Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia.
J Int AIDS Soc. 2020 Oct;23 Suppl 6(Suppl 6):e25603. doi: 10.1002/jia2.25603.
INTRODUCTION: There is little published literature about gay, bisexual and other men who have sex with men and transgender individuals (MSM and TG)'s use of social media in sub-Saharan Africa, despite repressive social and/or criminalizing contexts that limit access to physical HIV prevention. We sought to describe MSM and TG's online socializing in Nairobi and Johannesburg, identifying the characteristics of those socializing online and those not, in order to inform the development of research and health promotion in online environments. METHODS: Respondent-driven sampling surveys were conducted in 2017 in Nairobi (n = 618) and Johannesburg (n = 301) with those reporting current male gender identity or male sex assigned at birth and sex with a man in the last 12 months. Online socializing patterns, sociodemographic, sexual behaviour and HIV-testing data were collected. We examined associations between social media use and sociodemographic characteristics and sexual behaviours among all, and only those HIV-uninfected, using logistic regression. Analyses were RDS-II weighted. Thirty qualitative interviews were conducted with MSM and TG in each city, which examined the broader context of and motivations for social media use. RESULTS: Most MSM and TG had used social media to socialize with MSM in the last month (60% Johannesburg, 71% Nairobi), mostly using generic platforms (e.g. Facebook), but also gay-specific (e.g. Grindr). HIV-uninfected MSM and TG reporting riskier recent sexual behaviours had raised odds of social media use in Nairobi, including receptive anal intercourse (adjusted OR = 2.15, p = 0.006), buying (aOR = 2.24, p = 0.015) and selling sex with men (aOR = 2.17, p = 0.004). Evidence for these associations was weaker in Johannesburg, though socializing online was associated with condomless anal intercourse (aOR = 3.67, p = 0.003) and active syphilis (aOR = 13.50, p = 0.016). Qualitative findings indicated that while online socializing can limit risk of harm inherent in face-to-face interactions, novel challenges were introduced, including context collapse and a fear of blackmail. CONCLUSIONS: Most MSM and TG in these cities socialize online regularly. Users reported HIV acquisition risk behaviours, yet this space is not fully utilized for sexual health promotion and research engagement. Effective, safe and acceptable means of using online channels to engage with MSM/TG that account for MSM and TG's strategies and concerns for managing online security should now be explored, as complements or alternatives to existing outreach.
简介:在撒哈拉以南非洲,尽管社会环境压抑或刑事定罪限制了人们获得艾滋病毒预防的物理手段,但有关男男性行为者和跨性别者(MSM 和 TG)在社交媒体中使用情况的文献却很少。我们试图描述内罗毕和约翰内斯堡的 MSM 和 TG 的在线社交活动,确定在线社交者和非在线社交者的特征,以便为在线环境中的研究和健康促进提供信息。 方法:2017 年,在内罗毕(n=618)和约翰内斯堡(n=301)进行了应答驱动抽样调查,这些人报告称在过去 12 个月内具有当前的男性性别认同或男性出生性别,并与男性发生过性关系。收集了在线社交模式、社会人口统计学、性行为和 HIV 检测数据。我们使用逻辑回归检查了社交媒体使用与所有参与者以及仅未感染 HIV 的参与者的社会人口统计学特征和性行为之间的关联。分析结果采用 RDS-II 加权。在每个城市进行了 30 次与 MSM 和 TG 的定性访谈,探讨了社交媒体使用的更广泛背景和动机。 结果:大多数 MSM 和 TG 在过去一个月内使用社交媒体与 MSM 社交(约翰内斯堡 60%,内罗毕 71%),主要使用通用平台(如 Facebook),但也使用专门的同性恋平台(如 Grindr)。在报告风险更高的性行为的未感染 HIV 的 MSM 和 TG 中,在约翰内斯堡,包括接受肛交(调整后的 OR=2.15,p=0.006)、买(aOR=2.24,p=0.015)和卖(aOR=2.17,p=0.004),社交媒体使用的可能性更高。在约翰内斯堡,这些关联的证据较弱,但在线社交与无保护的肛交(aOR=3.67,p=0.003)和活跃的梅毒(aOR=13.50,p=0.016)有关。定性研究结果表明,尽管在线社交可以限制面对面互动中固有的伤害风险,但也带来了新的挑战,包括情境崩溃和被勒索的恐惧。 结论:这些城市的大多数 MSM 和 TG 经常在线社交。用户报告了艾滋病毒感染风险行为,但这一空间并未充分用于促进性健康和研究参与。现在应该探索使用在线渠道与 MSM/TG 接触的有效、安全和可接受的方法,这些方法考虑到 MSM 和 TG 管理在线安全的策略和关切,作为现有外联工作的补充或替代。
J Med Internet Res. 2015-5-25
Crit Public Health. 2020
Curr Opin HIV AIDS. 2019-9