This article explores the visual culture of social network applications (apps), using “safer-sex design” as an anchor to contemplate how different practices of looking at HIV co-constitute viral ...visibility. Drawing on science and technology studies and queer theories, this article traces viral visibility from its digital production through its marketization, and finally to its implications for gay men’s sexual communication in Taiwan. Through interviews with gay Taiwanese men and a social app developer and the visual analysis of Hornet, Grindr, and Scruff, this article describes how the precarity of viruses, knowledge of HIV prevention, and social stigmas against sexual minorities are brought together, staged, and made eligible (and ineligible) for public viewing. This article demonstrates how digital platform designs work to facilitate gay men’s sociosexual communication while ironically reinforcing stigmas against HIV/AIDS in Taiwan, and suggests a critical approach to the visual culture of social apps and queer health.
There is an urgent need to measure the impacts of COVID-19 among gay men and other men who have sex with men (MSM). We conducted a cross-sectional survey with a global sample of gay men and other MSM ...(n = 2732) from April 16, 2020 to May 4, 2020, through a social networking app. We characterized the economic, mental health, HIV prevention and HIV treatment impacts of COVID-19 and the COVID-19 response, and examined whether sub-groups of our study population are disproportionately impacted by COVID-19. Many gay men and other MSM not only reported economic and mental health consequences, but also interruptions to HIV prevention and testing, and HIV care and treatment services. These consequences were significantly greater among people living with HIV, racial/ethnic minorities, immigrants, sex workers, and socio-economically disadvantaged groups. These findings highlight the urgent need to mitigate the negative impacts of COVID-19 among gay men and other MSM.
New innovative technologies, such as mobile apps, have been developed to increase pre-exposure prophylaxis (PrEP) adherence and the use of log sex diaries. The contiguity of mobile apps reduces the ...recall bias that generally affects reported condom and PrEP use. However, none of the currently used mobile apps were designed for event-driven PrEP users, and few studies have demonstrated the potential usage of sex diary data to facilitate the understanding of the different HIV risks among heterogeneous profiles of sex diaries and PrEP use.
We aim to discriminate the heterogeneous profiles of sex events and PrEP use and examine the risk of condomless anal sex among different types of sex events.
We recruited 35 adult men who have sex with men from two medical centers in Taiwan since May 2020 and followed up for four months. Participants were on PrEP or willing to take PrEP. They were asked to log their sex events, PrEP use, and dosing regimens on a mobile app to improve their PrEP adherence. Latent class analysis was used to distinguish profiles of sex events and PrEP use. Indicators included correct intake of PrEP for each sex event, participants' sexual positioning, partner's HIV status, and age.
A total of 551 sex events were classified into three classes by latent class analysis: PrEP nonadherent flip-flopping (234/551, 42%), PrEP imperfect-adherent power bottoming (284/551, 52%), and PrEP adherent serodiscordant topping (33/551, 6%). "PrEP nonadherent flip-flopping" sex events were more likely to involve condomless anal sex than "PrEP imperfect-adherent power bottoming" (OR 1.83, 95% CI 1.03-3.25) after considering random intercepts for individuals, and this class needed to increase their PrEP adherence and use of condoms. "PrEP imperfect-adherent power bottoming" realized their own risk and packaged PrEP with condoms to protect themselves. Up to 99% (32/33) of sex events in "PrEP adherent serodiscordant topping" were protected by PrEP, but all of the sex events in this group were condomless.
Using the sex diary data could advance the capacity to identify high-risk groups. HIV prevention strategy should be more flexible and combine PrEP with condom use for future HIV prevention.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The global implementation of pre-exposure prophylaxis (PrEP)—a HIV prevention medicine—has evoked new hopes of ending AIDS. In 2016, a group of Taiwanese and Thai doctors and AIDS advocates initiated ...a PrEP delivery online platform to assist gay Taiwanese men to access the less expensive, generic versions of PrEP in Thailand. Drawing on science and technology studies, this article investigates how gay men’s bodies and sexualities and PrEP’s promise of ending AIDS become intertwined with the political and cultural economy of governmental regulation, pharmaceutical innovation, and personal mobility and pleasure. Building on the ethnographic fieldwork conducted in Taiwan and Thailand, it scrutinizes changing definitions of sexual health and surplus values of PrEP in two intertwined social settings: One is that of Taiwan’s online PrEP delivery system, which mediated between the top-down biomedical regulation of the pharmaceutical industry and Taiwanese state, and the other one is the transnational commercial transitions, which mediated through commercial ventures and individual recreational and consumer activities. By moving across various social landscapes, the article not only acknowledges the constraints put upon the individual by processes of commodification but also recognizes the possibilities and potentialities that are enacted by laypersons’ desires and migratory practices.
Introduction: While various antiretrovirals have been studied as potential candidates for long‐acting pre‐exposure prophylaxis (PrEP), the bimonthly injectable cabotegravir—the first long‐acting form ...of PrEP—was approved in 2021. Event‐driven (ED) PrEP has been the most prevalent dosing regimen among gay, bisexual and other men who have sex with men (GBMSM) in Taiwan, providing a unique setting to observe the preferences for long‐acting PrEP in a community where the daily regimen is not the mainstream method. This study aimed to determine the preferences for the different forms and dosing intervals of long‐acting PrEP that are currently in the development pipeline. Methods: We conducted a survey in 2021 by convenience sampling the users of social networking applications for GBMSM in Taiwan. Our survey included questions on sexual behaviours, current PrEP regimens and the preferences for potential candidates of long‐acting PrEP, such as implants, intramuscular and subcutaneous injections. We compared the Likert‐scale preference ratings for potential long‐acting options, and conducted logistic regression analysis to examine the factors associated with a preference for bimonthly intramuscular injections (2M IM) over ED and daily PrEP regimens, respectively. Results: A total of 1728 responses were eligible for analysis. Three percent of respondents (n = 52) were daily PrEP users; 11.5% (n = 198) were ED PrEP users. When not considering cost, current PrEP users—regardless of their original dosing regimen—were most likely to express preferences for monthly oral PrEP, followed by a 6‐month subcutaneous injectable (6M SC) and 2M IM. However, among non‐current PrEP users, monthly oral PrEP was the most preferred form, followed by ED, daily oral and 6M SC injectable. Multivariable logistic regression revealed that current daily users, those willing to take PrEP in the next 6 months and those with more sex partners in the last 12 months had a significant correlation with preferences for the 2M IM injectable over the ED PrEP. Conclusions: The monthly oral form was the most preferable long‐acting PrEP among GBMSM in Taiwan. Current daily PrEP users preferred the 2M IM injectable over the ED PrEP, which made the 2M IM injectable a potential alternative. Further studies should focus on how the cost and delivery affect PrEP preferences and their actual uptake.
In the era of social media, a large number of user-generated videos are uploaded to the Internet every day, capturing events all over the world. Reconstructing the event truth based on information ...mined from these videos has been an emerging challenging task. Temporal alignment of videos "in the wild" which capture different moments at different positions with different perspectives is the critical step. In this paper, we propose a hierarchical approach to synchronize videos. Our system utilizes clustered audio-signatures to align video pairs. Global alignment for all videos is then achieved via forming alignable video groups with self-paced learning. Experiments on the Boston Marathon dataset show that the proposed method achieves excellent precision and robustness.
Numerous studies have identified an association between the use of drugs in sexual contexts (chemsex) and HIV among gay, bisexual, and other men who have sex with men (GBMSM), although whether a ...causal relationship exists is contentious. An intricate relationship exists between chemsex, HIV treatment and prevention, harm reduction, and the provision of community-grounded health services. Furthermore, potential harms exist beyond HIV, such as intoxication and overdose. Community-engaged responses to chemsex involve social and cultural strategies of harm reduction and sexual health promotion before, during, and after a chemsex session. Ultimately, this Review calls for actions and collaborations aimed at developing a greater understanding of chemsex as a practice within different GBMSM subpopulations and to develop tailored harm-reduction models that can accommodate GBMSM who engage in chemsex in various ways and with varied effects.
This dissertation is an ethnographic study of contemporary gay Taiwanese men's sexual health with a focus on the circulation of HIV prevention medicine and blood management. In the 2010s, the ...governance of HIV/AIDS has undergone a significant shift, moving from biomedical treatment to prevention: pre-exposure prophylaxis (PrEP) is prescribed for HIV-negative individuals to prevent sexually contracting HIV. PrEP engenders a new serological condition, "HIV negative, on PrEP." By signaling the absence of virus and personal use of HIV biomedicine, "HIV negative, on PrEP" implies that this medicine works at the molecular level of human blood to suppress viral incubation and replication, and entails a medical and social urgency of constantly bringing the drug into an individual's body. This dissertation asks what it means to be “HIV negative, on PrEP” in the neoliberal, transnational context of drug consumption and regulation. In this project, I argue that serostatus associated with HIV biomedicine should not be seen as a fixed scientific category about one’s wellbeing, but instead a dynamic process of becoming “HIV negative, on PrEP.” I tell the story of how gay men, governments, AIDS advocates, pharmaceutical companies, and other social actors utilize "HIV negative, on PrEP" as a means to redefine sexual health during a time when drugs are newly introduced and not yet widely available or financially accessible. In doing so, I unearth the socio-economic tensions, health inequalities, and hegemonic oppressions against gay men amid the HIV biomedical prevention regime. A multi-sited ethnography conducted in Taiwan and Thailand from 2016 to 2019, this dissertation traces PrEP’s social trajectory and gay men’s socio-sexual practices to document the transformation of sexual health in four main chapters: government-led medical support programs, the AIDS advocacy organizations initiated drug-delivery model, gay men’s medical tourism to Thailand, and gay men’s sexual communication through smartphone social apps. Drawing on the theories and methods from the science and technology studies (STS), new feminist materialism, medical anthropology, and media studies, I offer an expansive and performative interpretation of health, safety, risk, and other taken-for-granted notions in public health, illustrating how gay Taiwanese men have undergone a biomedical and social transformation of blood management and body modification. In moving toward self-health enhancement, their bodies and sexualities have become intertwined with the economies of pharmaceutical innovation, governmental regulation, and personal mobility and pleasure. Ultimately, this dissertation contributes to the emerging scholarship of “Queer STS” by addressing the broader issues of the politics of self-medication, the marketization of HIV medicine, and the making of queer sexuality in the digital environment.
Sexualized drug use or “chemsex” in Taiwan commonly incorporates the use of methamphetamine. Our study aimed to assess the extent of severity of dependence of methamphetamine among MSM in Taiwan as ...well as motivations for engagement in chemsex.
Direct messages were sent to users of a large MSM social networking application in Taiwan between November 2018 and January 2019. MSM who had at least one experience of using drugs during sex in the preceding 12 months were invited to complete an online survey that assessed their sexual behavior, substance use and motivations for engaging in chemsex. The Severity of Dependence Scale was used to assess methamphetamine dependency. Multivariable logistic regression was used to determine the factors associated with methamphetamine dependency.
From a total of 1906 responses, 517 had used methamphetamine in their lifetime and were included in the analysis. The majority (87.2%) used more than one substance when engaging in chemsex in the past six months, while a quarter reported injection of methamphetamine within the last six months. The most commonly reported motivations for participants to engage in chemsex were to have fun, for relaxation, and to increase the intensity of the sexual experience. Nearly half (46.0%) exhibited signs of methamphetamine dependency. Lower monthly income, injection of methamphetamine, ever feeling lonely in the past 3 months and concerns about their substance use expressed by others were significantly associated with methamphetamine dependency.
A high proportion of MSM population who engaged in chemsex were at risk of developing methamphetamine dependency. While motivations for engaging in chemsex were diverse and suggest potential for enhanced sexual experience for some, community health organization for gay men's health and healthcare providers should be vigilant at identifying the risk of methamphetamine dependency and provide in-time, brief intervention or referrals when needed.
Critical drug studies explore the discursive and material dimensions of sexualised drug use to overcome individualised and often pathologising notions such as risk, safety, responsibility and ...pleasure. This article uses an object-oriented approach-following the use and flow of social apps, syringes and antiretroviral therapy (ART)-to analyse gay and bisexual Taiwanese men's drug practices. Interview data from fourteen men are used to articulate how objects were brought into gay and bisexual men's chemsex repertoire in ways that shaped individuals' safe-sex communication, intimacy maintenance and stigma negotiation. An object-oriented approach scrutinises risk, pleasure and identities in assemblages of the human and nonhuman, and can help identify new opportunities for implementing health promotion interventions and policies.
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