Developing a Typology of HIV/STI Testing Patterns Among Gay, Bisexual, and Queer Men: A Framework to Guide Interventions

Tan, Rayner Kay Jin; Kaur, Nashwinder; Chen, Mark; Wong, Chen Seong

doi:10.1177/1049732319870174

Cited by 4 publications

(3 citation statements)

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“…26 Singapore society holds largely conservative views around sexual behaviours, especially towards sexual relations before marriage, sexual relations between two adults of the same sex, and cohabitation before marriage. 27 Although scholars have largely attempted to characterise risk factors for HIV and other sexually transmitted infections among at-risk populations such as men who have sex with men, sex workers and their clients, as well as adolescents, [28][29][30][31][32][33][34][35] there is a gap in published studies on the sexual behaviour of Singaporeans in general, notwithstanding a few studies on sexual health in the general population. [36][37][38] Singapore's version of its 'lockdown', or COVID-19 movement control measures, were also known as the 'circuit breaker' period.…”

Section: Introductionmentioning

confidence: 99%

Partnership status, living arrangements, and changes in sexual behaviour and satisfaction during the COVID-19 lockdown: insights from an observational, cross-sectional online survey in Singapore

2021

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Background The SARS-CoV-2 (coronavirus disease 2019; COVID-19) pandemic and its concomitant movement control measures have had a profound impact on the world. In spite of its potential impact on sexual health, there is a lack of research on how the pandemic and its movement control measures have impacted sexual wellbeing among Singaporeans. Methods This observational, cross-sectional study was conducted from August to September 2020. Participants were recruited through an online survey instrument promoted through social media. Respondents self-reported their sexual behaviours and levels of sexual satisfaction prior to and during the COVID-19 pandemic movement control measures. Results We recruited a total of 562 participants, of whom 338 (60.1%) ever had a sexual experience. Singles (n=106, 31.4%) and those not living with their partners (n=115, 34.0%) reported a greater decrease in partnered sexual activities but a greater increase in individual sexual activities such as masturbation, sending and receiving nudes and watching pornography, relative to those who were living with their partners (n=117, 34.6%). Multivariable analyses indicated that relative to singles, those who were not living with their partners were more likely to experience a decrease in sexual satisfaction (adjusted prevalence ratio [aPR]=1.42, 95% CI [1.07, 1.90]), whereas those who were living with their partners were less likely to experience a decrease in sexual satisfaction (aPR=0.45, 95% CI [0.25, 0.81]). Conclusions Interventions may focus on enhancing sexual wellness by educating on and supporting individual or partnered sexual activities that may vary along the lines of partnership status and living arrangements during the implementation of movement control measures.

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Section: Introductionmentioning

confidence: 99%

Partnership status, living arrangements, and changes in sexual behaviour and satisfaction during the COVID-19 lockdown: insights from an observational, cross-sectional online survey in Singapore

2021

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“…Qualitative studies are needed to delineate the processes underlying different patterns of testing in local context. 31 As testing-related information was ascertained based on self-reporting by HIV-positive persons, some extent of misclassification due to recall bias could not be avoided.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017

et al. 2021

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ObjectiveTo assess the temporal trend and identify risk factors associated with the absence of previous HIV testing prior to their diagnosis among HIV-positive persons in Singapore.Study designCross-sectional.Setting and participantsWe analysed data of HIV-positive persons infected via sexual transmission, who were notified to the National HIV Registry in 2012–2017.OutcomesEpidemiological factors associated with the absence of HIV testing prior to diagnosis were determined separately for two groups of HIV-positive persons: early and late stages of HIV infection at diagnosis.Results2188 HIV-positive persons with information on HIV testing history and CD4 cell count were included in the study. The median age at HIV diagnosis was 40 years (IQR 30–51). Nearly half (45.1%) had never been tested for HIV prior to their diagnosis. The most common reason cited for no previous HIV testing was ‘not necessary to test’ (73.7%). The proportion diagnosed at late-stage HIV infection was significantly higher among HIV-positive persons who had never been tested for HIV (63.9%) compared with those who had undergone previous HIV tests (29.0%). Common risk factors associated with no previous HIV testing in multivariable logistic regression analysis stratified by stage of HIV infection were: older age at HIV diagnosis, lower educational level, detection via medical care and HIV infection via heterosexual transmission. In the stratified analysis for persons diagnosed at early-stage of HIV infection, in addition to the four risk factors, women and those of Malay ethnicity were also less likely to have previous HIV testing prior to their diagnosis.ConclusionTargeted prevention efforts and strategies are needed to raise the level of awareness of HIV/AIDS and to encourage early and regular screening among the at-risk groups by making HIV testing more accessible.

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“…Given the barriers to HIV and other STI testing reported by participants, many participants described how the introduction of HIVST would address certain barriers such as the lack of convenience or confidentiality in facility-based HIV testing. Furthermore, given that different factors may underpin regular or episodic patterns of testing for GBMSM, 28 we would expect that the availability of HIVST may provide additional incentives for both regular and episodic testing, especially among GBMSM, who face barriers in accessing facility-based testing.…”

Section: Discussionmentioning

confidence: 99%

Potential interactions between the pathways to diagnosis of HIV and other STIs and HIV self-testing: insights from a qualitative study of gay, bisexual and other men who have sex with men in Singapore

et al. 2020

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ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing.MethodsWe conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis.ResultsFor HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and external motivators, respectively. Availability of bundle tests, starting a new relationship and instances of mandatory testing motivated both simultaneous HIV and other STI testing. The fear of a positive diagnosis and lack of confidentiality were cited as internal and external barriers to HIV testing, respectively, while low perceived severity of other STI and the cost of STI tests were cited as internal and external barriers to other STI testing, respectively. We identified pathways to HIV and other STI testing and discussed how the introduction of HIVST may reduce opportunities for other STI testing.ConclusionsThe findings of this study suggest that introducing HIVST might weaken linkages to other STI testing if alternative strategies of promoting other STI testing are not simultaneously implemented. We recommend that future interventions address both the risks of HIV and other STI simultaneously, and that structural interventions promoting HIV and other STI preventions be balanced accordingly.

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Developing a Typology of HIV/STI Testing Patterns Among Gay, Bisexual, and Queer Men: A Framework to Guide Interventions

Cited by 4 publications

References 47 publications

Partnership status, living arrangements, and changes in sexual behaviour and satisfaction during the COVID-19 lockdown: insights from an observational, cross-sectional online survey in Singapore

Partnership status, living arrangements, and changes in sexual behaviour and satisfaction during the COVID-19 lockdown: insights from an observational, cross-sectional online survey in Singapore

Epidemiological factors associated with the absence of previous HIV testing among HIV-positive persons in Singapore, 2012–2017

Potential interactions between the pathways to diagnosis of HIV and other STIs and HIV self-testing: insights from a qualitative study of gay, bisexual and other men who have sex with men in Singapore

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