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Shrader CH, Craker L, Johnson AL, Rodriguez E, Skvoretz J, Self KJ, Kanamori M. Peer Influence on Motivation to Use Pre-Exposure Prophylaxis Among Latino Sexual Minority Men in Miami, Florida: A Network Autocorrelation Model. AIDS Patient Care STDS 2024; 38:370-379. [PMID: 39158979 DOI: 10.1089/apc.2024.0077] [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] [Indexed: 08/21/2024] Open
Abstract
Despite the availability of pre-exposure prophylaxis (PrEP), Latino sexual minority men (LSMM) continue to experience disparities in PrEP uptake and subsequently, HIV vulnerability. Social network norms are an underutilized solution to increase PrEP uptake. We used a peer influence model (network autocorrelation model) to examine the role of social network descriptive norms (i.e., actual behaviors) surrounding PrEP use. A total of 11 sociocentric networks of 13 friends (n = 143 LSMM) were recruited into our study from 2018 to 2019 in South Florida. Most participants were in PrEP pre-contemplation (n = 44), and almost one-third of our sample were using PrEP (n = 38). Three network autocorrelation models were estimated using an empirically informed Bayesian analysis. We found a positive association between participants' Motivational PrEP Cascade (MPC) position and their network members' (friends') cascade position based on three different measures of connection even when accounting for PrEP knowledge: friendship (ρ = 0.22; 95% CIa = 0.01-0.42), emotional closeness (ρ = 0.24; 95% CI = 0.03-0.44), and frequency of interaction (ρ = 0.22; CI = 0.03-0.42). Our findings highlight that an individual's progress in the MPC may be influenced by their network members' progress in the MPC, suggesting that LSMM using PrEP may serve as role models to their peers for PrEP use due to descriptive norms. Our findings further suggest that PrEP interventions for LSMM along the MPC can be implemented at the social network level.
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Affiliation(s)
- Cho Hee Shrader
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Lacey Craker
- Department of Public Health Science, School of Medicine, University of Miami Miller, Miami, Florida, USA
| | - Ariana L Johnson
- Department of Public Health Science, School of Medicine, University of Miami Miller, Miami, Florida, USA
| | - Edda Rodriguez
- Department of Public Health Science, School of Medicine, University of Miami Miller, Miami, Florida, USA
| | - John Skvoretz
- Department of Sociology, University of South Florida, Tampa, Florida, USA
| | - Kyle J Self
- Department of Educational and Psychological Studies, University of Miami, Miami, Florida, USA
| | - Mariano Kanamori
- Department of Public Health Science, School of Medicine, University of Miami Miller, Miami, Florida, USA
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Craker L, Rodriguez E, Johnson AL, Silvey R, Skvoretz J, Kanamori M. Examining physical and virtual sexual and drug risk venue co-attendance among PrEP-eligible Latinx sexual minority men. Sci Rep 2024; 14:17004. [PMID: 39043861 PMCID: PMC11266483 DOI: 10.1038/s41598-024-67814-z] [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: 04/12/2024] [Accepted: 07/16/2024] [Indexed: 07/25/2024] Open
Abstract
Disparities in Latinx sexual minority men (LSMM) pre-exposure prophylaxis (PrEP) initiation and adherence demonstrate the need for innovative strategies to improve outcomes along the PrEP Care Continuum. The purpose of this study was to examine physical and virtual risk venue co-attendance among LSMM of varying stages of PrEP use living in South Florida, an Ending the HIV Epidemic (EHE) priority jurisdiction. Venue co-attendance may be leveraged to support equitable dissemination and implementation (D&I) of HIV and drug use preventive interventions to LSMM. Ninety-four LSMM completed surveys on PrEP use and identified physical and virtual sexual and drug risk venues (where men seek sex partners and/or have sex or access or use drugs). Bivariate analyses examined differences in demographics and venue endorsement by PrEP status. Exponential random graph models examined endorsement of venues by PrEP status. One-mode projection visualizations portray the structure of venue co-attendance networks by PrEP status. Participants identified 49 physical and virtual sexual and drug risk venues. A homophily effect of PrEP status on venue endorsement was identified for both sexual and drug risk venues. Network size and density differed by PrEP status and whether the venue was identified as a sexual or drug risk location. Online dating apps, bars, and saunas had the highest centrality in each network type suggesting their potential role in implementing preventive programming. This study identified specific sexual and drug risk venues that may be leveraged to both disseminate targeted PrEP and harm reduction information and to implement interventions to improve PrEP uptake and adherence among LSMM living in EHE priority jurisdictions.
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Affiliation(s)
- Lacey Craker
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street Suite 1010, Miami, FL, 33136, USA
| | - Edda Rodriguez
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street Suite 1010, Miami, FL, 33136, USA
| | - Ariana L Johnson
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street Suite 1010, Miami, FL, 33136, USA
| | - Rebe Silvey
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street Suite 1010, Miami, FL, 33136, USA
| | - John Skvoretz
- Department of Sociology, University of South Florida, Tampa, FL, USA
| | - Mariano Kanamori
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street Suite 1010, Miami, FL, 33136, USA.
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Johnson AL, Butts SA, Rodriguez E, Craker L, Kanamori M, Doblecki-Lewis S. "Test-To-PrEP": Assessing Reach and Adoption of a New Approach to Increase HIV Testing and PrEP Knowledge Using HIV Self-Test Kit Distribution Through PrEP Clients' Social Networks. J Acquir Immune Defic Syndr 2023; 94:421-428. [PMID: 37949445 PMCID: PMC10651164 DOI: 10.1097/qai.0000000000003294] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/15/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND HIV self-testing (HIVST) can increase the reach of HIV testing. Preexposure prophylaxis (PrEP) clients may be ideal distributors of HIVST kits and PrEP information within their social networks. This study uses the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to evaluate the distribution of HIVST bundled with PrEP information ("Test-to-PrEP" kits) among egocentric friendship networks of PrEP users. METHODS The study was conducted in Miami from November 2021 to March 2022. Enrolled PrEP clients (egos; n = 100) were offered Test-to-PrEP kits for distribution. Egos and Test-to-PrEP kit users completed brief online surveys. Descriptive statistics are reported for participants, their reported network members, and users of the Test-to-PrEP kits. Logistic and Poisson regression assessed the relationship between characteristics of egos, alters, and the distribution of Test-to-PrEP kits. RESULTS The 100 enrolled egos reported a total of 414 alters. Participants received 293 Test-to-PrEP kits for distribution with 47 of the 100 participants distributing at least 1 kit. Of those who scanned the quick-response code and responded to the survey, 16.2% reported no previous HIV test and 38.5% reported no prior knowledge of PrEP; 32.5% reported interest in distributing Test-to-PrEP kits, 3 successfully distributed kits, and 2 initiated PrEP. CONCLUSIONS An approach using PrEP clients' social networks can disseminate HIVST bundled with PrEP information to critical populations including individuals lacking knowledge of PrEP or who have never been tested for HIV. Future studies will assess whether this use of network effects can increase reach and efficiency of HIV testing and PrEP information distribution.
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Affiliation(s)
- Ariana L. Johnson
- Department of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Stefani A. Butts
- Department of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Edda Rodriguez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lacey Craker
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mariano Kanamori
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Susanne Doblecki-Lewis
- Department of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA
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Shrader CH, Stoler J, Arroyo-Flores J, Doblecki-Lewis S, Carrico A, Safren S, Fallon S, Kanamori M. Geographic Disparities in Availability of Spanish-Language PrEP Services Among Latino Sexual Minority Men in South Florida. J Immigr Minor Health 2023; 25:374-381. [PMID: 36264402 PMCID: PMC10034758 DOI: 10.1007/s10903-022-01412-x] [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: 09/30/2022] [Indexed: 10/24/2022]
Abstract
Latino sexual minority men (LSMM) experience barriers in accessing HIV pre-exposure prophylaxis (PrEP), such as lack of proximate culturally-appropriate PrEP navigation services. We examined associations between LSMM's immigration status and Spanish-language PrEP service availability. LSMM clinically indicated for PrEP were recruited from October 2018 to August 2019 in South Florida and completed an interviewer-administered questionnaire. PrEP service navigators in South Florida were identified using the CDC PrEP Directory. We constructed network service areas of 1-, 2-, and 5-miles from Spanish-speaking PrEP navigators. We used multilevel logistic regression to examine associations of individual (i.e., age, income, immigration status, network density) and zip code-level (i.e., population density, poverty, HIV risk) measures with availability of Spanish-language PrEP navigation services. A total of 131 participants clustered into 60 zip codes in South Florida. Latin American-born LSMM reported higher immigration and discrimination stress, and were 91% less likely to have PrEP navigation service availability, relative to LSMM born in the US. Zip code-level HIV incidence was associated with higher service availability within a 1-mile network of Spanish-speaking PrEP navigators. Spanish-language PrEP navigation services were available in high-HIV incidence zip codes; however, Latin American-born LSMM experienced reduced availability. Immigration and discrimination stress may explain lack of availability.
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Affiliation(s)
| | - Justin Stoler
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Geography and Sustainable Development, College of Arts and Sciences, University of Miami, Coral Gables, FL, USA
| | | | | | - Adam Carrico
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Steven Safren
- Department of Psychology, College of Arts and Sciences, University of Miami, Coral Gables, FL, USA
| | | | - Mariano Kanamori
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
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Amboree TL, Nyitray AG, Schneider J, Gargurevich N, Kuo J, Chiao EY, Hwang LY, Fujimoto K. Are human papillomavirus knowledge and vaccine uptake associated with HIV status and social determinants of health in young sexual minority men? Prev Med Rep 2023; 32:102132. [PMID: 36798795 PMCID: PMC9925951 DOI: 10.1016/j.pmedr.2023.102132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
This brief report examines the relationship, if any, between human immunodeficiency virus (HIV) status, and individual-level and socio-sexual partner-level factors of social determinants of health (SDOH) that are associated with human papillomavirus (HPV) knowledge and vaccine uptake in young sexual minority men (YSMM). We used data from 126 YSMM recruited by network-based sampling during 2015-2016 in Houston, Texas. Descriptive statistics and regression analyses were conducted to test the association between HIV status, SDOH, and HPV knowledge and vaccine uptake. Those living with HIV had lower odds of knowledge of HPV-associated anal cancer (OR: 0.43, 95% CI: 0.18-0.97) and knowledge of HPV spreading via sexual contact (OR: 0.11, 95% CI: 0.01-0.64), and higher odds of HPV vaccine uptake (OR: 2.90, 95% CI: 1.11-8.02). HPV knowledge and vaccine uptake in YSMM was not associated with partner's attributes or individuals' SDOH factors in our study yet was significantly associated with HIV status. Future interventions are needed to increase HPV knowledge among individuals living with HIV and vaccine uptake particularly among YSMM living without HIV that are not engaged in healthcare.
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Affiliation(s)
- Trisha L. Amboree
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, 6620 Main St, Houston, TX 77030, USA,Corresponding author.
| | - Alan G. Nyitray
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA,Clinical Cancer Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA
| | - John Schneider
- Department of Medicine, University of Chicago, 5837 S. Maryland Ave, Chicago, IL 60637, USA,Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, Chicago, IL 60637 USA
| | - Nick Gargurevich
- Department of Statistics, Rice University, 6100 Main St, Houston, TX 77005, USA
| | - Jacky Kuo
- School of Public Health, University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA
| | - Elizabeth Y. Chiao
- The University of Texas MD Anderson Cancer Center, Departments of Epidemiology and Medical Oncology, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Lu-Yu Hwang
- School of Public Health, University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA
| | - Kayo Fujimoto
- School of Public Health, University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA
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