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Saliba B, Kang M, Wells N, Mao L, Prestage G, Hammoud MA. Hiding in plain sight: highlighting the research gap on access to HIV and other sexual health services for underrepresented gay men in developed Western countries - insights from a scoping review with a focus on Arab men. Sex Health 2024; 21:NULL. [PMID: 38164800 DOI: 10.1071/sh23131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Strategies pertaining to HIV and sexual health for gay, bisexual, and other men who have sex with men (GBMSM) have shifted focus towards underrepresented subgroups within some developed Western countries. Although emerging research exists on some subgroups, limited attention has been given to the needs of Arab GBMSM in these contexts. Considering they are part of a large diaspora, understanding their access to services is crucial. This paper focuses on Arab GBMSM as a case study within a scoping review, highlighting their hidden status within the broader landscape of HIV and sexual health research for GBMSM in the West. METHODS A multi-method search strategy was employed, including searching four electronic databases using several terms within each of the following search topics: Arab, GBMSM, HIV and other sexual health services, and developed Western countries. RESULTS Of the 384 articles found, only one addressed the research question and met the inclusion criteria, revealing a stark scarcity of research on access to HIV and sexual health services for this population. CONCLUSIONS This review highlights a paucity of research on access to HIV and sexual health services for underrepresented GBMSM populations in developed Western countries. The literature indicates that, for Arab men, this may be due to a difficulty in participant recruitment and poor data collection efforts. By focusing on one hidden population, we aim to advocate for inclusive policies and interventions that promote equitable sexual health access for all. Addressing this research gap aligns with broader local and global HIV strategies to reduce disparities among underrepresented GBMSM populations.
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Affiliation(s)
- Bernard Saliba
- Kirby Institute, UNSW Sydney, Kensington, NSW, Australia; and School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Melissa Kang
- Specialty of General Practice, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | | | - Limin Mao
- Centre for Social Research in Health, UNSW Sydney, Kensington, NSW, Australia
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2
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Rosales R, Zelaya DG, Moreno O, Figuereo V, Chavez SJ, Ordoñez S, Costas I, Ponce M, Miranda R. Latinx Sexual Minority Adolescent Substance Use: State of the Science and Call for Intersectional Minority Stressors and Protective Factors. CURRENT ADDICTION REPORTS 2023; 10:396-411. [PMID: 38774111 PMCID: PMC11104555 DOI: 10.1007/s40429-023-00503-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 05/24/2024]
Abstract
Purpose of review Latinx sexual minority adolescents (LSMA) are at an intersection of ethnic and sexual minority (SM) status and may experience heighten risk of substance use and related problems. These youth may also hold unique protective factors that help mitigate the effects of minority stress and curb substance use. Little is known, however, about the intersectional minority stressors (i.e., due to ethnicity and SM status) and protective factors related to substance use among this population. Recent Findings According to the minority stress model, there are unique minority stressors and resiliency factors that can help explain differences in behavioral health rates between white SM and SM of color. Research supports the notion that minority stressors (e.g., stigma/risk, homophobic bullying, and family rejection of SM status) confer risk for substance use among LSMA. In terms of resilience, less is known, but there may be some protective factors that have not been measured that could explain lower rates in some substances (i.e., club drugs and methamphetamine). Summary Little is known about how the intersections of ethnicity and SM status are associated with substance use in adolescence. Future research should assess the temporal relationship of multilevel (i.e., intrapersonal, relational, and system), intersectional (i.e., ethnicity and SM status) minority stressors and protective factors unique to LSMA on substance use. We propose that the findings from these future studies will help to create socioculturally appropriate behavioral health treatments that consider the intersectional risks and strengths within the LSMA population.
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Affiliation(s)
- Robert Rosales
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - David G Zelaya
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Oswaldo Moreno
- Virginia Commonwealth University, College of Humanities & Sciences, Department of Psychology, Richmond, VA, USA
| | - Victor Figuereo
- University of Pittsburgh, School of Social Work, Pittsburgh, PA, USA
| | - Sarah J Chavez
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Sophia Ordoñez
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Isabel Costas
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Melissa Ponce
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA; Emma Pendleton Bradley Hospital, Riverside, RI, USA
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Olivera MP, Salinas-Oñate N, Medina G, De la Hoz S. Subjective culture and HIV preventive behaviour among young Latin Americans: a systematic review. CULTURE, HEALTH & SEXUALITY 2022:1-18. [PMID: 35962535 DOI: 10.1080/13691058.2022.2106583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
Given high levels of new HIV infection globally, calls have been made for greater attention to the cultural variables that hinder prevention and testing. However, no reviews exist to systematise the findings. This study aimed to identify the cultural variables associated with three HIV preventive behaviours (condom use, HIV testing behaviour, and injection drug use with non-shared or sterilised syringes) among young Latin Americans. A systematic review was conducted guided by PRISMA-P criteria, on five databases (Web of Science, Scopus, PubMed, Medline and Scielo), which identified 2474 articles. Scientific articles and empirical studies that addressed cultural variables and HIV preventive behaviours among young people aged 15-24 years of age using Latin American samples were selected, with 37 articles being included in the final review. Six key cultural variables: the importance of female virginity; the role of trust in the couple's relationship; the disorienting effects of romantic love; the role of subjective norms; the importance of decision-making norms; and impulse control beliefs. Gender norms provide a framework for understanding sexual decision-making among young Latin Americans. Although young people have begun to adopt more egalitarian views of gender norms, deep-rooted beliefs about gender, sexuality and relationships continue to impact on HIV prevention behaviour.
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Affiliation(s)
- Mauro P Olivera
- Doctorado en Psicología, Universidad de La Frontera, Temuco, Chile
| | | | - Gustavo Medina
- Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
| | - Solange De la Hoz
- Departamento de Procesos Diagnósticos y Evaluación, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
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Hergenrather KC, Emmanuel D, Zeglin RJ, Ruda DJ, Rhodes SD. Men Who Have Sex With Men and HIV Risk Behavior: Exploring the Influence of Masculinity Within the Social Ecological Model. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:511-533. [PMID: 34874760 DOI: 10.1521/aeap.2021.33.6.511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In the United States, gay, bisexual men, and men who have sex with men (MSM) represent 86% of new HIV infections among males. Approximately 1 in 7 men with HIV are unaware of their HIV status (CDC, 2017, 2019a, 2020a). To explore influences on MSM HIV risk behavior, the authors performed a systematic review of quantitative studies conducted in the U.S. assessing what is purported as masculinity. From 30 identified studies, significant findings were framed within the Social Ecological Model (SEM) levels (e.g., Individual, Relationship, Community). SEM level themes were applied to create the Masculinity 10, a preliminary 10-item assessment to explore the influence of masculinity on MSM HIV risk behavior. To increase MSM engagement in HIV prevention and treatment, the influences of masculinity (e.g., attitude toward sexual minorities, appearance, emotion, temperament, substance use, sexual activity, social support, intimate relationships, health care) on HIV risk behavior should be further explored.
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Affiliation(s)
| | | | | | - David J Ruda
- The George Washington University, Washington, D.C
| | - Scott D Rhodes
- Wake Forest School of Medicine, Winston-Salem, North Carolina
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Schuyler A, Alidina Z, Dolcini MM, Harper G, Fortenberry JD, Singh R, Jamil O, Pollack L, Catania J. Pre-Exposure Prophylaxis (PrEP) Dissemination: Adapting Diffusion Theory to Examine PrEP Adoption. AIDS Behav 2021; 25:3145-3158. [PMID: 34152531 PMCID: PMC11298242 DOI: 10.1007/s10461-021-03345-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/24/2022]
Abstract
PrEP adoption among African-American men-who-have-sex-with-men (AAMSM) remains low. We applied Diffusion-of-Innovations (DOI) theory to understand PrEP adoption processes among young HIV-negative/status unknown AAMSM (AAYMSM; N = 181; 17-24 years). Quantitative and qualitative analyses were used to examine predictors of PrEP diffusion stages. Most AAYMSM were in the persuasion stage (PrEP-aware, hadn't adopted; 72.4%). Our results suggest that model antecedents are DOI stage-specific. PrEP awareness (knowledge stage) was associated with lower levels of social stigma (p < .03) and greater health literacy (p < .05), while sexual risk (p < .03) and education (p < .03) predicted PrEP adoption (12.2%). PrEP efficacy and side effects were primary innovation characteristics influencing adoption receptivity in the persuasion stage. Interventions to improve PrEP diffusion should be tailored to stage-specific antecedents depending on how a community is stratified across the DOI stages.
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Affiliation(s)
- Ashley Schuyler
- School of Social and Behavioral Health Sciences, Hallie E Ford Center for Healthy Children and Families, College of Public Health and Human Sciences, Oregon State University, 410 Waldo Hall, Corvallis, OR, 97331, USA.
| | - Zainab Alidina
- School of Social and Behavioral Health Sciences, Hallie E Ford Center for Healthy Children and Families, College of Public Health and Human Sciences, Oregon State University, 410 Waldo Hall, Corvallis, OR, 97331, USA
| | - M Margaret Dolcini
- School of Social and Behavioral Health Sciences, Hallie E Ford Center for Healthy Children and Families, College of Public Health and Human Sciences, Oregon State University, 410 Waldo Hall, Corvallis, OR, 97331, USA
| | - Gary Harper
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Ryan Singh
- Oregon Social Learning Center, Eugene, OR, USA
| | - Omar Jamil
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Lance Pollack
- University of California, San Francisco, San Francisco, CA, USA
| | - Joseph Catania
- School of Social and Behavioral Health Sciences, Hallie E Ford Center for Healthy Children and Families, College of Public Health and Human Sciences, Oregon State University, 410 Waldo Hall, Corvallis, OR, 97331, USA
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Parchem B, Aguayo-Romero RA, del Río-González AM, Calabrese SK, Poppen PJ, Zea MC. Perceptions of power and sexual pleasure associated with sexual behaviour profiles among Latino sexual minority men. CULTURE, HEALTH & SEXUALITY 2021; 23:1344-1360. [PMID: 32744462 PMCID: PMC7855680 DOI: 10.1080/13691058.2020.1781263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
In a body of research typically focused on risk reduction and disease prevention, other factors motivating the sexual behaviours of Latino sexual minority men, such as resource-based power and sexual pleasure, are less well understood. To this end, Latino immigrant sexual minority men living in New York City were surveyed about their sexual behaviours, perceived power differentials, and pleasure from insertive and receptive anal intercourse. Power and pleasure were examined as associations with behavioural profiles identified through latent class analysis, adjusting for age and partner type. Four latent classes of Latino sexual minority men were identified based on behaviours reported during the most recent sexual event: behaviourally insertive (14.2%), behaviourally versatile (25.9%), behaviourally receptive (29.2%), and limited penetrative behaviour (30.7%). Participants who derived pleasure from insertive and receptive anal intercourse had higher odds of belonging in the behaviourally insertive and behaviourally receptive class, respectively. Perceptions of resource-based power were not associated with class membership. Findings highlight the importance of sexual pleasure as a driver of sexual behaviour, irrespective of power dynamics. Sexual health curricula and interventions for sexual minority men should consider sexual pleasure and sex-affirmative frameworks when providing sexuality education and promoting sexual wellbeing.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Rodrigo A. Aguayo-Romero
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
- Brigham and Women’s Hospital, Harvard Medical School, The Fenway Institute, Boston, MA, USA
| | | | - Sarah K. Calabrese
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
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7
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Town MA, Walters KL, Orellana ER. Discriminatory distress, HIV risk behavior, and community participation among American Indian/Alaska Native men who have sex with men. ETHNICITY & HEALTH 2021; 26:646-658. [PMID: 30560701 PMCID: PMC6581640 DOI: 10.1080/13557858.2018.1557115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 11/23/2018] [Indexed: 06/09/2023]
Abstract
Objectives Research regarding men who have sex with men (MSM) indicates that exposure to discrimination based on race and sexuality are positively associated with increased incidence of unprotected anal intercourse (UAI). In an effort to better understand this association, we assessed the associations of discriminatory distress with UAI among a sample of 183 American Indian and Alaska Native (AI/AN) MSM using survey data drawn from the HONOR Project. Design The HONOR Project examined the relationship between trauma, coping, and health behaviors among Two-Spirits (a contemporary name for gender and sexual minorities among American Indian and Alaska Native people). Results Using multivariable logistic regression techniques, our analysis showed participants reporting higher mean levels of distress from two-spirit discrimination had higher odds of reporting UAI (OR = 1.99, 95% CI, 1.19-3.32) compared to those reporting lower levels of distress. This analysis also showed lower odds of engaging in UAI among participants reporting higher levels of participation in LGBT specific online forums (OR = 0.86, CI = 0.75, 0.99; p < .05) and attending Two-Spirit events (OR = 0.82, CI = 0.71, 0.94; p < .01). Conclusions Future prevention research and program designs should address the differential impact of discrimination and community participation on sexual behavior specifically among AI/AN MSM.
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Affiliation(s)
- Matthew A. Town
- Department of Public Health, Pacific University, Forest Grove, Oregon, United States
| | - Karina L. Walters
- School of Social Work, University of Washington, Seattle, Washington, United States
| | - E. Roberto Orellana
- School of Social Work, Portland State University, Portland, Oregon, United States
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8
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Brief Report: Sexual Debut Among 14- to 17-year-old Sexual Minority Males: A Preliminary Investigation of Early HIV Risk and Sexual Health Needs. J Acquir Immune Defic Syndr 2021; 84:280-284. [PMID: 32149857 DOI: 10.1097/qai.0000000000002342] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Adolescent sexual minority males (ASMM) are disproportionately at risk of HIV. PURPOSE This study documents the sexual debut behaviors of ASMM, tests whether sexual debut and sexual behavior differed by race/ethnicity, and explores the association between early anal sex debut and engaging in condomless anal sex. METHODS Sexually active ASMM (N = 118; ages 14-17) in the United States completed an online sexual health survey. We used Fisher exact tests to explore differences by race/ethnicity in sexual debut characteristics and hypothesized relationships between sexual debut and risk behavior. RESULTS The average age of sexual debut with a male partner was 14 years (SD = 2.4). Approximately one-third (31%) reported anal sex at their sexual debut, with non-Latino black/African American ASMM more likely to report anal sex at debut (63%) compared with non-Latino white (28%), Latino (21%), or mixed race/other identified youth (19%; χ = 12.1, P = 0.01). All participants (100%) who reported an anal sex debut before the age of 14 years reported engaging in condomless anal sex in their lifetime, compared to 60% of those who reported an anal sex debut when they were 14 years old or older (χ = 5.6, P = 0.03). Participants wanted information about how to safely and comfortably have anal sex (59%) and skills around partner communication (>50%) before debut. CONCLUSION Sexually active ASMM begin engaging in sexual behavior with other males early and with incomplete knowledge and skills regarding sexual health and safety.
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9
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Jeffries WL, Flores SA, Rooks-Peck CR, Gelaude DJ, Belcher L, Ricks PM, Millett GA. Experienced Homophobia and HIV Infection Risk Among U.S. Gay, Bisexual, and Other Men Who Have Sex with Men: A Meta-Analysis. LGBT Health 2020; 8:1-10. [PMID: 33372845 DOI: 10.1089/lgbt.2020.0274] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Experienced homophobia-negative treatment and perceptions that gay, bisexual, and other men who have sex with men (MSM) encounter because of their sexual orientations-may promote HIV infection among MSM. We conducted a rapid review and meta-analysis to examine experienced homophobia in relation to HIV infection risk. Methods: We searched Embase, MEDLINE, PsycINFO, and Sociological Abstracts to acquire data from U.S. studies published during 1992-2017. Studies examined experienced homophobia in relation to sexual risk behavior, poor HIV care continuum engagement, and diagnosed HIV infection. Random-effects models yielded summary odds ratios (ORs) and 95% confidence intervals (CIs). Results: Experienced homophobia was associated with having any sexual risk behavior (OR = 1.33, 95% CI = 1.25-1.42, I2 = 89.2%), receptive condomless anal sex (CAS) (OR = 1.33, 95% CI = 1.14-1.56, I2 = 63.6%), HIV-discordant CAS (OR = 1.66, 95% CI = 1.29-2.13, I2 = 85.3%), an increased number of sex partners (OR = 1.16, 95% CI = 1.13-1.19, I2 = 0.0%), diagnosed HIV infection (OR = 1.34, 95% CI = 1.10-1.64, I2 = 86.3%), and poor HIV care continuum engagement among MSM living with HIV (OR = 1.45, 95% CI = 1.02-2.08, I2 = 47.0%). Effect sizes for any sexual risk behavior were larger in samples with ≥50% Black or Latino (vs. White) MSM and for family-based mistreatment and perceived sexual minority stigma (vs. other homophobia types). Conclusion: Experienced homophobia is associated with HIV infection risk among MSM. Its association with sexual risk behavior may be stronger among Black and Latino (vs. White) MSM and for family-based mistreatment and perceived sexual minority stigma (vs. other homophobia types). Research is needed to better understand causality in these relationships and the role of interventions to reduce homophobia.
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Affiliation(s)
- William L Jeffries
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Stephen A Flores
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cherie R Rooks-Peck
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Deborah J Gelaude
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lisa Belcher
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Philip M Ricks
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gregorio A Millett
- amfAR, The Foundation for AIDS Research, Washington, District of Columbia, USA
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10
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Tieu HV, Koblin BA, Latkin C, Curriero FC, Greene ER, Rundle A, Frye V. Neighborhood and Network Characteristics and the HIV Care Continuum among Gay, Bisexual, and Other Men Who Have Sex with Men. J Urban Health 2020; 97:592-608. [PMID: 29845586 PMCID: PMC7560681 DOI: 10.1007/s11524-018-0266-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
In order for treatment as prevention to work as a national strategy to contain the HIV/AIDS epidemic in the United States (US), the HIV care continuum must become more robust, retaining more individuals at each step. The majority of people living with HIV/AIDS (PLWHA) in the US are gay, bisexual, and other men who have sex with men (MSM). Within this population, there are distinct race- and ethnicity-based disparities in rates of HIV infection, engagement, and retention in HIV care, and viral suppression. Compared with White MSM, HIV-infected Black MSM are less likely to be on anti-retroviral therapy (ART), adhere to ART, and achieve viral suppression. Among MSM living in urban areas, falling off the continuum may be influenced by factors beyond the individual level, with new research identifying key roles for network- and neighborhood-level characteristics. To inform multi-level and multi-component interventions, particularly to support Black MSM living in urban areas, a clearer understanding of the pathways of influence among factors at various levels of the social ecology is required. Here, we review and apply the empirical literature and relevant theoretical perspectives to develop a series of potential pathways of influence that may be further evaluated. Results of research based on these pathways may provide insights into the design of interventions, urban planning efforts, and assessments of program implementation, resulting in increased retention in care, ART adherence, and viral suppression among urban-dwelling, HIV-infected MSM.
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Affiliation(s)
- Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Frank C Curriero
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily R Greene
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Andrew Rundle
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA.
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White D, Palacios A. A Culturally Responsive Existential‐Phenomenological Approach for Counseling Black Sexual Minority Youth. THE JOURNAL OF HUMANISTIC COUNSELING 2020. [DOI: 10.1002/johc.12131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Dwayne White
- Department of Special Education, Rehabilitation, and CounselingAuburn University
| | - Alfredo Palacios
- Department of Special Education, Rehabilitation, and CounselingAuburn University
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12
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Ocasio MA, Tapia GR, Lozano A, Carrico A, Prado G. Internalizing Symptoms and Externalizing Behaviors in Latinx Adolescents with Same Sex Behaviors in Miami. JOURNAL OF LGBT YOUTH 2020; 19:396-412. [PMID: 36247028 PMCID: PMC9562298 DOI: 10.1080/19361653.2020.1777245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 06/01/2023]
Abstract
Sexual minorities report poorer mental health relative to heterosexual counterparts, but this is underexplored in Latinx youth. This study compares internalizing symptoms and externalizing behaviors in Latinx adolescents with Same Sex Behaviors (LASSB) to their Latinx adolescent peers who did not report same sex behaviors (non-LASSB). It also explores the moderating role of biculturalism on the relationship between internalizing symptoms and externalizing behaviors, and same-sex behaviors. Individual-level baseline data (Total N=1,634; LASSB n=195) from five trials of a preventive intervention for Latinx adolescents were synthesized. Normal and clinical levels of internalizing symptoms and externalizing behaviors were determined, and logistic regression models were conducted to determine the odds of LASSB reporting these behaviors relative to non-LASSB. Additional adjusted models tested for the moderating effect of biculturalism. LASSB reported significantly higher odds of normal levels of all externalizing behaviors and clinical levels of anxious/depressed compared to non-LASSB. Biculturalism significantly moderated the association between same-sex behavior and clinical levels of internalizing behaviors; however, in subgroup analyses among LASSB, biculturalism did not significantly predict any of these behaviors. Latinx adolescents exhibited mental health disparities by same-sex behavior. Biculturalism may be an important indicator for describing these disparities in LASSB and should be further explored.
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Affiliation(s)
- Manuel A. Ocasio
- Section of Adolescent Medicine, Department of Pediatrics, Tulane University School of Medicine, Address: 1440 Canal Street, Suite 966, New Orleans, LA 70112
| | - Gregory R. Tapia
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Address: 1120 NW 14 Street, 10 floor (R-669), Miami, FL 33136
| | - Alyssa Lozano
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Address: 1120 NW 14 Street, 10 floor (R-669), Miami, FL 33136
| | - Adam Carrico
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Address: 1120 NW 14 Street, 10 floor (R-669), Miami, FL 33136
| | - Guillermo Prado
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Address: 1120 NW 14 Street, 10 floor (R-669), Miami, FL 33136
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13
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Almeida EPDO, Rolim Neto ML. The lesbian, gay, bisexual and transgender movement: A systematic review with meta-analysis. Int J Soc Psychiatry 2020; 66:198-209. [PMID: 31659921 DOI: 10.1177/0020764019882966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To identify, through the conscientious, explicit and judicious use, the evidence about health behaviors and situations included in the decision making on individuals belonging to the lesbian, gay, bisexual and transgender (LGBT) group in the context of ethnic disparities and sexual minorities. METHODS A systematic review with meta-analysis meta-synthesis from searches in electronic databases SCOPUS and Virtual Health Library (VHL), portal that hosts databases such as MEDLINE, using the following descriptors MeSH (Medical Subject Headings): 'Sexual Minorities', 'Health', 'African Continental Ancestry Group' and 'Brazil'. To achieve safe and reproducible research, the authors decided to gather the descriptors using Boolean operators AND and OR, in the following manner: in the VHL, Sexual Minorities AND Health AND African Continental Ancestry Group OR Brazil; in SCOPUS, Sexual Minorities AND Health AND African Continental Ancestry Group. The selection of articles occurred in two stages. RESULTS Of the 52 results found, this study included 14 articles, according to the stages of screening and eligibility criteria. The research carried out proved to be scarce when related to Brazil, so that the review was constructed from studies carried out in international environment. CONCLUSION The scarcity of studies in this area suggested lack of knowledge on the health profiles of the LGBT Afro Population. The individualized attention proved to be insufficient and reveals the need for training health professionals aware of the aspects and health care for this population, with a view to implementing integral health policies that already exist.
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Catania JA, Dolcini MM, Harper G, Fortenberry D, Singh RR, Jamil O, Young AW, Pollack L, Orellana ER. Oral HIV Self-Implemented Testing: Performance Fidelity Among African American MSM. AIDS Behav 2020; 24:395-403. [PMID: 31732830 DOI: 10.1007/s10461-019-02711-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Oral-Self Implemented HIV Testing (Oral-SIT) offers a low-cost way to extend the reach of HIV testing systems. It is unclear, however, if high risk populations are able to perform the test with high fidelity. Using a simulation-based research design, we administered desensitized Oral-SIT kits to African American MSM (AAMSM; 17-24 years, N = 178). Participants were HIV negative or never tested, and had never self-administered an Oral-SIT kit. We assessed performance fidelity, and hypothesized antecedents. High levels of social stigma were associated with lower levels of training knowledge (Range = No Errors: 51.9%, 4 Errors: 0.6%) and performance fidelity (Range = No Errors: 39.9%, 3 Errors: 1.7%). Training knowledge and prior testing history were positively associated with performance fidelity. The present work extends research on HIV-related social stigma and suggests that social stigma inhibits knowledge acquisition and task performance. The Oral-SIT training materials were understood by individuals with a wide-range of educational backgrounds. Interventions are needed, however, to further improve Oral-SIT performance fidelity.
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Sanchez TH, Rai M, Zlotorzynska M, Jones J, Sullivan PS. Birth Cohort and Racial/Ethnic Differences in the Age of First Oral and Anal Sex Among U.S. Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:275-286. [PMID: 31664555 PMCID: PMC7018607 DOI: 10.1007/s10508-019-01508-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 06/21/2019] [Accepted: 06/27/2019] [Indexed: 05/28/2023]
Abstract
Earlier age of first sex has potential direct and indirect health effects later in life. Though there are multiple nationwide general population studies on ages of first sex, there is no such nationwide study of first male-male oral or anal sex among men who have sex with men (MSM). This may be important for understanding racial/ethnic disparities in HIV and sexually transmitted infection acquisition among young racial/ethnic minority MSM. Our study examined the birth cohort and racial/ethnic differences in ages of first male-male oral and anal sex using a diverse 2015 U.S. nationwide sample of 10,217 sexually active MSM. The mean age of first male-male oral sex was 18.0 years. Compared with older birth cohorts, those MSM born 1990-2000 were more likely to have younger age of first male-male oral sex. Compared to white MSM, Hispanic MSM and non-Hispanic black MSM were more likely to have younger age of first male-male oral sex with a man. The mean age of first male-male anal sex was 20.3 years. Compared with older birth cohorts, those MSM born 1990-2000 were more likely to have younger age of first male-male anal sex. Compared to white MSM, MSM of all other racial/ethnic groups were more likely to have younger age of first male-male anal sex. These findings emphasize the need for comprehensive and MSM-inclusive sexual health education for young teens and online sexual health resources for young gay, bisexual, queer, and other MSM.
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Affiliation(s)
- Travis H Sanchez
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
| | - Mona Rai
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Maria Zlotorzynska
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Jeb Jones
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Patrick S Sullivan
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
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De Santis JP, Quidley-Rodriguez N, Valdes B, Alves SL, Provencio-Vasquez E. Contemplating Co-Occurring Cultures: A Grounded Theory Study of Sexual Decision Making Among Hispanic Men Who Have Sex With Men. HISPANIC HEALTH CARE INTERNATIONAL 2019; 16:85-98. [PMID: 30157694 DOI: 10.1177/1540415318790554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction HIV infection continues to be a serious health concern globally. Of the 1.2 million people with HIV infection in the United States, men who have sex with men (MSM) account for 57% of cases. Hispanic/Latino individuals accounted for 24% of new HIV diagnoses, with male-to-male sexual contact responsible for the majority of cases. A factor in HIV prevention is the sexual decision-making process. The purpose of this study was to describe the process by which sexual decision making occurs among Hispanic MSM. Method Utilizing a grounded theory approach, 19 in-depth, semistructured interviews were conducted from participants ages 25 to 65 years living in South Florida. After consent, participants completed an in-depth interview. Interviews were audio-recorded and transcribed verbatim. Data were analyzed to identify categories and subcategories. Findings A theory grounded in the data called Contemplating Co-Occurring Cultures (Hispanic, gay, and health cultures) emerged that described the central phenomenon. These co-occurring cultures were the foundation of sexual decision making among participants. Conclusion Clinicians providing care to this population should be aware of the complexity of the sexual decision-making process. Awareness of these factors may provide the opportunity for HIV risk reduction strategies developed specifically for Hispanic MSM.
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Affiliation(s)
- Joseph P De Santis
- 1 University of Miami, Coral Gables, FL, USA.,2 University of Texas at El Paso, TX, USA
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17
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De Santis JP, Gattamorta KA, Valdes B, Sanchez M, Provencio-Vasquez E. The Relationship of Hispanic Cultural Factors and Sexual Behaviors of Hispanic Men who have Sex with Men. SEXUALITY & CULTURE 2019; 23:292-309. [PMID: 37090487 PMCID: PMC10121202 DOI: 10.1007/s12119-018-9557-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Background/Significance Hispanics are the largest ethnic minority group in the U.S., and account for 21% of new cases of HIV infection. Previous researchers have examined the relationship of Hispanic cultural factors and the sexual behaviors of Hispanic men who have sex with men (HMSM). However, the exact influence of Hispanic culture factors on the sexual behaviors of these men is currently unclear. Objective The purpose of this study was to investigate the relationship of selected Hispanic cultural factors and the sexual behaviors of a sample of HMSM. Method A descriptive, cross-sectional design was used to collect data from 125 Hispanic men in Miami-Dade County, FL. Participants completed standardized measures of Hispanic cultural factors, sexual behaviors, and a demographic questionnaire. Results Statistically significant positive correlations were noted between age and total cultural constructs, familism, personalism, and machismo. Statistically significant negative correlations were noted between education and total cultural constructs, and education and fatalism. No statistically significant correlation coefficients were noted between total cultural constructs and total sexual behaviors. However, statistically significant positive correlations were noted between condom use and personalism, and assertiveness and personalism. A statistically significant negative correlation was noted between familism and anal sex. Implications Nurses and other clinicians providing care for HMSM need awareness of certain Hispanic cultural factors (personalism and familism) that may be related to sexual behaviors among HMSM. More research is needed to understand how personalism and familism may be used as protective factors to decrease sexual risk of HMSM.
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Affiliation(s)
- Joseph P De Santis
- University of Miami School of Nursing and Health Studies. Coral Gables, FL USA
- University of Texas at El Paso. School of Nursing. El Paso, TX USA
| | - Karina A Gattamorta
- University of Miami School of Nursing and Health Studies. Coral Gables, FL USA
| | - Beatriz Valdes
- University of Miami School of Nursing and Health Studies. Coral Gables, FL USA
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18
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Kipke MD, Kubicek K, Wong CF, Robinson YA, Akinyemi IC, Beyer WJ, Hawkins W, Rice CE, Layland E, Bray BC, Belzer M. A Focus on the HIV Care Continuum Through the Healthy Young Men's Cohort Study: Protocol for a Mixed-Methods Study. JMIR Res Protoc 2019; 8:e10738. [PMID: 30679146 PMCID: PMC6365874 DOI: 10.2196/10738] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 10/02/2018] [Accepted: 10/14/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND No group is at greater risk for acquiring HIV than young men who have sex with men (YMSM), particularly black or African American (AA) and Hispanic or Latino (L) YMSM living in inner cities, who account for the largest number of new HIV infections each year. Although pre-exposure prophylaxis (PrEP), postexposure prophylaxis (PEP), and treatment as prevention hold enormous promise for changing the course of the epidemic, AA/L-YMSM are the least likely population to be receiving primary health care and HIV prevention/care and are the least likely to be using PrEP and PEP. OBJECTIVE The overarching aim of the Healthy Young Men's (HYM) cohort study is to conduct longitudinal research with a cohort of AA/L-YMSM to prevent new HIV infections, reduce transmission, and reduce HIV/AIDS-related disparities by focusing on successful engagement in care. Findings from this research will be used to inform the development of new interventions designed to engage AA/L-YMSM in the HIV prevention and care continua. METHODS Longitudinal research (baseline and follow-up assessments every 6 months for a total of 8 waves of data collection) is ongoing with a new cohort of 450 high-risk AA/L-YMSM in Los Angeles. Participants were recruited using a venue-based and social media sampling design. In addition to self-report surveys, the study protocol includes the collection of urine to assess recent use of illicit drugs and the collection of blood and rectal/throat swabs to test for current sexually transmitted infection (STI)/HIV infection. An additional sample of blood/plasma (10 mL for 4 aliquots and 1 pellet) is also collected and stored in the HYM cohort study biorepository for future research. By design, we recruited 400 HIV-negative participants and 50 HIV-positive (HIV+) participants. This mixed-methods study design includes collection and triangulated analysis of quantitative, qualitative, and biological measures (ie, drug use, STI/HIV testing, and adherence to antiretroviral therapy among HIV+ participants) at baseline and every 6 months. The HYM cohort study will provide a platform from which new and emerging biomedical prevention strategies (eg, PrEP, rectal microbicides, and PEP) and other HIV prevention and care engagement interventions can be developed and evaluated with AA/L-YMSM. RESULTS To date, all participants in the HYM cohort study have been recruited and baseline assessment has been conducted. CONCLUSIONS The findings from this research will be used to inform the development of new and/or adaptation of existing evidence-based HIV prevention interventions and interventions designed to engage this population in the HIV prevention and care continua. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/10738.
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Affiliation(s)
- Michele D Kipke
- Division of Research on Children, Youth and Families, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Katrina Kubicek
- Division of Research on Children, Youth and Families, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Carolyn F Wong
- Division of Research on Children, Youth and Families, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Yolo Akili Robinson
- Division of Research on Children, Youth and Families, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Ifedayo C Akinyemi
- Division of Research on Children, Youth and Families, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - William J Beyer
- Division of Research on Children, Youth and Families, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Wendy Hawkins
- Division of Research on Children, Youth and Families, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Cara E Rice
- The Methodology Center, The Pennsylvania State University, University Park, PA, United States
| | - Eric Layland
- The Methodology Center, The Pennsylvania State University, University Park, PA, United States
| | - Bethany C Bray
- The Methodology Center, The Pennsylvania State University, University Park, PA, United States
| | - Marvin Belzer
- Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, CA, United States
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19
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Lei Y, Zhang K, Xiao X, Tang C, Li X, Wang H. Sexual Roles, Risk Sexual Behaviours, and HIV Prevalence among Men who Have Sex with Men Seeking HIV Testing in Changsha, China. Curr HIV Res 2018; 16:174-181. [PMID: 29992887 PMCID: PMC6182933 DOI: 10.2174/1570162x16666180711101643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/11/2018] [Accepted: 07/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND HIV infection is prevalent among men who have sex with men (MSM), and sexual roles may be important factors related to it. This study aims to describe the sexual roles, risky sexual behaviors and HIV prevalence among MSM, and to determine associated factors for HIV prevalence. METHODS A convenient sampling method was used to recruit participants in a non-government organization in Changsha, China. The participants were asked to complete a 38-item self-administered questionnaire regarding demographic characteristics and risky sexual behaviours before collecting blood samples for HIV testing. Chi-square tests and logistic regression analysis were conducted with the Statistical Package for the Social Sciences Version 18.0 and other indexes were statistically described. RESULTS A total of 601 MSMs who came to a local non-government organization for voluntary counseling and testing completed a pencil-and-paper survey and were tested for HIV. The overall HIV prevalence of this sample was 13.3%, and that of the bottoms (16.3%) was similar to the versatiles (15.9%) but higher than the tops (6.1%). Bivariate analyses showed that there were significant differences in age, marital status, monthly income, sexual orientation, age at first sex, sex of the first sex partner, sex with a woman in the last 6 months, oral sex with a man in the last 6 months and role of oral sex among 3 subgroups of MSM (p < 0.05). Multivariate analyses indicated that MSMs who played the role of either the bottoms or the versatiles were more likely to be HIV positive than the tops. While MSMs who used condoms in anal sex in the last 6 months, had sex with a woman in the last 6 months or had oral sex with a man in the last 6 months were less likely to be HIV positive. CONCLUSION Different sexual roles are associated with high-risk sexual behaviors among MSMs and their HIV infection status. Further research should target preventive interventions, and improve the effectiveness of the intervention according to the characteristics of the subgroups to reduce the HIV transmission among Chinese MSM.
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Affiliation(s)
| | | | | | | | | | - Honghong Wang
- Address correspondence to this author at Xiangya School of Nursing of Central South University, 172 Tong Zi Po Road, Changsha 410013, Hunan, China; Tel: 86-731-82650270; Fax: 86-731-82650266; E-mail:
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20
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Wade R, Harper GW, Bauermeister JA. Psychosocial Functioning and Decisional Balance to Use Condoms in a Racially/Ethnically Diverse Sample of Young Gay/Bisexual Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:195-204. [PMID: 28233112 PMCID: PMC5569003 DOI: 10.1007/s10508-016-0912-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 10/19/2016] [Accepted: 11/25/2016] [Indexed: 06/06/2023]
Abstract
Young gay/bisexual and other men who have sex with men (YGBMSM; ages 18-24) are experiencing an increase in HIV infection rates, particularly if they are Black or Latino. Psychosocial functioning is consistently implicated in HIV risk behaviors; however, less is known about the role of these factors in YGBMSM's decision-making process to use condoms (i.e., decisional balance to use condoms; DBC). We examined whether YGBMSM's psychological functioning was associated differentially with their DBC across racial/ethnic groups. Using data from a cross-sectional web-survey of single YGBMSM (N = 1380; 9.9% Black; 18.6% Latino; 71.5% White), we performed racial/ethnic-specific multivariable regression models to explore the association between DBC and psychological factors (e.g., depression, anxiety), demographics (e.g., age, education, HIV status, prior STI diagnosis), and perceived difficulty implementing safer sex strategies. Black YGBMSM reported lower DBC if they reported higher depression symptoms (β = -.31, p < .05), were HIV-negative (β = -.20, p < .05), and had greater difficulty implementing safer sex strategies (β = -.32, p < .001). Latino participants reported greater DBC to use condoms if they reported greater anxiety symptoms (β = .21, p < .05). White participants reported greater DBC if they were younger (β = -.09, p < .01), did not report a prior STI (β = .10, p < .001), and had fewer difficulties implementing safer sex strategies (β = -.27, p < .001); DBC had no association to psychological well-being among White participants. Psychological factors may be differentially associated with DBC across racial/ethnic group categories. Health promotion initiatives targeting condom use may benefit from culturally tailored interventions that address psychosocial functioning and its role in YGBMSM's condom use decision-making.
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Affiliation(s)
- Ryan Wade
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Gary W Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - José A Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, 19104, USA.
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21
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Self-Perceived Viral Load and Sexual Risk Behavior Among Known HIV-Positive MSM in San Francisco, 2014. J Acquir Immune Defic Syndr 2017; 75 Suppl 3:S309-S315. [PMID: 28604432 DOI: 10.1097/qai.0000000000001405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Self-perceived viral suppression status among men who have sex with men (MSM) may impact HIV risk transmission behaviors. METHODS We conducted a 2014 cross-sectional survey of MSM in San Francisco and assessed differences in sexual risk behavior among known HIV-positive MSM based on viral suppression of HIV. We collected demographics, self-perceived viral load status, and sexual risk behavior and tested for viral load levels through laboratory assays. Men were categorized in a hierarchical schema of sexual risk behavior categories based on responses to questions regarding recent partners' HIV status, condom use, and sexual positioning. We used Fisher exact tests to assess for differences based on self-perceived viral load status. RESULTS Out of a sample of 96 known HIV-positive men, 59 men self-reported an undetectable HIV viral load and 9 men self-reported a detectable viral load consented to confirmatory laboratory testing. The sample of self-reported undetectable men had gradually larger proportions of higher-risk sexual practices, whereas the sample of detectable men was evenly distributed across sexual practices. This association was not statistically significant (P = 0.91). CONCLUSION Self-perceived viral suppression may influence sexual practices of known HIV-positive MSM, but small sample size, especially within the detectable category, hinders our ability to determine statistical significance. More research is necessary to assess how HIV-positive men account for viral load in sexual decision-making practices, and this research may inform resource allocation and clinical recommendations to maintain the health of MSM populations.
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22
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Swann G, Bettin E, Clifford A, Newcomb ME, Mustanski B. Trajectories of alcohol, marijuana, and illicit drug use in a diverse sample of young men who have sex with men. Drug Alcohol Depend 2017; 178:231-242. [PMID: 28667941 PMCID: PMC5616183 DOI: 10.1016/j.drugalcdep.2017.05.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 05/04/2017] [Accepted: 05/04/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Cross-sectional research has found that young men who have sex with men (YMSM) are more likely to engage in heavy drinking and to have higher rates of marijuana and other illicit drug use compared to their heterosexual peers, but considerably less is known about their patterns of substance use over time. METHODS In this study, we combined two longitudinal samples of racially diverse YMSM (N=552) and modeled their substance use trajectories from late-adolescence to young adulthood, including their frequency of alcohol use, frequency of marijuana use, and poly-drug use, using piecewise latent curve growth modeling to model change from ages 17-21 and change from ages 22-24. RESULTS We found that all three substance use behaviors increased linearly over the adolescent-to-adult transition. The trajectories for all three substance use behaviors were significantly correlated from ages 17-21. Black YMSM had significantly lower growth from ages 17-21 in alcohol, marijuana, and poly-drug use compared to White YMSM. Hispanic/Latino YMSM had significantly higher growth from ages 22-24 in alcohol use but significantly lower growth in poly-drug use compared to White YMSM. YMSM with higher alcohol frequency slopes and YMSM with higher marijuana use slopes were more likely to have alcohol-related and marijuana-related problems, respectively, at the last wave of the study. CONCLUSIONS The results of the present study suggest that the transition from adolescence to adulthood for YMSM is a time of increasing and co-varying substance use and may be a critical period for substance use behaviors to grow into substance use problems.
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Affiliation(s)
| | | | | | | | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, United States.
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Wade RM, Harper GW. Young Black Gay/Bisexual and Other Men Who Have Sex With Men: A Review and Content Analysis of Health-Focused Research Between 1988 and 2013. Am J Mens Health 2017; 11:1388-1405. [PMID: 26400714 PMCID: PMC5675205 DOI: 10.1177/1557988315606962] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Black young gay, bisexual, and other men who have sex with men (YGBMSM) are at high risk for negative health outcomes, though this population is underrepresented in the health literature. An extensive literature review and content analysis of health-related peer-reviewed articles (1988-2013) was conducted that targeted Black YGBMSM, examining five content areas: sexual health, health care, substance use, psychosocial functioning, and sociostructural factors. A coding sheet was created to collect information on all content areas and related subtopics and computed descriptive statistics. Out of 54 articles, most were published after 2004 ( N = 49; 90.7%) and addressed some aspect of sexual health ( N = 50; 92.6%). Few articles included content on psychosocial functioning, including bullying/harassment, suicide, and racial/ethnic identity. Data on health care delivery/receipt and health insurance were underrepresented; tobacco use and substance abuse were seldom addressed. Important sociostructural factors, including sexual networks and race-based discrimination, were poorly represented. Last, there was a noteworthy deficit of qualitative studies and research exploring intersectional identity and health. This review concludes that studies on Black YGBMSM health places sex at the forefront to the neglect of other critical health domains. More research is needed on the diverse health issues of a vulnerable and underexamined population.
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Fauk NK, Merry MS, Sigilipoe MA, Putra S, Mwanri L. Culture, social networks and HIV vulnerability among men who have sex with men in Indonesia. PLoS One 2017; 12:e0178736. [PMID: 28582451 PMCID: PMC5459452 DOI: 10.1371/journal.pone.0178736] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 05/18/2017] [Indexed: 11/19/2022] Open
Abstract
The current study aimed to explore cultural and social network influence on HIV vulnerability among Men who have Sex with Men (MSM) population in Yogyakarta, Indonesia. A qualitative inquiry employing in-depth one-on-one interviews was carried out with 24 MSM participants in July 2015. Data were analysed using a framework analysis and guided by the Social Networks Theory (SNT) as a conceptual framework. Findings indicated that prohibitive cultural perspectives and norms against same-sex marriage made them to conceal their sexual orientation and thus secretively engaging in unprotected sex that increased their predisposition to HIV transmission. The prohibitive cultures were also instrumental in the formation of MSM sexual networks that provided supportive environment for HIV-risky sexual practices among network partners. These findings provide information that can be used to improve HIV/AIDS service practices and policies. However, further studies with large numbers of MSM would be needed to improve the understanding of other HIV vulnerability determinants, the unique needs of MSM, and what and how programs could be conducted to reduce HIV vulnerability among MSM population.
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Affiliation(s)
- Nelsensius Klau Fauk
- Institute of Resource Governance and Social Change, Jl. R. W. Monginsidi II, Kel. Kelapa Lima, Kec. Kelapa Lima, Kupang, Nusa Tenggara Timur, Indonesia
- * E-mail:
| | - Maria Silvia Merry
- Medicine Faculty, Duta Wacana Christian University, Jl. Doktor Wahidin Sudiro Husodo, Yogyakarta, Indonesia
| | - Mitra Andhini Sigilipoe
- Medicine Faculty, Duta Wacana Christian University, Jl. Doktor Wahidin Sudiro Husodo, Yogyakarta, Indonesia
| | - Sukma Putra
- Bina Nusantara University International, Jl. Hang Lekir I, Senayan, Jakarta, Indonesia
| | - Lillian Mwanri
- Discipline of Public Health, School of Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Koblin BA, Egan JE, Nandi V, Sang JM, Cerdá M, Tieu HV, Ompad DC, Hoover DR, Frye V. Congruence of Home, Social and Sex Neighborhoods among Men Who Have Sex with Men, NYCM2M Study. J Urban Health 2017; 94:364-374. [PMID: 27646852 PMCID: PMC5481209 DOI: 10.1007/s11524-016-0074-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Substantial literature demonstrates the influence of the neighborhood environment on health behaviors and outcomes. But limited research examines on how gay and bisexual men experience and exist in various geographic and virtual spaces and how this relates to their sexual behavior. New York City Men 2 Men (NYCM2M) was a cross-sectional study designed to identify neighborhood-level characteristics within the urban environment that influence sexual risk behaviors, substance use, and depression among men who have sex with men (MSM) living in NYC. The sample was recruited using a modified venue-based time-space sampling methodology and through select websites and mobile applications. Whether key neighborhoods of human activity, where a participant resided (termed home), socialized (termed social), or had sex most often (termed sex), were the same or different was evaluated. "Congruence" (or the sameness) of home, social, and most often sex neighborhood was reported by 17 % of men, while 30 % reported that none of their neighborhoods were the same. The largest group of men (39 %) reported that their home and sex neighborhoods were the same but their social neighborhood was different while 10 % reported that their home neighborhood was different than their social and sex neighborhood; 5 % men reported same home and social neighborhoods with a different sex neighborhood. Complete neighborhood incongruence was highest among men who were Black and/or Latino, had lower education and personal income levels, and had greater financial insecurity. In adjusted analysis, serodiscordant condomless anal intercourse and condomless anal intercourse with partners from the Internet or mobile applications were significantly associated with having the same social and sex (but not home) neighborhoods. Understanding the complexity of how different spaces and places relate to the health and sexual behavior of MSM is essential for focusing interventions to best reach various populations of interest.
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Affiliation(s)
- Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, 310 E.67th Street, New York, NY, 10065, USA.
| | - James E Egan
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vijay Nandi
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, 310 E.67th Street, New York, NY, 10065, USA
| | - Jordan M Sang
- College of Global Public Health, New York University, New York, NY, USA
| | - Magdalena Cerdá
- Department of Emergency Medicine, School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, 310 E.67th Street, New York, NY, 10065, USA.,Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Danielle C Ompad
- College of Global Public Health, New York University, New York, NY, USA.,Center for Drug Use and HIV Research, NYU Rory Meyers College of Nursing, New York, NY, USA
| | - Donald R Hoover
- Department of Statistics and Biostatistics and Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Victoria Frye
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA.,Department of Community Health and Social Medicine, City College of New York, CUNY Medical School, City University of New York, New York, NY, USA
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Corsbie-Massay CL, Miller LC, Christensen JL, Appleby PR, Godoy C, Read SJ. Identity Conflict and Sexual Risk for Black and Latino YMSM. AIDS Behav 2017; 21:1611-1619. [PMID: 27553028 PMCID: PMC8457304 DOI: 10.1007/s10461-016-1522-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Young (aged 18-30) Black and Latino men who have sex with men are at a higher risk of contracting HIV than their White counterparts. In order to better understand the unique nature of sexual risk-taking, we examined the extent to which ethnic group, ethnic identity, and sexual pride predicted condomless anal sex with casual partners among 161 young men who have sex with men (YMSM) who identify as Black or Latino. Negative binomial regressions were conducted using a cross-sectional design. Sexual pride was a negative predictor of condomless anal sex across all participants, but this effect was moderated by ethnic exploration and ethnic group; the relationship between sexual pride and condomless anal sex was strengthened by greater ethnic exploration among Latino YMSM, and weakened by greater ethnic exploration among Black YMSM. Implications for intersectional identity, identity conflict, and HIV prevention among young gay men of color are discussed.
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Affiliation(s)
| | - Lynn C Miller
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA
| | | | - Paul R Appleby
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA
| | - Carlos Godoy
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA
| | - Stephen J Read
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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Disparities Within the Disparity-Determining HIV Risk Factors Among Latino Gay and Bisexual Men Attending a Community-Based Clinic in Los Angeles, CA. J Acquir Immune Defic Syndr 2017; 73:237-44. [PMID: 27163174 DOI: 10.1097/qai.0000000000001072] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Latino gay, bisexual, and other men who have sex with men (MSM) in the United States have a 50% greater incidence of HIV when compared with White MSM. Previous studies have analyzed factors contributing to condomless anal intercourse among Latino MSM, but few studies have followed cohorts of HIV-negative Latino MSM to determine circumstances for HIV infection. Informed by Syndemics theory, we examine behavioral, biological, and contextual factors associated with HIV infection for Latino MSM. METHODS Risk assessment and HIV testing data were analyzed for all initially HIV negative, Latino MSM (n = 3111) visiting a community-based clinic in Los Angeles, CA from January 2009 to June 2014. Survival analyses were used to determine characteristics of Latino MSM who became HIV positive during the study time frame. RESULTS Similar to previous studies of MSM, self-reported history of chlamydia, gonorrhea, and/or syphilis (adjusted hazard ratio (aHR): 1.97; CI: 1.28 to 3.04), receptive condomless anal intercourse (aHR: 1.7; CI: 1.16 to 2.49), and methamphetamine use (aHR: 1.99; CI: 1.15 to 3.43) predicted HIV infection. In addition, originating from Central America (aHR: 2.31; CI: 1.41 to 3.79), Latino ethnicity of the last sex partner (aHR: 1.67; CI: 1.16 to 2.39) and experiencing intimate partner violence (IPV) (aHR: 1.73; CI: 1.13 to 2.64) were also associated with HIV infection among Latino MSM. CONCLUSIONS This is the first study to show independent associations between IPV and HIV infection among Latino MSM. This study shows that psychosocial conditions such as IPV fuel HIV incidence among Latino MSM, and psychosocial interventions should be considered to reduce HIV disparities among Latino MSM.
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Wirtz JG, Wang Z, Kulpavarapos S. Testing Direct and Indirect Effects of Identity, Media Use, Cognitions, and Conversations on Self-Reported Physical Activity Among a Sample of Hispanic Adults. HEALTH COMMUNICATION 2017; 32:298-309. [PMID: 27230029 DOI: 10.1080/10410236.2016.1138377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article presents the results of a study testing the direct and indirect effects of identity, media use, cognitions and conversations on physical activity (PA). The study was guided by the O-S-O-R model (Markus & Zajonc, 1985), and it used data collected from a sample of Hispanic adults (N = 268) living in the U.S. Southwest. Exercise identity and ethnic identity were defined as pre-orientations (O1); use of PA-related media content was defined as the stimulus (S); reflective integration and conversations about PA-related media were post-orientations (O2); and self-reported physical activity was the behavioral response (R). Structural equation modeling was used to analyze the data, and several compelling results emerged. Exercise identity had a significant positive direct effect on PA and PA-related media use, as well as a significant positive indirect effect on conversations about PA-related media. PA-related media use exerted a strong and significant positive effect on conversations about PA-related media, as well as a significant positive indirect effect on PA. Finally, conversations about PA-related media content had a significant positive direct effect on PA. The results indicate that identity acts as a filter influencing what media content are selected and that cognitions and conversations about media content can serve as a link between media use and health behavior. Key words: O-S-O-R model, physical activity, Hispanic adults, identity, media use, conversation.
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Affiliation(s)
- John G Wirtz
- a Charles H. Sandage Department of Advertising , University of Illinois at Urbana-Champaign
| | - Zongyuan Wang
- b Institute of Communications Research , University of Illinois at Urbana-Champaign
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Lewis NM, Wilson K. HIV risk behaviours among immigrant and ethnic minority gay and bisexual men in North America and Europe: A systematic review. Soc Sci Med 2017; 179:115-128. [PMID: 28260636 DOI: 10.1016/j.socscimed.2017.02.033] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 01/19/2017] [Accepted: 02/22/2017] [Indexed: 02/07/2023]
Abstract
HIV surveillance systems show that gay, bisexual, and other men who have sex with men (MSM) bear a disproportionate burden of HIV in North American and European countries. Within the MSM category, HIV prevalence is often elevated among ethnic minority (i.e., Latino, Asian, and Black) MSM, many of whom are also foreign-born immigrants. Little research has focused specifically on foreign-born populations, though studies that provide data on the nativity of their samples offer an opportunity to investigate the potential role of transnational migration in informing HIV risk among ethnic minority MSM. This systematic review of ethnic minority MSM studies where the nativity of the sample is known provides a robust alternative to single studies measuring individual-level predictors of HIV risk behaviour. In this review, HIV prevalence, unprotected sex, drug use, and HIV testing are analysed in relation to the ethnicity, nativity, and location of the samples included. The results, which include high rates of HIV, unprotected sex, and stimulant use in foreign-born Latino samples and high rates of alcohol and club drug use in majority foreign-born Asian Pacific Islander (API) samples, provide baseline evidence for the theory of migration and HIV risk as syndemics within ethnic minority populations in North American and European countries. The findings also suggest that further research on the contextual factors influencing HIV risk among ethnic minority MSM groups and especially immigrants within these groups is needed. These factors include ethnic networks, individual post-migration transitions, and the gay communities and substance use cultures in specific destination cities. Further comparative work may also reveal how risk pathways differ across ethnic groups.
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Affiliation(s)
- Nathaniel M Lewis
- Geography & Environment, University of Southampton, 2508 Shackleton, Highfield Campus, Southampton, SO17 1BJ, UK.
| | - Kathi Wilson
- Department of Geography & Programs in Environment, University of Toronto Mississauga, Canada
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Gyura AN, McCauley SO. The Whole Family Serves: Supporting Sexual Minority Youth in Military Families. J Pediatr Health Care 2016; 30:414-23. [PMID: 26597449 DOI: 10.1016/j.pedhc.2015.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/08/2015] [Accepted: 10/23/2015] [Indexed: 11/18/2022]
Abstract
Sexual minority youth in military families have a unique set of stressors that affect their mental, emotional, and physical health. There is a pronounced gap in data addressing the specific stressors of this population and how they interact to impact the health of the adolescent. The culture of the United States military has historically been heterosexist and homophobic, propelled primarily by policies that restricted the recruitment and service of lesbian, gay, bisexual, or transgender individuals, leading to a continued secrecy around sexual orientation that may affect how sexual minority youth within the community view themselves. Homophobia, social stigma, and victimization lead to significant health disparities among sexual minority youth, and youth connected to the military have additional stressors as a result of frequent moves, parental deployment, and general military culture. Primary care providers must be aware of these stressors to provide a safe environment, thorough screening, and competent care for these adolescents.
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Toomey RB, Huynh VW, Jones SK, Lee S, Revels-Macalinao M. Sexual minority youth of color: A content analysis and critical review of the literature. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2016; 21:3-31. [PMID: 28367257 PMCID: PMC5370177 DOI: 10.1080/19359705.2016.1217499] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study analyzed the content of 125 unique reports published since 1990 that have examined the health and well-being-as well as the interpersonal and contextual experiences-of sexual minority youth of color (SMYoC). One-half of reports sampled only young men, 73% were noncomparative samples of sexual minority youth, and 68% of samples included multiple racial-ethnic groups (i.e., 32% of samples were mono-racial/ethnic). Most reports focused on health-related outcomes (i.e., sexual and mental health, substance use), while substantially fewer attended to normative developmental processes (i.e., identity development) or contextual and interpersonal relationships (i.e., family, school, community, or violence). Few reports intentionally examined how intersecting oppressions and privileges related to sexual orientation and race-ethnicity contributed to outcomes of interest. Findings suggest that research with SMYoC has been framed by a lingering deficit perspective, rather than emphasizing normative developmental processes or cultural strengths. The findings highlight areas for future research focused on minority stress, coping, and resilience of SMYoC.
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Affiliation(s)
- Russell B. Toomey
- Norton School of Family and Consumer Sciences, Family Studies and Human Development, The University of Arizona, Tucson, Arizona, USA
| | - Virginia W. Huynh
- Department of Child and Adolescent Development, California State University–Northridge, Northridge, California, USA
| | - Samantha K. Jones
- Human Development and Family Science, University of Missouri, Columbia, Missouri, USA
| | - Sophia Lee
- Department of Women Studies, San Diego State University, San Diego, California, USA
| | - Michelle Revels-Macalinao
- Department of Child and Adolescent Development, California State University–Northridge, Northridge, California, USA
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32
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Rose ID, Friedman DB. HIV information needs of parents of young men who have sex with men. Health Info Libr J 2016; 33:308-322. [PMID: 27381945 DOI: 10.1111/hir.12152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 05/21/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Young men who have sex with men (YMSM) have unique health concerns, including high rates of HIV infection. To prevent HIV, YMSM need credible information from trusted sources, specifically parents. Little is known about what health information resources parents of YMSM need to communicate with their child about HIV prevention. The primary objective of this study was to examine the proxy health information seeking behaviours of parents of YMSM and to identify information resources that parents need to communicate with their YMSM identified child about HIV prevention. METHODS Qualitative findings were grouped into four categories: parents' current health information sources; barriers to seeking health information; parents' health information needs; and recommendations for delivery of health information for parents. Ten in-depth interviews were conducted with parents of YMSM. RESULTS Parents reported consulting physicians and the Internet for HIV/AIDS information. They reported finding limited information targeted towards parents of YMSM and provided suggestions for improving the delivery of health information including training, websites and the local news. CONCLUSIONS Delivery of tailored HIV prevention information to parents may be effective in helping combat HIV among YMSM. Given that YMSM bear the greatest burden for HIV, this study highlights the need to include parents of YMSM in future interventions aimed at reducing YMSM's risk of HIV/AIDS.
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Affiliation(s)
- India D Rose
- Health, Research, Informatics, and Technology Division, ICF International, Atlanta, GA, USA
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Homonegativity, Religiosity, and the Intersecting Identities of Young Black Men Who Have Sex with Men. AIDS Behav 2016; 20:51-64. [PMID: 26373283 DOI: 10.1007/s10461-015-1200-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Young, Black men who have sex with men (YBMSM) are disproportionately affected by HIV. Homonegativity, or the stigma associated with homosexuality, may be an important social factor influencing racial disparities in HIV. This research, conducted using an intersectional framework, examines experiences of homonegativity among YBMSM with a particular emphasis on the influence of the Black Church. We conducted 30 semi-structured interviews with YBMSM ages 16-24. Interview transcripts were analyzed in MAXQDA using thematic content analysis, guided by principles of grounded theory and constant comparative method. The Black Church is an integral aspect of YBMSM's identity, history, family, and community life. As such, the Church's construction of homosexuality dominated throughout YBMSM's lives. The expectations of masculinity facing YBMSM emphasize expectations of physical and sexual dominance, which are viewed as incompatible with homosexuality. Participants describe complex decision-making around whether to disclose their sexuality and to whom, and weigh the consequences of disclosure and non-disclosure. For many YBMSM, their multiple, intersecting identities significantly influenced their experiences with homonegativity and their decisions about disclosing their sexual orientation. Findings lend support for the need to develop community-, family-, and church-based stigma reduction interventions that address homonegativity among YBMSM.
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Incidence of HIV Infection in Young Gay, Bisexual, and Other YMSM: The P18 Cohort Study. J Acquir Immune Defic Syndr 2015; 69:466-73. [PMID: 26115438 DOI: 10.1097/qai.0000000000000616] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTENT HIV infections continue to rise in a new generation of young gay, bisexual, and other young men who have sex with men (YMSM) despite 3 decades of HIV prevention and recent biomedical technologies to deter infection. OBJECTIVES To examine the incidence of HIV and the demographic, behavioral, and structural factors associated with incident infections. DESIGN A prospective cohort study. PARTICIPANTS Six hundred YMSM who were aged 18-19 years at baseline. RESULTS At baseline, 6 prevalent cases of HIV were detected. Over the course of 36 months and 6 additional waves of data collection, we identified 43 (7.2%) incident cases of HIV. Incident infections were marginally higher among those residing in neighborhoods with higher rates of HIV prevalence. Using Cox proportional hazards models, we detected that hazard ratios (HRs) for time to HIV seroconversion were significantly higher for black YMSM (HR = 7.46) and mixed/other race YMSM (HR = 7.99), and older age at sexual debut with another man was associated with a lower risk of HIV seroconversion (HR = 0.50), whereas low perceived familial socioeconomic status was marginally associated with an increased risk for HIV seroconversion (HR = 2.45). CONCLUSIONS These findings support the disparities for HIV that exist within the population of sexual minority men and suggest that we attend to behavioral, structural, and social conditions to effectively tailor HIV prevention for a new generation of YMSM with keen eyes to the conditions faced by racial and ethnic minority YMSM, which heightened their risk for acquiring HIV.
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Arrington-Sanders R, Morgan A, Ogunbajo A, Trent M, Harper GW, Fortenberry JD. The role of sexually explicit material in the sexual development of same-sex-attracted Black adolescent males. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:597-608. [PMID: 25677334 PMCID: PMC4408764 DOI: 10.1007/s10508-014-0416-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/15/2014] [Accepted: 09/27/2014] [Indexed: 05/12/2023]
Abstract
Sexually explicit material (SEM) (including Internet, video, and print) may play a key role in the lives of Black same-sex sexually active youth by providing the only information to learn about sexual development. There is limited school- and/or family-based sex education to serve as models for sexual behaviors for Black youth. We describe the role SEM plays in the sexual development of a sample of Black same-sex attracted (SSA) young adolescent males ages 15-19. Adolescents recruited from clinics, social networking sites, and through snowball sampling were invited to participate in a 90-min, semi-structured qualitative interview. Most participants described using SEM prior to their first same-sex sexual experience. Participants described using SEM primarily for sexual development, including learning about sexual organs and function, the mechanics of same-gender sex, and to negotiate one's sexual identity. Secondary functions were to determine readiness for sex; to learn about sexual performance, including understanding sexual roles and responsibilities (e.g., "top" or "bottom"); to introduce sexual performance scripts; and to develop models for how sex should feel (e.g., pleasure and pain). Youth also described engaging in sexual behaviors (including condom non-use and/or swallowing ejaculate) that were modeled on SEM. Comprehensive sexuality education programs should be designed to address the unmet needs of young, Black SSA men, with explicit focus on sexual roles and behaviors that may be inaccurately portrayed and/or involve sexual risk-taking (such as unprotected anal intercourse and swallowing ejaculate) in SEM. This work also calls for development of Internet-based HIV/STI prevention strategies targeting young Black SSA men who may be accessing SEM.
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Affiliation(s)
- Renata Arrington-Sanders
- Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, 200 North Wolfe Street, 2063, Baltimore, MD 21287, USA
| | - Anthony Morgan
- Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, 200 North Wolfe Street, 2063, Baltimore, MD 21287, USA
| | - Adedotun Ogunbajo
- Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, 200 North Wolfe Street, 2063, Baltimore, MD 21287, USA
| | - Maria Trent
- Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, 200 North Wolfe Street, 2063, Baltimore, MD 21287, USA
| | - Gary W. Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
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Camarena J, Rutter PA. Decolonizing Sex: A Multicultural and Gay Affirmative Approach to Counseling with African American and Latino Men Who Have Sex with Men. JOURNAL OF LGBT ISSUES IN COUNSELING 2015. [DOI: 10.1080/15538605.2014.997330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rhodes SD, McCoy TP. Condom use among immigrant Latino sexual minorities: multilevel analysis after respondent-driven sampling. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:27-43. [PMID: 25646728 PMCID: PMC4316741 DOI: 10.1521/aeap.2015.27.1.27] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This study explored correlates of condom use within a respondent-driven sample of 190 Spanish-speaking immigrant Latino sexual minorities, including gay and bisexual men, other men who have sex with men (MSM), and transgender person, in North Carolina. Five analytic approaches for modeling data collected using respondent-driven sampling (RDS) were compared. Across most approaches, knowledge of HIV and sexually transmitted infections (STIs) and increased condom use self-efficacy predicted consistent condom use and increased homophobia predicted decreased consistent condom use. The same correlates were not significant in all analyses but were consistent in most. Clustering due to recruitment chains was low, while clustering due to recruiter was substantial. This highlights the importance accounting for clustering when analyzing RDS data.
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Affiliation(s)
- Scott D. Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake, Forest School of Medicine, Winston-Salem, NC
| | - Thomas P. McCoy
- School of Nursing, University of North Carolina, Greensboro, NC
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Frye V, Nandi V, Egan J, Cerda M, Greene E, Van Tieu H, Ompad DC, Hoover DR, Lucy D, Baez E, Koblin BA. Sexual orientation- and race-based discrimination and sexual HIV risk behavior among urban MSM. AIDS Behav 2015; 19:257-69. [PMID: 25381561 DOI: 10.1007/s10461-014-0937-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Understanding what social factors are associated with risk of HIV acquisition and transmission among gay, bisexual and other men who have sex with men (MSM) is a critical public health goal. Experiencing discrimination may increase risk of HIV infection among MSM. This analysis assessed relations between experiences of sexual orientation- and race-based discrimination and sexual HIV risk behavior among MSM in New York City. 1,369 MSM completed a self-administered computerized assessment of past 3-month sexual behavior, experience of social discrimination and other covariates. Regression models assessed relations between recent experience of discrimination and sexual HIV risk behavior. Mean age was 32 years; 32 % were white; 32 % Latino/Hispanic; 25 % African American/Black. Of MSM who self-reported HIV-positive or unknown status (377), 7 % (N = 27) reported having unprotected insertive anal intercourse with an HIV-negative or unknown status partner ("HIV transmission risk"). Of MSM who self-reported HIV-negative status (992), 11 % (110) reported unprotected receptive anal intercourse with an HIV-positive or unknown status partner ("HIV acquisition risk"). HIV acquisition risk was positively associated with sexual orientation-based discrimination in home or social neighborhoods, but not race-based discrimination. We observed that sexual orientation-based discrimination was associated with sexual HIV risk behavior among urban-dwelling MSM. Addressing environmental sources of this form of discrimination, as well as the psychological distress that may result, should be prioritized in HIV prevention efforts.
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Affiliation(s)
- Victoria Frye
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, 310 East 67th Street, New York, NY, 10065, USA,
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Fields EL, Bogart LM, Smith KC, Malebranche DJ, Ellen J, Schuster MA. "I Always Felt I Had to Prove My Manhood": Homosexuality, Masculinity, Gender Role Strain, and HIV Risk Among Young Black Men Who Have Sex With Men. Am J Public Health 2015; 105:122-131. [PMID: 24832150 DOI: 10.2105/ajph.2013.301866] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. We explored gender role strain (GRS) arising from conflict between homosexuality and cultural conceptions of masculinity among young Black men who have sex with men (MSM). Methods. We conducted a categorical analysis (a qualitative, 3-stage, iterative analysis) of data from studies conducted in 2001 to 2006, which interviewed 35 men aged 18 to 24 years in 3 New York cities and Atlanta, Georgia. Results. Participants described rigid, often antihomosexual expectations of masculinity from their families, peers, and communities. Consistent with GRS, this conflict and pressure to conform to these expectations despite their homosexuality led to psychological distress, efforts to camouflage their homosexuality, and strategies to prove their masculinity. Participants believed this conflict and the associated experience of GRS might increase HIV risk through social isolation, poor self-esteem, reduced access to HIV prevention messages, and limited parental-family involvement in sexuality development and early sexual decision-making. Conclusions. Antihomosexual expectations of masculinity isolate young Black MSM during a developmental stage when interpersonal attachments are critical. GRS may influence sexual risk behavior and HIV risk and be an important target for HIV prevention.
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Affiliation(s)
- Errol Lamont Fields
- Errol L. Fields and Jonathan Ellen are with the Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, School of Medicine, and Katherine C. Smith is with the Department of Health Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Laura M. Bogart and Mark A. Schuster are with the Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, MA. David J. Malebranche is with Student Health Services, University of Pennsylvania, Philadelphia
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Ma M, Malcolm LR, Diaz-Albertini K, Klinoff VA, Leeder E, Barrientos S, Kibler JL. Latino cultural values as protective factors against sexual risks among adolescents. J Adolesc 2014; 37:1215-25. [PMID: 25233526 DOI: 10.1016/j.adolescence.2014.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 08/21/2014] [Accepted: 08/22/2014] [Indexed: 11/26/2022]
Abstract
The study objective was to examine the associations between cultural values and sexual risk factors among Latino youth. A sample of 226 Latino adolescents ages 13-16 completed a survey on cultural and sexual variables. Results indicate higher levels of Latino cultural orientation were related to greater sexual self-efficacy and fewer sexual partners for female adolescents and greater condom use self-efficacy for both males and females. Greater endorsement of simpatia (belief in interpersonal relationship harmony) was associated with sexual abstinence and greater sexual self-efficacy for all adolescents, and with being older at sexual debut for females. Stronger endorsement of respeto (respect towards parents and other authority figures) was correlated with a lower intention to have sex during secondary school and greater condom use self-efficacy. American cultural orientation was associated with less condom use. Our findings indicate Latino cultural values may serve as protective factors against sexual risk behaviors among Latino youth.
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Affiliation(s)
- Mindy Ma
- Nova Southeastern University, Farquhar College of Arts and Sciences, Division of Social and Behavioral Sciences, 3301 College Avenue, Fort Lauderdale, FL 33314, USA.
| | - Lydia R Malcolm
- Nova Southeastern University, Center for Psychological Studies, 3301 College Avenue, Fort Lauderdale, FL 33314, USA.
| | - Kristine Diaz-Albertini
- Nova Southeastern University, Center for Psychological Studies, 3301 College Avenue, Fort Lauderdale, FL 33314, USA.
| | - Vera A Klinoff
- Nova Southeastern University, Center for Psychological Studies, 3301 College Avenue, Fort Lauderdale, FL 33314, USA.
| | - Elisa Leeder
- Nova Southeastern University, Humanities and Social Sciences, 3301 College Avenue, Fort Lauderdale, FL 33314, USA.
| | - Sohani Barrientos
- Nova Southeastern University, Center for Psychological Studies, 3301 College Avenue, Fort Lauderdale, FL 33314, USA.
| | - Jeffrey L Kibler
- Nova Southeastern University, Center for Psychological Studies, 3301 College Avenue, Fort Lauderdale, FL 33314, USA.
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Levy ME, Wilton L, Phillips G, Glick SN, Kuo I, Brewer RA, Elliott A, Watson C, Magnus M. Understanding structural barriers to accessing HIV testing and prevention services among black men who have sex with men (BMSM) in the United States. AIDS Behav 2014; 18:972-96. [PMID: 24531769 PMCID: PMC4509742 DOI: 10.1007/s10461-014-0719-x] [Citation(s) in RCA: 193] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Structural-level factors have contributed to the substantial disproportionate rates of HIV among Black men who have sex with men (BMSM) in the United States. Despite insufficient HIV testing patterns, however, there is a void in research investigating the relationship between structural factors and access to HIV testing and prevention services among BMSM. Building on previous scholarly work and incorporating a dynamic social systems conceptual framework, we conducted a comprehensive review of the literature on structural barriers to HIV testing and prevention services among BMSM across four domains: healthcare, stigma and discrimination, incarceration, and poverty. We found that BMSM experience inadequate access to culturally competent services, stigma and discrimination that impede access to services, a deficiency of services in correctional institutions, and limited services in areas where BMSM live. Structural interventions that eliminate barriers to HIV testing and prevention services and provide BMSM with core skills to navigate complex systems are needed.
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Affiliation(s)
- Matthew E Levy
- Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, 950 New Hampshire Ave, NW, Washington, DC, 20052, USA,
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Holloway IW, Schrager SM, Wong CF, Dunlap SL, Kipke MD. Network correlates of sexual health advice seeking and substance use among members of the Los Angeles House and Ball communities. HEALTH EDUCATION RESEARCH 2014; 29:306-18. [PMID: 24452228 PMCID: PMC3959205 DOI: 10.1093/her/cyt152] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 12/17/2013] [Indexed: 05/24/2023]
Abstract
House and Ball communities (HBCs), represent a prime context for human immunodeficiency virus prevention with African American young men who have sex with men and transgender persons. This study sought to understand the composition and function of social support and sexual networks of HBC members in Los Angeles, California (N = 263). Participants were recruited using venue-based sampling and asked to report on sexual health advice seeking, alcohol use and illicit substance use. Participants were more likely to seek sexual health advice from social support network members compared with sexual network members [odds ratio (OR): 2.50, P < 0.001]. HBC members were more likely to get drunk (OR: 1.57; P < 0.05) and use illicit substances (OR: 1.87; P < 0.10) with House members and sexual network members compared with non-House members and social support network members. Health promotion programs tailored for the HBC should encourage open communication regarding sexual health; these interventions must include information about the role of substance use in sexual risk taking.
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Affiliation(s)
- Ian W. Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA 90095, USA, Division of Adolescent Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA, Community, Health Outcomes, & Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA and Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
| | - Sheree M. Schrager
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA 90095, USA, Division of Adolescent Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA, Community, Health Outcomes, & Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA and Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
| | - Carolyn F. Wong
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA 90095, USA, Division of Adolescent Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA, Community, Health Outcomes, & Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA and Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
| | - Shannon L. Dunlap
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA 90095, USA, Division of Adolescent Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA, Community, Health Outcomes, & Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA and Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
| | - Michele D. Kipke
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA 90095, USA, Division of Adolescent Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA, Community, Health Outcomes, & Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA and Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90027, USA
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Social network composition and sexual risk-taking among gay and bisexual men in Atlanta, GA. AIDS Behav 2014; 18:59-68. [PMID: 23904146 DOI: 10.1007/s10461-013-0569-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Social network composition is known to effect patterns of reported sexual risk-taking among men who have sex with men (MSM); however, consensus as to the directionality and size of these effects is lacking. We examined the relationships between novel aspects of social network composition and sexual risk-taking using a cross-sectional survey of 870 MSM. Social network composition was found to have mixed effects on reported sexual risk-taking: reporting proportionally more lesbian, gay, or bisexual (LGB)-identified friends and reporting friends who were on average significantly older than the respondent were both associated with reporting increased sexual risk, while reporting proportionally more LGB-identified friends in relationships and reporting a social network proportionally more aware of the respondent's homosexuality/bisexuality were both associated with reporting decreased sexual risk. The support structures created by differing social network compositions-and particularly the presence of LGB couples-may be a potential area for targeting sexual risk-reduction interventions for MSM.
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Poon MKL, Pui-Hing Wong J, Sutdhibhasilp N, Ho PTT, Wong B. Sexual practices and sex-seeking behaviours among East and Southeast Asian men who have sex with men in Toronto: Implications for HIV prevention. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2013. [DOI: 10.3138/cjhs.2013.2200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study explored sexual practices and sex-seeking behaviours in a sample of 222 East and Southeast Asian men recruited through two gay venues. Over half of the respondents reported having a current regular partner; the rate of unprotected anal sex with their regular partner was high (45.1%). Among all respondents, 74.8% (166) reported having casual sex with an average of 16 partners in the previous six months; 26.5% of these 166 respondents reported unprotected anal sex with their casual partners. Respondents used multiple venues to seek sex, but bathhouses and the internet were most commonly cited. Bivariate analysis demonstrated that respondents who sought men for sex via both bathhouses and the internet in the past six months were most likely to have had a casual partner, to have had unprotected anal sex with a casual partner, and to have had prior HIV and STI testing. In comparison to respondents who used only bathhouses to seek sex, respondents who used only the internet had fewer casual partners but were more likely to have unprotected anal sex with a casual partner. Given these findings, additional research is needed to further explore the individual and structural factors that shape the condom use behaviour of these sub-populations. HIV prevention efforts must include culturally relevant information about HIV and STI transmission to promote condom use. It is also critical to develop culturally and linguistically appropriate online prevention education for Asian MSM who seek sex primarily through the internet.
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Affiliation(s)
- Maurice Kwong-Lai Poon
- School of Social Work, York University, Toronto, ON
- Asian Community AIDS Services, Toronto, ON
| | - Josephine Pui-Hing Wong
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Canada
- Asian Community AIDS Services, Toronto, ON
| | | | - Peter Trung-Thu Ho
- Asian Community AIDS Services, Toronto, ON
- Regent Park Community Health Centre, Toronto
| | - Bernard Wong
- School of Social Work, York University, Toronto, ON
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Arrington-Sanders R, Leonard L, Brooks D, Celentano D, Ellen J. Older partner selection in young African-American men who have sex with men. J Adolesc Health 2013; 52:682-8. [PMID: 23523311 PMCID: PMC3664129 DOI: 10.1016/j.jadohealth.2012.12.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 12/05/2012] [Accepted: 12/13/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Young African-American (AA) men who have sex with men (YAAMSM) have experienced the greatest proportional increase in new HIV cases compared with other groups. Bridging sexual partnerships between YAAMSM and older aged cohorts with higher rates of primary HIV infection has emerged as an important independent risk factor for the development of HIV. We explored reasons young AAMSM cite for being attracted to and seeking an older partner and the interpersonal needs met within older sexual partnerships. METHODS Seventeen in-depth semistructured qualitative interviews were conducted in YAAMSM residing in a midsized urban city with high HIV prevalence. Two coders independently evaluated transcribed data to identify/collapse codes that emerged. We analyzed data using categorical and contextualizing analytic methods. RESULTS Two themes emerged from the text for seeking an older sexual partner: the emotional maturity the older partner represented and the ability of the older partner to expose the younger partner to more life experiences. In addition, two themes emerged around attraction: support and physical attractiveness of the older partner. Few men described seeking age-discordant relationships for the sole purpose of exchange sex. Older partners during first same-sex experience helped younger partners sort through sexual position and how to perform in relationships. CONCLUSIONS These interviews suggest that YAAMSM may be seeking older partners to fulfill desires to be in a stable, emotionally mature relationship and for exposure in the larger community. Prevention strategies aimed at targeting adolescent MSM age-discordant relationships will need to address the interpersonal needs met within older sexual partnerships.
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Affiliation(s)
- Renata Arrington-Sanders
- Division of General Pediatrics & Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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Hampton MC, Halkitis PN, Storholm ED, Kupprat SA, Siconolfi DE, Jones D, Steen JT, Gillen S, McCree DH. Sexual risk taking in relation to sexual identification, age, and education in a diverse sample of African American men who have sex with men (MSM) in New York City. AIDS Behav 2013; 17:931-8. [PMID: 22298339 DOI: 10.1007/s10461-012-0139-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
HIV disproportionately affects African American men who have sex with men (MSM) in the United States. To inform this epidemiological pattern, we examined cross-sectional sexual behavior data in 509 African American MSM. Bivariate logistic regression analyses were conducted to examine the extent to which age, education,and sexual identity explain the likelihood of engaging in sex with a partner of a specific gender and the likelihood of engaging in unprotected sexual behaviors based on partner gender. Across all partner gender types,unprotected sexual behaviors were more likely to be reported by men with lower education. Younger, non-gay identified men were more likely to engage in unprotected sexual behaviors with transgender partners, while older, non-gay identified men were more likely to engage in unprotected sexual behaviors with women. African American MSM do not represent a monolithic group in their sexual behaviors, highlighting the need to target HIV prevention efforts to different subsets of African American MSM communities as appropriate.
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Affiliation(s)
- Melvin C Hampton
- Center for Health, Identity, Behavior, & Prevention Studies, Steinhardt School of Culture, Education, & Human Development, New York University, 82 Washington Square East, Pless 555, New York, NY 10003, USA
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Voisin DR, Bird JDP, Shiu CS, Krieger C. "It's crazy being a Black, gay youth." Getting information about HIV prevention: a pilot study. J Adolesc 2012; 36:111-9. [PMID: 23218485 DOI: 10.1016/j.adolescence.2012.09.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 09/27/2012] [Accepted: 09/30/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Access and adoption of HIV prevention information are important criteria for reducing HIV infection rates among men who have sex with men. METHODS Using focus group data, researchers sought to identify sources of HIV prevention information and barriers to adopting protective behaviors among young African American men who have sex with men. Adolescents ages 18-24 were recruited for this study. Focus group data were analyzed to identify themes related to sources of HIV prevention information and barriers to adopting protective behaviors. RESULTS Researchers documented that family and friends, formal education, television, and the LGBT community were major sources for HIV prevention information. However, motivation for adopting such information was hampered by apathy, homophobia, and racism. CONCLUSION Feelings of powerlessness need to be addressed when targeting Black MSM with HIV prevention information.
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Affiliation(s)
- Dexter R Voisin
- University of Chicago, School of Social Service Administration, USA.
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George S, Phillips R, McDavitt B, Adams W, Mutchler MG. The cellular generation and a new risk environment: implications for texting-based sexual health promotion interventions among minority young men who have sex with men. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2012; 2012:247-256. [PMID: 23304294 PMCID: PMC3540519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
African American and Latino young men who have sex with men (YMSM) are at the forefront of the U.S. HIV epidemic. As members of the "cellular generation," these youth are very likely to use text messaging; yet, relatively little research has explored use of text messaging as a tool for sexual health promotion, particularly among racial ethnic minorities who are also sexual minorities. We report on the results of ten focus groups conducted among African American and Latino YMSM, aged 18-25, regarding their current texting practices and the feasibility/acceptability of text messaging as a means of conducting sexual health promotion. Our analyses revealed four main themes around their texting behaviors, texting preferences, perceived advantages/disadvantages of texting, and the "etiquette" of texting. We consider implications of these findings for the development of texting-based sexual health promotion interventions, particularly in conjunction with other existing interventions operating in a new risk environment.
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Affiliation(s)
- Sheba George
- Charles R. Drew University of Medicine and Science
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Abstract
PURPOSE In recent years, much attention has been devoted to understanding the HIV risk behaviors of younger men who have sex with men (MSM). Recent data suggest that HIV is becoming an increasing problem for older adults, but little attention has been devoted to understanding their HIV risk behaviors or the factors that underlie their risk taking. This study provides a comparison of these issues among younger and older MSM. METHODS The data come from a subset of younger (ages 18-39, n = 113) and older (ages 50+, n = 109) men participating in a national study of 332 men who use the Internet to find other men for unprotected sex. Men were sampled randomly from 16 websites. Data were collected via telephone interviews conducted in 2008 and 2009. RESULTS Younger and older men reported comparable involvement in HIV risk, including involvement in unprotected sex, proportion of sex acts involving internal ejaculation, number of times having anonymous sex, and number of times having multiple-partner sex. Generally speaking, the factors underlying the risk practices of younger and older men were quite different (e.g. self-esteem and condom use self-efficacy for younger men, versus HIV serostatus and depression for older men). CONCLUSIONS Older MSM using the Internet to find partners for unprotected sex engage in high rates of behaviors that place them at risk for contracting or transmitting HIV. They were just as likely as their younger counterparts to practice these behaviors. The factors "fueling" involvement in risk generally differ for older and younger men, thereby warranting the development of age-specific HIV interventions that can take into account the unique life circumstances and needs of older MSM.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, Silver Spring, MD 20910, USA.
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Calabrese SK, Reisen CA, Zea MC, Poppen PJ, Bianchi FT. The pleasure principle: the effect of perceived pleasure loss associated with condoms on unprotected anal intercourse among immigrant Latino men who have sex with men. AIDS Patient Care STDS 2012; 26:430-5. [PMID: 22663165 DOI: 10.1089/apc.2011.0428] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Sexual pleasure has been identified as an important consideration in decision-making surrounding condom use. We examined the impact of perceived pleasure loss associated with condom use on recent history of insertive and receptive unprotected anal intercourse (UAI) among Latino men who have sex with men (MSM) living in the United States. A total of 482 Dominican, Colombian, and Brazilian immigrant MSM were surveyed regarding sexual attitudes and practices via computer-assisted self-interviewing technology with audio enhancement (ACASI). Participants rated the pleasure they derived from protected and unprotected anal intercourse in each position (insertive and receptive) and also reported their HIV status, relationship status, and recent sexual history. Men who had engaged in both positions, with and without condoms (n=268), perceived a greater pleasure loss associated with condoms during anal intercourse in the insertive versus receptive position. Logistic regression analyses controlling for HIV status, relationship status, and age revealed that men who perceived greater pleasure loss from condoms were more likely to have engaged in UAI over the past 3 months (n[insertive]=297; n[receptive]=284). Findings indicate that the pleasure loss associated with condoms may be a key deterrent for their use in either sex position among Latino MSM. Therefore, pleasure needs to be prioritized in the development of condoms and other sexual safety measures as well as in the promotion of their use.
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Affiliation(s)
| | - Carol A. Reisen
- The George Washington University, Washington, District of Columbia
| | | | - Paul J. Poppen
- The George Washington University, Washington, District of Columbia
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