Sean D. Young

Online Social Networking Technologies, HIV Knowledge, and Sexual Risk and Testing Behaviors Among Homeless Youth

This study evaluates associations between online social networking and sexual health behaviors among homeless youth in Los Angeles. We analyzed survey data from 201 homeless youth accessing services at a Los Angeles agency. Multivariate (regression and logistic) models assessed whether use of (and topics discussed on) online social networking technologies affect HIV knowledge, sexual risk behaviors, and testing for sexually transmitted infections (STIs). One set of results suggests that using online social networks for partner seeking (compared to not using the networks for seeking partners) is associated with increased sexual risk behaviors. Supporting data suggest that (1) using online social networks to talk about safe sex is associated with an increased likelihood of having met a recent sex partner online, and (2) having online sex partners and talking to friends on online social networks about drugs and partying is associated with increased exchange sex. However, results also suggest that online social network usage is associated with increased knowledge and HIV/STI prevention among homeless youth: (1) using online social networks to talk about love and safe sex is associated with increased knowledge about HIV, (2) using the networks to talk about love is associated with decreased exchange sex, and (3) merely being a member of an online social network is associated with increased likelihood of having previously tested for STIs. Taken together, this study suggests that online social networking and the topics discussed on these networks can potentially increase and decrease sexual risk behaviors depending on how the networks are used. Developing sexual health services and interventions on online social networks could reduce sexual risk behaviors.

Social Networking Technologies as an Emerging Tool for HIV Prevention: A Cluster Randomized Trial

BACKGROUND Social networking technologies are an emerging tool for HIV prevention. OBJECTIVE To determine whether social networking communities can increase HIV testing among African American and Latino men who have sex with men (MSM). DESIGN Randomized, controlled trial with concealed allocation. (ClinicalTrials.gov: NCT01701206). SETTING Online. PATIENTS 112 MSM based in Los Angeles, more than 85% of whom were African American or Latino. INTERVENTION Sixteen peer leaders were randomly assigned to deliver information about HIV or general health to participants via Facebook groups over 12 weeks. After participants accepted a request to join the group, participation was voluntary. Group participation and engagement were monitored. Participants could request a free, home-based HIV testing kit and completed questionnaires at baseline and 12-week follow-up. MEASUREMENTS Participant acceptance of and engagement in the intervention and social network participation, rates of home-based HIV testing, and sexual risk behaviors. RESULTS Almost 95% of intervention participants and 73% of control participants voluntarily communicated using the social platform. Twenty-five of 57 intervention participants (44%) requested home-based HIV testing kits compared with 11 of 55 control participants (20%) (difference, 24 percentage points [95% CI, 8 to 41 percentage points]). Nine of the 25 intervention participants (36%) who requested the test took it and mailed it back compared with 2 of the 11 control participants (18%) who requested the test. Retention at study follow-up was more than 93%. LIMITATION Only 2 Facebook communities were included for each group. CONCLUSION Social networking communities are acceptable and effective tools to increase home-based HIV testing among at-risk populations. PRIMARY FUNDING SOURCE National Institute of Mental Health.

Calculus of Nonrigid Surfaces for Geometry and Texture Manipulation

The experience of motion sickness in a virtual environment may be measured through pre and postexperiment self-reported questionnaires such as the simulator sickness questionnaire (SSQ). Although research provides converging evidence that users of virtual environments can experience motion sickness, there have been no controlled studies to determine to what extent the users subjective response is a demand characteristic resulting from pre and posttest measures. In this study, subjects were given either SSQs both pre and postvirtual environment immersion, or only postimmersion. This technique tested for contrast effects due to demand characteristics in which administration of the questionnaire itself suggested to the participant that the virtual environment may produce motion sickness. Results indicate that reports of motion sickness after immersion in a virtual environment are much greater when both pre and postquestionnaires are given than when only a posttest questionnaire is used. The implications for assessments of motion sickness in virtual environments are discussedThe experience of motion sickness in a virtual environment may be measured through pre and postexperiment self-reported questionnaires such as the simulator sickness questionnaire (SSQ). Although research provides converging evidence that users of virtual environments can experience motion sickness, there have been no controlled studies to determine to what extent the users subjective response is a demand characteristic resulting from pre and posttest measures. In this study, subjects were given either SSQs both pre and postvirtual environment immersion, or only postimmersion. This technique tested for contrast effects due to demand characteristics in which administration of the questionnaire itself suggested to the participant that the virtual environment may produce motion sickness. Results indicate that reports of motion sickness after immersion in a virtual environment are much greater when both pre and postquestionnaires are given than when only a posttest questionnaire is used. The implications for assessments of motion sickness in virtual environments are discussedThe experience of motion sickness in a virtual environment may be measured through pre and postexperiment self-reported questionnaires such as the Simulator Sickness Questionnaire (SSQ). Although research provides converging evidence that users of virtual environments can experience motion sickness, there have been no controlled studies to determine to what extent the users subjective response is a demand characteristic resulting from pre and posttest measures. In this study, subjects were given either SSQs both pre and postvirtual environment immersion, or only postimmersion. This technique tested for contrast effects due to demand characteristics in which administration of the questionnaire itself suggested to the participant that the virtual environment may produce motion sickness. Results indicate that reports of motion sickness after immersion in a virtual environment are much greater when both pre and postquestionnaires are given than when only a posttest questionnaire is used. The implications for assessments of motion sickness in virtual environments are discussed.

Cost-Effectiveness of HIV Monitoring Strategies in Resource-Limited Settings – A Southern African Analysis

BACKGROUND Although the number of infected persons receiving highly active antiretroviral therapy (HAART) in low- and middle-income countries has increased dramatically, optimal disease management is not well defined. METHODS We developed a model to compare the costs and benefits of 3 types of human immunodeficiency virus monitoring strategies: symptom-based strategies, CD4-based strategies, and CD4 counts plus viral load strategies for starting, switching, and stopping HAART. We used clinical and cost data from southern Africa and performed a cost-effectiveness analysis. All assumptions were tested in sensitivity analyses. RESULTS Compared with the symptom-based approaches, monitoring CD4 counts every 6 months and starting treatment at a threshold of 200/muL was associated with a gain in life expectancy of 6.5 months (61.9 months vs 68.4 months) and a discounted lifetime cost savings of US

Social networking technologies as emerging tools for HIV prevention: A Cluster Randomized Trial

464 per person (US

Internet Use, Social Networking, and HIV/AIDS Risk for Homeless Adolescents

4069 vs US

HIV-related stigma, social norms, and HIV testing in Soweto and Vulindlela, South Africa: National Institutes of Mental Health Project Accept (HPTN 043).

3605, discounted 2007 dollars). The CD4-based strategies in which treatment was started at the higher threshold of 350/microL provided an additional gain in life expectancy of 5.3 months at a cost-effectiveness of US

Demand Characteristics in Assessing Motion Sickness in a Virtual Environment: Or Does Taking a Motion Sickness Questionnaire Make You Sick?

107 per life-year gained compared with a threshold of 200/microL. Monitoring viral load with CD4 was more expensive than monitoring CD4 counts alone, added 2.0 months of life, and had an incremental cost-effectiveness ratio of US

Harnessing Online Peer Education (HOPE): integrating C-POL and social media to train peer leaders in HIV prevention.

5414 per life-year gained relative to monitoring of CD4 counts. In sensitivity analyses, the cost savings from CD4 count monitoring compared with the symptom-based approaches was sensitive to cost of inpatient care, and the cost-effectiveness of viral load monitoring was influenced by the per test costs and rates of virologic failure. CONCLUSIONS Use of CD4 monitoring and early initiation of HAART in southern Africa provides large health benefits relative to symptom-based approaches for HAART management. In southern African countries with relatively high costs of hospitalization, CD4 monitoring would likely reduce total health care expenditures. The cost-effectiveness of viral load monitoring depends on test prices and rates of virologic failure.

Online Social Networking for HIV Education and Prevention: A Mixed Methods Analysis

BACKGROUND Social networking technologies are an emerging tool for HIV prevention. OBJECTIVE To determine whether social networking communities can increase HIV testing among African American and Latino men who have sex with men (MSM). DESIGN Randomized, controlled trial with concealed allocation. (ClinicalTrials.gov: NCT01701206). SETTING Online. PATIENTS 112 MSM based in Los Angeles, more than 85% of whom were African American or Latino. INTERVENTION Sixteen peer leaders were randomly assigned to deliver information about HIV or general health to participants via Facebook groups over 12 weeks. After participants accepted a request to join the group, participation was voluntary. Group participation and engagement were monitored. Participants could request a free, home-based HIV testing kit and completed questionnaires at baseline and 12-week follow-up. MEASUREMENTS Participant acceptance of and engagement in the intervention and social network participation, rates of home-based HIV testing, and sexual risk behaviors. RESULTS Almost 95% of intervention participants and 73% of control participants voluntarily communicated using the social platform. Twenty-five of 57 intervention participants (44%) requested home-based HIV testing kits compared with 11 of 55 control participants (20%) (difference, 24 percentage points [95% CI, 8 to 41 percentage points]). Nine of the 25 intervention participants (36%) who requested the test took it and mailed it back compared with 2 of the 11 control participants (18%) who requested the test. Retention at study follow-up was more than 93%. LIMITATION Only 2 Facebook communities were included for each group. CONCLUSION Social networking communities are acceptable and effective tools to increase home-based HIV testing among at-risk populations. PRIMARY FUNDING SOURCE National Institute of Mental Health.