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Sharma A, Gebrezgi F, Hamilton A, Boyd S, Sallabank G. HIV-related knowledge, risk perception, and minority stressors among South Asian sexual minority men in the United States. Int J STD AIDS 2024:9564624241273830. [PMID: 39138867 DOI: 10.1177/09564624241273830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
BACKGROUND South Asian gay, bisexual, and other men who have sex with men (GBM) in the United States have been persistently overlooked in HIV research and programming. To address this limitation, this article describes their HIV-related knowledge, risk perception, and minority stressors, with a focus on identifying variations between American-born individuals and immigrants. METHODS Participants were recruited from April-July 2022 through social media advertising and peer referral and surveyed about their sociodemographic and HIV-related behavioral characteristics. Previously validated scales were used to assess their HIV-related knowledge, risk perception, disclosure of sexual identity, experienced homophobia, and perceived racism within the sexual and gender minority community. Mann-Whitney-Wilcoxon tests were conducted to compare those born in the United States and those born abroad. RESULTS Of the 112 participants, 26 (23.21%) were American-born individuals and 86 (76.79%) were immigrants. Despite similar levels of sexual risk behaviors, such as having multiple male sex partners, engaging in condomless anal sex, and using alcohol or drugs immediately before or during sex, immigrants had lower levels of HIV-related knowledge (p = .0480) and risk perception (p = .0114) compared to American-born individuals. Immigrants were also less likely to have disclosed their sexual identity to family, friends, and society compared to American-born individuals (p = .0004). No differences were identified with respect to experiences of homophobia (p = .2303) or perceptions of racism (p = .4011). CONCLUSION Comprehensive HIV prevention efforts that address the social and cultural norms of South Asian GBM in the United States are needed.
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Affiliation(s)
- Akshay Sharma
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Feaven Gebrezgi
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - April Hamilton
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sara Boyd
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Escarfuller SG, Mitchell JW, Sanchez M. HIV Prevention Intervention-related Research with Adult, Sexual Minority Hispanic Men in the United States: A Systematic Review. J Racial Ethn Health Disparities 2024; 11:1888-1907. [PMID: 37340124 DOI: 10.1007/s40615-023-01659-6] [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: 02/13/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/22/2023]
Abstract
The systematic review describes aims to synthesize the HIV prevention intervention-related research conducted among adult, US sexual minority Hispanic men since 2012. Following PRISMA guidelines, 15 articles representing 14 studies were included in the review: 4 randomized controlled trials, 5 pilots, and 5 formative projects. Two interventions had PrEP-related outcomes whereas 7 focused on behavioral (e.g., condoms, testing) and/or educational outcomes. Few studies used digital health. All but one study was theoretically guided. Community engagement was a common and important thread in the included studies, with community-based participatory research being the most prevalent framework. The inclusion of cultural factors varied widely, as did the availability of Spanish language or bilingual study materials. Future research opportunities are discussed and recommendations to bolster HIV prevention interventions (e.g., tailoring) are presented. These include the need for greater integration of cultural factors (e.g., nuances related to the heterogeneity of Hispanic subgroups) and mitigating critical barriers to help improve uptake of evidence-based strategies in this population.
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Affiliation(s)
- Sebastian G Escarfuller
- Stempel College of Public Health and Social Work, Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, 33199, USA.
| | - Jason W Mitchell
- Stempel College of Public Health and Social Work, Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, 33199, USA
| | - Mariana Sanchez
- Stempel College of Public Health and Social Work, Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, 33199, USA
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3
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Gelaude D, Roland KB, Gaul Z, Reyes JV, Denson DJ. "Honesty, Communication and Trust Are What Bring Peace of Mind": Narratives of HIV Risk Among Hispanic/Latino Men Who Have Sex with Men in the Southern United States. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02106-w. [PMID: 39090367 DOI: 10.1007/s40615-024-02106-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/12/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
For Hispanic/Latino MSM (HLMSM) in the South, HIV burden remains high, and HIV elimination is a national priority. Between July and September 2016, using a strengths-based approach informed by resilience theory, we conducted qualitative interviews with HIV-negative HLMSM in five southern cities in the United States with elevated HIV prevalence. We analyzed data using a qualitative content analysis approach, assessing for interrater reliability. A brief behavioral survey was also conducted. We enrolled 51 HLMSM (mean age = 33 years, range = 15-63). HLMSM discussed the climate of fear about HIV and homosexuality impeding HIV prevention, including the impact of stigma and taboo. Three main strengths-based strategies emerged for preventing HIV: assessing partner risk, establishing boundaries for sexual interactions, and self-education. Future HIV prevention efforts may benefit from balancing risk-based approaches with those that emphasize resilience, address partner trustworthiness and safety, and focus on providing novel outlets for HIV prevention education.
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Affiliation(s)
- Deborah Gelaude
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE, MS E-59, Atlanta, GA, 30329-4027, USA.
| | - Katherine B Roland
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE, MS E-59, Atlanta, GA, 30329-4027, USA
| | - Zaneta Gaul
- DLH Corporation, 3565 Piedmont Rd, NE, Atlanta, GA. 30305, USA
| | - Jovanni V Reyes
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS S107-4, Atlanta, GA, 30341, USA
| | - Damian J Denson
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE, MS E-59, Atlanta, GA, 30329-4027, USA
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Wells KJ, Gordon JR, Carrizosa CM, Mozo EH, Lucido NC, Cobian Aguilar RA, Brady JP, Rojas SA, Ramers CB, Nogg KA, Fahey KML, Jones IJ, Rivera DB, Blashill AJ. Interpersonal and Community-Level Influences Across the PrEP Cascade Among Young Adult Latinx Men who Have Sex with Men Living in a US-Mexico Border Region: A Qualitative Study. AIDS Behav 2024; 28:759-773. [PMID: 37773474 PMCID: PMC10922111 DOI: 10.1007/s10461-023-04185-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/01/2023]
Abstract
Latinx men who have sex with men (MSM) are an at-risk population for new HIV diagnoses. Pre-exposure prophylaxis (PrEP) is a suite of biomedical approaches to prevent HIV infection. Latinx MSM are less likely to take PrEP compared to non-Latinx White MSM. This qualitative study identified interpersonal- and community-level barriers and facilitators of PrEP among young adult Latinx MSM. Using stratified purposeful sampling, 27 Latinx men, ages 19-29 years and living in a US-Mexico border region, completed self-report demographic surveys and participated in semi-structured in-depth interviews assessing barriers and facilitators to PrEP. Directed content analysis was used to identify both a priori and emerging themes. Most participants reported that other people, including peers, friends, partners, and health care providers were both supportive and discouraging of PrEP use. Participants' intersectional identities as members of both Latinx and LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer) communities both hindered and facilitated PrEP use.
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Affiliation(s)
- Kristen J Wells
- Department of Psychology, San Diego State University, San Diego, CA, 92120, USA.
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, 92120, USA.
| | - Janna R Gordon
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, 92120, USA
| | | | | | - Nicholas C Lucido
- Department of Psychology, San Diego State University, San Diego, CA, 92120, USA
| | - Rosa A Cobian Aguilar
- Department of Psychology, San Diego State University, San Diego, CA, 92120, USA
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, 92120, USA
| | - John P Brady
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, 92120, USA
| | - Sarah A Rojas
- Laura Rodriguez Research Institute-Family Health Centers of San Diego, San Diego, CA, 92102, USA
| | - Christian B Ramers
- Laura Rodriguez Research Institute-Family Health Centers of San Diego, San Diego, CA, 92102, USA
| | - Kelsey A Nogg
- San Diego State University Research Foundation, San Diego, CA, 92120, USA
| | - Kalina M L Fahey
- Department of Psychology, San Diego State University, San Diego, CA, 92120, USA
| | - Isaiah J Jones
- Department of Psychology, San Diego State University, San Diego, CA, 92120, USA
| | - David B Rivera
- Department of Psychology, San Diego State University, San Diego, CA, 92120, USA
| | - Aaron J Blashill
- Department of Psychology, San Diego State University, San Diego, CA, 92120, USA
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, 92120, USA
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Naidu J, Polonijo AN. Barriers and facilitators to HPV and meningococcal vaccination among men who have sex with men: a qualitative study. BMC Public Health 2023; 23:933. [PMID: 37221575 DOI: 10.1186/s12889-023-15847-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/08/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) have suboptimal uptake of human papillomavirus (HPV) and meningococcal vaccines. This study examines barriers and facilitators to HPV and meningococcal vaccination among MSM in a large, racially/ethnically diverse, and medically underserved U.S. region. METHODS In 2020, we conducted five focus groups with MSM living in the Inland Empire, California. Participants discussed (1) their knowledge about and attitudes toward HPV, meningococcal disease, and related vaccines; and (2) factors that would encourage or discourage vaccine uptake. Data were systematically analyzed to identify salient barriers and facilitators to vaccination. RESULTS Participants (N = 25) had a median age of 29. Most were Hispanic (68%), self-identified as gay (84%), and had college degrees (64%). Key barriers to vaccination included: (1) limited awareness and knowledge about HPV and meningococcal disease, (2) reliance on mainstream healthcare providers for vaccine information, (3) stigma and reluctance to disclose sexual orientation, (4) uncertainty about health insurance coverage and vaccine costs, and (5) distance and time required to access vaccines. Key facilitators to vaccination were: (1) vaccine confidence, (2) perceived severity of HPV and meningococcal disease, (3) bundling vaccination into routine healthcare, and (4) pharmacies as vaccination sites. CONCLUSIONS Findings highlight opportunities for HPV and meningococcal vaccine promotion, including targeted education and awareness campaigns for MSM, LGBT inclusivity training for healthcare providers, and structural interventions to improve vaccine accessibility.
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Affiliation(s)
- Justin Naidu
- Department of Sociology, University of California, Merced, 5200 North Lake Road, Merced, CA, 95343, USA
- Department of Public Health, University of California, Merced, 5200 North Lake Road, Merced, CA, 95343, USA
| | - Andrea N Polonijo
- Department of Sociology, University of California, Merced, 5200 North Lake Road, Merced, CA, 95343, USA.
- Health Sciences Research Institute, University of California, Merced, 5200 North Lake Road, Merced, CA, 95343, USA.
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Ramos-Olazagasti MA, Elkington KS, Wainberg ML, Feng T, Corbeil T, Canino GJ, Bird HR, Scorza P, Wildsmith E, Alegria M, Duarte CS. Does Context and Adversity Shape Sexual Behavior in Youth? Findings from Two Representative Samples of Puerto Rican Youth. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:217-231. [PMID: 36169776 PMCID: PMC9868044 DOI: 10.1007/s10508-022-02328-1] [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: 01/19/2020] [Revised: 02/23/2022] [Accepted: 03/12/2022] [Indexed: 06/16/2023]
Abstract
Sexual risk behaviors often co-occur. Understanding the heterogeneity in patterns of sexual behavior among youth and how context of majority and minoritized status may be related to these behaviors can inform targeted STIs/HIV interventions. Data are from the Boricua Youth Study, a longitudinal study of two probability samples of Puerto Rican youth recruited in the South Bronx (SBx) and the metropolitan area in Puerto Rico (PR). We identified patterns of sexual behaviors among young adults (ages 15-24) with sexual experience (N = 1,203) using latent class analysis. Analyses examined context differences and the prospective relationship between adverse childhood experiences (ACEs) (childhood maltreatment/violence, family/parental dysfunction) and patterns of sexual behaviors (age at first sex, number of sex partners, sex with a high-risk partner, condom use, sex while intoxicated, oral sex, anal sex). We identified five classes of sexual behaviors: (1) currently inactive (16.51%); (2) single partner, low activity (13.49%); (3) single partner, inconsistent condom use (32.19%); (4) single partner, sex without a condom (27.65%); and (5) multirisk (10.16%). Young adults from the SBx (minoritized context), those who identified as male, and those with higher child maltreatment/violence ACEs were more likely to be in the multi-risk class relative to the single partner, inconsistent condom use class. Those from the SBx were also more likely to be in the single partner, sex without condom class, relative to the single partner, inconsistent condom use class. Differences in young adults' patterns of sexual behaviors between the two contexts, one representing the minoritized context (SBx) contrasted to the majority context (PR), were not explained by ACEs. Findings highlight the heterogeneity in the patterns of sexual behaviors among Puerto Rican young adults as well as how such patterns vary based on sociocultural contexts. Exposure to child maltreatment/violence ACEs was related to the riskier patterns; however, they did not explain why riskier patterns of sexual behaviors were found in the SBx compared to PR. Results underscore the need for tailored interventions and more in-depth examination of differences across contexts.
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Affiliation(s)
- Maria A Ramos-Olazagasti
- Reproductive Health and Family Formation, Child Trends, 7315 Wisconsin Ave, Ste 1200W, Bethesda, MD, 20814, USA.
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA.
| | - Katherine S Elkington
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Milton L Wainberg
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Tianshu Feng
- New York State Psychiatric Institute, New York, NY, USA
| | | | - Glorisa J Canino
- Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico, USA
| | - Hector R Bird
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
| | - Pamela Scorza
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Elizabeth Wildsmith
- Reproductive Health and Family Formation, Child Trends, 7315 Wisconsin Ave, Ste 1200W, Bethesda, MD, 20814, USA
| | - Margarita Alegria
- Disparities Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Cristiane S Duarte
- Child and Adolescent Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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Effectiveness of interventions aimed at reducing HIV acquisition and transmission among gay and bisexual men who have sex with men (GBMSM) in high income settings: A systematic review. PLoS One 2022; 17:e0276209. [PMID: 36260550 PMCID: PMC9581368 DOI: 10.1371/journal.pone.0276209] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/30/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION HIV transmission continues among gay and bisexual men who have sex with men (GBMSM), with those who are younger, or recent migrants, or of minority ethnicity or who are gender diverse remaining at increased risk. We aimed to identify and describe recent studies evaluating the effectiveness of HIV prevention interventions for GBMSM in high income countries. METHODS We searched ten electronic databases for randomized controlled trials (RCTs), conducted in high income settings, and published since 2013 to update a previous systematic review (Stromdahl et al, 2015). We predefined four outcome measures of interest: 1) HIV incidence 2) STI incidence 3) condomless anal intercourse (CLAI) (or measure of CLAI) and 4) number of sexual partners. We used the National Institute for Health and Care Excellence (UK) Quality Appraisal of Intervention Studies tool to assess the quality of papers included in the review. As the trials contained a range of effect measures (e.g. odds ratio, risk difference) comparing the arms in the RCTs, we converted them into standardized effect sizes (SES) with 95% confidence intervals (CI). RESULTS We identified 39 original papers reporting 37 studies. Five intervention types were identified: one-to-one counselling (15 papers), group interventions (7 papers), online interventions (9 papers), Contingency Management for substance use (2 papers) and Pre-exposure Prophylaxis (PrEP) (6 papers). The quality of the studies was mixed with over a third of studies rated as high quality and 11% rated as poor quality. There was some evidence that one-to-one counselling, group interventions (4-10 participants per group) and online (individual) interventions could be effective for reducing HIV transmission risk behaviours such as condomless anal intercourse. PrEP was the only intervention that was consistently effective at reducing HIV incidence. CONCLUSIONS Our systematic review of the recent evidence that we were able to analyse indicates that PrEP is the most effective intervention for reducing HIV acquisition among GBMSM. Targeted and culturally tailored behavioural interventions for sub-populations of GBMSM vulnerable to HIV infection and other STIs should also be considered, particularly for GBMSM who cannot access or decline to use PrEP.
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Lee JJ, Aguirre J, Munguia L, Robles G, Ramirez Hernandez K, Ramirez JI, Leyva Vera CA, Duran MC. Engagement of Latino immigrant men who have sex with men for HIV prevention through eHealth: preferences across social media platforms. ETHNICITY & HEALTH 2022; 27:1684-1697. [PMID: 34152248 PMCID: PMC8688577 DOI: 10.1080/13557858.2021.1943322] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 06/08/2021] [Indexed: 05/12/2023]
Abstract
OBJECTIVE eHealth has growing potential to enhance access to HIV prevention for hard to reach populations, including young Latino immigrant men who have sex with men (MSM) in the United States. We examined the feasibility and acceptability of using eHealth tools, specifically social media platforms, to facilitate HIV testing and pre-exposure prophylaxis (PrEP) uptake among this population. DESIGN We utilized a community sensitive approach to conduct 30 in-depth interviews and five focus groups with young Latino immigrant MSM in Seattle, WA. Data were analyzed using thematic analysis with both data-driven inductive and a priori deductive approaches. RESULTS Participants were open to receiving HIV information via social media platforms. Participants recommended that social media content be tailored with their language preferences, cultural norms, and beliefs about HIV testing and PrEP in mind. Further, participants emphasized that content avoid stigmatizing HIV or Latino MSM's complex identities. CONCLUSIONS Results have implications for utilizing social media platforms and developing HIV prevention interventions for Latino immigrant MSM. Findings highlight that HIV prevention content should acknowledge how identities as an emerging adult, Latino, immigrant, and MSM, warrant unique consideration.
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Affiliation(s)
- Jane J Lee
- School of Social Work, University of Washington, Seattle, WA, USA
| | | | | | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | | | | | | | - Miriana C Duran
- Department of Health Services, University of Washington, Seattle, WA, USA
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Olivera MP, Salinas-Oñate N, Medina G, De la Hoz S. Subjective culture and HIV preventive behaviour among young Latin Americans: a systematic review. CULTURE, HEALTH & SEXUALITY 2022:1-18. [PMID: 35962535 DOI: 10.1080/13691058.2022.2106583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
Given high levels of new HIV infection globally, calls have been made for greater attention to the cultural variables that hinder prevention and testing. However, no reviews exist to systematise the findings. This study aimed to identify the cultural variables associated with three HIV preventive behaviours (condom use, HIV testing behaviour, and injection drug use with non-shared or sterilised syringes) among young Latin Americans. A systematic review was conducted guided by PRISMA-P criteria, on five databases (Web of Science, Scopus, PubMed, Medline and Scielo), which identified 2474 articles. Scientific articles and empirical studies that addressed cultural variables and HIV preventive behaviours among young people aged 15-24 years of age using Latin American samples were selected, with 37 articles being included in the final review. Six key cultural variables: the importance of female virginity; the role of trust in the couple's relationship; the disorienting effects of romantic love; the role of subjective norms; the importance of decision-making norms; and impulse control beliefs. Gender norms provide a framework for understanding sexual decision-making among young Latin Americans. Although young people have begun to adopt more egalitarian views of gender norms, deep-rooted beliefs about gender, sexuality and relationships continue to impact on HIV prevention behaviour.
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Affiliation(s)
- Mauro P Olivera
- Doctorado en Psicología, Universidad de La Frontera, Temuco, Chile
| | | | - Gustavo Medina
- Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
| | - Solange De la Hoz
- Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
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Zapata JP, de St Aubin E, Rodriguez-Diaz CE, Malave-Rivera S. Using a Structural-Ecological Model to Facilitate Adoption of Preexposure Prophylaxis Among Latinx Sexual Minority Men: A Systematic Literature Review. JOURNAL OF LATINX PSYCHOLOGY 2022; 10:169-190. [PMID: 37456610 PMCID: PMC10348365 DOI: 10.1037/lat0000204] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Research has consistently shown that individual, interpersonal, community and structural factors influence the degree to which individuals' access and utilize health care services, and these factors may play a role in explaining racial and ethnic differences in health care outcomes. Differences in HIV prevalence and treatment between Latinx adults and white adults in the U.S. must be considered in the context of these factors. However, much of the existing research connecting these factors and HIV/AIDS outcomes in Latinxs remains disparate, limited in scope, and has yet not been applied to the use of biomedical HIV preventions. The following systematic literature review examined research related to PrEP in Latinx sexual minority men (SMM) to build a structural-ecological framework of the existing research, while identifying gaps in the literature and areas for future research. We searched two electronic databases using a systematic review protocol, screened 71 unique records, and identified 23 articles analyzing data from Latinx SMM and intended and/or actual PrEP-use in the United States. Based on the present review, disparities in PrEP uptake by Latinx SMM could be explained, in part, by examining how all levels of the structural-ecological framework uniquely contributes to how Latinx SMM engage with HIV prevention measures and come to understand PrEP. It is clear from the existing literature base that some of the most prominent barriers deterring Latinx SMM from seeking PrEP services are the lack of information surrounding PrEP and HIV/gay stigmas. However, higher order structural-level risks can facilitate or reduce access to PrEP. We propose a structural-ecological model to help visualize multi-level domains of unique stressors that limit the implementation of PrEP among Latinxs. At this stage, the available literature provides little guidance beyond suggesting that culturally adapted interventions can be effective in this population. The model developed here provides that needed specificity regarding targeted interventions that will fit the needs of this population.
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Affiliation(s)
| | - Ed de St Aubin
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Carlos E Rodriguez-Diaz
- Department of Prevention and Community Health, The George Washington UniversityMilken, Institute School of Public Health
| | - Souhail Malave-Rivera
- Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico Medical sciences Campus
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11
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García M, Ramos SR, Aponte-Soto L, Ritchwood TD, Drabble LA. "Family before Anyone Else": A Qualitative Study on Family, Marginalization, and HIV among Hispanic or Latino/a/x Mexican Sexual Minority Males. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8899. [PMID: 35897270 PMCID: PMC9332740 DOI: 10.3390/ijerph19158899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
This study explored the influence family relationships have on HIV-related factors among Hispanic or Latino/a/x Mexican sexual minority cisgender males in San Antonio, TX, US. A total of 15 young adults (7 people living with HIV; PLWH) ages 21-30 completed a semi-structured interview. Data were transcribed verbatim and analyzed using thematic analysis. The following themes emerged: (1) family support; (2) mother-son relationships; (3) father-son relationships; (4) sibling support; (5) family marginalization of sexual minorities; and (6) internalized homophobia. People who reported being HIV negative were more likely to have a prominent mother-son relationship, strong sense of family, supportive siblings, and family acceptance as a sexual minority. PLWH were more likely to report a weak sense of family, being raised in a maternal-led household, and less likely to have a relationship with their father and siblings. Marginalization among participants regardless of HIV status included exposure to religious rhetoric stigmatizing sexual minorities and fathers' reinforcing Mexican traditional gender norms. In addition to encountering homophobia, PLWH were further marginalized by family members due to their HIV status. The findings suggest a need for greater attention to examining the impact of familial support of Hispanic or Latino/a/x Mexican sexual minority cisgender males as young adults with or at risk of HIV.
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Affiliation(s)
- Moctezuma García
- School of Social Work, San José State University, San Jose, CA 95112, USA;
| | | | - Lisa Aponte-Soto
- College of Science and Health, DePaul University, Chicago, IL 60604, USA;
| | - Tiarney D. Ritchwood
- Department of Family Medicine and Community Health, Duke University, Durham, NC 27710, USA;
| | - Laurie A. Drabble
- School of Social Work, San José State University, San Jose, CA 95112, USA;
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12
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Wang Y, Mitchell J, Liu Y. Evidence and implication of interventions across various socioecological levels to address HIV testing uptake among men who have sex with men in the United States: A systematic review. SAGE Open Med 2022; 10:20503121221107126. [PMID: 35795867 PMCID: PMC9251980 DOI: 10.1177/20503121221107126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/25/2022] [Indexed: 12/20/2022] Open
Abstract
Objectives Strengthening HIV testing uptake is critical to curtail the HIV epidemics among men who have sex with men in the United States. Despite the implementation of various interventions to promote HIV testing among men who have sex with men, few aggregated evidence is presented to reflect the "lessons learned" and inform future directions. The objective of this systematic review is to comprehensively summarize published studies that described, tested, and evaluated outcomes (e.g. efficacy, effectiveness, acceptability, feasibility and/or qualitative opinions) associated with an HIV testing intervention and identify gaps as well as opportunities to inform the design and implementation of future interventions to enhance HIV testing uptake among men who have sex with men in the United States. Methods We followed the PRISMA guidelines and conducted a systematic review of articles (published by 23 July 2021) by searching multiple databases (PubMed, MEDLINE, Web of Science and PsycINFO). Results Among the total number of 3505 articles found through multiple databases, 56 papers were included into the review. Interventional modules that demonstrated acceptability, feasibility and efficacy to improve HIV testing uptake among men who have sex with men include: HIV self-testing, interpersonal-level (e.g. peer-led, couple-based) interventions, personalized interventions and technology-based interventions (e.g. mHealth). Aggregated evidence also reflects the lack of individualized interventions that simultaneously address time-varying needs across multiple socioecological levels (e.g. individual, interpersonal, community, structural and societal). Conclusion Development of interventions to improve HIV testing rates and frequency of men who have sex with men has proliferated in recent years. Our review presents important implications in sustaining and improving interventions to address HIV testing uptake among men who have sex with men in the United States.
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Affiliation(s)
- Ying Wang
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Jason Mitchell
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Yu Liu
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
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13
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Galvan FH, Liu H, Brooks RA, Chen YT, Mendoza Lepe R. Using social and sexual networking mobile applications to promote HIV testing, medical care and prevention services among Latino men who have sex with men in Los Angeles County, California, USA. PLoS One 2022; 17:e0268406. [PMID: 35560041 PMCID: PMC9106153 DOI: 10.1371/journal.pone.0268406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 04/28/2022] [Indexed: 11/18/2022] Open
Abstract
HIV disproportionately affects Latinos versus Whites, with Latinos having higher rates of HIV. Additionally, many HIV-positive Latinos are unaware of their infection. Proyecto Protégete, an HIV prevention intervention developed for Latino men who have sex with men (MSM), used social and sexual networking mobile applications (apps) to recruit individuals for HIV testing and linkage to medical care and prevention services. This study occurred in Los Angeles County, California, USA from December 18, 2015 to April 22, 2017. The study’s primary aim was to assess Proyecto Protégete‘s ability to successfully recruit Latino MSM involved in high-risk sexual activities. A secondary aim was to evaluate its capacity to promote HIV testing and linkage to HIV medical care and prevention services among this population by comparing it to two programs with similar samples. Comparisons using Fisher’s Exact Test were conducted between Proyecto Protégete and the HIV testing program of the agency in which Proyecto Protégete was located and the County-funded HIV testing programs to compare the samples’ rates of HIV-positive Latino MSM identified through HIV testing and linked to HIV medical care and prevention services. Participants were recruited through seven apps. In Proyecto Protégete, 9,573 individuals completed the screener, 4,657 were eligible, and 359 (7.7% of those eligible) enrolled. Among those enrolled, 79% reported anal sex without a condom in the previous twelve months; 51% reported anal sex under the influence of alcohol. The HIV positivity rates were as follows: Proyecto Protégete, 1.71%; the agency, 1.25% (p = .293, compared to Proyecto Protégete); and the County, 1.09% (p = .172, compared to Proyecto Protégete). The rates of those confirmed as new HIV-positives and linked to medical care within 30 days were as follows: Proyecto Protégete, 71.4%; the agency, 81.5% (p = .450, compared to Proyecto Protégete); and the County, 77.3% (p = .503, compared to Proyecto Protégete). Proyecto Protégete had a higher rate of linked referrals to prevention services than the agency’s testing program (19.5% versus 8.3%, p < .001). Proyecto Protégete experienced successes in some areas but not in others. Future research should build on Proyecto Protégete’s experiences to promote HIV-related services among Latino MSM.
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Affiliation(s)
- Frank H. Galvan
- Department of Research and Evaluation, Bienestar Human Services, Inc., Los Angeles, California, United States of America
| | - Honghu Liu
- Division of Public Health & Community Dentistry, School of Dentistry, University of California, Los Angeles, California, United States of America
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
- Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California, United States of America
| | - Ronald A. Brooks
- Department of Research and Evaluation, Bienestar Human Services, Inc., Los Angeles, California, United States of America
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
- * E-mail:
| | - Ying-Tung Chen
- Department of Research and Evaluation, Bienestar Human Services, Inc., Los Angeles, California, United States of America
| | - Ricardo Mendoza Lepe
- Department of Research and Evaluation, Bienestar Human Services, Inc., Los Angeles, California, United States of America
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14
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Arends RM, Grintjes KJT, van den Heuvel TJ, Foeken-Verwoert EGJ, Schene AH, van der Ven AJAM, Schellekens AFA. Effectiveness of a group intervention to reduce sexual transmission risk behavior among MSM living with HIV: a non-randomized controlled pilot study. AIDS Care 2021; 34:515-526. [PMID: 34851810 DOI: 10.1080/09540121.2021.2002252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ABSTRACTWith an annual incidence of about 1.5 million new infections, HIV is an ongoing public health concern. Sexual transmission risk behavior (STRB) is a main driver of the HIV epidemic in most Western countries, particularly among specific populations such as men who have sex with men (MSM). This quasi-experimental pilot study examined the effectiveness of a ten-session group intervention, aiming to reduce STRB among a high-risk subpopulation of MSM living with HIV. Self-reported STRB, impulsivity, mental health symptoms, and functional impairment were compared between the intervention group (n = 12) and a control group (n = 16). At baseline, participants in the intervention group had higher levels of STRB, impulsivity, mental health problems, and functional impairment, compared to the control group. A significant time-by-group interaction effect revealed that after the intervention, STRB, impulsivity, and functional impairment reduced in the intervention group to levels comparable to the control group. These findings suggest that a targeted behavioral intervention might be an effective strategy to reduce persistent STRB and related factors in MSM living with HIV. Future studies should confirm these findings in larger samples, using randomized designs.
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Affiliation(s)
- Rachel M Arends
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Karin J T Grintjes
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Thom J van den Heuvel
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,GGNet, Scelta, Nijmegen, Netherlands
| | | | - Aart H Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Arnt F A Schellekens
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, Netherlands
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15
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Palfai TP, Luehring-Jones P. How Alcohol Influences Mechanisms of Sexual Risk Behavior Change: Contributions of Alcohol Challenge Research to the Development of HIV Prevention Interventions. AIDS Behav 2021; 25:314-332. [PMID: 34148189 DOI: 10.1007/s10461-021-03346-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 10/21/2022]
Abstract
This paper examines the contributions of laboratory-based alcohol challenge research (ACR) to the development of HIV prevention interventions. Following a brief overview of HIV prevention interventions and related health behavior change models, we discuss how alcohol may influence mechanisms of behavior change. The paper highlights the value of ACR for: (1) elucidating mechanisms of action through which alcohol affects sexual risk behavior, (2) testing how alcohol may influence mechanisms thought to underlie HIV prevention interventions, (3) clarifying moderators of the causal influences of alcohol, (4) identifying novel intervention targets, and (5) developing strategies to reduce sexual risk among those who consume alcohol. We conclude with a discussion of the importance of using experimental research to identify mechanisms of behavior change that are specific to populations at high risk for HIV and outline some key implications for developing HIV prevention interventions that integrate the role of alcohol.
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16
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Harkness A, Weinstein ER, Atuluru P, Vidal R, Rodriguez-Diaz CE, Safren SA. "Let's Hook Up When the Pandemic is Over:" Latinx Sexual Minority Men's Sexual Behavior During COVID-19. JOURNAL OF SEX RESEARCH 2021; 58:951-957. [PMID: 33661064 PMCID: PMC8417157 DOI: 10.1080/00224499.2021.1888064] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
COVID-19 led to substantial changes in individuals' lives due to preventive measures, including social distancing and "stay at home" orders. One type of social interaction likely impacted is intimacy and sexual relationships. Sexual minority men have long navigated the impact of another pandemic, HIV, on their sexual lives. This study explored the impact of COVID-19 on Latinx sexual minority men's (LSMM) sexual behaviors in South Florida, an HIV and COVID-19 epicenter. A rapid qualitative analysis of semi-structured interviews with LSMM (N = 20) revealed five themes: (1) increased sex with a primary partner, (2) fewer sexual partners, (3) continued pre-COVID-19 sexual activity, often following "quarantine fatigue," (4) opportunities and challenges related to navigating COVID-19 prevention and sex, and (5) using sexual networking apps in new ways. The findings suggest LSMM's resilience and their ongoing health needs during COVID-19, with implications for interventions to promote LSMM's safe and satisfying sex.
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Affiliation(s)
- Audrey Harkness
- Department of Public Health Sciences, University of Miami, Clinical Research Center, Miami, FL, USA
| | | | - Pranusha Atuluru
- Department of Medicine, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Ronald Vidal
- Department of Public Health Sciences, University of Miami, Clinical Research Center, Miami, FL, USA
| | - Carlos E. Rodriguez-Diaz
- Milken Institute of School of Public Health, The George Washington University, Washington, DC, USA
- University of Puerto Rico-Medical Sciences Campus, School of Public Health, San Juan, PR, USA
| | - Steven A. Safren
- Department of Psychology, University of Miami, Coral Gables, FL, USA
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17
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Shah HS, Grieb SMD, Flores-Miller A, Yenokyan K, Castellanos-Aguirre J, Greenbaum A, Page KR. Sólo Se Vive Una Vez: Evaluation of a Social Marketing Campaign Promoting HIV Screening and Prevention for Immigrant Latinxs. AIDS Behav 2021; 25:3024-3033. [PMID: 33566213 PMCID: PMC8373748 DOI: 10.1007/s10461-021-03165-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 12/04/2022]
Abstract
Latinxs in the U.S. are disproportionately affected by HIV and more likely to have delayed diagnosis than their non-Latinx peers. We developed and implemented Sólo Se Vive Una Vez (You Only Live Once), the first Spanish-language campaign aimed at improving HIV testing and prevention among Latinx immigrants in Baltimore, Maryland. Sólo Se Vive Una Vez featured a website (www.solovive.org) and social marketing campaign promoting free HIV testing through the Baltimore City Health Department (BCHD) clinic and Latinx outreach team. The campaign was not associated with a change in the overall number of Latinxs obtaining HIV testing. However, Latinx HIV testers who reported being exposed to the campaign had significantly higher rates of high-risk sexual behaviors, mean number of sexual partners, and substance use. The campaign was also associated with increased PrEP referrals through the BCHD Latinx outreach team.
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Affiliation(s)
- Harita S Shah
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Medicine, University of Chicago, Chicago, IL, USA.
| | | | - Alejandra Flores-Miller
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Baltimore City Health Department, Baltimore, MD, USA
| | - Karine Yenokyan
- Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | | | | | - Kathleen R Page
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Baltimore City Health Department, Baltimore, MD, USA
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18
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Shrader CH, Arroyo-Flores J, Skvoretz J, Fallon S, Gonzalez V, Safren S, Algarin A, Johnson A, Doblecki-Lewis S, Kanamori M. PrEP Use and PrEP Use Disclosure are Associated with Condom Use During Sex: A Multilevel Analysis of Latino MSM Egocentric Sexual Networks. AIDS Behav 2021; 25:1636-1645. [PMID: 33387134 PMCID: PMC8667162 DOI: 10.1007/s10461-020-03080-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 01/16/2023]
Abstract
Pre-exposure prophylaxis (PrEP) is integral to HIV prevention; however, the influence of PrEP use and PrEP use disclosure on condom use is unclear among Latinx men who have sex with men (LMSM). This study explored associations of LMSM PrEP use and use disclosure on consistent dyadic condom use in the past 6 months. Participants were 130 HIV-negative PrEP and non-PrEP using LMSM ages 20-39 years. Two-level logistic regression models assessing individual- and dyadic-level predictors on condom use were fitted using R. Participants reported a mean of four sexual partners (n = 507 dyads). Participants who reported using PrEP or having more sexual partners were more likely to use condoms; however, participants who reported disclosing PrEP use were less likely to use condoms. Future longitudinal studies should characterize approaches to increase informed personal health choices and conversations about PrEP, condom use, and other HIV risk-reduction strategies using network methodologies.
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Affiliation(s)
- Cho-Hee Shrader
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 1006, Miami, FL, 33132, USA.
| | - Juan Arroyo-Flores
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 1006, Miami, FL, 33132, USA
| | - John Skvoretz
- Department of Sociology, University of South Florida, 4202 East Fowler Ave CPR 107, Tampa, FL, 33630, USA
| | - Stephen Fallon
- Latinos Salud, 2330 Wilton Dr, Wilton Manors, FL, 33305, USA
| | - Victor Gonzalez
- Latinos Salud, 2330 Wilton Dr, Wilton Manors, FL, 33305, USA
| | - Steven Safren
- Department of Psychology, University of Miami, 5665 Ponce De Leon Blvd, Room 463, Coral Gables, FL, 33146, USA
| | - Angel Algarin
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Ariana Johnson
- Division of Epidemiology, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 1006, Miami, FL, 33136, USA
| | - Susanne Doblecki-Lewis
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street #853, Miami, FL, 33136, USA
| | - Mariano Kanamori
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 1006, Miami, FL, 33132, USA
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19
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Patel VV, Rawat S, Dange A, Lelutiu-Weinberger C, Golub SA. An Internet-Based, Peer-Delivered Messaging Intervention for HIV Testing and Condom Use Among Men Who Have Sex With Men in India (CHALO!): Pilot Randomized Comparative Trial. JMIR Public Health Surveill 2020; 6:e16494. [PMID: 32297875 PMCID: PMC7193444 DOI: 10.2196/16494] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/08/2020] [Accepted: 02/22/2020] [Indexed: 01/18/2023] Open
Abstract
Background Leveraging internet-based communication tools (eg, messaging apps, SMS text messaging, and email) may be an effective avenue for delivery of HIV prevention messages to men who have sex with men (MSM) in India, but there are limited models for such internet-based interventions. Objective The CHALO! pilot was an online educational and behavioral intervention aimed to determine the feasibility, acceptability, and preliminary impact of a peer-delivered, internet-based messaging intervention for HIV testing and consistent condom use for MSM in India. The messages addressed barriers to HIV testing and condom use and were theoretically based on the information-motivation-behavioral skills model. Methods Between February and March 2015, we recruited, enrolled, and randomized 244 participants via online advertisements on mobile dating apps and Facebook. Eligible men (18 years or older, sexually active with other men, and self-reported HIV-negative or unknown status) were randomized to receive educational and motivational messages framed as either approach (ie, a desirable outcome to be achieved) or avoidance (an undesirable outcome to be avoided) over 12 weeks via internet-based messaging platforms. Participants completed online surveys at baseline and immediately postintervention. Results Participants were similar across arms with respect to sociodemographic and behavioral characteristics. Over 82.0% (200/244) of participants were retained (ie, viewed final messages), and 52.3% (130/244) of them completed the follow-up survey. Of those completing the follow-up survey, 82.3% (107/130) liked or strongly liked participating in CHALO!. The results showed a significant increase in self-reported HIV testing in the past 6 months from baseline to follow-up (41/130, 31.5% to 57/130, 43.8%; P=.04). When including those who reported intentions to test, this percentage increased from 44.6% (58/130) at baseline to 65.4% (85/130) at follow-up (P<.01). When examining intentions to test among those without prior HIV testing, intentions increased from 32% (16/50) of the sample at baseline to 56% (28/50) of the sample at follow-up (P=.02). Condom use during anal sex did not significantly change from baseline to follow-up. HIV testing and condom use did not significantly differ between approach and avoidance conditions at follow-up. Conclusions As one of the first studies of an online HIV prevention intervention for Indian MSM, CHALO! was feasible to implement by a community-based organization, was acceptable to participants, and demonstrated potential to improve HIV testing rates.
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Affiliation(s)
- Viraj V Patel
- Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, United States
| | | | | | - Corina Lelutiu-Weinberger
- François-Xavier Bagnoud Center, School of Nursing, Rutgers Biomedical and Health Sciences, Newark, NJ, United States
| | - Sarit A Golub
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States
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20
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Loza O, Curiel ZV, Beltran O, Ramos R. Methamphetamine Use and Sexual Risk Behaviors among Men Who Have Sex With Men in a Mexico-US Border City. Am J Addict 2020; 29:111-119. [PMID: 31908109 PMCID: PMC7895453 DOI: 10.1111/ajad.12985] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 11/06/2019] [Accepted: 12/15/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Methamphetamine (meth) use and its related risk behaviors for HIV among men who have sex with men (MSM) are a public health concern across the Mexico-US border. This study aims to contribute to the limited literature of meth use and sexual risk behaviors among Latino MSM on the Mexico-US border. METHODS Data were drawn from the Meth Pilot Study (2014-2015) among men who use meth (n = 100). Descriptive statistics and bivariate analysis comparing MSM to non-MSM were conducted using Pearson's χ2 test, Fisher's exact tests, and Mann-Whitney U test; all tests were conducted using SPSS v.25. RESULTS Most participants obtained meth in El Paso, Texas (87.2%), used meth orally (65.2%) or smoked (78.3%), and the most common reason for initiation was curiosity. Significant differences (P < .05) in meth use behaviors and sexual risk behaviors between MSM and non-MSM who used meth included: median number of sex partners (7 vs 3), being penetrated anally by last sexual partner (31.6% vs 1.4%), and engaging in transactional sex ever (63.2% vs 9.6%) and past 12 months (52.6% vs 6.8%). Finally, rates of HIV positivity were higher among MSM than non-MSM (10.5% vs 1.4%). DISCUSSION AND CONCLUSIONS Among men who use meth, MSM are engaging in higher HIV risk behaviors compared with non-MSM. Understanding these risks could help identify candidates for pre-exposure prophylaxis (PrEP) and evidence-based substance use disorder treatment options. SCIENTIFIC SIGNIFICANCE This study reveals that Latino MSM who use meth is a high-risk group for HIV and a need for tailored interventions. (Am J Addict 2020;29:111-119).
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Affiliation(s)
- Oralia Loza
- Department of Public Health Sciences, The University of Texas at El Paso, El Paso, Texas
| | - Zuleika V. Curiel
- Texas Tech University Health Sciences Center El Paso, El Paso, Texas
| | | | - Rebeca Ramos
- Alliance of Border Collaboratives, El Paso, Texas
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21
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Higa DH, Crepaz N, McDonald CM, Adegbite-Johnson A, DeLuca JB, Kamitani E, Sipe TA. HIV Prevention Research on Men Who Have Sex With Men: A Scoping Review of Systematic Reviews, 1988-2017. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:1-S7. [PMID: 32073309 DOI: 10.1521/aeap.2020.32.1.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In the United States, men who have sex with men (MSM) are disproportionately affected by HIV. To identify research gaps and inform HIV prevention for MSM, we conducted a scoping review of systematic reviews using CDC's Prevention Research Synthesis database. Eligibility criteria comprised English-language systematic reviews focused on HIV prevention for MSM, published during 1988-2017, and included at least one U.S. primary study. We coded data type, subpopulations, topics, and key findings. To assess study quality, we used the Assessment of Multiple Systematic Reviews (AMSTAR). Among 129 relevant systematic reviews, study quality was high or moderate for 63%. Most common topics were sexual behavior and disease vulnerability. The most frequently mentioned MSM subgroups were HIV-positive, Black or African American, and young. Research gaps include Hispanic/Latino MSM, pre-exposure prophylaxis (PrEP), treatment as prevention, social determinants of health, health disparities, syndemics, and protective factors for sexual health.
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Affiliation(s)
- Darrel H Higa
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Nicole Crepaz
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Christina M McDonald
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | | | - Julia B DeLuca
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Emiko Kamitani
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Theresa Ann Sipe
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
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22
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Garcia M, Saw G. Socioeconomic disparities associated with awareness, access, and usage of Pre-Exposure Prophylaxis among Latino MSM ages 21-30 in San Antonio, TX. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2019; 18:206-211. [PMID: 31308833 PMCID: PMC6628255 DOI: 10.1080/15381501.2019.1607795] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 04/10/2019] [Indexed: 06/10/2023]
Abstract
HIV continues to disproportionately affect Latino men who have sex with men (MSM) and disparities are even greater in the South. This study examines the implications of socioeconomic status (SES) associated with awareness, access, and usage of PrEP. Latino MSM (N=154) from San Antonio, TX completed a self-administered survey. Results revealed that PrEP uptake was significantly lower for low SES Latino MSM. PrEP related barriers included lack of awareness, stigmas, and side effects. Findings underscore the importance for a multi-systemic approach to enhance awareness and access of PrEP for Latino MSM with varying levels of SES in the South.
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Affiliation(s)
- Moctezuma Garcia
- Houston Health Department, 8000 N Stadium Dr, Houston, TX
77054; Phone: 832-393-4639
- Center for Interdisciplinary Research on AIDS, Yale
University, New Haven, CT
| | - Guan Saw
- College of Education and Human Development, University of
Texas at San Antonio, San Antonio, TX; Phone: 210-458-4370
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23
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Abstract
Progress in reducing HIV infections has been suboptimal despite availability of effective prevention and treatment interventions and national strategies to bring them to scale. As part of a community-driven process, we expanded previous epidemiologic models using updated surveillance data from the Centers for Disease Control and Prevention to estimate quantitative parameters for ambitious but attainable national HIV prevention goals. We estimated new HIV infections could be reduced by up to 67% and prevalence could begin to decline by 2030 if 95% targets for diagnosis, care retention, and viral suppression are met by 2025 and an additional 20% of transmissions are averted through targeted interventions such as pre-exposure prophylaxis. Notably, this would require the percentage of diagnosed persons retained in HIV care to increase by more than 35 percentage points, which would necessitate innovative models and a substantial expansion of supportive services. Although the HIV incidence reduction goal of 90% as unveiled in the 2019 State of the Union Address is likely unachievable with the current intervention toolkit, it is possible to begin to substantially reduce HIV prevalence in the next decade with sufficient investments and innovation.
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Affiliation(s)
- Heather Bradley
- Department of Population Health Sciences, Georgia State University School of Public Heath, Urban Life Building, 140 Decatur Street, Ste. 463, Atlanta, GA, 30303, USA.
| | - Eli S Rosenberg
- School of Public Health, University at Albany-SUNY, New York, USA
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24
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Seelman KL, Miller JF, Fawcett ZER, Cline L. Do transgender men have equal access to health care and engagement in preventive health behaviors compared to cisgender adults? SOCIAL WORK IN HEALTH CARE 2018; 57:502-525. [PMID: 29708468 DOI: 10.1080/00981389.2018.1462292] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Using 2015 Behavioral Risk Factor Surveillance System data, this study investigates whether transgender men have equal access to health care and engagement in preventive health behaviors compared to cisgender adults in the U.S. and whether race/ethnicity, socioeconomic status, and rural residence moderate these relationships. Once controlling for sociodemographic factors, we do not find differences for transgender men. Rural transgender men were less likely to have a personal doctor or receive a blood cholesterol screening than their urban peers; transgender men with less education were more likely to have a cholesterol screening. We detail implications for social workers within health care.
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Affiliation(s)
- Kristie L Seelman
- a School of Social Work , Georgia State University , Atlanta , GA , USA
| | - Jordan F Miller
- b Department of Sociology , Georgia State University , Atlanta , GA , USA
| | - Zoe E R Fawcett
- b Department of Sociology , Georgia State University , Atlanta , GA , USA
| | - Logan Cline
- b Department of Sociology , Georgia State University , Atlanta , GA , USA
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