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Nadarzynski T, Frost M, Miller D, Wheldon CW, Wiernik BM, Zou H, Richardson D, Marlow LAV, Smith H, Jones CJ, Llewellyn C. Vaccine acceptability, uptake and completion amongst men who have sex with men: A systematic review, meta-analysis and theoretical framework. Vaccine 2021; 39:3565-3581. [PMID: 34034949 DOI: 10.1016/j.vaccine.2021.05.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/16/2021] [Accepted: 05/04/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Due to an increased risk of sexually transmitted infections (STIs), gay, bisexual and other men who have sex with men (MSM) have been recommended to receive vaccinations against human papillomavirus, meningitis C and hepatitis A/B. This review aimed to compare the rates of vaccine acceptability, uptake and completion, and to identify determinants of vaccine outcomes specific to MSM to inform a theoretical framework. METHODS In January 2020 four databases were explored to identify vaccination behaviours and associated factors among MSM. A narrative systematic review and meta-analysis were performed. Data were synthesised for theoretical modelling. RESULTS Seventy-eight studies, mostly from the USA, were included. The average vaccine acceptability was 63% (median = 72%, range: 30%-97%), vaccine uptake 45% (median = 42%, range: 5%-100%) and vaccine completion 47% (median = 45%, range: 12%-89%). Six categories of factors associated with vaccination acceptability, uptake and completion were conceptualised: Individual (e.g., demographic and psychosocial); Interpersonal (e.g., peer education); Healthcare provider (e.g., vaccine recommendation); Organisational and practice setting (e.g., routine collection of patient sexual orientation information that is integrated into a clinical decision support system); Community environment (e.g., targeted health promotion campaigns); and National, state and local policy environment (e.g., public health guidelines targeting MSM). CONCLUSION Despite overall high levels of acceptability, uptake and completion rates were below targets predicted by cost-effectiveness modelling across all recommended vaccines. These parameters may need to be adjusted for more precise estimations of cost-effectiveness. Addressing the multiple levels of determinants, as outlined in our theoretical framework, will help guide interventions to increase vaccine completion among MSM.
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Affiliation(s)
| | - Miles Frost
- The University of Southampton, Southampton, United Kingdom
| | - Danny Miller
- The University of Westminster, London, United Kingdom
| | | | | | - Huachun Zou
- Sun Yat-sen University, School of Public Health, Shenzhen, China
| | - Daniel Richardson
- Brighton & Sussex University Hospitals NHS Trust, Brighton; Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom
| | - Laura A V Marlow
- Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Helen Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | | | - Carrie Llewellyn
- Brighton & Sussex Medical School, University of Sussex, Falmer, United Kingdom
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Den Daas C, Adam PCG, Vermey K, Zuilhof W, de Wit JBF. Factors associated with self-reported hepatitis B virus vaccination status among men who have sex with men in the Netherlands. Sex Health 2020; 17:444-452. [PMID: 33176905 DOI: 10.1071/sh20082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/28/2020] [Indexed: 11/23/2022]
Abstract
Background Reducing the number of new acute hepatitis B virus (HBV) infections to zero by 2022 is an important goal in the Netherlands. Free HBV vaccination is available for population groups at higher risk of infection, including men who have sex with men (MSM). Identifying correlates of HBV vaccination among MSM can guide the development of health promotion interventions to increase coverage of HBV vaccination. METHODS We assessed factors associated with the HBV vaccination status of 4270 MSM in the Netherlands. Data were collected through the 2018 online Men & Sexuality survey. RESULTS Multinomial regression analysis showed that lower education level, having never tested for HIV, not recently diagnosed with a sexually transmissible infection, recently having had sex abroad and unknown HBV testing status were associated with higher odds of being unvaccinated as opposed to fully vaccinated. Living in Amsterdam and testing HBV negative were associated with lower odds of being unvaccinated as opposed to fully vaccinated. Age (25-39 years vs younger ages), living in Amsterdam and using pre-exposure prophylaxis decreased the odds to be partly vaccinated as opposed to fully vaccinated; having a migration background increased these odds. CONCLUSIONS HBV vaccination rates among MSM will not reduce HBV transmission to zero. HBV promotion should focus on MSM outside of Amsterdam who are likely less connected with sexual health services and may be at lower (perceived) risk. The factors identified related to HBV vaccination status provide guidance for health promotion interventions to increase uptake and vaccination completion among MSM.
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Affiliation(s)
- C Den Daas
- Health Psychology Group, University of Aberdeen Institute of Applied Health Sciences, Foresterhill, Aberdeen, AB25 2ZD, Scotland; and Centre for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands; and Interdisciplinary Social Science, Utrecht University, PO Box 80140, 3508 TC, Utrecht, the Netherlands; and Corresponding author.
| | - P C G Adam
- Centre for Social Research in Health, John Goodsell Building, UNSW Sydney, Sydney, NSW 2052, Australia; and Institute for Prevention and Social Research (IPSR), Minrebroederstraat 7a, 3512 GS, Utrecht, the Netherlands
| | - K Vermey
- STI Aids Netherlands, Condensatorweg 54, 1014 AX, Amsterdam, the Netherlands
| | - W Zuilhof
- STI Aids Netherlands, Condensatorweg 54, 1014 AX, Amsterdam, the Netherlands
| | - J B F de Wit
- Interdisciplinary Social Science, Utrecht University, PO Box 80140, 3508 TC, Utrecht, the Netherlands; and Centre for Social Research in Health, John Goodsell Building, UNSW Sydney, Sydney, NSW 2052, Australia; and Institute for Prevention and Social Research (IPSR), Minrebroederstraat 7a, 3512 GS, Utrecht, the Netherlands
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3
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Frew PM, Holloway IW, Goldbeck C, Tan D, Wu E, Jauregui J, Fenimore VL, Randall LA, Lutz CS, Mendel J, Aikin AL, Nowak GJ, Bednarczyk RA. Development of a measure to assess vaccine confidence among men who have sex with men. Expert Rev Vaccines 2018; 17:1053-1061. [PMID: 30433837 PMCID: PMC9993617 DOI: 10.1080/14760584.2018.1541405] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Recent serogroup C meningococcal disease outbreaks led to meningococcal vaccine recommendations for Southern California men who have sex with men (MSM). Assessment of vaccine confidence is critical to improving vaccine coverage in the context of disease outbreaks wherein immunization(s) are recommended. METHODS We surveyed MSM using venue-based sampling and began development of the vaccine confidence index (VCI) with 30 survey items corresponding to trust- and safety-related perceptions. We performed exploratory factor analyses and computed the Cronbach's alpha coefficient to assess internal consistency of the VCI. We created a categorical confidence variable (low, medium, and high confidence) and conducted bivariate and multivariate analyses to evaluate associations with reported confidence and immunization uptake. RESULTS Ten survey items were included in the final VCI and formed the confidence measure. Participants with low confidence had the lowest levels of reported uptake for both meningococcal vaccines. Confidence differed significantly (p ≤ 0.05) between MSM who indicated they received vaccines recommended within the context of the outbreak and those who did not. CONCLUSIONS Our VCI is sensitive to a number of issues that may influence vaccine confidence. It is useful for assessing MSM trust and acceptance of recommended immunizations and may be used to inform intervention development.
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Affiliation(s)
- Paula M Frew
- a Department of Medicine, Division of Infectious Diseases , Emory University School of Medicine , Atlanta , GA , USA.,b Rollins School of Public Health, Hubert Department of Global Health , Emory University , Atlanta , GA , USA.,c Emory Center for AIDS Research , Atlanta , GA , USA
| | - Ian W Holloway
- d Department of Social Welfare , UCLA Luskin School of Public Affairs , Los Angeles , CA , USA.,e UCLA Center for AIDS Research , Los Angeles , CA , USA.,f California HIV/AIDS Policy Research Center , Los Angeles , CA , USA
| | - Cameron Goldbeck
- d Department of Social Welfare , UCLA Luskin School of Public Affairs , Los Angeles , CA , USA.,f California HIV/AIDS Policy Research Center , Los Angeles , CA , USA
| | - Diane Tan
- d Department of Social Welfare , UCLA Luskin School of Public Affairs , Los Angeles , CA , USA
| | - Elizabeth Wu
- d Department of Social Welfare , UCLA Luskin School of Public Affairs , Los Angeles , CA , USA
| | - Juan Jauregui
- d Department of Social Welfare , UCLA Luskin School of Public Affairs , Los Angeles , CA , USA
| | - Vincent L Fenimore
- b Rollins School of Public Health, Hubert Department of Global Health , Emory University , Atlanta , GA , USA
| | - Laura A Randall
- a Department of Medicine, Division of Infectious Diseases , Emory University School of Medicine , Atlanta , GA , USA
| | - Chelsea S Lutz
- a Department of Medicine, Division of Infectious Diseases , Emory University School of Medicine , Atlanta , GA , USA
| | - Judith Mendel
- g Health and Human Services , National Vaccine Program Office , Washington , DC , USA
| | - Ann L Aikin
- g Health and Human Services , National Vaccine Program Office , Washington , DC , USA
| | - Glen J Nowak
- h University of Georgia Grady College of Journalism and Mass Communication , Athens , GA , USA
| | - Robert A Bednarczyk
- b Rollins School of Public Health, Hubert Department of Global Health , Emory University , Atlanta , GA , USA.,i Emory Vaccine Center , Atlanta , GA , USA
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4
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Vet R, de Wit JB, Das E. Factors associated with hepatitis B vaccination among men who have sex with men: a systematic review of published research. Int J STD AIDS 2015; 28:534-542. [PMID: 26503555 DOI: 10.1177/0956462415613726] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This systematic review identified and synthesised evidence from published research regarding personal and environmental factors associated with hepatitis B virus (HBV) vaccination uptake among gay men and other men who have sex with men (MSM) in low prevalence, high-income countries. A systematic literature search identified 18 eligible papers that addressed factors potentially associated with HBV vaccination uptake among MSM, of which 16 reported research conducted in the US. Studies assessed possible associations between HBV vaccination among MSM and socio-demographic characteristics, behavioural and social-cognitive factors and indicators of health service access. Converging evidence was found for associations between HBV vaccination and younger age, gay self-identification, and not using alcohol and drugs; evidence suggests a lack of association between HBV vaccination and ethnicity. There was converging evidence for associations between HBV vaccination and social-cognitive factors, in particular knowledge, perceived vulnerability and perceived severity regarding HBV infection, and perceived barriers to HBV vaccination. Evidence further supported associations between HBV vaccination and indicators of health service access. While research regarding factors associated with HBV vaccination among MSM remains limited, the identified correlates of HBV vaccination among MSM provide important guidance for the development of health promotion interventions to effectively increase coverage of HBV vaccination among MSM.
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Affiliation(s)
- Raymond Vet
- 1 Department of Social and Organizational Psychology, Utrecht University, Utrecht, the Netherlands.,2 Raymond Vet is now at Ray of Light, Health Coaching & Consultancy, Amsterdam, the Netherlands
| | - John Bf de Wit
- 1 Department of Social and Organizational Psychology, Utrecht University, Utrecht, the Netherlands.,3 Centre for Social Research in Health, UNSW Australia, Sydney, Australia
| | - Enny Das
- 4 Centre for Language Studies, Radboud University, Nijmegen, the Netherlands
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5
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Roushan N, Nasiri Toosi M, Meysamie A, Esteghamati AR, Hajrassuliha H. Hepatitis B knowledge among Iranian adolescents: a national survey. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:e11558. [PMID: 24693383 PMCID: PMC3955498 DOI: 10.5812/ircmj.11558] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 08/06/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hepatitis B is the most prevalent chronic infectious liver disease worldwide with serious sequelae. Prevention of the infection can be provided by universal vaccination and improvement in knowledge and behavior about disease transmission. Provision of any educational program requires inquiry about target group baseline knowledge. OBJECTIVES The aim of this study was to assess Iranian adolescents' knowledge about hepatitis B (HBV) and associated factors. PATIENTS AND METHODS We conducted a questionnaire-based national survey of 18-year-old adolescents according to stratified cluster random sampling in Iran during 2007. RESULTS Response rate was 87%. Most adolescents (60%) knew that HBV infects the liver. Percentage of adolescents who gave correct answers to major routes of HBV transmission were as follows: spouse of an infected person 59%, multi-partners 66%, intravenous drug use 73%, body piercing 55% and personal belongings 55%. Higher levels of education, living in rural areas, marriage and (except for body piercing) female gender were associated with better knowledge. The knowledge of HBV infected individuals about major routes of HBV transmission was low (P < 0.001). CONCLUSIONS There are important deficits in adolescents' knowledge about HBV that requires attention of health educators to tailor educational programs for specific groups.
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Affiliation(s)
- Nader Roushan
- Department of Internal Medicine, Division of Gastroenterology, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Nader Roushan, Department of Internal Medicine, Division of Gastroenterology, Tehran University of Medical Sciences, Tehran, Iran. Tel/Fax: +98-2166939922, E-mail:
| | - Mohsen Nasiri Toosi
- Department of Internal Medicine, Division of Gastroenterology, Tehran University of Medical Sciences, Tehran, Iran
| | - Alipasha Meysamie
- Department of Preventive and Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdoul-Reza Esteghamati
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
- Center for Disease Control and Prevention of Iran, Tehran, Iran
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Matthews JE, Stephenson R, Sullivan PS. Factors associated with self-reported HBV vaccination among HIV-negative MSM participating in an online sexual health survey: a cross-sectional study. PLoS One 2012; 7:e30609. [PMID: 22363453 PMCID: PMC3281854 DOI: 10.1371/journal.pone.0030609] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 12/25/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A substantial proportion of men who have sex with men (MSM) in the United States remain unvaccinated against hepatitis B. We sought to understand which factors are associated with vaccination among HIV-negative MSM. METHODOLOGY/PRINCIPAL FINDINGS Data were from a 2010 web-based survey of adult MSM. We calculated the prevalence of self-reported hepatitis B vaccination among 1,052 HIV-negative or HIV-untested men who knew their hepatitis B vaccination status, and used multivariate logistic regression to determine associated factors. 679 (64.5%) MSM reported being vaccinated. Younger men were more likely to report being vaccinated than older men, and there was a significant interaction between age and history of hepatitis B testing. Men with at least some college education were at least 2.1 times as likely to be vaccinated as men with a high school education or less (95% CI = 1.4-3.1). Provider recommendation for vaccination (aOR = 4.2, 95% CI = 2.4-7.4) was also significantly associated with receipt of vaccination. CONCLUSIONS/SIGNIFICANCE Providers should assess sexual histories of male patients and offer those patients with male sex partners testing for hepatitis infection and vaccinate susceptible patients. There may be particular opportunities for screening and vaccination among older and more socioeconomically disadvantaged MSM.
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Affiliation(s)
- Jonathan E. Matthews
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
| | - Rob Stephenson
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
| | - Patrick S. Sullivan
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America
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7
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Abstract
Less than half of gay and bisexual men indicated they had received some doses of hepatitis B virus vaccine. Hepatitis B virus vaccination was higher among men who were 18 to 29 years old (compared to those 50-59 years old), gay, or had received flu vaccine within the last year.
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Affiliation(s)
- Paul L. Reiter
- UNC Gillings School of Global Public Health
- Lineberger Comprehensive Cancer Center
| | - Noel T. Brewer
- UNC Gillings School of Global Public Health
- Lineberger Comprehensive Cancer Center
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8
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Gilbert LK, Levandowski BA, Scanlon KE, Peterson RS. A comparison of hepatitis A and hepatitis B measures among vaccinated and susceptible online men who have sex with men. Int J STD AIDS 2010; 21:400-5. [PMID: 20606219 DOI: 10.1258/ijsa.2009.009010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Hepatitis A virus (HAV) and hepatitis B virus (HBV) continue to be major health concerns among men who have sex with men (MSM). The Internet both facilitates high-risk sexual encounters and provides opportunities for promoting healthy behaviours. This study compared self-reported HAV and HBV vaccination levels, based on demographics, health characteristics, hepatitis knowledge, attitudes and risk behaviours among MSM using an online survey posted from February through June 2005. Each participant (n = 968) reported whether they were vaccinated, infected or susceptible for hepatitis A and/or for hepatitis B. Men whose health-care provider recommended vaccination were 12.91 (95% confidence interval [CI] 8.11, 20.55) times more likely to be vaccinated against HAV and 17.93 (95% CI 10.82, 29.70) times more likely to be vaccinated against HBV than those at risk of infection, respectively. These data provide essential information for public health professionals to successfully promote vaccination among members of this population.
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Affiliation(s)
- L K Gilbert
- American Social Health Association, Research Triangle Park, NC 27709, USA.
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9
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Baars JE, Boon BJ, Garretsen HF, van de Mheen D. The reach of a hepatitis B vaccination programme among men who have sex with men. Eur J Public Health 2010; 21:333-7. [DOI: 10.1093/eurpub/ckq117] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Bull SS, Vallejos D, Levine D, Ortiz C. Improving recruitment and retention for an online randomized controlled trial: experience from the Youthnet study. AIDS Care 2008; 20:887-93. [PMID: 18777217 DOI: 10.1080/09540120701771697] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of the study was to present recruitment and retention findings for an Internet based HIV prevention trial evaluated using a randomized controlled design among 15-25-year-olds accessing a website on the Internet. We used a combination of automated electronic and personalized approaches to increase and diversify recruitment, verify participant eligibility and increase retention. We posted 3.5 million banner advertisements, 9354 individuals clicked on the advertisement, 8950 completed an eligibility screener and 3298 a baseline survey; we flagged 675 of these as suspicious and enrolled 2623 individuals. Of these, 2082 (79%) completed a follow-up at one-month and 1398 (53%) completed a two-month follow-up. This retention rate is the highest we have seen for an Internet-based HIV-prevention trial. Our procedures can be replicated in other trials. We stress the importance of using a combination of automated and personalized techniques to increase enrollment, verify eligibility and promote retention.
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Affiliation(s)
- S S Bull
- University of Colorado at Denver and Health Sciences Center, Colorado Health Outcomes Program, Aurora, US.
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11
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Amesty S, Ompad DC, Galea S, Fuller CM, Wu Y, Koblin B, Vlahov D. Prevalence and Correlates of Previous Hepatitis B Vaccination and Infection Among Young Drug-users In New York City. J Community Health 2008; 33:139-48. [DOI: 10.1007/s10900-007-9082-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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12
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Exploring the health behavior disparities of gay men in the United States: comparing gay male university students to their heterosexual peers. ACTA ACUST UNITED AC 2008; 3:15-23. [PMID: 18029312 DOI: 10.1300/j463v03n01_03] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Little is known about the health disparities that affect gay men in the United States. Using data collected from an online Internet-based assessment, we sought to compare health-compromising behaviors of gay male university students to their heterosexual peers. Participants included 1,014 self-reported males. Mean age was 20 years (+/-2.5; range 17-30). Of these men, 43 (4.2%) self identified as gay and 971 (95.8%) self identified as heterosexual. After adjusting for age, race, academic classification, residence type, and clustering within university, gay men had higher odds of reporting inconsistent condom use; reporting multiple partners within the past 30 days; reporting a lifetime history of illicit drug use. Understanding the health behavior disparities between gay and heterosexual men is crucial to identifying associated factors and intervening upon them using appropriate and meaningful tailored strategies to reduce these disparities and improve health outcomes.
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13
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Kaneko N. Association between condom use and perceived barriers to and self-efficacy of safe sex among young women in Japan. Nurs Health Sci 2008; 9:284-9. [PMID: 17958678 DOI: 10.1111/j.1442-2018.2007.00338.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study aimed to assess the relationships between condom-use behaviors and perceived barriers to and self-efficacy of safe sex among young women in Japan. The data were obtained from a total of 456 participants who reported having had sex in the past. The initial analysis examined the associations between condom use and demographics, perceived condom-use barriers, and perceived self-efficacy of safe sex items. Variables displaying significance in the bivariate analysis were inserted into a multivariate model to determine the adjusted odds ratios. The variables most highly associated with condom use included age and the lifetime number of sex partners. The perceptual barriers included "condoms reduce sexual sensation", "confidence in using condoms from beginning to end", and "confidence to refuse sex if neither my partner nor I have a condom at hand". The findings suggest that behavior-change interventions that focus on addressing the perceived barriers and enhancing self-efficacy might be effective in order to promote consistent condom use.
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Affiliation(s)
- Noriyo Kaneko
- School of Nursing, Nagoya City University, Nagoya City, Japan.
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14
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Rhodes SD, Hergenrather KC. Attitudes and beliefs about hepatitis B vaccination among gay men: the Birmingham Measurement Study. JOURNAL OF HOMOSEXUALITY 2008; 55:124-149. [PMID: 18928048 DOI: 10.1080/00918360802129386] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This study was designed to develop reliable and valid quantitative measures of the beliefs and attitudes toward hepatitis B virus (HBV) vaccination among gay men, using a community-based participatory research approach. A convenience sample of 358 gay men was recruited in two gay bars. Exploratory factor analysis performed on the first split-half sample was used to assess the factor structure from five scales measuring beliefs about HBV vaccination. The scales were based on constructs from the health belief model and the social cognitive theory. Confirmatory factor analysis was performed on the remaining half-sample using structural equation modeling. Multivariable analysis further validated the scales. These findings propose standardized measures that may be useful in assessing the beliefs and attitudes of gay men toward HBV vaccination to guide intervention design and evaluation.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Divisions of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063, USA.
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Rhodes SD, Hergenrather KC, Yee LJ, Knipper E, Wilkin AM, Omli MR. Characteristics of a sample of men who have sex with men, recruited from gay bars and Internet chat rooms, who report methamphetamine use. AIDS Patient Care STDS 2007; 21:575-83. [PMID: 17711382 DOI: 10.1089/apc.2007.0002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Crystal methamphetamine is a highly addictive stimulant that initially gained popularity in the western region of the United States and has spread to all regions of the country. This study was designed to identify factors associated with methamphetamine use among men who have sex with men (MSM) in North Carolina. Participants were recruited in five gay bars and in five geographically defined Internet chat rooms concurrently in 2005 to complete a brief assessment of drug use and other risk behaviors. Of the 1189 MSM who completed the assessment, mean age was 29 years. Two thirds self-identified as black/African American or other minorities, and 25% as bisexual. Nearly 6% reported using methamphetamines during the past 30 days. In multivariable analysis, MSM who reported using methamphetamines were more likely to report higher education; health insurance coverage; inconsistent condom use during anal sex within the past 3 months; a history of sexually transmitted disease (STD) infection; positive HIV serostatus; and use of medications designed to treat erectile dysfunction. A lack of data exists on methamphetamine use among MSM in the southeastern United States, particularly in nonurban regions. Because the southeastern United States carries a disproportionate HIV, AIDS, and STD burden, our findings underscore the need for further research and intervention.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the Maya Angelou Research Center on Minority Health, Wake Forest University Health Sciences, Winston-Salem, North Carolina 27157-1063, USA.
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Pequegnat W, Rosser BRS, Bowen AM, Bull SS, DiClemente RJ, Bockting WO, Elford J, Fishbein M, Gurak L, Horvath K, Konstan J, Noar SM, Ross MW, Sherr L, Spiegel D, Zimmerman R. Conducting Internet-based HIV/STD prevention survey research: considerations in design and evaluation. AIDS Behav 2007; 11:505-21. [PMID: 17053853 DOI: 10.1007/s10461-006-9172-9] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2005] [Accepted: 08/24/2006] [Indexed: 10/24/2022]
Abstract
The aim of this paper is to advance rigorous Internet-based HIV/STD Prevention quantitative research by providing guidance to fellow researchers, faculty supervising graduates, human subjects' committees, and review groups about some of the most common and challenging questions about Internet-based HIV prevention quantitative research. The authors represent several research groups who have gained experience conducting some of the first Internet-based HIV/STD prevention quantitative surveys in the US and elsewhere. Sixteen questions specific to Internet-based HIV prevention survey research are identified. To aid rigorous development and review of applications, these questions are organized around six common criteria used in federal review groups in the US: significance, innovation, approach (broken down further by research design, formative development, procedures, sampling considerations, and data collection); investigator, environment and human subjects' issues. Strategies promoting minority participant recruitment, minimizing attrition, validating participants, and compensating participants are discussed. Throughout, the implications on budget and realistic timetabling are identified.
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Affiliation(s)
- Willo Pequegnat
- Center for Mental Health Research on AIDS, National Institute of Mental Health, Bethesda, MD, USA
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17
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Rhodes SD, Yee LJ. Using hepatitis A and B vaccination as a paradigm for effective HIV vaccine delivery. Sex Health 2007; 4:121-7. [PMID: 17524290 DOI: 10.1071/sh06069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Accepted: 04/26/2007] [Indexed: 11/23/2022]
Abstract
Background: An understanding of vaccine acceptance and uptake is imperative for successful vaccination of populations that will be primary targets for vaccination after a vaccine against HIV is developed and ready for dissemination. Experiences with vaccination against vaccine-preventable hepatitis (VPH) among men who have sex with men (MSM) may offer key insights to inform future HIV vaccination strategies. The purpose of this analysis was to explore what is known currently about vaccination among MSM, using knowledge gained from vaccination against VPH, and to identify important considerations from these experiences that must be explored further as a vaccine against HIV is promoted among MSM. Because cultural and political differences make it difficult to extrapolate findings from studies in one country to another, we have focused our analyses on studies conducted in the USA. Methods: Through a qualitative systematic review of published reports, we identified eight studies that reported correlates of VPH among MSM in the USA. Results: Six major domains of variables associated with vaccination against VPH were identified, including: demographics (e.g. younger age, higher educational attainment); increased vaccine knowledge; increased access to health care; provider recommendation; behaviours (e.g. same-sex behaviour, health-promoting and disease-preventing behaviours); and psychosocial factors (e.g. openness about one’s sexual orientation, reduced barriers to being vaccinated, self-efficacy). Conclusions: Further research is needed to understand vaccination behaviour among MSM and to maximise acceptance and uptake after a vaccine exists. Experiences with VPH provide a real-world model on which to base preliminary assumptions about acceptance and uptake of a vaccine against HIV.
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Affiliation(s)
- Scott D Rhodes
- Section on Society and Health, Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University Health Sciences, Medical Center Boulevard, Winston-Salem, NC 27157-1063, USA.
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Abstract
PURPOSE OF REVIEW Hepatitis B virus infection is prevalent worldwide and is a significant cause of morbidity and mortality particularly in Asia. Adults chronically infected with hepatitis B virus remain a significant potential source of sexually transmitted hepatitis B. The purpose of this article is to review the recent literature relating to hepatitis B virus transmission with particular emphasis on sexual transmission and efforts to prevent spread. RECENT FINDINGS The introduction of hepatitis B virus vaccine and the implementation of universal childhood vaccination for hepatitis B in some countries have led to a dramatic reduction in the number of children with chronic hepatitis B. However, recent reports suggest that we are not as successful in preventing infection by sexual transmission. It is clear that sexual transmission of hepatitis B virus is still widespread and is a major problem in certain high-risk groups such as men who have sex with men, intravenous drug users, prisoners and sex workers. Significant problems remain with respect to education and vaccination within these groups. SUMMARY Hepatitis B virus remains a major health burden but it is preventable by education and vaccination. Greater resources are required to expand vaccination to the at-risk, sexually active adult populations if the World Health Organization ideal of hepatitis B virus eradication is to be realized and the burden of hepatitis B virus-related morbidity and mortality contained.
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Affiliation(s)
- Mark Atkins
- Department of Microbiology, Chelsea and Westminster Hospital, Fulham Road, London, UK.
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Rhodes SD, Hergenrather KC. Using an integrated approach to understand vaccination behavior among young men who have sex with men: stages of change, the health belief model, and self-efficacy. J Community Health 2003; 28:347-62. [PMID: 14535600 DOI: 10.1023/a:1025444629753] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Studies continue to show that the majority of men who have sex with men (MSM) in the United States remain unvaccinated against hepatitis A (HAV); such limited vaccination coverage is a missed opportunity for preventing disease. This study sought to identify beliefs and attitudes associated with motivational readiness for vaccination against HAV among MSM, using a theoretically-integrated framework. Questionnaire data were collected from 358 MSM through bar outreach. MSM with increased readiness to complete the two-dose series perceived lower practical barriers and reported greater healthcare provider communication about their sexual orientation and risk behavior. They also perceived higher benefits to vaccination and higher severity of infection, and had higher self-efficacy to complete the vaccine series. Relationships between stages of change and theory-based constructs from the health belief model and the social learning theory follow predicted patterns suggesting that these theories may provide useful frameworks for understanding vaccination readiness and intervention strategy development among MSM.
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Affiliation(s)
- Scott D Rhodes
- Section on Social Sciences and Health Policy, Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1063, USA.
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Diamond C, Thiede H, Perdue T, Secura GM, Valleroy L, Mackellar D, Corey L. Viral hepatitis among young men who have sex with men: prevalence of infection, risk behaviors, and vaccination. Sex Transm Dis 2003; 30:425-32. [PMID: 12916134 DOI: 10.1097/00007435-200305000-00009] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Men who have sex with men (MSM) are at risk for acquiring hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV). GOAL The goal was to describe the seroprevalence of and risk factors for viral hepatitis, the frequency of vaccination against HAV and HBV, and reasons for lack of vaccination among young MSM. STUDY DESIGN We performed hepatitis serologies on 833 MSM aged 15 to 29 years who attended public venues in King County, Washington. RESULTS While 14.6% were HAV-immune due to vaccination, 13.9% had prior HAV infection; 57.9% were susceptible and 13.5% had unclear status. While 24.5% were HBV-immune due to vaccination, 13.3% had prior HBV infection; 44.2% were susceptible and 18.0% had unclear status. Prior HBV infection was associated with prior HAV infection. Men unvaccinated against HAV or HBV were unaware of the vaccines or had never been offered vaccination or perceived themselves at low risk for infection. Among 10 HCV-seropositive men, 70.0% reported injection drug use. CONCLUSION MSM must be vaccinated at an early age to prevent acquisition of HAV and HBV. Given the frequency of coinfection with HAV and HBV, a combined vaccine would be useful in this population.
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Affiliation(s)
- Catherine Diamond
- University of California Irvine Medical Center, 101 City Drive South, Building 11, Route 81, Orange, CA 92868, USA.
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Rhodes SD, Diclemente RJ. Psychosocial predictors of hepatitis B vaccination among young African-American gay men in the deep south. Sex Transm Dis 2003; 30:449-54. [PMID: 12916138 DOI: 10.1097/00007435-200305000-00013] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite recommendations for vaccination against hepatitis B virus (HBV) of men who have sex with men (MSM), most remain unvaccinated. GOAL The goal of this study was to identify attitudes and beliefs associated with vaccination against HBV among black MSM. STUDY DESIGN The Birmingham Vaccine Acceptance Questionnaire was used to collect data from gay bar patrons. RESULTS Of the 143 participants, nearly 42% reported at least one dose of HBV vaccine. In multivariable analysis, characteristics associated with vaccination were a decreased perception of barriers to HBV vaccination (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.22-0.61; P = 0.001); increased perceived medical severity (OR, 5.34; 95% CI, 2.38-11.96; P = 0.001) and personal severity (OR, 2.22; 95% CI, 1.38-3.56; P = 0.006) of HBV infection; and increased perceived general medical self-efficacy (OR, 9.22; 95% CI, 3.52-24.11; P = 0.0001) and personal self-efficacy (OR, 2.3; 95% CI, 1.14-4.63; P = 0.008) to complete the three-dose series. CONCLUSIONS Our findings underscore the need to increase vaccination through innovative approaches to reduce perceived barriers to vaccination while increasing perceived severity of HBV infection and self-efficacy to complete the vaccine series.
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Affiliation(s)
- Scott D Rhodes
- Department of Public Health Services, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1063, USA.
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Rhodes SD, Bowie DA, Hergenrather KC. Collecting behavioural data using the world wide web: considerations for researchers. J Epidemiol Community Health 2003; 57:68-73. [PMID: 12490652 PMCID: PMC1732282 DOI: 10.1136/jech.57.1.68] [Citation(s) in RCA: 286] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To identify and describe advantages, challenges, and ethical considerations of web based behavioural data collection. METHODS This discussion is based on the authors' experiences in survey development and study design, respondent recruitment, and internet research, and on the experiences of others as found in the literature. RESULTS The advantages of using the world wide web to collect behavioural data include rapid access to numerous potential respondents and previously hidden populations, respondent openness and full participation, opportunities for student research, and reduced research costs. Challenges identified include issues related to sampling and sample representativeness, competition for the attention of respondents, and potential limitations resulting from the much cited "digital divide", literacy, and disability. Ethical considerations include anonymity and privacy, providing and substantiating informed consent, and potential risks of malfeasance. CONCLUSIONS Computer mediated communications, including electronic mail, the world wide web, and interactive programs will play an ever increasing part in the future of behavioural science research. Justifiable concerns regarding the use of the world wide web in research exist, but as access to, and use of, the internet becomes more widely and representatively distributed globally, the world wide web will become more applicable. In fact, the world wide web may be the only research tool able to reach some previously hidden population subgroups. Furthermore, many of the criticisms of online data collection are common to other survey research methodologies.
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Affiliation(s)
- S D Rhodes
- The Department of Health Behavior and Health Education, University of North Carolina School of Public Health, Chapel Hill, NC 27599, USA.
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Rhodes SD, Hergenrather KC, Yee LJ. Increasing hepatitis B vaccination among young African-American men who have sex with men: simple answers and difficult solutions. AIDS Patient Care STDS 2002; 16:519-25. [PMID: 12513900 DOI: 10.1089/108729102761041074] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Using a bar-based sample, we identified factors associated with hepatitis B virus (HBV) vaccination among young African American men who have sex with men (MSM). The mean (+/- standard deviation [SD]) age of the 170 participants was 26 +/- 6.5 years. Nearly 40% reported at least one dose of vaccine; the remainder were completely unvaccinated. Approximately 22% (37) reported having never heard of HBV. Less than 7% of participants reported using condoms the majority of the time during oral intercourse within the past 3 months, and approximately 50% reported using condoms the majority of the time during anal intercourse within the past 3 months. In multivariable analysis, variables associated with vaccination were younger age (odds ratio [OR], 0.44 per 10-year increase in age; 95% confidence interval [CI]: 0.21-0.93, p = 0.032), higher educational attainment (OR, 4.6; 95% CI: 1.17-12.59, p = 0.003), homosexual as opposed to bisexual behavior (OR, 0.15; 95% CI: 0.06-0.41, p = 0.0001), and recent visits to a health care provider (OR, 4.31; 95% CI: 2.08-8.94, p = 0.0001). Our findings underscore the need to reach MSM for HBV vaccination. Innovative approaches are necessary to ensure the prevention of infection, transmission and disease among individuals with limited education, bisexual MSM, and men who have limited access to health care.
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Affiliation(s)
- Scott D Rhodes
- University of North Carolina School of Public Health, Chapel Hill, North Carolina 27599-7440, USA.
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Yee LJ, Rhodes SD. Understanding correlates of hepatitis B virus vaccination in men who have sex with men: what have we learned? Sex Transm Infect 2002; 78:374-7. [PMID: 12407244 PMCID: PMC1744531 DOI: 10.1136/sti.78.5.374] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Hepatitis B infection (HBV) is prevalent among men who have sex with men (MSM) and may lead to significant morbidity and death. Although an effective vaccine exists vaccination rates among MSM are low. We conducted a systematic review to synthesise the various findings from empirical correlational studies to understand HBV vaccination and series completion among MSM. METHODS We systematically searched the Medline, PubMed, EMBASE, CINAHL, ERIC, and Web of Science databases to identify the breadth of published studies pertaining to HBV vaccination among MSM and to synthesise findings from these studies to better identify common themes that may direct future research and intervention approaches. RESULTS Eight papers specifically addressed correlates of HBV vaccination among MSM. Six domains were identified as predictors of vaccination: (1) demographic variables such as younger age and higher education level; (2) knowledge of the vaccine; (3) access to health care; (4) level of "outness" regarding one's same sex sexual orientation; (5) behavioural factors including sexual and drug use behaviour; and (6) psychosocial variables. Three papers addressed predictors of vaccine series completion among MSM, observing two main domains: (1) demographic variables such as younger age and higher income level; and, (2) behavioural factors including sexual and health promotion behaviours. CONCLUSIONS Continued educational efforts, creation of environments that facilitate proper risk factor evaluation, and access to low cost vaccine may facilitate vaccine uptake. Although we observed important trends in the studies we reviewed, there is a lack of empirical research regarding this important public health issue.
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Affiliation(s)
- L J Yee
- Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Department of Infectious and Tropical Diseases, Keppel Street, London WC1E 7HT, UK.
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Rhodes SD, DiClemente RJ, Cecil H, Hergenrather KC, Yee LJ. Risk among men who have sex with men in the United States: a comparison of an Internet sample and a conventional outreach sample. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2002; 14:41-50. [PMID: 11900109 DOI: 10.1521/aeap.14.1.41.24334] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study compared the demographics and risk behaviors of two samples of men who have sex with men (MSM), using cross-sectional data that were collected via the Internet and through conventional bar-based outreach. The Internet sample was significantly older, more likely to identify as "bisexual," and less educated than the bar sample. After controlling for age and education, few differences were observed between the samples. However, three variables that markedly differentiated the samples were history of sexually transmitted disease infection, HIV serostatus, and sources utilized to obtain health information. No difference in Internet use was found. Based on the possible decreased social desirability promoted by the use of electronic data collection methodologies, these findings provide preliminary evidence that Internet and bar respondents are similar and that the Internet may serve as an expedient as well as reliable methodology to increase understanding of risk among MSM.
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Affiliation(s)
- Scott D Rhodes
- Department of Health Behavior, School of Public Health, University of Alabama, Birmingham, USA.
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