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Reid SC, Wang V, Assaf RD, Kaloper S, Murray AT, Shoptaw S, Gorbach P, Cassels S. Novel Location-Based Survey Using Cognitive Interviews to Assess Geographic Networks and Hotspots of Sex and Drug Use: Implementation and Validation Study. JMIR Form Res 2023; 7:e45188. [PMID: 37347520 DOI: 10.2196/45188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND The Ending the HIV Epidemic initiative in the United States relies on HIV hotspots to identify where to geographically target new resources, expertise, and technology. However, interventions targeted at places with high HIV transmission and infection risk, not just places with high HIV incidence, may be more effective at reducing HIV incidence and achieving health equity. OBJECTIVE We described the implementation and validation of a web-based activity space survey on HIV risk behaviors. The survey was intended to collect geographic information that will be used to map risk behavior hotspots as well as the geography of sexual networks in Los Angeles County. METHODS The survey design team developed a series of geospatial questions that follow a 3-level structure that becomes more geographically precise as participants move through the levels. The survey was validated through 9 cognitive interviews and iteratively updated based on participant feedback until the saturation of topics and technical issues was reached. RESULTS In total, 4 themes were identified through the cognitive interviews: functionality of geospatial questions, representation and accessibility, privacy, and length and understanding of the survey. The ease of use for the geospatial questions was critical as many participants were not familiar with mapping software. The inclusion of well-known places, landmarks, and road networks was critical for ease of use. The addition of a Google Maps interface, which was familiar to many participants, aided in collecting accurate and precise location information. The geospatial questions increased the length of the survey and warranted the inclusion of features to simplify it and speed it up. Using nicknames to refer to previously entered geographic locations limited the number of geospatial questions that appeared in the survey and reduced the time taken to complete it. The long-standing relationship between participants and the research team improved comfort to disclose sensitive geographic information related to drug use and sex. Participants in the cognitive interviews highlighted how trust and inclusive and validating language in the survey alleviated concerns related to privacy and representation. CONCLUSIONS This study provides promising results regarding the feasibility of using a web-based mapping survey to collect sensitive location information relevant to ending the HIV epidemic. Data collection at several geographic levels will allow for insights into spatial recall of behaviors as well as future sensitivity analysis of the spatial scale of hotspots and network characteristics. This design also promotes the privacy and comfort of participants who provide location information for sensitive topics. Key considerations for implementing this type of survey include trust from participants, community partners, or research teams to overcome concerns related to privacy and comfort. The implementation of similar surveys should consider local characteristics and knowledge when crafting the geospatial components.
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Affiliation(s)
- Sean C Reid
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Vania Wang
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Ryan D Assaf
- Benioff Homelessness and Housing Initiative, Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Sofia Kaloper
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Alan T Murray
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Steven Shoptaw
- Family Medicine and Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Pamina Gorbach
- Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Susan Cassels
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
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Geographic Distribution of HIV Transmission Networks in the United States. J Acquir Immune Defic Syndr 2021; 85:e32-e40. [PMID: 32740373 DOI: 10.1097/qai.0000000000002448] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Understanding geographic patterns of HIV transmission is critical to designing effective interventions. We characterized geographic proximity by transmission risk and urban-rural characteristics among people with closely related HIV strains suggestive of potential transmission relationships. METHODS We analyzed US National HIV Surveillance System data of people diagnosed between 2010 and 2016 with a reported HIV-1 partial polymerase nucleotide sequence. We used HIV TRAnsmission Cluster Engine (HIV-TRACE) to identify sequences linked at a genetic distance of ≤0.5%. For each linked person, we assessed median distances between counties of residence at diagnosis by transmission category and urban-rural classification, weighting observations to account for persons with multiple linked sequences. RESULTS There were 24,743 persons with viral sequence linkages to at least one other person included in this analysis. Overall, half (50.9%) of persons with linked viral sequences resided in different counties, and the median distance from persons with linked viruses was 11 km/7 miles [interquartile range (IQR), 0-145 km/90 miles]. Median distances were highest for men who have sex with men (MSM: 14 km/9 miles; IQR, 0-179 km/111 miles) and MSM who inject drugs, and median distances increased with increasing rurality (large central metro: 0 km/miles; IQR, 0-83 km/52 miles; nonmetro: 103 km/64 miles; IQR, 40 km/25 miles-316 km/196 miles). CONCLUSION Transmission networks in the United States involving MSM, MSM who inject drugs, or persons living in small metro and nonmetro counties may be more geographically dispersed, highlighting the importance of coordinated health department efforts for comprehensive follow-up and linkage to care.
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He L, Pan X, Yang J, Ma Q, Jiang J, Wang W, Qiu J, Zou Y, Wang P, Zhao D, Wang H, Jiang T. HIV risk behavior and HIV testing among rural and urban men who have sex with men in Zhejiang Province, China: A respondent-driven sampling study. PLoS One 2020; 15:e0231026. [PMID: 32240244 PMCID: PMC7117739 DOI: 10.1371/journal.pone.0231026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/15/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Currently, human immunodeficiency virus (HIV) sentinel surveillance among men who have sex with men (MSM) in China conducted in large and medium-sized cities, and no HIV sentinel surveillance conducted in rural areas. HIV testing and intervention is predominantly conducted in urban areas, there have been a limited number of studies in rural areas MSM, it is necessary to conduct the investigation of HIV risk sexual behavior, HIV testing among rural and urban MSM. METHOD Between December 2013 and August 2015, a cross-sectional study was conducted in rural and urban areas in Zhejiang Province using respondent-driven sampling (RDS). Participants completed face-to-face interviewer-administered questionnaire surveys and were tested for HIV. RESULTS A total of 710 MSM participants were recruited, of whom 36.1% were from rural areas. The overall HIV prevalence was 16.6%, and was considerably lower among MSM living in rural areas (3.9%) than those living in urban areas (24.2%). 61.1% participants had not condom use with male sexual behavior in the past 6 months (86.7% in rural areas and 46.7% in urban areas). The social demographic and behavioral characteristics had significance difference among rural and urban MSM. Multivariate logistic regression revealed that, compared to men living in urban areas, MSM living in rural areas MSM were more likely to use dating apps to find sexual partners, were more likely to engage in bisexual behavior, and had lower condom use. 43.0% participants had been tested for HIV in the past year (41.8% in rural areas and 43.6% in urban areas). Multivariate logistic regression also revealed that among participants living in rural areas, having rural health insurance and not accepting HIV intervention were associated with lower HIV testing rates, while a higher monthly income and through use of internet to find sexual partner were associated with higher rates of HIV testing. CONCLUSION High risk behavior was prevalent, and HIV testing rates were low among MSM living in rural areas compare to urban areas in Zhejiang Province, therefore, preventative intervention measures should be immediately among rural MSM urgently to reduce HIV transmission and to promote HIV testing.
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Affiliation(s)
- Lin He
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xiaohong Pan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
- * E-mail: (XP); (QM)
| | - Jiezhe Yang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Qiaoqin Ma
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
- * E-mail: (XP); (QM)
| | - Jun Jiang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Wei Wang
- Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Jiaquan Qiu
- Kaihua county Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Yazhou Zou
- Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Ping Wang
- Jiangshan Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Dongshe Zhao
- Lucheng district Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Hui Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Tingting Jiang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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Vaughan AS, Kramer MR, Cooper HLF, Rosenberg ES, Sullivan PS. Activity spaces of men who have sex with men: An initial exploration of geographic variation in locations of routine, potential sexual risk, and prevention behaviors. Soc Sci Med 2016; 175:1-10. [PMID: 28040577 DOI: 10.1016/j.socscimed.2016.12.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 11/17/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
Theory and research on HIV and among men who have sex with men (MSM) have long suggested the importance of non-residential locations in defining structural exposures. Despite this, most studies within these fields define place as a residential context, neglecting the potential influence of non-residential locations on HIV-related outcomes. The concept of activity spaces, defined as a set of locations to which an individual is routinely exposed, represents one theoretical basis for addressing this potential imbalance. Using a one-time online survey to collect demographic, behavioral, and spatial data from MSM, this paper describes activity spaces and examines correlates of this spatial variation. We used latent class analysis to identify categories of activity spaces using spatial data on home, routine, potential sexual risk, and HIV prevention locations. We then assessed individual and area-level covariates for their associations with these categories. Classes were distinguished by the degree of spatial variation in routine and prevention behaviors (which were the same within each class) and in sexual risk behaviors (i.e., sex locations and locations of meeting sex partners). Partner type (e.g. casual or main) represented a key correlate of the activity space. In this early examination of activity spaces in an online sample of MSM, patterns of spatial behavior represent further evidence of significant spatial variation in locations of routine, potential HIV sexual risk, and HIV prevention behaviors among MSM. Although prevention behaviors tend to have similar geographic variation as routine behaviors, locations where men engage in potentially high-risk behaviors may be more spatially focused for some MSM than for others.
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Affiliation(s)
- Adam S Vaughan
- Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.
| | - Hannah L F Cooper
- Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA.
| | - Eli S Rosenberg
- Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.
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Foley BT, Leitner T, Paraskevis D, Peeters M. Primate immunodeficiency virus classification and nomenclature: Review. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2016; 46:150-158. [PMID: 27789390 PMCID: PMC5136504 DOI: 10.1016/j.meegid.2016.10.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/19/2016] [Accepted: 10/21/2016] [Indexed: 12/25/2022]
Abstract
The International Committee for the Taxonomy and Nomenclature of Viruses does not rule on virus classifications below the species level. The definition of species for viruses cannot be clearly defined for all types of viruses. The complex and interesting epidemiology of Human Immunodeficiency Viruses demands a detailed and informative nomenclature system, while at the same time it presents challenges such that many of the rules need to be flexibly applied or modified over time. This review outlines the nomenclature system for primate lentiviruses and provides an update on new findings since the last review was written in 2000.
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Affiliation(s)
- Brian T Foley
- Theoretical Biology and Biophysics Group, T-6 Mail Stop K710, Los Alamos National Laboratory, Los Alamos, NM 87545, USA.
| | - Thomas Leitner
- Theoretical Biology and Biophysics Group, T-6 Mail Stop K710, Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - Dimitrios Paraskevis
- National and Kapodistrian University of Athens, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, Athens, Greece
| | - Martine Peeters
- UMI233-TransVIHMI, Institut de Recherche pour le Développement (IRD), INSERM U1175, University of Montpellier, Montpellier, France; IBC, Computational Biology Institute, 34095 Montpellier, France
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Rodrigues NCP, Almeida ASD, Braga JU, O'Dwyer G, Apratto Junior PC, Daumas RP, Lino VTS, Andrade MKDN, Monteiro DLM, Barros MBDL. Spatial dynamics of AIDS incidence in the elderly in Rio de Janeiro, Brazil, 1997-2011. CAD SAUDE PUBLICA 2016; 31:1721-31. [PMID: 26375650 DOI: 10.1590/0102-311x00152914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The dynamics of the spread of the AIDS epidemic ranges according to the characteristics of each geographical region in different population groups. The aim of this study was to evaluate spatial and temporal trends of the AIDS epidemic among the elderly in the State of Rio de Janeiro, Brazil. A retrospective study using spatial analysis techniques was conducted among AIDS cases (≥ 60 years) diagnosed from 1997-2011. The Poisson regression model was used to assess the relationship between year of diagnosis and incidence of AIDS, adjusted by sex. The AIDS epidemic began in the south coast of the state and gradually reached neighboring cities. The highest rates were found in regions around Rio de Janeiro and Niterói cities. The highest smoothed rates of the period were observed in Niterói in 2002-2006: 11.87/100,000 (men) and 8,5/100,000 (women). AIDS incidence rates among the elderly have stabilized in recent decades. To prevent HIV from spreading further among the general population, greater attention should be given to the older population.
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Affiliation(s)
| | | | - José Ueleres Braga
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, BR
| | - Gisele O'Dwyer
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, BR
| | | | - Regina Paiva Daumas
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, BR
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Non-infectious in-cell HIV-1 protease assay utilizing translocalization of a fluorescent reporter protein and apoptosis induction. Arch Pharm Res 2015; 38:2201-7. [DOI: 10.1007/s12272-015-0651-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/10/2015] [Indexed: 10/23/2022]
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Hoenigl M, Green N, Mehta SR, Little SJ. Risk Factors for Acute and Early HIV Infection Among Men Who Have Sex With Men (MSM) in San Diego, 2008 to 2014: A Cohort Study. Medicine (Baltimore) 2015; 94:e1242. [PMID: 26222863 PMCID: PMC4554110 DOI: 10.1097/md.0000000000001242] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The objectives of this study were to identify risk factors associated with acute and early HIV infection (AEH) among men who have sex with men (MSM) undergoing community HIV testing and to compare demographics in those diagnosed with AEH with those diagnosed at chronic stage of HIV infection.In this retrospective cohort study, we analyzed risk factors associated with AEH among 8925 unique MSM (including 200 with AEH [2.2%] and 219 [2.5%] with newly diagnosed chronic HIV infection) undergoing community-based, confidential AEH screening in San Diego, California.The combination of condomless receptive anal intercourse (CRAI) plus ≥5 male partners, CRAI with an HIV-positive male, CRAI with a person who injects drugs, and prior syphilis diagnosis were significant predictors of AEH in the multivariable Cox regression model. Individuals reporting ≥1 of these 4 risk factors had a hazard ratio of 4.6 for AEH. MSM diagnosed with AEH differed in race (P = 0.005; more reported white race [P = 0.001], less black race [P = 0.030], trend toward less Native American race [P = 0.061]), when compared to those diagnosed with chronic HIV infection, while there was no difference observed regarding age.We established a multivariate model for the predicting risk of AEH infection in a cohort of MSM undergoing community HIV screening, which could be potentially used to discern those in need of further HIV nucleic acid amplification testing for community screening programs that do not test routinely for AEH. In addition, we found that race differed between those diagnosed with AEH and those diagnosed at chronic stage of HIV infection underlining the need for interventions that reduce stigma and promote the uptake of HIV testing for black MSM.
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Affiliation(s)
- Martin Hoenigl
- From the Division of Infectious Diseases, University of California San Diego (UCSD), San Diego, California (MH, NG, SRM, SJL); Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine (MH); Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria (MH); and Veterans Affairs Healthcare System, San Diego, California (SRM)
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