Acceptability and Feasibility of Geographically Explicit Ecological Momentary Assessment Among Men Who Have Sex with Men

Isabelle Sheck,Jacky M Jennings,Carla Tilchin,David H Epstein,Jessica Wagner,Albert Burgess-Hull

doi:10.1007/s10508-021-02159-6

Abstract

Syphilis among men who have sex with men (MSM) has increased greatly in the past twenty years in the U.S. Geographically explicit ecological momentary assessment (GEMA), in which behaviors are geotagged and contextualized in time and space, may contribute to a greater understanding of transmission risk. The objective was to determine the acceptability and feasibility of GEMA for assessing HIV and syphilis transmission risk behaviors among a sample of MSM. Participants responded to a brief survey five times a day for two weeks. Feasibility was measured by participant recruitment, enrollment, prompts received and answered, geotagged prompts, and technical interference with data collection. Acceptability was measured by ratings of enjoyment and willingness for future participation. Summaries of five behavioral measures from the brief survey were calculated. Among the 83 participants contacted, 67.5% (56) expressed interest, 98% (55) were scheduled, and 81.8% (45) were enrolled. Participants answered 78.3% (2,277) of prompts received and 87.7% (1,998) of answered prompts were geotagged. Overall, 70.5% (31) enjoyed participating and 91.1% (41) were willing to participate in the future. Among prompts answered, missingness was low for five behavioral measures (range 0.2% (4) to 0.7% (16)). Feasibility and acceptability were high and missingness was low on behavioral measures in this MSM study population. Most participants reported that they would participate again. Future work should focus on whether GEMA improves our understanding of syphilis and HIV transmission risk.

Highlights

Syphilis among gay, bisexual and other men who have sex with men (MSM) has increased greatly in the United States (U.S.) over the past twenty years (Centers for Disease Control and Prevention [CDC], 2019)
Reported cases of syphilis continue to be characterized by a high rate of HIV co-infection, among MSM (CDC, 2019)
While data suggest that multiple factors may be contributing to the syphilis and HIV co-infection epidemic among MSM, a handful of studies suggest that drug use and stimulant use, such as methamphetamine use, in combination with sex may be a significant contributing factor (Drückler et al, 2018; Landovitz et al, 2013; Bourne et al, 2018; Race, 2015; Chew et al, 2013; Klitzman et al, 2000; Stall & Purcell, 2000; Waldo et al, 2000; Jennings et al, 2021)

Summary

Introduction

Bisexual and other men who have sex with men (MSM) has increased greatly in the United States (U.S.) over the past twenty years (Centers for Disease Control and Prevention [CDC], 2019). Primary and secondary syphilis rates have increased almost every year since 2001, and in 2019, 56.7% of cases were among MSM (CDC, 2020, 2021). Reported cases of syphilis continue to be characterized by a high rate of HIV co-infection, among MSM (CDC, 2019). Standard data collection techniques rely on retrospective recall periods of three-, six- or twelve-month time periods. The retrospective nature and length of recall time may lead to

Objectives

Results

Conclusion