Engagement of Latino immigrant men who have sex with men for HIV prevention through eHealth: preferences across social media platforms

BACKGROUND Black and Hispanic men who have sex with men in the United States continue to be disproportionately affected by HIV and AIDS. Uptake of and knowledge about biobehavioral HIV prevention approaches, such as treatment as prevention and preexposure prophylaxis, are especially low in these populations. eHealth campaigns and social media messaging about treatment as prevention and preexposure prophylaxis may help to fill this gap in knowledge and lead to increased uptake of such strategies; however, no evidence exists of the effects of these targeted forms of communication on treatment as prevention and preexposure prophylaxis uptake in these populations. OBJECTIVE We describe the protocol for a 3-part study aiming to develop and evaluate an eHealth intervention with information about treatment as prevention and preexposure prophylaxis for HIV-positive and HIV-negative black and Hispanic men who have sex with men. METHODS Phases 1 and 2 will involve focus groups and cognitive interviews with members of the target populations, which we will use to create a culturally tailored, interactive website and applicable social media messaging for these men. Phase 3 will be a small randomized controlled trial of the eHealth intervention, in which participants will receive guided social media messages plus the newly developed website (active arm) or the website alone (control arm), with assessments at baseline and 6 months. RESULTS Participant recruitment began in August 2017 and will end in August 2020. CONCLUSIONS Public health interventions are greatly needed to increase knowledge about and uptake of biobehavioral HIV prevention strategies such as treatment as prevention and preexposure prophylaxis among black and Hispanic men who have sex with men. eHealth communication campaigns offer a strategy for engaging these populations in health communication about biobehavioral HIV prevention. CLINICALTRIAL ClinicalTrials.gov NCT03404531; https://www.clinicaltrials.gov/ct2/show/NCT03404531 (Archived by WebCite at http://www.webcitation.org/70myofp0R). REGISTERED REPORT IDENTIFIER RR1-10.2196/11047

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Population Size Estimation of Gay and Bisexual Men and Other Men Who Have Sex With Men Using Social Media-Based Platforms (Preprint)

10.2196/preprints.9321 ◽

2017 ◽

Author(s):

Stefan Baral ◽

Rachael M Turner ◽

Carrie E Lyons ◽

Sean Howell ◽

Brian Honermann ◽

...

Keyword(s):

Social Media ◽

Hiv Prevention ◽

Population Size ◽

The United States ◽

Size Estimation ◽

Same Sex ◽

Care Needs ◽

Population Size Estimates ◽

Sex With Men ◽

Size Estimates

BACKGROUND Gay, bisexual, and other cisgender men who have sex with men (GBMSM) are disproportionately affected by the HIV pandemic. Traditionally, GBMSM have been deemed less relevant in HIV epidemics in low- and middle-income settings where HIV epidemics are more generalized. This is due (in part) to how important population size estimates regarding the number of individuals who identify as GBMSM are to informing the development and monitoring of HIV prevention, treatment, and care programs and coverage. However, pervasive stigma and criminalization of same-sex practices and relationships provide a challenging environment for population enumeration, and these factors have been associated with implausibly low or absent size estimates of GBMSM, thereby limiting knowledge about the dynamics of HIV transmission and the implementation of programs addressing GBMSM. OBJECTIVE This study leverages estimates of the number of members of a social app geared towards gay men (Hornet) and members of Facebook using self-reported relationship interests in men, men and women, and those with at least one reported same-sex interest. Results were categorized by country of residence to validate official size estimates of GBMSM in 13 countries across five continents. METHODS Data were collected through the Hornet Gay Social Network and by using an a priori determined framework to estimate the numbers of Facebook members with interests associated with GBMSM in South Africa, Ghana, Nigeria, Senegal, Côte d'Ivoire, Mauritania, The Gambia, Lebanon, Thailand, Malaysia, Brazil, Ukraine, and the United States. These estimates were compared with the most recent Joint United Nations Programme on HIV/AIDS (UNAIDS) and national estimates across 143 countries. RESULTS The estimates that leveraged social media apps for the number of GBMSM across countries are consistently far higher than official UNAIDS estimates. Using Facebook, it is also feasible to assess the numbers of GBMSM aged 13-17 years, which demonstrate similar proportions to those of older men. There is greater consistency in Facebook estimates of GBMSM compared to UNAIDS-reported estimates across countries. CONCLUSIONS The ability to use social media for epidemiologic and HIV prevention, treatment, and care needs continues to improve. Here, a method leveraging different categories of same-sex interests on Facebook, combined with a specific gay-oriented app (Hornet), demonstrated significantly higher estimates than those officially reported. While there are biases in this approach, these data reinforce the need for multiple methods to be used to count the number of GBMSM (especially in more stigmatizing settings) to better inform mathematical models and the scale of HIV program coverage. Moreover, these estimates can inform programs for those aged 13-17 years; a group for which HIV incidence is the highest and HIV prevention program coverage, including the availability of pre-exposure prophylaxis (PrEP), is lowest. Taken together, these results highlight the potential for social media to provide comparable estimates of the number of GBMSM across a large range of countries, including some with no reported estimates.

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HIV Information Acquisition and Use among Young Black Men Who Have Sex with Men Who Use the Internet: A Mixed Methods Study (Preprint)

10.2196/preprints.22986 ◽

2020 ◽

Author(s):

Megan Threats ◽

Keosha Bond

Keyword(s):

Social Media ◽

Hiv Prevention ◽

Health Information ◽

Black Men ◽

Information Acquisition ◽

Healthcare Providers ◽

The Internet ◽

Prevention And Treatment ◽

Online Spaces ◽

Sex With Men

BACKGROUND Background: Human immunodeficiency virus (HIV) disproportionately affects young black men who have sex with men (YBMSM) in the United States. Electronic health (eHealth) and mobile health (mHealth) hold significant potential for supporting engagement in HIV prevention and care, and the delivery of HIV information to YBMSM. OBJECTIVE To investigate technology utilization, internet access, and HIV information acquisition and use among YBMSM. METHODS An online survey and semi-structured interviews were conducted. Survey findings informed the development of the interview guide. Descriptive statistics were used to characterize the survey sample, and interview data was analyzed thematically using modified grounded theory methodologies. RESULTS Among the internet sample (N=83), the average age was 29.2 years, 41% of participants self-reported living with HIV, 43.4% were HIV-negative, and 15.6% were unsure of their HIV-status. Most participants (95%) acquired HIV information through the Internet while using a mobile phone. Online HIV information was intentionally sought from consumer health information websites (37.3%), government health information websites (30%), and social media sites (17%). Most men incidentally acquired HIV information via advertisements on social media sites and geospatial dating applications (65.39%), postings on social media sites from their online social ties (53.84%), and advertisements while browsing the Internet (48.72%). Despite the Internet being the top source of HIV information, healthcare providers were the most preferred (50.6%) and trusted (96%) source of HIV information. HIV information was used to facilitate the utilization of HIV prevention and treatment services. The qualitative sample included YBMSM across a range of ages and at different points of engagement in HIV prevention and treatment. Qualitative findings included the importance of the Internet as a primary source of HIV information. The Internet was used due to its ease of accessibility, the ability to maintain anonymity while searching for sensitive information, and to mitigate against stigma in healthcare settings. Participants used HIV information to assess their risk for HIV/AIDS, support their self-efficacy for HIV prevention and treatment, inform patient-doctor communication, and to learn about HIV prevention and treatment options. Men expressed concerns about their diminishing access to online spaces for HIV information exchange among YBMSM due to website censorship policies, and the “stigmatizing” tone of HIV information presented in mass media campaigns. CONCLUSIONS YBMSM in this sample had high utilization of the internet and mobile technologies for HIV information acquisition and use, but diminished access to their preferred and most trusted source of HIV information: healthcare providers. Future eHealth and mHealth HIV prevention and treatment interventions should support communication between patients and healthcare providers. Findings demonstrate the need for culturally appropriate HIV messaging, and online spaces for informational support exchange among YBMSM.

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Are men who have sex with men at higher risk for HIV in Latin America more aware of PrEP?

PLoS ONE ◽

10.1371/journal.pone.0255557 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255557

Author(s):

Ryan D. Assaf ◽

Kelika A. Konda ◽

Thiago S. Torres ◽

E. Hamid Vega-Ramirez ◽

Oliver A. Elorreaga ◽

...

Keyword(s):

Social Media ◽

Latin America ◽

Hiv Infection ◽

Risk Index ◽

Secondary Analysis ◽

Hiv Infections ◽

Social Media Platforms ◽

Unknown Status ◽

Sex With Men ◽

Prep Awareness

Introduction PrEP awareness in Latin America has been poorly characterized, with studies in Brazil, Mexico, and Peru highlighting awareness of 65% among gay, bisexual and other men who have sex with men (MSM). We assessed the association between higher risk of HIV infection, indicative of PrEP eligibility, and PrEP awareness among MSM from these countries. Methods This was a secondary analysis of a web-based survey advertised on social media platforms from March-June 2018 in Brazil, Mexico and Peru. Eligible individuals were cisgender MSM, ≥18 years old, HIV negative or of unknown status, who lived in these countries, and provided informed consent. Higher risk of HIV infection was defined as having 10 or more points in the HIV Risk Index for MSM (HIRI-MSM). We used multivariable Poisson regression models to calculate adjusted prevalence ratios (aPR) testing the association between higher risk for HIV and PrEP awareness. Results After exclusions, 19,457 MSM were included in this analysis. In Brazil, 53.8% were classified as higher risk for HIV, 51.9% in Mexico, and 54.2% in Peru. Higher risk for HIV was minimally associated with PrEP awareness among those in Brazil (aPR 1.04, 95% CI 1.01, 1.06), but no such association was observed in Mexico or Peru. Having more than a high school education, high income, daily use of geosocial networking (GSN) applications, and substance use were associated with PrEP awareness. Conclusion Higher risk of HIV infection was associated with increased PrEP awareness in Brazil. However, this association was weak indicating that PrEP awareness could be strengthened with further prevention efforts. In the remaining countries, results were non-conclusive between risk and awareness. Interventions to increase PrEP awareness are paramount to increase PrEP willingness and uptake and in turn prevent new HIV infections. Social media platforms could play an important role to achieve this goal.

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User and Message Level Correlated of Endorsement and Engagement for HIV-related Messages on Twitter (Preprint)

10.2196/preprints.32718 ◽

2021 ◽

Author(s):

Stephen Bonett ◽

Jimin Oh ◽

Elissa Kranzler ◽

Bruno Saconi ◽

Robin Stevens

Keyword(s):

Social Media ◽

Young Adults ◽

Hiv Prevention ◽

Secondary Analysis ◽

Young Men ◽

Factors Associated ◽

Prevention Messages ◽

Youth And Young Adults ◽

Social Media Platforms ◽

The Impact

BACKGROUND Youth and young adults continue to experience high rates of HIV, and are also frequent users of social media. Social media platforms such as Twitter can bolster efforts to promote HIV prevention for these individuals, and while HIV-related messages exist on Twitter, little is known about the impact or reach of these messages for this population. OBJECTIVE This study aims to address this gap in the literature by identifying user and message characteristics that are associated with tweet endorsement (favorited) and engagement (retweeted) among youth and young men (ages 13-24). METHODS In a secondary analysis of data from a study of HIV-related messages posted by young men on Twitter, we used model selection techniques to examine user and tweet-level factors associated with tweet endorsement and engagement. RESULTS Tweets from personal user accounts garnered greater endorsement and engagement than tweets from institutional users (aOR = 3.27, 95% CI [2.75, 3.89], p < .001). High follower count was associated with increased endorsement and engagement (aOR = 1.05, 95% CI [1.04 - 1.06], p < .001); tweets that discussed STIs garnered lower endorsement and engagement (aOR = 0.59, 95% CI [0.47 – 1.74], p < .001). CONCLUSIONS Findings suggest practitioners should partner with youth to design and disseminate HIV prevention messages on social media, incorporate content that resonates with youth audiences, and work to challenge stigma and foster social norms conducive to open conversation about sex, sexuality, and health.

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Partner Selection among Latino Immigrant Men Who Have Sex with Men

Archives of Sexual Behavior ◽

10.1007/s10508-009-9510-x ◽

2009 ◽

Vol 39 (6) ◽

pp. 1321-1330 ◽

Cited By ~ 15

Author(s):

Fernanda T. Bianchi ◽

Michele G. Shedlin ◽

Kelly D. Brooks ◽

Marcelo Montes Penha ◽

Carol A. Reisen ◽

...

Keyword(s):

Partner Selection ◽

Latino Immigrant ◽

Sex With Men ◽

Immigrant Men

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Supporting Health Among Young Men Who Have Sex With Men and Transgender Women With HIV: Lessons Learned From Implementing the weCare Intervention

Health Promotion Practice ◽

10.1177/1524839920936241 ◽

2020 ◽

Vol 21 (5) ◽

pp. 755-763 ◽

Cited By ~ 1

Author(s):

Amanda E. Tanner ◽

Lilli Mann-Jackson ◽

Eunyoung Y. Song ◽

Jorge Alonzo ◽

Katherine R. Schafer ◽

...

Keyword(s):

Social Media ◽

Health Outcomes ◽

Mobile Applications ◽

Transgender Women ◽

Lessons Learned ◽

Clinical Environment ◽

Care Needs ◽

Social Media Platforms ◽

Women With Hiv ◽

Sex With Men

Young gay, bisexual, and other men who have sex with men and transgender women with HIV, particularly those who are racial or ethnic minorities, often have poor health outcomes. They also utilize a wide array of social media. Accordingly, we developed and implemented weCare, an mHealth (mobile health) intervention where cyberhealth educators utilize established social media platforms (e.g., Facebook, texting, and GPS-based mobile applications [“apps”]) designed for social and sexual networking) to improve HIV-related care engagement and health outcomes. As part of the process evaluation of weCare, we conducted 32 interviews with intervention participants ( n = 18) and HIV clinic providers and staff ( n = 14). This article highlights three key intervention characteristics that promoted care engagement, including that weCare is (1) targeted (e.g., using existing social media platforms, similarity between intervention participants and cyberhealth educator, and implementation within a supportive clinical environment), (2) tailored (e.g., bidirectional messaging and trusting relationship between participants and cyberhealth educators to direct interactions), and (3) personalized (e.g., addressing unique care needs through messaging content and flexibility in engagement with intervention). In addition, interviewees’ recommendations for improving weCare focused on logistics, content, and the ways in which the intervention could be adapted to reach a larger audience. Quality improvement efforts to ensure that mHealth interventions are relevant for young gay, bisexual, and other men who have sex with men and transgender women are critical to ensure care engagement and support health outcomes.

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“La Familia” HIV prevention program: A focus on disclosure and family acceptance for Latino immigrant MSM to the USA

Salud Pública de México ◽

10.21149/spm.v55s4.5154 ◽

2013 ◽

Vol 55 (Supl.4) ◽

pp. 491 ◽

Cited By ~ 5

Author(s):

Rita M Melendez ◽

Jorge Zepeda ◽

Rafael Samaniego ◽

Deepalika Chakravarty ◽

Gabriela Alaniz

Keyword(s):

Sexual Orientation ◽

Hiv Prevention ◽

Prevention Program ◽

Control Group ◽

Structural Factors ◽

Latino Immigrant ◽

Before And After ◽

Family Acceptance ◽

The Usa ◽

Sex With Men

Objective. The objective of this study was to pilot test and evaluate a HIV prevention program that used a Freirean approach to engage Latino immigrant MSM (men who have sex with men) on issues of sexual orientation, family acceptance, stigma as well as HIV prevention and sexual risk behaviors. Materials and methods. Participants were evaluated using a survey before and after participation in the program and compared to a control group. Focus groups where participants discussed their experiences in the program as well as perceptions of the program were held and analyzed. Results. Survey results indicate that after their participation in the program, participants increased their safer sex behaviors, comfort disclosing their sexual orientation and support from friends. Conclusions. HIV prevention needs to incorporate cultural, social and structural factors.

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Comparing Web-Based Platforms for Promoting HIV Self-Testing and Pre-Exposure Prophylaxis Uptake in High-Risk Men Who Have Sex With Men: Protocol for a Longitudinal Cohort Study (Preprint)

10.2196/preprints.20417 ◽

2020 ◽

Author(s):

Shea M Lemley ◽

Jeffrey D Klausner ◽

Sean D Young ◽

Chrysovalantis Stafylis ◽

Caroline Mulatya ◽

...

Keyword(s):

Social Media ◽

Hiv Prevention ◽

Hiv Testing ◽

Relative Effectiveness ◽

Web Based ◽

Dating Apps ◽

Self Testing ◽

Self Test ◽

Sex With Men ◽

Exposure Prophylaxis

BACKGROUND The majority of those living with HIV in the United States are men who have sex with men (MSM), and young, minority MSM account for more new HIV infections than any other group. HIV transmission can be reduced through detection and early treatment initiation or by starting pre-exposure prophylaxis (PrEP), but rates of testing are lower than recommended among MSM, and PrEP uptake has been slow. Although promoting HIV testing and PrEP uptake by placing advertisements on web-based platforms — such as social media websites and dating apps — is a promising approach for promoting HIV testing and PrEP, the relative effectiveness of HIV prevention advertising on common web-based platforms is underexamined. OBJECTIVE This study aims to evaluate the relative effectiveness of advertisements placed on 3 types of web-based platforms (social media websites, dating apps, and informational websites) for promoting HIV self-testing and PrEP uptake. METHODS Advertisements will be placed on social media websites (Facebook, Instagram, and Twitter), dating apps (Grindr, Jack’d, and Hornet), and informational search websites (Google, Yahoo, and Bing) to recruit approximately 400 young (18-30 years old), minority (Black or Latino) MSM at elevated risk of HIV exposure. Recruitment will occur in 3 waves, with each wave running advertisements on 1 website from each type of platform. The number of participants per platform is not prespecified, and recruitment in each wave will occur until approximately 133 HIV self-tests are ordered. Participants will complete a baseline survey assessing risk behavior, substance use, psychological readiness to test, and attitudes and then receive an electronic code to order a free home-based HIV self-test kit. Two follow-ups are planned to assess HIV self-test results and PrEP uptake. RESULTS Recruitment was completed in July 2020. CONCLUSIONS Findings may improve our understanding of how the platform users’ receptivity to test for HIV differs across web-based platforms and thus may assist in facilitating web-based HIV prevention campaigns. CLINICALTRIAL ClinicalTrials.gov NCT04155502; https://clinicaltrials.gov/ct2/show/NCT04155502 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/20417

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