scholarly journals Using Geosocial Networking Apps and HIV Risk Behavior among Men Who Have Sex with Men: Case-Crossover Analysis of Respondents to an Online Survey Delivered via Blued in China (Preprint)

2019 ◽  
Author(s):  
Justin Knox ◽  
Enoch Chen ◽  
Qinying He ◽  
Guowu Liu ◽  
Jeb Jones ◽  
...  
Keyword(s):  
Online Survey ◽  
Online Dating ◽  
Conditional Logistic Regression ◽  
Hiv Risk Behavior ◽  
Sensitivity Analyses ◽  
Anal Sex ◽  
Cross Sectional Survey ◽  
Case Crossover ◽  
Crossover Analysis ◽  
Sex With Men

BACKGROUND HIV disproportionately affects the estimated 21 million men who have sex with men (MSM) who live in China. The HIV epidemic is largely driven by unprotected anal sex (sex not protected by condoms or HIV pre-expsoure prophylaxis). The possible association between unprotected anal sex and the use of a geospatial networking apps has been a subject of scientific debate. OBJECTIVE This study assesses whether users of a gay geospatial networking app in China were more likely to use condoms when they met their partners online versus offline. A case-crossover analysis, with each person serving as his own control, was employed to address the potential bias that men looking for sex partners through an online dating medium might have inherently different (and riskier) patterns of sexual behavior compared to men not using the online dating medium. METHODS A cross-sectional survey was administered in 2018 to adult, male users of Blued (a gay geospatial networking app) in Beijing, Tianjin, Sichuan, and Yunnan China. A case-crossover analysis was conducted among 1,311 MSM not taking pre-exposure prophylaxis (PrEP) who reported both unprotected and protected anal sex in the past 6 months. Multivariable conditional logistic regression was used to quantify the association of where the partnership was initiated (offline or online) and unprotected anal sex, controlling for other interval-level covariates. Four sensitivity analyses were conducted to assess other potential sources of bias. RESULTS We identified 1311 matched instances where a person reported both an unprotected anal sex act and a protected anal sex acts in the last 6 months. Of the most recent unprotected anal sex acts, 22% (n=292), were initiated offline. Of the most recent protected anal sex acts, 16% (n=214), were initiated offline. In multivariable analyses, initiating a partnership offline was positively associated with unprotected anal sex (OR 2.66, 95% CI 1.84 – 3.85, p<.001), compared to initiating a partnership online. These results were robust to each of the different sensitivity analyses we conducted. CONCLUSIONS Among Blued users in these four Chinese cities, men were less likely to have unprotected anal sex in partnerships that they initiated online compared to partnerships that they initiated offline. The relationship was strong, with over 2.5 times the likelihood of engaging in unprotected anal sex in partnerships initiated offline compared to those initiated online. These findings suggest that geospatial networking apps are a proxy for, and not a cause of, high risk behaviors for HIV infection, and that these platforms should be viewed as a useful venue to identify individuals at risk for HIV transmission to allow for targeted service provision. CLINICALTRIAL

scholarly journals The Value of Local Heatwave Impact Assessment: A Case-Crossover Analysis of Hospital Emergency Department Presentations in Tasmania, Australia

2019 ◽  
Vol 16 (19) ◽  
pp. 3715 ◽  
Author(s):  
Sharon L. Campbell ◽  
Tomas A. Remenyi ◽  
Grant J. Williamson ◽  
Christopher J. White ◽  
Fay H. Johnston
Keyword(s):  
Emergency Department ◽  
Capacity Planning ◽  
Conditional Logistic Regression ◽  
Hospital Emergency Department ◽  
Hospital Emergency ◽  
Case Crossover ◽  
Crossover Analysis ◽  
The Impact ◽  
The Relationship ◽  
Local Research

Heatwaves have been identified as a threat to human health, with this impact projected to rise in a warming climate. Gaps in local knowledge can potentially undermine appropriate policy and preparedness actions. Using a case-crossover methodology, we examined the impact of heatwave events on hospital emergency department (ED) presentations in the two most populous regions of Tasmania, Australia, from 2008–2016. Using conditional logistic regression, we analyzed the relationship between ED presentations and severe/extreme heatwaves for the whole population, specific demographics including age, gender and socio-economic advantage, and diagnostic conditions that are known to be impacted in high temperatures. ED presentations increased by 5% (OR 1.05, 95% CI 1.01–1.09) across the whole population, by 13% (OR 1.13, 95% CI 1.03–1.24) for children 15 years and under, and by 19% (OR 1.19, 95% CI 1.04–1.36) for children 5 years and under. A less precise association in the same direction was found for those over 65 years. For diagnostic subgroups, non-significant increases in ED presentations were observed for asthma, diabetes, hypertension, and atrial fibrillation. These findings may assist ED surge capacity planning and public health preparedness and response activities for heatwave events in Tasmania, highlighting the importance of using local research to inform local practice.

scholarly journals Antiretroviral pre-exposure prophylaxis preferences among men who have sex with men in Vietnam: results from a nationwide cross-sectional survey

Sexual Health ◽  
2016 ◽  
Vol 13 (5) ◽  
pp. 465 ◽  
Author(s):  
Catherine E. Oldenburg ◽  
Bao Le ◽  
Hoang Thi Huyen ◽  
Dinh Duc Thien ◽  
Nguyen Hoang Quan ◽  
...  
Keyword(s):  
Online Survey ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Rectal Microbicides ◽  
Logistic Regression Models ◽  
Aids Epidemic ◽  
Sex With Men ◽  
Long Acting ◽  
Rectal Microbicide ◽  
Exposure Prophylaxis

Background The HIV/AIDS epidemic in Vietnam is concentrated in subgroups of the population, including men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is a viable strategy for HIV prevention, but knowledge about and preferences for PrEP delivery among Vietnamese MSM are not well understood. Methods: In 2015, an online survey was conducted with recruitment via social networking websites for MSM and peer recruitment. A description of daily oral, long-acting injectable, and rectal microbicide formulations of PrEP was provided to participants. Participants were asked about their prior awareness of and interest in PrEP, and ranked their most preferred PrEP modality. Multivariable logistic regression models were used to assess factors associated with having heard of PrEP and preference for each PrEP modality. Results: Of 548 participants who answered demographic and PrEP-related questions, 26.8% had previously heard of PrEP and most (65.7%) endorsed rectal microbicides as their most preferred PrEP delivery modality. Commonly-cited perceived barriers to uptake of PrEP included concern about side-effects, perception about being HIV positive, and family or friends finding out about their sexual behaviour. In multivariable models, older participants less often endorsed rectal microbicides (adjusted odds ratio (AOR) 0.95 per year, 95% confidence interval (CI) 0.91–0.99) and more often endorsed long-acting injectables (AOR 1.08 per year, 95% CI 1.03 to 1.14) as their preferred PrEP modality. Participants who were willing to pay more for PrEP less often endorsed rectal microbicides (AOR 0.81, 95% CI 0.72–0.92) and more often endorsed long-acting injectables (AOR 1.17, 95% CI 1.01–1.35) and daily oral pills (AOR 1.16, 95% CI 1.00–1.35) as their preferred form of PrEP. Conclusions: A variety of PrEP modalities were acceptable to MSM in Vietnam, but low knowledge of PrEP may be a barrier to implementation.

scholarly journals A Cross-Sectional Survey on Attitudes of Men Who Have Sex With Men Towards Anal Self-Examination for Detection of Anal Syphilis

2021 ◽  
Author(s):  
Ei T Aung ◽  
Christopher K Fairley ◽  
Jason J Ong ◽  
Tiffany P Phillips ◽  
Marcus Y Chen ◽  
...  
Keyword(s):  
Secondary Syphilis ◽  
Health Clinic ◽  
Median Frequency ◽  
Anal Sex ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Future ◽  
Receptive Anal Sex ◽  
Sex With Men ◽  
Self Examination

Abstract Studies suggest men who have sex with men (MSM) practising receptive anal sex are more likely to present with secondary syphilis, implying primary anorectal lesions are likely to be missed. If men could detect anorectal lesions in the primary stage by regular anal self-examination (ASE), transmission could be reduced by early diagnosis and treatment. We aimed to explore the attitudes of MSM on performing ASE to detect primary anorectal syphilis. An online anonymous cross-sectional survey among MSM over 18 years of age living in Australia, was conducted between July and November 2020 and recruitment was from a sexual health clinic and social media. A total of 574 MSM completed the survey (median age: 34 [IQR 27–45]): 32% (183) had previously performed ASE. Among 56% (374) who had never performed ASE, 68% (250) would consider performing ASE in the future with a preferred median frequency of 2 times per 4 weeks (IQR: 1–4), whilst men who were already performing ASE were performing it at median 1 per 4 weeks (IQR: 0.2-3). Almost two-thirds of MSM who had never performed ASE were willing to adopt ASE practice in the future. Studies are required to determine the effectiveness of ASE for syphilis detection.

scholarly journals High Ambient Temperature and Infant Mortality in Philadelphia, Pennsylvania: A Case–Crossover Study

2020 ◽  
Vol 110 (2) ◽  
pp. 189-195
Author(s):  
Leah H. Schinasi ◽  
Joan Rosen Bloch ◽  
Steven Melly ◽  
Yuzhe Zhao ◽  
Kari Moore ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Ambient Temperature ◽  
Conditional Logistic Regression ◽  
Large Data ◽  
Logistic Regression Models ◽  
Climate Change Effects ◽  
Case Crossover ◽  
Modifiable Factors ◽  
Crossover Analysis ◽  
Heat Vulnerability

Objective. To quantify the association between heat and infant mortality and identify factors that influence infant vulnerability to heat. Methods. We conducted a time-stratified case–crossover analysis of associations between ambient temperature and infant mortality in Philadelphia, Pennsylvania, during the warm months of 2000 through 2015. We used conditional logistic regression models to estimate associations of infant mortality with daily temperatures on the day of death (lag 0) and for averaging periods of 0 to 1 to 0 to 3 days before the day of death. We explored modification of associations by individual and census tract–level characteristics and by amounts of green space. Results. Risk of infant mortality increased by 22.4% (95% confidence interval [CI] = 5.0%, 42.6%) for every 1°C increase in minimum daily temperature over 23.9°C on the day of death. We observed limited evidence of effect modification across strata of the covariates. Conclusions. Our results contribute to a growing body of evidence that infants are a subpopulation that is particularly vulnerable to climate change effects. Further research using large data sets is critically needed to elucidate modifiable factors that may protect infants against heat vulnerability.

scholarly journals Factors Associated with Use of Latex Condom-Compatible Lubricants by Men Who Have Sex with Men in India: Implications for HIV Prevention

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Shreena Ramanathan ◽  
Venkatesan Chakrapani ◽  
Lakshmi Ramakrishnan ◽  
Prabuddhagopal Goswami ◽  
Diwakar Yadav ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Large Scale ◽  
Cluster Sampling ◽  
Anal Sex ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Indian States ◽  
Factors Associated ◽  
Water Based ◽  
Sex With Men

We examined the prevalence and type of rectal lubricants use and factors associated with exclusive use of latex-condom compatible lubricants (water-based lubricants) among men who have sex with men (MSM) using data from a large-scale cross-sectional survey conducted in 2009/10 in three Indian states. Using time-location cluster sampling, 3880 MSM were recruited from cruising sites. We used multiple logistic regression to assess the association between type of lubricants used and sociodemographic and programmatic indicators. Among those who reported using lubricants (64%) more than half (53%) exclusively used water-based lubricants, less than one-tenth used exclusively oil-based lubricants, and nearly 40% used both water-based and oil-based lubricants. Factors associated with exclusive use of water-based lubricants were exposure to HIV prevention interventions (AOR: 6.18, 95% CI 4.82 to 7.92) and kothi-identified MSM—feminine/anal-receptive (AOR: 2.56, 95% CI 2.12 to 3.10). Targeted HIV interventions among MSM need to promote and distribute latex condom-compatible lubricants for use during anal sex—irrespective of their presumed or stated sexual role in anal sex, and educate them not to use oil-based lubricants with condoms.

scholarly journals Use of primary care data to predict those most vulnerable to cold weather: a case-crossover analysis

2018 ◽  
Vol 68 (668) ◽  
pp. e146-e156 ◽  
Author(s):  
Peter Tammes ◽  
Claudio Sartini ◽  
Ian Preston ◽  
Alastair D Hay ◽  
Daniel Lasserson ◽  
...  
Keyword(s):  
Energy Efficiency ◽  
Conditional Logistic Regression ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Winter Mortality ◽  
Sociodemographic Characteristics ◽  
Clinical Factors ◽  
Risk Of Death ◽  
Case Crossover ◽  
Crossover Analysis

BackgroundThe National Institute for Health and Care Excellence (NICE) recommends that GPs use routinely available data to identify patients most at risk of death and ill health from living in cold homes.AimTo investigate whether sociodemographic characteristics, clinical factors, and house energy efficiency characteristics could predict cold-related mortality.Design and settingA case-crossover analysis was conducted on 34 777 patients aged ≥65 years from the Clinical Practice Research Datalink who died between April 2012 and March 2014. The average temperature of date of death and 3 days previously were calculated from Met Office data. The average 3-day temperature for the 28th day before/after date of death were calculated, and comparisons were made between these temperatures and those experienced around the date of death.MethodConditional logistic regression was applied to estimate the odds ratio (OR) of death associated with temperature and interactions between temperature and sociodemographic characteristics, clinical factors, and house energy efficiency characteristics, expressed as relative odds ratios (RORs).ResultsLower 3-day temperature was associated with higher risk of death (OR 1.011 per 1°C fall; 95% CI = 1.007 to 1.015; P<0.001). No modifying effects were observed for sociodemographic characteristics, clinical factors, and house energy efficiency characteristics. Analysis of winter deaths for causes typically associated with excess winter mortality (N = 7710) showed some evidence of a weaker effect of lower 3-day temperature for females (ROR 0.980 per 1°C, 95% CI = 0.959 to 1.002, P = 0.082), and a stronger effect for patients living in northern England (ROR 1.040 per 1°C, 95% CI = 1.013 to 1.066, P = 0.002).ConclusionIt is unlikely that GPs can identify older patients at highest risk of cold-related death using routinely available data, and NICE may need to refine its guidance.

scholarly journals Factors associated with willingness to use Pre-exposure prophylaxis in Brazil, Mexico and Peru: an online survey among men who have sex with men (Preprint)

2019 ◽  
Author(s):  
Thiago Silva Torres ◽  
Kelika Konda ◽  
E. Hamid Vega-Ramirez ◽  
Oliver Antonio Elorreaga Reyes ◽  
Dulce Diaz-Sosa ◽  
...  
Keyword(s):  
Latin American ◽  
Online Survey ◽  
Sex Partners ◽  
Anal Sex ◽  
Factors Associated ◽  
Sex With Men ◽  
Prep Awareness ◽  
Willingness To Use ◽  
Exposure Prophylaxis ◽  
Oral Prep

BACKGROUND HIV epidemics disproportionally affect key populations including men who have sex with men (MSM). HIV prevalence among MSM varies from 17% in Brazil and Mexico to 13% in Peru, while it is below 0.5% for the general population. Pre-exposure prophylaxis (PrEP) with daily oral emtricitabine/tenofovir is being implemented in the context of combination HIV prevention. Reports on PrEP awareness, willingness to use, and acceptability among MSM have started to emerge over the last few years. Previously reported factors associated with willingness to use PrEP include: awareness, low cost, higher sexual risk behavior, prior sexually transmitted infection, and unwillingness to use condoms. OBJECTIVE This study aims to evaluate the factors associated with willingness to use daily oral PrEP among MSM in three Latin American, middle-income countries (Brazil, Mexico and Peru). METHODS This online cross-sectional survey was advertised in two gay social network apps (Grindr and Hornet) used by MSM to find sex partners and on Facebook during two months in 2018. Inclusion criteria were ≥18 years of age, cisgender men, and HIV-negative by self-report. Eligible individuals answered questions on: demographics, behavior, and PrEP (awareness, willingness to use, barriers and facilitators). Multivariable logistic regression modeling was performed to assess the factors associated with willingness to use daily oral PrEP in each country. RESULTS From a total sample of 43,687 individuals, 19,457 (45%) MSM were eligible and completed the online survey (Brazil: 58%, Mexico: 31%, Peru: 11%); median age was 28 years (IQR: 24-34), almost half lived in large urban cities and 89% self-defined as homosexual. Most of the participants were recruited on Grindr (69%). Almost 20% had never tested for HIV and condomless receptive anal sex was reported by 46% in the previous 6 months. A total of 13,110 (67%) would be eligible for PrEP (adapted from WHO risk criteria), but only 10% of participants had high HIV risk perception. PrEP awareness was reported by 65%, this was lower in Peru (46%). Overall, willingness to use PrEP was reported by 64%, highest in Mexico (70%) and lowest in Peru (58%). In multivariate regression models adjusted for age, schooling, and income: in each country willingness to use PrEP was positively associated with PrEP awareness and PrEP facilitators (e.g. free PrEP and HIV testing), and negatively associated with behavioral (e.g., concerned by daily pill regimen) and belief barriers (e.g., sex partners may expect condomless anal sex). CONCLUSIONS In this first cross-country online survey in Latin America, willingness to use PrEP was found to be high and directly related to PrEP awareness. Interventions to increase awareness and PrEP knowledge about safety and efficacy are crucial to increase PrEP demand. This study provides important information to support the implementation of PrEP in Brazil, Mexico and Peru.

Sign in / Sign up

Export Citation Format

Share Document