23 results on '"Rosenberger, Joshua G."'
Search Results
2. An Experimental Study of the Effects of Patient Race, Sexual Orientation, and Injection Drug Use on Providers' PrEP-Related Clinical Judgments.
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Calabrese SK, Kalwicz DA, Modrakovic D, Earnshaw VA, Edelman EJ, Bunting SR, Del Río-González AM, Magnus M, Mayer KH, Hansen NB, Kershaw TS, Rosenberger JG, Krakower DS, and Dovidio JF
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- Female, Homosexuality, Male, Humans, Judgment, Male, Sexual Behavior, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV Infections prevention & control, Pre-Exposure Prophylaxis, Sexual and Gender Minorities
- Abstract
Social biases may influence providers' judgments related to pre-exposure prophylaxis (PrEP) and patients' consequent PrEP access. US primary and HIV care providers (n = 370) completed an experimental survey. Each provider reviewed one fictitious medical record of a patient seeking PrEP. Records varied by patient race (Black or White) and risk behavior (man who has sex with men [MSM], has sex with women [MSW], or injects drugs [MID]). Providers reported clinical judgments and completed measures of prejudice. Minimal evidence of racially biased judgments emerged. Providers expressing low-to-moderate sexual prejudice judged the MSM as more likely than the MSW to adhere to PrEP, which was associated with greater PrEP prescribing intention; sexual prejudice was negatively associated with anticipated MSM adherence. Providers judged the MID to be at higher risk, less likely to adhere, less safety-conscious, and less responsible than both the MSM and MSW; adverse adherence and responsibility judgments were associated with lower prescribing intention., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2022
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3. Optimizing Provider Preexposure Prophylaxis (PrEP) Training: A Cross-Sectional Analysis of Recommendations from Providers Across the PrEP Implementation Cascade.
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Rao S, Reed AE, Parchem B, Edelman EJ, Magnus M, Hansen NB, Kershaw TS, Earnshaw VA, Krakower DS, Dovidio JF, Mayer KH, Underhill K, Rosenberger JG, Ogburn DF, Betancourt JR, and Calabrese SK
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- Cross-Sectional Studies, Health Knowledge, Attitudes, Practice, Humans, Practice Patterns, Physicians', Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV Infections prevention & control, Pre-Exposure Prophylaxis
- Abstract
Expanding PrEP access necessitates training that supports healthcare providers' progression along the PrEP implementation cascade, moving from PrEP awareness to prescription. We surveyed 359 USA providers about PrEP training content and format recommendations. We examined the association between cascade location and training recommendations. Most providers were aware of PrEP (100%), willing to prescribe PrEP (97.2%), had discussed PrEP with patients (92.2%), and had prescribed PrEP (79.9%). Latent class regression analysis revealed that cascade location was associated with training recommendations. Although all providers recommended PrEP-specific content (e.g., patient eligibility), providers who were located further along the cascade also recommended more comprehensive content, including sexual history-taking and sexual and gender minority competence training. Providers further along the cascade were also more likely to recommend interactive training formats (e.g., role-playing). These insights from providers furthest along the cascade indicate the importance of including comprehensive content and interactive formats in future PrEP training initiatives., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2022
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4. Sexual Subcultures and HIV Prevention Methods: An Assessment of Condom Use, PrEP, and TasP Among Gay, Bisexual, and Other Men Who Have Sex with Men Using a Social and Sexual Networking Smartphone Application.
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Schnarrs PW, Jones SS, Parsons JT, Baldwin A, Rosenberger JG, Lunn MR, and Rendina HJ
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- Bisexuality, Condoms, Humans, Male, Sexual Partners, Smartphone, HIV Infections prevention & control, Homosexuality, Male, Sexual Behavior, Sexual and Gender Minorities
- Abstract
Despite being grouped together in epidemiological risk categories, gay, bisexual, and other men who have sex with men (GBM) are not a homogenous group. In addition to traditional segmentation along race, ethnicity, and socioeconomic status, many GBM also identify with sexual subcultural communities. Previous research has shown differences across a variety of health outcomes between these sexual subcultural communities. The purpose of this study was to determine whether HIV prevention practices among GBM differed according to sexual subcultural community. The study was conducted in collaboration with a popular social and sexual networking smartphone application company. A total of 23,577 GBM responded to the survey. A latent class analysis identified 6 distinct classes related to sexual subcultural community identification. We found significant differences across sociodemographic characteristics, HIV prevention practices, and condomless anal sex in the past 6 months related to sexual subculture identification. Findings suggest that sexual subcultural identity is related to decision-making around HIV prevention among GBM. Differences in HIV prevention strategies are likely a function of group norms, unique shared experiences among GBM identifying with a particular sexual subculture community, and sociodemographic characteristics associated with these groups. As such, sexual subculture identity should be considered in developing interventions and social marketing campaigns to increase uptake of biomedical HIV prevention tools among GBM. Identifying group norms and shared experiences related to HIV prevention practices among sexual subcultures is necessary to understand the role these identities play in lives of GBM, especially as it relates to their sexual health and well-being.
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- 2021
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5. Factors Associated with the Discordance between Perception of Being HIV Infected and HIV Sexual Risk Taking among Social Media-Using Black, Hispanic, and White Young Men Who Have Sex with Men.
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Bennett CL, Marks SJ, Rosenberger JG, Bauermeister JA, Clark MA, Liu T, Mayer KH, and Merchant RC
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- Adolescent, Black or African American statistics & numerical data, HIV Infections prevention & control, HIV Infections transmission, Hispanic or Latino statistics & numerical data, Homosexuality, Male ethnology, Humans, Male, Mass Screening, Sexual Behavior, United States, White People statistics & numerical data, Young Adult, HIV Infections psychology, Perception, Risk-Taking, Sexual and Gender Minorities psychology, Social Media
- Abstract
Among HIV-uninfected, social media-using black, Hispanic, and white young men who have sex with men (YMSM) who had condomless anal sex but had not been HIV tested within the past year, we aimed to determine the extent of discordance between perception of having an undiagnosed HIV infection and HIV risk-taking behaviors. Despite reporting condomless anal sex without HIV testing, 64% of 358 YMSM participants perceived having an undiagnosed HIV infection as "unlikely" and 12% as "impossible." Having a primary care provider and being Hispanic were associated with greater discordance. Interventions to decrease the discordance between perceived and actual HIV risk are needed for this higher HIV risk population.
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- 2020
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6. Characterizing HIV risk among cisgender men in Latin America who report transgender women as sexual partners: HIV risk in Latin America men.
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Reisner SL, Perez-Brumer A, Oldenburg CE, Gamarel KE, Malone J, Leung K, Mimiaga MJ, Rosenberger JG, and Biello KB
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- Adult, Cross-Sectional Studies, Female, HIV Infections diagnosis, HIV Infections epidemiology, Heterosexuality, Humans, Latin America epidemiology, Male, Middle Aged, Social Networking, Transgender Persons, Transsexualism, Young Adult, HIV Infections transmission, Risk-Taking, Sexual Behavior, Sexual Partners, Unsafe Sex statistics & numerical data
- Abstract
Cisgender men (CM) who report transgender women (TW) as sexual partners are an understudied population in the HIV epidemic in Latin America. The current study sought to characterize this group in a 2012 cross-sectional online survey of Latin American CM who were members of a sexual networking website for men who have sex with men (N = 11,847). Multivariable logistic regression models were fit to estimate demographic, behavioral, and psychosocial correlates of having a TW sexual partner and engaging in condomless sex. Overall, 0.9% (n = 106) reported a TW sexual partner in the last 12 months; of these, 76.4% (n = 81) reported condomless sex in the last three months. Identifying as bisexual or heterosexual compared to gay, and specifying a versatile sexual role preference compared to insertive were associated with reporting a recent TW sex partner (all p < 0.05). HIV-negative serostatus, lifetime STI history, and alcohol dependence were associated with recent condomless sex (all p < 0.05). CM with TW sexual partners have distinct HIV-related vulnerabilities. Future research is needed to understand CM who report TW sexual partners, including their sexual preferences and practices, sexual networks, exposure to stigma, biomedical prevention interest and uptake, and acceptability of integrating alcohol abuse screening into sexual health services.
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- 2019
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7. Blood Donation, Sexual Practices, and Self-Perceived Risk for HIV in the United States Among Young Adult Men Who Have Sex With Men.
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Wentz AE, Merchant RC, Clark MA, Liu T, Rosenberger JG, Bauermeister JA, and Mayer KH
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- Adolescent, Blood Donors supply & distribution, Humans, Internet, Male, Social Media, Surveys and Questionnaires, United States, Young Adult, Blood Donors psychology, HIV Infections diagnosis, HIV Infections prevention & control, Homosexuality, Male statistics & numerical data, Risk-Taking, Self Concept, Sexual Behavior statistics & numerical data
- Abstract
Objectives: In the United States, all men who have sex with men (MSM) were banned from donating blood from 1985 through 2015. In 2016, the guideline was amended such that men who had sexual contact with other men within the previous 12 months could not donate blood. We aimed to identify blood donation practices and their relationship with HIV risk and testing among young adult MSM (YMSM) at risk for having HIV., Methods: In 2014, we recruited HIV-negative non-Hispanic black, Hispanic, and non-Hispanic white YMSM aged 18-24 from across the United States through social media platforms to complete an online survey. Among these YMSM who previously donated blood, we conducted a secondary analysis examining the relationship between having donated blood within the past 12 months and sexual risk behavior from recent condomless anal intercourse (CAI), HIV testing, and self-perceived risk of having an undiagnosed HIV infection., Results: Of the 2261 YMSM surveyed, 1104 (48.8%) had ever previously donated blood and 305 (13.5%) had donated blood within the past 12 months. Of the 305 blood donors, 50 (16.4%) had ever had CAI before their most recent blood donation. Among YMSM who donated blood, past-12-month blood donation was more likely among YMSM who never had CAI (adjusted odds ratio [aOR] = 1.84; 95% confidence interval [CI], 1.24-2.73) than among YMSM who had CAI and more likely among YMSM who believed it was not possible at all that they had an undiagnosed HIV infection (aOR = 1.57; 95% CI, 1.14-2.16) than among YMSM who believed there was any possibility of having an undiagnosed HIV infection; it was not related to past-12-month HIV testing., Conclusions: YMSM donated blood frequently, suggesting that the deferral process in place did not prevent YMSM from donating blood. The current donor screening process should be reconsidered if it is to prevent YMSM from donating blood. Future research could identify screening questions that permit YMSM with a low risk of HIV infection to donate blood while maintaining the safety of the blood supply.
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- 2019
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8. The impact of social support and partner relationship dynamics on engagement in HIV care and antiretroviral treatment adherence among MSM in Latin America.
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Anderson K, Biello K, Rosenberger JG, Novak D, Mayer K, Carey K, and Mimiaga MJ
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- Adult, Continuity of Patient Care, Disclosure, HIV, HIV Infections epidemiology, HIV Infections psychology, Humans, Latin America epidemiology, Male, Young Adult, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, Homosexuality, Male psychology, Medication Adherence psychology, Sexual Partners, Social Support
- Abstract
In Latin America (LA), HIV prevalence among MSM is estimated at thirty times greater than in the general male population. Little is known about the role of social support or disclosure status in relation to the HIV care continuum among LA MSM. Using multivariable logistic generalized estimation equations, we assessed the impact of social support satisfaction and disclosure status on engagement in HIV care, ART initiation, and ART adherence with data from an online, multinational sample of HIV infected MSM in Latin America (N = 2,350). 80.0% were engaged in HIV care, 71% initiated ART, and among those, 37% reported missing at least one dose in the past month. In multivariable models, compared to being very satisfied with social support, being somewhat satisfied (aOR = 0.73, 95% CI 0.56, 0.95) or somewhat dissatisfied (aOR = 0.83, 95% CI 0.70, 0.98) were associated with reduced odds of reporting 100% ART adherence. Disclosure of status was associated with a greater odds of HIV care engagement (OR = 1.63, 95% CI 1.28, 2.07) and ART initiation (OR = 1.55, 95% CI 1.30, 1.84). Greater satisfaction with social support and comfort disclosing HIV status to these sources were associated with improved engagement in HIV care and greater initiation of ART among MSM in LA.
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- 2018
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9. Comparison of Home-Based Oral Fluid Rapid HIV Self-Testing Versus Mail-in Blood Sample Collection or Medical/Community HIV Testing By Young Adult Black, Hispanic, and White MSM: Results from a Randomized Trial.
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Merchant RC, Clark MA, Liu T, Romanoff J, Rosenberger JG, Bauermeister J, and Mayer KH
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- AIDS Serodiagnosis, Adolescent, Black or African American statistics & numerical data, Black People statistics & numerical data, HIV Infections prevention & control, HIV Infections psychology, Hispanic or Latino statistics & numerical data, Homosexuality, Male psychology, Homosexuality, Male statistics & numerical data, Humans, Male, Outcome and Process Assessment, Health Care, Postal Service, Serologic Tests, White People statistics & numerical data, Young Adult, Black or African American psychology, Black People psychology, Diagnostic Tests, Routine methods, HIV, HIV Infections diagnosis, Hispanic or Latino psychology, Homosexuality, Male ethnology, Mass Screening methods, Mouth virology, White People psychology
- Abstract
We aimed to determine in a randomized trial if young adult black, Hispanic, and white men-who-have-sex-with-men (YMSM) are more likely to complete home-based oral fluid rapid HIV self-testing than either mail-in blood sample collection or medical facility/community organization-based HIV testing. Stratified by race/ethnicity, participants were randomly assigned to use a free oral fluid rapid HIV self-test (n = 142), a free mail-in blood sample collection HIV test (n = 142), or be tested at a medical facility/community organization of their choice (n = 141). Of the 425 participants, completion of assigned test (66% oral fluid vs. 40% mail-in blood sample vs. 56% medical facility/community), willingness to refer (36% oral fluid vs. 20% mail-in blood sample vs. 26% medical facility/community), and legitimate referrals (58% oral fluid vs. 43% mail-in blood sample vs. 43% medical facility/community) were greater in the oral fluid rapid HIV self-test than the mail-in blood sample collection HIV test arm, but not the medical facility/community testing arm. There were no differences in assigned test completion by race/ethnicity. Although free home-based oral fluid rapid HIV self-testing showed moderate promise in facilitating HIV testing among black, Hispanic, and white YMSM, it did not lead to greater testing than directing these YMSM to medical facility/community HIV testing venues. ClinicalTrials.gov Identifier: NCT02369627.
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- 2018
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10. Discordance of voluntary HIV testing with HIV sexual risk-taking and self-perceived HIV infection risk among social media-using black, Hispanic, and white young-men-who-have-sex-with-men (YMSM).
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Alexovitz KA, Merchant RC, Clark MA, Liu T, Rosenberger JG, Bauermeister J, and Mayer KH
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- Adolescent, HIV Infections epidemiology, HIV Infections prevention & control, Homosexuality, Male statistics & numerical data, Humans, Male, Mass Screening, Risk Factors, Self Concept, Sexual Partners, United States, Young Adult, Black or African American psychology, HIV Infections diagnosis, Hispanic or Latino psychology, Homosexuality, Male psychology, Risk-Taking, Social Media, White People psychology
- Abstract
Discordance between self-perceived HIV risk and actual risk-taking may impede efforts to promote HIV testing among young adult men-who-have-sex-with-men (YMSM) in the United States (US). Understanding the extent of, and reasons for, the discordance of HIV risk self-perception, HIV risk-taking and voluntary HIV testing among black, Hispanic and white YMSM could aid in the development of interventions to increase HIV testing among this higher HIV risk population. HIV-uninfected 18-24-year-old black, Hispanic, and white YMSM were recruited from across the US through multiple social media websites. Participants were queried about their voluntary HIV testing history, perception of currently having an undiagnosed HIV infection, and condomless anal intercourse (CAI) history. We assessed the association between previous CAI and self-perceived possibility of currently having an HIV infection by HIV testing status using Cochran-Mantel-Haenszel testing. Of 2275 black, Hispanic and white social media-using 18-24 year-old YMSM, 21% had never been tested for HIV voluntarily, 87% ever had CAI with another man, 77% believed that it was perhaps possible (as opposed to not possible at all) they currently could have an undiagnosed HIV infection, and 3% who reported CAI with casual or exchange partners, but had not been tested for HIV, self-perceived having no possibility of being HIV infected. Of 471 YMSM who had not been HIV tested, 57% reported CAI with casual or exchange partners, yet self-perceived having no possibility of being HIV infected. Per the Cochran-Mantel-Haenszel test results, among those reporting HIV risk behaviors, the self-perception of possibly being HIV-infected was not greater among those who had never been tested for HIV, as compared to those who had been tested. Future interventions should emphasize promoting self-realization of HIV risk and translating that into seeking and accepting voluntary HIV testing among this higher HIV risk population.
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- 2018
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11. Potential Healthcare Insurance and Provider Barriers to Pre-Exposure Prophylaxis Utilization Among Young Men Who Have Sex with Men.
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Marks SJ, Merchant RC, Clark MA, Liu T, Rosenberger JG, Bauermeister J, and Mayer KH
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- Adult, Black or African American statistics & numerical data, Ambulatory Care Facilities, Black People statistics & numerical data, Health Care Costs, Hispanic or Latino statistics & numerical data, Humans, Male, Patient Acceptance of Health Care ethnology, Sexual Behavior, Socioeconomic Factors, Surveys and Questionnaires, United States, White People statistics & numerical data, Young Adult, HIV Infections prevention & control, Health Services Accessibility statistics & numerical data, Homosexuality, Male ethnology, Homosexuality, Male statistics & numerical data, Patient Acceptance of Health Care statistics & numerical data, Pre-Exposure Prophylaxis
- Abstract
Young adult men-who-have-sex-with-men (YMSM) continue to have among the highest incidence of HIV infection in the United States. Pre-exposure prophylaxis (PrEP) is an effective and safe method of preventing HIV infection; however, despite US Food and Drug Administration approval, utilization remains low, in part, due to structural barriers, particularly access to healthcare. In this study, we used social media to recruit black, Hispanic, and white HIV-uninfected 18- to 24-year-old YMSM. Participants completed an online survey about their sexual behavior, healthcare access, and previous use of PrEP. Of the 2297 YMSM surveyed, only 3.4% had used PrEP. PrEP use was associated with higher levels of education, living alone, older age, higher levels of sexual activity, and greater healthcare access, specifically having healthcare insurance and a clinic or primary care provider (PCP) from whom they received care. Among PrEP nonusers, 65% met at least one of the US Centers for Disease Control and Prevention recommended indications for PrEP use, and of these, 59% had healthcare insurance and received care in a clinic and/or had a PCP. Multi-variable multi-nomial logistic regression modeling identified disparities in access to healthcare by age, race/ethnicity, education, and region. Specifically, older YMSM, blacks and Hispanics, those with fewer years of formal education, and residents of the southern and the western United States were more likely to lack healthcare access. These results demonstrate both potential opportunities and barriers to the scale-up of PrEP among YMSM.
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- 2017
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12. HIV prevalence, sexual behaviours and engagement in HIV medical care among an online sample of sexually active MSM in Venezuela.
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Perez-Brumer AG, Oldenburg CE, Biello KB, Novak DS, Rosenberger JG, and Mimiaga MJ
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- Adult, Condoms statistics & numerical data, Cross-Sectional Studies, HIV Infections prevention & control, Health Surveys, Homosexuality, Male ethnology, Homosexuality, Male statistics & numerical data, Humans, Internet, Male, Patient Acceptance of Health Care ethnology, Prevalence, Risk Factors, Risk-Taking, Sexual Partners, Social Networking, Unsafe Sex statistics & numerical data, Venezuela, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV Infections epidemiology, Homosexuality, Male psychology, Medication Adherence, Patient Acceptance of Health Care statistics & numerical data, Sexual Behavior
- Abstract
In Venezuela, members of a social and sexual partner networking site for men who have sex with men (MSM) completed an online survey regarding sexual behaviours and HIV medical care. Among the 2851 respondents, self-reported HIV prevalence was 6.6%. Of participants living with HIV, 73.2% reported taking antiretroviral medication and 56.6% reported complete adherence within the past month. Participants living with HIV were more likely to be older (aOR = 1.04 per one-year increase in age, 95% CI: 1.02, 1.06) and diagnosed with a sexually transmitted infection in the previous year (aOR 3.26, 95% CI: 2.11, 5.04). These data provide further understanding of the HIV epidemic among MSM in Venezuela, and potential targets for HIV prevention interventions., (© The Author(s) 2016.)
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- 2016
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13. Multiple syndemic psychosocial factors are associated with reduced engagement in HIV care among a multinational, online sample of HIV-infected MSM in Latin America.
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Biello KB, Oldenburg CE, Safren SA, Rosenberger JG, Novak DS, Mayer KH, and Mimiaga MJ
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- Adolescent, Adult, Continuity of Patient Care, HIV Infections drug therapy, HIV Infections psychology, Humans, Internet, Latin America epidemiology, Male, Self Report, Surveys and Questionnaires, Young Adult, HIV Infections epidemiology, Homosexuality, Male psychology, Homosexuality, Male statistics & numerical data, Patient Acceptance of Health Care statistics & numerical data
- Abstract
Latin America has some of the highest levels of antiretroviral therapy (ART) coverage of any developing region in the world. Early initiation and optimal adherence to ART are necessary for improved health outcomes and reduction in onward transmission. Previous work has demonstrated the role of psychosocial problems as barriers to uptake and adherence to ART, and recently, a syndemic framework has been applied to the role of multiple psychosocial syndemic factors and adherence to ART, in the USA. However, to our knowledge, these associations have not been investigated outside of the USA, nor in a multi-country context. To address these gaps, we assessed the association between multiple co-occurring psychosocial factors and engagement in HIV-related medical care and adherence to ART among a large, multinational sample of sexually-active HIV-infected men who have sex with men in Latin America. Among the 2020 respondents, 80.7% reported currently receiving HIV-related medical care, 72.3% reported currently receiving ART; among those, 62.5% reported 100% adherence. Compared with experiencing no psychosocial health problems, experiencing five or more psychosocial health problems is associated with 42% lower odds of currently receiving HIV-related medical care (adjusted odds ratio, aOR = 0.58, 95% CI 0.36, 0.95) and of currently receiving ART (aOR = 0.58, 95% CI 0.38, 0.91). The number of psychosocial health problems experienced was associated with self-reported ART adherence in a dose-response relationship; compared to those with none of the factors, individuals with one syndemic factor had 23% lower odds (aOR = 0.77, 95% CI 0.60, 0.97) and individuals with five or more syndemic factors had 72% lower odds (aOR = 0.28, 95% CI 0.14, 0.55) of reporting being 100% adherent to ART. Addressing co-occurring psychosocial problems as potential barriers to uptake and adherence of ART in Latin America may improve the effectiveness of secondary prevention interventions.
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- 2016
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14. High prevalence of multiple syndemic conditions associated with sexual risk behavior and HIV infection among a large sample of Spanish- and Portuguese-speaking men who have sex with men in Latin America.
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Mimiaga MJ, Biello KB, Robertson AM, Oldenburg CE, Rosenberger JG, O'Cleirigh C, Novak DS, Mayer KH, and Safren SA
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- Adult, Cross-Sectional Studies, Humans, Latin America epidemiology, Male, Prevalence, Young Adult, HIV Infections epidemiology, Homosexuality, Male psychology, Homosexuality, Male statistics & numerical data, Unsafe Sex statistics & numerical data
- Abstract
The HIV epidemic in Latin America is highly concentrated in men who have sex with men (MSM). In the United States, multiple co-occurring psychosocial conditions have been shown to act as intertwined epidemics to potentiate HIV transmission among MSM. To date, no study has examined the role of syndemics and condomless sex among MSM in Latin America. In 2012, an online survey was conducted among members of the largest social/sexual networking website for MSM in Latin America. Participants were asked about demographics, sexual behaviors, HIV/STI diagnoses, and psychosocial well-being, including depression, suicidal ideation, hazardous alcohol use, hard drug use during sex, history of childhood/adolescent sexual abuse, intimate partner violence, and sexual compulsivity. Multivariable logistic generalized estimation equations were used to assess the relationship of syndemic factors and (1) engagement in higher risk condomless anal sex and (2) self-report of prior HIV diagnosis. Among 24,274 survey respondents, 74.6 % of the sample had at least one syndemic factor. In an additive model, syndemics were associated with increased odds of higher risk condomless anal sex, ranging from adjusted odds ratio of 1.31 (95 % CI 1.20, 1.43) for one syndemic factor to 4.06 (95 % CI 3.25, 5.09) for 6/7 syndemic factors. Similarly, syndemics were associated with increased odds of HIV infection (p < .0001). This study provides initial evidence that intertwined syndemics increase HIV risk behavior and HIV infection among MSM in Latin America. In the Latin American context, comprehensive HIV prevention interventions for MSM should be developed and tested that simultaneously address co-occurring psychosocial conditions and HIV risk.
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- 2015
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15. Engagement in HIV care and sexual transmission risk behavior among men who have sex with men using online social/sexual networking in Latin America.
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Magidson JF, Biello KB, Safren SA, Rosenberger JG, Novak DS, Mayer KH, and Mimiaga MJ
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- Adult, Anti-HIV Agents therapeutic use, Female, HIV Infections prevention & control, Homosexuality, Male ethnology, Humans, Latin America epidemiology, Logistic Models, Male, Medication Adherence, Middle Aged, Patient Acceptance of Health Care ethnology, Residence Characteristics, Risk Factors, Risk-Taking, Secondary Prevention, Sexual Partners, Socioeconomic Factors, Unsafe Sex statistics & numerical data, Young Adult, HIV Infections drug therapy, Homosexuality, Male psychology, Internet, Patient Acceptance of Health Care statistics & numerical data, Sexual Behavior, Social Networking
- Abstract
HIV/AIDS in Latin America is concentrated among men who have sex with men (MSM). However, accurate estimates of engagement in HIV care in this population can be difficult to ascertain because many do not self-identify as MSM. Given evidence of decreased HIV transmissibility in the context of antiretroviral therapy (ART) adherence, identifying individuals not in care who are engaging in HIV transmission risk behavior is crucial for secondary prevention. Primary aims of this study were to examine engagement in care from testing to ART adherence among MSM using online social/sexual networking across Latin America, and whether individuals not in care at each step reported greater sexual transmission risk behavior than those in care. In the overall sample (n=28,779), approximately 75% reported ever being tested for HIV, and 9% reported having received an HIV diagnosis. Among known HIV-infected individuals, 20% reported not being in care, 30% reported not taking ART, and 55% reported less than 100% ART adherence. Over one-third of HIV-infected individuals reported sexual HIV transmission risk behavior, defined as unprotected anal intercourse (UAI) with a male partner of different/unknown HIV serostatus in the past three months. HIV-infected individuals not engaged in care more often reported UAI compared to those in care (OR=1.29; 95% CI=1.01-1.66). Although not statistically significant, HIV-infected individuals not on ART more often reported UAI compared to those on ART (OR=1.18; 95% CI=0.94-1.47). Individuals who reported less than 100% ART adherence more often reported UAI compared to individuals with 100% adherence (OR=1.55; 95% CI=1.26-1.90). Findings demonstrate that a substantial portion of HIV-infected MSM in Latin America who are likely not virologically suppressed from lack of ART use or adherence report sexual HIV transmission risk. Tailoring secondary HIV prevention for MSM in Latin America who are not in HIV care or adherent to ART may be warranted.
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- 2015
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16. Using a two-step method to measure transgender identity in Latin America/the Caribbean, Portugal, and Spain.
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Reisner SL, Biello K, Rosenberger JG, Austin SB, Haneuse S, Perez-Brumer A, Novak DS, and Mimiaga MJ
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- Adolescent, Adult, Caribbean Region, Cross-Cultural Comparison, Cross-Sectional Studies, Female, HIV Infections prevention & control, Health Status Indicators, Humans, Latin America, Male, Middle Aged, Population Surveillance, Portugal, Regression Analysis, Reproductive Health, Risk-Taking, Sexual Behavior, Socioeconomic Factors, Spain, Suicide, Young Adult, Gender Identity, HIV Infections psychology, Transgender Persons psychology, Transsexualism psychology
- Abstract
Few comparative data are available internationally to examine health differences by transgender identity. A barrier to monitoring the health and well-being of transgender people is the lack of inclusion of measures to assess natal sex/gender identity status in surveys. Data were from a cross-sectional anonymous online survey of members (n > 36,000) of a sexual networking website targeting men who have sex with men in Spanish- and Portuguese-speaking countries/territories in Latin America/the Caribbean, Portugal, and Spain. Natal sex/gender identity status was assessed using a two-step method (Step 1: assigned birth sex, Step 2: current gender identity). Male-to-female (MTF) and female-to-male (FTM) participants were compared to non-transgender males in age-adjusted regression models on socioeconomic status (SES) (education, income, sex work), masculine gender conformity, psychological health and well-being (lifetime suicidality, past-week depressive distress, positive self-worth, general self-rated health, gender related stressors), and sexual health (HIV-infection, past-year STIs, past-3 month unprotected anal or vaginal sex). The two-step method identified 190 transgender participants (0.54%; 158 MTF, 32 FTM). Of the 12 health-related variables, six showed significant differences between the three groups: SES, masculine gender conformity, lifetime suicidality, depressive distress, positive self-worth, and past-year genital herpes. A two-step approach is recommended for health surveillance efforts to assess natal sex/gender identity status. Cognitive testing to formally validate assigned birth sex and current gender identity survey items in Spanish and Portuguese is encouraged.
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- 2014
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17. Epidemiology of sexual health in the virtual environment: a multinational online survey of Spanish- and Portuguese-speaking men who use an internet sexual networking site.
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Biello KB, Rosenberger JG, Novak DS, Robertson AM, Mayer KH, and Mimiaga MJ
- Subjects
- Adult, Condoms statistics & numerical data, Cross-Sectional Studies, HIV Infections ethnology, Health Surveys, Homosexuality, Male psychology, Humans, Male, Portugal epidemiology, Prevalence, Risk-Taking, Sexual Behavior ethnology, Sexual Behavior statistics & numerical data, Spain epidemiology, Young Adult, HIV Infections prevention & control, Homosexuality, Male statistics & numerical data, Internet, Reproductive Health ethnology, Sexual Partners, Social Networking
- Abstract
There is limited data on the sexual health of users of sexual networking websites for men who have sex with men (MSM) in Latin America. Members of a MSM-targeted social/sexual networking website in Latin America, Spain, and Portugal participated in an online sexual health survey. Among 36,063 respondents, nearly 90 % reported having anal or vaginal intercourse in the past 3 months. Among sexually active men, 53.2 % used condoms inconsistently. In the past year, 54 % of respondents reported undergoing sexually transmitted infections (STI) testing and 67 % reported testing yearly or more often for HIV. Self-reported HIV prevalence was 9.1 %. Differences were seen by geographic region. Unprotected intercourse with partners of different or unknown HIV status was associated with recent STI diagnosis (OR = 1.83, t = 13.15, d.f. = 21, p < .001) and HIV diagnosis (OR = 2.20, t = 14.00, d.f. = 21, p < .001). Online surveys are a promising tool for HIV/STI surveillance and prevention internationally to reach an important subset of MSM.
- Published
- 2014
- Full Text
- View/download PDF
18. Limited Awareness and Low Immediate Uptake of Pre-Exposure Prophylaxis among Men Who Have Sex with Men Using an Internet Social Networking Site.
- Author
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Krakower DS, Mimiaga MJ, Rosenberger JG, Novak DS, Mitty JA, White JM, and Mayer KH
- Subjects
- Adult, Bisexuality, Cross-Sectional Studies, Female, Humans, Internet, Interviews as Topic, Male, Middle Aged, Odds Ratio, HIV Infections prevention & control, Health Knowledge, Attitudes, Practice, Homosexuality, Male, Post-Exposure Prophylaxis, Social Networking
- Abstract
Background: In 2010, the iPrEx trial demonstrated that oral antiretroviral pre-exposure prophylaxis (PrEP) reduced the risk of HIV acquisition among high-risk men who have sex with men (MSM). The impact of iPrEx on PrEP knowledge and actual use among at-risk MSM is unknown. Online surveys were conducted to assess PrEP awareness, interest and experience among at-risk MSM before and after iPrEx, and to determine demographic and behavioral factors associated with these measures., Methods and Findings: Cross-sectional, national, internet-based surveys were administered to U.S. based members of the most popular American MSM social networking site 2 months before (n = 398) and 1 month after (n = 4 558) publication of iPrEx results. Comparisons were made between these samples with regards to PrEP knowledge, interest, and experience. Data were collected on demographics, sexual risk, and experience with post-exposure prophylaxis (PEP). Regression analyses were performed to identify factors associated with PrEP awareness, interest, and experience post-iPrEx. Most participants were white, educated, and indicated high-risk sexual behaviors. Awareness of PrEP was limited pre- and post-iPrEx (13% vs. 19%), whereas interest levels after being provided with a description of PrEP remained high (76% vs. 79%). PrEP use remained uncommon (0.7% vs. 0.9%). PrEP use was associated with PEP awareness (OR 7.46; CI 1.52-36.6) and PEP experience (OR 34.2; CI 13.3-88.4). PrEP interest was associated with older age (OR 1.01; CI 1.00-1.02), unprotected anal intercourse with ≥1 male partner in the prior 3 months (OR 1.40; CI 1.10-1.77), and perceiving oneself at increased risk for HIV acquisition (OR 1.20; CI 1.13-1.27)., Conclusions: Among MSM engaged in online networking, awareness of PrEP was limited 1 month after the iPrEx data were released. Utilization was low, although some MSM who reported high-risk behaviors were interested in using PrEP. Studies are needed to understand barriers to PrEP utilization by at-risk MSM.
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- 2012
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19. The Internet as a valuable tool for promoting a new framework for sexual health among gay men and other men who have sex with men.
- Author
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Rosenberger JG, Reece M, Novak DS, and Mayer KH
- Subjects
- Humans, Male, Attitude to Health, HIV Infections prevention & control, Health Promotion methods, Homosexuality, Male, Internet statistics & numerical data
- Published
- 2011
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20. Relations between circumcision status, sexually transmitted infection history, and HIV serostatus among a national sample of men who have sex with men in the United States.
- Author
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Jozkowski K, Rosenberger JG, Schick V, Herbenick D, Novak DS, and Reece M
- Subjects
- Adolescent, Adult, Condoms statistics & numerical data, HIV Infections prevention & control, Humans, Internet, Male, Middle Aged, Sexual Behavior, Surveys and Questionnaires, United States epidemiology, Young Adult, Circumcision, Male statistics & numerical data, HIV Infections epidemiology, HIV Seropositivity epidemiology, Homosexuality, Male, Sexually Transmitted Diseases epidemiology
- Abstract
Circumcision's potential link to HIV/sexually transmitted infections (STI) has been at the center of recent global public health debates. However, data related to circumcision and sexual health remain limited, with most research focused on heterosexual men. This study sought to assess behavioral differences among a large sample of circumcised and noncircumcised men who have sex with men (MSM) in the United States. Data were collected from 26,257 U.S. MSM through an online survey. Measures included circumcision status, health indicators, HIV/STI screening and diagnosis, sexual behaviors, and condom use. Bivariate and regression analyses were conducted to determine differences between HIV/STI status, sexual behaviors, and condom use among circumcised and noncircumcised men. Circumcision status did not significantly predict HIV testing (p > 0.05), or HIV serostatus (p > 0.05), and there were no significant differences based on circumcision status for most STI diagnosis [syphilis, gonorrhea, chlamydia, human papilloma virus (HPV)]. Being noncircumcised was predictive of herpes-2 diagnosis, however, condom use mediated this relationship. These data provide one of the first large national assessments of circumcision among MSM. While being noncircumcised did not increase the likelihood of HIV and most STI infections, results indicated that circumcision was associated with higher rates of condom use, suggesting that those who promote condoms among MSM may need to better understand condom-related behaviors and attitudes among noncircumcised men to enhance the extent to which they are willing to use condoms consistently.
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- 2010
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21. The moderating role of love in the relationship between partner type and condom use among women engaging in paid vaginal sex
- Author
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Roth, Alexis M., Rosenberger, Joshua G., Hensel, Devon J., Wiehe, Sarah E., Fortenberry, J. Dennis, and Wagner, Karla D.
- Subjects
Adult ,Condoms ,Sexual Partners ,Sexual Behavior ,Humans ,Female ,HIV Infections ,Prospective Studies ,Love ,Article - Abstract
Background Relationship characteristics and day-to-day variation in affective state have been associated with HIV risk behaviour. However, no research has assessed the impact of these factors on event-level condom use among women engaging in transactional sex.Twenty-six women engaging in transactional sex were enrolled in a prospective study of their sexual health. They completed diaries about multi-level predictors of condom use during vaginal sex twice, daily.Over 4 weeks, 18 participants reported 87 paid/traded vaginal intercourse events. Of these, 51.7% were condom protected. The majority of paid/traded events (81.5%) occurred with a non-romantic partner. After controlling for partner type, feeling in love on a given day was associated with higher odds of condom use during paid/traded sexual events, while having sex on the weekend and at night were associated with lower odds of condom use (all P≤0.05). There was a significant interaction between being in love and using condoms during transactional sex (P0.01). In paid/traded sexual events with romantic partners, the frequency of condom use was 71.4% (5/7) when women did not report love and 40% (4/10) when love was reported. In sexual events with non-romantic partners, the frequency of condom use was 43.8% (14/32) when women did not report love and 59.5% (22/37) when love was reported.Women were less likely to report protected sex with romantic partners and more likely to report protected sex with non-romantic partners when they are in love. Interventions focusing on the link between day-to-day variation in affective state on condom use may help women with risk management across partner types.
- Published
- 2016
22. RESEARCH AND PRACTICE. Transactional Sex Among Men Who Have Sex With Men in Latin America: Economic, Sociodemographic, and Psychosocial Factors.
- Author
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Oldenburg, Catherine E., Perez-Brumer, Amaya G., Biello, Katie B., Landers, Stewart J., Rosenberger, Joshua G., Novak, David S., Mayer, Kenneth H., and Mimiaga, Matthew J.
- Subjects
SEX work ,SEXUAL intercourse ,BISEXUAL people ,CHILD sexual abuse ,CONFIDENCE intervals ,STATISTICAL correlation ,GAY men ,HIV infections ,MOTIVATION (Psychology) ,MULTIVARIATE analysis ,PROBABILITY theory ,RESEARCH funding ,SEXUALLY transmitted diseases ,STATISTICS ,SURVEYS ,UNEMPLOYMENT ,LOGISTIC regression analysis ,UNSAFE sex ,INTIMATE partner violence ,DATA analysis software ,ATTITUDES toward sex ,ODDS ratio ,ECONOMICS ,PSYCHOLOGY - Abstract
Objectives. We assessed factors associated with engagement in transactional sex among men who have sex with men recruited from one of the largest Internet sites for men seeking social or sexual interactions with other men in Latin America. Methods. We constructed multilevel logistic regression models to analyze factors associated with engagement in transactional sex in 17 Latin American countries in 2012. Results. Of 24 051 respondents, 1732 (7.2%) reported being paid for sexual intercourse in the past 12 months. In a multivariable model, higher country-level unemployment was associated with increased odds of transactional sex (adjusted odds ratio [AOR] = 1.07 per 1% increase in unemployment; 95% confidence interval [CI] = 1.00, 1.13). Individual or interpersonal factors associated with increased odds of engagement in transactional sex included self-reported HIV (AOR = 1.33; 95% CI = 1.04, 1.69) or sexually transmitted infection (AOR = 1.33; 95% CI = 1.11, 1.59), childhood sexual abuse history (AOR = 1.75; 95% CI = 1.48, 2.06), intimate partner violence (past 5 years, AOR = 1.68; 95% CI = 1.45, 1.95), and sexual compulsivity (AOR = 1.77; 95% CI = 1.49, 2.11). Conclusions. Structural-level economic interventions and those that address individual and interpersonal factors may improve HIV prevention efforts among men who have sex with men who engage in transactional sex. (Am J Public Health. 2015;105:e95–e102. doi:10.2105/AJPH.2014.302402) [ABSTRACT FROM AUTHOR]
- Published
- 2015
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23. Gay and Bisexual Latino Men's Sexual Health and Behaviors: A National Online Sample.
- Author
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SCHNARRS, PHILLIP W., ROSENBERGER, JOSHUA G., SCHICK, VANESSA R., NOVAK, DAVID S., HERBENICK, DEBBY, and REECE, MICHAEL
- Subjects
- *
AGE distribution , *BISEXUAL people , *CONDOMS , *CONFIDENCE intervals , *EMPLOYMENT , *EPIDEMIOLOGY , *GAY men , *HEALTH behavior , *HEALTH status indicators , *HISPANIC Americans , *HIV infections , *SEXUAL health , *MARITAL status , *MASTURBATION , *MEDICAL screening , *ORAL sex , *QUESTIONNAIRES , *HUMAN sexuality , *SEXUALLY transmitted diseases , *ANAL sex , *LOGISTIC regression analysis , *DATA analysis , *EDUCATIONAL attainment , *DATA analysis software , *DESCRIPTIVE statistics - Abstract
Latino men represent a quickly growing segment of the U.S. population. As such, it is important to document the health of these individuals. Data were collected from one of the largest gay networking Web sites in the U.S. Using multivariate logistic regression relationships between participant characteristics and sexual health outcomes and behaviors were examined. The sample included 1,880 Latino men self-identifying as gay (83.7%) and bisexual (16.3%). Findings suggest the majority of men had not tested positive for any STD (86.8 - 92.0%) or HIV (79.9%), however overall STD testing was low (33.9%) compared to HIV testing (55.6%) during the previous year. Additionally, education level, employment, sexual orientation, and relationship status significantly influenced a variety of sexual behaviors and sexual health outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
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