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Holloway IW, Wu ESC, Boka C, Young N, Hong C, Fuentes K, Kärkkäinen K, Beikzadeh M, Avendaño A, Jauregui JC, Zhang A, Sevillano L, Fyfe C, Brisbin CD, Beltran RM, Cordero L, Parsons JT, Sarrafzadeh M. Novel Machine Learning HIV Intervention for Sexual and Gender Minority Young People Who Have Sex With Men (uTECH): Protocol for a Randomized Comparison Trial. JMIR Res Protoc 2024; 13:e58448. [PMID: 39163591 DOI: 10.2196/58448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Sexual and gender minority (SGM) young people are disproportionately affected by HIV in the United States, and substance use is a major driver of new infections. People who use web-based venues to meet sex partners are more likely to report substance use, sexual risk behaviors, and sexually transmitted infections. To our knowledge, no machine learning (ML) interventions have been developed that use web-based and digital technologies to inform and personalize HIV and substance use prevention efforts for SGM young people. OBJECTIVE This study aims to test the acceptability, appropriateness, and feasibility of the uTECH intervention, a SMS text messaging intervention using an ML algorithm to promote HIV prevention and substance use harm reduction among SGM people aged 18 to 29 years who have sex with men. This intervention will be compared to the Young Men's Health Project (YMHP) alone, an existing Centers for Disease Control and Prevention best evidence intervention for young SGM people, which consists of 4 motivational interviewing-based counseling sessions. The YMHP condition will receive YMHP sessions and will be compared to the uTECH+YMHP condition, which includes YMHP sessions as well as uTECH SMS text messages. METHODS In a study funded by the National Institutes of Health, we will recruit and enroll SGM participants (aged 18-29 years) in the United States (N=330) to participate in a 12-month, 2-arm randomized comparison trial. All participants will receive 4 counseling sessions conducted over Zoom (Zoom Video Communications, Inc) with a master's-level social worker. Participants in the uTECH+YMHP condition will receive curated SMS text messages informed by an ML algorithm that seek to promote HIV and substance use risk reduction strategies as well as undergoing YMHP counseling. We hypothesize that the uTECH+YMHP intervention will be considered acceptable, appropriate, and feasible to most participants. We also hypothesize that participants in the combined condition will experience enhanced and more durable reductions in substance use and sexual risk behaviors compared to participants receiving YMHP alone. Appropriate statistical methods, models, and procedures will be selected to evaluate primary hypotheses and behavioral health outcomes in both intervention conditions using an α<.05 significance level, including comparison tests, tests of fixed effects, and growth curve modeling. RESULTS This study was funded in August 2019. As of June 2024, all participants have been enrolled. Data analysis has commenced, and expected results will be published in the fall of 2025. CONCLUSIONS This study aims to develop and test the acceptability, appropriateness, and feasibility of uTECH, a novel approach to reduce HIV risk and substance use among SGM young adults. TRIAL REGISTRATION ClinicalTrials.gov NCT04710901; https://clinicaltrials.gov/study/NCT04710901. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/58448.
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Affiliation(s)
- Ian W Holloway
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Elizabeth S C Wu
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Callisto Boka
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Nina Young
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Chenglin Hong
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kimberly Fuentes
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kimmo Kärkkäinen
- Department of Computer Science, UCLA Samueli School Of Engineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Mehrab Beikzadeh
- Department of Computer Science, UCLA Samueli School Of Engineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Alexandra Avendaño
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Juan C Jauregui
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Aileen Zhang
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Lalaine Sevillano
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
- School of Social Work, Portland State University, Portland, OR, United States
| | - Colin Fyfe
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Cal D Brisbin
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Raiza M Beltran
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | - Luisita Cordero
- Department of Social Welfare, UCLA Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Majid Sarrafzadeh
- Department of Computer Science, UCLA Samueli School Of Engineering, University of California, Los Angeles, Los Angeles, CA, United States
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Künzler-Heule P, Schmidt AJ, Fierz K, Battegay M, Engberg S, Kouyos RD, Nöstlinger C, Stöckle M, Béguelin C, Delaloye J, Schmid P, Rougemont M, Braun DL, Fehr JS, Nicca D. Exploring group differences in the response to a sexual risk reduction intervention to prevent hepatitis C virus reinfection in HIV-infected MSM: a mixed-methods study. AIDS Care 2024; 36:442-451. [PMID: 37182220 DOI: 10.1080/09540121.2023.2208318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 04/21/2023] [Indexed: 05/16/2023]
Abstract
To prevent hepatitis C virus (HCV) reinfection, within the Swiss HCVree Trial, a preventive risk reduction intervention was implemented alongside curative treatment. Formative qualitative research identified three response patterns to the intervention. This mixed-methods study's aim was to cross-validate group differences in (a) the content of sexual risk reduction goals set during intervention and (b) the extent of their behavioural change in condomless anal intercourse with non-steady partners (nsCAI), sexualised and intravenous drug use at start and six-month post-intervention. Qualitative thematic analysis was used to summarise goal setting domains. Quantitative descriptive analysis was used to evaluate group differences based on assumptions of the group descriptions. Results largely confirmed assumptions on inter-group response differences in goal setting and behaviour: as expected group 1 Avoid risks showed the lowest HCV risk profile with changes in nsCAI. Group 2 Minimize-risks and Group 3 Accept-risks showed unchanged nsCAI. Group 3 had the highest HCV risk profile. Differences in their goal preferences (1: condom use; 2 reduction blood exposure; 3 safer dating) highlight diversity in attitudes to behavioural change. Our results improve understanding of variability in intervention responses such as changes in attitudes and behaviour. This provides evidence for intervention tailoring and outcome measurement.
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Affiliation(s)
- Patrizia Künzler-Heule
- Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland
- Department of Gastroenterology/Hepatology and Department of Nursing Development, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Axel J Schmidt
- Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Sigma Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Katharina Fierz
- Zurich University of Applied Sciences (ZUAS), Winterthur, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Sandra Engberg
- Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland
- University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA
| | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Marcel Stöckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Charles Béguelin
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Julie Delaloye
- Intensive Care Unit, Department of Intensive Care Medicine, University of Lausanne and University Hospital Center, Lausanne, Switzerland
| | - Patrick Schmid
- Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Mathieu Rougemont
- Primary Care Medicine Unit, University Hospital of Geneva, Geneva, Switzerland
| | - Dominique L Braun
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Jan S Fehr
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
- Department of Public & Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Dunja Nicca
- Nursing Science, Department Public Health, Medical Faculty, University of Basel, Basel, Switzerland
- Department of Public & Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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3
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Mehta N, Gupta S, Kularathne Y. The Role and Impact of Artificial Intelligence in Addressing Sexually Transmitted Infections, Nonvenereal Genital Diseases, Sexual Health, and Wellness. Indian Dermatol Online J 2023; 14:793-798. [PMID: 38099049 PMCID: PMC10718125 DOI: 10.4103/idoj.idoj_426_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 12/17/2023] Open
Abstract
The potential of artificial intelligence (AI) in diagnosing and managing sexually transmitted infections (STIs), nonvenereal genital diseases, and overall sexual health is immense. AI shows promise in STI screening and diagnosis through image recognition and patient data analysis, potentially increasing diagnostic accuracy while ensuring inclusivity. AI can fuel the transformation of e-health and direct-to-consumer services, enhancing targeted screening and personalized interventions while improving the user-friendliness of services. There is a significant role for AI in sexual education, particularly its use in interactive, empathetic chatbots. AI's integration into health care as a decision support tool for primary health-care providers can boost real-time diagnostic accuracy. Furthermore, AI's use in big data can enhance real-time epidemiology, predictive analysis, and directed interventions at population levels. However, challenges such as real-world diagnostic accuracy, liability, privacy concerns, and ethical dilemmas persist. Future directions include an emphasis on inclusivity, language accommodation, and swift research-to-practice transitions. Collaboration among policymakers, researchers, and health-care providers is needed to leverage AI's transformative potential in sexual health.
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Affiliation(s)
- Nikhil Mehta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Janulis P, Goodreau SM, Morris M, Birkett M, Phillips G, Risher K, Mustanski B, Jenness SM. Partnership types and coital frequency as predictors of gonorrhea and chlamydia among young MSM and young transgender women. Int J STD AIDS 2023; 34:694-701. [PMID: 37146303 PMCID: PMC10524890 DOI: 10.1177/09564624231173728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Sexually transmitted infections pose a major public health challenge in the United States and this burden is especially acute in subpopulations like young men who have sex with men (YMSM) and young transgender women (YTW). Yet, the direct behavioral antecedents of these infections are not well understood making it difficult to identify the cause of recent increases in incidence. This study examines how variations in partnership rates and the number of condomless sex acts are associated with STI infections among YMSM-YTW. METHOD This study leveraged 3 years of data from a large longitudinal cohort of YMSM-YTW. A series of generalized linear mixed models examined the association between the number of condomless anal sex acts, number of one-time partners, number of casual partners, and number of main partners and chlamydia, gonorrhea, or any STI. RESULTS Results indicated the number of casual partners was associated with gonorrhea [aOR = 1.17 (95% CI: 1.08, 1.26)], chlamydia [aOR = 1.12 (95% CI: 1.05, 1.20)], and any STI [aOR = 1.14 (95% CI: 1.08, 1.21)] while the number of one-time partners was only associated with gonorrhea [aOR = 1.13 (95% CI: 1.02, 1.26)]. The number of condomless anal sex acts was not associated with any outcome. CONCLUSION These findings suggest the number of casual partners is a consistent predictor of STI infection among YMSM-YTW. This may reflect the quick saturation of risk within partnerships making the number of partners, rather than the number of acts, the more relevant factor for STI risk.
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Affiliation(s)
- Patrick Janulis
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Steven M Goodreau
- Departments of Anthropology and Epidemiology, University of Washington, Seattle, WA, USA
| | - Martina Morris
- Departments of Statistics and Sociology, University of Washington, Seattle, WA, USA
| | - Michelle Birkett
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Gregory Phillips
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Kathryn Risher
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
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5
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Eleuteri S, Toso M. How the smartphone apps can improve your sexual wellbeing. Int J Impot Res 2023:10.1038/s41443-023-00730-4. [PMID: 37414872 DOI: 10.1038/s41443-023-00730-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023]
Abstract
The use of smartphones and other technological devices has rapidly increased in the last few years, along with the availability of various applications that can be downloaded on iOS or Android devices. In this narrative review, we included most of the literature found on the specific topic of smartphone apps related to sexual health. Using the two databases PubMed and PsycInfo, we conducted research by the following terms: "apps" and "sexual wellbeing"; "apps" and "sexual health"; "mhealth" and "sex"; "mhealth", "apps" and "sex". We selected all articles written in English within the last 6 years to ensure the accessibility and consider the rapid changes in this field. The article highlights that many populations are interested in gaining information on a wide range of topics relating to sexual practices, potential risks, coercion, sexual violence and the prevention and recognition of potentially dangerous situations. Some findings suggest that sex education for sexual minority adolescents should focus on online sexual safety. Despite their value, many concerns and limitations must be solved, and future research studies are needed to explore how to fix them.
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6
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Wang Y, Mitchell J, Liu Y. Evidence and implication of interventions across various socioecological levels to address HIV testing uptake among men who have sex with men in the United States: A systematic review. SAGE Open Med 2022; 10:20503121221107126. [PMID: 35795867 PMCID: PMC9251980 DOI: 10.1177/20503121221107126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/25/2022] [Indexed: 12/20/2022] Open
Abstract
Objectives Strengthening HIV testing uptake is critical to curtail the HIV epidemics among men who have sex with men in the United States. Despite the implementation of various interventions to promote HIV testing among men who have sex with men, few aggregated evidence is presented to reflect the "lessons learned" and inform future directions. The objective of this systematic review is to comprehensively summarize published studies that described, tested, and evaluated outcomes (e.g. efficacy, effectiveness, acceptability, feasibility and/or qualitative opinions) associated with an HIV testing intervention and identify gaps as well as opportunities to inform the design and implementation of future interventions to enhance HIV testing uptake among men who have sex with men in the United States. Methods We followed the PRISMA guidelines and conducted a systematic review of articles (published by 23 July 2021) by searching multiple databases (PubMed, MEDLINE, Web of Science and PsycINFO). Results Among the total number of 3505 articles found through multiple databases, 56 papers were included into the review. Interventional modules that demonstrated acceptability, feasibility and efficacy to improve HIV testing uptake among men who have sex with men include: HIV self-testing, interpersonal-level (e.g. peer-led, couple-based) interventions, personalized interventions and technology-based interventions (e.g. mHealth). Aggregated evidence also reflects the lack of individualized interventions that simultaneously address time-varying needs across multiple socioecological levels (e.g. individual, interpersonal, community, structural and societal). Conclusion Development of interventions to improve HIV testing rates and frequency of men who have sex with men has proliferated in recent years. Our review presents important implications in sustaining and improving interventions to address HIV testing uptake among men who have sex with men in the United States.
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Affiliation(s)
- Ying Wang
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Jason Mitchell
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Yu Liu
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
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Hecht J, Zlotorzynska M, Sanchez TH, Wohlfeiler D. Gay Dating App Users Support and Utilize Sexual Health Features on Apps. AIDS Behav 2022; 26:2081-2090. [PMID: 35018547 PMCID: PMC9046136 DOI: 10.1007/s10461-021-03554-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 12/21/2022]
Abstract
Men who have sex with men (MSM) frequently meet sex partners through dating apps. Research has demonstrated an association between app use and greater number of sex partners and STIs, but dating apps also pose an opportunity for intervention. By advocating for sexual health features on dating apps, Building Healthy Online Communities (BHOC) aims to increase communication about sexual health among app users. In partnership with Emory University, BHOC added questions to an annual survey of MSM. The questions assessed awareness and uptake of profile fields and sexual health features on the dating apps. Among survey participants, 67% (6737/10,129) reported using dating apps to meet a partner in the past year. Among this group, 77% (4993/6525) reported awareness of sexual health features. 61% of app users (2866/4721) who were aware of them reported using one or more sexual health features. BHOC continues to advocate for increased uptake of these features.
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Affiliation(s)
- Jennifer Hecht
- Building Healthy Online Communities, Springboard HealthLab, 5601 Van Fleet Ave, Richmond, CA, 94804, USA.
| | - Maria Zlotorzynska
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Travis H Sanchez
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Dan Wohlfeiler
- Building Healthy Online Communities, Springboard HealthLab, 5601 Van Fleet Ave, Richmond, CA, 94804, USA
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Goedel WC, Sutten Coats C, Sowemimo-Coker G, Moitra E, Murphy MJ, van den Berg JJ, Chan PA, Nunn AS. Gay and Bisexual Men's Recommendations for Effective Digital Social Marketing Campaigns to Enhance HIV Prevention and Care Continuity. AIDS Behav 2021; 25:1619-1625. [PMID: 33231845 DOI: 10.1007/s10461-020-03078-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 10/22/2022]
Abstract
Because use of geosocial-networking smartphone applications ('apps') is ubiquitous among men who have sex with men (MSM), online-to-offline service models that include advertisements on these apps may improve engagement with effective HIV prevention and treatment services. Through our formative qualitative study, we conducted individual in-depth interviews (n = 30) and focus group discussions (n = 18) with MSM in Rhode Island to develop a digital social marketing campaign aimed at increasing HIV testing, including how best to reach men by advertising on apps. Qualitative data analysis revealed that participants were frequently exposed to pop-up advertisements on apps. These advertisements are viewed as invasive and, as such, many expressed a preference for other formats (e.g., direct messages, banner advertisements). Men expressed a preference for provocative images and phrases to catch their attention followed with fact-driven messaging to motivate them to engage with services offline. Findings from this study offer several practical recommendations for developing a social marketing campaign that uses advertisements on apps to increase HIV testing among MSM, including using formats other than pop-up advertisements and pairing fact-driven messaging with eye-catching images to direct them to trusted local clinical services.
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Murphy M, Tao J, Goedell WC, Berk J, Chu CT, Nunn A, Sosnowy C, Chan P. Characterizing substance use among men who have sex with men presenting to a sexually transmitted infection clinic. Int J STD AIDS 2021; 32:314-321. [PMID: 33292093 DOI: 10.1177/0956462420965076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Illicit substance use poses a significant public health challenge in the United States. Certain populations are disproportionately impacted by substance use disorders. Men who have sex with men (MSM) have been shown to be three to four times more likely to report substance use compared to the general population. MSM also make up a disproportionate number of new cases of STIs. The impact of substance use disorders on STI and HIV infection risk has been well documented among this vulnerable population. Understanding the intersection of substance use and sexual risk is important to design effective interventions to reduce substance use and risk of STIs. However, little is known about the relationship between venues used to arrange sexual encounters including hook-up apps and substance use. This study describes the demographics and social network characteristics of MSM who presented to an STI clinic in Rhode Island including reported substance use and the primary hook-up venues used for meeting sexual partners. The results show that individuals using online venues to meet sexual partners were more likely to report substance use, indicating the possible utility of interventions using social media to address the unique vulnerability of STI and HIV infection for substance using MSM.
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Affiliation(s)
- Matthew Murphy
- Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Jun Tao
- Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | | | - Justin Berk
- Department of Pediatrics, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Christina T Chu
- Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Amy Nunn
- Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- School of Public Health, Brown University, Providence, RI, USA
| | - Collette Sosnowy
- Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Philip Chan
- Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- School of Public Health, Brown University, Providence, RI, USA
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The role of sexual compulsivity in unprotected intercourse among STI patients in Shanghai, China. BMC Public Health 2021; 21:141. [PMID: 33446160 PMCID: PMC7809841 DOI: 10.1186/s12889-021-10186-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background Sexual compulsivity (SC) and its relationship with unprotected intercourse (UI) have long been an intriguing topic, but its existential meaning in the management of public health or, more precisely, sexually transmitted infections (STIs) has rarely been studied to date. This study examines whether SC plays a role in UI among sexually active STI patients. Method A cross-sectional study was conducted in two sexual transmitted disease (STD) clinicals of Shanghai Skin Diseases Hospital in Shanghai. Totally 664 sexually active STI patients were included. Results The ages of the 664 participants ranged from 18 to 76 years, with 58.73% between 26 and 40 years old. 449 (191 male and 258 female) reported had UI during the past 6 months. Although the only statistically significant difference (p < 0.01) was in relation to UI with a casual sexual partner, the difference between male/female and regular/casual sexual partners remained evident. Conclusions SC is evidently a potential predictor of UI with a casual sexual partner in male STI patients, while the use of condoms is more likely to be affected by other factors. In addition to general sexual education, counseling interventions should be provided by health institutions, and specific intervention methods targeting gender and sexual partners should be considered.
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Lankowski A, Sánchez H, Hidalgo J, Cabello R, Duerr A. Sex-on-premise venues, associated risk behaviors, and attitudes toward venue-based HIV testing among men who have sex with men in Lima, Perú. BMC Public Health 2020; 20:521. [PMID: 32306942 PMCID: PMC7168867 DOI: 10.1186/s12889-020-08604-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 03/27/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In Perú, HIV disproportionately affects men who have sex with men (MSM). Despite widespread access to treatment, the high rate of new HIV infections has remained unchanged over the last decade. Low knowledge of HIV status associated with late diagnosis is a key factor underlying the high HIV incidence observed in this setting, creating conditions for efficient onward transmission. Improving access to HIV testing and prevention services for those at highest risk is an important public health priority. Sex-on-premise venues (SOPVs) - saunas, sex clubs, pornographic movie theaters, hourly hotels, and bars/discos with areas where sex is permitted - may be opportune sites for outreach; however, further research on SOPVs and the populations who frequent them is needed to inform such efforts. METHODS We conducted a cross-sectional online survey of adult MSM in Lima, Perú to evaluate patterns of SOPV attendance, associated sexual risk behaviors, and attitudes toward SOPV-based interventions. Participants were recruited through outreach to social media networks affiliated with local LGBTQ-aligned community groups. Our primary analytic objective was to estimate the association of HIV-related sexual risk behaviors and SOPV attendance. Additionally, we performed exploratory analyses to describe risk behavior stratified by SOPV category and to examine the relationship between SOPV attendance and the use of online platforms to meet sex partners. RESULTS Overall, 389 MSM completed the survey from November 2018 through May 2019, of whom 68% reported attending an SOPV in the last 3 months. SOPV attendance was associated with multiple sexual risk behaviors, including transactional sex, group sex, substance use around the time of sex, and higher number of partners. Over two thirds of SOPV attendees indicated they would accept HIV testing if offered at SOPVs. CONCLUSIONS SOPV attendance was common among MSM in Lima who participated in our survey, and SOPV attendees reported significantly greater engagement in sexual risk behaviors related to HIV transmission. Attitudes toward hypothetical SOPV-based interventions were generally favorable. These findings suggest that outreach at SOPVs may be an effective mechanism for reaching a particularly high-risk sub-population of MSM in Perú to deliver targeted HIV testing and prevention interventions.
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Affiliation(s)
- Alexander Lankowski
- Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.
- Vaccine & Infectious Disease and Public Health Science Divisions, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | | | | | | | - Ann Duerr
- Vaccine & Infectious Disease and Public Health Science Divisions, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Departments of Epidemiology and Global Health, University of Washington School of Public Health, Seattle, WA, USA
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12
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Abstract
PURPOSE OF REVIEW This study aims to review the epidemiology of sexually transmitted infections (STIs) among men who have sex with men (MSM) and suggest control measures. RECENT FINDINGS Despite declines in new HIV diagnosis, bacterial STIs among MSM have dramatically risen since the late 1990s. This increase occurred concurrent with introduction of effective antiretroviral therapy, the advent of electronic mechanisms for meeting sex partners and population-level changes in sexual behavior, including decreased condom use. HIV pre-exposure prophylaxis (PrEP) is now further diminishing condom use, though its impact on STIs is uncertain. A plan to confront the MSM STI epidemic should include increased HIV/STI testing promoted through expanded public health clinical infrastructure, health care system reform to improve the care of gender and sexual minorities and promote low-barrier care, re-invigorated condom promotion, and scientific innovation. There is an urgent need to implement new STI control measures while continuing to expand PrEP use.
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Affiliation(s)
- Meena S Ramchandani
- Department of Medicine, Harborview Medical Center, University of Washington, Mailstop: 359777, 325 Ninth Avenue, Seattle, WA, 98104, USA.
- Public Health-Seattle and King County HIV/STD Program, Seattle, WA, USA.
| | - Matthew R Golden
- Department of Medicine, Harborview Medical Center, University of Washington, Mailstop: 359777, 325 Ninth Avenue, Seattle, WA, 98104, USA
- Public Health-Seattle and King County HIV/STD Program, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
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13
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Saberi P, Neilands TB, Lally MA, Hosek SG, Hightow-Weidman L. The Association between Use of Online Social Networks to Find Sex Partners and Sexually Transmitted Infection Diagnosis among Young Men Who Have Sex with Men and Transgender Women Living with HIV. J Int Assoc Provid AIDS Care 2019; 18:2325958219867324. [PMID: 31389285 PMCID: PMC6900576 DOI: 10.1177/2325958219867324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/23/2019] [Accepted: 07/02/2019] [Indexed: 11/17/2022] Open
Abstract
We conducted a cross-sectional analysis of baseline data from the Adolescent Trials Network for HIV/AIDS Interventions to examine the association between the use of social media sites to find sex partners and recent diagnosis of sexually transmitted infections (STIs) among 13- to 24-year-old men who have sex with men and transgender women living with HIV. We used linear regression to determine the relationship between the number of STIs and the number of social media sites used to find sex partners with each type of sex act included in the analysis. Secondary analyses substituted frequency of social media site use for number of social media sites. Among 741 participants, for every 1 social media account used to find sex partners, there was a 2.53% (95% confidence interval: 0.28-5.54) increase in STIs. This association was mediated through condomless receptive anal intercourse or condomless insertive anal intercourse but not barrierless oral intercourse. Similar but attenuated associations were found when frequency of social media site use was substituted for number of social media sites. Future research should examine innovative interventions on these social media sites with respect for its users.
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Affiliation(s)
- Parya Saberi
- Department of Medicine, University of California San Francisco, San
Francisco, CA, USA
| | - Torsten B. Neilands
- Department of Medicine, University of California San Francisco, San
Francisco, CA, USA
| | - Michelle A. Lally
- Department of Medicine, Alpert Medical School of Brown University and
Lifespan Hospital System, Providence, RI, USA
| | - Sybil G. Hosek
- Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL,
USA
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