scholarly journals HIV Prioritization and Risk Perception Among an Online Sample of Men Who Have Sex With Men in the United States

2018 ◽  
Vol 12 (4) ◽  
pp. 676-687 ◽  
Author(s):  
Erin M. Kahle ◽  
Akshay Sharma ◽  
Stephen P. Sullivan ◽  
Rob Stephenson
Keyword(s):  
Hiv Prevention ◽  
Hiv Testing ◽  
Risk Behavior ◽  
Hiv Risk ◽  
Perceived Risk ◽  
The United States ◽  
The Past ◽  
Hiv Test ◽  
Life Issues ◽  
Sex With Men

Men who have sex with men (MSM) may prioritize interpersonal and structural factors, such as LGBTQ-related inequalities, housing instability, financial insecurity, and relationship seeking, over HIV prevention. The aim of this study was to assess how MSM prioritize HIV relative to other factors and the association between HIV prioritization, HIV testing and sexual risk behavior, and perceived risk. Data were collected from a national online survey of MSM in the United States assessing HIV knowledge and prioritization. Participants ranked HIV prevention relative to LGBTQ-related concerns and life issues (e.g., housing, job, relationship). Adjusted regression models were conducted to assess the association of HIV prioritization with HIV testing and condomless anal sex (CAS) and to evaluate associations between perceived risk and HIV risk behavior. Among 516 participants, HIV prevention was ranked significantly higher among MSM reporting recent CAS ( p = .04) and HIV testing within the past ( p = .02); HIV prevention was prioritized higher relative to life issues among MSM reporting last HIV test more than 1 year ago ( p = .02). Perceived HIV risk was significantly associated with higher HIV prioritization relative to LGBTQ concerns ( p = .001) and life issues ( p = .001). Higher HIV perceived risk was associated with lower odds of any CAS ( p < .001) and higher odds of having an HIV test in the past year ( p < .001). In this online study, HIV prioritization was identified as differentially associated with HIV testing, sexual risk behavior, and perceived HIV risk. HIV prevention programs should integrate strategies to address social and structural inequalities based on priority needs of MSM.

scholarly journals Birth Cohort Variations Across Functional Knowledge of HIV Prevention Strategies, Perceived Risk, and HIV-Associated Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States

2018 ◽  
Vol 12 (6) ◽  
pp. 1824-1834 ◽  
Author(s):  
Akshay Sharma ◽  
Erin M. Kahle ◽  
Stephen P. Sullivan ◽  
Rob Stephenson
Keyword(s):  
Hiv Prevention ◽  
Birth Cohort ◽  
Perceived Risk ◽  
The United States ◽  
Prevention Strategies ◽  
The Past ◽  
Hiv Prevention Strategies ◽  
Functional Knowledge ◽  
Sex With Men ◽  
Exposure Prophylaxis

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain heavily impacted by HIV. The purpose of this study was to describe intergenerational differences in functional knowledge of HIV prevention strategies, perceived risk, recent condomless anal sex (CAS), and HIV testing behavior. Eight hundred sexually active GBMSM were recruited via Facebook from August to September 2015, and administered a Web-based survey which included 12 multiple-choice questions to elicit data regarding functional knowledge of different HIV prevention approaches (e.g., condom use, pre-exposure prophylaxis post-exposure prophylaxis, treatment as prevention, circumcision). Cumulative logit and multivariable logistic models were formulated to examine birth cohort variations across four analytic outcomes. Younger generations were significantly more knowledgeable, as were GBMSM with higher education. Non-Hispanic non-White GBMSM and those reporting a bisexual/other sexual orientation had lower functional knowledge. Younger generations were equally concerned about contracting HIV as their older counterparts. Perceived risk was significantly higher among non-Hispanic non-White and Hispanic GBMSM, but lower among those with higher education and those in a relationship. Finally, birth cohort variations with respect to engaging in CAS with ≥2 men in the past 3 months and testing for HIV in the past year were not markedly pronounced. Younger GBMSM might be more knowledgeable about HIV prevention strategies compared to their predecessors, but are equally concerned about contracting HIV. Researchers and practitioners should consider intergenerational and other demographic differences while designing multifaceted HIV prevention programs for GBMSM.

scholarly journals Barriers to HIV Testing and Opportunities for Expansion Using Home-Based HIV Self-Testing: Results of a National Study of Higher HIV Risk Young Men Who Have Sex With Men

SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110168
Author(s):  
Sarah J. Marks ◽  
Roland C. Merchant ◽  
Melissa A. Clark ◽  
Tao Liu ◽  
Joshua G. Rosenberger ◽  
...  
Keyword(s):  
Hiv Testing ◽  
The United States ◽  
National Study ◽  
National Guidelines ◽  
The Past ◽  
Home Based ◽  
Self Testing ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Sex With Men

HIV incidence among young adult men-who-have-sex-with-men (YMSM) is among the highest in the United States (US), yet YMSM have lower rates of HIV testing than most other MSM. Among 1,835 U.S. Black, Hispanic, and White YMSM who reported condomless anal intercourse (CAI) in the prior year, 30% (95% confidence interval [CI]: [28%, 32%]) had not been tested for HIV in the past year as recommended by national guidelines, and 19% (95% CI: [17%, 21%]) had never been tested. Factors associated with not being tested in the past year included not having a primary care provider (PCP)) (odds ratio [OR]: 2.00, 95% CI: [1.53, 2.60]), discomfort with asking a PCP for an HIV test (OR: 2.66, 95% CI: [2.05, 3.44]), living in a smaller community (OR: 1.71, 95% CI: [1.35, 2.18]), younger age (OR: 2.00, 95% CI: [1.53, 2.60]), and greater self-perception of having an undiagnosed HIV infection (OR: 1.46, 95% CI: [1.07, 1.99]). YMSM who had not been tested in the prior year were less likely to know where to get tested, yet were interested in trying home-based HIV self-testing. This study shows that knowledge, clinician-relationship, geographic, and perceptional barriers must be overcome to improve HIV testing among YMSM. Home-based HIV self-testing may address some of these barriers, particularly for YMSM living in smaller communities.

scholarly journals Back to Basics: Correlates of HIV Risk in a Community Sample of Haiti

2020 ◽  
Author(s):  
Manisha Joshi ◽  
Guitele J. Rahill ◽  
Christopher Rice ◽  
Paul Phycien ◽  
Cameron Burris ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Community Sample ◽  
Hiv Prevalence ◽  
Hiv Status ◽  
Hiv Knowledge ◽  
The Past ◽  
Hiv Test ◽  
Hiv Awareness

AbstractHaiti has a 2.2 % HIV prevalence (highest in the Caribbean); this has diminished from over 12% in the past three decades (depending on sex and gender, province, and neighborhood). Preliminary studies indicate that in the Cite Soleil neighborhood of Haiti (HIV prevalence >3%) as in socioeconomically equivalent adjacent neighborhoods, over 50% of girls and women experience non-partner sexual violence (NPSV), typically perpetrated by groups of men. Rates of NPSV against men in those neighborhoods were not available. Coercive sex heightens HIV risk. Accurate HIV knowledge empowers individuals (including survivors of NPSV) to assess personal HIV risk and increases likelihood of getting tested and of determining personal HIV status; thus, accurate HIV knowledge is foundational to behavioral risk reduction for victims in future consensual relationships and to engagement in either the HIV prevention or care continuum.Between March and July 2017, we surveyed individuals 18 years or older (210 women, 257 men), assessing experience of NPSV, HIV knowledge, history of HIV testing, knowledge of HIV status, assessment of self-risk, and sexual risk behaviors. Nearly 30% of men and 24% of women endorsed having experienced NPSV. Knowledge of HIV transmission was low: 90% endorsed HIV myths, e.g. transmission occurs via public toilets, via sharing a glass with or by being exposed to a cough or sneeze from a person living with HIV. High endorsement of these myths contrasted with low endorsement of protective behavior: Only 14.3 % used a condom during consensual sex in the past year. Only 47.9% of the respondents had ever attended an HIV awareness program; 16% of knew their HIV status, although 79% assessed their HIV risk as moderate to high. Results regressing knowledge of HIV testing on participant characteristics indicated that women (OR=2.8), individuals with a partner (OR=2.2), individuals who attended an HIV awareness class (OR=2.1), individuals who knew someone with HIV (OR=3.9), and individuals who had an HIV test (OR=33.5) were more likely to know what an HIV test is. Participants who endorsed experiencing NPSV (OR=0.33) and those who had been diagnosed with an STI (OR=0.44) were less likely to know about HIV testing.Experience of NPSV combined with low HIV knowledge, awareness and testing heighten the HIV prevention needs of Cite Soleil residents and underscore the need to return to basics on the road to HIV eradication in that context.

Men Who Have Sex With Men and HIV Risk Behavior: Exploring the Influence of Masculinity Within the Social Ecological Model

2021 ◽  
Vol 33 (6) ◽  
pp. 511-533
Author(s):  
Kenneth C. Hergenrather ◽  
Diona Emmanuel ◽  
Robert J. Zeglin ◽  
David J. Ruda ◽  
Scott D. Rhodes
Keyword(s):  
Risk Behavior ◽  
Hiv Risk ◽  
Ecological Model ◽  
The United States ◽  
Social Ecological Model ◽  
Hiv Risk Behavior ◽  
Bisexual Men ◽  
Social Ecological ◽  
The Social ◽  
Sex With Men

In the United States, gay, bisexual men, and men who have sex with men (MSM) represent 86% of new HIV infections among males. Approximately 1 in 7 men with HIV are unaware of their HIV status (CDC, 2017, 2019a, 2020a). To explore influences on MSM HIV risk behavior, the authors performed a systematic review of quantitative studies conducted in the U.S. assessing what is purported as masculinity. From 30 identified studies, significant findings were framed within the Social Ecological Model (SEM) levels (e.g., Individual, Relationship, Community). SEM level themes were applied to create the Masculinity 10, a preliminary 10-item assessment to explore the influence of masculinity on MSM HIV risk behavior. To increase MSM engagement in HIV prevention and treatment, the influences of masculinity (e.g., attitude toward sexual minorities, appearance, emotion, temperament, substance use, sexual activity, social support, intimate relationships, health care) on HIV risk behavior should be further explored.

scholarly journals What happens after HIV self-testing? Results from a longitudinal cohort of Chinese men who have sex with men

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weiming Tang ◽  
Wenting Huang ◽  
Haidong Lu ◽  
Bolin Cao ◽  
Dan Wu ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Condom Use ◽  
Hiv Testing ◽  
Consistent Condom ◽  
Consistent Condom Use ◽  
Longitudinal Cohort ◽  
Prevention Services ◽  
Self Testing ◽  
Hiv Test ◽  
Sex With Men

Abstract Background HIV self-testing (HIVST) is a promising approach to expand HIV testing. HIVST is a process in which a person performs an HIV test and interprets the result. Negative HIVST results may encourage men who have sex with men (MSM) to use HIV prevention services. The objective of this study was to examine behaviors (e.g., facility-based HIV testing, condom use) after a negative HIVST test result among Chinese MSM. Methods We collected data from MSM in eight Chinese cities over a 12-month period. This is a secondary analysis of longitudinal cohort data collected as part of an intervention trial to increase HIV testing. Men completed a survey that described sociodemographic information, sexual behaviors, HIV self-testing, and facility-based HIV testing. Men who completed at least one follow-up survey were included in this analysis. Generalized linear mixed models were used to evaluate whether HIVST increased subsequent facility-based HIV testing and consistent condom use. Results We included 1219 men. Most men (78.7%) were under 30 years old and had never been married (87.0%). 755 (61.9%) men tested for HIV and 593 (49.3%) men self-tested during the study period. At baseline, among men who had never been tested for HIV, 44.9% (314/699) initiated HIVST during the study period. HIVST was associated with subsequent facility-based testing (aOR of 1.87, 95% CI: 1.47–2.37). HIVST was also associated with subsequent consistent condom use (aOR = 1.53, 95% CI: 1.13–2.06). Conclusion HIVST was associated with subsequent facility-based HIV testing and consistent condom use. HIVST may enhance uptake of related HIV prevention services at facilities, suggesting the need for more implementation research.

scholarly journals 1630. Voluntary HIV Testing and Self-Realization of Risk of HIV Infection Among Young Men-Who-Have-Sex-with-Men in the Miami-Dade Area

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S595-S595
Author(s):  
Hampton Ocon ◽  
Samir Sabbag
Keyword(s):  
Public Health ◽  
High Risk ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Perceived Risk ◽  
Health Initiatives ◽  
History Of ◽  
Sex With Men ◽  
Public Health Initiatives

Abstract Background According to the Centers for Disease Control and Prevention, Miami-Dade County has the highest rate of new HIV diagnoses in the Nation. So far, a large focus of public health initiatives has been spreading awareness of HIV testing locations, but this form of voluntary testing relies on individuals realizing that they are at risk of HIV infection in the first place. Consequently, a major obstacle to encouraging young men-who-have-sex-with-men (YMSM) to test themselves for HIV is their own self-perceived risk of having an undetected infection. Methods In an effort to better understand the discordance between high-risk sexual behavior and HIV testing among this high-risk population, YMSM (18–24) were surveyed through smartphone applications that facilitate sexual encounters in the Miami-Dade area (eg Grindr, Scruff). Users were asked about their history of condomless anal intercourse (CAI), their HIV testing habits, and whether or not they believe it possible that they are currently infected with HIV. An analysis of the relationship between CAI and self-perception of possible HIV infection was performed using Cochran-Mantel–Haenszel testing. Results Of the 843 eligible responses, 667 reported a history of voluntary HIV testing while 176 had never voluntarily tested. 726 respondents reported a history of CAI and 131 of these have never voluntarily tested. Of the 843 total participants, 1.6% were in the highest HIV risk group, which is those who have engaged in CAI with an exchange/casual partner, have never voluntarily tested for HIV, and have no self-perceived risk of being currently infected. According to data analysis, YMSM who have engaged in CAI but have never been tested for HIV were not more likely to have a self-perceived possibility of infection when compared with those who have voluntarily tested (P < 0.595). Conclusion This suggests that many high-risk YMSM are not voluntarily testing themselves for HIV not because they do not have access to testing, but rather because they do not perceive themselves as being possibly infected in the first place. Therefore, in addition to increasing access to HIV testing, new public health initiatives must be designed to facilitate YMSM understanding their own personal HIV risk. Disclosures All authors: No reported disclosures.

scholarly journals 1961. Grindr™ on Screen Activity on iPhones Correlates with HIV Risk and Substance Use in Men Who Have Sex with Men, San Diego

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S63-S64 ◽  
Author(s):  
Martin Hoenigl ◽  
Susan J Little ◽  
Jamila K Stockman ◽  
Britt Skaathun ◽  
David Grelotti ◽  
...  
Keyword(s):  
Substance Use ◽  
Risk Behavior ◽  
Hiv Risk ◽  
San Diego ◽  
Screening Program ◽  
Objective Measure ◽  
The United States ◽  
Hiv Risk Behavior ◽  
Substance Users ◽  
Sex With Men

Abstract Background Technology has changed the way men-who-have-sex-with-men (MSM) seek sex; ≥60% of MSM in the United States use the internet to find sex partners, primarily via Grindr™ which is the most used dating app among MSM. Studies to date have mostly evaluated Grindr™ use as a dichotomous variable and found inconsistent results regarding associations with increased HIV risk behavior. Importantly, Grindr™ “on-screen” activity is monitored by phones and can provide an objective measure of app usage. Here we aimed to assess Grindr™ “on-screen” activity in MSM undergoing community-based HIV and sexually transmitted infection (STI) screening in San Diego, and to correlate activity with sexual risk behavior and substance use. Methods This nested cohort study was conducted between December 2018 and April 2019 and leveraged our “Good to Go” (AI106039) screening program for participant recruitment. During their testing encounter participants not on HIV PrEP were provided with surveys on demographics, substance use and risk behavior during previous 3 months, and Grindr™ usage. Participants with iPhones were instructed on how to assess Grindr™ on-screen activity (i.e., time on-screen during last 7 days) on their phones (Figure 1). Risk behavior was classified using the validated San Diego Early Test (SDET) Score (Figure 2). Results Overall 378/784 (48%) MSM participants indicated that they had opened Grindr™ during the previous 7 days. Grindr™ users had higher SDET scores than those not using Grindr™ (median SDET 2, IQR 0–5; mean 2.29) while there was no difference in proportion of substance users (alcohol and marijuana excluded, 21% vs. 17%; P = 0.14). Of 231 MSM who indicated recent Grindr™ use (61%) had iPhones; median on-screen activity during the previous 7 days was 144 minutes (range 1–2,640 minutes). Participants with high Grindr™ utilization (>80th percentile of time on screen corresponding to >480 minutes), had significantly higher SDET scores (median 5 vs. 2; mean 4.02 vs. 3.26; P < 0.001) and a tendency toward a higher proportion of substance users (29% vs. 20%) than those with lower Grindr™ utilization. Conclusion This study introduces Grindr™ on-screen activity as an objective measure that can help identify MSM at high risk for HIV. 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

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