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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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Boudewyns V, Uhrig JD, Williams PA, Anderson SKE, Stryker JE. Message Framing Strategies to Promote the Uptake of PrEP: Results from Formative Research with Diverse Adult Populations in the United States. AIDS Behav 2024; 28:535-546. [PMID: 38151665 DOI: 10.1007/s10461-023-04242-6] [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: 11/28/2023] [Indexed: 12/29/2023]
Abstract
There are no evidence-based recommendations for communicating about pre-exposure prophylaxis (PrEP) as part of a broader HIV-prevention messaging approach. To inform future message development related to PrEP uptake, we interviewed 235 individuals across ten locations in the U.S. to explore their understanding and perceptions of draft HIV prevention messages and assess their overall preferences for a broad or PrEP-focused messaging approach. Participants responded favorably to and related to both draft messages. Participants who were not aware of PrEP were more likely to say the broad HIV-prevention message was personally relevant than those aware of PrEP. There were no significant differences in perceived personal relevance for the PrEP-focused message. Qualitative findings suggest that HIV prevention messages should use specific well-defined terms, include links to additional information, and use choice-enhancing language that emphasizes personal agency and frames the call to action as an informed decision among an array of effective prevention options.
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Affiliation(s)
- Vanessa Boudewyns
- RTI International, 3040 E. Cornwallis Road, PO Box 12194, Research Triangle Park, NC, USA.
| | - Jennifer D Uhrig
- RTI International, 3040 E. Cornwallis Road, PO Box 12194, Research Triangle Park, NC, USA
| | - Pamela A Williams
- RTI International, 3040 E. Cornwallis Road, PO Box 12194, Research Triangle Park, NC, USA
| | - Stefanie K E Anderson
- Division of HIV Prevention, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jo Ellen Stryker
- Division of HIV Prevention, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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3
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Eaton LA, Watson RJ, Maksut JL, Rucinski KB, Earnshaw VA, Berman M. Elevated Perceived Risk for HIV as a Barrier to Accessing Health Care Among Black Men Who Have Sex with Men. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 21:917-925. [PMID: 32504393 DOI: 10.1007/s11121-020-01135-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We sought to examine how self-perception of risk for HIV and HIV status information avoidance are related to HIV testing uptake and engagement in routine health care among Black men who have sex with men (BMSM)-the group at highest risk for HIV in the USA. To do so, we used generalized linear modeling and serial mediation modeling to assess data from 342 HIV-negative BMSM collected from 2017 to 2019 in Atlanta, GA, USA. Participants reported considerable concern for testing HIV-positive; 40% reported believing they would test positive for HIV; 27% reported being "extremely concerned about getting HIV"; and 17% reported worrying about HIV "all the time". Mediation analyses demonstrated that greater concern for HIV was associated with longer intervals since the last HIV test and the last health-care appointment. BMSM perceived themselves to be at considerable risk for HIV, but critically, this outlook did not yield improved health-care behaviors. Findings highlight the need to reconceptualize our public health approach to reaching BMSM. Emphasizing risk behavior and targeting efforts toward BMSM may have unintended consequences and need to be reevaluated. Despite continued efforts to improve HIV-related outcomes, we are failing to meet the needs of BMSM.
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Affiliation(s)
- Lisa A Eaton
- Institute for Collaboration on Health, Intervention, and Policy University of Connecticut, 2006 Hillside Rd, Storrs, CT, 06269-1248, USA
| | - Ryan J Watson
- Institute for Collaboration on Health, Intervention, and Policy University of Connecticut, 2006 Hillside Rd, Storrs, CT, 06269-1248, USA.
| | - Jessica L Maksut
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Katherine B Rucinski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Valerie A Earnshaw
- Human Development and Family Sciences, University of Delaware, 240 Academy St, Newark, DE, 19716, USA
| | - Marcie Berman
- Institute for Collaboration on Health, Intervention, and Policy University of Connecticut, 2006 Hillside Rd, Storrs, CT, 06269-1248, USA
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4
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Turner CM, Trujillo D, Le V, Wilson EC, Arayasirikul S. Event-Level Association Between Daily Alcohol Use and Same-Day Nonadherence to Antiretroviral Therapy Among Young Men Who Have Sex With Men and Trans Women Living With HIV: Intensive Longitudinal Study. JMIR Mhealth Uhealth 2020; 8:e22733. [PMID: 33055070 PMCID: PMC7596651 DOI: 10.2196/22733] [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] [Received: 07/21/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Young trans women (TW) and men who have sex with men (MSM) are disproportionately impacted by HIV. Optimizing adherence to antiretroviral therapy (ART) is one mechanism by which public health experts aim to achieve favorable HIV health outcomes while reducing disease transmission. However, alcohol use is prevalent among young TW and MSM and threatens optimal adherence. In addition, the daily variations in alcohol use and ART adherence and their association with each other are poorly understood, warranting more appropriate methodological approaches, such as analysis of ecological momentary assessment (EMA) data. OBJECTIVE The aim of this analysis is to characterize the association between daily alcohol use and same-day ART nonadherence captured by an EMA study of young MSM and TW living with HIV in San Francisco. METHODS Young MSM and TW enrolled in the Health eNav digital HIV care navigation intervention were included in the analytic sample (N=113). Data on alcohol and ART use were collected by daily EMA surveys administered via text messaging and were analyzed over 30 days of follow-up. A multivariable mixed-effects logistic regression model adjusting for baseline sociodemographic characteristics was specified to investigate whether daily alcohol use was associated with same-day ART nonuse. RESULTS Daily alcohol use was associated with higher same-day ART nonuse. On average, participants drank alcohol on 15.20 (SD 8.93) days and used ART on 15.19 (SD 10.16) days out of 30 days. Daily alcohol use was associated with 1.89 (95% CI 1.14-3.15) times the adjusted odds of same-day ART nonuse for each participant. CONCLUSIONS Results are consistent with other analyses of daily alcohol and ART use and underscore the importance of individually targeted interventions that are sensitive to each participant's dynamic risk environment. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/16406.
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Affiliation(s)
- Caitlin Marie Turner
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.,Doctoral Program in Epidemiology & Translational Science, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States
| | - Dillon Trujillo
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States
| | - Victory Le
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.,California School of Professional Psychology, Alliant International University, San Francisco, CA, United States
| | - Erin C Wilson
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States
| | - Sean Arayasirikul
- Trans Research Unit for Equity, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.,Department of Pediatrics, School of Medicine, University of California, San Francisco, CA, United States
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5
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Gilbert M, Michelow W, Dulai J, Wexel D, Hart T, Young I, Martin S, Flowers P, Donelle L, Ferlatte O. Provision of online HIV-related information to gay, bisexual and other men who have sex with men: a health literacy-informed critical appraisal of Canadian agency websites. Sex Health 2020; 16:39-46. [PMID: 30620885 DOI: 10.1071/sh18092] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 08/06/2018] [Indexed: 01/16/2023]
Abstract
Background HIV risk and prevention information is increasingly complex and poses challenges for gay, bisexual and other men who have sex with men (GBMSM) seeking to find, understand and apply this information. A directed content analysis of Canadian HIV websites to see what information is provided, how it is presented and experienced by users, was conducted. METHODS Eligible sites provided information relevant for GBMSM on HIV risk or prevention, were from community or government agencies, and were aimed at the public. Sites were found by using a Google search using French and English search terms, from expert suggestions and a review of links. Eligibility and content for review was determined by two reviewers, and coded using a standardised form. Reading grade level and usability scores were assessed through Flesch-Kincaid and LIDA instruments. RESULTS Of 50 eligible sites, 78% were from community agencies and 26% were focussed on GBMSM. Overall, fewer websites contained information on more recent biomedical advances (e.g. pre-exposure prophylaxis, 10%) or community-based prevention strategies (e.g. seroadaptive positioning, 10%). Many sites had high reading levels, used technical language and relied on text and prose. And 44% of websites had no interactive features and most had poor usability scores for engageability. CONCLUSIONS Overall, less information about emerging topics and a reliance on text with high reading requirements was observed. Our study speaks to potential challenges for agency website operators to maintain information relevant to GBMSM which is up-to-date, understandable for a range of health literacy skills and optimises user experience.
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Affiliation(s)
- Mark Gilbert
- Ontario HIV Treatment Network, 600-1300 Yonge Street, Toronto, Ontario M4T 1X3, Canada
| | - Warren Michelow
- The University of British Columbia, 2329 West Mall, Vancouver, British Columbia V6T 1Z4, Canada
| | - Joshun Dulai
- Community-Based Research Centre for Gay Men's Health, 1007-808 Nelson Street, Vancouver, British Columbia V6Z 2H2, Canada
| | - Daniel Wexel
- Community-Based Research Centre for Gay Men's Health, 1007-808 Nelson Street, Vancouver, British Columbia V6Z 2H2, Canada
| | - Trevor Hart
- Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada
| | - Ingrid Young
- University of Glasgow, University Avenue, Glasgow G12 8QQ, United Kingdom
| | - Susan Martin
- University of Glasgow, University Avenue, Glasgow G12 8QQ, United Kingdom
| | - Paul Flowers
- Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, United Kingdom
| | - Lorie Donelle
- Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada
| | - Olivier Ferlatte
- Community-Based Research Centre for Gay Men's Health, 1007-808 Nelson Street, Vancouver, British Columbia V6Z 2H2, Canada
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Abstract
Black people living with HIV (BPLWH) are less likely to adhere to antiretroviral treatment than are members of other racial/ethnic groups. Data were combined from two studies of BPLWH (n = 239) to estimate adherence trajectories using a semiparametric, group-based modeling strategy over three time-points (spanning 6 months). Analyses identified three groups of individuals (high-stable, moderately low-stable, low-decreasing). Multinomial logistic regressions were used to predict trajectory membership with multiple levels of socio-ecological factors (structural, institutional/health system, community, interpersonal/network, individual). Older age was associated with being in the high-stable group, whereas substance use, lower perceived treatment effectiveness, and lower quality healthcare ratings were related to being in the moderately low-stable group. In sum, multiple socio-ecological factors contribute to adherence among BPLWH and thus could be targeted in future intervention efforts.
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Turner CM, Arayasirikul S, Trujillo D, Lê V, Wilson EC. Social Inequity and Structural Barriers to Completion of Ecological Momentary Assessments for Young Men Who Have Sex With Men and Trans Women Living With HIV in San Francisco. JMIR Mhealth Uhealth 2019; 7:e13241. [PMID: 31066714 PMCID: PMC6530262 DOI: 10.2196/13241] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/25/2019] [Accepted: 03/29/2019] [Indexed: 01/15/2023] Open
Abstract
Background Ecological momentary assessments (EMAs) administered via text messaging facilitate real-time data collection. With widespread cell phone access, EMAs are becoming more available to even the most disenfranchised communities, such as those living with HIV. However, structural barriers disproportionately burden young men who have sex with men (MSM) and trans women (TW) living with HIV and threaten participation in HIV research. Objective We aim to identify structural barriers to completing EMA text surveys nested within a digital HIV care intervention for young MSM and TW living with HIV in San Francisco. Methods A total of 10,800 EMA text messages were delivered daily over 90 days to 120 participants enrolled in the Health eNav intervention (2017-2018) at the San Francisco Department of Public Health. EMA surveys inquired about participants’ daily affect, sexual behaviors, substance use, and treatment adherence. Survey completion was calculated after 30, 60, and 90 days of follow-up. We described characteristics of nonstarters (those who provided less than four complete responses to the first seven EMA surveys) and analyzed structural correlates of days to first weeklong or more EMA survey noncompletion using multivariable Cox proportional hazards regression. Qualitative interviews were used to evaluate the acceptability of EMA surveys. Results Participants completed 4384 of 10,800 (40.59%) EMA surveys. Completion of 70% or more of EMA surveys was attained by 56 of 120 participants (46.7%) at 30 days of follow-up, 40/120 (33.3%) at 60 days of follow-up, and 30/120 (25.0%) by the end of the 90-day study period. Twenty-eight participants (23.3%) were identified as nonstarters, and were more likely to be recently incarcerated (prevalence ratio [PR] 2.3, 95% CI 1.3-4.4), forego basic needs for HIV medications (PR 2.4, 95% CI 1.3-4.5), and be diagnosed with HIV in the last year (PR 2.2, 95% CI 1.1-4.1). Adjusting for nonstarters, young MSM and TW living in temporary/transitional housing (adjusted hazard ratio [aHR] 1.8, 95% CI 1.1-3.0), foregoing HIV medications to afford basic needs (aHR 1.7, 95% CI 1.1-2.7), and having less than a college education (aHR 3.5, 95% CI 1.4-9.0) had greater hazard of weeklong or more EMA survey noncompletion. Overall, there was high acceptability of the EMA surveys. Conclusions Although access to and use of technology is increasingly ubiquitous, this analysis demonstrates persisting gaps in EMA completion by socioeconomic factors such as incarceration, education level, housing, and competing needs for young MSM and TW living with HIV in San Francisco. Moreover, those recently diagnosed with HIV were more likely to experience an immediate drop-off in completing EMA surveys. EMAs are feasible for individuals not experiencing social inequity and structural barriers. HIV prevention technologies addressing these barriers and leveraging similar methodology may prove effective for young MSM and TW living with HIV.
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Affiliation(s)
- Caitlin M Turner
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Sean Arayasirikul
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Dillon Trujillo
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Victory Lê
- San Francisco Department of Public Health, San Francisco, CA, United States
| | - Erin C Wilson
- San Francisco Department of Public Health, San Francisco, CA, United States
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8
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Closson K, Chown S, Armstrong HL, Wang L, Bacani N, Ho D, Jollimore J, Olarewaju G, Moore DM, Roth EA, Hogg RS, Lachowsky NJ. HIV leadership programming attendance is associated with PrEP and PEP awareness among young, gay, bisexual, and other men who have sex with men in Vancouver, Canada. BMC Public Health 2019; 19:429. [PMID: 31014296 PMCID: PMC6480620 DOI: 10.1186/s12889-019-6744-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 04/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young gay, bisexual, and other men who have sex with men (YGBM) may have reduced engagement and knowledge of HIV care and biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and Treatment as Prevention (TasP), compared with adult GBM. We sought to understand differences in HIV prevention awareness, health care access, and service utilization between youth (16-29 years) and adult (≥30 year) GBM, as well as factors associated with attendance in HIV leadership programming among YGBM living in the publicly funded PrEP setting of Vancouver, Canada. METHODS Sexually-active GBM were recruited using respondent-driven sampling (RDS) from February 2012 to February 2015. Participants completed an in-person computer-assisted self-interview every 6 months, up to February 2017, with questions on sociodemographic factors, awareness of biomedical HIV prevention strategies, and an HIV treatment optimism-skepticism scale. Participants were asked if they had ever attended either of two HIV-leadership programs designed for YGBM. Both programs involve multiple GBM-led education and social networking sessions operated by community-based organizations in Vancouver. Multivariable Glimmix confounder models assessed differences between youth and adult GBM. Among younger men, bivariate analyses examined factors associated with HIV-leadership program attendance. RESULTS Of 698 GBM who enrolled in the longitudinal study, 36.8% were less than 30 years old at the first study visit. After controlling for gender identification, sexual orientation, HIV status, and income in the past 6 months, younger GBM (n = 257/698) had lower awareness of biomedical HIV prevention strategies and less HIV treatment optimism compared with older GBM (n = 441/698). Among younger GBM who attended HIV-leadership programs (n = 50), greater awareness of biomedical HIV prevention strategies and higher HIV treatment optimism were reported, compared with non-attendees. CONCLUSION Younger GBM, who are disproportionately affected by the HIV epidemic, are less aware of new prevention technologies than older GBM, but attending peer-based HIV-leadership programs ameliorates age-disparities in HIV-prevention knowledge and treatment optimism.
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Affiliation(s)
- Kalysha Closson
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
| | - Sarah Chown
- YouthCO HIV & Hep C Society, 205-568 Seymour St., Vancouver, BC V6B 3J5 Canada
| | - Heather L. Armstrong
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
| | - Darren Ho
- Community-Based Research Centre for Gay Men’s Health, 1007-808 Nelson St., Vancouver, BC V6Z 2H2 Canada
| | - Jody Jollimore
- Community-Based Research Centre for Gay Men’s Health, 1007-808 Nelson St., Vancouver, BC V6Z 2H2 Canada
| | - Gbolahan Olarewaju
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
| | - David M. Moore
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
| | - Eric A. Roth
- Department of Anthropology, University of Victoria, Cornett Building B228, 3800 Finnerty Road, Victoria, BC V8P 5C2 Canada
| | - Robert S. Hogg
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
| | - Nathan J. Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6 Canada
- School of Public Health and Social Policy, University of Victoria, Human and Social Development Building B202, 3800 Finnerty Road, Victoria, BC V8P 5C2 Canada
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Jones J, Grey JA, Purcell DW, Bernstein KT, Sullivan PS, Rosenberg ES. Estimating Prevalent Diagnoses and Rates of New Diagnoses of HIV at the State Level by Age Group Among Men who Have Sex With Men in the United States. Open Forum Infect Dis 2018; 5:ofy124. [PMID: 30652108 DOI: 10.1093/ofid/ofy124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/28/2018] [Indexed: 11/14/2022] Open
Abstract
Background Men who have sex with men (MSM) in the United States experience a disproportionate rate of diagnosis of HIV. Surveillance data demonstrate age-based disparities among MSM, with higher rates of diagnosis among MSM age ≤34 years nationally. Population size estimates within age group at the state level have not been available to determine rates for each state. We estimated the size of the MSM population in 5 age groups in each state and estimated the rate of prevalent HIV diagnoses in 2013 and new HIV diagnoses in 2014. Methods We used data from the General Social Survey, American Community Survey, and previously published estimates from the National Health and Nutrition Examination Survey to estimate the population of MSM in 5 age groups at the state level. We combined these estimates with surveillance data to estimate age-stratified rates of prevalent diagnoses in 2013 and new diagnoses in 2014 in each state. We estimated standardized prevalence and diagnosis ratios comparing the Northeast, South, and West regions with the Midwest. Results Rates of prevalent diagnoses increased with increasing age, and rates of new diagnoses were highest among younger age groups. In the United States, the new diagnosis rate among those age 18-24 years in 2014 was 1.4 per 100 MSM without a diagnosis. The highest diagnosis rates were observed among men age ≤34 years in the South. Conclusions Age-stratified estimates of HIV prevalence and new diagnosis rates at the state level can inform public health prevention strategies and resource allocation.
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Affiliation(s)
- Jeb Jones
- Department of Epidemiology, Emory University, Atlanta, Georgia
| | - Jeremy A Grey
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David W Purcell
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kyle T Bernstein
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Eli S Rosenberg
- Department of Epidemiology and Biostatistics, University at Albany, Albany, New York
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10
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"Blocking" and "Filtering": a Commentary on Mobile Technology, Racism, and the Sexual Networks of Young Black MSM (YBMSM). J Racial Ethn Health Disparities 2018; 6:231-236. [PMID: 29713916 DOI: 10.1007/s40615-018-0493-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/16/2018] [Accepted: 04/20/2018] [Indexed: 01/09/2023]
Abstract
While research investigates the role and influence of geo-social networking (GSN) applications on HIV, less is known about the impact of GSN functions on disease transmission. In our formative research on young Black men who have sex with men's (YBMSM) technology use patterns and preferences for a smartphone-based HIV prevention intervention, we found that study participants used GSN "block" and "filter" functions as protective mechanisms against racism and racial sexual discrimination. Yet, we suggest that these functions may unintentionally create restrictive sexual networks that likely increase their risk for disease transmission. As such, we contend that attention to the unintended effects of these protective mechanisms against racism on GSN applications is fundamentally a public health issue that requires more research and explicit intervention. Ultimately, we use this work to hypothesize the role of blocking and filtering as a strategy to avoid racism on GSN applications that may partly explain HIV disparities among YBMSM.
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11
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Chemnasiri T, Beane CR, Varangrat A, Chaikummao S, Chitwarakorn A, Van Griensven F, Holtz TH. Risk Behaviors Among Young Men Who Have Sex With Men in Bangkok: A Qualitative Study to Understand and Contextualize High HIV Incidence. JOURNAL OF HOMOSEXUALITY 2018; 66:533-548. [PMID: 29308991 PMCID: PMC6409201 DOI: 10.1080/00918369.2017.1422941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The Bangkok Men Who Have Sex With Men (MSM) Cohort Study has shown high HIV incidence (8-12/100 person-years) among 18-21-year-old MSM. These data led to a further study using qualitative methods among young (18-24 years old) MSM in order to understand the factors driving the HIV epidemic among YMSM. We conducted eight focus group discussions and 10 key informant interviews among YMSM in Bangkok, Thailand. Sociodemographic and behavioral data were collected using a questionnaire. We audio-recorded, transcribed, and analyzed qualitative and questionnaire data using computer software. The categories relating to risk behavior were (1) the use of social networks for seeking sexual partners and the marketing promotions of MSM entertainment venues, (2) social influence by peers and older MSM, (3) easy access to high parties and group sex, (4) easy access to club drugs, (5) conceptions related to HIV risk, and (6) sexual preferences of YMSM. Increased HIV testing, same-sex education, and YMSM-specific HIV prevention efforts are urgently needed for YMSM in Bangkok.
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Affiliation(s)
- Tareerat Chemnasiri
- Thailand Ministry of Public Health—U.S., Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Chelsey R. Beane
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anchalee Varangrat
- Thailand Ministry of Public Health—U.S., Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Supaporn Chaikummao
- Thailand Ministry of Public Health—U.S., Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Anupong Chitwarakorn
- Department of Disease Control, Thailand Ministry of Public Health, Nonthaburi, Thailand
| | - Frits Van Griensven
- Thai Red Cross AIDS Research Centre and HIV Netherlands Australia Thailand Collaboration (HIVNAT), Bangkok, Thailand
- Division of Preventive Medicine and Public Health, Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California, USA
| | - Timothy H. Holtz
- Thailand Ministry of Public Health—U.S., Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Halkitis PN, Bub K, Stults CB, Bates FC, Kapadia F. Latent Growth Curve Modeling of Non-Injection Drug Use and Condomless Sexual Behavior from Ages 18 to 21 in Gay, Bisexual, and Other YMSM: The P18 Cohort Study. Subst Use Misuse 2018; 53:101-113. [PMID: 28820622 PMCID: PMC6085877 DOI: 10.1080/10826084.2017.1334067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND HIV/AIDS continues to be a health disparity faced by sexual minority men, and is exacerbated by non-injection drug use. OBJECTIVES We sought to delineate growth in non-injection drug use and condomless sex in a sample of racially and economically diverse of gay, bisexual, and other young men who have sex with men (YMSM) as they emerged into adulthood between the ages of 18 and 21 and who came of age in the post-HAART era. METHODS Behavioral data on drug use and condomless sex, collected via a calendar based technique over 7 waves of a cohort study of 600 YMSM, were analyzed using latent growth curve modeling to document patterns of growth in these behaviors, their associations, and the extent to which patterns and associations are moderated by race/ethnicity and socioeconomic status. RESULTS Significant growth was noted in the frequencies of condomless oral and anal intercourse, alcohol to intoxication, marijuana use, and inhalant nitrate use. High levels of association were noted between all behaviors across time but associations did not differ by either race/ethnicity or socioeconomic status. The link between drug use and risky sexual behavior continue to be evident in YMSM with significant increases in these behaviors demonstrated as YMSM transition between adolescence and young adulthood. Conclusions/Importance: Healthcare for a new generation of sexual minority males must address the synergy of these behaviors and also nest HIV prevention and care within a larger context of sexual minority health that acknowledges the advances made in the last three decades.
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Affiliation(s)
- Perry N Halkitis
- a Department of Biostatistics, School of Public Health , Rutgers University , Piscataway Township , New Jersey , USA.,b Department of Social and Behavioral Health Sciences, School of Public Health , Rutgers University , Piscataway Township , New Jersey , USA.,c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA
| | - Kristen Bub
- e College of Education , University of Illinois , Chicago , Illinois , USA
| | - Christopher B Stults
- c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA
| | - Francesca C Bates
- c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA
| | - Farzana Kapadia
- c Center for Health, Identity, Behavior & Prevention Studies , College of Global Public Health, New York University , New York , New York , USA.,d Department of Population Health, School of Medicine , New York University
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Hood KB, Shook NJ, Belgrave FZ. "Jimmy Cap Before You Tap": Developing Condom Use Messages for African American Women. JOURNAL OF SEX RESEARCH 2017; 54:651-664. [PMID: 27136298 DOI: 10.1080/00224499.2016.1168351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study examined which characteristics of persuasive communications are most effective in changing African American women's condom use attitudes. Focus groups were convened with 40 African American women (Mage = 25.54, SD = 4.67) to assess their opinions on current effective strategies used to promote condom use among their peers. Participants discussed effective characteristics of messaging campaigns (i.e., source, message type, channel) and how these could be used in future prevention messages. Findings revealed that making messages that are fun, catchy, and informative, delivered frequently through social media, TV, or radio by a peer or celebrity would be perceived as most effective in changing young African American women's attitudes. Other themes that emerged were that condom use is more strongly associated with pregnancy prevention than HIV prevention and that sexual partners were perceived to have negative condom use attitudes. Recommendations centered on increasing exposure of HIV prevention messages by placing messages on the Internet and including a funny phrase or jingle in the message so that it is easy to remember and could potentially serve as a conversation starter for discussing safe sex with partners.
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Affiliation(s)
| | | | - Faye Z Belgrave
- c Center for Cultural Experiences in Prevention , Virginia Commonwealth University
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Holloway IW, Winder TJ, Lea CH, Tan D, Boyd D, Novak D. Technology Use and Preferences for Mobile Phone-Based HIV Prevention and Treatment Among Black Young Men Who Have Sex With Men: Exploratory Research. JMIR Mhealth Uhealth 2017; 5:e46. [PMID: 28408360 PMCID: PMC5408136 DOI: 10.2196/mhealth.6436] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 01/22/2017] [Accepted: 01/29/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Black young men who have sex with men (BYMSM) experience higher human immunodeficiency virus (HIV) incidence than their white and Latino counterparts. OBJECTIVE The aim of our study was to understand BYMSM's preferences for mobile phone-based HIV prevention and treatment in order to inform culturally tailored interventions to reduce the spread of HIV and improve HIV treatment outcomes in this population. METHODS Qualitative focus groups (N=6) with BYMSM aged 18-29 years (N=41; 46%, 19/41 HIV-positive) were conducted to elucidate their preferences for the design and delivery of mobile phone-based HIV prevention and treatment interventions. A modified grounded theory approach to data analysis was undertaken using ATLAS.ti textual analysis software. RESULTS Participants preferred holistic health interventions that did not focus exclusively on HIV prevention and treatment. Issues of privacy and confidentiality were paramount. Participants preferred functionality that enables discreet connections to culturally competent health educators and treatment providers who can address the range of health and psychosocial concerns faced by BYMSM. CONCLUSIONS Mobile phone-based HIV prevention has the potential to increase engagement with HIV prevention and treatment resources among BYMSM. For these approaches to be successful, researchers must include BYMSM in the design and creation of these interventions.
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Affiliation(s)
- Ian W Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, United States
| | - Terrell Ja Winder
- Department of Sociology, University of California, Los Angeles, CA, United States
| | | | - Diane Tan
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, United States
| | - Donte Boyd
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, United States
| | - David Novak
- OLB Research Institute, Online Buddies, Inc., Cambridge, MA, United States
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Abstract
A group of nine states in the Southern United States, hereafter referred to as the targeted states, has experienced particularly high HIV diagnosis and case fatality rates. To provide additional information about the HIV burden in this region, we used CDC HIV surveillance data to examine characteristics of individuals diagnosed with HIV in the targeted states (2011), 5-year HIV and AIDS survival, and deaths among persons living with HIV (2010). We used multivariable analyses to explore the influence of residing in the targeted states at diagnosis on deaths among persons living with HIV after adjustment for demographics and transmission risk. In 2011, the targeted states had a higher HIV diagnosis rate (24.5/100,000 population) than the US overall (18.0/100,000) and higher proportions than other regions of individuals diagnosed with HIV who were black, female, younger, and living in suburban and rural areas. Furthermore, the targeted states had lower HIV and AIDS survival proportions (0.85, 0.73, respectively) than the US overall (0.86, 0.77, respectively) and the highest death rate among persons living with HIV of any US region. Regional differences in demographics and transmission risk did not explain the higher death rate among persons living with HIV in the targeted states indicating that other factors contribute to this disparity. Differences in characteristics and outcomes of individuals with HIV in the targeted states are critical to consider when creating strategies to address HIV in the region, as are other factors identified in previous research to be prominent in the region including poverty and stigma.
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Yang Z, Huang Z, Dong Z, Zhang S, Han J, Jin M. Prevalence of high-risky behaviors in transmission of HIV among high school and college student MSM in China: a meta-analysis. BMC Public Health 2015; 15:1272. [PMID: 26690367 PMCID: PMC4687281 DOI: 10.1186/s12889-015-2614-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 12/15/2015] [Indexed: 11/24/2022] Open
Abstract
Background The aim of this study was to investigate the prevalence of high-risky behaviors, such as unprotected anal intercourse (UAI) in the last 6 months, condom using in their last homosexual anal intercourse, No. of male partners in the last 6 months among high school and college male students who have sex with men (MSM) in China. Methods The relevant trials were retrieved up to June 2015 from several public databases, and a meta-analysis was conducted according to the published studies. The estimated rate and its 95 % confidence intervals (CI) of the relevant indexes among high school and college student MSM were collected and calculated using a fixed-effects model (the Mantel-Haenszel method) or a random-effects model (the DerSimonian and Laird method) when appropriate. Results A total of 15 studies (18 research data), including 3297 student MSM, were performed in this meta-analysis. The overall results showed that the rate of student MSM who reported having had UAI in the last 6 months was 65.2 % (95 % CI = 60.2 % to 70.1 %), the prevalence of student MSM having more than one male partner in the last 6 months was 58.2 % (95 % CI = 51.1 % to 65.4 %), the rate of student MSM who reported using a condom in their last homosexual anal intercourse experience was 57.5 % (95 % CI = 49.8 % to 65.1 %), the prevalence of student MSM who were infected with HIV was 3.8 % (95 % CI = 2.5 % to 5.1 %), and the rate of student MSM who were infected with syphilis was 4.6 % (95 % CI = 3.8 % to 5.4 %). Conclusions There are high UAI prevalence and low condom using rate in the last homosexual anal intercourse experience among high school and college student MSM in China, and corresponding control measures for this group and more effective health education of student MSM are required to prevent HIV or sexually transmitted diseases from spreading to the general population.
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Affiliation(s)
- Zhongrong Yang
- Huzhou Center for Disease Control and Prevention, Huzhou, 313000, Zhejiang Province, China.
| | - Zhaohui Huang
- Anhui Provincial Family Planning Institute of Science and Technology, Hefei, 230000, Anhui Province, China.
| | - Zhengquan Dong
- Huzhou Center for Disease Control and Prevention, Huzhou, 313000, Zhejiang Province, China.
| | - Sichao Zhang
- Huzhou Center for Disease Control and Prevention, Huzhou, 313000, Zhejiang Province, China.
| | - Jiankang Han
- Huzhou Center for Disease Control and Prevention, Huzhou, 313000, Zhejiang Province, China.
| | - Meihua Jin
- Huzhou Center for Disease Control and Prevention, Huzhou, 313000, Zhejiang Province, China.
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Marcus U, an der Heiden M, Gassowski M, Kruspe M, Drewes J. The impact of meeting locations for men having sex with men on the risk for bacterial sexually transmitted infections: analyses from a cross-sectional online survey. BMJ Open 2015; 5:e009107. [PMID: 26537499 PMCID: PMC4636635 DOI: 10.1136/bmjopen-2015-009107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Opportunities for men having sex with men (MSM) to meet each other have very much improved by new communication technologies. Meeting venue-based characteristics can impact how many partners are met and how much sexual risk is taken. We analysed the association between physical and virtual venues and the risk for bacterial sexually transmitted infections (bSTIs) among participants in an MSM online survey. METHODS Data were collected during 2013/2014 with a survey targeting MSM living in Germany. The impact of the meeting place with the last non-steady anal sex partner on diagnosis with a bSTI in the previous year was analysed using bivariate and multivariate regression analysis, taking into account self-reported HIV status, serostatus communication, condom use, partner number, age and city size. RESULTS The study sample consisted of 8878 respondents (7799 not diagnosed with HIV; 1079 diagnosed with HIV). Meeting partners online was most common (62% HIV-/51% HIV+), followed by sex venues (11% HIV-/25% HIV+); other venues were each reported by 2-6% of the respondents. Venue-dependent proportions reporting bSTIs in the recent year were 2-4 folds higher among men diagnosed with HIV. In multivariate analysis, HIV status was the strongest predictor for bSTIs (OR=5.0; 95% CI 2.8 to 8.7). Compared with meeting partners online, sex (OR 1.6; 95% CI 1.0 to 2.5) and social venues (OR 1.9; 95% CI 1.4 to 2.6) were associated with increased bSTI risk for men not diagnosed with HIV, but the risk when meeting partners by smartphone apps was only of borderline significance (OR 1.5; 95% CI 0.9 to 2.3). For men diagnosed with HIV, bSTI risk increased for sex venues (OR 1.5; 95% CI 1.1 to 2.1), and was lower for non-gay/other venues (OR 0.2; 95% CI 0.1 to 0.5). CONCLUSIONS Venues are connected to social-behavioural facets of corresponding sexual encounters, and may be important arenas for differential HIV and STI education, treatment and prevention.
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Affiliation(s)
- U Marcus
- Department of Infectious Disease Epidemiology, Robert Koch-Institut, Berlin, Germany
| | - M an der Heiden
- Department of Infectious Disease Epidemiology, Robert Koch-Institut, Berlin, Germany
| | - M Gassowski
- Department of Infectious Disease Epidemiology, Robert Koch-Institut, Berlin, Germany
| | - M Kruspe
- Department of Public Health, Free University, Berlin, Germany
| | - J Drewes
- Department of Public Health, Free University, Berlin, Germany
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Gay and bisexual men's awareness and knowledge of treatment as prevention: findings from the Momentum Health Study in Vancouver, Canada. J Int AIDS Soc 2015; 18:20039. [PMID: 26268817 PMCID: PMC4534712 DOI: 10.7448/ias.18.1.20039] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 06/10/2015] [Accepted: 06/17/2015] [Indexed: 11/08/2022] Open
Abstract
Introduction Awareness and knowledge of treatment as prevention (TasP) was assessed among HIV-positive and HIV-negative gay, bisexual and other men who have sex with men (GBMSM) in Vancouver, Canada. Methods Baseline cross-sectional survey data were analyzed for GBMSM enrolled, via respondent-driven sampling (RDS), in the Momentum Health Study. TasP awareness was defined as ever versus never heard of the term “TasP.” Multivariable logistic regression identified covariates of TasP awareness. Among those aware of TasP, men's level of knowledge of TasP was explored through an examination of self-perceived knowledge levels, risk perceptions and short-answer definitions of TasP which were coded as “complete” if three TasP-related components were identified (i.e. HIV treatment, viral suppression and prevention of transmission). Information source was also assessed. Analyses were stratified by HIV status and RDS adjusted. Results Of 719 participants, 23% were HIV-positive, 68% Caucasian and median age was 33 (Interquartile range (IQR) 26,47). Overall, 46% heard of TasP with differences by HIV status [69% HIV-positive vs. 41% HIV-negative GBMSM (p<0.0001)]. In adjusted models: HIV-positive GBMSM were more likely to have heard of TasP if they were Canadian born, unemployed, not using party drugs and had higher CD4 counts; HIV-negative GBMSM were more likely to have heard of TasP if they were Caucasian (vs. Aboriginal), students, had higher education, a regular partner and multiple sexual partners. Among those aware of TasP 91% of HIV-positive and 69% of HIV-negative GBMSM (p<0.0001) felt they knew “a lot” or “a bit in general” about TasP; 64 and 41% (p=0.002) felt HIV treatment made the risk of transmission “a lot lower”; and 21 and 13% (p<0.0001) demonstrated “complete” TasP definitions. The leading information source was doctors (44%) for HIV-positive GBMSM and community agencies (38%) for HIV-negative GBMSM, followed by gay media for both populations (34%). Conclusions Nearly half of GBMSM in this study reported having heard of TasP, yet only 14% demonstrated complete understanding of the concept. Variations in TasP awareness and knowledge by HIV status, and key socio-demographic, behavioural and clinical factors, highlight a need for health communication strategies relevant to diverse communities of GBMSM in order to advance overall TasP health literacy.
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Lelutiu-Weinberger C, Pachankis JE, Gamarel KE, Surace A, Golub SA, Parsons JT. Feasibility, Acceptability, and Preliminary Efficacy of a Live-Chat Social Media Intervention to Reduce HIV Risk Among Young Men Who Have Sex With Men. AIDS Behav 2015; 19:1214-27. [PMID: 25256808 PMCID: PMC4375068 DOI: 10.1007/s10461-014-0911-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Given the popularity of social media among young men who have sex with men (YMSM), and in light of YMSM's elevated and increasing HIV rates, we tested the feasibility, acceptability and preliminary efficacy of a live chat intervention delivered on Facebook in reducing condomless anal sex and substance use within a group of high risk YMSM in a pre-post design with no control group. Participants (N = 41; 18-29 years old) completed up to eight one-hour motivational interviewing and cognitive behavioral skills-based online live chat intervention sessions, and reported on demographic, psychosocial, and behavioral characteristics at baseline and immediately post-intervention. Analyses indicated that participation in the intervention (n = 31) was associated with reductions of days of drug and alcohol use in the past month and instances of anal sex without a condom (including under the influence of substances), as well as increases in knowledge of HIV-related risks at 3-month follow-up. This pilot study argues for the potential of this social media-delivered intervention to reduce HIV risk among a most vulnerable group in the United States, in a manner that was highly acceptable to receive and feasible to execute. A future randomized controlled trial could generate an intervention blueprint for providers to support YMSM's wellbeing by reaching them regardless of their geographical location, at a low cost.
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Affiliation(s)
- Corina Lelutiu-Weinberger
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA, URL: http://cunyhart.org/
| | - John E. Pachankis
- Chronic Disease Epidemiology, Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
| | - Kristi E. Gamarel
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
- Alpert Medical School of Brown University, 167 Point Street, Providence, RI 023093, USA
| | - Anthony Surace
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
| | - Sarit A. Golub
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
- Health Psychology and Basic and Applied Social Psychology Doctoral Programs, the Graduate Center, CUNY, 365 Fifth Avenue, New York, NY 10016, USA
| | - Jeffrey T. Parsons
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
- Health Psychology and Basic and Applied Social Psychology Doctoral Programs, the Graduate Center, CUNY, 365 Fifth Avenue, New York, NY 10016, USA
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36th Street, 9th Floor, New York, NY 10018, USA
- CUNY School of Public Health at Hunter College, 2180 Third Avenue, New York, NY 10035, USA
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Goedel WC, Duncan DT. Geosocial-Networking App Usage Patterns of Gay, Bisexual, and Other Men Who Have Sex With Men: Survey Among Users of Grindr, A Mobile Dating App. JMIR Public Health Surveill 2015; 1:e4. [PMID: 27227127 PMCID: PMC4869243 DOI: 10.2196/publichealth.4353] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 03/27/2015] [Accepted: 04/17/2015] [Indexed: 12/04/2022] Open
Abstract
Background Geosocial-networking apps like Grindr have been used increasingly among men who have sex with men (MSM) to meet anonymous partners. These mobile dating apps employ global positioning system technology to facilitate connections with other users based on their current location. These new technologies have generated quicker and easier modes for men who have sex with men to meet potential partners based on attraction and physical proximity. Objective The aim of this study is to describe geosocial-networking app use and recent sexual behaviors of MSM in the Atlanta metropolitan statistical area. Methods Our sample was recruited from Grindr, the most commonly used of these mobile apps among MSM, using broadcast advertising. Advertisements were displayed over the course of a 72-hour period and participants were directed to a Web-based survey. Results In total, 604 men clicked through the advertisement, and 92 users completed the survey. One-third (38.0%) of the men reported using these mobile apps to meet new sexual partners, and one-fifth (18.5%) used them to “kill time” when bored. Men reporting currently being in a relationship were less likely to report using these mobile apps to meet other MSM to date or to find a boyfriend or romantic partner, but more likely to report using these mobile apps to meet other MSM to have sex, X224=12.1, P=.016. Respondents had current accounts on 3.11 mobile apps (SD 1.84) on average, with Grindr being the most common (100%), followed by Scruff (52.5%), and Jack’d (45.7%). Most men were most active in the late night (40.2%), and on weekdays (64.1%). Each day, on average, men reported opening these mobile apps 8.38 times (SD 8.10) and spent 1.31 hours (SD 1.15) on these mobile apps. The age respondents began using these mobile apps was associated with the age at their first instance of insertive anal sex (r80=.527, P<.001) and receptive anal sex (r76=.527, P<.001). Conclusions These findings suggest that MSM use multiple mobile apps and spend significant time on them. For these reasons, HIV prevention interventions could be delivered on these mobile apps.
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Affiliation(s)
- William C Goedel
- School of MedicineDepartment of Population HealthNew York UniversityNew York, NYUnited States.,Global Institute of Public HealthNew York UniversityNew York, NYUnited States.,College of Arts and ScienceDepartment of SociologyNew York UniversityNew York, NYUnited States
| | - Dustin T Duncan
- School of MedicineDepartment of Population HealthNew York UniversityNew York, NYUnited States.,Global Institute of Public HealthNew York UniversityNew York, NYUnited States.,Center for Drug Use and HIV ResearchCollege of NursingNew York UniversityNew York, NYUnited States.,Population CenterNew York UniversityNew York, NYUnited States.,Center for Data ScienceNew York UniversityNew York, NYUnited States
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Pérez-Figueroa RE, Kapadia F, Barton SC, Eddy JA, Halkitis PN. Acceptability of PrEP Uptake Among Racially/Ethnically Diverse Young Men Who Have Sex With Men: The P18 Study. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:112-25. [PMID: 25915697 PMCID: PMC4550097 DOI: 10.1521/aeap.2015.27.2.112] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Pre-exposure prophylaxis (PrEP) is considered an effective biomedical approach for HIV prevention. However, there is limited understanding of PrEP uptake among racially/ethnically and socioeconomically diverse young men who have sex with men (YMSM). This study examined attitudes and perceptions toward PrEP uptake among YMSM by conducting semistructured interviews with a sample (N = 100) of YMSM in New York City. Thematic analysis was employed to explore key issues related to attitudes and perceptions toward PrEP utilization. Findings suggest that self-perceived risk for HIV transmission, enjoying unprotected sex, and being in a romantic relationship were associated with PrEP uptake. The most prominent barriers to PrEP uptake included costs, adherence regimen, and access. In summary, these findings underscore the importance of addressing behavioral and structural factors in maximizing the effectiveness of PrEP. In addition, PrEP implementation programs ought to consider the role of social and structural challenges to PrEP uptake and adherence among YMSM.
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Enhancing benefits or increasing harms: community responses for HIV among men who have sex with men, transgender women, female sex workers, and people who inject drugs. J Acquir Immune Defic Syndr 2014; 66 Suppl 3:S319-28. [PMID: 25007203 DOI: 10.1097/qai.0000000000000233] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Studies completed over the past 15 years have consistently demonstrated the importance of community-level determinants in potentiating or mitigating risks for the acquisition and transmission of HIV. Structural determinants are especially important in mediating HIV risk among key populations, including men who have sex with men, people who inject drugs, sex workers of all genders, and transgender women. The objective of this systematic review was to synthesize the evidence characterizing the community-level determinants that potentiate or mitigate HIV-related outcomes for key populations. The results of the review suggest that although health communication programs represent community-level strategies that have demonstrated the effectiveness in increasing the uptake of HIV testing and decreasing the experienced stigma among people living with HIV, there are limited studies focused on key populations in low- and middle-income settings. Moreover, interpretation from the 22 studies that met inclusion and exclusion criteria reinforce the importance of the continued measurement of community-level determinants of HIV risks and of the innovation in tools to effectively address these risks as components of the next generation of the HIV response. Consequently, the next generation of effective HIV prevention science research must improve our understanding of the multiple levels of HIV risk factors, while programming for key populations must address each of these risk levels. Failure to do so will cost lives, harm communities, and undermine the gains of the HIV response.
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Acceptability of smartphone application-based HIV prevention among young men who have sex with men. AIDS Behav 2014; 18:285-96. [PMID: 24292281 DOI: 10.1007/s10461-013-0671-1] [Citation(s) in RCA: 155] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Young men who have sex with men (YMSM) are increasingly using mobile smartphone applications ("apps"), such as Grindr, to meet sex partners. A probability sample of 195 Grindr-using YMSM in Southern California were administered an anonymous online survey to assess patterns of and motivations for Grindr use in order to inform development and tailoring of smartphone-based HIV prevention for YMSM. The number one reason for using Grindr (29 %) was to meet "hook ups." Among those participants who used both Grindr and online dating sites, a statistically significantly greater percentage used online dating sites for "hook ups" (42 %) compared to Grindr (30 %). Seventy percent of YMSM expressed a willingness to participate in a smartphone app-based HIV prevention program. Development and testing of smartphone apps for HIV prevention delivery has the potential to engage YMSM in HIV prevention programming, which can be tailored based on use patterns and motivations for use.
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Sherriff N, Gugglberger L. A European Seal of Approval for ‘gay’ businesses: findings from an HIV-prevention pilot project. Perspect Public Health 2013; 134:150-9. [DOI: 10.1177/1757913913481540] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Aims: ‘Gay’ businesses can be important settings through which to deliver health promotion interventions to vulnerable populations, such as men who have sex with men (MSM) regarding HIV prevention. This article draws on data from the European Everywhere project, which represents the first scheme to develop and pre-test a common framework for HIV/STI prevention in ‘gay’ businesses across eight European countries. Methods: The scientific basis of the Everywhere framework was developed using a comprehensive consensus-building process over 30 months. This process included: formative scoping research; interviews with 54 ‘gay’ businesses; meetings/workshops with representatives from project partners, ‘gay’ businesses, public health administrations and external experts; 15 interviews and three focus groups with project partners; a five-month pilot action phase in eight countries, together with support from the project’s Advisory Group; and all Everywhere project partners including the Scientific Steering Committee. Results: A voluntary European code setting out differentiated HIV/STI-prevention standards for ‘gay’ businesses (including sex venues, ‘gay’ and ‘gay’ friendly social spaces, travel agencies, hotels, dating websites) was developed and piloted in eight European cities. During a five-month pilot action, 83 ‘gay’ businesses were certified with the Everywhere Seal of Approval representing a considerable increase on the expected pilot target of 30. Conclusions: Everywhere offers a major contribution to the public health and/or health promotion field in the form of a practical, policy-relevant, settings-based HIV-prevention framework for ‘gay’ businesses that is common across eight European countries. Findings suggest that a European-wide model of prevention is acceptable and feasible to businesses.
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Affiliation(s)
- Nigel Sherriff
- Centre for Health Research, University of Brighton, Falmer, Brighton, UK
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