Disruptions in sexually transmitted infection (STI) testing infrastructure during the COVID-19 pandemic threaten to impact STI service delivery for adolescents. Within a large pediatric primary care network, we compared STI testing encounters between the pandemic period and an analogous prepandemic period. The STI test counts decreased and test positivity increased during the pandemic period.
Background Adolescents and young adults in the age range of 13-24 years are at the highest risk of developing HIV infections. As social media platforms are extremely popular among youths, researchers can utilize these platforms to curb the HIV epidemic by investigating the associations between the discourses on HIV infections and the epidemiological data of HIV infections. Objective The goal of this study was to examine how Twitter activity among young men is related to the incidence of HIV infection in the population. Methods We used integrated human-computer techniques to characterize the HIV-related tweets by male adolescents and young male adults (age range: 13-24 years). We identified tweets related to HIV risk and prevention by using natural language processing (NLP). Our NLP algorithm identified 89.1% (2243/2517) relevant tweets, which were manually coded by expert coders. We coded 1577 HIV-prevention tweets and 17.5% (940/5372) of general sex-related tweets (including emojis, gifs, and images), and we achieved reliability with intraclass correlation at 0.80 or higher on key constructs. Bivariate and multivariate analyses were performed to identify the spatial patterns in posting HIV-related tweets as well as the relationships between the tweets and local HIV infection rates. Results We analyzed 2517 tweets that were identified as relevant to HIV risk and prevention tags; these tweets were geolocated in 109 counties throughout the United States. After adjusting for region, HIV prevalence, and social disadvantage index, our findings indicated that every 100-tweet increase in HIV-specific tweets per capita from noninstitutional accounts was associated with a multiplicative effect of 0.97 (95% CI [0.94-1.00]; P=.04) on the incidence of HIV infections in the following year in a given county. Conclusions Twitter may serve as a proxy of public behavior related to HIV infections, and the association between the number of HIV-related tweets and HIV infection rates further supports the use of social media for HIV disease prevention.
Network factors have been proposed as potential drivers of racial disparities in HIV among Black and Latino men who have sex with men (MSM). This review aimed to synthesize the extant literature on networks and racial disparities in HIV among MSM and identify potential directions for future research. We searched databases for peer-reviewed articles published between January 1, 2008 and July 1, 2018. Articles were included if the sample was comprised primarily of racial/ethnic minority MSM and measured one or more network characteristics. (n = 25). HIV prevalence in networks, social support, and structural barriers were linked to disparities in HIV for Black MSM. Future research should focus on intervention development around social support and other strategies for risk reduction within networks. Given the contribution of structural factors to racial/ethnic HIV disparities, network-level interventions should be paired with policies that improve access to housing, jobs, and education for MSM. Keywords Racial disparities • Networks • Systematic review • HIV/AIDS • Men who have sex with men Resumen Los factores de redes han sido propuestos como posibles elementos contribuyentes a las disparidades raciales en el VIH entre hombres Afro-Americanos y Latinos que tienen sexo con hombres (HSH). Esta revisión sintetiza la literatura existente sobre redes y disparidades raciales en el VIH entre HSH e identifica posibles direcciones para investigaciones en el futuro. Revisamos estudios publicados entre el 1 de enero del 2008 y el 1 de julio, 2018. Los estudios se incluyeron si la muestra estuvo compuesta principalmente por HSH de minorías raciales/étnicas y si midieron una o más características de la red (n = 25). La prevalencia del VIH en redes, el apoyo social, y las barreras estructurales estaban vinculadas a los disparidades en el VIH entre Afro-Americanos y Latinos HSH. Investigaciones en el futuro deberían centrarse en el desarrollo de intervenciones relacionadas con el apoyo social y otras estrategias para la reducción de riesgo dentro de redes. Dada la importancia de factores estructurales, las intervenciones de red deben estar emparejadas con políticas que mejoren el acceso a la vivienda, el empleo, y la educación para los HSH de minorías raciales/étnicas.
Background: Little is known about users’ intervention engagement and use patterns within eHealth interventions. We describe these patterns among young men who have sex with men (YMSM) who participated in a brief eHealth intervention designed to increase HIV testing. Methods: We merged pilot trial participants’ survey data (N=86) with their paradata (e.g., system data recorded during interaction with the intervention). We created engagement (time spent on components) and use (interaction with features) metrics, and explored whether they differed by participant characteristics. Results: Engagement (mean=322.67 seconds, SD= 385.40) and use (mean=10.28 clicks on features) varied between groups. Racial/ethnic minorities clicked on fewer features (mean=8.30) than their Non-Hispanic White men (mean=12.00). Use was associated with older age (r=.19), greater educational attainment (r=.25), and a greater number of methods to connect online (r=.38). Conclusions: Paradata can help researchers understand how users interact with eHealth interventions, and inform which components to retain or redesign. Efforts to systematically collect, analyze, and report paradata in eHealth HIV prevention and care interventions are warranted.
A better understanding of the social-structural factors that influence HIV vulnerability is crucial to achieve the goal of ending the HIV epidemic by 2030. Given the role of neighborhoods in HIV outcomes, synthesis of findings from such research is key to inform efforts toward HIV eradication. We conducted a systematic review to examine the relationship between neighborhood-level factors (e.g., poverty) and HIV vulnerability (via sexual behaviors and substance use). We searched six electronic databases for studies published from January 1, 2007 through November 30, 2017 (PROSPERO CRD42018084384). We also mapped the studies’ geographic distribution to determine whether they aligned with high HIV prevalence areas and/or the “Ending the HIV Epidemic: A Plan for the United States”. Fifty-five articles met inclusion criteria. Neighborhood disadvantage, whether measured objectively or subjectively, is one of the most robust correlates of HIV vulnerability. Tests of associations more consistently documented a relationship between neighborhood-level factors and drug use than sexual risk behaviors. There was limited geographic distribution of the studies, with a paucity of research in several counties and states where HIV incidence/prevalence is a concern. Neighborhood influences on HIV vulnerability are the consequence of centuries-old laws, policies and practices that maintain racialized inequities (e.g., racial residential segregation, inequitable urban housing policies). We will not eradicate HIV without multi-level, neighborhood-based approaches to undo these injustices. Our findings inform future research, interventions and policies.
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