print view Emory Login:
(Login to submit or manage theses and dissertations)

Contact Us

Instructions

Frequently Asked Questions

ETD Help

Policies and Procedures

Copyright and Patents

Access Restrictions

Search ETDs:
Advanced Search
Browse by:
Browse ProQuest
Search ProQuest

Laney Graduate School

Rollins School of Public Health

Candler School of Theology

Emory College

Emory Libraries

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

Wagenaar, Bradley H. (2012)
Master's Thesis (79 pages)
Committee Chair / Thesis Adviser: Sullivan, Patrick S
Committee Members:
Research Fields: Health Sciences, Epidemiology; Health Sciences, Public Health; Health Sciences, Education
Partnering Agencies: Emory University schools, faculty or affiliated programs
Keywords: Epidemiology; HIV/AIDS; MSM; Infectious Disease;
Program: Rollins School of Public Health, Epidemiology (Global Epidemiology)
Permanent url: http://pid.emory.edu/ark:/25593/bnqdg

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) --

Files

application/pdf Dissertation/Thesis 79 pages (9.6 MB) [Access copy of Dissertation/Thesis]
Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.