scholarly journals Creating a Theoretically Grounded Gaming App to Increase Adherence to Pre-Exposure Prophylaxis: Lessons From the Development of the Viral Combat Mobile Phone Game (Preprint)

2018 ◽  
Author(s):  
Laura Whiteley ◽  
Leandro Mena ◽  
Lacey K Craker ◽  
Meredith Garver Healy ◽  
Larry K Brown
Keyword(s):  
Hiv Risk ◽  
Future Orientation ◽  
The United States ◽  
Care Providers ◽  
Behavioral Skills ◽  
Game Development ◽  
Care Clinic ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Gaming Intervention

BACKGROUND In the United States, young minority men who have sex with men (MSM) are most likely to become infected with HIV. The use of antiretroviral medications to reduce the risk of acquiring HIV infection (pre-exposure prophylaxis, PrEP) is an efficacious and promising prevention strategy. There have been significant advances regarding PrEP, including the definitive demonstration that PrEP reduces HIV acquisition and the development of clinical prescribing guidelines. Despite these promising events, the practical implementation of PrEP can be challenging. Data show that PrEP’s safety and effectiveness could be greatly compromised by suboptimal adherence to treatment, and there is concern about the potential for an increase in HIV risk behavior among PrEP users. Due to these challenges, the prescribing of PrEP should be accompanied by behavioral interventions to promote adherence. OBJECTIVE This study aimed to develop an immersive, action-oriented iPhone gaming intervention to improve motivation for adherence to PrEP. METHODS Game development was guided by social learning theory, taking into consideration the perspectives of young adult MSM who are taking PrEP. A total of 20 young men who have sex with men (YMSM; aged 18-35 years) were recruited from a sexually transmitted infection (STI), HIV testing, and PrEP care clinic in Jackson, Mississippi, between October 2016 and June 2017. They participated in qualitative interviews guided by the information-motivation-behavioral skills (IMB) model of behavior change. The mean age of participants was 26 years, and all the participants identified as male. Acceptability of the game was assessed with the Client Service Questionnaire and session evaluation form. RESULTS A number of themes emerged that informed game development. YMSM taking PrEP desired informational game content that included new and comprehensive details about the effectiveness of PrEP, details about PrEP as it relates to doctors’ visits, and general information about STIs other than HIV. Motivational themes that emerged were the desire for enhancement of future orientation; reinforcement of positive influences from partners, parents, and friends; collaboration with health care providers; decreasing stigma; and a focus on personal relevance of PrEP-related medical care. Behavioral skills themes centered around self-efficacy and strategies for adherence to PrEP and self-care. CONCLUSIONS We utilized youth feedback, IMB, and agile software development to create a multilevel, immersive, action-oriented iPhone gaming intervention to improve motivation for adherence to PrEP. There is a dearth of gaming interventions for persons on PrEP. This study is a significant step in working toward the development and testing of an iPhone gaming intervention to decrease HIV risk and promote adherence to PrEP for YMSM.

Structural Stigma Affects Access to Pre- and Post-exposure Prophylaxis and HIV Risk among Men Who Have Sex with Men (MSM) in the United States

2014 ◽  
Vol 30 (S1) ◽  
pp. A22-A23 ◽  
Author(s):  
Catherine Oldenburg ◽  
Amaya Perez-Brumer ◽  
Mark Hatzenbuehler ◽  
Douglas Krakower ◽  
David Novak ◽  
...  
Keyword(s):  
United States ◽  
Hiv Risk ◽  
The United States ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Sex With Men ◽  
Exposure Prophylaxis

Developing targeted HIV risk predictors for young black men who have sex with men: a two-city comparative study

2020 ◽  
Vol 31 (4) ◽  
pp. 335-344
Author(s):  
Anthony C Nguyen ◽  
Lindsay E Young ◽  
Matthew R Beymer ◽  
Sze-Chuan Suen
Keyword(s):  
United States ◽  
Los Angeles ◽  
Black Men ◽  
Hiv Risk ◽  
The United States ◽  
Risk Indicator ◽  
Screening Guidelines ◽  
Control And Prevention ◽  
Sex With Men ◽  
Exposure Prophylaxis

HIV burden in the United States is geographically and demographically heterogeneous. While efforts over the last few decades have reduced HIV incidence, young black men who have sex with men (YBMSM) account for a significant portion of new HIV diagnoses compared to any other race and age group. The Centers for Disease Control and Prevention has allocated funding to help reduce HIV in the YBMSM community; however, their recommended screening/treatment criteria do not emphasize demographic specificity. To better guide more applicable screening guidelines specifically for YBMSM, we examine demographic, behavioral, sexual network, and biological predictors of HIV status among YBMSM in two demographically distinct cities with high HIV burden in the United States: Chicago, IL and Los Angeles, CA. We perform multivariable logistic regressions to identify predictors of HIV in these populations. We found that having a history of syphilis was the only statistically significant predictor across both cities despite inclusion of other characteristics previously shown to be associated with HIV among YBMSM. Syphilis history could be a powerful HIV risk indicator for YBMSM and, therefore, should be integrated into clinical screening practices for critical biomedical prevention options like HIV pre-exposure prophylaxis.

scholarly journals Prescribing of Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis by HIV Medical Providers in the United States, 2013–2014

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
John Weiser ◽  
Shikha Garg ◽  
Linda Beer ◽  
Jacek Skarbinski
Keyword(s):  
Human Immunodeficiency Virus ◽  
Prevalence Ratio ◽  
The United States ◽  
Hiv Care ◽  
Care Providers ◽  
Persons Who Inject Drugs ◽  
Provider Characteristics ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Exposure Prophylaxis

Abstract Background Clinical trials have demonstrated the effectiveness of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) for reducing HIV acquisition. Understanding how HIV care providers are prescribing PrEP is necessary to ensure success of this prevention strategy. Methods During 2013–2014, we surveyed US HIV care providers who also provided care to HIV-negative patients. We estimated percentages who had prescribed PrEP and assessed associations between provider characteristics and PrEP prescribing. Results An estimated 26% (95% confidence interval [CI], 20–31) had ever prescribed PrEP. Of these, 74% (95% CI, 61–87) prescribed for men who have sex with men (MSM), 30% (95% CI, 21–39) for women who have sex with men, 23% (95% CI, 9–37) for men who have sex with women, 23% (95% CI, 15–30) for uninfected partners in HIV-discordant couples trying to conceive, and 1% (95% CI, 0–2) for persons who inject drugs. The following provider characteristics were significantly associated with having prescribed PrEP: male vs female (32% vs 16%; adjusted prevalence ratio [aPR], 1.5; 95% CI, 1.0–2.2), lesbian/gay/bisexual vs heterosexual orientation (50% vs 21%; aPR, 2.0; 95% CI, 1.3–2.9), and HIV caseload (>200, 51–200, and ≤50 patients, 39%, 29%, and 14%, respectively; >200 vs ≤50 patients, aPR 2.4, 95% CI 1.1–5.2, and 51–200 vs ≤50 patients, aPR 2.2, 95% CI 1.2–4.0). Conclusions In 2013–2014, one quarter of HIV care providers reported having prescribed PrEP, most commonly for MSM and rarely for persons who inject drugs. Lesbian/gay/bisexual providers and male providers were more likely than others to have prescribed PrEP. Additional efforts may enable more providers to prescribe PrEP to underserved clients needing the service.

scholarly journals Developing a Mobile App (LYNX) to Support Linkage to HIV/Sexually Transmitted Infection Testing and Pre-Exposure Prophylaxis for Young Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Albert Liu ◽  
Kenneth Coleman ◽  
Kelly Bojan ◽  
Pedro Alonso Serrano ◽  
Temitope Oyedele ◽  
...  
Keyword(s):  
Controlled Trial ◽  
The United States ◽  
Mobile App ◽  
Transmitted Infection ◽  
Behavioral Skills ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Pilot Rct ◽  
Sex With Men ◽  
Exposure Prophylaxis

BACKGROUND Young men who have sex with men (YMSM) in the United States have among the highest incidence of HIV and sexually transmitted infection (STI) and the lowest uptake of HIV and STI testing and pre-exposure prophylaxis (PrEP). Nearly universal mobile phone ownership among youth provides an opportunity to leverage mobile health apps to increase HIV/STI testing and PrEP uptake among YMSM. OBJECTIVE The goals of this project are to develop and refine LYNX, a novel mobile app to support linkage to HIV/STIs testing and PrEP services among YMSM in the United States, and to evaluate the acceptability and feasibility of LYNX in a pilot randomized controlled trial (RCT). METHODS This research protocol will be conducted in 3 phases: an iterative development phase with a series of 3 focus groups among 20 YMSM to refine the LYNX app; an open technical pilot among 15 YMSM to optimize usability of the app; and then a 6-month pilot RCT among 60 HIV-uninfected YMSM at risk for HIV acquisition. Developed using the Information, Motivation, and Behavioral skills theoretical model, the LYNX app includes an electronic diary to track sexual behaviors (information), a personalized risk score to promote accurate risk perception (information/motivation), testing reminders (motivation/behavioral skills), and access to home-based HIV/STI testing options and geospatial-based HIV/STI testing care sites (behavioral skills). Feasibility and acceptability will be assessed through app analytics of usage patterns and acceptability scales administered via computer-assisted self-interview at 3 and 6 months. We will also evaluate preliminary efficacy by comparing the proportion of YMSM who test at least once during the 6-month pilot and the proportion who successfully link to a PrEP provider in the intervention versus control groups. RESULTS Formative work is currently underway. The LYNX pilot RCT will begin enrollment in October 2018, with study results available in 2019. CONCLUSIONS The LYNX app is one of the first mobile apps designed to increase HIV/STI testing and PrEP uptake among YMSM. As low-perceived risk is a barrier to HIV/STI testing and PrEP use among youth, the personalized risk assessment and interactive sexual diary in LYNX could assist YMSM in better understanding their HIV risk and providing motivation to test for HIV/STIs and initiate PrEP. Coupled with community-based recruitment, this novel mobile app has great potential to reach and engage YMSM not currently involved in care and increase rates of HIV/STI testing and PrEP uptake in this vulnerable population. CLINICALTRIAL ClinicalTrials.gov NCT03177512; https://clinicaltrials.gov/ct2/show/NCT03177512 (Archived by WebCite at http://www.webcitation.org/73c917wAw) INTERNATIONAL REGISTERED REPOR DERR1-10.2196/10659

Perceptions of Contexts of Intimate Partner Violence Among Young, Partnered Gay, Bisexual and Other Men Who Have Sex With Men in the United States

2021 ◽  
pp. 088626052110014
Author(s):  
Rob Stephenson ◽  
Lynae A. Darbes ◽  
Matthew T Rosso ◽  
Catherine Washington ◽  
Lisa Hightow-Weidman ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Health Care Providers ◽  
Partner Violence ◽  
The United States ◽  
Intimate Partner ◽  
Care Providers ◽  
Male Couples ◽  
Younger Men ◽  
Sex With Men ◽  
Controlling Behaviors

There has been a growth in research illustrating that gay, bisexual, and other men who have sex with men (GBMSM) experience intimate partner violence (IPV) at rates that are comparable to those among heterosexual women. However, the majority of research on IPV among same-sex male couples has focused on adults, and research on the experience of IPV among younger men (those aged under 18), remains at a nascent stage, despite knowledge that IPV is often common among younger men. This article adds to the growing body of literature on IPV among young GBMSM (YGBMSM) through of an analysis of qualitative data from in-depth interviews (IDI) with GBMSM aged 15–19 ( n = 30) in romantic relationships partnerships. The study sought to explore issues of relationship development, relationship contexts, and understandings of IPV. More than one-half of the sample reported experiencing some form of IPV in their current or past relationships. Participants described a range of experiences of IPV, including physical IPV, emotional IPV, sexual IPV, and controlling behaviors. Emotional IPV in the form of negative comments and controlling behaviors such as jealousy were the most commonly reported forms of violence behaviors. Although few participants reported experiencing physical or sexual IPV, several discussed concerns about giving, and partners’ acknowledging, sexual consent. Antecedents to IPV included wanting or feeling pressured to participate in normative development milestones, short-lived relationships, and societal stigma. Interventions that develop content on IPV and that reflect the lived realities of YGBMSM who are experiencing their first relationships are urgently needed. Study findings also support the need for training teachers, health care providers, and parents to identify signs of IPV and provide them with the knowledge and skills to talk to YGBMSM about relationships and violence to reduce IPV.

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 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.

Factors influencing uptake of pre-exposure prophylaxis: some qualitative insights from an intervention study of men who have sex with men in China

Sexual Health ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 39 ◽  
Author(s):  
Chunxing Liu ◽  
Yingying Ding ◽  
Zhen Ning ◽  
Meiyang Gao ◽  
Xing Liu ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Intervention Study ◽  
Implementation Strategies ◽  
Self Assessment ◽  
Risk Beliefs ◽  
Group Data ◽  
Prep Implementation ◽  
Substantial Risk ◽  
Sex With Men ◽  
Exposure Prophylaxis

Background: Pre-exposure prophylaxis (PrEP) is a biomedical approach for preventing the acquisition of HIV in populations at substantial risk for HIV. However, its uptake among men who have sex with men (MSM) is low in China. The study aimed to identify factors that might influence MSM’s uptake and use of PrEP. Methods: In-depth interviews were conducted with 32 self-identified MSM from a PrEP intervention study evaluating daily oral tenofovir disoproxil fumarate (TDF) to prevent HIV infection. Of these men, 11 were presently using the ‘TDF’ group; 8 from the ‘change-over’ group (i.e. initially used PrEP but subsequently quitted); and 13 from the non-user group. Data were analysed using thematic approach. Results: Perception of low HIV risk, mistrust of the national PrEP program, and concerns of side effects were the main reasons for not wanting to use PrEP. Also, lack of main sexual partner’s support, difficulties in adhering to the daily TDF regimen, and the inconvenient schedules in securing the medicine were the major reasons for not wanting to use or quitting the use of PrEP. On the other hand, perceived high HIV risk, beliefs in efficacy of PrEP, and worries of transmitting HIV to families were the major motives for PrEP uptake. Conclusions: Findings suggest that PrEP implementation strategies should first address issues including but not limited to accurate self-assessment of HIV risk, mistrust and limited knowledge about medical trials and PrEP, and ease of accessing PrEP.

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