Papers by Stuart Michaels
Journal of Pediatric Health Care
Introduction: Adolescent sexual minority males (ASMM) are at disproportionate risk of HIV infecti... more Introduction: Adolescent sexual minority males (ASMM) are at disproportionate risk of HIV infection. The purpose of this study was to assess ASMM's attitudes about sexual health, barriers/ facilitators to accessing HIV prevention, and actual versus ideal interactions for receiving sexual health care and information. Method: Two online and two in-person focus groups were conducted with ASMM from across the United States. Qualitative data were analyzed using content analysis. Results: Twenty-one racially diverse ASMM participated (average age = 16.4 years). Online focus groups were superior for reaching the target population. Four themes emerged: 1. identity formation and sources of support, 2. challenges to obtaining sexual health information, 3. attitudes/beliefs about sex and sexual behaviors, and 4. barriers to HIV prevention. Discussion: These findings illustrate current gaps in sexual health knowledge, as well as barriers and facilitators to obtaining sexual health information, sexual health care, and affirming education and support for ASMM.
LGBT Health, 2020
Purpose: The purpose of this study was to assess the feasibility and efficacy of using advertisem... more Purpose: The purpose of this study was to assess the feasibility and efficacy of using advertisements (ads) on Facebook, Instagram, and Snapchat to recruit a national sample of adolescent sexual minority males ages 13-18 and transgender youth ages 13-24 for a web survey. Methods: The Survey of Today's Adolescent Relationships and Transitions (START) used targeted ads as survey recruitment tools. We assessed the efficacy of these varied forms of recruitment ads in reaching our target population. To understand how our sample differed from a national probability sample targeting the general adolescent population, we compared START respondents with sexual minority men identified from the 2017 Youth Risk Behavior Survey (YRBS). Results: The use of targeted language produced higher rates of completes per click compared with ads without targeted language. Video ads (compared with static images) were more effective at recruiting younger respondents. START and YRBS samples differed along lines of sexual identity, race and ethnicity, and age. The START sample had a greater percentage of Hispanic/Latino and Other/Multiracial respondents relative to the YRBS sample, thus providing additional data on these underserved sexual minority youth. Conclusion: The factors associated with design decisions for a hard-to-reach, non-probability sample impact the likelihood that respondents engage in and complete a survey. The ads proved to be effective and efficient at recruiting the targeted population.
Traditional probability-based sampling strategies are impractically expensive for surveying rare ... more Traditional probability-based sampling strategies are impractically expensive for surveying rare populations because of the large scale in-field screening required to find sufficient numbers of eligible persons. As a result, rare or hidden populations are often studied using versions of convenience samples, including non-probability Web panels, for which selection probabilities are unknown, designbased inference is not applicable, and study results not necessarily projectable to the target population. In an effort to improve methods for surveying rare or hidden population, NORC conducted a pilot study which tested a cost-effective alternative that combines probability sampling and Respondent-Driven Sampling (RDS) which we refer to as Web-based RDS. The initial, or seed, probability sample source for the pilot study is NORC’s AmeriSpeak Panel®, which is a household, multi-client panel that uses the NORC National Frame to construct an address-based nationally representative sample pan...
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2021
Supplemental Digital Content is Available in the Text.
AIDS Education and Prevention, 2020
Men and women of color have had low pre-exposure prophylaxis (PrEP) uptake. How one's preferr... more Men and women of color have had low pre-exposure prophylaxis (PrEP) uptake. How one's preferred source of health information shapes attitudes toward PrEP is unclear. We conducted cross-sectional surveys to assess changes in PrEP awareness, knowledge, and attitudes, trusted sources for PrEP information, and associations between trusted source of information and PrEP knowledge and attitudes. Participants were recruited from six areas served by community health centers in Chicago, IL (two health centers); Jackson, MS; Newark, NJ; Philadelphia, PA; and Washington, D.C. during June-September 2015 (n = 160) and June-September 2016 (n = 200). Participants were Black (74%), heterosexual (81%), and largely unaware of PrEP (72%). Participants who trusted health experts and community organizations for PrEP information had lower percentages of agreeing with statements indicative of negative PrEP attitudes. Interventions that increase PrEP awareness as well as knowledge and favorable attitudes might help increase PrEP use in communities with high HIV prevalence.
Psycho-Oncology, 2010
Objective: The objective of this study was to assess the prevalence and associated factors of sex... more Objective: The objective of this study was to assess the prevalence and associated factors of sexual activity, sexual problems or sexual satisfaction in French early-stage breast cancer survivors (BCS). Methods: Eight hundred and fifty eligible, post-treatment (6 months-5 years) female patients, aged 18-70 years, randomly selected from a consultation list, were invited to fill in questionnaires exploring quality of life (EORTC QLQ-C30 and QLQ-BR23), body image scale, and sexuality (Sexual Activity Questionnaire-SAQ; Relationship and Sexuality Scale; French Sexual Behaviour Survey-CSF). Results: Fifty-three percent of BCS agreed to participate. Participating women (n 5 378) were younger, more often premenopausal at diagnosis and with a more recent diagnosis than non-respondents. The prevalence of sexual problems was significantly higher in BCS compared with adjusted data from a French female representative sample (po0.0001). In logistic regression, no sexual activity (R 2 5 0.37) or sexual dissatisfaction (R 2 5 0.28) were associated with the feeling of emotional separation in the couple or of partner's fear of sexual intercourse, lower emotional functioning, poorer body image, or co-morbidities. In sexually active women (71% of respondents), lower frequency of sexual activity (R 2 5 0.26), lower sexual pleasure (R 2 5 0.22), or higher sexual discomfort (R 2 5 0.22) were associated with the feeling of emotional separation in the couple or of partner's fear of sexual intercourse, lower emotional functioning, age (450 years), nausea, or insomnia (all Hosmer-Lemeshow tests: p 5 NS). Conclusions: Psychological factors including the perception of the couple relationship appeared prominent in BCS women's experience of sexual problems.
Journal of Adolescent Health, 2022
Purpose: Adolescents and Emerging Adults with Special Healthcare Needs (AEASHCN) must develop sel... more Purpose: Adolescents and Emerging Adults with Special Healthcare Needs (AEASHCN) must develop self-management skills in preparation for transition to adult-based care. However, AEASHCN are not being adequately prepared for transition, resulting in poor health outcomes for some AEASHCN during the transfer period. These poor health outcomes are greater for AEASHCN who are underinsured (public insurance or self-pay). The purpose of this study is to quali-tatively explore the role of insurance in the preparation, transfer, and engagement stages of transition for AEASHCN from three sub-speciality services at a large, urban children ’ s hospital. Methods: This study included a convenience sample of participants from a cohort of 137 AEASHCN from the Gastroenterology, Rheu-matology, and Renal clinical services who participated in a randomized control trial (RCT) designed to promote health self-management. Participants were 18-25 years of age. All genders and race/ethnic groups were included. One-to-one qualitative interviews were performed using open-ended, semi-structured questions to elicit the participant ’ s experience with preparation for and experience with transition from pediatric- to adult-based care. Interviews were conducted until saturationwas reached. Interviews were audio-taped, transcribed, and veri fi ed for accuracy. Demographic charac-teristics were summarized using descriptive statistics. Qualitative responses were analyzed using the Framework Method. All authors reviewed a subset of the transcripts to generate initial codes for repeated phrases and topics, which were applied to transcripts until no new codes were identi fi ed. Transcripts were read and coded independently by pairs of coders. Discrepant codes were discussed until consensus was reached. Using Atlas.ti, the codes were indexed and sorted into larger subthemes and fi nal themes. All coded quotes were reviewed by the coders, and overarching themes were agreed Purpose: Sexual and gender minority (SGM) youth experience more negative mental health conditions, like depression and suicidal ideation, than cisgender and heterosexual youth. However, relatively little data exist on the COVID-19 pandemic ’ s effects on mental health and suicide-related disparities. Factors associated with poor mental health (e.g., physical isolation, increased time at home with parents/ caregivers) changed during the pandemic and may differentially impact SGM youth. This presentation describes fi ndings from a recent web-based, longitudinal survey of U.S. adolescents, comparing SGM to non-SGM youth across key mental health and suicide outcomes over two waves of data collected during the pandemic. Methods: CDC ’ s Division of Adolescent and School Health contracted with NORC at the University of Chicago to conduct the longitudinal COVID Experiences Surveys, an assessment of the pandemic ’ s impact on the health and well-being of children and adolescents. Adolescent respondents age 13-19 were recruited using AmeriSpeak (cid:1) , NORC ’ s probability-based survey panel representative of the U.S. household population (Wave 1: Oct-Dec 2020, n ¼ 727; Wave 2: Mar-May 2021, n ¼ 569). Respondents reporting their sexual identity as lesbian, gay, bisexual, or something else were categorized as sexual minority. Respondents reporting a gender identity different than their sex assigned at birth (e.g., assigned male at birth/identi fi ed as female, assigned female at birth/identi fi ed as male), identi fi ed as transgender, or identi fi ed as not male, female, or transgender were categorized as gender minority. Youth not identi fi ed as sexual or gender minority were categorized as non-SGM. Mental health and suicide risk were operationalized with validated measures adapted from state and local Youth Risk Behavior Surveys and the Flint Adolescent Study, including stress, mental health quality of life, symptoms of depression and anxiety, and suicide-related behaviors. Chi-square tests compared mental health and suicide outcomes across SGM status. Odds ratios (OR) and
Transgender Health, 2021
Purpose: The purpose of this research is to explore the relationship between substance use and se... more Purpose: The purpose of this research is to explore the relationship between substance use and sexual risk behaviors among transgender youth. Methods: Data from the transgender subsample of the Sur...
Journal of Adolescent Health, 2020
PURPOSE Sexual and gender minority youth (SGM), an umbrella term encompassing gay, bisexual, and ... more PURPOSE Sexual and gender minority youth (SGM), an umbrella term encompassing gay, bisexual, and transgender youth, experience disproportionately high rates of new HIV infections, and recent advances in biomedical HIV prevention modalities hold promise in reducing new infections. However, the extent to which SGM youth are aware of and willing to use these modalities is unknown. METHODS Using data from the Survey of Today's Adolescents Relationships and Transitions, we analyze awareness of and willingness to take HIV pre-exposure prophylaxis (PrEP), nonoccupational HIV post-exposure prophylaxis, and rectal microbicides among adolescent sexual minority males aged 13-18 years and transgender youth aged 13-24 years. RESULTS Overall, we found a majority of our respondents were not aware of any of these prevention modalities. Across both subsamples, age and outness to a health care provider were associated with increased PrEP awareness, and any anal sex was associated with PrEP willingness. CONCLUSIONS These findings highlight the importance of provider education on how to discuss SGM issues with patients and educate them about HIV prevention options.
1. clarifies some... conceptual issues [on the nature and definition of homosexuality]/reviews pr... more 1. clarifies some... conceptual issues [on the nature and definition of homosexuality]/reviews prior prevalence data/examines in detail some key results of the most comprehensive scientific survey of sexual behavior in the US to date concepts and ...
Social Science Computer Review
Social media recruitment is no longer an uncharted avenue for survey research. The results thus f... more Social media recruitment is no longer an uncharted avenue for survey research. The results thus far provide evidence of an engaging means of recruiting hard-to-reach populations. Questions remain, however, regarding whether the data collected using this method of recruitment produce quality data. This article assesses one aspect that may influence the quality of data gathered through nonprobability sampling using social media advertisements for a hard-to-reach sexual and gender minority youth population: recruitment design formats. The data come from the Survey of Today’s Adolescent Relationships and Transitions, which used a variety of forms of advertisements as survey recruitment tools on Facebook, Instagram, and Snapchat. Results demonstrate that design decisions such as the format of the advertisement (e.g., video or static) and the use of eligibility language on the advertisements impact the quality of the data as measured by break-off rates and the use of nonsubstantive respon...
Journal of Official Statistics
This article presents the results of a pilot feasibility study comparing two alternative recruitm... more This article presents the results of a pilot feasibility study comparing two alternative recruitment approaches based on Respondent Driven Sampling using initial seeds selected from a US nationally representative panel, AmeriSpeak, to augment the number of lesbian, gay, bisexual, and transgender (LGBT) respondents to a short web survey on smoking, discrimination, and health. In the nomination condition after completing the survey both LGBT and non-LGBT seeds were invited to share the names and email address of up to four LGBT persons they knew. In the recruitment condition, seeds were given four unique PINs and links to the survey to distribute to LGBT persons. Both conditions were successful in producing new LGBT respondents. The recruitment condition was much more productive. LGBT seeds (and their recruits) were much connected to and willing to contact other LGBT people they knew to participate in a survey. Comparisons of characteristics and responses from the initial samples and ...
Journal of Pediatric Health Care
Journal des anthropologues
Journal of medical Internet research, Jan 14, 2018
This is a case study from an HIV prevention project among young black men who have sex with men. ... more This is a case study from an HIV prevention project among young black men who have sex with men. Individual-level prevention interventions have had limited success among young black men who have sex with men, a population that is disproportionately affected by HIV; peer network-based interventions are a promising alternative. Facebook is an attractive digital platform because it enables broad characterization of social networks. There are, however, several challenges in using Facebook data for peer interventions, including the large size of Facebook networks, difficulty in assessing appropriate methods to identify candidate peer change agents, boundary specification issues, and partial observation of social network data. This study aimed to explore methodological challenges in using social Facebook networks to design peer network-based interventions for HIV prevention and present techniques to overcome these challenges. Our sample included 298 uConnect study respondents who answered...
Sexually Transmitted Infections
ObjectiveYoung black men who have sex with men (YBMSM) in the USA represent a subgroup that has t... more ObjectiveYoung black men who have sex with men (YBMSM) in the USA represent a subgroup that has the highest HIV incidence among the overall population. In the USA, pre-exposure prophylaxis (PrEP) is an effective prevention intervention to prevent HIV acquisition when taken regularly. Neighbourhood and network factors may relate to PrEP awareness, but have not been studied in YBMSM. This study aimed to examine the relationship of neighbourhood and network characteristics with PrEP awareness among YBMSM.MethodsWe used data collected from a sample of 618 YBMSM in Chicago (2013–2014). Home addresses were collected for participants and enumerated network members. Administrative data (eg, 2014 American Community Survey, Chicago Department of Public Health) were used to describe residence characteristics. Network member characteristics were also collected (eg, sexual partners’ sex-drug use, confidant network members who were also MSM). Multilevel analysis was performed to examine the relat...
Journal of acquired immune deficiency syndromes (1999), Feb 8, 2017
Debate remains as to the relative HIV transmission contributions from individuals who are recentl... more Debate remains as to the relative HIV transmission contributions from individuals who are recently HIV infected and individuals who have long-term infections. In this study, we examine the relationship between new HIV seroconversions occurring among young Black men who have sex with men (YBMSM) and network proximity to recently or long-term HIV infected individuals. A cohort of YBMSM (N = 618) was generated through respondent driven sampling across three waves. A recent HIV infection was defined as either: 1) a confirmed seroconversion ≤9 months prior to interview date or 2) a laboratory confirmed acute infection; long-term HIV infected individuals were defined as a diagnosis date ≥9 months prior to interview date. RDS-weighted logistic regression was utilized to examine network proximity of HIV transmission events to HIV infected individuals in the network. Within the cohort, 343 (55.5%) participants were identified as HIV seronegative at baseline. Of these, 33 (9.6%) seroconverted...
LGBT health, 2017
The goal of this research is to advance the study of health disparities faced by older sexual and... more The goal of this research is to advance the study of health disparities faced by older sexual and gender minorities by assessing comprehension of and improving measures of sexual and gender identity in surveys. Cognitive interviews were conducted by expert interviewers with 48 non-lesbian, gay, bisexual, and transgender (non-LGBT) and 9 LGBT older English and Spanish speakers. All respondents were able to answer questions about their sex assigned at birth and current gender identity successfully despite some cisgender respondents' lack of clear understanding of the transgender response option. On the contrary, while the vast majority of English speakers could answer the question about their sexual identity successfully, almost 60% of the non-LGBT Spanish speakers did not select the "heterosexual, that is, not gay (or lesbian)" response category. Qualitative probing of their response process pointed mainly to difficulties understanding the term "heterosexual,"...
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Papers by Stuart Michaels