Mapping virtual platforms to estimate the population size of men who have sex with men (MSM) who use internet to find sexual partners: implications to enhance HIV prevention among MSM in Kenya

Introduction: Men who have sex with men (MSM) in Kenya face a disproportionate HIV disease burden. Over the last few years, the use of virtual platforms and internet sites to seek male sexual partners has increased manyfold in Kenya. New approaches are required to map, estimate and profile MSM who operate through virtual platforms to design interventions for them. Methods: This study was conducted in three counties in Kenya: Kiambu, Kisumu and Mombasa with MSM who use virtual platforms such as geosocial networking (GSN) and social networking applications to find and connect with male sex partners. The platforms were profiled through a multi-stage approach and the number of MSM associated with these platforms were estimated. In the final stage, 435 respondents randomly selected from the virtual platforms were interviewed in a secure location after informed consent. Data analysis focused on calculating an estimate of MSM for each virtual platform in each site, adjusting for duplicate profiles and multiple registrations. Results: We identified 24 GSN apps, 18 Facebook accounts/pages and 18 WhatsApp groups across the three counties, with Facebook being the preferred platform. Kiambu had the highest number of estimated MSM at 3,635 (95%CI = 3,335 to 3,990) followed by Kisumu at 1,567 (95%CI = 1,480 to 1,665) and Mombasa at 1,469 (95%CI = 1,335 to 1,604) who used virtual platforms to find other male sexual partners. On average, each MSM had 3.7 profiles on multiple platforms, with an average of 2.1 profiles used in the past month. Conclusions: The use of conventional population size estimation approaches that focus on physical sites alone may underestimate the total number of MSM in a geography. Virtual mapping should be used in conjunction with conventional hot spot based size estimation methodologies to estimate numbers of MSM to set programmatic targets.

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Men who have sex with men in China have relatively low numbers of sexual partners

Infectious Disease Reports ◽

10.4081/idr.2011.e10 ◽

2011 ◽

Vol 3 (1) ◽

pp. 10 ◽

Cited By ~ 4

Author(s):

Lei Zhang ◽

Eric Pui Fung Chow ◽

David P. Wilson

Keyword(s):

Median Number ◽

Sexual Partners ◽

Hiv Prevalence ◽

Comprehensive Review ◽

The Past ◽

Male Sexual Partners ◽

Sex With Men ◽

Over Time

HIV prevalence is increasing rapidly among men who have sex with men (MSM) in China and potentially associated with the number of male sexual partners that each man has on average. This study estimates the distribution of the number of male sexual partners among Chinese MSM through a comprehensive review of English and Chinese published literature. The overall median number of male sexual partners of Chinese MSM in the past 6 months China was estimated to be 1.5 (95% CI, 1.1-1.9) and 3.8 (95% CI 1.5-6.9) sexual partners in the past 6-month and 12-month periods respectively. An estimated 31% of sexual partners of MSM in China are regular partners, 54% are casual partners, and 16% are commercial partners. The reported numbers of sexual partners has not changed over time during the past decade. The numbers of male sexual partners reported by Chinese MSM is consistently lower than other settings and may not be sufficient to explain the recent rapid increase in HIV prevalence.

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Prevalence of and factors associated with unprotected anal intercourse with regular and nonregular male sexual partners among newly diagnosed HIV-positive men who have sex with men in China

HIV Medicine ◽

10.1111/hiv.12500 ◽

2017 ◽

Vol 18 (9) ◽

pp. 635-646 ◽

Cited By ~ 11

Author(s):

Z Wang ◽

X Wu ◽

JTF Lau ◽

PKH Mo ◽

WWS Mak ◽

...

Keyword(s):

Anal Intercourse ◽

Unprotected Anal Intercourse ◽

Sexual Partners ◽

Hiv Positive ◽

Newly Diagnosed ◽

Factors Associated ◽

Male Sexual Partners ◽

Sex With Men ◽

Hiv Positive Men

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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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Seeking Male Sexual Partners via Internet and Traditional Venues among Chinese Men Who Have Sex with Men: Implications for HIV Risk Reduction Interventions

AIDS and Behavior ◽

10.1007/s10461-016-1371-4 ◽

2016 ◽

Vol 20 (10) ◽

pp. 2222-2230 ◽

Cited By ~ 15

Author(s):

Yu Liu ◽

Juan Wang ◽

Han-Zhu Qian ◽

Hongjie Liu ◽

Lu Yin ◽

...

Keyword(s):

Risk Reduction ◽

Hiv Risk ◽

Sexual Partners ◽

Chinese Men ◽

Hiv Risk Reduction ◽

Male Sexual Partners ◽

Sex With Men ◽

Hiv Risk Reduction Interventions

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Population Size Estimation Methods: Searching for the Holy Grail (Preprint)

10.2196/preprints.25076 ◽

2020 ◽

Author(s):

Joyce J Neal ◽

Dimitri Prybylski ◽

Travis Sanchez ◽

Wolfgang Hladik

Keyword(s):

Population Size ◽

Sex Workers ◽

Population Size Estimation ◽

Estimation Methods ◽

Size Estimation ◽

Empirical Methods ◽

Program Outcomes ◽

Gold Standard Method ◽

Response Planning ◽

Sex With Men

UNSTRUCTURED Accurate size estimates of key populations (eg, sex workers, people who inject drugs, transgender people, and men who have sex with men) can help to ensure adequate availability of services to prevent or treat HIV infection; inform HIV response planning, target setting, and resource allocation; and provide data for monitoring and evaluating program outcomes and impact. A gold standard method for population size estimation does not exist, but quality of estimates could be improved by using empirical methods, multiple data sources, and sound statistical concepts. To highlight such methods, a special collection of papers in JMIR Public Health and Surveillance has been released under the title “Key Population Size Estimations.” We provide a summary of these papers to highlight advances in the use of empirical methods and call attention to persistent gaps in information.

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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

JMIR Public Health and Surveillance ◽

10.2196/publichealth.9321 ◽

2018 ◽

Vol 4 (1) ◽

pp. e15 ◽

Cited By ~ 15

Author(s):

Stefan Baral ◽

Rachael M Turner ◽

Carrie E Lyons ◽

Sean Howell ◽

Brian Honermann ◽

...

Keyword(s):

Social Media ◽

Population Size ◽

Gay And Bisexual Men ◽

Population Size Estimation ◽

Bisexual Men ◽

Size Estimation ◽

And Bisexual ◽

Sex With Men

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Where are all the gay guys? Using Google Trends to Inform the Population Size Estimation and Spatial Distribution and of Gay, Bisexual, and Other Men Who Have Sex with Men: Proof of Concept (Preprint)

JMIR Public Health and Surveillance ◽

10.2196/27385 ◽

2021 ◽

Author(s):

Kiffer Card ◽

Nathan J. Lachowsky ◽

Robert S. Hogg

Keyword(s):

Spatial Distribution ◽

Population Size ◽

Population Size Estimation ◽

Google Trends ◽

Proof Of Concept ◽

Size Estimation ◽

Sex With Men

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Programmatic mapping and size estimation of female sex workers, transgender sex workers and men who have sex with men in İstanbul and Ankara, Turkey

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054894 ◽

2021 ◽

pp. sextrans-2020-054894

Author(s):

Deniz Gokengin ◽

Georgetta Aybek ◽

Sevgi O Aral ◽

James Blanchard ◽

Demir Serter ◽

...

Keyword(s):

Sex Workers ◽

Hot Spots ◽

Implementation Strategies ◽

Peak Time ◽

Sex Partners ◽

Size Estimation ◽

Programme Implementation ◽

Night Time ◽

Prevention Services ◽

Sex With Men

ObjectivesDespite a growing HIV threat, there is no definition and characterisation of key populations (KPs), who could be the major drivers of the epidemic in Turkey. We used programmatic mapping to identify locations where KPs congregate, estimate their numbers and understand their operational dynamics to develop appropriate HIV programme implementation strategies.MethodsFemale and transgender sex workers (FSWs and TGSWs), and men who have sex with men (MSM) were studied in İstanbul and Ankara. Within each district, hot spots were identified by interviewing key informants and a crude spot list in each district was developed. The spot validation process was led by KP members who facilitated spot access and interviews of KPs associated with that spot. Final estimates were derived by aggregating the estimated number of KPs at all spots, which was adjusted for the proportion of KPs who visit multiple spots, and for the proportion of KPs who do not visit spots.ResultsFSWs were the largest KP identified in İstanbul with an estimate of 30 447 (5.8/1000 women), followed by 15 780 TGSWs (2.9/1000 men) and 11 656 MSM (2.1/1000). The corresponding numbers in Ankara were 9945 FSWs (5.2/1000 women), 1770 TGSWs (1/1000 men) and 5018 MSM (2.5/1000 men). Each KP had unique typologies based on the way they find and interact with sex partners. MSM were mostly hidden and a higher proportion operated through internet and phone-based applications. Night time was the peak time with Friday, Saturday and Sunday being the peak days of activity in both İstanbul and Ankara.ConclusionsThis study has highlighted the presence of a substantial number of FSWs, TGSW and MSM in İstanbul and Ankara. The information obtained from this study can be used to set priorities for resource allocation and provide HIV prevention services where coverage could be the highest.

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