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Dangerfield Ii DT, Anderson JN, Wylie C, Bluthenthal R, Beyrer C, Farley JE. A Multicomponent Intervention (POSSIBLE) to Improve Perceived Risk for HIV Among Black Sexual Minority Men: Feasibility and Preliminary Effectiveness Pilot Study. JMIR Hum Factors 2024; 11:e54739. [PMID: 38861707 DOI: 10.2196/54739] [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: 11/20/2023] [Revised: 02/17/2024] [Accepted: 04/22/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Increased pre-exposure prophylaxis (PrEP) use is urgently needed to substantially decrease HIV incidence among Black sexual minority men. Low perceived risk for HIV (PRH) is a key unaddressed PrEP barrier for Black sexual minority men. Peers and smartphone apps are popular intervention tools to promote community health behaviors, but few studies have used these together in a multicomponent strategy. Therefore, we designed a multicomponent intervention called POSSIBLE that used an existing smartphone app called PrEPme (Emocha Mobile Health, Inc) and a peer change agent (PCA) to increase PRH as a gateway to PrEP. OBJECTIVE This paper aims to describe the feasibility and preliminary impact of POSSIBLE on PRH and willingness to accept a PrEP referral among Black sexual minority men. METHODS POSSIBLE was a theoretically guided, single-group, 2-session pilot study conducted among Black sexual minority men from Baltimore, Maryland between 2019 and 2021 (N=69). POSSIBLE integrated a PCA and the PrEPme app that allows users to self-monitor sexual risk behaviors and chat with the in-app community health worker to obtain PrEP service information. PRH was assessed using the 8-item PRH scale before and after baseline and follow-up study visits. At the end of each study visit, the PCA referred interested individuals to the community health worker to learn more about PrEP service options. RESULTS The average age of participants was 32.5 (SD 8.1, range 19-62) years. In total, 55 (80%) participants were retained for follow-up at month 1. After baseline sessions, 29 (42%) participants were willing to be referred to PrEP services, 20 (69%) of those confirmed scheduled appointments with PrEP care teams. There were no statistically significant differences in PRH between baseline and follow-up visits (t122=-1.36; P=.17). CONCLUSIONS We observed no statistically significant improvement in PRH between baseline and month 1. However, given the high retention rate and acceptability, POSSIBLE may be feasible to implement. Future research should test a statistically powered peer-based approach on PrEP initiation among Black sexual minority men. TRIAL REGISTRATION ClinicalTrials.gov NCT04533386; https://clinicaltrials.gov/study/NCT04533386.
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Affiliation(s)
- Derek T Dangerfield Ii
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Janeane N Anderson
- University of Tennessee Health Science Center, Memphis, TN, United States
| | - Charleen Wylie
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Ricky Bluthenthal
- Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Chris Beyrer
- Duke Global Health Institute, Durham, NC, United States
| | - Jason E Farley
- Johns Hopkins School of Nursing, Baltimore, MD, United States
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Chambers LC, Tapia KA, Srinivasan S, Proll S, Morgan JL, Hoffman NG, Lowens MS, Glick SN, Khosropour CM, Golden MR, Hughes JP, Manhart LE, Fredricks DN. The Relationship Between Insertive Oral and Anal Sex and Select Measures of the Composition of the Urethral Microbiota Among Men Who Have Sex With Men. Sex Transm Dis 2024; 51:407-414. [PMID: 38403292 PMCID: PMC11088528 DOI: 10.1097/olq.0000000000001959] [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: 02/27/2024]
Abstract
BACKGROUND Sexual behavior may influence the composition of the male urethral microbiota, but this hypothesis has not been tested in longitudinal studies of men who have sex with men (MSM). METHODS From December 2014 to July 2018, we enrolled MSM with nongonococcal urethritis (NGU) attending a sexual health clinic. Men attended 5 in-clinic visits at 3-week intervals, collected weekly urine specimens at home, and reported daily antibiotics and sexual activity on weekly diaries. We applied broad-range 16S rRNA gene sequencing to urine. We used generalized estimating equations to estimate the association between urethral sexual exposures in the prior 7 days (insertive oral sex [IOS] only, condomless insertive anal intercourse [CIAI] only, IOS with CIAI [IOS + CIAI], or none) and Shannon index, number of species (observed, oral indicator, and rectal indicator), and specific taxa, adjusting for recent antibiotics, age, race/ethnicity, HIV, and preexposure prophylaxis. RESULTS Ninety-six of 108 MSM with NGU attended ≥1 follow-up visit. They contributed 1140 person-weeks of behavioral data and 1006 urine specimens. Compared with those with no urethral sexual exposures, those with IOS only had higher Shannon index ( P = 0.03 ) but similar number of species and presence of specific taxa considered, adjusting for confounders; the exception was an association with Haemophilus parainfluenzae . CIAI only was not associated with measured aspects of the urethral microbiota. IOS + CIAI was only associated with presence of H. parainfluenzae and Haemophilus . CONCLUSIONS Among MSM after NGU, IOS and CIAI did not seem to have a substantial influence on measured aspects of the composition of the urethral microbiota.
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Affiliation(s)
- Laura C. Chambers
- Department of Epidemiology, University of Washington,
Seattle, Washington
| | - Kenneth A. Tapia
- Department of Global Health, University of Washington,
Seattle, Washington
| | - Sujatha Srinivasan
- Vaccine and Infectious Disease Division, Fred Hutchinson
Cancer Center, Seattle, Washington
| | - Sean Proll
- Vaccine and Infectious Disease Division, Fred Hutchinson
Cancer Center, Seattle, Washington
| | - Jennifer L. Morgan
- HIV/STI/HCV Program, Public Health – Seattle and
King County, Seattle, Washington
| | - Noah G. Hoffman
- Department of Laboratory Medicine and Pathology, University
of Washington, Seattle, Washington
| | - M. Sylvan Lowens
- HIV/STI/HCV Program, Public Health – Seattle and
King County, Seattle, Washington
| | - Sara N. Glick
- Department of Epidemiology, University of Washington,
Seattle, Washington
- HIV/STI/HCV Program, Public Health – Seattle and
King County, Seattle, Washington
- Department of Medicine, University of Washington, Seattle,
Washington
| | | | - Matthew R. Golden
- Department of Epidemiology, University of Washington,
Seattle, Washington
- HIV/STI/HCV Program, Public Health – Seattle and
King County, Seattle, Washington
- Department of Medicine, University of Washington, Seattle,
Washington
| | - James P. Hughes
- Department of Biostatistics, University of Washington,
Seattle, Washington
| | - Lisa E. Manhart
- Department of Epidemiology, University of Washington,
Seattle, Washington
- Department of Global Health, University of Washington,
Seattle, Washington
| | - David N. Fredricks
- Vaccine and Infectious Disease Division, Fred Hutchinson
Cancer Center, Seattle, Washington
- Department of Medicine, University of Washington, Seattle,
Washington
- Department of Microbiology, University of Washington,
Seattle, Washington
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Arizmendi C, Wang S, Kaplan S, Weinfurt K. Evaluating Recall Periods for Patient-Reported Outcome Measures: A Systematic Review of Quantitative Methods. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:518-526. [PMID: 38342366 DOI: 10.1016/j.jval.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 01/09/2024] [Accepted: 01/17/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVES The current guidance for selection of recall periods recommends considering the design of the study, nature of the condition, patient's burden and ability to recall, and intent of the outcome measure. Empirical study of the accuracy of recall periods is recommended; however, there is not consensus on how to quantitatively evaluate the consistency of results from patient-reported outcome measures (PROMs) with different recall periods. We conducted a systematic review to describe quantitative methods for evaluating results obtained from PROMs with differing recall periods to lay the groundwork for establishing consensus. METHODS We searched MEDLINE, Embase, Scopus, and American Psychological Association PsycINFO for studies where participants are given the same health-related measure (eg, quality of life, well-being, functioning, and pain) with differing recall periods. RESULTS A total of 7174 abstracts were screened. The 30 included studies reflected a wide range of domains, including pain, fatigue, and sexual behavior and function. The recall periods ranged from momentary to 6 months. The analytic approaches varied, including different methods for assessing relative agreement, absolute agreement, and for assessing combined relative and absolute agreement. CONCLUSIONS We found variability in how PROM recall periods were evaluated, suggesting an opportunity for greater consensus on methodological approach. As a starting point, we provide recommendations for which methods are preferred for which contexts.
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Affiliation(s)
- Cara Arizmendi
- Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Suwei Wang
- Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Samantha Kaplan
- Medical Center Library, Duke University School of Medicine, Durham, NC, USA
| | - Kevin Weinfurt
- Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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Chambers LC, Morgan JL, Lowens MS, Robinson TS, Romano SS, Leipertz GL, Glick SN, Khosropour CM, Hughes JP, Golden MR, Fredricks DN, Manhart LE. The Incidence Rate of Sexual Behaviors Among Cisgender Men Who Have Sex with Men Attending a Sexual Health Clinic. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:751-759. [PMID: 35930134 PMCID: PMC9892175 DOI: 10.1007/s10508-022-02370-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/27/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
Although nuanced parameterization of sexual behavior may improve estimates from mathematical models of human immunodeficiency virus and sexually transmitted infection transmission, prospective estimates of the incidence of specific sexual behaviors among men who have sex with men (MSM) are limited. From December 2014 to July 2018, MSM with and without nongonococcal urethritis (NGU) completed weekly diaries over 3-12 weeks. Incidence rates of any sex, receptive anal sex, insertive anal sex, insertive oral sex, receptive rimming, and receptive hand-penile contact were 1.19, 0.28, 0.66, 0.90, 0.24, and 0.85 episodes per person-week, respectively, among 104 MSM with NGU at baseline, and 1.33, 0.54, 0.32, 0.95, 0.44, and 0.88 episodes per person-week, respectively, among 25 MSM without NGU at baseline. Most receptive anal sex (NGU + 83%, NGU - 86%) and insertive anal sex (NGU + 85%, NGU - 76%) episodes were condomless. MSM engaged in sex just over once per week, and condom use was infrequent. Insertive oral sex and receptive hand-penile contact were the most common behaviors.
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Affiliation(s)
- Laura C Chambers
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA.
| | - Jennifer L Morgan
- HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA
| | - M Sylvan Lowens
- HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA
| | - Tashina S Robinson
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
| | - Sarah S Romano
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
| | - Gina L Leipertz
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
| | - Sara N Glick
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
- HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Christine M Khosropour
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
| | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Matthew R Golden
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
- HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - David N Fredricks
- Department of Medicine, University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Microbiology, University of Washington, Seattle, WA, USA
| | - Lisa E Manhart
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
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5
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Dangerfield Ii DT, Anderson JN, Wylie C, Arrington-Sanders R, Bluthenthal RN, Beyrer C, Farley JE. Refining a Multicomponent Intervention to Increase Perceived HIV Risk and PrEP Initiation: Focus Group Study Among Black Sexual Minority Men. JMIR Form Res 2022; 6:e34181. [PMID: 35947442 PMCID: PMC9403828 DOI: 10.2196/34181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 04/28/2022] [Accepted: 07/08/2022] [Indexed: 11/26/2022] Open
Abstract
Background Increased preexposure prophylaxis (PrEP) initiation is needed to substantially decrease HIV incidence among Black sexual minority men (BSMM). However, BSMM perceive others as PrEP candidates instead of themselves and are less likely than other groups to use PrEP if prescribed. Peers and smartphone apps are popular HIV prevention intervention tools typically used independently. However, they could be useful together in a multicomponent strategy to improve perceived HIV risk and PrEP initiation for this group. Information regarding attitudes and preferences toward this multicomponent strategy is limited. Objective The goal of this study is to obtain attitudes and perspectives regarding the design of a multicomponent intervention that uses a smartphone app and a peer change agent (PCA) to increase perceived HIV risk and PrEP initiation. The intervention will be refined based on thematic findings for a culturally responsive approach. Methods Data were obtained guided by life course theory and the health belief model using 12 focus groups and 1 in-depth interview among HIV-negative BSMM from Baltimore, MD, between October 2019 and May 2020 (n=39). Groups were stratified by the following ages: 18 to 24 years, 25 to 34 years, and 35 years and older. Participants were provided details regarding an existing mobile app diary to self-monitor sexual behaviors and a hypothetical PCA with whom to review the app. Facilitators posed questions regarding perceived HIV risk, attitudes toward the app, working with a PCA, and preferences for PCA characteristics and approaches. Results Most participants identified as homosexual, gay, or same gender-loving (26/38, 68%), were employed (26/38, 69%), single (25/38, 66%), and interested in self-monitoring sexual behaviors (28/38, 68%). However, themes suggested that participants had low perceived HIV risk, that self-monitoring sexual behaviors using a mobile app diary was feasible but could trigger internalized stigma, and that an acceptable PCA should be a possible self for BSMM to aspire to but they still wanted clinicians to “do their job.” Conclusions HIV-negative BSMM have dissonant attitudes regarding perceived HIV risk and the utility of a mobile app and PCA to increase perceived HIV risk and PrEP initiation. Future research will explore the feasibility, acceptability, and preliminary impact of implementing the multicomponent intervention on perceived HIV risk and PrEP initiation among BSMM in a pilot study.
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Affiliation(s)
- Derek T Dangerfield Ii
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Us Helping Us, People Into Living, Inc, Washington, DC, United States
| | - Janeane N Anderson
- University of Tennessee Health Science Center, Memphis, TN, United States
| | - Charleen Wylie
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | - Ricky N Bluthenthal
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| | - Christopher Beyrer
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jason E Farley
- Johns Hopkins School of Nursing, Baltimore, MD, United States
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6
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Chiou PY, Liao PH, Liu CY, Hsu YT. Effects of mobile health on HIV risk reduction for men who have sex with men. AIDS Care 2019; 32:316-324. [PMID: 31558040 DOI: 10.1080/09540121.2019.1668531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Mobile health (M-Health) has become a novel method for HIV prevention and the effects need to be promoted. The study purpose was to exam how a smartphone application (app) reduces HIV risky behaviour in men who have sex with men (MSM). The Safe Behaviour and Screening (SBS) app was developed, and included five features: record, output, and resources connection; information provision; testing services; interaction; and online statistics. A random assignment was used. The experimental group used the SBS app for six months. The control group did not use any intervention. There were 130 participants in the experimental group, and 135 in the control group. The average age of all subjects was 27.38 (SD = 5.56). Compared to the control group, the experimental group had significantly higher mean score of safe behaviour knowledge, motivation, and skills; percentage of condom use during anal intercourse; frequency of searching for testing resources and getting HIV and syphilis tests. The frequency of anal intercourse and recreational drug usage were significantly lower in the experimental group. The SBS app could decrease the HIV risky behaviour among MSM and be applied to HIV prevention and nursing intervention.
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Affiliation(s)
- Piao-Yi Chiou
- Department of Nursing, Medical College, National Taiwan University, Taipei City, Taiwan (R.O.C)
| | - Pei-Hung Liao
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan (R.O.C.)
| | - Chieh-Yu Liu
- Department of Speech language pathology and audiology, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan (R.O.C.)
| | - Yu-Tz Hsu
- Department of Infection, Mackay Memorial Hospital, Taipei City, Taiwan (R.O.C.)
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Cook SH, Valera P, Wood EP, Calebs BJ, Wilson PA. Understanding Attachment Transitions Through the Lived Experiences of Young Black Gay and Bisexual Men. JOURNAL OF SEX RESEARCH 2019; 56:604-619. [PMID: 29578810 PMCID: PMC6158107 DOI: 10.1080/00224499.2018.1440280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
We conducted a mixed-methods study to identify factors that influence transitions in attachment style between childhood and adulthood among 28 young Black gay and bisexual men (YBGBM) in the United States. We used a phenomenological approach to data integration, with the major component to the results being garnered from the qualitative interviews. We organized our results by four attachment transition groups: stable secure (secure attachment in childhood and young adulthood), stable insecure (insecure attachment in childhood and young adulthood), secure to insecure (secure in childhood and insecure in adulthood) and insecure to secure (insecure in childhood and secure in adulthood). Within each of the typologies, two major themes emerged: social support and religion. Generally, transitions from secure to insecure attachment were related to experiences of perceived rejection by a parental figure during adolescence that corresponded with sexual orientation disclosure. Transitions from insecure to secure attachment appeared to be related to the absence of an attachment figure early in life, but with the acquisition of an attachment figure during early to late adolescence. The findings from our study suggest a need for attachment-based approaches to social support interventions, as well as for an increased understanding of social and cultural factors that impact attachment changes among practitioners who use attachment-based therapy models for YBGBM.
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Affiliation(s)
- Stephanie H. Cook
- College of Global Public Health, Department of Biostatistics and Department of Social and Behavioral Sciences, New York University, New York, NY, 715 Broadway, Room 1014
- Corresponding Author: Phone: 212-998-5635,
| | - Pamela Valera
- Rutegers School of Public Health, Rutgers University
| | - Erica P. Wood
- College of Global Public Health, Department of Biostatistics and Department of Social and Behavioral Sciences, New York University, New York, NY, 715 Broadway, Room 1014
| | - Benjamin J. Calebs
- Department of Psychological and Brain Sciences, University of Louisville
| | - Patrick A. Wilson
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health
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8
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Newcomb ME, Swann G, Mohr D, Mustanski B. Do Diary Studies Cause Behavior Change? An Examination of Reactivity in Sexual Risk and Substance Use in Young Men Who Have Sex with Men. AIDS Behav 2018; 22:2284-2295. [PMID: 29332235 DOI: 10.1007/s10461-018-2027-3] [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: 01/28/2023]
Abstract
Behavioral diaries are frequently used for observing sexual and substance use behaviors, but participating in diary studies may cause behavior change. This study examined change in sexual and substance use behaviors among young men who have sex with men (YMSM) in a two-month diary study compared to control. An analytic sample of 324 YMSM was randomized to receive daily diaries, weekly diaries, or no diaries (control) for 2 months. Half of the diary participants were randomized to receive automated weekly feedback. Between-subjects analyses found no evidence of change in sexual or substance use behaviors from baseline to 2-month follow-up when comparing the diary conditions to control. Within-persons growth mixture models of all diary data showed significant decreases in condomless anal sex (CAS) and illicit drug use. Weekly automated feedback had no effect on behavior change. Findings provide evidence of change in CAS and illicit drug use amongst diary participants.
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Affiliation(s)
- Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA.
| | - Gregory Swann
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA
| | - David Mohr
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA
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Ecological momentary assessments for self-monitoring and counseling to optimize methamphetamine treatment and sexual risk reduction outcomes among gay and bisexual men. J Subst Abuse Treat 2018; 92:17-26. [PMID: 30032940 DOI: 10.1016/j.jsat.2018.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 06/11/2018] [Accepted: 06/13/2018] [Indexed: 01/15/2023]
Abstract
This pilot study evaluated the use of smartphone ecological momentary assessments (EMA) for self-monitoring to optimize treatment outcomes among gay and bisexual men enrolled in an outpatient methamphetamine abuse treatment service program. Participants (N = 34) received EMA prompts five times daily to self-monitor their methamphetamine use, cravings, sexual risk behaviors, and associated triggers and affect throughout the 8-week treatment program. Participants were randomized into either a self-directed condition with access to a web-based EMA response visualization dashboard ("EMA + Dashboard"; n = 16); or, a counselor-supported condition incorporating weekly, 30-min, one-on-one counseling sessions to review and discuss the participant's self-monitoring data on the dashboard ("EMA + Dashboard + Counselor"; n = 18). Pilot participants were compared with historical controls (n = 102) as the reference group in multiple regression analyses to assess the impact of the two study conditions on the treatment service program outcomes. Study participants with weekly counseling (EMA + Dashboard + Counselor) exhibited significantly greater reductions in the number of condomless anal intercourse episodes than historical controls (IRR = 0.02, 95% CI [0.00, 0.30]), whereas the reduction was of similar magnitude as controls in the EMA + Dashboard self-directed condition (IRR = 0.23, 95% CI [0.02, 3.56]). Treatment effects were not significant for comparisons between the two study conditions and historical controls for self-reported methamphetamine use (EMA + Dashboard: IRR = 1.06, 95% CI [0.32, 3.49]; EMA + Dashboard+Counselor: IRR = 0.46, 95% CI [0.14, 1.49]), number of male partners (EMA + Dashboard: IRR = 1.02, 95% CI [0.39, 2.61]; EMA + Dashboard+Counselor: IRR = 0.54, 95% CI [0.20, 1.45]), and the likelihood of providing a urine sample that tested positive for methamphetamine metabolites (EMA + Dashboard: OR = 1.00, 95% CI [0.79, 1.25]; EMA + Dashboard + Counselor: OR = 0.93, 95% CI [0.74, 1.16]). The pilot study provides preliminary evidence that the treatment outcome for condomless anal intercourse can be improved through a combination of smartphone- and counselor-assisted self-monitoring.
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Swann G, Newcomb ME, Mustanski B. Validation of the HIV Risk Assessment of Sexual Partnerships (H-RASP): Comparison to a 2-Month Prospective Diary Study. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:121-131. [PMID: 28733826 PMCID: PMC5756508 DOI: 10.1007/s10508-017-1033-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 06/29/2017] [Accepted: 07/02/2017] [Indexed: 05/07/2023]
Abstract
The HIV Risk Assessment of Sexual Partnerships (H-RASP) was developed in order to create a retrospective measure of sexual risk-taking that can account for the differing contexts of sexual partnership(s) within a specified period of time. In order to validate the H-RASP relative to other methods of measuring sexual risk-taking, measurements from the H-RASP were compared to data from a prospective diary study of 95 young men who have sex with men over the same two-month period. We found that the H-RASP was not significantly different at measuring participants' total number of sexual partners and total number of anal sex partners in comparison with the diaries. The two measures were significantly different in measurement of total number of condomless anal sex (CAS) partners and number of CAS acts within partnerships, such that participants on average estimated more CAS partners and acts in the H-RASP. The two measures shared 40.8% of variance on measurement of CAS partners and 44.6% of variance on CAS acts within partnerships. These results suggest that even though the H-RASP is not a perfect replication of prospective diary data, it captures a moderate proportion of the same variance, and, in the case of CAS acts within partnerships, a proportion of the variance that likely would not be measured by retrospective measures that do not ask about behaviors specific to partnerships.
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Affiliation(s)
- Gregory Swann
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA.
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA.
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
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11
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Use of a Prospective Sex Diary to Study Anal Lubricant and Enema Use Among High Risk Men Who Have Sex With Men-Implications for Human Immunodeficiency Virus Prevention. Sex Transm Dis 2017; 43:476-8. [PMID: 27419813 DOI: 10.1097/olq.0000000000000473] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Longitudinal data on episodes of receptive anal intercourse (RAI), lubricant, and enema use in 41 sexually active men who have sex with men were collected using a prospective sex diary. Data on 550 episodes of RAI showed that lubricants were used in 489 (88.9%) of 550 episodes and enemas were used in 165 (30%) of 550 RAI episodes.
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12
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Chen JA, Gilmore AK, Wilson NL, Smith RE, Quinn K, Peterson AP, Fearey E, Shoda Y. Enhancing Stress Management Coping Skills Using Induced Affect and Collaborative Daily Assessment. COGNITIVE AND BEHAVIORAL PRACTICE 2017; 24:226-244. [PMID: 31007501 DOI: 10.1016/j.cbpra.2016.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The purpose of this paper is to highlight the use of induced affect (IA) and collaborative (therapeutic) assessment (CA) as components of Cognitive-Affective Stress Management Training (CASMT). IA is a technique for rehearsing cognitive and physical relaxationcoping skills under conditions of high affective arousal, which has been shown to result in high levels of coping self-efficacy. CA provides diary-based feedback to clients about the processes underlying theirstress experiences and helps identify affect-arousing experiences to be targeted by IA. We include descriptions of the IA technique and anonline stress and coping daily diary, as well as sample transcripts illustrating how CA is integrated into CASMT and how IA evokes high affective arousal and skills rehearsal. To illustrate idiographic assessment, we also describe threetreatment cases involving female clients between the ages of 20 and 35 with anxiety symptoms who participated in six weeks of CASMT and reported their daily stress and coping experiences (before, during, and following the intervention)for a total of ten weeks. The resulting time series data, analyzed using Simulation Modeling Analysis (SMA), revealed that all clients reported improved negative affect regulation over the course of treatment, yet they exhibited idiographic patterns of change on other outcome and coping skills variables. These results illustrate how IA and CA may be used to enhance emotional self-regulation and how time-series analyses can identify idiographic aspects of treatment response that would not be evident in group data.
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Affiliation(s)
- Jessica A Chen
- University of Washington, Department of Psychology, Box 351525 Seattle, WA 98195, USA
| | - Amanda K Gilmore
- University of Washington, Department of Psychology, Box 351525 Seattle, WA 98195, USA
| | - Nicole L Wilson
- University of Washington, Department of Psychology, Box 351525 Seattle, WA 98195, USA
| | - Ronald E Smith
- University of Washington, Department of Psychology, Box 351525 Seattle, WA 98195, USA
| | - Kevin Quinn
- University of Washington, Department of Psychology, Box 351525 Seattle, WA 98195, USA
| | - A Paige Peterson
- University of Washington, Department of Psychology, Box 351525 Seattle, WA 98195, USA
| | - Eliot Fearey
- University of Washington, Department of Psychology, Box 351525 Seattle, WA 98195, USA
| | - Yuichi Shoda
- University of Washington, Department of Psychology, Box 351525 Seattle, WA 98195, USA
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Card KG, Lachowsky NJ, Cui Z, Shurgold S, Armstrong HL, Rich AJ, Forrest JI, Gislason M, Moore DM, Roth EA, Hogg RS. An Event-Level Analysis of the Interpersonal Factors Associated With Condomless Anal Sex Among Gay, Bisexual, and Other Men Who Have Sex With Men (MSM) With Online-Met Partners. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2017; 29:154-174. [PMID: 28467159 PMCID: PMC5564309 DOI: 10.1521/aeap.2017.29.2.154] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The interpersonal determinants of condomless anal sex (CAS) within online-initiated sexual relationships remain poorly understood. Therefore, respondent-driven sampling was used to recruit a prospective cohort of sexually active gay, bisexual, and other men who have sex with men (MSM), aged ≥ 16 years in Vancouver, Canada. Follow-up occurred every 6 months, up to seven visits; at each visit participants reported their last sexual encounter with their five most recent partners. Stratified by self-reported HIV status, individual-level, interpersonal, and situational covariates of event-level CAS with partners met online were modeled using generalized estimating equations (GEE). CAS was reported during 32.4% (n = 1,015/3,133) of HIV-negative/unknown men's events, and 62.1% (n = 576/928) of HIV-positive men's events. Social (i.e., collective identity, altruism, network size social embeddedness) and situational (i.e., number of encounters, location, comparative age, seroconcordance, substance use) factors were identified as important correlates of CAS. Implications include the need for HIV prevention addressing social contexts associated with CAS.
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Affiliation(s)
- Kiffer G Card
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Simon Fraser University, Burnaby, British Columbia
| | - Nathan J Lachowsky
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- School of Public Health & Social Policy, University of Victoria, Victoria, British Columbia
| | - Zishan Cui
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Susan Shurgold
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Heather L Armstrong
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver
| | - Ashleigh J Rich
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Jamie I Forrest
- School of Population and Public Health, University of British Columbia, Vancouver
| | | | - David M Moore
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver
- B.C. Centre for Disease Control, Vancouver
| | - Eric A Roth
- Department of Anthropology, University of Victoria, British Columbia
| | - Robert S Hogg
- B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Simon Fraser University, Burnaby, British Columbia
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14
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Newcomb ME, Swann G, Estabrook R, Corden M, Begale M, Ashbeck A, Mohr D, Mustanski B. Patterns and Predictors of Compliance in a Prospective Diary Study of Substance Use and Sexual Behavior in a Sample of Young Men Who Have Sex With Men. Assessment 2016; 25:403-414. [PMID: 27586686 DOI: 10.1177/1073191116667584] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Behavioral diaries are used for observing health-related behaviors prospectively. Little is known about patterns and predictors of diary compliance to better understand differential attrition. An analytic sample of 241 young men who have sex with men (YMSM) from a 2-month diary study of substance use and sexual behavior were randomized to complete daily or weekly timeline followback diaries. Latent class growth analyses were used to analyze data. Weekly and daily diary groups produced similar compliance patterns: high, low, and declining compliance groups. Black YMSM were more likely to be in the declining compared with the high compliance group. YMSM who were randomly assigned to receive automated feedback about risk behaviors did not differ in compliance rate compared with those who did not. Risk behavior engagement did not predict compliance in the daily condition, but some substances predicted compliance in the weekly condition. Implications for observational and behavior change methods are discussed.
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Affiliation(s)
| | | | | | | | | | | | - David Mohr
- 1 Northwestern University, Chicago, IL, USA
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15
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Abstract
The majority of HIV prevention studies and programs have targeted individuals or operated at the community level. This has also been the standard approach when incorporating technology (e.g., web-based, smartphones) to help improve HIV prevention efforts. The tides have turned for both approaches: greater attention is now focusing on couple-based HIV prevention and using technology to help improve these efforts for maximizing reach and potential impact. To assess the extent that technology has been used to help advance HIV prevention with couples, a literature review was conducted using four databases and included studies that collected data from 2000 to early 2015. Results from this review suggest that technology has primarily been used to help advance HIV prevention with couples as a tool for (1) recruitment and data collection and (2) intervention development. Challenges and limitations of conducting research (e.g., validity of dyadic data) along with future directions for how technology (e.g., mHealth, wearable sensors) can be used to advance HIV prevention with couples are then discussed. Given the growing and near ubiquitous use of the Internet and smartphones, further efforts in the realm of mHealth (e.g., applications or "apps") and eHealth are needed to develop novel couple-focused HIV-preventive interventions.
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Affiliation(s)
- Jason W Mitchell
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1021, Miami, FL, 33136, USA.
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16
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Rendina HJ, Ventuneac A, Mustanski B, Grov C, Parsons JT. Prospective Measurement of Daily Health Behaviors: Modeling Temporal Patterns in Missing Data, Sexual Behavior, and Substance Use in an Online Daily Diary Study of Gay and Bisexual Men. AIDS Behav 2016; 20:1730-43. [PMID: 26992392 DOI: 10.1007/s10461-016-1359-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Daily diary and other intensive longitudinal methods are increasingly being used to investigate fluctuations in psychological and behavioral processes. To inform the development of this methodology, we sought to explore predictors of and patterns in diary compliance and behavioral reports. We used multilevel modeling to analyze data from an online daily diary study of 371 gay and bisexual men focused on sexual behavior and substance use. We found that greater education and older age as well as lower frequency of substance use were associated with higher compliance. Using polynomial and trigonometric functions, we found evidence for circaseptan patterns in compliance, sexual behavior, and substance use, as well as linear declines in compliance and behavior over time. The results suggest potential sources of non-random patterns of missing data and suggest that trigonometric terms provide a similar but more parsimonious investigation of circaseptan rhythms than do third-order polynomial terms.
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Affiliation(s)
- H Jonathon Rendina
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA
| | - Ana Ventuneac
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christian Grov
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Jeffrey T Parsons
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA.
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave., New York, NY, USA.
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA.
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17
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Fleming FM, Matovu F, Hansen KS, Webster JP. A mixed methods approach to evaluating community drug distributor performance in the control of neglected tropical diseases. Parasit Vectors 2016; 9:345. [PMID: 27305942 PMCID: PMC4910194 DOI: 10.1186/s13071-016-1606-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/25/2016] [Indexed: 11/10/2022] Open
Abstract
Background Trusted literate, or semi-literate, community drug distributors (CDDs) are the primary implementers in integrated preventive chemotherapy (IPC) programmes for Neglected Tropical Disease (NTD) control. The CDDs are responsible for safely distributing drugs and for galvanising communities to repeatedly, often over many years, receive annual treatment, create and update treatment registers, monitor for side-effects and compile treatment coverage reports. These individuals are ‘volunteers’ for the programmes and do not receive remuneration for their annual work commitment. Methods A mixed methods approach, which included pictorial diaries to prospectively record CDD use of time, structured interviews and focus group discussions, was used to triangulate data on how 58 CDDs allocated their time towards their routine family activities and to NTD Programme activities in Uganda. The opportunity costs of CDD time were valued, performance assessed by determining the relationship between time and programme coverage, and CDD motivation for participating in the programme was explored. Results Key findings showed approximately 2.5 working weeks (range 0.6–11.4 working weeks) were spent on NTD Programme activities per year. The amount of time on NTD control activities significantly increased between the one and three deliveries that were required within an IPC campaign. CDD time spent on NTD Programme activities significantly reduced time available for subsistence and income generating engagements. As CDDs took more time to complete NTD Programme activities, their treatment performance, in terms of validated coverage, significantly decreased. Motivation for the programme was reported as low and CDDs felt undervalued. Conclusions CDDs contribute a considerable amount of opportunity cost to the overall economic cost of the NTD Programme in Uganda due to the commitment of their time. Nevertheless, programme coverage of at least 75 %, as required by the World Health Organisation, is not being achieved and vulnerable individuals may not have access to treatment as a consequence of sub-optimal performance by the CDDs due to workload and programmatic factors. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1606-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fiona M Fleming
- Schistosomiasis Control Initiative, Imperial College London, London, UK.
| | - Fred Matovu
- School of Economics, Makerere University, Kampala, Uganda
| | - Kristian S Hansen
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Joanne P Webster
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK.,Department of Pathology and Pathogen Biology, Centre for Emerging, Endemic and Exotic Diseases (CEEED), Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK
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18
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Benotsch EG, Zimmerman RS, Cathers L, Heck T, McNulty S, Pierce J, Perrin PB, Snipes DJ. Use of the Internet to Meet Sexual Partners, Sexual Risk Behavior, and Mental Health in Transgender Adults. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:597-605. [PMID: 25428577 DOI: 10.1007/s10508-014-0432-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 10/25/2014] [Accepted: 10/31/2014] [Indexed: 06/04/2023]
Abstract
The purpose of this study was to examine the use of the internet to meet sexual partners among transgender individuals and examine correlates of this use, including sexual risk behavior, discrimination experiences, and mental health. A sample of 166 transgender adults (112 male-to-female transgender women and 54 female-to-male transgender men) were recruited in community venues and anonymously completed measures assessing these variables. Most participants (64.5 %) were HIV-negative, 25.2 % were HIV-positive, and 10.3 % did not know their HIV status. Overall, 33.7 % of participants reported having met a sexual partner over the internet, which did not differ significantly between transgender women and men. Among these individuals, transgender women reported significantly more lifetime internet sexual partners (median = 3) than transgender men (median = 1). Use of the internet to meet sexual partners was associated with lower self-esteem but not with depression, anxiety, somatic distress or discrimination experiences. Among transgender women, use of the internet to meet sexual partners was associated with each of the 11 sexual risk behaviors examined, including having multiple partners, sex under the influence of drugs, number of unprotected anal or vaginal sex acts, and history of commercial sex work. The use of the internet to meet partners was not associated with sexual risk behavior among transgender men (0/11 variables assessed). Although the internet is a common mode of meeting sexual partners among some transgender adults, it may also be a potential venue for prevention interventions targeting transgender individuals at particularly high risk for HIV acquisition.
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Affiliation(s)
- Eric G Benotsch
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284, USA.
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA.
- Institute for Women's Health, Virginia Commonwealth University, Richmond, VA, USA.
| | - Rick S Zimmerman
- College of Nursing, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Laurie Cathers
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA
- Institute for Women's Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Ted Heck
- Virginia Department of Health, Richmond, VA, USA
| | | | - Juan Pierce
- Minority Health Consortium, Richmond, VA, USA
| | - Paul B Perrin
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284, USA
| | - Daniel J Snipes
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284, USA
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19
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Bauermeister JA, Pingel ES, Jadwin-Cakmak L, Harper GW, Horvath K, Weiss G, Dittus P. Acceptability and preliminary efficacy of a tailored online HIV/STI testing intervention for young men who have sex with men: the Get Connected! program. AIDS Behav 2015; 19:1860-74. [PMID: 25638038 DOI: 10.1007/s10461-015-1009-y] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Southeast Michigan accounts for over 70 % of all HIV/STI cases in the state, with young men who have sex with men (YMSM) between the ages of 13 and 24 encumbering the largest burden in HIV/STI incidence. Using community-based participatory research principles, we developed and pilot tested a web-based, randomized control trial seeking to promote HIV/STI testing ("Get Connected!") among YMSM (N = 130; ages 15-24). Randomized participants completed a baseline assessment and shown a test-locator condition (control) or a tailored, personalized site (treatment). At 30-day follow-up, we found high acceptability among YMSM in both conditions, yet higher credibility of intervention content among YMSM in the treatment group (d = .55). Furthermore, 30 participants reported testing by following, with the majority of these participants (73.3 %; n = 22) completing the treatment condition, a clinically meaningful effect (d = .34) suggesting preliminary efficacy for the intervention. These results demonstrate the potential of the intervention, and suggest that a larger efficacy trial may be warranted.
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Affiliation(s)
- José A Bauermeister
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA.
| | - Emily S Pingel
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | - Laura Jadwin-Cakmak
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | - Gary W Harper
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | | | - Gretchen Weiss
- National Association of County and City Health Officials (NACCHO), Washington, DC, USA
| | - Patricia Dittus
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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20
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Bauermeister JA, Pingel ES, Jadwin-Cakmak L, Harper GW, Horvath K, Weiss G, Dittus P. Acceptability and preliminary efficacy of a tailored online HIV/STI testing intervention for young men who have sex with men: the Get Connected! program. AIDS Behav 2015. [PMID: 25638038 DOI: 10.1007/sl0461-015-1009-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Southeast Michigan accounts for over 70 % of all HIV/STI cases in the state, with young men who have sex with men (YMSM) between the ages of 13 and 24 encumbering the largest burden in HIV/STI incidence. Using community-based participatory research principles, we developed and pilot tested a web-based, randomized control trial seeking to promote HIV/STI testing ("Get Connected!") among YMSM (N = 130; ages 15-24). Randomized participants completed a baseline assessment and shown a test-locator condition (control) or a tailored, personalized site (treatment). At 30-day follow-up, we found high acceptability among YMSM in both conditions, yet higher credibility of intervention content among YMSM in the treatment group (d = .55). Furthermore, 30 participants reported testing by following, with the majority of these participants (73.3 %; n = 22) completing the treatment condition, a clinically meaningful effect (d = .34) suggesting preliminary efficacy for the intervention. These results demonstrate the potential of the intervention, and suggest that a larger efficacy trial may be warranted.
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Affiliation(s)
- José A Bauermeister
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA.
| | - Emily S Pingel
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | - Laura Jadwin-Cakmak
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | - Gary W Harper
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | | | - Gretchen Weiss
- National Association of County and City Health Officials (NACCHO), Washington, DC, USA
| | - Patricia Dittus
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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21
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Huang CE, Cassels SL, Winer RL. Self-reported sex partner dates for use in measuring concurrent sexual partnerships: correspondence between two assessment methods. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:873-883. [PMID: 25391584 PMCID: PMC4382421 DOI: 10.1007/s10508-014-0414-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Revised: 09/09/2014] [Accepted: 09/20/2014] [Indexed: 06/04/2023]
Abstract
Although prevalence of concurrent sexual partnerships is increasingly investigated as a driver of HIV epidemics, its measurement varies and its role in transmission dynamics remains contested. Relying on different methods of obtaining self-reported partnership histories may lead to significant differences in prevalence. This study examined the reliability of two methods for assessing dates of sex and the implications for measuring concurrent sexual partnerships. We conducted a cross-sectional reliability study using self-reported survey data from 650 women ages 18-65 years, recruited online nationwide for human papillomavirus natural history studies from 2007 to 2012. Intermethod reliability of first and last sex with the most recent partner was assessed using weighted kappa. Intraclass correlation coefficient was estimated for intramethod reliability across two consecutive questionnaires administered 4 months apart. Point prevalence of concurrent sexual partnerships at 6 months prior to the questionnaire date was similar between the two question formats (10.5 % for categorical and 10.9 % for continuous). The range between the minimum and maximum cumulative prevalence for 12 months was larger when using the categorical questions (17.0-29.6 % compared to 27.6-28.6 % using the continuous questions). Agreement between the two question formats was moderate for the date of first sex with the most recent partner (κ = 0.56, 95 % CI 0.48-0.64) and almost perfect for the date of last sex (κ = 0.93, 95 % CI 0.91-0.94). Longitudinal agreement for date of first sex was high for the continuous date question (ICC = 0.89, 95 % CI 0.86-0.92). Results of this reliability study can be used to inform the design of future studies of concurrent sexual partnerships and their association with HIV.
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Affiliation(s)
- Claire E. Huang
- HPV Research Group, Department of Epidemiology, University
of Washington, Box 359933, 325 9th Ave., Seattle, WA 98104
| | - Susan L. Cassels
- HPV Research Group, Department of Epidemiology, University
of Washington, Box 359933, 325 9th Ave., Seattle, WA 98104
- Department of Global Health, University of Washington,
Seattle, WA USA
- Department of Geography, University of California, Santa
Barbara, CA USA
| | - Rachel L. Winer
- HPV Research Group, Department of Epidemiology, University
of Washington, Box 359933, 325 9th Ave., Seattle, WA 98104
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22
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Glick SN, Golden MR. Early male partnership patterns, social support, and sexual risk behavior among young men who have sex with men. AIDS Behav 2014; 18:1466-75. [PMID: 24356869 DOI: 10.1007/s10461-013-0678-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Few data exist on the early sexual behavior patterns of contemporary young men who have sex with men (YMSM), the social context of these patterns, and which of these factors influence risk for HIV and other sexually transmitted infections (STI). We enrolled 94 YMSM (age 16-30) into a 1-year cohort study with serial online retrospective surveys and HIV/STI testing. The first three partnerships of YMSM were characterized by relatively high rates of unprotected anal sex and a rapidly expanding sexual repertoire, but also increasing rates of HIV status disclosure. During follow-up, 17 % of YMSM reported any nonconcordant unprotected anal intercourse (NCUAI) and 15 % were newly diagnosed with HIV/STI. Sex education in high school and current maternal support were protective against HIV/STI, while isolation from family and friends was associated with recent NCUAI. Social support-including from parents, peers, and school-based sex education-may help mitigate HIV/STI risk in this population.
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Affiliation(s)
- Sara Nelson Glick
- Department of Epidemiology and Biostatistics, The George Washington University, 2100-W Pennsylvania Ave NW, 8th Floor, Washington, DC, 20037, USA,
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23
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Newcomb ME, Mustanski B. Diaries for observation or intervention of health behaviors: factors that predict reactivity in a sexual diary study of men who have sex with men. Ann Behav Med 2014; 47:325-34. [PMID: 24081918 PMCID: PMC3972382 DOI: 10.1007/s12160-013-9549-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Behavioral diaries for observation of health-related behaviors assume absence of reactivity (i.e., change in behavior resulting from observation), while self-monitoring diaries maximize reactivity for behavior change. Little is known about when and for whom behavioral diary studies become self-monitoring interventions. PURPOSE This study evaluated the moderating effects of social cognitive variables on reactivity in sexual risk behavior and risk appraisals in a diary study of men who have sex with men (MSM). METHODS One hundred forty-three MSM completed weekly online sexual diaries for 3 months. Analyses were conducted with hierarchical linear modeling. RESULTS There was no evidence of reactivity for the sample as a whole. Social cognitive variables (e.g., risk reduction motivation, condom use intentions, and social norms) moderated reactivity in study outcomes. For example, more highly motivated MSM experienced declines in serodiscordant unprotected anal intercourse over time. CONCLUSIONS Effectiveness of behavioral self-monitoring strategies may vary depending on social cognitive domains.
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Affiliation(s)
- Michael E Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA,
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24
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Stalgaitis C, Glick SN. The use of web-based diaries in sexual risk behaviour research: a systematic review. Sex Transm Infect 2014; 90:374-81. [PMID: 24723619 DOI: 10.1136/sextrans-2013-051472] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND An increasing number of studies have used the diary method, which provides quantitative event-level data about sexual encounters. Diaries are an attractive tool for sexual behaviour research, yet little is known about the range of uses, methodological issues and best practices associated with this technology. OBJECTIVES To conduct a systematic review of the literature regarding the use of web-based diaries in sexual risk behaviour studies. DESIGN Systematic review. DATA SOURCES Five bibliographical databases, supplemented by references from previous reviews. METHODS Eligible studies were published in English before August 2013, used the internet to transmit data from collection device to study staff, and measured behaviours affecting HIV or sexually transmitted infection transmission risk. The primary author conducted an initial screen to eliminate irrelevant articles. Both authors conducted full-text reviews to determine final articles. We abstracted data on diary methodology, validity and reactivity (behaviour change caused by diary completion). RESULTS Twenty-three articles representing 15 studies were identified. Most diaries were collected daily for 1 month via websites, and completion was generally high (>80%). Compensation varied by study and was not associated with completion. Studies comparing diary with retrospective survey data demonstrated evidence of over-reporting on retrospective tools, except for the least frequent behaviours. Most studies that assessed reactivity as a result of diary completion demonstrated some change in behaviour associated with frequent monitoring. CONCLUSIONS Web-based diaries are an effective means of studying sexual risk behaviour. More uniform reporting and further research on the extent of reactivity are needed.
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Affiliation(s)
- Carolyn Stalgaitis
- Department of Epidemiology and Biostatistics, The George Washington University, Washington, District of Columbia, USA
| | - Sara Nelson Glick
- Department of Epidemiology and Biostatistics, The George Washington University, Washington, District of Columbia, USA
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Parsons JT, Lelutiu-Weinberger C, Botsko M, Golub SA. A randomized controlled trial utilizing motivational interviewing to reduce HIV risk and drug use in young gay and bisexual men. J Consult Clin Psychol 2013; 82:9-18. [PMID: 24364800 DOI: 10.1037/a0035311] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Young gay and bisexual men (YGBM) are disproportionally at risk of HIV infection due to sexual risk behaviors, which are often exacerbated by recreational drug use. However, there have been no evidence-based interventions targeting substance-using YGBM. This study was designed to test a brief motivational interviewing (MI) intervention to reduce both risky sex and drug use among HIV-negative YGBM. METHOD A total of 143 non-treatment-seeking YGBM (ages 18-29 years) who reported recent unprotected anal intercourse (UAI) and recreational drug use were randomized to 4 sessions of MI or 4 sessions of content-matched education. Participants were followed every 3 months for 1 year, and behavior change was examined across conditions and time for aggregated and day-level drug use and UAI. RESULTS Regardless of condition, participants reported significant reductions in UAI and substance use over time. However, YGBM in the MI condition were 18% less likely to use drugs and 24% less likely to engage in UAI than YGBM in the education condition. CONCLUSIONS The results support the utility of MI, compared with a content-matched education condition, to significantly reduce both UAI and drug use among YGBM. Interventions may benefit from an emphasis on substance use reductions, which might indirectly lead to less frequent UAI. Future research efforts should examine whether this type of brief MI intervention is effective when delivered by clinic or community settings utilized by YGBM.
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Affiliation(s)
- Jeffrey T Parsons
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York
| | - Corina Lelutiu-Weinberger
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York
| | - Michael Botsko
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York
| | - Sarit A Golub
- Department of Psychology, Hunter College of the City University of New York
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Glick SN, Feng Q, Popov V, Koutsky LA, Golden MR. High rates of incident and prevalent anal human papillomavirus infection among young men who have sex with men. J Infect Dis 2013; 209:369-76. [PMID: 23956439 DOI: 10.1093/infdis/jit441] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There are few published estimates of anal human papillomavirus (HPV) infection rates among young men who have sex with men (YMSM). METHODS We estimated incidence and prevalence of type-specific anal HPV infection using clinician-collected anal swabs for HPV DNA testing obtained during a 1-year prospective study of 94 YMSM (mean age, 21 years) in Seattle. RESULTS Seventy percent of YMSM had any HPV infection detected during the study, and HPV-16 and/or -18 were detected in 37%. The incidence rate for any new HPV infection was 38.5 per 1000 person-months and 15.3 per 1000 person-months for HPV-16/18; 19% had persistent HPV-16/18 infection. No participant tested positive for all 4 HPV types in the quadrivalent vaccine. The number of lifetime male receptive anal sex partners was significantly associated with HPV infection. The prevalence of HPV-16/18 was 6% among YMSM with a history of 1 receptive anal sex partner and 31% among YMSM with ≥ 2 partners. CONCLUSIONS Although the high prevalence of HPV among YMSM highlights the desirability of vaccinating all boys as a strategy to avert the morbidity of HPV infection, most YMSM appear to remain naive to either HPV-16 or -18 well into their sexual lives and would benefit from HPV immunization.
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Affiliation(s)
- Sara Nelson Glick
- Department of Epidemiology and Biostatistics, The George Washington University, Washington, District of Columbia
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