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  • 1
    Online Resource
    Online Resource
    Correlations between community-level HIV preexposure prophylaxis coverage and individual-level sexual behaviors among United States MSM
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  AIDS Vol. 36, No. 14 ( 2022-11-15), p. 2015-2023
    Details
    In: AIDS, Ovid Technologies (Wolters Kluwer Health), Vol. 36, No. 14 ( 2022-11-15), p. 2015-2023
    Abstract: To evaluate if community-level HIV PrEP coverage is correlated with individual sexual behaviors. Design: We used demographic, behavioral, and sexual network data from ARTnet, a 2017–2019 study of United States MSM. Methods: Multivariable regression models with a Bayesian modeling framework were used to estimate associations between area-level PrEP coverage and seven sexual behavior outcomes [number of total, main, and casual male partners (network degree); count of one-time partnerships; consistent condom use in one-time partnerships; and frequency of casual partnership anal sex (total and condomless)], controlling for individual PrEP use. Results: PrEP coverage ranged from 10.3% (Philadelphia) to 38.9% (San Francisco). Total degree was highest in Miami (1.35) and lowest in Denver (0.78), while the count of one-time partners was highest in San Francisco (11.7/year) and lowest in Detroit (1.5/year). Adjusting for individual PrEP use and demographics, community PrEP coverage correlated with total degree [adjusted incidence rate ratio (aIRR) = 1.73; 95% credible interval (CrI), 0.92–3.44], casual degree (aIRR = 2.05; 95% CrI, 0.90–5.07), and count of one-time partnerships (aIRR = 1.90; 95% CrI, 0.46–8.54). Without adjustment for individual PrEP use, these associations strengthened. There were weaker or no associations with consistent condom use in one-time partnerships (aIRR = 1.68; 95% CrI, 0.86–3.35), main degree (aIRR = 1.21; 95% CrI, 0.48–3.20), and frequency of casual partnership condomless anal sex (aIRR = 0.23; 95% CrI, 0.01–3.60). Conclusion: Most correlations between community PrEP coverage and sexual behavior were explained by individual PrEP use. However, some residual associations remained after controlling for individual PrEP use, suggesting that PrEP coverage may partially drive community-level differences in sexual behaviors.
    Type of Medium: Online Resource
    ISSN: 0269-9370 , 1473-5571
    URL: Article
    DOI: 10.1097/QAD.0000000000003343
    RVK:
    XA 16838
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2012212-3
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  • 2
    Online Resource
    Online Resource
    Egocentric sexual networks of men who have sex with men in the United States: Results from the ARTnet study
    Elsevier BV ; 2020
    In:  Epidemics Vol. 30 ( 2020-03), p. 100386-
    Details
    In: Epidemics, Elsevier BV, Vol. 30 ( 2020-03), p. 100386-
    Type of Medium: Online Resource
    ISSN: 1755-4365
    URL: Article
    DOI: 10.1016/j.epidem.2020.100386
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2467993-8
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  • 3
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    HIV and Sexually Transmitted Infection Epidemic Potential of Networks of Men Who Have Sex With Men in Two Cities
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Epidemiology Vol. 32, No. 5 ( 2021-09), p. 681-689
    Details
    In: Epidemiology, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 5 ( 2021-09), p. 681-689
    Abstract: The speed with which a pathogen circulates in a sexual network is a function of network connectivity. Cross-sectional connectivity is a function of network features like momentary degree and assortative mixing. Temporal connectivity is driven by partner acquisition rates. The forward-reachable path (FRP) has been proposed as a summary measure of these two aspects of transmission potential. We use empirical data from San Francisco and Atlanta to estimate the generative parameters of the FRP and compare results to the HIV/sexually transmitted infection epidemics in each city. Methods: We used temporal exponential random graph models to estimate the generative parameters for each city’s dynamic sexual network from survey data. We then simulated stochastic dynamic networks from the fitted models and calculated the FRP for each realization, overall, and stratified by partnership type and demographics. Results: The overall mean and median paths were higher in San Francisco than in Atlanta. The overall paths for each city were greater than the sum of the paths in each individual partnership network. In the casual partnership network, the mean path was highest in the youngest age group and lowest in the oldest age group, despite the fact that the youngest group had the lowest mean momentary degree and past-year partner counts. Conclusions: The FRP by age group revealed the additional utility of the measure beyond the temporal and cross-sectional network connectivity measures. Other nonnetwork factors are still necessary to infer total epidemic potential for any specific pathogen.
    Type of Medium: Online Resource
    ISSN: 1044-3983
    URL: Article
    DOI: 10.1097/EDE.0000000000001390
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2042095-X
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  • 4
    Online Resource
    Online Resource
    Individual HIV Risk versus Population Impact of Risk Compensation after HIV Preexposure Prophylaxis Initiation among Men Who Have Sex with Men
    Public Library of Science (PLoS) ; 2017
    In:  PLOS ONE Vol. 12, No. 1 ( 2017-1-6), p. e0169484-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 12, No. 1 ( 2017-1-6), p. e0169484-
    Type of Medium: Online Resource
    ISSN: 1932-6203
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1371/journal.pone.0169484
    DOI: 10.1371/journal.pone.0169484.g001
    DOI: 10.1371/journal.pone.0169484.g002
    DOI: 10.1371/journal.pone.0169484.g003
    DOI: 10.1371/journal.pone.0169484.t001
    DOI: 10.1371/journal.pone.0169484.t002
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2017
    detail.hit.zdb_id: 2267670-3
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  • 5
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    Association between HIV PrEP indications and use in a national sexual network study of US men who have sex with men
    Wiley ; 2021
    In:  Journal of the International AIDS Society Vol. 24, No. 10 ( 2021-10)
    Details
    In: Journal of the International AIDS Society, Wiley, Vol. 24, No. 10 ( 2021-10)
    Abstract: HIV pre‐exposure prophylaxis (PrEP) is effective in preventing HIV transmission. United States Public Health Service (USPHS) clinical practice guidelines define biobehavioral indications for initiation. To assess guideline implementation, it is critical to quantify PrEP nonusers who are indicated and PrEP users who are not indicated. We sought to estimate current PrEP use among US men who have sex with men (MSM), characterize whether their PrEP use aligned with their current indications for PrEP, and assess whether the association between PrEP indications and PrEP use differed by demography or geography. Methods Using data from a US web‐based sexual network study of MSM between 2017 and 2019, we measured PrEP usage and assessed whether respondents met indications for PrEP. Log‐binomial regression was used to estimate the relationship between PrEP indications and PrEP use, with adjustment for geography, age and race/ethnicity. Results Of 3508 sexually active, HIV‐negative MSM, 34% met indications for PrEP. The proportion with current PrEP use was 32% among MSM meeting indications and 11% among those without indications. Nearly 40% of those currently using PrEP did not meet indications for PrEP, and 68% of MSM with indications for PrEP were not currently using PrEP. After adjusting for geography and demographics, MSM with PrEP indications were about three times as likely to be currently using PrEP. This association varied slightly, but not significantly, by geographic region, age and race/ethnicity. Conclusions Indications for PrEP strongly predicted current PrEP use among US MSM. However, we identified substantial misalignment between indications and use in both directions (indicated MSM who were not benefitting from PrEP, and MSM taking PrEP while not presently being indicated). PrEP underuse by those at greatest risk for HIV acquisition may limit the projected impact of PrEP implementation, despite reported increases in PrEP provision. This calls for further implementation efforts to improve PrEP delivery to those most in need during periods of elevated sexual risk and to close the gap between indications and uptake.
    Type of Medium: Online Resource
    ISSN: 1758-2652 , 1758-2652
    URL: Issue
    URL: Article
    DOI: 10.1002/jia2.v24.10
    DOI: 10.1002/jia2.25826
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2467110-1
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  • 6
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    Online Resource
    Epidemiological Impact of Expedited Partner Therapy for Men Who Have Sex With Men: A Modeling Study
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Sexually Transmitted Diseases Vol. 46, No. 11 ( 2019-11), p. 697-705
    Details
    In: Sexually Transmitted Diseases, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. 11 ( 2019-11), p. 697-705
    Abstract: Expedited partner therapy (EPT) is an intervention for patients with gonorrhea or chlamydia, providing index patients with prescriptions or medication to give to their partners. Expedited partner therapy is recommended for heterosexuals but not for men who have sex with men (MSM), partially due to concerns about overtreatment of uninfected partners and missed opportunities for human immunodeficiency virus (HIV) diagnosis. Methods We extended our stochastic network-based mathematical model of HIV, gonorrhea, and chlamydia among MSM to include EPT. The EPT implementation was simulated for 10 years. Counterfactual scenarios varied EPT coverage, provision, uptake, and partnership window duration. We estimated sexually transmitted infection (STI) incidence, proportion of infections averted, and process outcomes under each scenario. Results Delivery of EPT to 20% of eligible MSM index patients (coverage) reduced cumulative STI incidence by 27% (interquartile range, 13%–39%) over 10 years compared with current estimated STI screening levels. A 20% increase in providing medication to non–index partners (provision) averted 32% (interquartile range, 20%–41%) of STI infections compared with estimated STI screening levels. When targeted by partnership type, EPT solely to casual partners maximized the population-level infections averted. The proportion of partners given medication who had no current STI varied from 52% to 63%, depending on coverage level. The proportion of partners given medication with undiagnosed HIV infection was 4% across scenarios. Conclusions Expedited partner therapy could reduce bacterial STI incidence for MSM. However, this intervention could result in missed opportunities for HIV/STI prevention and a substantial increase in use of antimicrobials by STI-uninfected MSM, raising concerns about cost and antimicrobial resistance.
    Type of Medium: Online Resource
    ISSN: 1537-4521 , 0148-5717
    URL: Article
    DOI: 10.1097/OLQ.0000000000001058
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2055170-8
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  • 7
    Online Resource
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    Estimated Number of Men Who Have Sex With Men With Indications for HIV Pre-exposure Prophylaxis in a National Sexual Network Study
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  JAIDS Journal of Acquired Immune Deficiency Syndromes Vol. 84, No. 1 ( 2020-05-1), p. 10-17
    Details
    In: JAIDS Journal of Acquired Immune Deficiency Syndromes, Ovid Technologies (Wolters Kluwer Health), Vol. 84, No. 1 ( 2020-05-1), p. 10-17
    Abstract: A 2015 CDC analysis estimated that 24.7% of sexually active men who have sex with men (MSM) had indications for HIV pre-exposure prophylaxis (PrEP) based on 2014 US Public Health Service (USPHS) clinical practice guidelines. Given that the USPHS revised these guidelines in 2017, updated estimates of the fraction of MSM indicated for PrEP overall and stratified by demographic factors and geography are needed to scale-up PrEP for MSM in the US. Methods: We conducted a national web-based study of 4904 MSM aged 15–65 who had ever had sex with another man between July 2017 and January 2019. We estimated the percentage of HIV-negative, sexually active MSM meeting USPHS indications for PrEP by demographic category. Results: Of 3511 sexually active, HIV-negative MSM, 34.0% (95% confidence interval: 32.4 to 35.6) met USPHS indications for PrEP, with percentages consistent across US census region and varying slightly by race/ethnicity (Black: 32.2%, White: 33.7%, Hispanic: 36.4%, Other: 33.6%). Among individuals meeting USPHS PrEP indications, 93.5% reported condomless anal intercourse in the prior 6 months. Among all survey respondents, PrEP eligibility was lowest among non-Hispanic black (18.4%) and younger respondents (15–17: 4.1%; 18–24: 18.1%). Conclusions: Estimated percentages of MSM meeting indications for PrEP exceeded the previous CDC estimate across race/ethnicity, age, and census regions, with one-third of adult, sexually active, HIV-negative MSM exhibiting indications for PrEP. This study suggests, given current guidelines for PrEP indications, that a different fraction of eligible MSM could be receiving PrEP than previously estimated.
    Type of Medium: Online Resource
    ISSN: 1525-4135
    URL: Article
    DOI: 10.1097/QAI.0000000000002300
    RVK:
    XA 10000
    RVK:
    XA 51942
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2038673-4
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  • 8
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    Bacterial Sexually Transmitted Infection Screening Rates by Symptomatic Status Among Men Who Have Sex With Men in the United States: A Hierarchical Bayesian Analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Sexually Transmitted Diseases Vol. 46, No. 1 ( 2019-1), p. 25-30
    Details
    In: Sexually Transmitted Diseases, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. 1 ( 2019-1), p. 25-30
    Abstract: Prevention of bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM) requires timely disease detection, but this is complicated by asymptomatic infection. We estimated screening/testing rates by symptomatic status to evaluate adherence to Centers for Disease Control and Prevention STI screening guidelines. Methods In a cross-sectional study of 2572 US MSM aged 15 to 65 years in 2017 to 2018, we measured the reported number of asymptomatic STI screens in the past 2 years versus tests prompted by disease symptoms. Using negative binominal regression within a hierarchical Bayesian framework, we estimated yearly rates of asymptomatic screening and symptomatic testing by geographic, demographic, and behavioral factors. Results Human immunodeficiency virus (HIV) status was most strongly associated with all testing/screening frequency (incidence rate ratio [IRR], 1.72; 95% credible interval [Crl] , 1.49, 1.97). The HIV-uninfected MSM had 0.14 (95% credible interval [CrI], 0.12–0.17) symptomatic tests and 0.88 (95% CrI, 0.77–1.01) asymptomatic screens per year. The HIV-infected MSM had 0.25 (95% CrI, 0.18–0.35) symptomatic tests and 1.53 (95% CrI, 1.24–1.88) asymptomatic screens per year. Rates of asymptomatic screening were higher among black compared with white MSM (IRR, 1.41; 95% CrI, 1.15–1.73), but weakly associated with number of past-year sexual partners (IRR, 1.01; 95% CrI, 1.00–1.01). Overall, 85% to 90% of diagnostic events were asymptomatic screens. Conclusions Self-reported rates of STI screening were close to Centers for Disease Control and Prevention's recommended overall annual screening frequency, but with gaps defined by demographics and behavioral risk. Targeted screening efforts may be indicated specifically for younger MSM and those with multiple partners.
    Type of Medium: Online Resource
    ISSN: 1537-4521 , 0148-5717
    URL: Article
    DOI: 10.1097/OLQ.0000000000000896
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2055170-8
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