set programmatic targets.
Collapse
Affiliation(s)
- Faran Emmanuel
- Institute of Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Japheth Kioko
- Partners for Health and Development in Africa, Nairobi, Kenya
| | - Helgar Musyoki
- National AIDS and STI Control Programme, Ministry of Health, Nairobi, Kenya
| | - Shem Kaosa
- Partners for Health and Development in Africa, Nairobi, Kenya
| | | | | | | | - Janet Musimbi
- Partners for Health and Development in Africa, Nairobi, Kenya
| | | | - James Blanchard
- Institute of Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Shajy Isac
- Institute of Global Public Health, University of Manitoba, Winnipeg, Canada
- India Health Action Trust, Delhi, India
| | - Parinita Bhattacharjee
- Institute of Global Public Health, University of Manitoba, Winnipeg, Canada
- Partners for Health and Development in Africa, Nairobi, Kenya
| |
Collapse
|
7
|
Nguyen LH, Nguyen HLT, Larsson M, Tran BX, L Stein M, Rocha LEC, Strömdahl S. An exploratory assessment of the preference for eHealth interventions to prevent HIV and sexually transmitted infections among men who have sex with men in Hanoi, Vietnam. BMC Public Health 2020; 20:1387. [PMID: 32917157 PMCID: PMC7488431 DOI: 10.1186/s12889-020-09449-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 08/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Electronic health (eHealth) interventions are promising in HIV and sexually transmitted infections (STIs) prevention among men who have sex with men (MSM), given a high rate of the Internet use in this population. This study determined the preferences for eHealth interventions to prevent HIV and STIs among MSM in Hanoi, Vietnam to guide the development of future eHealth interventions. METHODS Five focus group discussions (FGD) were conducted with 35 MSM recruited by purposive sampling in January 2018 in Hanoi, Vietnam. The FGDs addressed attitudes towards the feasibility and uptake of HIV/STI interventions via online modalities such as smartphone applications (apps, social network sites, or emails); preferences and concerns regarding an online HIV/STI intervention. FGDs were audio-recorded and transcribed verbatim. Content analysis was used to determine themes. RESULTS MSM reported that they commonly searched for information regarding HIV/STI and sexual health on Facebook and a variety of mobile apps. They perceived a lack of reliable online sources, a high need, and interest for an online intervention. Most of them preferred short and concise messages without perceived sensitive words such as "HIV" or "STI". Diversity of online modalities were preferred with information from credible sources about HIV/STI symptoms, testing and treatment, safe sex practices and testing locations with a focus on safe MSM-friendly clinics. Concerns about the need to trust the organization behind the online information and interventions, and the importance of confidentiality when participating in online interventions were raised. CONCLUSION High acceptance and perceived need for an online HIV/STI intervention were reported. The importance of establishing trust within the MSM community as a reliable source of information was emphasized, as well as the importance of confidentiality.
Collapse
Affiliation(s)
- Long Hoang Nguyen
- Department of Global Public Health Sciences, Karolinska Institutet, SE-171 77, Stockholm, Sweden. .,Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.
| | | | - Mattias Larsson
- Department of Global Public Health Sciences, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Bach Xuan Tran
- Department of Health Economics, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,Department of Health, Behaviours, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mart L Stein
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Luis E C Rocha
- Department of Economics & Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Susanne Strömdahl
- Department of Global Public Health Sciences, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden
| |
Collapse
|
8
|
Martinez EZ, Morigi TZ, Galdino G, McFarland W, Zucoloto ML. Sex-seeking mobile application use and risk behavior among men who have sex with men in Brazil. Int J STD AIDS 2020; 31:1161-1168. [PMID: 32915700 DOI: 10.1177/0956462420945940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This is a cross-sectional study based on an open web survey with the primary objective to assess associations between the use of apps for seeking sex partners and vulnerabilities related to human immunodeficiency virus (HIV) acquisition among men who have sex with men (MSM) in Brazil. Participants were recruited to the study through ads posted in social media such as Twitter, Facebook, and WhatsApp. Consenting respondents completed a questionnaire on demographics, history of sexually transmitted infections (STIs), and risk behaviors and perceptions, including calculation of the Risk Behavior Score for HIV infection proposed by Rocha et al. Among the 859 participants, 714 (83.1%) reported they used apps for seeking sex partners. Use of apps for seeking sex partners was associated with high-risk behavior for HIV infection, self-reported syphilis, self-perception of HIV risk, and use of marijuana. The use of apps for seeking sex partners has rapidly become the norm for MSM in Brazil. The associations with STIs and risk behaviors should be seen as an opening to improve public health, presenting opportunities to promote knowledge, safer sex practices, and referral to HIV/STI screening and prevention interventions.
Collapse
Affiliation(s)
- Edson Zangiacomi Martinez
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP USP), Ribeirão Preto, Brazil
| | - Thais Zanin Morigi
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP USP), Ribeirão Preto, Brazil
| | - Guilherme Galdino
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP USP), Ribeirão Preto, Brazil.,Universidade de Ribeirão Preto (UNAERP), Ribeirão Preto, Brazil
| | | | - Miriane Lucindo Zucoloto
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP USP), Ribeirão Preto, Brazil
| |
Collapse
|
9
|
Bhattacharjee P, Isac S, Musyoki H, Emmanuel F, Olango K, Kuria S, Ongaro MK, Walimbwa J, Musimbi J, Mugambi M, Kaosa S, Kioko J, Njraini M, Melon M, Onyoni J, Bartilol K, Becker M, Lorway R, Pickles M, Moses S, Blanchard J, Mishra S. HIV prevalence, testing and treatment among men who have sex with men through engagement in virtual sexual networks in Kenya: a cross-sectional bio-behavioural study. J Int AIDS Soc 2020; 23 Suppl 2:e25516. [PMID: 32589341 PMCID: PMC7319161 DOI: 10.1002/jia2.25516] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION In Kenya, men who have sex with men (MSM) are increasingly using virtual sites, including web-based apps, to meet sex partners. We examined HIV testing, HIV prevalence, awareness of HIV-positive status and linkage to antiretroviral therapy (ART), for HIV-positive MSM who solely met partners via physical sites (PMSM), compared with those who did so in virtual sites (either solely via virtual sites (VMSM), or via both virtual and physical sites (DMSM)). METHODS We conducted a cross-sectional bio-behavioural survey of 1200 MSM, 15 years and above, in three counties in Kenya between May and July 2019, using random sampling of physical and virtual sites. We classified participants as PMSM, DMSM and VMSM, based on where they met sex partners, and compared the following between groups using chi-square tests: (i) proportion tested; (ii) HIV prevalence and (iii) HIV care continuum among MSM living with HIV. We then performed multivariable logistic regression to measure independent associations between network engagement and HIV status. RESULTS 177 (14.7%), 768 (64.0%) and 255 (21.2%), of participants were classified as PMSM, DMSM and VMSM respectively. 68.4%, 70.4% and 78.5% of PMSM, DMSM and VMSM, respectively, reported an HIV test in the previous six months. HIV prevalence was 8.5% (PMSM), 15.4% (DMSM) and 26.7% (VMSM), p < 0.001. Among those living with HIV, 46.7% (PMSM), 41.5% (DMSM) and 29.4% (VMSM) were diagnosed and aware of their status; and 40.0%, 35.6% and 26.5% were on antiretroviral treatment. After adjustment for other predictors, MSM engaged in virtual networks remained at a two to threefold higher risk of prevalent HIV: VMSM versus PMSM (adjusted odds ratio 3.88 (95% confidence interval (CI) 1.84 to 8.17) p < 0.001); DMSM versus PMSM (2.00 (95% CI 1.03 to 3.87), p = 0.040). CONCLUSIONS Engagement in virtual networks is associated with elevated HIV risk, irrespective of individual-level risk factors. Understanding the difference in characteristics among MSM-seeking partners in different sites will help HIV programmes to develop subpopulation-specific interventions.
Collapse
Affiliation(s)
- Parinita Bhattacharjee
- Centre for Global Public HealthUniversity of ManitobaWinnipegCanada
- Technical Support UnitPartners for Health and Development in AfricaNairobiKenya
| | - Shajy Isac
- Centre for Global Public HealthUniversity of ManitobaWinnipegCanada
- India Health Action TrustNew DelhiIndia
| | - Helgar Musyoki
- National AIDS and STI Control ProgrammeMinistry of HealthNairobiKenya
| | - Faran Emmanuel
- Centre for Global Public HealthUniversity of ManitobaWinnipegCanada
| | | | | | | | | | - Janet Musimbi
- Technical Support UnitPartners for Health and Development in AfricaNairobiKenya
| | - Mary Mugambi
- National AIDS and STI Control ProgrammeMinistry of HealthNairobiKenya
| | - Shem Kaosa
- Technical Support UnitPartners for Health and Development in AfricaNairobiKenya
| | - Japheth Kioko
- Technical Support UnitPartners for Health and Development in AfricaNairobiKenya
| | - Margret Njraini
- Technical Support UnitPartners for Health and Development in AfricaNairobiKenya
| | - Memory Melon
- Technical Support UnitPartners for Health and Development in AfricaNairobiKenya
| | - Juddie Onyoni
- Technical Support UnitPartners for Health and Development in AfricaNairobiKenya
| | - Kigen Bartilol
- National AIDS and STI Control ProgrammeMinistry of HealthNairobiKenya
| | - Marissa Becker
- Centre for Global Public HealthUniversity of ManitobaWinnipegCanada
| | - Robert Lorway
- Centre for Global Public HealthUniversity of ManitobaWinnipegCanada
| | | | - Stephen Moses
- Centre for Global Public HealthUniversity of ManitobaWinnipegCanada
| | - James Blanchard
- Centre for Global Public HealthUniversity of ManitobaWinnipegCanada
| | - Sharmistha Mishra
- St. Michael’s HospitalDepartment of MedicineUniversity of TorontoTorontoCanada
- Institute of Medical SciencesUniversity of TorontoTorontoCanada
- Institute of Health Policy Management and EvaluationDalla Lana School of Public HealthUniversity of TorontoTorontoCanada
| |
Collapse
|
10
|
Dangerfield DT, Carmack CC, Gilreath TD, Duncan DT. Latent classes of partner-seeking venues and sexual risk among men who have sex with men in Paris, France. Int J STD AIDS 2020; 31:502-509. [PMID: 32295477 DOI: 10.1177/0956462419899012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In France, men who have sex with men (MSM) experience the highest HIV incidence. MSM who use multiple venues such as bars and smartphone apps to find sexual partners have greater HIV and sexually transmitted infection risk than those who use a single physical or online venue. To explore the role of venues and sexual behavior on HIV risk, we used latent class analysis to highlight underlying profiles of 580 MSM in Paris, France. Three latent classes emerged: Multi-venue Users (19%), Non-serosorting App Users (49%), and Serosorting App Users (32%). Multi-venue Users had the highest probabilities of condomless receptive anal intercourse (CRAI) and condomless insertive anal intercourse (CIAI), group sex, and meeting partners at venues such as bars or online. Non-serosorting App Users had the lowest probabilities of CRAI, CIAI, and condomless serosorting. Serosorting App Users had an 87% chance of condomless serosorting. MSM reporting a pre-exposure prophylaxis history had 14 and 5 times the odds of being classified as Multi-venue Users and Serosorting App Users than Non-serosorting App Users. MSM were 3% more likely to be Multi-venue Users than Non-serosorting App Users for every one-year increase in age. Interventions addressing sexual risk behaviors among MSM in France should consider tailored risk-reduction and prevention messaging.
Collapse
Affiliation(s)
| | - Chakema C Carmack
- Department of Psychological Health and Learning Sciences, University of Houston, Houston, TX, USA
| | - Tamika D Gilreath
- Department of Health and Kinesiology, Texas A&M University, Houston, TX, USA
| | - Dustin T Duncan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| |
Collapse
|
11
|
Patten S, Doria N, Joy P, Sinno J, Spencer R, Leblanc MA, Holmes D, Numer M. Sexualized drug use in virtual space: A scoping review of how gay, bisexual and other men who have sex with men interact online. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2020. [DOI: 10.3138/cjhs.2019-0052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The purpose of this article is to review the scope of the current literature on sexualized drug use (SDU) among gay, bisexual and other men who have sex with men (GBMSM), particularly in online spaces. Over the last decade, there has been a rapid emergence of online venues for GBMSM to interact for sexual purposes. These spaces have also been infused with various substances that influence or shape the sexual interactions among GBMSM. Employing a scoping review methodology, we explored the interplay between GBMSM, SDU, and online dating and hookup apps. This scoping review presents four themes emerging from the literature: the connection between social networking apps (SNAs) and SDU, the planning and coordination of sex parties, accessing drugs through SNAs, and the coded language that emerges on SNAs. These findings synthesize the important relationship between GBMSM and SDUs, and identify the implications for health promotion.
Collapse
Affiliation(s)
- San Patten
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Nicole Doria
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Phillip Joy
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Jad Sinno
- Department of Psychiatry, Dalhousie University, Halifax, NS
| | - Rebecca Spencer
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Marc-Andre Leblanc
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Dave Holmes
- School of Nursing, University of California Irvine, Irvine, CA
| | - Matthew Numer
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| |
Collapse
|
12
|
Case-control study of risk factors for incident syphilis infection among men who have sex with men in Tokyo, Japan. Western Pac Surveill Response J 2019; 10:1-8. [PMID: 32133205 PMCID: PMC7043094 DOI: 10.5365/wpsar.2019.10.1.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Introduction In Japan, syphilis notifications have increased. Men who have sex with men (MSM) in Tokyo have contributed substantially to the increase in syphilis notifications. We thus aimed to determine the correlates of incident syphilis among them. Methods MSM who attended a Tokyo clinic that serves sexual minorities were recruited in a case-control study in 2015. A case was seropositive for primary/secondary/asymptomatic syphilis at enrolment visit and seronegative at prior visit or had oral ulcers positive for Treponema pallidum DNA at enrolment. For each case, two controls seronegative at enrolment and prior visit were selected. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated to assess for correlates of case status. Results Among 35 cases, the median age was 37 (range = 21–63) years and was similar to the 71 controls. Among HIV-positive participants (26 cases and 67 controls), cases were independently associated with higher frequency of anal or oral sex (OR = 3.4; 95% CI = 1.4–8.6; increase per category from < 1/month, ≥ 1/month but < 1/week, to ≥ 1/week) and no or inconsistent condom use during anal or oral sex (OR = 3.0; 95% CI = 1.1–8.3; increase per category from using every time, occasionally, to never), adjusted for residency and time between visits. Discussion Modifiable behaviours were associated with incident syphilis, and dissemination of prevention messages are needed.
Collapse
|
13
|
Strong C, Yu YF, Zou H, Ku WW, Lee CW, Ko NY. Sexual network and detection of anogenital human papillomavirus in a community cohort of men who have sex with men in Taiwan. PLoS One 2019; 14:e0216784. [PMID: 31075133 PMCID: PMC6510428 DOI: 10.1371/journal.pone.0216784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 04/29/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We examined the association between anogenital human papillomavirus (HPV) infection and sexual networks in men who have sex with men (MSM). METHODS A total of 253 MSM, 20 years of age and older, were recruited from the community in Southern Taiwan in 2015-2016. At baseline and at each follow-up visit, MSM were screened for HPV to identify 37 HPV genotypes. At the six-month follow-up, MSM were asked to fill out an egocentric network assessment and to report the last five persons with whom they had sex regarding the characteristics of sexual behavior with each network member. RESULTS A total of 182 participants (71.9%) returned for the follow-up and one third had at least one HPV type detected. A higher level of bridging network position calculated by the level of constraints in the network was significantly less likely to have HPV detection at the anal site. A high level of concurrency was associated with penile HPV detection (AOR = 3.16, 95% CI = 1.01-9.86). CONCLUSIONS Identifying network-related characteristics can advance our understanding of high-risk populations and for prioritizing HPV vaccine recommendations.
Collapse
Affiliation(s)
- Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- * E-mail:
| | - Yi-Fang Yu
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Wen-Wei Ku
- Division of Infectious Diseases, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Wen Lee
- Fengshan Lee Chia Wen Urologic Clinic, Kaohsiung, Taiwan
| | - Nai-Ying Ko
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Nursing, National Cheng Kung University and Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
14
|
Prescott MR, Hern J, Petersen M, Santos GM. Does HIV Pre-Exposure Prophylaxis Modify the Effect of Partnership Characteristics on Condom Use? A Cross-Sectional Study of Sexual Partnerships Among Men Who Have Sex with Men in San Francisco, California. AIDS Patient Care STDS 2019; 33:167-174. [PMID: 30932698 DOI: 10.1089/apc.2018.0179] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Increasing rates of sexually transmitted infections (STIs) in the United States among men who have sex with men (MSM) have raised concerns that pre-exposure prophylaxis (PrEP) has been associated with higher engagement in condomless anal intercourse (CAI). While partnership characteristics have previously been found to influence condom use, the extent to which PrEP use may modify their effect on CAI remains unknown. A secondary analysis of 535 sexual partnerships from a cross-sectional study in San Francisco was conducted to evaluate interactions between PrEP use and partnership characteristics on CAI. Bivariate and multivariate generalized estimating equation (GEE) logistic regression models were used to estimate relative measures of association, adjusted for confounding by seroconcordance and partnership type, as well as account for repeated partnerships per respondent. Partnerships where both partners used biomedical prevention had significantly greater odds of CAI [odds ratio (OR) = 5.19, 95% confidence interval (CI): 2.27-11.9] compared to those where only one partner used biomedical prevention, while those where neither partner used biomedical prevention had significantly lower odds of CAI (OR = 0.61, 95% CI: 0.40-0.93). There was no significant association between meeting place (online vs. offline) and sexual risk taking (OR = 1.03, p = 0.894). Having one partner disclose their HIV status (compared to neither partner having disclosed) was associated with significantly higher odds of CAI among partnerships of PrEP-using MSM [adjusted OR (aOR) = 5.28, 95% CI: 1.91-14.61], while the association was not significant among the partnerships of non-PrEP-using MSM (aOR = 1.29, 95% CI: 0.75-2.21). Differences in condom use among MSM using PrEP may not be well explained by differences in the effect of partnership characteristics. MSM using PrEP appear to commonly practice biomedical matching and high engagement in CAI with other biomedical prevention users, which could indicate relatively concentrated sexual networks and partly explain their disproportionate risk for STIs. Future studies should further investigate biomedical matching to develop interventions that further promote the sexual health of those using PrEP.
Collapse
Affiliation(s)
- Maximo R. Prescott
- San Francisco Department of Public Health, Center for Public Health Research, San Francisco, California
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California
| | - Jaclyn Hern
- San Francisco Department of Public Health, Center for Public Health Research, San Francisco, California
| | - Maya Petersen
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California
| | - Glenn-Milo Santos
- San Francisco Department of Public Health, Center for Public Health Research, San Francisco, California
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, California
| |
Collapse
|
15
|
Wei L, Chen L, Zhang H, Yang Z, Zou H, Yuan T, Xiao Y, Liu S, Tan W, Xie W, Liu L, Cheng J, Zhao J. Use of gay app and the associated HIV/syphilis risk among non-commercial men who have sex with men in Shenzhen, China: a serial cross-sectional study. Sex Transm Infect 2019; 95:496-504. [PMID: 30918120 DOI: 10.1136/sextrans-2018-053902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/08/2019] [Accepted: 01/26/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Geosocial networking application specific to men who have sex with men (MSM) (gay app) has revolutionised the social networking of MSM globally, much concern was raised over its linkage to HIV/syphilis risk. This study sought to examine the association between use of gay app and sexual behaviours and HIV/syphilis risk among Chinese MSM. METHODS Eligible MSM were recruited through combined offline methods from 2015 to 2017 in Shenzhen, China, with data collected including demographics, sexual behaviours, app use, recreational drug use and HIV testing. All participants are required to sign a written informed consent and take a confidential HIV and syphilis testing. RESULTS The prevalence of app use among non-commercial MSM (NcMSM) has rapidly increased from 12.5% in 2015 to 52.6% in 2017. The primary four apps used were Blued (97.2%), Aloha (18.4%), Jack'd (14.1) and Zank (14.1%). After controlling for confounders, HIV prevalence was still significantly lower among app users than non-app users (adjusted odds ratios [AOR]: 0.77, 95% CI 0.61 to 0.97), yet the lower prevalence of syphilis was not significant (AOR: 0.97, 95% CI 0.76 to 1.23). App-using NcMSM were more likely to be younger, unmarried, self-identified as homosexuality and having higher education level and income than non-app-using NcMSM. App-using NcMSM had higher rate of consistent condom use and HIV testing, higher level of knowledge on HIV/AIDS prevention and condom use; however, they were more likely to have multiple sexual partners, practice receptive role in anal sex and use recreational drug. CONCLUSIONS App-using NcMSM are more likely to have sexual risk behaviours as well as risk-reduction behaviours such as consistent condom use and HIV testing. Scaled-up and innovative venue-based HIV interventions are warranted for these high-risk MSM frequent social venues with less condom use and fewer HIV tests. Meanwhile, gay app should alternatively serve as an intervention and education platform for the MSM hard-to-reach via venue-based approaches.
Collapse
Affiliation(s)
- Lan Wei
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Lin Chen
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Haibo Zhang
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhengrong Yang
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Huachun Zou
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China.,School of Public Health, Sun Yat-Sen University, Guangzhou, China.,Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Tanwei Yuan
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yuejiao Xiao
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shaochu Liu
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wei Tan
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wei Xie
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Liegang Liu
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinquan Cheng
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Jin Zhao
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| |
Collapse
|
16
|
Gexha Bunjaku D, Deva E, Gashi L, Kaçaniku-Gunga P, Comins CA, Emmanuel F. Programmatic Mapping to Estimate Size, Distribution, and Dynamics of Key Populations in Kosovo. JMIR Public Health Surveill 2019; 5:e11194. [PMID: 30835241 PMCID: PMC6423465 DOI: 10.2196/11194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/23/2018] [Accepted: 11/09/2018] [Indexed: 02/03/2023] Open
Abstract
Background The burden of an HIV epidemic in Kosovo lies among the key populations (KPs) of female sex workers (FSWs), men who have sex with men (MSM), and people who inject drugs (PWIDs). The available interventions for KPs are fragmented and lack sufficient and appropriate granularity of information needed to develop large-scale outreach programs. Objective The aim of this study was to estimate the size and distribution of these populations to create evidence for developing action plans for HIV prevention. Methods The programmatic mapping approach was used to collect systematic information from key informants, including geographic and virtual locations in 26 municipalities of Kosovo between February to April 2016. In level 1, information was gathered about KPs’ numbers and locations through 1537 key informant interviews within each municipality. Level 2 involved validating these spots by conducting another 976 interviews with KPs congregating at those spots. Population size estimates were calculated for each spot, and finally a national-level estimate was developed, which was corrected for duplication and overlaps. Results Of the estimated 6814 MSM (range: 6445 to 7117), nearly 4940 operate through the internet owing to the large stigma and discrimination against same-sex relationships. Geo-based MSM (who operate through physical spots) congregate at a few spots with large spot sizes (13.3 MSM/spot). Three-fourths of the MSM are distributed in 5 major municipalities. Fridays and Saturdays are the peak days of operation; however, the number only increases by 5%. A significant number are involved in sex work, that is, provide sex to other men for money. PWIDs are largely geo-based; 4973 (range: 3932 to 6015) PWIDs of the total number of 5819 (range: 4777 to 6860) visit geographical spots, with an average spot size of 7.1. In smaller municipalities, they mostly inject in residential locations. The numbers stay stable during the entire week, and there are no peak days. Of the 5037 (range: 4213 to 5860) FSWs, 20% use cell phones, whereas 10% use websites to connect with clients. The number increases by 25% on weekends, especially in larger municipalities where sex work is mostly concentrated. Other than a few street-based spots, most spots are establishments run by pimps, which is reflective of the highly institutionalized, structured, and organized FSW network. Conclusions This study provides valuable information about the population size estimates as well as dynamics of each KP, which is the key to developing effective HIV prevention strategies. The information should be utilized to develop microplans and effectively provide HIV prevention services to various KPs.
Collapse
Affiliation(s)
- Dafina Gexha Bunjaku
- National Institute of Public Health, Department of Epidemiolo, Pristina, Kosovo, Albania
| | - Edona Deva
- Community Development Fund, Kosovo, Albania
| | - Luljeta Gashi
- National Institute of Public Health, Department of Epidemiolo, Pristina, Kosovo, Albania
| | | | - Carly A Comins
- Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Faran Emmanuel
- Centre for Global Public Health, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
17
|
Lau STH, Choi KWY, Chen J, Mak WPH, Yeung HKCA, Tucker J, Wong WCW. Study protocol for a peer-led web-based intervention to promote safe usage of dating applications among young adults: a cluster randomized controlled trial. Trials 2019; 20:102. [PMID: 30728064 PMCID: PMC6364485 DOI: 10.1186/s13063-018-3167-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 12/29/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Dating applications are a popular platform to meet new people. At the same time, they have been associated with risks such as unsafe sexual behavior and privacy concerns in young adults. This paper presents a study protocol of a cluster randomized controlled trial (RCT) to evaluate the effectiveness of a peer-led web-based intervention to promote its safe usage in young adults. METHODS The study design is an open-labeled cluster RCT with an intervention and a placebo control arm. The intervention group will receive a web-based intervention developed through focus group discussions, a crowdsourcing contest, and a Peer-Vetted Creative Production (PVCP) workshop. The control group will receive a web-based resource on health and exercise. We aim to recruit approximately 338 young adults aged 17-27 years from three tertiary educational institutions in Hong Kong with the class as the cluster unit. Based on the Information, Motivation, and Behavioral Skills (IMB) model, the primary outcome of this study is self-efficacy in using dating applications measured by the General Self Efficacy Scale. Secondary outcomes include change in risk perception measured by the Risk Propensity Scale and a Risk Assessment Tool. Questionnaires will be administered before the intervention, after the intervention, and at one-month follow-up. Intention-to-treat analysis and multilevel regression modeling will be used to evaluate differences in outcomes between groups and the factors affecting these outcomes, respectively. DISCUSSION Dating application usage presents opportunities as well as challenges to young adults meeting new friends. Innovative and relatable interventions are needed to promote the safe usage of dating applications to this population. Practical knowledge gained from the development process may be helpful for future intervention utilizing the peer-led approach. If effective, the intervention will be disseminated to non-governmental organizations and educational institutions to be used as a teaching resource. TRIAL REGISTRATION ClinicalTrials.gov, NCT03685643 . Registered on 26 September 2018. University of Hong Kong Clinical Trials Registry, HKUCTR-2512.
Collapse
Affiliation(s)
- Stephanie Tsz Hei Lau
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Kitty Wai Ying Choi
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Julie Chen
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | | | - Ho Kong Christopher Au Yeung
- Department of Social Science, School of Humanities and Social Science, Hang Seng Management College, Hong Kong, Hong Kong
| | - Joseph Tucker
- University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - William Chi-Wai Wong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
| |
Collapse
|
18
|
Frank K. Rethinking Risk, Culture, and Intervention in Collective Sex Environments. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:3-30. [PMID: 29748787 DOI: 10.1007/s10508-018-1153-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 11/28/2017] [Accepted: 01/11/2018] [Indexed: 05/16/2023]
Abstract
This article provides a narrative overview of research on HIV/STI risk and collective sexual behavior based on an inclusive analysis of research on environments where people gather for sexual activity-sex clubs, swingers' clubs, bathhouses, parks, private sex parties, etc. The aim is to analyze how collective sex has been approached across disciplines to promote conversation across paradigms and suggest new lines of inquiry. Attention to context-such as the location of sex-was a necessary redress to universalizing models of sexual risk-taking behavior, leading to insights rooted in the particularities of each environment and its users. However, the identification of ever more precise risk groups or environmental idiosyncrasies eventually becomes theoretically restrictive, leading to an overestimation of the uniqueness of sexual enclaves, and of the difference between any given enclave and the broader social milieu. Using a theoretical framework of transgression to interpret the interdisciplinary literature, similarities in the spatial and social organization of collective sex environments are identified. Insights generated from this complementary perspective are then applied to understandings of collective sex: first, the example of male-female (MF) "swingers" is used to illustrate the need to establish, rather than assume, the distinctiveness of each non-normative sexual enclave, and to broaden the conceptualization of context; second, questions are raised about the practicality of interventions in collective sex environments. Finally, new lines of intellectual inquiry are suggested to shed light not just on collective sex but on sociosexual issues more generally, such as increasing protective sexual health behavior or negotiating consent in sexual encounters.
Collapse
Affiliation(s)
- Katherine Frank
- Department of Sociology, University of Nevada, Las Vegas, Las Vegas, NV, 89557, USA.
| |
Collapse
|
19
|
Card KG, Armstrong HL, Lachowsky NJ, Cui Z, Zhu J, Roth EA, Hogg RS. Patterns of Online and Offline Connectedness Among Gay, Bisexual, and Other Men Who Have Sex with Men. AIDS Behav 2018; 22:2147-2160. [PMID: 29076033 PMCID: PMC5920783 DOI: 10.1007/s10461-017-1939-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study examined patterns of connectedness among 774 sexually-active gay, bisexual, and other men who have sex with men (GBM), aged ≥ 16 years, recruited using respondent-driven sampling in Metro Vancouver. Latent class analysis examined patterns of connectedness including: attendance at gay venues/events (i.e., bars/clubs, community groups, pride parades), social time spent with GBM, use of online social and sex seeking apps/websites, and consumption of gay media. Multinomial regression identified correlates of class membership. A three-class LCA solution was specified: Class 1 "Socialites" (38.8%) were highly connected across all indicators. Class 2 "Traditionalists" (25.7%) were moderately connected, with little app/website-use. Class 3 "Techies" (35.4%) had high online connectedness and relatively lower in-person connectedness. In multivariable modelling, Socialites had higher collectivism than Traditionalists, who had higher collectivism than Techies. Socialites also had higher annual incomes than other classes. Techies were more likely than Traditionalists to report recent serodiscordant or unknown condomless anal sex and HIV risk management practices (e.g., ask their partner's HIV status, get tested for HIV). Traditionalists on the other hand were less likely to practice HIV risk management and had lower HIV/AIDS stigma scores than Socialites. Further, Traditionalists were older, more likely to be partnered, and reported fewer male sex partners than men in other groups. These findings highlight how patterns of connectedness relate to GBM's risk management.
Collapse
Affiliation(s)
- Kiffer G Card
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
- Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada.
- C/O Faculty of Health Sciences, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Heather L Armstrong
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Nathan J Lachowsky
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Zishan Cui
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Julia Zhu
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Eric A Roth
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Department of Anthropology, University of Victoria, Victoria, BC, Canada
| | - Robert S Hogg
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada
| |
Collapse
|
20
|
Yang C, Latkin C, Tobin K, Seal D, Koblin B, Chander G, Siconolfi D, Flores S, Spikes P. An Event-Level Analysis of Condomless Anal Intercourse with a HIV-Discordant or HIV Status-Unknown Partner Among Black Men Who Have Sex with Men from a Multi-site Study. AIDS Behav 2018; 22:2224-2234. [PMID: 29779160 PMCID: PMC6021207 DOI: 10.1007/s10461-018-2161-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Despite the high HIV incidence and prevalence among black men who have sex with men (BMSM), little research has examined partner characteristics, partner seeking venue, sexual position, substance use, and sexual risk behavior at the sex event-level among BMSM. Using the baseline data from a multi-site study of 807 BMSM stratified by their HIV status, the goal of this study was to conduct a detailed event-level analysis of 1577 male anal sex events to assess the factors associated with condomless anal intercourse (CLAI) with a HIV-discordant or HIV status-unknown partner. We found CLAI with an HIV-discordant or unknown HIV status partner among HIV-negative BMSM was negatively associated with having sex with a main partner, and was positively associated with taking both receptive and insertive sexual positions during sex. As compared to a sex partner met at bar, night club or dance club, HIV-positive BMSM were less likely to engage in CLAI with HIV-discordant and unknown HIV status partner met at party or friend's house or at community organizations. HIV-positive BMSM had lower odds of engaging in CLAI with HIV-discordant and unknown HIV status partner if they had insertive sexual position or both receptive and insertive sexual positions. These results underscore the importance of delineating unique sex event-level factors associated with sexual risk behavior depending on individuals' HIV status. Our findings suggest event-level partner characteristics, sexual position, and partner seeking venues may contribute to disparities in HIV incidence.
Collapse
Affiliation(s)
- Cui Yang
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD, 21205, USA.
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD, 21205, USA
| | - Karin Tobin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD, 21205, USA
| | - David Seal
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Beryl Koblin
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Geetanjali Chander
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Stephen Flores
- National Center for HIV/AIDS, Viral, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pilgrim Spikes
- National Center for HIV/AIDS, Viral, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
21
|
Weiss KM, Jonas KJ, Guadamuz TE. Playing and Never Testing: Human Immunodeficiency Virus and Sexually Transmitted Infection Testing Among App-Using MSM in Southeast Asia. Sex Transm Dis 2018; 44:406-411. [PMID: 28608790 DOI: 10.1097/olq.0000000000000624] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Little is known about mobile application (app)-based behavior of men who have sex with men (MSM) in Thailand. A cross-sectional online assessment of app users in Bangkok found that more than a quarter have never tested for human immunodeficiency virus (HIV) and 1 in 3 never tested for sexually transmitted infections (STI). STI testing patterns and HIV testing frequency were highly associated with each other in multinomial logistic regression. In the midst of an escalating epidemic where HIV incidence among MSM is highest in Asia, apps can serve to engage those least likely to be reached by traditional methods of recruitment and outreach in Thailand.
Collapse
Affiliation(s)
- Kevin M Weiss
- From the *Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, †Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands; ‡Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; and §Department of Society and Health and the Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | | | | |
Collapse
|
22
|
Guadamuz TE, Boonmongkon P. Ice parties among young men who have sex with men in Thailand: Pleasures, secrecy and risks. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 55:249-255. [PMID: 29691128 DOI: 10.1016/j.drugpo.2018.04.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 03/29/2018] [Accepted: 04/04/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Crystal methamphetamine (ice) has become the substance of choice among young men who have sex with men (YMSM) in urban Thailand. Yet, there is scarce data on this phenomenon, partly due to the difficulty in accessing men who will disclose and openly discuss the social contexts, meanings and risks surrounding ice practice. We present an ethnography of ice parties, critically discussing the in-depth social meanings of ice; the sexual socialities and the secrecy surrounding its use; the transactions between older and younger men; and the role of the Internet and mobile technology. METHODS Forty repeated narrative interviews (life stories), ten focus group discussions, as well as systematic online and offline observations were conducted over a three-year period. Purposive sampling was used to recruit study participants in a variety of online and offline spaces and through working closely with local Thai community-based organizations serving MSM. To be eligible, participants had to be between 18 and 29 years, able to converse in Thai, had used ice, and had anal sex with another man in the past 6 months. We also strived for sample variability with respects to socio-demographic characteristics (e.g., age, educational attainment and living situation). Data analysis was conducted in Thai by two researchers using the constant comparative method based on grounded theory. RESULTS On surface, participants described ice parties as exclusive, in trend, luxurious, fun and pleasurable-a kind of modern camaraderie among beautiful men. In reality, however, this group phenomenon was a social hierarchy containing several important players with relational power to one another, to the ice itself and to the physical space where ice was being consumed. These players included ice suppliers, party hosts, party guests and "icetenders." The paper also discusses the sociality of secrecy that surrounds ice parties as well as the power relations between older relatively rich men who provide ice and the younger men who crave for the chemical, pointing to the risks associated with engagement at ice parties, including instances of rape, violence and unsafe sex. For some participants, ice use was part of their "everyday life," or even believed to be a "rites of passage." For others, it involved sexual silence in cases where they were forced to have (unprotected) sex with certain persons or engage in high-risk activities against their will. CONCLUSIONS Ice parties, where high-risk practices were common, power and agency quickly became relational and negotiable. This paper illuminated the secret sociality of ice so that public health efforts will be better equipped with understanding and reaching out to young men who may be at heightened risk for HIV, STI, violence and other health concerns. Ice parties can, for example, be seen as opportunities for harm-reduction strategies whereby young men are not judged for the activities they engage, but are instead respected and approached in a contextualized, non-judgmental way. Finally, icetenders and party hosts may be individuals where public health practitioners can target and include in the development of novel harm-reduction programs.
Collapse
Affiliation(s)
- Thomas E Guadamuz
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakorn Pathom, Thailand; Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakorn Pathom, Thailand.
| | - Pimpawun Boonmongkon
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakorn Pathom, Thailand; Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakorn Pathom, Thailand
| |
Collapse
|
23
|
Faster and Riskier? Online Context of Sex Seeking Among Men Who Have Sex With Men in China. Sex Transm Dis 2017; 44:239-244. [PMID: 28282651 DOI: 10.1097/olq.0000000000000575] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many men who have sex with men (MSM) seek sex partners online, creating barriers and opportunities for human immunodeficiency virus prevention. The purpose of this study was to examine the characteristics of MSM and the risks associated with seeking sex through websites, gay apps, and both platforms in China. METHODS Data were collected through a cross-sectional online survey from September through October 2014 from 3 large gay Web portals. Sociodemographic information, sexual behaviors, and online sex seeking behaviors were measured. Multinomial logistic regression was performed to compare sexual risk behaviors among website users, gay app users, and men who used both platforms. RESULTS Of the 1201 participants, 377 (31.4%) were website-only users, 487 (40.5%) were gay app-only users, and 337 (28.0%) were men who used both platforms. These 3 MSM subgroups have distinct sociodemographic characteristics. Overall, 57.6% of participants reported having engaged in condomless anal sex with their last male partner in the past 6 months, but there was no significant difference in condomless sex between the 3 groups. Men who used both platforms viewed more sexually transmitted disease-related messages than website-only users (adjusted odds ratio, 2.19; 95% confidence interval, 1.57-3.05). CONCLUSIONS Condom usage behaviors were unaffected by the medium through which sexual partners were found. However, the high frequency of condomless sex suggests that websites and gay apps are both risk environments. This study suggests using multiple platforms for human immunodeficiency virus/sexually transmitted disease social media interventions may be useful.
Collapse
|
24
|
Spicknall IH, Gift TL, Bernstein KT, Aral SO. Sexual networks and infection transmission networks among men who have sex with men as causes of disparity and targets of prevention. Sex Transm Infect 2017; 93:307-308. [DOI: 10.1136/sextrans-2016-052676] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/09/2017] [Accepted: 03/16/2017] [Indexed: 11/04/2022] Open
|
25
|
Navani-Vazirani S, Heylen E, Deardorff J, Srikrishnan AK, Vasudevan CK, Solomon D, Ekstrand ML. The Role of Sex Work Pay in Moderating the Effect of Mobile Phone Solicitation on Condom Practices: An Analysis of Female Sex Workers in India. ACTA ACUST UNITED AC 2017; 4. [PMID: 29202126 DOI: 10.24966/acrs-7370/100008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Mobile phones remain a largely untapped resource in the ongoing challenge to address Female Sex Worker (FSW) health, including HIV prevention services, in India. An important step towards designing effective mobile phone-based initiatives for FSWs is clarifying the contextual influences of mobile phone solicitation on sexual risk behavior. In this paper, we extend previously identified associations between mobile phone solicitation and condom practices by examining whether this association is moderated by sex work pay and offer key considerations for future research and implementation. Specifically, we conducted an analysis among 589 Indian FSWs, where FSWs who did not use mobile phones to solicit clients had the lowest mean sex work pay (INR 394/ USD 6.54) compared to FSWs who used both mobile and traditional strategies (INR 563/ USD 9.34). Our analysis indicate low paid FSWs who used mobile phones concurrently with traditional strategies had 2.46 times higher odds of inconsistent condom use compared to low paid FSWs who did not use mobile phones for client solicitation. No such effect was identified among high paid FSWs. These findings also identified group level differences among FSWs reporting different mobile phone solicitation strategies, including violence, client condom use and HIV status. Our results indicate that low pay does moderate the association between mobile phone solicitation and condom practices, but only among a sub-set of low paid FSWs. These findings also demonstrate the utility of classification by different mobile phone solicitation strategies for accurate assessment of sexual risk among mobile phone soliciting FSWs. In turn, this paves the way for novel approaches to utilize mobile phones for FSW HIV prevention. We discuss one such example, a mobile phone-based rapid screening tool for acute HIV infection targeting Indian FSWs.
Collapse
Affiliation(s)
| | - E Heylen
- Center for AIDS Prevention, University of California, San Francisco, California, USA
| | - J Deardorff
- School of Public Health, University of California, Berkeley, USA
| | - A K Srikrishnan
- YR Gaitonde Centre for AIDS Research and Education (YRG CARE), Chennai, Tamil Nadu, India
| | - C K Vasudevan
- YR Gaitonde Centre for AIDS Research and Education (YRG CARE), Chennai, Tamil Nadu, India
| | - D Solomon
- SHADOWS, Chirala, Andhra Pradesh, India
| | - M L Ekstrand
- School of Public Health, University of California, Berkeley, USA.,Center for AIDS Prevention, University of California, San Francisco, California, USA.,St. John's Research Institute, Bangalore, Karnataka, India
| |
Collapse
|
26
|
Lee VC, Sullivan PS, Baral SD. Global travel and HIV/STI epidemics among MSM: what does the future hold? Sex Health 2017; 14:51-58. [DOI: 10.1071/sh16099] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/27/2016] [Indexed: 11/23/2022]
Abstract
Infectious disease epidemics occur within dynamic systems and environments that shape risk and, ultimately, the spread of infectious diseases. Gay men and other men who have sex with men (MSM) are disproportionately impacted by HIV everywhere in the world. Several emerging trends present risks for sustained or increased HIV acquisition and transmission, and the growth of global travel in the context of emerging online platforms for social/sexual networking is discussed here. Four factors associated with travel that could potentiate HIV transmission are highlighted: different patterns of sexual risk behaviours during travel; the growth of online tools to meet sex partners more efficiently; the global heterogeneity of HIV strains; and the potential for diassortative mixing of men from high- and low-HIV prevalence areas. Prevention tools and services must rise to these challenges, and innovative mobile applications and programs have played, and will continue to play, an important role in supporting MSM at risk for or living with HIV during their periods of travel.
Collapse
|
27
|
Ekstrand ML, Rawat S, Patankar P, Heylen E, Banu A, Rosser BRS, Wilkerson JM. Sexual identity and behavior in an online sample of Indian men who have sex with men. AIDS Care 2016; 29:905-913. [PMID: 28027656 DOI: 10.1080/09540121.2016.1271103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Indian men who have sex with men are disproportionately impacted by HIV. While prevention efforts to date have focused on men who visit drop-in centers or physical cruising sites, little is known about men who are meeting sexual partners on virtual platforms. This paper explores issues related to sexual identity and sexual behaviors in an online sample of men who identified as gay (n = 279) or bisexual (n = 123). There were significant differences in outedness between the two groups, with 48% of bisexually identified men reporting that they were out to "no one" and 82% stating that they present themselves as heterosexual to family and friends. Corresponding rates for gay-identified men were 15% and 41%, respectively (both p < .001). Twenty-nine percent of bisexually identified men reported being married, compared to only 3% of the gay-identified men (p < .001). Bisexually identified men were also more likely to report having exclusively insertive anal sex (49% vs 30% p < .001), while gay-identified men were more likely to report exclusively receptive anal sex (41% vs 13% p < .0001). Rates of unprotected anal sex (UAS) in the two groups were similar; however, married men were significantly more likely to report unprotected vaginal sex (76% vs 35%, p < .012). Positive attitudes toward UAS and lower self-efficacy were associated with sexual risk in both groups; however, substance use was associated with sexual risk only among bisexually identified men. These findings show that a large proportion of Indian bisexually identified men lead closeted lives, especially in their interactions with friends and family, with the vast majority presenting as heterosexual. The lower condom use with wives may be due to societal pressures to have children. The results suggest that bisexually identified men may benefit from targeted programs and non-directive, non-judgmental individual or couples counseling which emphasizes condom use with both male and female partners.
Collapse
Affiliation(s)
- Maria L Ekstrand
- a Division of Prevention Science, Department of Medicine, Center for AIDS Prevention Studies , University of California , San Francisco , CA , USA.,b St John's Research Institute, St John's National Academy of Health Sciences , Bengaluru , India
| | | | | | - Elsa Heylen
- a Division of Prevention Science, Department of Medicine, Center for AIDS Prevention Studies , University of California , San Francisco , CA , USA
| | - Asha Banu
- d The Tata Institute of Social Sciences , Mumbai , India
| | - B R Simon Rosser
- e Division of Epidemiology and Community Health , University of Minnesota , Minneapolis , MN , USA
| | - J Michael Wilkerson
- f School of Public Health , The University of Texas Health Sciences Center at Houston (UTHealth) Houston , TX , USA
| |
Collapse
|
28
|
Responding to the syphilis outbreak in Japan: piloting a questionnaire to evaluate potential risk factors for incident syphilis infection among men who have sex with men in Tokyo, Japan, 2015. Western Pac Surveill Response J 2016; 7:36-39. [PMID: 27757259 PMCID: PMC5053135 DOI: 10.5365/wpsar.2016.7.2.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
29
|
Abstract
Increasingly, gay and bisexual men (GBM) meet casual sex partners online and this has been associated with sexual risk behavior. How do GBM meet regular partners? This online anonymous survey of 4215 GBM included 2562 men with a primary regular partner (PRP) who were included in these analyses. Mean age of the sample was 38.1 years. 60.3 % had met their PRP at least 2 years earlier. Meeting their PRP online increased from 14.0 % before 2001 to 79.9 % in 2013-2014. At all time points, men who met their PRP online were somewhat older than those who met their PRP offline. Regardless of how they met their PRP, most men met casual sex partners online. Among GBM, meeting sexual and romantic partners online has replaced other methods, for all age groups. The population of GBM who use the internet for this purpose is now equivalent to all sexually active GBM.
Collapse
|
30
|
Guadamuz TE, Cheung DH, Wei C, Koe S, Lim SH. Young, Online and in the Dark: Scaling Up HIV Testing among MSM in ASEAN. PLoS One 2015; 10:e0126658. [PMID: 25973907 PMCID: PMC4431680 DOI: 10.1371/journal.pone.0126658] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 04/06/2015] [Indexed: 02/01/2023] Open
Abstract
Background Poor HIV testing uptake by MSM may be attributable to unique challenges that are localized in Southeast Asia. Objective To characterize MSM who never tested for HIV, to identify correlates of never testing, and to elucidate the perceived barriers to HIV testing. Methods The present study used data from the Asian Internet MSM Sex Survey (AIMSS) and restricted the analysis to 4,310 MSM from the ten member countries of the Association of South East Asian Nations (ASEAN). Results Among MSM participants from ASEAN in our sample, 1290 (29.9%) reported having never been tested for HIV, 471 (10.9%) tested for HIV more than 2 years ago, and 2186 (50.7%) reported their last test date was between 6 months and two years ago, with only 363 (8.4%) of these men having been tested in the past 6 months. In multivariable logistic regression, younger MSM (age 15–22 years old [AOR: 4.60, 95% CI: 3.04–6.96]), MSM with lower education (secondary school or lower [AOR: 1.37, 95% CI: 1.03–1.83]), MSM who identify as bisexual or heterosexual (compared to gay-identified) (AOR: 1.94, 95% CI: 1.60–2.35), and MSM who had never used a condom with male partners (AOR: 1.61, 95% CI: 1.32–1.97) had higher odds of never been HIV tested. Main reason for not being tested was a low risk perception of HIV exposure (n = 390, 30.2%). Conclusion Current HIV prevention response must not leave MSM “in the dark,” but instead meet them where they are by utilizing the Internet creatively through social media and smart phones. As ASEAN Economic Community (AEC) is quickly becoming a reality, so must there be an equally fast and united response to slowing down the HIV epidemics among MSM in ASEAN.
Collapse
Affiliation(s)
- Thomas E. Guadamuz
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
- Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
- * E-mail:
| | - Doug H. Cheung
- Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics & Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America
| | | | - Sin How Lim
- Center of Excellence for Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
31
|
Kerr ZY, Pollack LM, Woods WJ, Blair J, Binson D. Use of multiple sex venues and prevalence of HIV risk behavior: identifying high-risk men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:443-51. [PMID: 25245930 PMCID: PMC4323634 DOI: 10.1007/s10508-014-0352-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 12/05/2013] [Accepted: 03/19/2014] [Indexed: 05/28/2023]
Abstract
The National HIV/AIDS Strategy emphasizes the importance of bringing prevention to the most at risk populations. Interventions targeting all men who have sex with men (MSM) fail in that respect because only a minority engages in behavior that is likely to lead to HIV infection. Previous studies have shown that MSM who seek male sexual partners in more than one venue type (e.g., bathhouse, cruising area, online) are most likely to engage in unprotected anal intercourse (UAI), compared to men who only meet partners in any one of these setting types or who do not use venues. The present study reports differences in prevalence of UAI among MSM by their use of venue sites to meet sexual partners. A probability sample of 459 bathhouse patrons completed exit surveys. In the 3 months before the current bathhouse visit, 63.5 % visited a bathhouse (not including the visit at which they were recruited), 46.7 % visited a cruising area, 46.5 % used online cruise sites to find sex partners, and 30.9 % reported UAI. While UAI was associated with online cruise site use, prevalence of UAI with men met online was relatively low. The odds of UAI among men who used all three venues were significantly higher compared to men using zero [odds ratio (OR) = 4.4; 95 % confidence interval (CI) 1.6, 12.1)] one (OR = 5.3; 95 % CI 2.2, 12.8) or two venues (OR = 4.3; 95 % CI 1.9, 9.6). The findings suggest that prevention would benefit from screening for venue use to help identify men with the greatest behavioral risk.
Collapse
Affiliation(s)
- Zachary Y. Kerr
- Department of Epidemiology, The University of North Carolina, Chapel Hill
| | - Lance M. Pollack
- Center for AIDS Prevention Studies, University of California San Francisco
| | - William J. Woods
- Center for AIDS Prevention Studies, University of California San Francisco
| | | | - Diane Binson
- Center for AIDS Prevention Studies, University of California San Francisco
| |
Collapse
|
32
|
Holtz TH, Pattanasin S, Chonwattana W, Tongtoyai J, Chaikummao S, Varangrat A, Mock PA. Longitudinal analysis of key HIV-risk behavior patterns and predictors in men who have sex with men, Bangkok, Thailand. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:341-8. [PMID: 25637308 DOI: 10.1007/s10508-014-0427-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 10/07/2014] [Accepted: 10/17/2014] [Indexed: 05/27/2023]
Abstract
The HIV incidence among Thai men who have sex with men (MSM) enrolled in the Bangkok MSM Cohort Study (BMCS) has remained high since its inception in 2006. The purpose of this BMCS analysis was to determine: (1) changes in three HIV-risk behaviors (unprotected anal intercourse (UAI), recreational drug use, and multiple sexual partners i.e., more than four male/transgender partner) over time; and (2) factors associated with each one separately. Thai MSM aged 18 years or older and living in Bangkok were eligible to participate in the BMCS. At each follow-up visit, participants were asked to report their sexual and drug behaviors in the previous 4 months. We conducted a longitudinal analysis using generalized estimating equations logistic regression that included 1,569 MSM who were enrolled from 2006 to 2010 and contributed at least one follow-up visit. For each four-month visit increase, we found a 2, 1, and 1 % decrease in odds for reported UAI, recreational drug use, and multiple sexual partners, respectively. We found significant predictors associated with three HIV-risk behaviors such as binge drinking, participation in group sex, and use of erectile dysfunction drugs. The statistically significant decrease in odds of HIV-risk behaviors among the participants is encouraging; however, continued vigilance is required to address the factors associated with HIV-risk behaviors through currently available interventions reaching MSM.
Collapse
Affiliation(s)
- Timothy H Holtz
- HIV/STD Research Program, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, P.O. Box 139, Nonthaburi, 11000, Thailand,
| | | | | | | | | | | | | |
Collapse
|
33
|
Schnall R, Travers J, Rojas M, Carballo-Diéguez A. eHealth interventions for HIV prevention in high-risk men who have sex with men: a systematic review. J Med Internet Res 2014; 16:e134. [PMID: 24862459 PMCID: PMC4051738 DOI: 10.2196/jmir.3393] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 04/25/2014] [Accepted: 05/13/2014] [Indexed: 01/20/2023] Open
Abstract
Background While the human immunodeficiency virus (HIV) incidence rate has remained steady in most groups, the overall incidence of HIV among men who have sex with men (MSM) has been steadily increasing in the United States. eHealth is a platform for health behavior change interventions and provides new opportunities for the delivery of HIV prevention messages. Objective The purpose of this systematic review was to examine the use of eHealth interventions for HIV prevention in high-risk MSM. Methods We systematically searched PubMed, OVID, ISI Web of Knowledge, Google Scholar, and Google for articles and grey literature reporting the original results of any studies related to HIV prevention in MSM and developed a standard data collection form to extract information on study characteristics and outcome data. Results In total, 13 articles met the inclusion criteria, of which five articles targeted HIV testing behaviors and eight focused on decreasing HIV risk behaviors. Interventions included Web-based education modules, text messaging (SMS, short message service), chat rooms, and social networking. The methodological quality of articles ranged from 49.4-94.6%. Wide variation in the interventions meant synthesis of the results using meta-analysis would not be appropriate. Conclusions This review shows evidence that eHealth for HIV prevention in high-risk MSM has the potential to be effective in the short term for reducing HIV risk behaviors and increasing testing rates. Given that many of these studies were short term and had other limitations, but showed strong preliminary evidence of improving outcomes, additional work needs to rigorously assess the use of eHealth strategies for HIV prevention in high-risk MSM.
Collapse
Affiliation(s)
- Rebecca Schnall
- Columbia University, School of Nursing, New York, NY, United States.
| | | | | | | |
Collapse
|