Disclosure of HIV Serostatus and Pre-exposure Prophylaxis Use on Internet Hookup Sites Among Men Who have Sex with Men.

Men who have sex with men (MSM) who use websites and smartphone applications to meet sexual partners ("hookup sites") may be at increased HIV risk. Many sites provide profile options to disclose HIV status and pre-exposure prophylaxis (PrEP) use. Little is known about the acceptability of disclosure options which may guide sexual decision-making. We evaluated 104 MSM presenting to a publicly-funded STD clinic. Most (86%) had met a partner online in the last 12 months; 55 and 27% reported using the HIV and PrEP disclosure options, respectively. White MSM were less likely to disclose HIV status than MSM of color (46% vs 74%, p < 0.05). Fifty-three percent of men were more likely to contact a potential partner who disclosed being HIV-negative, and 48% were more likely to do so if the person disclosed being on PrEP. Future HIV prevention approaches should promote disclosure options among MSM meeting partners online.

Statewide Evaluation of New HIV Diagnoses in Rhode Island: Implications for Prevention.

OBJECTIVES: Patterns of HIV transmission vary widely across demographic groups. Identifying and engaging these groups are necessary to prevent new infections and diagnose disease among people who are unaware of their infection. The objective of this study was to determine characteristics of newly diagnosed individuals across an entire state to determine patterns of HIV transmission. METHODS: We evaluated data on people with new HIV diagnoses in Rhode Island from 2013 through 2015. We performed a latent class analysis (LCA) to identify underlying demographic and behavioral characteristics of people with newly diagnosed HIV. RESULTS: Of 167 people with new HIV diagnoses interviewed in Rhode Island from 2013 through 2015, 132 (79%) were male, 84 (50%) were nonwhite, 112 (67%) were men who have sex with men (MSM), 112 (67%) were born in the United States, and 61 (37%) were born in Rhode Island. LCA revealed 2 major classes. Of the 98 people in class 1, 96% were male, 85% were MSM, 80% were white, 94% were born in the United States, and 80% believed they acquired HIV in Rhode Island. Class 2 was 63% male and 69% Hispanic/Latino; 29% were born in the United States, and 61% believed they acquired HIV in Rhode Island. CONCLUSIONS: Most new HIV diagnoses in Rhode Island were among MSM born in the United States, and a substantial number were likely infected in-state. People with newly diagnosed HIV who were foreign-born, including Hispanic/Latino and heterosexual groups, were less likely to have acquired HIV in Rhode Island than were MSM. HIV prevention approaches, including pre-exposure prophylaxis, should be adapted to the needs of specific groups. Rhode Island offers lessons for other states focused on eliminating HIV transmission.

Partner notification outcomes after integration of an on-site disease intervention specialist at a sexually transmitted disease clinic.

BACKGROUND: Partner notification services (PNS) are highly effective in reducing transmission of sexually transmitted diseases (STDs). We assessed outcomes of PNS before and after integration of an on-site disease intervention specialist (DIS) at a publicly-funded STD clinic. METHODS: From August 2014 to December 2015, patients testing positive for infectious syphilis or gonorrhea at the Rhode Island STD Clinic were referred to on-site DIS for partner notification. Data on PNS outcomes were reviewed for eight months before integration of DIS at the clinic and compared to eight months after. RESULTS: Of the 145 index patients referred for PNS during the study period (n = 58 before DIS integration, n = 87 after), 86% were interviewed. DIS integration resulted in a significantly greater proportion of index patients interviewed overall (92% versus 76%, p<0.01), on the day of diagnosis (85% versus 61%; p<0.01), and in person at the STD clinic (64% versus 11%; p<0.01). However, there was no significant difference in number of sexual partners named or treated. CONCLUSIONS: Integrating DIS at a publicly-funded STD clinic resulted in a greater number of index cases interviewed, a greater number interviewed in person, and a greater number interviewed on the day of diagnosis. Challenges remain in identifying and engaging partners for treatment.

A Network Analysis of Sexually Transmitted Diseases and Online Hookup Sites Among Men Who Have Sex With Men.

BACKGROUND: Sexually transmitted diseases (STDs) are increasing among gay, bisexual, and other men who have sex with men (MSM). Little is known about the use of websites and mobile phone applications to meet sexual partners ("hookup sites") and association with STD diagnoses. METHODS: We performed a demographic and behavioral assessment of 415 MSM presenting to the Rhode Island STD clinic. Bivariate and multivariable analyses assessed associations between using hookup sites and testing positive for syphilis, gonorrhea, or chlamydia. Venue-based affiliation networks were created to evaluate hookup sites and their association with STD diagnoses. RESULTS: Among 415 MSM, 78% reported meeting a partner online in the last 12 months, and 25% tested positive for at least one STD. Men who met partners online were more likely to be white (67% vs. 54%, P = 0.03) and have more than 10 lifetime partners (87% vs. 58%, P < 0.05). The most commonly used hookup sites included Grindr (78%), Scruff (35%), and Tinder (22%). In the multivariable analysis, only Scruff use was associated with testing positive for an STD (odds ratio, 2.28; 95% confidence interval, 1.09-4.94). However, among men who met partners online, 75% of men diagnosed as having an STD had met a sexual partner on Grindr, including 100% of those who were diagnosed as having gonorrhea. CONCLUSIONS: Use of hookup sites was nearly ubiquitous among MSM undergoing STD screening. Specific hookup sites were significantly associated with STD diagnoses among MSM. Greater efforts are needed to promote STD screening and prevention among MSM who meet partners online.