scholarly journals COVID-19-Related Disruptions to HIV Testing and Prevention Among Young Sexual Minority Men 17–24 Years Old: A Qualitative Study Using Synchronous Online Focus Groups, April–September 2020

Author(s):  
Juan Pablo Zapata ◽  
Madeline Dang ◽  
Katherine G. Quinn ◽  
Keith J. Horvath ◽  
Rob Stephenson ◽  
...  
2020 ◽  

BACKGROUND: The health and well-being of those sexual-minority men who are often behaviourally defined as men who have sex with men (MSM) is affected by a system of interlinked factors that interact on the structural, interpersonal, and individual levels. Recently, two of the most common MSM health issues have been (a) the risks of acquiring sexually transmitted infections (STIs), mostly HIV, and (b) the sexualized use of addictive substances, known as chemsex. AIMS: On the basis of the first comprehensive Czech dataset to integrate several mutually interlinked factors on the behavioural, as well as the psychological and structural domains, we attempt to shed light on the barriers to HIV testing and adherence to safer sex practices, including the most thorough description of the chemsex phenomenon that is available. We aim to go beyond the behavioural perspective and draw links to the well-being and satisfaction of this sexual minority and their sex lives. METHODS: A series of descriptive statistical analyses was conducted on a sample of 547 respondents obtained within a self-administered online survey. RESULTS: More than half of our respondents (55%) and three-quarters (72%) of the men younger than 25 years have never been tested for HIV. One-third of the respondents considered testing services to be insufficiently friendly to gay, bisexual, or other men, and they also reported stigmatization and discrimination by healthcare workers as a problem that exists. 84% of the MSM have experience with anal sex; 43% of them always use condoms. Of all the respondents, nearly 6% have had at least one chemsex experience during their life. Only 46% of the MSM reported being satisfied with their sex lives; 52% of those who were dissatisfied attributed this to “not having a steady partner” and 49% to “not having any sex”. CONCLUSION: The sexual behaviour of MSM and their experience with HIV testing, chemsex, perceived stigma, and satisfaction with their sex lives are among the phenomena that deserve to be more regularly covered by relevant epidemiological examinations. Although our current analysis was more exploratory than in-depth, it may contribute to a better understanding of the syndemic and multifactorial conditions that influence the sexual behaviour of MSM, including the minority stress that may be rooted in deficiencies in our understanding of these populations.


2021 ◽  
Author(s):  
Derek T. Dangerfield II ◽  
Charleen Wylie

BACKGROUND Pre-exposure prophylaxis (PrEP) substantially reduces risk of HIV infection. Tele-health interventions could improve PrEP initiation and adherence for high incidence groups such as Black sexual minority men (BSMM). However, BSMM remain underrepresented in clinical trials and culturally responsive ways to improve PrEP tele-health trial participation among BSMM is needed. OBJECTIVE To fill this gap, this study identified ethical and culturally responsive study activities to improve PrEP tele-health clinical trials participation among BSMM. METHODS Data come from seven virtual, synchronous focus groups among 28 BSMM ages 18-34 were conducted from April to August 2020 to identify culturally responsive research activities to improve PrEP clinical trial research participation. Focus groups included a brief survey followed distributed online via Qualtrics™ followed by a virtual, synchronous focus group conducted via Zoom lasting between 50 and 75 minutes. Focus groups were stratified by age (18-24 vs 25-34) and outlined the components of an example PrEP tele-health randomized controlled trial and probed on domains of the study design- research motivations, study funding, recruitment activities, informed consent, randomization, follow-up, and end of the study activities. Participants were asked targeted questions regarding the ethics and trustworthiness of the study and ways that researchers could gain their trust in the PrEP tele-health trial along the protocol. RESULTS Focus groups resulted in 2 groups of 18-24 year olds and 5 groups of 25-35 year olds. The average age of participants was 27.2 years (SD 4.4). Ten (38.4) reported a bachelor’s degree was their highest education completed; 21% reported some graduate degree or higher. Most reported working full-time (57.1%) and being single or not in a committed relationship (75%). Most (85.7) reported using at least one drug before sex in the 6 months prior to study. Everyone reported ever hearing about PrEP and 35% were current PrEP users. Overall, focus groups yielded themes related to how researcher intentions, study funding, recruitment activities, informed consent details, randomization, and study team interactions during and after during the study impact trust and participation. CONCLUSIONS Medical/research mistrust persists among BSMM. Given the salience of medical mistrust, future studies should test the relative impact of implementing findings on research participation in a PrEP tele-health clinical trial.


2020 ◽  
Vol 19 (1) ◽  
pp. 42-54
Author(s):  
A. Lina Rosengren ◽  
Thibaut Davy-Mendez ◽  
Lisa B. Hightow-Weidman

2020 ◽  
Author(s):  
Derek Dangerfield II ◽  
Charleen Wylie ◽  
Janeane Anderson

BACKGROUND Focus groups are useful to support HIV prevention research among U.S. subpopulations such as Black gay, bisexual, and other Black sexual minority men (BSMM). Virtual synchronous focus groups provide an electronic means to obtaining qualitative data and are convenient to implement. However, the protocols for conducting virtual, synchronous focus groups in HIV prevention research among BSMM are lacking. OBJECTIVE This paper describes the protocols and acceptability of conducting virtual, synchronous focus groups in HIV prevention research among BSMM. METHODS Data come from two studies in which eight virtual, synchronous focus groups among a sample of HIV-negative BSMM in urban U.S. cities such as Baltimore, MD, Los Angeles, CA, Atlanta, GA, and Chicago, IL were conducted (n=39). Participants were recruited from a combination of active and passive recruitment strategies and focus groups were conducted via Zoom. Both studies were stratified by age and included data come from 2 groups of BSMM 18-24, 5 groups of BSMM ages 25-34 and 1 group age 35 years and older. Participants were asked to complete an electronic satisfaction survey distributed to their email through a private email link. RESULTS The age of participants ranged from 18 to 44 years (M=28.3, SD=6.0). Most reported not preferring in-person focus group participation. Regarding virtual focus group participation, 86% reported that they “strongly agreed” that they were satisfied participating in a focus group online, the remainder reported “agree.” Regarding a preference of providing written informed consent, 33% reported “strongly disagree,” 13.3% reported “disagree,” and 36.7% reported “neither agree nor disagree.” Regarding privacy, most reported “strongly agree” or “agree” that their information was safe to share with other participants in the group. Regarding the incentive, 44.8% reported strongly agreeing that they were satisfied with the incentive and 51.7% reported ‘agree.” CONCLUSIONS Conducting virtual, synchronous focus groups in HIV prevention research among BSMM is feasible. However, careful consideration and attention to safety, privacy, and culture is necessary for optimal focus group participation. Focus group facilitators must be explicitly trained to build rapport, ensure privacy, thoroughly explain study goals and safety protocols, and manage focus groups among BSMM. Conducting virtual, synchronous focus groups could be a useful modality to recruit and engage BSMM who are otherwise hard-to-reach.


2021 ◽  
Vol 33 (2) ◽  
pp. 143-157
Author(s):  
Rodman Turpin ◽  
Maria Khan ◽  
Joy Scheidell ◽  
Jonathan Feelemyer ◽  
Christopher Hucks-Ortiz ◽  
...  

Black sexual minority men (BSMM) and Black transgender women (BTW) have disproportionately high HIV prevalence, making HIV testing critical for treatment and prevention. Racism and homophobia may be barriers to testing among BSMM/BTW, particularly in the context of previous incarceration. We analyzed a subsample (n = 655) of HIV-negative, previously incarcerated BSMM/BTW in the HIV Prevention Trials Network 061 study, generating prevalence ratios and interaction terms testing associations between experienced racism and homophobia with past-year HIV testing. Both racism (aPR = 0.83, 95% CI [0.70, 0.98]) and homophobia (aPR: 0.68, 95% CI [0.48, 0.98]) were associated with lower testing, although their interaction was associated with unexpectedly higher testing (Interaction aPR = 1.77, 95% CI [1.25, 2.49]). Among BSMM/BTW with a history of incarceration, racism and homophobia are barriers to HIV testing. Positive interactions between racism and homophobia could be explained by numerous factors (e.g., resilience, coping) and warrants further study.


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