Community-oriented Motivational Interviewing (MI): A novel framework extending MI to address COVID-19 vaccine misinformation in online social media platforms.

Researchers have linked circulating misinformation in online platforms to low COVID-19 vaccine uptake. Two disparate literatures provide relevant initial guidance to address the problem. Motivational Interviewing (MI) effectively reduces vaccine hesitancy in clinical environments; meanwhile, social scientists note inoculation, rebuttal, and appeals to accuracy are persuasive in digital contexts. A tension is inherent in these approaches. MI in digital forums may induce an 'illusory truth effect,' wherein falsehoods appear more accurate through repetition. Yet, rebutting misinformation directly may elicit backfire or reactance effects, motivating some to amplify their presentation of misinformation. Building on Identity Process Theory, we propose a theoretical framework for conducting MI-based infodemiology interventions among digital communities that conceptualizes the community in toto (rather than one specific person) as the unit of focus. Case examples from interventions on public Facebook posts illustrate three processes unique to such interventions: 1) Navigating tension between addressing commenters and "bystanders"; 2) Activating pro-vaccine bystanders; and 3) Reframing uncertainty or information individuals might find concerning or threatening according to implied collective values. This paper suggests community-oriented MI can maximize persuasive effects on bystanders while minimizing potential reactance from those with committed beliefs, thereby guiding community-oriented public health messaging interventions enacted in digital environments.

Perceived Risk, Optimistic Bias, and United Action: A socio-ecological examination of COVID-19 prevention behaviors among sexual minority men.

Sexual minority men (SMM) disproportionately experience psychosocial risk factors and comorbid health concerns (e.g., HIV infection) that increase their vulnerability to COVID-19 infection and distress. The current study applied a socioecological approach to the Health Belief model to understand associations among perceived risk, optimistic bias (a perceived lower risk relative to similar others), united action (perceived community capacity for collective action) and COVID-19 behavioral prevention strategies among COVID-19-negative adult cisgender SMM. Participants (n = 859), recruited via a geo-location-based dating app in May 2020, completed an online survey. Results indicated significant interactions between perceived risk and optimistic bias on social distancing (B = -.03, p < .05), and between perceived risk and united action on number of preventive precautions (B = -.01, p < .01) and number of casual sex partners (B= -.20, p < .05). At low and average levels of perceived risk, socioecological constructs were positively associated with behavioral prevention strategies. At average levels of perceived risk and above, united action was negatively associated with number of casual sex partners, demonstrating evidence of the interaction between perception of interpersonal and community factors and perceptions of one's own risk. These findings may help to inform how to mobilize increased engagement in COVID-19 behavioral prevention strategies among cisgender SMM.

Partners' Consensus About Joint Effort and COVID-19 Prevention Among Sexual Minority Men.

The current study examined the relevance of relationship functioning to partners' agreement or consensus about joint effort surrounding COVID-19 prevention. Interdependence theory has been widely used to understand how relationship partners influence health behavior, including how sexual minority male (SMM) couples regulate HIV risk. Couples with better relationship functioning tend to be more successful at negotiating joint (shared) goals and subsequently accomplishing them. The study recruited 134 cis-male, SARS-CoV-2 negative adults in relationships with cis-male partners from phone-based social networking applications. Participants completed an online survey assessing relationship functioning (Perceived Relationship Components Questionnaire), COVID-19 prevention behaviors, and risk perceptions. Partners' consensus around joint COVID-19 prevention effort was assessed using an adapted version of the Preferences for Sexual Health Outcomes scale. Path analyses indicated that consensus for joint prevention effort predicted social distancing (B = 0.23; p = .001) and the number of other COVID-19 prevention behaviors engaged in (B = 0.17; p = .003) above and beyond perceived risk and relationship functioning. Relationship satisfaction predicted higher levels of consensus for joint COVID-19 prevention effort (B = 0.40; p = .029). Findings suggest that the theoretical foundations of successful HIV prevention interventions that utilize joint goal formation may generalize to the prediction of COVID-19 prevention behavior and may be leveraged to mitigate the risk of SARS-CoV-2 infection among SMM in relationships. Interventions that overlook the potential for dyadic regulation of health behavior may miss opportunities to capitalize on shared coping resources and fail to address relational barriers to prevention.

Self-efficacy, social distancing, and essential worker status dynamics among SGM people.

As of October 2020, the COVID-19 pandemic has accounted for over 210,000 deaths in the U.S. Sexual and gender minority populations are more likely to work in essential industries while bearing a disproportionate burden of the virus. Constructs consistent with Protection Motivation Theory (perceived severity, vulnerability, self-efficacy, and response efficacy) were measured using an abridged version of Kleczkowski et al.'s 4-factor Protection Motivation Theory Psychological Measures to examine social distancing behaviors of these populations. 32.6% of the sample were essential workers. Greater self-efficacy predicted stricter social distancing behaviors. Non-essential and unemployed worker statuses were associated with increased odds of stricter social distancing behaviors relative to essential worker status. Essential worker status predicted lower self-efficacy. The indirect effect of essential worker status on social distancing through self-efficacy was significant. Findings suggest that interventions that encourage social distancing through enhanced self-efficacy may optimize health for sexual and gender minority essential workers.

Keeps me awake at night: The potential of the COVID-19 pandemic to affect sleep quality among sexual minority men in the U.S.A.

Sleep health, a crucial component and predictor of physical and mental health, has likely been adversely impacted by the stress and disruption wrought by the COVID-19 pandemic. This brief report sought to assess self-reported sleep quality among sexual minority men across the U.S.A. in the early months of the pandemic. In a cross-sectional online survey of a racially-diverse sample of 477 sexual minority men (mean age of 41.2; range 18-75 years) recruited from popular geo-social networking apps in early May 2020, participants reported on their recent experiences regarding sleep and mental health (anxiety, depression, and pessimistic repetitive future thinking). Almost 75% endorsed some level of restless sleep in the past week, 203 (42.6%) reported worse-than-usual sleep quality since the pandemic, and 77 (16.1%) reported sleeping longer than usual but not feeling better rested. Further, of the 280 reporting worse-than-usual sleep or feeling not rested, almost 85% reported that worry about the pandemic had been contributing to their troubles with falling or staying asleep. Rates of worsened sleep were highest among those whose financial situation had been adversely affected and those not in full-time employment, whereas restless sleep was highest among those in the Northeast region of the U.S.A., which, during the study's timeframe of late April and early May 2020, was the most severely affected by the pandemic. Greater emotional distress was associated with each sleep variable. Addressing and improving sleep health is critical to overall health and requires particular attention during the COVID-19 pandemic.

Evaluating the impact of COVID-19: A cohort comparison study of drug use and risky sexual behavior among sexual minority men in the U.S.A.

BACKGROUND: Sexual minority men who use drugs have high sexual HIV transmission risk. Sexual interactions may also increase COVID-19 risk.This study compared marijuana use, other illegal drugs use (i.e. cocaine/crack, methamphetamine, MDMA/ecstasy, GHB, and ketamine) and sexual behavior with casual partners among sexual minority cismen active on social networking and dating applications before and during the COVID-19 epidemic. METHODS: This cohort-control study compared 455 adult respondents (surveyed May 6th to 17th, 2020) and a matched sample selected from 65,707 respondents surveyed pre-COVID. Participants were recruited on social networking and dating applications and completed surveys online. RESULTS: The proportion reporting marijuana use declined significantly in the COVID cohort (34.5 % versus 45.7 % pre-COVID,p < .001) as did their illegal drug use (11.0 % versus 22.9 % pre-COVID, p < .001). While the number of casual partners per month was stable, the proportion reporting condomless anal sex with casual partners declined significantly during COVID (26.4 % versus 71.6 % pre-COVID, p < .001). The effect of illegal drug use (excluding marijuana) on number of casual partners per month (aRR = 1.45 pre-COVID versus 2.84, p < .01) and odds of condomless anal sex (aOR = 2.00 pre-COVID versus 5.22, p = .04) were significantly greater in the COVID cohort. CONCLUSIONS: While the proportion of participants reporting drug use and condomless anal sex with casual partners declined in the COVID cohort, the association between drug use and sexual behavior was magnified. Sexual minority men who use drugs are significantly more likely to engage in sexual behaviors that place them at risk for HIV and COVID-19 transmission.