A Comparison of Online HIV Behavioral Surveillance Among Men Who Have Sex with Men in the United States and Mexico: Key Similarities and Differences Between American Men’s Internet Survey and Encuesta de Sexo Entre Hombres, 2017 Open Access
Williams, Alice (Spring 2020)
Background: Men who have sex with men (MSM) are disproportionately affected by HIV in many countries globally. To better understand the HIV epidemic among MSM, many countries have adopted online HIV behavioral surveillance systems to monitor HIV prevalence, risk behaviors, and use of prevention services. In North America, behavioral surveillance of the HIV epidemic in MSM has been country-specific and existing surveillance systems have not been expanded to include neighboring countries that may share similar HIV epidemiological profiles.
Objective: This study aimed to identify key similarities and differences between American MSM from the American Men’s Internet Survey (AMIS) and Mexican MSM from Encuesta de Sexo Entre Hombres (ESEH) with respect to three main outcomes of interest: HIV prevalence, condomless anal sex in the previous 12 months, and HIV testing.
Methods: In the United States, AMIS is an annual, web-based, cross-sectional behavioral survey of American MSM. In Mexico, ESEH was piloted in 2017 as an online, cross-sectional behavioral survey of Mexican MSM. Multivariable modeling was used to compare associations between selected participant characteristics and the three main outcomes of interest by the AMIS or ESEH studies.
Results: In total, 6,868 AMIS U.S. MSM participants and 14,178 ESEH Mexican MSM participants were considered. AMIS participants were significantly older, with 42.3% of AMIS participants ages ≥40 years compared to only 9.1% of ESEH participants. In both studies, younger participants ages 18-29 years had lower HIV prevalence compared to those aged ≥40 and HIV prevalence gradually increased with age. Young participants ages 18-24 years had a lower prevalence of HIV testing in the previous 12 months compared to those ≥40years in both AMIS (aPR= 0.79, 95% CI: 0.74, 0.84) and ESEH (aPR= 0.80, 95% CI: 0.74, 0.86).
Conclusions: Despite differences between the two sample populations on some baseline characteristics, associations between selected participant characteristics and the three main outcomes of interest were fairly consistent across AMIS and ESEH. Based on these similarities, interventions in the U.S. and Mexico could be developed collaboratively to target similar HIV risk factors and improve HIV prevention strategies, particularly HIV testing.
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