1
|
Gibson LP, Kramer EB, Wrigley J, Probst M, Bryan AD. Gay community involvement and the sexual health behaviours of sexual minority men: a systematic review and directions for future research. Health Psychol Rev 2024; 18:299-318. [PMID: 37458157 DOI: 10.1080/17437199.2023.2236180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
Considerable research has examined how involvement in gay-affiliated communities is associated with sexual health behaviours in sexual minority men (i.e., gay, bisexual, and other men who have sex with men), yet findings in this domain are often contradictory and inconclusive. This systematic review aimed to (a) synthesise the related empirical literature, and (b) identify potential factors driving inconsistent findings. Peer-reviewed publications were included if they contained quantitative data and at least one measure of the statistical association between gay community involvement and sexual health behaviour. The search strategy was implemented in six databases and returned 6,409 articles, of which 86 met the inclusion criteria. There was considerable heterogeneity in how gay community involvement was assessed across studies. Although gay community involvement was consistently associated with greater engagement in protective behaviours across studies, the association between gay community involvement and risk behaviours appeared to depend on how gay community involvement was conceptualised and measured (e.g., nightlife involvement vs. political activism). Findings emphasise a need for studies that employ validated measures that reflect the multidimensional nature of gay community involvement, as well as research designs better suited to address the causal effects of community involvement on HIV/STI transmission and prevention.
Collapse
Affiliation(s)
- Laurel P Gibson
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Emily B Kramer
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Jordan Wrigley
- Center for Data & Digital Scholarship, University Libraries, University of Colorado Boulder, Boulder, CO, USA
| | - Maxwell Probst
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Angela D Bryan
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| |
Collapse
|
2
|
Zhang H, Wang M, Zhang Y, Tan S, Huang H, Zhu J, Tian W, Mo J, Mo J, Cen P, Ning C. Usability of dual HIV/syphilis self-testing among men who have sex with men in China: study protocol for a three-arm randomised controlled trial. BMJ Open 2022; 12:e059034. [PMID: 36216414 PMCID: PMC9558798 DOI: 10.1136/bmjopen-2021-059034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION HIV self-testing (HIVST) provides a key measure for the early detection of HIV infection in men who have sex with men (MSM). However, dual HIV/syphilis self-testing in the MSM population has not been studied. We describe a randomised controlled trial to evaluate the effect of dual HIV/syphilis self-testing on the testing frequency among MSM in China. METHODS AND ANALYSIS This randomised controlled trial will be implemented in Guangxi, China. 330 MSM, including 255 frequent testers and 75 less frequent testers, will be recruited and randomly assigned in a 1:1:1 ratio into one of three arms: a site-based testing arm, a single HIVST arm and a dual HIV/syphilis self-testing arm. Participants in the single HIVST arm and dual HIV/syphilis self-testing arm will receive two free finger-prick-based HIVST or HIV/syphilis self-testing kits at enrolment. The data will be collected at five separate times: baseline, 3 months, 6 months, 9 months and 12 months. The primary outcome is the mean frequency of HIV testing used by MSM after intervention comparing each group during the study period. The secondary outcome includes changes in sex behaviours (eg, number of male sex partners and the proportion of consistent condom use) and the mean number of HIV tests used by the social network members over the study period. ETHICS AND DISSEMINATION The study protocol was reviewed and approved by the Medical Ethics Committee of Guangxi Medical University, China (20210173). The study results will be disseminated through conferences and academic journals. TRIAL REGISTRATION NUMBER ChiCTR2100050898.
Collapse
Affiliation(s)
- Hong Zhang
- Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Min Wang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Yun Zhang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Sumin Tan
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Haimei Huang
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiawen Zhu
- The Second Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Weiyi Tian
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Jinli Mo
- The Second Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Jieling Mo
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
| | - Ping Cen
- AIDS/STD Control and Prevention, Nanning Municipal Center for Disease Prevention and Control, Nanning, Guangxi, China
| | - Chuanyi Ning
- Nursing College, Guangxi Medical University, Nanning, Guangxi, China
- Key Lab of AIDS Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| |
Collapse
|
3
|
Alarmingly High HIV Prevalence Among Adolescent and Young Men Who have Sex with Men (MSM) in Urban Indonesia. AIDS Behav 2021; 25:3687-3694. [PMID: 34143341 PMCID: PMC8560664 DOI: 10.1007/s10461-021-03347-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/23/2022]
Abstract
Indonesia’s HIV epidemic is concentrated among key populations. While prevalence among men who have sex with men (MSM) is high, transmission among young MSM (15–24-years-old) remains poorly understood. We conducted a respondent driven sampling survey of 211 young MSM in urban Bandung, Indonesia in 2018–2019 to estimate HIV prevalence and associated risk factors. Thirty percent of young MSM were HIV antibody positive. This is nearly 100-fold greater than Indonesia’s population prevalence and sevenfold higher than average estimates for young MSM across Asia and the Pacific Region. Individual risk factors associated with HIV infection were being 20–24 years old, having a steady partner and preferring the receptive position during sex. Issues of stigma, discrimination and social exclusion were common. Few young MSM who were open with friends and family members about their sexual identity. Among those that were, close to half reported experiencing feelings of aversion from these groups. Wider structural factors that reduce social tolerance, restrict the rights of young MSM and compel concealment of sexual identity are likely to fuel high-risk behaviors and limit access to essential testing care and support services including pre-exposure prophylaxis which is not yet widely available. Urgent health, social, legal and political actions are required to respond to these factors and reduce the disproportionate contribution of young MSM to Indonesia’s HIV epidemic.
Collapse
|
4
|
Wu D, Zhou Y, Yang N, Huang S, He X, Tucker J, Li X, Smith KM, Ritchwood T, Jiang X, Liu X, Wang Y, Huang W, Ong J, Fu H, Bao H, Pan S, Dai W, Tang W. Social Media-Based Secondary Distribution of Human Immunodeficiency Virus/Syphilis Self-testing Among Chinese Men Who Have Sex with Men. Clin Infect Dis 2021; 73:e2251-e2257. [PMID: 32588883 PMCID: PMC8492201 DOI: 10.1093/cid/ciaa825] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/17/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Social media and secondary distribution (distributing self-testing kits by indexes through their networks) both show strong promise to improve human immunodeficiency virus (HIV) self-testing uptake. We assessed an implementation program in Zhuhai, China, which focused on the secondary distribution of HIV/syphilis self-test kits among men who have sex with men (MSM) via social media. METHODS Men aged ≥16 years, born biologically male, and ever had sex with another man were recruited as indexes. Banner ads on a social media platform invited the participants to apply for up to 5 self-test kits every 3 months. Index men paid a deposit of US$15/kit refundable upon submitting a photograph of a completed test result via an online submission system. They were informed that they could distribute the kits to others (referred to as "alters"). RESULTS A total of 371 unique index men applied for 1150 kits (mean age, 28.7 [standard deviation, 6.9] years), of which 1141 test results were returned (99%). Among them, 1099 were valid test results; 810 (74%) were from 331 unique index men, and 289 tests (26%) were from 281 unique alters. Compared to index men, a higher proportion of alters were naive HIV testers (40% vs 21%; P < .001). The total HIV self-test reactivity rate was 3%, with alters having a significantly higher rate than indexes (5% vs 2%; P = .008). A total of 21 people (3%) had a reactive syphilis test result. CONCLUSIONS Integrating social media with the secondary distribution of self-test kits may hold promise to increase HIV/syphilis testing coverage and case identification among MSM.
Collapse
Affiliation(s)
- Dan Wu
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Insititute of Global Health and Sexually Transmitted Infection Research, Southern Medical University, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Yi Zhou
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Nancy Yang
- University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Shanzi Huang
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Xi He
- Zhuhai Xutong Voluntary Services Center, Zhuhai, China
| | - Joseph Tucker
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
- University of North Carolina Project–China, Guangzhou, China
| | - Xiaofeng Li
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Kumi M Smith
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Tiarney Ritchwood
- Family Medicine and Community Health, Duke University, Durham, North Carolina, USA
| | | | - Xuan Liu
- University of North Carolina Project–China, Guangzhou, China
| | - Yehua Wang
- University of North Carolina Project–China, Guangzhou, China
| | - Wenting Huang
- Behavioral Sciences and Health Education, Emory University, Georgia, Atlanta, USA
| | - Jason Ong
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Hongyun Fu
- Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Huanyu Bao
- University of North Carolina Project–China, Guangzhou, China
| | - Stephen Pan
- Department of Health and Environmental Sciences, Xi’an Jiaotong Liverpool University, Suzhou, China
| | - Wencan Dai
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Weiming Tang
- Insititute of Global Health and Sexually Transmitted Infection Research, Southern Medical University, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- University of North Carolina Project–China, Guangzhou, China
| |
Collapse
|
5
|
Huang L, Wu H, Yan H, Liang Y, Li Q, Shui J, Han Z, Tang S. Syphilis Testing as a Proxy Marker for a Subgroup of Men Who Have Sex With Men With a Central Role in HIV-1 Transmission in Guangzhou, China. Front Med (Lausanne) 2021; 8:662689. [PMID: 34307399 PMCID: PMC8293274 DOI: 10.3389/fmed.2021.662689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/26/2021] [Indexed: 12/09/2022] Open
Abstract
Objectives: The objectives of this study were to distinguish the role of men who have sex with men (MSM) with or without syphilis testing in HIV-1 transmission and to provide molecular evidence of syphilis testing as a proxy marker for identifying the subgroup of MSM. Methods: HIV-1 transmission clusters were constructed by HIV-TRACE and Cluster Picker using HIV-1 pol sequences from 729 newly diagnosed HIV-infected MSM from 2008 to 2012 in Guangzhou, China. The role of MSM in HIV-1 transmission networks was determined by a node influence measurement and centrality analysis. The association between syphilis testing and factors related to HIV-1 transmission and antiretroviral treatment (ART) were analyzed by the Cox regression model. Results: Among HIV-infected MSM, 56.7% did not test for syphilis at the time of HIV-1 diagnosis. MSM without syphilis testing was a specific subgroup of MSM with a larger closeness centrality and clustering coefficient than the recipients of syphilis testing (P < 0.001), indicating their central position in the HIV-1 transmission networks. The median degree and radiality within HIV-1 transmission networks as well as the median K-shell scores were also greater for MSM without syphilis testing (P < 0.001), suggesting their relatively greater contribution in transmitting HIV-1 than the receipts of syphilis testing. MSM with syphilis testing usually did not disclose their occupation or were more likely to be unemployed or to take non-skilled jobs, to have a history of sexually transmitted infections (STIs), and to be AIDS patients when diagnosed with HIV-1 infection (P < 0.05). Multivariable Cox regression analysis indicated that syphilis testing per se did not promote the engagement of ART (P = 0.233) or affect the speed of CD4+ T cell count recovery after treatment (P = 0.256). Conclusions: Our study identifies syphilis testing as a proxy marker of a specific subgroup of HIV-infected MSM who refuse syphilis testing during HIV-1 diagnosis with an important role in HIV-1 transmission. Specific prevention and intervention targeting MSM without syphilis testing during HIV-1 care are urgently needed.
Collapse
Affiliation(s)
- Liping Huang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Hao Wu
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Huanchang Yan
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yuanhao Liang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qingmei Li
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jingwei Shui
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zhigang Han
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China.,Institute of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Shixing Tang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China.,Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| |
Collapse
|