Fields Errol L, Evans Kimberly N, Liu Yang, Thornton Nicole, Long Amanda, Uzzi Mudia, Gaul Zaneta, Buchacz Kate, King Hope, Jennings Jacky M
Johns Hopkins School of Medicine, Baltimore, MD, USA.
Johns Hopkins School of Public Health, Baltimore, MD, USA.
AIDS Behav. 2025 Mar 24. doi: 10.1007/s10461-025-04676-0.
Geosocial networking applications (GSN apps) are important tools for HIV/sexually transmitted infection prevention among men who have sex with men (MSM). Strategies for identifying high transmission and acquisition among GSN app users are needed to prioritize public health response. Community viral load (CVL) is associated with HIV transmission and can be used to identify populations with behaviors/environment associated with HIV/STI risk. We sought to determine user profile characteristics and utilization patterns associated with GSN app use in high CVL census tracts (CT). We used routine HIV surveillance data from in-care individuals and their viral loads at the point of diagnosis to estimate CVL in 200 CTs across Baltimore City. CTs were ordered based on CVL and categorized into quantiles from high to low. Among GSN user profiles, multiple imputation methods were used to complete missing profile characteristics. We then used imputed datasets to explore the association between profile characteristics, app utilization times, and app use in high CVL CTs using a Poisson regression model with robust error variances. Data on 606 profiles were collected originally and imputed 50 times to create a complete data set for analysis. GSN app users were aged 18-65 years [mean = 33.9, 95% confidence interval (CI): 33.1-34.7], with 52.2% Black (95% CI: 47.9- 56.5%), 6.8% living with HIV (95% CI: 4.4- 9.2%), 39.1% in high CVL CTs (95% CI: 35.2- 43.0%), 50.6% use at nighttime (95% CI: 46.7- 54.6%) and 51.6% use during the weekend (95% CI: 47.6- 55.6%). Black MSM users [Relative risk (RR) = 1.12, 95% CI: 1.04-1.20] were associated with GSN app use in high CVL CTs. MSM with profiles listing versatile sex position preference (RR = 1.12, 95% CI: 1.02-1.23) and profiles listing top sex position preference (RR = 1.13, 95% CI: 1.03-1.23) were associated with GSN app use in high and medium CVL CTs. GSN app user profiles of people in high and medium CVL CTs, especially Black MSM and those who report top and versatile sexual positions, may benefit from online prevention messages and real-time notification of health resources presently available in their communities to reduce HIV transmission.
地理社交网络应用程序（GSN应用）是在男男性行为者（MSM）中预防艾滋病毒/性传播感染的重要工具。需要制定策略来识别GSN应用用户中的高传播和高感染风险人群，以便优先采取公共卫生应对措施。社区病毒载量（CVL）与艾滋病毒传播相关，可用于识别具有与艾滋病毒/性传播感染风险相关的行为/环境的人群。我们试图确定与高CVL普查区（CT）中GSN应用使用相关的用户档案特征和使用模式。我们使用了来自接受治疗的个体的常规艾滋病毒监测数据及其诊断时的病毒载量，以估计巴尔的摩市200个CT中的CVL。根据CVL对CT进行排序，并从高到低分为若干分位数。在GSN用户档案中，使用多重插补方法来补充缺失的档案特征。然后，我们使用插补数据集，通过具有稳健误差方差的泊松回归模型，探索档案特征、应用使用时间与高CVL CT中应用使用之间的关联。最初收集了606份档案的数据，并进行了50次插补，以创建一个完整的数据集进行分析。GSN应用用户年龄在18 - 65岁之间[平均 = 33.9，95%置信区间（CI）：33.1 - 34.7]，其中52.2%为黑人（95% CI：47.9 - 56.5%），6.8%感染艾滋病毒（95% CI：4.4 - 9.2%），39.1%位于高CVL CT中（95% CI：35.2 - 43.0%），50.6%在夜间使用（95% CI：46.7 - 54.6%），51.6%在周末使用（95% CI：47.6 - 55.6%）。黑人MSM用户[相对风险（RR） = 1.12，95% CI：1.04 - 1.20]与高CVL CT中的GSN应用使用相关。档案中列出通用性行为姿势偏好的MSM（RR = 1.12，95% CI：1.02 - 1.23）和列出上位性行为姿势偏好的MSM（RR = 1.13，95% CI：1.03 - 1.23）与中高CVL CT中的GSN应用使用相关。中高CVL CT中的人群，尤其是黑人MSM以及那些报告上位和通用性行为姿势的人，其GSN应用用户档案可能会受益于在线预防信息以及目前其社区中可用的健康资源实时通知，以减少艾滋病毒传播。
