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#Testathome: Implementing 2 Phases of a HIV Self-Testing Program Through Community-Based Organization Partnerships in New York City. Sex Transm Dis 2021; 47:S48-S52. [PMID: 32149962 DOI: 10.1097/olq.0000000000001151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Access to human immnodeficiency virus (HIV) testing in New York City (NYC) has increased, but disparities in testing rates still exist among most communities impacted by HIV. HIV self-tests (HIVSTs) present an opportunity to address testing barriers, but HIV-affected communities experience difficulties accessing HIVSTs, including lack of awareness and cost. To support increased access to HIVSTs, the NYC Health Department launched a partnership with select organizations to pilot distribution of free HIVSTs in 2 phases among priority populations across NYC. METHODS Organizations that were diverse in their missions, experiences, capacities and populations served were recruited through a formal application process. The program initially launched with 10 organization partners (phase 1); as the pilot continued, partners identified necessary revisions to the program and launched a second phase in year 2. Both phases included outreach to NYC priority populations, HIVST distribution/redemption, and a follow-up survey. RESULTS From March 2017 to August 2019, organizations distributed 75 HIVSTs during phase 1 and 252 during phase 2. All intended priority populations were reached, notably, those who had never tested before: 35% in phase 1 and 12% in phase 2. Over half of the follow-up survey respondents reported testing sooner. Respondents reported liking the HIVST because it did not require a visit to a clinic (84%) and preferred an HIVST to testing in a clinic (92%). CONCLUSIONS Through 2 phases of implementation, this innovative partnership was able to reach and offer HIVSTs to priority populations across NYC. This program supports the feasibility of distributing HIVSTs through close partnerships with diverse organizations.
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Wan Mohd Yunus WMA, Musiat P, Brown JSL. Innovative Self-Confidence Webinar Intervention for Depression in the Workplace: A Focus Group Study and Systematic Development. Behav Sci (Basel) 2020; 10:bs10120193. [PMID: 33339086 PMCID: PMC7765479 DOI: 10.3390/bs10120193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
Brief face-to-face self-confidence workshops were effective in reducing depression among the public. Technological advances have enabled traditional face-to-face interventions to be adapted using unique technology-mediated platforms. This article details the formative development of a self-confidence web-based seminar (webinar) intervention for workplace depression. The first section discusses a qualitative study that explores the feasibility and acceptability of adapting the self-confidence workshops into a webinar platform on employees in the workplace. The second section describes the systematic development of this new webinar intervention informed by the qualitative study findings, a published systematic review, and previous face-to-face self-confidence workshops. The qualitative study involves three focus groups (n = 10) conducted in a small organization. Three themes were identified relevant to the running of the new self-confidence webinars in the workplace: personal (content, time and duration preference, features of the webinar, individual participation, personalization), interpersonal (stigma from others, engagement with participants/presenter, moderated interaction), and organizational (endorsement from management, work demand). For the intervention development, the format, structure, features, and content of the self-confidence webinar intervention are described. Features such as file sharing, virtual whiteboard, live chat, and poll are explained with the intervention primarily based on cognitive behavior therapy and coping flexibility concepts.
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Affiliation(s)
- Wan Mohd Azam Wan Mohd Yunus
- Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3. floor, 20014 Turku, Finland
- Department of Psychology, School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Skudai 81310, Malaysia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 8AF, UK;
- Correspondence:
| | - Peter Musiat
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 8AF, UK;
| | - June S. L. Brown
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 8AF, UK;
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Baral S, Turner RM, Lyons CE, Howell S, Honermann B, Garner A, Hess R, Diouf D, Ayala G, Sullivan PS, Millett G. Population Size Estimation of Gay and Bisexual Men and Other Men Who Have Sex With Men Using Social Media-Based Platforms. JMIR Public Health Surveill 2018; 4:e15. [PMID: 29422452 PMCID: PMC5824103 DOI: 10.2196/publichealth.9321] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 11/22/2017] [Accepted: 12/08/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gay, bisexual, and other cisgender men who have sex with men (GBMSM) are disproportionately affected by the HIV pandemic. Traditionally, GBMSM have been deemed less relevant in HIV epidemics in low- and middle-income settings where HIV epidemics are more generalized. This is due (in part) to how important population size estimates regarding the number of individuals who identify as GBMSM are to informing the development and monitoring of HIV prevention, treatment, and care programs and coverage. However, pervasive stigma and criminalization of same-sex practices and relationships provide a challenging environment for population enumeration, and these factors have been associated with implausibly low or absent size estimates of GBMSM, thereby limiting knowledge about the dynamics of HIV transmission and the implementation of programs addressing GBMSM. OBJECTIVE This study leverages estimates of the number of members of a social app geared towards gay men (Hornet) and members of Facebook using self-reported relationship interests in men, men and women, and those with at least one reported same-sex interest. Results were categorized by country of residence to validate official size estimates of GBMSM in 13 countries across five continents. METHODS Data were collected through the Hornet Gay Social Network and by using an a priori determined framework to estimate the numbers of Facebook members with interests associated with GBMSM in South Africa, Ghana, Nigeria, Senegal, Côte d'Ivoire, Mauritania, The Gambia, Lebanon, Thailand, Malaysia, Brazil, Ukraine, and the United States. These estimates were compared with the most recent Joint United Nations Programme on HIV/AIDS (UNAIDS) and national estimates across 143 countries. RESULTS The estimates that leveraged social media apps for the number of GBMSM across countries are consistently far higher than official UNAIDS estimates. Using Facebook, it is also feasible to assess the numbers of GBMSM aged 13-17 years, which demonstrate similar proportions to those of older men. There is greater consistency in Facebook estimates of GBMSM compared to UNAIDS-reported estimates across countries. CONCLUSIONS The ability to use social media for epidemiologic and HIV prevention, treatment, and care needs continues to improve. Here, a method leveraging different categories of same-sex interests on Facebook, combined with a specific gay-oriented app (Hornet), demonstrated significantly higher estimates than those officially reported. While there are biases in this approach, these data reinforce the need for multiple methods to be used to count the number of GBMSM (especially in more stigmatizing settings) to better inform mathematical models and the scale of HIV program coverage. Moreover, these estimates can inform programs for those aged 13-17 years; a group for which HIV incidence is the highest and HIV prevention program coverage, including the availability of pre-exposure prophylaxis (PrEP), is lowest. Taken together, these results highlight the potential for social media to provide comparable estimates of the number of GBMSM across a large range of countries, including some with no reported estimates.
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Affiliation(s)
- Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Rachael M Turner
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Carrie E Lyons
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Sean Howell
- Hornet Gay Social Network, San Francisco, CA, United States
| | - Brian Honermann
- Public Policy Office, The Foundation for AIDS Research, Washington, DC, United States
| | - Alex Garner
- Hornet Gay Social Network, San Francisco, CA, United States
| | - Robert Hess
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | | | - George Ayala
- The Global Forum for MSM and HIV, Oakland, CA, United States
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Greg Millett
- Public Policy Office, The Foundation for AIDS Research, Washington, DC, United States
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Degroote L, Plaete J, De Bourdeaudhuij I, Verloigne M, Van Stappen V, De Meester A, Poppe L, Van der Mispel C, Crombez G. The Effect of the eHealth Intervention 'MyPlan 1.0' on Physical Activity in Adults Who Visit General Practice: A Quasi-Experimental Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E228. [PMID: 29385770 PMCID: PMC5858297 DOI: 10.3390/ijerph15020228] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/23/2018] [Accepted: 01/26/2018] [Indexed: 11/16/2022]
Abstract
Physical inactivity is one of the major risk factors for poor health in the world. Therefore, effective interventions that promote physical activity are needed. Hence, we developed an eHealth intervention for adults, i.e., 'MyPlan 1.0', which includes self-regulation techniques for behaviour change. This study examined the effect of 'MyPlan 1.0' on physical activity (PA) levels in general practice. 615 adults (≥18 years) were recruited in 19 Flemish general practices, for the intervention group (n = 328) or for the wait-list control group (n = 183). Participants in the intervention group received the web-based intervention 'MyPlan 1.0' and were prompted to discuss their personal advice/action plan with their general practitioner. Participants in the wait-list control group only received general advice from the website. Self-reported physical activity was assessed with the International Physical Activity Questionnaire (IPAQ) at baseline and after one month. A three-level (general practice, adults, time) regression analysis was conducted in MLwiN. Significant intervention effects were found for total PA and moderate to vigorous PA with an increase for the intervention group compared to a decrease in the control condition. However, there was a high dropout rate in the intervention group (76%) and the wait-list control group (57%). Our self-regulation intervention was effective in increasing physical activity levels in adults. Future studies should consider strategies to prevent the large dropout from participants.
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Affiliation(s)
- Laurent Degroote
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Gent, Belgium;
| | - Jolien Plaete
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
| | - Maïté Verloigne
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
| | - Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
| | - An De Meester
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
| | - Louise Poppe
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Gent, Belgium;
| | - Celien Van der Mispel
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Gent, Belgium;
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Gent, Belgium;
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El-Tholoth HS, Alqahtani FD, Aljabri AA, Alfaryan KH, Alharbi F, Alhowaimil AA, Alkharji A, Alrwaily A, Obied A, Al-Afraa T. Knowledge and attitude about sexually transmitted diseases among youth in Saudi Arabia. Urol Ann 2018; 10:198-202. [PMID: 29719334 PMCID: PMC5907331 DOI: 10.4103/ua.ua_14_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Sexually transmitted diseases (STDs) are one of the most serious diseases in the world. Our aim was to explore the knowledge and attitude about STDs among the youth. Patients and Methods This cross-sectional survey was conducted from August 1 to August 13, 2016. Male and female youth between 18 and 25 years were invited to participate in the survey using social media open to all Internet users consisting of questions and statements about STDs, and then the data were analyzed. Results We received 5040 responses to the survey; out of these participants 76.6% were females and 23.4% were males with a mean age 21.5 and most of them were single (85.1%). We noticed that most of the respondents selected the Internet (71.7%) as the main source of their knowledge about STDs followed by school, television, and others, respectively. In spite of, 94.08% knew that human immunodeficiency virus/AIDS is an STD, only 43.61% knew that herpes simplex virus is an STD, and only 31.03% knew that Chlamydia is an STD. A high percent (93.1%) agreed that sexual intercourse transmits STDs. Only 59.6% agreed that condom does not provide complete protection from STDs. To our surprise, only 55% considered themselves capable of protecting themselves against STDs. About 95.8% of the participants agreed that STDs should be taught in schools, while 4.2% disagreed. Conclusion We noticed a lack of participant's knowledge regarding the types, mode of transmission, and the ways of protections from STDs and their desire to find out information about STDs. Hence, awareness programs about STDs should be started that aim at encouraging youth to follow our religion and culture.
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Affiliation(s)
- Hossam S El-Tholoth
- Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Fahad D Alqahtani
- Department of Urology, College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdullah A Aljabri
- Department of Urology, College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Khalid H Alfaryan
- Department of Urology, College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Fares Alharbi
- Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Albaraa A Alhowaimil
- Department of Urology, College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Ali Alkharji
- Department of Urology, College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulrahman Alrwaily
- Department of Urology, College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Ali Obied
- Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Tala Al-Afraa
- Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Mason L. Knowledge of sexually transmitted infections and sources of information amongst men. ACTA ACUST UNITED AC 2016; 125:266-71. [PMID: 16353457 DOI: 10.1177/146642400512500608] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to investigate menís awareness of sexually transmitted infections (STIs) and sexual health services, together with the best ways of providing information about them. Information was collated via a self-administered questionnaire, which was answered by 429 men, giving a response rate of 31%. Men aged 16+ living in two primary care trusts (PCTs) in the north-west of England were accessed through a range of different sources, including social, educational, health, work and religious facilities. Despite the high rates of STIs in the north-west, approximately one in five men had not heard of herpes, syphilis or chlamydia. One in ten had not heard of gonorrhoea. The majority of men were unaware that many STIs could be asymptomatic. Only 13% knew where their local genitourinary medicine (GUM) clinic was. The main deterrents to accessing the clinic were embarrassment and not knowing where it was. Menís knowledge of STIs is limited, particularly in relation to the symptoms. The best way of providing information, according to the respondents, was through their general practitioner (GP). However, in practice this might be difficult, as men are reluctant users of GP services in general. Knowledge of the whereabouts of the local GUM clinics is also limited. Although most men thought that they would visit their GP if they thought they might have an STI, this may result from them not knowing the alternatives, rather than having a real choice. More information, targeted wisely, is thus necessary in order to educate men about STIs and service provision.
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Affiliation(s)
- Linda Mason
- Centre for Research in Healthcare, Faculty of Health and Applied Social Sciences, Liverpool John Moores University, England.
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Blackstock OJ, Cunningham CO, Haughton LJ, Garner RY, Norwood C, Horvath KJ. Higher eHealth Literacy is Associated With HIV Risk Behaviors among HIV-Infected Women Who Use the Internet. J Assoc Nurses AIDS Care 2015; 27:102-8. [PMID: 26456347 DOI: 10.1016/j.jana.2015.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 09/08/2015] [Indexed: 11/26/2022]
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Qvarnström A, Oscarsson MG. Experiences of and attitudes towards HIV/STI prevention among holidaymaking men who have sex with men living in Sweden: a cross-sectional Internet survey. Scand J Public Health 2015; 43:490-6. [PMID: 25834067 DOI: 10.1177/1403494815578320] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2015] [Indexed: 11/16/2022]
Abstract
AIM Foreign travellers and men who have sex with men (MSM) are prioritised groups for human immunodeficiency virus/sexually transmitted infection (HIV/STI) prevention efforts in Sweden because of high prevalence of sexual risk-taking. This study aims to describe experiences of and attitudes towards HIV/STI prevention efforts, prior to travelling abroad, among MSM, and to investigate the kinds of prevention efforts that are desirable. METHODS The study is based on survey responses from 656 MSM who had travelled abroad. Recruitment took place through a Nordic website, and had a cross-sectional design. The analysis has mainly been descriptive, but bivariate analyses were performed using the chi-square test. The level of significance was p <.05. RESULTS Only a few of the participants had encountered HIV/STI prevention efforts in Sweden (5%) and abroad (23%), and a majority (58%) felt that it should be more prevalent. Having free access to condoms and lubricants was preferred among 68% of the men. Furthermore, having written information, as opposed to oral, was also preferred (68% vs. 26%). MSM felt that it was easy to find out information (79%) and claimed they would use the Internet to do so (87%). CONCLUSIONS Service providers who offer their services to travellers are encouraged to provide helpful links to information about sexual health. Information that is geared towards risk groups such as young adults should be presented with awareness that MSM are also part of that group. It is important for information to be conveyed respectfully to everyone, but perhaps MSM in particular, since they may have experienced feelings of being stigmatised or discriminated against previously.
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Affiliation(s)
- Anna Qvarnström
- Department of Health and Caring Sciences, Linnaeus University, Sweden
| | - Marie G Oscarsson
- Department of Health and Caring Sciences, Linnaeus University, Sweden
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A web-based personally controlled health management system increases sexually transmitted infection screening rates in young people: a randomized controlled trial. J Am Med Inform Assoc 2015; 22:805-14. [DOI: 10.1093/jamia/ocu052] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 12/29/2014] [Indexed: 01/19/2023] Open
Abstract
Abstract
Objective To determine if a web-based personally controlled health management system (PCHMS) could increase the uptake of sexually transmitted infections (STI) screening among a young university population.
Methods A non-blinded parallel-group randomized controlled trial was conducted. Participants aged 18–29 years were recruited from a university environment between April and August 2013, and randomized 1:1 to either the intervention group (immediate online PCHMS access) or control group (no PCHMS access). The study outcome was self-reported STI testing, measured by an online follow-up survey in October 2013.
Results Of the 369 participants allocated to the PCHMS, 150 completed the follow-up survey, and of the 378 in the control group, 225 completed the follow-up survey. The proportion of the PCHMS group who underwent an STI test during the study period was 15.3% (23/150) compared with 7.6% (17/225) in the control group (P = .017). The difference in STI testing rates within the subgroup of sexually active participants (20.4% (23/113) of the PCHMS group compared with 9.6% (15/157) of the control group) was significantly higher (P = .027) than among non-sexually active participants.
Discussion Access to the PCHMS was associated with a significant increase in participants undergoing STI testing. This is also the first study to demonstrate efficacy of a PCHMS targeting a health concern where susceptibility is generally perceived as low and the majority of infections are asymptomatic.
Conclusion PCHMS interventions may provide an effective means of increasing the demand for STI testing which, combined with increased opportunistic testing by clinicians, could reduce the high and sustained rates of STIs in young people.
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Blackstock OJ, Shah PA, Haughton LJ, Horvath KJ, Cunningham CO. HIV-infected Women's Perspectives on the Use of the Internet for Social Support: A Potential Role for Online Group-based Interventions. J Assoc Nurses AIDS Care 2014; 26:411-9. [PMID: 25749532 DOI: 10.1016/j.jana.2014.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 11/14/2014] [Indexed: 11/30/2022]
Abstract
While the development and implementation of HIV-related online interventions has expanded, few have been tailored for women or have leveraged Web 2.0's capabilities to provide social support. We conducted semi-structured interviews with 27 women with HIV at an urban community health center to understand their perspectives on the potential role of the Internet and the use of an online group format to provide social support. Data were analyzed using the constant comparative method. We identified six themes: a need for groups and increased sense of connectedness, convenience and accessibility, trust as a precondition for participating, online groups as a potential facilitator or barrier to expression, limited digital access and literacy, and privacy concerns. Overall, women were highly supportive of online group-based interventions but acknowledged the need for increased digital access and Internet navigation training. Hybrid (in-person and online) interventions may be most useful for women with HIV.
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Tong SF, Khoo EM, Low WY, Ng CJ, Wong CH, Yusoff HM, Abu Bakar AI, Tan HM, Jiwa M. Health Innovation Project: A Concept Paper on a Virtual Health Promotion Program for Men. JOURNAL OF MEN'S HEALTH 2014. [DOI: 10.1089/jomh.2013.0020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Grov C, Breslow AS, Newcomb ME, Rosenberger JG, Bauermeister JA. Gay and bisexual men's use of the Internet: research from the 1990s through 2013. JOURNAL OF SEX RESEARCH 2014; 51:390-409. [PMID: 24754360 PMCID: PMC4154140 DOI: 10.1080/00224499.2013.871626] [Citation(s) in RCA: 206] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We document the historical and cultural shifts in how gay and bisexual men have used the Internet for sexuality between the 1990s and 2013-including shifting technology as well as research methods to study gay and bisexual men online. Gay and bisexual men have rapidly taken to using the Internet for sexual purposes: for health information seeking, finding sex partners, dating, cybersex, and pornography. Men have adapted to the ever-evolving technological advances that have been made in connecting users to the Internet-from logging on via dial-up modem on a desktop computer to geo-social-sexual networking via handheld devices. In kind, researchers have adapted to the Internet to study gay and bisexual men. Studies have carefully considered the ethics, feasibility, and acceptability of using the Internet to conduct research and interventions. Much of this work has been grounded in models of disease prevention, largely as a result of the ongoing HIV/AIDS epidemic. The need to reduce HIV in this population has been a driving force to develop innovative research and Internet-based intervention methodologies. The Internet, and specifically mobile technology, is an environment gay and bisexual men are using for sexual purposes. These innovative technologies represent powerful resources for researchers to study and provide outreach.
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Affiliation(s)
- Christian Grov
- Brooklyn College and the Graduate Center of CUNY, New York, NY. USA
- The Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY. USA
| | - Aaron S. Breslow
- The Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY. USA
| | - Michael E. Newcomb
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Joshua G. Rosenberger
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | - Jose A Bauermeister
- The Center for Sexuality & Health Disparities, University of Michigan, Ann Arbor, MI, USA
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Wohlfeiler D, Hecht J, Volk J, Raymond HF, Kennedy T, McFarland W. How can we improve online HIV and STD prevention for men who have sex with men? Perspectives of hook-up website owners, website users, and HIV/STD directors. AIDS Behav 2013; 17:3024-33. [PMID: 23180156 PMCID: PMC3610790 DOI: 10.1007/s10461-012-0375-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Internet-based interventions have potential to reduce HIV and STD transmission among men who meet male sexual partners online. From November 2009 to May 2010 we surveyed dating and hook-up website users (n = 3,050), website owners (n = 18), and health department HIV/STD directors (n = 81) to identify structural and behavioral prevention interventions that could be implemented online and which a majority of website users were willing to use, owners were willing to implement, and HIV/STD directors perceived to be effective. A majority of each of the three stakeholder groups agreed on the following: (1) automated HIV/STD testing reminders, (2) local STD test site directories, (3) links to sex-positive safe sex videos, (4) access to sexual health experts, (5) profile options to include safer sex preference, (6) chat rooms for specific sexual interests, (7) filtering partners by their profile information, and (8) anonymous e-card partner notification for STD exposure. Findings help build consensus about how to prioritize resources for implementing online HIV and STD prevention interventions and highlight differences between stakeholders to guide future discussion about how to advance prevention efforts.
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Affiliation(s)
- Dan Wohlfeiler
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California at San Francisco, San Francisco, CA
| | - Jennifer Hecht
- STOP AIDS Project, San Francisco AIDS Foundation, San Francisco, CA
| | - Jonathan Volk
- Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA
- San Francisco Department of Public Health, San Francisco, CA
| | | | - Tom Kennedy
- STOP AIDS Project, San Francisco AIDS Foundation, San Francisco, CA
| | - Willi McFarland
- Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA
- San Francisco Department of Public Health, San Francisco, CA
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Kingdon MJ, Storholm ED, Halkitis PN, Jones DC, Moeller RW, Siconolfi D, Solomon TM. Targeting HIV prevention messaging to a new generation of gay, bisexual, and other young men who have sex with men. JOURNAL OF HEALTH COMMUNICATION 2013; 18:325-342. [PMID: 23320963 DOI: 10.1080/10810730.2012.727953] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
HIV prevention messaging has been shown to reduce or delay high-risk sexual behaviors in young men who have sex with men (YMSM). Since the onset of the HIV/AIDS epidemic, a new generation of YMSM has come of age during an evolution in communication modalities. Because both these communication technologies and this new generation remain understudied, the authors investigated the manner in which YMSM interact with HIV prevention messaging. In particular, the authors examined 6 venues in which YMSM are exposed to, pay attention to, and access HIV prevention information: the Internet, bars/dance clubs, print media, clinics/doctors' offices, community centers/agencies, and educational classes. Data were drawn from a community-based sample of 481 racially and ethnically diverse YMSM from New York City. Significant differences in exposure to HIV prevention messaging venues emerged with respect to age, race/ethnicity, and sexual orientation. Attention paid to HIV prevention messages in various venues differed by age and sexual orientation. Across all venues, multivariate modeling indicated YMSM were more likely to access HIV messaging from the same venues at which they paid attention, with some variability explained by person characteristics (age and perceived family socioeconomic status). This suggests that the one-size-fits-all approach does not hold true, and both the venue and person characteristics must be considered when generating and disseminating HIV prevention messaging.
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Affiliation(s)
- Molly J Kingdon
- The Center for Health, Identity, Behavior, and Prevention Studies, The Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA.
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Hong O, Eakin BL, Chin DL, Feld J, Vogel S. An Internet-Based Tailored Hearing Protection Intervention for Firefighters. Health Promot Pract 2012; 14:572-9. [DOI: 10.1177/1524839912462031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Noise-induced hearing loss is a significant occupational injury for firefighters exposed to intermittent noise on the job. It is important to educate firefighters about using hearing protection devices whenever they are exposed to loud noise. Computer technology is a relatively new health education approach and can be useful for tailoring specific aspects of behavioral change training. The purpose of this study is to present the development process of an Internet-based tailored intervention program and to assess its efficacy. Method. The intervention programs were implemented for 372 firefighters (mean age = 44 years, Caucasian = 82%, male = 95%) in three states (California, Illinois, and Indiana). The efficacy was assessed from firefighters’ feedback through an Internet-based survey. Results. A multimedia Internet-based training program was developed through (a) determining program content and writing scripts, (b) developing decision-making algorithms for tailoring, (c) graphic design and audio and video productions, (d) creating computer software and a database, and (e) postproduction quality control and pilot testing. Participant feedback regarding the training has been very positive. Participants reported that they liked completing the training via computer (83%) and also that the Internet-based training program was well organized (97%), easy to use (97%), and effective (98%) and held their interest (79%). Almost all (95%) would recommend this Internet training program to other firefighters. Conclusion. Interactive multimedia computer technology using the Internet was a feasible mode of delivery for a hearing protection intervention among firefighters. Participants’ favorable feedback strongly supports the continued utilization of this approach for designing and developing interventions to promote healthy behaviors.
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Affiliation(s)
- OiSaeng Hong
- University of California San Francisco, San Francisco, CA, USA
| | | | - Dal Lae Chin
- University of California San Francisco, San Francisco, CA, USA
| | - Jamie Feld
- NorthShore University HealthSystem, Glenview, IL, USA
| | - Stephen Vogel
- NorthShore University HealthSystem, Glenview, IL, USA
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Methamphetamine use, transmission risk behavior and internet use among HIV-infected patients in medical care, San Francisco, 2008. AIDS Behav 2012; 16:396-403. [PMID: 21190073 PMCID: PMC3274665 DOI: 10.1007/s10461-010-9869-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Methamphetamine use is associated with adverse health outcomes and HIV incidence. Few studies have assessed methamphetamine use, sexual behavior and Internet use among HIV-infected patients. Surveys were administered to a sample of HIV-infected patients seeking medical care in a San Francisco county hospital and university-based clinic. In 2008, 35% of homosexual participants, 26% of heterosexual participants and 11% of female participants reported methamphetamine use in the past year. Of participants, 29% reported using the Internet to find sex partners; Internet-users versus non-Internet-users reported a higher median number of sex partners in 6 months (4 vs. 1), were more likely to report unprotected sex (32 vs. 10%), and higher rates of methamphetamine use in the past 12 months (48 vs. 24%). Given the association among methamphetamine use, increased sex partners and Internet use, the Internet may present a new and effective medium for interventions to reduce methamphetamine-associated sexual risk behavior.
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Hightow-Weidman LB, Pike E, Fowler B, Matthews DM, Kibe J, McCoy R, Adimora AA. HealthMpowerment.org: feasibility and acceptability of delivering an internet intervention to young Black men who have sex with men. AIDS Care 2012; 24:910-20. [PMID: 22272759 DOI: 10.1080/09540121.2011.647677] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Young Black men who have sex with men (BMSM) are disproportionately affected by HIV/AIDS in the USA and continue to experience rapidly increasing HIV incidence. We designed a tailored, theory-based interactive HIV/STI prevention website for young BMSM, called HealthMpowerment.org (HMP) and conducted a small pilot trial comparing HMP to currently available HIV/STI websites. We present findings demonstrating feasibility and acceptability of delivering the intervention to the target population of young BMSM. Retention rates were 90% and 78% at one- and three-month follow-ups, respectively. Evaluation immediately after the intervention's completion revealed that participants who used the HMP website reported high levels of user satisfaction and interest and low levels of website difficulty and frustration. At the end of the intervention, there was a trend in increased behavioral intentions to use condoms and engage in preparatory condom use behaviors in the intervention group compared to the control group (p=0.10). We observed a reduction in mean scores on the CES-D scale among those in the intervention group that was not seen in the control group at the one-month follow-up, though this was not statistically significant. Feedback from exit interviews with study participants suggested that HMP is relevant to the prevention needs of young BMSM. Overall, the findings support the acceptability and feasibility of delivering this prevention program to a group that has few interventions despite bearing a significant burden of the epidemic. Future trials, combining Internet and mobile phone technologies, are planned to test HMP among larger and more diverse populations of young BMSM.
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Affiliation(s)
- Lisa B Hightow-Weidman
- Division of Infectious Diseases, Department of Medicine, UNC School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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[Attitudes toward online HIV/sexually-transmitted infection prevention programs and Internet user profiles among men who have sex with men]. GACETA SANITARIA 2011; 26:123-30. [PMID: 22047624 DOI: 10.1016/j.gaceta.2011.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 05/20/2011] [Accepted: 06/02/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To describe the attitudes of men who have sex with men (MSM) toward online HIV/sexually-transmitted infection (STI) prevention programs and to identify and characterize user profiles with regard to their attitudes toward online prevention programs. METHOD A survey in gay venues or via the internet was completed by 2,044 participants from Madrid, Barcelona, Bilbao and San Sebastián (Spain). The survey explored socio-demographic variables, sexual behavior and other risk behaviors associated with HIV infection, as well as attitudes toward online prevention programs. The statistical analysis included factor analysis and non-hierarchical cluster analysis. RESULTS Most MSM had positive attitudes towards online HIV/STI prevention programs. Factor analysis revealed two factors: online prevention aimed at interaction and online prevention aimed at information. Based on these factors, three user profiles were identified: users oriented toward informative and interactive online prevention (53.5%), users oriented toward interactive online prevention (25.9%) and users were not oriented toward online prevention (20.7%). On characterizing these profiles, we observed a significant presence of men who were not interested in online prevention among those with a lower educational level, bisexual men and HIV-positive men. Conversely, those most receptive to online prevention were men self-identified as gay, those with a bachelors degree, those who had been tested for HIV and those who were HIV-negative. CONCLUSION The internet can facilitate sexual health promotion among MSM. Characterization of user profiles offers the possibility of segmenting prevention programs and of combining online and offline strategies.
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Kubicek K, Carpineto J, McDavitt B, Weiss G, Kipke MD. Use and perceptions of the internet for sexual information and partners: a study of young men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2011; 40:803-16. [PMID: 20809373 PMCID: PMC3000442 DOI: 10.1007/s10508-010-9666-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 01/15/2010] [Accepted: 06/20/2010] [Indexed: 05/09/2023]
Abstract
The Internet has opened many doors with its accessibility to information, entertainment and web-based communities. For young men who have sex with men (YMSM), the Internet can provide access to information on relevant sexual behavior and health information, stories from other men about relationship issues, and a venue for locating potential sexual and dating partners. Understanding YMSM's motivations for going online for information, advice or sexual relationships, is important as the Internet becomes increasingly used not only as a space to find sexual partners, but also as a venue for HIV and STI interventions. Having an understanding of the risks associated with searching for partners online, and how and why YMSM use the Internet for a variety of purposes, can inform the development of more effective Internet-based risk reduction programs. This article presents qualitative and quantitative data from the Healthy Young Men's Study, a longitudinal study of an ethnically diverse cohort of 526 YMSM. Qualitative interviews (N = 24) described not only the prevalence of using the Internet for finding sexual partners and the possible benefits and risks associated with that practice, but also the processes and perceptions of using this mechanism. Our data indicate that YMSM used the Internet to find information related to sex and sexuality, seek friendships, sexual partners as well as "hook-ups" or casual sex. Findings were presented in relation to how YMSM researchers and interventionists can identify how to most effectively reach YMSM through online methods.
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Affiliation(s)
- Katrina Kubicek
- Community, Health Outcomes, and Intervention Research Program, The Saban Research Institute, Childrens Hospital Los Angeles, Los Angeles, CA 90028, USA.
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20
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Berg RC, Tikkanen R, Ross MW. Predictors of reporting bareback sex among a diverse sample of MSM recruited through a Swedish website. AIDS Care 2011; 23:1644-51. [PMID: 22117126 DOI: 10.1080/09540121.2011.565035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to understand how person, health and sexual behavior, HIV-risk cognitions, and gay community involvement relate to barebacking among 3634 men who have sex with men (MSM) recruited by way of the Swedish website QX.se. In this sample, 10% reported that they had engaged in barebacking in the past year. Variables found to be statistically significant in the bivariate analyses were incorporated into a logistic regression domain-specific model. Variables that remained significantly associated with barebacking in domain 1 were being HIV-positive and having had a sexually transmitted infection (STI) in the past year. The variable talked with someone in HIV services remained significant in domain 2, and for domain 3, the variable used the Internet to look for a bareback partner remained significant. Two variables, believing taking semen in one's mouth involves no or low risk of HIV transmission and believing that engaging in insertive unprotected anal intercourse (IUAI) involves no or low risk of HIV transmission, remained significant in domain 4. The final multivariate regression analysis included six variables (from domains 1 to 4) and had a significant fit (χ (2)(6) = 2.571, p=0.958). The likelihood of engaging in barebacking was higher for those men who reported being HIV-positive (odds ratio [OR] = 2.77), having had an STI in the past year (OR = 1.67), and having used the Internet to look for a bareback partner (OR = 12.59). This first study to explore the predictors of bareback sex among a Nordic MSM sample suggests that bareback sex among northern European MSM is less common than among other samples. The findings reconfirm that MSM who engage in bareback sex may represent a unique subset of MSM with distinct HIV prevention needs.
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Affiliation(s)
- Rigmor C Berg
- Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
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Hightow-Weidman LB, Fowler B, Kibe J, McCoy R, Pike E, Calabria M, Adimora A. HealthMpowerment.org: development of a theory-based HIV/STI website for young black MSM. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2011; 23:1-12. [PMID: 21341956 PMCID: PMC3509545 DOI: 10.1521/aeap.2011.23.1.1] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Black men who have sex with men (BMSM) are disproportionately affected by the HIV epidemic, yet few prevention interventions have been developed specifically for them. Recent studies suggest that the Internet is a promising intervention delivery avenue. We describe results from our formative work in developing a theory-based online HIV/STI prevention intervention for young BMSM including focus groups, semistructured interviews, and usability testing. The Intervention, HealthMpowerment.org , was created based on the Institute of Medicine's integrated model of behavior change with extensive input from young BMSM. Key interactive Web site features include live chats, quizzes, personalized health and "hook-up/sex" journals, and decision support tools for assessing risk behaviors. Creating an interactive HIV/sexually transmitted infection web site for BMSM was a complex process requiring many adjustments based on iterative feedback throughout all development stages. Preliminary satisfaction, content acceptability, and usability findings support the use of the Internet to deliver risk reduction messages to young BMSM.
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Affiliation(s)
- Lisa B Hightow-Weidman
- Division of Infectious Diseases, Department of Medicine, UNC School of Medicine, University of North Carolina, Chapel Hill, 27599-7030, USA.
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Bull SS, Lloyd L, Rietmeijer C, McFarlane M. Recruitment and retention of an online sample for an HIV prevention intervention targeting men who have sex with men: the smart sex quest project. AIDS Care 2010; 16:931-43. [PMID: 15511725 DOI: 10.1080/09540120412331292507] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
There is an increasing interest in developing interventions for HIV and STD prevention that can be delivered on the Internet. However, we know little about what it takes to identify, recruit and retain participants in interventions so that we can test their efficacy and effectiveness. Objectives for this investigation were to evaluate rates of recruitment and retention in an Internet-based randomized controlled trial (RCT) to increase sexually transmitted disease (STD) prevention among men who have sex with men (MSM). The Smart Sex Quest study was a RCT conducted online. Eligible participants were MSM, at least 18 years old and US residents. After completing a baseline risk assessment, participants were exposed to tailored or control messages and asked to return to the site at three months for a follow-up interview. From January 2002 through June 2003, 3,625 persons logged on as potential study participants; of these, 563 were not eligible, while 1,286 left the site without filling out a baseline survey. Complete baseline data were available for 1,776 participants, all of whom were eligible to complete a follow-up. Complete follow-up data were available for 270 (15.2%) participants. While the Internet is a valuable tool for conducting research, conducting this longitudinal research online was severely affected by a loss to follow-up, and analyzing outcome data was hampered by significant differences between those who did and did not complete the study. Alternate ways to recruit for and evaluate online trials must be considered.
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Affiliation(s)
- S Salyers Bull
- Colorado Health Outcomes Program, University of Colorado Health Sciences Center, Aurora, CO 80045-0508, USA.
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Rakhmatulina MR, Vasil'eva MY, Rakhmatulina MR, Vasiliyeva MY. Internet as a source of information on sexual and reproductive healthfor teenagers. VESTNIK DERMATOLOGII I VENEROLOGII 2010. [DOI: 10.25208/vdv789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The article presents the results of Russian and foreign studies on using the Internet as an information source for teenagers about
sexually transmitted infections. The possibility to revive the primary prevention system to fight sexually transmitted infections has been discussed, and quality criteria for present-day medical resources have been examined.
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Reback CJ, Ling D, Shoptaw S, Rohde J. Developing a Text Messaging Risk Reduction Intervention for Methamphetamine-Using MSM: Research Note. Open AIDS J 2010; 4:116-22. [PMID: 20657827 PMCID: PMC2905770 DOI: 10.2174/1874613601004030116] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 11/15/2009] [Accepted: 11/25/2009] [Indexed: 12/03/2022] Open
Abstract
Men who have sex with men (MSM) who use methamphetamine experience high risks for HIV infection due to sexual transmission behaviors often engaged in when under the influence of methamphetamine. Methamphetamine-using MSM use various forms of information technology (IT) communication such as instant messaging, social networking sites, and websites to facilitate a sexual and/or drug “hook up.” Given the acceptability of IT communication in their daily lives, an IT intervention represents an appropriate strategy to reach and intervene with out-of-treatment, methamphetamine-using MSM. The aim of this study was to conduct formative work to develop a text messaging intervention to reduce methamphetamine use and high-risk sexual behaviors among out-of-treatment MSM, which involved conducting focus groups, community partners’ meetings, and a pre-test intervention. These activities culminated in the development of a two-week, text-messaging intervention that delivered real-time electronic correspondence based on the behavioral change theories of Social Support Theory, Health Belief Model, and Social Cognitive Theory. The focus groups, community meetings, and pre-test were used to identify the IT communication device, the text messages that best support risk reduction and healthier behavioral choices, and logo, flyer and website development. The input and feedback from the target population and community partners were critical to the successful development of a culturally appropriate intervention. The knowledge gleaned from the formative work of this study will be vitally helpful in designing future IT studies.
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Blas MM, Alva IE, Carcamo CP, Cabello R, Goodreau SM, Kimball AM, Kurth AE. Effect of an online video-based intervention to increase HIV testing in men who have sex with men in Peru. PLoS One 2010; 5:e10448. [PMID: 20454667 PMCID: PMC2862715 DOI: 10.1371/journal.pone.0010448] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Accepted: 11/27/2009] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although many men who have sex with men (MSM) in Peru are unaware of their HIV status, they are frequent users of the Internet, and can be approached by that medium for promotion of HIV testing. METHODS We conducted an online randomized controlled trial to compare the effect of HIV-testing motivational videos versus standard public health text, both offered through a gay website. The videos were customized for two audiences based on self-identification: either gay or non-gay men. The outcomes evaluated were 'intention to get tested' and 'HIV testing at the clinic.' FINDINGS In the non-gay identified group, 97 men were randomly assigned to the video-based intervention and 90 to the text-based intervention. Non-gay identified participants randomized to the video-based intervention were more likely to report their intention of getting tested for HIV within the next 30 days (62.5% vs. 15.4%, Relative Risk (RR): 2.77, 95% Confidence Interval (CI): 1.42-5.39). After a mean of 125.5 days of observation (range 42-209 days), 11 participants randomized to the video and none of the participants randomized to text attended our clinic requesting HIV testing (p = 0.001). In the gay-identified group, 142 men were randomized to the video-based intervention and 130 to the text-based intervention. Gay-identified participants randomized to the video were more likely to report intentions of getting an HIV test within 30 days, although not significantly (50% vs. 21.6%, RR: 1.54, 95% CI: 0.74-3.20). At the end of follow up, 8 participants who watched the video and 10 who read the text visited our clinic for HIV testing (Hazard Ratio: 1.07, 95% CI: 0.40-2.85). CONCLUSION This study provides some evidence of the efficacy of a video-based online intervention in improving HIV testing among non-gay-identified MSM in Peru. This intervention may be adopted by institutions with websites oriented to motivate HIV testing among similar MSM populations. TRIAL REGISTRATION Clinicaltrials.gov NCT00751192.
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Affiliation(s)
- Magaly M Blas
- Unit of Epidemiology, HIV and STD, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Kubicek K, Beyer WJ, Weiss G, Iverson E, Kipke MD. In the dark: young men's stories of sexual initiation in the absence of relevant sexual health information. HEALTH EDUCATION & BEHAVIOR 2010; 37:243-63. [PMID: 19574587 PMCID: PMC2866104 DOI: 10.1177/1090198109339993] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A growing body of research has investigated the effectiveness of abstinence-only sexual education. There remains a dearth of research on the relevant sexual health information available to young men who have sex with men (YMSM). Drawing on a mixed-methods study with 526 YMSM, this study explores how and where YMSM receive relevant information on sexual health/behavior. Findings indicate that information related to gay men's sexuality is not readily available from family, friends, or schools. At initiation of anal intercourse, respondents generally had limited information about HIV and sexually transmitted infections (STIs). In some cases, this resulted in the perception that activities such as unprotected sex were "low risk." Many mentioned they first learned about anal sex during their sexual debut, describing painful and/or unpleasant experiences. Some relied on older/more experienced partners, the Internet, and pornography for information. Findings are discussed in relation to how providers can help YMSM build solid foundations of sexual education to protect them from STI and HIV infection.
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Affiliation(s)
- Katrina Kubicek
- Community, Health Outcomes, and Intervention Research Program, The Saban Institute, Childrens Hospital Los Angeles, California 90028, USA.
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27
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Berg RC. Barebacking: a review of the literature. ARCHIVES OF SEXUAL BEHAVIOR 2009; 38:754-764. [PMID: 19160033 DOI: 10.1007/s10508-008-9462-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Revised: 05/06/2008] [Accepted: 08/13/2008] [Indexed: 05/27/2023]
Abstract
This article synthesizes the peer-reviewed literature about barebacking, an HIV risk behavior that is generally understood as intentional unprotected anal intercourse between men where HIV transmission is a possibility. Of the 42 academic reports identified in the Anglophone literature, the greatest attention is given to U.S. publications and empirical projects. The variable nomenclature about barebacking is recognized and it is concluded that although epidemiological data suggest prevalence of barebacking varies across regions, time, and serostatus, the majority of men who have sex with men (MSM) do not intentionally seek out condomless anal sex. Findings show that macro-, meso-, interpersonal-, and intrapersonal level factors, such as homonegativity, community norms, partner intimacy, and drug use, converge to influence the likelihood that an individual will bareback. A conceptual framework to examine the reciprocal and dynamic relationships sustaining barebacking is proposed. In examining the theoretical and methodological limitations of the research about barebacking, the atheoretical nature of the studies, failure to report analyses conducted, and suboptimal measures are included among the study constraints. Furthermore, in research to date, the majority of participants have been white, urban, and gay-identified; thus, more research is needed to capture the viewpoints of diverse MSM communities. There has also been an overly individualistic focus on barebacking which needs to be tempered by greater consideration of the impact of macro- and meso-level factors upon MSM's behavior. With respect to programmatic responses, more culturally bound strategies are called for.
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Affiliation(s)
- Rigmor C Berg
- Norwegian Knowledge Center for the Health Services, Box 7004, St Olavs plass, 0130, Oslo, Norway.
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Abstract
BACKGROUND Little data exist on Internet and email use among STD clinic patients for research and clinical care communication. METHODS An anonymous cross-sectional survey of STD clinic patients aged >/=18 years in Seattle, WA, March 13 to 22, 2006. RESULTS Of 489 study period patients, 251 (51%) completed the questionnaire. Participants had a median age of 30 (range 18-66) years and were 69% male, 56% white, 19% black, 9% Hispanic, and 7% Asian/Pacific Islander. Of all participants, 75% had some postsecondary education but half reported an annual income of <US$15,000. Of 251 participants, 200 (80%) reported using the Internet from a private location at least once a week, 190 (76%) had their own email that they check at least 3 times a week, and 144 (57%) were willing to receive an email reminding them to come back for a follow-up appointment if diagnosed with an STD. Men who have sex with men were more likely than women and heterosexual men to be regular Internet and email users (92% vs. 70%, P = 0.001) and to have met a sex partner over the Internet during the past year (69% vs. 11%, P <0.001). Higher educational level and income, but not age or gender, were also associated with Internet and email use, as was racial/ethnic background (86% of whites, 48% of blacks, 73% of Hispanics, 100% of Asians/Pacific Islanders, and 57% of others, P <0.001). CONCLUSIONS Internet and email use are common and acceptable to many STD clinic patients for research and clinical purposes.
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Internet based HIV prevention research targeting rural MSM: feasibility, acceptability, and preliminary efficacy. J Behav Med 2008; 31:463-77. [PMID: 18770021 DOI: 10.1007/s10865-008-9171-6] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Accepted: 08/19/2008] [Indexed: 10/21/2022]
Abstract
Internet delivered primary prevention interventions for HIV risk reduction present significant challenges. Changing lifestyle behaviors, such as beginning to use condoms, is difficult and men seeking dates on line may want to avoid thinking about HIV risk which may lead to low initiation and high dropout rates. Many Internet delivered HIV risk reduction programs have mimicked face-to-face outreach programs, failing to take advantage of the Internet's capabilities or did not conduct evaluation. This study focuses on examining the feasibility, acceptability, and efficacy of an Internet delivered HIV risk reduction program for rural men who have sex with men (MSM). The program included online recruiting, three intervention modules, each with two sessions, online questionnaires. The intervention was developed based on iterative research and the Information-Motivation-Behavioral skills model. Participants (N = 475) were randomly assigned to one of six module orders and data were collected automatically at pre-test and after each module. Data supports the feasibility and acceptability of the program as demonstrated by good retention and rapid program completion. Knowledge, self-efficacy, outcome expectancies and motivation increase in a dose response fashion. Post-intervention behavior changes included reduced anal sex and significant increases in condom use. Limitations include a short follow-up period, a predominantly young white rural sample, and the lack of an attention control. Overall the results of the study provide support for the efficacy of Internet-based interventions to reduce risk of HIV infection. Results also support traditional research methods to evaluate HIV prevention programs delivered exclusively through the Internet.
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Abstract
This theory-driven study explored the phenomenon barebacking among Men who have Sex with Men (MSM) Internet users. Two hundred and forty men were recruited online and asked to complete a web-based survey. Forty percent of men in this geographically diverse sample reported engaging in bareback sex. Consistent with other research, findings demonstrate that compared with non-barebackers, men who engage in bareback sex are more likely to use alcohol in sexual contexts, use the Internet to meet sex partners, engage in any unsafe sex, and report higher degree of sexual sensation seeking. They are also more likely to report lower perception of safer sex social norms and lower self-efficacy for limiting HIV risk. Lack of concept discrimination between unprotected anal intercourse and barebacking suggests barebacking is a neologism that serves as a manifestation of the changing nature of sexual risk taking among some MSM. Opportunities for reducing the rate of HIV transmission among MSM are suggested.
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Affiliation(s)
- Rigmor C Berg
- Department of Kinesiology, Rice University, 6100 S. Main St., MS-545, Houston, TX 77005, USA.
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Horvath KJ, Rosser BRS, Remafedi G. Sexual risk taking among young internet-using men who have sex with men. Am J Public Health 2008; 98:1059-67. [PMID: 18445804 DOI: 10.2105/ajph.2007.111070] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the characteristics of young Internet-using men who have sex with men (MSM) and risks associated with seeking sex online, offline, or through both strategies. METHODS Data were obtained from MSM aged 18 to 24 years who completed a 45-minute online survey regarding sex and Internet use in the preceding 3 months. RESULTS Significantly more Internet-using MSM who had met sexual partners both online and offline (43%) reported unprotected anal intercourse than did those who had met sexual partners exclusively online (29%) or offline (34%). MSM who met sexual partners exclusively offline reported the fewest partners but the greatest proportion of partnerships involving unprotected anal intercourse (49%). Meeting sexual partners both online and offline (odds ratio [OR]=3.38-58.42) and being drunk (OR=1.57) or high (OR=2.24) increased the odds of having more sexual partners. The same factors increased the odds of having unprotected anal intercourse (online and offline sexual partners, OR=1.60; being drunk, OR=1.43; being high, OR=1.61). CONCLUSIONS Risky sexual behavior was prevalent among all of the study subgroups. Our findings suggest that online sex seeking is associated with greater numbers of sexual partners but neither promotes nor discourages unprotected anal intercourse. Regardless of where sexual partners met, being drunk and high were significant risks for unprotected anal intercourse.
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Affiliation(s)
- Keith J Horvath
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA.
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Vest JR, Valadez AM, Hanner A, Lee JH, Harris PB. Using e-mail to notify pseudonymous e-mail sexual partners. Sex Transm Dis 2008; 34:840-5. [PMID: 17621245 DOI: 10.1097/olq.0b013e318073bd5d] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Quantify the factors associated with reporting sexual partners only known by, or able to be contacted by, an e-mail address (pseudonymous partners) and evaluate the efforts of provider partner notification when only an e-mail address was available. STUDY DESIGN Persons with pseudonymous e-mail sexual partners were compared with unmatched controls. Associations were quantified by odds ratios and the effectiveness of provider partner notification attempts was assessed by comparison of outcomes of pseudonymous e-mail sexual partners and sexual partners with traditional contact information. RESULTS Factors associated with having pseudonymous e-mail sexual partners included: male sex, white non-Hispanic, history of prior sexually transmitted diseases, multiple sexual partners, and reporting male-to-male sexual contact. Efforts at provider partner notification via e-mail were successful with 49.7% of pseudonymous partners notified and 40.1% evaluated. CONCLUSIONS Internet-based forms of communications can be utilized as means to contact and identify risk partners. If this avenue is not utilized, public health agencies may be unable to intervene with a potentially growing percentage of at-risk persons.
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Affiliation(s)
- Joshua R Vest
- Austin/Travis County Health and Human Services Department, Austin, TX, USA.
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Kaneko N. Association between condom use and perceived barriers to and self-efficacy of safe sex among young women in Japan. Nurs Health Sci 2008; 9:284-9. [PMID: 17958678 DOI: 10.1111/j.1442-2018.2007.00338.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study aimed to assess the relationships between condom-use behaviors and perceived barriers to and self-efficacy of safe sex among young women in Japan. The data were obtained from a total of 456 participants who reported having had sex in the past. The initial analysis examined the associations between condom use and demographics, perceived condom-use barriers, and perceived self-efficacy of safe sex items. Variables displaying significance in the bivariate analysis were inserted into a multivariate model to determine the adjusted odds ratios. The variables most highly associated with condom use included age and the lifetime number of sex partners. The perceptual barriers included "condoms reduce sexual sensation", "confidence in using condoms from beginning to end", and "confidence to refuse sex if neither my partner nor I have a condom at hand". The findings suggest that behavior-change interventions that focus on addressing the perceived barriers and enhancing self-efficacy might be effective in order to promote consistent condom use.
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Affiliation(s)
- Noriyo Kaneko
- School of Nursing, Nagoya City University, Nagoya City, Japan.
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Richters J, Grulich AE, de Visser RO, Smith AMA, Rissel CE. Sex in Australia: Autoerotic, esoteric and other sexual practices engaged in by a representative sample of adults. Aust N Z J Public Health 2007; 27:180-90. [PMID: 14696709 DOI: 10.1111/j.1467-842x.2003.tb00806.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To describe the prevalence of a range of autoerotic and other non-coital sexual practices among Australians. METHOD Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years (response rate 73.1%). Respondents were asked whether in the past year they had: masturbated, engaged in various other autoerotic activities, or engaged in any of six other non-coital or esoteric practices. RESULTS Half of the respondents (65% men, 35% women) had masturbated in the past year. Nearly half (48%) of the men and 25% of the women had masturbated in the past four weeks, among whom men had done so a mean of 5.8 times and women 3.3 times. About a quarter of all respondents had watched an X-rated film (37% men, 16% women), 12% of men and 14% of women had used a sex toy, and 17% of men and 2% of women had visited an Internet sex site. 17% of men and 14% of women had engaged in digital-anal stimulation with a partner. Phone sex, role play or dressing up, bondage and discipline, sadomasochism or dominance and submission (BDSM-DS), fisting (rectal or vaginal, insertive or receptive) and rimming (oral-anal stimulation) were all engaged in by less than 5% of the sample. CONCLUSION Most of the practices studied were engaged in by more men than women. A range of autoerotic activities are both substitutes for partnered sex and additional sources of pleasure for people with sexual partners.
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Affiliation(s)
- Juliet Richters
- National Centre in HIV Social Research, University of New South Wales, Sydney.
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Lu HY, Palmgreen PC, Zimmerman RS, Lane DR, Alexander LJ. Personality traits as predictors of intentions to seek online information about STDs and HIV/AIDS among junior and senior college students in Taiwan. ACTA ACUST UNITED AC 2007; 9:577-83. [PMID: 17034325 DOI: 10.1089/cpb.2006.9.577] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of this cross-sectional study is to examine how personality traits such as sensation- seeking and impulsive decision-making affect Taiwanese college students' intentions to seek online information about sexually transmitted diseases (STDs) and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Five hundred thirty-five (n = 535) junior and senior college students in Taiwan were recruited and completed self-report questionnaires. This study found high sensation-seekers were more likely to seek information about STDs and HIV/AIDS on the Internet than low sensation-seekers. Impulsive decision-makers were less likely than rational decision-makers to seek information about STDs and HIV/AIDS on the Internet. These findings suggest that personality needs to be considered as an exploratory factor which potentially influences intentions to seek STD and HIV/AIDS information on the Internet among Taiwanese college students.
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Affiliation(s)
- Hung-Yi Lu
- Department of Communication and Graduate Institute of Telecommunications, National Chung Cheng University, Taiwan.
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Roberto AJ, Zimmerman RS, Carlyle KE, Abner EL. A computer-based approach to preventing pregnancy, STD, and HIV in rural adolescents. JOURNAL OF HEALTH COMMUNICATION 2007; 12:53-76. [PMID: 17365349 DOI: 10.1080/10810730601096622] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
A computer- and Internet-based intervention was designed to influence several variables related to the prevention of pregnancy, sexually transmitted diseases (STDs), and human immunodeficiency virus (HIV) in rural adolescents. The intervention was guided by the extended parallel process model and was evaluated using a pretest-post-test control group design with random assignment at the school level. Three hundred and twenty-six tenth-grade males and females enrolled in two rural Appalachian public high schools completed the survey at both points in time. Results indicate the vast majority (88.5%) of students in the experimental school completed at least one activity (M = 3.46 for those doing at least one activity). Further, both the overall program and all but one of the activities were rated positively by participants. Regarding the effects of the intervention, results indicate that students in the experimental school were less likely to initiate sexual activity and had greater general knowledge, greater condom negotiation self-efficacy, more favorable attitudes toward waiting to have sex, and greater situational self-efficacy than in the control school. In tandem, the results suggest that the computer-based programs may be a cost-effective and easily replicable means of providing teens with basic information and skills necessary to prevent pregnancy, STDs, and HIV.
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Affiliation(s)
- Anthony J Roberto
- School of Communication, The Ohio State University, Columbus, Ohio 43210, USA.
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Roberto AJ, Zimmerman RS, Carlyle KE, Abner EL, Cupp PK, Hansen GL. The effects of a computer-based pregnancy, STD, and HIV prevention intervention: a nine-school trial. HEALTH COMMUNICATION 2007; 21:115-24. [PMID: 17523857 DOI: 10.1080/10410230701306990] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
A computer-based intervention was designed to change perceived threat, perceived efficacy, attitudes, and knowledge regarding pregnancy, STD, and HIV prevention in rural adolescents. The intervention, which was guided largely by the extended parallel process model (Witte, 1992), was implemented and evaluated in nine rural high schools using an institutional cycle pretest-posttest control-group design (Campbell & Stanley, 1963; Cook & Campbell, 1979). Eight-hundred eighty-seven ninth-graders completed the survey at both points in time. Process evaluation results indicated that the intervention was implemented as intended, and that over 91% of students in the treatment group completed at least one of the six computer-based activities (M = 3.46, SD = 1.44 for those doing at least one activity). Two-way mixed-model repeated-measures analysis of variance revealed that students in the treatment group outperformed students in the control group on knowledge, condom self-efficacy, attitude toward waiting to have sex, and perceived susceptibility to HIV. These results suggest that computer-based programs may be a cost-effective and easily replicable means of providing teens with basic information and skills necessary to prevent pregnancy, STDs, and HIV.
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Cooper A, Safir MP, Rosenmann A. Workplace Worries: A Preliminary Look at Online Sexual Activities at the Office—Emerging Issues for Clinicians and Employers. ACTA ACUST UNITED AC 2006; 9:22-9. [PMID: 16497115 DOI: 10.1089/cpb.2006.9.22] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Concerns about the impact of online sexual activities (OSA) on work-life are drastically increasing. This study examined 3,466 respondents who reported OSA, 18.5% of whom reported engaging in OSA at work. They were compared with the 81.5% who engaged in OSA at home, on average time spent in OSA, workplace policies regarding OSA, and relationship status. Two themes were identified and discussed: opportunity and sexual distress. Our findings indicate that participants are cognizant of issues of opportunity (e.g., the OSA from home group was more likely to indicate their workplace has established policies regarding OSA), and privacy, representing an important aspect of this theme (e.g., participants engaging in OSA at work were found to be twice as likely to have extra-marital affairs, compared with the OSA from home group). Secondly, our data suggests that many participants, especially from the OSA at work group, experience OSA-related distress. Engaging in OSA at the workplace may result in decreased productivity, issues of sexual harassment, and concerns about employee well-being. Clearly stated and consistently enforced policies regulating OSA are likely to mitigate workplace OSA. However, a significant minority of employees may have difficulties curbing OSA. Therefore, more sophisticated strategies to deal with workplace OSA should be established. Additional implications of importance for organizations and mental health professionals who support them are discussed.
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Affiliation(s)
- Al Cooper
- San Jose Marital and Sexuality Centre, Santa Clara, and Pacific Graduate School of Psychology, Palo Alto, California, USA
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Noar SM, Clark A, Cole C, Lustria MLA. Review of interactive safer sex Web sites: practice and potential. HEALTH COMMUNICATION 2006; 20:233-41. [PMID: 17137415 DOI: 10.1207/s15327027hc2003_3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The Internet is increasingly being viewed as a health promotion tool with enormous potential. However, this potential cannot be realized if Web sites do not utilize the features that make the Internet a "hybrid" mass and interpersonal communication medium. The purpose of this study was to examine interactive safer sex Web sites on a number of dimensions. A comprehensive search that included Internet search engines, links from well-known sites, and previously published reviews yielded 21 Web sites that met criteria. Web sites were coded on dimensions including targeting of the Web sites, safer sex messages presented, theoretical strategies utilized, interactivity, and other characteristics. Results indicate that a moderate amount of targeting of Web sites exists, especially on age group (e.g., teenagers); the most prevalent safer sex messages were to "use condoms" and "be sexually abstinent"; raising the perceived threat of sexually transmitted diseases and HIV was the most prevalent theoretical strategy used to motivate safer sex; and finally, a moderate amount of interactivity was found on the Web sites, with most Web sites containing 4 or 5 features out of 15 features examined. Evidence that Web sites were tailoring information or messages to individuals was not found. Implications of these results for improving safer sex Web sites and developing interventions online are discussed.
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Affiliation(s)
- Seth M Noar
- Department of Communication, University of Kentucky, Lexington 40506, USA.
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The Emergence of Barebacking Among Gay and Bisexual Men in the United States: A Public Health Perspective. ACTA ACUST UNITED AC 2005. [DOI: 10.1300/j236v09n03_02] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Elford J, Bolding G, Davis M, Sherr L, Hart G. Web-based behavioral surveillance among men who have sex with men: a comparison of online and offline samples in London, UK. J Acquir Immune Defic Syndr 2005; 35:421-6. [PMID: 15097159 DOI: 10.1097/00126334-200404010-00012] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the characteristics of men who have sex with men (MSM) surveyed online (through gay Internet chat rooms and profiles) and offline (in community venues) in London, UK. METHODS In February and March 2002, 879 MSM completed a self-administered pen-and-paper questionnaire distributed in central London gyms (offline sample). In May and June 2002, 1218 London MSM completed a self-administered questionnaire online, accessed through Internet chat rooms and profiles on gaydar and gay.com. RESULTS Compared with men surveyed offline, those surveyed online were significantly less likely to only have sex with men (89 vs. 94%), to be in a relationship with a man (44 vs. 52%), or to have been tested for HIV (68 vs. 80%) (P < 0.001). Men recruited online were also younger (mean age, 34 vs. 36 years) and less likely to have had a higher education (67 vs. 79%) (P < 0.001). However, differences between online and offline samples were less pronounced for HIV-positive men and more pronounced for HIV-negative men and those who had never been tested for HIV. Regardless of HIV status, men recruited online were more likely to report high-risk sexual behavior (i.e., unprotected anal intercourse with a partner of unknown or discordant HIV status) than men surveyed offline (32 vs. 22%, P < 0.001). Men recruited online were also significantly more likely to have used the Internet to look for sex (85 vs. 45%, P < 0.001); for HIV-positive and negative men, seeking sex on the Internet was associated with high-risk sexual behavior (P < 0.01). In multivariate analysis, after controlling for confounding factors, being surveyed online was independently associated with high-risk sexual behavior for HIV-negative and never-tested men (HIV-negative men, adjusted odds ratio for online vs. offline samples, 1.73; 95% CI, 1.23, 2.42; P < 0.01; never-tested men adjusted odds ratio 2.45; 95% CI, 1.40, 4.29; P < 0.01). This was not the case for HIV-positive men (adjusted odds ratio for online vs. offline samples, 1.32; 95% CI, 0.69, 2.50; P = 0.4). CONCLUSION The Internet offers valuable opportunities for conducting behavioral surveillance among MSM because it reaches some men who may not be easily accessed in the community yet who are at high risk for HIV and sexually transmitted diseases. Comparisons of the social, demographic, and behavioral characteristics of online and offline samples must, however, take into account the confounding effects of HIV status and seeking sex on the Internet.
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Affiliation(s)
- Jonathan Elford
- City University London, Institute of Health Sciences, St. Bartholomew School of Nursing and Midwifery,London, UK.
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Boekeloo BO, Griffin MA. Review of Clinical Trials Testing the Effectiveness of Clinician Intervention Approaches to Prevent Sexually Transmitted Diseases in Adolescent Outpatients. Curr Pediatr Rev 2005; 1:173-185. [PMID: 25657616 PMCID: PMC4315618 DOI: 10.2174/1573396054065457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Identify approaches for improving clinician provision of sexually transmitted diseases (STDs) prevention services among outpatient adolescents. METHODS Reviewed all peer-reviewed, published clinical trials identified through computerized searches (MEDLINE, PsychINFO) evaluating STD prevention services to outpatient adolescents by clinicians. RESULTS Five trials were identified examining changes in clinician provision of STD prevention services. Two of these trials resulted in adolescent self-reported risk reduction but neither of these trials effectively demonstrated reductions in objectively measured STD incidence. Nine clinical trials were identified that compared clinician with non-clinician provision of STD prevention services. Four of these trials resulted in adolescent self-reported risk reduction, and one of these trials demonstrated a reduction in objectively measured STD incidence. CONCLUSIONS Trials indicate that improvement in outpatient adolescent STD incidence is possible with non-clinicians as interventionists, and perhaps clinicians as interventionists if clinicians are supported by other educational resources. Opportunities for personalized, interactive adolescent education appears key to intervention success. The clinician role that is tested in most trials is confined to a single brief encounter with little attention to: development of clinician skills, quality of psychosexual risk assessment and tailoring to meet individual adolescent need, systems-level resources and supports, the parental role, or the impact of incorporating prevention into an ongoing adolescent-clinician relationship.
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Affiliation(s)
- Bradley O Boekeloo
- University of Maryland, Department of Public and Community Health, College Park, Maryland 20742, 301-405-8546, FAX: 301-314-6598
| | - Melinda A Griffin
- University of Maryland, Department of Public and Community Health, College Park, Maryland 20742, 301-405-8546, FAX: 301-314-6598
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Fernández MI, Varga LM, Perrino T, Collazo JB, Subiaul F, Rehbein A, Torres H, Castro M, Bowen GS. The Internet as recruitment tool for HIV studies: viable strategy for reaching at-risk Hispanic MSM in Miami? AIDS Care 2005; 16:953-63. [PMID: 15511727 DOI: 10.1080/09540120412331292480] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although use of the Internet as a vehicle for HIV/STI research is increasing, its viability to recruit at-risk populations such as Hispanic men who have sex with men (HMSM) to participate in community-based HIV studies is in its infancy. We report on the first 171 participants enrolled in an ongoing study exploring use of the Internet to recruit Hispanic men who have sex with men (HMSM) living in Miami-Dade County, Florida to participate in community-based studies. We report our initial success with chat-room recruitment and describe the sexual and drug use practices of the initial set of participants who were recruited through the Internet. In addition, we describe the formative work conducted to develop the Internet recruitment procedures we are testing. In two months, we spent 211 hours recruiting in chat-rooms and engaged 735 chatters. One hundred and seventy-six men came to our community sites; 172 (98%) were eligible and completed an audio computer-assisted self-interview. In the previous six months, 94.7% of participants had anal sex; 48.9% did not use condoms for anal sex or used them inconsistently; and 48.5% had used club drugs. Six-month use rates for individual drugs were: poppers (31.6%), cocaine (15.8%), ecstasy (14%) and crystal methamphetamines (11.7%). Use of club drugs was significantly associated with unprotected insertive and unprotected receptive anal sex. These initial findings point to the Internet's potential as a tool for recruiting at-risk Hispanic MSM for community studies.
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Affiliation(s)
- M I Fernández
- University of Miami School of Medicine, Department of Epidemiology and Public Health, Miami, FL 33101, USA.
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Fernández MI, Perrino T, Collazo JB, Varga LM, Marsh D, Hernandez N, Rehbein A, Bowen GS. Surfing new territory: club-drug use and risky sex among Hispanic men who have sex with men recruited on the Internet. J Urban Health 2005; 82:i79-88. [PMID: 15738317 PMCID: PMC3456161 DOI: 10.1093/jurban/jti027] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The Internet presents unique and growing opportunities for conducting HIV/ STD research. This article reports on the first 171 participants enrolled in an ongoing study examining use of the Internet to recruit Hispanic men who have sex with men (HMSM) living in an AIDS epicenter to participate in community-based studies. First, it describes initial success with chatroom recruitment. Second, it compares the demographic, psychosocial, and sexual risk practices among HMSM recruited through the Internet who had used club drugs in the last 6 months and those who had not. In 2 months, 211 hours were spent recruiting in chatrooms; 735 chatroom users were engaged. Researchers used a scripted dialogue to describe the study and to invite chatroom users to visit the study's community sites for screening and enrollment. One hundred and seventy-six men came to the community sites; 172 (98%) were eligible and completed an audio-computer assisted self-interview. In the last 6 months, 48.5% of the sample had used club drugs [defined as cocaine, crystal methamphetamines (crystal), amyl nitrites (poppers), Ecstasy, gamma-hydroxybutyrate (GHB), ketamine (Special K), and Viagra]. The proportion of men reporting use of each drug was: cocaine (15.8%), crystal (11.7%), poppers (31.6%), Ecstasy (14%), GHB (3.5%), Special K (3.5%), and Viagra (19.3%). In multivariate analyses, having higher number of sex partners, having higher social isolation scores, and having engaged in unprotected receptive anal intercourse were significantly associated with club-drug use. These initial findings suggest that high-risk HMSM can be successfully recruited through chatroom dialogues to participate in community-based HIV studies. The alarmingly high rates of club-drug use and risky sexual practices among HMSM underscore the need for effective HIV preventive interventions for this population.
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Affiliation(s)
- M Isabel Fernández
- Behavioral Health Promotion Program (D-93), Department of Epidemiology and Public Health, University of Miami School of Medicine, PO Box 016069, Miami, FL 33101, USA.
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Brown G, Maycock B, Burns S. Your picture is your bait: use and meaning of cyberspace among gay men. JOURNAL OF SEX RESEARCH 2005; 42:63-73. [PMID: 15795806 DOI: 10.1080/00224490509552258] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The Internet is seen by many as a form of cyberspace or environment in which to interact and socialise. This research project drew from the data of a quantitative and qualitative study of gay men in Perth, Western Australia. We examined gay men's usage patterns of chat rooms and other social aspects of the Internet to meet sexual partners. We then reviewed in detail the meanings gay men have for the various Internet environments, and the range of friendship, relationship, casual, or esoteric sex-seeking goals. We argue that gay men view and engage with the Internet differently from how they view and engage with other more traditional gay spaces. This different approach influences how interaction between the men, either online or face-to-face, progresses and how assumptions and expectations are built. This has implications for how sexual health promotion interventions determine the appropriate role and relationship they have with these online social spaces.
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Affiliation(s)
- Graham Brown
- Western Australian Centre for Health Promotion Research, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia.
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Hirshfield S, Remien RH, Walavalkar I, Chiasson MA. Crystal methamphetamine use predicts incident STD infection among men who have sex with men recruited online: a nested case-control study. J Med Internet Res 2004; 6:e41. [PMID: 15631965 PMCID: PMC1550619 DOI: 10.2196/jmir.6.4.e41] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2004] [Revised: 07/09/2004] [Accepted: 08/19/2004] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Among men who have sex with men (MSM), the number of newly diagnosed human immunodeficiency virus (HIV) infections has increased by approximately 60% since 1999. Factors that may be contributing to this resurgence include a widely reported increase in bacterial sexually transmitted diseases (STDs) among HIV-positive and HIV-negative MSM, as well as unsafe sexual practices. OBJECTIVE This research was undertaken to learn more about risk behaviors associated with an incident STD among MSM. METHODS A nested case-control study was conducted, using data from a cross-sectional Internet survey of MSM (N=2643), which investigated risk behaviors during a 6-month period in 2001. Chi-square and logistic regression methods were used to estimate the likelihood of acquiring an incident STD versus no STD. RESULTS Eighty-five percent of the respondents were white, 46% were under age 30, and 80% had met sex partners online; 7% were HIV-positive. Men with an incident STD were more likely than men without an STD to report drug use (crystal methamphetamine odds ratio 3.8; 95% confidence interval 2.1-6.7; cocaine OR 2.3; 95% CI 1.2-4.2; ecstasy OR 2.2; 95% CI 1.3-3.8; Viagra OR 2.1; 95% CI 1.2-3.7), alcohol before or during sex (OR 1.9; 95% CI 1.2-2.9), and high-risk sexual behavior (unprotected anal intercourse OR 5.0; 95% CI 2.8-8.9; multiple sex partners OR 5.9; 95% CI 2.5-13.8). In the multivariate analysis, significant independent predictors associated with an incident STD were crystal methamphetamine use (adjusted OR 2.0; 95% CI 1.1-3.8), unprotected anal intercourse (adjusted OR 3.4; 95% CI 1.9-6.3), and 6 or more sex partners during the study period (adjusted OR 3.3; 95% CI 1.4-7.8). CONCLUSION Identifying and treating MSM who have STDs, or who are at increased risk for acquiring STDs, is crucial in preventing the further spread of disease. In addition, there is a need to integrate HIV/STD and substance use prevention and education into Web-based and community-based venues.
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Affiliation(s)
- Sabina Hirshfield
- Medical and Health Research Association of New York City, Inc, 40 Worth Street, Suite 720, New York NY 10013, USA.
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The Development of a Public-Private Partnership to Improve HIV/AIDS Consumers' Access to Quality Health Information. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2004. [DOI: 10.1300/j381v08n03_02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Rhodes SD. Hookups or health promotion? An exploratory study of a chat room-based HIV prevention intervention for men who have sex with men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2004; 16:315-327. [PMID: 15342334 DOI: 10.1521/aeap.16.4.315.40399] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This study sought to explore an online intervention that was initiated by an AIDS service organization to reduce sexual risk within a geographically-oriented chat room frequented by men who have sex with men (MSM). Analyses of bio lines, user profiles, and chat room discussions were used to understand and characterize the online prevention intervention. Six predominate discussion topics were identified, including (a) sexual risk reduction strategies (e.g., safer "barebacking"), (b) HIV testing options, (c) local alternatives for nonsexual social support, (d) referrals for youth, (e) resources related to "coming out," and (f) access to risk reduction materials and supplies. The perceived anonymity promoted by the Internet and the health educator's established relationship with the men in the chat room contributed to the success of this intervention. This analysis suggests that an online HIV/AIDS prevention intervention may reach MSM inaccessible in traditional venues typically used for intervention delivery.
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Affiliation(s)
- Scott D Rhodes
- The Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1063, USA.
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Rietmeijer CA, Bull SS, McFarlane M, Patnaik JL, Douglas JM. Risks and benefits of the internet for populations at risk for sexually transmitted infections (STIs): results of an STI clinic survey. Sex Transm Dis 2003; 30:15-9. [PMID: 12514436 DOI: 10.1097/00007435-200301000-00004] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Internet is increasingly used for the recruitment of sex partners, potentially leading to increased risks for sexually transmitted infections (STIs). Less is known about the use of the Internet as a resource for STI education and prevention. GOAL To evaluate the use of the Internet for sex-seeking and STI information purposes by clients of a large STI clinic. STUDY DESIGN A 10-item survey was conducted among clients of the Denver Metro Health (STI) Clinic who visited the clinic for a new problem between September 2000 and May 2001. RESULTS Among 4,741 clients surveyed, 2,159 (45.5%) had Internet access. Of these, 138 (6.4%) reported to have gone on-line with the specific purpose of finding a sex partner and 146 (6.8%) reported having sex with a partner they found over the Internet. Internet sex-seeking was more common among men who have sex with men (MSM; 77/269, or 28.6%) than among men who have sex with women (MSW; 52/1,176, or 4.4%; P < 0.0001) and higher among MSW than among women (9/714, or 1.3%; P < 0.001). The Internet was accessed by 604 persons (28.0%) to find information on STIs. Of these, 65.1% did so for general STI information, 36.3% for information on HIV, 25.7% for information on genital herpes, 22.4% for information on chlamydia, 21.7% for information on HPV, 19.9% for information on gonorrhea, 16.1% for information on syphilis, and 9.3% for other information. Of persons seeking sex, 54.4% accessed the Internet for STI information, compared to 26.2% of persons not seeking sex (P < 0.0001). CONCLUSIONS Among STI clinic clients in Denver, nearly half have access to the Internet. Sex-seeking appears to be most prevalent among MSM. Internet use for STI information is common among those with Internet access and even more widespread among those who access the Internet to seek sex. Research is needed to develop and evaluate Internet-based STI-prevention interventions.
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Affiliation(s)
- Cornelis A Rietmeijer
- Denver Public Health Department, Denver Health Medical Center, Denver, Colorado, USA.
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