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Oginni OA, Adelola AI, Ogunbajo A, Opara OJ, Akanji M, Ibigbami OI, Afolabi OT, Akinsulore A, Mapayi BM, Mosaku SK. Antiretroviral therapy non-adherence and its association with psychosocial factors in Nigeria: comparative study of sexual minority and heterosexual men living with HIV. AIDS Care 2024; 36:1369-1381. [PMID: 38869985 DOI: 10.1080/09540121.2024.2366511] [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: 12/07/2023] [Accepted: 06/03/2024] [Indexed: 06/15/2024]
Abstract
Sexual minority men (gay, bisexual and other men who have sex with men; SMM) in Nigeria are disproportionately affected by HIV compared to heterosexual men. There is a dearth of research on the correlates of antiretroviral therapy (ART) non-adherence and correlates in both groups. The current study examined the associations of ART non-adherence with sociodemographic and psychosocial characteristics among a sample of Nigerian heterosexual and SMM. Between March and September 2014, we surveyed 120 SMM and 108 heterosexual men receiving ART in Lagos and Abuja, Nigeria. We specified univariate and multivariable linear regression models to examine correlates of ART non-adherence. We found that 50.8% and 29.6% of sexual minority and heterosexual men respectively self-reported ART non-adherence which was significantly associated with psychosocial factors such as stigma, depressive symptoms, and suicidality. Mental health care and psychosocial support should be incorporated into routine HIV care for Nigerian SMM living with HIV.
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Affiliation(s)
- Olakunle Ayokunmi Oginni
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | | | | | | | | | - Olanrewaju Ibikunle Ibigbami
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | | | - Adesanmi Akinsulore
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Boladale Moyosore Mapayi
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Samuel Kolawole Mosaku
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
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Aytenew TM, Demis S, Birhane BM, Asferie WN, Simegn A, Nibret G, Kassaw A, Asnakew S, Tesfahun Y, Andualem H, Bantie B, Kassaw G, Kefale D, Zeleke S. Non-Adherence to Anti-Retroviral Therapy Among Adult People Living with HIV in Ethiopia: Systematic Review and Meta-Analysis. AIDS Behav 2024; 28:609-624. [PMID: 38157133 PMCID: PMC10876791 DOI: 10.1007/s10461-023-04252-4] [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] [Accepted: 12/08/2023] [Indexed: 01/03/2024]
Abstract
Human immunodeficiency virus remains a global public health problem. Despite efforts to determine the prevalence of non-adherence to ART and its predictors in Ethiopia, various primary studies presented inconsistent findings. Therefore, this review aimed to determine the pooled prevalence of non-adherence to ART and identify its predictors. We have searched PubMed, Google Scholar and Web of Science databases extensively for all available studies. A weighted inverse-variance random-effects model was used to compute the overall non-adherence to ART. The pooled prevalence of non-adherence to ART was 20.68% (95% CI: 17.74, 23.61); I2 = 98.40%; p < 0.001). Educational level of primary school and lower [AOR = 3.5, 95%CI: 1.7, 7.4], taking co-medications [AOR = 0.45, 95%CI: 0.35, 0.59], not using memory aids [AOR = 0.30, 95%CI: 0.13, 0.71], depression [AOR = 2.0, 95%CI: 1.05, 3.79], comorbidity [AOR = 2.12, 95%CI: 1.16, 3.09), under-nutrition [AOR = 2.02, 95%CI: 1.20, 3.43], not believing on ART can control HIV [AOR = 2.31, 95%CI: 1.92, 2.77], lack of access to health facilities [AOR = 3.86, 95%CI: 1.10, 13.51] and taking ART pills uncomfortably while others looking [AOR = 5.21, 95%CI: 2.56, 10.53] were significantly associated with non-adherence to anti-retroviral therapy. The overall pooled prevalence of non-adherence to ART was considerably high in Ethiopia. Educational status, taking co-medications, not using memory aids, depression, comorbidity, under nutrition, not believing on anti-retroviral therapy controls HIV, lack of access to health facilities and taking ART pills uncomfortably were independent predictors of non-adherence to ART in Ethiopia. Therefore, healthcare providers, adherence counselors and supporters should detect non-adherence behaviors and patients' difficulties with ART early, and provide intensive counseling to promote adherence.
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Affiliation(s)
- Tigabu Munye Aytenew
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Solomon Demis
- Department of Maternity and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Worku Necho Asferie
- Department of Maternity and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amare Simegn
- Department of Reproductive Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gedefaye Nibret
- Department of Reproductive Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amare Kassaw
- Department of Pediatrics and Child health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sintayehu Asnakew
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yohannes Tesfahun
- Department of Emergency and Critical Care Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Henock Andualem
- Department of Medical Laboratory, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Berihun Bantie
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gebrie Kassaw
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Demewoz Kefale
- Department of Pediatrics and Child health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Shegaw Zeleke
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Yang X, Li L, Zhang N, Hao L, Zhu X, Yu H, Wang G, Kang D. Analysis on epidemiological characters and HIV care continuum of HIV-infected students: a retrospective cohort study in Shandong province, China. BMC Infect Dis 2023; 23:496. [PMID: 37501181 PMCID: PMC10373422 DOI: 10.1186/s12879-023-08476-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUD The proportion of HIV-infected students in China showed an increasing trend. This study aimed to identify the epidemiological characteristics and the HIV care continuum for HIV-infected students in Shandong Province, China. METHODS Case report and follow-up data of HIV-infected students were obtained from the National HIV/AIDS comprehensive response information management system. Logistic regression analyses were used to analyze the associating factors of HIV-infected students accepting CD4 + T cells (CD4) test and antiviral therapy (ART) in 30 days, and ArcGIS software was used for the spatial anlysis. RESULTS From 2017 to 2019, 403 HIV-infected students were reported in Shandong Province. The majority of them were male (99.5%) and transmitted through homosexual sexual activity(92.1%). Most of them lived in Jinan city and Qingdao city. 68.5% (276 cases) accepted CD4 test in 30 days, and 48.6% (196 cases) started ART in 30 days. The heterosexual transmitted cases (AOR = 0.458, 95%CI: 0.210-0.998), patients accepting HIV care in western area (AOR = 0.266,95%CI: 0.147-0.481) were less likely to test CD4 within 30 days; patients aged 23-25 (AOR = 2.316, 95%CI: 1.009-5.316) and patients who had tested CD4 within 30 days (AOR = 4.377; 95%CI: 2.572-7.447) prefered to receive ART within 30 days; patients accepted HIV care in central area (AOR = 0.407; 95%CI: 0.251-0.657) and western area (AOR = 0.508; 95%CI: 0.261-0.989) and patients diagnosed by voluntary blood donation (AOR = 0.352; 95%CI: 0.144-0.864) were less willing to receive ART in 30 days. CONCLUSIONS The HIV care continuum of HIV-infected students in Shandong Province still needed strenghthing. More health education and case management should be done for cases transmitted through heterosexual behavior, accepted HIV care in central and western area, and diagnosed by voluntary blood donation.
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Affiliation(s)
- Xingguang Yang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Ling Li
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Na Zhang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Lianzheng Hao
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Xiaoyan Zhu
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Haiying Yu
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Guoyong Wang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
| | - Dianmin Kang
- Shandong Center for Disease Control and Prevention, Jinan, 250014, China
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Rutstein SE, Sibley AL, Huffstetler HE, Nguyen TTD, Tran HV, Le Minh G, Sripaipan T, Nguyen M, Miller WC, Eron JJ, Gay CL, Go VF. Acceptability and feasibility of long-acting injectable antiretroviral therapy for HIV-infected persons who inject drugs in Vietnam: A qualitative study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 31:100603. [PMID: 36879789 PMCID: PMC9985034 DOI: 10.1016/j.lanwpc.2022.100603] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND In Vietnam, HIV prevalence among people who inject drugs (PWID) is several times higher than in the general population (15% versus 0.3%). PWID also experience higher rates of HIV-related mortality, driven by poor antiretroviral therapy (ART) adherence. Long-acting injectable ART (LAI) is a compelling opportunity to improve treatment outcomes, but acceptability and feasibility among HIV-infected PWID remains unexplored. METHODS We conducted key informant in-depth interviews in Hanoi, Vietnam (February-November 2021). Participants were purposively sampled and included policymakers, ART clinic staff, and HIV-infected PWID. We applied the Consolidated Framework for Implementation Research to guide study design and analysis, using thematic coding to develop and iteratively refine a codebook and characterize barriers and facilitators to LAI implementation. FINDINGS We interviewed 38 key stakeholders: 19 PWID, 14 ART clinic staff, and five policymakers. Participants were enthusiastic about LAI convenience, highlighting less frequent and more discreet dosing. However, contrasting providers, several policymakers suggested LAI was not needed given perceived exceptional oral ART outcomes and rare viral failure among PWID. Policymakers also criticized strategies prioritizing PWID for LAI, emphasizing equity, whereas providers identified PWID as an ideal population for LAI given adherence challenges. LAI complexity, including storage and administration logistics, were deemed surmountable with training and resources. Finally, providers and policymakers acknowledged that adding LAI to drug formularies was key, but an onerous process. INTERPRETATION Although anticipated to be resource-intensive, LAI was a welcome addition for interviewed stakeholders and likely an acceptable alternative to oral ART among PWID living with HIV in Vietnam. Despite enthusiasm among PWID and providers that LAI could improve viral outcomes, some policymakers-whose buy-in is critical to LAI implementation-opposed strategies that preferentially distributed LAI to PWID, highlighting values of equity and revealing differences in perceived HIV outcomes among PWID. Results provide a vital foundation for developing LAI implementation strategies. FUNDING Supported by National Institutes of Health.
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Affiliation(s)
- Sarah E. Rutstein
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, North Carolina 27599, USA
| | - Adams L. Sibley
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, North Carolina 27599, USA
| | - Hanna E. Huffstetler
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, North Carolina 27599, USA
| | | | | | | | - Teerada Sripaipan
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, North Carolina 27599, USA
| | - Minh Nguyen
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, North Carolina 27599, USA
| | - William C. Miller
- Department of Epidemiology, The Ohio State University, 1841 Neil Ave, Columbus, Ohio 43210, USA
| | - Joseph J. Eron
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, North Carolina 27599, USA
| | - Cynthia L. Gay
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, North Carolina 27599, USA
| | - Vivian F. Go
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, North Carolina 27599, USA
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Game-based health education to improve ART adherence of newly diagnosed young people with HIV: protocol for a stepped-wedge design randomized controlled trial. BMC Public Health 2022; 22:2251. [PMID: 36460991 PMCID: PMC9719159 DOI: 10.1186/s12889-022-14708-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Antiretroviral therapy (ART) is one of the most effective ways for HIV-infected to treat AIDS. However, it is difficult to start ART among young people those newly diagnosed HIV-infection in China, and their adherence to ART is poor. We have designed an AIDS educational game called AIDS Fighter · Health Defense, which could improve the AIDS-related knowledge and has the potential to improve AIDS prevention ability of young students. In this study, AIDS Fighter · Health Defense will be used with newly diagnosed young people with HIV to evaluate the education effect of the game in improving ART adherence. DESIGN A stepped-wedge design randomized controlled trial will be conducted to confirm the education effect of AIDS Fighter · Health Defense on improving ART adherence of newly diagnosed young people with HIV, and to verify when to start game-based health education could be more effective for newly diagnosed young people with HIV. METHODS Participants will receive AIDS education from health workers and start ART when diagnosed with HIV and assigned into four groups randomly. The first step group to the fourth step group will receive AIDS Fighter · Health Defense in turn at the star of ART, one week, one month and three months after the start of ART. The primary outcomes are medication adherence, CD4( +) T cell count, and HIV viral load. The secondary outcomes are ART-related knowledge, ART-related skills, psychological resilience, and self-discrimination. Assessments will be completed before the intervention and one week, first month, and third month of the intervention, and then a one-year follow-up evaluation will be conducted after the intervention. DISCUSSION AIDS Fighter · Health Defense may be an effective approach to help newly diagnosed young people with HIV to improve ART adherence. A stepped-wedge design randomized controlled trial of this study may find the optimal time of AIDS education to improve ART adherence of newly diagnosed young people with HIV. REGISTRATION NUMBER Chinese Clinical Trial Registry: ChiCTR2200059766, registered 11 May 2022. http://www.chictr.org.cn/showproj.aspx?proj=169420.
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Qin P, He J, Yang X, Chen S, Chen X, Jiang H, Fung AWT, Wang Z, Lau JTF. The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e32968. [PMID: 35984684 PMCID: PMC9440416 DOI: 10.2196/32968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 06/13/2022] [Accepted: 06/26/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Neurocognitive impairments are prevalent among older people in China. It is more problematic among older people living with HIV. OBJECTIVE This study aims to compare neurocognitive performance between older people living with HIV and HIV-negative controls, and to explore whether the association between HIV status and neurocognitive performance was mediated by depressive symptoms and level of physical activity. METHODS A cross-sectional study was conducted in Yongzhou, China. All people living with HIV aged ≥50 years listed in the registry were invited. Frequency matching was used to sample HIV-negative controls from the general population according to the distribution of age, sex, and years of formal education of older people living with HIV. A total of 315 older people living with HIV and 350 HIV-negative controls completed the face-to-face interview and comprehensive neuropsychological assessment of seven domains (learning, memory, working memory, verbal fluency, processing speed, executive function, and motor skills). RESULTS As compared to HIV-negative controls, older people living with HIV performed worse in global score and all seven domains (P<.05). HIV infection was associated with higher depressive symptoms (P<.001) and lower level of physical activity (P<.001). Depressive symptoms and physical activity were negatively correlated (P<.001). Depressive symptoms and level of physical activity mediated the association between HIV status and global z-score and four domain z-scores of neurocognitive performance (learning, memory, verbal fluency, and processing speed). CONCLUSIONS Change in mental health and physical activity after HIV infection may partially explain why older people living with HIV are more susceptible to neurocognitive impairment. Promoting mental health and physical activity are potential entry points to slow down the progress of neurocognitive impairment among older people living with HIV.
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Affiliation(s)
- Pei Qin
- Shenzhen Qianhai Shekou Free Zone Hospital, Shenzhen, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Jianmei He
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Xue Yang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Siyu Chen
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Xi Chen
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Hui Jiang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ada Wai Tung Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Joseph Tak Fai Lau
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Affilliated Kangning Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China
- School of Mental Health, Wenzhou Medical University, Wen Zhou, China
- School of Public Health, Zhejiang University, Zhejiang, China
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Yang Z, Wei L, Xie W, Chen L, Yang Z, Zhang Y, Liu S, Tan W, Zheng C, Gan Y, Li D, Zou H, Chen W, Ma L, Ju N, Sun Y, Lv F, Zhao J. Estimating Changes in Population Size and Behavioral Characteristics in Men Who Have Sex With Men Between 2014 and 2019: Longitudinal Study. JMIR Public Health Surveill 2022; 8:e34150. [PMID: 35972779 PMCID: PMC9428784 DOI: 10.2196/34150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 05/18/2022] [Accepted: 06/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background Men who have sex with men (MSM) are at high risk for HIV infection. Accurate estimation of the population size and monitoring the risk sexual behavioral change of MSM is of great importance to develop targeted HIV prevention and interventions. Objective The goal of the research was accurate estimation of the population size and monitoring the risk sexual behavioral change of MSM. Methods Street interception investigation methods were conducted among males aged 16 years and older in selected sites in Shenzhen in 2014 and 2019. A population survey was used to estimate the population size of MSM. Logistic regression analysis was applied to evaluate the difference in behavioral characteristics in MSM from 2014 to 2019. Results In this study, we surveyed 10,170 participants in 2014, of whom 448 (4.41%, 95% CI 4.01%-4.80%) participants were men who have ever had sex with another man (MSMe) and 229 (2.25%, 95% CI 1.96%-2.54%) were men who had sex with another man in the previous 6 months (MSMa). A total of 10,226 participants were surveyed in 2019, of which 500 (4.90%, 95% CI 4.47%-5.31%) and 208 (2.03%, 95% CI 1.76%-2.31%) participants were MSMe and MSMa, respectively. The results showed that the population size of MSM who are active (MSMa) in Shenzhen was 155,469 (2.29%, 95% CI 2.28%-2.30%) in 2014 and 167,337 (2.05%, 95% CI 2.04%-2.06%) in 2019. It was estimated that there were about 12,005,445 (2.04%, 95% CI 2.04%-2.04%) MSMa in China in 2019. Compared with 2014, the MSMa in 2019 were more likely to seek sex partners through mobile phone apps and less likely to have male and female sex partners in addition to having inconsistent condom use and more than 6 sex partners in the previous 6 months. Conclusions In Shenzhen, the proportion of MSMa among the general male population was lower in 2019 than in 2014, and the prevalence of HIV risk behavior was reduced in 2019. Although the preferred platform to find male sex partners among MSM has changed, intervention with high–HIV risk MSM could still help to reduce HIV risk behaviors among the whole MSM group. Because MSM prefer to seek sex partners through mobile phone apps, further study is needed to strengthen internet interventions with high–HIV risk MSM to curb the spread of HIV.
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Affiliation(s)
- Zijie Yang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China.,School of Public Health, Peking Unversity, Beijing, China.,School of Public Health, Shantou Unversity, Shantou, China
| | - Lan Wei
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wei Xie
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Lin Chen
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhengrong Yang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yan Zhang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shaochu Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wei Tan
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Chenli Zheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yongxia Gan
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Dongmin Li
- National Center for AIDS/Sexually Transmitted Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huachun Zou
- School of Public Health, Sun Yat-sen University, Shenzhen, China
| | - Wanying Chen
- National Center for AIDS/Sexually Transmitted Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ling Ma
- Binhu District Centers for Disease Control and Prevention, Wuxi, China
| | - Niu Ju
- School of Public Health, Sun Yat-sen University, Shenzhen, China
| | - Yinghui Sun
- School of Public Health, Sun Yat-sen University, Shenzhen, China
| | - Fan Lv
- National Center for AIDS/Sexually Transmitted Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jin Zhao
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China.,School of Public Health, Shantou Unversity, Shantou, China
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Witkovic YD, Kim HC, Bright DJ, Tan JY. Recruiting Black Men Who Have Sex With Men (MSM) Couples via Dating Apps: Pilot Study on Challenges and Successes. JMIR Form Res 2022; 6:e31901. [PMID: 35394432 PMCID: PMC9034429 DOI: 10.2196/31901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/06/2021] [Accepted: 12/09/2021] [Indexed: 01/30/2023] Open
Abstract
Background HIV disproportionately impacts Black men who have sex with men (MSM), and targeting the primary relationship (ie, couples) using mobile technology for health holds promise for HIV prevention. Web-based recruitment of MSM is commonly employed in HIV prevention and intervention research. However, little known about recruiting Black MSM couples on the internet in the United States. Objective This study describes the process of recruiting Black MSM couples over social networking and dating apps frequented by MSM. We describe the activities for recruiting, screening, and enrolling participants as part of a randomized trial employing a multipronged recruitment approach. Methods Black MSM in couples were recruited via three apps (ie, Jack’d, Adam4Adam, and Growlr) between May 2020 and March 2021 during the COVID-19 pandemic in the United States. Black MSM couples were eligible if one or both partners are Black, MSM, and living with HIV, and if both partners were 18 years or older, and have been together for at least 2 months in what they both consider a primary relationship (ie, one in which both partners reported feeling most committed to over any other partner or relationship). Results A total of 10 Black MSM couples (n=20) were enrolled via social networking apps. App recruitment activities were a combination of passive (eg, in-app advertisements) and active (eg, direct messaging of users) engagement. Recruitment approaches varied by the social networking app owing to differences in app features. A full-time recruiter experienced challenges such as bugs (ie, technical errors in computer program or system), navigating technical requirements specific to each app, and web-based harassment. Conclusions Despite challenges, it was possible to recruit Black MSM couples virtually into research as part of a multipronged recruitment strategy. We identify tips for using web-based dating and other social networking apps as part of a recruitment strategy in future research with Black MSM couples.
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Affiliation(s)
- Yong Darin Witkovic
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
| | - Hyunjin Cindy Kim
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States
| | - Darius Jovon Bright
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States
| | - Judy Y Tan
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, United States
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Chiou PY, Hung CC, Chen CY. Sexual Partner Referral for HIV Testing Through Social Networking Platforms: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e32156. [PMID: 35380540 PMCID: PMC9019628 DOI: 10.2196/32156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/29/2021] [Accepted: 12/18/2021] [Indexed: 11/19/2022] Open
Abstract
Background Men who have sex with men (MSM) who undergo voluntary HIV counseling and testing (VCT) often report condomless anal sexual intercourse, having many sexual partners, and being exposed to risky sexual networks. Limited research has discussed the application of motivational interviewing and convenience referral platforms to facilitate the referral of sexual partners for HIV testing among MSM. Objective This study aimed to evaluate the effects of VCT referral by sexual partners through social networking platforms and the test results after elicited interviews with MSM; compare the characteristics and risk behaviors among MSM tested without referral, index subjects, and referred sexual partners; and explore unknown sexual affiliations through visualizing and quantifying the social network graph. Methods This was a cross-sectional study. Purposeful sampling was used to recruit index subjects from a community HIV screening station frequented by MSM in Taipei City on Friday and Saturday nights. Respondent-driven sampling was used to recruit sexual partners. Partner-elicited interviews were conducted by trained staff before VCT to motivate MSM to become index subjects and refer sexual partners via the Line app, or to disclose the accounts and profiles of sexual partners on relevant social networking platforms. Referred sexual partners received rapid HIV testing, and the recruitment process was repeated until leads were exhausted. Results After the interviews, 28.2% (75/266) of MSM were successfully persuaded to become index subjects in the first wave, referring 127 sexual partners via the Line app for rapid HIV testing and disclosing 40 sexual partners. The index subjects and tested sexual partners had more sexual partners (F2=3.83, P=.02), more frequent anal intercourse (F2=10.10, P<.001), and higher percentages of those who had not previously received HIV testing (χ21=6.1, P=.047) compared with MSM tested without referrals. The new HIV-seropositivity rate among tested sexual partners was 2.4%, which was higher than the rate in the other 2 groups. The social network analysis revealed the following 4 types of sexual affiliation: chain, Y, star, and complicated. Among the HIV-negative sexual partners, 26.9% (43/160) had sexual affiliations with HIV-positive nodes, and 40% (10/25) were untested sexual partners with a direct sexual affiliation with an HIV-positive node. Four transmission bridges were found in the network graph. Conclusions Partner-elicited interviews can effectively promote referral for HIV testing and case identification via Line, and can clarify unknown sexual affiliations of MSM to facilitate the development of a tailored prevention program. Social network analysis is needed for an insightful understanding of the different network structures.
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Affiliation(s)
- Piao-Yi Chiou
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chien-Yu Chen
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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10
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Nguyen PT, Van Nguyen H, Le PM, Phung HT, Dao ATM, Hayashi K, Gilmour S. Translation, validation and psychometric properties of Effort-Reward Imbalance questionnaire among nurses in Vietnam. Prev Med Rep 2022; 25:101692. [PMID: 35223385 PMCID: PMC8855701 DOI: 10.1016/j.pmedr.2021.101692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/10/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022] Open
Abstract
Effort-Reward imbalance scale helps measure and manage work stress and mental issue. It is validated using confirmatory factor analysis and logistic regression model. The scale has adequate reliability and validity to be used among Vietnamese nurses. Poor self-rated health is more often reported among nurses with higher ER-ratio. Vietnamese scale is available for managing health forces, toward Health for All.
We translated the Effort-Reward imbalance questionnaire, an instrument for measuring work stress, into the Vietnamese language and investigated its psychometric properties among nurses in Vietnam. In a hospital-based cross-sectional study design, we sampled and interviewed 207 nurses working full-time (response rate 83%). We evaluated the internal consistency using standardized Cronbach's alpha coefficients and structural validity using confirmatory factor analysis. Discriminative validity was assessed by comparing the measured scores between age groups, gender, education levels, income groups, and job positions. In addition, we confirmed the criterion validity by investigating its association with self-reported health using simple and multiple logistic regression models. Most of the participants were female (73.3%), young (average 28.5 years old), and had education levels of college or higher (53.5%). We observed sufficient internal consistency in effort, reward, and over-commitment scales (Cronbach's alpha 0.80, 0.76, and 0.68, respectively). Confirmatory factor analysis of the three-factor hierarchical model showed an acceptable fit and fair construct validity with most moderate or stronger (>0.3) factor loading coefficients. Poor self-rated health was more likely in respondents in both Effort-Reward ratio's middle tertile (adjusted Odd-Ratio = 2.80, p-value = 0.031) and highest tertile (adjusted Odd-Ratio = 2.64, p-value = 0.05), adjusting for age, gender, and education levels. The Effort-reward imbalance scale has adequate reliability and validity for assessing work stress among nurses in Vietnam. Its significant association with poor self-rated health warrants further investigation. The validated instrument can help measure the effort-reward imbalance to manage better work-related emotional strains and mental health issues among nurses and ensure human resources' stability in healthcare in Vietnam.
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Affiliation(s)
- Phuong The Nguyen
- Graduate School of Public Health, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
- Division of Surveillance and Policy Evaluation, Institute for Cancer Control, National Cancer Center, 5 Chome-1-1 Tsukiji, Chuo City, Tokyo 104-0045, Japan
- Corresponding author at: St. Luke's International University Graduate School of Public Health, 3-6-2 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
| | - Huy Van Nguyen
- Graduate School of Public Health, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
- Health Innovation and Transformation Centre, Federation University, University Drive, Mount Helen, VIC 3350, Australia
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, The Albert Sherman Center, Worcester, MA 01605, USA
| | - Phuong Mai Le
- Graduate School of Public Health, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
| | - Huyen Thi Phung
- Hanoi Medical University Hospital, 01 Ton That Tung Street, Dong Da district, Hanoi, Viet Nam
| | - An Thi Minh Dao
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, The Albert Sherman Center, Worcester, MA 01605, USA
- School of Public Health, The University of Queensland, 288 Herston Road, The University of Queensland, Herston, QLD 4006, Australia
- Institution for Preventive Medicine and Public Health, Hanoi Medical University, 01 Ton That Tung Street, Dong Da district, Hanoi, Viet Nam
| | - Kuniyoshi Hayashi
- Graduate School of Public Health, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo 104-0044, Japan
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11
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Xu Q, Nali MC, McMann T, Godinez H, Li J, He Y, Cai M, Lee C, Merenda C, Araojo R, Mackey TK. Unsupervised Machine Learning to Detect and Characterize Barriers to Pre-exposure Prophylaxis Therapy: Multiplatform Social Media Study. JMIR INFODEMIOLOGY 2022; 2:e35446. [PMID: 37113799 PMCID: PMC10014091 DOI: 10.2196/35446] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/18/2022] [Accepted: 03/07/2022] [Indexed: 04/29/2023]
Abstract
Background Among racial and ethnic minority groups, the risk of HIV infection is an ongoing public health challenge. Pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV when taken as prescribed. However, there is a need to understand the experiences, attitudes, and barriers of PrEP for racial and ethnic minority populations and sexual minority groups. Objective This infodemiology study aimed to leverage big data and unsupervised machine learning to identify, characterize, and elucidate experiences and attitudes regarding perceived barriers associated with the uptake and adherence to PrEP therapy. This study also specifically examined shared experiences from racial or ethnic populations and sexual minority groups. Methods The study used data mining approaches to collect posts from popular social media platforms such as Twitter, YouTube, Tumblr, Instagram, and Reddit. Posts were selected by filtering for keywords associated with PrEP, HIV, and approved PrEP therapies. We analyzed data using unsupervised machine learning, followed by manual annotation using a deductive coding approach to characterize PrEP and other HIV prevention-related themes discussed by users. Results We collected 522,430 posts over a 60-day period, including 408,637 (78.22%) tweets, 13,768 (2.63%) YouTube comments, 8728 (1.67%) Tumblr posts, 88,177 (16.88%) Instagram posts, and 3120 (0.6%) Reddit posts. After applying unsupervised machine learning and content analysis, 785 posts were identified that specifically related to barriers to PrEP, and they were grouped into three major thematic domains: provider level (13/785, 1.7%), patient level (570/785, 72.6%), and community level (166/785, 21.1%). The main barriers identified in these categories included those associated with knowledge (lack of knowledge about PrEP), access issues (lack of insurance coverage, no prescription, and impact of COVID-19 pandemic), and adherence (subjective reasons for why users terminated PrEP or decided not to start PrEP, such as side effects, alternative HIV prevention measures, and social stigma). Among the 785 PrEP posts, we identified 320 (40.8%) posts where users self-identified as racial or ethnic minority or as a sexual minority group with their specific PrEP barriers and concerns. Conclusions Both objective and subjective reasons were identified as barriers reported by social media users when initiating, accessing, and adhering to PrEP. Though ample evidence supports PrEP as an effective HIV prevention strategy, user-generated posts nevertheless provide insights into what barriers are preventing people from broader adoption of PrEP, including topics that are specific to 2 different groups of sexual minority groups and racial and ethnic minority populations. Results have the potential to inform future health promotion and regulatory science approaches that can reach these HIV and AIDS communities that may benefit from PrEP.
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Affiliation(s)
- Qing Xu
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
| | - Matthew C Nali
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
- Global Health Program, Department of Anthropology University of California La Jolla, CA United States
| | - Tiana McMann
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
- Global Health Program, Department of Anthropology University of California La Jolla, CA United States
| | | | - Jiawei Li
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
| | - Yifan He
- S-3 Research San Diego, CA United States
| | - Mingxiang Cai
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
| | - Christine Lee
- Office of Minority Health and Health Equity, U.S. Food and Drug Administration Silver Spring, MD United States
| | - Christine Merenda
- Office of Minority Health and Health Equity, U.S. Food and Drug Administration Silver Spring, MD United States
| | - Richardae Araojo
- Office of Minority Health and Health Equity, U.S. Food and Drug Administration Silver Spring, MD United States
| | - Tim Ken Mackey
- S-3 Research San Diego, CA United States
- Global Health Policy and Data Institute San Diego, CA United States
- Global Health Program, Department of Anthropology University of California La Jolla, CA United States
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12
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Tang J, Zheng Y, Yu Z, Zhang D, Yu X, Ren J, Li M, Luo Y, Tian M, Chen Y. Evaluation of an AIDS educational mobile game (AIDS Fighter · Health Defense) for young students to improve AIDS-related knowledge, stigma and attitude of high-risk behaviors in China: A Randomized Controlled Trial. JMIR Serious Games 2021; 10:e32400. [PMID: 34870603 PMCID: PMC8822421 DOI: 10.2196/32400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The AIDS epidemic among young students is serious, and effective preventive interventions are urgently needed. Game-based intervention has become an innovative way to change healthy behaviors, and we have developed an AIDS educational game called AIDS Fighter · Health Defense. In this study we tested the effect of an AIDS Fighter · Health Defense for young students to improve AIDS-related knowledge, stigma and attitude of high-risk behaviors in Southwest China. OBJECTIVE To test the effect of an AIDS educational game (AIDS Fighter · Health Defense) for young students to improve AIDS-related knowledge, stigma and attitude of high-risk behaviors in Southwest China. METHODS A randomized controlled trial was conducted from September 14 to September 27, 2020. Ninety-six students from two classes in a middle school were selected by stratified cluster sampling in Luzhou City, China. The two classes were randomly divided into the intervention group (n=50) and the control group (n=46). The intervention group received AIDS educational game (AIDS Fighter · Health Defense); the control group learned AIDS-related knowledge through independent learning on the QQ chat group. The AIDS-related knowledge questionnaire, the stigma scale, the attitude questionnaire on AIDS-related high-risk behaviors were used to measure the effect of an AIDS educational game by face-to-face. The user's experience of the game was assessed by the Educational Game User Experience Evaluation Scale. The difference was statistically significant with P≤0.05. RESULTS After the intervention, the AIDS knowledge awareness rate (±S, %) of the intervention group and the control group were 70.09±11.58 and 57.49±16.58(t=4.282, P<0.001). The stigma scores of the two groups were 2.44±0.57 and 2.48±0.47(t=0.373, P =0.710), The positive rate (±S, %) of attitudes of high-risk AIDS behaviors of the two groups were 82.00±23.44 and 79.62±17.94(t=0.555, P =0.580. The mean percentage of the game evaluation as excellent was 54.73%, and 31.45% of good, 13.09% of medium, 0.73% of poor. CONCLUSIONS AIDS Fighter · Health Defense could increase the AIDS-related knowledge among young students, but the effect of the game in reducing AIDS-related stigma and improving the attitudes of high-risk AIDS behaviors has not appeared. Long-term effects and large-scale studies are needed to assess the efficacy of game-based intervention. CLINICALTRIAL Chinese Clinical Trial Registry: ChiCTR2000038230. Registered 14 September 2020.
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Affiliation(s)
- Jian Tang
- Department of Operating Room, The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Yu Zheng
- Department of Rheumatology and Immunology, The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Zhaolan Yu
- Department of Nephrology,The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Daiying Zhang
- Department of Operating Room, The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Xingli Yu
- Department of Operating Room, The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Jianlan Ren
- Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, CN
| | - Mei Li
- Southwest Medical University, School of Nursing, Luzhou, CN
| | - Yue Luo
- Southwest Medical University, School of Nursing, Luzhou, CN
| | - Min Tian
- Southwest Medical University, School of Nursing, Luzhou, CN
| | - Yanhua Chen
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, 25 Taiping Street, Jiangyang District, Luzhou, CN.,Southwest Medical University, School of Nursing, Luzhou, CN
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13
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Majam M, Phatsoane M, Hanna K, Faul C, Arora L, Makthal S, Kumar A, Jois K, Lalla-Edward ST. Utility of a Machine-Guided Tool for Assessing Risk Behavior Associated With Contracting HIV in Three Sites in South Africa: Protocol for an In-Field Evaluation. JMIR Res Protoc 2021; 10:e30304. [PMID: 34860679 PMCID: PMC8686409 DOI: 10.2196/30304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/25/2021] [Accepted: 09/10/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Mobile technology has helped to advance health programs, and studies have shown that an automated risk prediction model can successfully be used to identify patients who exhibit a high probable risk of contracting human immunodeficiency virus (HIV). A machine-guided tool is an algorithm that takes a set of subjective and objective answers from a simple questionnaire and computes an HIV risk assessment score. OBJECTIVE The primary objective of this study is to establish that machine learning can be used to develop machine-guided tools and give us a deeper statistical understanding of the correlation between certain behavioral patterns and HIV. METHODS In total, 200 HIV-negative adult individuals across three South African study sites each (two semirural and one urban) will be recruited. Study processes will include (1) completing a series of questions (demographic, sexual behavior and history, personal, lifestyle, and symptoms) on an application system, unaided (assistance will only be provided upon user request); (2) two HIV tests (one per study visit) being performed by a nurse/counselor according to South African national guidelines (to evaluate the prediction accuracy of the tool); and (3) communicating test results and completing a user experience survey questionnaire. The output metrics for this study will be computed by using the participants' risk assessment scores as "predictions" and the test results as the "ground truth." Analyses will be completed after visit 1 and then again after visit 2. All risk assessment scores will be used to calculate the reliability of the machine-guided tool. RESULTS Ethical approval was received from the University of Witwatersrand Human Research Ethics Committee (HREC; ethics reference no. 200312) on August 20, 2020. This study is ongoing. Data collection has commenced and is expected to be completed in the second half of 2021. We will report on the machine-guided tool's performance and usability, together with user satisfaction and recommendations for improvement. CONCLUSIONS Machine-guided risk assessment tools can provide a cost-effective alternative to large-scale HIV screening and help in providing targeted counseling and testing to prevent the spread of HIV. TRIAL REGISTRATION South African National Clinical Trial Registry DOH-27-042021-679; https://sanctr.samrc.ac.za/TrialDisplay.aspx?TrialID=5545. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/30304.
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Affiliation(s)
- Mohammed Majam
- Ezintsha, Faculty of Health Sciences, University of Witswatersrand, Johannesburg, South Africa
| | - Mothepane Phatsoane
- Ezintsha, Faculty of Health Sciences, University of Witswatersrand, Johannesburg, South Africa
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14
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Xu J, Luo Y, Dong H, Zhao G. Effects of internet exposure on sexual partners and sexual risk behavior among sexually experienced college males in China: evidence from an institutional-based cross-sectional study (Preprint). JMIR Public Health Surveill 2021; 8:e31847. [PMID: 35499864 PMCID: PMC9112083 DOI: 10.2196/31847] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/24/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background As a young subgroup, college students have become the main users of mobile social networks. Considering that people can indiscriminately access explicit sexual content on the internet, coupled with the increase of HIV infections in male college students, the role of the internet in meeting sexual partners and its correlation to risky sexual behavior has become an important topic. Objective The aim of this study is to explore the effects of internet exposure on sexual partners and sexual risk behavior among sexually experienced male college students. Methods An institution-based cross-sectional study design was used to collect data through a paper-based questionnaire administered to male college students recruited from colleges and gay organizations in Hangzhou, Zhejiang Province, China. A total of 1045 sexually experienced male students were incorporated in our analysis, with the following information collected: sociodemographic characteristics, sexual intercourse–related behaviors, and sexually transmitted disease (STD) knowledge. Mann-Whitney U and Kruskal-Wallis tests were used to examine differences regarding basic characteristics and sexual risk behaviors between male college students who meet sexual partners via the internet and those who do not. Sequential logistic regression models were employed to examine the influence of meeting sexual partners via the internet on risky sexual behaviors after controlling for other factors. Results The mean age of the sexually experienced male students was 21.6 (SD 2.0) years. The likelihood of risky sexual behavior was varied, yet it was the highest for those who aim to meet paid sexual partners (145/192, 75.5% to 19/22, 86.4%), followed by those seeking partners for love or romance (258/435, 59.3%). Compared to non-internet partner seekers, internet partner seekers tended to have more casual intercourse (292/542, 53.9% versus 51/503, 10.1%), paid intercourse (32/542, 5.9% versus 12/503, 2.4%), and intercourse with same-sex partners (349/542, 64.4% versus 41/503, 8.2%); they were also more likely to use psychoactive drugs (125/349, 35.8% versus 5/41, 12.2%) and have more than 2 partners. With the increase of HIV and STD knowledge, the probability of having unprotected intercourse decreased for non-internet partner seekers. However, it increased for internet partner seekers with a rising HIV knowledge score. Sequential logistic regression showed that meeting sexual partners on the internet was statistically associated with sexual risk behaviors with multiple sexual partners (odds ratio 4.434; P<.001). Conclusions Meeting sexual partners via the internet is a common behavior among sexually experienced male college students, and those who meet partners on the internet exhibited higher levels of risky sexual behaviors although they had sufficient HIV and STD knowledge; this is especially true for students who aimed to find partners for sexual intercourse. Thus, more attention should be paid to young adults to address the risky sexual behaviors that may contribute to STD spread among this population.
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Affiliation(s)
- Junfang Xu
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Luo
- Shenzhen Pingshan District Center for Disease Control and Prevention, Hangzhou, China
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Hengjin Dong
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Gang Zhao
- Hangzhou Center for Disease Control and Prevention, Hangzhou, China
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