Emily S. Pingel

Data Quality in web-based HIV/AIDS research: Handling Invalid and Suspicious Data.

Invalid data may compromise data quality. We examined how decisions made to handle these data may affect the relationship between Internet use and HIV risk behaviors in a sample of young men who have sex with men (YMSM). We recorded 548 entries during the 3-month period and created six analytic groups (i.e., full sample, entries initially tagged as valid, suspicious entries, valid cases mislabeled as suspicious, fraudulent data, and total valid cases) using data quality decisions. We compared these groups on the sample’s composition and their bivariate relationships. Forty-one cases were marked as invalid, affecting the statistical precision of our estimates but not the relationships between variables. Sixty-two additional cases were flagged as suspicious entries and found to contribute to the sample’s diversity and observed relationships. Using our final analytic sample, we found that very conservative criteria regarding data exclusion may prevent researchers from observing true associations. We discuss the implications of data quality decisions and its implications for the design of future HIV/AIDS web surveys.Invalid data may compromise data quality. We examined how decisions taken to handle these data may affect the relationship between Internet use and HIV risk behaviors in a sample of young men who have sex with men (YMSM). We recorded 548 entries during the three-month period, and created 6 analytic groups (i.e., full sample, entries initially tagged as valid, suspicious entries, valid cases mislabeled as suspicious, fraudulent data, and total valid cases) using data quality decisions. We compared these groups on the samples composition and their bivariate relationships. Forty-one cases were marked as invalid, affecting the statistical precision of our estimates but not the relationships between variables. Sixty-two additional cases were flagged as suspicious entries and found to contribute to the samples diversity and observed relationships. Using our final analytic sample (N = 447; M = 21.48 years old, SD = 1.98), we found that very conservative criteria regarding data exclusion may prevent researchers from observing true associations. We discuss the implications of data quality decisions and its implications for the design of future HIV/AIDS web-surveys.

PrEP Awareness and Perceived Barriers Among Single Young Men who have Sex with Men

Pre-exposure prophylaxis (PrEP) has the potential to help reduce new HIV infections among young men who have sex with men (YMSM). Using a cross-sectional survey of YMSM (N=1,507; ages 18-24), we gauged YMSMs PrEP awareness and PrEP-related beliefs regarding side effects, accessibility, and affordability. Overall, 27% of the sample had heard about PrEP; 1% reported ever using PrEP prior to sex. In a multivariate logistic regression, we found that YMSM were more likely to have heard about PrEP if they were older, more educated, were residentially unstable in the prior 30 days, had insurance, or reported having at least one sexually transmitted infection in their lifetime. We found no differences by race/ethnicity, history of incarceration, or recent sexual risk behavior. In multivariate linear regression models, Black and Latino YMSM were more likely than Whites to state they would not use PrEP because of side effect concerns. YMSM were more likely to indicate that they would not be able to afford PrEP if they did not have insurance or if they had a prior sexually transmitted infection, PrEP rollout may be hindered due to lack of awareness, as well as perceived barriers regarding its use. We propose strategies to maximize equity in PrEP awareness and access if it is to be scaled up among YMSM.

Data Quality in HIV/AIDS Web-Based Surveys

Invalid data may compromise data quality. We examined how decisions made to handle these data may affect the relationship between Internet use and HIV risk behaviors in a sample of young men who have sex with men (YMSM). We recorded 548 entries during the 3-month period and created six analytic groups (i.e., full sample, entries initially tagged as valid, suspicious entries, valid cases mislabeled as suspicious, fraudulent data, and total valid cases) using data quality decisions. We compared these groups on the sample’s composition and their bivariate relationships. Forty-one cases were marked as invalid, affecting the statistical precision of our estimates but not the relationships between variables. Sixty-two additional cases were flagged as suspicious entries and found to contribute to the sample’s diversity and observed relationships. Using our final analytic sample, we found that very conservative criteria regarding data exclusion may prevent researchers from observing true associations. We discuss the implications of data quality decisions and its implications for the design of future HIV/AIDS web surveys.Invalid data may compromise data quality. We examined how decisions taken to handle these data may affect the relationship between Internet use and HIV risk behaviors in a sample of young men who have sex with men (YMSM). We recorded 548 entries during the three-month period, and created 6 analytic groups (i.e., full sample, entries initially tagged as valid, suspicious entries, valid cases mislabeled as suspicious, fraudulent data, and total valid cases) using data quality decisions. We compared these groups on the samples composition and their bivariate relationships. Forty-one cases were marked as invalid, affecting the statistical precision of our estimates but not the relationships between variables. Sixty-two additional cases were flagged as suspicious entries and found to contribute to the samples diversity and observed relationships. Using our final analytic sample (N = 447; M = 21.48 years old, SD = 1.98), we found that very conservative criteria regarding data exclusion may prevent researchers from observing true associations. We discuss the implications of data quality decisions and its implications for the design of future HIV/AIDS web-surveys.

Butch tops and femme bottoms? Sexual positioning, sexual decision making, and gender roles among young gay men.

Gender and power are theoretical constructs linked to discussions of sexual transmission of HIV/AIDS among heterosexual couples. Despite the fact that HIV rates are rising among young men who have sex with men in the United States, work examining the role of gender in sexual decision making of young men who have sex with men remains in its infancy. Through qualitative interviews with 34 young gay men (YGM), the authors seek to contribute to the literature in this area by focusing on the ways that YGM understand and enact sexual positions during anal sex. The authors’ results highlight the diversity of YGM’s sexual preferences, as well as the high degree of sexual fluidity. Ideas of gender appear to inform part of this process; however, YGM critiqued conventional gender norms and emphasized the centrality of relationships (i.e., casual vs. romantic) in their sexual decision making. The authors discuss the importance of considering gender and interpersonal factors when designing HIV/AIDS prevention messages for YGM.

Creating Comprehensive, Youth Centered, Culturally Appropriate Sex Education: What Do Young Gay, Bisexual, and Questioning Men Want?

We examined young gay, bisexual, and questioning men’s (YGBQM) experiences with school-based sex education as they sought to learn about sex and sexual health, and their suggestions for improving same-sex education resources. Thematic analysis of 30 in-depth interviews with YGBQM (ages 18–24) underscored the discrepancies between the existing school-based sex education curricula and YGBQM’s perceived sex education needs. Our results show that many youths’ sexuality and same-sex sexual behaviors are excluded in sex education lessons; however, YGBQM noted that they sought out other resources (e.g., websites) to answer their questions. We discuss YGBQM’s ideas for the creation of a sex and sexual health website that would be tailored for youth like themselves, including topics and features that an ideal website would contain. In addition, we present recommended changes to existing school-based sexual education curricula.

Butch Tops and Femme Bottoms? Constructions of Masculinity by Young Men Who Have Sex with Men Seeking Partners Online

Gender and power are theoretical constructs linked to discussions of sexual transmission of HIV/AIDS among heterosexual couples. Despite the fact that HIV rates are rising among young men who have sex with men in the United States, work examining the role of gender in sexual decision making of young men who have sex with men remains in its infancy. Through qualitative interviews with 34 young gay men (YGM), the authors seek to contribute to the literature in this area by focusing on the ways that YGM understand and enact sexual positions during anal sex. The authors’ results highlight the diversity of YGM’s sexual preferences, as well as the high degree of sexual fluidity. Ideas of gender appear to inform part of this process; however, YGM critiqued conventional gender norms and emphasized the centrality of relationships (i.e., casual vs. romantic) in their sexual decision making. The authors discuss the importance of considering gender and interpersonal factors when designing HIV/AIDS prevention messages for YGM.

Achieving Safety: Safer Sex, Communication, and Desire Among Young Gay Men

Conceptualizations of safer sex practices among young gay men (YGM) are frequently structured around communication between partners and the subsequent utilization or absence of condoms in a sexual encounter. Drawing on a sample of 34 in-depth interviews with YGM, ages 18 to 24, the authors explore the ways in which conceptualizations and definitions of safer sex are discussed and enacted. Placing attention on their safer sex practices, the authors analyze the conversations that do and do not occur among YGM and their partners, including the strategies (e.g., negotiated safety, condom communication and negotiation) that are commonly perceived as most useful by YGM. The authors provide recommendations regarding how to craft safer sex messages for YGM by considering their competing demands.

“A Safe Way to Explore” Reframing Risk on the Internet Amidst Young Gay Men’s Search for Identity

Internet use provides a vital opportunity for sexual-minority youth to learn about sexual desires and pursue partnerships otherwise publically stigmatized. Researchers, however, have portrayed the Internet as an inherently risky venue for HIV or sexually transmitted infection (STI) transmission among young gay men (YGM). We therefore investigated how YGM use the Internet during adolescence and emerging adulthood. In the course of 34 in-depth, semistructured interviews with a sample of self-identified YGM, 18 to 24 years of age, we inquired about initial experiences of online dating. We found that YGM benefit online through exploration of their sexual identities, while simultaneously encountering and negotiating sources of risk. In examining YGM’s perceptions of risk, we hope to reach a greater understanding of the opportunities for HIV prevention and health promotion among YGM.

The role of provider interactions on comprehensive sexual healthcare among young men who have sex with men

Testing for both HIV and STIs is an essential component of comprehensive sexual healthcare for young men who have sex with men (YMSM). Using data collected from YMSM living in the Detroit metropolitan area (N = 304, ages 18-29; 51% Black, 25% White, 14% Latino), we examined YMSMs access to a medical provider in the prior year and tested whether a providers conversation regarding HIV/STI prevention was associated with their type of testing behavior: Non-Testers, HIV-Only Testing, and HIV and STI Testing. Over half (56.7%) reported a routine provider visit in the previous year. Visits were associated with having insurance, provider comfort, and prior HIV and/or STI testing. Among YMSM who visited a doctor, our multinomial regression exhibited that those whose provider discussed HIV/STI prevention were most likely to have tested for both HIV and STIs, as compared to the HIV Only and Never Tester categories. Patient-provider communication regarding HIV/STI prevention is critical to motivate comprehensive sexual healthcare access among YMSM. Strategies that enable providers to discuss HIV/STI prevention with YMSM in a sex-positive manner may help maximize comprehensive testing.

Coming Out to Dad: Young Gay and Bisexual Men's Experiences Disclosing Same-Sex Attraction to Their Fathers

Few studies have examined the relationship between young gay and bisexual men (YGBM) and their fathers. Based on a phenomenological framework, this study investigated the role of fathers in YGBM’s coming-out experience, focusing on how fathers responded to disclosure of same-sex attraction, how fathers’ responses compared with sons’ expectations, and what sons perceived as having influenced their fathers’ responses. Semistructured in-depth interviews with 30 gay and bisexual men aged 18 to 24 years were conducted as part of a larger study; topics explored in the interview included experiences coming out to family and others. Nineteen participants’ narratives included discussion about their fathers and were included in the current analyses. The YGBM who were interviewed perceived a complex range of responses upon coming out to their fathers, ranging from enthusiastic acceptance to physical violence. Participants spoke of fathers who were accepting in different manners and who often held contradictory attitudes about same-sex attraction. Fathers’ responses commonly differed from sons’ expectations, which were informed by homophobic talk and gendered expectations. Sons spoke about what informed their expectations as well as what they perceived as influencing their fathers’ responses, including gender norms, beliefs regarding the cause of same-sex attraction, religious and sociopolitical views, and concerns about HIV/AIDS. Particularly striking was the pervasive influence of hegemonic masculinity throughout the YGBM’s stories. The implications of these findings for future research and intervention development are discussed, as well as study strengths and limitations.