This paper describes young men who have sex with men (YMSM) experiences with sexually transmitted infections (STIs) diagnosis, treatment, disclosure to partners, and changes in thinking and behavior. Reactions were diverse, the most common being surprise and concern. Most participants sought treatment, although the type of provider varied. Providers tended to retest participants, but some did so at the incorrect anatomical site. Participants who felt comfortable talking to providers about STIs tended to use their regular provider or one who specialized in gay/bisexual men’s health. Most participants described changes in their thinking and behavior (e.g., increased condom use, fewer sex partners, questioning whether or not they could trust their partners). Most participants disclosed to at least one partner, but some did not remember or were not in contact with partners. Implications for public policy and STI prevention are discussed.

This paper examines agreements with one’s most recent partner, individual differences across types of partnerships and agreements, and predictors of condomless anal sex (CAS). Two-thirds of participants did not have agreements. Monogamous agreements were most common among those who were seriously dating their partner, but also present among those who were casually dating their partner and those who were not dating their partner. Participants who were seriously dating their partner reported the most frequent sexual health communication. Participants without agreements reported the lowest frequency of and comfort with sexual health communication. Participants who were seriously dating their partner and those with monogamous agreements were most likely to report CAS. HIV prevention should address communication with serious and casual partners.

In this paper, we examine the impact of recruitment venue on participant demographics, behavioral HIV risks, and enrollment. Keep It Up participants were screened for eligibility from community-based organizations, Facebook, dating apps, and outreach events. There were significant differences by venue in age, race/ethnicity, sexual orientation, relationship status, and region of recruitment. There were no significant differences by venue in attrition during the enrollment process. The only difference in attrition was by race/ethnicity. Compared to White participants, eligible Black and Latino participants were significantly less likely to enroll in the intervention. There were also no significant differences by recruitment venue in sexual risk behaviors among enrolled participants. These findings suggest that recruitment into online HIV interventions from a variety of venues is feasible for diverse YMSM who are at similar risk for HIV infection.

This paper examines demographic differences in drug use and drug use before sex. Marijuana was the most commonly used drug, but alkyl nitrites (“poppers”), cocaine, and Ecstasy were also commonly used. Drug use was more prevalent among older and White young men who have sex with men, and it was similar across cities, although use of poppers and polydrug use were more common in New York City. Our data generally support national prevention efforts. 

This paper utilizes qualitative data from Keep It Up to examine young men who have sex with men goals for sexual risk reduction. Goals tended to focus on strategies used to prepare for safer sex or strategies to be used during sex. In both areas, five categories of strategies were identified: skill-related, intrapersonal, social, contextual, and instrumental. Findings suggest opportunities for more tailored eHealth intervention by focusing on strategies in domains of most use to the individual. Future research should include longitudinal assessment of barriers and facilitators to goal adherence, utility of goals in increasing safer sex behaviors, and changes to goals over time.

This paper examines the prevalence and risk factors for rectal and urethral chlamydia and gonorrhea. Viability of self-collected samples was examined as a potential method to increase STI screening for young men who have sex with men (YMSM) without access to STI testing clinics. Results indicated that 15.1% of participants tested positive for an STI, 13.0% for a rectal STI, 3.4% for a urethral STI, and 1.2% for both

This paper describes the protocol for the Keep It Up 2.0 intervention. Baseline enrollment for the RCT was completed on December 30, 2015, and assessment of intervention outcomes occurred at 3-, 6-, and 12-month time points. Our approach is innovative in linking an eHealth solution to HIV and STI home testing, as well as serving as a model for integrating scalable behavioral prevention into other biomedical prevention strategies. 

In this paper, we examined differences in pre-exposure prophylaxis (PrEP) awareness and use. While 67.5 % of participants reported awareness of PrEP, 8.7 % indicated using the medication. Awareness, but not use, varied by demographic variables. PrEP-users had twice as many condomless anal sex partners and more condomless anal sex acts than non-users. Future research should aim to improve PrEP awareness and uptake among YMSM and address condom use.