Protocol for a Respondent-Driven Sampling Study Exploring the Roles of Peer Norms in HIV-Related Practices of Gay Men

Iryna Zablotska, John de Wit, Graham Brown, Bruce Maycock, Christopher Fairley, Michelle McKechnie, Garrett Prestage

Curtin University, Bentley, Australia.
Melbourne School of Population Health, University of Melbourne and Melbourne Sexual Health Centre, Melbourne, Australia.
National Centre in HIV Social Research, University of New South Wales, Paddington, Australia.
The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia;Curtin University, Bentley, Australia.
The Kirby Institute, University of New South Wales, Paddington, Australia.
The Kirby Institute, University of New South Wales, Paddington, Australia;The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.

DOI: 10.4236/wja.2013.34041                

Abstract

Introduction: Sexual behaviour among gay and other men who have sex with men (GMSM) is influenced by the shared understanding of HIV/STI risk and peer norms regarding sexual behaviour. However, there is little research evidence to support this relationship. The unique geographic spread of Australian communities, the history of Australian HIV epidemic and the different patterns in risky sexual practices and HIV diagnoses across Australia present an opportunity to explore the role of social norms and GMSM behaviours in shaping different patterns of HIV epidemics. We describe the protocol of the study of contemporary norms in networks and communities of GMSM (CONNECT) which investigates gay community behavioural norms and practices. Methods: CONNECT is aimed to 1) identify the patterns of connections between individuals in GMSM communities and assess how they shape HIV-related behaviours; 2) describe the relationship between social norms and sexual practices; and 3) compare the norms and patterns of behaviour in geographically and epidemiologically distinct GMSM populations in three Australian states New South Wales, Victoria and Western Australia, in order to identify local community norms and barriers to effective HIV prevention. This quantitative cross-sectional study uses respondent-driven sampling (RDS) for recruitment. Results: Analyses will be carried out on individual and community level and will investigate the relationship between community-level behavioural norms and associated practices of individuals. Conclusion: CONNECT is anticipated to inform HIV prevention services to better target and increase the effectiveness of the current health promotion for GMSM in the context of increasing HIV/STI incidence.

 

Keywords

HIV; GMSM; Networks; Behaviour; Community Norms

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	HIV, “Viral Hepatitis and Sexually Transmissible Infections in Australia,” Annual Surveillance Report 2010, The University of New South Wales, Sydney, 2010.
[2]	Australian Government Department of Health and Aging, “6th National HIV Strategy (2010-2013),” Australian Government Department of Health and Aging, Canberra, 2010.
[3]	R. J. Guy, A. McDonald, M. Bartlett, J. Murray, C. M. Giele, T. M. Davey, et al., “HIV Diagnoses in Australia: Diverging Epidemics within a Low-Prevalence Country,” Medical Journal of Australia, Vol. 187, No. 8, 2007, pp. 437-440.
[4]	N. MacDonald, S. Dougan, C. A. McGarrigle, K. Baster, B. D. Rice, B. G. Evans, et al., “Recent Trends in Diagnoses of HIV and Other Sexually Transmitted Infections in England and Wales among Men Who Have Sex with Men,” Sexually Transmitted Infections, Vol. 80, No. 6, 2004, pp. 492-497. http://dx.doi.org/10.1136/sti.2004.011197
[5]	U. Marcus, L. Voss, C. Kollan and O. Hamouda, “HIV Incidence Increasing in MSM in Germany: Factors Influencing Infection Dynamics,” Eurosurveillance, Vol. 11, No. 9, 2006, pp. 157-160.
[6]	R. J. Wolitski, R. O. Valdiserri, P. H. Denning and W. C. Levine, “Are We Headed for a Resurgence of the HIV Epidemic among Men Who Have Sex with Men?” American Journal of Public Health, Vol. 91, No. 6, 2001, pp. 883-888. http://dx.doi.org/10.2105/AJPH.91.6.883
[7]	A. McDonald, “HIV/AIDS, Viral Hepatitis and Sexually Transmissible Infections in Australia: Annual Surveillance Report 2008,” Australian Institute of Health and Welfare, Canberra, 2008.
[8]	J. Elford, “Changing Patterns of Sexual Behaviour in the Era of Highly Active Antiretroviral Therapy,” Current Opinion in Infectious Diseases, Vol. 19, No. 1, 2006, pp. 26-32. http://dx.doi.org/10.1097/01.qco.0000199018.50451.e1
[9]	N. Crepaz, T. A. Hart and G. Marks, “Highly Active Antiretroviral Therapy and Sexual Risk Behavior: A MetaAnalytic Review,” JAMA, Vol. 292, No. 2, 2004, pp. 224-236. http://dx.doi.org/10.1001/jama.292.2.224
[10]	L. Mao, J. M. Crawford, H. J. Hospers, G. P. Prestage, A. E. Grulich, J. M. Kaldor, et al., “‘Serosorting’ in Casual Anal Sex of HIV-Negative Gay Men Is Noteworthy and Is Increasing in Sydney, Australia,” AIDS, Vol. 20, No. 8, 2006, pp. 1204-1206. http://dx.doi.org/10.1097/01.aids.0000226964.17966.75
[11]	F. Jin, J. Crawford, G. P. Prestage, I. Zablotska, J. Imrie, S. C. Kippax, et al., “Unprotected Anal Intercourse, Risk Reduction Behaviours, and Subsequent HIV Infection in a Cohort of Homosexual Men,” AIDS, Vol. 23, No. 9, 2009, pp. 243-252. http://dx.doi.org/10.1097/QAD.0b013e32831fb51a
[12]	G. Prestage, J. Ferris, J. Grierson, R. Thorpe, I. Zablotska, J. Imrie, et al., “Homosexual Men in Australia: Population, Distribution and HIV Prevalence,” Sex Health, Vol. 5, No. 2, 2008, pp. 97-102. http://dx.doi.org/10.1071/SH07080
[13]	I. B. Zablotska, G. Prestage, A. E. Grulich and J. Imrie, “Differing Trends in Sexual Risk Behaviours in Three Australian States: New South Wales, Victoria and Queensland, 1998-2006,” Sex Health, Vol. 5, No. 2, 2008, pp. 125-130. http://dx.doi.org/10.1071/SH07076
[14]	I. B. Zablotska, J. Crawford, J. Imrie, G. Prestage, F. Jin, A. Grulich, et al., “Increases in Unprotected Anal Intercourse with Serodiscordant Casual Partners among HIV-Negative Gay Men in Sydney,” AIDS and Behavior, Vol. 13, No. 4, 2009, pp. 638-644. http://dx.doi.org/10.1007/s10461-008-9506-x
[15]	I. B. Zablotska, G. Prestage, M. Middleton, D. Wilson and A. E. Grulich, “Contemporary HIV Diagnoses Trends in Australia Can Be Predicted by Trends in Unprotected Anal Intercourse among Gay Men,” AIDS, Vol. 24, No. 12, 2010, pp. 1955-1958. http://dx.doi.org/10.1097/QAD.0b013e32833bf74a
[16]	“A Think Tank: Why Are HIV Notifications Flat in NSW 1998-2006?” Consensus Statement: NSW Health, 2007. http://www.health.nsw.gov.au/sexualhealth/Documents/HIV-consensus-statement.pdf
[17]	S. Kippax, R. W. Connell, G. Dowsett and J. Crawford, “Sustaining Safe Sex: Gay Communities Respond to AIDS,” The Falmer Press, London, Washington DC, 2008.
[18]	G. Prestage, F. Jin, I. Zablotska, J. Imrie, J. M. Kaldor and A. E. Grulich, “Trends in HIV Prevalence among Homosexual and Bisexual Men in Eastern Australian States,” Sex Health, Vol. 5, No. 2, 2008, pp. 103-107. http://dx.doi.org/10.1071/SH07074
[19]	G. Brown, B. Maycock, G. Prestage and P. V. Ven, “Sex in Two Cities-Gay Men, Risk and HIV in Perth and Sydney,” Asia-Pacific Journal of Public Health/Asia-Pacific Academic Consortium for Public Health, Vol. 16, No. 2, 2004, pp. 3-8.
[20]	M. S. Rowe and G. W. Dowsettz, “Sex, Love, Friendship, Belonging and Place: Is There a Role for ‘Gay Community’ in HIV Prevention Today?” Culture, Health & Sexuality, Vol. 10, No. 4, 2008, pp. 329-344. http://dx.doi.org/10.1080/13691050701843098
[21]	S. Kippax and K. Race, “Sustaining Safe Practice: Twenty Years on,” Social Science & Medicine, Vol. 57, No. 1, 2003, pp. 1-12. http://dx.doi.org/10.1016/S0277-9536(02)00303-9
[22]	R. W. Connell, G. W. Dowsett, P. Rodden, M. D. Davis, L. Watson and D. Baxter, “Social Class, Gay Men and AIDS Prevention,” Australian Journal of Public Health, Vol. 15, No. 3, 1991, pp. 178-189. http://dx.doi.org/10.1111/j.1753-6405.1991.tb00332.x
[23]	G. Hart and M. Boulton, “Sexual Behaviour in Gay Men: Towards a Sociology of Risk,” In: P. Aggleton, P. Davis and G. Hart, Eds., AIDS: Safety, Sexuality and Risk, Taylor and Francis Ltd., London, 1995.
[24]	T. Rhodes, “Risk Theory in Epidemic Times: Sex, Drugs and the Social Organisation of Risk Behaviour,” Sociology of Health & Illness, Vol. 19, No. 2, 1997, p. 227. http://dx.doi.org/10.1111/1467-9566.00047
[25]	S. Kippax, S. Slavin, J. Ellard, O. Hendry, J. Richters, A. Grulich, et al., “Seroconversion in Context,” AIDS Care, Vol. 15, No. 6, 2003, pp. 839-852. http://dx.doi.org/10.1080/09540120310001618685
[26]	R. H. Jones and C. N. Candlin, “Constructing Risk across Timescales and Trajectories: Gay Men’s Stories of Sexual Encounters,” Health, Risk and Society, Vol. 5, No. 2, 2003, pp. 199-213. http://dx.doi.org/10.1080/1369857031000123966
[27]	A. Bandura, “Social Foundations of Thought and Action: A Social Cognitive Theory,” Prentice-Hall, Englewood Cliffs, 1986.
[28]	E. Rogers, “Diffusion of Innovations,” Free Press, New York, 1983.
[29]	H. Liu, H. Liu, Y. Cai, A. G. Rhodes and F. Hong, “Money Boys, HIV Risks, and the Associations between Norms and Safer Sex: A Respondent-Driven Sampling Study in Shenzhen, China,” AIDS and Behavior, Vol. 13, No. 4, 2009, pp. 652-662.
[30]	J. L. Peterson, R. Rothenberg, J. M. Kraft, C. Beeker and R. Trotter, “Perceived Condom Norms and HIV Risks among Social and Sexual Networks of Young African American Men Who Have Sex with Men,” Health Education Research, Vol. 24, No. 1, 2009, pp. 119-127. http://dx.doi.org/10.1093/her/cyn003
[31]	J. S. Koopman and J. W. Lynch, “Individual Causal Models and Population System Models in Epidemiology,” American Journal of Public Health, Vol. 89, No. 8, 1999, pp. 1170-1174. http://dx.doi.org/10.2105/AJPH.89.8.1170
[32]	D. Heckathorn, S. Semaan, R. Broadhead and J. Hughes, “Extensions of Respondent-Driven Sampling: A New Approach to the Study of Injecting Drug Users Aged 18 -25,” AIDS and Behavior, Vol. 6, No. 1, 2002, pp. 55-67. http://dx.doi.org/10.1023/A:1014528612685
[33]	R. Magnani, K. Sabin, T. Saidel and D. Heckathorn, “Review of Sampling Hard-To-Reach and Hidden Populations for HIV Surveillance,” AIDS, Vol. 19, Suppl. 2, 2005, pp. S67-S72. http://dx.doi.org/10.1097/01.aids.0000172879.20628.e1
[34]	A. S. Klovdahl, “Social Networks and the Spread of Infectious Diseases: The AIDS Example,” Social Science & Medicine, Vol. 21, No. 11, 1985, pp. 1203-1216. http://dx.doi.org/10.1016/0277-9536(85)90269-2
[35]	C. A. Latkin, V. Forman, A. Knowlton and S. Sherman, “Norms, Social Networks, and HIV-Related Risk Behaviors among Urban Disadvantaged Drug Users,” Social Science & Medicine, Vol. 56, No. 3, 2003, pp. 465-476. http://dx.doi.org/10.1016/S0277-9536(02)00047-3
[36]	S. M. Goodreau, “Advances in Exponential Random Graph (p*) Models Applied to a Large Social Network,” Social Networks, Vol. 29, No. 2, 2007, pp. 231-248. http://dx.doi.org/10.1016/j.socnet.2006.08.001
[37]	A. Klovdahl, “Social Network Research and Human Subjects Protection: Towards More Effective Infectious Disease Control,” Social Networks, Vol. 27, No. 2, 2005, pp. 119-137. http://dx.doi.org/10.1016/j.socnet.2005.01.006
[38]	A. Smith, J. Grierson, H. von Doussa, M. Pitts and T. Clement, “Mapping Gay Men’s Communities,” Monograph Number 73, Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, 2009.
[39]	M. Xiridou, R. Geskus, J. de Wit, R. Coutinho and M. Kretzschmar, “The Contribution of Steady and Casual Partnerships to the Incidence of HIV Infection among Homosexual Men in Amsterdam,” AIDS, Vol. 17, No. 7, 2003, pp. 1029-1038. http://dx.doi.org/10.1097/00002030-200305020-00012
[40]	I. G. Stolte, J. B. de Wit, A. van Eeden, R. A. Coutinho and N. H. Dukers, “Perceived Viral Load, but Not Actual HIV-1-RNA Load, Is Associated with Sexual Risk Behaviour among HIV-Infected Homosexual Men,” AIDS, Vol. 18, No. 14, 2004, pp. 1943-1949. http://dx.doi.org/10.1097/00002030-200409240-00010
[41]	M. J. Salganik and D. Heckathorn, “Sampling and Estimation in Hidden Populations Using Respondent Driven Sampling,” Sociological Methodology, Vol. 34, No. 1, 2004, pp. 193-239. http://dx.doi.org/10.1111/j.0081-1750.2004.00152.x