15 results on '"Sharma, Akshay"'
Search Results
2. Distribution of HIV Self-tests by Men Who have Sex with Men (MSM) to Social Network Associates.
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Patel, Shilpa N., Chavez, Pollyanna R., Borkowf, Craig B., Sullivan, Patrick S., Sharma, Akshay, Teplinskiy, Ilya, Delaney, Kevin P., Hirshfield, Sabina, Wesolowski, Laura G., McNaghten, A. D., and MacGowan, Robin J.
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DIAGNOSIS of HIV infections ,SELF diagnosis ,SOCIAL networks ,CONSUMER attitudes ,SURVEYS ,RESEARCH funding ,DESCRIPTIVE statistics ,HEALTH ,INFORMATION resources ,MEN who have sex with men - Abstract
Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2023
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3. Perceptions and Experiences of Returning Self-collected Specimens for HIV, Bacterial STI and Potential PrEP Adherence Testing among Sexual Minority Men in the United States.
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Sharma, Akshay, Gandhi, Monica, Sallabank, Gregory, Merrill, Leland, and Stephenson, Rob
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SEXUALLY transmitted disease diagnosis ,DIAGNOSIS of HIV infections ,DIAGNOSIS of bacterial diseases ,HEALTH services accessibility ,GONORRHEA ,HAIR analysis ,BLOOD collection ,INTERVIEWING ,EXPERIENCE ,PRE-exposure prophylaxis ,SELF-efficacy ,DRUGS ,SEXUAL minorities ,URINE collection & preservation ,RESEARCH funding ,COLLECTION & preservation of biological specimens ,PATIENT compliance ,MEN who have sex with men ,GAY men ,PSYCHOLOGY of HIV-positive persons ,CHLAMYDIA infections - Abstract
Few studies among gay, bisexual and other men who have sex with men (GBMSM) have examined facilitators and barriers to self-collecting specimens for extragenital STI screening, and none have evaluated attitudes towards self-collecting hair samples that can be utilized for PrEP drug level testing to assess adherence. To address this gap, we interviewed 25 sexually active GBMSM who were offered a choice to self-collect and return finger-stick blood samples (for actual HIV testing), pharyngeal swabs, rectal swabs and urine specimens (for actual gonorrhea and chlamydia testing), and hair samples (to visually determine their adequacy for PrEP drug level testing): 11 who returned all, 4 who returned some, and 10 who did not return any. Participants found self-collecting finger-stick blood samples and rectal swabs more challenging than other specimens. Frequently discussed facilitators of return included an opportunity to confirm one's HIV or STI status, limited access to a healthcare provider and a desire to advance research focusing on home-based testing. Commonly cited barriers to return included low self-efficacy pertaining to self-collection and apprehension around the possibility of delay or loss of specimens during transit. Offering additional support such as real-time video conferencing may prove helpful in future field-based research with GBMSM. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Engaging Black or African American and Hispanic or Latino Men Who Have Sex With Men for HIV Testing and Prevention Services Through Technology: Protocol for the iSTAMP Comparative Effectiveness Trial.
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Dana, Ruth, Sullivan, Stephen, MacGowan, Robin J., Chavez, Pollyanna R., Wall, Kristin M., Sanchez, Travis H., Stephenson, Rob, Hightow-Weidman, Lisa, Johnson, Jeffrey A., Smith, Amanda, Sharma, Akshay, Jones, Jeb, Hannah, Marissa, Trigg, Monica, Wei Luo, Caldwell, Joanna, and Sullivan, Patrick Sean
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MEN who have sex with men ,DIAGNOSIS of HIV infections ,HIV prevention ,PATIENT self-monitoring ,RANDOMIZED controlled trials ,COST effectiveness - Abstract
Background: Gay, bisexual, and other men who have sex with men (MSM), particularly Black or African American MSM (BMSM) and Hispanic or Latino MSM (HLMSM), continue to be disproportionately affected by the HIV epidemic in the United States. Previous HIV self-testing programs have yielded high testing rates, although these studies predominantly enrolled White, non-Hispanic MSM. Mobile health tools can support HIV prevention, testing, and treatment. This protocol details an implementation study of mailing free HIV self-tests (HIVSTs) nested within a randomized controlled trial designed to assess the benefit of a mobile phone app for increasing the uptake of HIV prevention and other social services. Objective: This study was a comparative effectiveness trial of innovative recruitment and testing promotion strategies intended to effectively reach cisgender BMSM and HLMSM. We evaluated the use of a mobile app for increasing access to care. Methods: Study development began with individual and group consultations that elicited feedback from 3 core groups: HIV care practitioners and researchers, HIV service organization leaders from study states, and BMSM and HLMSM living in the study states. Upon completion of the formative qualitative work, participants from 11 states, based on the observed areas of highest rate of new HIV diagnoses among Black and Hispanic MSM, were recruited through social networking websites and smartphone apps. After eligibility was verified, participants consented and were randomized to the intervention arm (access to the Know@Home mobile app) or the control arm (referral to web resources). We provided all participants with HIVSTs. The evaluation of the efficacy of a mobile phone app to support linkage to posttest prevention services that included sexually transmitted infection testing, pre-exposure prophylaxis initiation, antiretroviral treatment, and acquisition of condoms and compatible lubricants has been planned. Data on these outcomes were obtained from several sources, including HIVST-reporting surveys, the 4-month follow-up survey, laboratory analyses of dried blood spot cards returned by the participant, and data obtained from the state health department surveillance systems. Where possible, relevant subgroup analyses were performed. Results: During the formative development phase, 9 consultations were conducted: 6 in-depth individual discussions and 3 group consultations. From February 2020 through February 2021, we enrolled 2093 MSM in the randomized controlled trial from 11 states, 1149 BMSM and 944 HLMSM. Conclusions: This study was designed and implemented to evaluate the effectiveness of recruitment strategies to reach BMSM and HMSM and of a mobile app with regard to linkage to HIV prevention or treatment services. Data were also obtained to allow for the analyses of cost and cost-effectiveness related to study enrollment, HIV testing uptake, identification of previously undiagnosed HIV, sexually transmitted infection testing and treatment, and linkage to HIV prevention or treatment services. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Acceptability and Feasibility of Self-Collecting Biological Specimens for HIV, Sexually Transmitted Infection, and Adherence Testing Among High-Risk Populations (Project Caboodle!): Protocol for an Exploratory Mixed-Methods Study
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Sharma, Akshay, Stephenson, Rob, Sallabank, Gregory, Merrill, Leland, Sullivan, Stephen, and Gandhi, Monica
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medicine.medical_specialty ,020205 medical informatics ,sexually transmitted diseases ,Gonorrhea ,Ethnic group ,02 engineering and technology ,Men who have sex with men ,03 medical and health sciences ,Pre-exposure prophylaxis ,0302 clinical medicine ,Phone ,sexual minorities ,Health care ,Protocol ,0202 electrical engineering, electronic engineering, information engineering ,Medicine ,Confidentiality ,030212 general & internal medicine ,10. No inequality ,pre-exposure prophylaxis ,Chlamydia ,business.industry ,social networking ,General Medicine ,medicine.disease ,3. Good health ,Family medicine ,business ,HIV infections - Abstract
Background: Men who have sex with men (MSM) in the United States experience a disproportionate burden of HIV and bacterial sexually transmitted infections (STIs), such as gonorrhea and chlamydia. Screening levels among MSM remain inadequate owing to barriers to testing such as stigma, privacy and confidentiality concerns, transportation issues, insufficient clinic time, and limited access to health care. Self-collection of specimens at home and their return by mail for HIV and bacterial STI testing, as well as pre-exposure prophylaxis (PrEP) adherence monitoring, could be a resource-efficient option that might mitigate some of these barriers. Objective: Project Caboodle! is a mixed-methods study that explores the acceptability and feasibility of self-collecting and returning a bundle of 5 different specimens for HIV and bacterial STI testing, as well as PrEP adherence monitoring, among sexually active HIV-negative or unknown status MSM in the United States aged 18 to 34 years. Methods: Participants will be recruited using age, race, and ethnicity varied advertising on social networking websites and mobile gay dating apps. In Phase 1, we will send 100 participants a box containing materials for self-collecting and potentially returning a finger-stick blood sample (for HIV testing), pharyngeal swab, rectal swab, and urine specimen (for gonorrhea and chlamydia testing), and hair sample (to assess adequacy for potential PrEP adherence monitoring). Specimen return will not be incentivized, and participants can choose to mail back all, some, or none of the specimens. Test results will be delivered back to participants by trained counselors over the phone. In Phase 2, we will conduct individual in-depth interviews using a video-based teleconferencing software (VSee) with 32 participants from Phase 1 (half who returned all specimens and half who returned some or no specimens) to examine attitudes toward and barriers to completing various study activities. Results: Project Caboodle! was funded in May 2018, and participant recruitment began in March 2019. The processes of designing a study logo, creating advertisements, programming Web-based surveys, and finalizing step-by-step written instructions accompanied by color images for specimen self-collection have been completed. The boxes containing 5 self-collection kits affixed with unique identification stickers are being assembled, and shipping procedures (for mailing out boxes to participants and for specimen return by participants using prepaid shipping envelopes) and payment procedures for completing the surveys and in-depth interviews are being finalized. Conclusions: Self-collection of biological specimens at home and their return by mail for HIV and bacterial STI testing, as well as PrEP adherence monitoring, might offer a practical and convenient solution to improve comprehensive prevention efforts for high-risk MSM. The potentially reduced time, expense, and travel associated with this approach could facilitate a wider implementation of screening algorithms and remote monitoring strategies. International Registered Report Identifier (IRRID): PRR1-10.2196/13647
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- 2019
6. The Influence of Relationship Dynamics and Sexual Agreements on Perceived Partner Support and Benefit of PrEP Use Among Same-Sex Male Couples in the U.S.
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Kahle, Erin M., Sharma, Akshay, Sullivan, Stephen, and Stephenson, Rob
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HIV prevention ,INTERPERSONAL relations ,PREVENTIVE medicine ,MEN'S health ,SPOUSES ,MULTIPLE regression analysis ,SOCIAL support ,INTIMATE partner violence ,MEN who have sex with men ,SEXUAL partners ,DESCRIPTIVE statistics - Abstract
Use of Pre-exposure prophylaxis (PrEP) for HIV prevention by men who have sex with men (MSM) may be impacted by relationship dynamics. We assessed perceived partner support of PrEP use and benefit of PrEP by relationship characteristics among male couples. Baseline data from a randomized control trial of video-based HIV counseling and testing among male couples in the U.S. were used in adjusted multilevel regression models to assess individual and dyadic characteristics. Among 659 participants, 73.3% thought their partner would be supportive of their PrEP use; 26.7% reported their partner would not support PrEP use, which was significantly associated with intimate partner violence (IPV) (p = 0.008). Most (57.7%) did not believe PrEP would be beneficial to them or their partner. Couples with a sexual agreement allowing outside partners were significantly associated with higher perceived support of partners for PrEP (p < 0.001) and benefit of PrEP use (p < 0.001). Perceived partner support of PrEP was high but perceived benefit of PrEP was low, both shaped by relationship dynamics that highlight the need for tailored dyadic interventions. The association between perceived PrEP support and IPV points to the need to integrate relationship contexts in HIV prevention programs. [ABSTRACT FROM AUTHOR]
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- 2020
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7. Threat and impact of HIV compared to other health conditions among an online sample of gay, bisexual and other men who have sex with men in the U.S.
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Kahle, Erin M., Suarez, Nicholas, Sharma, Akshay, Sullivan, Stephen, and Stephenson, Rob
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HIV infections & psychology ,GAY Americans ,CONFIDENCE intervals ,INTERNET ,STATISTICAL sampling ,SELF-evaluation ,SURVEYS ,CROSS-sectional method ,DATA analysis software ,MEN who have sex with men ,DESCRIPTIVE statistics ,ODDS ratio ,ATTITUDES toward illness - Abstract
Gay, bisexual and other men who have sex with men (GBMSM) experience greater health disparities, and concern about other health conditions may decrease engagement in HIV prevention. This study assessed perceived threat and impact of HIV relative to other health concerns among GBMSM. Data were from a national online survey of GBMSM conducted between August and September 2015. Participants ranked concern about contracting HIV and impact of HIV on their health compared with other health conditions. The association of HIV threat and impact with recent condomless anal sex (CAS) and HIV testing were assessed using regression models. Among 466 participants, threat and impact of HIV were ranked lower compared to cancer, Alzheimer's and heart disease. Concern about getting HIV was associated with greater odds of recent HIV testing (adjOR 1.1, 95%CI 1.02–1.18) and lower CAS (adjOR 0.86, 95%CI 0.78–0.94). Among GBMSM, other health conditions may be perceived as a greater threat and higher impact on health compared with HIV. Integrating complex health care concerns with HIV prevention strategies may increase engagement in prevention. [ABSTRACT FROM AUTHOR]
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- 2020
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8. Discordant Reporting of Partner Labels, HIV Testing and Sexual Behavior Among a Sample of Partnered Men Who have Sex with Men in the US.
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Stephenson, Rob, Sullivan, Stephen, Sharma, Akshay, and Kahle, Erin
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DIAGNOSIS of HIV infections ,HIV prevention ,HIV infection risk factors ,INTERPERSONAL relations ,RISK-taking behavior ,HUMAN sexuality ,PSYCHOSOCIAL factors ,MEN who have sex with men ,SEXUAL partners - Abstract
There is growing evidence that sexual behaviors among male couples are strongly shaped by emotional and quality characteristics of the relationship, and that the labels that men attach to their relationships may indicate how men perceive and engage in risk taking. There has been a lack of attention to how male couples label their relationships, and how discordant understandings of relationship labels may shape HIV risk behavior. Using data from a sample of 804 partnered men who have sex with men, this analysis examines associations between discordant relationship labeling and participation in HIV testing and sexual behavior. Men who labeled their relationship differently from their partners were less likely to have been recently tested for HIV and more likely to engage in sexual risk. The results underscore the need to develop interventions that provide spaces and skills for men to learn how to effectively navigate HIV risks in their relationships. [ABSTRACT FROM AUTHOR]
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- 2020
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9. Relationship Characteristics Associated with Perceptions of Partners' HIV Testing Behavior Among Male Couples.
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Sharma, Akshay, Kahle, Erin, Sullivan, Stephen, and Stephenson, Rob
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DIAGNOSIS of HIV infections ,HIV prevention ,PSYCHOLOGICAL adaptation ,COMMUNICATION ,CONFIDENCE intervals ,SEXUAL health ,INTERPERSONAL relations ,RISK-taking behavior ,TRUST ,PSYCHOSOCIAL factors ,MEN who have sex with men ,SEXUAL partners ,ODDS ratio - Abstract
Partnered men who have sex with men are not immune to the risk of HIV. Analyzing dyadic data from 360 male couples recruited from April 2016 to June 2017, we examined how relationship characteristics might influence HIV testing behavior and perceptions of partners' HIV testing. Increasing levels of mutual trust were associated with lower odds of both partners (versus neither) having been tested in the past year (aOR = 0.91, 95% CI 0.83–0.99), but increasing levels of communal coping were associated with higher odds (aOR = 1.06, 95% CI 1.02–1.10). Only one partner was more likely to be correct about whether or not his partner had been tested in the past year (versus both) if someone had broken their sexual agreement (aOR = 2.60, 95% CI 1.17–5.76). Increasing differences in trust (aOR = 1.10, 95% CI 1.01–1.20) were also associated with higher odds of only one partner being correct. Dyadic HIV prevention efforts should incorporate skills building around negotiating sexual agreements and constructive communication. [ABSTRACT FROM AUTHOR]
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- 2020
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10. Distribution of HIV Self-tests by HIV-Positive Men Who Have Sex with Men to Social and Sexual Contacts.
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Wesolowski, Laura, Chavez, Pollyanna, Sullivan, Patrick, Freeman, Arin, Sharma, Akshay, Mustanski, Brian, McNaghten, A. D., and MacGowan, Robin
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DIAGNOSIS of HIV infections ,HOMOSEXUALITY ,INTERNET ,SURVEYS ,ANAL sex ,ONLINE social networks ,MEN who have sex with men ,SELF diagnosis - Abstract
Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
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11. Perceptions of HIV Self-Testing Among Men Who Have Sex With Men in the United States: A Qualitative Analysis.
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Freeman, Arin E., Sullivan, Patrick, Higa, Darrel, Sharma, Akshay, MacGowan, Robin, Hirshfield, Sabina, Greene, George J., Gravens, Laura, Chavez, Pollyanna, McNaghten, A. D., Johnson, Wayne D., and Mustanski, Brian
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HIV prevention ,FOCUS groups ,INTERVIEWING ,MEDICAL ethics ,PRIVACY ,HEALTH self-care ,QUALITATIVE research ,MEN who have sex with men ,PATIENTS' attitudes ,SELF diagnosis - Abstract
HIV testing is the gateway into both prevention and treatment services. It is important to understand how men who have sex with men (MSM) perceive HIV self-tests. We conducted focus groups and individual interviews to collect feedback on two HIV self-tests, and on a dried blood spot (DBS) specimen collection kit. Perceptions and attitudes around HIV self-testing (HIVST), and willingness to distribute HIV self-tests to others were assessed. MSM reported HIVST to be complementary to facility-based testing, and liked this approach because it offers privacy and convenience, does not require counseling, and could lead to linkage to care. However, they also had concerns around the accuracy of HIV self-tests, their cost, and receiving a positive test result without immediate access to follow-up services. Despite these issues, they perceived HIVST as a positive addition to their HIV prevention toolbox. [ABSTRACT FROM AUTHOR]
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- 2018
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12. Pilot Evaluation of the Ability of Men Who Have Sex with Men to Self-Administer Rapid HIV Tests, Prepare Dried Blood Spot Cards, and Interpret Test Results, Atlanta, Georgia, 2013.
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MacGowan, Robin J., Chavez, Pollyanna R., Gravens, Laura, Wesolowski, Laura G., Sharma, Akshay, McNaghten, A. D., Freeman, Arin, Sullivan, Patrick S., Borkowf, Craig B., Michele Owen, S., and for the eSTAMP Study Group
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DIAGNOSIS of HIV infections ,BLOOD testing ,BEHAVIOR modification ,FISHER exact test ,METROPOLITAN areas ,PUBLIC health surveillance ,HEALTH self-care ,PILOT projects ,DATA analysis software ,MEN who have sex with men - Abstract
Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2018
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13. Willingness to distribute free rapid home HIV test kits and to test with social or sexual network associates among men who have sex with men in the United States.
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Sharma, Akshay, Chavez, Pollyanna R., MacGowan, Robin J., McNaghten, A.D., Mustanski, Brian, Gravens, Laura, Freeman, Arin E., and Sullivan, Patrick S.
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DIAGNOSTIC equipment , *DIAGNOSIS of HIV infections , *DRUG delivery systems , *HOME care services , *SOCIAL networks , *SURVEYS , *TIME , *MEN who have sex with men - Abstract
Peer-driven HIV prevention strategies can be effective in identifying high-risk persons with undiagnosed infections. Besides individual self-testing, other potential uses of rapid home HIV test kits include distributing them, and testing with others within one's social or sexual networks. We sought to identify factors associated with the willingness to engage in these alternative activities among men who have sex with men (MSM) in the United States. From May to October 2014, we surveyed 828 HIV-negative or unknown status MSM about multiple aspects of rapid home HIV testing. A greater proportion indicated being likely to distribute free oral fluid (OF) tests compared to free finger-stick blood (FSB) tests (91% versus 79%), and almost three-fourths (72%) reported being likely to test with their friends or sex partners in the future. MSM not identifying as homosexual/gay were less willing to distribute OF tests, and those with lower educational attainment were more willing to distribute FSB tests. MSM unaware of their HIV status were less likely to report potentially testing with others using free rapid home HIV tests compared to those who were HIV-negative. Finally, MSM willing to self-test were more likely to report future test kit distribution, and those willing to distribute kits were more likely to report potentially testing with others. Engaging individuals with positive attitudes towards these strategies in prevention efforts could help increase HIV testing levels among MSM. A greater understanding of the potential public health impact of rapid home HIV test kits is necessary. [ABSTRACT FROM PUBLISHER]
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- 2017
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14. Individual HIV Risk versus Population Impact of Risk Compensation after HIV Preexposure Prophylaxis Initiation among Men Who Have Sex with Men.
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Jenness, Samuel M., Sharma, Akshay, Goodreau, Steven M., Rosenberg, Eli S., Weiss, Kevin M., Hoover, Karen W., Smith, Dawn K., and Sullivan, Patrick
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MEN who have sex with men , *HIV infection risk factors , *HIV infection transmission , *CONDOMS , *UNSAFE sex , *DISEASES - Abstract
Objectives: Risk compensation (RC) could reduce or offset the biological prevention benefits of HIV preexposure prophylaxis (PrEP) among those at substantial risk of infection, including men who have sex with men (MSM). We investigated the potential extent and causal mechanisms through which RC could impact HIV transmission at the population and individual levels. Methods: Using a stochastic network-based mathematical model of HIV transmission dynamics among MSM in the United States, we simulated RC as a reduction in the probability of condom use after initiating PrEP, with heterogeneity by PrEP adherence profiles and partnership type in which RC occurred. Outcomes were changes to population-level HIV incidence and individual-level acquisition risk. Results: When RC was limited to MSM highly/moderately adherent to PrEP, 100% RC (full replacement of condoms) resulted in a 2% relative decline in incidence compared to no RC, but an 8% relative increase in infection risk for MSM on PrEP. This resulted from confounding by indication: RC increased the number of MSM indicated for PrEP as a function of more condomless anal intercourse among men otherwise not indicated for PrEP; this led to an increased PrEP uptake and subsequent decline in incidence. Conclusions: RC is unlikely to decrease the prevention impact of PrEP, and in some cases RC may be counterintuitively beneficial at the population level. This depended on PrEP uptake scaling with behavioral indications. Due to the increased acquisition risk associated with RC, however, clinicians should continue to support PrEP as a supplement rather than replacement of condoms. [ABSTRACT FROM AUTHOR]
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- 2017
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15. Evaluating interventions to promote routine preventive screenings: A comparison of analytical outcomes.
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Sharma, Akshay, Johnson, Brent A., and Sullivan, Patrick S.
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MEDICAL screening , *HEALTH outcome assessment , *PUBLIC health , *MAMMOGRAMS , *HEALTH promotion - Abstract
Background Often in public health, we are interested in promoting routine preventive screenings (e.g., blood glucose monitoring, hypertension screening, or mammography). Evaluating novel interventions to encourage frequent screenings using randomized controlled trials can help inform evidence-based health promotion programs. When the desired behavior change is a recurrent event, specifying the most meaningful study outcomes may prove challenging. Methods To understand the efficiency of multiple approaches for evaluating an intervention seeking to increase regular health screenings we (a) simulated several replications of a trial with a positive intervention effect under various censoring scenarios, (b) formulated three different analytical outcome definitions (screening a certain number of times during the entire study period versus not, screening at least once within a clinically meaningful time period versus not, “hazard” or instantaneous rate of screening), and (c) compared them with regard to interpreting results and estimating power at different sample sizes. Results Approaches which better utilize detailed prospective data, while also accounting for within-participant correlations, are less likely to miss the actual underlying benefits conferred by a new prevention strategy compared to relying on a dichotomous measure derived from aggregating events over the study duration. Such approaches are also more powerful in realistic scenarios wherein some participants are lost to follow-up over time. Conclusions Researchers should carefully consider the choice of analytical outcomes and strive to employ more efficient approaches that model comprehensive event-specific information, rather than summarizing repeated measures into less-informative dichotomous responses, while designing and conducting trials with recurrent preventive screenings. [ABSTRACT FROM AUTHOR]
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- 2015
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