Perceptions Towards Condom Use, Sexual Activity, and HIV Disclosure among HIV-Positive African American Men Who Have Sex with Men: Implications for Heterosexual Transmission

Introduction: The HIV epidemic continues to expand in Central Asia, bridging from injecting drug users to the general population, largely through heterosexual transmission. This study describes medical students’ attitudes and behaviours regarding HIV and sexual practices in response to recently introduced HIV curriculum. Methodology: Medical students in Almaty, Kazakhstan, were invited to participate in a cross-sectional survey between April and November, 2013. The survey assessed participant’s risk behaviours (e.g., injecting drug use, condom use), concerns related to HIV infection risk (e.g., medical care exposures, personal behaviours), and ability to identify HIV-positive individuals without asking their status. Bivariate analyses (Chi-square test or Fisher’s exact test) and multivariate analysis (log-binomial regression) were conducted. Results: Of 647 medical students, the majority were female (82.2%) and single (92.8%) with a median age of 21-22 years. Sexual activity was reported by 176 (27.2%); males were substantially more likely to report sexual activity (74.8% males vs. 16.9% females, p <.0001). The majority of sexually active medical students (65.6% and 68.3% males and females, respectively) believe they can determine if their partner is HIV-positive without asking or seeking a laboratory test. This proportion is much higher (92.6%) among married or cohabitating women. No association between perceived ability to ascertain HIV status and condom use was identified. Conclusions: The medical students in our study had a relatively naïve perception of HIV risk, and their knowledge of risk did not translate to appropriate precautionary behaviours. Much work remains if the epidemic in Central Asia is to be contained.

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Differences Between HIV-Positive and HIV-Negative African American Men Who Have Sex with Men in Two Major U.S. Metropolitan Areas

Archives of Sexual Behavior ◽

10.1007/s10508-011-9891-5 ◽

2011 ◽

Vol 42 (2) ◽

pp. 267-278 ◽

Cited By ~ 4

Author(s):

Beatrice “Bean” E. Robinson ◽

Jennifer S. Galbraith ◽

Rebecca E. Swinburne Romine ◽

Qing Zhang ◽

Jeffrey H. Herbst

Keyword(s):

African American ◽

Metropolitan Areas ◽

African American Men ◽

Hiv Positive ◽

Sex With Men ◽

Hiv Negative

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A Realistic Talking Human Embodied Agent Mobile Phone Intervention to Promote HIV Medication Adherence and Retention in Care in Young HIV-Positive African American Men Who Have Sex With Men: Qualitative Study (Preprint)

10.2196/preprints.10211 ◽

2018 ◽

Author(s):

Mark Dworkin ◽

Apurba Chakraborty ◽

Sangyoon Lee ◽

Colleen Monahan ◽

Lisa Hightow-Weidman ◽

...

Keyword(s):

African American ◽

Focus Groups ◽

Mobile Phone ◽

African American Men ◽

Retention In Care ◽

Hiv Positive ◽

Behavioral Skills ◽

African American Msm ◽

Sex With Men ◽

Embodied Agent

BACKGROUND Avatars and embodied agents are a promising innovation for human health intervention because they may serve as a relational agent that might augment user engagement in a behavioral change intervention and motivate behavioral change such as antiretroviral adherence and retention in care. OBJECTIVE This study aimed to develop a theory-driven talking avatar-like embodied agent mobile phone intervention guided by the information-motivation-behavioral skills model to promote HIV medication adherence and retention in care in young African American men who have sex with men (MSM). METHODS We performed 5 iterative focus groups in Chicago with HIV-positive African American MSM aged 18-34 years to inform the ongoing development of a mobile phone app. Participants for the focus groups were recruited from 4 University of Illinois at Chicago Community Outreach Intervention Project sites located in different high HIV incidence areas of the city and the University of Illinois at Chicago HIV clinic using fliers and word of mouth. The focus group data analysis included developing an ongoing list of priorities for app changes and discussion between two of the investigators based on the project timeline, resources, and to what extent they served the app’s objectives. RESULTS In this study, 16 men participated, including 3 who participated in two groups. The acceptability for an embodied agent app was universal in all 5 focus groups. The app included the embodied agent response to questions and antiretroviral regimen information, adherence tracking, CD4 count and viral load tracking, motivational spoken messages, and customizability. Concerns that were identified and responded to in the development process included privacy, stigma, avoiding the harsh or commanding tone of voice, avoiding negative motivational statements, and making reminder functions for a variety of health care interactions. CONCLUSIONS An avatar-like embodied agent mHealth approach was acceptable to young HIV-positive African American MSM. Its relational nature may make it an effective method of informing, motivating, and promoting health behavioral skills. Furthermore, the app’s ease of access, stigma-free environment, and audiovisual format may help overcome some adherence barriers reported in this population.

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