Tag: MSM

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EMIS 2017 Journal Articles 2017

Determinants of PrEP Uptake, Intention and Awareness in the Netherlands: A Socio-Spatial Analysis

Int J Environ Res Public Health. 2022 Jul 20;19(14):8829. doi: 10.3390/ijerph19148829.

Authors: Haoyi Wang, Oladipupo Shobowale, Chantal den Daas, Eline Op de Coul, Bouko Bakker, Aryanti Radyowijati, Koenraad Vermey, Arjan van Bijnen, Wim Zuilhof , Kai J Jonas

Abstract

PrEP uptake in the Netherlands is growing but remains at suboptimal levels. Hence, the analysis of hurdles is paramount. Given the initial focus of PrEP provision among men-who-have-sex-with-men (MSM) via a demonstration project that was launched in June 2015, AmPrEP in Amsterdam, and pharmacies in the main urban areas (so called “Randstad”, entailing Amsterdam, Utrecht, Leiden, The Hague and Rotterdam), investigating regional differences is necessary. This study seeks to unravel regional differences jointly with the psycho-social determinants of PrEP uptake. This cross-sectional study included 3232 HIV-negative MSM recruited via the Dutch subsample of the European-MSM-Internet-Survey in late 2017 (EMIS-2017), which aimed to inform interventions for MSM who are highly affected by infections with HIV and other sexually transmitted infections. Prevalence and the standardised prevalence ratio (SPR) of PrEP awareness, intention and uptake were measured on a regional level (Randstad vs. the rest of the country). Multi-level logistic modelling was conducted to identify the association of PrEP uptake with PrEP awareness and intention, socio-demographic, psycho-social determinants and random effects from regional differences. MSM from the Randstad used more PrEP (SPR = 1.4 vs. 0.7) compared to the rest of the country, but there were minor differences for awareness and intention. The regional distinction was estimated to explain 4.6% of the PrEP use variance. We observed a greater influence from PrEP intention (aOR = 4.5, 95% CI 2.0-10.1), while there was limited influence from the awareness of PrEP (aOR = 0.4, 95% CI 0.04-4.4). Lower education (aOR = 0.4, 95% CI 0.2-0.9) was negatively associated with PrEP uptake; however, no significant difference was found between middle (aOR = 1.2, 95% CI 0.7-2.0) and high education. We showed that regional differences-MSM in non-urban regions-and other psycho-social determinants account for lower PrEP uptake. Based on these findings, more fine-tuned PrEP access with a focus on non-urban regions can be implemented, and tailored campaigns increasing intention/use can be conducted among target populations.

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EMIS 2017 Journal Articles 2017

Chemsex users in Czechia: EMIS survey

Cent Eur J Public Health. 2022 Jun;30(2):86-92. doi: 10.21101/cejph.a6923.

Authors: Xenie Uholyeva, Michal Pitoňák

Abstract

Objectives: Chemsex is a phenomenon highly relevant to public health concerns. Our primary aim is to describe the Czech chemsex scene regarding substances used, sexual behaviour, mental health, sexual life satisfaction, internalization of homonegative attitudes, and prevalent chemsex patterns.

Methods: The data from the European Men Who Have Sex With Men Internet Survey (EMIS) 2017 were used. The mental health of chemsex users was assessed by the Patient Health Questionnaire 4 (PHQ4), internalized homonegativity was measured using the Short Internalized Homonegativity Scale. A sample of 87 men who have sex with men (MSM) chemsex users and a comparison group of 261 MSM were selected from the total sample of 1,688 respondents. Mann-Whitney and χ2 tests were used to compare groups.

Results: Active chemsex users made up 5% of the sample (87 of 1,688), with an average age of 37 years. Chemsex users were more likely to engage in condomless sex with non-steady partners (χ2 = 46.8, p < 0.001), and had dramatically more STIs, such as HIV (χ2 = 52.9, p < 0.001), HCV (χ2 = 25.9, p < 0.001), and syphilis (χ2 = 41.5, p < 0.001). Chemsex users frequently injected drugs (n = 19, 20%). More than half (n = 48; 55%) of chemsex users had sober sex in the last 4 weeks. Chemsex culture was associated with riskier substance use, both in terms of mode and frequency. The mental health of chemsex users in our sample did not differ significantly from the comparison group (χ2 = 0.2, p < 0.7). Chemsex users did not conceal their sexual identity more often than the comparison group, on the contrary, 69% (n = 59) of them were out to most significant others, compared to 53% (n = 134) in the comparison group (χ2 = 8.8, p < 0.05). In addition, we did not find differences in the degree of internalized homonegativity (χ2 = 0.9, p < 0.4). Chemsex users were clearly and significantly more satisfied with their sex life than the comparison group (Mann-Whitney U test, p < 0.001).

Conclusions: In our sample, chemsex use was not associated with a negative impact on health or wellbeing. Our results suggest that chemsex is not a homogeneous phenomenon. Many different patterns and subcultures exist, some of them are riskier, some safer than others.

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EMIS 2017 Journal Articles 2017

What is the empirical basis for converting banded ordinal data on numbers of sex partners among MSM into a continuous scale level variable? A secondary analysis of 13 surveys across 17 countries

BMC Med Res Methodol 22, 59 (2022). https://doi.org/10.1186/s12874-021-01483-8

Authors: Ana Mendez‑Lopez, Ford Hickson, Klaus Jansen, Nathan Lachowsky, Fiona Burns, Cinta Folch, Annie Velter, Peter Weatherburn, Ulrich Marcus , Ursula von Rüden, Massimo Mirandola, Lorenzo Gios, Jamie Frankis, David J. Brennan and Axel J. Schmidt

Abstract

Background: To provide empirically based guidance for substituting partner number categories in large MSM surveys with mean numbers of sexual and condomless anal intercourse (CAI) partners in a secondary analysis of survey data.

Methods: We collated data on numbers of sexual and CAI partners reported in a continuous scale (write-in number) in thirteen MSM surveys on sexual health and behaviour across 17 countries. Pooled descriptive statistics for the number of sexual and CAI partners during the last twelve (N = 55,180) and 6 months (N = 31,759) were calculated for two sets of categories commonly used in reporting numbers of sexual partners in sexual behaviour surveys.

Results: The pooled mean number of partners in the previous 12 months for the total sample was 15.8 partners (SD = 36.6), while the median number of partners was 5 (IQR = 2–15). Means for number of partners in the previous 12 months for the first set of categories were: 16.4 for 11–20 partners (SD = 3.3); 27.8 for 21–30 (SD = 2.8); 38.6 for 31–40 (SD = 2.4); 49.6 for 41–50 (SD = 1.5); and 128.2 for ‘more than 50’ (SD = 98.1). Alternative upper cut-offs: 43.4 for ‘more than 10’ (SD = 57.7); 65.3 for ‘more than 20’ (SD = 70.3). Self-reported partner numbers for both time frames consistently exceeded 200 or 300. While there was substantial variation of overall means across surveys, the means for all chosen categories were very similar. Partner numbers above nine mainly clustered at multiples of tens, regardless of the selected time frame. The overall means for CAI partners were lower than those for sexual partners; however, such difference was completely absent from all categories beyond ten sexual and CAI partners.

Conclusions: Clustering of reported partner numbers confirm common MSM sexual behaviour surveys’ questionnaire piloting feedback indicating that responses to numbers of sexual partners beyond 10 are best guesses rather than precise counts, but large partner numbers above typical upper cut-offs are common.

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EMIS 2017 International reports 2017

Maps for “Dublin Declaration Monitoring” 2017

The EMIS Network. EMIS-2017 – The European Men-Who-Have-Sex-With-Men Internet Survey. Maps from the EMIS-2017 Report.

Authors: Peter Weatherburn, Ford Hickson, David S. Reid, Susanne B. Schink, Ulrich Marcus, Axel J. Schmidt

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EMIS 2017 Journal Articles 2017

From HIV-testing to Gay Health Centres: A Mapping of European “Checkpoints”

HIV and Viral Hepatitis (Conference), Malta 2017 – PS2/04; (doi: 10.13140/RG.2.2.26988.77441)

Authors: Axel J. Schmidt, Dirk Sander, Teymur Noori

Abstract

Background

In Europe, HIV/STIs are concentrated in certain vulnerable groups, above all, men who have sex with men (MSM). For this reason, targeted HIV testing interventions are paramount. In 2002, a community-based HIV testing service using rapid HIV-tests was established in Amsterdam and given the name “Checkpoint”. Since then, the concept of community-based centres (CBCs) for HIV-testing and other sexual health services has spread throughout Europe, and many such centres have been established using the name “Checkpoint” (CP). Over the years, many centres have offered more comprehensive services regarding gay health, including testing for other sexually transmitted infections (STIs), counselling on drugs use, vaccination, and even provision of HIV treatment. The aim of this study to map community-based (and other) sexual health centres targeting gay and other MSM in Europe.

Methods

In preparation of the second round of the European MSM Internet Survey (EMIS-2017), the EMIS-Network, consisting of more than 80 academic, governmental, and non-governmental organisations, was contacted by e-mail (08/2015) to identify “Checkpoints” and other sexual health centres for gay men throughout Europe. 56 centres were identified and 54 responded. Representatives for the centres were asked for the exact address of the centre, the year it opened (as an HIV-testing / gay health centre) and the current opening hours per week.

Results

Community-based centres (CBCs, N=44) were distinguished from traditional clinics/private practices (“clinics”, N=10), although such binary classification is not always clear-cut. The label “community-based”, in this context, involves ownership and/or decision power by a collective of gay men. The proportion of gay men among employees was 67% in CBCs and 41% in clinics. CP Riga and Odense had no gay men employed, while CP Amsterdam, Aarhus, Bern, Copenhagen reported less than 50%. The majority of CBCs (68%) and clinics (80%) had gay physicians employed or closely attached.

Recommendations

The list is still incomplete, especially NHS services (UK) and clinics offering gay-friendly HIV-testing are missing. However we believe we covered all comprehensive sexual health services for MSM in Europe that fall into the upper right quadrant of Figure 2. The added value of maintaining up-to-date listing of CBCs is their use in online mapping services and integration in geolocation-based dating-apps targeting MSM. Experience with the European HIV-Testing-Week has shown that reaching out to MSM through push notifications with a spectrum of HIV services and opening times of Checkpoints is both cost-effective and accepted by the community.

Poster available online

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EMIS 2010 Journal Articles 2010

Проектът ЕМIS – участие на България. Резултати от хив-тестването на респондентите

Health Policy and Management, 2014; 2:21–26. (ISSN1313-4981)

Authors: Emilia Naseva, Tonka Varleva, Petar Tsintsarski, Eva Papazova, Vyara Gancheva, Hristo Taskov

Abstract

The group of men who have sex with men (MSM), is the most affected by HIV, both in Western and Central European countries and in our country. Therefore, the European Commission has funded internet study of MSM community in 33 countries, covering the period from April 2009 to September 2011. The respondents from Bulgaria are 1036. The results of the study in our country showed that more than half of the involved subjects (52.3%) identified themselves as gay or homosexual, one in four (27.7%) considered themselves as bisexual, and 17.1% do not use any term to define their sexual behaviour. Those who claim to know their HIV status are only 68.5% of all respondents; the remaining 31.2% are not sure. It is a concern that a significant proportion (61.4%) of respondents who did not know their HIV status and are sure that they are HIV negative. The information from the survey could be used as a corrective to the already taken initiatives and as a supplement to the new prevention strategies when planning new activities for reducing the spread of HIV/AIDS in Bulgaria at national and regional level. [Article in Bulgarian]

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