AIDS Educ Prev
· 2023 Feb · PMID 36735228
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Research into mediated contact hypothesis shows that exposure to people sharing their stories of living with a stigmatized condition can decrease negative stereotypes and improve willingness to engage in future interpers...Research into mediated contact hypothesis shows that exposure to people sharing their stories of living with a stigmatized condition can decrease negative stereotypes and improve willingness to engage in future interpersonal contact, but results are inconsistent. In this study, we offer novel reasons for why mediated intergroup contact can facilitate positive inter-group outcomes, by focusing on audience members' perceptions of the storyteller's character (i.e., perceptions of attributes or features that make up an individual). Our model was tested (N = 369, U.S. adults) with video-recorded stories from the Centers for Disease Control and Prevention's Let's Stop HIV Together campaign. The results showed that, as predicted, viewers' perceptions of the storyteller's character as more fluid and more multidimensional predicted stronger transportation into the story, which predicted greater perceptions of group variability and more intergroup ease. Implications for character perceptions as mechanisms of contact effects, communication's role in shaping character perceptions, and reducing HIV stigma are discussed.
Crepaz N, Salabarría-Peña Y, Mullins MM
… +2 more, Gunn JKL, Higa DH
AIDS Educ Prev
· 2023 Feb · PMID 36735227
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This systematic review synthesized published literature (January 2008-October 2021) about the association between social determinants of health (SDOH) and HIV testing among Hispanic/Latino gay, bisexual, and other men wh...This systematic review synthesized published literature (January 2008-October 2021) about the association between social determinants of health (SDOH) and HIV testing among Hispanic/Latino gay, bisexual, and other men who have sex with men (HLMSM), a group disproportionally affected by HIV. Having higher education than a high school diploma, health insurance and access to health care services, and visiting a health care provider in the past 12 months were some of the determinants associated with HIV testing, while limited English proficiency was associated with reduced odds of HIV-testing among HLMSM. More research is needed to understand the relationship of SDOH (especially neighborhood) and HIV testing, how SDOH may affect HIV testing among different HLMSM groups, and how to increase self-testing and use of e-health in this priority population. Additionally, culturally and linguistically appropriate multilevel interventions and health services for HLMSM are urgently needed to diagnose HIV as early as possible after infection.
Hanass-Hancock J, Bhengu N, Exner T
… +6 more, Magusthwa S, Harrison A, Dolezal C, Miller L, Bauman L, Hoffman S
AIDS Educ Prev
· 2023 Feb · PMID 36735226
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This article describes the processes of transforming an in-person group-based intervention to promote uptake of PrEP among young woman in South Africa to an online interactive "workshop" during the COVID-19 pandemic. Beg...This article describes the processes of transforming an in-person group-based intervention to promote uptake of PrEP among young woman in South Africa to an online interactive "workshop" during the COVID-19 pandemic. Beginning in person and continuing virtually, we used a step-by-step participatory approach with multiple stakeholder groups to develop nine activities to increase knowledge about, as well as motivation and intention to take PrEP, and to address gender-based barriers to PrEP. Activities were informed by our theoretical framework and formative work with young women ages 18-25. We demonstrate how we developed a gender-enhanced online PrEP workshop that was interactive, group-based, and in accordance with elements of established successful intervention design; why WhatsApp emerged as the most accessible application for the young women in our workshop; and how an intervention with a hybrid approach-alternating between chat box and live sessions-combined with verbal, written, and emoji-based communication enabled interaction among participants.
Mizuno Y, Koenig LJ, Wilkes AL
… +11 more, Gelaude D, Carter J, Scales White L, Spikes P, Randall L, Tesfaye CL, Glusberg D, Gale B, King A, Frew PM, Schoua-Glusberg A
AIDS Educ Prev
· 2022 Dec · PMID 36454137
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To better understand utilization of HIV prevention, care, and treatment services by young men who have sex with men (YMSM) and young transgender persons (YTG), of Black race or Hispanic/Latino/Latina ethnicity in the U.S...To better understand utilization of HIV prevention, care, and treatment services by young men who have sex with men (YMSM) and young transgender persons (YTG), of Black race or Hispanic/Latino/Latina ethnicity in the U.S. South, we conducted semi-structured interviews with 127 clients at one of four community based organizations (CBOs) in Miami, Atlanta, New Orleans/Baton Rouge, or Columbia, South Carolina. Across sites, the service that most commonly drew respondents into the CBO was HIV and STD testing. Other services commonly used included HIV/STI treatment, counseling services/support groups, and PrEP services. Social/organizational/structural facilitators of service utilization include the welcoming climate/culture of the CBOs, ease of access to the services, and transportation services to reach the CBOs. Suggested service enhancements include broader range of comprehensive, navigational-type services beyond HIV testing and service co-location. Research on how to reduce stigma in the surrounding communities may help reduce health disparities experienced by these populations.
AIDS Educ Prev
· 2022 Dec · PMID 36454136
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Pre-exposure prophylaxis (PrEP) stigma has been found to be a major barrier to PrEP acceptability and uptake. Research has found that different ethnic/cultural groups display varying levels of PrEP stigma. This article s...Pre-exposure prophylaxis (PrEP) stigma has been found to be a major barrier to PrEP acceptability and uptake. Research has found that different ethnic/cultural groups display varying levels of PrEP stigma. This article studies sex conservatism and internalized homonegativity as two sexuality- and culture-related aspects that influence PrEP stigma and intention to use PrEP. An online survey of 279 young gay and bisexual men in Hong Kong found that internalized homonegativity was positively associated with PrEP stigma. Respondents who were more conservative about sex showed lower intention to use PrEP, whereas those who had higher income and more positive attitudes about PrEP were more likely to express intention to use PrEP. This study provides novel empirical evidence for understanding PrEP stigma and uptake from a sexuality and cultural perspective. The influence of sexuality- and culture-related factors on PrEP stigma and uptake warrants greater attention, especially in the Asia-Pacific region.
Kolstee J, MacGibbon J, Prestage G
… +9 more, Clackett S, Paynter H, Bavinton BR, Broady TR, Ellard J, Murphy DA, de Wit J, Power C, Holt M
AIDS Educ Prev
· 2022 Dec · PMID 36454135
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Condoms have been the primary form of HIV prevention for gay and bisexual men (GBM) for most of the HIV epidemic. The introduction of biomedical HIV prevention may have changed attitudes towards condoms. Data from repeat...Condoms have been the primary form of HIV prevention for gay and bisexual men (GBM) for most of the HIV epidemic. The introduction of biomedical HIV prevention may have changed attitudes towards condoms. Data from repeated national online surveys of GBM in Australia were used to examine how attitudes towards condoms and confidence discussing condoms with partners changed in the period 2011-2019. The proportion of all participants who reported a positive experience in using condoms remained low and unchanged (9.6% in 2011 to 6.0% in 2019). Confidence in discussing condoms with partners decreased over time (from 72.2% in 2011 to 56.6% in 2019). Confidence in discussing condoms was associated with concern about sexually transmitted infections, and more consistent condom use. Sustaining confidence in using condoms may be more challenging as biomedical prevention methods become more commonly used.
AIDS Educ Prev
· 2022 Dec · PMID 36454134
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While sub-Saharan African migrants are recognized as a key population in the HIV epidemics, they are absent from the PrEP delivery system and in particular women. The central argument of this article is that PrEP for Bla...While sub-Saharan African migrants are recognized as a key population in the HIV epidemics, they are absent from the PrEP delivery system and in particular women. The central argument of this article is that PrEP for Black African migrant women is an ambivalent offer that makes it necessary to understand how migration, gender, sexuality, and origin interact. Bringing together a sociologist and a prevention project manager, this article looks at how Belgian prevention professionals navigate with this ambivalent offer. From semi-directive interviews we explore how PrEP is constructed as a prevention tool for this population. The results show that different causalities are attributed to their absence from PrEP delivery system. This pluralism leads us to argue that there is a real blurring in the definition of this public as a "priority" in terms not only of representations and practices but also of political agenda.
Bundy C, Xavier Hall CD, Foran JE
… +3 more, Jozsa K, Newcomb ME, Mustanski B
AIDS Educ Prev
· 2022 Dec · PMID 36454133
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Research has begun to examine sexual behavior during the COVID-19 pandemic using quantitative methods, but less is known about the context surrounding these changes using qualitative methods, including corresponding chan...Research has begun to examine sexual behavior during the COVID-19 pandemic using quantitative methods, but less is known about the context surrounding these changes using qualitative methods, including corresponding changes in risk reduction methods. This qualitative study, guided by the Integrated Behavioral Model, examines the pandemic's impact on PrEP adherence among young men who have sex with men in Chicago. PrEP-using participants from a cohort study were recruited into a 90-day diary study measuring sexual behaviors and PrEP use. Between April and September 2020, a subset of participants was recruited for qualitative interviews ( = 28) exploring prevention strategies, including the impact of the pandemic. Although most were highly adherent pre-pandemic, many took fewer pills or discontinued during the pandemic due to decreased sex. Findings suggest the importance of counseling for PrEP reinitiation as "seasons of HIV risk" increase, as well as use of telehealth as a facilitator of PrEP use throughout the pandemic.
Rhodes SD, Tanner AE, Mann-Jackson L
… +10 more, Alonzo J, Refugio Aviles L, Galindo CA, Bessler PA, Courtenay-Quirk C, Smart BD, Garcia M, Goldenberg T, Sucaldito AD, Reboussin BA
AIDS Educ Prev
· 2022 Dec · PMID 36454131
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The COVID-19 pandemic has profoundly affected the conduct of community-based and community-engaged research. Prior to the pandemic, our community-based participatory research partnership was testing ChiCAS, an in-person,...The COVID-19 pandemic has profoundly affected the conduct of community-based and community-engaged research. Prior to the pandemic, our community-based participatory research partnership was testing ChiCAS, an in-person, group-level behavioral intervention designed to promote uptake of pre-exposure prophylaxis (PrEP), condom use, and medically supervised gender-affirming hormone therapy among Spanish-speaking transgender Latinas. However, the pandemic required adaptations to ensure the safe conduct of the ChiCAS intervention trial. In this article, we describe adaptations to the trial within five domains. Transgender women are disproportionately affected by HIV, and it is essential to find ways to continue research designed to support their health within the context of the COVID-19 pandemic and future infectious disease outbreaks, epidemics, and pandemics. These adaptations offer guidance for ongoing and future community-based and community-engaged research during the COVID-19 pandemic and/or potential subsequent outbreaks (e.g., monkeypox), epidemics, and pandemics, particularly within under-served marginalized and minoritized communities.
Lee YG, Zhakupova G, Vinogradov V
… +9 more, Paine EA, Laughney CI, Reeder K, Davis A, Hunt T, Mergenova G, Primbetova S, Terlikbayeva A, Wu E
AIDS Educ Prev
· 2022 Oct · PMID 36181500
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This study examined substance use and sexual risk correlates of HIV testing among cisgender gay, bisexual, and other men (MSM) and transgender and nonbinary individuals (TSM) who have sex with men in Kazakhstan. We analy...This study examined substance use and sexual risk correlates of HIV testing among cisgender gay, bisexual, and other men (MSM) and transgender and nonbinary individuals (TSM) who have sex with men in Kazakhstan. We analyzed baseline data from an HIV prevention trial collected prior to intervention deployment ( = 304). Multivariable logistic regression analyses revealed that lifetime HIV testing was positively associated with poly-drug use (AOR = 4.4, 95% CI [2.0, 9.9]) and negatively with sexual risk (AOR = 0.4, 95% CI [0.2, 1.0]). Similarly, recent HIV testing was positively associated with polydrug use (AOR = 2.7, 95% CI [1.4, 5.2]) and negatively with sexual risk (AOR = 0.5, 95% CI [0.3, 0.9]). Current HIV testing was negatively associated with sexual risk (AOR = 0.6, 95% CI [0.3. 0.9]). Findings support the value of integrating drug treatment with HIV testing among MSM and TSM in Kazakhstan.
Henry BF, Hartmann J, Goddard-Eckrich D
… +6 more, Chang M, Wu E, Hunt T, Gilbert L, Wimberly AS, El-Bassel N
AIDS Educ Prev
· 2022 Oct · PMID 36181499
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Stressful life events are prevalent among justice-involved populations and are associated with sexual risk behaviors and partner communication regarding safe-sex practices. We describe patterns of stress exposure for het...Stressful life events are prevalent among justice-involved populations and are associated with sexual risk behaviors and partner communication regarding safe-sex practices. We describe patterns of stress exposure for heterosexual couples (where males are under community supervision) and how stress patterns are associated with sexual risk behaviors and communication (460 individuals; 230 couples). Latent class analysis identified patterns of stress. Multinominal logistic regression models identified associations between sex, race, ethnicity, and stress classes. Multilevel Poisson regression models described relationships between sexual risk behaviors and frequency of communication about condoms/HIV, and stress classes. We found four classes that differed by sex, race, and ethnicity and were associated with the number of sexual partners, condom use self-efficacy, discussing condoms with partner, and discussing HIV prevention with partner. Partner class was associated with the number of sexual partners. Findings inform future assessment/interventions for sexual health that consider patterns of stress and demographics.
Nemoto T, Xie H, Iwamoto M
… +3 more, Piroth K, Hazratzai M, Teh YK
AIDS Educ Prev
· 2022 Oct · PMID 36181498
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HIV risk behaviors and psychological well-being among men who have sex with men (MSM) in Kuala Lumpur, Malaysia ( = 140), were quantitatively described in relation to demographic and psychosocial factors. Most participan...HIV risk behaviors and psychological well-being among men who have sex with men (MSM) in Kuala Lumpur, Malaysia ( = 140), were quantitatively described in relation to demographic and psychosocial factors. Most participants were tested for HIV and 41.4% reported living with HIV. Malay participants had significantly higher levels of depression ( < .05), homophobia ( < .01), and needs for social support ( < .01) than Chinese. More Chinese participants reported suicidal thoughts than Malaysians < .05). A multivariate analysis revealed that participants with gay/MSM-identified or had lower levels of self-esteem showed significantly higher levels of depression. Future intervention projects should address depression and mental health issues among MSM and strengthen self-esteem and social support through culturally competent support and individual counseling programs (e.g., addressing MSM's conflicts with religious beliefs and norms). Structural changes must be made incrementally to reduce homophobia against MSM in Malaysia while advocating human rights.
López Rios J, Lentz C, Balán IC
… +4 more, Grosskopf N, D'Angelo A, Stief M, Grov C
AIDS Educ Prev
· 2022 Oct · PMID 36181497
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One-quarter of gay, bisexual, and other men who have sex with men (GBMSM) with diagnosed HIV are not engaged in HIV care. Between 2018 and 2019, 50 GBMSM completed qualitative interviews 3 months after receiving an HIV-p...One-quarter of gay, bisexual, and other men who have sex with men (GBMSM) with diagnosed HIV are not engaged in HIV care. Between 2018 and 2019, 50 GBMSM completed qualitative interviews 3 months after receiving an HIV-positive result. Interviews explored barriers to and facilitators of engagement and retention in HIV testing and care. Thematic analysis revealed five major themes: (1) reason for HIV testing (e.g., self-testing), (2) linkage to care (e.g., appointment/logistic issues and social support as encouragement), (3) barriers to engagement in care (e.g., financial burden, competing priorities, and fear/stigma), (4) facilitators of engagement (e.g., financial assistance, patient-provider relationships, auxiliary support services, and health agency), and (5) PrEP as a missed prevention opportunity. Addressing individual-, social-, and policy-level barriers could improve GBMSM's engagement in HIV care. Further, capitalizing on GBMSM's health agency through partnerships with local agencies and fostering better patient-provider relationships could optimize HIV care continuity.
Suarez NA, Cooper AC, Kaczkowski W
… +3 more, Li J, Robin L, Sims VM
AIDS Educ Prev
· 2022 Oct · PMID 36181496
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Lesbian, gay, and bisexual (LGB) adolescents are often at higher risk than their heterosexual peers for adverse sexual health, violence, mental health, and substance use outcomes. Schools are a vital resource for enhanci...Lesbian, gay, and bisexual (LGB) adolescents are often at higher risk than their heterosexual peers for adverse sexual health, violence, mental health, and substance use outcomes. Schools are a vital resource for enhancing protective behaviors and reducing risk behaviors. Sixteen school districts selected schools to implement a sexual health program (exposed) or usual programming (unexposed). We analyzed LGB student health outcomes using 2015 and 2017 Youth Risk Behavior Surveys. Analyses compared LGB student health outcomes by exposure status across time points using a multilevel approach. Program exposure was associated with decreased odds of ever having sex, ever testing for HIV, and using effective hormonal birth control, and an increased odds of condom use. There were no significant findings among secondary violence, mental health, and substance use outcomes. This evaluation highlights the potential for schools to reduce sexual risk behaviors among LGB youth, and opportunities to improve access to health services.
Tran NK, Martinez O, Scheim AI
… +2 more, Goldstein ND, Welles SL
AIDS Educ Prev
· 2022 Oct · PMID 36181495
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Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) was recently approved for HIV prevention as an alternative to daily oral PrEP. We explored preferences and attitudes toward LAI-PrEP among Black, Hispanic/Latino...Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) was recently approved for HIV prevention as an alternative to daily oral PrEP. We explored preferences and attitudes toward LAI-PrEP among Black, Hispanic/Latino, and White gay, bisexual, and other men who have sex with men (GBM) using focus groups ( = 13) and in-depth interviews ( = 17). Participants expressed differing levels of interest in LAI-PrEP. While important benefits of LAI-PrEP included convenience, provider-facilitated PrEP discussion, and expansion of PrEP options, participants raised concerns about treatment efficacy and side effects, discomfort with needles/injections, cost, and frequency of clinic visits. Our findings highlight ongoing challenges with accessing HIV-prevention tools and provide guidance for developing strategies to enhance LAI-PrEP uptake among GBM.
Sun CJ, Seloilwe ES, Magowe M
… +2 more, Dithole K, Lawrence JSS
AIDS Educ Prev
· 2022 Aug · PMID 35994581
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The COVID-19 pandemic and resulting public health response has disrupted the lives of adolescents and their families worldwide. We evaluated the impact of the pandemic on attitudes, beliefs, and sexual risk behavior amon...The COVID-19 pandemic and resulting public health response has disrupted the lives of adolescents and their families worldwide. We evaluated the impact of the pandemic on attitudes, beliefs, and sexual risk behavior among adolescents in Botswana. Participants were recruited using household-based sampling across residential districts (blocks) in and around Gaborone, Botswana, and completed surveys on laptop computers at a private, central location. We compared baseline survey data from 380 adolescents who completed the survey pre-pandemic ( = 139) to those who completed the survey intra-pandemic ( = 241). Participants had a mean age of 15.2 years; 58.6% were girls and 41.4% were boys. Intra-pandemic, participants reported greater engagement in transactional sex (38.1% compared to 13.6% pre-pandemic, <. 05), more favorable attitudes toward transactional sex with sugar daddies and sugar mommies ( <. 05), greater intentions to remain sexually active in the future (29.2% vs.13.6%, respectively, <.05), and lower self-efficacy in handling risky sexual situations ( < .01). Public health interventions that lessen these concerning shifts in attitudes and behaviors will be key to protecting the sexual health of adolescents and to supporting their safe transition to adulthood.
AIDS Educ Prev
· 2022 Aug · PMID 35994580
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In India, male sex workers (MSW) are among the most vulnerable populations at higher risk for HIV and other sexually transmitted infections (STIs) and may seek health care services less frequently. A community-based samp...In India, male sex workers (MSW) are among the most vulnerable populations at higher risk for HIV and other sexually transmitted infections (STIs) and may seek health care services less frequently. A community-based sample of 100 MSW in Chennai, India, completed a baseline assessment as part of a behavioral intervention to reduce the acquisition and transmission of HIV. MSW reported an average of 12.2 ( = 17.7) condomless anal sex acts with male clients in the past month, yet only 48% accessed health care services in the past 3 months. In a multivariable model adjusted for relevant covariates, MSW who accessed health care services in the past 3 months were more likely to be tested for HIV/STIs and report routine HIV testing over the past 12 months. Future HIV prevention efforts among MSW in India should incorporate referrals for accessing general health care services and identify specific barriers to health care engagement among this group.
Barré T, Sogni P, Zaegel-Faucher O
… +9 more, Wittkop L, Marcellin F, Carrieri P, Gervais A, Levier A, Rosenthal E, Salmon-Céron D, Protopopescu C, ANRS CO13 HEPAVIH Study Group
AIDS Educ Prev
· 2022 Aug · PMID 35994579
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Overweight is increasingly prevalent in people living with HIV (PLWH), and is a high risk factor for metabolic disorders in this population. PLWH co-infected with hepatitis C virus (HCV) have a higher risk of metabolic d...Overweight is increasingly prevalent in people living with HIV (PLWH), and is a high risk factor for metabolic disorders in this population. PLWH co-infected with hepatitis C virus (HCV) have a higher risk of metabolic disorders than their mono-infected counterparts. The putative relationship between cannabis use and body weight found in the general population has never been documented in HIV-HCV co-infected people. We tested whether cannabis use is associated with body mass index (BMI), overweight, and underweight in HCV co-infected PLWH ( = 992). Mixed-effects linear and logistic regression models were used to study the association between cannabis use and the three outcomes over time. After multivariable adjustment, cannabis use was inversely associated with BMI. Cannabis use was associated with a lower and higher risk of overweight and underweight, respectively. Cannabis use should be assessed and taken into account in the clinical management of the HIV-HCV co-infected population.
Bauermeister JA, Tingler RC, Ho K
… +10 more, Scheckter R, McClure T, Davis J, Piper J, Friedland BA, Edick S, Song M, Jiao Y, Hendrix CW, Hoesley C
AIDS Educ Prev
· 2022 Aug · PMID 35994578
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Multipurpose prevention technologies (MPT) have been increasingly researched for their dual-purpose preventative properties against HIV and other STIs. The acceptability of PC-1005, a topical MPT candidate, was explored...Multipurpose prevention technologies (MPT) have been increasingly researched for their dual-purpose preventative properties against HIV and other STIs. The acceptability of PC-1005, a topical MPT candidate, was explored among men and women participating in the MTN-037 Phase I trial at two U.S. sites (Pittsburgh, PA, and Birmingham, AL). We triangulated quantitative and qualitative assessments of the acceptability of three volumes (4 mL, 16 mL, 32 mL) of PC-1005 administered rectally (N = 12; 6 males, 6 females). Participants rated overall gel acceptability on a scale of 1-10, with a median of 7.17 ( = 2.04) and had positive feelings about all three dose volumes, citing them to be very comfortable or comfortable (dose 1 = 91.7%; dose 2 = 91.7%; dose 3 = 83.3%). High acceptability of and comfort with all three dose volumes shows promise for PC-1005 as an MPT to prevent HIV and STIs, warranting future clinical development.
Li J, Timpe Z, Suarez N
… +3 more, Ashley CL, Rasberry CN, Robin L
AIDS Educ Prev
· 2022 Aug · PMID 35994577
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This study adopts a socio-ecological framework and examines school- and district-level influences on sexual behaviors among high school students from 16 school districts that were federally funded to conduct a school-bas...This study adopts a socio-ecological framework and examines school- and district-level influences on sexual behaviors among high school students from 16 school districts that were federally funded to conduct a school-based, multilevel sexual health program. We drew cross-sectional data from the 2015 and 2017 Youth Risk Behavior Survey from funded school districts containing 648 schools and 101,728 students. We used multilevel modeling to determine the percentage of variance in sexual health outcomes explained at school and district levels, overall and by race/ethnicity and biological sex. We found protective behaviors such as using hormonal birth control had considerable district-level variance (10.1%) while sexual risk behaviors such as having multiple sex partners showed considerable school-level variance (12.7%). We also found significant subgroup heterogeneity in the variance. Findings indicate school-based interventions should address all levels of influences of the educational system to effectively improve a myriad of student sexual health outcomes.