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      The Comparability of Men Who Have Sex With Men Recruited From Venue-Time-Space Sampling and Facebook: A Cohort Study

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          Abstract

          Background

          Recruiting valid samples of men who have sex with men (MSM) is a key component of the US human immunodeficiency virus (HIV) surveillance and of research studies seeking to improve HIV prevention for MSM. Social media, such as Facebook, may present an opportunity to reach broad samples of MSM, but the extent to which those samples are comparable with men recruited from venue-based, time-space sampling (VBTS) is unknown.

          Objective

          The objective of this study was to assess the comparability of MSM recruited via VBTS and Facebook.

          Methods

          HIV-negative and HIV-positive black and white MSM were recruited from June 2010 to December 2012 using VBTS and Facebook in Atlanta, GA. We compared the self-reported venue attendance, demographic characteristics, sexual and risk behaviors, history of HIV-testing, and HIV and sexually transmitted infection (STI) prevalence between Facebook- and VTBS-recruited MSM overall and by race. Multivariate logistic and negative binomial models estimated age/race adjusted ratios. The Kaplan-Meier method was used to assess 24-month retention.

          Results

          We recruited 803 MSM, of whom 110 (34/110, 30.9% black MSM, 76/110, 69.1% white MSM) were recruited via Facebook and 693 (420/693, 60.6% black MSM, 273/693, 39.4% white MSM) were recruited through VTBS. Facebook recruits had high rates of venue attendance in the previous month (26/34, 77% among black and 71/76, 93% among white MSM; between-race P=.01). MSM recruited on Facebook were generally older, with significant age differences among black MSM ( P=.02), but not white MSM ( P=.14). In adjusted multivariate models, VBTS-recruited MSM had fewer total partners (risk ratio [RR]=0.78, 95% CI 0.64-0.95; P=.01) and unprotected anal intercourse (UAI) partners (RR=0.54, 95% CI 0.40-0.72; P<.001) in the previous 12 months. No significant differences were observed in HIV testing or HIV/STI prevalence. Retention to the 24-month visit varied from 81% for black and 70% for white MSM recruited via Facebook, to 77% for black and 78% for white MSM recruited at venues. There was no statistically significant differences in retention between the four groups (log-rank P=.64).

          Conclusions

          VBTS and Facebook recruitment methods yielded similar samples of MSM in terms of HIV-testing patterns, and prevalence of HIV/STI, with no differences in study retention. Most Facebook-recruited men also attended venues where VTBS recruitment was conducted. Surveillance and research studies may recruit via Facebook with little evidence of bias, relative to VBTS.

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          Understanding Racial HIV/STI Disparities in Black and White Men Who Have Sex with Men: A Multilevel Approach

          Patrick Sullivan, John Peterson, Eli Rosenberg … (2014)
          Background The reasons for black/white disparities in HIV epidemics among men who have sex with men have puzzled researchers for decades. Understanding reasons for these disparities requires looking beyond individual-level behavioral risk to a more comprehensive framework. Methods and Findings From July 2010-Decemeber 2012, 803 men (454 black, 349 white) were recruited through venue-based and online sampling; consenting men were provided HIV and STI testing, completed a behavioral survey and a sex partner inventory, and provided place of residence for geocoding. HIV prevalence was higher among black (43%) versus white (13% MSM (prevalence ratio (PR) 3.3, 95% confidence interval (CI): 2.5–4.4). Among HIV-positive men, the median CD4 count was significantly lower for black (490 cells/µL) than white (577 cells/µL) MSM; there was no difference in the HIV RNA viral load by race. Black men were younger, more likely to be bisexual and unemployed, had less educational attainment, and reported fewer male sex partners, fewer unprotected anal sex partners, and less non-injection drug use. Black MSM were significantly more likely than white MSM to have rectal chlamydia and gonorrhea, were more likely to have racially concordant partnerships, more likely to have casual (one-time) partners, and less likely to discuss serostatus with partners. The census tracts where black MSM lived had higher rates of poverty and unemployment, and lower median income. They also had lower proportions of male-male households, lower male to female sex ratios, and lower HIV diagnosis rates. Conclusions Among black and white MSM in Atlanta, disparities in HIV and STI prevalence by race are comparable to those observed nationally. We identified differences between black and white MSM at the individual, dyadic/sexual network, and community levels. The reasons for black/white disparities in HIV prevalence in Atlanta are complex, and will likely require a multilevel framework to understand comprehensively.
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            Correlates of HIV Acquisition in a Cohort of Black Men Who Have Sex with Men in the United States: HIV Prevention Trials Network (HPTN) 061

            Beryl Koblin, Kenneth H Mayer, Susan Eshleman … (2013)
            Background Black men who have sex with men (MSM) in the United States (US) are affected by HIV at disproportionate rates compared to MSM of other race/ethnicities. Current HIV incidence estimates in this group are needed to appropriately target prevention efforts. Methods From July 2009 to October 2010, Black MSM reporting unprotected anal intercourse with a man in the past six months were enrolled and followed for one year in six US cities for a feasibility study of a multi-component intervention to reduce HIV infection. HIV incidence based on HIV seroconversion was calculated as number of events/100 person-years. Multivariate proportional hazards modeling with time-dependent covariates was used to identify correlates of HIV acquisition. Results Of 1,553 Black MSM enrolled, 1,164 were HIV-uninfected at baseline and included in follow-up. Overall annual HIV incidence was 3.0% (95% confidence interval (CI): 2.0, 4.4%) and 5.9% among men ≤30 years old (95% CI: 3.6, 9.1%). Men ≤30 years old reported significantly higher levels of sexual risk and were more likely to have a sexually transmitted infection diagnosed during follow-up. Younger men also were more likely to not have a usual place for health care, not have visited a health care provider recently, and to have unmet health care needs. In multivariate analysis, age ≤30 years (hazard ratio (HR): 3.4; 95% CI: 1.4, 8.3) and unprotected receptive anal intercourse with HIV-positive or unknown status partners (HR: 4.1; 95% CI: 1.9, 9.1) were significantly associated with HIV acquisition. Conclusion In the largest cohort of prospectively-followed Black MSM in the US, HIV incidence was high, particularly among young men. Targeted, tailored and culturally appropriate HIV prevention strategies incorporating behavioral, social and biomedical based interventions are urgently needed to lower these rates.
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              Patterns of lifetime and recent HIV testing among men who have sex with men in New York City who use Grindr.

              Christian Grov, Connie Jimenez, H Jonathon Rendina … (2013)
              Rates of HIV infection continue to rise for men who have sex with men (MSM), and may be partially due to lack of testing among groups at risk for HIV. Mobile applications have demonstrated promise to identify at-risk MSM, though more research is needed to address testing patterns among this population. We conducted an online survey of 1,351 MSM in the New York City (NYC) area recruited from Grindr and analyzed predictors of lifetime and past-year testing using Pearson's chi-squared statistic, Fisher's exact tests, and logistic regression. A majority (90 %) of men had been tested within their lifetimes, and most (71 %) had been tested within the prior year. Among those who had never been tested (n = 135), one-third had engaged in unprotected anal intercourse (UAI) in the prior 3 months and nearly one-third identified themselves as HIV-negative rather than unknown. Older age, reporting an HIV-negative (versus unknown) status, and recent UAI were independently associated with lifetime testing. Greater proportions of men who had recently engaged in UAI reported testing within the past year compared with those who had not engaged in UAI. Overall, rates of testing among MSM in this sample exceeded those of the general population, including the general population in NYC. A greater proportion of this sample had never tested compared to a population-based sample of NYC MSM, though a higher percentage had also tested in the past year. This study demonstrated that 1 in 10 NYC men using Grindr and 1 in 5 who were 18-24 years of age had never received an HIV test in their lives. Using the existing infrastructure and popularity of mobile technology such as Grindr to identify and link men to information regarding HIV testing may be a useful strategy for prevention.
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                Author and article information

                Contributors
                Alfonso C Hernandez-Romieu:
                Rollins School of Public HealthDepartment of EpidemiologyEmory UniversityRoom 444 GCR Bldg1518 Clifton RdAtlanta, GA, 30322United States1 404 727 89741 404 712 8392alfonso.claudio.hernandez@emory.edu
                ORCID: http://orcid.org/0000-0002-3971-337X
                Journal
                Journal ID (nlm-ta): JMIR Res Protoc
                Journal ID (iso-abbrev): JMIR Res Protoc
                Journal ID (publisher-id): ResProt
                Title: JMIR Research Protocols
                Publisher: JMIR Publications Inc. (Toronto, Canada )
                ISSN (Electronic): 1929-0748
                Publication date Collection: Jul-Sep 2014
                Publication date (Electronic): 17 July 2014
                Volume: 3
                Issue: 3
                Electronic Location Identifier: e37
                Affiliations
                [1] 1Rollins School of Public Health Department of Epidemiology Emory University Atlanta, GAUnited States
                [2] 2Division of Infectious Diseases School of Medicine Emory University Atlanta, GAUnited States
                [3] 3College of Arts and Sciences Department of Psychology Georgia State University Atlanta, GAUnited States
                [4] 4Rollins School of Public Health Hubert Department of Global Health Emory University Atlanta, GAUnited States
                [5] 5School of Public Health Georgia State University Atlanta, GAUnited States
                [6] 6Rollins School of Public Health Department of Behavioral Sciences and Health Education Emory University Atlanta, GAUnited States
                Author notes
                Corresponding Author: Alfonso C Hernandez-Romieu alfonso.claudio.hernandez@ 123456emory.edu
                Author information
                http://orcid.org/0000-0002-3971-337X
                http://orcid.org/0000-0002-7728-0587
                http://orcid.org/0000-0003-1133-4762
                http://orcid.org/0000-0001-5611-0119
                http://orcid.org/0000-0003-4357-2298
                http://orcid.org/0000-0002-0153-3517
                http://orcid.org/0000-0002-7723-0715
                http://orcid.org/0000-0002-3078-9124
                http://orcid.org/0000-0002-1695-8075
                Article
                Publisher ID: v3i3e37
                DOI: 10.2196/resprot.3342
                PMC ID: 4129125
                PubMed ID: 25048694
                SO-VID: 4793e182-169c-47a9-8dbb-7385cb1b3be8
                Copyright © ©Alfonso C Hernandez-Romieu, Patrick S Sullivan, Travis H Sanchez, Colleen F Kelley, John L Peterson, Carlos del Rio, Laura F Salazar, Paula M Frew, Eli S Rosenberg. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 17.07.2014.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                Date received : 24 February 2014
                Date revision requested : 19 March 2014
                Date revision received : 14 April 2014
                Date accepted : 31 May 2014
                Categories
                Subject: Original Paper
                Subject: Original Paper

                Keywords: men who have sex with men, msm,facebook,venue-based time sampling,online msm,social media recruitment of msm
                Data availability:
                Keywords: men who have sex with men, msm, facebook, venue-based time sampling, online msm, social media recruitment of msm

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