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He Y, Tang Y, Hua Q, Li X, Ge Y, Liu Y, Tang R, Tian Y, Li W. Exploring Dynamic Changes in HIV-1 Molecular Transmission Networks and Key Influencing Factors: Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e56593. [PMID: 38810253 PMCID: PMC11170051 DOI: 10.2196/56593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/19/2024] [Accepted: 05/05/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND The HIV-1 molecular network is an innovative tool, using gene sequences to understand transmission attributes and complementing social and sexual network studies. While previous research focused on static network characteristics, recent studies' emphasis on dynamic features enhances our understanding of real-time changes, offering insights for targeted interventions and efficient allocation of public health resources. OBJECTIVE This study aims to identify the dynamic changes occurring in HIV-1 molecular transmission networks and analyze the primary influencing factors driving the dynamics of HIV-1 molecular networks. METHODS We analyzed and compared the dynamic changes in the molecular network over a specific time period between the baseline and observed end point. The primary factors influencing the dynamic changes in the HIV-1 molecular network were identified through univariate analysis and multivariate analysis. RESULTS A total of 955 HIV-1 polymerase fragments were successfully amplified from 1013 specimens; CRF01_AE and CRF07_BC were the predominant subtypes, accounting for 40.8% (n=390) and 33.6% (n=321) of the specimens, respectively. Through the analysis and comparison of the basic and terminal molecular networks, it was discovered that 144 sequences constituted static molecular networks, and 487 sequences contributed to the formation of dynamic molecular networks. The findings of the multivariate analysis indicated that the factors occupation as a student, floating population, Han ethnicity, engagement in occasional or multiple sexual partnerships, participation in anal sex, and being single were independent risk factors for the dynamic changes observed in the HIV-1 molecular network, and the odds ratio (OR; 95% CIs) values were 2.63 (1.54-4.47), 1.83 (1.17-2.84), 2.91 (1.09-7.79), 1.75 (1.06-2.90), 4.12 (2.48-6.87), 5.58 (2.43-12.80), and 2.10 (1.25-3.54), respectively. Heterosexuality and homosexuality seem to exhibit protective effects when compared to bisexuality, with OR values of 0.12 (95% CI 0.05-0.32) and 0.26 (95% CI 0.11-0.64), respectively. Additionally, the National Eight-Item score and sex education experience were also identified as protective factors against dynamic changes in the HIV-1 molecular network, with OR values of 0.12 (95% CI 0.05-0.32) and 0.26 (95% CI 0.11-0.64), respectively. CONCLUSIONS The HIV-1 molecular network analysis showed 144 sequences in static networks and 487 in dynamic networks. Multivariate analysis revealed that occupation as a student, floating population, Han ethnicity, and risky sexual behavior were independent risk factors for dynamic changes, while heterosexuality and homosexuality were protective compared to bisexuality. A higher National Eight-Item score and sex education experience were also protective factors. The identification of HIV dynamic molecular networks has provided valuable insights into the characteristics of individuals undergoing dynamic alterations. These findings contribute to a better understanding of HIV-1 transmission dynamics and could inform targeted prevention strategies.
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Affiliation(s)
- Yan He
- Department of Infection Management, Nanjing Drum Tower Hospital, Nanjing, China
| | - Ying Tang
- Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qun Hua
- Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xin Li
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - You Ge
- School of Public Health, Southeast University, Nanjing, China
| | - Yangyang Liu
- School of Public Health, Southeast University, Nanjing, China
| | - Rong Tang
- Nanjing Qixia District Center for Disease Control and Prevention, Nanjing, China
| | - Ye Tian
- Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Li
- Children's Hospital of Nanjing Medical University, Nanjing, China
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Patterson MS, Francis AN, Gagnon LR, Prochnow T. I'll be there for you: The effects of exercise engagement on social support provision within undergraduate students' personal networks. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37437203 DOI: 10.1080/07448481.2023.2227730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 04/20/2023] [Accepted: 06/11/2023] [Indexed: 07/14/2023]
Abstract
Objective: To use social network analysis to examine exercise participation relative to health and wellness support provision within students' networks. Participants: 513 undergraduates from a large private university completed online surveys. Methods: Multilevel modeling assessed exercise engagement at the individual and dyadic level and support provision from network members. Results: More support was perceived by first and second-year students and individuals who reported more exercise engagement. Significant others, roommates, siblings, female network members, and those who exercised often provided greater support. Greater support was reported when both the participant and their social tie were involved in the campus group-exercise program. Conclusion: This study suggests individual and dyadic-level exercise was related to undergraduates feeling more supported. Findings support campus group exercise programs as opportunities to create reciprocal supportive ties for college students. Future research could further explore ways exercise and social support, particularly in group settings, affect health and well-being.
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Affiliation(s)
- M S Patterson
- Department, of Health Behavior, Texas A&M University, College Station, Texas, USA
| | - A N Francis
- Department, of Health Behavior, Texas A&M University, College Station, Texas, USA
| | - L R Gagnon
- Community Health Center of Southeast Kansas, Pittsburg, Kansas, USA
| | - T Prochnow
- Department, of Health Behavior, Texas A&M University, College Station, Texas, USA
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Falade-Nwulia O, Felsher M, Kidorf M, Tobin K, Yang C, Latkin C. The impact of social network dynamics on engagement in drug use reduction programs among men and women who use drugs. J Subst Abuse Treat 2022; 137:108713. [PMID: 34969578 PMCID: PMC9086095 DOI: 10.1016/j.jsat.2021.108713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/02/2021] [Accepted: 12/14/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cross-sectional studies have shown strong relationships between social network characteristics and substance use disorder (SUD) treatment engagement. The current study examined associations between longitudinal changes in egocentric social networks of male and female people who use drugs (PWUD) and engagement in drug use reduction programs, broadly defined as either formal SUD treatment or self-help groups. METHOD Using data from an HIV prevention and care study in Baltimore, MD, this study categorized PWUD into those who engaged and did not engage in any drug use reduction programs over two follow-ups during a one-year observation window. The study used multivariate logistic generalized estimating equations (GEE) to examine associations between network composition and stability measures and drug use reduction program engagement, stratified by gender. RESULTS Of the 176 subjects participating in drug use reduction programs at baseline, 56.3% remained engaged at one year. Among both male and female respondents, higher turnover into non-kin networks was associated with increased odds of engagement in drug use reduction programs (AOR 1.4; 95% CI: 1.1-1.9, AOR 1.3; 95% CI: 1.0-1.8, respectively). For males, retention of intimate partner networks was associated with increased odds of program engagement (AOR 2.9; 95% CI: 1.1-7.6); for females, higher turnover into kin networks was associated with decreased odds of engagement (AOR 0.8; 95% CI: 0.5-1.0). CONCLUSION Evaluation of associations between social network characteristics and drug use reduction program engagement appears to benefit from longitudinal analyses that are stratified by gender. Efforts to improve retention in formal SUD treatment or self-help groups might consider intervening through social networks, perhaps by increasing overall levels of social support.
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Affiliation(s)
| | - Marisa Felsher
- Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Michael Kidorf
- Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Karin Tobin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Cui Yang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Carl Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Network Characteristics Associated with HIV Testing Conversations Among Transgender Women in Los Angeles County, California. AIDS Behav 2021; 25:2336-2347. [PMID: 33609204 DOI: 10.1007/s10461-021-03196-x] [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: 02/09/2021] [Indexed: 10/22/2022]
Abstract
This study examined associations between transgender women's social network characteristics, perceived network member HIV risk/protective behaviors and HIV testing conversations between transgender women and their network members. From July 2015 to September 2016, 264 transgender women who nominated 2529 social network members completed surveys on sociodemographic characteristics, HIV risk/protective behaviors, and egocentric social networks. Mixed-effects logistic regression evaluated discussion of HIV testing with network member characteristics and perceived HIV risk/protective behaviors. HIV testing conversations were positively associated with being named as a trans "mother" (aOR 2.05; 95% CI 1.03-4.06) relationships of longer duration, and the following network member characteristics: perception as a confidant (3.09; 1.89-5.05), discussion of condom use (29.65; 16.75-52.49), knowledge of HIV pre-exposure prophylaxis (4.14; 2.11-8.15), and receipt of HIV testing (22.13; 11.47-42.69). HIV testing conversations were negatively associated with relationships where stimulants were used (aOR 0.32; 95% CI 0.12-0.84). These results indicate the importance of leveraging close relationship networks to increase HIV testing and the potential role for network-based HIV prevention strategies among transgender women.
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Burgette JM, Rankine J, Culyba AJ, Chu KH, Carley KM. Best Practices for Modeling Egocentric Social Network Data and Health Outcomes. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:18-34. [PMID: 33973482 DOI: 10.1177/19375867211013772] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE/AIM We describe best practices for modeling egocentric networks and health outcomes using a five-step guide. BACKGROUND Social network analysis (SNA) is common in social science fields and has more recently been used to study health-related topics including obesity, violence, substance use, health organizational behavior, and healthcare utilization. SNA, alone or in conjunction with spatial analysis, can be used to uniquely evaluate the impact of the physical or built environment on health. The environment can shape the presence, quality, and function of social relationships with spatial and network processes interacting to affect health outcomes. While there are some common measures frequently used in modeling the impact of social networks on health outcomes, there is no standard approach to social network modeling in health research, which impacts rigor and reproducibility. METHODS We provide an overview of social network concepts and terminology focused on egocentric network data. Egocentric, or personal networks, take the perspective of an individual who identifies their own connections (alters) and also the relationships between alters. RESULTS We describe best practices for modeling egocentric networks and health outcomes according to the following five-step guide: (1) model selection, (2) social network exposure variable and selection considerations, (3) covariate selection related to sociodemographic and health characteristics, (4) covariate selection related to social network characteristics, and (5) analytic considerations. We also present an example of SNA. CONCLUSIONS SNA provides a powerful repertoire of techniques to examine how relationships impact attitudes, experiences, and behaviors-and subsequently health.
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Affiliation(s)
- Jacqueline M Burgette
- Department of Dental Public Health, 6614University of Pittsburgh School of Dental Medicine, PA, USA.,Department of Pediatric Dentistry, 12317University of Pittsburgh School of Dental Medicine, PA, USA
| | - Jacquelin Rankine
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, 12317University of Pittsburgh School of Medicine, PA, USA
| | - Alison J Culyba
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, 12317University of Pittsburgh School of Medicine, PA, USA
| | - Kar-Hai Chu
- Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, PA, USA
| | - Kathleen M Carley
- Center for Computational Analysis of Social and Organizational Systems, School of Computer Science, 6612Carnegie Mellon University, Pittsburgh, PA, USA
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Young LE, Ramachandran A, Schumm LP, Khanna AS, Schneider JA. The potential of online social networking data for augmenting the study of high-risk personal networks among young men who have sex with men at-risk for HIV. SOCIAL NETWORKS 2020; 63:201-212. [PMID: 33100488 PMCID: PMC7583251 DOI: 10.1016/j.socnet.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Capturing dynamics in high-risk personal networks is essential for preventing HIV transmission. Online social networking data offer incentive to augment traditional selfreported approaches for network enumeration. To explore what online networks reveal about dynamics among high-risk associates, we examine the relationship between egocentric confidant and sex networks and personal Facebook friendship networks of a cohort of young Black men who have sex with men. Although overlap exists between self-reported and Facebook associates, the stabilities of each were unrelated. Confidants who were also Facebook friends with a respondent were, however, more likely to be retained. Thus, Facebook networks contain stable confidants.
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Affiliation(s)
- Lindsay E Young
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
- Department of Medicine, University of Chicago, Chicago, IL
| | - Arthi Ramachandran
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
- Department of Medicine, University of Chicago, Chicago, IL
- Center for Data Science and Public Policy, University of Chicago, Chicago, IL
| | - L Phillip Schumm
- Department of Public Health Sciences, University of Chicago, Chicago, IL
| | - Aditya S Khanna
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
- Department of Medicine, University of Chicago, Chicago, IL
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
- Department of Medicine, University of Chicago, Chicago, IL
- Department of Public Health Sciences, University of Chicago, Chicago, IL
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Kan WC, Chou W, Chien TW, Yeh YT, Chou PH. The Most-Cited Authors Who Published Papers in JMIR mHealth and uHealth Using the Authorship-Weighted Scheme: Bibliometric Analysis. JMIR Mhealth Uhealth 2020; 8:e11567. [PMID: 32379053 PMCID: PMC7319608 DOI: 10.2196/11567] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/22/2018] [Accepted: 01/26/2020] [Indexed: 12/20/2022] Open
Abstract
Background Many previous papers have investigated most-cited articles or most productive authors in academics, but few have studied most-cited authors. Two challenges are faced in doing so, one of which is that some different authors will have the same name in the bibliometric data, and the second is that coauthors’ contributions are different in the article byline. No study has dealt with the matter of duplicate names in bibliometric data. Although betweenness centrality (BC) is one of the most popular degrees of density in social network analysis (SNA), few have applied the BC algorithm to interpret a network’s characteristics. A quantitative scheme must be used for calculating weighted author credits and then applying the metrics in comparison. Objective This study aimed to apply the BC algorithm to examine possible identical names in a network and report the most-cited authors for a journal related to international mobile health (mHealth) research. Methods We obtained 676 abstracts from Medline based on the keywords “JMIR mHealth and uHealth” (Journal) on June 30, 2018. The author names, countries/areas, and author-defined keywords were recorded. The BCs were then calculated for the following: (1) the most-cited authors displayed on Google Maps; (2) the geographical distribution of countries/areas for the first author; and (3) the keywords dispersed by BC and related to article topics in comparison on citation indices. Pajek software was used to yield the BC for each entity (or node). Bibliometric indices, including h-, g-, and x-indexes, the mean of core articles on g(Ag)=sum (citations on g-core/publications on g-core), and author impact factor (AIF), were applied. Results We found that the most-cited author was Sherif M Badawy (from the United States), who had published six articles on JMIR mHealth and uHealth with high bibliometric indices (h=3; AIF=8.47; x=4.68; Ag=5.26). We also found that the two countries with the highest BC were the United States and the United Kingdom and that the two keyword clusters of mHealth and telemedicine earned the highest indices in comparison to other counterparts. All visual representations were successfully displayed on Google Maps. Conclusions The most cited authors were selected using the authorship-weighted scheme (AWS), and the keywords of mHealth and telemedicine were more highly cited than other counterparts. The results on Google Maps are novel and unique as knowledge concept maps for understanding the feature of a journal. The research approaches used in this study (ie, BC and AWS) can be applied to other bibliometric analyses in the future.
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Affiliation(s)
- Wei-Chih Kan
- Department of Nephrology, Chi Mei Medical Center, Taiwan, Tainan, Taiwan.,Department of Biological Science and Technology, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Willy Chou
- Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chung Shan Medical University, Taichun, Taiwan
| | - Tsair-Wei Chien
- Department of Medical Research, Chi Mei Medical Center, Taiwan, Tainan, Taiwan
| | - Yu-Tsen Yeh
- Medical School, St George's, University of London, London, United Kingdom
| | - Po-Hsin Chou
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Biello KB, Goedel WC, Edeza A, Safren SA, Mayer KH, Marshall BD, Latkin C, Mimiaga MJ. Network-Level Correlates of Sexual Risk Among Male Sex Workers in the United States: A Dyadic Analysis. J Acquir Immune Defic Syndr 2020; 83:111-118. [PMID: 31929400 PMCID: PMC7262793 DOI: 10.1097/qai.0000000000002230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Male sex workers (MSWs) are at increased risk of HIV infection in the United States. Research is limited on sexual and drug use network characteristics of MSWs. SETTING Community-based organization and health center in 2 US Northeast cities. METHODS One hundred MSWs completed a behavioral assessment and sexual and drug network inventory. Using dyadic analyses, we assessed whether network characteristics, including sex worker-male client age, race, and HIV status homophily and risk multiplexity (ie, overlap in drug-use and sex networks), were associated with condom use. RESULTS MSW participants' mean age was 33.6. Two-thirds identified as Black or Latino, 12% identified as heterosexual, and 90% reported recent drug use. Participants reported an average of 5.3 male clients in the past month (SD = 3.4), and having anal sex with 74% of these clients, at a rate of 2.2 times per month (SD = 4.6). Participants reported inconsistent condom use during anal sex with 53% of clients. In multivariable models, inconsistent condom use was more common in relationships with presumed HIV status homophily [odds ratio (OR): 1.25; 95% confidence interval (CI): 1.07 to 1.46] and sexual and drug network multiplexity (OR: 1.19; 95% CI: 1.09 to 1.30); and less common within relationships where the client is older than the MSW participant (OR: 0.83; 95% CI: 0.74 to 0.93). Number of multiplex relationships was positively associated with number of condomless anal sex acts with male clients (incidence rate ratio: 1.35; 95% CI: 1.19 to 1.54). CONCLUSIONS Network characteristics may contribute to disproportionate HIV risk among MSWs. Modeling studies should include network characteristics when simulating HIV transmission, and future HIV interventions should address the role of networks.
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Affiliation(s)
- Katie B. Biello
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
- Fenway Institute, Fenway Health, Boston, MA
| | - William C. Goedel
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
| | - Alberto Edeza
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
| | - Steven A. Safren
- Fenway Institute, Fenway Health, Boston, MA
- Department of Psychology, College of Arts and Sciences, University of Miami, Coral Gables, Florida
| | - Kenneth H. Mayer
- Fenway Institute, Fenway Health, Boston, MA
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA
- Department of Global Health and Population, T.H. Chan School of Public Health, Harvard University, Cambridge, MA
| | - Brandon D.L. Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
| | - Carl Latkin
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Matthew J. Mimiaga
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
- Fenway Institute, Fenway Health, Boston, MA
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Injection drug use, unknown HIV positive status, and self-reported current PrEP use among Black men who have sex with men attending U.S. Black pride events, 2014-2017. Drug Alcohol Depend 2020; 207:107808. [PMID: 31855657 PMCID: PMC7552112 DOI: 10.1016/j.drugalcdep.2019.107808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Black gay, bisexual, and other men who have sex with men (BMSM) are at elevated risk for HIV infection in the United States. BMSM who inject drugs may be face even higher HIV risk. METHODS Random time-location sampling was used to survey BMSM attending Black Pride events in 6 U.S. cities about HIV risk and protective behaviors, including injection drug use, prior HIV testing, and pre-exposure prophylaxis (PrEP). 3429 individuals who reported a HIV negative/unknown serostatus at enrollment were included in the analysis. HIV status was determined by in-field rapid HIV testing. RESULTS 3.6% of BMSM had injected drugs in their lifetime and 58.5% of BMSM who had injected drugs reported sharing syringes in the past six months. BMSM who had injected drugs more commonly reported current PrEP use than BMSM who had never injected (32.5% vs. 8.2%, p < 0.001). BMSM who had injected drugs were 3.6-fold (95% CI: 2.4, 5.4) more likely to report currently using PrEP than BMSM who had never injected after adjustment for sociodemographic, substance use, and sexual risk characteristics. Among BMSM who reported ever injecting drugs (n = 123), 31.7% tested HIV positive. HIV prevalence did not differ by self-reported PrEP use among BMSM who had injected drugs (p = 0.59). CONCLUSIONS BMSM who inject drugs who reported currently using PrEP were no less likely to test positive for HIV than those who did not use PrEP. Wrap-around services to support consistent PrEP use and long-acting PrEP formulations may improve the effectiveness of PrEP among BMSM who inject drugs.
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Abstract
Roughly 1 in 7 people living with HIV in the United States is unaware of their sero-status, signaling that individuals may be underestimating their risk for HIV. Few studies have examined the effect of socio-structural and socio-cognitive factors on HIV risk perceptions. This analysis identifies individual, interpersonal and network influences on HIV risk perceptions among high-risk heterosexuals. Data come from the Colorado Springs study, a CDC-funded project focused on HIV transmission among high-risk heterosexuals. Using social network data, analyses were first conducted at the individual-level using a partial proportional odds regression to identify predictors of self-perceived HIV risk. Next, multivariate binary logistic regression using GEE was used to examine predictors of perceptions of network member's HIV risk. Interpersonal characteristics such as perceptions of network member's HIV risk, racial homophily, and engagement in multiplexity (co-occurrence of drug-use, needle sharing and sex within relationships) were significantly associated with respondents' self-perceived HIV risk. Factors associated with perceptions of network member's HIV risk include self-perceived HIV risk, emotional closeness within relationships, and density of drug ties. Analyses found HIV risk perception is the product of not only individual-level factors, but also interpersonal and social network processes. We also found a reciprocal relationship between individuals' perceptions of their own risk and the risk of their associates/network members. Findings highlight the need for understanding risk perception as a function of interpersonal relationships, social constructions, including socio-cognitive processes.
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Affiliation(s)
- Emmanuel Koku
- Department of Sociology, Drexel University, 3201 Arch Street ~ Room 288, Philadelphia, PA, 19104, USA
| | - Marisa Felsher
- Dornsife School of Public Health, Drexel University, 3215 Market St., Philadelphia, PA, 19104, USA.
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11
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Violette LR, Niemann LA, McMahan VM, Katz DA, Chavez PR, Clark HA, Cornelius-Hudson A, Ethridge SF, McDougal SJ, Ure Ii G, Stekler JD, Delaney KP. Group Sex Events Among Cisgender Men Who Have Sex With Men: Cross-Sectional and Longitudinal Survey Study to Explore Participation and Risk-Taking Behaviors. JMIR Res Protoc 2019; 8:e15426. [PMID: 31774403 PMCID: PMC6906620 DOI: 10.2196/15426] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Abstract
Background Group sex events (GSEs) are common among cisgender men who have sex with men (MSM), pose a unique risk profile for HIV and sexually transmitted disease (STD) transmission, and may be on the rise, in part because of Web-based networking platforms. However, collecting data on GSEs can be challenging, and many gaps exist in our knowledge about GSE participation among MSM. Objective The objective of this study was to develop survey questions addressing aggregate and partner-specific group sex behaviors to measure prevalence of GSEs and associated risks in persons participating in Project Diagnostic Evaluation To Expand Critical Testing Technologies (DETECT), including MSM seeking HIV and STD testing at a public clinic in Seattle, Washington. Methods We developed a computer self-assisted survey that included questions about participant demographics, sexual history, and risk behaviors, including group sex, as a part of Project DETECT, a Centers for Disease Control and Prevention–funded study evaluating point-of-care HIV tests. Aggregate and partner-specific questions asked about participation in all GSEs, threesomes, and four-or-more-somes including questions about number and HIV status of sex partners and condom use during the events. To evaluate question performance, we assessed the discrepancies in reporting between the aggregate and partner-specific questions, quantified question refusal rates, and calculated the additional time required to answer the GSE questions. Information about network density (number of partnerships of overlapping duration) was estimated and compared for MSM who did and did not report GSEs. Results Among 841 visits by 690 MSM who were asked any group sex survey question, participation in a GSE of any type in the past 3 months was reported at 293 visits (293/841, 34.8%). We found that 9.0% (76/841) of MSM in the sample reported ≥1 four-or-more-some in the partner-specific questions but did not report in the aggregate. The proportion of refusals on any given aggregate GSE-related question ranged from 0% (0/273) to 10.6% (15/141) (median 2.6%) and partner-specific questions ranged from 0% (0/143) to 22% (5/23) (median 3.0%), with questions about four-or-more-somes having the highest proportions of refusals. Completing the aggregate group sex questions added 1 to 2 minutes and the partner-specific questions added an additional 2 to 4 minutes per partner to the total survey length. As expected, the partner-specific GSE questions documented higher density of sexual networks that was not captured by asking about total partner counts and overlap of specific partnerships. Conclusions We found that the Project DETECT survey was able to obtain nuanced information about GSEs. The question skip patterns and consistency checks were effective, and survey fatigue was minimal. More research is needed on GSEs, and our survey represents a promising data collection tool to help fill gaps in knowledge about the subject.
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Affiliation(s)
- Lauren R Violette
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Lisa A Niemann
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Vanessa M McMahan
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - David A Katz
- HIV/STD Program, Public Health - Seattle & King County, Seattle, WA, United States
| | - Pollyanna R Chavez
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Hollie A Clark
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Steven F Ethridge
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sarah J McDougal
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - George Ure Ii
- Department of Medicine, University of Washington, Seattle, WA, United States
| | - Joanne D Stekler
- Department of Medicine, University of Washington, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States.,Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Kevin P Delaney
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
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