1
|
Alarcón Gutiérrez M, Palma Díaz D, Forns Cantón ML, Fernández-López L, García de Olalla P, Rius Gibert C. Trends in Sexual Health of Gay, Bisexual, and Other Men Who Have Sex with Men, and Transgender Individuals: Apps Driven Testing Program for HIV and Other STIs in Barcelona, Spain (2016-2023). J Community Health 2024; 49:429-438. [PMID: 38063976 PMCID: PMC10981613 DOI: 10.1007/s10900-023-01310-9] [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] [Accepted: 11/08/2023] [Indexed: 04/02/2024]
Abstract
Gay, bisexual and other men who have sex with men (GBMSM) and transgender individuals face heightened risks of HIV and other sexually transmitted infections (STIs). Surveillance within these populations is critical, and community testing services play a pivotal role in preventing and controlling HIV and STIs. This study investigates the trends in HIV, syphilis and hepatitis C (HCV) infections among participants in an apps-driven rapid test program from 2016 to 2023 in Barcelona, Spain, examining associated factors. Trend analysis utilized Wilcoxon-type test and associated factors were determined through multivariate logistic analysis. The prevalence of new HIV diagnosis was 1.81% (CI 1.18-2.64), active syphilis was 3.37% (CI 2.46-4.50) and acute HCV was 0.40% (CI 0.11-1.02). While infection rates showed no significant changes, there was significant increasing in sex work and chemsex and decreasing in condom use. Additionally, a peak in dating apps use for sex and a specific reduction in number of sexual partners were observed in 2020. Factors associated with HIV diagnoses included migrant status (aOR = 11.19; CI 2.58-48.53) and inconsistent condom use during the previous 12 months (aOR = 3.12; CI 1.02-9.51). For syphilis, associated factors were migrant status (aOR = 2.46; CI 1.14-5.29), inconsistent condom use (aOR = 3.38; CI 1.37-8.36), and chemsex practice during the previous 12 months (aOR = 2.80; CI 1.24-6.30). Our findings emphasize the need for tailored interventions, including culturally sensitive outreach for migrants and comprehensive strategies addressing substance use in sexual contexts. Technological innovations and targeted educational initiatives could reduce the burden of HIV and STIs within the GBMSM and transgender communities, providing valuable insights for public health strategies.
Collapse
Affiliation(s)
- Miguel Alarcón Gutiérrez
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Epidemiology Service, Agència de Salut Pública de Barcelona, Barcelona, Spain.
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.
| | - David Palma Díaz
- Epidemiology Service, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Department of International Health, Care and Public Health Research Institute-CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Laura Fernández-López
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Patricia García de Olalla
- Epidemiology Service, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau, Barcelona, Spain
| | - Cristina Rius Gibert
- Epidemiology Service, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau, Barcelona, Spain
| |
Collapse
|
2
|
Mustanski B, Queiroz A, Merle JL, Zamantakis A, Zapata JP, Li DH, Benbow N, Pyra M, Smith JD. A Systematic Review of Implementation Research on Determinants and Strategies of Effective HIV Interventions for Men Who Have Sex with Men in the United States. Annu Rev Psychol 2024; 75:55-85. [PMID: 37722749 PMCID: PMC10872355 DOI: 10.1146/annurev-psych-032620-035725] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Men who have sex with men (MSM) are disproportionately affected by HIV, accounting for two-thirds of HIV cases in the United States despite representing ∼5% of the adult population. Delivery and use of existing and highly effective HIV prevention and treatment strategies remain suboptimal among MSM. To summarize the state of the science, we systematically review implementation determinants and strategies of HIV-related health interventions using implementation science frameworks. Research on implementation barriers has focused predominantly on characteristics of individual recipients (e.g., ethnicity, age, drug use) and less so on deliverers (e.g., nurses, physicians), with little focus on system-level factors. Similarly, most strategies target recipients to influence their uptake and adherence, rather than improving and supporting implementation systems. HIV implementation research is burgeoning; future research is needed to broaden the examination of barriers at the provider and system levels, as well as expand knowledge on how to match strategies to barriers-particularly to address stigma. Collaboration and coordination among federal, state, and local public health agencies; community-based organizations; health care providers; and scientists are important for successful implementation of HIV-related health innovations.
Collapse
Affiliation(s)
- Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA;
- Third Coast Center for AIDS Research, Chicago, Illinois, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Artur Queiroz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA;
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - James L Merle
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Alithia Zamantakis
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA;
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Juan Pablo Zapata
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA;
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Dennis H Li
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA;
- Third Coast Center for AIDS Research, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Nanette Benbow
- Third Coast Center for AIDS Research, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Maria Pyra
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA;
| | - Justin D Smith
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
3
|
Bell S, Ranuschio B, Waldron JM, Barnes L, Sheik-Yosef N, Villalobos E, Wackens J, Liboro RM. Pandemic upon Pandemic: Middle-Aged and Older Men Who Have Sex with Men Living with HIV Coping and Thriving during the Peak of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5979. [PMID: 37297583 PMCID: PMC10252860 DOI: 10.3390/ijerph20115979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
When the COVID-19 pandemic emerged in early 2020, not only did it abruptly impede the progress that was being made toward achieving global targets to end the HIV pandemic, but it also created significant impacts on the physical and mental health of middle-aged and older men who have sex with men living with HIV. Utilizing a qualitative, community-based participatory research approach, we conducted semi-structured, one-on-one interviews with 16 ethnoracially diverse, middle-aged and older men who have sex with men living with HIV residing in Southern Nevada, to examine the different ways the COVID-19 pandemic directly impacted their physical and mental health, and explore how they eventually coped and thrived during the peak of the crisis. Using thematic analysis to analyze our interview data, we identified three prominent themes: (1) challenges to obtaining credible health information, (2) the physical and mental health impacts of the COVID-19-pandemic-imposed social isolation, and (3) digital technologies and online connections for medical and social purposes. In this article, we extensively discuss these themes, the current discourse on these themes in academic literature, and how the perspectives, input, and lived experiences of our participants during the peak of the COVID-19 pandemic could be critical to addressing issues they had already been experiencing prior to the emergence of the pandemic in 2020, and just as importantly, helping us best prepare in stark anticipation of the next potentially devastating pandemic.
Collapse
Affiliation(s)
- Sherry Bell
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - Brandon Ranuschio
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - John M. Waldron
- LGBTQIA+ Community Center of Southern Nevada (The Center), Las Vegas, NV 89101, USA;
| | - Lianne Barnes
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - Nadia Sheik-Yosef
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - Esmeralda Villalobos
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - Janelle Wackens
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - Renato M. Liboro
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
- Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
| |
Collapse
|
4
|
Tanner AE, Palakshappa D, Morse CG, Mann-Jackson L, Alonzo J, Garcia M, Wright E, Dharod A, Isom S, Sucaldito AD, Aviles LR, Rhodes SD. Exploring the consequences of food insecurity and harnessing the power of peer navigation and mHealth to reduce food insecurity and cardiometabolic comorbidities among persons with HIV: protocol for development and implementation trial of weCare/Secure. Trials 2022; 23:998. [PMID: 36510319 PMCID: PMC9743787 DOI: 10.1186/s13063-022-06924-3] [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: 09/20/2022] [Accepted: 11/12/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Food insecurity, or the lack of consistent access to nutritionally adequate and safe foods, effects up to 50% of people living with HIV (PWH) in the United States (US). PWH who are food insecure have lower antiretroviral adherence, are less likely to achieve viral suppression, and are at increased risk developing of serious illnesses, including cardiometabolic comorbidities. The objectives of this study are to better understand how food insecurity contributes to the development of cardiometabolic comorbidities among PWH and to test a novel bilingual peer navigation-mHealth intervention (weCare/Secure) designed to reduce these comorbidities in food-insecure PWH with prediabetes or Type 2 diabetes (T2DM). METHODS In Aim 1, we will recruit a longitudinal cohort of 1800 adult (≥18 years) PWH from our clinic-based population to determine the difference in the prevalence and incidence of cardiometabolic comorbidities between food-secure and food-insecure PWH. Food insecurity screening, indicators of cardiometabolic comorbidities, and other characteristics documented in the electronic health record (EHR) will be collected annually for up to 3 years from this cohort. In Aim 2, we will conduct a randomized controlled trial among a sample of food-insecure PWH who have prediabetes or T2DM to compare changes in insulin sensitivity over 6 months between participants in weCare/Secure and participants receiving usual care. In Aim 3, we will conduct semi-structured individual in-depth interviews to explore the effect of the intervention among intervention participants with varying insulin sensitivity outcomes. TRIAL STATUS Aim 1 (longitudinal cohort) recruitment began in May 2022 and is ongoing. Aim 2 (intervention) recruitment is planned for spring 2023 and is expected to be completed in spring 2024. Aim 3 (process evaluation) data collection will occur after sufficient completion of the 6-month assessment in Aim 2. Final results are anticipated in fall 2025. CONCLUSIONS This research seeks to advance our understanding of how food insecurity impacts the development of cardiometabolic comorbidities among PWH and how food insecurity interventions may alleviate relevant comorbidities. Given the growing interest among health systems in addressing food insecurity, if the intervention is found to be efficacious, it could be broadly disseminated across HIV clinical care settings. TRIAL REGISTRATION ClinicalTrials.gov NCT04943861 . Registered on June 29, 2021.
Collapse
Affiliation(s)
- Amanda E. Tanner
- grid.266860.c0000 0001 0671 255XDepartment of Public Health Education, University of North Carolina Greensboro, Coleman 437E, Greensboro, NC 27402 USA
| | - Deepak Palakshappa
- grid.241167.70000 0001 2185 3318Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Caryn G. Morse
- grid.241167.70000 0001 2185 3318Section on Infectious Diseases, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Lilli Mann-Jackson
- grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Jorge Alonzo
- grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Manuel Garcia
- grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Elena Wright
- grid.241167.70000 0001 2185 3318Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Ajay Dharod
- grid.241167.70000 0001 2185 3318Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Department of Internal Medicine, Informatics and Analytics, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Wake Forest Center for Healthcare Innovation, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Wake Forest Center for Biomedical Informatics, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Scott Isom
- grid.241167.70000 0001 2185 3318Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Ana D. Sucaldito
- grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Lucero Refugio Aviles
- grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Scott D. Rhodes
- grid.241167.70000 0001 2185 3318Section on Infectious Diseases, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, USA ,grid.241167.70000 0001 2185 3318Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA
| |
Collapse
|
5
|
"My Friends Would Believe My Word": Appropriateness and Acceptability of Respondent-Driven Sampling in Recruiting Young Tertiary Student Men Who Have Sex with Men for HIV/STI Research in Nairobi, Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127331. [PMID: 35742579 PMCID: PMC9223518 DOI: 10.3390/ijerph19127331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023]
Abstract
(1) Background: We conducted formative research to assess the appropriateness and acceptability of respondent-driven sampling (RDS) in recruiting tertiary student men who have sex with men (TSMSM) into a prospective human immunodeficiency virus/sexually transmitted infection (HIV/STI) biobehavioral survey in Nairobi, Kenya. (2) Methods: Between September and October 2020, semi-structured qualitative interviews were held with service providers from organizations that serve MSM (n = 3), and TSMSM (n = 13). Interviews were conducted in English, audio-recorded and transcribed, then thematically analyzed using NVivo version 11. (3) Results: Service providers reflected that RDS was appropriate due to the large though concealed networks of TSMSM. TSMSM perceived RDS to be acceptable based on their large social network sizes and the trust that existed amongst themselves. TSMSM were concerned about participating due to the risk of being outed as MSM and hence emphasized that researchers needed to assure them of their confidentiality and include MSM as part of the study team to encourage participation. (4) Conclusions: RDS was perceived as both an appropriate and acceptable sampling method. Use of RDS should be considered as a strategy for recruiting young, marginalized populations for HIV/STI research.
Collapse
|
6
|
Schwartz J, Grimm J, Zimmerman R, Clement M. Information Seeking and MSM's Beliefs about PrEP and Condoms. HEALTH COMMUNICATION 2022; 37:889-896. [PMID: 33494635 DOI: 10.1080/10410236.2021.1876323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study examined how frequently men who have sex with men (MSM) used a selection of sources, including news media, social media, health organizations, and dating/hookup apps, for HIV information. Additionally, the study explored the extent to which MSM's efficacy beliefs about pre-exposure prophylaxis (PrEP) and perceptions of condom importance could be predicted by the sources they used. A sample of MSM (N= 969) were surveyed online. Results showed that respondents obtained information about HIV most often from HIV organizations, LGBT organizations, and dating/hookup apps, particularly the apps Growlr, Scruff, and Grindr. Use of the app Scruff was the strongest source-based predictor of beliefs about both PrEP and condoms. Implications for health promotion are discussed.
Collapse
Affiliation(s)
- Joseph Schwartz
- Department of Communication Studies, Northeastern University
| | - Josh Grimm
- Manship School of Mass Communication, Louisiana State University
| | | | | |
Collapse
|
7
|
Mwaniki SW, Mugo PM, Palanee-Phillips T. Project BESPOKE (Integrated Bio-Behavioral Assessment of HIV and STI Among Young Tertiary Student Men Who Have Sex With Men in Nairobi, Kenya): A Respondent-Driven Sampling Survey Protocol. Front Public Health 2021; 9:619694. [PMID: 34708012 PMCID: PMC8542710 DOI: 10.3389/fpubh.2021.619694] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Globally, men who have sex with men (MSM) are a key population for the human immunodeficiency virus (HIV) epidemic. Among MSM, young men who have sex with men (YMSM) are disproportionately affected by HIV and other sexually transmitted infections (STI). However, there is a dearth of research and interventions targeting HIV/STI prevention among YMSM. In Kenya, there is paucity of knowledge on the burden of HIV/STI and related factors among YMSM, including tertiary student men who have sex with men (TSMSM). The barriers TSMSM experience in accessing and utilizing health services in their learning institutions have seldom been explored. In the context of healthcare providers (HCP) working in tertiary institutions, little is known about their knowledge, attitudes, and practices toward providing services to TSMSM. Methods: The aims of the study are to: estimate prevalence and correlates of HIV/STI among TSMSM; estimate population size of TSMSM; explore experiences of TSMSM with access and utilization of health services; and assess HCP knowledge of, attitudes toward, and practices in provision of services to TSMSM. A mixed-methods approach will be used in three phases: Phase I-formative qualitative research will be conducted to understand TSMSM social networks, select "seeds", and explore strategies for implementing a respondent-driven sampling (RDS) survey. Interviews will be conducted with at least three staff who work in community based/non-governmental organizations (CBO/NGO) that serve MSM and at least 10 TSMSM. Phase II-an integrated bio-behavioral assessment (IBBA) will be conducted, where 200 TSMSM recruited by RDS will be offered HIV/STI testing, complete a behavioral survey, and provide information for population size estimation (PSE). Phase III-in-depth interviews will be held with 20 TSMSM selected from 200 TSMSM in phase II, to explore their experiences with access and utilization of healthcare services. Focus group discussions (FGD) will be conducted with HCP working in tertiary institutions to assess their knowledge of, attitudes toward, and practices in providing services to TSMSM. Data collection started in September 2020 and is expected to end by September 2021. Discussion: Findings from this study will be useful in informing HIV/STI prevention programming for TSMSM, by policy makers such the Kenyan ministries of health and education, tertiary education institutions, service providers, advocacy groups, and other interested stakeholders.
Collapse
Affiliation(s)
- Samuel Waweru Mwaniki
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- University Health Services, University of Nairobi, Nairobi, Kenya
| | - Peter Mwangi Mugo
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Thesla Palanee-Phillips
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
8
|
Hermosa-Bosano C, Paz C, Hidalgo-Andrade P, Aguayo-Romero R. Sexual Behaviors and HIV/STI Prevention Strategies Among Sexual Minority Men in Ecuador Who Use Geosocial Networking Apps. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3011-3021. [PMID: 34585282 PMCID: PMC8563564 DOI: 10.1007/s10508-021-02093-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 06/15/2021] [Accepted: 06/24/2021] [Indexed: 06/13/2023]
Abstract
Around the world, geosocial networking apps have become widely popular among sexual minority men (SMM). This research analyzed the sexual behaviors and HIV and STI prevention strategies (HIV/STI testing, HIV/STI inquiry, and HIV/STI disclosure) of an online-recruited sample of 284 SMM living in Ecuador. Sexting and oral sex were the most common sexual behaviors among SMM in the sample. Most participants had low perceptions of HIV and STI risk; 85% reported being tested for HIV and 70% for STIs. Being older predicted higher odds of being tested for either HIV or STIs at least once. Being single also predicted HIV testing. Future interventions in the country should explore apps' utility as intervention tools to spread information about sexual health and HIV prevention strategies, such as condom use and event-driven PrEP. Apps can also facilitate connections to sexual health services, including programs for PrEP initiation and linkage to HIV treatment. They should also focus on promoting sexual harm reduction conversations among potential app-met sexual partners.
Collapse
Affiliation(s)
- Carlos Hermosa-Bosano
- School of Psychology, Universidad de Las Américas, Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, Quito, 170124, Ecuador.
| | - Clara Paz
- School of Psychology, Universidad de Las Américas, Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, Quito, 170124, Ecuador
| | - Paula Hidalgo-Andrade
- School of Psychology, Universidad de Las Américas, Redondel del Ciclista, Antigua Vía a Nayón, Campus UDLAPark, Quito, 170124, Ecuador
| | - Rodrigo Aguayo-Romero
- Brigham and Women's Hospital, Harvard Medical School, The Fenway Institute, Boston, MA, USA
| |
Collapse
|
9
|
Srinivas ML, Ritchwood TD, Zhang TP, Li J, Tucker JD. Social innovation in sexual health: a scoping review towards ending the HIV epidemic. Sex Health 2021; 18:5-12. [PMID: 33632381 DOI: 10.1071/sh20030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/24/2020] [Indexed: 12/30/2022]
Abstract
As donor financial support decreases, ending the HIV epidemic in Asia will require novel and sustainable approaches. Social innovation, a community-engaged process that links social change and health improvement, may be useful for helping to end the HIV epidemic in Asia. A scoping review to examine social innovation strategies in sexual health for the Asian region was conducted. The research identified focused on three types of social innovation: (1) microfinance; (2) social entrepreneurship; and (3) social enterprise. Microfinance provides financial opportunities (e.g. banking services, job opportunities) to spur local entrepreneurship and healthier behaviours. Social entrepreneurship uses business principles and tools (e.g. crowdsourcing, human-centred design) to improve health. Social enterprise is a business with a social mission. Further research is needed to measure the efficacy and cost-effectiveness of social innovation strategies in improving HIV services.
Collapse
Affiliation(s)
- Megan L Srinivas
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Bioinformatics, 130 Mason Farm Road, 2nd Floor, Chapel Hill, NC 27599, USA; and Corresponding author.
| | - Tiarney D Ritchwood
- Family Medicine and Community Health, Duke University School of Medicine, DUMC 2914, Durham, NC 27710, USA
| | - Tiange P Zhang
- Department of Medicine, Loyola University Chicago Stritch School of Medicine, 2160 South First Avenue, Maywood, IL 60153, USA
| | - Jingjing Li
- Social Entrepreneurship to Spur Health (SESH), No. 2 Lujing Road, Guangzhou, 510095, China; and University of North Carolina-Project China, No. 2 Lujing Road, Guangzhou, 510095, China
| | - Joseph D Tucker
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Bioinformatics, 130 Mason Farm Road, 2nd Floor, Chapel Hill, NC 27599, USA; and University of North Carolina-Project China, No. 2 Lujing Road, Guangzhou, 510095, China; and International Diagnostics Centre, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, 202, LSHTM, 15-17 Tavistock Place, London, WC1E 7HT, UK
| |
Collapse
|
10
|
Strong C, Wu HJ, Tseng YC, Yuan CW, Yu YF, Liao JC, Chen YW, Hung YC, Li CW, Huang PH, Ko NY, Ku SWW. Mobile App (UPrEPU) to Monitor Adherence to Pre-exposure Prophylaxis in Men Who Have Sex With Men: Protocol for a User-Centered Approach to Mobile App Design and Development. JMIR Res Protoc 2020; 9:e20360. [PMID: 33258793 PMCID: PMC7738248 DOI: 10.2196/20360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/07/2020] [Accepted: 11/10/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Daily and on-demand pre-exposure prophylaxis (PrEP) has been well demonstrated to effectively prevent HIV acquisition for men who have sex with men (MSM). More than half of the MSM PrEP users in Taiwan prefer on-demand PrEP; however, on-demand PrEP involves a complicated dosing regimen because it requires precoital and postcoital dosing and sex events are hard to anticipate. Although there are a growing number of mobile apps designed to improve access to HIV prevention services and HIV medication adherence, few mobile apps focus on adherence to PrEP or are designed to accommodate a complicated, on-demand PrEP dosing schedule. OBJECTIVE The aim of this project is to evaluate the usability of a newly developed mobile app (UPrEPU) to assist MSM PrEP users to self-monitor their adherence to either daily or on-demand PrEP using a user-centered scheme. METHODS This research will be conducted in 2 phases: app development and usability study. In the app development phase, we will first conduct formative research with end users and stakeholders through in-depth interviews; the results will provide PrEP users' and PrEP navigators' personas as material used in the app conceptualization stage. PrEP navigators are individuals in the health care system that help HIV-negative individuals who need assistance in accessing PrEP care. A low-fidelity prototype of the app feature will be formatted by applying a participatory design approach to engage PrEP users, designers, and app developers in the design process of the app. Then, a high-fidelity prototype of the app will be developed for the usability study and refined iteratively by the multidisciplinary team and new internal testers. Internal testers include the research team consisting of experts in public health, infectious disease, and industrial design and a close network of the research team that is taking PrEP. In the usability study phase, we will enroll 70 MSM PrEP users and follow them up for 4 months. Usability, feasibility, and effectiveness of adherence monitoring will be evaluated. RESULTS Refinement of the UPrEPU app is currently ongoing. The usability study commenced in May 2020. CONCLUSIONS The UPrEPU app is one of the first apps designed to help MSM PrEP users to self-manage their PrEP schedule better regardless of dosing modes. With a design-thinking approach and adapting to the cultural context in Taiwan's MSM population, this novel app will have substantial potential to be acceptable and feasible and contribute to the reduction of new HIV infections. TRIAL REGISTRATION ClinicalTrials.gov NCT04248790; https://clinicaltrials.gov/ct2/show/NCT04248790. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/20360.
Collapse
Affiliation(s)
- Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan
| | - Huei-Jiuan Wu
- Department of Public Health, College of Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan.,Kirby Institute, University of New South Wales, Sydney, Australia
| | - Yuan-Chi Tseng
- Institute of Service Science, National Tsing Hua University, Hsinchu City, Taiwan.,Department of Industrial Engineering and Engineering Management, National Tsing Hua University, Hsinchu City, Taiwan
| | - Chien-Wen Yuan
- Graduate Institute of Library & Information Studies, National Taiwan Normal University, Taipei, Taiwan
| | - Yi-Fang Yu
- Department of Public Health, College of Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan
| | - Jay Chiehen Liao
- Department of Public Health, College of Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan
| | - Yi-Wen Chen
- Department of Public Health, College of Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan
| | - Yi-Chen Hung
- Institute of Service Science, National Tsing Hua University, Hsinchu City, Taiwan
| | - Chia-Wen Li
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan
| | - Po-Hsien Huang
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng-Kung University and Hospital, Tainan City, Taiwan.,Taiwan Love and Hope Association, Kaohsiung City, Taiwan
| | - Stephane Wen-Wei Ku
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
11
|
Platteau T, Herrijgers C, de Wit J. Digital chemsex support and care: The potential of just-in-time adaptive interventions. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 85:102927. [PMID: 32932125 DOI: 10.1016/j.drugpo.2020.102927] [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: 05/04/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 01/22/2023]
Abstract
Chemsex among gay, bisexual and other men who have sex with men (GBMSM) has received increasing attention as a public health concern in recent years. Chemsex can affect a variety of aspects of the lives of GBMSM and contribute to physical, social and emotional health burden. Starting from a continuum perspective of chemsex, rather than a binary view of problematic vs. non-problematic use, we argue that men engaging in chemsex at different points in their chemsex journey may benefit from tailored and personalized support to cope with the various and evolving challenges and concerns that may be related to their chemsex behavior. To date, interactive digital communication technologies are not much used to provide support and care for GBMSM engaging in chemsex, neither for community-based support and care nor by health services. This suggests potential for missed opportunities, as GBMSM are generally avid users of these technologies for social connections and hookups, including in relation to chemsex. Recent research has provided emerging evidence of the potential effects of so-called just in time adaptive interventions (JITAI) to provide effective support and care for a variety of health issues. JITAI hold much promise for the provision of appropriate, tailored support and care for GBMSM at different points in the chemsex journey. Co-designing JITAI with potential users and other stakeholders (co-design) is key to success. At the Institute for Tropical Medicine, in Antwerp (Belgium), we initiated the Chemified project to develop an innovative digital chemsex support and care tool for GBMSM. This project illustrates how current understanding of chemsex as a journey can be integrated with a JITAI approach and make use of co-design principles to advance the available support and care for GBMSM engaging in chemsex.
Collapse
Affiliation(s)
- T Platteau
- Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium; Open University, Department of Psychology, Heerlen, the Netherlands.
| | - C Herrijgers
- Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium
| | - J de Wit
- Utrecht University, Department of Social Sciences, Utrecht, the Netherlands
| |
Collapse
|
12
|
Tanner AE, Mann-Jackson L, Song EY, Alonzo J, Schafer KR, Ware S, Horridge DN, Garcia JM, Bell J, Hall EA, Baker LS, Rhodes SD. Supporting Health Among Young Men Who Have Sex With Men and Transgender Women With HIV: Lessons Learned From Implementing the weCare Intervention. Health Promot Pract 2020; 21:755-763. [PMID: 32757841 DOI: 10.1177/1524839920936241] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Young gay, bisexual, and other men who have sex with men and transgender women with HIV, particularly those who are racial or ethnic minorities, often have poor health outcomes. They also utilize a wide array of social media. Accordingly, we developed and implemented weCare, an mHealth (mobile health) intervention where cyberhealth educators utilize established social media platforms (e.g., Facebook, texting, and GPS-based mobile applications ["apps"]) designed for social and sexual networking) to improve HIV-related care engagement and health outcomes. As part of the process evaluation of weCare, we conducted 32 interviews with intervention participants (n = 18) and HIV clinic providers and staff (n = 14). This article highlights three key intervention characteristics that promoted care engagement, including that weCare is (1) targeted (e.g., using existing social media platforms, similarity between intervention participants and cyberhealth educator, and implementation within a supportive clinical environment), (2) tailored (e.g., bidirectional messaging and trusting relationship between participants and cyberhealth educators to direct interactions), and (3) personalized (e.g., addressing unique care needs through messaging content and flexibility in engagement with intervention). In addition, interviewees' recommendations for improving weCare focused on logistics, content, and the ways in which the intervention could be adapted to reach a larger audience. Quality improvement efforts to ensure that mHealth interventions are relevant for young gay, bisexual, and other men who have sex with men and transgender women are critical to ensure care engagement and support health outcomes.
Collapse
Affiliation(s)
- Amanda E Tanner
- University of North Carolina at Greensboro, Greensboro, NC, USA
| | | | | | - Jorge Alonzo
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Samuella Ware
- University of North Carolina at Greensboro, Greensboro, NC, USA
| | | | | | - Jonathan Bell
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Logan S Baker
- University of Virginia's College at Wise, Wise, VA, USA
| | | |
Collapse
|
13
|
Maloney KM, Bratcher A, Wilkerson R, Sullivan PS. Electronic and other new media technology interventions for HIV care and prevention: a systematic review. J Int AIDS Soc 2020; 23:e25439. [PMID: 31909896 PMCID: PMC6945883 DOI: 10.1002/jia2.25439] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 11/04/2019] [Accepted: 12/04/2019] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Electronic and other new media technologies (eHealth) can facilitate large-scale dissemination of information and effective delivery of interventions for HIV care and prevention. There is a need to both monitor a rapidly changing pipeline of technology-based care and prevention methods and to assess whether the interventions are appropriately diversified. We systematically review and critically appraise the research pipeline of eHealth interventions for HIV care and prevention, including published studies and other funded projects. METHODS Two peer-reviewed literature databases were searched for studies describing the development, trial testing or implementation of new technology interventions, published from September 2014 to September 2018. The National Institutes of Health database of grants was searched for interventions still in development. Interventions were included if eHealth was utilized and an outcome directly related to HIV treatment or prevention was targeted. We summarized each intervention including the stage of development, eHealth mode of delivery, target population and stage of the HIV care and prevention continua targeted. RESULTS AND DISCUSSION Of 2178 articles in the published literature, 113 were included with 84 unique interventions described. The interventions utilize a variety of eHealth technologies and target various points on the prevention and care continua, with greater emphasis on education, behaviour change and testing than linkage to medical care. There were a variety of interventions for HIV care support but none for PrEP care. Most interventions were developed for populations in high income countries. An additional 62 interventions with funding were found in the development pipeline, with greater emphasis on managing HIV and PrEP care. CONCLUSIONS Our systematic review found a robust collection of eHealth interventions in the published literature as well as unpublished interventions still in development. In the published literature, there is an imbalance of interventions favouring education and behaviour change over linkage to care, retention in care, and adherence, especially for PrEP. The next generation of interventions already in the pipeline might address these neglected areas of care and prevention, but the development process is slow. Researchers need new methods for more efficient and expedited intervention development so that current and future needs are addressed.
Collapse
Affiliation(s)
| | - Anna Bratcher
- Department of EpidemiologyUniversity of CaliforniaLos AngelesCAUSA
| | | | | |
Collapse
|
14
|
Chiou PY, Liao PH, Liu CY, Hsu YT. Effects of mobile health on HIV risk reduction for men who have sex with men. AIDS Care 2019; 32:316-324. [PMID: 31558040 DOI: 10.1080/09540121.2019.1668531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Mobile health (M-Health) has become a novel method for HIV prevention and the effects need to be promoted. The study purpose was to exam how a smartphone application (app) reduces HIV risky behaviour in men who have sex with men (MSM). The Safe Behaviour and Screening (SBS) app was developed, and included five features: record, output, and resources connection; information provision; testing services; interaction; and online statistics. A random assignment was used. The experimental group used the SBS app for six months. The control group did not use any intervention. There were 130 participants in the experimental group, and 135 in the control group. The average age of all subjects was 27.38 (SD = 5.56). Compared to the control group, the experimental group had significantly higher mean score of safe behaviour knowledge, motivation, and skills; percentage of condom use during anal intercourse; frequency of searching for testing resources and getting HIV and syphilis tests. The frequency of anal intercourse and recreational drug usage were significantly lower in the experimental group. The SBS app could decrease the HIV risky behaviour among MSM and be applied to HIV prevention and nursing intervention.
Collapse
Affiliation(s)
- Piao-Yi Chiou
- Department of Nursing, Medical College, National Taiwan University, Taipei City, Taiwan (R.O.C)
| | - Pei-Hung Liao
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan (R.O.C.)
| | - Chieh-Yu Liu
- Department of Speech language pathology and audiology, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan (R.O.C.)
| | - Yu-Tz Hsu
- Department of Infection, Mackay Memorial Hospital, Taipei City, Taiwan (R.O.C.)
| |
Collapse
|
15
|
Tanner AE, Song EY, Mann-Jackson L, Alonzo J, Schafer K, Ware S, Garcia JM, Arellano Hall E, Bell JC, Van Dam CN, Rhodes SD. Preliminary Impact of the weCare Social Media Intervention to Support Health for Young Men Who Have Sex with Men and Transgender Women with HIV. AIDS Patient Care STDS 2018; 32:450-458. [PMID: 30398955 PMCID: PMC6909718 DOI: 10.1089/apc.2018.0060] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Young racial/ethnic minority men who have sex with men (MSM) and transgender women with HIV often have poor health outcomes. They also utilize a wide array of social media. Accordingly, we developed and implemented weCare, a social media intervention utilizing Facebook, texting, and GPS-based mobile social and sexual networking applications to improve HIV-related care engagement and health outcomes. We compared viral load suppression and clinic appointment attendance among 91 participants during the 12-month period before and after weCare implementation. McNemar's chi-square test analyses were conducted comparing the pre- and postintervention difference using paired data. Since February 2016, intervention staff and 91 intervention participants (79.1% African American and 13.2% Latino, mean age = 25) exchanged 13,830 messages during 3,758 conversations (average: 41.3 conversations per participant) across a variety of topics, including appointment reminders, medication adherence, problem solving, and reducing barriers. There were significant reductions in missed HIV care appointments (68.0% vs. 53.3%, p = 0.04) and increases in viral load suppression (61.3% vs. 88.8%, p < 0.0001) 12 months postimplementation. Our results highlight the initial success of weCare in improving care engagement and viral suppression. Social media is an important tool, especially for young MSM and transgender women, to support individual- (e.g., viral suppression) and community- (e.g., reduced transmission efficiency) level health. It may also be a useful tool for improving engagement with biomedical HIV prevention tools (e.g., PrEP use).
Collapse
Affiliation(s)
- Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Eunyoung Y. Song
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Katherine Schafer
- Section on Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Samuella Ware
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina
| | - J. Manuel Garcia
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Elias Arellano Hall
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Jonathan C. Bell
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Cornelius N. Van Dam
- Regional Center for Infectious Disease, Cone Health, Greensboro, North Carolina
- University of North Carolina AHEC-Greensboro, Greensboro, North Carolina
| | - Scott D. Rhodes
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- Section on Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
16
|
Rhodes SD, Tanner AE, Mann-Jackson L, Alonzo J, Horridge DN, Van Dam CN, Trent S, Bell J, Simán FM, Vissman AT, Nall J, Andrade M. Community-Engaged Research as an Approach to Expedite Advances in HIV Prevention, Care, and Treatment: A Call to Action. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:243-253. [PMID: 29969308 PMCID: PMC6055521 DOI: 10.1521/aeap.2018.30.3.243] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Throughout the world, we continue to face profound challenges to reducing the impact of the HIV epidemic. Community-engaged research has emerged as an approach to increase our understanding of HIV and reduce health disparities, increase health equity, and promote community and population health. Our partnership has conducted more than 25 community-engaged research studies in the U.S. and Guatemala, and members have identified nine themes to facilitate community-engaged research and expedite advances in HIV prevention, care, and treatment. These themes include the inclusion of multisectoral partners, trust building and maintenance, the alignment of partner priorities, a can-do attitude, capacity and desire to move beyond service and conduct research, flexibility, power sharing, empowerment, an assets orientation, the shared and timely use of findings, and a stepwise approach. To reduce HIV disparities, community-engaged research is as critical now as ever, and we desperately need to reinvigorate our commitment to and support of it.
Collapse
Affiliation(s)
- Scott D Rhodes
- Wake Forest School of Medicine, Winston-Salem, North Carolina
- Wake Forest Clinical and Translational Science Institute Program in Community Engagement
| | | | - Lilli Mann-Jackson
- Wake Forest School of Medicine, Winston-Salem, North Carolina
- Wake Forest Clinical and Translational Science Institute Program in Community Engagement
| | - Jorge Alonzo
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Cornelius N Van Dam
- Regional Center for Infectious Diseases, Cone Health, Greensboro, North Carolina
| | | | - Jonathan Bell
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Aaron T Vissman
- Center for Health and Human Services Research, Talbert House, Cincinnati, Ohio
| | - Jennifer Nall
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | |
Collapse
|
17
|
Hookup App Use, Sexual Behavior, and Sexual Health Among Adolescent Men Who Have Sex With Men in the United States. J Adolesc Health 2018; 62:708-715. [PMID: 29784114 PMCID: PMC5967650 DOI: 10.1016/j.jadohealth.2018.01.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/02/2018] [Accepted: 01/02/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE Geosocial networking applications (e.g., "hookup apps") are widely used among adult men who have sex with men (MSM). Little is known about adolescent MSM's (AMSM) use of these apps. Exploratory research is needed as AMSM's app use poses various ethical, legal, and sexual health concerns. This article examined AMSM's app use patterns and its associations with their sexual health and behavior. METHODS Two hundred sexually experienced AMSM in the United States (M age = 16.6, 49% racial/ethnic minority) completed online survey questions assessing their use of apps specific to MSM and not specific to MSM to meet partners for dating and sex, as well as their sexual behavior and HIV risk. RESULTS Overall, 52.5% of participants (n = 105) reported using MSM-specific apps to meet partners for sex. Of these, most participants reported having oral (75.7%, n = 78) and anal sex (62.1%, n = 64) with those partners. Of those who reported having anal sex, 78.1% (n = 50) had sex with those partners more than once, and only 25.0% (n = 16) always used condoms with those partners. Relative to those who used only non-MSM-specific apps, MSM-specific app users reported more sex partners and condomless anal sex partners, greater perceived risk of HIV, more engagement in sexual health services, and greater odds of HIV testing. CONCLUSIONS Use of MSM-specific apps was not uncommon among this sample of AMSM. Patterns of risk behavior and HIV testing were similar to samples of adult MSM app users. Further research should investigate AMSM's app-related sexual and HIV/sexually transmitted infection prevention decision-making to guide sexual health education efforts for AMSM.
Collapse
|
18
|
Rhodes SD, Mann-Jackson L, Alonzo J, Simán FM, Vissman AT, Nall J, Abraham C, Aronson RE, Tanner AE. Engaged for Change: A Community-Engaged Process for Developing Interventions to Reduce Health Disparities. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2017; 29:491-502. [PMID: 29283276 PMCID: PMC5798238 DOI: 10.1521/aeap.2017.29.6.491] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The science underlying the development of individual, community, system, and policy interventions designed to reduce health disparities has lagged behind other innovations. Few models, theoretical frameworks, or processes exist to guide intervention development. Our community-engaged research partnership has been developing, implementing, and evaluating efficacious interventions to reduce HIV disparities for over 15 years. Based on our intervention research experiences, we propose a novel 13-step process designed to demystify and guide intervention development. Our intervention development process includes steps such as establishing an intervention team to manage the details of intervention development; assessing community needs, priorities, and assets; generating intervention priorities; evaluating and incorporating theory; developing a conceptual or logic model; crafting activities; honing materials; administering a pilot, noting its process, and gathering feedback from all those involved; and editing the intervention based on what was learned. Here, we outline and describe each of these 13 steps.
Collapse
Affiliation(s)
- Scott D. Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, and the CTSI Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, NC
| | | | - Aaron T. Vissman
- Center for Health and Human Services Research, Talbert House, Cincinnati, OH
| | - Jennifer Nall
- Forsyth County Department of Public Health, Winston-Salem, NC
| | | | | | - Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC
| |
Collapse
|
19
|
Tanner AE, Mann L, Song E, Alonzo J, Schafer K, Arellano E, Garcia JM, Rhodes SD. weCARE: A Social Media-Based Intervention Designed to Increase HIV Care Linkage, Retention, and Health Outcomes for Racially and Ethnically Diverse Young MSM. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:216-30. [PMID: 27244190 PMCID: PMC5010783 DOI: 10.1521/aeap.2016.28.3.216] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Estimates suggest that only about 30% of all individuals living with HIV in the U.S. have achieved viral suppression. Men who have sex with men (MSM), particularly racial/ethnic minority young MSM, are at increased risk for HIV infection and may have even lower viral suppression rates. HIV testing rates among MSM are low, and when tested, racial/ethnic minority young MSM have disproportionately lower rates of retention in care and viral suppression compared to other subgroups. This article describes the design and development of weCare, our social media-based intervention to improve care linkage and retention and health outcomes among racially and ethnically diverse MSM, ages 13-34, living with HIV that will be implemented and evaluated beginning in late 2016. The intervention harnesses established social media that MSM between these ages commonly use, including Facebook, text messaging, and established GPS-based mobile applications (apps). We are using community-based participatory research (CBPR) to enhance the quality and validity of weCare, equitably involving community members, organization representatives, healthcare providers, clinic staff, and academic researchers.
Collapse
Affiliation(s)
- Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro
| | - Lilli Mann
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Eunyoung Song
- Department of Social Sciences & Health Policy and Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Jorge Alonzo
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Katherine Schafer
- Section on Infectious Diseases, Wake Forest University Health Sciences
| | - Elías Arellano
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Jesus M. Garcia
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| | - Scott D. Rhodes
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine
| |
Collapse
|