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Kolstee J, MacGibbon J, Prestage G, Clackett S, Paynter H, Bavinton BR, Broady TR, Ellard J, Murphy DA, de Wit J, Power C, Holt M. Changing Attitudes Towards Condoms Among Australian Gay and Bisexual Men in the PrEP Era: An Analysis of Repeated National Online Surveys 2011-2019. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:453-466. [PMID: 36454135 DOI: 10.1521/aeap.2022.34.6.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Condoms have been the primary form of HIV prevention for gay and bisexual men (GBM) for most of the HIV epidemic. The introduction of biomedical HIV prevention may have changed attitudes towards condoms. Data from repeated national online surveys of GBM in Australia were used to examine how attitudes towards condoms and confidence discussing condoms with partners changed in the period 2011-2019. The proportion of all participants who reported a positive experience in using condoms remained low and unchanged (9.6% in 2011 to 6.0% in 2019). Confidence in discussing condoms with partners decreased over time (from 72.2% in 2011 to 56.6% in 2019). Confidence in discussing condoms was associated with concern about sexually transmitted infections, and more consistent condom use. Sustaining confidence in using condoms may be more challenging as biomedical prevention methods become more commonly used.
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Affiliation(s)
| | - James MacGibbon
- Centre for Social Research in Health, UNSW Sydney, Australia
| | | | | | - Heath Paynter
- Australian Federation of AIDS Organisations, Sydney, Australia
| | | | | | - Jeanne Ellard
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | | | - John de Wit
- Kirby Institute, UNSW Sydney, Australia
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | | | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Australia
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2
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Parchem B, Aguayo-Romero RA, Alizaga NM, del Río-González AM, Poppen PJ, Zea MC. Identity and Relational Factors Associated with Sexual Role and Positioning for Anal Sex among Colombian Sexual Minority Men. JOURNAL OF SEX RESEARCH 2022; 59:911-919. [PMID: 35080994 PMCID: PMC9314459 DOI: 10.1080/00224499.2022.2026287] [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] [Indexed: 06/14/2023]
Abstract
This study aimed to identify Top, Bottom, and Versatile sexual role identities and anal sex behavior profiles using latent class analysis in a sample of 942 sexual minority men living in Bogotá. A Versatile-insertive and receptive class (52.2%) was the most prevalent of the four resulting classes, whereas the least common was a class (1.7%) that did not use labels and had a low probability of anal sex. We examined whether identity and relational factors (i.e., sexual orientation, LGBT collective identity, and partner type) were associated with profiles. Gay identity was associated with versatile and receptive classes and bisexual identity was associated with insertive and versatile classes. LGBT collective identity was associated with the class characterized by Bottom identity and receptive positioning. Partner type was not associated with class membership, but versatile behaviors were more common among encounters with a main partner. Models using data at different timescales offered consistent patterns of behavior between the last encounter and the past three months, though the versatile class in the three-month model split into two classes based on frequency of versatile positioning. Findings highlight the relationship between sexual identity and positioning and can inform interventions for sexual health education and identity development.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
| | - Rodrigo A. Aguayo-Romero
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
- Brigham and Women’s Hospital/ Harvard Medical School/ The Fenway Institute, Boston, MA
| | | | | | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
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3
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Velter A, Ousseine Y, Duchesne L, Lydie N. Non-use of combination HIV prevention tools and its determinants among men who have sex with men living in France. Infect Dis Now 2022; 52:341-348. [DOI: 10.1016/j.idnow.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/03/2022] [Accepted: 06/17/2022] [Indexed: 10/17/2022]
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4
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Parchem B, Aguayo-Romero RA, Alizaga NM, Poppen PJ, Cecilia Zea M. Sexual Role Identity and Anal Sex Positioning among Brazilian, Colombian, and Dominican Immigrant Sexual Minority Men. JOURNAL OF SEX RESEARCH 2022; 59:632-642. [PMID: 34080929 PMCID: PMC8639841 DOI: 10.1080/00224499.2021.1922574] [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] [Indexed: 05/03/2023]
Abstract
Sexual role identities for anal sex and anal sex positionings are often conflated in research. This study aimed to identify profiles of sexual minority men based on sexual role identity and anal sex positioning and determine correlates of these profiles, including individual (i.e., HIV-status identity, condom use, partner type, sexual orientation) and cultural (i.e., same-race partnering, country of birth, acculturation) factors. A sample of Brazilian, Colombian, and Dominican immigrant sexual minority men (n = 480) living in New York City were surveyed about identity and positioning at the two most recent encounters. Individual and cultural factors were examined as correlates of profiles identified through latent class analysis. Four latent classes were identified: No Labels (12%), Receptive Bottoms (16%), Insertive Tops (23%), Insertive and Receptive Versatiles (49%). We found a concordance rate of ~70% between identity and behavior. A proportion (12%) of behaviorally versatile men chose not to use sexual role labels. Living with HIV was associated with receptive and versatile classes, sex with main partners was associated with versatility, and sexual orientation differed across classes. Identity and behavior should not be used interchangeably in research or applied domains, particularly given the complexities of versatility and men who prefer to not use labels.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
| | - Rodrigo A. Aguayo-Romero
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
- Brigham and Women’s Hospital/ Harvard Medical School/ The Fenway Institute, Boston, MA
| | | | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
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5
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Gichane MW, Rosenberg NE, Zimmer C, Pettifor AE, Maman S, Maseko B, Moracco KE. Individual and Relationship-Level Correlates of Transactional Sex Among Adolescent Girls and Young Women in Malawi: A Multilevel Analysis. AIDS Behav 2022; 26:822-832. [PMID: 34426863 PMCID: PMC8840914 DOI: 10.1007/s10461-021-03442-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 11/28/2022]
Abstract
Transactional sex increases HIV risk among adolescent girls and young women (AGYW). Understanding the individual and dyadic nature of transactional sex may provide evidence for risk reduction interventions. Multilevel logistic regression was used to cross-sectionally examine correlates of transactional sex among AGYW in Lilongwe, Malawi. Participants (N = 920) reported 1227 relationships. Individual-level associations were found between being divorced/widowed (AOR 5.07, 95% CI 1.93, 13.25), married (AOR 0.26, 95% CI 0.09, 0.72), or unstably housed (AOR 7.11, 95% CI 2.74, 18.47) and transactional sex. At the relationship-level, transactional sex occurred in relationships with: non-primary primary partners (AOR 4.06, 95% CI 2.37, 6.94), perceived partner concurrency (AOR 1.85, 95% CI 1.11, 3.08), and feared violence with couples HIV testing (AOR 2.81, 95% CI 1.26, 6.29), and less likely to occur in relationships with children (AOR 0.15, 95% CI 0.06, 0.38). Multiple co-occurring social and structural vulnerabilities increase transactional sex engagement warranting the need for social protection and gender transformative approaches.
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Affiliation(s)
- Margaret W Gichane
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Obstetrics, Gynecology & Reproductive Sciences, Advancing New Standards in Reproductive Health, University of California, San Francisco, Oakland, CA, USA.
| | - Nora E Rosenberg
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- UNC Project, University of North Carolina at Chapel Hill, Lilongwe, Malawi
| | - Catherine Zimmer
- HW Odum Institute for Research in Social Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Audrey E Pettifor
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Suzanne Maman
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bertha Maseko
- UNC Project, University of North Carolina at Chapel Hill, Lilongwe, Malawi
| | - Kathryn E Moracco
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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6
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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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Robles G, Bosco SC, Sauermilch D, Starks TJ. Population-Specific Correlates of Sexual Arrangements and Communication in a National Sample of Latinx Sexual Minority Men. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1449-1460. [PMID: 34080072 PMCID: PMC8272519 DOI: 10.1007/s10508-021-02009-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/23/2021] [Accepted: 04/09/2021] [Indexed: 05/25/2023]
Abstract
While the literature on sexual arrangements has expanded considerably, less is known about sexual arrangements among ethnically diverse populations, particularly Latinx sexual minority men (LSMM). Relationship research may overlook culturally salient correlates (e.g., ideals of masculinity or immigration-related factors) of sexual arrangements. The current study explored relationship-related factors (i.e., sexual arrangements, sexual communication, and relationship functioning) as well as Latino-specific factors, including dominant cultural views of masculinity (machismo/caballerismo) and immigration among partnered LSMM. Participants were recruited nationwide through social media and geo-location dating apps. All participants were aged 18 or older, cisgender male, lived in the U.S., including Puerto Rico, were able to read in either English or Spanish, and indicated they were currently in a relationship with a cismale partner. Multinomial regression was used to calculate the odds of being in an open or monogamish arrangement relative to a monogamous arrangement. Multivariable linear regression analysis was conducted to examine factors related to sexual communication. Language spoken with partner, adherence to more general heteronormative beliefs (genderism), and substance use were associated with specific sexual arrangement groups. The findings also suggested that birthplace, language spoken with partner variables, and machismo were associated with specific sexual arrangements and with sexual communication. This study highlights that factors associated with sexual arrangements and sexual communication may be population specific. The current study points to a complex interplay between culturally relevant ideals of masculinity and sexual arrangements as well as sexual communication among partnered Latinx sexual minority men.
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Affiliation(s)
- Gabriel Robles
- School of Social Work, Rutgers University, 390 George Street, New Brunswick, NJ, 08901, USA.
| | - Stephen C Bosco
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of the City University of New York, New York, NY, USA
| | - Daniel Sauermilch
- Department of Counseling and Clinical Psychology, Teachers College of Columbia University, New York, New York, NY, USA
| | - Tyrel J Starks
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of the City University of New York, New York, NY, USA
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
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Shrader CH, Arroyo-Flores J, Skvoretz J, Fallon S, Gonzalez V, Safren S, Algarin A, Johnson A, Doblecki-Lewis S, Kanamori M. PrEP Use and PrEP Use Disclosure are Associated with Condom Use During Sex: A Multilevel Analysis of Latino MSM Egocentric Sexual Networks. AIDS Behav 2021; 25:1636-1645. [PMID: 33387134 PMCID: PMC8667162 DOI: 10.1007/s10461-020-03080-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 01/16/2023]
Abstract
Pre-exposure prophylaxis (PrEP) is integral to HIV prevention; however, the influence of PrEP use and PrEP use disclosure on condom use is unclear among Latinx men who have sex with men (LMSM). This study explored associations of LMSM PrEP use and use disclosure on consistent dyadic condom use in the past 6 months. Participants were 130 HIV-negative PrEP and non-PrEP using LMSM ages 20-39 years. Two-level logistic regression models assessing individual- and dyadic-level predictors on condom use were fitted using R. Participants reported a mean of four sexual partners (n = 507 dyads). Participants who reported using PrEP or having more sexual partners were more likely to use condoms; however, participants who reported disclosing PrEP use were less likely to use condoms. Future longitudinal studies should characterize approaches to increase informed personal health choices and conversations about PrEP, condom use, and other HIV risk-reduction strategies using network methodologies.
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Affiliation(s)
- Cho-Hee Shrader
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 1006, Miami, FL, 33132, USA.
| | - Juan Arroyo-Flores
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 1006, Miami, FL, 33132, USA
| | - John Skvoretz
- Department of Sociology, University of South Florida, 4202 East Fowler Ave CPR 107, Tampa, FL, 33630, USA
| | - Stephen Fallon
- Latinos Salud, 2330 Wilton Dr, Wilton Manors, FL, 33305, USA
| | - Victor Gonzalez
- Latinos Salud, 2330 Wilton Dr, Wilton Manors, FL, 33305, USA
| | - Steven Safren
- Department of Psychology, University of Miami, 5665 Ponce De Leon Blvd, Room 463, Coral Gables, FL, 33146, USA
| | - Angel Algarin
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Ariana Johnson
- Division of Epidemiology, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 1006, Miami, FL, 33136, USA
| | - Susanne Doblecki-Lewis
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street #853, Miami, FL, 33136, USA
| | - Mariano Kanamori
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Suite 1006, Miami, FL, 33132, USA
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Diaz JE, Schrimshaw EW, Tieu HV, Nandi V, Koblin BA, Frye V. Acculturation as a Moderator of HIV Risk Behavior Correlates Among Latino Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2029-2043. [PMID: 31858309 PMCID: PMC7302998 DOI: 10.1007/s10508-019-01604-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/16/2019] [Accepted: 12/03/2019] [Indexed: 05/18/2023]
Abstract
Acculturation is associated with increased sexual risk behaviors among heterosexual Latinos, but its influence among Latino gay, bisexual, and other men who have sex with men (MSM) remains less clear. Elements of acculturation may create distinct lived experiences among sexual minority Latinos, moderating how beneficial and adverse influences contribute to their sexual risk behaviors. Latino MSM living in New York City (n = 412) were recruited using a modified time-space venue- and web-based sampling method. Negative binomial regression models estimated associations between indicators of acculturation (i.e., language use, nativity status, ethnic identification), sexual minority stressors (i.e., internalized homophobia, sexual orientation-based discrimination), peer condom use norms, and the number of serodiscordant condomless anal intercourse (SDCAI) encounters. Acculturation indicators were then tested as simultaneous moderators of the influence of each predictor variable on the outcome. The association between internalized homophobia and SDCAI was significant only among English language speakers (aIRR = 3.05 [2.13, 4.37]) and those born outside of the U.S. (foreign-born = 0, aIRR = 0.17 [0.08, 0.36]). Sexual orientation-based discrimination and SDCAI were also positively associated among both English-speaking (aIRR = 1.82 [1.22, 2.72]) and foreign-born men (aIRR = 0.34 [0.14, 0.84]). Stronger ethnic identification also moderated the protective effects of peer condom use norms on SDCAI (aIRR = 0.28 [0.15, 0.52]). Results suggest that different dimensions of acculturation help shape how both stressors and protective factors influence HIV risk among Latino MSM. Future research is needed to examine the mechanisms through which these differences in acculturation may act on sexual risk behaviors among Latino MSM.
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Affiliation(s)
- José E Diaz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA.
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Eric W Schrimshaw
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Vijay Nandi
- Laboratory of Data Analytic Services, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, 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
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York, NY, USA
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HIV Prevention Method Preferences Within Sexual Partnerships Reported by HIV-Negative MSM and TW in Tijuana, Mexico. AIDS Behav 2020; 24:839-846. [PMID: 30945030 DOI: 10.1007/s10461-019-02492-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To assess the potential for decreased condom use as pre-exposure prophylaxis (PrEP) is scaled-up in Latin America, we examined HIV prevention method preferences (neither PrEP nor condoms, condoms only, PrEP only, or PrEP with condoms) within 1302 sexual partnerships reported by 397 HIV-negative men who have sex with men (MSM) and transgender women (TW) in Tijuana, Mexico. Using PrEP with condoms (56%) was preferred to using condoms only (24%), using PrEP only (17%), and using neither PrEP nor condoms (3%). Compared to using condoms only, using PrEP only was preferred within primary (adjusted odds ratio [AOR] = 4.13, 95% confidence interval [CI] 1.92, 8.90) and condomless sex practicing (AOR = 6.97, 95% CI 3.92, 12.40) partnerships, suggesting PrEP use may not displace condom use among MSM and TW in Tijuana and other similar settings.
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11
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Bavinton BR, Grulich AE, Duncan D, Zablotska IB, Prestage GP. How partnership type and HIV seroconcordance affect HIV transmission risk in regular sexual partnerships: a cross-sectional survey of Australian gay and bisexual men. Sex Health 2019. [PMID: 28637581 DOI: 10.1071/sh16198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Regular sexual partnerships among gay and bisexual men (GBM) who practice condomless anal intercourse (CLAI) have not been well characterised in terms of partnership type, HIV seroconcordance and risk of HIV transmission. Primarily sexual regular partnerships, although commonly reported by gay men, have largely been ignored in research and HIV prevention. Among regular partners reporting CLAI with each other, we determined factors differentiating romantic or committed relationships from partnerships organised primarily around sex ('fuckbuddies') and estimated the proportion of CLAI presenting risk for HIV transmission. METHODS An online, cross-sectional survey of Australian GBM was conducted. Univariate and multivariate generalised estimating equations were used to determine statistical associations. RESULTS Men reported on 2250 regular sexual partnerships. Over half the partnerships were romantic or committed relationships. Over half the partnerships were HIV-negative seroconcordant (54.9%), 3.1% were HIV-positive seroconcordant, 5.2% were serodiscordant and 36.8% were of unknown seroconcordance. Potential risks presented by CLAI were sometimes mitigated by protective factors, such as having a clear spoken agreement about sex with outside partners, having fewer outside partners, openly discussing HIV risk and having an agreement to reduce risk from outside partners. These protective factors were more often found in romantic or committed relationships than among primarily sexual partnerships, and were less often found in partnerships of unknown seroconcordance. CONCLUSION CLAI is more common among regular sexual partnerships considered to be of a romantic, committed nature. However, factors associated with such romantic or committed partnerships can also protect against HIV transmission risk. Unknown seroconcordance, particularly lack of communication about HIV status among primarily sexual partnerships, is a key risk factor that needs to be addressed by HIV education.
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Affiliation(s)
| | | | - Duane Duncan
- University of New England, Armidale, NSW 2351, Australia
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12
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Maclin-Akinyemi C, Thurston IB, Howell KH, Jamison LE, Anderson MB. The protective roles of ethnic identity and community cohesion on substance use among Black women experiencing adversity. J Ethn Subst Abuse 2019; 20:225-240. [PMID: 31185850 DOI: 10.1080/15332640.2019.1622477] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study employs a strengths-based approach to explore associations of ethnic identity and community cohesion with substance use among Black women experiencing adversity. Black women (N = 107; Mage = 34.2, SD = 7.7) completed interviews about their sociodemographics, HIV status, intimate partner violence exposure, ethnic identity, community connectedness, and substance use. Hierarchical linear regression analysis was used to examine associations of ethnic identity and community cohesion with substance use, accounting for age and socioeconomic status. The overall model was significant, with greater ethnic identity (β = -.25, p < .01) and more community cohesion (β = -.29, p < .01) associated with lower substance use. Findings highlight the value of contextual factors in substance use prevention among Black women.
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Affiliation(s)
| | - Idia B Thurston
- Department of Psychology, The University of Memphis, Memphis, Tennessee.,Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Kathryn H Howell
- Department of Psychology, The University of Memphis, Memphis, Tennessee
| | - Lacy E Jamison
- Department of Psychology, The University of Memphis, Memphis, Tennessee
| | - Mollie B Anderson
- Department of Psychology, The University of Memphis, Memphis, Tennessee
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13
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Sexual Migration and HIV Risk in a Sample of Brazilian, Colombian and Dominican Immigrant MSM Living in New York City. J Immigr Minor Health 2019; 21:115-122. [PMID: 29497902 DOI: 10.1007/s10903-018-0716-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We examined motivations for migration to the United States (US) among 482 Brazilian, Colombian, and Dominican men who have sex with men (MSM). Participants' most common reason for migration was to improve their financial situation (49%), followed by sexual migration in order to affirm their sexual orientation (40%). Fewer endorsed sexual migration motivated by avoiding persecution due to being gay (13%). We conducted further analyses among 276 participants who migrated after age 15 and were HIV-negative at the time of migration. We hypothesized that sexual migration would be associated with greater likelihood of HIV acquisition post-migration. Hierarchical logistic regression analysis indicated that sexual migration motivated by avoiding persecution due to being gay was associated with increased odds of contracting HIV after arrival in the US whereas sexual migration to lead a gay life was not. Our findings highlight the importance of addressing the negative impact of anti-gay discrimination in countries of origin.
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Prescott MR, Hern J, Petersen M, Santos GM. Does HIV Pre-Exposure Prophylaxis Modify the Effect of Partnership Characteristics on Condom Use? A Cross-Sectional Study of Sexual Partnerships Among Men Who Have Sex with Men in San Francisco, California. AIDS Patient Care STDS 2019; 33:167-174. [PMID: 30932698 DOI: 10.1089/apc.2018.0179] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Increasing rates of sexually transmitted infections (STIs) in the United States among men who have sex with men (MSM) have raised concerns that pre-exposure prophylaxis (PrEP) has been associated with higher engagement in condomless anal intercourse (CAI). While partnership characteristics have previously been found to influence condom use, the extent to which PrEP use may modify their effect on CAI remains unknown. A secondary analysis of 535 sexual partnerships from a cross-sectional study in San Francisco was conducted to evaluate interactions between PrEP use and partnership characteristics on CAI. Bivariate and multivariate generalized estimating equation (GEE) logistic regression models were used to estimate relative measures of association, adjusted for confounding by seroconcordance and partnership type, as well as account for repeated partnerships per respondent. Partnerships where both partners used biomedical prevention had significantly greater odds of CAI [odds ratio (OR) = 5.19, 95% confidence interval (CI): 2.27-11.9] compared to those where only one partner used biomedical prevention, while those where neither partner used biomedical prevention had significantly lower odds of CAI (OR = 0.61, 95% CI: 0.40-0.93). There was no significant association between meeting place (online vs. offline) and sexual risk taking (OR = 1.03, p = 0.894). Having one partner disclose their HIV status (compared to neither partner having disclosed) was associated with significantly higher odds of CAI among partnerships of PrEP-using MSM [adjusted OR (aOR) = 5.28, 95% CI: 1.91-14.61], while the association was not significant among the partnerships of non-PrEP-using MSM (aOR = 1.29, 95% CI: 0.75-2.21). Differences in condom use among MSM using PrEP may not be well explained by differences in the effect of partnership characteristics. MSM using PrEP appear to commonly practice biomedical matching and high engagement in CAI with other biomedical prevention users, which could indicate relatively concentrated sexual networks and partly explain their disproportionate risk for STIs. Future studies should further investigate biomedical matching to develop interventions that further promote the sexual health of those using PrEP.
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Affiliation(s)
- Maximo R. Prescott
- San Francisco Department of Public Health, Center for Public Health Research, San Francisco, California
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California
| | - Jaclyn Hern
- San Francisco Department of Public Health, Center for Public Health Research, San Francisco, California
| | - Maya Petersen
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California
| | - Glenn-Milo Santos
- San Francisco Department of Public Health, Center for Public Health Research, San Francisco, California
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, California
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15
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Klassen BJ, Fulcher K, Chown SA, Armstrong HL, Hogg RS, Moore DM, Roth EA, Lachowsky NJ. "Condoms are … like public transit. It's something you want everyone else to take": Perceptions and use of condoms among HIV negative gay men in Vancouver, Canada in the era of biomedical and seroadaptive prevention. BMC Public Health 2019; 19:120. [PMID: 30691426 PMCID: PMC6350294 DOI: 10.1186/s12889-019-6452-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The emergence of biomedical and seroadaptive HIV prevention strategies has coincided with a decline in condom use among gay men. METHODS We undertook a social ecological analysis of condom use and perceptions using nineteen semi-structured interviews with HIV negative gay men in Vancouver, Canada who used HAART-based prevention strategies. RESULTS Contributors to inconsistent condom use were found at various levels of the social ecological model. Ongoing concern regarding HIV transmission and belief in the proven efficacy of condoms motivated contextual use. When condoms were not used, participants utilized seroadaptive and biomedical prevention strategies to mitigate risk. CONCLUSIONS These findings indicate that notions of "safety" and "risk" based on consistent condom use are eroding as other modes of prevention gain visibility. Community-based and public health interventions will need to shift prevention messaging from advocacy for universal condom use toward combination prevention in order to meet gay men's current prevention needs. Interventions should advance gay men's communication and self-advocacy skills in order to optimize these strategies.
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Affiliation(s)
- Benjamin J Klassen
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Department of History, Simon Fraser University, Burnaby, BC, Canada
| | - Karyn Fulcher
- School of Public Health & Social Policy, University of Victoria, room B202, HSD Building, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada
| | | | - Heather L Armstrong
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Robert S Hogg
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - David M Moore
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria, Victoria, BC, Canada.,Centre for Addictions Research of British Columbia, Victoria, BC, Canada
| | - Nathan J Lachowsky
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada. .,School of Public Health & Social Policy, University of Victoria, room B202, HSD Building, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada.
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16
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Allen SH, Leslie LA. Considering the Role of Nativity in the Health and Psychological Wellbeing of Black LGBT Adults. JOURNAL OF HOMOSEXUALITY 2018; 66:1769-1796. [PMID: 30222074 DOI: 10.1080/00918369.2018.1511134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Recent scholars have underscored how the experiences of LGBT people of color cannot be fully understood by considering only the independent contributions of race and sexual orientation. Framed by an intersectional lens, the current study seeks to address this gap in understanding by considering the role of nativity on the health and wellbeing of Black sexual minority adults; we also examined the moderating effects of family support and racial community climate on this relationship. Using national data from the Social Justice Sexuality Project (N = 2,166), we discovered that foreign-born Black LGBT adults had similar levels of psychological wellbeing and physical health as their native counterparts; family support and racial community climate did not moderate this relationship. Our findings did, however, substantiate the importance of family and community support for all Black LGBT adults, regardless of immigration status. Implications of this finding, in addition to directions for future intersectional work on racial minority LGBT people, are discussed.
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Affiliation(s)
- Samuel H Allen
- Department of Family Science, University of Maryland , College Park , Maryland , USA
| | - Leigh A Leslie
- Department of Family Science, University of Maryland , College Park , Maryland , USA
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17
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Zeglin RJ, Hergenrather KC, Poppen PJ, Choi J, Reisen C, Zea MC. Latino Sexual Beliefs Scale: An Exploratory Factor Analysis of Latino Men Who Have Sex With Men. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:299-308. [PMID: 28585155 DOI: 10.1007/s10508-017-0988-3] [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: 12/20/2016] [Revised: 02/28/2017] [Accepted: 04/03/2017] [Indexed: 06/07/2023]
Abstract
The catalyzing forces behind risky sexual behavior are a rich area of interest for public health researchers concerned with reducing HIV risk. Social cognitive theory would suggest that sexual beliefs are a viable example of one such influential agent. Recognizing that culture plays an important role in forming such sexual beliefs, and seeking to understand the unique HIV risks present for Latino men who have sex with men (MSM), this article presents an exploratory factor analysis of the 13-item Latino Sexual Beliefs Scale (LSBS) created as part of a larger study to investigate predictors of condom use among a sample of 482 MSM born in Brazil, Colombia, and the Dominican Republic and living in the U.S. The current analysis identified two psychometric factors in the LSBS as Romantic Exigency (containing six items with a mean loading of .62) and Sexual Acquiescence (containing seven items with a mean loading of .57). This is the first factor analysis conducted on the 13-item LSBS and represents the first known quantitative measure of Latino cultural sexual beliefs related to condom use for Latino MSM. Implications for future research include further validation, use in studies exploring the role of sexual beliefs on condom use, and possible thematic targets in HIV risk reduction interventions.
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Affiliation(s)
- Robert J Zeglin
- Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, FL, 32224, USA.
| | - Kenneth C Hergenrather
- Department of Counseling and Human Development, The George Washington University, Washington, DC, 20037, USA
| | - Paul J Poppen
- Department of Psychology, The George Washington University, Washington, DC, 20037, USA
| | - Jaehwa Choi
- Department of Educational Leadership, The George Washington University, Washington, DC, 20037, USA
| | - Carol Reisen
- Department of Psychology, The George Washington University, Washington, DC, 20037, USA
| | - Maria Cecilia Zea
- Department of Psychology, The George Washington University, Washington, DC, 20037, USA
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18
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Jaspal R, Williamson I. Identity management strategies among HIV-positive Colombian gay men in London. CULTURE, HEALTH & SEXUALITY 2017; 19:1374-1388. [PMID: 28463037 DOI: 10.1080/13691058.2017.1314012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study set out to explore the social-psychological aspects of living with HIV among a group of HIV-positive Colombian gay men in London, and the strategies that they deployed to manage ensuing threats to their identities. Focus group and individual interview data were collected from 14 Colombian gay men living with HIV, and were analysed using qualitative thematic analysis and identity process theory. The following themes are discussed: (1) identity struggles and conflicts in Colombia, (2), managing multiple layers of social stigma in England, and (3) changing interpersonal and intergroup dynamics, which highlight the inter-connections between sexual prejudice, sexual risk-taking and HIV stigma. Identity may be chronically threatened due to the multiple layers of stigma, which can limit the coping strategies available to individuals. Findings strongly support the need for action and programmes to highlight and tackle both racism and HIV stigma on the gay scene and to fund more specific resources for sub-communities of gay, bisexual and other men who have sex with men, which employ appropriately trained and culturally competent staff.
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Affiliation(s)
- Rusi Jaspal
- a Faculty of Health and Life Sciences , De Montfort University , Leicester , UK
- b Faculty of Arts, Psychology and Theology , Abo Akademi University , Turku , Finland
| | - Iain Williamson
- a Faculty of Health and Life Sciences , De Montfort University , Leicester , UK
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19
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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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20
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Hickson DA, Mena LA, Wilton L, Tieu HV, Koblin BA, Cummings V, Latkin C, Mayer KH. Sexual Networks, Dyadic Characteristics, and HIV Acquisition and Transmission Behaviors Among Black Men Who Have Sex With Men in 6 US Cities. Am J Epidemiol 2017; 185:786-800. [PMID: 28402405 PMCID: PMC5860251 DOI: 10.1093/aje/kww144] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/15/2016] [Accepted: 03/15/2016] [Indexed: 12/24/2022] Open
Abstract
The role of sexual networks in the epidemiology of human immunodeficiency virus (HIV) among black men who have sex with men (MSM) is poorly understood. Using data from 1,306 black MSM in the BROTHERS Study (2009-2010) in the United States, we examined the relationships between multiple sexual dyadic characteristics and serodiscordant/serostatus-unknown condomless sex (SDCS). HIV-infected participants had higher odds of SDCS when having sex at least weekly (odds ratio (OR) = 2.41, 95% confidence interval (CI): 1.37, 4.23) or monthly (OR = 1.94, 95% CI: 1.17, 3.24) versus once to a few times a year. HIV-uninfected participants had higher odds of SDCS with partners met offline at sex-focused venues (OR = 1.79, 95% CI: 1.15, 2.78) versus partners met online. In addition, having sex upon first meeting was associated with higher odds of SDCS (OR = 1.49, 95% CI: 1.21, 1.83) than was not having sex on first meeting, while living/continued communication with sexual partner(s) was associated with lower odds of SDCS (weekly: OR = 0.64, 95% CI: 0.47, 0.85; monthly: OR = 0.60, 95% CI: 0.44, 0.81; yearly: OR = 0.58, 95% CI: 0.39, 0.85) versus discontinued communication. Persons with primary/steady nonprimary partners versus commercial partners had lower odds of SDCS regardless of HIV serostatus. This suggests the need for culturally relevant HIV prevention efforts for black MSM that facilitate communication with sexual partners especially about risk reduction strategies, including preexposure prophylaxis.
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Affiliation(s)
- DeMarc A. Hickson
- Correspondence to Dr. DeMarc A. Hickson, My Brother's Keeper Inc., Center for Research, Evaluation, and Environmental and Policy Change, 510 George Street, Jackson, MS 39202 (e-mail: )
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21
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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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22
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Correlates of sexual risk for HIV among US-born and foreign-born Latino men who have sex with men (MSM): an analysis from the Brothers y Hermanos study. J Immigr Minor Health 2016; 17:47-55. [PMID: 23949695 DOI: 10.1007/s10903-013-9894-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Little research has been conducted to examine whether correlates of sexual risk vary by nativity among Latino men who have sex with men (MSM). We used cross sectional data collected from 870 Latino MSM recruited with respondent-driven sampling techniques. For each sub-sample (US-born and foreign-born), we assessed the association between each of the potential correlates (substance use, acculturation, social support, and social discrimination) and sexual risk behavior. Illicit drug use was associated with increased odds of sexual risk behavior in both US-born (OR = 2.17, 95% CI 1.17-4.03) and foreign-born (OR = 1.86, 1.14-3.05) subgroups. Multivariate correlates specific to foreign-born men included binge drinking (OR = 1.91, 1.17-3.14), 15 years or longer spent in the US (OR = 1.79, 1.06-3.03) and exposure to social discrimination (OR = 2.02, 1.03-3.99). Given the diversity of Latino MSM, information from research that identifies both common and different HIV risk factors across subgroups of Latino MSM may help better tailor HIV prevention programs.
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23
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Sexual Orientation, Gender Identity and Perceived Source of Infection Among Men Who Have Sex with Men (MSM) and Transgender Women (TW) Recently Diagnosed with HIV and/or STI in Lima, Peru. AIDS Behav 2016; 20:2178-2185. [PMID: 26767533 DOI: 10.1007/s10461-015-1276-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Risk perception and health behaviors result from individual-level factors influenced by specific partnership contexts. We explored individual- and partner-level factors associated with partner-specific perceptions of HIV/STI risk among 372 HIV/STI-positive MSM and transgender women (TW) in Lima, Peru. Generalized estimating equations explored participants' perception of their three most recent partner(s) as a likely source of their HIV/STI diagnosis. Homosexual/gay (PR = 2.07; 95 % CI 1.19-3.61) or transgender (PR = 2.84; 95 % CI 1.48-5.44) partners were more likely to be considered a source of infection than heterosexual partners. Compared to heterosexual respondents, gay and TW respondents were less likely to associate their partner with HIV/STI infection, suggesting a cultural link between gay or TW identity and perceived HIV/STI risk. Our findings demonstrate a need for health promotion messages tailored to high-risk MSM partnerships addressing how perceived HIV/STI risk aligns or conflicts with actual transmission risks in sexual partnerships and networks.
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24
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Predictors of crystal methamphetamine use in a community-based sample of UK men who have sex with men. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 36:43-6. [DOI: 10.1016/j.drugpo.2016.06.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 06/05/2016] [Accepted: 06/08/2016] [Indexed: 11/18/2022]
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25
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Melendez-Torres GJ, Hickson F, Reid D, Weatherburn P, Bonell C. Findings from within-subjects comparisons of drug use and sexual risk behaviour in men who have sex with men in England. Int J STD AIDS 2016; 28:250-258. [PMID: 27013616 DOI: 10.1177/0956462416642125] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Epidemiological evidence for the encounter-level association between sexualised drug use and unprotected anal intercourse in men who have sex with men is unclear and has not examined men who have sex with men in England. To estimate this association, we compared dyadic sexual encounters within respondents. We used encounter-level data from a longitudinal online survey of men who have sex with men living in England and multilevel models to test univariate and multivariate associations between any respondent or partner drug use, specific respondent drug use, additional situational characteristics and unprotected anal intercourse. Based on 6742 encounters from 2142 men who have sex with men, respondent drug use and respondent use of certain specific drugs were associated with increased unprotected anal intercourse odds. In univariate models, partner drug use was associated with increased unprotected anal intercourse odds, but in multivariate models, only non-specific knowledge of partner drug use was associated with the same. Encounters with non-regular-and-steady partners or that were not HIV-seroconcordant were associated with decreased unprotected anal intercourse odds. This is the first within-subjects comparison of drug use and unprotected anal intercourse conducted on a sample from England, and the largest of its kind. Findings are consistent with other studies, though associations between drug use and unprotected anal intercourse are shaped by social contexts that may change over time.
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Affiliation(s)
- G J Melendez-Torres
- 1 Warwick Evidence, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Ford Hickson
- 2 Sigma Research, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - David Reid
- 2 Sigma Research, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Peter Weatherburn
- 2 Sigma Research, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Chris Bonell
- 3 Department of Social Science, UCL Institute of Education, University College London, London, UK
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26
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Martinez O, Wu E, Frasca T, Shultz AZ, Fernandez MI, López Rios J, Ovejero H, Moya E, Chavez Baray S, Capote J, Manusov J, Anyamele CO, López Matos J, Page JSH, Carballo-Diéguez A, Sandfort TGM. Adaptation of a Couple-Based HIV/STI Prevention Intervention for Latino Men Who Have Sex With Men in New York City. Am J Mens Health 2016; 11:181-195. [PMID: 25846772 DOI: 10.1177/1557988315579195] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Predominantly Spanish-speaking Latino men who have sex with men (MSM) and their same-sex partners continue to be at high risk for HIV and STIs. Behavioral research has identified how relationship dynamics for male couples are associated with sexual risk behavior. Connect 'n Unite (CNU), an evidence-based HIV/STI prevention intervention originally created for Black MSM and their same-sex partners, was adapted for predominantly Spanish-speaking Latino MSM and their same-sex partners on the assumption that its key elements would be translatable while its efficacy would be retained. A systematic adaptation process utilizing qualitative methods was used, including intervention adaptation sessions with 20 predominantly Spanish-speaking Latino gay couples and 10 health service providers. The process included five steps: (1) engaging community stakeholders, (2) capturing the lived experiences of Latino gay couples, (3) identifying intervention priorities, (4) integrating the original intervention's social cognitive theory into a relationship-oriented, ecological framework for Latino gay couples, and (5) adapting intervention activities and materials. The adapted intervention, which we called Latinos en Pareja or Latinos in a Relationship, incorporates elements that effective HIV prevention interventions share, including: a solid theoretical foundation; emphasis on increasing risk reduction norms, sexual communication skills and social support for protection; and guidance on how to utilize available, culturally and linguistically appropriate services. The systematic adaptation approach used for a couples-based HIV prevention intervention also can be employed by other researchers and community stakeholders to adapt evidence-based interventions that promote wellness, linkage to care, and disease prevention for populations not originally targeted.
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Affiliation(s)
- Omar Martinez
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | - Elwin Wu
- 2 Columbia University, New York, NY, USA
| | - Timothy Frasca
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | - Andrew Zach Shultz
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | | | - Javier López Rios
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | | | - Eva Moya
- 5 University of Texas at El Paso, El Paso, TX, USA
| | | | | | | | - Chukwuemeka O Anyamele
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | | | | | - Alex Carballo-Diéguez
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | - Theo G M Sandfort
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
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27
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Individual-Level, Partnership-Level, and Sexual Event-Level Predictors of Condom Use During Receptive Anal Intercourse Among HIV-Negative Men Who Have Sex with Men in Los Angeles. AIDS Behav 2016; 20:1315-26. [PMID: 26471884 DOI: 10.1007/s10461-015-1218-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We examined individual-level, partnership-level, and sexual event-level factors associated with condom use during receptive anal intercourse (RAI) among 163 low-income, racially/ethnically diverse, HIV-negative men who have sex with men (MSM) in Los Angeles (2007-2010). At baseline, 3-month, and 12-month visits, computer-assisted self-interviews collected information on ≤3 recent male partners and the last sexual event with those partners. Factors associated with condom use during RAI at the last sexual event were identified using logistic generalized linear mixed models. Condom use during RAI was negatively associated with reporting ≥ high school education (adjusted odds ratio [AOR] = 0.32, 95 % confidence interval [CI] 0.11-0.96) and methamphetamine use, specifically during RAI events with non-main partners (AOR = 0.20, 95 % CI 0.07-0.53) and those that included lubricant use (AOR = 0.20, 95 % CI 0.08-0.53). Condom use during RAI varies according to individual-level, partnership-level, and sexual event-level factors that should be considered in the development of risk reduction strategies for this population.
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28
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Martinez O, Wu E, Levine EC, Muñoz-Laboy M, Spadafino J, Dodge B, Rhodes SD, Rios JL, Ovejero H, Moya EM, Baray SC, Carballo-Diéguez A, Fernandez MI. Syndemic factors associated with drinking patterns among Latino men and Latina transgender women who have sex with men in New York City. ADDICTION RESEARCH & THEORY 2016; 24:466-476. [PMID: 28077938 PMCID: PMC5222534 DOI: 10.3109/16066359.2016.1167191] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Alcohol consumption is a significant public health concern among Latino men and Latina transgender women who have sex with men. However, characteristics and behaviors associated with alcohol consumption in this population, particularly in regard to the complex influence of syndemic factors, remain understudied. The purpose of this study was to examine predictors of high-risk alcohol consumption (i.e. binge or heavy drinking). Between January and March of 2014, 176 Latino men and Latina transgender women in New York City completed an interviewer-administered questionnaire. We developed a syndemics scale to reflect the total number of syndemic factors - clinically significant depression, childhood sexual abuse, intimate partner violence, and discrimination - reported by each participant. We also carried out a multinomial logistic regression model predicting binge and heavy drinking. Forty-seven percent of participants reported high-risk alcohol consumption in the past 30 days (21% binge and 26% heavy). Approximately 16% of participants reported no syndemic factors, 27% reported one factor, 39% reported two factors, and 18% reported three or four. In the multinomial logistic regression model, our syndemic factors scale was not significantly associated with binge drinking. However, participants who reported three or four factors were significantly more likely to report heavy drinking. In addition, having multiple sexual partners was associated with an increased risk of binge and heavy drinking; involvement in a same-sex relationship was associated with binge drinking. Further work is needed to develop effective prevention intervention approaches for high-risk alcohol consumption within this population.
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Affiliation(s)
- Omar Martinez
- Temple University School of Social Work, Philadelphia, PA, USA
| | - Elwin Wu
- School of Social Work at Columbia University, New York, NY, USA
| | - Ethan C. Levine
- Department College of Liberal Arts at Temple University, Philadelphia, PA, USA
| | | | | | - Brian Dodge
- School of Public Health at Indiana University - Bloomington, Bloomington, IN, USA
| | | | - Javier López Rios
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Hugo Ovejero
- Lutheran Family Health Center, Brooklyn, NY, USA
| | - Eva M. Moya
- School of Social Work at the University of Texas at El Paso, El Paso, TX, USA
| | - Silvia Chavez Baray
- School of Social Work at the University of Texas at El Paso, El Paso, TX, USA
| | - Alex Carballo-Diéguez
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - M. Isabel Fernandez
- Department of Public Health at Nova Southeastern University, Fort Lauderdale, FL, USA
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De Santis JP, Provencio-Vasquez E, Mata HJ, Martinez J. Depression and Co-Occurring Health Determinants of Hispanic Men with HIV Infection in the U.S.-Mexico Border Region: A Pilot Study. JOURNAL OF SOCIAL SERVICE RESEARCH 2016; 42:305-312. [PMID: 27375306 PMCID: PMC4927083 DOI: 10.1080/01488376.2015.1112872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
HIV infection among Hispanic men is a public health concern. Certain factors have been identified that may contribute to the high rates of HIV infection among Hispanic men such as migration, acculturation, poverty, and depression. Hispanic men with HIV infection are at risk for additional co-occurring health issues. Given limited research few studies have focused specifically on Hispanic men with HIV infection residing in a U.S.-Mexico border community. This pilot study surveyed participants (n = 39), to better understand co-occurrence of health determinants, especially depression among Hispanic men with HIV infection. The study's findings indicate that clinicians need to be aware that factors may influence depression among people with Hispanic men with HIV infection. Clinicians also need awareness of the impact of depression on adherence to HIV care and treatment among Hispanic men with HIV infection. More research is needed to explore the relationship of HIV-related stigma, HIV disclosure, social support, and depression among Hispanic men with HIV infection.
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Affiliation(s)
- Joseph P De Santis
- University of Miami School of Nursing & Health Studies, Coral Gables, FL USA 33146
| | | | - Holly J Mata
- University of Texas at El Paso School of Nursing, El Paso, TX USA 79968
| | - Jacob Martinez
- University of Miami School of Nursing & Health Studies, Coral Gables, FL USA 33146
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Melendez-Torres GJ, Hickson F, Reid D, Weatherburn P, Bonell C. Nested Event-Level Case-Control Study of Drug Use and Sexual Outcomes in Multipartner Encounters Reported by Men Who Have Sex with Men. AIDS Behav 2016; 20:646-54. [PMID: 26139422 DOI: 10.1007/s10461-015-1127-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Previous event-level analyses have often, but not always, found significant associations between drug use and sexual risk behaviour in men who have sex with men (MSM), but these analyses have rarely considered either multipartner encounters specifically, or other sexual outcomes such as pleasure and control. Using data from an internet-based longitudinal survey of MSM, we tested the association between drug use by respondent and by partners and unprotected anal intercourse (UAI), pleasure and control over sexual activity. Overall respondent substance use was significantly associated with increased odds of UAI, though not with pleasure or control. Respondent use of crystal methamphetamine was significantly associated with both increased odds of UAI and decreased odds of control over sexual activity. This analysis agrees with previous studies of dyadic encounters, and specifically suggests that the association between crystal methamphetamine and sexual risk behaviour may be mediated by loss of control.
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Affiliation(s)
- G J Melendez-Torres
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.
| | - Ford Hickson
- Sigma Research, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - David Reid
- Sigma Research, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Peter Weatherburn
- Sigma Research, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Chris Bonell
- Social Science Research Unit, UCL Institute of Education, University College London, London, UK
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31
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Lau JTF, Mo PKH, Gu J, Hao C, Lai CHY. Association of Situational and Environmental Factors With Last Episode of Unprotected Anal Intercourse Among MSM in Hong Kong: A Case-Crossover Analysis. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:26-42. [PMID: 26829255 DOI: 10.1521/aeap.2016.28.1.26] [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 study investigates event-specific factors that differentiate the last episodes of unprotected anal intercourse (UAI) from protected anal intercourse (PAI) with regular partner (RP) among 213 men who have sex with men (MSM) who did not use condoms consistently using case-crossover analysis. Factors positively associated with the last episode of UAI with RP included: two situational factors (i.e., participant's suggestion to have UAI, alcohol use) and three environmental/setting factors (i.e., sex took place overseas, during a weekday and not at home). Negative associations with an episode of UAI with RP included: five situational factors (i.e., discussion about condom use prior to sex, RP's suggestion to have PAI, participant's suggestion to have PAI, perception that RP would like to use a condom, participant's planning to use a condom) and two environmental/setting factors (i.e., condoms placed at the venue where sex took place, partner possessed a condom). Thus, these significant event-specific factors explained under which circumstances some MSM would use and would not use condoms during anal sex with RP.
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Affiliation(s)
- Joseph T F Lau
- Centre for Health Behaviours Research, Faculty of Medicine, The School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
- The Chinese University of Hong Kong Shenzhen Research Institute, Shatin, Hong Kong
- Centre for Medical Anthropology and Behavioral Health, Sun Yat-sen University, Guangzhou, China
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, Faculty of Medicine, The School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
- The Chinese University of Hong Kong Shenzhen Research Institute, Shatin, Hong Kong
| | - Jing Gu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chun Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - CoCo H Y Lai
- Centre for Health Behaviours Research, Faculty of Medicine, The School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
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Gamarel KE, Golub SA. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships. Ann Behav Med 2015; 49:177-86. [PMID: 25124457 DOI: 10.1007/s12160-014-9646-3] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND In the USA, men who have sex with men (MSM) in primary partnerships are at elevated risk for human immunodeficiency virus (HIV) infection. Pre-exposure prophylaxis (PrEP), a new biomedical prevention strategy, has potential to reduce HIV transmission. This study examined predictors of PrEP adoption intentions among HIV-negative MSM in primary partnerships. METHODS The sample included HIV-negative MSM (n = 164) who participated in an ongoing cross-sectional study with an in-person interview examining PrEP adoption intentions. RESULTS Higher HIV risk perception, intimacy motivations for condomless sex, recent condomless anal sex with outside partners, education, and age were each independently associated with PrEP adoption intentions. In a multivariate model, only age, education, and intimacy motivations for condomless sex were significantly associated with PrEP adoption intentions. CONCLUSIONS Intimacy motivations may play a central role in PrEP adoption for MSM couples. Incorporating relationship dynamics into biomedical strategies is a promising avenue for research and intervention.
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Affiliation(s)
- Kristi E Gamarel
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Avenue, New York, NY, 10065, USA
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Kobrak P, Ponce R, Zielony R. New arrivals to New York City: vulnerability to HIV among urban migrant young gay men. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:2041-2053. [PMID: 25896489 DOI: 10.1007/s10508-015-0494-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 01/13/2015] [Accepted: 01/22/2015] [Indexed: 06/04/2023]
Abstract
This qualitative study explored the social experiences and HIV-related sexual practices of 30 young gay and bisexual men who moved to New York City in the past 3 years from other countries or elsewhere in the United States. For many migrants, a key basis of vulnerability to HIV was their engagement with New York City's unfamiliar sexual culture. Many recent arrivals migrated from places with small gay communities and low HIV prevalence, and some came with a practice of limited condom use. Participants described encountering an abundance of sexual opportunity in New York City, accessible to even the newest arrivals through internet sex sites. Some migrants expressed surprise that few men they met were interested in dating or establishing trust before having sex. Although frequent HIV testing was common, HIV status, testing history, and condom use were seldom discussed with sex partners for some men even with new partners or before sex without condoms. International and in-country migrants who are beginning to navigate New York City's gay sexual culture may be more vulnerable to HIV infection than established residents if they are inexperienced in encountering vast sexual opportunity, are less practiced in local norms of sexual communication, or if their lack of economic resources or social connections encourages them to have sex for money or shelter. This article suggests HIV prevention interventions for urban migrants and other men who have sex with men.
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Affiliation(s)
- Paul Kobrak
- Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, 42-09 28 Street, Long Island City, Queens, NY, 11101, USA,
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Zeglin RJ. Assessing the role of masculinity in the transmission of HIV: a systematic review to inform HIV risk reduction counseling interventions for men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1979-1990. [PMID: 25917411 PMCID: PMC5502076 DOI: 10.1007/s10508-015-0501-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 01/24/2015] [Accepted: 01/28/2015] [Indexed: 05/31/2023]
Abstract
HIV affects over 1.2 million people in the United States; a substantial number are men who have sex with men (MSM). Despite an abundance of literature evaluating numerous social/structural and individual risk factors associated with HIV for this population, relatively little is known regarding the individual-level role of masculinity in community-level HIV transmission risk. To address this gap, the current analysis systematically reviewed the masculinity and HIV literature for MSM. The findings of 31 sources were included. Seven themes were identified: (1) number of partners, (2) attitudes toward condoms, (3) drug use, (4) sexual positioning, (5) condom decision-making, (6) attitudes toward testing, and (7) treatment compliance. These factors, representing the enactment of masculine norms, potentiate the spread of HIV. The current article aligns these factors into a masculinity model of community HIV transmission. Opportunities for counseling interventions include identifying how masculinity informs a client's cognitions, emotions, and behaviors as well as adapting gender-transformative interventions to help create new conceptualizations of masculinity for MSM clients. This approach could reduce community-level HIV incidence.
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Affiliation(s)
- Robert J Zeglin
- Department of Counseling and Human Development, George Washington University, 2134 G St. NW, 3rd Floor, Washington, DC, 20037, USA,
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35
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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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36
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A mixed-methods study of condom use and decision making among adolescent gay and bisexual males. AIDS Behav 2014; 18:1955-69. [PMID: 24906532 DOI: 10.1007/s10461-014-0810-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Young men who have sex with men have the highest rates of new HIV infections in the U.S., but they have been understudied relative to other populations. As a formative step for the development of a text messaging HIV prevention intervention, this mixed methods study aimed to understand how adolescent gay and bisexual males (AGBM) make decisions about condom use and factors that may differ based on age, sexual experience, and rural versus urban residency. Four online, asynchronous focus groups were conducted with 75 14-18 year old AGBM across the U.S. Qualitative analyses uncovered themes related to relationship influences on condom use (e.g. marriage, trust), access issues, and attitudes and experiences that both encouraged as well as discouraged condom use. Mixed methods analyses explored differences between groups in endorsement of themes. For example, younger and sexually experienced participants were more likely to report the cost of condoms was prohibitive and sexually experienced and rural youth were more likely to describe being influenced by emotional aspects of the relationship. These data highlight both opportunities for as well as the importance of tailoring HIV prevention programs for sub-groups of AGBM.
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37
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Cai Y, Lau JTF. Multi-dimensional factors associated with unprotected anal intercourse with regular partners among Chinese men who have sex with men in Hong Kong: a respondent-driven sampling survey. BMC Infect Dis 2014; 14:205. [PMID: 24735186 PMCID: PMC3996134 DOI: 10.1186/1471-2334-14-205] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 04/10/2014] [Indexed: 11/14/2022] Open
Abstract
Background The HIV prevalence and incidence among men who have sex with men (MSM) are high. Unprotected anal intercourse (UAI) with male regular partners (RP) is an important but under-emphasized risk behavior. The current study aimed to describe the prevalence of UAI with regular partner and the associated multi-dimensional factors with UAI among MSM in Hong Kong, China. Methods Respondent Driven Sampling method was used to recruit participants. A total of 285 participants were recruited, of whom 211 (75.1%) had had anal sex with RP in the last six months and their data were analyzed in this report. Weighed data were presented and logistic regression methods were fit. Results Participants’ high risk behaviors in the last six months included high prevalence of having had UAI with RP (45.8%), having had non-regular male sex partners (NRP: 27.3%) and UAI with such partners (18.9%). Adjusted for socio-demographic variables, factors associated with UAI with RP included: 1) substances use prior to having anal sex (65.7% versus 43.8%; AOR =2.36; 95% CI =1.07-5.18), 2) worry that condom use symbolizes mistrust (67.9% versus 44.3%; AOR = 2.91; 95% CI =1.19-7.10), 3) a lower perceived degree of the RP’s acceptance of condom use (91.7% versus 38.3%; AOR = 22.70; 95% CI =6.20-83.10), and 4) a higher level of impulsivity (61.1% versus 35.0%; AOR =4.02; 95% CI = 1.62-9.97). Two of these four variables, substances use (ORm = 2.28, 95% CI = 1.01-5.16) and perceived lower level of RP’s acceptance of condom use (ORm = 17.22; 95% CI = 5.06-58.62) were selected by the forward stepwise logistic regression model. Conclusions MSM with RP in Hong Kong is subjected to high risk of HIV transmission. Risk factors of UAI are multi-dimensional and interventions need to take into account factors of structural, interpersonal and individual levels.
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Affiliation(s)
| | - Joseph T F Lau
- Centre for Health Behaviors Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, 5/F,, School of Public Health, Prince of Wales Hospital, Shatin, NT, Hong Kong 030000, PR China.
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Nelson KM, Thiede H, Jenkins RA, Carey JW, Hutcheson R, Golden MR. Personal and contextual factors related to delayed HIV diagnosis among men who have sex with men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2014; 26:122-133. [PMID: 24694326 PMCID: PMC4059174 DOI: 10.1521/aeap.2014.26.2.122] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Delayed HIV diagnosis among men who have sex with men (MSM) in the United States continues to be a significant personal and public health issue. Using qualitative and quantitative data from 75 recently tested, HIV-sero-positive MSM (38 delayed and 37 nondelayed testers), the authors sought to further elucidate potential personal and contextual factors that may contribute to delayed HIV diagnosis among MSM. Findings indicate that MSM who experience multiple life stressors, whether personal or contextual, have an increased likelihood of delaying HIV diagnosis. Furthermore, MSM who experience multiple life stressors without the scaffolding of social support, stable mental health, and self-efficacy to engage in protective health behaviors may be particularly vulnerable to delaying diagnosis. Interventions targeting these factors as well as structural interventions targeting physiological and safety concerns are needed to help MSM handle their life stressors more effectively and seek HIV testing in a timelier manner.
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Affiliation(s)
| | - Hanne Thiede
- Public Health – Seattle & King County, Seattle, WA
| | | | - James W. Carey
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Matthew R. Golden
- Public Health – Seattle & King County, Seattle, WA
- School of Public Health and Community Medicine, University of Washington, Seattle, WA
- School of Medicine, University of Washington, Seattle, WA
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Prause N, Steele VR, Staley C, Sabatinelli D. Late positive potential to explicit sexual images associated with the number of sexual intercourse partners. Soc Cogn Affect Neurosci 2014; 10:93-100. [PMID: 24526189 DOI: 10.1093/scan/nsu024] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Risky sexual behaviors typically occur when a person is sexually motivated by potent, sexual reward cues. Yet, individual differences in sensitivity to sexual cues have not been examined with respect to sexual risk behaviors. A greater responsiveness to sexual cues might provide greater motivation for a person to act sexually; a lower responsiveness to sexual cues might lead a person to seek more intense, novel, possibly risky, sexual acts. In this study, event-related potentials were recorded in 64 men and women while they viewed a series of emotional, including explicit sexual, photographs. The motivational salience of the sexual cues was varied by including more and less explicit sexual images. Indeed, the more explicit sexual stimuli resulted in enhanced late positive potentials (LPP) relative to the less explicit sexual images. Participants with fewer sexual intercourse partners in the last year had reduced LPP amplitude to the less explicit sexual images than the more explicit sexual images, whereas participants with more partners responded similarly to the more and less explicit sexual images. This pattern of results is consistent with a greater responsivity model. Those who engage in more sexual behaviors consistent with risk are also more responsive to less explicit sexual cues.
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Affiliation(s)
- Nicole Prause
- Department of Psychiatry, University of California, 760 Westwood Blvd 38-145, Los Angeles, CA 90024, USA, The Mind Research Network and University of New Mexico, 101 Yale Blvd. NE, Albuquerque, NM, 87106 USA, Idaho State University, Counseling and Testing Center, 921 South 8th Avenue, Pocatello, ID, 83209 USA, and Department of Psychology, University of Georgia, Athens, GA, 30602-3013 USA
| | - Vaughn R Steele
- Department of Psychiatry, University of California, 760 Westwood Blvd 38-145, Los Angeles, CA 90024, USA, The Mind Research Network and University of New Mexico, 101 Yale Blvd. NE, Albuquerque, NM, 87106 USA, Idaho State University, Counseling and Testing Center, 921 South 8th Avenue, Pocatello, ID, 83209 USA, and Department of Psychology, University of Georgia, Athens, GA, 30602-3013 USA
| | - Cameron Staley
- Department of Psychiatry, University of California, 760 Westwood Blvd 38-145, Los Angeles, CA 90024, USA, The Mind Research Network and University of New Mexico, 101 Yale Blvd. NE, Albuquerque, NM, 87106 USA, Idaho State University, Counseling and Testing Center, 921 South 8th Avenue, Pocatello, ID, 83209 USA, and Department of Psychology, University of Georgia, Athens, GA, 30602-3013 USA
| | - Dean Sabatinelli
- Department of Psychiatry, University of California, 760 Westwood Blvd 38-145, Los Angeles, CA 90024, USA, The Mind Research Network and University of New Mexico, 101 Yale Blvd. NE, Albuquerque, NM, 87106 USA, Idaho State University, Counseling and Testing Center, 921 South 8th Avenue, Pocatello, ID, 83209 USA, and Department of Psychology, University of Georgia, Athens, GA, 30602-3013 USA
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40
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Mustanski B, Parsons JT. Introduction to the special section on sexual health in gay and bisexual male couples. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:17-9. [PMID: 24297661 DOI: 10.1007/s10508-013-0228-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Brian Mustanski
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA,
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Newcomb ME, Ryan DT, Garofalo R, Mustanski B. The effects of sexual partnership and relationship characteristics on three sexual risk variables in young men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:61-72. [PMID: 24217953 PMCID: PMC3891854 DOI: 10.1007/s10508-013-0207-9] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Young men who have sex with men (YMSM) in the United States are experiencing an alarming increase in HIV incidence. Recent evidence suggests that the majority of new HIV infections in YMSM occur in the context of serious relationships, which underscores the importance of examining predictors of sexual risk behavior in the context of sexual partnerships, including relationship type, sexual partner characteristics, and relationship dynamics. The current study aimed to evaluate relationship and sexual partnership influences on sexual risk behavior in YMSM, including differentiating between multiple sexual risk variables (i.e., any unprotected anal or vaginal intercourse, unprotected insertive anal or vaginal intercourse, and unprotected receptive anal intercourse). More serious/familiar partnerships were associated with more sexual risk across all three risk variables, while wanting a relationship to last was protective against risk across all three risk variables. Some variables were differentially linked to unprotected insertive sex (partner gender) or unprotected receptive sex (partner age, partner race, believing a partner was having sex with others, and partners repeated across waves). Sexual risk behavior in YMSM is inconsistent across sexual partnerships and appears to be determined in no small part by sexual partner characteristics, relationship dynamics, and sexual role (i.e., insertive or receptive partner). These influences are critical in understanding sexual risk in YMSM and provide important targets for intervention.
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Affiliation(s)
- Michael E Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA,
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Mustanski B, Starks T, Newcomb ME. Methods for the design and analysis of relationship and partner effects on sexual health. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:21-33. [PMID: 24243003 PMCID: PMC3924882 DOI: 10.1007/s10508-013-0215-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Sexual intercourse involves two people and many aspects of sexual health are influenced by, if not dependent on, interpersonal processes. Yet, the majority of sexual health research involves the study of individuals. The collection and analysis of dyadic data present additional complexities compared to the study of individuals. The aim of this article was to describe methods for the study of dyadic processes related to sexual health. One-sided designs, including the PLM, involve a single individual reporting on the characteristics of multiple romantic or sexual relationships and the associations of these factors with sexual health outcomes are then estimated. This approach has been used to study how relationship factors, such as if the relationship is serious or casual, are associated with engagement in HIV risk behaviors. Such data can be collected cross-sectionally, longitudinally or through the use of diaries. Two-sided designs, including the actor-partner interdependence model, are used when data are obtained from both members of the dyad. The goal of such approaches is to disentangle intra- and inter-personal effects on outcomes (e.g., the ages of an individual and his partner may influence sexual frequency). In distinguishable datasets, there is some variable that allows the analyst to differentiate between partners within dyads, such as HIV status in a serodiscordant couple. When analyzing data from these dyads, effects can be assigned to specific types of partners. In exchangeable dyadic datasets, no variable is present that distinguishes between couple members across all dyads. Extensions of these approaches are described.
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Affiliation(s)
- Brian Mustanski
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA,
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Bianchi FT, Reisen CA, Gonzales FA, Arroyo JC, Zea MC, Poppen PJ. Sex with sex workers among latino day laborers in Suburban Maryland. ARCHIVES OF SEXUAL BEHAVIOR 2013; 42:835-49. [PMID: 23070528 PMCID: PMC4745421 DOI: 10.1007/s10508-012-0010-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Revised: 02/04/2012] [Accepted: 05/29/2012] [Indexed: 06/01/2023]
Abstract
Using the structural-environmental conceptual framework, this study employed mixed methods to address the question of whether sex with female sex workers contributes to HIV risk among male immigrant Latino day laborers in suburban Maryland. Because contextual factors can greatly affect HIV risk for both sex workers and their clients, this study investigated the organizational structure of sex work, factors that predicted men's hiring of sex workers, sexual behaviors performed with sex workers, and the use of condoms. Qualitative research was conducted to inform the development of a quantitative survey, but also provided crucial descriptions about the motivations, locations, arrangements, and sexual activities related to sex work. Key informant interviews (N = 10), in-depth interviews with day laborers (N = 10) and Latina female sex workers (N = 4), and two focus groups with day laborers (N = 11) were conducted, and a quantitative survey administered via Audio-enhanced Computer-assisted Self-interviewing (N = 174). Condom use was nearly universal in encounters with female sex workers, thus indicating that the sex workers were not an important source of HIV transmission in this context. Logistic regression was performed to test a model predicting sex with sex workers. Latino day laborers who reported more immigrant stress and who did not have a partner in the U.S. were more likely to have had sex with a sex worker, as were men who reported binge drinking. Structural and social conditions influenced the hiring of sex workers. Further research is warranted to better understand the interrelationships among these circumstances and to inform the development of programs to address them.
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Affiliation(s)
- Fernanda T Bianchi
- Department of Psychology, George Washington University, 2125 G St. NW, Washington, DC, 20052, USA.
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Molina Y, Ramirez-Valles J. HIV/AIDS stigma: measurement and relationships to psycho-behavioral factors in Latino gay/bisexual men and transgender women. AIDS Care 2013; 25:1559-68. [PMID: 23668809 PMCID: PMC3800251 DOI: 10.1080/09540121.2013.793268] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite the increased interest in HIV/AIDS stigma and its negative effects on the health and social support of people living with HIV/AIDS (PLWHA), little attention has been given to its assessment among Latino gay/ bisexual men and transgender women (GBT) living with HIV/AIDS. The purpose of this paper is twofold: to develop a multidimensional assessment of HIV/AIDS stigma for Latino GBT living with HIV/AIDS, and to test whether such stigma is related to self-esteem, safe sex self-efficacy, social support, and alcohol, and drug use. The sample included 170 HIV+ Latino GBT persons. The results revealed three dimensions of stigma: internalized, perceived, and enacted HIV/AIDS stigma. Enacted HIV/AIDS stigma comprised two domains: generalized and romantic and sexual. Generalized enacted HIV/AIDS stigma was related to most outcomes. Internalized HIV/AIDS stigma mediated the associations between generalized enacted HIV/AIDS stigma and self-esteem and safe sex self-efficacy. In addition, romantic and sexual enacted HIV/AIDS stigma significantly predicted drug use. Perceived HIV/AIDS stigma was not associated with any outcome. These findings expand the understanding of the multidimensionality of stigma and the manner in which various features impact marginalized PLWHA.
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Affiliation(s)
- Y. Molina
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - J. Ramirez-Valles
- Community Health Sciences University of Illinois-Chicago, Chicago, IL, USA
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Tucker A, de Swardt G, Struthers H, McIntyre J. Understanding the needs of township men who have sex with men (MSM) health outreach workers: exploring the interplay between volunteer training, social capital and critical consciousness. AIDS Behav 2013; 17 Suppl 1:S33-42. [PMID: 22903420 DOI: 10.1007/s10461-012-0287-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This article considers the complex ways volunteer outreach workers can frame their engagement with a community-based HIV prevention programme for South African township MSM. Drawing on research conducted during the Ukwazana programme in Cape Town it begins by exploring limitations towards MSM participation with programme facilitators (namely previous feelings of mistrust and community homophobia) and strategies developed to offset these concerns. It then considers how great care must also be taken to appreciate how volunteers from marginalised groups can frame training as a key condition for participation. To understand this it is therefore necessary for facilitators to acknowledge a number of additional concerns. These include community status, a lack of bonding social capital between volunteers and a highly developed from of critical consciousness by volunteers regarding HIV prevention possibilities. This article therefore suggests that effort to initially engage marginalised communities must also be met with effort to understand the complex ways volunteers relate to other MSM and to each other.
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Tucker A, Liht J, de Swardt G, Jobson G, Rebe K, McIntyre J, Struthers H. An exploration into the role of depression and self-efficacy on township men who have sex with men's ability to engage in safer sexual practices. AIDS Care 2013; 25:1227-35. [PMID: 23387517 DOI: 10.1080/09540121.2013.764383] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Men who have sex with men (MSM) in South Africa remain at particular risk of HIV infection. The Ukwazana baseline survey is the first to explore this risk in relation to psychological factors associated with unprotected anal intercourse (UAI). A cohort of 316 MSM from township peri-urban Cape Town took part in the survey. The survey found that 55.2% had engaged in UAI over the preceding 6 months. Depression was significantly associated with UAI. Respondents with self-efficacy scores less than two standard deviations above the mean were also more likely to have engaged in UAI. A Sobel test for mediation highlighted that the depression-UAI association was partially mediated by self-efficacy, indicating that most of the effect of depression on UAI was not covarying with self-efficacy. This study, therefore, highlights that both depression and self-efficacy should be considered factors to be addressed in HIV-prevention programmes aimed at peri-urban MSM.
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Affiliation(s)
- Andrew Tucker
- a Department of Geography , The University of Cambridge Centre for Gender Studies , Cambridge , UK
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Sexual event-level characteristics of condom use during anal intercourse among HIV-negative men who have sex with men. Sex Transm Dis 2012; 39:550-5. [PMID: 22706218 DOI: 10.1097/olq.0b013e31824f1da4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Condom use remains central to sexually transmitted infections/HIV prevention among gay men and other men who have sex with men (MSM). To support the development of accurate and appropriate interventions, a better understanding is needed as to how the characteristics of a given sexual event differentially influence condom use during anal intercourse. METHODS Daily diary data were collected from (n = 3877) HIV-negative MSM who were members of several online Web sites facilitating social or sexual interactions with other men. Sexual event-specific factors related to condom use during anal intercourse were evaluated using logistic regression, with generalized estimating equation adjustment for multiple within-participant sexual events (STATA, 10.0; all P < 0.05). RESULTS Participants contributed 25,149 behavioral diaries. Of these, men reported 730 (2.9%) acts of anal intercourse as insertive partner and 662 (2.6%) as receptive partner. Condoms were used during 25.5% (n = 184) of insertive events, and 18.8% (n = 125) of receptive events. For both insertive and receptive anal roles, condom use was more likely with casual partners (OR = 4.24-6.59). Positive ratings of sexual pleasure were associated with condom use among men who were the insertive partner during anal intercourse, whereas condom nonuse was significantly related to higher ratings of pleasure among men who were the receptive partner. CONCLUSIONS Event-level relational and sexual-situational factors predict condom use differently, depending on whether men are the insertive or receptive partner in anal intercourse. Understanding these differences will help clinicians and health educators engage MSM in dialogue to increase condom use in situations where it is warranted.
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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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Taylor BS, Chiasson MA, Scheinmann R, Hirshfield S, Humberstone M, Remien RH, Wolitski RJ, Wong T. Results from two online surveys comparing sexual risk behaviors in Hispanic, black, and white men who have sex with men. AIDS Behav 2012; 16:644-52. [PMID: 21691760 DOI: 10.1007/s10461-011-9983-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Many men who have sex with men (MSM) are among those who increasingly use the internet to find sexual partners. Few studies have compared behavior by race/ethnicity in internet-based samples of MSM. We examined the association of race/ethnicity with HIV risk-related behavior among 10,979 Hispanic, black, and white MSM recruited online. Significant variations by race/ethnicity were found in: age, income level, sexual orientation, number of lifetime male and female sexual partners, and rates of unprotected anal intercourse (UAI). Black and Hispanic men were more likely to report anal intercourse during the last sexual encounter, but white men were more likely to report UAI. In multivariate analysis, UAI was associated with HIV infection and sex with a main partner. Significant risk behavior variations by race/ethnicity were found. Research is needed to better target online interventions to MSM who engage in UAI or have other risk factors for transmitting or acquiring HIV.
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Affiliation(s)
- Barbara S Taylor
- Department of Medicine, University of Texas Health Sciences Center at San Antonio, 7703 Floyd Curl Drive MSC-7881, San Antonio, TX 78229, USA.
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Bedoya CA, Mimiaga MJ, Beauchamp G, Donnell D, Mayer KH, Safren SA. Predictors of HIV transmission risk behavior and seroconversion among Latino men who have sex with men in Project EXPLORE. AIDS Behav 2012; 16:608-17. [PMID: 21390540 DOI: 10.1007/s10461-011-9911-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In the US, Latino MSM are disproportionately affected by HIV, yet there is a paucity of data for this risk group. To this end, we examined data on Latino and non-Latino white MSM who participated across six cities in a 2-year randomized behavioral intervention study-Project EXPLORE. At baseline, Latinos reported significantly more serodiscordant unprotected anal intercourse (SDUA) than non-Latinos. Longitudinal predictors of SDUA included marijuana, poppers, amphetamines and heavy drinking, as well as lower self-efficacy, poorer communication skills, weaker safe-sex norms and more enjoyment of risky sex. For HIV infection, Latinos had significantly higher seroconversion rate over follow-up than non-Latinos. Longitudinal predictors of seroconversion among Latinos included poppers and SDUA. Intervention effects did not significantly differ between Latino and non-Latinos. Findings support HIV intervention work with Latino MSM that includes skills training/counseling to address attitudes about safe sex and impact of substance use on HIV-risk behavior and acquisition.
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