Targeting social media may increase HIV testing among gay men

Two men kiss as they sit in a riverside park in New York, May 9, 2012.

Reuters/Lucas Jackson

(Reuters Health) – Promoting HIV testing on some of the same social media sites that men who have sex with men and transgender people use to meet friends and sex partners can raise testing rates in these communities, according to results of a U.S. trial.

“Our results are surprising because we were not sure that men and transgender persons would readily accept HIV testing information within the social media and social networking sites that some of them use,” said lead author Scott D. Rhodes of Wake Forest School of Medicine in Winston-Salem, North Carolina. “But we learned that after trust was built, they were eager for information about HIV testing and guidance about how to access testing services.”

We assume that people are knowledgeable about HIV and how to get tested, but that’s not the case, he told Reuters Health by email.

The researchers used the intervention in two online communities and posted in another two forums without the intervention for comparison. The communities, including Adam4Adam, BlackGayChat, Craigslist and Gay.com, are designed for users to meet up in person, so the researchers targeted geographic locations 200 to 330 miles apart to prevent user overlap.

Within each online outlet, a health educator created a public profile and posted triggers about the importance of HIV testing, his availability to help and information on where testing services were available. The profiles were accessible to anyone and the health educator would engage with users who instant-messaged him.

On Craigslist, the educator posted HIV testing information and triggers every three to four hours from 9 a.m. to 5 p.m. Monday through Friday in 2013 and 2014.

The researchers offered site users $10 to complete an assessment, including information on drug and alcohol use, age, race, sexual orientation, HIV status and testing history over the previous year.

More than 1,000 users completed the assessment and most declined the $10 compensation. On average users were 40 years old, almost all reported sex with at least one man and one-third reported sex with at least one woman over the last year.

At the beginning of the year, about 35 percent of users in each group reported having been tested for HIV over the previous 12 months. After the intervention was complete, 64 percent of those in the intervention communities said they had been tested for HIV in the previous year compared to 40 percent of those in the control groups, as reported in Clinical Infectious Diseases.

“Gay and bisexual men as well as transgender women are disproportionally impacted by HIV (that is, by virtue of being a gay or bisexual man, or transgender woman, you are more likely to come in contact with HIV), and thus it is important to ensure frequent HIV testing and linkage to treatment,” said Christian Grov of the CUNY Graduate School of Public Health and Health Policy in New York City, who was not part of the new study.

These groups did respond to the social media intervention, Rhodes said.

“HIV testing is important for anyone who is sexually active, and the CDC recommends that all individuals get tested at least once in their lifetimes and those with risk factors get tested more frequently,” he said.

The intervention was easy to implement, only requiring one health professional and access to the Internet, so it could be widely implemented within social media by health departments and clinics and other organizations working to prevent HIV, he said.

“However, in addition to the health educator’s training, the health educator was skilled in building relationships with social media users, maintaining boundaries, being patient, having a sense of humor, and being comfortable networking with other organizations as well, particularly those offering HIV testing,” he said.

The users in this study were older and mostly white, noted Dr. Lisa Hightow-Weidman of the University of North Carolina at Chapel Hill School of Medicine, who was not part of the new study.

“Interventions to increase testing should be designed to reach younger men who have sex with men, particularly MSM of color as they are the group most impacted by the HIV epidemic in the U.S.,” she said by email.

SOURCE: bit.ly/1VTuWPY Clinical Infectious Disease, online March 14, 2016.

Targeting social media may increase HIV testing among gay men

Viral hepatitis testing: time to innovate – and deliver!

The Hepatitis Testing Innovation Contest, which is accepting submissions until 1 March 2016, feels like a welcome breath of fresh air. Social Entrepreneurship for Sexual Health (SESH) organized the contest in collaboration with the World Health Organization’s Global Hepatitis Programme to highlight novel ways that service providers have found to increase hepatitis B virus (HBV) and hepatitis C virus (HCV) testing.

Winning entries will be included in the forthcoming WHO hepatitis testing guidelines. This is a terrific way, in my opinion, to tackle the problem of undiagnosed HBV and HCV – one of the greatest obstacles to reducing liver-related illness and death worldwide.

News of the contest got my creative juices flowing. As I walked over to the University of Barcelona last week, I found myself wondering if some future testing initiative might build on the example of BCN Checkpoint, a programme that is well known in Barcelona’s communities of men who have sex with men.

I was recalling what Ferran Pujol, the director of BCN Checkpoint, once told me about how his community-based programme had stumbled upon a strategy that helped to almost triple the number of HIV tests administered.

What if the testing counselor is a celebrity?

How many HIV tests did this man inspire?

Requests for BCN Checkpoint’s services soared in 2009 – the same year that one of the organization’s staff testing counselors, Sergio Lara, was crowned Mr. Gay Europe! BCN Checkpoint went from administering 1,228 HIV tests in 2008 to 2,485 in 2009, and 3,425 in 2010.

That made me wonder about the concept of a ‘celebrity’ testing counselor – might it perhaps be a replicable model?

I floated the idea to Ferran, who continues to oversee BCN Checkpoint. He immediately noted that the programme’s ongoing popularity – almost 7,000 HIV tests administered in 2015 – is not being driven by a 2009 beauty pageant.

“BCN Checkpoint is known for the low barrier to get tested, peers who are able to talk about sexuality, no judgments on how many times you want to get tested, and the increased number of services and technology,” he said.

The take-away lesson?

Achieving sustained population-level viral hep testing increases will require more than clever concepts. I anticipate that testing interventions that make an impact in the coming years will provide models of innovation and also be built on the same tried-and-true principles that Ferran identified.

In other words, the way forward is to innovate and integrate the best of what we’ve learned about people-centred public health.

BCN Checkpoint HIV testing, 2007–2015

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For information about how to enter SESH’s Hepatitis Testing Innovation Contest, go to http://www.seshglobal.org/heptestcontest/. The contest deadline is 1 March 2016.

Hepatology, Medicine and Policy is now accepting submissions. For more information, visit: www.hmap.biomedcentral.com.

Viral hepatitis testing: time to innovate – and deliver!

Israeli Hospital Testing Testicle-zapping Cure for Infertility in Men

Sperm swimming toward an egg.

A hand-held electrocuting contraption that’s giving men hope is now being tested on human patients at Israel’s Sheba Medical Center after a successful study on animals, the Daily Mail reported on Monday.

The device, dubbed the Micro 400 Matrix, reportedly increased sperm count in the animal subjects by 200 to 1,600 percent, giving hope that a non-invasive solution for men with a low sperm count has been found. 

The method by which the Matrix achieved such results however, may not be so welcome. 

With a quick zap, the Matrix releases a moderate pulse of electricity with a positive charge into the testicles, countering the sperm’s natural negative charge. Luckily for potential patients, the amount of electricity released is said to be “below sensation levels,” and therefore, painless.

Planned human trials will involve 10 men lacking a measurable level of sperm in their semen. The subjects will use the device daily for entire year, hopefully enabling them to naturally impregnate their partners.

Israeli Hospital Testing Testicle-zapping Cure for Infertility in Men

Fewer Pap smear tests due to rewritten guidelines led to less STI testing: study

Sheryl Ubelacker, The Canadian Press
Published Thursday, October 15, 2015 6:00PM EDT

TORONTO — Young women in Ontario are being screened for sexually transmitted infections far less often since updated guidelines reduced the frequency of Pap tests for cervical cancer, a study suggests.

Researchers at St. Michael’s Hospital in Toronto found the guidelines, which were rewritten in 2012, reduced Pap smear rates by 60 per cent in the year after their introduction — and that led to a 50 per cent drop in gonorrhea and chlamydia testing among women aged 15 to 24. Patients were also less likely to be screened for syphilis, hepatitis C and HIV.

Prior to 2012, women were advised to start cervical cancer screening within three years of becoming sexually active, followed by annual testing. After three normal Pap test results, subsequent screening was recommended every two or three years until age 70.

The updated guidelines by Cancer Care Ontario recommend starting Pap tests at age 21 for women who have been sexually active, with three-year screening intervals if test results are normal.

The advice differs slightly from guidelines by the Canadian Task Force on Preventive Health Care, which recommends that routine Pap tests for women start at age 25 and continue every three years until age 70, when they can cease if a woman has had three successive negative tests in the previous 10 years.

“Historically, we know that Pap tests and STI screening are linked because they’re often performed at the same time,” said lead author Dr. Tali Bogler, a family physician at St. Mike’s.

But because women aren’t visiting their doctors as often for Pap smears, that’s caused a drop in screening for STIs, she said Thursday, noting that chlamydia and gonorrhea are common among young women and incidence of those infections is on the rise.

In the last decade, chlamydia rates have jumped 72 per cent, while gonorrhea rates have gone up by more than 50 per cent.

The study, published Thursday in the journal Canadian Family Physician, tracked patient charts across five primary care sites at St. Michael’s Hospital in the year before the guidelines changed and in the year after.

Researchers found rates of Pap smear testing among women in the study dropped from 42 per cent before the guideline change to 17 per cent after, and screening of gonorrhea and chlamydia decreased from 40 per cent to 20 per cent.

“Our findings suggest a possibly harmful public health consequence,” said Bogler.

“So I think a big piece of this is really educating the public, and especially young women, to understand that even though they haven’t had a Pap test, they need to be screened for STIs if they’re at risk.”

Often, women can be infected with an STI like chlamydia or gonorrhea and have no symptoms. But left untreated, the infection can last a long time and cause pelvic inflammatory disease, which can lead to chronic pelvic pain, infertility or an ectopic pregnancy in women who do conceive.

“Therefore it’s critical that family physicians find new and innovative ways to screen for STIs in sexually active women under 25,” she said, suggesting that doctors might not think about asking a patient about their sexual health or STI risk during visits unrelated to Pap testing.

“Physicians should think about that when they’re coming in for a cough or cold or other things that (provide) other opportunities to screen for STIs.”

While such testing is often done with a vaginal swab during the procedure to screen for cervical cancer, self-administered urine-based testing can also pick up sexually transmitted infections “and can be easily extended into community settings,” she said.

Bogler said this non-invasive testing method could be used in high schools, universities and other community outreach sites to help young women access treatment and avoid the long-term health complications of an untreated STI.

Fewer Pap smear tests due to rewritten guidelines led to less STI testing: study