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Alarcón Gutiérrez M, Palma Díaz D, Alberny Iglesias M, Ruiz Riera R, Guayta-Escolies R, García de Olalla P, Rius Gibert C. Response Rate, Acceptability and Effectiveness of an Intervention Offering HIV/STI Testing Via Apps Among Gay, Bisexual, and Other Men Who Have Sex With Men in Barcelona, Spain, from 2016 to 2020. AIDS Behav 2024; 28:1345-1355. [PMID: 37768426 PMCID: PMC10940395 DOI: 10.1007/s10461-023-04165-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 09/29/2023]
Abstract
We evaluated the response rate, acceptability, and effectiveness of a preventive programme offering rapid HIV and other STI testing, as well as sexual counselling to gay, bisexual, and other men who have sex with men (GBMSM) via dating apps over a 4-year period. The programme was carried out in 9 out of the 10 districts in the city of Barcelona, Spain. The response rate was defined as the proportion of people responding to the message sent, acceptability as the proportion of those responding favourably, and effectiveness as the proportion of users requesting a test. We performed univariate analysis and multivariate logistic regression in relation with the response rate, acceptability and effectiveness. A total of 5,254 messages were send to different users. The response rate was 33.1% (n = 1,741), acceptability was 86.2% (n = 1,500), and effectiveness was 10.1% (n = 532). The factors associated with user response were recent connection to the app (aOR = 1.85; CI:1.39-2.46) and the presence of a profile photograph (aOR = 1.34; CI:1.11-1.64). Acceptability was associated with recent connection to the app (aOR = 1.98; CI:1.09-3.58). Effectiveness was associated with lower reported age (aOR = 0.98; CI:0.97-0.99), contact before 14:00 (aOR = 2.47; CI: 1.77-3.46), and recent connection to the app (aOR = 4.89; CI:1.98-12.08). Effectiveness was also greater in districts that were more disadvantaged or had fewer sexual health services. This study demonstrates that the use of these apps is an acceptable and effective method of prevention and sexual health promotion in GBMSM in this setting and identifies the associated factors that could guide such interventions.
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Affiliation(s)
- Miguel Alarcón Gutiérrez
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Epidemiology service, Agència de Salut Pública de Barcelona, Barcelona, Spain.
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.
| | - David Palma Díaz
- Epidemiology service, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Department of International Health, Care and Public Health Research Institute - CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Rafael Ruiz Riera
- Direcció Estratègica d'Atenció Primària i Comunitària, Health Department, Generalitat de Catalunya, Barcelona, Spain
| | - Rafael Guayta-Escolies
- Projects and Research Directorate, Council of Pharmacists Colleges of Catalonia, Barcelona, Spain
| | - Patricia García de Olalla
- Epidemiology service, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau, Barcelona, Spain
| | - Cristina Rius Gibert
- Epidemiology service, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau, Barcelona, Spain
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Hahn AL, Michaels CL, Khawly G, Nichols TK, Baez P, Ozoria Ramirez S, Juarez Padilla J, Stonbraker S, Olender S, Schnall R. Comparison of evaluation methods for improving the usability of a Spanish mHealth tool. Int J Med Inform 2024; 184:105355. [PMID: 38368698 PMCID: PMC10923187 DOI: 10.1016/j.ijmedinf.2024.105355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE Mobile health (mHealth) technology is now widely used across health conditions and populations. The rigorous development of these tools has yielded improved health outcomes, yet the ideal approach for developing mHealth tools continues to evolve, indicating the need for rigorous usability evaluation methods. This study compares two usability evaluation methods - cognitive interviews and usability assessments employing a think-aloud approach - for adapting an evidence-based mHealth tool from English into Spanish. METHODS We conducted cognitive interviews and usability assessments using a think-aloud protocol to evaluate the usability of an HIV mHealth application among 40 Spanish-speaking adults with HIV in New York City, NY, and La Romana, Dominican Republic. The Health IT Usability Evaluation Model (Health-ITUEM) was used to guide the analysis of qualitative data collected from each method. RESULTS Participants (N = 40) averaged 43 years old (SD = 12.26; range 20-79), identified primarily Hispanic/Latino (92.5 %), and resided in La Romana (50 %) or New York City (50 %). Both usability evaluation methods yielded similar findings, highlighting learnability and information needs as crucial components of participant feedback for the mHealth application. Cognitive interviews captured participants' perspectives on the app's interface and design. On the other hand, results from usability assessments offered insights into participants' competency while interacting with the mHealth tool. CONCLUSION Findings from this study highlight the contributions and limitations of including cognitive interviews and task-based usability assessments using a think-aloud approach in mHealth usability testing. Future research should employ a multi-method approach, incorporating complementary usability evaluation methods and engaging participants in multiple assessments. Using complementary usability evaluation methods may provide a more comprehensive understanding of the usability and participant experience aspects of a mHealth tool compared to using a single usability evaluation method.
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Affiliation(s)
| | - Claudia L Michaels
- Columbia University School of Nursing, New York, NY, United States; Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Gabriella Khawly
- Columbia University School of Nursing, New York, NY, United States; Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Tyler K Nichols
- Columbia University School of Nursing, New York, NY, United States
| | - Pamela Baez
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | | | | | - Samantha Stonbraker
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora CO, United States
| | - Susan Olender
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Rebecca Schnall
- Columbia University School of Nursing, New York, NY, United States; Mailman School of Public Health, Columbia University, New York, NY, United States
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Luehring-Jones P, Fulford D, Palfai TP, Simons JS, Maisto SA. Alcohol, Sexual Arousal, and Partner Familiarity as Predictors of Condom Negotiation: An Experience Sampling Study. AIDS Behav 2024; 28:854-867. [PMID: 37751109 DOI: 10.1007/s10461-023-04189-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
Numerous contextual factors contribute to risky sexual decision-making among men who have sex with men (MSM), with experimental laboratory-based studies suggesting that alcohol consumption, sexual arousal, and partner familiarity have the potential to impact condom negotiations during sexual encounters. The purpose of the current study was to extend this line of inquiry outside of the laboratory and into the everyday lives of MSM. We collected six weeks of daily data on alcohol consumption and sexual behaviors from 257 moderate- and heavy-drinking MSM to examine the within- and between-subjects effects of alcohol consumption, average daily sexual arousal, and partner familiarity on condom negotiation processes during sexual encounters. We hypothesized that alcohol consumption, higher levels of average daily sexual arousal, and greater partner familiarity would all contribute to a reduced likelihood of condom negotiation prior to sexual activity, and that they would also affect the difficulty of negotiations. Contrary to hypotheses, none of these three predictors had significant within-subjects effects on condom negotiation outcomes. However, partner familiarity and average daily sexual arousal did exert significant between-subjects effects on the incidence of negotiation and negotiation difficulty. These findings have important implications for risk-reduction strategies in this population. They also highlight the challenges of reconciling results from experimental laboratory research and experience sampling conducted outside of the laboratory on sexual risk behavior.
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Affiliation(s)
- Peter Luehring-Jones
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA.
| | - Daniel Fulford
- Department of Occupational Therapy and Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Tibor P Palfai
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Jeffrey S Simons
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | - Stephen A Maisto
- Department of Psychology, Syracuse University, Syracuse, NY, USA
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Pravosud V, Ballard AM, Holloway IW, Young AM. Latent Class Analysis of Online Platforms for Partner-Seeking and Sexual Behaviors Among Men Who Have Sex with Men from Central Kentucky. AIDS Behav 2024; 28:1015-1028. [PMID: 37824036 DOI: 10.1007/s10461-023-04210-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Abstract
Little is known whether engagement in sexual behaviors associated with potential HIV risks differs by subgroups of men who have sex with men (MSM), who are distinct regarding patterns of use of online tools for partner-seeking. Using latent class analysis, we revealed four classes of app-using MSM (n = 181, 18-34 y.o., 82.4% identified as White and non-Hispanic) residing in Central Kentucky: the Grindr/Tinder class; the Poly App Use class of MSM-oriented apps; the General Social Media class, and the Bumble class. Unadjusted penalized logistic regressions showed associations of the Poly App Use class with increased numbers of receptive anal sex partners and reporting condomless receptive anal sex. Adjusting for other covariates, poly app users versus others were more likely to be older (25-34 vs. 18-24, AOR = 3.81, 95%CI = 1.70-9.03), to report past six-month illicit drug use (AOR = 2.93, 95%CI = 1.25-7.43) and to have ever used pre-exposure prophylaxis (AOR = 2.79, 95%CI = 1.10-7.12). Poly app users had behavior profiles associated with an elevated HIV risk and also reported HIV-related protective behaviors likely indicating increased risk awareness among this class. Our findings warrant differentiation of behavior profiles by patterns of app use and suggest not to generalize sexual behaviors associated with potential HIV risks to all app-using MSM.
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Affiliation(s)
- Vira Pravosud
- Northern California Institute for Research and Education, University of California San Francisco, San Francisco VA Medical Center, San Francisco, CA, USA.
| | - April M Ballard
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Ian W Holloway
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA, USA
| | - April M Young
- Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington, KY, USA
- Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
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Sinno J, Macapagal K, Mustanski B. Social Media and Online Dating Safety Practices by Adolescent Sexual and Gender Diverse Men: Mixed-Methods Findings From the SMART Study. J Adolesc Health 2024; 74:113-122. [PMID: 37791926 DOI: 10.1016/j.jadohealth.2023.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 07/19/2023] [Accepted: 07/28/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Sexual and gender diverse youth (SGDY) develop and employ safety strategies on their own to manage risks while using dating apps. This study aimed to describe the online dating safety practices of SGDY and determine the effectiveness of an eHealth HIV-prevention educational intervention with dating safety content to promote future safety behaviors. METHODS SGDY aged 13-18 from across the United States (N = 1087) were assigned to increasingly intensive HIV-prevention educational programs using a sequential multiple-assignment randomized trial design. Data were collected at three time points, each three months apart. Participants were asked multiple-choice and open-ended questions about the safety practices they used online and in person; mixed-methods described the safety behaviors of SGDY. Logistic regressions were used to determine psychosocial predictors of safety behaviors and the effectiveness of the intervention in promoting future safety practices. RESULTS 60% (n = 662) of participants used dating apps, most of whom reported using online (96.4%, n = 638) and in-person (92.9%, n = 615) safety strategies, such as limiting the disclosure of personal information or meeting other users in public. Outness and previous victimization were important psychosocial predictors of engaging in safety behaviors. Additionally, participants who received the online safety education were over 50% more likely to employ certain safety behaviors than SGDY who did not. DISCUSSION While most SGDY reported at least 1 type of safety strategy when dating online, safety practices differed across psychosocial variables, such as outness. This study provides evidence for the effectiveness of an eHealth educational intervention tailored to SGDY to promote additional safety behaviors.
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Affiliation(s)
- Jad Sinno
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; Department of Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
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Wang M. Safe on Blued? A Qualitative Exploration of Sex, Risk, and Stigma on a Gay Social Application in China. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:596-607. [PMID: 38601809 PMCID: PMC10903620 DOI: 10.1080/19317611.2023.2260797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 09/14/2023] [Indexed: 04/12/2024]
Abstract
Introduction Mobile dating apps emerged with the development of technology, for example, Blued in China, becoming a new risk field for gay men in the AIDS era. Users use social apps to chat online and date offline to achieve the satisfaction of lust or sexual practice, but the risk of AID looms over the whole process of using apps. Methods Nineteen interviewees were invited to participate in this study, which included gay men who were using or had used Blued. The content of the semi-structured interviews focused on the relationship between gay social apps and HIV risk. Results The study finds Blued interweaved with sex, risk, and stigma. Blued is sexualized due to sexual intentions and practices. There is also a sexual stratification of risk with Blued and its users based on socioeconomic factors. Users experience a dilemma between pursuing sex while being concerned about latent risk within a context of stigmatization. Conclusions Blued is sexualized in terms of the process of stimulating sexual gratification and facilitating sexual practices. The experience of Blued is an example of sexual stratification, and a structure of desire based on app users and app uses. Furthermore, the social stigma against men who have sex with men is transferred to Blued, which bears the stigma of "AIDS-Blued" with a dual stigma-HIV-related and homosexual stigma. However, with the authorized approval of Blued in public health, Blued could play an essential role in HIV/AIDS prevention and control.
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Affiliation(s)
- Ming Wang
- School of Social Development, East China Normal University, Shanghai, China
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Zhang H, Sanchez T, Zlotorzynska M, Baral S, Hecht J. Experiences of Stigma and HIV Status Associated with Awareness and Usage of Safer Sex Functions in Dating Apps Among MSM, 2019 American Men's Internet Survey (AMIS) Study. AIDS Behav 2023; 27:3603-3611. [PMID: 37421546 DOI: 10.1007/s10461-023-04074-4] [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] [Accepted: 04/29/2023] [Indexed: 07/10/2023]
Abstract
Dating apps represent opportunities to implement sexual health interventions among gay, bisexual, and other men who have sex with men (MSM), particularly those who may avoid traditional health services due to intersecting stigmas. We used multivariable models to explore whether stigma experience was associated with awareness and usage of safer sex functions in dating apps among 7700 MSM who completed a 2019 US nationwide online survey. Perceived community intolerance of gay and bisexual men was associated with reduced awareness of sexual health strategy profile options (adjusted prevalence ratio [aPR] 0.95; 95% confidence interval [95% CI] 0.93-0.98) and sexual health information and resources (aPR 0.97; 95% CI 0.94-0.99). Stigma from family and friends was associated with increased usage of app-based sexual health reminders (aPR 1.14; 95% CI 1.02-1.28) and sexual health information and resources (aPR 1.16; 95% CI 1.04-1.31). Stigma experience of MSM should be considered in optimizing app-based sexual health interventions.
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Affiliation(s)
- Haisu Zhang
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Travis Sanchez
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
| | - Maria Zlotorzynska
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Stefan Baral
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21215, USA
| | - Jen Hecht
- Building Healthy Online Communities, Springboard Health Lab, Richmond, USA
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Dai Z, Mi G, Yu F, Chen G, Wang X, He Q. Using a Geosocial Networking App to Investigate New HIV Infections and Related Risk Factors Among Student and Nonstudent Men Who Have Sex With Men in Chengdu, China: Open Cohort Study. J Med Internet Res 2023; 25:e43493. [PMID: 37505891 PMCID: PMC10422168 DOI: 10.2196/43493] [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: 10/13/2022] [Revised: 12/26/2022] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND In China, condomless sex among men who have sex with men (MSM) is the primary route of HIV infection in young people. Chengdu is a hotspot for reported HIV cases among young people nationwide. Extensive use of geosocial networking (GSN) smartphone apps has dramatically changed the pattern of sexual behavior among young MSM (YMSM). However, data on HIV incidence and the risk behavior of YMSM using the GSN app are still obscure. OBJECTIVE This study aims to analyze and understand the HIV incidence and its risk factors among YMSM using GSN apps in Chengdu, China. METHODS An open cohort study was conducted among YMSM aged 18-24 years through a gay GSN smartphone app in Chengdu, China, from July 2018 to December 2020. Every participant completed a web-based questionnaire on sociodemographic characteristics, sexual behaviors, and other related statuses; made a reservation for a web-based HIV testing; and then voluntarily got tested at the designated testing site. At least one additional HIV test was taken via the app during the study period, and participants were evaluated at the end of the study or at the time of HIV seroconversion. By dividing the sum of the observed HIV seroconversions by the observed person-years, HIV incidence was calculated and compared between the student and nonstudent MSM. Univariate and multivariate (Cox proportional hazards regression) analyses were used to discuss the risk factors for new HIV infections. RESULTS In the study cohort, 24 seroconversions occurred among 625 YMSM who took at least two HIV tests through the app during the study period, contributing to 505 observed person-years. The HIV incidence rate per 100 person-years was 4.75 (95% CI 2.89-6.61) among all MSM, 3.60 (95% CI 1.27-5.93) among student MSM, and 5.88 (95% CI 2.97-8.79) among nonstudent MSM. In addition, the HIV incidence per 100 person-years was 11.11 (95% CI 4.49-17.73) among those who had resided in the area for 6 months or less and 7.14 (95% CI 1.52-12.77) among those with senior high school or less education. Two or more sexual partners (adjusted hazards ratio [HR] 3.63, 95% CI 1.08-12.23) in the preceding 6 months was a risk factor for new HIV infections. Consistent condom use for anal sex (adjusted HR 0.38, 95% CI 0.16-0.88) and insertive anal sex only (adjusted HR 0.10, 95% CI 0.01-0.75) in the preceding 6 months were protective factors for new HIV infections. CONCLUSIONS The rate of new HIV infections among YMSM who actively used GSN smartphone apps was high, especially among migrant nonstudent MSM. Targeted interventions on GSN smartphone apps should be implemented to provide demand-adapted prevention and services to reduce the threat of HIV.
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Affiliation(s)
- Zhen Dai
- Department of Sexually Transmitted Disease, AIDS Prevention and Control, Chengdu Center for Disease Control and Prevention, Chengdu, China
| | | | - Fei Yu
- BlueCity Holdings, Beijing, China
| | - Guodong Chen
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Xiaodong Wang
- Chengdu Tongle Social Work Service Center, Chengdu, China
| | - Qinying He
- Department of Sexually Transmitted Disease, AIDS Prevention and Control, Chengdu Center for Disease Control and Prevention, Chengdu, China
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Magno L, Medeiros DSD, Soares F, Grangeiro A, Caires P, Fonseca T, Westin MR, Dourado I. Factors associated to HIV prevalence among adolescent men who have sex with men in Salvador, Bahia State, Brazil: baseline data from the PrEP1519 cohort. CAD SAUDE PUBLICA 2023; 39Suppl 1:e00154021. [PMID: 36995866 DOI: 10.1590/0102-311xen154021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/11/2021] [Indexed: 03/29/2023] Open
Abstract
Adolescent men who have sex with men (AMSM) are at a heightened vulnerability for human immunodeficiency virus (HIV). This study aimed to estimate the prevalence of HIV and associated individual, social, and programmatic factors among AMSM in Salvador, Bahia State, Brazil. This is a cross-sectional study which analyzed baseline data from the PrEP1519 cohort in Salvador. Descriptive, bivariate, and multivariate analyses were conducted using the dimensions of vulnerability to HIV as hierarchical levels of analysis. Logistic regression models were used to estimate the odds ratios (OR) of the association between predictor variables and HIV infection. The prevalence of HIV infection among the 288 AMSM recruited to the project was 5.9% (95%CI: 3.7-9.3). Adjusted analysis showed a statistically significant association between self-identifying as a sex worker (OR = 3.74, 95%CI: 1.03-13.60) and HIV infection. Other associations with borderline statistical significance were the use of application programs to find sexual partners (OR = 3.30, 95%CI: 0.98-11.04), low schooling level (OR = 3.59, 95%CI: 0.96-13.41), failing to be hired or being dismissed from a job because of sexual orientation (OR = 2.88, 95%CI: 0.89-9.28), and not using health services as a usual source of care (OR = 3.14, 95%CI: 0.97-10.17). We found a high HIV prevalence among AMSM in Salvador. Furthermore, our study found that individual, social, and programmatic factors were associated with HIV infection among these AMSM. We recommend intensifying HIV combined-prevention activities for AMSM.
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Acharya S, Karanjkar V, Chougule S, Katkar S, Patil S, Dwivedi V, Deshpande P, Setia MS. Online partner seeking and high-risk behaviour in men who have sex with men and male-to-female transgendered people in Mumbai, India: Implications for prevention strategies. PLoS One 2023; 18:e0284602. [PMID: 37115735 PMCID: PMC10146510 DOI: 10.1371/journal.pone.0284602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND It is important to understand the current internet-related sexual behaviours of high-risk groups such as men who have sex with men (MSM). We designed the present study to understand the types of online/mobile apps used by MSM and male-to-female transgendered people/hijras [TGH] in Mumbai, India. We also compared the internet-related 'partner seeking' and 'sexual behaviours' in MSM and TGH in Mumbai, India. METHODS This is a cross-sectional analysis of secondary data collected (April to June 2020) from 8582 MSM and 4163 TGH from five targeted intervention programmes each in Mumbai, Maharashtra, India. Data on demographics, years of association with the intervention, number and type of online/mobile apps used, sexual behaviours including partners from virtual space and non-virtual (physical) space, group sex, attending parties, mobility for sexual partners, and HIV status were collected. RESULTS MSM were more likely to have mobile phone (88% vs 51%, p < 0.001) and internet access over the phone (78% vs 27%; p < 0.001) compared with TGH. The common apps used by MSM were Grindr (48%), Facebook (42%), and Blued (36%). MSM were more likely to have partners from virtual space (91% vs 67%; p < 0.001). A higher proportion of MSM had attended parties (28% vs 2%; p < 0.001), had group sex (16% vs 6%; p < 0.001), and were mobile for sex (25% vs 4%). MSM and TGH who had partners from virtual space were significantly more likely to report 'missed a condom at least once during penetrative sex in the past one week' (17% vs 12%; p<0.001). In HIV positive MSM, group sex, parties, and mobility for sex, were only in those who reported partners from the virtual space. CONCLUSIONS Internet-based interventions for MSM should be incorporated in the existing targeted intervention programme and outreach workers should be trained in virtual outreach services. Among TGH, given the low reach and use of smartphones and apps, internet-based interventions may not be such a useful option, and the existing physical targeted intervention programmes should be strengthened.
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Affiliation(s)
- Shrikala Acharya
- Mumbai Districts AIDS Control Society, Mumbai, India
- Seth G S Medical College and KEM Hospital, Mumbai, India
| | | | | | | | - Shashikant Patil
- UW International Training and Education Center for Health, Mumbai, India
| | | | - Prashant Deshpande
- UW International Training and Education Center for Health, Mumbai, India
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Marqués-Sánchez P, Bermejo-Martínez D, Quiroga Sánchez E, Calvo-Ayuso N, Liébana-Presa C, Benítez-Andrades JA. Men who have sex with men: An approach to social network analysis. Public Health Nurs 2023; 40:73-79. [PMID: 36217564 PMCID: PMC10092328 DOI: 10.1111/phn.13138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/05/2022] [Accepted: 09/13/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Dating apps for men who have sex with men (MSM) have favored unprotected sexual encounters; other unsafe practices, including drug use, are widespread. No evidence is available from the perspective of the structure of their relationships, a personal aspect included in all nursing meta-paradigms. AIM To study the structure of MSM networks through dating and contact applications and this relationship to risky sexual activities such as condom use, chemsex (sex while using drug), and group sex. DESIGN Descriptive cross-sectional study. SAMPLE A total of 32 MSM participants from Madrid (Spain). MEASUREMENTS Socio-demographic and structural variables with Social Network Analysis (SNA) metrics. Data on condom use, drug use during encounters, and group sex were included. RESULTS Twenty-five percent of respondents practiced chemsex, and 75% of these used poppers. MSM with higher socioeconomic status participated in group sex sessions more frequently than those with lower socioeconomics. Within the network analysis, the relationships strong showed greater ease in having unprotected anal intercourse. CONCLUSION SNA can be effective in the study of MSM sexual networks and their risk behaviors for community nurses to improve their interventions in sexual health promotion.
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Affiliation(s)
- Pilar Marqués-Sánchez
- SALBIS Research Group, Department of Nursing and Physiotherapy, Campus de Ponferrada s/n, Universidad de León, Ponferrada, Spain
| | - David Bermejo-Martínez
- Department of Nursing and Physiotherapy, Campus de Ponferrada s/n, Universidad de León, Ponferrada, Spain
| | - Enedina Quiroga Sánchez
- SALBIS Research Group, Department of Nursing and Physiotherapy, Campus de Ponferrada s/n, Universidad de León, Ponferrada, Spain
| | - Natalia Calvo-Ayuso
- Department of Nursing and Physiotherapy, Campus de Ponferrada s/n, Universidad de León, Ponferrada, Spain
| | - Cristina Liébana-Presa
- SALBIS Research Group, Department of Nursing and Physiotherapy, Campus de Ponferrada s/n, Universidad de León, Ponferrada, Spain
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Nazli A, Garner A, Gokengin D. Awareness of HIV pre-exposure prophylaxis among men who have sex with men using apps for sexual encounters in Turkiye. Int J STD AIDS 2022; 33:1124-1133. [DOI: 10.1177/09564624221126867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background New HIV diagnoses are rising in Turkiye. Men who have sex with men (MSM) are estimated to be the main driver of the epidemic. Pre-exposure prophylaxis (PrEP) was proven to be effective in reducing new HIV diagnoses and PrEP recently became available in Turkiye. Objective To assess awareness of and willingness to use PrEP and the level of off-licence use among MSM. Methods An anonymous self-completed questionnaire was sent out over the Hornet Gay Social Network from December 2019 to February 2020, available in Turkish and Arabic. It included 20 questions on HIV and STI testing, PrEP awareness, PrEP use, willingness to use, chemsex and sexual happiness level. Results Overall 4761 respondents who responded to more than 1/3 of the questions were eligible for analyses; 5.5% was Arabic speaking. The mean age was 30.5 years, 31.4% had never tested for HIV, 40.5% knew what PrEP was, the most common source of knowledge was the internet (44.5%), 2.5% (120) had used PrEP in the last 12 months and 1.7% (83) was current users. PrEP users had accessed drugs over the internet (47.6%), pharmacy (23%), and friends (13.8%). Almost 40% were willing to use PrEP in the following 6 months. Younger and Arabic speaking respondents had lower rates of HIV testing ( p = .001) and lower awareness for PrEP than comparators ( p = .004). Conclusion Awareness and willingness to use PrEP is high among MSM in Turkiye. The recent availability of PrEP in the country is a big step forward in terms of prevention.
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Affiliation(s)
- Arzu Nazli
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Alex Garner
- Mpact Global Action for Gay Men’s Health and Rights, California, US
| | - Deniz Gokengin
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
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13
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Cohen S, Shamri-Zeevi L, Honig O. Art therapy for chemsex: A pilot study of representations of memories among this subset of self-identified gay men as expressed in gouache painting. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Schnall R, Liu J, Alvarez G, Porras T, Ganzhorn S, Boerner S, Huang MC, Trujillo P, Cioe P. A Smoking Cessation Mobile App for Persons Living With HIV: Preliminary Efficacy and Feasibility Study. JMIR Form Res 2022; 6:e28626. [PMID: 35980739 PMCID: PMC9437787 DOI: 10.2196/28626] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/07/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The prevalence of smoking in the United States general population has gradually declined to the lowest rate ever recorded; however, this has not been true for persons with HIV. OBJECTIVE We conducted a pilot test to assess the feasibility and efficacy of the Lumme Quit Smoking mobile app and smartwatch combination with sensing capabilities to improve smoking cessation in persons with HIV. METHODS A total of 40 participants were enrolled in the study and randomly assigned 1:1 to the control arm, which received an 8-week supply of nicotine replacement therapy, a 30-minute smoking cessation counseling session, and weekly check-in calls with study staff, or to the intervention arm, which additionally received the Lumme Quit Smoking app and smartwatch. RESULTS Of the 40 participants enrolled, 37 completed the follow-up study assessments and 16 used the app every day during the 56-day period. During the 6-month recruitment and enrollment period, 122 people were screened for eligibility, with 67.2% (82/122) deemed ineligible. Smoking criteria and incompatible tech were the major reasons for ineligibility. There was no difference in the proportion of 7-day point prevalence abstinence by study arm and no significant decrease in exhaled carbon monoxide for the intervention and control arms separately. However, the average exhaled carbon monoxide decreased over time when analyzing both arms together (P=.02). CONCLUSIONS Results suggest excellent feasibility and acceptability of using a smoking sensor app among this smoking population. The knowledge gained from this research will enable the scientific community, clinicians, and community stakeholders to improve tobacco cessation outcomes for persons with HIV. TRIAL REGISTRATION ClinicalTrials.gov NCT04808609; https://clinicaltrials.gov/ct2/show/NCT04808609.
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Affiliation(s)
- Rebecca Schnall
- Columbia University School of Nursing, New York, NY, United States
| | - Jianfang Liu
- Columbia University School of Nursing, New York, NY, United States
| | | | - Tiffany Porras
- Zucker School of Medicine, Hofstra University, Hempstead, NY, United States
| | - Sarah Ganzhorn
- Columbia University School of Nursing, New York, NY, United States
| | - Samantha Boerner
- Center for Psychedelic Medicine, Department of Psychiatry, NYU Langone Health, New York, NY, United States
- New York University Grossman School of Medicine, New York, NY, United States
- Bellevue Hospital Center, New York, NY, United States
| | - Ming-Chun Huang
- Case School of Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Paul Trujillo
- Columbia University School of Nursing, New York, NY, United States
| | - Patricia Cioe
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, United States
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15
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Pravosud V, Ballard AM, Holloway IW, Young AM. Online Partner Seeking and Sexual Behaviors Among Men Who Have Sex With Men From Small and Midsized Towns: Cross-sectional Study. JMIR Form Res 2022; 6:e35056. [PMID: 35687395 PMCID: PMC9233248 DOI: 10.2196/35056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Men who have sex with men (MSM) residing outside of large urban areas are underrepresented in research on online partner seeking and sexual behaviors related to transmission of HIV. OBJECTIVE We aimed to determine associations between the use of the internet or social networking apps (online tools) to meet partners for sex, dating, or for both purposes (online partner seeking) and sexual behaviors among MSM residing in small and midsized towns in Kentucky, United States. METHODS Using peer-referral sampling and online self-administered questionnaires, data were collected from 252 men, aged 18 to 34 years, who had recently (past 6 months) engaged in anal sex with another man and resided in Central Kentucky. Using multivariable logistic regression models, we assessed associations of online partner seeking and HIV-related sexual behaviors. RESULTS Most (181/252, 71.8%) of the participants reported using online tools for partner seeking. Of these 181 respondents, 166 (91.7%) had used online tools to meet partners for sex (n=45, 27.1% for sex only; and n=121, 72.9% for sex and dating) and 136 (75.1%) had used online tools to meet partners for dating (n=15, 11% for dating only; and n=121, 89% for sex and dating). Adjusted analyses revealed that MSM who had engaged in condomless insertive and receptive anal intercourse were less likely to report online partner seeking (adjusted odds ratio [aOR] 0.22, 95% CI 0.07-0.68; P=.009 and aOR 0.25, 95% CI 0.10-0.66; P=.005, respectively). Increased number of insertive and receptive anal sex partners and substance use before or during sex were associated with higher odds of online partner seeking (aOR 1.31, 95% CI 1.11-1.55; P=.001; aOR 1.20, 95% CI 1.05-1.39; P=.008; and aOR 2.50, 95% CI 1.41-4.44; P=.002, respectively). CONCLUSIONS Among MSM who reside outside of large urban areas and practice online partner seeking, HIV risk-reduction interventions should address safer sex practices, including the risks for HIV transmission associated with alcohol or drug use before or during sex. MSM who do not practice online partner seeking are in need of continued outreach to reduce condomless anal sex.
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Affiliation(s)
- Vira Pravosud
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, United States
| | - April M Ballard
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, United States
| | - Ian W Holloway
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - April M Young
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, United States
- Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, United States
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16
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Li C, Tang W, Ho HC, Zhao P, Chen L, Wang Y, Xiong M, Yang B, Zheng H, Wang C. Online sex-seeking among Chinese heterosexual men who seek care in sexually transmitted infections clinics: a cross-sectional study. Arch Public Health 2022; 80:149. [PMID: 35650641 PMCID: PMC9158293 DOI: 10.1186/s13690-022-00903-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 05/22/2022] [Indexed: 11/11/2022] Open
Abstract
Background The Internet has become an important virtual venue for men who have sex with men to seek sexual partners, with a high potential threat to spread sexually transmitted infections (STIs). However, the online sex-seeking use and its risk causing STIs spread remain unclear among heterosexual men. We conducted a cross-sectional study to investigate the use of online sex-seeking venues and the related risky sex activities (e.g. condomless sex, quick sex) in STIs clinics in Guangdong, China. Methods These STIs clinics were involved in the Guangdong governmental sentinel network and we recruited heterosexual men (age > = 18) between March and August 2018. Multivariable logistic regression models were used to identify the factors associated with online sex-seeking use and risky sex activities with online sex partners. Results 191 of 2,154 participants (8.9%) ever sought sex online. Among users,16.8% met their partners in-person within 24 h, 31.4% engaged in condomless sex with their last online partner. Online sex-seeking was positively associated with a) Ever been diagnosed with STIs (aOR = 3.0, 95%CI:2.0–4.6), and b) Had casual sex in the last three months (aOR = 3.3, 95%CI 2.4–4.6). Condomless sex with the last online partner was negatively associated with the correct answer of “Having only one partner can reduce the risk to infect HIV” (aOR = 0.3, 95%CI:0.1–0.8). Conclusion In China, online sex-seeking and its related risky sexual activities are not rare among heterosexual men. Future prevention strategies to reduce STIs incidence should especially target heterosexual men engaging in online sex-seeking. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00903-5.
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17
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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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Sood SK, Rawat KS, Kumar D. Analytical mapping of information and communication technology in emerging infectious diseases using CiteSpace. TELEMATICS AND INFORMATICS 2022; 69:101796. [PMID: 35282387 PMCID: PMC8901238 DOI: 10.1016/j.tele.2022.101796] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/24/2022] [Accepted: 02/28/2022] [Indexed: 11/05/2022]
Abstract
The prevalence of severe infectious diseases has become a major global health concern. Currently, the COVID-19 outbreak has spread across the world and has created an unprecedented humanitarian crisis. The proliferation of novel viruses has put traditional health systems under immense pressure and posed several serious issues. Henceforth, early detection, identification, rapid testing, and advanced surveillance systems are required to address public health emergencies. However, Information and Communication Technology (ICT) tackles several issues raised by this pandemic and significantly improves the quality of services in the health care sector. This paper presents an ICT-assisted scientometric analysis of infectious diseases, namely, airborne, food & waterborne, fomite-borne, sexually transmitted illnesses, and vector-borne illnesses. It assesses the international research status of this field in terms of citation structure, prolific journals, and country contributions. It has used the CiteSpace tool to address the visualization needs and in-depth insights of scientific literature to pinpoint core hotspots, research frontiers, emerging research areas, and ICT trends. The research finding reveals that mobile apps, telemedicine, and artificial intelligence technologies have greater scope to reduce the threats of infectious diseases. COVID-19, influenza, HIV, and malaria viruses have been identified as research hotspots whereas COVID-19, contact tracing applications, security and privacy concerns about users' data are the recent challenges in this field that need to address. The United States has produced higher research output in all domains of infectious diseases. Furthermore, it explores the co-occurrence network analysis and intellectual landscape of each domain of infectious diseases. It provides potential research directions and insightful clues to researchers and the academic fraternity for further research.
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Affiliation(s)
- Sandeep Kumar Sood
- Department of Computer Aplications, National Institute of Technology, Kurukshetra, Haryana 136119, India
| | - Keshav Singh Rawat
- Department of Computer Science and Informatics, Central University of Himachal Pradesh, Dharmashala, Himachal Pradesh 176215, India
| | - Dheeraj Kumar
- Department of Computer Science and Informatics, Central University of Himachal Pradesh, Dharmashala, Himachal Pradesh 176215, India,Corresponding author
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Fan S, Li P, Hu Y, Gong H, Yu M, Ding Y, Luo Z, Wu G, Ouyang L, Zou H. Geosocial Networking Smartphone App Use and High-Risk Sexual Behaviors Among Men Who Have Sex With Men Attending University in China: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e31033. [PMID: 35343911 PMCID: PMC9002592 DOI: 10.2196/31033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/09/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gay apps are smartphone-based geosocial networking apps where many men who have sex with men (MSM) socialize and seek sex partners. Existing studies showed that gay app use is associated with greater odds of high-risk sexual behaviors and potentially more HIV infections. However, little is known about this behavior among young MSM. OBJECTIVE We conducted this study to understand gay app use and its influencing factors among MSM attending university in China. METHODS From January to March 2019, participants were recruited from 4 regions with large populations of college students in China: Chongqing, Guangdong, Shandong, and Tianjin. The eligibility criteria were MSM aged 16 years or older, self-identified as a university student, and being HIV negative. A self-administered online structured questionnaire was used to collect data on sociodemographic information, sexual behaviors, gay app use, substance use, and HIV testing history. We performed multivariable log-binomial regression to assess correlates of seeking sex partners via gay apps. RESULTS A total of 447 MSM attending university with an average age of 20.4 (SD 1.5) years were recruited. Almost all participants (439/447, 98.2%) reported gay app use at some point in their life, and 240/439 (53.7%) reported ever seeking sex partners via gay apps. Blued (428/439, 97.5%) was the most popular gay app. Higher proportions of sexual risk behaviors (including seeking sex partners via apps [P<.001], engaging in group sex [P<.001], having multiple sex partners [P<.001], unawareness of sex partners' HIV status [P<.001], and using recreational drugs during sex [P<.02]) were positively associated with the increase in the frequency of gay app use. In multivariable analysis, participants who used gay apps to seek sex partners might be more likely to have multiple sex partners in the past 3 months (adjusted prevalence ratio [APR] 1.53, 95% CI 1.33-1.76; P<.001), engage in group sex in the past 3 months (APR 1.55, 95% CI 1.35-1.78; P<.001), and have sex partners with unknown or positive HIV status (APR 1.72, 95% CI 1.46-2.01; P<.001). CONCLUSIONS Seeking sex partners via gay apps may associate with the increased high-risk sexual behaviors among MSM attending university. The causality between seeking sex partners via gay apps and increased high-risk sexual behaviors should be further investigated so as to inform potential policies for HIV prevention. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900020645; http://www.chictr.org.cn/showprojen.aspx?proj=34741.
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Affiliation(s)
- Song Fan
- School of Public Health, Southwest Medical University, Luzhou, China.,School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Peiyang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuqing Hu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Hui Gong
- Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Maohe Yu
- Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Yi Ding
- Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Zhenzhou Luo
- Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Guohui Wu
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Lin Ouyang
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.,Kirby Institute, University of New South Wales, Sydney, Australia.,School of Public Health, Shanghai Jiao Tong University, Shanghai, China
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20
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Hermosa-Bosano C, Hidalgo-Andrade P, Paz C. Geosocial Networking Apps Use Among Sexual Minority Men in Ecuador: An Exploratory Study. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2995-3009. [PMID: 34117560 PMCID: PMC8563596 DOI: 10.1007/s10508-021-01921-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 01/04/2021] [Accepted: 01/15/2021] [Indexed: 06/04/2023]
Abstract
Geosocial networking applications (GSN apps) have become important socialization contexts for sexual minority men (SMM). Despite their popularity, there is limited research carried out in Latin American countries and no single previous study done in Ecuador. To fill this gap, this exploratory study described and analyzed the relationships between the sociodemographic characteristics of SMM using GSN apps, their sought and fulfilled expectations, profile shared and sought characteristics, and the evaluation of their experiences as users including their perceptions of support, and discrimination. We used an online recruited sample of 303 participants enrolled between November 2019 and January 2020. Most respondents used Grindr and reported spending up to 3 h per day using apps. Most common sought expectations were getting distracted, meeting new friends, and meeting people for sexual encounters. The least met expectation was meeting someone to build a romantic relationship with. When asked about their profiles, participants reported sharing mainly their age, photographs, and sexual role. Participants also prioritized these characteristics when looking at others' profiles. When asked about their experiences, most reported having been discriminated against, weight being the main reason for it. Some participants also indicated having received emotional support from other users. Correlation analyses indicated significant but weak relationships among the variables. Results indicated a positive correlation between time as an active GSN app user and higher experiences of discrimination. Likewise, higher number of used apps related positively with levels of received support. These results provide information that could inform future research in the country and the region regarding GSN apps use among SMM, socialization practices, and modern dating tools.
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Affiliation(s)
- Carlos Hermosa-Bosano
- School of Psychology, Universidad de Las Américas (UDLA), Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, 170124, Quito, Ecuador.
| | - Paula Hidalgo-Andrade
- School of Psychology, Universidad de Las Américas (UDLA), Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, 170124, Quito, Ecuador
| | - Clara Paz
- School of Psychology, Universidad de Las Américas (UDLA), Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, 170124, Quito, Ecuador
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21
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Burton CL, Clark KA, Pachankis JE. Risk From Within: Intraminority Gay Community Stress and Sexual Risk-Taking Among Sexual Minority Men. Ann Behav Med 2021; 54:703-712. [PMID: 32206770 DOI: 10.1093/abm/kaaa014] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sexual minority men remain highly impacted by the human immunodeficiency virus (HIV) with social stress being a clear predictor of their risk for infection. The past several decades of stress research regarding sexual minority men's HIV-risk behaviors has almost exclusively focused on the influence of stress emanating from outside the gay community (e.g., stigma-related stress, or minority stress, such as heterosexist discrimination). However, recent evidence suggests that sexual minority men also face stress from within their own communities. PURPOSE We sought to examine whether stress from within the gay community, or intraminority gay community stress, might influence sexual minority men's risk behaviors, including HIV-risk behaviors, over-and-above more commonly examined stressors affecting this risk. METHODS We tested whether intraminority gay community stress was associated with sexual minority men's HIV-risk behaviors in a large national survey of sexual minority men (Study 1), and experimentally tested intraminority gay community stress's impact on behavioral risk-taking and attitudes toward condom use (Study 2). RESULTS Self-reported exposure to intraminority gay community stress was positively associated with HIV-risk behaviors when accounting for the effects of several commonly examined minority stressors and general life stress (Study 1). Participants who were rejected from an online group of other sexual minority men evidenced greater risk-taking in a subsequent task and reported fewer benefits of condom use than participants who were accepted by the online group, when accounting for state affect (Study 2). CONCLUSIONS Sexual minority men's experiences of stress and rejection stemming from their own community may be an important and overlooked predictor of HIV infection and transmission.
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Affiliation(s)
- Charles L Burton
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, Suite, New Haven, CT
| | - Kirsty A Clark
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, Suite, New Haven, CT
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, Suite, New Haven, CT
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22
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Xu J, Luo Y, Dong H, Zhao G. Effects of internet exposure on sexual partners and sexual risk behavior among sexually experienced college males in China: evidence from an institutional-based cross-sectional study (Preprint). JMIR Public Health Surveill 2021; 8:e31847. [PMID: 35499864 PMCID: PMC9112083 DOI: 10.2196/31847] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/24/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background As a young subgroup, college students have become the main users of mobile social networks. Considering that people can indiscriminately access explicit sexual content on the internet, coupled with the increase of HIV infections in male college students, the role of the internet in meeting sexual partners and its correlation to risky sexual behavior has become an important topic. Objective The aim of this study is to explore the effects of internet exposure on sexual partners and sexual risk behavior among sexually experienced male college students. Methods An institution-based cross-sectional study design was used to collect data through a paper-based questionnaire administered to male college students recruited from colleges and gay organizations in Hangzhou, Zhejiang Province, China. A total of 1045 sexually experienced male students were incorporated in our analysis, with the following information collected: sociodemographic characteristics, sexual intercourse–related behaviors, and sexually transmitted disease (STD) knowledge. Mann-Whitney U and Kruskal-Wallis tests were used to examine differences regarding basic characteristics and sexual risk behaviors between male college students who meet sexual partners via the internet and those who do not. Sequential logistic regression models were employed to examine the influence of meeting sexual partners via the internet on risky sexual behaviors after controlling for other factors. Results The mean age of the sexually experienced male students was 21.6 (SD 2.0) years. The likelihood of risky sexual behavior was varied, yet it was the highest for those who aim to meet paid sexual partners (145/192, 75.5% to 19/22, 86.4%), followed by those seeking partners for love or romance (258/435, 59.3%). Compared to non-internet partner seekers, internet partner seekers tended to have more casual intercourse (292/542, 53.9% versus 51/503, 10.1%), paid intercourse (32/542, 5.9% versus 12/503, 2.4%), and intercourse with same-sex partners (349/542, 64.4% versus 41/503, 8.2%); they were also more likely to use psychoactive drugs (125/349, 35.8% versus 5/41, 12.2%) and have more than 2 partners. With the increase of HIV and STD knowledge, the probability of having unprotected intercourse decreased for non-internet partner seekers. However, it increased for internet partner seekers with a rising HIV knowledge score. Sequential logistic regression showed that meeting sexual partners on the internet was statistically associated with sexual risk behaviors with multiple sexual partners (odds ratio 4.434; P<.001). Conclusions Meeting sexual partners via the internet is a common behavior among sexually experienced male college students, and those who meet partners on the internet exhibited higher levels of risky sexual behaviors although they had sufficient HIV and STD knowledge; this is especially true for students who aimed to find partners for sexual intercourse. Thus, more attention should be paid to young adults to address the risky sexual behaviors that may contribute to STD spread among this population.
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Affiliation(s)
- Junfang Xu
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Luo
- Shenzhen Pingshan District Center for Disease Control and Prevention, Hangzhou, China
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Hengjin Dong
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Gang Zhao
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
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The Association between Dating Apps and Alcohol Consumption in an Italian Sample of Active Users, Former Users, and Non-Users. SOCIAL SCIENCES 2021. [DOI: 10.3390/socsci10070249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
To date, the relationship between alcohol use and dating app use has been investigated mostly in conjunction with sexual activities and in homosexual men. For this reason, the aim of this study was to explore the association between dating app use and alcohol consumption among the general population. A cross-sectional study was conducted including app users, non-users, and former users: 1278 respondents completed an online ad hoc questionnaire assessing dating app use, motivations for installing dating apps, alcohol use, and demographics. Multiple logistic regression analysis was run to investigate the association between dating app use, demographic features, and alcohol consumption. Whereas educational level, age, and gender significantly contributed to the regular consumption of alcohol, dating app use did not account for a significant amount of variance between regular and not regular drinkers. However, people who installed and used dating apps with the motivation of searching for sexual partners were more likely to be regular drinkers. Among the active users, heavy app users were less likely to drink regularly. The study indicates that underlying factors (sexual aspects, motives for using the apps) and the intensity of using the apps may mediate the relationship between dating app use and alcohol use.
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24
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Ocasio MA, Fernandez MI, Joseph JM, Rezai R. Engaging Sexual and Gender Minority Youth in HIV Interventions Through Gay Dating Apps: Recruitment Protocol. JMIR Res Protoc 2021; 10:e28864. [PMID: 34156342 PMCID: PMC8277323 DOI: 10.2196/28864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND HIV continues to disproportionately impact sexual and gender minority youth (SGMY) in the United States. Public health efforts have increasingly focused on developing efficacious interventions to curb the spread of HIV among SGMY and help those living with HIV achieve and sustain viral suppression. However, recruiting and engaging SGMY in prevention and care interventions is challenging. OBJECTIVE During the past decade, gay dating apps have quickly emerged as popular web-based spaces in which SGMY congregate. Although the recruitment of SGMY through these apps has been commonly reported, advertisement is the typical modality used, and direct recruitment approaches are not adequately described. This study aims to describe the process for developing a direct recruitment protocol for use in gay dating apps. METHODS The Adolescent Medicine Trials Network Comprehensive Adolescent Research and Engagement Studies is a community-based research program consisting of 3 interrelated studies testing scalable behavioral interventions to improve HIV prevention and care engagement among youth aged 12-24 years in Los Angeles and New Orleans. To supplement our in-person recruitment approaches for Comprehensive Adolescent Research and Engagement Studies, the New Orleans site formed a gay dating app recruitment team. In April 2018, the team developed a loosely structured protocol that included study-specific profiles and sample language to guide initial recruitment efforts. Two self-identified Black, gay cisgender male field recruiters field-tested the protocol on the popular gay dating app Jack'd. During the field test, the recruitment team met weekly to discuss the recruiters' experiences and user reactions. For example, we learned the importance of addressing concerns about study legitimacy and identifying appropriate ways to describe the study. We iteratively incorporated these lessons learned into the final protocol and developed a training program and tracking procedures before moving to full-scale implementation at both sites. RESULTS Adhering to this protocol yielded 162 enrollments in New Orleans (332 total enrollments across the two sites) throughout the recruitment period (April 2018 to August 2019). Most of these participants were sexual minority cisgender males (91%), and the remainder were identified as members of gender minority groups. We outlined step-by-step instructions on training staff, engaging users, and scheduling and tracking recruitment activities. CONCLUSIONS This paper provides a practical guide for researchers and community-based providers to implement a gay dating app recruitment protocol. Our experience indicates that gay dating app recruitment is feasible and fruitful when the staff members are knowledgeable, flexible, honest, and respectful to the user. Perhaps the most salient lesson we learned in approaching gay dating app users is the importance of setting clear and transparent intentions without judgment. As gay dating apps continue to increase in popularity, researchers need to stay vigilant to changing formats and develop systematic approaches to harness their potential as invaluable recruitment strategies for SGMY. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/28864.
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Affiliation(s)
- Manuel A Ocasio
- Department of Pediatrics, School of Medicine, Tulane University, New Orleans, LA, United States
| | - Maria Isabel Fernandez
- College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Ja'Lon M Joseph
- Department of Pediatrics, School of Medicine, Tulane University, New Orleans, LA, United States
| | - Roxana Rezai
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, United States
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- Department of Pediatrics, School of Medicine, Tulane University, New Orleans, LA, United States.,College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States.,Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, United States.,Los Angeles LGBT Center, Los Angeles, CA, United States.,UT Southwestern Medical Center, Dallas, TX, United States.,School of Medicine, University of California, San Fransisco, San Fransisco, CA, United States.,Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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25
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Flesia L, Fietta V, Foresta C, Monaro M. Cigarette Smoking and Dating App Use: Findings from a Survey in a Sample of Adults in Italy. Eur J Investig Health Psychol Educ 2021; 11:557-569. [PMID: 34708835 PMCID: PMC8314363 DOI: 10.3390/ejihpe11020040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/11/2021] [Accepted: 06/12/2021] [Indexed: 11/25/2022] Open
Abstract
Existing studies in the literature indicate an association between the use of dating apps and substance-related behaviours (i.e., alcohol consumption, drug consumption). However, to date, no studies investigated the relation between dating app use and smoking. This study aims to explore this association. A total of 1278 respondents completed an online ad hoc questionnaire assessing demographics, smoking habits, dating app use, motivations for using dating apps. Multiple logistic regression analyses were run to investigate the relation between demographics and dating apps use on tobacco consumption. Being active user was significantly associated with being smoker, light daily and moderate-to-heavy smoker. Among users, using apps with the motive of searching for friends accounted for lower odds of smoking, light daily smoking and moderate-to-heavy smoking. However, heavy dating app users were less likely to smoke, to be light daily smokers and to be moderate-to-heavy smokers. The study indicates an association between using the apps and smoking, suggesting that motives for using the apps and intensity of use may moderate this association.
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Affiliation(s)
- Luca Flesia
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35128 Padova, Italy;
- Correspondence: ; Tel.: +39-340-1535924
| | - Valentina Fietta
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (V.F.); (M.M.)
| | - Carlo Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35128 Padova, Italy;
| | - Merylin Monaro
- Department of General Psychology, University of Padova, 35131 Padova, Italy; (V.F.); (M.M.)
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26
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Mi GD, Zhang BB, Yu F, Ren XL, Ong JJ, Fan YQ, Guo FH, Li CJ, Zhang MZ, Zhang MY. HIV incidence among men who have sex with men using geosocial networking smartphone application in Beijing, China: an open cohort study. Infect Dis Poverty 2021; 10:27. [PMID: 33795011 PMCID: PMC8017803 DOI: 10.1186/s40249-021-00814-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Sexual transmission among men who have sex with men (MSM) is the dominant route of HIV transmission in China. Extensive use of geosocial networking (GSN) smartphone application (app) has dramatically changed the pattern of sexual behaviors and HIV risk among MSM, but data on HIV incidence and the changing risk behaviors of GSN app-using MSM are limited. We aims to assess the HIV incidence and its correlates among gay GSN app-using MSM in China. Methods We constructed an open cohort which was initiated and maintained using a GSN app to assess the HIV incidence among app-using MSM, recruited from June 2017 to December 2018. MSM completed an online questionnaire on their sociodemographic characteristics, sexual behaviors, recreational drug use and sexually transmitted infections status. Then each man had an HIV test, and those tested negatives were enrolled into the cohort. Participants completed follow-ups with additional HIV tests though the app during the study period, and were censored at HIV seroconversion or study end date. HIV incidence was calculated by dividing the sum of observed HIV seroconversions by the observed person-time. Univariate (Chi-square test and Fisher’s exact test) and multivariate (proportional hazards regression) analyses were used to examine correlates of HIV incidence. Results A total of 6957 HIV negative MSM were enrolled in the open cohort, 37 seroconversions occurred among 1937 men contributing 1065 observed person-years: HIV incidence was 3.47 per 100 person-years [95% confidence interval (CI): 2.37–4.57]. More than five sexual partners [hazard ratio (HR) = 2.65, 95% CI: 1.04–6.67], and sex with HIV positive partners (HR = 3.82, 95% CI: 1.16–12.64) in the preceding six months were positively associated with HIV seroconversion. Consistent condom use for anal sex (HR = 0.27, 95% CI: 0.07–0.96), and reporting insertive anal sex only (HR = 0.23, 95% CI: 0.08–0.62) in the preceding six months were protective factors for HIV seroconversion. Conclusions Tailored interventions targeting app-using MSM are urgently needed given their high risk of HIV. As a new tool for accessing MSM at higher HIV risk, GSN smartphone app could play an important role in HIV research among MSM. ![]()
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Affiliation(s)
- Guo-Dong Mi
- Danlan Beijing Media Limited, Beijing, China
| | - Bin-Bin Zhang
- School of Medicine, Nankai University, 94, Weijin Road, Tianjin, 300071, China
| | - Fei Yu
- Danlan Beijing Media Limited, Beijing, China
| | - Xian-Long Ren
- Beijing Center for Diseases Control and Prevention, Beijing, China
| | - Jason J Ong
- Central Clinical School, Monash University, Melbourne, Australia.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Ya-Qi Fan
- School of Medicine, Nankai University, 94, Weijin Road, Tianjin, 300071, China
| | - Feng-Hua Guo
- School of Medicine, Nankai University, 94, Weijin Road, Tianjin, 300071, China
| | | | - Mian-Zhi Zhang
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Min-Ying Zhang
- School of Medicine, Nankai University, 94, Weijin Road, Tianjin, 300071, China.
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27
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Knox J, Chen YN, He Q, Liu G, Jones J, Wang X, Sullivan P, Siegler A. Use of Geosocial Networking Apps and HIV Risk Behavior Among Men Who Have Sex With Men: Case-Crossover Study. JMIR Public Health Surveill 2021; 7:e17173. [PMID: 33448934 PMCID: PMC7846440 DOI: 10.2196/17173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/06/2020] [Accepted: 12/09/2020] [Indexed: 02/02/2023] Open
Abstract
Background HIV disproportionately affects men who have sex with men (MSM) in China. The HIV epidemic is largely driven by unprotected anal sex (ie, sex not protected by condoms or HIV pre-exposure prophylaxis [PrEP]). The possible association between unprotected anal sex and the use of geospatial networking apps has been the subject of scientific debate. Objective This study assessed whether users of a gay geospatial networking app in China were more likely to use condoms when they met their partners online versus offline. A case-crossover analysis, with each person serving as his own control, was employed to address the potential bias that men looking for sex partners through an online dating medium might have inherently different (and riskier) patterns of sexual behavior than men who do not use online dating media. Methods A cross-sectional survey was administered in 2018 to adult male users of Blued—a gay geospatial networking app—in Beijing, Tianjin, Sichuan, and Yunnan, China. A case-crossover analysis was conducted among 1311 MSM not taking PrEP who reported engaging in both unprotected and protected anal sex in the previous 6 months. Multivariable conditional logistic regression was used to quantify the association between where the partnership was initiated (offline or online) and the act of unprotected anal sex, controlling for other interval-level covariates. Four sensitivity analyses were conducted to assess other potential sources of bias. Results We identified 1311 matched instances where a person reported having both an unprotected anal sex act and a protected anal sex act in the previous 6 months. Of the most recent unprotected anal sex acts, 22.3% (292/1311), were initiated offline. Of the most recent protected anal sex acts, 16.3% (214/1311), were initiated offline. In multivariable analyses, initiating a partnership offline was positively associated with unprotected anal sex (odds ratio 2.66, 95% CI 1.84 to 3.85, P<.001) compared with initiating a partnership online. These results were robust to each of the different sensitivity analyses we conducted. Conclusions Among Blued users in 4 Chinese cities, men were less likely to have unprotected anal sex in partnerships that they initiated online compared with those that they initiated offline. The relationship was strong, with over 2.5 times the likelihood of engaging in unprotected anal sex in partnerships initiated offline compared with those initiated online. These findings suggest that geospatial networking apps are a proxy for, and not a cause of, high-risk behaviors for HIV infection; these platforms should be viewed as a useful venue to identify individuals at risk for HIV transmission to allow for targeted service provision.
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Affiliation(s)
- Justin Knox
- Columbia University, New York, NY, United States
| | - Yi-No Chen
- Emory University, Atlanta, GA, United States
| | - Qinying He
- Center for Disease Control and Prevention, Chengdu, China
| | - Guowu Liu
- Center for Disease Control and Prevention, Beijing, China
| | - Jeb Jones
- Emory University, Atlanta, GA, United States
| | - Xiaodong Wang
- Chengdu Tongle Social Work Service Center, Chengdu, China
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Hoenigl M, Little SJ, Grelotti D, Skaathun B, Wagner GA, Weibel N, Stockman JK, Smith DM. Grindr Users Take More Risks, but Are More Open to Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis: Could This Dating App Provide a Platform for HIV Prevention Outreach? Clin Infect Dis 2020; 71:e135-e140. [PMID: 31677383 PMCID: PMC7583417 DOI: 10.1093/cid/ciz1093] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 11/01/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Technology has changed the way that men who have sex with men (MSM) seek sex. More than 60% of MSM in the United States use the internet and/or smartphone-based geospatial networking apps to find sex partners. We correlated use of the most popular app (Grindr) with sexual risk and prevention behavior among MSM. METHODS A nested cohort study was conducted between September 2018 and June 2019 among MSM receiving community-based human immunodeficiency virus (HIV) and sexually transmitted infection (STI) screening in central San Diego. During the testing encounter, participants were surveyed for demographics, substance use, risk behavior (previous 3 months), HIV pre-exposure prophylaxis (PrEP) use, and Grindr usage. Participants who tested negative for HIV and who were not on PrEP were offered immediate PrEP. RESULTS The study included 1256 MSM, 1090 of whom (86.8%) were not taking PrEP. Overall, 580 of 1256 (46%) participants indicated that they used Grindr in the previous 7 days. Grindr users reported significantly higher risk behavior (greater number of male partners and condomless sex) and were more likely to test positive for chlamydia or gonorrhea (8.6% vs 4.7% of nonusers; P = .005). Grindr users were also more likely to be on PrEP (18.7% vs 8.7% of nonusers; P < .001) and had fewer newly diagnosed HIV infections (9 vs 26 among nonusers; P = .014). Grindr users were also nearly twice as likely as nonusers to initiate PrEP (24.6% vs 14%; P < .001). CONCLUSIONS Given the higher risk behavior and greater acceptance of PrEP among MSM who used Grindr, Grindr may provide a useful platform to promote HIV and STI testing and increase PrEP uptake.
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Affiliation(s)
- Martin Hoenigl
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, California, USA
| | - Susan J Little
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, California, USA
| | - David Grelotti
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Britt Skaathun
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, California, USA
| | - Gabriel A Wagner
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, California, USA
| | - Nadir Weibel
- Department of Computer Science and Engineering, University of California, San Diego, La Jolla, California, USA
| | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, California, USA
| | - Davey M Smith
- Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, California, USA
- Veterans Affairs Healthcare System, San Diego, California, USA
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29
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Martinez EZ, Morigi TZ, Galdino G, McFarland W, Zucoloto ML. Sex-seeking mobile application use and risk behavior among men who have sex with men in Brazil. Int J STD AIDS 2020; 31:1161-1168. [PMID: 32915700 DOI: 10.1177/0956462420945940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This is a cross-sectional study based on an open web survey with the primary objective to assess associations between the use of apps for seeking sex partners and vulnerabilities related to human immunodeficiency virus (HIV) acquisition among men who have sex with men (MSM) in Brazil. Participants were recruited to the study through ads posted in social media such as Twitter, Facebook, and WhatsApp. Consenting respondents completed a questionnaire on demographics, history of sexually transmitted infections (STIs), and risk behaviors and perceptions, including calculation of the Risk Behavior Score for HIV infection proposed by Rocha et al. Among the 859 participants, 714 (83.1%) reported they used apps for seeking sex partners. Use of apps for seeking sex partners was associated with high-risk behavior for HIV infection, self-reported syphilis, self-perception of HIV risk, and use of marijuana. The use of apps for seeking sex partners has rapidly become the norm for MSM in Brazil. The associations with STIs and risk behaviors should be seen as an opening to improve public health, presenting opportunities to promote knowledge, safer sex practices, and referral to HIV/STI screening and prevention interventions.
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Affiliation(s)
- Edson Zangiacomi Martinez
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP USP), Ribeirão Preto, Brazil
| | - Thais Zanin Morigi
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP USP), Ribeirão Preto, Brazil
| | - Guilherme Galdino
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP USP), Ribeirão Preto, Brazil.,Universidade de Ribeirão Preto (UNAERP), Ribeirão Preto, Brazil
| | | | - Miriane Lucindo Zucoloto
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP USP), Ribeirão Preto, Brazil
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Hampel B, Kusejko K, Kouyos RD, Böni J, Flepp M, Stöckle M, Conen A, Béguelin C, Künzler‐Heule P, Nicca D, Schmidt AJ, Nguyen H, Delaloye J, Rougemont M, Bernasconi E, Rauch A, Günthard HF, Braun DL, Fehr J, Anagnostopoulos A, Battegay M, Bucher HC, Calmy A, Cavassini M, Ciuffi A, Dollenmaier G, Egger M, Elzi L, Fellay J, Furrer H, Fux CA, Haerry D, Hasse B, Hirsch HH, Hoffmann M, Hösli I, Huber M, Kahlert C, Kaiser L, Keiser O, Klimkait T, Kovari H, Ledergerber B, Martinetti G, Martinez de Tejada B, Marzolini C, Metzner KJ, Müller N, Paioni P, Pantaleo G, Perreau M, Rudin C, Scherrer AU, Schmid P, Speck R, Tarr P, Trkola A, Vernazza P, Wandeler G, Weber R, Yerly S. Chemsex drugs on the rise: a longitudinal analysis of the Swiss HIV Cohort Study from 2007 to 2017. HIV Med 2020; 21:228-239. [DOI: 10.1111/hiv.12821] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 12/22/2022]
Affiliation(s)
- B Hampel
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
- Department of Public Health Epidemiology, Biostatistics and Public Health Institute University of Zurich Zurich Switzerland
| | - K Kusejko
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - RD Kouyos
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - J Böni
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - M Flepp
- Center of Infectious Diseases Zurich Zurich Switzerland
| | - M Stöckle
- Division of Infectious Diseases & Hospital Epidemiology University Hospital Basel University Basel Basel Switzerland
| | - A Conen
- Division of Infectious Diseases and Hospital Hygiene Cantonal Hospital Aarau Aarau Switzerland
| | - C Béguelin
- Department of Infectious Diseases Bern University Hospital University of Bern Bern Switzerland
| | - P Künzler‐Heule
- Institute of Nursing Science University of Basel, and University Hospital Basel Basel Switzerland
| | - D Nicca
- Institute of Nursing Science University of Basel, and University Hospital Basel Basel Switzerland
| | - AJ Schmidt
- Division of Infectious Diseases Cantonal Hospital St. Gallen St. Gallen Switzerland
| | - H Nguyen
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - J Delaloye
- Division of Infectious Diseases University Hospital Lausanne Lausanne Switzerland
| | - M Rougemont
- Division of Infectious Diseases University Hospital Geneva Geneva Switzerland
| | - E Bernasconi
- Division of Infectious Diseases Regional Hospital Lugano Lugano Switzerland
| | - A Rauch
- Department of Infectious Diseases Bern University Hospital University of Bern Bern Switzerland
| | - HF Günthard
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - DL Braun
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Institute of Medical Virology University of Zurich Zurich Switzerland
| | - J Fehr
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Zurich University of Zurich Zurich Switzerland
- Department of Public Health Epidemiology, Biostatistics and Public Health Institute University of Zurich Zurich Switzerland
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Swipe right: the emergence of dating-app facilitated sexual assault. A descriptive retrospective audit of forensic examination caseload in an Australian metropolitan service. Forensic Sci Med Pathol 2020; 16:71-77. [PMID: 32026384 DOI: 10.1007/s12024-019-00201-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
The use of dating 'apps' to facilitate real-word social encounters between strangers is culturally mainstream. Sexual assaults facilitated following dating-app meetings have been reported in the media, and anecdotally noted at increasing frequency by clinical forensic physicians. Limited empirical data suggests there has been a marked increase in real life sexual offences facilitated in this manner. There is little additional information known about the circumstances of these alleged incidents. This retrospective audit of a small forensic examination caseload from an Australian metropolitan clinical forensic medicine service identified that 14% (11 of 76) of alleged sexual assaults where complainants underwent a forensic examination were facilitated following a dating-app meeting. Further analysis of these cases identified that all complainants were female, most under 30 years of age. All alleged a single male perpetrator and in over half of the cases the complainant was impaired. In all cases where it was asked (n = 9), the alleged incident occurred at the first face-to-face meeting. More than half of the incidents occurred at the alleged perpetrator's private residence. Anogenital injuries were observed at the time of forensic examination in 60% of cases, and 70% had visible body injuries. There was no reported condom use. Only one complainant had no observable injury. This small case series quantified a high proportion of forensic sexual assault examination caseload as being facilitated by dating-app meetings, and identified some common features that may be characteristic of alleged sexual assaults occurring in this manner. The authors propose a larger prospective period of data collection at the time of forensic medical examination, to characterize the features of sexual assaults allegedly occurring following app-based meetings.
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Grov C, Stief M, Westmoreland DA, MacCrate C, Mirzayi C, Nash D. Maximizing Response Rates to Ads for Free At-Home HIV Testing on a Men-for-Men Geosocial Sexual Networking App: Lessons Learned and Implications for Researchers and Providers. HEALTH EDUCATION & BEHAVIOR 2020; 47:5-13. [PMID: 31896287 DOI: 10.1177/1090198119893692] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Internet-based recruitment can be effective in reaching large numbers of geographically diverse individuals. Geosocial sexual networking apps on smartphones have emerged as the modal way in which men who have sex with men (MSM) meet sex partners, and as venues for sexual health research. We report on the performance of three types of ads-text-only, text with male figure (no face), and text with male figure (with face)-used on a geosocial sexual networking app to advertise free at-home HIV testing and to enroll in an online study. We ran five 2-week-long ads on a popular MSM geosocial app between fall 2017 and spring 2018 (~2.19 million impressions). Ads were evaluated in terms of the click-through rate (CTR = advertisement clicks/advertisement impressions), conversion rates (CR = number of enrolled participants/ad-generated clicks), cost per enrolled participant, and demographic composition of survey respondents. We enrolled n = 4,023 individuals, n = 2,430 of whom completed HIV testing-$6.21 spent on advertising per participant enrolled and $10.29 spent for everyone who completed HIV testing. Cost per enrolled participant was associated with the content of the ad used-ads featuring male figures (with or without a face shown) were more cost efficient than ads featuring text alone. These ads also outperformed text-only ads across a range of metrics, including responsiveness among younger MSM as well as MSM of color. Advertising materials that combine text with images may have greater appeal among priority populations.
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Affiliation(s)
| | | | | | | | | | - Denis Nash
- The City University of New York New York, NY, USA
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Young LE, Fujimoto K, Schneider JA. Facebook group affiliation ties, group topics, and HIV behavioral characteristics among young Black men who have sex with men: Potential for public health intervention. SSM Popul Health 2019; 9:100510. [PMID: 31993491 PMCID: PMC6978475 DOI: 10.1016/j.ssmph.2019.100510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/24/2019] [Accepted: 10/30/2019] [Indexed: 11/24/2022] Open
Abstract
•YBMSM were more likely to belong to personal/professional development groups.•YBMSM clustered around pairs of LGBTQ identity, sex, and nightlife groups.•Regular testers tended to belong to LGBTQ identity and nightlife groups.•Those who engaged in condomless sex tended to affiliate with LGBTQ identity groups.•Those who were aware of PrEP aware tended to affiliate with chat groups.
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Affiliation(s)
- Lindsay E. Young
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination (CCHE), Chicago, IL, USA
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center, Houston, USA
| | - John A. Schneider
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination (CCHE), Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, USA
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Queiroz AAFLN, Matos MCB, Araújo TMED, Reis RK, Sousa ÁFL. Infecções sexualmente transmissíveis e fatores associados ao uso do preservativo em usuários de aplicativos de encontro no Brasil. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Resumo Objetivos Caracterizar os usuários brasileiros de aplicativos de encontro baseados em geolocalização, estimar a prevalência de Infecções Sexualmente Transmissíveis (ISTs) e fatores associados ao uso do preservativo. Métodos Estudo descritivo, transversal, com amostra de 2.250 homens que fazem sexo com homens (HSH) de todo o Brasil. Utilizou-se da rede social Facebook® para a coleta e divulgação da pesquisa, por meio de uma postagem impulsionada semanalmente, de novembro de 2016 a janeiro de 2017. Os dados foram analisados de forma uni e bivariada com o auxílio do software SPSS. Resultados Houve a predominância de participantes jovens (25 anos), com ensino superior completo (57,8%) e homossexuais (75,7%), que conheceram os seus parceiros através de aplicativos (64,1%), utilizando, principalmente, o Tinder ® (57,3%) e Grindr® (53,3%) para fins sexuais (69,7%). A prevalência de ISTs foi de 11,1%, sendo 7,1 de HIV. Foram fatores associados ao uso de preservativos: conhecer o parceiro pelo app (p=0,003), utilizar o Grindr ® (p=0,002), Scruff ® (p=0,027) ou Hornet ® (p<0,001), usar os apps para amizade (p<0,001), sexo (p<0,001) ou relacionamento (p<0,001), frequência de uso do aplicativo (p<0,001) e utilizar os apps durante à noite (p=0,003). Conclusão Os usuários são jovens, com alto nível educacional e que demonstram familiaridade com os apps pelo tempo de uso. A prevalência de ISTs foi elevada, sobretudo da infecção pelo HIV. Características sociodemográficas e particularidades do uso e consumo dos apps estão associadas a utilização consistente do preservativo, principalmente o motivo de uso, frequência, horário e aplicativo utilizado.
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Luo Q, Wu Z, Chen Z, Ma Y, Mi G, Liu X, Xu J, Rou K, Zhao Y, Scott SR. App use frequency and condomless anal intercourse among men who have sex with men in Beijing, China: a cross-sectional study. Int J STD AIDS 2019; 30:1146-1155. [PMID: 31558122 DOI: 10.1177/0956462419860293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Gay dating applications (apps) are popular among men who have sex with men (MSM) in China. This study examined the relationship between gay dating app use frequency and condomless anal intercourse (CAI) in a sample of MSM in Beijing. In October 2017, a web-based, cross-sectional survey was conducted among MSM from Beijing, China. Demographics, frequency of app use, and sexual behaviors were collected and analyzed. Multivariable logistic regression and restricted cubic splines were used to evaluate the association between app use frequency and CAI. Of the 9280 participants, the proportion of CAI within one month prior to the survey was 43.3%, and 43.7% logged onto the app ≥11 times per week. In adjusted logistic regression analysis, logging onto the app 6–10 times per week and ≥11 times per week were inversely associated with CAI (adjusted odds ratio [AOR] =0.88 [95%CI, 0.78–0.99]; AOR = 0.88 [95%CI, 0.82–0.97], respectively). Among those 40 years of age or older, logging onto the app ≥11 times per week was associated with lower rates of CAI (AOR = 0.57 [95%CI, 0.40–0.81]). Results indicate that frequent app use was associated with lower odds of CAI among MSM in Beijing, China. Innovative interventions, which take advantage of this popular media platform, should be developed as such apps have been found to reduce the odds of CAI in Beijing.
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Affiliation(s)
- Qianqian Luo
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.,School of Nursing, Binzhou Medical University, Yantai, China
| | - Zunyou Wu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Yue Ma
- Blue City Holdings, Ltd, Beijing, China
| | - Guodong Mi
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.,Blue City Holdings, Ltd, Beijing, China
| | - Xuejiao Liu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Xu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Keming Rou
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhao
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sarah R Scott
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Queiroz AAFLN, Sousa AFLD, Brignol S, Araújo TME, Reis RK. Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil. Braz J Infect Dis 2019; 23:298-306. [PMID: 31472125 PMCID: PMC9427977 DOI: 10.1016/j.bjid.2019.07.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/21/2019] [Accepted: 07/28/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction The elderly population is increasingly benefiting from recent technological advances. In this scenario, geolocation-based dating applications provide a viable alternative for finding partners in a practical and timely manner, but may be accompanied by certain risk behaviors for HIV infection. Although there are considerable number of users over 50 on these applications, no studies have addressed this problem. The aim of the present study was to analyze factors of vulnerability to HIV/Aids among the population of men who have sex with men (MSM) age 50 years or older who use dating apps. Methods This was a cross-sectional, population-survey-based, analytical study, conducted exclusively online with a sample of 412 MSM. The data was collected from the following apps: Grindr®, Hornet®, Scruff® and Daddy Hunter®. Results Factors associated with a higher chance of having HIV were: sexual relations with an HIV-infected partner (ORa = 5.53; 95%CI = 2.23–13.73); chemsex (ORa = 3.97; 95%CI = 1.72–8.92); and, above all, having an HIV-infected partner (ORa = 8.02; 95%CI = 2.01–32.01). The belief that apps increase protection against sexually transmitted infections (ORa = 0.43; 95%CI = 0.19–0.95) and not being familiar with post-exposure prophylaxis (ORa = 0.43; 95%CI = 0.19–0.95) were associated with decreased chances of having HIV. Conclusions We highlight some important factors that structure the vulnerability of the MSM surveyed in relation to HIV infection. The findings should be used to customize care for this population, which could bring them in more for health care services.
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Affiliation(s)
| | - Alvaro Francisco Lopes de Sousa
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil; Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.
| | - Sandra Brignol
- Universidade Federal Fluminense, Departamento de Saúde Pública, Rio de Janeiro, RJ, Brazil.
| | | | - Renata K Reis
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil.
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Young LE, Fujimoto K, Alon L, Zhang L, Schneider JA. The multiplex social environments of young Black men who have sex with men: How online and offline social structures impact HIV prevention and sex behavior engagement. JOURNAL OF SOCIAL STRUCTURE : JOSS 2019; 20:70-95. [PMID: 32855626 PMCID: PMC7449318 DOI: 10.21307/joss-2019-007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
In the United States, young Black men who have sex with men (YBMSM) remain disproportionately affected by HIV. The social networks in which YBMSM are embedded are generally understood to be critical factors in understanding their vulnerability. In this study, we acknowledge the relational richness of YBMSMs' social environments (what we define as multiplexity) and their increasing prioritization of online social networking sites (SNS). Specifically, we investigate whether protective and/or risky features of YBMSMs' Facebook friendships and group affiliations are related to their HIV prevention and sex behavior engagement, while also accounting for features of their offline confidant (or support) and sex networks. Using data from a population-based cohort study of YBMSM living in Chicago (N=268), we perform a series of multiple logistic regression analyses to examine associations between features of YBMSMs' Facebook, confidant, and sexual networks with three prevention outcomes and three sex behavior outcomes, while also controlling for factors at the individual and structural levels. Results show that network features play a more significant role in predicting engagement in sex behaviors than prevention behaviors. Specifically, having more confidants, having confidants who are family members, meeting sex partners online, having more YBMSM Facebook friends, belonging to Facebook groups with an LGBTQ focus, and having greater subject diversity in one's Facebook group affiliations were significantly associated with one or more sex behavior outcomes. We conclude with a discussion of the implications of our findings for HIV prevention intervention efforts.
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Affiliation(s)
- Lindsay E Young
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Kayo Fujimoto
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Leigh Alon
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Liang Zhang
- Harris School of Public Policy, University of Chicago, Chicago, IL, USA
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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Stahlman S, Lyons C, Sullivan PS, Mayer KH, Hosein S, Beyrer C, Baral SD. HIV incidence among gay men and other men who have sex with men in 2020: where is the epidemic heading? Sex Health 2019; 14:5-17. [PMID: 27491699 DOI: 10.1071/sh16070] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 06/07/2016] [Indexed: 12/19/2022]
Abstract
The goal to effectively prevent new HIV infections among gay, bisexual, and other men who have sex with men (MSM) is more challenging now than ever before. Despite declines in the late 1990s and early 2000s, HIV incidence among MSM is now increasing in many low- and high-income settings including the US, with young, adolescent, and racial/ethnic minority MSM being among those at highest risk. Potentiating HIV risks across all settings are individual-, network-, and structural-level factors such as stigma and lack of access to pre-exposure prophylaxis (PrEP) and antiretroviral treatment as prevention. To make a sustained impact on the epidemic, a concerted effort must integrate all evidence-based interventions that will most proximally decrease HIV acquisition and transmission risks, together with structural interventions that will support improved coverage and retention in care. Universal HIV treatment, increased access to HIV testing, and daily oral PrEP have emerged as integral to the prevention of HIV transmission, and such efforts should be immediately expanded for MSM and other populations disproportionately affected by HIV. Respect for human rights and efforts to combat stigma and improve access to prevention services are needed to change the trajectory of the HIV pandemic among MSM.
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Affiliation(s)
- Shauna Stahlman
- Johns Hopkins Bloomberg School of Public Health, Center for Public Health and Human Rights, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Carrie Lyons
- Johns Hopkins Bloomberg School of Public Health, Center for Public Health and Human Rights, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA
| | - Kenneth H Mayer
- Fenway Health, The Fenway Institute, 1340 Boylston Street, 8th floor, Boston, MA 02215, USA
| | - Sean Hosein
- CATIE (Canada's AIDS Treatment Information Exchange), 555 Richmond Street West, Suite 505, Box 1104, Toronto, ON M5V 3B1, Canada
| | - Chris Beyrer
- Johns Hopkins Bloomberg School of Public Health, Center for Public Health and Human Rights, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Stefan D Baral
- Johns Hopkins Bloomberg School of Public Health, Center for Public Health and Human Rights, Department of Epidemiology, 615 N. Wolfe Street, Baltimore, MD 21205, USA
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Representations of Pre-exposure Prophylaxis, Informal Antiretroviral Medication Use for HIV Prevention, and Diversion on Geosocial Networking Apps among Men Who Have Sex with Men. AIDS Behav 2019; 23:1790-1796. [PMID: 30255385 DOI: 10.1007/s10461-018-2281-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The use of geosocial networking applications (e.g., Grindr) among men who have sex with men (MSM) is common. Yet scant research has examined how antiretroviral medications (ARVs)-including informal use-diversion and pre-exposure prophylaxis (PrEP) are presented inside of the applications. The present study examines this phenomenon. Data are drawn from a qualitative study (N = 39) of the scope and magnitude of the informal market of ARV use for HIV prevention among MSM. Twenty-five participants reported seeing references to ARVs inside the applications. Men described geosocial networking application users' presentations of ARVs as being related to: PrEP use among HIV-negative MSM, the sale and/or use of illicit drugs (e.g., methamphetamine), informal trade/sale for HIV-prevention, and PrEP use among HIV-positive men. Findings suggest continued desire for and acceptability of PrEP as HIV prevention tool and that geosocial networking apps are being used to facilitate the exchange and informal use of ARVs for HIV-prevention. Geosocial networking applications represent a promising and important platform to educate MSM about safe and effective use of PrEP and the risks related to diversion and informal ARV use.
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40
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Sousa AFL, Queiroz AAFLN, Fronteira I, Lapão L, Mendes IAC, Brignol S. HIV Testing Among Middle-Aged and Older Men Who Have Sex With Men (MSM): A Blind Spot? Am J Mens Health 2019; 13:1557988319863542. [PMID: 31288596 PMCID: PMC6620727 DOI: 10.1177/1557988319863542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 06/09/2019] [Accepted: 06/13/2019] [Indexed: 12/30/2022] Open
Abstract
Middle-aged and older men who have sex with men (MSM) are one of the most underestimated populations with regard to HIV/AIDS infection, despite the worldwide trend of increasing prevalence in recent years. This population also has low rates of testing, although rare studies are done exclusively with middle-aged and older MSM assessing the factors associated with this prevalence. Thus, based on data from an exclusive online survey with middle-aged and older MSM who use geolocation-based dating applications, the purpose of the study was to analyze factors associated with not taking the HIV test among middle-aged (50 years old) and older MSM in Brazil. Using a modification of time-location sampling adapted to virtual reality, 412 volunteers were approached in Grindr®, Hornet®, SCRUFF®, and Daddyhunt®. The multivariate logistic regression model was adopted to produce adjusted odds ratios (ORa), considering a significance level at .05. There were factors associated with not taking the test: being in a relationship (ORa: 0.24; 95% CI [0.10, 0.53]); knowing partner through the applications (ORa: 1.84; 95% CI [1.07, 3.15]); not knowing the serological status (ORa: 5.07; 95% CI [1.88, 13.67]); ejaculating outside of anal cavity (ORa: 1.79; 95% CI [1.04, 3.05]); practicing sex without penetration (ORa: 2.30; 95% CI [1.17, 4.50]); not taking the test as a form of prevention (ORa: 2.83; 95% CI [1.05, 7.68]); and rarely using Viagra in sexual intercourse (ORa: 1.91; 95% CI [1.20, 3.65]). There is a blind spot in the prevalence of HIV testing in older MSM because this population is not being covered by services, which compromises the overall response to HIV, the goals set for universal health coverage.
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Affiliation(s)
- Alvaro Francisco Lopes Sousa
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo (USP), Brazil
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Portugal
| | | | - Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Portugal
| | - Luís Lapão
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Portugal
| | | | - Sandra Brignol
- Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
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Wei L, Chen L, Zhang H, Yang Z, Zou H, Yuan T, Xiao Y, Liu S, Tan W, Xie W, Liu L, Cheng J, Zhao J. Use of gay app and the associated HIV/syphilis risk among non-commercial men who have sex with men in Shenzhen, China: a serial cross-sectional study. Sex Transm Infect 2019; 95:496-504. [PMID: 30918120 DOI: 10.1136/sextrans-2018-053902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/08/2019] [Accepted: 01/26/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Geosocial networking application specific to men who have sex with men (MSM) (gay app) has revolutionised the social networking of MSM globally, much concern was raised over its linkage to HIV/syphilis risk. This study sought to examine the association between use of gay app and sexual behaviours and HIV/syphilis risk among Chinese MSM. METHODS Eligible MSM were recruited through combined offline methods from 2015 to 2017 in Shenzhen, China, with data collected including demographics, sexual behaviours, app use, recreational drug use and HIV testing. All participants are required to sign a written informed consent and take a confidential HIV and syphilis testing. RESULTS The prevalence of app use among non-commercial MSM (NcMSM) has rapidly increased from 12.5% in 2015 to 52.6% in 2017. The primary four apps used were Blued (97.2%), Aloha (18.4%), Jack'd (14.1) and Zank (14.1%). After controlling for confounders, HIV prevalence was still significantly lower among app users than non-app users (adjusted odds ratios [AOR]: 0.77, 95% CI 0.61 to 0.97), yet the lower prevalence of syphilis was not significant (AOR: 0.97, 95% CI 0.76 to 1.23). App-using NcMSM were more likely to be younger, unmarried, self-identified as homosexuality and having higher education level and income than non-app-using NcMSM. App-using NcMSM had higher rate of consistent condom use and HIV testing, higher level of knowledge on HIV/AIDS prevention and condom use; however, they were more likely to have multiple sexual partners, practice receptive role in anal sex and use recreational drug. CONCLUSIONS App-using NcMSM are more likely to have sexual risk behaviours as well as risk-reduction behaviours such as consistent condom use and HIV testing. Scaled-up and innovative venue-based HIV interventions are warranted for these high-risk MSM frequent social venues with less condom use and fewer HIV tests. Meanwhile, gay app should alternatively serve as an intervention and education platform for the MSM hard-to-reach via venue-based approaches.
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Affiliation(s)
- Lan Wei
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Lin Chen
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Haibo Zhang
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhengrong Yang
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Huachun Zou
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China.,School of Public Health, Sun Yat-Sen University, Guangzhou, China.,Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Tanwei Yuan
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yuejiao Xiao
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shaochu Liu
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wei Tan
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wei Xie
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Liegang Liu
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinquan Cheng
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Jin Zhao
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
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42
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Fontenot HB, Rosenberger JG, McNair KT, Mayer KH, Zimet G. Perspectives and preferences for a mobile health tool designed to facilitate HPV vaccination among young men who have sex with men. Hum Vaccin Immunother 2019; 15:1815-1823. [PMID: 30625049 DOI: 10.1080/21645515.2019.1568156] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
We sought to understand young men who have sex with men (YMSM) perspectives and preferred features for a mobile health (mHealth) tool designed to facilitate human papillomavirus (HPV) vaccination. YMSM were recruited on a popular social/sexual networking app to participate in online focus groups. Discussions were designed to elicit what the men would want in a mHealth tool specific for sexual health and HPV. Demographic data were analyzed using descriptive statistics and focus group data were analyzed using conventional content analysis. Forty-eight YMSM participated. Mean age was 23.4 years, and 70.0% reported their race as Black. Qualitative themes included general HPV knowledge and awareness, current patterns in technology use, desired app qualities, and desired app content. Youth described varying levels of HPV knowledge, utilized apps to engage socially, and for travel, banking, gaming, news and entertainment, and few used apps to facilitate personal health or engage with healthcare systems. Participants desired credible, relatable, secure, and easy to use interfaces that provided sexual health and HPV information in a positive context. They described ways to creatively engage and directly connect youth to health providers. We identified a culturally relevant youth driven approach to facilitate HPV vaccination and sexual health among YMSM.
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Affiliation(s)
- Holly B Fontenot
- a Connell School of Nursing, Boston College , Chestnut Hill , MA , USA.,b Fenway Health/The Fenway Institute , Boston , MA , USA
| | - Joshua G Rosenberger
- c Department of Behavioral Health, Penn State University , University Park , PA , USA
| | - Katelyn T McNair
- a Connell School of Nursing, Boston College , Chestnut Hill , MA , USA
| | - Kenneth H Mayer
- b Fenway Health/The Fenway Institute , Boston , MA , USA.,d Beth Israel Deaconess Medical Center, Department of Medicine, Boston MA/Harvard Medical School , Boston , MA , USA
| | - Gregory Zimet
- e Section of Adolescent Medicine, Indiana University School of Medicine , Indianapolis , IN , USA
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Finding Sex Partners Through Social Media Among Men Who Have Sex with Men in Hanoi, Vietnam. J Community Health 2019; 43:146-156. [PMID: 28677027 DOI: 10.1007/s10900-017-0397-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Many men who have sex with men (MSM) in low and middle income countries search for male sexual partners via social media in part due to societal stigma and discrimination, yet little is known about the sexual risk profiles of MSM social media users. This cross-sectional study investigates the prevalence of social media use to find male sex partners in Hanoi, Vietnam and examines associations between social media use and sociodemographic and behavioral characteristics, including levels of internalized, perceived and enacted stigma, high-risk sexual behaviors, and HIV testing. 205 MSM were recruited from public venues where MSM congregate as well as through snowball sampling and completed an anonymous survey. MSM who found their male sexual partners using social media in the last year were more likely to have completed a university or higher degree (aOR 2.6; 95% CI 1.2-5.7), experience high levels of MSM-related perceived stigma (aOR 3.0; 95% CI 1.1-8.0), and have more than ten lifetime male sexual partners (aOR 3.2; 95% CI 1.3-7.6) compared to those who did not use social media. A niche for social media-based interventions integrating health and stigma-reduction strategies exists in HIV prevention programs for MSM.
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Queiroz AAFLN, Sousa ÁFLD, Matos MCB, Araújo TME, Reis RK, Moura MEB. Knowledge about HIV/AIDS and implications of establishing partnerships among Hornet® users. Rev Bras Enferm 2019; 71:1949-1955. [PMID: 30156682 DOI: 10.1590/0034-7167-2017-0409] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/06/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the knowledge of men, who have sex with men who use geolocation-based dating software, about HIV/AIDS, and the implications of establishing partnerships. METHOD Descriptive study with 30 Hornet® users. The statements generated had statistical treatment in the IRaMuTeQ software, analyzed through the Descending Hierarchical Classification. RESULTS The sexual frequency in the last 30 days was 2.9 partners, of which 2.1 were found by the application, of which 63.3% reported having sex without condoms. There were four classes: Knowledge about HIV/AIDS prevention measures; PrEP/truvada as a measure of HIV/AIDS prevention; Risky behaviors in relation to HIV infection; Establishment of sexual partnerships through applications. CONCLUSION Hornet users have insufficient knowledge about HIV prevention measures, especially when discarding the male condom. The relationships established through the application are permeated by high individual vulnerability and behaviors that have potential exposure to the risk of HIV infection.
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Affiliation(s)
| | | | | | | | - Renata Karina Reis
- Universidade de São Paulo, School of Nursing of Ribeirão Preto. Ribeirão Preto, São Paulo, Brazil
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Saberi P, Neilands TB, Lally MA, Hosek SG, Hightow-Weidman L. The Association between Use of Online Social Networks to Find Sex Partners and Sexually Transmitted Infection Diagnosis among Young Men Who Have Sex with Men and Transgender Women Living with HIV. J Int Assoc Provid AIDS Care 2019; 18:2325958219867324. [PMID: 31389285 PMCID: PMC6900576 DOI: 10.1177/2325958219867324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/23/2019] [Accepted: 07/02/2019] [Indexed: 11/17/2022] Open
Abstract
We conducted a cross-sectional analysis of baseline data from the Adolescent Trials Network for HIV/AIDS Interventions to examine the association between the use of social media sites to find sex partners and recent diagnosis of sexually transmitted infections (STIs) among 13- to 24-year-old men who have sex with men and transgender women living with HIV. We used linear regression to determine the relationship between the number of STIs and the number of social media sites used to find sex partners with each type of sex act included in the analysis. Secondary analyses substituted frequency of social media site use for number of social media sites. Among 741 participants, for every 1 social media account used to find sex partners, there was a 2.53% (95% confidence interval: 0.28-5.54) increase in STIs. This association was mediated through condomless receptive anal intercourse or condomless insertive anal intercourse but not barrierless oral intercourse. Similar but attenuated associations were found when frequency of social media site use was substituted for number of social media sites. Future research should examine innovative interventions on these social media sites with respect for its users.
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Affiliation(s)
- Parya Saberi
- Department of Medicine, University of California San Francisco, San
Francisco, CA, USA
| | - Torsten B. Neilands
- Department of Medicine, University of California San Francisco, San
Francisco, CA, USA
| | - Michelle A. Lally
- Department of Medicine, Alpert Medical School of Brown University and
Lifespan Hospital System, Providence, RI, USA
| | - Sybil G. Hosek
- Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL,
USA
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Xu J, Yu H, Tang W, Leuba SI, Zhang J, Mao X, Wang H, Geng W, Jiang Y, Shang H. The Effect of Using Geosocial Networking Apps on the HIV Incidence Rate Among Men Who Have Sex With Men: Eighteen-Month Prospective Cohort Study in Shenyang, China. J Med Internet Res 2018; 20:e11303. [PMID: 30578225 PMCID: PMC6320406 DOI: 10.2196/11303] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/10/2018] [Accepted: 09/27/2018] [Indexed: 12/19/2022] Open
Abstract
Background Men who have sex with men (MSM) frequently seek partners through mobile apps (geosocial networking [GSN] apps). However, it is unclear whether GSN apps’ use is associated with the increase in HIV incidence among MSM. Objective The aim of this study was to clarify the characteristics of GSN apps’ users and to determine the association and putative mechanisms between GSN apps’ use behavior and HIV incidence. Methods We conducted an 18-month prospective cohort study of MSM in Shenyang, China, and the participants were surveyed every 3 months from March 2015 to December 2016. An in-person interview collected information on sociodemographics, GSN apps’ use, recreational drug use, and sexual behaviors. In addition, blood was drawn to test for HIV and syphilis. We used a multivariable Cox regression model to determine possible predictors for increased HIV incidence. Results Of the enrolled 686 HIV-negative MSM, 431 (431/686, 62.8%) were GSN apps’ users. Compared with GSN apps’ nonusers, GSN apps’ users were younger; had an earlier age of sexual debut; and in the past 3 months, were more likely to have used recreational drugs, more likely to have had 5 or more casual partners (CPs), more likely to have had group sex with males, and more likely to have had condomless anal intercourse (CAI) with male steady partners (SPs). In addition, 59.4% (256/431) of the GSN apps’ users were willing to accept HIV and AIDS prevention information push services through GSN apps. In total, 19 MSM seroconverted to HIV during the follow-up period; the HIV incidence density rate was 8.5 (95% CI 5.0-13.5) per 100 person-years (PY) among GSN apps’ users and 2.0 (95% CI 0.4-5.8) per 100 PY among nonusers. New HIV infections were independently associated with ever using GSN apps to seek male sexual partners (P=.04) and in the past 3 months, using recreational drugs (P=.048), having group sex with males (P=.01), and having CAI with male CPs (P=.02). Conclusions GSN apps’ use is associated with higher HIV incidence and may be mediated through recreational drug use and having multiple CPs. Researchers must develop an intervention propagated through GSN apps to reach this high-risk population to mitigate the HIV epidemic in the MSM community.
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Affiliation(s)
- Junjie Xu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Huan Yu
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Weiming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Sequoia I Leuba
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jing Zhang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Xiang Mao
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Hongyi Wang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Wenqing Geng
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Yongjun Jiang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Hong Shang
- Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China
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Wang H, Zhang L, Zhou Y, Wang K, Zhang X, Wu J, Wang G. The use of geosocial networking smartphone applications and the risk of sexually transmitted infections among men who have sex with men: a systematic review and meta-analysis. BMC Public Health 2018; 18:1178. [PMID: 30326887 PMCID: PMC6192100 DOI: 10.1186/s12889-018-6092-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 10/04/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Geosocial networking smartphone applications (apps) are popular tools for seeking sexual partners among men who have sex with men (MSM). We evaluated app use and risk of sexually transmitted infections (STIs) in app-using MSM (app-users) by a systematic review and meta-analysis. METHODS A literature search for relevant studies was performed. We extracted date of STIs (ever being diagnosed with human immunodeficiency virus [HIV], syphilis, gonorrhea and chlamydia) and sexual behavior (e.g., number of app-met partners, unprotected anal/oral sex, HIV testing) from the eligible studies. Pooled proportions and odds ratios (ORs) with 95% confidence intervals (95% CIs) were estimated. RESULTS Twenty-five studies were included. The self-reported prevalence of prior diagnosis of HIV among app-users ranged from 2.2 to 37.7%, and the pooled prevalence of HIV infection was 6% (95% CI, 4-11%). Compared with non-users, app-users were more likely to have gonorrhea (OR = 2.36; 95% CI, 2.07-2.70) and chlamydia (OR = 2.22; 95% CI, 1.92-2.56). The two groups were similar in terms of diagnoses of HIV (OR = 0.89, 95% CI, 0.68-1.16) and syphilis (OR = 1.92; 95% CI, 0.91-4.03). However, when one study that caused substantial heterogeneity was omitted, the pooled OR for app-users to contract syphilis became 3.00 (95% CI, 1.84-4.91) . CONCLUSIONS MSM who seek sexual partners using apps may be more likely to have STIs as than are non-users.
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Affiliation(s)
- Haidong Wang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Tangshan Bay Eco City, Caofeidian District, Tangshan, 063210, People's Republic of China
| | - Lu Zhang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Tangshan Bay Eco City, Caofeidian District, Tangshan, 063210, People's Republic of China
| | - Ying Zhou
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Tangshan Bay Eco City, Caofeidian District, Tangshan, 063210, People's Republic of China
| | - Keke Wang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Tangshan Bay Eco City, Caofeidian District, Tangshan, 063210, People's Republic of China
| | - Xiaoya Zhang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Tangshan Bay Eco City, Caofeidian District, Tangshan, 063210, People's Republic of China
| | - Jianhui Wu
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Tangshan Bay Eco City, Caofeidian District, Tangshan, 063210, People's Republic of China.
| | - Guoli Wang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Tangshan Bay Eco City, Caofeidian District, Tangshan, 063210, People's Republic of China.
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Goedel WC, Duncan DT. Contextual factors in geosocial-networking smartphone application use and engagement in condomless anal intercourse among gay, bisexual, and other men who have sex with men who use Grindr. Sex Health 2018; 13:549-554. [PMID: 27712610 DOI: 10.1071/sh16008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 08/09/2016] [Indexed: 11/23/2022]
Abstract
Background Geosocial-networking smartphone applications (apps) have been used increasingly by men who have sex with men (MSM) to meet new sexual partners. The purpose of this study was to examine associations between contexts of app use (e.g. using apps when drinking) and condomless anal intercourse among a sample of MSM who use these apps. METHODS MSM (n=174) in New York City were recruited through Grindr, a geosocial-networking app popular among MSM, using broadcast advertisements asking MSM to complete an Internet-based survey about their app use and sexual behaviours. Log-binomial regression models were fit to assess the association between each of the six app-use contexts (e.g. using apps when lonely, when drinking) and engagement in condomless insertive and receptive anal intercourse with one or more partners in the past 3 months. RESULTS Engagement in condomless receptive and insertive anal intercourse with one or more partners in the preceding 3 months was common (39.7% and 43.1% respectively) and was associated with several app-use contexts. For example, significant associations (P<0.05) were observed between alcohol and other drug use when using these apps and engagement in condomless receptive and insertive anal intercourse. CONCLUSION Given that 57.5% of respondents had engaged in condomless anal intercourse in the preceding 3 months and the associations of app-use contexts with condomless sexual behaviours, these findings suggest that reductions in substance use may lead to safer sexual practices among MSM who use apps to meet sexual partners.
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Affiliation(s)
- William C Goedel
- Department of Population Health, School of Medicine, New York University, Spatial Epidemiology Lab, 227 East 30th Street, Cube 628A, New York, NY 10016, USA
| | - Dustin T Duncan
- Department of Population Health, School of Medicine, New York University, Spatial Epidemiology Lab, 227 East 30th Street, Cube 628A, New York, NY 10016, USA
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Jiménez-Vázquez V, Onofre-Rodríguez DJ, Benavides-Torres RA, Garza-Elizondo ME, Torres-Obregon R. [Use of online sexual material and safe sex in men who have sex with men]. Rev Int Androl 2018; 17:88-93. [PMID: 30177459 DOI: 10.1016/j.androl.2018.05.004] [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: 12/11/2017] [Revised: 02/19/2018] [Accepted: 05/07/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Sexual material online has represented, from its origins, an important role in the life of men who have sex with men. Internet, which has become a vehicle without restriction for its access, has favored an increase in the use of this material, and has had an impact on the sexual behavior of these men. OBJECTIVE To determine if the use of online sexual material influences safe sexual behavior in men who have sex with men. MATERIAL AND METHOD An analytical observational study was conducted, with a sample of 251 men who have sex with men from a city in northeastern Mexico. The respondent driven sampling was used, an ad hoc sociodemographic and sexuality data questionnaire was applied, and a questionnaire to measure the use of online sexual material and questionnaire on safe sexual behavior. RESULTS The simple linear regression model shows that the use of online sexual material negatively influences safe sexual behavior (R2=0.062; F[1,249]=16.937; p<0.01). CONCLUSIONS The findings provide the guideline to continue with studies in the investigation of said sociocultural variable and its consideration is proposed in the programs focused on the prevention of HIV in this population.
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Affiliation(s)
- Vicente Jiménez-Vázquez
- Facultad de Enfermería, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Dora Julia Onofre-Rodríguez
- Facultad de Enfermería, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, México.
| | - Raquel Alicia Benavides-Torres
- Facultad de Enfermería, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, México
| | - María Eugenia Garza-Elizondo
- Facultad de Enfermería, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Reyna Torres-Obregon
- Facultad de Enfermería, Unidad Saltillo, Universidad Autónoma de Coahuila, Saltillo, México
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50
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Duncan DT, Chaix B, Regan SD, Park SH, Draper C, Goedel WC, Gipson JA, Guilamo-Ramos V, Halkitis PN, Brewer R, Hickson DA. Collecting Mobility Data with GPS Methods to Understand the HIV Environmental Riskscape Among Young Black Men Who Have Sex with Men: A Multi-city Feasibility Study in the Deep South. AIDS Behav 2018; 22:3057-3070. [PMID: 29797163 PMCID: PMC6076855 DOI: 10.1007/s10461-018-2163-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
While research increasingly studies how neighborhood contexts influence HIV among gay, bisexual and other men who have sex with men (MSM) populations, to date, no research has used global positioning system (GPS) devices, an innovative method to study spatial mobility through neighborhood contexts, i.e., the environmental riskscape, among a sample of Black MSM. The purpose of this study was to examine the feasibility of collecting two-week GPS data (as measured by a pre- and post-surveys as well as objectively measured adherence to GPS protocol) among a geographically-diverse sample of Black MSM in the Deep South: Gulfport, MS, Jackson, MS, and New Orleans LA (n = 75). GPS feasibility was demonstrated including from survey items, e.g. Black MSM reported high ratings of pre-protocol acceptability, ease of use, and low levels of wear-related concerns. Findings from this study demonstrate that using GPS methods is acceptable and feasible among Black MSM in the Deep South.
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Affiliation(s)
- Dustin T Duncan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA.
| | - Basile Chaix
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
- Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Seann D Regan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Su Hyun Park
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Cordarian Draper
- Center for Research, Evaluation and Environmental & Policy Change, My Brother's Keeper, Inc, Jackson, MS, USA
| | - William C Goedel
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - June A Gipson
- Center for Community-Based Programs, My Brother's Keeper, Inc, Jackson, MS, USA
| | - Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health (CLAFH), Silver School of Social Work, New York University, New York, NY, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University School of Public Health, New Brunswick, NJ, USA
| | - Russell Brewer
- Louisiana Public Health Institute (LPHI), New Orleans, LA, USA
| | - DeMarc A Hickson
- Center for Research, Evaluation and Environmental & Policy Change, My Brother's Keeper, Inc, Jackson, MS, USA
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