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Salazar-Vizcaya L, Kusejko K, Günthard HF, Böni J, Metzner KJ, Braun DL, Nicca D, Bernasconi E, Calmy A, Darling KEA, Wandeler G, Kouyos RD, Rauch A. An Approach to Quantifying the Interaction between Behavioral and Transmission Clusters. Viruses 2022; 14:v14040784. [PMID: 35458514 PMCID: PMC9032082 DOI: 10.3390/v14040784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 02/04/2023] Open
Abstract
We hypothesize that patterns of sexual behavior play a role in the conformation of transmission networks, i.e., the way you behave might influence whom you have sex with. If that was the case, behavioral grouping might in turn correlate with, and potentially predict transmission networking, e.g., proximity in a viral phylogeny. We rigorously present an intuitive approach to address this hypothesis by quantifying mapped interactions between groups defined by similarities in sexual behavior along a virus phylogeny while discussing power and sample size considerations. Data from the Swiss HIV Cohort Study on condom use and hepatitis C virus (HCV) sequences served as proof-of-concept. In this case, a strict inclusion criteria contrasting with low HCV prevalence hindered our possibilities to identify significant relationships. This manuscript serves as guide for studies aimed at characterizing interactions between behavioral patterns and transmission networks. Large transmission networks such as those of HIV or COVID-19 are prime candidates for applying this methodological approach.
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Affiliation(s)
- Luisa Salazar-Vizcaya
- Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (G.W.); (A.R.)
- Correspondence:
| | - Katharina Kusejko
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091 Zurich, Switzerland; (K.K.); (H.F.G.); (K.J.M.); (D.L.B.); (R.D.K.)
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland;
| | - Huldrych F. Günthard
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091 Zurich, Switzerland; (K.K.); (H.F.G.); (K.J.M.); (D.L.B.); (R.D.K.)
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland;
| | - Jürg Böni
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland;
| | - Karin J. Metzner
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091 Zurich, Switzerland; (K.K.); (H.F.G.); (K.J.M.); (D.L.B.); (R.D.K.)
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland;
| | - Dominique L. Braun
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091 Zurich, Switzerland; (K.K.); (H.F.G.); (K.J.M.); (D.L.B.); (R.D.K.)
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland;
| | - Dunja Nicca
- Institute of Nursing Science, University of Basel, 4056 Basel, Switzerland;
- Department of Public Health, Epidemiology, Biostatistics and Public Health Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland;
- University of Southern Switzerland, 6928 Manno, Switzerland
- Division of Infectious Diseases, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Alexandra Calmy
- Division of Infectious Diseases, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Katharine E. A. Darling
- Infectious Diseases Service, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland;
- University of Lausanne, 1015 Lausanne, Switzerland
| | - Gilles Wandeler
- Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (G.W.); (A.R.)
| | - Roger D. Kouyos
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, 8091 Zurich, Switzerland; (K.K.); (H.F.G.); (K.J.M.); (D.L.B.); (R.D.K.)
- Institute of Medical Virology, University of Zurich, 8057 Zurich, Switzerland;
| | - Andri Rauch
- Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (G.W.); (A.R.)
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Emotion Efficacy Improves Prediction of HIV/AIDS Risky Behaviors: A Modified Information-Motivation-Behavioral Skills Model. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021. [DOI: 10.1007/s10942-021-00410-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Piersiala K, Krajewski J, Dadej D, Loroch A, Czerniak W, Rozpłochowski B, Kierepa A, Mozer-Lisewska I. Correlates of inconsistent condom use and drug use among men having sex with men in Poland: a cross-sectional study. Int J STD AIDS 2021; 31:894-902. [PMID: 32702284 PMCID: PMC7750669 DOI: 10.1177/0956462420929136] [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] [Indexed: 12/01/2022]
Abstract
The number of new human immunodeficiency virus (HIV) diagnoses is rising in many
parts of Europe. We sought to evaluate the rising prevalence of new HIV
diagnoses in Poland, where the majority of newly-diagnosed HIV cases are men
having sex with men (MSM). This study aims to measure the prevalence of condom
use and drug use and to identify risk factors for contracting sexually
transmitted infections (STIs) among MSM in Poland by distributing an anonymous
online survey aimed toward MSM. Among the 1438 participants who completed valid
surveys, those with low education level and greater than 100 prior sexual
partners showed the highest odds for inconsistent condom use (adjusted odds
ratio [aOR] 3.027, 2.044, respectively). Participants who identified themselves
as heterosexuals, with multiple sexual partners and living in big cities showed
the highest odds for drug use (aOR 4.869, 3.305, 1.720, respectively). This
study identifies groups at the highest risk of HIV/STIs and provides valuable
information for public health experts to develop targeted STI prevention
campaigns.
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Affiliation(s)
- Krzysztof Piersiala
- Student Research Group at the Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland.,Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Joanna Krajewski
- Student Research Group at the Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Daniela Dadej
- Student Research Group at the Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Anna Loroch
- Student Research Group at the Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Witold Czerniak
- Student Research Group at the Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Błażej Rozpłochowski
- Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Agata Kierepa
- Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Iwona Mozer-Lisewska
- Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
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Künzler-Heule P, Fierz K, Schmidt AJ, Rasi M, Bogdanovic J, Kocher A, Engberg S, Battegay M, Nöstlinger C, Lehner A, Kouyos R, Schmid P, Braun DL, Fehr J, Nicca D. Response to a sexual risk reduction intervention provided in combination with hepatitis C treatment by HIV/HCV co-infected men who have sex with men: a reflexive thematic analysis. BMC Infect Dis 2021; 21:319. [PMID: 33823783 PMCID: PMC8022541 DOI: 10.1186/s12879-021-06003-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/16/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Hepatitis C virus reinfections in HIV-positive men-who-have-sex-with-men (MSM) challenge the effectiveness of antiviral treatment. To fight this problem, an adapted sexual risk reduction intervention was implemented within a hepatitis C treatment trial. Following this, the current study had two aims and describes 1) how the program was received by participants; and 2) their responses to the program regarding sexual risk taking. Based on the participants' input, we hoped to judge the intervention's potential for scale-up. METHODS Seventeen participants who received the sexual risk reduction intervention in addition to hepatitis C treatment were recruited for semi-structured interviews six to 12 months post-intervention. We evaluated the responses via reflexive thematic analysis and applied the concept of sense-making. RESULTS Giving hepatitis C a place and living without it again illustrates how participants received the program and how their experiences were altered by the impact of sense-making. Based on their responses, we allocated participants to three groups: 1. Avoid risks: get rid of hepatitis C for life. For these men, hepatitis C remained a life-threatening disease: they actively modified their risk behavior and felt supported by the intervention in maintaining their behavioral changes. 2. Minimize risks: live as long as possible without hepatitis C. In contrast to group 1, these men saw hepatitis C as a manageable disease. The intervention facilitated reflection on risks and how to develop behavioral changes that suited them individually. 3. Accept risks; live with the risk of hepatitis C. These men perceived behavioral changes as much more difficult than "easy" medical treatment. They expected to either undergo repeated rounds of treatment or stay HCV re-infected. CONCLUSION These results illustrate the diversity of men's responses and their decisions regarding sexual risk behavior after participating in a combination of antiviral treatment and a sexual risk reduction intervention. Two major aspects were identified: 1) Teachable moments, particularly at the time of diagnosis/treatment, could offer an opportunity to develop openness for behavioral change; 2) adapting sexual risk reduction interventions to sense-making patterns could help to improve its effectiveness. Support for reducing infection risk and raising awareness of preventative measures are additional benefits. TRIAL REGISTRATION Clinical Trial Number: NCT02785666 , 30.05.2016.
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Affiliation(s)
- Patrizia Künzler-Heule
- Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland.,Department of Gastroenterology/Hepatology and Department of Nursing, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Katharina Fierz
- Zurich University of Applied Sciences (ZUAS), Winterthur, Switzerland
| | - Axel Jeremias Schmidt
- Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.,Sigma Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Manuela Rasi
- Department of Public & Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Jasmina Bogdanovic
- Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Agnes Kocher
- Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Sandra Engberg
- Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland.,School of Nursing, University of Pittsburgh, Pittsburgh, USA
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.,Medical Faculty, University of Basel, Basel, Switzerland
| | | | | | - Roger Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Patrick Schmid
- Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Dominique Laurent Braun
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Jan Fehr
- Department of Public & Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.,Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Dunja Nicca
- Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland. .,Department of Public & Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
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5
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Salazar-Vizcaya L, Kusejko K, Schmidt AJ, Carrillo-Montoya G, Nicca D, Wandeler G, Braun DL, Fehr J, Darling KEA, Bernasconi E, Schmid P, Günthard HF, Kouyos RD, Rauch A. Clusters of Sexual Behavior in Human Immunodeficiency Virus-positive Men Who Have Sex With Men Reveal Highly Dissimilar Time Trends. Clin Infect Dis 2021; 70:416-424. [PMID: 30874293 DOI: 10.1093/cid/ciz208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/08/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Separately addressing specific groups of people who share patterns of behavioral change might increase the impact of behavioral interventions to prevent transmission of sexually transmitted infections. We propose a method based on machine learning to assist the identification of such groups among men who have sex with men (MSM). METHODS By means of unsupervised learning, we inferred "behavioral clusters" based on the recognition of similarities and differences in longitudinal patterns of condomless anal intercourse with nonsteady partners (nsCAI) in the HIV Cohort Study over the last 18 years. We then used supervised learning to investigate whether sociodemographic variables could predict cluster membership. RESULTS We identified 4 behavioral clusters. The largest behavioral cluster (cluster 1) contained 53% of the study population and displayed the most stable behavior. Cluster 3 (17% of the study population) displayed consistently increasing nsCAI. Sociodemographic variables were predictive for both of these clusters. The other 2 clusters displayed more drastic changes: nsCAI frequency in cluster 2 (20% of the study population) was initially similar to that in cluster 3 but accelerated in 2010. Cluster 4 (10% of the study population) had significantly lower estimates of nsCAI than all other clusters until 2017, when it increased drastically, reaching 85% by the end of the study period. CONCLUSIONS We identified highly dissimilar behavioral patterns across behavioral clusters, including drastic, atypical changes. The patterns suggest that the overall increase in the frequency of nsCAI is largely attributable to 2 clusters, accounting for a third of the population.
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Affiliation(s)
- Luisa Salazar-Vizcaya
- Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, Switzerland
| | - Katharina Kusejko
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Axel J Schmidt
- Division of Infectious Diseases and Infection Control, Cantonal Hospital St. Gallen, Switzerland.,Sigma Research, London School of Hygiene and Tropical Medicine, United Kingdom
| | | | - Dunja Nicca
- Institute of Nursing Science, University of Basel, Switzerland
| | - Gilles Wandeler
- Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, Switzerland
| | - Dominique L Braun
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Jan Fehr
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland
| | - Katharine E A Darling
- Infectious Diseases Service, Department of Medicine, University Hospital of Lausanne (CHUV), Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Lugano Regional Hospital, Switzerland
| | - Patrick Schmid
- Division of Infectious Diseases and Infection Control, Cantonal Hospital St. Gallen, Switzerland
| | - Huldrych F Günthard
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Switzerland
| | - Andri Rauch
- Department of Infectious Diseases, Bern University Hospital Inselspital, University of Bern, Switzerland
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GPS: A Randomized Controlled Trial of Sexual Health Counseling for Gay and Bisexual Men Living With HIV. Behav Ther 2021; 52:1-14. [PMID: 33483108 DOI: 10.1016/j.beth.2020.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 11/22/2022]
Abstract
Gay, bisexual, and other men who have sex with men (GBM) continue to have high rates of HIV and sexually transmitted infections, including syphilis. GBM have therefore been identified by public health agencies as a high-priority population to reach with prevention initiatives. Despite the importance of mental health in preventing HIV and related infections, there is a shortage of credentialed mental health professionals to deliver behavioral Counseling interventions. The current study evaluated the efficacy of GPS, a community-based and peer-delivered sexual health promotion motivational interviewing-based intervention for HIV-positive GBM who engaged in condomless anal sex (CAS) in the past 2 months. GPS prevention counseling demonstrated a 43% relative reduction at 3-month follow-up in CAS with serodiscordant partners and significant reductions in sexual compulsivity. The study demonstrated that community-based counselors can administer an efficacious motivational interviewing program, and suggests a continued benefit of counseling methods to promote the sexual health of higher risk populations.
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Wilkerson JM, Rhoton JM, Li D, Rawat S, Patankar P, Rosser BRS, Ekstrand ML. Information, Motivation, and Self-Efficacy Among Men Who Have Sex With Men and Transgender Women in the State of Maharashtra, India. HEALTH EDUCATION & BEHAVIOR 2019; 46:304-311. [PMID: 30205760 PMCID: PMC6734545 DOI: 10.1177/1090198118796880] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND India's National AIDS Control Programme calls for, among other things, targeted behavioral interventions that address determinants contributing to new infections among men who have sex with men (MSM) and hijras (transgender women). AIM To determine if the information-motivation-behavioral skills model was transferable to an Indian context. METHODS We recruited 442 MSM and 7 hijras into an online cross-sectional study that asked questions about condom use knowledge, motivation, self-efficacy, and sexual behavior. Structural equation modeling was used to test the overall information-motivation-behavioral skills structure. RESULTS Condom use and HIV risk knowledge did not significantly predict condom use self-efficacy or having condomless anal sex with more than one male partner in the past 3 months, and knowledge was not significantly correlated with attitudes toward barebacking. Despite this, the final structural model explained 14.4% of the variance in condom use self-efficacy and 20.0% of the variance in risky sexual behavior. Overall fit of the model was good: χ2(201, N = 447) = 445.002, p < .0001, root mean square error of approximation = .052, 90% CI [.046, .059], comparative fit index = .989, Tucker-Lewis Index = .987. CONCLUSION The public health response to India's HIV epidemic is currently different than in the West due to differences in medication access and public health infrastructure. As Indian MSM and hijras learn more about the effectiveness of viral suppression and hopefully have greater access to preexposure prophylaxis, researchers should monitor for changing attitudes toward condoms and be prepared to collaborate with the public health infrastructure in order to develop interventions that reinforce positive attitudes toward condom use.
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Affiliation(s)
- J. Michael Wilkerson
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas, USA
| | - Jayson M. Rhoton
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas, USA
| | - Dennis Li
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas, USA
| | | | | | - B. R. Simon Rosser
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Maria L. Ekstrand
- University of California San Francisco Center for AIDS Prevention Studies, San Francisco, California, USA
- St John’s Research Institute of St John’s National Academy of Health Sciences, Bengaluru, India
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Jiang H, Chen X, Li J, Tan Z, Cheng W, Yang Y. Predictors of condom use behavior among men who have sex with men in China using a modified information-motivation-behavioral skills (IMB) model. BMC Public Health 2019; 19:261. [PMID: 30832640 PMCID: PMC6399930 DOI: 10.1186/s12889-019-6593-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 02/25/2019] [Indexed: 01/11/2023] Open
Abstract
Background Men who have sex with men (MSM) are at high risk for human immunodeficiency virus (HIV) infection in China. Correct and consistent condom use is one of the most effective strategies for preventing the spread of HIV. This study developed a modified Information-Motivation-Behavioral Skills (IMB) model to predict condom use behavior among Chinese MSM. Methods A cross-sectional study was conducted to collect data using self-administered electronic questionnaire. Participants were recruited from HIV Voluntary Counseling and Testing clinics in six district Centers for Disease Control and Prevention in Guangzhou and two community-based HIV service centers (Lingnan Partners and Zhitong Charity) from May to September 2017. Structural equation modeling was performed to develop the modified IMB model with extended multilevel factors. Results Among the 976 MSM included, 52.05% had engaged in anal intercourse with a condom every time. The final modified IMB model fitted the data more ideally than the conventional model. The final modified IMB model revealed that behavioral skills positively contributed directly to condom use (β = 0.385, p < 0.001) and partially mediated the associations between information (β = 0.106, p = 0.005) and motivation (β = 0.390, p < 0.001) and condom use. Regarding the extended multilevel factors, education, income, receiving HIV prevention services, sexual partner seeking behavior, depression, intimate partner violence, and child sexual abuse had indirect impacts on condom use that were mediated by information, motivation, and/or behavioral skills (p < 0.05). All paths from the latent variable to the corresponding observed variables were statistically significant (p < 0.001). Conclusion The modified IMB model with extended multilevel factors could serve as a theoretical framework for behavioral interventions for condom use among Chinese MSM. Further prospective studies are needed to examine the predictive power of the modified IMB model. Electronic supplementary material The online version of this article (10.1186/s12889-019-6593-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Xiaobin Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Zhimin Tan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China
| | - Weibin Cheng
- Department of AIDS/STD Control and Prevention, Guangzhou Center for Disease Control and Prevention, No. 1 Qide Road, Baiyun District, Guangzhou, China.
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, No. 283 Jianghai Road, Haizhu District, Guangzhou, China.
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Validation of the AIDS Prevention Questionnaire: A Brief Self-Report Instrument to Assess Risk of HIV Infection and Guide Behavioral Change. AIDS Behav 2019; 23:272-282. [PMID: 30008051 DOI: 10.1007/s10461-018-2224-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This paper describes the process of building and validating the AIDS Prevention Questionnaire (CPS), a brief HIV risk assessment measure. An initial 64-items bank was filled out by 466 young people (192 men and 274 women), aged between 17 and 26 years (M = 20.62; SD = 2.15). The exploratory factor analysis revealed five components: Knowledge about HIV, Condom Attitudes, Intentions of Condom Use, Safe sexual behavior and Stigma and discrimination towards people living with HIV. This structure was confirmed by confirmatory factor analysis. The internal consistency for the different components ranged from .67 to .74. Moreover, CPS has a classification system that allows determining the level of risk. These results support the AIDS Prevention Questionnaire as a valid and reliable measure to detect earlier the risk for HIV infection and to design adjusted preventive interventions.
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10
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Wilkerson JM, Noor SW, Rhoton JM, Li D, Rosser BRS. Differentially classified methamphetamine-using men who have sex with men: A latent class analysis. Drug Alcohol Depend 2018; 192:129-136. [PMID: 30248559 PMCID: PMC6746229 DOI: 10.1016/j.drugalcdep.2018.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 06/30/2018] [Accepted: 07/03/2018] [Indexed: 12/19/2022]
Abstract
CONTEXT Substance use interventions for methamphetamine-using men who have sex with men (MSM) are limited by the assumption that they are a uniform group. We hypothesized that an LCA would identify distinct patterns of substance use and demographic and psychosocial variables associated with different substance-using groups would aid in understanding distinctions. Using cross-sectional data from 343 methamphetamine-using MSM, we conducted an LCA to model the patterns of polysubstance use then examined how the classes varied on psychosocial variables defined by the Information-Motivation-Behavioral Skills (IMB) model. FINDINGS Because we were interested in identifying patterns of polysubstance use (PSU) among our sample, we identified four classes: minimal PSU, marijuana PSU, cocaine/hallucinogens PSU, and designer drugs/heroin PSU. Men in the marijuana PSU class were less likely to have positive attitudes towards methamphetamine than participants in the other three classes. Men in the Cocaine and Hallucinogens PSU class were more likely to have higher PANAS scores (OR = 13.00 [3.25, 52.07]) compared to the other classes, and they were more likely to have higher self-efficacy to enact safer substance use strategies (OR = 10.72 [3.23, 35.47]). MSM in the Designer Drug and Heroin PSU class were more likely to have a diagnosis of Hepatitis B (OR = 4.07 [0.86, 19.36] despite having higher knowledge of sexual health practices (OR = 0.55 [0.36, 0.84]. CONCLUSIONS Differential classification for methamphetamine-using MSM suggests an opportunity for tailored interventions and secondary prevention programs. By understanding how men vary on illicit substance use, interventionists can routinely screen and link men before they potentially progress to another classification.
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Affiliation(s)
- J. Michael Wilkerson
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 7000 Fannin St #1200, Houston, TX, 77030, USA
| | - Syed W. Noor
- Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada
| | - Jayson M. Rhoton
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 7000 Fannin St #1200, Houston, TX, 77030, USA
| | - Dennis Li
- Northwestern University, 633 Clark St., Evanston, IL, 60208, USA
| | - B. R. Simon Rosser
- University of Minnesota School of Public Health, 420 Delaware St. SE, Minneapolis, MN 55455, USA
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Nebot Giralt A, Nöstlinger C, Lee J, Salami O, Lallemant M, Ouma O, Nyamongo I, Marchal B. Understanding the acceptability and adherence to paediatric antiretroviral treatment in the new formulation of pellets (LPV/r): the protocol of a realist evaluation. BMJ Open 2017; 7:e014528. [PMID: 28360249 PMCID: PMC5372016 DOI: 10.1136/bmjopen-2016-014528] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Improving access to paediatric HIV treatment requires both large-scale treatment programmes and medication that is adapted to infants and children's needs. The WHO recommends lopinavir/ritonavir as first-line antiretroviral therapy for all HIV-infected children younger than 3 years. There is currently little evidence on the acceptability of, and adherence to, a formulation of this combination treatment if given in the form of pellets. This protocol presents how we will carry a realist evaluation to assess the factors that contribute to the acceptability and adherence to the new pellets formulation in 3 hospitals in Kenya. METHODS We structured the protocol along the realist evaluation cycle following 4 steps: (1) the initial programme theory, (2) the study design, (3) the data collection methods and (4) the data analysis plan. Theories of behavioural sciences were reviewed for frames that could provide insights into how using such new formulations may contribute to better acceptability and adherence. ETHICS AND DISSEMINATION This study was approved by the Institutional Review Board of the Institute of Tropical Medicine, the Ethical Committee of the University Hospital Antwerp and the Kenyatta National Hospital/University of Nairobi Ethics and Research Committee. We aim to disseminate the findings through international conferences and peer-reviewed journals and to share them with Drugs for Neglected Diseases initiative's (DNDi) programme managers and with the Kenyan healthcare providers. DISCUSSION In developing this study, we encountered some challenges. First, methods to measure the acceptability of any formulation and adherence to it are not standardised. The second challenge is common in realist evaluation and relates to how to choose from different potentially interesting theoretical frameworks. We identified relevant and empirically tested theories from behavioural science that may be helpful in our study. We will test them in 3 settings by exploring the multilevel factors that influence acceptability and adherence of this new paediatric Antiretroviral (ARV) formulation.
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Affiliation(s)
| | | | - Janice Lee
- Drugs for Neglected Diseases Initiative, Geneva, Switzerland
| | | | - Marc Lallemant
- Drugs for Neglected Diseases Initiative, Geneva, Switzerland
| | - Onyango Ouma
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Isaac Nyamongo
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Hart TA, Willis AC, Simpson SH, Julien RE, Hoe D, Leahy B, Maxwell J, Adam BD. Gay Poz Sex: A Sexual Health Promotion Intervention for HIV-Positive Gay and Bisexual Men. COGNITIVE AND BEHAVIORAL PRACTICE 2016. [DOI: 10.1016/j.cbpra.2015.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Implementation and Operational Research: Computer-Assisted Intervention for Safer Sex in HIV-Positive Men Having Sex With Men: Findings of a European Randomized Multi-Center Trial. J Acquir Immune Defic Syndr 2016; 71:e63-72. [PMID: 26866955 PMCID: PMC4770369 DOI: 10.1097/qai.0000000000000882] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Men who have sex with men (MSM) are the key population most affected by HIV in Europe. We performed the first European multicenter, simple-randomized parallel-group study to test the effectiveness of a theory-guided computer-assisted intervention to improve safer sex among HIV-positive men who have sex with men. METHODS Between February, 2011 and February, 2013, 112 participants were enrolled in 8 different European HIV-care settings. Intervention participants received 3 individual counseling sessions facilitated by trained service providers using computer-assisted tools. The control-group received sexual health advice delivered as part of regular HIV care. Outcome behavior (self-reported condom use at last intercourse; combined HIV transmission risk score), its influencing factors, and mediating variables were assessed at baseline, and at 3 and 6 months follow-up. Mixed effects models were used to compare primary outcomes (condom use at last intercourse, HIV transmission risk score), and mediation analysis to explore intervention effects. RESULTS Condom use at last intercourse increased more among intervention than control participants at 3 months follow-up (odds ratio of 3.83; P = 0.03), but not significantly at 6 months follow-up. Intervention participants reported a lower transmission risk at 3 months follow-up than controls (odds ratio compared with baseline of 11.53 and 1.28, respectively; P = 0.008), but this effect became nonsignificant at 6 months. Intervention effects were mediated by the proximal variables, self-efficacy to negotiate condom use and condom attitudes. CONCLUSIONS This intervention showed short-term effectiveness. The intervention should be replicated in other settings, eventually investigating if booster-counseling sessions would yield a longer lasting effect.
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Pantalone DW, Puckett JA, Gunn HA. Psychosocial Factors and HIV Prevention for Gay, Bisexual, and Other Men Who Have Sex with Men. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2016. [DOI: 10.1111/spc3.12234] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nöstlinger C, Borms R, Dec-Pietrowska J, Dias S, Rojas D, Platteau T, Vanden Berghe W, Kok G. Development of a theory-guided pan-European computer-assisted safer sex intervention. Health Promot Int 2015; 31:782-792. [PMID: 26092853 DOI: 10.1093/heapro/dav061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
HIV is a growing public health problem in Europe, with men-having-sex-with-men and migrants from endemic regions as the most affected key populations. More evidence on effective behavioral interventions to reduce sexual risk is needed. This article describes the systematic development of a theory-guided computer-assisted safer sex intervention, aiming at supporting people living with HIV in sexual risk reduction. We applied the Intervention Mapping (IM) protocol to develop this counseling intervention in the framework of a European multicenter study. We conducted a needs assessment guided by the information-motivation-behavioral (IMB) skills model, formulated change objectives and selected theory-based methods and practical strategies, i.e. interactive computer-assisted modules as supporting tools for provider-delivered counseling. Theoretical foundations were the IMB skills model, social cognitive theory and the transtheoretical model, complemented by dual process models of affective decision making to account for the specifics of sexual behavior. The counseling approach for delivering three individual sessions was tailored to participants' needs and contexts, adopting elements of motivational interviewing and cognitive-behavioral therapy. We implemented and evaluated the intervention using a randomized controlled trial combined with a process evaluation. IM provided a useful framework for developing a coherent intervention for heterogeneous target groups, which was feasible and effective across the culturally diverse settings. This article responds to the need for transparent descriptions of the development and content of evidence-based behavior change interventions as potential pillars of effective combination prevention strategies.
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Affiliation(s)
- Christiana Nöstlinger
- Department of Public Health, ITM's HIV/AIDS Center, Institute of Tropical Medicine, Nationalestraat 155, Antwerp B-2000, Belgium
| | | | | | - Sonia Dias
- Institute of Tropical Medicine and Hygiene, Lisbon, Portugal
| | - Daniela Rojas
- MIRE (Mission Innovation, Recherche, Évaluation), AIDES, Paris, France
| | - Tom Platteau
- Department of Clinical Sciences, ITM's HIV/AIDS Center, ITM, Antwerp, Belgium
| | - Wim Vanden Berghe
- Department of Public Health, ITM's HIV/AIDS Center, Institute of Tropical Medicine, Nationalestraat 155, Antwerp B-2000, Belgium
| | - Gerjo Kok
- Faculty of Psychology, University of Maastricht, Maastricht, The Netherlands
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Lacefield K, Negy C, Schrader RM, Kuhlman C. Comparing Psychosocial Correlates of Condomless Anal Sex in HIV-Diagnosed and HIV-Nondiagnosed Men Who Have Sex with Men: A Series of Meta-Analyses of Studies from 1993-2013. LGBT Health 2015; 2:200-20. [PMID: 26788669 DOI: 10.1089/lgbt.2014.0069] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Men who have sex with men (MSM) continue to be overrepresented in rates of incidence and prevalence of human immunodeficiency virus (HIV). Both HIV-diagnosed (HIV-D) and HIV-nondiagnosed (HIV-N) MSM report a variety of reasons for intentional and unintentional nonuse of condoms. Elucidating and comparing reasons for continued engagement in condomless anal sex specific to both HIV-D and HIV-N MSM likely is important to identifying effective prevention. METHODS This study employed meta-analytic methods to evaluate and compare correlates to condomless anal sex in both HIV-D and HIV-N MSM from primary studies from 1993 to February 2013. RESULTS Of the 19 individual correlates assessed within the subgroup of HIV-D MSM, variables that achieved significant effect were alcohol, mind-altering substance use, sexual-enhancement medication, intentional condom nonuse, self-efficacy, attitudes toward condom use, social support, gay identity, compulsivity, trading sex, and number of sex partners. Those that were statistically non-significant were intention to use a condom, perceived risk, perceived norms, perceived responsibility, HIV medical management, treatment optimism, mental health, and setting. Of the 12 correlates assessed within the subgroup of HIV-N MSM, variables that achieved significant effect were alcohol, mind-altering substance use, intentional condom nonuse, attitudes toward condom use, perceived risk, and setting. Those observed as statistically non-significant were perceived norms, social support, gay identity, mental health, trading sex, and number of sex partners. CONCLUSION Study results have clinical implications that may guide future prevention research and practice by highlighting risk variables shared between HIV-N and HIV-D MSM, as well as variables observed to be unique to each group that may warrant more tailored intervention. Further investigation is recommended to elucidate the relationships among these variables such that optimal intervention can be determined.
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Affiliation(s)
- Katharine Lacefield
- 1 Department of Psychology, VA Maryland Healthcare System , Baltimore, Maryland.,2 Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Charles Negy
- 3 Department of Psychology, University of Central Florida , Orlando, Florida
| | - Ronald M Schrader
- 4 Department of Dialysis, DCI Corporate Quality Management , Albuquerque, New Mexico
| | - Christina Kuhlman
- 3 Department of Psychology, University of Central Florida , Orlando, Florida
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Grau LE, Krasnoselskikh TV, Shaboltas AV, Skochilov RV, Kozlov AP, Abdala N. Cultural adaptation of an intervention to reduce sexual risk behaviors among patients attending a STI clinic in St. Petersburg, Russia. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2014; 14:400-10. [PMID: 23322231 DOI: 10.1007/s11121-012-0301-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cultural adaptation is an important step in the process of implementing health promotion interventions that, having been proven to be effective in one culture, are being applied in another. This study describes the results of a formative investigation to culturally adapt a STI/HIV risk reduction intervention for use in St. Petersburg, Russia. Analyses of data from brief elicitation interviews, focus groups, community experts, and a pilot test of the adapted intervention identified environmental, cognitive-information processing, and affect-motivation factors that needed to be addressed during the adaptation process. The participant/counselor relationship was adapted to reflect a hierarchical (cf. collaborative) relationship in order to accommodate Russian expectations about patient interactions with healthcare experts. Key skills building activities (e.g., identification of personal risk behaviors, role-playing) were approached gradually or indirectly in order to maintain participants' engagement in the intervention, and close-ended questions were added to assist participants in understanding unfamiliar concepts such as "triggers" and self-efficacy. Information about the prevalence of HIV/STI infections and alcohol use included data specific to St. Petersburg to increase the personal relevance of these materials and messages. Intervention components were tailored to participants' risk reduction and informational needs. No gender differences that would have justified adaptation of the intervention approach or content were noted. Examples of specific adaptations and the key issues to attend to when adapting behavioral interventions for use in Russian clinical settings are discussed.
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Affiliation(s)
- Lauretta E Grau
- Yale University School of Public Health, New Haven, CT 06520-8034, USA.
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Fisher WA, Fisher JD, Shuper PA. Social Psychology and the Fight Against AIDS. ADVANCES IN EXPERIMENTAL SOCIAL PSYCHOLOGY 2014. [DOI: 10.1016/b978-0-12-800284-1.00003-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Platteau T, Müller MC, Nideröst S, Csepe P, Dedes N, Apers L, Schrooten W, Nöstlinger C. Patients' Satisfaction with Sexual and Reproductive Health Services Delivered in HIV Clinics across European Regions. Cent Eur J Public Health 2013; 21:123-7. [DOI: 10.21101/cejph.a3839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Nguyen HV, Dunne MP, Debattista J. Predictors of recent HIV testing among male street laborers in urban Vietnam. J Health Psychol 2013; 19:1066-78. [PMID: 23682063 DOI: 10.1177/1359105313483645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study assessed the prevalence of and factors associated with HIV testing among male street laborers. In a cross-sectional survey, social mapping was done to recruit and interview 450 men aged 18-59 years in Hanoi. Although many of these men engaged in multiple risk behaviors for HIV, only 19.8 percent had been tested for HIV. A modified theoretical model provided better fit than the conventional Information-Motivation-Behavioral Skills model, as it explained much more variance in HIV testing. This model included three Information-Motivation-Behavioral components and four additional factors, namely, the origin of residence, sexual orientation, the number of sexual partners, and the status of condom use.
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