From (Un)Willingness to InvolveMENt: Development of a Successful Study Brand for Recruitment of Diverse MSM to a Longitudinal HIV Research

"No more COVID-19 messages via social media, please": the mediating role of COVID-19 message fatigue between information overload, message avoidance, and behavioral intention

Employing the stressor-strain-outcome framework, this study demonstrates that COVID-19 information overload on social media exerts a significant effect on the level of fatigue toward COVID-19-related messages. This feeling of message fatigue also makes people avoid another exposure to similar types of messages while diminishing their intentions to adopt protective behaviors in response to the pandemic. Information overload regarding COVID-19 on social media also has indirect effects on message avoidance and protective behavioral intention against COVID-19, respectively, through the feeling of fatigue toward COVID-19 messages on social media. This study emphasizes the need to consider message fatigue as a significant barrier in delivering effective risk communication.

Measuring information overload and message fatigue toward COVID-19 prevention messages in USA and China

COVID-19 prevention messages are a crucial component of disease mitigation strategies and the primary driver of health decision-making during the global pandemic. However, the constant and repetitive nature of COVID-19 messaging may cause unintended consequences. Among the commonly observed phenomena are information overload and message fatigue, which might be experienced differently depending on cultural background. Using measurement invariance testing, this study compared how individuals from two countries-USA (n = 493) and China (n = 571)-experienced information overload and message fatigue toward COVID-19 prevention messages. Findings revealed that people in China showed significantly lower level of information overload and message fatigue than those in the USA. This study explores the extent of the unintended persuasive effects that people have experienced during the COVID-19 pandemic in different societies, a comparison which has never been studied before, even outside of the context of COVID-19. The study also provides much-needed practical insights to develop public health initiatives that improve COVID-19 prevention communication, which can further reduce these unintended effects in both countries, and has implications for other countries as well.

Young at risk-people in Maputo City, Mozambique, present a high willingness to participate in HIV trials: Results from an HIV vaccine preparedness cohort study

INTRODUCTION

Vaccine efficacy testing requires engagement of willing volunteers with high disease incidence. We evaluated factors associated with willingness to participate in potential future HIV vaccine trials in Maputo, Mozambique.

METHODS

Adults aged 18-35 years without HIV and who reported at least two sexual partners in the 3 months prior to screening were enrolled into a 24-month observational study. They were asked at screening and exit if they would be willing to participate in a theoretical HIV vaccine study. Bivariate and multivariate logistic regression analyses were done between willingness to participate, demographic, sexual behavior, and motivational factors for screening visit data. Logistic regression with generalized estimating equations (GEE) was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors potentially associated with willingness to participate for data from both visits.

RESULTS

A total of 577 participants without HIV were eligible, including 275 (48%) women. The mean age was 22.2 (SD ± 3.9) years. At screening 529 (92%) expressed willingness to participate and the proportion remained stable at 378 (88%) of the 430 participants retained through the exit visit (p = 0.209). Helping the country (n = 556) and fear of needles (n = 26) were the top motive and barrier for willingness to participate, respectively. Results from the GEE binary logistic regression (screening visit and exit visit) showed that wanting to learn how to avoid risk behaviors (aOR 3.33, 95% CI: 1.61-6.86) and feeling protected against HIV infection (aOR 2.24, 95% CI: 1.07-4.7) were associated with willingness to participate in HIV vaccine studies.

CONCLUSION

The majority of our study population in Mozambique expressed willingness to participate in a theoretical HIV vaccine trial. Participation in a HIV vaccine trial was seen as a way to contribute to the fight against HIV but was associated with some unrealistic expectations such as protection against HIV. This reinforces the need for continuous mobilization and awareness of potential participants to HIV vaccine trial.

Condom use during COVID-19: Findings from an Australian sample of heterosexual young adults

Condoms are a valuable tool in combating the continued spread of sexually transmitted infections (STIs). Despite the fact that condoms are effective and easily accessible, young adults report inconsistent condom use and young adults represent a disproportionately large amount of new STI cases annually. The Behavioural Immune System theory suggests that health behaviours, such as condom use, are impacted by cognitive activation of perceived threat of disease. The advent of the COVID-19 pandemic may then have unforeseen impacts on condom use and the spread of STIs. The present study investigated changes in condom use during the pandemic, and any associations these changes may have had with perceived vulnerability to COVID-19. An Australian sample of 269 students completed a survey asking them to recall their condom use prior to COVID-19, and then their current condom use. Final analyses included a sample of 149 sexually active heterosexual participants. Results revealed a general decline in condom use. Single and coupled participants both reported less frequent condom use, but this decrease was more pronounced among single people. Gender did not moderate these effects. Surprisingly, diminished condom use was not significantly related to perceived threat of COVID-19. Findings of the present study have concerning implications for sexual health and sexual messaging during pandemics.

What motivates gay and bisexual men to participate in PrEP-related research?

Pre-Exposure Prophylaxis (PrEP) has been demonstrated effective at preventing HIV among key populations like gay and bisexual men (GBM). Yet, there remains a continued need to engage GBM in PrEP behavioral and clinical research (e.g., to monitor adherence and retention in the PrEP treatment cascade). We report on the factors motivating GBM to participate in a PrEP behavioral study, with the aim of our results to inform future recruitment efforts for future PrEP research. In 2015-2016, 103 PrEP-using GBM in NYC completed qualitative interviews about their experiences on PrEP. Participants were also asked about factors that motivated them to join the study. Thematic analysis was used analyze the data. We identified five salient themes as rationale for joining the study: 58.3% cited altruistic reasons, 32% reported intellectual curiosity in the subject matter, 30.1% indicated that remuneration inspired them, 18.4% indicated that familiarity or referral to the research institute influenced their decision. Researchers attempting to enroll PrEP-using GBM may benefit from attending to the altruistic and intellectually curious nature of this population. Further, researchers may benefit from establishing familiarity among diverse communities of GBM. This in turn may contribute to the successful engagement of GBM for PrEP research.

Comparative Analysis of Recruitment Strategies in a Study of Men Who Have Sex with Men (MSM) in Metropolitan Detroit

HIV/AIDS-related research requires recruitment of representative samples of MSM; yet, we know little about the comparative yield, diversity and cost-benefit tradeoffs between different recruitment venues. We compared 11 recruitment venues used for nine HIV prevention-related focus groups with MSM in Metropolitan Detroit. Of the 64 participants, 24 were clients recruited via an HIV/AIDS-focused nonprofit, 20 from Grindr advertisements, 6 from university-student email lists, and 5 from flyers/palmcards. Significantly more African-American, low-income and HIV-positive participants were recruited via the nonprofit. The best cost-benefit tradeoffs were for organizational Facebook posts, email groups, personal networking, and nonprofit recruitment. Grindr increased the size of the sample, though at greater expense. Facebook and Scruff advertisements and gay bar outreach represented greater costs than benefits. Only 11.6% of Grindr respondents attended the focus groups. A mix of online and offline recruitment venues can generate a large and diverse sample of MSM, but venue performance is uneven.

Contributions of Qualitative Research in Informing HIV/AIDS Interventions Targeting Black MSM in the United States

This article presents a systematic review of qualitative studies focusing on human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among Black men who have sex with men (BMSM) in the United States. We reviewed studies that were published between 1980 and 2014. Qualitative methods employed in the studies reviewed include in-depth interviews, focus groups, participant observation, and ethnography. We searched several databases (PubMed, PsychINFO, JSTOR, ERIC, Sociological Abstracts, and Google Scholar) for relevant articles using the following broad terms: "Black men" "Black gay/bisexual" or "Black men who have sex with men," and "qualitative" and/or "ethnography." We include 70 studies in this review. The key themes observed across studies were (1) heterogeneity, (2) layered stigma and intersectionality, (3) risk behaviors, (4) mental health, (5) resilience, and (6) community engagement. The review suggests that sexual behavior and HIV-status disclosure, sexual risk taking, substance use, and psychological well-being were contextually situated. Interventions occurring at multiple levels and within multiple contexts are needed to reduce stigma within the Black community. Similarly, structural interventions targeting religious groups, schools, and health care systems are needed to improve the health outcomes among BMSM. Community engagement and using community-based participatory research methods may facilitate the development and implementation of culturally appropriate HIV/AIDS interventions targeting BMSM.