Browsing by Author "Dodge, Brian"

Now showing 1 - 10 of 18
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    A Contextual Approach to the Psychological Study of Identity Concealment: Examining Direct, Interactive, and Indirect Effects of Structural Stigma on Concealment Motivation Across Proximal and Distal Geographic Levels
    (Sage, 2021) Lattanner, Micah R.; Ford, Jessie; Bo, Na; Tu, Wanzhu; Pachankis, John E.; Dodge, Brian; Hatzenbuehler, Mark L.; Biostatistics, School of Public Health
    Psychological theories of identity concealment locate the ultimate source of concealment decisions within the social environment, yet most studies have not explicitly assessed stigmatizing environments beyond the immediate situation. We advanced the identity-concealment literature by objectively measuring structural forms of stigma related to sexual orientation (e.g., social policies) at proximal and distal geographic levels. We linked these measures to a new, population-based data set of 502 gay and bisexual men (residing in 44 states and Washington, DC; 269 counties; and 354 cities) who completed survey items about stigma, including identity-concealment motivation. Among gay men, the association between structural stigma and concealment motivation was (a) observed across three levels (city, county, and state), (b) conditional on one's exposure at another geographic level (participants reported the least motivations to conceal their identity if they resided in both cities and states that were lowest in structural stigma), and (c) mediated by subjective perceptions of greater structural stigma.
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    Adolescents' Discussion of Sexual and Reproductive Health Care Topics With Providers: Findings From a Nationally Representative Probability Sample of U.S. Adolescents
    (Elsevier, 2021-03) Hensel, Devon J.; Herbenick, Debby; Beckmeyer, Jonathon J.; Fu, Tsung-chieh; Dodge, Brian; Pediatrics, School of Medicine
    Purpose National practice guidelines encourage providers address sexual and reproductive health (SRH) as part of all clinical encounters with adolescents. Yet, no studies provide nationally representative estimates of how frequently adolescents are screened. Methods Data were adolescent participants (aged 14–17 years; N = 826) in the 2018 National Survey of Sexual Health and Behavior, an online, nationally representative study of sexual health experiences of people in the U.S. SRH variables were: (all no/yes) pregnancy prevention, sexual identity, STD/HIV prevention, sexual difficulties, sexually transmitted infections testing, and sexual activity. We used descriptive statistics and weighted logistic regression (Stata 16.0; all p < .05) to examine differences in the odds of SRH discussion with provider by sexual identity, age, gender, and race/ethnicity. Results The coverage of SRH topics was poor. The most common topic was asking about sexual activity (52.9%), and the least common was being offered a sexually transmitted infection test (21.7%). An adolescent’s sexual identity, race/ethnicity, and age affected the odds of topic screening. Conclusions Health care providers appear to both infrequently and inconsistently address key SRH topics during encounters with young people. Targeted interventions should focus on strengthening the regularity and depth of clinicians’ SRH conversations regardless of adolescent demographic or history.
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    Considerations in the Measurement and Reporting of Withdrawal: Findings from the 2018 National Survey of Sexual Health and Behavior
    (Elsevier, 2019-08) Fu, Tsung-chieh; Hensel, Devon J.; Beckmeyer, Jonathon J.; Dodge, Brian; Herbenick, Debby; Medicine, School of Medicine
    Introduction Although withdrawal use is routinely measured as part of contraceptive surveillance in the United States, its assessment may be prone to underreporting and measurement errors. Additionally, at the population level, little is known about subjective experiences of withdrawal. Aim To measure respondents’ frequency of and reasons for engaging in extra-vaginal ejaculation in the past year, and to compare contraceptive withdrawal vs extra-vaginal/anal ejaculation during the most recent sexual event. Methods The 2018 National Survey of Sexual Health and Behavior is a U.S. nationally representative probability survey of adolescents and adults. This study was administered in February–March 2018 via GfK Research’s KnowledgePanel. Respondents who reported consensual penile-vaginal intercourse in the past year were included in the analysis. Logistic regression was used to assess factors associated with finding extra-vaginal ejaculation sexy/arousing. Main Outcome Measures Main outcomes were the frequency of and reasons for extra-vaginal ejaculation in the past year, as well as reported contraceptive withdrawal use and the location of ejaculation at the most recent penile-vaginal intercourse. Results In the past year, approximately 60% of respondents reported engaging in any extra-vaginal ejaculation; pregnancy prevention and sexual pleasure were given as common reasons. Those who were men, white, or aged 25–29 were more likely to find extra-vaginal ejaculation sexy or arousing; no gender differences were observed in their partner’s perception of this act. Prevalence of selecting withdrawal on the contraceptive inventory was 12.2% (95% CI 10.6–14.0) at last sexual event, whereas extra-vaginal/anal ejaculation was reported by 20.8% (95% CI 18.7–23.0). This lack of concordance in differing measures was observed consistently across all age groups, and approximately 12% to 14% of individuals reported an ejaculation location that did not correspond to their withdrawal use. Clinical Implications The results of this study have implications for how healthcare providers discuss withdrawal with their patients and counsel them on using extra-vaginal ejaculation as part of their contraceptive use or part of their sexual repertoire. Strengths & Limitations This is the first nationally representative study to directly compare contraceptive withdrawal to extra-vaginal ejaculation. Limited data were collected at event level regarding motivations for extra-vaginal ejaculation, pregnancy attitudes, perceptions of condoms and sexually transmitted infection prevention, or exposure to erotic media, thus limiting further assessment of relationships between various factors and extra-vaginal/anal ejaculation. Conclusion We found that reporting of withdrawal as a contraceptive method vs extra-vaginal/anal ejaculation was inconsistent and that extra-vaginal/anal ejaculation was commonly used for reasons other than pregnancy prevention; future research should use more precise measures of “withdrawal.”
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    Detection of Rectal Chlamydia trachomatis in Heterosexual Men Who Report Cunnilingus
    (Wolters Kluwer, 2019-07-01) Batteiger, Teresa A.; Jordan, Stephen J.; Toh, Evelyn; Fortenberry, Lora; Williams, James A.; LaPradd, Michelle; Katz, Barry; Fortenberry, J. Dennis; Dodge, Brian; Arno, Janet; Batteiger, Byron E.; Nelson, David E.; Microbiology and Immunology, School of Medicine
    Background. Rectal infection with Chlamydia trachomatis (CT) is frequent in women who deny receptive anal sex and is thought to arise from autoinoculation of the rectum from vaginal secretions. An alternate hypothesis is that oral sex inoculates and establishes gastrointestinal tract infection. Distinguishing these hypotheses is difficult in women. In men, autoinoculation is unlikely and heterosexual men frequently perform oral sex, but rarely participate in receptive anal exposure behaviors. Methods. We enrolled high-risk men with and without nongonococcal urethritis (NGU) who presented to a sexually transmitted infection clinic in Indianapolis, Indiana. Urine and rectal swabs were collected and tested for urogenital and rectal CT, Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG). Men completed surveys concerning symptoms, sexual orientation, and detailed recent and lifetime oral and anal sexual behaviors. Results. Rectal CT was detected in 2/84 (2.4%) heterosexual men who reported cunnilingus, but no lifetime receptive anal behaviors. All of the men who denied receptive anal behaviors were negative for rectal NG and MG. In homosexual and bisexual men, rectal CT prevalence was high (9.7%) and rectal NG (4.8%) and MG (4.8%) were also detected. Conclusions. We detected rectal CT infections in heterosexual men who reported cunnilingus but denied receptive anal behaviors. Oral sex may be a risk factor for rectal CT infection via oral inoculation of the gastrointestinal tract. Summary. We observed a low incidence of rectal C. trachomatis infection in heterosexual men.
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    Differences in risk behaviours, HIV/STI testing and HIV/STI prevalence between men who have sex with men and men who have sex with both men and women in China
    (SAGE, 2016-09) Davis, Alissa; Best, John; Luo, Juhua; Van Der Pol, Barbara; Dodge, Brian; Meyerson, Beth; Aalsma, Matthew; Wei, Chongyi; Tucker, Joseph D.; Department of Epidemiology, Richard M. Fairbanks School of Public Health
    Differences in risk behaviours between men who have sex with men (MSM) and men who have sex with both men and women (MSMW) have important implications for HIV and sexually transmitted infection (STI) transmission. We examined differences in risk behaviours, HIV/STI testing, self-reported HIV/STI diagnoses, and linkage to HIV care between MSM and MSMW across China. Participants were recruited through three MSM-focused websites in China. An online survey containing items on socio-demographics, risk behaviours, testing history, self-reported HIV/STI diagnosis, and linkage to and retention in HIV care was completed from September to October 2014. Chi square tests and logistic regression analyses were conducted. MSMW were less likely to use a condom during last anal sex (p ≤ 0.01) and more likely to engage in group sex (p ≤ 0.01) and transactional sex (p ≤ 0.01) compared to MSM. Self-reported HIV/STI testing and positivity rates between MSM and MSMW were similar. Among HIV-infected MSM, there was no difference in rates of linkage to or retention in antiretroviral therapy when comparing MSM and MSMW. Chinese MSM and MSMW may benefit from different HIV and STI intervention and prevention strategies. Achieving a successful decrease in HIV/STI epidemics among Chinese MSM and MSMW will depend on the ability of targeted and culturally congruent HIV/STI control programmes to facilitate a reduction in risk behaviours.
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    Do Adolescents and Young Adults Learn About Condoms from Healthcare Providers? Findings from a US Probability Sample
    (Springer, 2022-06) Beckmeyer, Jonathon J.; Patterson, Callie L.; Fu, Tsung-Chieh; Hensel, Devon J.; Dodge, Brian; Herbenick, Debby; Medicine, School of Medicine
    Introduction Using data from the 2018 National Survey of Sexual Health and Behavior, we determined the prevalence and content of adolescents’ and young adults’ communication with healthcare providers about condom use. Methods Adolescents (14–17 years old; n = 283) and young adults (18–24 years old, n = 225), who discussed sexual health with a healthcare provider in the past year, reported if they had discussed condom use with a healthcare provider, and among those who did, they also reported why healthcare providers recommended condoms, if they demonstrated correct condom use, and/or provided condoms. Data collection occurred in February and March 2018. Results Most adolescents (71.0%) and young adults (66.7%) who discussed sexual health with a healthcare provider reported discussing condom use. Condoms were most often recommended for both pregnancy and STD prevention. Fewer adolescents and young adults were shown how to use condoms (11.4% of adolescents; 5.7% of young adults) or provided condoms (14.9% of adolescents; 14.7% of young adults). Only 3.2% of adolescents and 1.3% of young adults had healthcare providers who discussed, demonstrated, and provided condoms. Conclusions Sexual health conversations with healthcare providers are likely to include condoms. But few adolescents and young adults were shown how to use condoms or provide condoms.
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    HIV Risk and Prevention Outcomes in a Probability-Based Sample of Gay and Bisexual Men in the United States
    (Wolters Kluwer, 2019-12-01) Dodge, Brian; Ford, Jessie; Bo, Na; Tu, Wanzhu; Pachankis, John; Herbenick, Debby; Mayer, Kenneth; Hatzenbuehler, Mark L.; Biostatistics, School of Public Health
    Background: Although gay and bisexual men (GBM) represent the largest group of HIV-infected individuals in the United States, nearly all evidence on their HIV risk and prevention outcomes derive from nonprobability samples. Setting: A probability-based cohort of GBM (N = 502) from 45 states and Washington, DC. Methods: Cross-sectional survey. Results: Among HIV-negative/unknown/untested GBM, only 6.7% reported using pre-exposure prophylaxis (PrEP) in the past 6 months. Two-thirds (63.3%) of PrEP users reported daily adherence in the past week. Over half (54.2%) of GBM reported not using a condom during anal sex with their most recent male partner; of these men, 93.8% were not on PrEP. Most GBM had been tested for HIV (80.7%) and other sexually transmitted infections (67.1%) in their lifetime, with 45.2% having tested for HIV during the past year. Among those ever tested, 14.1% reported being HIV infected, whereas an additional 8.9% reported testing positive for at least one other sexually transmitted infection after their most recent test. All HIV-positive GBM reported being currently on antiretroviral treatment, and 94.7% reported an undetectable viral load, but nearly one-third (30.4%) reported not taking their medication every day during the past month. A majority of HIV-negative/unknown/untested GBM (64.3%) reported that they had never discussed HIV prevention with their primary health care provider. Conclusions: Our findings present a decidedly mixed picture regarding the success of the US National HIV/AIDS Strategy in meeting its stated goals of addressing HIV risk among the general population of GBM.
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    Intimate Partner Violence and Correlates With Risk Behaviors and HIV/STI Diagnoses Among Men Who Have Sex With Men and Men Who Have Sex With Men and Women in China: A Hidden Epidemic
    (Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2015-07) Davis, Alissa; Best, John; Wei, Chongyi; Luo, Juhua; Van Der Pol, Barbara; Meyerson, Beth; Dodge, Brian; Aalsma, Matthew; Tucker, Joseph; Social Entrepreneurship for Sexual Health Research Group; Department of Pediatrics, IU School of Medicine
    BACKGROUND: Intimate partner violence (IPV) research has primarily focused on heterosexual couples but has largely ignored IPV among men who have sex with men (MSM). We examined IPV prevalence among MSM and men who have sex with men and women (MSMW) in China. METHODS: Men who have sex with men older than 16 years were recruited through 3 MSM-focused Web sites in China. An online survey containing items on sociodemographics, risk behaviors, IPV, and self-reported HIV or sexually transmitted infection diagnosis was completed. Multivariate regression was used to examine associations between IPV and risk behaviors and an HIV or sexually transmitted infection diagnosis. RESULTS: Among 610 participants, 182 (29.8%) reported experiencing at least 1 type of IPV. Men who have sex with both men and women were at significantly greater risk for IPV (adjusted odds ratio [AOR], 1.65; 95% confidence interval [CI], 1.08-2.53) compared with MSM. Men who had experienced IPV were more likely to have participated in group sex (AOR, 1.86; 95% CI, 1.08-3.21), to have had sex in exchange for gifts or money (AOR, 5.06; 95% CI, 2.47-10.35), and to report a positive HIV diagnosis (AOR, 2.59; 95% CI, 1.22-5.51). CONCLUSIONS: There is a hidden epidemic of IPV among MSM in China, especially among MSMW. The hidden nature of MSM and MSMW suggests the need for a clinical environment more conducive to disclosure. Research is needed to understand the pathways linking IPV and HIV risk among MSM to optimize the design of effective interventions.
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    Knowledge of Zika and perception of risk among sexually-active adults in the United States of America: results from a nationally representative sample
    (World Health Organization, 2018-06-07) Guerra-Reyes, Lucia; Fu, Tsung-chieh Jane; Williams, Deana; Herbenick, Debby; Dodge, Brian; Reece, Michael; Fortenberry, J. Dennis; Medicine, School of Medicine
    Objective To examine knowledge of Zika transmission and risk perception and to assess variability by condom use in a probability sample of sexually-active adults in the United States. Methods Data for this study came from the 2016 wave of the National Survey of Sexual Health and Behavior, a nationally representative probability sample of adults in the United States. Data were collected in November 2016 via a cross-sectional Internet-based survey administered to members of a Knowledge Panel, an address-based random sample service managed by GfK. A weighted subsample (n = 1 713) of sexually active adults, 18 – 50 years of age, was included in analyses. Results More than 90% of men and women reported low or no perceived risk of Zika. Most participants identified mosquito bite as a route of transmission, while significantly fewer identified sexual intercourse (≈ 40%) and vertical (29% men, 41% women) transmission routes. Conclusion Sexually-active adults in the United States, especially young men, lack awareness of sexual and vertical transmission of Zika Virus. Given the likely endemic nature of Zika, this low-risk perception is an important prevention challenge. Zika prevention messaging should address lesser known transmission routes, emphasize male education, and promote correct and consistent condom use.