HIV Knowledge and Associated Factors among Internet-Using Men Who Have Sex with Men (MSM) in South Africa and the United States Public
Wagenaar, Bradley H. (2012)
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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