About This ProjectAfrican American men who have sex with men (MSMs) are at higher risk for new HIV infections in rural communities and most likely to be under diagnosed. We hope to explain the reasons for this disparity in order to help public health officials craft better intervention strategies to prevent the spread of HIV. Funding will enable us to collect baseline data on HIV risk perceptions, behaviors and testing practices in MSMs living in rural Louisiana.
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What is the context of this research?
Within MSMs, African Americans are infected and under diagnosed at rates 3- and 6-times that of other races and ethnicities. These trends are especially notable in Louisiana, where 62% of 74% of new HIV cases in 2011 were in MSMs and African Americans, respectively; of the new MSMs diagnosed, 64% were African American.
Data from the CDC suggest that high baseline HIV prevalence, increasing rates of unprotected anal intercourse (UAI), lack of awareness, and untreated HIV in MSMs (not on antiretroviral therapy) contribute significantly to the ongoing epidemic. The majority of this data was collected in large metropolitan areas, and information on people living in rural areas is lacking, especially in the Southeastern United States.
Persons living in rural locales face unique barriers to care such as difficulty with transportation, reduced numbers of healthcare providers, lower rates of health insurance, and higher rates of stigma and discrimination than their urban counterparts.
What is the significance of this project?
Given the high incidence and prevalence of HIV in MSMs, the expansion of HIV into rural communities, and the unique barriers faced by rural persons seeking healthcare, information on MSMs at risk for or infected with HIV is needed. MSMs in the rural South face unique barriers due to societal discrimination (fear of losing friends/family/job from being “outed”) and a lack of state or federal laws prohibiting employment and/or marriage discrimination.
For these reasons, information on this population is often hard to obtain or is incomplete. Our study strives to gather as much data on this population as possible without sacrificing anonymity or putting participants at risk for discrimination. We feel this data will help us steer desperately needed HIV intervention efforts for MSMs in central Louisiana.
What are the goals of the project?
Our aim is to collect baseline data on HIV risk perceptions, behaviors, and testing practices in MSMs living in rural Louisiana.
This will be done with two anonymous surveys: the first will be given to all HIV-positive men at our local HIV clinic (The Tulane University Medical Group’s CD4 Clinic), the second will be given to men in the community at a Lesbian, Gay, Bisexual, and Transgender (LGBT)-friendly coffee shop in downtown Alexandria, Louisiana, or online via Survey Monkey (for anonymity reasons).
We plan to advertise the online survey and testing day on Facebook sites, Craigslist Central Louisiana and other social networking sites.
We are surveying all males and not just “gay males” as not all MSMs identify as gay or bisexual, and our survey is designed to capture risk behavior and not necessarily sexual orientation. Once the data is collected and analyzed, we will use it to target HIV testing and intervention efforts in rural central Louisiana.
The budget will pay for $5 coffee shop gift cards that we plan to distribute to survey participants. If we meet our stretch goal, we will be able to enroll more participants ( the current budget allows for 100 participants), and expand recruitment efforts on popular MSM social media aps (Grindr, Manhunt, etc) which charge a premium for advertising or survey research.
Meet the Team
Team BioDr. Van Sickels is an Assistant Professor and full-time faculty member at Tulane University Hospital. He is a board-certified infectious disease physician with extensive experience caring for people living with HIV and AIDS, and has presented research in the field of HIV and AIDS at several national meetings. In addition, he is the medical director of Tulane’s CD4 clinic in Alexandria, Louisiana.
Dr. Seal is an Assistant Professor and full-time faculty member at Louisiana State University Health Sciences Center New Orleans. She is a board-certified infectious disease physician working at the LSU HIV outpatient clinic (HOP). She has research experience and has published papers on health disparities in HIV seen in rural communities.
Dr. Abrams-Downey is an internal medicine resident at Tulane University Hospital
Dr. LaCross is an internal medicine resident at Tulane University Hospital
Dr. Marsh is an internal medicine resident at Tulane University Hospital
Dr. Anthony Marsh
Dr. Alexandra Abrams-Downey, Dr. Christoher LaCross, Dr. Anthony Marsh, Dr. Paula Seal, Dr. Nicholas Van Sickels
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Additional Information1. Centers for Disease Control and Prevention. (2013) Epidemiology of HIV Infection through 2011; http://www.cdc.gov/hiv/pdf/statistics_surveillance_Epi-HIV-infection.pdf. Accessed 2014 February 8.
2. Louisiana Department of Health and Human Services (2012) National Black HIV/AIDS Awareness Day Fact Sheet;http://new.dhh.louisiana.gov/assets/oph/HIVSTD/hiv-aids/2013/2013BlackAwareness.pdf; Accessed 2014 February 8.
3. Louisiana Department of Health and Human Services (2012) National Gay Men’s HIV/AIDS Awareness Day Fact Sheethttp://new.dhh.louisiana.gov/assets/oph/HIVSTD/hiv-aids/2012/MSMPublisherFActSheet2012.pdf; Accessed 2014 February 8.
4. Centers for Disease Control and Prevention. (2013) HIV Testing and Risk Behaviors Among Gay, Bisexual, and other Men Who Have Sex With Men- United States.http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6247a4.htm; Accessed 2014 Feb 8.
5. Health Resources and Services Administration (2010). HIV/AIDS in Rural America.http://www.hrsa.gov/ruralhealth/about/hivfacts.pdf; Accessed 2014 Feb 8.
6. Koblin BA, Mayer KH, Eshleman SH et al. Correlates of HIV Acquisition in a Cohort of Black Men Who Have Sex With Men in the United States: HIV Prevention Trials Network (HTPN) 061. PLoS One 2013; 8: e70413.
7. Mayer KH, Ducharme R, Zaller N, et al. Unprotected Sex, Underestimated Risk, Undiagnosed HIV and Sexually Transmitted Diseases Among Men Who Have Sex With Men Accessing Testing Services in a New England Bathhouse. J Acquir Immune Defic Syndr. 2012 February 1; 59(2): 194-198.
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