Amsterdam 2015
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| Abstract #2108 - Generation 2.0 - using the internet in the fight against HIV | ||||
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Session: 37.3: Generation 2.0 - using the internet in the fight against HIV (Symposium) on Thursday @ 14.30-16.00 in C002 Chaired by Tawanda Makusha, Alastair van Heerden Authors: Presenting Author: Mrs Elske Marra - GGD Amsterdam, Netherlands |
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| Additional Authors: | ||||
| Aim: Searching for sex partners on the Internet increases the risk of engaging in unprotected sex among men who have sex with men (MSM). One way of increasing thought-out decisions regarding protected or unprotected sex to avoid HIV-transmission, is by talking about risk related topics. The aim of this study was to identify the motives of men who have sex with male sexpartners through dating on the internet en for being open or silent about HIV status/viral load/sexual transmitted infection (STI) testing behavior towards potential casual sexual partners met on the Internet. Additionally, the effects of these conversations on sexual practice were studied. | ||||
| Method / Issue: This mixed methods study is designed as a triptic, together forming the whole study. First 10 MSM were recruited via snowball sampling, who participated in semi-structured interviews. The aim of the interviews was to map the motives these men have for talking or keeping silent about HIV status/viral load/STI testing behavior towards online met sex partners. Interviews were analyzed according an adapted version of the Disclosure Processes Model (DPM). Based on literature and the results of the interviews a one-sample web-based questionnaire was composed to which 371 MSM participated. Assessment of relations between independent and dependent variables was analyzed using two-way multiple response analysis including chi2 tests and multinomial logistic regression analysis. To corroborate the results of the interviews and questionnaire, and to explore the influence of social context, 4 focus groups were held, 2 with key stakeholders in the field of HIV prevention 2 with MSM. The focus groups were also analyzed according to an iterative process based on the DPM. | ||||
| Results / Comments: Participants included in this study were mainly Dutch (85%) MSM identifying themselves as gay (94%) with a higher education (62%) aged between 16-74 year. In the interviews experienced stigma regarding HIV and ignorance about HIV were the main drivers for not talking about HIV. Most interview participants did not often talk about HIV status/viral load/STI testing behavior with casual sex partners they met online. Many factors were related to talking/keeping silent about HIV/viral load/STI testing behavior. HIV positive MSM talk about HIV status more often than HIV negative MSM (OR 2.3, 95%CI: 1.04-5.14). MSM who don’t have a relationship talk less about STI testing behavior compared to those in a relationship (OR 0.48, 95%CI: 0.24-0.97). Additionally non-Dutch MSM talk about STI testing behavior more often (OR 2.83 95%CI: 1.14-7.06). The most important motive for keeping silent about HIV status among HIV positive was “If the potential partner does not start a conversation about HIV I assume he will also have HIV”, whereas HIV negative keep silent because “If someone has HIV, he would tell me”. Motives for talking are often based on enabling condomless sex and protect personal or partner’s health. Motives for keeping silent are often based on fear of stigma, ignorance about HIV and enabling condomless sex. | ||||
| Discussion: Multiple factors are associated with talking or keeping silent about HIV status/viral load/sexual transmitted infection testing behavior among both HIV positive and HIV negative MSM with sex partners they meet on the Internet. In general it seems that talking about HIV prior to sexual contact with sex partners met on the Internet can influence safe sexual practice and could therefore be useful to introduce in HIV prevention strategies. | ||||
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