scholarly journals Association Between HIV PrEP Indications and Use in a National Sexual Network Study of Men Who Have Sex with Men

2021 ◽  
Author(s):  
Kevin M Weiss ◽  
Pragati Prasad ◽  
Travis Sanchez ◽  
Steven M Goodreau ◽  
Samuel M Jenness
Keyword(s):  
Hiv Transmission ◽  
Guideline Implementation ◽  
Sexual Network ◽  
Web Based ◽  
Preexposure Prophylaxis ◽  
Binomial Regression ◽  
Sex With Men ◽  
Using Data ◽  
The Relationship ◽  
Hiv Negative

BACKGROUND: HIV preexposure prophylaxis (PrEP) is effective in preventing HIV transmission. US Public Health Service (USPHS) clinical practice guidelines define biobehavioral indications for initiation. To assess guideline implementation, it is critical to quantify PrEP non-users who are indicated and PrEP users who are not indicated. METHODS: Using data from a national web-based study of men who have sex with men (MSM) between 2017 and 2019, we estimated the association between PrEP use and PrEP indications. Log-binomial regression was used to estimate the relationship between PrEP indications and PrEP use, adjusted for geography and demographics. RESULTS: Of 3508 sexually active, HIV-negative MSM, 34% met indications for PrEP. The proportion with current PrEP use was 32% among those meeting indications and 11% among those without indications. Nearly 40% of those currently using PrEP did not meet indications for PrEP, and 68% of MSM with indications for PrEP were not currently using PrEP. After adjusting for geography and demographics, MSM with PrEP indications were about 3 times as likely to be currently using PrEP. This association varied slightly by geography and demography. CONCLUSIONS: Indications for PrEP strongly predicted current PrEP use among MSM. However, we identified substantial misalignment between indications and use in both directions (indicated MSM who were not benefitting from PrEP, and MSM taking PrEP while not presently being indicated). This calls for further implementation efforts to improve PrEP delivery to those most in need during periods of elevated sexual risk.

scholarly journals Population-Level Sexual Mixing According to HIV Status and Preexposure Prophylaxis Use Among Men Who Have Sex With Men in Montreal, Canada: Implications for HIV Prevention

2019 ◽  
Vol 189 (1) ◽  
pp. 44-54 ◽  
Author(s):  
Linwei Wang ◽  
Nasheed Moqueet ◽  
Gilles Lambert ◽  
Daniel Grace ◽  
Ricky Rodrigues ◽  
...  
Keyword(s):  
Population Level ◽  
Hiv Positive ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Preexposure Prophylaxis ◽  
Immunodeficiency Virus ◽  
Mixing Patterns ◽  
Sex With Men ◽  
The Relationship ◽  
Hiv Negative

Abstract Using cross-sectional survey data (Engage, 2017–2018) from 1,137 men who have sex with men, ≥16 years old, in Montreal, we compared observed human immunodeficiency virus (HIV) seroconcordance in previous-6-months’ sexual partnerships with what would have been observed by chance if zero individuals serosorted. Of 5 recent partnerships where both individuals were HIV-negative, we compared observed concordance in preexposure prophylaxis (PrEP) use with the counterfactual if zero individuals selected partners based on PrEP use. We estimated the concordance by chance using a balancing-partnerships approach assuming proportionate mixing. HIV-positive respondents had a higher proportion of HIV-positive partners (66.4%, 95% confidence interval (CI): 64.0, 68.6) than by chance (23.9%, 95% CI: 23.1, 24.7). HIV-negative respondents (both on and not on PrEP) had higher proportions of HIV-negative partners (82.9% (95% CI: 81.1, 84.7) and 90.7% (95% CI: 89.6, 91.7), respectively) compared with by chance (76.1%, 95% CI: 75.3, 76.9); however, those on PrEP had a higher proportion of HIV-positive partners than those not on PrEP (17.1% (95% CI: 15.3, 18.9) vs. 9.3% (95% CI: 8.3, 10.4). Those on PrEP also had a higher proportion of partners on PrEP among their HIV-negative partners (50.6%, 95% CI: 42.5, 58.8) than by chance (28.5%, 95% CI: 27.5, 29.4). The relationship between PrEP and sexual-mixing patterns demonstrated by less population-level serosorting among those on PrEP and PrEP-matching warrants consideration during PrEP roll-out.

Fraud Detection Protocol for Web-Based Research Among Men Who Have Sex With Men: Development and Descriptive Evaluation (Preprint)

2018 ◽  
Author(s):  
April M Ballard ◽  
Trey Cardwell ◽  
April M Young
Keyword(s):  
Survey Research ◽  
Hiv Transmission ◽  
Personal Information ◽  
Fraud Detection ◽  
Detection Algorithm ◽  
Cross Sectional ◽  
Web Based ◽  
Young Msm ◽  
Data Survey ◽  
Sex With Men

BACKGROUND Internet is becoming an increasingly common tool for survey research, particularly among “hidden” or vulnerable populations, such as men who have sex with men (MSM). Web-based research has many advantages for participants and researchers, but fraud can present a significant threat to data integrity. OBJECTIVE The purpose of this analysis was to evaluate fraud detection strategies in a Web-based survey of young MSM and describe new protocols to improve fraud detection in Web-based survey research. METHODS This study involved a cross-sectional Web-based survey that examined individual- and network-level risk factors for HIV transmission and substance use among young MSM residing in 15 counties in Central Kentucky. Each survey entry, which was at least 50% complete, was evaluated by the study staff for fraud using an algorithm involving 8 criteria based on a combination of geolocation data, survey data, and personal information. Entries were classified as fraudulent, potentially fraudulent, or valid. Descriptive analyses were performed to describe each fraud detection criterion among entries. RESULTS Of the 414 survey entries, the final categorization resulted in 119 (28.7%) entries identified as fraud, 42 (10.1%) as potential fraud, and 253 (61.1%) as valid. Geolocation outside of the study area (164/414, 39.6%) was the most frequently violated criterion. However, 33.3% (82/246) of the entries that had ineligible geolocations belonged to participants who were in eligible locations (as verified by their request to mail payment to an address within the study area or participation at a local event). The second most frequently violated criterion was an invalid phone number (94/414, 22.7%), followed by mismatching names within an entry (43/414, 10.4%) and unusual email addresses (37/414, 8.9%). Less than 5% (18/414) of the entries had some combination of personal information items matching that of a previous entry. CONCLUSIONS This study suggests that researchers conducting Web-based surveys of MSM should be vigilant about the potential for fraud. Researchers should have a fraud detection algorithm in place prior to data collection and should not rely on the Internet Protocol (IP) address or geolocation alone, but should rather use a combination of indicators.

Food Insecurity Partially Mediates the Association Between Drug Use and Depressive Symptoms among Men who have Sex with Men in Los Angeles, California

2021 ◽  
pp. 1-26
Author(s):  
David A. Wiss ◽  
Marjan Javanbakht ◽  
Michael J. Li ◽  
Michael Prelip ◽  
Robert Bolan ◽  
...  
Keyword(s):  
Food Security ◽  
Depressive Symptoms ◽  
High Risk ◽  
Los Angeles ◽  
Drug Use ◽  
Food Insecurity ◽  
Hiv Positive ◽  
Sex With Men ◽  
The Relationship ◽  
Hiv Negative

Abstract Objective: To understand the relationship between drug use, food insecurity (FI), and mental health among men who have sex with men (MSM). Design: Cohort study (2014-2019) with at least one follow-up. Setting: Visits at 6-month intervals included self-assessment for FI and depressive symptoms. Urine testing results confirmed drug use. Factors associated with FI were assessed using multiple logistic regression with random effects for repeated measures. General structural equation modeling tested whether FI mediates the relationship between drug use and depressive symptoms. Participants: Data were from HIV-positive and high-risk HIV negative MSM in Los Angeles, CA (n=431; 1,192 visits). Results: At baseline, FI was reported by 50.8% of participants, depressive symptoms in 36.7%, and 52.7% of urine screening tests were positive for drugs (i.e., marijuana, opioids, methamphetamine, cocaine, ecstasy). A positive drug test was associated with a 96% increase in the odds of being food insecure (95% CI: 1.26-3.07). Compared to those with high food security, individuals with very low food security have a nearly 7-fold increase in the odds of reporting depressive symptoms (95% CI: 3.71-11.92). Findings showed 14.9% of the association between drug use (exposure) and depressive symptoms (outcome) can be explained by FI (mediator). Conclusion: The prevalence of FI among this cohort of HIV-positive and high-risk HIV-negative MSM was high; the association between drug use and depressive symptoms was partially mediated by FI. Findings suggest that enhancing access to food and nutrition may improve mood in the context of drug use, especially among MSM at risk for HIV-transmission.

scholarly journals The Relationship between Near-Repeat Street Robbery and the Environment: Evidence from Malmö, Sweden

2020 ◽  
Vol 9 (4) ◽  
pp. 188
Author(s):  
Markus Rasmusson ◽  
Marco Helbich
Keyword(s):  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Socioeconomic Indicators ◽  
Law Enforcement Agencies ◽  
Environmental Characteristics ◽  
Binomial Regression ◽  
Using Data ◽  
Near Repeat ◽  
The Relationship ◽  
Crime Event

Near-repeat crime refers to a pattern whereby one crime event is soon followed by a similar crime event at a nearby location. Existing research on near-repeat crime patterns is inconclusive about where near-repeat patterns emerge and which physical and social factors influence them. The present research addressed this gap by examining the relationship between initiator events (i.e., the first event in a near-repeat pattern) and environmental characteristics to estimate where near-repeat patterns are most likely to emerge. A two-step analysis was undertaken using data on street robberies reported in Malmö, Sweden, for the years 2006–15. After determining near-repeat patterns, we assessed the correlations between initiator events and criminogenic places and socioeconomic indicators using a negative binomial regression at a street segment level. Our results show that both criminogenic places and socioeconomic indicators have a significant influence on the spatial variation of initiator events, suggesting that environmental characteristics can be used to explain the emergence of near-repeat patterns. Law enforcement agencies can utilize the findings in efforts to prevent further street robberies from occurring.

scholarly journals 1281. Awareness of U=U Among Gay and Bisexual Men Who Have Sex with Men

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S461-S461
Author(s):  
Meredith E Clement ◽  
Rick Zimmerman ◽  
Josh Grimm ◽  
Joseph Schwartz
Keyword(s):  
Hiv Transmission ◽  
Gay And Bisexual Men ◽  
Bisexual Men ◽  
Hiv Status ◽  
Anal Sex ◽  
And Bisexual ◽  
Sex With Men ◽  
Living With Hiv ◽  
Hiv Negative ◽  
Strong Agreement

Abstract Background The “Undetectable = Untransmittable” (“U=U”) campaign is gaining traction, but prior studies from 2012–2017 have shown that the proportion of gay and bisexual men who have sex with men (GBMSM) who are aware of or have perceived accuracy of U=U is low. We report findings from a survey administered to GBMSM in 2018 to understand whether the landscape is changing with respect to U=U message dissemination. Methods GBMSM were recruited on gay dating apps to complete a 96 question survey. Survey data were collected in April-August of 2018. Collected data elements included demographic information, HIV status, ART and PrEP use, and beliefs and opinions regarding HIV transmission. Results 969 GBMSM completed the survey; of whom, 678 had analyzable data (241 had never had anal sex with a man and 54 were missing ≥1 of the variables used in the analysis). Average age was 43 years, 65% were white, 15% black, 15% white, and 15% were HIV-infected (of whom 92% were on anti-retrovirals). Of the 85% who were HIV-uninfected, 39% were on PrEP. In response to the statement that a person with an undetectable viral load cannot transmit HIV to an HIV-uninfected person, 24% strongly agreed. Among HIV-negative GBMSM, 33% of those on PrEP agreed and 12% of those not on PrEP agreed. Among those living with HIV, 42% agreed. A multivariable logistic regression was run to explain correlates of strong agreement with U=U, using the following variables: age, education, being Black, being Hispanic, relationship status, number of lifetime male sexual partners, condom use with most recent anal sex, HIV status, PrEP use, and attitudes about living with HIV. Variables associated with strong agreement with U=U were living with HIV (AOR = 1.63, P < 0.001), taking PrEP (AOR = 2.85, P < 0.001), most recent encounter’s condom use (AOR = 2.22, P = 0.003), and having positive attitudes about living with HIV (AOR= 1.93, P < 0.001). Table 1 shows percentages for each of these variables (bivariate relationships) strongly agreeing with U=U. Conclusion Now that U=U has been scientifically proven, the challenge is public awareness. U=U awareness seems to be improving among GBMSM, with HIV-negative GBMSM making the greatest strides. Education around U=U and PrEP efficacy may help reduce guilt around HIV transmission and alleviate HIV stigma. Disclosures All authors: No reported disclosures.

scholarly journals A Web-Based Study of HIV Prevention in the Era of Pre-Exposure Prophylaxis Among Vulnerable HIV-Negative Gay and Bisexual Men, Transmen, and Transwomen Who Have Sex With Men: Protocol for an Observational Cohort Study (Preprint)

2019 ◽  
Author(s):  
Denis Nash ◽  
Matthew Stief ◽  
Caitlin MacCrate ◽  
Chloe Mirzayi ◽  
Viraj V Patel ◽  
...  
Keyword(s):  
High Risk ◽  
Hiv Prevention ◽  
Hiv Testing ◽  
The United States ◽  
Racially Diverse ◽  
Web Based ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
Hiv Negative

BACKGROUND Gay, bisexual, and other men who have sex with men continue to bear a large burden of the HIV epidemic in the United States and are among the only populations with increasing incidence in recent years. OBJECTIVE The Together 5000 (T5K) Study aimed to enroll a US-based, racially diverse sample of HIV-negative men, transmen, and transwomen who are not on pre-exposure prophylaxis (PrEP) into an observational cohort to inform the design, implementation, scale-up, and evaluation of HIV prevention programs. METHODS We used internet-based strategies to enroll a large, racially diverse national sample of HIV-negative men, transmen, and transwomen aged 16 to 49 years at high risk of HIV acquisition via sexual networking apps. Study participants are contacted every 6 months (in between annual surveys) for a brief survey on HIV testing, HIV diagnosis, and PrEP use (ie, attempts to access, PrEP initiation, and PrEP discontinuation). Participants complete annual self-administered at-home HIV testing and Web-based surveys. Using baseline serologic data and self-reported HIV testing history, we reconstructed a cohort of persons who were HIV negative at 12 months before baseline to estimate HIV incidence leading up to cohort enrollment. RESULTS The study sample included 8777 participants from all 50 US states, Puerto Rico, and Guam; 50.91% (4468/8777) were persons of color and 25.30% (2221/8777) were young individuals aged 16 to 24 years. Per eligibility criteria, all T5K participants reported having sex with >2 male partners in the 90 days before enrollment, self-reported not having been diagnosed with HIV, and were not actively taking PrEP. In addition, 79.39% (6968/8777) reported >2 insertive condomless anal sex (CAS) acts, 61.02% (5356/8777) reported >1 receptive CAS acts in the past 90 days. Furthermore, most (7525/8777, 85.74%) reported never having taken PrEP. In total, 70.25% (6166/8777) were sent a self-administered at-home HIV test kit and 82.29% (5074/6166) of those sent a kit returned a sample for testing. The HIV incidence rate during the 12-month period leading up to enrollment was estimated to be 2.41 (95% CI 2.02-2.90) per 100 person-years. CONCLUSIONS A large, national, and racially diverse fully Web-based cohort of HIV-negative men, transmen, and transwomen at high risk for HIV seroconversion has successfully been recruited into longitudinal follow-up. This cohort is at high risk for HIV acquisition and can provide important insights related to the real-world uptake, impact, and equity of HIV prevention interventions in the United States. Participants can be invited to participate in trials aimed at testing strategies to improve the uptake of and engagement in these interventions. INTERNATIONAL REGISTERED REPORT RR1-10.2196/13715

Social determinants of self-reported pre-exposure prophylaxis use among a national sample of US men who have sex with men

2019 ◽  
Vol 96 (5) ◽  
pp. 368-374
Author(s):  
Brian A Chu ◽  
Erick R Castellanos ◽  
Manuel M Gonzales ◽  
Thomas W Gaither
Keyword(s):  
Social Determinants ◽  
Hiv Transmission ◽  
National Sample ◽  
Black Msm ◽  
The South ◽  
Southern Us ◽  
The Usa ◽  
Sex With Men ◽  
Using Data ◽  
Exposure Prophylaxis

PurposeVarious disparities exist in HIV transmission among men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) has been shown to decrease the acquisition of HIV, but there is variation in uptake within the MSM population. We aim to characterise PrEP use and correlates of self-reported PrEP use in a large national sample of urban MSM in the USA.MethodsUsing data from a geosocial-networking application, a national sample (n=3744) from the largest 50 metropolitan centres in the USA was obtained.ResultsWe found 18.1% (95% CI 16.8 to 19.3) of profiles reported using PrEP, with decreased reported PrEP use in younger MSM aged 18–24 years (adjusted OR (aOR)=0.5, 95% CI 0.3 to 0.7), obese MSM (aOR=0.5, 95% CI 0.3 to 0.9), black MSM (aOR=0.6, 95% CI 0.4 to 0.9) and MSM in the South (aOR=0.7, 95% CI 0.5 to 0.9).ConclusionSignificant disparities exist in PrEP reporting by age and among black, Southern US and obese MSM. More research is needed to better understand these disparities.

Is rectal gonorrhoea a lead indicator of HIV transmission among men who have sex with men in Victoria, Australia?

Sexual Health ◽  
2013 ◽  
Vol 10 (2) ◽  
pp. 188
Author(s):  
Anna L. Wilkinson ◽  
Megan S. C. Lim ◽  
Mark Stoové ◽  
Christopher K. Fairley ◽  
Marcus Chen ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Sexual Health ◽  
Hiv Transmission ◽  
Health Centre ◽  
P Value ◽  
Hiv Diagnosis ◽  
Sex With Men ◽  
Hiv Negative

Objectives To examine whether rectal gonorrhoea (RG; Neisseria gonorrhoeae) can be used as a lead indicator of trends in HIV diagnosis in men who have sex with men (MSM). Methods: Data from a metropolitan sexual health centre in Victoria, Australia, on RG and HIV tests in HIV-negative MSM from January 2006 to December 2011 were examined. Results: Allowing RG a 12-month lead over HIV showed no concordance in proportion positive (r = 0.27; P-value = 0.28). Conclusions: The data do not support use of RG trends as a lead indicator of trends in HIV among MSM.

Preliminary evidence of HIV seroconversion among HIV-negative men who have sex with men taking non-prescribed antiretroviral medication for HIV prevention in Miami, Florida, USA

Sexual Health ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 193 ◽  
Author(s):  
Mance E. Buttram ◽  
Steven P. Kurtz
Keyword(s):  
Hiv Prevention ◽  
Hiv Transmission ◽  
Qualitative Interviews ◽  
Transmission Risk ◽  
Accurate Information ◽  
Limited Information ◽  
Antiretroviral Medication ◽  
Hiv Seroconversion ◽  
Sex With Men ◽  
Hiv Negative

Background Limited information suggests that men who have sex with men (MSM) are informally obtaining antiretroviral medication (ARVs) and using them for HIV pre-exposure prophylaxis (PrEP). Methods: Data are drawn from an on-going study examining the use of non-prescribed ARVs for PrEP. To date, 24 qualitative interviews have been conducted with HIV-negative, substance-using MSM living in Miami, Florida, USA. Data are presented from two participants who reported HIV seroconversion while using non-prescribed ARVs for PrEP. Results: Preliminary data indicate that some young MSM: (i) lack awareness of and accurate information about the efficacious use of PrEP; (ii) obtain non-prescribed ARVs from HIV-positive sex partners and use these medications for PrEP in a way that does not provide adequate protection against HIV infection or cohere with established guidelines; and (iii) engage in multiple HIV transmission risk behaviours, including condomless anal sex and injection drug use. Conclusions: The informal, non-prescribed and non-medically supervised use of ARVs for HIV prevention has the potential to undermine the protective benefits of PrEP and leave men unprotected against HIV transmission and at risk for ARV resistance.

scholarly journals The relationship between pornography use and sexual behaviours among at-risk HIV-negative men who have sex with men

Sexual Health ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. 166 ◽  
Author(s):  
Lisa A. Eaton ◽  
Demetria N. Cain ◽  
Howard Pope ◽  
Jonathan Garcia ◽  
Chauncey Cherry
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Sexual Risk ◽  
Risk Taking ◽  
Sexual Risk Taking ◽  
Intervention Trial ◽  
Anal Sex ◽  
Sex With Men ◽  
The Relationship ◽  
Hiv Negative

Objectives Although pornography is widely available and frequently used among many adults in the USA, little is known about the relationship between pornography and risk factors for HIV transmission among men who have sex with men. Methods: Baseline assessments from a behavioural intervention trial for at-risk men who have sex with men were conducted in Atlanta, GA in 2009. Univariate and multivariate generalised linear models were used to assess the relationships between known risk factors for HIV infection, time spent viewing pornography, and sex behaviours. Results: One hundred forty-nine men reporting HIV-negative status and two or more unprotected anal sex partners in the past 6 months were enrolled in an intervention trial and completed survey assessments. Time spent viewing pornography was significantly associated with having more male sexual partners (B = 0.45, SE = 0.04, P < 0.001) and unprotected insertive anal sex acts (B = 0.28, SE = 0.04, P < 0.001). Moreover, increased substance use (drug use, B = 0.61, SE = 0.14, P < 0.001; alcohol use, B = 0.03, SE = 0.01, P < 0.01) and decreased perception of risk for HIV infection (B = –0.09, SE = 0.04, P < 0.05) were found to be significantly associated with greater time spent viewing pornography. Conclusions: This exploratory study is novel in that it sheds light on the associations between viewing pornography and sexual risk taking for HIV infection. Future studies in this area should focus on understanding how the content of pornography; in particular, the viewing of unprotected and protected sex acts, may affect sexual risk taking behaviour.

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