Trends in Internet Use Among Men Who Have Sex With Men in the United States.
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ABSTRACT:
SUBMITTER: Paz-Bailey G
PROVIDER: S-EPMC5871925 | biostudies-literature | 2017 Jul
REPOSITORIES: biostudies-literature
Publications
Trends in Internet Use Among Men Who Have Sex With Men in the United States.
Paz-Bailey Gabriela G Hoots Brooke E BE Xia Mingjing M Finlayson Teresa T Prejean Joseph J Purcell David W DW
Journal of acquired immune deficiency syndromes (1999) 20170701
<h4>Background</h4>Internet-based platforms are increasingly prominent interfaces for social and sexual networking among men who have sex with men (MSM).<h4>Methods</h4>MSM were recruited through venue-based sampling in 2008, 2011, and 2014 in 20 US cities. We examined changes in internet use (IU) to meet men and in meeting the last partner online among MSM from 2008 to 2014 using Poisson regression with generalized estimating equations to calculate adjusted prevalence ratios (APRs). We also exa ...[more]
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Project description:IntroductionPre-exposure prophylaxis (PrEP) is a key HIV prevention technology, and is a pillar of a comprehensive HIV prevention approach for men who have sex with men (MSM). Because there have been no national data to characterize trends in the PrEP continuum in the United States, overall and for key demographic groups of MSM, we aimed to describe the extent to which PrEP awareness, willingness and use changed over time, overall and for specific groups of MSM critical for HIV prevention (e.g. Black and Hispanic MSM, younger MSM, MSM in rural areas and MSM without health coverage).MethodsThe American Men's Internet Survey (AMIS) is an annual survey of US MSM conducted in the United States among MSM aged ?15 years since 2013. We analysed data on trends in elements of the PrEP continuum (awareness, willingness and use of PrEP) in a sample of 37,476 HIV-negative/unknown status MSM from December 2013 through November 2017. We evaluated trends in continuum steps overall and among demographic subgroups using Poisson models with Generalized Estimating Equations. For 2017 data, we used logistic regression to compare the prevalence of PrEP use among demographic groups.ResultsOverall, 51.4% (n = 19,244) of AMIS respondents were PrEP-eligible across study years. Between 2013 and 2017, PrEP awareness increased from 47.4% to 80.6% willingness to use PrEP increased from 43.9% to 59.5% and PrEP use in the past 12 months increased from 1.7% to 19.9%. In 2017, use of PrEP was lower for men who were younger, lived outside of urban areas, and lacked health insurance; PrEP use was not different among Black, Hispanic and white MSM.ConclusionsOur data show progress in use of PrEP among US MSM, but also reveal mismatches between PrEP use and epidemic need. We call for additional support of PrEP initiation, especially among young, non-urban and uninsured MSM. Black and Hispanic MSM report levels of PrEP use no different from white MSM, but given higher HIV incidence for Black and Hispanic MSM, parity in use is not sufficient for epidemic control or health equity.
| S-EPMC7062633 | biostudies-literature
Project description:It remains unclear how the seemingly ubiquitous use of the internet impacts user's offline personal relationships, particularly those that are romantic or sexual. Therefore, we conducted a national online survey to better understand the associations among internet use, sexual behavior, and adjustment called the Sexual Behaviors, Internet Use, and Psychological Adjustment Survey (SIPS). Here, we report patterns of sexual behavior in a sample of adults (N = 1987; ages 18-70) in the United States to establish its representativeness and consistency with similar recent surveys. We found age- and sex-related trends in oral, vaginal, and anal sex in terms of prevalence, frequency, number of partners, and age of initiation consistent with prior studies. We also detected differences in sexual behaviors based on relationship status and sexual orientation, but small and relatively few significant differences across racial and ethnic groups. The results confirm and expand upon trends identified in prior national surveys of sexual behavior, establishing the representativeness of the SIPS sample for use in future research examining the links among sexual behaviors and romantic relationships, internet use, and adjustment.
| S-EPMC8345845 | biostudies-literature
Project description:The American Men's Internet Survey (AMIS) is an annual Web-based behavioral survey of men who have sex with men (MSM) who live in the United States. This Rapid Surveillance Report describes the fifth cycle of data collection (July 2017 to November 2017: AMIS 2017). The key indicators are the same as those previously reported for past AMIS cycles (December 2013 to May 2014: AMIS 2013; November 2014 to April 2015: AMIS 2014; September 2015 to April 2016: AMIS 2015; and September 2016 to February 2017: AMIS 2016). The AMIS methodology has not substantively changed since AMIS 2016. The MSM were recruited from a variety of websites using banner advertisements and email blasts. Additionally, participants from AMIS 2016 who agreed to be recontacted for future research were emailed a link to AMIS 2017. Men were eligible to participate if they were aged ?15 years, resided in the United States, provided a valid US zone improvement plan code, and reported ever having sex with a man or identified as gay or bisexual. The analysis was limited to those who reported having oral or anal sex with a male partner in the past 12 months. We examined demographic and recruitment characteristics using multivariable regression modeling (P<.05) stratified by the participants' self-reported HIV status. The AMIS 2017 round of data collection resulted in 10,049 completed surveys from MSM representing every US state, Puerto Rico, and Guam. Participants were mainly non-Hispanic white, over the age of 40 years, living in the Southern United States and urban areas, and recruited from geospatial social networking websites. The plurality (4485/10,049, 44.6%) of participants was in the 40 years and older age group, followed by the youngest age group, 15 to 24 years (2726/10,049, 27.1%). Self-reported HIV prevalence was 9.6% (964/10,049). Compared with HIV-negative or unknown-status participants, HIV-positive participants were more likely to have had anal sex without a condom with a male partner in the past 12 months (adjusted odds ratio [aOR] 2.21, 95% CI 1.86-2.63) and more likely to have had anal sex without a condom with a serodiscordant or an unknown-status partner (aOR 3.13, 95% CI 2.71-3.62). The reported use of marijuana in the past 12 months was higher among HIV-positive participants than HIV-negative or unknown status participants (aOR 1.29, 95% CI 1.09-1.51). The reported use of methamphetamines and other illicit substances in the past 12 months was higher among HIV-positive participants than HIV-negative or unknown status participants (aOR 5.57, 95% CI 4.38-7.09 and aOR 1.93, 95% CI 1.65-2.27, respectively). Most HIV-negative or unknown status participants (7330/9085, 80.7%) reported ever taking an HIV test previously, and 60.6% (5504/9085) reported undergoing HIV testing in the past 12 months. HIV-positive participants were more likely to report testing and diagnosis of sexually transmitted infections than HIV-negative or unknown status participants (aOR 2.85, 95% CI 2.46-3.31 and aOR 2.73, 95% CI 2.29-3.26, respectively).
| S-EPMC7186873 | biostudies-literature
Project description:The American Men's Internet Survey (AMIS) is an annual Web-based behavioral survey of men who have sex with men (MSM) living in the United States. This Rapid Surveillance Report describes the fourth cycle of data collection (September 2016 through February 2017; AMIS 2016). The key indicators are the same as previously reported for AMIS (December 2013 through May 2014, AMIS 2013; November 2014 through April 2015, AMIS 2014; and September 2015 through April 2016, AMIS 2015). The AMIS survey methodology has not substantively changed since AMIS 2015. MSM were recruited from a variety of websites using banner advertisements and email blasts. Additionally, participants from AMIS 2015 who agreed to be recontacted for future research were emailed a link to the AMIS 2016 survey. Men were eligible to participate if they were ?15 years old, resided in the United States, provided a valid US zone improvement plan code, and reported ever having sex with a man or identified as gay or bisexual. We examined demographic and recruitment characteristics using multivariable regression modeling (P<.05) stratified by participants' self-reported HIV status. The AMIS 2016 round of data collection resulted in 10,166 completed surveys from MSM representing every US state, Puerto Rico, Guam, and the US Virgin Islands. Participants were mainly non-Hispanic white, over the age of 40 years, living in the Southern United States and urban areas, and recruited from general social networking websites. Self-reported HIV prevalence was 10.80% (1098/10,166). Compared to HIV-negative/unknown-status participants, HIV-positive participants were more likely to have had anal sex without a condom with a male partner in the past 12 months (75.77% vs 65.88%, P<.001) and more likely to have had anal sex without a condom with a serodiscordant or unknown-status partner (33.24% vs 16.06%, P<.001). The reported use of marijuana, methamphetamines, and other illicit substances in the past 12 months was higher among HIV-positive participants than among HIV-negative/unknown-status participants (28.05% vs 24.99%, 11.48% vs 2.16%, and 27.60% vs 18.22%, respectively; all P<.001). Most HIV-negative/unknown-status participants (79.93%, 7248/9068) reported ever having a previous HIV test, and 56.45% (5119/9068) reported undergoing HIV testing in the past 12 months. HIV-positive participants were more likely to report testing and diagnosis of sexually transmitted infections than HIV-negative/unknown-status participants (70.86% vs 40.13% and 24.04% vs 8.97%, respectively; both P<.001).
| S-EPMC6401665 | biostudies-literature
Project description:The American Men's Internet Survey (AMIS) is an annual Web-based behavioral survey of men who have sex with men (MSM) living in the United States. This Rapid Surveillance Report describes the third cycle of data collection (September 2015 through April 2016; AMIS-2015). The key indicators are the same as previously reported for AMIS (December 2013-May 2014, AMIS-2013; November 2014-April 2015, AMIS-2014). The AMIS survey methodology has not substantively changed since AMIS-2014. MSM were recruited from a variety of websites using banner advertisements and email blasts. Additionally, participants from AMIS-2014 who agreed to be recontacted for future research were emailed a link to the AMIS-2015 survey. Men were eligible to participate if they were age 15 years and older, resided in the United States, provided a valid US ZIP code, and reported ever having sex with a man. We examined demographic and recruitment characteristics using multivariable regression modeling (P<.05) stratified by participants' self-reported human immunodeficiency virus (HIV) status. The AMIS-2015 round of data collection resulted in 10,217 completed surveys from MSM representing every US state and Puerto Rico. Participants were mainly non-Hispanic white, older than 40 years, living in the US South, living in urban areas, and recruited from general social networking websites. Self-reported HIV prevalence was 9.35% (955/10,217). Compared to HIV-negative/unknown status participants, HIV-positive participants were more likely to have had anal sex without a condom with any male partner in the past 12 months (75.50%, 721/955 vs 63.09%, 5843/9262, P<.001) and more likely to have had anal sex without a condom with a serodiscordant or unknown status partner (34.45%, 329/955 vs 17.07%, 1581/9262, P<.001). The reported use of marijuana and other illicit substances in the past 12 months was higher among HIV-positive participants than HIV-negative/unknown status participants (marijuana use: 24.61%, 235/955 vs 22.96%, 2127/9262; other illicit substance use: 28.59%, 273/955 vs 17.51%, 1622/9262, respectively; both P<.001). Most HIV-negative/unknown status participants (79.11%, 7327/9262) reported ever having a previous HIV test, and 55.69% (5158/9262) reported HIV testing in the past 12 months. HIV-positive participants were more likely to report sexually transmitted infection (STI) testing and diagnosis compared to HIV-negative/unknown status participants (STI testing: 71.73%, 685/955 vs 38.52%, 3568/9262; STI diagnosis: 25.65%, 245/955 vs 8.12%, 752/9262, respectively; both P<.001).
| S-EPMC5390111 | biostudies-literature
Project description:BackgroundSocial and legal acceptance of long-term same-sex partnerships in the United States has increased over the past decade which may impact sexual partnering among men who have sex with men (MSM). Identifying whether and how partnering trends have evolved at a national level could improve understanding of HIV transmission and prevention among MSM partnerships.MethodsWe used Centers for Disease Control and Prevention's National HIV Behavioral Surveillance data (2008, 2011, and 2014) to study trends in the number and partner type composition (main/casual) of male sex partners among US MSM. Changes over time were assessed in Poisson regression models with the link function tailored to the count and binary outcomes.ResultsThe mean total number of partners in the past year increased, while the mean number of main partners remained stable. The percentage of MSM with both main and casual partners increased, and we observed a shift from having ≥1 main and 0 casual partners to having ≥1 main and ≥2 casual partners. Condomless anal sex in the past year increased regardless of partner composition.DiscussionFindings suggest casual partnering among MSM has increased in recent years, including among those with ≥1 main partners. Both partner-based and individual prevention programs remain critical to reaching MSM.
| S-EPMC6647032 | biostudies-literature
Project description:BackgroundHuman papillomavirus (HPV) and HPV-associated cancer rates are high among men who have sex with men (MSM). The US Advisory Committee on Immunization Practices recommends HPV vaccination for all MSM through age 26 years. We examined trends in HPV vaccine uptake among young US MSM between 2014 and 2017.MethodsCochran-Armitage tests and estimated annual percentage changes were used to examine annual trends (2014-2017) in HPV vaccination initiation among US MSM ≤26 years as of 2011 who participated in a nationwide annual cross-sectional online survey. We identified independent correlates of HPV vaccination in 2017 using Poisson regression modeling.ResultsThere were 2,381 participants in 2014; 4,143 in 2015; 3,926 in 2016; and 3,407 in 2017. Mean age was 23.5 years, 39% lived in metropolitan areas, and 37% lived in the South. HPV vaccination significantly increased (P < 0.0001) from 22.5% in 2014 to 37.6% in 2017 (estimated annual percentage change = 17.4%). HPV vaccination was significantly greater for MSM who were younger, had health insurance, saw a healthcare provider in the past 12-months, resided in the Northeast, resided in metropolitan areas, had higher household income, disclosed their sexual identity to health care provider, and had gonorrhea/chlamydia diagnosis in the past 12-months.ConclusionsHuman papillomavirus vaccination among MSM increased from 2014 to 2017, but vaccine uptake varied significantly by MSM subgroup. Despite favorable trends, the HPV vaccination coverage for this population (37.6%) is less than half of the Healthy People 2020 target (80%). Additional efforts are needed to increase coverage.
| S-EPMC6667229 | biostudies-literature
Project description:BackgroundTo examine trends in state-level policy support for sexual minorities and HIV outcomes among men who have sex with men (MSM).MethodsThis longitudinal analysis linked state-level policy support for sexual minorities [N = 94 metropolitan statistical areas (MSAs) in 38 states] to 7 years of data (2008-2014) from the Centers for Disease Control and Prevention on HIV outcomes among MSM. Using latent growth mixture modeling, we combined 11 state-level policies (eg, nondiscrimination laws including sexual orientation as a protected class) from 1999 to 2014, deriving the following 3 latent groups: consistently low policy support, consistently high policy support, and increasing trajectory of policy support. Outcomes were HIV diagnoses per 10,000 MSM, late diagnoses (number of deaths within 12 months of HIV diagnosis and AIDS diagnoses within 3 months of HIV diagnosis) per 10,000 MSM, AIDS diagnoses per 10,000 MSM with HIV, and AIDS-related mortality per 10,000 MSM with AIDS.ResultsCompared with MSAs in states with low policy support and increasing policy support for sexual minorities, MSAs in states with the highest level of policy support had lower risks of HIV diagnoses [risk difference (RD) = -37.9, 95% confidence interval (CI): -54.7 to -21.0], late diagnoses (RD = -12.5, 95% CI: -20.4 to -4.7), and AIDS-related mortality (RD = -33.7, 95% CI: -61.2 to -6.2), controlling for time and 7 MSA-level covariates. In low policy support states, 27% of HIV diagnoses, 21% of late diagnoses, and 10% of AIDS deaths among MSM were attributable to the policy climate.ConclusionThe state-level policy climate related to sexual minorities was associated with HIV health outcomes among MSM and could be a potential public health tool for HIV prevention and care.
| S-EPMC7429252 | biostudies-literature
Project description:State-level structural stigma and its consequences in healthcare settings shape access to pre-exposure prophylaxis (PrEP) for HIV prevention among gay, bisexual, and other men who have sex with men (GBMSM). Our objective was to assess the relationships between same-sex marriage laws, a measure of structural stigma at the state level, provider-patient communication about sex, and GBMSM awareness and use of PrEP. Using data from the Fenway Institute's MSM Internet Survey collected in 2013 (N = 3296), we conducted modified Poisson regression analyses to evaluate associations between same-sex marriage legality, measures of provider-patient communication, and PrEP awareness and use. Living in a state where same-sex marriage was legal was associated with PrEP awareness (aPR 1.27; 95% CI 1.14, 1.41), as were feeling comfortable discussing with primary care providers that they have had sex with a man (aPR 1.63; 95% CI 1.46, 1.82), discussing with their primary care provider having had condomless sex with a man (aPR 1.65; 95% CI 1.49, 1.82), and discussing with their primary care provider ways to prevent sexual transmission of HIV (aPR 1.39; 95% CI 1.26, 1.54). Each of these three measures of provider-patient communication were additionally associated with PrEP awareness and use. In sum, structural stigma was associated with reduced PrEP awareness and use. Policies that reduce stigma against GBMSM may help to promote PrEP and prevent HIV transmission.
| S-EPMC10149581 | biostudies-literature
Project description:Background Despite recent improvements in hypertension control overall, the extent to which these trends apply to the most extreme forms of elevated blood pressure-hypertensive crises requiring hospitalization-in both women and men at risk remains unknown. Methods and Results Using data from the National Inpatient Sample, we estimated sex-pooled and sex-specific temporal trends in hypertensive crisis hospitalization and case fatality rates over serial time periods: years 2002 to 2006, 2007 to 2011, and 2012 to 2014. Over the entire study period (years 2002-2014), there were an estimated 918 392±9331 hypertensive crisis hospitalizations and 4377±157 in-hospital deaths. Hypertensive crisis represented 0.23%±0.002% of all hospitalizations during the entire study period: 0.24%±0.002% for men and 0.22%±0.002% for women. In multivariable analyses adjusting for age, race or ethnicity, and cardiovascular conditions, the odds of experiencing a hospitalization primarily for hypertensive crisis increased annually for both men (odds ratio [OR], 1.083 per year; 95% CI, 1.08-1.09) and women (OR, 1.07 per year, 95% CI, 1.07-1.08) with a higher rate of increase observed in men compared with women (P<0.001). The multivariable-adjusted odds of death during hypertensive crisis hospitalization decreased annually and similarly for men (OR, 0.89 per year; 95% CI, 0.86-0.92) and for women (0.92 per year; 95% CI, 0.90-0.94). Conclusions Hypertensive crisis hospitalizations have steadily increased, slightly more among men than women, along with an observed increase in the burden of cardiovascular conditions. These trends, observed despite contemporaneous improvements in hypertension prevention and control nationwide, warrant further investigations to identify contributing factors that could be amenable to targeted interventions.
| S-EPMC9245827 | biostudies-literature