Informing the Development of a Mobile Phone HIV Testing Intervention: Intentions to Use Specific HIV Testing Approaches Among Young Black Transgender Women and Men Who Have Sex With Men

Abstract

BackgroundRegular human immunodeficiency virus (HIV) testing of persons at risk is critical to HIV prevention. Infrequent HIV testing and late diagnosis of HIV infection have been observed among young black men who have sex with men (MSM) and transwomen (transgender women)—two groups overrepresented in the HIV epidemic.ObjectiveThe objective of this study was to inform the development of a brief mobile phone intervention to increase HIV testing among young black MSM and transwomen by providing a tailored recommendation of an optimal HIV testing approach. We identified demographic, behavioral, psychosocial, and sociostructural factors associated with intentions to use three specific HIV testing approaches: self-testing, testing at a clinic or other provider, and couples HIV testing and counseling (CHTC).MethodsIndividuals were eligible for a Web-based survey if they were male at birth; were between the ages of 16 and 29 years; self-identified as black, African American, Caribbean black, African black, or multiethnic black; were not known to be HIV-infected; and reported insertive or receptive anal intercourse with a man or transwoman in the last 12 months. Recruitment occurred via banner advertisements placed on a range of social and sexual networking websites and apps in New York City and nationally, and via events attended by young black MSM and transwomen in New York City. Intention to test by each testing method was analyzed using logistic regression with best subset models and stepwise variable selection.ResultsAmong 169 participants, intention to use a self-test was positively associated with comfort in testing by a friend or a partner at home (Adjusted odds ratio, AOR, 2.40; 95% CI 1.09-5.30), and stigma or fear as a reason not to test (AOR 8.61; 95% CI 2.50-29.68) and negatively associated with higher social support (AOR 0.48; 95% CI 0.33-0.72) and having health insurance (AOR 0.21; 95% CI 0.09-0.54). Intention to test at a clinic or other provider was positively associated with self-efficacy for HIV testing (AOR 2.87; 95% CI 1.48-5.59) and social support (AOR 1.98; 95% CI 1.34-2.92), and negatively associated with a lifetime history of incarceration (AOR 0.37; 95% CI 0.16-0.89). Intention to test by CHTC was negatively associated with higher educational level (Some college or Associate’s degree vs high school graduate or less [AOR 0.81; 95% CI 0.39-1.70]; Bachelor’s degree or more vs high school graduate or less [AOR 0.28; 95% CI 0.11-0.70]).ConclusionsUnique factors were associated with intention to test using specific testing approaches. These data will be critical for the development of a tailored intervention that shows promise to increase comfort and experiences with a variety of testing approaches among young black MSM and transwomen.

Assessing the Cross-Cultural Adaptation and Translation of a Text-Based Mobile Smoking Cessation Program in Samoa (TXTTaofiTapaa): Pilot Study

“…Mobile phones can deliver programs to support behavioral change [ 1 , 2 ], data management or surveillance [ 3 , 4 ], and other essential public health activities. The use of mobile phones could potentially promote health and gender equity [ 5 , 6 ] and enhance community empowerment [ 7 , 8 ]. Short message service (SMS) text messaging, in particular, has been shown to be a simple and effective intervention for improving health service delivery in pregnant women [ 9 , 10 ], infectious disease cases [ 11 , 12 ], weight loss cases [ 13 ], and diabetes cases [ 14 ] and increasingly for smoking cessation support [ 15 - 18 ].…”

Perceptions of HIV Self-Testing Among Men Who Have Sex With Men in the United States: A Qualitative Analysis

“…Users of HIVST have the autonomy to include other individuals in their testing experience such as their partners, friends, or family members. Given the growing evidence in support of couples HIV testing among MSM, the use of HIVST with main partners is being explored in multiple studies (Koblin et al, 2017;Neme, Goldenberg, Stekler, Sullivan, & Stephenson, 2015;Stephenson, Freeland, et al, 2017;Stephenson, Suarez, et al, 2017;Sullivan, Wall, et al, 2014;Wall et al, 2016). Partners can be a source of comfort and support during the HIV testing experience and can help mitigate the emotional distress that may occur after receiving a positive test result (Martinez et al, 2014).…”

“…Partners can be a source of comfort and support during the HIV testing experience and can help mitigate the emotional distress that may occur after receiving a positive test result (Martinez et al, 2014). Additionally, recent studies demonstrated an association between support provided by non-partner and intentions to test for HIV (Frye et al, 2015;Koblin et al, 2017).…”

Intervention to Match Young Black Men and Transwomen Who Have Sex With Men or Transwomen to HIV Testing Options (All About Me): Protocol for a Randomized Controlled Trial

“…Questions about sexual behaviors in the prior 3 months include the number of anal or vaginal sex partners, insertive and receptive anal sex, condom use, and HIV status of partners. Questions about use of substances in the prior 3 months include marijuana, stimulants (powder cocaine, crack cocaine, methamphetamine), prescription drugs, poppers, erectile dysfunction drugs, and club drugs [ 38 ]. Presence of depressive symptoms is measured with the Patient Health Questionnaire 2 (PHQ-2) [ 39 ].…”

“…The computerized algorithm that provides a personalized recommendation of the optimal HIV testing approach for individuals was based on the findings from a quantitative survey described previously [ 38 ]. The survey collected data on intentions to test by self-test, couples HIV testing and counseling, and at a clinic or other provider, as well as awareness and comfort levels with specific testing modalities, sociostructural factors, behavioral risk, peer norms, social support, and stigma [ 38 ]. Stepwise selection multivariable modeling identified variables statistically independently associated with intention to test by each of three specific HIV testing methods ( Table 1 ; reported previously in [ 38 ]).…”