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Lin Y, Li C, Liao M, Jiao K, Ma J, Yan Y, Li Y, Wu T, Cheng C, Cao Y, Jia W, Zhao Z, Wang L, Hua D, Li R, Guo N, Meng J, Ma W. Associations between perceived and actual risk of HIV infection and HIV prevention services uptake among men who have sex with men in Shandong province, China: a cross-sectional study. BMC Public Health 2024; 24:1470. [PMID: 38822308 PMCID: PMC11143659 DOI: 10.1186/s12889-024-18985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Associations between perceived and actual risk of HIV infection and HIV prevention services uptake are inconclusive. This study aimed to evaluate the discrepancy between the perceived and actual HIV risk, and quantify the associations between perceived and actual risk of HIV infection and three HIV prevention services utilization among men who have sex with men (MSM) in Shandong province, China. METHODS A cross-sectional study was conducted in Shandong province in June 2021. Participants were eligible if they were born biologically male, aged 18 years or older, had negative or unknown HIV status, and had sex with men in the past year. Participants were recruited online. The discrepancy between their perceived and actual risk of HIV infection was evaluated by calculating the Kappa value. Bayesian model averaging was used to assess the associations between perceived and actual risk of HIV infection and HIV prevention services uptake. RESULTS A total of 1136 MSM were recruited, most of them were 30 years old or younger (59.9%), single (79.5%), with at least college education level (74.7%). Most participants (97.4%) perceived that they had low risk of HIV infection, and 14.1% were assessed with high actual risk. The discrepancy between their perceived and actual risk of HIV infection was evaluated with a Kappa value of 0.076 (P < 0.001). HIV testing uptake had a weak association with perceived high HIV prevalence among social networks (aOR = 1.156, post probability = 0.547). The perceived high HIV prevalence among national MSM was positive related to willingness to use PrEP (aOR = 1.903, post probability = 0.943) and PEP (aOR = 1.737, post probability = 0.829). Perceived personal risk (aOR = 4.486, post probability = 0.994) and perceived HIV prevalence among social networks (aOR = 1.280, post probability = 0.572) were related to history of using PrEP. Perceived personal risk (aOR = 3.144, post probability = 0.952), actual risk (aOR = 1.890, post probability = 0.950), and perceived risk among social networks (aOR = 1.502, post probability = 0.786) were related to history of using PEP. CONCLUSIONS There is discordance between perceived and actual personal risk of HIV infection among MSM in China. HIV risk assessment and education on HIV prevalence among MSM should be strengthened to assist high-risk populations aware their risk accurately and hence access HIV prevention services proactively.
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Affiliation(s)
- Yuxi Lin
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chuanxi Li
- Qilu Hospital of Shandong University, Jinan, China
| | - Meizhen Liao
- Institution for AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Kedi Jiao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jing Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yu Yan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yijun Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Taoyu Wu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chunxiao Cheng
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yanwen Cao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wenwen Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhonghui Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lina Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Dongdong Hua
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ruixiao Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ningning Guo
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jing Meng
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
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Ibrahim K, Kahle EM, Christiani Y, Suryani S. Utilization of Social Media for the Prevention and Control of HIV/AIDS: A Scoping Review. J Multidiscip Healthc 2024; 17:2443-2458. [PMID: 38799010 PMCID: PMC11127661 DOI: 10.2147/jmdh.s465905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/04/2024] [Indexed: 05/29/2024] Open
Abstract
Social media has been used widely in public health for understanding health risks and intervening to improve health. However, the utilization of social media for HIV prevention and control interventions has not been clearly characterized. We conducted a scoping review on the utilization of social media for HIV prevention and control to identify gaps in the literature and highlight opportunities for future research and intervention. A comprehensive search of seven databases was performed: PubMed, Embase, CINAHL Complete (EBSCO), PsycInfo (EBSCO), Scopus, and WOS (Science Citation Index Expanded (SCI-EXPANDED). The Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used as a framework. A total of 790 articles were screened at the title and abstract level, and 78 were screened at the full-text level. Twenty-three articles met the eligibility criteria for review. We found that Facebook was still the most common social media service used to reach target populations. Lesbian, gay, bisexual and transgender (LGBT) individuals were the primary groups and were the most common targets of social media-based HIV prevention interventions. Outcomes of social media-based interventions, such as increased HIV testing, social networking and social support, condom use attitudes, behavioral skills, and research participation, were reported. Most social media-based interventions have emphasized HIV prevention, with fewer interventions focused on improving linkage to care and adherence to treatment among people living with HIV. Future studies may benefit from using social media for interventions to improve HIV-related outcomes in high-risk populations. This review highlights the potential and challenges of social media approaches for HIV/AIDS prevention and control.
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Affiliation(s)
- Kusman Ibrahim
- Postdoctoral Fellow, School of Nursing, University of Michigan, USA; Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
| | - Erin M Kahle
- Department of Health Behavior and Biological Science, School of Nursing, and Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | | | - Suryani Suryani
- Department of Mental Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
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Yin X, Pan J, Xu F. Effects of Wuxi CDC WeChat official account article features on user engagement in health promotion. BMC Public Health 2024; 24:756. [PMID: 38468225 PMCID: PMC10929147 DOI: 10.1186/s12889-024-18277-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/05/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE To identify the characteristics of subscribers to assess users' needs and analyze the features of articles published on Wuxi CDC WeChat official account (WOA) to evaluate the effectiveness of health education dissemination and guide future communication strategies. METHODS Collect data from the WeChat official account (WOA) of the Wuxi Center for Disease Control and Prevention (CDC) to identify factors affecting the effectiveness of health education dissemination as measured by shares and 100% reading completion rate between January 1, 2022, and December 31, 2022. Multivariate logistic regression analysis was utilized to identify influencing features of articles associated with health education dissemination. RESULTS By the end of 2022, our account had accumulated 891,170 subscribers, of which, 523,576 were females (58.75%), 349,856 were males (39.3%), mainly located in third-tier cities (82.59%). Age distribution peaked in the 26-35 and 36-45 age groups (43.63% and 30.6%, respectively). A total of 170 articles were included in the analysis. Multivariate logistic regression analysis revealed that articles with a lower word count (OR = 0.999, 95% CI = 0.998 ~ 1), lower picture count (OR = 0.892, 95% CI = 0.828 ~ 0.962), dominated headlines (OR = 2.454, 95% CI = 1.234 ~ 4.879) and thematically focused on Nutrition and food-borne diseases (OR = 5.728, 95% CI = 1.778 ~ 18.458) demonstrated higher engagement, as measured by shares and 100% completion rates. CONCLUSIONS Our findings suggest that future content should prioritize conciseness, optimize images, and align with subscriber interests, particularly in nutrition and food hygiene. Additionally, maintaining informative yet engaging content formats remains crucial for maximizing reach and impact.
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Affiliation(s)
- Xinyi Yin
- Department of Health Promotion, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, 214023, Wuxi, China.
| | - Junxia Pan
- Department of Health Promotion, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, 214023, Wuxi, China
| | - Fanfan Xu
- Department of Health Promotion, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, 214023, Wuxi, China.
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Chung D, Meng Y. Willingness to reduce alcohol consumption predicted by short-form video exposure, media involvement, psychological bias, and cognitive factor. Front Psychol 2024; 15:1213539. [PMID: 38356765 PMCID: PMC10865499 DOI: 10.3389/fpsyg.2024.1213539] [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: 04/28/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Through previous studies, Chinese college students are known to be prone to alcohol consumption, which can lead to health-risk behaviors such as high blood pressure, heart disease, stroke, liver disease, and digestive problems. However, little is known about how popular social media platforms (e.g., short-form video applications) can positively impact their willingness to reduce alcohol consumption. This study was guided by the theory of optimistic bias; we investigated the direct, mediated, and moderating effects of exposure to anti-alcohol consumption short-form videos and short-form video involvement on Chinese college students' willingness to reduce their alcohol consumption. Methods The current study has an empirical cross-sectional design and employed an online survey from September 1st, 2022, to November 1st, 2022. The survey specifically targeted Chinese college students, who are the most common users of short-form video applications. The accumulated data underwent rigorous examination, including hierarchical regression, mediation, and moderation analyses, all conducted using the PROCESS macro 4.0 within SPSS version 22. Results A total of 434 participants, aged 18-24 years, were included in this study. There were mediating effects regarding Chinese college students' exposure to anti-alcohol consumption short-form videos (β = 0.35, p < 0.01, 95% CI [0.17, 0.63]) and short-form video involvement (β = 0.44, p < 0.001, 95% CI [0.20, 0.65]) on their willingness to reduce alcohol consumption via reversed optimistic bias. Moreover, perceived prevention of heavy drinking control (β = 0.05, p < 0.001, 95% CI [0.01, 0.09]) played mediating roles in the relationship between exposure to anti-alcohol consumption short-form videos and willingness to reduce alcohol consumption. Conclusion This study is one of the earliest studies to examine the intricate effects of exposure to anti-alcohol consumption short-form videos and short-form video involvement on the willingness to reduce alcohol consumption among Chinese college students. In addition, this study confirms that regardless of whether Chinese college students are conscientious, exposure to anti-alcohol consumption short-form videos did not increase their level of reversed optimistic bias. The empirical findings of this study are critical and can provide practical insights for Chinese health departments that encourage Chinese college students to minimize alcohol consumption.
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Affiliation(s)
- Donghwa Chung
- School of Journalism and Communication, Central China Normal University, Wuhan, China
| | - Yanfang Meng
- School of Journalism and Communication, Beijing Institute of Graphic Communication, Beijing, China
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Mboussi DAS, Lin Y, Fornah L, Ma W. Impact of Social Media Use on HIV Testing and Related Mediator among Men Who Have Sex with Men in Shandong Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5383. [PMID: 37047997 PMCID: PMC10093945 DOI: 10.3390/ijerph20075383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Abstract
In China, HIV testing is the important first step of HIV prevention and treatment cascades but is not widely adopted by men who have sex with men (MSM). However, social media has been increasingly used to promote and improve HIV testing. This study aimed to assess the impact of social media use on HIV testing and explore the mediator in the relationship between social media and HIV testing. The authors conducted a cross-sectional study among 935 MSM participants in 11 cities in Shandong Province from 14 September to 6 December 2020. Multivariable regression was conducted to assess the relationship between social media use and HIV testing uptake, and mediation analysis was used to assess the mediation effect of HIV testing self-efficacy in the relationship between social media use and HIV testing. The present study findings showed that social media use was related to HIV testing (aOR = 3.024, 95% CI: 1.869, 4.892) and HIV self-testing uptake (aOR = 1.894, 95% CI: 1.228, 2.922), but was not related to HIV facility-based testing (aOR = 1.709, 95% CI: 0.806, 3.625, p = 0.162). A mediation effect of HIV testing self-efficacy was found between social media use and HIV testing (indirect effect: 0.13, 95% CI: 0.01, 0.29), facility-based testing (indirect effect: 0.05, 95% CI: 0.003, 0.16), and self-testing uptake (indirect effect: 0.07, 95% CI: 0.01, 0.16). Social media could be an effective tool to improve HIV testing, and healthcare providers should pay more attention to HIV testing self-efficacy in HIV testing promotion.
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Affiliation(s)
- Daisy Aurore Steinely Mboussi
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yuxi Lin
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Lovel Fornah
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
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HIV Testing Strategies, Types of Tests, and Uptake by Men Who have Sex with Men and Transgender Women: A Systematic Review and Meta-analysis. AIDS Behav 2023; 27:678-707. [PMID: 35984608 DOI: 10.1007/s10461-022-03803-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 11/01/2022]
Abstract
This systematic review and meta-analysis investigated the effectiveness of strategies and types of tests on HIV testing uptake by men who have sex with men (MSM) and transgender women (TGW), and in reaching PLWH. Articles published up to July 2020 were identified from major electronic databases and grey literature. Data were extracted and assessed for risk of bias. Estimates were pooled using random-effect meta-analysis while heterogeneity was evaluated by Cochran's Q test and I2. This study is registered with PROSPERO (CRD42020192740). Of 6820 titles, 263 studies (n = 67,288 participants) were included. The testing strategies reported in most studies were community- (71.2%) and facility-based (28.8%). Highest uptake, with facility-based testing, occurred and reached more PLWH while with standard laboratory tests, it occurred with the highest HIV prevalence among MSM. However, urine test showed a highest rate of new HIV infection. Multiple test combinations had the highest uptake and reached more PLWH among TGW. Various testing strategies, considering barriers and regional differences, and different test types, need be considered, to increase uptake among MSM and TGW.
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Hong C, Yu F, Xue H, Zhang D, Mi G. HIV Testing Among Gay, Bisexual, and Other Men Who Have Sex with Men During the COVID-19 Pandemic in China: Implications for Promoting HIV Self-Testing Among Key Populations. AIDS Patient Care STDS 2022; 36:451-457. [PMID: 36394476 DOI: 10.1089/apc.2022.0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The COVID-19 pandemic has created additional barriers to accessing sexual health services among gay, bisexual, and other men who have sex with men (GBMSM) in China. Yet, little is known about the frequency of HIV testing and how GBMSM get tested during the pandemic. We surveyed an online sample of GBMSM recruited on a gay networking app in China. Among 956 sexually active, 70.1% had received an HIV test in the past 6 months. Among these, 61.0% reported having undergone HIV self-testing (HIVST). Young GBMSM aged 18-24 years old were more likely to receive a recent HIV test, and the number of sexual partners was associated with recent HIV testing [adjusted odds ratio (AOR) = 1.14, 95% confidence interval (CI): 1.03-1.20]. Among those who had a recent HIV test, young GBMSM and those who had anal sex with both main partner and casual partners were more likely to utilize HIVST (AOR = 1.83, 95% CI: 1.16-2.84), as well as GBMSM who did not use a condom the last time engaged in anal sex (AOR = 1.57, 95% CI: 1.06-2.34). Among GBMSM never tested for HIV, a majority perceived low risk of HIV, while some suggested that they did not know where to get tested or they were scared of finding out they had HIV. HIVST has the potential to fill the gap in HIV testing among Chinese GBMSM, and future HIV testing programs should emphasize HIV education, accurate information dissertation, and timely point-to-care services.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, UCLA Luskin of Public Affairs, Los Angeles, California, USA
| | - Fei Yu
- Danlan Beijing Media Limited, Beijing, China
| | - Hui Xue
- Danlan Beijing Media Limited, Beijing, China
| | - Dapeng Zhang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guodong Mi
- Danlan Beijing Media Limited, Beijing, China
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Zhao T, Cao Z, Jiang Z, Bulloch G, Qiu Y, Liu L, Wang L, Li Y, Jia C, Guo L, Wu Z. Providing HIV testing in men who have sex with men through a gay social networking app in China: A qualitative interview study with multisectoral service providers. Front Public Health 2022; 10:1056720. [PMID: 36466506 PMCID: PMC9714668 DOI: 10.3389/fpubh.2022.1056720] [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: 10/13/2022] [Accepted: 11/02/2022] [Indexed: 11/18/2022] Open
Abstract
Objective We explored the feasibility of app-based HIV testing services (AHTS) among men who have sex with men (MSM) according to the perspectives of testing service providers. Methods Twenty-one current or previous AHTS providers participated in a semi-structured interview which explored the facilitators and barriers to AHTS. Ten participants originating from the Center for Disease Control and Prevention (CDC) and 11 from the non-governmental organization (NGO) in Shijiazhuang, China took part in this study. Interviews was transcribed verbatim, and the socioecological model (SEM) was applied to thematic analysis. Results Twenty-one participants from AHTS services commented on the integration of online appointment schedules into HIV testing services. AHTS was deemed a convenient and efficient method for MSM and service providers to choose their preferred location and times. Moreover, it allowed for important HIV-related information to be accessed online and targeted toward at-risk individuals. Participants thought MSM may feel unsure about personal information security being stored within a privatized app and was considered a barrier to AHTS's usability. As such, they believed establishing a government-led national online platform for AHTS would allow for greater trust from MSM, rather than a social media app. Conclusion By linking booking services to an online platform, AHTS was deemed a convenient and efficient method for HIV testing services, especially for young MSM who are familiar with smartphone applications. To improve the use of these services, AHTS apps should focus on ensuring the confidentiality of personal information and internet security to build trust between MSM and service providers.
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Affiliation(s)
- Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China,National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaobing Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China,National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhen Jiang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Gabriella Bulloch
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Yanchao Qiu
- Shijiazhuang Municipal Center for Disease Control and Prevention, Shijiazhuang, China
| | - Lihua Liu
- Shijiazhuang Municipal Center for Disease Control and Prevention, Shijiazhuang, China
| | - Lijing Wang
- Shijiazhuang Fifth Hospital, Shijiazhuang, China
| | - Yingxia Li
- Shijiazhuang Fifth Hospital, Shijiazhuang, China
| | - Ce Jia
- The “Tongxing” Non-Governmental Organization, Shijiazhuang, China
| | - Li Guo
- The “Tongxing” Non-Governmental Organization, Shijiazhuang, China
| | - Zunyou Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China,National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,*Correspondence: Zunyou Wu
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Jiao K, Wei R, Lin Y, Li C, Wang L, Ma W. Alcohol consumption and utilization of HIV prevention services among men who have casual sex with women in China. AIDS Care 2022; 35:564-571. [PMID: 36369927 DOI: 10.1080/09540121.2022.2142928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Men who have casual sex with women (MCSW) have played an important role in HIV new infections in China. Research studies have shown that heavy alcohol consumption can increase the risk of HIV infection. The cross-sectional study was conducted in two cities in China from December 2018 to May 2019 to examine the association between alcohol consumption and utilization of HIV prevention services among MCSW. Convenience sampling was used to recruit participants and 400 MCSW were recruited in this study. There were 238 (59.6%), 213 (53.4%) and 129 (32.4%) participants having utilized HIV prevention services, condom promotion and distribution or HIV counseling and testing (CPD/HCT) services, and peer education services in the past 12 months, respectively. MCSW who were identified as heavy drinkers were less likely to utilize HIV prevention services and CPD/HCT services compared with non-drinkers. For youngsters, those who are in the local household and those who are married/cohabitating, heavy drinkers was less likely to utilize HIV prevention services. This study highlights the significance of intensive education on heavy drinkers of MCSW, particularly for high-risk subgroups. Targeting resources for integrated HIV prevention efforts with alcohol-using MCSW should be considered by public health policymakers.
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Affiliation(s)
- Kedi Jiao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, PR People’s Republic of China
| | - Ran Wei
- Shandong Provincial Chest Hospital, Jinan, PR People’s Republic of China
| | - Yuxi Lin
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, PR People’s Republic of China
| | - Chuanxi Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, PR People’s Republic of China
| | - Lin Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, PR People’s Republic of China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, PR People’s Republic of China
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Sabin LL, Thulasingam M, Carwile M, Babu SP, Knudsen S, Dong L, Stephens J, Fernandes P, Cintron C, Horsburgh CR, Salgame P, Ellner JJ, Sarkar S, Hochberg NS. 'People listen more to what actors say': A qualitative study of tuberculosis-related knowledge, behaviours, stigma, and potential interventions in Puducherry, India. Glob Public Health 2022; 17:2898-2910. [PMID: 34657567 DOI: 10.1080/17441692.2021.1990372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
India has made substantial advancements in reducing the burden of tuberculosis (TB), but persons living with active TB (PLWATB) still face myriad challenges in seeking and receiving care, including TB-related stigma. To meet the END TB targets, it is critical that PLWATB engage in care and are able to adhere to treatment. This qualitative study aimed to understand TB-related stigma (perceived, enacted, and internalised) and possible interventions to reduce stigma in Puducherry and Tamil Nadu, India. We conducted 47 in-depth interviews with PLWATB and household members and eight focus group discussions: two each with PLWATB, their household members, healthcare workers, and key informants. We found varying TB-related knowledge: the vast majority of interview participants reported incorrect modes of transmission, although most were also aware that TB is curable. Participants reported high levels of perceived stigma, with nearly two-thirds of PLWATB choosing to hide their disease to avoid being stigmatised in their community. Participants supported interventions including celebrity advocacy and school-based programming to increase community knowledge and reduce enacted stigma as well as support groups and counselling to reduce internalised stigma in PLWATB. This study has the potential to inform future interventions to reduce TB-related stigma in India.
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Affiliation(s)
- Lora L Sabin
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | | | - Madeline Carwile
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | | | - Selby Knudsen
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Lijia Dong
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Jessie Stephens
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Priyanka Fernandes
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chelsie Cintron
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - C Robert Horsburgh
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | | | | | - Sonali Sarkar
- Department of Preventive and Social Medicine, JIPMER, Puducherry, India
| | - Natasha S Hochberg
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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He J, Li J, Jiang S, Cheng W, Jiang J, Xu Y, Yang J, Zhou X, Chai C, Wu C. Application of machine learning algorithms in predicting HIV infection among men who have sex with men: Model development and validation. Front Public Health 2022; 10:967681. [PMID: 36091522 PMCID: PMC9452878 DOI: 10.3389/fpubh.2022.967681] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/02/2022] [Indexed: 01/25/2023] Open
Abstract
Background Continuously growing of HIV incidence among men who have sex with men (MSM), as well as the low rate of HIV testing of MSM in China, demonstrates a need for innovative strategies to improve the implementation of HIV prevention. The use of machine learning algorithms is an increasing tendency in disease diagnosis prediction. We aimed to develop and validate machine learning models in predicting HIV infection among MSM that can identify individuals at increased risk of HIV acquisition for transmission-reduction interventions. Methods We extracted data from MSM sentinel surveillance in Zhejiang province from 2018 to 2020. Univariate logistic regression was used to select significant variables in 2018-2019 data (P < 0.05). After data processing and feature selection, we divided the model development data into two groups by stratified random sampling: training data (70%) and testing data (30%). The Synthetic Minority Oversampling Technique (SMOTE) was applied to solve the problem of unbalanced data. The evaluation metrics of model performance were comprised of accuracy, precision, recall, F-measure, and the area under the receiver operating characteristic curve (AUC). Then, we explored three commonly-used machine learning algorithms to compare with logistic regression (LR), including decision tree (DT), support vector machines (SVM), and random forest (RF). Finally, the four models were validated prospectively with 2020 data from Zhejiang province. Results A total of 6,346 MSM were included in model development data, 372 of whom were diagnosed with HIV. In feature selection, 12 variables were selected as model predicting indicators. Compared with LR, the algorithms of DT, SVM, and RF improved the classification prediction performance in SMOTE-processed data, with the AUC of 0.778, 0.856, 0.887, and 0.942, respectively. RF was the best-performing algorithm (accuracy = 0.871, precision = 0.960, recall = 0.775, F-measure = 0.858, and AUC = 0.942). And the RF model still performed well on prospective validation (AUC = 0.846). Conclusion Machine learning models are substantially better than conventional LR model and RF should be considered in prediction tools of HIV infection in Chinese MSM. Further studies are needed to optimize and promote these algorithms and evaluate their impact on HIV prevention of MSM.
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Affiliation(s)
- Jiajin He
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinhua Li
- School of Software Technology, Zhejiang University, Ningbo, China
| | - Siqing Jiang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Cheng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jun Jiang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yun Xu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jiezhe Yang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xin Zhou
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Chengliang Chai
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China,*Correspondence: Chengliang Chai
| | - Chao Wu
- School of Public Affairs, Zhejiang University, Hangzhou, China,Chao Wu
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12
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Li C, Xiong Y, Muessig KE, Tang W, Huang H, Mu T, Tong X, Yu J, Yang Z, Sherer R, Hazra A, Lio J, Matthews DD, Fisher EB, Li L, Tucker JD. Community-engaged mHealth intervention to increase uptake of HIV pre-exposure prophylaxis (PrEP) among gay, bisexual and other men who have sex with men in China: study protocol for a pilot randomised controlled trial. BMJ Open 2022; 12:e055899. [PMID: 35537794 PMCID: PMC9092176 DOI: 10.1136/bmjopen-2021-055899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 04/12/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION The large number of key populations in China who would benefit from HIV pre-exposure prophylaxis (PrEP) in the context of limited health system capacity and public awareness will pose challenges for timely PrEP scale-up, suggesting an urgent need for innovative and accessible interventions. This study aims to develop and pilot test a theory-informed, tailored mobile phone intervention that was codeveloped by young gay men, HIV clinicians and public health researchers to increase engagement in PrEP education and initiation among Chinese gay, bisexual and other men who have sex with men (GBMSM), who bear a disproportionate burden of HIV infections and remain underserved in the healthcare system. METHODS AND ANALYSIS This two-phase study includes a formative assessment using in-depth interviews (N=30) and a 12-week experimental pilot study using a two-arm randomised controlled trial design (N=70). The primary intervention is delivered through a WeChat-based mini-app (a program built into a Chinese multipurpose social media application) developed by young GBMSM from a 2019 crowdsourcing hackathon. Using mixed methods, we will further investigate the specific needs and concerns among GBMSM in terms of using PrEP as an HIV prevention strategy, how their concerns and PrEP use behaviours may change with exposure to the mini-app intervention during the study period and how we can further refine this intervention tool to better meet GBMSM's needs for broader implementation. ETHICS AND DISSEMINATION This study and its protocols have been reviewed and approved by the Institutional Review Boards of the University of North Carolina at Chapel Hill, USA (19-3481), the Guangdong Provincial Dermatology Hospital, China (2020031) and the Guangzhou Eighth People's Hospital, China (202022155). Study staff will work with local GBMSM community-based organisations to disseminate the study results to participants and the community via social media, workshops and journal publications. TRIAL REGISTRATION NUMBER The study was prospectively registered on clinicaltrials.gov (NCT04426656) on 11 June 2020.
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Affiliation(s)
- Chunyan Li
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Yuan Xiong
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Kathryn E Muessig
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Haojie Huang
- Wuhan Tongxing LGBTQ Center, Wuhan, Hubei, China
| | - Tong Mu
- Qingdao Eighth People's Hospital, Qingdao, Shandong, China
| | - Xiaokai Tong
- Xi'an Polytechnic University, Xi'an, Shaanxi, China
| | | | - Zeyu Yang
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Renslow Sherer
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Aniruddha Hazra
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Jonathan Lio
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Derrick D Matthews
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Edwin B Fisher
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Linghua Li
- Infectious Diseases Research Department, Guangzhou Eighth People's Hospital, Guangzhou, Guangdong, China
| | - Joseph D Tucker
- Institute of Global Health and Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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13
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Li S, Zhang J, Mao X, Lu T, Gao Y, Zhang W, Wang H, Chu Z, Hu Q, Jiang Y, Geng W, Shang H, Xu J. Feasibility of Indirect Secondary Distribution of HIV Self-test Kits via WeChat Among Men Who Have Sex With Men: National Cross-sectional Study in China. J Med Internet Res 2021; 23:e28508. [PMID: 34698651 PMCID: PMC8579221 DOI: 10.2196/28508] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/30/2021] [Accepted: 07/05/2021] [Indexed: 01/24/2023] Open
Abstract
Background HIV self-testing (HIVST) kits are common in key sexually active populations. Direct secondary distribution of HIVST kits (DSDHK) is effective in improving the uptake of HIVST. However, there are concerns about the various limitations of DSDHK, including limited geographic reach, payment problems, and need for face-to-face interactions. Objective In this study, we aim to evaluate the feasibility and characteristics of indirect secondary distribution of HIVST kits (ISDHK) via WeChat (distributing HIVST application links and follow-up HIVST kits to partners) among men who have sex with men (MSM). Methods From October 2017 to September 2019, an HIVST recruitment advertisement was disseminated on the WeChat social media platform to invite MSM to apply for the HIVST kits (referred to as index participants [IPs]). All MSM participants were encouraged to distribute the HIVST application link to their friends and sexual partners (referred to as alters) through their social networks. All the alters were further encouraged to continue distributing the HIVST application link. All participants paid a deposit (US $7), which was refundable upon completion of the questionnaire, and uploaded the test results via a web-based survey system. Results A total of 2263 MSM met the criteria and successfully applied for HIVST. Of these, 1816 participants returned their HIVST results, including 1422 (88.3%) IPs and 394 (21.7%) alters. More alters had condomless anal intercourse, a higher proportion of them had never previously tested for HIV, and they showed a greater willingness to distribute HIVST kits to their sexual partners (P=.002) than the IPs. After controlling for age, education, and income, the alters had a greater proportion of MSM who had never tested for HIV before (adjusted odds ratio [aOR] 1.29, 95% CI 1.00-1.68), were more willing to distribute the HIVST application link (aOR 1.71, 95% CI 1.21-2.40), had a lower number of sexual partners (aOR 0.71, 95% CI 0.57-0.90), and were less likely to search for sexual partners on the web (aOR 0.78, 95% CI 0.60-1.02) than IPs. In comparison, the rates of reactive HIVST results, conducting HIV confirmatory tests, HIV seropositivity, and initiation of HIV antiretroviral therapy were similar for IPs and alters. Conclusions The ISDHK model of distributing HIVST application links among the MSM population via social media is feasible. The ISDHK model should be used to supplement the DSDHK model to enable a greater proportion of the MSM population to know their HIV infection status.
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Affiliation(s)
- Shangcao Li
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Jing Zhang
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Xiang Mao
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Tianyi Lu
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Yangyang Gao
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Wenran Zhang
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Hongyi Wang
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Zhenxing Chu
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Qinghai Hu
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Yongjun Jiang
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Wenqing Geng
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Hong Shang
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
| | - Junjie Xu
- NHC Key Laboratory of AIDS Immunology, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang,Liaoning Province, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China
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14
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Ma X, Lu J, Liu W. Influencing Factors on Health Information to Improve Public Health Literacy in the Official WeChat Account of Guangzhou CDC. Front Public Health 2021; 9:657082. [PMID: 34414152 PMCID: PMC8369197 DOI: 10.3389/fpubh.2021.657082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/04/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Social media is used as a new channel for health information. In China, the official WeChat account is becoming the most popular platform for health information dissemination, which has created a good opportunity for the Centers for Disease Control and Prevention to facilitate health information online to improve emergency public health literacy. Methods: Data were collected from the Guangzhou CDC i-Health official WeChat account between April 1, 2018 and April 30, 2019. Descriptive analysis was performed for basic information about the followers and posts of the official WeChat account. Multiple logistic regression analysis was used to analyze the association among various factors of posts on engagement of followers of the official WeChat account. Results: Among 187,033 followers, the total numbers of post views, shares, likes, add to favorites, and comments for 213 posts were 1,147,308, 8,4671, and 5,535, respectively. Engagement of followers peaked on the dissemination date and gradually declined. The main post topics were health education posts and original posts. In the multiple logistic regression model, the number of post views was found to be significantly associated with infectious disease posts (AOR: 3.20, 95% CI: 1.16-8.81), original posts (AOR: 10.20, 95% CI: 1.17-89.28), and posts with title-reflected content (AOR: 2.93, 95% CI: 1.16-8.81). Conclusion: Our findings facilitate the government to formulate better strategies and improve the effectiveness of public information dissemination.
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Affiliation(s)
- Xiaowei Ma
- Department of Public Health Emergency Preparedness and Response, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jianyun Lu
- Department of Infectious Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Weisi Liu
- Department of Health Education and Promotion, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
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15
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Goodwin G. Social Media, Grindr, and PrEP: Sexual Health Literacy for Men Who Have Sex with Men in the Internet Age. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2021. [DOI: 10.1080/15398285.2021.1902227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Gavin Goodwin
- School of Information Studies, McGill University, Montreal, Canada
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16
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Nwafor JN, Kanmodi KK, Amoo BA. How Enlightening and Reliable Are Cancer-Related Posts on Social Media Platforms? Opinions of a Sample of Nigerians. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2021. [DOI: 10.1055/s-0041-1729776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Introduction On social media, several pieces of cancer-related information are being shared among people. This study aims to survey the Nigerian public, exploring their opinions on the influence (as per enlightenment) of cancer-related information on social media on them, and explore their opinions on the reliability of cancer-related posts they see on social media platforms.
Methods This study was a descriptive cross-sectional online survey of 236 Nigerians, using an e-questionnaire. Collected data were analyzed using SPSS version 20 software (IBM Corp, New York, NY, United States).
Results The majority (56.4%) of the respondents were females, 66.5% were within the age range of 20 to 29 years, and 92.4% had tertiary level of education. Virtually all (98.7%) of them had an Internet-enabled phone, and 99.6% were users of social media. The most used social media platform among them was WhatsApp while the most educative social media platform, according to them, was Facebook. Also, 96.6% (227/235) of those respondents who were social media users were of the opinion that social media is very useful for cancer education. However, only 68.5% (161/235) of them had learnt something new about cancer on social media platforms, of which 23.0% (37/161) rated the cancer information they have accessed on social media to be somewhat reliable.
Conclusion Social media is highly influential in educating Nigerians on issues pertaining to cancer. However, not all cancer-related information posted on various social media platforms is reliable; hence, social media users should always take extra caution while consuming cancer-related posts on social media platforms.
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Affiliation(s)
- Jacob Njideka Nwafor
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
- Mental and Oral Health Development Organization Inc, Birnin Kebbi, Nigeria
| | - Kehinde Kazeem Kanmodi
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
- Mental and Oral Health Development Organization Inc, Birnin Kebbi, Nigeria
- Department of Community Health, Aminu Musa Habib College of Health Science and Technology, Yauri, Nigeria
| | - Babatunde Abiodun Amoo
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
- Mental and Oral Health Development Organization Inc, Birnin Kebbi, Nigeria
- Society for Family Health, Abuja, Nigeria
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17
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Li J, Shan D, Liu P, Liu H, Cai L, Zhang H, Zhang L, Zhang D. Sex-seeking on the internet and mobile-based applications among young people in China: An online survey. Int J STD AIDS 2021; 32:403-410. [PMID: 33612032 DOI: 10.1177/0956462420971940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to investigate young people's risk behaviors in use of social network applications for sexual purposes. Snowball sampling technique was used to recruit participants online. Logistic regressions were performed to examine interrelationships among risk behaviors and sex-seeking platforms (A, B, C, D, and others). The prevalence of online sex-seeking was 22.2% (1156/5199) among people with sexual experience, and the most debut online sex-seeking happened in 15-24 years old in both men and women (79.8%, 590/739 vs 86.1%, 359/417). The risk behaviors varied in different platforms among 730 young people age 15-24 years. Among men, participants seeking sex via B were more likely to engage in concurrent sexual partnership (aOR: 1.64; 95% CI: 1.01-2.66). Participants seeking sex via C were more likely to engage in drug use (aOR: 1.74; 95% CI: 1.01-3.02) and condomless sex (aOR: 1.75; 95% CI: 1.04-2.95). Participants seeking sex via A, C, or D were all less likely to have homosexual behaviors. Among women, participants seeking sex via B were more likely to have condomless sex (aOR: 2.06; 95% CI: 1.10-3.86). The study indicated that emerging of the HIV epidemic in young people might be driven by risk behaviors during online sex-seeking. Effective intervention programs need to target on different social network platforms.
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Affiliation(s)
- Jian Li
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Duo Shan
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Liu
- Chinese Association of STD and AIDS Prevention and Control, Beijing, China
| | - Hui Liu
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lingping Cai
- China HIV/AIDS Information Network, Beijing, China
| | | | - Lei Zhang
- China HIV/AIDS Information Network, Beijing, China
| | - Dapeng Zhang
- National Center for AIDS/STD Control and Prevention196543, Chinese Center for Disease Control and Prevention, Beijing, China
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18
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Queiroz AAFLN, Sousa ÁFLD, Araújo TMED, Brignol S, Reis RK, Fronteira I, Moura MEB. High rates of unprotected receptive anal sex and vulnerabilities to HIV infection among Brazilian men who have sex with men. Int J STD AIDS 2021; 32:368-377. [PMID: 33533301 DOI: 10.1177/0956462420968994] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study aimed to evaluate unprotected receptive anal sex intercourse (URAI) rates and vulnerabilities to HIV infection among men who have sex with men (MSM) that use geosocial networking dating apps in Brazil. An online, analytical, cross-sectional study was carried out with 2,250 MSM. The analyzed variables were grouped according to domains of vulnerability and analyzed by bi and multivariate statistics to calculate the Adjusted Odds Ratios (aOR). The prevalence of self-reported HIV was 7.1%; and of URAI, 23.4%. The studied variables that increased the chances of engaging in URAI were: identifying as homosexual (aOR = 8.30; 95%CI = 5.68:12.04), pansexual (aOR = 5.01; 95%CI = 2.04:12.38), or bisexual (aOR = 3.14; 95%CI = 2.03:4.80), using apps for obtaining sex (aOR = 1.3; 95%CI = 1.0:1.5), engaging in group sex (aOR = 1.6; 95%CI = 1.3:2.0), and reporting chemsex (aOR = 1.5; 95%CI = 1.1:2.0). Self-reported positive HIV status was associated with: less than a minimum wage income (aOR = 1.78; 95%CI = 1.22:2.58), lower education (aOR = 1.86; 95%CI = 1.31 CI; 2,64), not knowing the partner's HIV status (aOR = 1.84; 95%CI = 1.06:3.19), practicing group sex (aOR = 1.67; 95%CI = 1.04; 2.68), and chemsex (aOR = 2.03; 95%CI =1.06:3.19). The applications interaction is shaped by their own users to better meet their desires and needs. However, this behavior exposes individuals to HIV vulnerabilities.
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Affiliation(s)
| | - Álvaro Francisco Lopes de Sousa
- School of Nursing of Ribeirão Preto, 28133Universidade de São Paulo, São Paulo, Brazil.,Global Health and Tropical Medicine, GHTM, 70907Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisbon, Portugal
| | | | - Sandra Brignol
- Institute of Collective Health, Universidade Federal Fluminense, Niterói, Brazil
| | - Renata Karina Reis
- School of Nursing of Ribeirão Preto, 28133Universidade de São Paulo, São Paulo, Brazil
| | - Inês Fronteira
- Global Health and Tropical Medicine, GHTM, 70907Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisbon, Portugal
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19
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Ganesh R, Singh S, Mishra R, Sagar R. The quality of online media reporting of celebrity suicide in India and its association with subsequent online suicide-related search behaviour among general population: An infodemiology study. Asian J Psychiatr 2020; 53:102380. [PMID: 32937236 PMCID: PMC7455521 DOI: 10.1016/j.ajp.2020.102380] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/25/2020] [Indexed: 01/25/2023]
Abstract
The literature reports increased suicide rates among general population in the weeks following the celebrity suicide, known as the Werther effect. The World Health Organization (WHO) has developed guidelines for responsible media reporting of suicide. The present study aimed to assess the quality of online media reporting of a recent celebrity suicide in India and its impact on the online suicide related search behaviour of the population. A total of 200 online media reports about Sushant Singh Rajput's suicide published between 14th to 20th June 2020 were assessed for quality of reporting following the checklist prepared using the WHO guidelines. Further, we examined the change in online suicide-seeking and help-seeking search behaviour of the population following celebrity suicide for the month of June using selected keywords. In terms of potentially harmful media reportage, 85.5 % of online reports violated at least one WHO media reporting guideline. In terms of potentially helpful media reportage, only 13 % articles provided information about where to seek help for suicidal thoughts or ideation. There was a significant increase in online suicide-seeking (U = 0.5, p < 0.05) and help-seeking (U = 6.5, p < 0.05) behaviour after the reference event, when compared to baseline. However, the online peak search interest for suicide-seeking was greater than help-seeking. This provides support for a strong Werther effect, possibly associated with poor quality of media reporting of celebrity suicide. There is an urgent need for taking steps to improve the quality of media reporting of suicide in India.
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Affiliation(s)
- Ragul Ganesh
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Swarndeep Singh
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Rajan Mishra
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
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20
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Fearon E, Bourne A, Tenza S, Palanee‐Phillips T, Kabuti R, Weatherburn P, Nutland W, Kimani J, Smith AD. Online socializing among men who have sex with men and transgender people in Nairobi and Johannesburg and implications for public health-related research and health promotion: an analysis of qualitative and respondent-driven sampling survey data. J Int AIDS Soc 2020; 23 Suppl 6:e25603. [PMID: 33000904 PMCID: PMC7527758 DOI: 10.1002/jia2.25603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/09/2020] [Accepted: 07/21/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION There is little published literature about gay, bisexual and other men who have sex with men and transgender individuals (MSM and TG)'s use of social media in sub-Saharan Africa, despite repressive social and/or criminalizing contexts that limit access to physical HIV prevention. We sought to describe MSM and TG's online socializing in Nairobi and Johannesburg, identifying the characteristics of those socializing online and those not, in order to inform the development of research and health promotion in online environments. METHODS Respondent-driven sampling surveys were conducted in 2017 in Nairobi (n = 618) and Johannesburg (n = 301) with those reporting current male gender identity or male sex assigned at birth and sex with a man in the last 12 months. Online socializing patterns, sociodemographic, sexual behaviour and HIV-testing data were collected. We examined associations between social media use and sociodemographic characteristics and sexual behaviours among all, and only those HIV-uninfected, using logistic regression. Analyses were RDS-II weighted. Thirty qualitative interviews were conducted with MSM and TG in each city, which examined the broader context of and motivations for social media use. RESULTS Most MSM and TG had used social media to socialize with MSM in the last month (60% Johannesburg, 71% Nairobi), mostly using generic platforms (e.g. Facebook), but also gay-specific (e.g. Grindr). HIV-uninfected MSM and TG reporting riskier recent sexual behaviours had raised odds of social media use in Nairobi, including receptive anal intercourse (adjusted OR = 2.15, p = 0.006), buying (aOR = 2.24, p = 0.015) and selling sex with men (aOR = 2.17, p = 0.004). Evidence for these associations was weaker in Johannesburg, though socializing online was associated with condomless anal intercourse (aOR = 3.67, p = 0.003) and active syphilis (aOR = 13.50, p = 0.016). Qualitative findings indicated that while online socializing can limit risk of harm inherent in face-to-face interactions, novel challenges were introduced, including context collapse and a fear of blackmail. CONCLUSIONS Most MSM and TG in these cities socialize online regularly. Users reported HIV acquisition risk behaviours, yet this space is not fully utilized for sexual health promotion and research engagement. Effective, safe and acceptable means of using online channels to engage with MSM/TG that account for MSM and TG's strategies and concerns for managing online security should now be explored, as complements or alternatives to existing outreach.
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Affiliation(s)
- Elizabeth Fearon
- Department of Global Health & DevelopmentLondon School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | - Adam Bourne
- Australian Research Centre in Sex, Health & SocietyLa Trobe UniversityMelbourneAustralia
| | - Siyanda Tenza
- Wits Reproductive Health and HIV InstituteSchool of Clinical MedicineUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Thesla Palanee‐Phillips
- Wits Reproductive Health and HIV InstituteSchool of Clinical MedicineUniversity of the WitwatersrandJohannesburgSouth Africa
| | | | - Peter Weatherburn
- Sigma ResearchDepartment of Public Health, Environments and SocietyLondon School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | - Will Nutland
- Sigma ResearchDepartment of Public Health, Environments and SocietyLondon School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | - Joshua Kimani
- Partners for Health and DevelopmentNairobiKenya
- Department of Community Health SciencesUniversity of Manitoba (UoM)WinnipegCanada
| | - Adrian D Smith
- Nuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
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21
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Zhang Y, Cao B, Wang Y, Peng TQ, Wang X. When Public Health Research Meets Social Media: Knowledge Mapping From 2000 to 2018. J Med Internet Res 2020; 22:e17582. [PMID: 32788156 PMCID: PMC7453331 DOI: 10.2196/17582] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 05/12/2020] [Accepted: 07/25/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social media has substantially changed how people confront health issues. However, a comprehensive understanding of how social media has altered the foci and methods in public health research remains lacking. OBJECTIVE This study aims to examine research themes, the role of social media, and research methods in social media-based public health research published from 2000 to 2018. METHODS A dataset of 3419 valid studies was developed by searching a list of relevant keywords in the Web of Science and PubMed databases. In addition, this study employs an unsupervised text-mining technique and topic modeling to extract research themes of the published studies. Moreover, the role of social media and research methods adopted in those studies were analyzed. RESULTS This study identifies 25 research themes, covering different diseases, various population groups, physical and mental health, and other significant issues. Social media assumes two major roles in public health research: produce substantial research interest for public health research and furnish a research context for public health research. Social media provides substantial research interest for public health research when used for health intervention, human-computer interaction, as a platform of social influence, and for disease surveillance, risk assessment, or prevention. Social media acts as a research context for public health research when it is mere reference, used as a platform to recruit participants, and as a platform for data collection. While both qualitative and quantitative methods are frequently used in this emerging area, cutting edge computational methods play a marginal role. CONCLUSIONS Social media enables scholars to study new phenomena and propose new research questions in public health research. Meanwhile, the methodological potential of social media in public health research needs to be further explored.
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Affiliation(s)
- Yan Zhang
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Yifan Wang
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Tai-Quan Peng
- Department of Communication, Michigan State University, East Lansing, MI, United States
| | - Xiaohua Wang
- School of Media and Communication, Shenzhen University, Shenzhen, China
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22
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Harnessing digital data and data science to achieve 90-90-90 goals to end the HIV epidemic. Curr Opin HIV AIDS 2020; 14:481-485. [PMID: 31449089 DOI: 10.1097/coh.0000000000000584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Effective public health interventions depend on timely, accurate surveillance. Harnessing digital data (including internet searches, social media, and online media) and data science is an emerging approach to complement traditional surveillance in public health but has been underutilized in HIV prevention and treatment. RECENT FINDINGS We highlight recent examples that illustrate how social media data can be applied to HIV surveillance and prevention interventions. SUMMARY To achieve 90-90-90 goals to end the HIV epidemic, we encourage traditional public health researchers to partner with data scientists to supplement HIV surveillance programs with social media analytics to refine estimates of HIV infections and key populations at risk and to identify subgroups and regions where prevention and treatment efforts need to be bolstered. We also encourage interdisciplinary teams to design interventions to promote HIV prevention and linkage to care by leveraging digital media, such as search engines and social media, that have the potential to reach millions of people instantaneously.
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23
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Wong WCW, Yang NS, Li J, Li H, Wan EYF, Fitzpatrick T, Xiong Y, Seto WK, Chan P, Liu R, Tang W, Tucker JD. Crowdsourcing to promote hepatitis C testing and linkage-to-care in China: a randomized controlled trial protocol. BMC Public Health 2020; 20:1048. [PMID: 32615951 PMCID: PMC7330974 DOI: 10.1186/s12889-020-09152-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background Hepatitis C virus (HCV) is a growing public health problem with a large disease burden worldwide. In China many people living with HCV are unaware of their hepatitis status and not connected to care and treatment. Crowdsourcing is a technique that invites the public to create health promotion materials and has been found to increase HIV testing uptake, including in China. This trial aims to evaluate crowdsourcing as a strategy to improve HCV awareness, testing and linkage-to-care in China. Methods A randomized controlled, two-armed trial (RCT) is being conducted in Shenzhen with 1006 participants recruited from primary care sectors of The University of Hong Kong-Shenzhen Hospital. Eligible participants are ≥30 years old; a resident in Shenzhen for at least one month after recruitment; no screening for HCV within the past 12 months and not known to have chronic HCV; and, having a WeChat social media account. Allocation is 1:1. Both groups will be administered a baseline and a follow-up survey (4-week post-enrollment). The intervention group will receive crowdsourcing materials to promote HCV testing once a week for two weeks and feedback will be collected thereafter, while the control group will receive no promotional materials. Feedback collected will be judged by a panel and selected to be implemented to improve the intervention continuously. Those identified positive for HCV antibodies will be referred to gastroenterologists for confirmation and treatment. The primary outcome will be confirmed HCV testing uptake, and secondary outcomes include HCV confirmatory testing and initiation of HCV treatment with follow-ups with specialist providers. Data will be collected on Survey Star@ via mobile devices. Discussion This will be the first study to evaluate the impact of crowdsourcing to improve viral hepatitis testing and linkage-to-care in the health facilities. This RCT will contribute to the existing literature on interventions to improve viral hepatitis testing in primary care setting, and inform future strategies to improve HCV care training for primary care providers in China. Trial registration Chinese Clinical Trial Registry. ChiCTR1900025771. Registered September 7th, 2019, http://www.chictr.org.cn/showprojen.aspx?proj=42788
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Affiliation(s)
- William C W Wong
- Department of General Practice, HKU-Shenzhen Hospital, Shenzhen, China.,Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Nancy S Yang
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Jingjing Li
- University of North Carolina Project-China, 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China. .,Social Entrepreneurship to Spur Health (SESH), 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China.
| | - Hang Li
- Department of General Practice, HKU-Shenzhen Hospital, Shenzhen, China
| | - Eric Y F Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China.,Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
| | | | - Yuan Xiong
- University of North Carolina Project-China, 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China.,Social Entrepreneurship to Spur Health (SESH), 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China
| | - Wai-Kay Seto
- Department of Medicine, The University of Hong Kong, Hong Kong, China.,State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China.,Department of Medicine, HKU-Shenzhen Hospital, Shenzhen, China
| | - Polin Chan
- World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Ruihong Liu
- Department of General Practice, HKU-Shenzhen Hospital, Shenzhen, China
| | - Weiming Tang
- University of North Carolina Project-China, 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China.,Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Joseph D Tucker
- University of North Carolina Project-China, 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China.,Social Entrepreneurship to Spur Health (SESH), 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China.,Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
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24
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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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25
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Gamariel F, Isaakidis P, Tarquino IAP, Beirão JC, O’Connell L, Mulieca N, Gatoma HP, Cumbe VFJ, Venables E. Access to health services for men who have sex with men and transgender women in Beira, Mozambique: A qualitative study. PLoS One 2020; 15:e0228307. [PMID: 31999760 PMCID: PMC6992190 DOI: 10.1371/journal.pone.0228307] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 01/13/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES HIV prevalence and incidence are higher among key populations including Men who have Sex with Men (MSM) and transgender women in low and middle income countries, when compared to the general population. Despite World Health Organisation guidelines on the provision of services to key populations recommending an evidence-based, culturally relevant and rights-based approach, uptake of HIV services in many resource-limited and rights-constrained settings remains low. Médecins Sans Frontières (MSF) has been offering health services for MSM and transgender women in Beira, Mozambique since 2014 using a peer-educator driven model, but uptake of services has not been as high as expected. This qualitative study aimed to learn more about these key populations in Beira, their experiences of accessing MSM- and transgender-friendly services and their use of face-to-face and virtual networks, including social media, for engagement with health care. METHODS In-depth interviews were carried out with MSM and transgender women who were 1) enrolled in, 2) disengaged from or 3) never engaged in MSF's programme. Purposive and snowball sampling were used to recruit the different groups of interviewees. Interviews were conducted in Portuguese, transcribed and translated into English before being coded and manually analysed using a thematic network framework. RESULTS Nine transgender women and 18 cisgender MSM participated in the study. Interviewees ranged in age from 19 to 47 years, with a median age of 29. Three main themes emerged from the data: perceptions of stigma and discrimination, experiences of the peer-educator driven model and the use of face-to-face and virtual platforms for communication and engagement, including social media. Interviewees reported experiencing stigma and discrimination because of their gender or sexual identity. HIV-related stigma and health-care setting discrimination, including gossip and breach of confidentiality, were also reported. Although the presence of the peer-educators and their outreach activities were appreciated, they had limited visibility and an over-focus on health and HIV. The face-to-face networks of MSM and transgender women were small and fragmented. Virtual networks such as Facebook were mainly used for flirting, dating and informal communication. Most interviewees were at ease using social media and would consider it as a means of engaging with health messaging. CONCLUSIONS MSM and transgender women have challenges in accessing health services due to being stigmatised because of their gender identity and their sexual behaviour, and often experience stigma at home, in health-care facilities and in their communities. Peer-driven models of engagement were appreciated but have limitations. There is an untapped potential for further expansion and engagement with face-to-face and virtual platforms to reach MSM and transgender women in settings with a high HIV burden, and to provide them with essential information about HIV and their health.
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Affiliation(s)
| | - Petros Isaakidis
- Médecins Sans Frontières, Southern Africa Medical Unit (SAMU), Cape Town, South Africa
| | | | | | - Lucy O’Connell
- Médecins Sans Frontières, Southern Africa Medical Unit (SAMU), Cape Town, South Africa
| | | | | | | | - Emilie Venables
- Médecins Sans Frontières, Southern Africa Medical Unit (SAMU), Cape Town, South Africa
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine,University of Cape Town, Cape Town, South Africa
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26
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Hu M, Xu C, Wang J. Spatiotemporal Analysis of Men Who Have Sex With Men in Mainland China: Social App Capture-Recapture Method. JMIR Mhealth Uhealth 2020; 8:e14800. [PMID: 32012086 PMCID: PMC7007599 DOI: 10.2196/14800] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 10/31/2019] [Accepted: 11/15/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND In China, the cases of newly diagnosed HIV/AIDS in men who have sex with men (MSM) have increased more than tenfold since 2006. However, the MSM population size, geographical distribution, and migration patterns are largely unknown. OBJECTIVE Our aim is to estimate the number, spatial distribution, and migration of MSM populations in mainland China using big data from social networking. METHODS We collected 85 days of data on online users of a social networking MSM app in mainland China. Daily online MSM users and their migration across the country were investigated during a holiday period and a nonholiday period. Using the capture-mark-recapture model, we designed an experiment consisting of two independent samples to estimate the total provincial MSM population. RESULTS The estimate of MSM in mainland China was 8,288,536 (95% CI 8,274,931-8,302,141), accounting for 1.732% (95% CI 1.729%-1.734%) of adult men aged 18 to 64 years. The average daily number of MSM social networking online across mainland China was 1,198,682 during the nonholiday period. The five provinces (including municipalities) with the highest average number of daily online MSM numbers were Guangdong (n=141,712), Jiangsu (n=90,710), Zhejiang (n=72,212), Shandong (n=68,065), and Beijing (n=66,057). The proportion of daily online MSM among adult men in different cities varied from 0.04% to 0.96%, with a mean of 0.20% (SD 0.14%). Three migrating centers-Guangdong, Beijing, and the Yangtze River Delta (Shanghai-Zhejiang-Jiangsu)-accounted for 57.23% of MSM migrants in the county. CONCLUSIONS The percentage of MSM among adult men in mainland China is at the middle level compared with other Asia and Pacific countries. However, the number of MSM is very large, and the distribution is uneven. Both MSM distribution and migration are highly affected by socioeconomic status.
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Affiliation(s)
- Maogui Hu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
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27
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Liu C, Zhang Y, Pan SW, Cao B, Ong JJ, Fu H, Wu D, Fu R, Wei C, Tucker JD, Tang W. Anticipated HIV stigma among HIV negative men who have sex with men in China: a cross-sectional study. BMC Infect Dis 2020; 20:44. [PMID: 31941445 PMCID: PMC6961233 DOI: 10.1186/s12879-020-4778-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 01/08/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Anticipated HIV stigma, i.e., the expectation of adverse experiences from one's seroconversion, is associated with both negative psychological and behavioral outcomes. We know little about anticipated HIV stigma's relationship with emerging technologies, such as HIV self-testing (HIVST) and online sex-seeking platforms, that have become popular among populations that are disproportionately affected by HIV/AIDS. This study examined correlates of anticipated HIV stigma among Chinese men who have sex with men (MSM). METHODS In July 2016, MSM, who were ≥ 16 years old and self-reported as HIV negative or unknown, were recruited from a gay mobile phone application in China. Information regarding socio-demographics, sexual behaviors, sexual health service utilization, and anticipated HIV stigma were collected. Anticipated HIV stigma (i.e., negative attitude toward future stigmatization of HIV seroconversion by others) was measured as the mean score from a 7-item Likert-scale ranging from 1 (low) to 4 (high). Generalized linear models were conducted to examine the factors associated with the anticipated HIV stigma scores. RESULTS Overall, 2006 men completed the survey. Most men completed high school (1308/2006, 65.2%) and had an annual personal income of ≤9200 USD (1431/2006, 71.3%). The mean anticipated HIV stigma score for the participants was 2.98 ± 0.64. Using social media to seek sexual partners was associated with higher anticipated HIV stigma (Adjusted β = 0.11, 95% confidence interval (CI): 0.05 to 0.17, p = 0.001). HIV self-testing (Adjusted β = - 0.07, 95%CI: - 0.13 to - 0.01, p = 0.02) and having disclosed one's sexual orientation to a healthcare provider (Adjusted β = - 0.16, 95%CI: - 0.22 to - 0.96, p < 0.001) were associated with lower anticipated HIV stigma. CONCLUSION Our data suggested that anticipated HIV stigma is still common among Chinese MSM not living with HIV. Tailored anti-HIV stigma campaigns on social media are especially needed, and the promotion of HIVST may be a promising approach.
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Affiliation(s)
- Chuncheng Liu
- University of California San Diego, La Jolla, CA USA
- University of North Carolina Project-China, Guangzhou, China
| | - Ye Zhang
- University of North Carolina Project-China, Guangzhou, China
- Kirby Institution, UNSW, Sydney, Australia
| | - Stephen W. Pan
- University of North Carolina Project-China, Guangzhou, China
- Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - Bolin Cao
- University of North Carolina Project-China, Guangzhou, China
- Shenzhen University, Shenzhen, China
| | - Jason J. Ong
- University of North Carolina Project-China, Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, UK
| | - Hongyun Fu
- University of North Carolina Project-China, Guangzhou, China
- Eastern Virginia Medical School, Norfolk, VA USA
| | - Dan Wu
- University of North Carolina Project-China, Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, UK
| | - Rong Fu
- University of North Carolina Project-China, Guangzhou, China
- Guangzhou CDC, Guangzhou, China
| | - Chongyi Wei
- University of North Carolina Project-China, Guangzhou, China
- Rutgers – The State University of New Jersey, New Brunswick, NJ USA
| | - Joseph D. Tucker
- University of North Carolina Project-China, Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, UK
- Dermatology Hospital of Southern Medical University and the University of North Carolina Project-China, No.2 Lujing Road, Guangzhou, 510095 China
- University of North Carolina Chapel Hill, Chapel Hill, NC USA
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University and the University of North Carolina Project-China, No.2 Lujing Road, Guangzhou, 510095 China
- University of North Carolina Chapel Hill, Chapel Hill, NC USA
- Institute of Global Health and STI Research, Southern Medical University, Guangzhou, China
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28
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Luo Q, Wu Z, Chen Z, Ma Y, Mi G, Liu X, Xu J, Rou K, Zhao Y, Scott SR. App use frequency and condomless anal intercourse among men who have sex with men in Beijing, China: a cross-sectional study. Int J STD AIDS 2019; 30:1146-1155. [PMID: 31558122 DOI: 10.1177/0956462419860293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Gay dating applications (apps) are popular among men who have sex with men (MSM) in China. This study examined the relationship between gay dating app use frequency and condomless anal intercourse (CAI) in a sample of MSM in Beijing. In October 2017, a web-based, cross-sectional survey was conducted among MSM from Beijing, China. Demographics, frequency of app use, and sexual behaviors were collected and analyzed. Multivariable logistic regression and restricted cubic splines were used to evaluate the association between app use frequency and CAI. Of the 9280 participants, the proportion of CAI within one month prior to the survey was 43.3%, and 43.7% logged onto the app ≥11 times per week. In adjusted logistic regression analysis, logging onto the app 6–10 times per week and ≥11 times per week were inversely associated with CAI (adjusted odds ratio [AOR] =0.88 [95%CI, 0.78–0.99]; AOR = 0.88 [95%CI, 0.82–0.97], respectively). Among those 40 years of age or older, logging onto the app ≥11 times per week was associated with lower rates of CAI (AOR = 0.57 [95%CI, 0.40–0.81]). Results indicate that frequent app use was associated with lower odds of CAI among MSM in Beijing, China. Innovative interventions, which take advantage of this popular media platform, should be developed as such apps have been found to reduce the odds of CAI in Beijing.
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Affiliation(s)
- Qianqian Luo
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.,School of Nursing, Binzhou Medical University, Yantai, China
| | - Zunyou Wu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Yue Ma
- Blue City Holdings, Ltd, Beijing, China
| | - Guodong Mi
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.,Blue City Holdings, Ltd, Beijing, China
| | - Xuejiao Liu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Xu
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Keming Rou
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhao
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sarah R Scott
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Wei L, Chen L, Zhang H, Yang Z, Liu S, Tan W, Xie W, Liu L, Zhao J, Cheng J. Relationship between gay app use and HIV testing among men who have sex with men in Shenzhen, China: a serial cross-sectional study. BMJ Open 2019; 9:e028933. [PMID: 31446409 PMCID: PMC6721534 DOI: 10.1136/bmjopen-2019-028933] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 07/05/2019] [Accepted: 07/10/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To investigate the relationship between gay app use and HIV testing among men who have sex with men (MSM). DESIGN Serial cross-sectional study. SETTING A newly well-developed city in China. PARTICIPANTS 4935 MSM were recruited through offline sampling methods from 2015 to 2017. PRIMARY AND SECONDARY OUTCOMES The primary outcome is the difference in HIV testing between app and non-app users. RESULTS 2872 (58.2%) and 2159 (43.7%) participated MSM had been tested for HIV within lifetime and the past year, respectively. Compared with non-app-using MSM, app-using MSM had a significantly higher prevalence of HIV testing within lifetime (adjusted OR (AOR): 1.48, 95% CI 1.27 to 1.72) and the past year (AOR: 1.36, 95% CI 1.18 to 1.57). App-using MSM were more likely to take an HIV test at the Centers for Disease Control and Prevention (AOR: 1.48, 95% CI 1.24 to 1.76) and community-based organisations (AOR: 1.71, 95% CI 1.44 to 2.03), but less often at gay venues (AOR: 0.49, 95% CI 0.37 to 0.63). Meanwhile, app-using MSM were more likely to take self-testing (AOR: 1.61, 95% CI 1.21 to 2.14). Predictors of HIV testing in the past year were: having an education level of college or higher (AOR: 1.29, 95% CI 1.01 to 1.65), being self-identified as a homosexual (AOR: 1.23, 95% CI 1.02 to 1.46), being recruited through clinic-based sampling (AOR: 1.30, 95% CI 1.06 to 1.60), using gay app (AOR: 1.49, 95% CI 1.21 to 1.83), engaging in group sex (AOR: 1.64, 95% CI 1.23 to 2.19), having received HIV-related service (AOR: 5.49, 95% CI 4.57 to 6.60), having a high level of HIV-related knowledge (AOR: 1.33, 95% CI 1.10 to 1.61) and high-risk perception (AOR: 2.95, 95% CI 1.40 to 6.23). CONCLUSIONS Gay app use was significantly associated with increased HIV testing among MSM hard to reach by traditional outreach. Therefore, it is imperative to expand HIV testing among non-app-using MSM. Continued efforts, innovative strategies and increased resource are highly needed to realise the first '90' target.
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Affiliation(s)
- Lan Wei
- Department of AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lin Chen
- Department of AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Haibo Zhang
- Department of AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhengrong Yang
- Department of AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shaochu Liu
- Department of AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wei Tan
- Department of AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Wei Xie
- Department of AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Liegang Liu
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jin Zhao
- Department of AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Jinquan Cheng
- Department of AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
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Chai Y, Luo H, Zhang Q, Cheng Q, Lui CSM, Yip PSF. Developing an early warning system of suicide using Google Trends and media reporting. J Affect Disord 2019; 255:41-49. [PMID: 31125860 DOI: 10.1016/j.jad.2019.05.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/12/2019] [Accepted: 05/13/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Conventional surveillance systems for suicides typically suffer from a substantial time lag of six months to two years. This study aims to develop an early warning system of possible suicide outbreaks in Hong Kong using Google Trends and suicide-related media reporting. METHODS Data on 3,534 suicides from 2011 to 2015 were obtained from Hong Kong Census and Statistics Department, and the Coroner's Court. Using data from Google Trends and features extracted from media reporting on suicide news, we fitted Poisson regression models to predict the number and estimate the intensity of suicides on a weekly basis, for six subgroups, defined by gender and age. We adopted the cumulative sum (CUSUM) control chart-based method to identify outbreaks of suicide. RESULTS The proposed model was able to predict the number of suicides with reasonably low normalized root mean squared errors, ranging from 15.6% for young females to 24.16% for old females. The suicide intensity curves were well captured by the proposed models for young males and females, but not for other groups. The Sensitivity, Precision and F1 Score of the CUSUM-based method were 50%, 100% and 67% for young females, and 93%, 54% and 68% for young males. LIMITATIONS This study focused only on predicting the number of suicides in the current week, not in the future weeks. The model did not include social media, socioeconomic and climate data. CONCLUSIONS Our results indicate that Google Trends search terms and media reporting data may be valuable data sources for predicting possible outbreak of suicides in Hong Kong. The proposed system could support effective and targeted interventions.
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Affiliation(s)
- Yi Chai
- Department of Social Work and Social Administration, Faculty of social Sciences, The University of Hong Kong, Hong Kong, China
| | - Hao Luo
- Department of Social Work and Social Administration, Faculty of social Sciences, The University of Hong Kong, Hong Kong, China; Department of Computer Science, Faculty of Engineering, The University of Hong Kong, Hong Kong, China
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, China; Shenzhen Research Institute of City University of Hong Kong, Guangdong, China.
| | - Qijin Cheng
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Paul S F Yip
- Department of Social Work and Social Administration, Faculty of social Sciences, The University of Hong Kong, Hong Kong, China; Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
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31
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Yang X, Kovarik CL. A systematic review of mobile health interventions in China: Identifying gaps in care. J Telemed Telecare 2019; 27:3-22. [PMID: 31319759 DOI: 10.1177/1357633x19856746] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Mobile health has a promising future in the healthcare system in most developed countries. China's rapidly developing mobile technology infrastructure offers an unprecedented opportunity for wide adoption of mobile health interventions in the delivery of effective and timely healthcare services. However, there is little data on the current extent of the mobile health landscape in China. The aim of this study was to systematically review the existing mobile health initiatives in China, characterise the technology used, disease categories targeted, location of the end user (urban versus rural), and examine the potential effects of mobile health on health system strengthening in China. Furthermore, we identified gaps in development and evaluation of the effectiveness of mobile health interventions. METHODS A systematic review of the literature published from 18 December 2015 - 3 April 2019 was conducted and yielded 2863 articles from English and Chinese retrieval database and trial registries, including PubMed, EMBASE, China National Knowledge of Infrastructure and World Health Organization International Clinical Trials Registry Platform. Studies were included if they used mobile health to support patient healthcare outcomes. RESULTS A total of 1129 full-text articles were assessed and 338 were included in this study. The review found that most studies targeted client education and behaviour change via applications (apps) (65.4%), including WeChat, and text messaging (short text messages) (19.8%) to improve patient medical treatment outcomes such as compliance and appointment reminders. The most common disease-specific mobile health interventions focused primarily on chronic disease management and behaviour change in cardiology (13.3%), endocrinology/diabetes (12.1%), behavioural health (11.8%), oncology (11.2%) and neurology (6.8%). The mobile health interventions related to nutrition (0.6%) and chronic respiratory diseases (1.6%) are underrepresented in mobile health in comparison to the burden of disease in China. The majority (90.0%) of the mobile health interventions were conducted exclusively in urban areas, with few opportunities reaching rural populations. CONCLUSIONS Overall, mobile health has a promising future in China, with recent rapid growth in initiatives. The majority are focused on education and behaviour change in the realm of chronic diseases and target patients in urban areas. The imbalance in mobile health between the urban and rural areas, as well as between population disease spectrum and health service delivery, pose substantial dilemmas. However, mobile health may be redirected to correct this imbalance, possibly improving access to healthcare services, and filling the gaps in order to improve health equity for the underserved populations in China.
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Affiliation(s)
- Xiaoshi Yang
- Department of Social Medicine, China Medical University, P.R. China.,Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, USA
| | - Carrie L Kovarik
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, USA
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Durvasula M, Pan SW, Ong JJ, Tang W, Cao B, Liu C, Terris-Prestholt F, Tucker JD. Enhancing Public Health Messaging: Discrete-Choice Experiment Evidence on the Design of HIV Testing Messages in China. Med Decis Making 2019; 39:568-582. [PMID: 31354096 PMCID: PMC6786945 DOI: 10.1177/0272989x19859344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction. While a growing literature documents the effectiveness of public health messaging on social media, our understanding of the factors that encourage individuals to engage with and share messages is limited. In the context of human immunodeficiency virus (HIV) among men who have sex with men (MSM) in China, rising incidence and low testing rates despite decades of interventions suggest the need for effective, targeted messaging to reach underserved populations. Social media platforms and sex-seeking apps present a promising avenue, as web-based strategies can take advantage of existing trust within dense social networks. Methods. We conducted an online discrete-choice experiment in January 2017 with MSM from across China. Participants were presented with 6 choice tasks, each composed of 2 messages about HIV testing, and were asked in which scenario they were more likely to share the content. Participants were given information about the source of the HIV testing message, the social media sharing platform, and the recipients with whom they would share the message. They were given the option of sharing 1 message or neither. Multinomial and mixed logit models were used to model preferences within 4 subgroups. Results. In total, 885 MSM joined the survey, completing 4387 choice tasks. The most important attribute for 3 of the 4 subgroups was social media sharing platform. Men were more willing to share messages on sex-seeking mobile applications and less willing to share materials on generic (non-MSM) social media platforms. We found that men with more active online presences were less willing to share HIV testing messages on generic social media platforms. Conclusions. Our findings suggest that sex-seeking platforms represent a targeted, efficient method of actively engaging MSM in public health interventions.
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Affiliation(s)
- Maya Durvasula
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill,
27599, USA
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, 510095, China
| | - Stephen W. Pan
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, 510095, China
- Department of Health and Environmental Sciences, Xi’an Jiaotong-Liverpool University, Suzhou, 215123,
China
| | - Jason J. Ong
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, 510095, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, WC1E
7HT, UK
| | - Weiming Tang
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill,
27599, USA
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, 510095, China
| | - Bolin Cao
- School of Mass Media and Communication, Shenzhen University, Shenzhen, 518060, China
| | - Chuncheng Liu
- Department of Sociology, University of California San Diego, San Diego, CA, 92093, USA
| | - Fern Terris-Prestholt
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, WC1E
7HT, UK
| | - Joseph D. Tucker
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill,
27599, USA
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, 510095, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, WC1E
7HT, UK
- Dermatology Hospital, Southern Medical University, Guangzhou, 510095, China
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Yun K, Xu J, Leuba S, Zhu Y, Zhang J, Chu Z, Geng W, Jiang Y, Shang H. Development and Validation of a Personalized Social Media Platform-Based HIV Incidence Risk Assessment Tool for Men Who Have Sex With Men in China. J Med Internet Res 2019; 21:e13475. [PMID: 31215509 PMCID: PMC6604506 DOI: 10.2196/13475] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/25/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Personalized risk assessments can help medical providers determine targeted populations for counseling and risk reduction interventions. OBJECTIVE The objective of this study was to develop a social media platform-based HIV risk prediction tool for men who have sex with men (MSM) in China based on an independent MSM cohort to help medical providers determine target populations for counseling and risk reduction treatments. METHODS A prospective cohort of MSM from Shenyang, China, followed from 2009 to 2016, was used to develop and validate the prediction model. The eligible MSM were randomly assigned to the training and validation dataset, and Cox proportional hazards regression modeling was conducted using predictors for HIV seroconversion selected by the training dataset. Discrimination and calibration were performed, and the related nomogram and social media platform-based HIV risk assessment tool were constructed. RESULTS The characteristics of the sample between the training dataset and the validation dataset were similar. The risk prediction model identified the following predictors for HIV seroconversion: the main venue used to find male sexual partners, had condomless receptive or insertive anal intercourse, and used rush poppers. The model was well calibrated. The bootstrap C-index was 0.75 (95% CI 0.65-0.85) in the training dataset, and 0.60 (95% CI 0.45-0.74) in the validation dataset. The calibration plots showed good agreement between predicted risk and the actual proportion of no HIV infection in both the training and validation datasets. Nomogram and WeChat-based HIV incidence risk assessment tools for MSM were developed. CONCLUSIONS This social media platform-based HIV infection risk prediction tool can be distributed easily, improve awareness of personal HIV infection risk, and stratify the MSM population based on HIV risk, thus informing targeted interventions for MSM at greatest risk for HIV infection.
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Affiliation(s)
- Ke Yun
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Junjie Xu
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Sequoia Leuba
- Department of Epidemiology, University of North Carolina, Chapel Hill, American Samoa
| | - Yunyu Zhu
- Hebei Yuanqiao Information Technology Co, Ltd, Shijiazhuang, China
| | - Jing Zhang
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Zhenxing Chu
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Wenqing Geng
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Yongjun Jiang
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Hong Shang
- Key Laboratory of AIDS Immunology of National Health Commission of the People's Republic of China, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, China.,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
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Manciuc C, Levandowski BA, Muir E, Radulescu A, Barbosu M, Dye TD. Access to digital and social media among Romanian HIV/AIDS clinical providers. Glob Health Action 2019; 11:1513445. [PMID: 30188258 PMCID: PMC6136351 DOI: 10.1080/16549716.2018.1513445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The WHO/UNAIDS suggests that digital tools – such as social media and online training opportunities, can connect providers in difficult social and medical contexts to providers elsewhere for guidance, support, and advice. Social media is emerging as an innovative option for connecting clinicians together and for enhancing access to professional resources. In Romania, characterized by an atypical HIV/AIDS epidemic which is further challenged by a range of access complexities, it is unclear how often – and which kinds of – social media clinicians use to support clinical care. This study was conducted to ascertain social media use for clinical providers based in two regions of Romania (Transylvania and Moldavia) who face distance challenges that could potentially be alleviated by social media interaction. We used an online survey to understand what social media are currently popular and perceived to be useful for learning clinical information. Descriptive and bivariate analyses were conducted. Providers indicated Facebook and WhatsApp were the most common social media platforms, with 62% and 45% reporting daily use, respectively. Providers who used one media platform were significantly more likely to use another social media platform (p < .05). These data are helpful for creating an online training platform on HIV/AIDS for Romanian clinical providers.
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Affiliation(s)
- Carmen Manciuc
- a Department of Infectious Disease , Grigore T. Popa, University of Medicine and Pharmacy , Iași , Romania
| | - Brooke A Levandowski
- b Department of Obstetrics and Gynecology , University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
| | - Erin Muir
- b Department of Obstetrics and Gynecology , University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
| | - Amanda Radulescu
- c Department of Epidemiology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj-Napoca , Romania
| | - Monica Barbosu
- b Department of Obstetrics and Gynecology , University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
| | - Timothy D Dye
- b Department of Obstetrics and Gynecology , University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
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Cao B, Saha PT, Leuba SI, Lu H, Tang W, Wu D, Ong J, Liu C, Fu R, Wei C, Tucker JD. Recalling, Sharing and Participating in a Social Media Intervention Promoting HIV Testing: A Longitudinal Analysis of HIV Testing Among MSM in China. AIDS Behav 2019; 23:1240-1249. [PMID: 30632008 DOI: 10.1007/s10461-019-02392-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Social media interventions may enhance HIV services among key populations, including men who have sex with men (MSM). This longitudinal analysis examined the effect of recalling, sharing, and participating in different components of a social media intervention on HIV testing among MSM. The social media intervention included six images/texts and information about an online local community contest to promote testing. Of the 1033 men, they recalled a mean of 2.7 out of six images and shared an average of one image online. 34.5% of men recalled information on the online local community contest and engaged in a mean of 1.3 contest. Recalling images/texts (aOR = 1.13, 95% CI 1.02-1.25) and recalling a local contest (aOR = 1.59, 95% CI 1.13-1.24) were associated with facility-based HIV testing. This study has implications for the development and evaluation of social media interventions to promote HIV testing.
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Cao B, Saffer AJ, Yang C, Chen H, Peng K, Pan SW, Durvasula M, Liu C, Fu H, Ong JJ, Tang W, Tucker JD. MSM Behavior Disclosure Networks and HIV Testing: An Egocentric Network Analysis Among MSM in China. AIDS Behav 2019; 23:1368-1374. [PMID: 30680538 PMCID: PMC6511288 DOI: 10.1007/s10461-019-02404-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Men who have sex with men (MSM) disclose same-sex behaviors with others, creating disclosure networks. This study examined the characteristics of disclosure networks that are associated with HIV testing among MSM in China through an online nationwide survey. Name-generator questions were used to ask each participant ("ego") to nominate up to five social network members ("alters") with whom he had disclosed same-sex behaviors. Among the 806 men, the average disclosure network size was 4.05. MSM who reported larger disclosure networks were more likely to have been tested for HIV (aOR 1.21, 95% CI 1.08-1.34). The most common disclosure network alters were friends (45.1%), followed by sex partners (18.7%) and healthcare professionals (2.5%). Men who disclosed to healthcare professionals were more likely to test for HIV compared to men who disclosed to family members (aOR 5.43, 95% CI 2.11-14.04). Our findings can inform disclosure network-based interventions to promote MSM HIV testing.
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Affiliation(s)
- Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, China
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
| | - Adam J Saffer
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Cui Yang
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Hexin Chen
- Department of Media and Communication, City University of Hong Kong, Hong Kong, Hong Kong
| | - Kun Peng
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau, China
| | - Stephen W Pan
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
- Department of Public Health, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Maya Durvasula
- Sanford School of Public Policy, Duke University, Durham, USA
| | - Chuncheng Liu
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
- Department of Sociology, University of California, San Diego, La Jolla, USA
| | - Hongyun Fu
- Eastern Virginia Medical University, Norfolk, USA
| | - Jason J Ong
- Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, UK
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
- Guangdong Provincial Centre for Skin Diseases and STI Control, Number 2 Lujing Road, Guangzhou, China
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China.
- Social Entrepreneurship to Spur Health (SESH), Guangzhou, China.
- University of North Carolina at Chapel Hill, Chapel Hill, USA.
- London School of Hygiene and Tropical Medicine, London, UK.
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Zhao P, Liu L, Zhang Y, Cheng H, Cao B, Liu C, Wang C, Yang B, Wei C, Tucker JD, Tang W. The interaction between HIV testing social norms and self-efficacy on HIV testing among Chinese men who have sex with men: results from an online cross-sectional study. BMC Infect Dis 2018; 18:541. [PMID: 30376818 PMCID: PMC6208016 DOI: 10.1186/s12879-018-3454-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 10/23/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Increasing human immunodeficiency virus (HIV) testing is critical for HIV control. This study aimed to evaluate the interaction between social norms and self-efficacy on HIV testing among Chinese men who have sex with men (MSM). METHODS We conducted an online survey in eight Chinese cities in Shandong and Guangdong Provinces in July 2016. We included participants who were born as a male, at least 16 years old, currently living in one of the designated cities, and had ever engaged in anal sex with a man. We collected information regarding socio-demographics, high-risk behaviors, and history of HIV and other STI testing. We coded sensitivity to social norms using six items asking participants about their perceived social norm regarding HIV testing. We coded HIV testing self-efficacy using a separate six-item scale. We interpreted higher mean scores as higher sensitivity to social norms and higher self-efficacy, respectively. We conducted logistic regressions to evaluate the interaction between self-efficacy and social norms on HIV testing. RESULTS A total of 2105 men completed the survey. The mean age of the participants was 25.97 ± 6.42 years. Over four-fifths (85.9%) of participants were unmarried, 22.7% were students, and 64.6% at least had a college degree. 62.5 and 32.6% of participants ever and tested HIV in the last three months, respectively. With respect to uptake of HIV testing in the last three months, the adjusted odds ratio was 1.01(95% CI: 0.96-1.06) for higher sensitivity to social norms and 1.09 (95% CI: 1.05-1.14) for higher self-efficacy, with an interaction effect of 1.02 (95% CI: 1.01-1.03), respectively. With respect to uptake of lifetime HIV testing, the adjusted odds ratio was 1.03(95% CI: 0.99-1.07) for higher sensitivity to social norms and 1.15 (95% CI: 1.11-1.19) for higher self-efficacy, with an interaction effect of 1.02 (95% CI: 1.01-1.04), respectively. CONCLUSIONS Our survey demonstrated that there is a significant association between the uptake of HIV testing with sensitivity to the social norm, higher self-efficacy, as well as the interaction between them. Tailored studies for improving HIV testing among MSM in China can combine these two interventions together.
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Affiliation(s)
- Peizhen Zhao
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Li Liu
- Nanjing Municipal Center for Disease Control and Prevention, Jiangsu, China
| | - Ye Zhang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Huanhuan Cheng
- The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Bolin Cao
- SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095 China
| | - Chuncheng Liu
- SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
| | - Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Chongyi Wei
- Social and Behavioral Health Sciences, School of Public Health, Rutgers University, Piscataway, NJ USA
| | - Joseph D. Tucker
- SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095 China
- School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Weiming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- SESH study group of University of North Carolina at Chapel Hill, Guangzhou, China
- University of North Carolina at Chapel Hill Project-China, Guangzhou, 510095 China
- School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, USA
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Zhang Q, Chai Y, Li X, Young SD, Zhou J. Using internet search data to predict new HIV diagnoses in China: a modelling study. BMJ Open 2018; 8:e018335. [PMID: 30337302 PMCID: PMC6196849 DOI: 10.1136/bmjopen-2017-018335] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 06/18/2018] [Accepted: 08/20/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Internet data are important sources of abundant information regarding HIV epidemics and risk factors. A number of case studies found an association between internet searches and outbreaks of infectious diseases, including HIV. In this research, we examined the feasibility of using search query data to predict the number of new HIV diagnoses in China. DESIGN We identified a set of search queries that are associated with new HIV diagnoses in China. We developed statistical models (negative binomial generalised linear model and its Bayesian variants) to estimate the number of new HIV diagnoses by using data of search queries (Baidu) and official statistics (for the entire country and for Guangdong province) for 7 years (2010 to 2016). RESULTS Search query data were positively associated with the number of new HIV diagnoses in China and in Guangdong province. Experiments demonstrated that incorporating search query data could improve the prediction performance in nowcasting and forecasting tasks. CONCLUSIONS Baidu data can be used to predict the number of new HIV diagnoses in China up to the province level. This study demonstrates the feasibility of using search query data to predict new HIV diagnoses. Results could potentially facilitate timely evidence-based decision making and complement conventional programmes for HIV prevention.
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Affiliation(s)
- Qingpeng Zhang
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- City University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Yi Chai
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Xiaoming Li
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Sean D Young
- University of California Institute for Prediction Technology, Department of Family Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Jiaqi Zhou
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Kowloon, Hong Kong SAR, China
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Fitzpatrick T, Zhou K, Cheng Y, Chan PL, Cui F, Tang W, Mollan KR, Guo W, Tucker JD. A crowdsourced intervention to promote hepatitis B and C testing among men who have sex with men in China: study protocol for a nationwide online randomized controlled trial. BMC Infect Dis 2018; 18:489. [PMID: 30268114 PMCID: PMC6162889 DOI: 10.1186/s12879-018-3403-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 09/20/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The World Health Organization recommends all men who have sex with men (MSM) receive Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) testing. MSM in China are a high-risk group for HBV and HCV infection, but test uptake is low. Crowdsourcing invites a large group to solve a problem and then shares the solution with the public. This nationwide online randomized controlled trial will evaluate the effectiveness of a crowdsourced intervention to increase HBV and HCV testing among MSM in China. METHODS Seven hundred MSM will be recruited through social media operated by MSM organizations in China. Eligible participants will be born biologically male, age 16 years or older, report previous anal sex with another man, and reside in China. After completing a baseline online survey, participants will be randomly assigned to intervention or control arms with a 1:1 allocation ratio. The intervention will include two components: (1) a multimedia component will deliver two videos and two images promoting HBV and HCV testing developed through a crowdsourcing contest in China; (2) a participatory component will invite men to submit suggestions for how to improve crowdsourced videos and images. The control arm will not view any images or videos and will not be invited to submit suggestions. All participants will be offered reimbursement for HBV and HCV testing costs. The primary outcome is HBV and HCV test uptake confirmed through electronic submission of test report photos within four weeks of enrolment. Secondary outcomes include self-reported HBV and HCV test uptake, HBV vaccination uptake, and change in stigma toward people living with HBV after four weeks. Primary and secondary outcomes will be calculated using intention to treat and as-exposed analyses and compared using two-sided 95% confidence intervals. DISCUSSION Few previous studies have evaluated interventions to increase HBV and HCV testing in middle-income countries with a high burden of hepatitis. Delivering a crowdsourced intervention using social media is a novel approach to increasing hepatitis testing rates. HBV and HCV test uptake will be confirmed through test report photos, avoiding the limitations of self-reported testing outcomes. TRIAL REGISTRATION NCT03482388 (29 March 2018).
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Affiliation(s)
| | - Kali Zhou
- Department of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, USA
| | - Yu Cheng
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Po-Lin Chan
- Division of Communicable Disease, World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology, Peking University, Beijing, China
| | - Weiming Tang
- UNC - Project China, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katie R Mollan
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wilson Guo
- Gillings School of Global Public Health - Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joseph D Tucker
- UNC - Project China, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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40
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Htut KM, Mon MM, Aye ZM, Ni LL. Young key affected population in Myanmar: are there any challenges in seeking information and care for HIV/sexually transmitted infections and reproductive health? F1000Res 2018; 7:1515. [PMID: 30519458 PMCID: PMC6249637 DOI: 10.12688/f1000research.16029.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2018] [Indexed: 12/02/2022] Open
Abstract
Background: Unmet needs and barriers in seeking HIV/STI and RH information and care are present especially among young key affected population (YKAP). Therefore, the study was conducted to determine the health seeking behaviors of YKAP regarding HIV/STI and RH, and challenges in seeking health information and care. Methods: A cross-sectional, mixed-methods study was conducted at two large cities in Myanmar. Face-to-face interviews were conducted with YKAP aged 15-24 years. In-depth interviews and key informant interviews were done with YKAP and health care providers. Descriptive statistics and bivariate analyses were done for quantitative data and thematic analysis was applied for qualitative data. Results: A total of 119 young men who have sex with men (YMSM) and 123 young female sex workers (YFSW) included in the study. Mean age of YMSM and YFSW were 20.9±2.4 and 21.7±2.2 years. Over 30% of YMSM and 49.3% of YFSW had experience of any STI symptom. Particularly, 17% of YMSM and 10% of YFSW had genital ulcer, and majority sought health care at NGO clinics. About 37% of YMSM and 40% of YFSW visited Drop-in-center (DIC) within one to six months. Over 13% of YMSM and 14.6% of YFSW had challenges in seeking HIV/STI and RH information. YMSM/YFSW type and age of YMSM were associated with visit to DIC. Lesser proportions of Tha-nge (43.5%), younger age YMSM (66.7%), brothel-based YFSW (47.9%) visited DIC than others (p<0.05). Challenges and unmet needs expressed by YKAP were reluctance in asking health information, worry for future fertility, consequences of anal sex and contraception. Challenges expressed by providers were limited time during outreach service and difficulty in reaching entertainment-based sex workers. Conclusions: Special attention in provision of health information should be paid to YKAP since there is a considerable proportion of YKAP with unmet need in seeking HIV/STI/RH information and care.
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Affiliation(s)
- Kyaw Min Htut
- Department of Medical Research, Ministry of Health and Sports, Yangon, 11191, Myanmar
| | - Myo Myo Mon
- Department of Medical Research, Ministry of Health and Sports, Yangon, 11191, Myanmar
| | - Zin Mar Aye
- Department of Medical Research, Ministry of Health and Sports, Yangon, 11191, Myanmar
| | - Lwin Lwin Ni
- Department of Medical Research, Ministry of Health and Sports, Yangon, 11191, Myanmar
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Htut KM, Mon MM, Aye ZM, Ni LL. Young key affected population in Myanmar: are there any challenges in seeking information and care for HIV/sexually transmitted infections and reproductive health? F1000Res 2018; 7:1515. [PMID: 30519458 PMCID: PMC6249637 DOI: 10.12688/f1000research.16029.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2018] [Indexed: 09/01/2023] Open
Abstract
Background: Unmet needs and barriers in seeking HIV/STI and RH information and care are present especially among young key affected population (YKAP). Therefore, the study was conducted to determine the health seeking behaviors of YKAP regarding HIV/STI and RH, and challenges in seeking health information and care. Methods: A cross-sectional, mixed-methods study was conducted at two large cities in Myanmar. Face-to-face interviews were conducted with YKAP aged 15-24 years. In-depth interviews and key informant interviews were done with YKAP and health care providers. Descriptive statistics and bivariate analyses were done for quantitative data and thematic analysis was applied for qualitative data. Results: A total of 119 young men who have sex with men (YMSM) and 123 young female sex workers (YFSW) included in the study. Mean age of YMSM and YFSW were 20.9±2.4 and 21.7±2.2 years. Over 30% of YMSM and 49.3% of YFSW had experience of any STI symptom. Particularly, 17% of YMSM and 10% of YFSW had genital ulcer, and majority sought health care at NGO clinics. About 37% of YMSM and 40% of YFSW visited Drop-in-center (DIC) within one to six months. Over 13% of YMSM and 14.6% of YFSW had challenges in seeking HIV/STI and RH information. YMSM/YFSW type and age of YMSM were associated with visit to DIC. Lesser proportions of Tha-nge (43.5%), younger age YMSM (66.7%), brothel-based YFSW (47.9%) visited DIC than others (p<0.05). Challenges and unmet needs expressed by YKAP were reluctance in asking health information, worry for future fertility, consequences of anal sex and contraception. Challenges expressed by providers were limited time during outreach service and difficulty in reaching entertainment-based sex workers. Conclusions: Special attention in provision of health information should be paid to YKAP since there is a considerable proportion of YKAP with unmet need in seeking HIV/STI/RH information and care.
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Affiliation(s)
- Kyaw Min Htut
- Department of Medical Research, Ministry of Health and Sports, Yangon, 11191, Myanmar
| | - Myo Myo Mon
- Department of Medical Research, Ministry of Health and Sports, Yangon, 11191, Myanmar
| | - Zin Mar Aye
- Department of Medical Research, Ministry of Health and Sports, Yangon, 11191, Myanmar
| | - Lwin Lwin Ni
- Department of Medical Research, Ministry of Health and Sports, Yangon, 11191, Myanmar
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Guo Y, Xu Z, Qiao J, Hong YA, Zhang H, Zeng C, Cai W, Li L, Liu C. Development and Feasibility Testing of an mHealth (Text Message and WeChat) Intervention to Improve the Medication Adherence and Quality of Life of People Living with HIV in China: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2018; 6:e10274. [PMID: 30181109 PMCID: PMC6231726 DOI: 10.2196/10274] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/31/2018] [Accepted: 06/18/2018] [Indexed: 11/13/2022] Open
Abstract
Background Most people living with HIV (PLWH) reside in middle- and low-income countries with limited access to health services. Thus, cost-effective interventions that can reach a large number of PLWH are urgently needed. Objective The objective of our study was to assess the feasibility and acceptability of an mHealth intervention among PLWH in China. Methods Based on previous formative research, we designed an mHealth intervention program that included sending weekly reminders to participants via text messages (short message service, SMS) and articles on HIV self-management three times a week via a popular social media app WeChat. A total of 62 PLWH recruited from an HIV outpatient clinic were randomly assigned to intervention or control group. The intervention lasted for 3 months, and all participants were assessed for their medication adherence, presence of depression, quality of life (QoL), and CD4 (cluster of differentiation 4) counts. Upon completing the intervention, we interviewed 31 participants to further assess the feasibility and acceptability of the study. Results At baseline, the intervention and control groups did not differ in terms of demographic characteristics or any of the major outcome measures. About 85% (53/62) of the participants completed the intervention, and they provided valuable feedback on the design and content of the intervention. Participants preferred WeChat as the platform for receiving information and interactive communication for ease of access. Furthermore, they made specific recommendations about building trust, interactive features, and personalized feedback. In the follow-up assessment, the intervention and control groups did not differ in terms of major outcome measures. Conclusions This pilot study represents one of the first efforts to develop a text messaging (SMS)- and WeChat-based intervention that focused on improving the medication adherence and QoL of PLWH in China. Our data indicates that an mHealth intervention is feasible and acceptable to this population. The data collected through this pilot study will inform the future designs and implementations of mHealth interventions in this vulnerable population. We recommend more innovative mHealth interventions with rigorous designs for the PLWH in middle- and low-income countries. Trial Registration Chinese Clinical Trial Registry ChiCTR1800017987; http://www.chictr.org.cn/showprojen.aspx?proj=30448 (Archived by WebCite at http://www.webcitation.org/71zC7Pdzs) Registered Report Ientifier RR1-10.2196/
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Affiliation(s)
- Yan Guo
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Zhimeng Xu
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiaying Qiao
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Y Alicia Hong
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX, United States
| | - Hanxi Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chengbo Zeng
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weiping Cai
- Department of Infectious Disease, Eighth People's Hospital, Guangzhou, China
| | - Linghua Li
- Department of Infectious Disease, Eighth People's Hospital, Guangzhou, China
| | - Cong Liu
- Department of Infectious Disease, Eighth People's Hospital, Guangzhou, China
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Hartnup B, Dong L, Eisingerich AB. How an Environment of Stress and Social Risk Shapes Student Engagement With Social Media as Potential Digital Learning Platforms: Qualitative Study. JMIR MEDICAL EDUCATION 2018; 4:e10069. [PMID: 30006324 PMCID: PMC6064037 DOI: 10.2196/10069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/20/2018] [Accepted: 06/21/2018] [Indexed: 05/11/2023]
Abstract
BACKGROUND Social media has been increasingly used as a learning tool in medical education. Specifically, when joining university, students often go through a phase of adjustment, and they need to cope with various challenges such as leaving their families and friends and trying to fit into a new environment. Research has shown that social media helps students to connect with old friends and to establish new relationships. However, managing friendships on social media might intertwine with the new learning environment that shapes students' online behaviors. Especially, when students perceive high levels of social risks when using social media, they may struggle to take advantage of the benefits that social media can provide for learning. OBJECTIVE This study aimed to develop a model that explores the drivers and inhibitors of student engagement with social media during their university adjustment phase. METHODS We used a qualitative method by interviewing 78 undergraduate students studying medical courses at UK research-focused universities. In addition, we interviewed 6 digital technology experts to provide additional insights into students' learning behaviors on social media. RESULTS Students' changing relationships and new academic environment in the university adjustment phase led to various factors that affected their social media engagement. The main drivers of social media engagement were maintaining existing relationships, building new relationships, and seeking academic support. Simultaneously, critical factors that inhibited the use of social media for learning emerged, namely, collapsed online identity, uncertain group norms, the desire to present an ideal self, and academic competition. These inhibitors led to student stress when managing their social media accounts, discouraged them from actively engaging on social media, and prevented the full exploitation of social media as an effective learning tool. CONCLUSIONS This study identified important drivers and inhibitors for students to engage with social media platforms as learning tools. Although social media supported students to manage their relationships and support their learning, the interaction of critical factors, such as collapsed online identity, uncertain group norms, the desire to present an ideal self, and academic competition, caused psychological stress and impeded student engagement. Future research should explore how these inhibitors can be removed to reduce students' stress and to increase the use of social media for learning. More specifically, such insights will allow students to take full advantage of being connected, thus facilitating a richer learning experience during their university life.
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Affiliation(s)
- Becky Hartnup
- Imperial College Business School, Imperial College London, London, United Kingdom
| | - Lin Dong
- Imperial College Business School, Imperial College London, London, United Kingdom
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Guo Y, Hong YA, Qiao J, Xu Z, Zhang H, Zeng C, Cai W, Li L, Liu C, Li Y, Zhu M, Harris NA, Yang C. Run4Love, a mHealth (WeChat-based) intervention to improve mental health of people living with HIV: a randomized controlled trial protocol. BMC Public Health 2018; 18:793. [PMID: 29940921 PMCID: PMC6019517 DOI: 10.1186/s12889-018-5693-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/11/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND People living with HIV (PLWH) suffer from high rates of mental illness; but targeted effective interventions are limited, especially in developing countries. High penetration of smartphone usage and widespread acceptance of social media applications provide an unprecedented opportunity for mobile-based health interventions (mHealth interventions) in resource-limited settings like China. The current report describes the design and sample characteristics of the Run4Love randomized controlled trial (RCT) aimed at improving mental health in PLWH in China. METHODS A total of 300 PLWH with elevated depressive symptoms were recruited and randomized into either the intervention or control group. Participants in the intervention group received an adapted cognitive-behavioral stress management (CBSM) course delivered by the enhanced WeChat platform (for 3 months) and were motivated to engage in physical activities. Progress of the participants was automatically tracked and monitored with timely feedback and rewards. The control group received a brochure on nutrition for PLWH in addition to standard care. The outcome assessments are conducted at baseline, 3, 6, and 9 months using tablets. The primary outcome is depressive symptoms measured by the scale of the Center for Epidemiology Studies Depression (CES-D). Secondary outcomes include quality of life, chronic stress measured with biomarker of hair cortisol, and other measures of stress and depression, self-efficacy, coping, HIV-related stigma, physical activity, and patient satisfaction. Mixed effects model with repeated measures (MMRM) will be used to analyze the intervention effects. DISCUSSION The Run4Love study is among the first efforts to develop and evaluate a multicomponent and integrated mHealth intervention to improve the mental health and quality of life of PLWH. Once proven effective, Run4Love could be scaled up and potentially integrated into the routine case management of PLWH and adapted to other populations with chronic diseases. TRIAL REGISTRATION Chinese Clinical Trial Registry - ChiCTR-IPR-17012606 , registered on 07 September 2017.
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Affiliation(s)
- Yan Guo
- School of Public Health, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
- Center for Migrant Health Policy, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
| | - Y. Alicia Hong
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, 212 Adriance Lab Road, College Station, TX 77843 USA
| | - Jiaying Qiao
- Department of Infectious Disease, Guangzhou Number Eight People’s Hospital, #627 Dongfeng Road, Guangzhou, 510080 China
| | - Zhimeng Xu
- Johns Hopkins Bloomberg School of Public Health Baltimore, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Hanxi Zhang
- School of Public Health, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
- Center for Migrant Health Policy, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
| | - Chengbo Zeng
- School of Public Health, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
- Center for Migrant Health Policy, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
| | - Weiping Cai
- School of Public Health, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
- Center for Migrant Health Policy, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
| | - Linghua Li
- Department of Infectious Disease, Guangzhou Number Eight People’s Hospital, #627 Dongfeng Road, Guangzhou, 510080 China
| | - Cong Liu
- Johns Hopkins Bloomberg School of Public Health Baltimore, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Yiran Li
- Johns Hopkins Bloomberg School of Public Health Baltimore, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Mengting Zhu
- Johns Hopkins Bloomberg School of Public Health Baltimore, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Nathan Asher Harris
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, #74 Zhongshan 2nd Road, Guangzhou, 510080 China
| | - Cui Yang
- Johns Hopkins Bloomberg School of Public Health Baltimore, 615 N. Wolfe Street, Baltimore, MD 21205 USA
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Cao B, Zhao P, Bien C, Pan S, Tang W, Watson J, Mi G, Ding Y, Luo Z, Tucker JD. Linking young men who have sex with men (YMSM) to STI physicians: a nationwide cross-sectional survey in China. BMC Infect Dis 2018. [PMID: 29776395 DOI: 10.1186/s12879-018-3145-2.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many young men who have sex with men (YMSM) are reluctant to seek health services and trust local physicians. Online information seeking may encourage YMSM to identify and see trustworthy physicians, obtain sexual health services, and obtain testing for sexually transmitted infections (STIs). This study examined online STI information seeking behaviors among Chinese YMSM and its association with offline physician visits. METHODS We conducted a nationwide online survey among YMSM through WeChat, the largest social media platform in China. We collected information on individual demographics, sexual behaviors, online STI information seeking, offline STI testing, and STI physician visits. We examined the most commonly used platforms (search engines, governmental websites, counseling websites, generic social media, gay mobile apps, and mobile medical apps) and their trustworthiness. We assessed interest and willingness to use an MSM-friendly physician finder function embedded within a gay mobile app. Logistic regression models were used to examine the correlation between online STI information searching and offline physician visits. RESULTS A total of 503 men completed the survey. Most men (425/503, 84.5%) searched for STI information online. The most commonly used platform to obtain STI information were search engines (402/425, 94.5%), followed by gay mobile apps (201/425, 47.3%). Men reported high trustworthiness of information received from gay mobile apps. Men also reported high interest (465/503, 92.4%) and willingness (463/503, 92.0%) to use a MSM-friendly physician finder function within such apps. Both using general social media (aOR =1.14, 95%CI: 1.04-1.26) and mobile medical apps (aOR =1.16, 95%CI: 1.01-1.34) for online information seeking were associated with visiting a physician. CONCLUSION Online STI information seeking is common and correlated with visiting a physician among YMSM. Cultivating partnerships with the emerging mobile medical apps may be useful for disseminating STI information and providing better physician services to YMSM.
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Affiliation(s)
- Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, China.,University of North Carolina Project - China, Guangzhou, China
| | - Peipei Zhao
- Shenzhen Nanshan Chronic Disease Control Center, Shenzhen, China
| | - Cedric Bien
- University of North Carolina Project - China, Guangzhou, China
| | - Stephen Pan
- University of North Carolina Project - China, Guangzhou, China
| | - Weiming Tang
- University of North Carolina Project - China, Guangzhou, China.,School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Julia Watson
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Yi Ding
- Shenzhen Nanshan Chronic Disease Control Center, Shenzhen, China
| | - Zhenzhou Luo
- Shenzhen Nanshan Chronic Disease Control Center, Shenzhen, China
| | - Joseph D Tucker
- University of North Carolina Project - China, Guangzhou, China. .,School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. .,London School of Hygiene and Tropical Medicine, London, UK.
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Cao B, Zhao P, Bien C, Pan S, Tang W, Watson J, Mi G, Ding Y, Luo Z, Tucker JD. Linking young men who have sex with men (YMSM) to STI physicians: a nationwide cross-sectional survey in China. BMC Infect Dis 2018; 18:228. [PMID: 29776395 PMCID: PMC5960109 DOI: 10.1186/s12879-018-3145-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 05/10/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Many young men who have sex with men (YMSM) are reluctant to seek health services and trust local physicians. Online information seeking may encourage YMSM to identify and see trustworthy physicians, obtain sexual health services, and obtain testing for sexually transmitted infections (STIs). This study examined online STI information seeking behaviors among Chinese YMSM and its association with offline physician visits. METHODS We conducted a nationwide online survey among YMSM through WeChat, the largest social media platform in China. We collected information on individual demographics, sexual behaviors, online STI information seeking, offline STI testing, and STI physician visits. We examined the most commonly used platforms (search engines, governmental websites, counseling websites, generic social media, gay mobile apps, and mobile medical apps) and their trustworthiness. We assessed interest and willingness to use an MSM-friendly physician finder function embedded within a gay mobile app. Logistic regression models were used to examine the correlation between online STI information searching and offline physician visits. RESULTS A total of 503 men completed the survey. Most men (425/503, 84.5%) searched for STI information online. The most commonly used platform to obtain STI information were search engines (402/425, 94.5%), followed by gay mobile apps (201/425, 47.3%). Men reported high trustworthiness of information received from gay mobile apps. Men also reported high interest (465/503, 92.4%) and willingness (463/503, 92.0%) to use a MSM-friendly physician finder function within such apps. Both using general social media (aOR =1.14, 95%CI: 1.04-1.26) and mobile medical apps (aOR =1.16, 95%CI: 1.01-1.34) for online information seeking were associated with visiting a physician. CONCLUSION Online STI information seeking is common and correlated with visiting a physician among YMSM. Cultivating partnerships with the emerging mobile medical apps may be useful for disseminating STI information and providing better physician services to YMSM.
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Affiliation(s)
- Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, China.,University of North Carolina Project - China, Guangzhou, China
| | - Peipei Zhao
- Shenzhen Nanshan Chronic Disease Control Center, Shenzhen, China
| | - Cedric Bien
- University of North Carolina Project - China, Guangzhou, China
| | - Stephen Pan
- University of North Carolina Project - China, Guangzhou, China
| | - Weiming Tang
- University of North Carolina Project - China, Guangzhou, China.,School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Julia Watson
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Yi Ding
- Shenzhen Nanshan Chronic Disease Control Center, Shenzhen, China
| | - Zhenzhou Luo
- Shenzhen Nanshan Chronic Disease Control Center, Shenzhen, China
| | - Joseph D Tucker
- University of North Carolina Project - China, Guangzhou, China. .,School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. .,London School of Hygiene and Tropical Medicine, London, UK.
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47
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Cao B, Gupta S, Wang J, Hightow-Weidman LB, Muessig KE, Tang W, Pan S, Pendse R, Tucker JD. Social Media Interventions to Promote HIV Testing, Linkage, Adherence, and Retention: Systematic Review and Meta-Analysis. J Med Internet Res 2017; 19:e394. [PMID: 29175811 PMCID: PMC5722976 DOI: 10.2196/jmir.7997] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 09/19/2017] [Accepted: 10/11/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Social media is increasingly used to deliver HIV interventions for key populations worldwide. However, little is known about the specific uses and effects of social media on human immunodeficiency virus (HIV) interventions. OBJECTIVE This systematic review examines the effectiveness of social media interventions to promote HIV testing, linkage, adherence, and retention among key populations. METHODS We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and Cochrane guidelines for this review and registered it on the International Prospective Register of Systematic Reviews, PROSPERO. We systematically searched six databases and three conference websites using search terms related to HIV, social media, and key populations. We included studies where (1) the intervention was created or implemented on social media platforms, (2) study population included men who have sex with men (MSM), transgender individuals, people who inject drugs (PWID), and/or sex workers, and (3) outcomes included promoting HIV testing, linkage, adherence, and/or retention. Meta-analyses were conducted by Review Manager, version 5.3. Pooled relative risk (RR) and 95% confidence intervals were calculated by random-effects models. RESULTS Among 981 manuscripts identified, 26 studies met the inclusion criteria. We found 18 studies from high-income countries, 8 in middle-income countries, and 0 in low-income countries. Eight were randomized controlled trials, and 18 were observational studies. All studies (n=26) included MSM; five studies also included transgender individuals. The focus of 21 studies was HIV testing, four on HIV testing and linkage to care, and one on antiretroviral therapy adherence. Social media interventions were used to do the following: build online interactive communities to encourage HIV testing/adherence (10 studies), provide HIV testing services (9 studies), disseminate HIV information (9 studies), and develop intervention materials (1 study). Of the studies providing HIV self-testing, 16% of participants requested HIV testing kits from social media platforms. Existing social media platforms such as Facebook (n=15) and the gay dating app Grindr (n=10) were used most frequently. Data from four studies show that HIV testing uptake increased after social media interventions (n=1283, RR 1.50, 95% CI 1.28-1.76). In the studies where social media interventions were participatory, HIV testing uptake was higher in the intervention arm than the comparison arm (n=1023, RR 1.64, 95% CI 1.19-2.26). CONCLUSIONS Social media interventions are effective in promoting HIV testing among MSM in many settings. Social media interventions to improve HIV services beyond HIV testing in low- and middle-income countries and among other key populations need to be considered. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO): CRD42016048073; http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42016048073 (Archived by WebCite at http://www. webcitation.org/6usLCJK3v).
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Affiliation(s)
- Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, China
- University of North Carolina Project-China, Guangzhou, China
- SESH Global, Guangzhou, China
| | - Somya Gupta
- World Health Organization South-East Asia Region, New Delhi, India
| | - Jiangtao Wang
- School of Journalism and Communication, Jinan University, Guangzhou, China
| | - Lisa B Hightow-Weidman
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kathryn E Muessig
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- SESH Global, Guangzhou, China
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Stephen Pan
- University of North Carolina Project-China, Guangzhou, China
- SESH Global, Guangzhou, China
| | - Razia Pendse
- World Health Organization South-East Asia Region, New Delhi, India
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China
- SESH Global, Guangzhou, China
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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