HIV Knowledge and Associated Factors among Internet-Using Men Who Have Sex with Men (MSM) in South Africa and the United States Open Access

Wagenaar, Bradley H. (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/1c18dg65s?locale=en
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Abstract

Background:
We compared factors associated with low HIV/AIDS knowledge among internet-using MSM in
South Africa and the United States.
Methods:
1,154 MSM in the US and 439 MSM in South Africa, recruited through Facebook.com,
completed an online survey using a US-validated HIV knowledge scale (HIV-KQ-18). Separate
multivariable logistic regression models were built, one for the US and one for South Africa, using a
dichotomized variable of scoring less than and equal to 13/18 ("low knowledge") on the HIV-KQ-18 as
outcome.
Results:
Median knowledge scores were 16/18 for both groups of respondents. For South African MSM,
factors associated with low knowledge were: a high school education or less (adjusted odds ratio [aOR]:
2.5, 95% confidence interval [CI]: 1.4-4.6), not using condom-compatible lubrication during last anal sex
with another man (aOR: 1.9, CI: 1.0-3.5), number of gay or bisexual acquaintances (aOR: 0.89, CI: 0.81-
0.99), being unemployed (aOR: 2.2, CI: 1.0-4.6), and testing HIV negative (aOR: 0.30, CI: 0.16-0.59) or
testing HIV positive (aOR: 0.15, CI: 0.03-0.74) compared to those never HIV tested. For US MSM,
associated factors were: a high school education or less (aOR: 2.7, CI: 1.9-3.8), low pride and acceptance
of homosexuality (aOR: 1.3, CI: 1.2-1.5), age 18-24 (aOR: 2.3, CI: 1.3-3.8) or age 50+ (aOR: 3.2, CI: 1.6-
6.3) compared to age 25-29, Hispanic ethnicity compared to white non-Hispanic (aOR: 1.9, CI: 1.1-3.2),
and testing HIV positive (aOR: 0.34, CI: 0.16-0.69) or testing HIV negative (aOR: 0.59, CI: 0.39-0.89)
compared to those tested.
Conclusions:
Those developing programs for MSM in South Africa should weigh these data and other relevant
factors, and might consider focusing education services towards MSM with limited education, less
integration into gay/bisexual communities, no HIV testing history, limited use of condom-compatible
lube, and the unemployed. In the United States, Hispanic MSM, those with limited education, no HIV
testing history, low pride/acceptance of homosexuality, and those aged 18-24 or 50+ may be at risk for
gaps in HIV knowledge.




Table of Contents

Table of Contents

08 - Introduction

10 - Methods

12 - Results

12 - Factors Associated with Low Knowledge among Both Cohorts

12 - Factors Associated with Low Knowledge among South African MSM

13 - Factors Associated with Low Knowledge among MSM in the United States

13 - Discussion

15 - Limitations

16 - Conclusions

17 - References

20 - Tables

20 - Table 1. Demographic and behavioral characteristics of 1,154 US and 439 South African men who have sex with men (MSM) who completed online Facebook HIV survey, June-November 2010

21 - Table 2. 1,154 US and 439 South African men who have sex with men (MSM) who completed online Facebook survey answering HIV-KQ-18 questions correctly, incorrectly, "don't know", or by skipping, June-November 2010

22 - Table 3. Multivariable logistic regression models for 1,154 US and 439 South African men who have sex with men (MSM) using scoring in lowest quintile on HIV-KQ-18 knowledge scores as outcome

23 - Figures

23 - Figure 1. Histogram of number correct on the HIV-KQ-18 knowledge scale for 1,154 US men who have sex with men (MSM) who completed online Facebook survey, June-November 2010

23 - Figure 2. Histogram of number correct on the HIV-KQ-18 knowledge scale for 439 South African men who have sex with men (MSM) who completed online Facebook survey, June-November 2010

24 - Appendices

24 - Internet Survey for South Africa and United States

55 - Annotated SAS 9.3 Programming Code

70 - IRB approval

71 - Published Paper in Public Library of Science One (PLoS ONE)

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