Background Social networks are increasingly recognized as important points of intervention, yet relatively few intervention studies of respiratory infection transmission have utilized a network design. Here we describe the design, methods, and social network structure of a randomized intervention for isolating respiratory infection cases in a university setting over a 10-week period. Methodology/Principal Findings 590 students in six residence halls enrolled in the eX-FLU study during a chain-referral recruitment process from September 2012-January 2013. Of these, 262 joined as “seed” participants, who nominated their social contacts to join the study, of which 328 “nominees” enrolled. Participants were cluster-randomized by 117 residence halls. Participants were asked to respond to weekly surveys on health behaviors, social interactions, and influenza-like illness (ILI) symptoms. Participants were randomized to either a 3-Day dorm room isolation intervention or a control group (no isolation) upon illness onset. ILI cases reported on their isolation behavior during illness and provided throat and nasal swab specimens at onset, day-three, and day-six of illness. A subsample of individuals (N=103) participated in a sub-study using a novel smartphone application, iEpi, which collected sensor and contextually-dependent survey data on social interactions. Within the social network, participants were significantly positively assortative by intervention group, enrollment type, residence hall, iEpi participation, age, gender, race, and alcohol use (all P<0.002). Conclusions/Significance We identified a feasible study design for testing the impact of isolation from social networks in a university setting. These data provide an unparalleled opportunity to address questions about isolation and infection transmission, as well as insights into social networks and behaviors among college-aged students. Several important lessons were learned over the course of this project, including feasible isolation durations, the need for extensive organizational efforts, as well as the need for specialized programmers and server space for managing survey and smartphone data.
In addition to the growing morbidity and mortality related to the 2019 novel coronavirus (SAR-CoV-2) pandemic, social distancing measures during the pandemic may result in increased intimate partner violence (IPV). However, it is yet unknown if gay, bisexual, and other men who have sex with men (GBMSM)’s IPV risk has increased during this time. This article describes and analyzes IPV experiences during the COVID-19 pandemic in a sample of coupled-GBMSM in the United States. We hypothesized that pandemic-driven stressors would be associated with increased IPV prevalence and severity. A sample of 214 coupled men living in the US who had previously participated in HIV-related couple studies was surveyed in July-September 2020. Respondents reported demographic, sexual and substance use behaviors, and relationship characteristics. Surveys also collected data on pandemic-related life-changes (employment, substance use, COVID-19 illness). IPV victimization and perpetration were measured with the Gay and Bisexual Men Intimate Partner Violence scale and measured individually experienced or perpetrated violence, sexual, emotional, monitoring, or controlling behaviors, and if a given behavior was new and/or had changed in frequency during the pandemic. Reported prevalence and pandemic-related changes in victimization and perpetration were described. New or more frequent IPV victimization was modeled against employment, substance use changes, COVID-19 illness, and outside sexual partners (modified by a couple’s sexual agreement). IPV perpetration prevalence was 15.17%, 34.44% of which was new or more frequent. Victimization prevalence was 14.95%, of which 46.88% was new or more frequent. After adjustment, outside sexual partners were associated with IPV among those with nonmonogamous sexual agreements; each outside sexual partner increased the odds of new or more frequent victimization by 70% ( OR = 1.70; 95% CI [1.16, 2.51]). Given this study’s documented rise in IPV among a sample of coupled men, additional research into IPV predictors, interventions, and support strategies in GBMSM populations are warranted.
Little is known about the impact of the coronavirus pandemic and control measures on gay, bisexual, and other men who have sex with men (GBMSM) couples. The goal of this study was to investigate individual-level relationship satisfaction during the COVID-19 pandemic in a sample of 209 coupled GBMSM in the United States. We analyzed reported happiness and feelings about a relationship’s future and assessed the odds of changing relationship happiness and investment associated with pandemic-related life changes (pandemic-related employment change; COVID-19 illness; high-risk of severe illness), using logistic and multinomial logit models. Fifty-five percent of participants ( N = 114) reported that their relationship happiness had not changed during the pandemic, but 30% ( N = 62) reported increased relationship happiness. 25% ( N = 53) reported they had become more invested in their relationship’s future during the pandemic, and only one participant reported decreased investment. The odds of increased relationship investment was significantly associated with pandemic-related employment change (adjusted odds ratio (aOR), 95% confidence interval (CI): 2.19 [1.04, 4.61]) and increased sex during the pandemic (aOR: 4.38 [1.55, 12.41]). Those with a pandemic-related employment change also had significantly higher odds of increased relationship happiness than those without a change (aOR: 2.10 [1.01, 4.35]). COVID-19 cases that reported being at higher risk of serious COVID-19 disease had higher odds of decreased relationship happiness than high-risk non-cases (aOR: 6.58 [1.10, 39.39]). Additional research in this area is warranted to minimize the long-term impacts of the pandemic on coupled GBMSM.
Background Central to measuring the impact of the COVID-19 pandemic on HIV is understanding the role of loss of access to essential HIV prevention and care services created by clinic and community-based organization closures. In this paper, we use a comprehensive list of HIV prevention services in four corridors of the US heavily impacted by HIV, developed as part of a large RCT, to illustrate the potential impact of service closure on LGBTQ+ youth. Methods We identified and mapped LGBTQ+ friendly services offering at least one of the following HIV-related services: HIV testing; STI testing; PrEP/PEP; HIV treatment and care; and other HIV-related services in 109 counties across four major interstate corridors heavily affected by HIV US Census regions: Pacific (San Francisco, CA to San Diego, CA); South-Atlantic (Washington, DC to Atlanta, GA); East-North-Central (Chicago, IL to Detroit, MI); and East-South-Central (Memphis, TN to New Orleans, LA). Results There were a total of 831 LGBTQ+ youth-friendly HIV service providers across the 109 counties. There was a range of LGBTQ+ youth-friendly HIV-service provider availability across counties (range: 0–14.33 per 10,000 youth aged 13–24 (IQR: 2.13), median: 1.09); 9 (8.26%) analyzed counties did not have any LGBTQ+ youth-friendly HIV service providers. The Pearson correlation coefficient for the correlation between county HIV prevalence and LGBTQ+ youth-friendly HIV service provider density was 0.16 (p = 0.09), suggesting only a small, non-statistically significant linear relationship between a county’s available LGBTQ+ youth-friendly HIV service providers and their HIV burden. Conclusions As the COVID-19 pandemic continues, we must find novel, affordable ways to continue to provide sexual health, mental health and other support services to LGBTQ+ youth.
Office-based workplaces are an important but understudied context for infectious disease transmission. We examined the feasibility of two different sensors (Opos and Bluetooth beacons) for collecting person-to-person contacts and hand hygiene in office-based workplaces. Opo is an interaction sensor that captures sensor-to-sensor interactions through ultrasonic frequencies, which correspond to face-to-face contacts between study participants. Opos were additionally used to measure hand hygiene events by affixing sensors to soap and alcohol-based hand sanitizer dispensers. Bluetooth beacons were used in conjunction with a smartphone application and recorded proximity contacts between study participants. Participants in two office sites were followed for one-week in their workplace in March 2018. Contact patterns varied by time of day and day of the week. Face-to-face contacts were of shorter mean duration than proximity contacts. Supervisors had fewer proximity contacts but more face-to-face contacts than non-supervisors. Self-reported hand hygiene was substantively higher than sensor-collected hand hygiene events and duration of hand washing events was short (median: 9 seconds, range: 2.5–33 seconds). Given that office settings are key environments in which working age populations spend a large proportion of their time and interactions, a better characterization of empirical social networks and hand hygiene behaviors for workplace interactions are needed to mitigate outbreaks and prepare for pandemics. Our study demonstrates that implementing sensor technologies for tracking interactions and behaviors in offices is feasible and can provide new insights into real-world social networks and hygiene practices. We identified key social interactions, variability in hand hygiene, and differences in interactions by workplace roles. High-resolution network data will be essential for identifying the most effective ways to mitigate infectious disease transmission and develop pandemic preparedness plans for the workplace setting.
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