Self-efficacy and HIV testing among Latino emerging adults: examining the moderating effects of distress tolerance and sexual risk behaviors

BACKGROUND Preventing and reducing substance use disorders, sexually transmitted infections (STIs)/HIV, and teen pregnancy, and the associated risk behaviors (ie, substance use and sexual risk behaviors) among youth remain public health priorities in the United States. Equally important is improving the uptake of STI/HIV testing among the youth. Mobile health (mHealth) apps may be a solution to ameliorate these public health concerns; however, few mHealth preventive interventions have demonstrated efficacy in reducing substance use or sexual risk behaviors or improving the uptake of STI/HIV testing among the youth, particularly in clinic settings. OBJECTIVE This small-scale study aimed to examine the feasibility of conducting a pilot randomized controlled trial (RCT). We evaluated the effects of Storytelling 4 Empowerment (S4E), relative to enhanced usual practice, on the potential mechanisms by which behavior change occurs, namely clinician-youth risk communication, prevention knowledge, and substance use and sexual risk refusal self-efficacy. We also assessed the ability to measure targeted outcomes of past 30-day substance use (ie, alcohol, tobacco, and other drug use), condomless sex, and alcohol or drug use before sex, as well as the uptake of STI/HIV testing. METHODS Employing community-based participatory research principles, 50 youths aged 13 to 21 years were recruited from a youth-centered community health clinic in Southeast Michigan, randomized sequentially to either S4E or enhanced usual practice, and assessed at baseline, immediately postintervention, and 30 days postintervention. S4E consists of 3 modules, including alcohol and drug use, tobacco, and STI/HIV. RESULTS Relative to youth in the enhanced usual practice group, S4E participants demonstrated higher youth-clinician risk communication (mean 3.22, SD 1.67) and increases in prevention knowledge (∆ score mean 0.36, SD 0.51) and self-efficacy (∆ score mean 0.16, SD 0.47). In addition, youth in the S4E group showed reductions in the proportions of past 30-day overall substance use (Cohen h=0.71, 95% CI 0.15 to 1.27), as well as past 30-day alcohol (Cohen h=0.71, 95% CI 0.15 to 1.27), tobacco (Cohen h=0.17, 95% CI −0.39 to 0.73), and drug use (Cohen h=1.28, 95% CI 0.72 to 1.84). The results also suggest a reduction in the proportion of youths who reported past 30-day condomless sex (Cohen h=0.18, 95% CI −0.38 to 0.74) and alcohol use before sex (Cohen h=0.44, 95% CI −0.12 to 1.00). Finally, the findings also demonstrated an increase in the proportion of youths who reported STI/HIV testing over time (Cohen h=0.16, 95% CI −0.39 to 0.72). CONCLUSIONS The findings suggest the feasibility of a small-scale pilot RCT. S4E demonstrated shifts in the hypothesized direction, reducing substance use, sexual risk behaviors, and improving the uptake of STI/HIV testing among youth in a clinic setting. The findings suggest that a larger RCT may be warranted. CLINICALTRIAL ClinicalTrails.gov NCT03855410, https://clinicaltrials.gov/ct2/show/NCT03855410.

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1253. Sex-on-Premise Venue (SOPV) Attendance Among Men Who Have Sex with Men (MSM) in Lima, Perú: Results From a Cross-Sectional Web-Based Survey

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1116 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S450-S451

Author(s):

Alexander Lankowski ◽

Hugo Sanchez ◽

Jose Hidalgo ◽

Robinson Cabello ◽

Ann Duerr

Keyword(s):

Risk Factors ◽

Hiv Testing ◽

Sexual Risk ◽

Risk Behaviors ◽

Sexual Risk Behaviors ◽

Sex Partners ◽

Cross Sectional ◽

Web Based ◽

Prevention Interventions ◽

Sex With Men

Abstract Background In Perú, where the HIV epidemic is concentrated among men who have sex with men (MSM), incidence has not changed appreciably over the last decade despite the rapid scale-up of free antiretroviral treatment (ART). New strategies for delivering effective HIV testing and prevention services to at-risk populations are greatly needed. Because most adult MSM in Perú live at home with family where it may be difficult to bring new sex partners, sex-on-premise venues (SOPVs)—such as saunas, sex clubs, and hourly hotels—might represent opportune sites at which to offer targeted HIV testing and prevention interventions. Methods From November 26, 2018 through April 15, 2019 we conducted a cross-sectional web-based survey using REDCap to assess the prevalence of SOPV attendance and associated sexual risk behaviors among MSM in Lima, Perú. SOPVs were defined as saunas, sex clubs, adult movie theaters, hotels, or bars/discos known to permit sex. We recruited participants by disseminating an anonymous survey link through local gay social media networks, with no monetary incentive to complete the survey. We asked participants how/where they met any sex partners from the prior 3 months, where they went for sex, and about HIV-associated sexual risk factors, including self-reported HIV status. We used the Pearson chi-squared test and Student’s t-test to assess whether the frequency of sexual risk behaviors differed based on SOPV attendance. Results Among n = 324 cis-gender MSM completing the survey, 16% identified as bisexual. Median age was 30 years, 62% lived at home with family, 50% had a university education or higher, and 29% reported being HIV+. 65% of respondents reported attending an SOPV to meet a partner and/or have sex in the prior 3 months. SOPV attendees were significantly more likely to report transactional sex, group sex, sex under the influence of alcohol, popper use, and have a higher number of sex partners (table). Conclusion SOPV attendance is common among MSM in Lima and associated with higher levels of several sexual behavioral risk factors. In light of this, SOPVs warrant further consideration as potential sites of outreach to offer HIV testing and prevention interventions designed to reach MSM at high risk for HIV infection. Disclosures All authors: No reported disclosures.

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PIN50 NON-SEXUAL RISK BEHAVIORS ARE ASSOCIATED WITH INCREASED ODDS OF HIV TESTING: RESULTS FROM THE 2017 BRFSS

Value in Health ◽

10.1016/j.jval.2020.04.518 ◽

2020 ◽

Vol 23 ◽

pp. S176-S177

Author(s):

V. Yelverton ◽

P. Hung ◽

J. Ostermann

Keyword(s):

Hiv Testing ◽

Sexual Risk ◽

Risk Behaviors ◽

Sexual Risk Behaviors

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A reply to “Low HIV testing rates among US women who report anal sex and other HIV sexual risk behaviors”

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.02.012 ◽

2019 ◽

Vol 220 (5) ◽

pp. 509

Author(s):

Paris N. Stowers

Keyword(s):

Hiv Testing ◽

Sexual Risk ◽

Risk Behaviors ◽

Sexual Risk Behaviors ◽

Anal Sex ◽

Hiv Sexual Risk ◽

Hiv Sexual Risk Behaviors

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Minority Stressors Associated with Sexual Risk Behaviors and HIV Testing in a U.S. Sample of Transgender Individuals

AIDS and Behavior ◽

10.1007/s10461-018-2054-0 ◽

2018 ◽

Vol 22 (9) ◽

pp. 3111-3116 ◽

Cited By ~ 7

Author(s):

Brian A. Rood ◽

Jennifer J. Kochaver ◽

Elizabeth A. McConnell ◽

Miles Q. Ott ◽

David W. Pantalone

Keyword(s):

Hiv Testing ◽

Sexual Risk ◽

Risk Behaviors ◽

Sexual Risk Behaviors

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Sex-on-Premise Venues, Associated Risk Behaviors, and Attitudes toward Venue-Based HIV Testing among Men Who Have Sex with Men in Lima, Perú

10.21203/rs.2.18416/v2 ◽

2020 ◽

Author(s):

Alexander Lankowski ◽

Hugo Sánchez ◽

José Hidalgo ◽

Robinson Cabello ◽

Ann Duerr

Keyword(s):

Hiv Testing ◽

Sexual Risk ◽

Risk Behaviors ◽

Online Survey ◽

Sexual Risk Behaviors ◽

Hiv Infections ◽

High Rate ◽

Access To Treatment ◽

Cross Sectional ◽

Sex With Men

Abstract Background. In Perú, HIV disproportionately affects men who have sex with men (MSM). Despite widespread access to treatment, the high rate of new HIV infections has remained unchanged over the last decade. Low knowledge of HIV status associated with late diagnosis is a key factor underlying the high HIV incidence observed in this setting, creating conditions for efficient onward transmission. Improving access to HIV testing and prevention services for those at highest risk is an important public health priority. Sex-on-premise venues (SOPVs) – saunas, sex clubs, pornographic movie theaters, hourly hotels, and bars/discos with areas where sex is permitted – may be opportune sites for outreach; however, further research on SOPVs and the populations who frequent them is needed to inform such efforts. Methods . We conducted a cross-sectional online survey of adult MSM in Lima, Perú to evaluate patterns of SOPV attendance, associated sexual risk behaviors, and attitudes toward SOPV-based interventions. Participants were recruited through outreach to social media networks affiliated with local LGBTQ-aligned community groups. Our primary analytic objective was to estimate the association of HIV-related sexual risk behaviors and SOPV attendance. Additionally, we performed exploratory analyses to describe risk behavior stratified by SOPV category and to examine the relationship between SOPV attendance and the use of online platforms to meet sex partners. Results. Overall, 389 MSM completed the survey from November 2018 through May 2019, of whom 68% reported attending an SOPV in the last three months. SOPV attendance was associated with multiple sexual risk behaviors, including transactional sex, group sex, substance use around the time of sex, and higher number of partners. Over two thirds of SOPV attendees indicated they would accept HIV testing if offered at SOPVs. Conclusions. SOPV attendance was common among MSM in Lima who participated in our survey, and SOPV attendees reported significantly greater engagement in sexual risk behaviors related to HIV transmission. Attitudes toward hypothetical SOPV-based interventions were generally favorable. These findings suggest that outreach at SOPVs may be an effective mechanism for reaching a particularly high-risk sub-population of MSM in Perú to deliver targeted HIV testing and prevention interventions.

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