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Dai M, Xia S, Calabrese C, Ma X, Chen T. Risk and demographic factors associated with STI testing adherence among non-single men who have sex with men (MSM) in the United States. J Behav Med 2024:10.1007/s10865-024-00524-z. [PMID: 39356454 DOI: 10.1007/s10865-024-00524-z] [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: 08/17/2023] [Accepted: 09/17/2024] [Indexed: 10/03/2024]
Abstract
Though men who have sex with men (MSM) are disproportionately affected by sexually transmitted infections (STIs), factors that impact STI testing adherence among non-single MSM remain under-explored. While being in a relationship per se does not necessarily increase one's risk for STIs, certain behavioral risks and demographic factors may impact STI testing adherence. Through a sample of 296 non-single MSM located in the United States, we examined key behavioral and demographic factors and their associations with adherence to CDC's STI testing guidelines. Overall, the results showed inconsistent STI testing adherence rates among divergent subgroups of higher-risk non-single MSM. First, non-single MSM who take PrEP were more likely to adhere to STI testing and showed significantly higher adherence rates than those who do not take PrEP, but adherence rates were not related to nor significantly different than those who reported extra-relational sex or condomless anal sex. Further, STI testing adherence was positively associated with having a shorter relationship length, identifying as non-White, and living in an LGBTQ+-friendly neighborhood. Practical implications and recommendations for clinical practices, persuasive messages, and promotion strategies are discussed.
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Affiliation(s)
- Minhao Dai
- School of Communication and Media, Kennesaw State University, Kennesaw, GA, 30144, USA.
| | - Shilin Xia
- Department of Communication, University of Maryland, College Park, MD, USA
| | | | - Xin Ma
- Department of Communication, University of Macau, Macao, China
| | - Tianen Chen
- Department of Communication, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
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Coleman TA, Phillips NE, Rizkalla C, Tran B, Coulombe S, Davis C, Cameron R, Travers R, Wilson C, Woodford M. Exploring community enabling factors associated with recent HIV testing in a regional sample of gay, bisexual, and other men who have sex with men. AIDS Care 2022; 35:942-952. [PMID: 35637571 DOI: 10.1080/09540121.2022.2074959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
HIV testing and diagnosis are the gateway into treatment and eventual viral suppression. With gay, bisexual, and other men who have sex with men (GBMSM) persistently over-representing new HIV diagnoses in Canada, combined with the evolving nature of community social connection, an exploration of factors associated with recent HIV testing is warranted. As most studies of GBMSM rely on samples obtained from larger metropolitan regions, examining HIV testing from an under-researched region is necessary. With data collected from an online survey of LGBTQ+ persons 16 or older living, working, or residing in the Region of Waterloo, Ontario, Canada, we used multinomial logistic regression to explore socio-demographic, behavioural, and psychosocial factors associated with recent HIV testing for GBMSM. In the final multivariate multinomial logistic regression model: sense of belonging was associated with more recently testing, as was having an increasing proportion of LGBT friends, app use to find sex partners in the past 12 months, access to the local AIDS service organization, and general sense of belonging to local community, among other. This analysis highlights the continued importance of enabling and need factors when accessing testing, and suggests areas for further testing promotion in physical and virtual spaces frequented by GBMSM.
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Affiliation(s)
- Todd A. Coleman
- Department of Health Sciences, Wilfrid Laurier University, Ontario, Canada
| | | | - Celina Rizkalla
- Department of Health Sciences, Wilfrid Laurier University, Ontario, Canada
| | - Billy Tran
- Department of Health Sciences, Wilfrid Laurier University, Ontario, Canada
- Institute of Medical Science, University of Toronto, Ontario, Canada
| | - Simon Coulombe
- Department of Psychology, Wilfrid Laurier University, Ontario, Canada
| | - Charlie Davis
- Department of Psychology, Wilfrid Laurier University, Ontario, Canada
| | - Ruth Cameron
- Department of Psychology, Wilfrid Laurier University, Ontario, Canada
- AIDS Committee of Cambridge, Kitchener, Waterloo and Area, Ontario, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Ontario, Canada
| | - Ciann Wilson
- Department of Psychology, Wilfrid Laurier University, Ontario, Canada
| | - Michael Woodford
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Ontario, Canada
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Lachowsky NJ, Saxton PJW, Dickson NP, Hughes AJ, Summerlee AJS, Dewey CE. National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand. BMJ Open 2020; 10:e039896. [PMID: 33203634 PMCID: PMC7674106 DOI: 10.1136/bmjopen-2020-039896] [Citation(s) in RCA: 2] [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: 11/16/2022] Open
Abstract
OBJECTIVES To assess trends in sexual health outcomes among men who have sex with men (MSM) disaggregated by ethnicity. DESIGN Repeated cross-sectional. SETTING Behavioural surveillance data from 2006, 2008, 2011 and 2014 were collected in-person and online across Aotearoa New Zealand. PARTICIPANTS Eligible participants were self-identified men aged 16 years or older who reported sex with another man in the past 5 years. We classified 10 525 participants' ethnicities: Asian (n=1003, 9.8%), Māori (Indigenous people of Aotearoa New Zealand, n=1058, 10.3%), Pacific (n=424, 4.1%) and European (n=7867, 76.8%). OUTCOME MEASURES The sexual health outcomes examined were >20 recent (past 6 months) male sexual partners, past-year sexually transmitted infection (STI) testing, past-year STI diagnosis, lifetime and past-year HIV testing, lifetime HIV-positive diagnosis and any recent (past 6 months) condomless anal intercourse with casual or regular partners. RESULTS When disaggregated, Indigenous and ethnic minority groups reported sexual health trends that diverged from the European MSM and each other. For example, Asian MSM increased lifetime HIV testing (adjusted OR, AOR=1.31 per survey cycle, 95% CI 1.17 to 1.47) and recent HIV testing (AOR=1.14, 95% CI 1.02 to 1.28) with no changes among Māori MSM or Pacific MSM. Condomless anal intercourse with casual partners increased among Māori MSM (AOR=1.13, 95% CI 1.01 to 1.28) with no changes for Asian or Pacific MSM. Condomless anal intercourse with regular partners decreased among Pacific MSM (AOR=0.83, 95% CI 0.69 to 0.99) with no changes for Asian or Māori MSM. CONCLUSIONS Population-level trends were driven by European MSM, masking important differences for Indigenous and ethnic minority sub-groups. Surveillance data disaggregated by ethnicity highlight inequities in sexual health service access and prevention uptake. Future research should collect, analyse and report disaggregated data by ethnicity to advance health equity.
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Affiliation(s)
- Nathan J Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Peter J W Saxton
- Social and Community Health, The University of Auckland, Auckland, Auckland, New Zealand
| | - Nigel Patrick Dickson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | | | - Cate E Dewey
- Population Medicine, University of Guelph, Guelph, Ontario, Canada
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4
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Nelson LE, Ajiboye W, Djiadeu P, Odhiambo AJ, Pedersen C, Ramos SR, Lofters A, Mbuagbaw L, Williams G. A Web-Based Intervention to Reduce Decision Conflict Regarding HIV Pre-Exposure Prophylaxis: Protocol for a Clinical Trial. JMIR Res Protoc 2020; 9:e15080. [PMID: 32348250 PMCID: PMC7324994 DOI: 10.2196/15080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/29/2019] [Accepted: 02/04/2020] [Indexed: 01/08/2023] Open
Abstract
Background HIV pre-exposure prophylaxis (PrEP) is recommended for populations at high ongoing risk for infection. There are noted racial disparities in the incidence of HIV and other sexually transmitted infections (STIs) for African, Caribbean, and Canadian Black (ACB, black) populations in Ontario, Canada. Although blacks represent only 4.7% of the Ontario population, they account for 30% of HIV prevalence and 25% of new infections in the province. The existing clinical public health practice toolkit has not been sufficient to optimize PrEP uptake, despite the overwhelming evidence of PrEP’s efficacy for reducing HIV transmission risk. Since its establishment as an effective HIV prevention tool, the major focus in behavioral research on PrEP has been on understanding and improving adherence. To date, there is no known formalized intervention in place designed to support ACB men and women at high risk of making high-quality decisions regarding the adoption of PrEP as an HIV prevention practice. Objective We propose 2 aims to address these gaps in HIV prevention and implementation science. First, the Ottawa Decision Support Framework (ODSF) for use in the PrEP decisional needs of black patients was adapted. Second, the decision support intervention to estimate effect size compared with control conditions in reducing decision conflict and predicting adherence over 60 days was pilot tested. Methods In aim 1, we propose a cross-sectional qualitative descriptive study using data collected from key informant interviews with eligible PrEP patients (n=30) and surveys with health professionals (n=20) involved in HIV PrEP management. Data obtained from aim 1 will be used to develop a decision support intervention based on the ODSF. In aim 2, the adopted decision support intervention using a block-randomized design to estimate effect size compared with control conditions in reducing decision conflict and predicting adherence over 60 days was pilot tested. Hypothesis testing will be de-emphasized in favor of generating effect size estimates. Results A research award was funded on March 25, 2017 (Multimedia Appendix 1). Ethical approval was received on March 25, 2019 (with supplemental approval received on May 10, 2019). Data collection started on April 9, 2019. As of September 30, 2019, we enrolled 29 patients and 24 health care providers for aim 1. We are currently analysing the data collected for aim 1. Aim 2 is scheduled to start in May 2020. Conclusions This study will provide evidence-based information on the decisional needs of black patients who are at risk of HIV and have been offered PrEP. The study will also test the effect of decision support intervention in reducing decision conflict, adoption of PrEP, and adherence to PrEP. International Registered Report Identifier (IRRID) PRR1-10.2196/15080
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Affiliation(s)
- LaRon E Nelson
- MAP Center for Urban Health Solution, St. Michael's Hospital, Toronto, ON, Canada.,Yale School of Nursing, Yale University, New Haven, CT, United States
| | - Wale Ajiboye
- MAP Center for Urban Health Solution, St. Michael's Hospital, Toronto, ON, Canada
| | - Pascal Djiadeu
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Apondi J Odhiambo
- MAP Center for Urban Health Solution, St. Michael's Hospital, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Cheryl Pedersen
- MAP Center for Urban Health Solution, St. Michael's Hospital, Toronto, ON, Canada
| | - S Raquel Ramos
- New York University, Rory Meyers College of Nursing, New York, NY, United States
| | - Aisha Lofters
- MAP Center for Urban Health Solution, St. Michael's Hospital, Toronto, ON, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada
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Morales-Miranda S, Loya-Montiel I, Ritter J, Rocha-Jiménez T, Gordon L, García J, Flores C, Silverman JG. Factors associated with HIV testing among men who have sex with men in Guatemala City. Int J STD AIDS 2019; 30:577-585. [PMID: 30813861 DOI: 10.1177/0956462419826393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Although men who have sex with men (MSM) have the highest human immunodeficiency virus (HIV) prevalence in Guatemala, prevention efforts have been focused on other vulnerable populations. Respondent-driven sampling was used to recruit 444 MSM in Guatemala City to explore factors related to HIV testing among MSM. About 56% of participants reported HIV testing in the past 12 months, which was associated with a public MSM status (adjusted odds ratio (AOR) 2.08; 95% CI 1.02-4.26), participating in peer HIV prevention intervention (AOR 3.71; 95% CI 1.86-7.43), having at least one casual male partner (AOR 2.16; 95% CI 1.11-4.20), and practicing only insertive anal sex (AOR 3.35; 95% CI 1.59-7.09). Men with comprehensive HIV knowledge (AOR 2.63; 95% CI 1.38-5.02) were also more likely to have been tested. Further interventions in Guatemala targeting the most hidden MSM are needed.
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Affiliation(s)
| | - Itzel Loya-Montiel
- 2 Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Julie Ritter
- 3 St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Teresita Rocha-Jiménez
- 6 Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Leah Gordon
- 4 Oregon Health and Science University, Portland, OR, USA
| | - Judith García
- 5 Centro Nacional de Epidemiología, Ministerio de Salud Pública y Asistencia Social, Guatemala City, Guatemala
| | - Carlos Flores
- 5 Centro Nacional de Epidemiología, Ministerio de Salud Pública y Asistencia Social, Guatemala City, Guatemala
| | - Jay G Silverman
- 6 Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California, San Diego, La Jolla, CA, USA
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Peiris-John R, Wong A, Sobrun-Maharaj A, Ameratunga S. Stakeholder views on factors influencing the wellbeing and health sector engagement of young Asian New Zealanders. J Prim Health Care 2017; 8:35-43. [PMID: 27477373 DOI: 10.1071/hc15011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In New Zealand, while the term 'Asians' in popular discourse means East and South-east Asian peoples, Statistics New Zealand's definition includes people of many nationalities from East, South and South-east Asia, all with quite different cultural norms, taboos and degrees of conservatism. In a context where 'Asian' youth data are typically presented in aggregate form, there are notable gaps in knowledge regarding the contextual determinants of health in this highly heterogeneous group. This qualitative study explored key stakeholder views on issues that would be most useful to explore on the health and wellbeing of Asian youth and processes that would foster engagement of Asian youth in health research. METHODS Interviews were conducted with six key stakeholders whose professional activities were largely focused on the wellbeing of Asian people. The general inductive approach was used to identify and analyse themes in the qualitative text data. FINDINGS Six broad themes were identified from the key stakeholder interviews framed as priority areas that need further exploration: cultural identity, integration and acculturation; barriers to help-seeking; aspects to consider when engaging Asian youth in research (youth voice, empowerment and participatory approach to research); parental influence and involvement in health research; confidentiality and anonymity; and capacity building and informing policy. CONCLUSION With stakeholders strongly advocating the engagement of Asian youth in the health research agenda this study highlights the importance of engaging youth alongside service providers to collaborate on research and co-design responsive primary health care services in a multicultural setting. KEYWORDS Asian youth; New Zealand; health research; minority health; Community and social participation.
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Affiliation(s)
- Roshini Peiris-John
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
| | - Agnes Wong
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Amritha Sobrun-Maharaj
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Shanthi Ameratunga
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
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7
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Prevalence and associated risk characteristics of HIV infection based on anal sexual role among men who have sex with men: a multi-city cross-sectional study in Western China. Int J Infect Dis 2016; 49:111-8. [PMID: 27312581 DOI: 10.1016/j.ijid.2016.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 02/18/2016] [Accepted: 06/07/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The HIV prevalence among men who have sex with men (MSM) in Western China is substantial and increasing at an alarming rate. The current HIV infection prevalence among MSM in Western China and its associated risk characteristics were explored by looking at different anal sexual roles separately. METHODS A total 1245 MSM recruited by convenience sampling from multiple sources and areas in the Chongqing and Sichuan region were interviewed using an anonymous self-administered questionnaire with the assistance of investigators and then underwent HIV testing. Multivariate logistic regression was used to identify factors independently associated with HIV infection. RESULTS Of the 1235 respondents who reported their sexual roles during anal sex with men, the overall HIV antibody positive rate was 21.21% (262/1235). With regard to the different anal sex roles, HIV-positive rates were significantly higher among men who played the '0.5' role (versatile, equal) and '0' role (only bottom or versatile, but mostly bottom) during anal sex with men than among those who played the '1' role (only top or versatile, but mostly top) (26.41% for '0.5' role, 26.20% for '0' role, and 15.19% for '1' role; Chi-square=22.66, p<0.0001). Statistically significant differences were not found between the '0.5' role and '0' role groups (p > 0.05). The '1' role MSM who had an education level lower than senior high school, a rural household registration, and low self-perceived severity status of AIDS, the '0.5' role MSM who had an education level lower than senior high school and had not undergone HIV testing in the recent 1 year, and the '0' role MSM who were retired or unemployed and had been diagnosed with a sexually transmitted disease by a doctor in the recent 6 months were more likely to be HIV-infected. CONCLUSIONS In this study, the HIV prevalence among MSM was alarmingly high. Moreover, the '0.5' and '0' role MSM were found to have a higher risk of infection compared to the '1' role MSM, while respective risk characteristics were not completely the same across the three groups. Along with routine preventive intervention services, more focused and specific interventions are needed to target anal sex role classes separately.
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Neville S, Adams J. Views about HIV/STI and health promotion among gay and bisexual Chinese and South Asian men living in Auckland, New Zealand. Int J Qual Stud Health Well-being 2016; 11:30764. [PMID: 27211584 PMCID: PMC4876194 DOI: 10.3402/qhw.v11.30764] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 11/20/2022] Open
Abstract
Ethnic minority gay, bisexual, and other men who have sex with men (MSM) are considered to have a high risk for HIV infection. The aim of this study was to identify some of the ways Chinese and South Asian MSM talk about and understand issues related to HIV/STI and health promotion, as well as highlighting some of this group's health promoting behaviours. A qualitative study using face-to-face interviews with 44 Chinese and South Asian MSM living in Auckland, New Zealand, was undertaken. Following data analysis, four major themes were identified: the importance of condoms, condom use, HIV/STI practices, and HIV health promotion. The results showed that the men interviewed had a good understanding of the benefits of using condoms for anal sex. They also reported strong recall of the local HIV health promotion campaigns which seek to influence men's behaviours through promotion of a single, unequivocal message to always use a condom for anal sex. The men however did not always report consistent condom use, and a range of reasons why this happened were identified. Among the men who discussed testing practices, regular testing was much more likely to have occurred in men who have lived in New Zealand for more than 5 years. These results suggest that future health promotion initiatives should be tailored to ensure the needs of Chinese and South Asian MSM are appropriately addressed when promoting condom use for anal sex.
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Affiliation(s)
- Stephen Neville
- Department of Nursing, Auckland University of Technology, Auckland, New Zealand;
| | - Jeffery Adams
- SHORE & Whariki Research Centre, Massey University, Auckland, New Zealand
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Grover E, Grosso A, Ketende S, Kennedy C, Fonner V, Adams D, Sithole B, Mnisi Z, Maziya SL, Baral S. Social cohesion, social participation and HIV testing among men who have sex with men in Swaziland. AIDS Care 2016; 28:795-804. [PMID: 26824888 DOI: 10.1080/09540121.2015.1131971] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Social cohesion and social participation are social factors that may help reduce HIV risks and optimize health-seeking behaviors. We examined the association between these factors and HIV testing in the last 12 months among men who have sex with men (MSM) in Swaziland using a cross-sectional survey conducted with 326 men, 18 years of age or older reporting having sex with another man in the last 12 months. Social capital analyses included measures of social cohesion and social participation. The social cohesion measurement scale was created through exploratory factor analysis using polychoric correlations to determine unidimensionality and Cronbach's Alpha to assess internal consistency. The measurement scale was divided at the 25th and 75th percentiles using "high," "medium" and "low" levels of social cohesion for between-group comparisons. The social participation index included four questions regarding participation, resulting in a participation index ranging from 0 to 4. In the final multivariate logistic regression model, an increase in the level of social participation was found to be significantly associated with HIV testing in the last 12 months, adjusting for age, income, reporting a casual partner, family exclusion and rejection by other MSM due to sexual orientation (adjusted odds ratio [aOR]: 1.3, 95% confidence interval [CI] 1.1-1.7, p < .01). MSM with high social cohesion had almost twice the odds of HIV testing in the last 12 months (aOR: 1.8, 95% CI 1.1-3.3, p < .05) as MSM with medium social cohesion, though the overall social cohesion variable was not found to be significant using a Wald test in either the adjusted or unadjusted logistic regression models. These data suggest that building solidarity and trust within and between groups may be a strategy to improve uptake of HIV testing.
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Affiliation(s)
- Elise Grover
- a Key Populations Program, Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Ashley Grosso
- a Key Populations Program, Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Sosthenes Ketende
- a Key Populations Program, Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Caitlin Kennedy
- b Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Virginia Fonner
- c Department of Psychiatry and Behavioral Sciences , Medical University of South Carolina , Charleston , SC , USA
| | - Darrin Adams
- a Key Populations Program, Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | | | - Zandile Mnisi
- e Swaziland National AIDS Program , Mbabane , Swaziland
| | | | - Stefan Baral
- a Key Populations Program, Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
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Mohammadnezhad M, Fetuu FP, Mangum T, Alakalia JQ, Lucas JJ. A Systematic Review Study on Prevalence, Determinants, and Risk Factors of HIV/AIDS among Pacific Countries. WORLD JOURNAL OF AIDS 2016. [DOI: 10.4236/wja.2016.64024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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11
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Yi S, Tuot S, Chhoun P, Brody C, Pal K, Oum S. Factors associated with recent HIV testing among high-risk men who have sex with men: a cross-sectional study in Cambodia. BMC Public Health 2015; 15:743. [PMID: 26231524 PMCID: PMC4522123 DOI: 10.1186/s12889-015-2096-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/24/2015] [Indexed: 12/02/2022] Open
Abstract
Background Despite remarkable success in the fight against HIV, HIV prevalence in many countries remains high among key populations including men who have sex with men (MSM), and HIV testing rates is relatively low among this hard-to-reach population. This cross-sectional study explores factors associated with recent HIV testing among MSM in Cambodia. Methods This study was conducted in 2014 and included 384 MSM randomly selected from two provinces of Battembang and Siem Reap, using a two-stage cluster sampling method. A structured questionnaire was used for face-to-face interviews to collect data on socio-demographic characteristics, HIV testing history, sexual behaviors, HIV testing attitudes, and HIV knowledge. Multivariate logistic regression analysis was performed to identify factors independently associated with recent HIV testing. Results Mean age of the participants was 23.4 (SD = 5.2). Of total, 83.6 % had been tested for HIV at least once in their lifetime, and 65.1 % had been tested for HIV in the past six months. After controlling for other covariates, MSM who had been tested for HIV in the past six months were significantly more likely to regard themselves as female (AOR = 2.29, 95 % CI = 1.06-5.37), have received some form of HIV education in the past six months (AOR = 3.97, 95 % CI = 1.91-8.26), perceive that they were at higher HIV risk compared to the general population (AOR = 2.48, 95 % CI = 1.14-4.86), have been diagnosed with an STI in the past six months (AOR = 3.19, 95 % CI = 1.02-9.24), report using a condom at last sexual intercourse with a man or woman (AOR = 2.24, 95 % CI = 1.06-3.13), and report using a condom at last sexual intercourse with a boyfriend (AOR = 2.17, 95 % CI = 1.04-5.31). Conclusions This study highlights the common practices of risky sexual behaviors and relatively low rate of recent HIV testing among MSM in Cambodia. HIV education and social marketing should be expanded and tailored for MSM, specifically addressing the risk of unprotected anal intercourse and the importance of regular HIV testing for early enrolment in the care and treatment cascade.
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Affiliation(s)
- Siyan Yi
- Research Center, KHANA, No. 33, Street 71, P.O Box 2311-PP3, Phnom Penh, Cambodia. .,Center for Global Health Research, Public Health Program, Touro University California, 1310 Club Drive, Vallejo, CA, 94594, USA.
| | - Sovannary Tuot
- Research Center, KHANA, No. 33, Street 71, P.O Box 2311-PP3, Phnom Penh, Cambodia.
| | - Pheak Chhoun
- Research Center, KHANA, No. 33, Street 71, P.O Box 2311-PP3, Phnom Penh, Cambodia.
| | - Carinne Brody
- Center for Global Health Research, Public Health Program, Touro University California, 1310 Club Drive, Vallejo, CA, 94594, USA.
| | - Khuondyla Pal
- Research Center, KHANA, No. 33, Street 71, P.O Box 2311-PP3, Phnom Penh, Cambodia.
| | - Sopheap Oum
- Research Center, KHANA, No. 33, Street 71, P.O Box 2311-PP3, Phnom Penh, Cambodia.
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Li X, Wu G, Lu R, Feng L, Fan W, Xiao Y, Sun Z, Zhang H, Xing H, Shao Y, Ruan Y. HIV-testing behavior and associated factors among MSM in Chongqing, China: results of 2 consecutive cross-sectional surveys from 2009 to 2010. Medicine (Baltimore) 2014; 93:e124. [PMID: 25501047 PMCID: PMC4602788 DOI: 10.1097/md.0000000000000124] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The high and climbing human immunodeficiency virus (HIV) rates among Chinese men who have sex with men (MSM) bring huge pressure and challenge to acquired immune deficiency syndrome response work in China. This study examined HIV-testing behavior and describes the characteristics of recently tested MSM in Chongqing to address targeting HIV prevention interventions. Two consecutive cross-sectional surveys were conducted among Chongqing MSM using respondent-driven sampling in 2009 and 2010. Information was collected regarding details on demographic characteristics, sexual practices with male and female partners, and HIV-testing experiences. Univariate and multivariate logistic regression analyses were performed to identify factors independently associated with recent HIV testing.The final sample size included in our analyses was 992. The overall HIV prevalence was 13.4%, and HIV prevalence increased significantly from 11.6% in 2009 to 15.4% in 2010 (P = 0.08). The overall rate of HIV testing in the past 12 months was 44.6%, and the self-reported rates decreased significantly from 47.8% in 2009 to 41.1% in 2010 (P = 0.03). Factors independently associated with recent HIV testing included living in Chongqing >1 year (adjusted odds ratio [AOR] 1.8, 95% confidence interval [CI] 1.1-2.9), the age of most recent male partner ≤ 25 (AOR 1.5, 95% CI 1.1-2.1), not having unprotected insertive anal sex with most recent male partner in the past 6 months (AOR 1.5, 95% CI 1.1-2.0), disclosing HIV status to most recent male partner (AOR 2.8, 95% CI 2.0-3.8), and holding lower level of HIV-related stigma (AOR 1.1 per scale point, 95% CI 1.0-1.1). The extremely high HIV prevalence and low annual testing level put MSM at high risk of HIV infection and transmission, and it is a priority to promote regular HIV testing among this group in order to control the spread of HIV in Chongqing, China.
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Affiliation(s)
- Xuefeng Li
- From the State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing (XL, YX, ZS, HZ, HX, YS, YR); Karamay Center for Disease Control and Prevention, Karamay (XL); Chongqing Center for Disease Control and Prevention, Chongqing, P.R. China (GW, RL, LF); and Department of Public Health, College of Health and Human Services, Western Kentucky University, Bowling Green, Kentucky (WF). Drs Xuefeng Li, Guohui Wu, and Rongrong Lu contributed equally to the writing of this article
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