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Yan X, Ni Y, Lu Y, Wang Q, Tang W, Tan RKJ, Tucker JD, Hall BJ, Baral S, Song H, Zhou Y, Wu D. Homoprejudiced Violence Experiences and High-Risk Sexual Behaviors among Chinese Men Who Have Sex with Men: Depression Severity and Recreational Drug Usage as Potential Mediators. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1265-1276. [PMID: 38172350 DOI: 10.1007/s10508-023-02775-4] [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: 01/18/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024]
Abstract
Homoprejudiced violence is a type of aggression against an individual or a community based on their actual or perceived sexual orientation. It may be linked to risks of acquiring HIV/STI via psychosocial variables. This study explored the association between homoprejudiced violence experiences and high-risk sexual behaviors, and potential psychosocial mediators. Using cross-sectional survey data collected in China through Blued among men who have sex with men (MSM) in January 2021, this study conducted multiple mediation analyses. Standard instruments were used to collect data on depressive symptoms in the last two weeks (PHQ-9), recreational drug usage in the last three months, and ever experiencing homoprejudiced violence (12-item survey instrument). Dependent variables were having condomless anal sex and having three or more sexual partners in the last three months. Among 1828 MSM, nearly half (847, 46%) had experienced homoprejudiced violence. Twenty-three percent (427) reached a score that suggested moderate or severe depression and 35% (644) had used recreational drugs. In the last three months, 40% (731) had condomless anal sex and 34% (626) had three or more sexual partners. The indirect mediational coefficients through depression on condomless anal sex and multiple sexual partners were 0.04 (95% CI: [0.02, 0.07]) and 0.02 (95% CI: [0.001, 0.05]), respectively. The indirect mediational coefficient of homoprejudiced violence experience on multiple sexual partners through recreational drug use was 0.05 (95% CI: [0.03, 0.08]). These findings suggest that more comprehensive interventions are needed to address the syndemic of homoprejudiced violence, mental health issues, and HIV/STI-related risks.
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Affiliation(s)
- Xumeng Yan
- Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue Nanjing, Nanjing, 211166, Jiangsu, China
- University of North Carolina Project-China, Guangzhou, China
- Department of Community Health Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Yuxin Ni
- University of North Carolina Project-China, Guangzhou, China
- Department of Health Law Policy and Management, Boston University, Boston, MA, USA
| | - Ying Lu
- University of North Carolina Project-China, Guangzhou, China
| | - Qianyun Wang
- University of North Carolina Project-China, Guangzhou, China
- Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rayner Kay Jin Tan
- University of North Carolina Project-China, Guangzhou, China
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- International Diagnostics Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Brian J Hall
- Center for Global Health Equity, New York University Shanghai, Shanghai, China
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yi Zhou
- Department of HIV/AIDS Prevention and Control, Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Dan Wu
- Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue Nanjing, Nanjing, 211166, Jiangsu, China.
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Zimmermann HML, Postma LR, Achterbergh RCA, Reyniers T, Schim van der Loeff MF, Prins M, de Vries HJC, Hoornenborg E, Davidovich U. The Impact of Pre-exposure Prophylaxis on Sexual Well-Being Among Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1829-1841. [PMID: 33619674 DOI: 10.1007/s10508-020-01833-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 05/12/2023]
Abstract
Pre-exposure prophylaxis (PrEP) is a promising strategy to reduce HIV incidence among men who have sex with men (MSM). How and when PrEP is used could in part be influenced by its impact on the sexual well-being of its users. Yet, the impact of PrEP on sexual well-being has received little attention in current literature and is not well-understood. We conducted 43 in-depth interviews (June 2017-June 2018) with HIV-negative MSM who started PrEP within the Amsterdam PrEP study. We used purposive sampling to select participants who (1) reported changes on well-being indicators; (2) switched between PrEP-dosing regimens; (3) neither changed regimens nor changed on well-being indicators. Transcribed interviews were qualitatively analyzed by means of an open-coding process. Results showed that PrEP minimized HIV-related fear, increased self-esteem, and reduced stigma and shame about having condomless anal sex. The psychological relief provided by PrEP also enabled relaxation which reduced pain during anal sex. PrEP use increased the diversity of partner choices and improved the perceived quality of sexual relationships and the ability to develop relationships. Along with this positive impact, almost half of interviewees reported concurrent negative experiences. In some cases, PrEP triggered more extreme sexual behaviors and/or problematic increases in preoccupation with sex and drug use. These were perceived as having a negative impact on sexual relationships, sexual well-being, PrEP adherence, and general health. In conclusion, our findings suggest that PrEP contributes to improvements in sexual well-being that go beyond protection from HIV. Counseling strategies should be devised to help PrEP users mitigate possible co-existing negative consequences of PrEP use.
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Affiliation(s)
- Hanne M L Zimmermann
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands.
| | - Lisa R Postma
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Roel C A Achterbergh
- Department of Infectious Diseases, STI Outpatient Clinic, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Thijs Reyniers
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
- Department of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
- Department of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Henry J C de Vries
- Department of Infectious Diseases, STI Outpatient Clinic, Public Health Service of Amsterdam, Amsterdam, The Netherlands
- Department of Dermatology, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Elske Hoornenborg
- Department of Infectious Diseases, STI Outpatient Clinic, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Udi Davidovich
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
- Department of Social Psychology, University of Amsterdam, Amsterdam, The Netherlands
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3
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Mental Health Services for Men Who Have Sex with Men in China. Community Ment Health J 2021; 57:380-386. [PMID: 32594327 PMCID: PMC7765735 DOI: 10.1007/s10597-020-00660-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 06/11/2020] [Indexed: 10/24/2022]
Abstract
This study explores the presence of mental health challenges and related service utilization among MSM in China. An online cross-sectional survey recruited 520 MSM in Guangdong, China, to evaluate the participants' psychiatric symptoms, service fulfillment, and challenges. A high proportion of the participants experienced at least one psychiatric symptom in the past year, but less than half of their mental health service needs were fulfilled. The preferred agencies for mental health services were provincial and city-level general hospitals or primary health centers. Lack of knowledge and misconceptions of mental health services were the primary reasons for not receiving necessary services. Mental health service fulfillment was associated with younger age, lower education, higher income, local residency, cohabitation, and disclosure of MSM status. The high rate of mental health issues and gaps in service seeking indicates an urgent need to increase mental health awareness among MSM.
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Yang Z, Qi S, Zeng L, Han X, Pan Y. Work-Family Conflict and Primary and Secondary School Principals' Work Engagement: A Moderated Mediation Model. Front Psychol 2021; 11:596385. [PMID: 33584432 PMCID: PMC7876373 DOI: 10.3389/fpsyg.2020.596385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/18/2020] [Indexed: 11/30/2022] Open
Abstract
With the development of positive psychology, work engagement has received widespread attention from researchers in the fields of positive organizational behavior and occupational health. Some studies have shown that work-family conflict has an important influence on individual behaviors and attitudes, but little research has studied the influence of work-family conflict on work engagement. The present study examined whether the relationship between work-family conflict and work engagement was mediated by job satisfaction, and whether the mediating role was moderated by affective commitment. We surveyed 358 Chinese primary and secondary school principals using the Work-Family Conflict Scale, Job Satisfaction Scale, Affective Commitment Scale, and Work Engagement Scale. The results revealed that there is a significant negative correlation between work-family conflict and primary and secondary school principals' work engagement, and this relationship was partially mediated by job satisfaction. Moreover, affective commitment played a moderating role in the relationship between job satisfaction and work engagement. Specifically, the relationship between job satisfaction and work engagement was significant for primary and secondary school principals with high and low affective commitment. The current study contributes to a better understanding of the relationship between work-family conflict and work engagement.
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Affiliation(s)
- Zhongping Yang
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Shisan Qi
- School of Psychology, Inner Mongolia Normal University, Hohhot, China
| | - Lianping Zeng
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Xiaohong Han
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Yun Pan
- School of Psychology, Guizhou Normal University, Guiyang, China
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Miltz AR, Rodger AJ, Phillips AN, Sewell J, Edwards S, Allan S, Sherr L, Johnson AM, Burman WJ, Lampe FC. Opposing associations of depression with sexual behaviour: implications for epidemiological investigation among gay, bisexual and other men who have sex with men. Sex Transm Infect 2021; 97:613-618. [PMID: 33431606 PMCID: PMC8606445 DOI: 10.1136/sextrans-2020-054634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/18/2020] [Accepted: 12/06/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this report is to investigate the nature of the relationship between depression and condomless sex (CLS) among gay, bisexual and other men who have sex with men (GBMSM). METHODS Data are from the Antiretrovirals, Sexual Transmission Risk and Attitude (ASTRA) study of people living with HIV and attending one of eight HIV outpatient clinics in England (2011-2012) and the Attitudes to and Understanding of Risk of Acquisition of HIV (AURAH) study of HIV-negative/unknown status individuals attending one of 20 genitourinary medicine clinics in England (2013-2014). This analysis included GBMSM only. For each study, the prevalence of depressive symptoms (Patient Health Questionnaire-9 score ≥10) was presented according to three categories of sex in the past 3 months (considering anal/vaginal sex with men/women and anal sex with men in separate definitions): (1) no sex, (2) condom-protected sex only and (3) CLS. Multinomial logistic regression with 'condom-protected sex only' as the reference group was used to adjust for age and (for ASTRA participants) time since HIV diagnosis. RESULTS There were opposing associations of depression with recent sexual behaviour: the prevalence of depression was higher among those who reported no sex and those who reported CLS, compared with those who reported condom-protected sex only. Among the 2170 HIV-positive GBMSM in ASTRA, considering anal/vaginal sex with men/women, the prevalence of depressive symptoms was 32%, 20% and 28%, respectively, among men reporting no sex (n=783), condom-protected sex only (n=551) and CLS (n=836) (global p<0.001). Among the 1477 HIV-negative GBMSM in AURAH, the prevalence of depressive symptoms was 12%, 8% and 13%, respectively, for no sex (n=137), condom-protected sex only (n=487) and CLS (n=853) (global p=0.017). Patterns were similar after adjustment and when only considering anal sex between men. CONCLUSIONS Depression may be linked both to lack of sexual activity and to sexual risk taking. When investigating associations between depression and CLS, it is important to separate out individuals reporting condom-protected sex only from those reporting no sex.
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Affiliation(s)
- Ada R Miltz
- Institute for Global Health, University College London, London, UK
| | - Alison J Rodger
- Institute for Global Health, University College London, London, UK
| | | | - Janey Sewell
- Institute for Global Health, University College London, London, UK
| | - Simon Edwards
- Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Sris Allan
- City of Coventry NHS Healthcare Centre, Coventry, UK
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
| | - Anne M Johnson
- Institute for Global Health, University College London, London, UK
| | | | - Fiona C Lampe
- Institute for Global Health, University College London, London, UK
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Miltz AR, Rodger AJ, Lepri AC, Sewell J, Nwokolo NC, Allan S, Scott C, Ivens D, Lascar M, Speakman A, Phillips AN, Sherr L, Collins S, Elford J, Lampe FC. Investigating Conceptual Models for the Relationship Between Depression and Condomless Sex Among Gay, Bisexual, and Other Men Who have Sex with Men: Using Structural Equation Modelling to Assess Mediation. AIDS Behav 2020; 24:1793-1806. [PMID: 31782068 PMCID: PMC7220884 DOI: 10.1007/s10461-019-02724-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study is to investigate five hypothesized mechanisms of causation between depression and condomless sex with ≥ 2 partners (CLS2+) among gay, bisexual, and other men who have sex with men (GBMSM), involving alternative roles of self-efficacy for sexual safety and recreational drug use. Data were from the AURAH cross-sectional study of 1340 GBMSM attending genitourinary medicine clinics in England (2013–2014). Structural equation modelling (SEM) was used to investigate which conceptual model was more consistent with the data. Twelve percent of men reported depression (PHQ-9 ≥ 10) and 32% reported CLS2+ in the past 3 months. AURAH data were more consistent with the model in which depression was considered to lead to CLS2+ indirectly via low self-efficacy for sexual safety (indirect Beta = 0.158; p < 0.001) as well as indirectly via higher levels of recreational drug use (indirect Beta = 0.158; p < 0.001). SEM assists in understanding the relationship between depression and CLS among GBMSM.
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Affiliation(s)
- A R Miltz
- Institute for Global Health, University College London, London, UK.
| | - A J Rodger
- Institute for Global Health, University College London, London, UK
| | - A Cozzi Lepri
- Institute for Global Health, University College London, London, UK
| | - J Sewell
- Institute for Global Health, University College London, London, UK
| | | | - S Allan
- City of Coventry Healthcare Centre, Coventry, UK
| | - C Scott
- West London Centre for Sexual Health, London, UK
| | - D Ivens
- Royal Free Hospital, London, UK
| | - M Lascar
- Whipps Cross Hospital, London, UK
| | - A Speakman
- Institute for Global Health, University College London, London, UK
| | - A N Phillips
- Institute for Global Health, University College London, London, UK
| | - L Sherr
- Institute for Global Health, University College London, London, UK
| | | | - J Elford
- City, University of London, London, UK
| | - F C Lampe
- Institute for Global Health, University College London, London, UK
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Nöstlinger C, Reyniers T, Smekens T, Apers H, Laga M, Wouters K, Vuylsteke B. Drug use, depression and sexual risk behaviour: a syndemic among early pre-exposure prophylaxis (PrEP) adopters in Belgium? AIDS Care 2020; 32:57-64. [PMID: 32160759 DOI: 10.1080/09540121.2020.1739218] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Little is known about how interacting psychosocial problems may influence sexual behaviour among men having sex with men taking Pre-exposure prophylaxis (PrEP). This study assessed (1) the prevalence of depression, recreational drug-use and sexual risk behaviour; (2) changes in these psychosocial conditions over time; and (3) the interaction of drug use and depression with sexual risk behaviour. We analysed data of the Belgian Be-PrEP-ared cohort study (N = 200). We assessed depression using the PHQ-9, recreational drug use and receptive condomless anal intercourse (rCAI) with anonymous partners. Frequencies of psychosocial problems were compared at baseline, 9 and 18 months follow-up (FU). Bivariate associations between depression and drug-use behaviour, and their interaction with rCAI with anonymous sexual partners using was examined using linear regression. Receptive CAI increased from 41% at baseline to 53% at M18 (p = 0.038). At baseline, we found an interaction effect of poly-drug use and depression, potentiating rCAI with anonymous partners. Participants reporting poly-drug use associated with depression were significant more likely to report this type of sexual risk behaviour than those who did not report this association (p = 0.030). The high level of intertwined psychosocial problems call for multi-level interventions for those PrEP users experiencing a syndemic burden.
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Affiliation(s)
| | - Thijs Reyniers
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Tom Smekens
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Hanne Apers
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Marie Laga
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kristien Wouters
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Scheidell JD, Dyer TP, Severe M, Tembunde YE, Young KE, Khan MR. Childhood Traumatic Experiences and Receptive Anal Intercourse Among Women. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2020; 52:23-30. [PMID: 32096340 PMCID: PMC8034482 DOI: 10.1363/psrh.12129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 10/01/2019] [Accepted: 10/31/2019] [Indexed: 06/10/2023]
Abstract
CONTEXT Receptive anal intercourse (RAI), which has become increasingly common among U.S. heterosexual women, is associated with STDs, including HIV, when it is unprotected and coercive. Childhood traumatic experiences may increase sexual risk behavior, but the relationship between childhood trauma and RAI among women has not been examined. METHODS Data from 4,876 female participants in Waves 1 (1994-1995), 3 (2001-2002) and 4 (2007-2008) of the National Longitudinal Study of Adolescent to Adult Health were used to examine associations between nine self-reported childhood traumas (neglect; emotional, physical and sexual abuse; parental binge drinking and incarceration; and witnessing, being threatened with and experiencing violence) and RAI during adulthood using modified Poisson regression analysis. Whether depression, low self-esteem, drug use, relationship characteristics or sex trade involvement mediated the relationship between trauma and RAI was also explored. RESULTS Forty percent of the sample reported having engaged in receptive anal intercourse. After adjustment for sociodemographic characteristics, eight of the nine childhood traumas were associated with increased risk of RAI (adjusted prevalence ratios, 1.2-1.5); the strongest association was with experience of violence. Each unit increase in the number of traumas yielded a 16% increase in RAI prevalence. In mediation analyses, only drug use and relationship factors slightly attenuated the association between childhood trauma and RAI (1.2 for each). CONCLUSIONS Women with a history of childhood trauma may be at increased risk of engaging in RAI, highlighting the importance of screening and trauma-informed education in sexual health settings. Pathways linking childhood trauma and RAI among women are complex and warrant further research.
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Affiliation(s)
- Joy D Scheidell
- Department of Population Health, New York University School of Medicine, New York
| | - Typhanye P Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park
| | - MacRegga Severe
- Department of Population Health, New York University School of Medicine, New York
| | - Yazmeen E Tembunde
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park
| | - Kailyn E Young
- Department of Population Health, New York University School of Medicine, New York
| | - Maria R Khan
- Department of Population Health, New York University School of Medicine, New York
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Moeller RW, Seehuus M, Wahl L, Gratch I. Use of PrEP, sexual behaviors and mental health correlates in a sample of gay, bisexual and other men who have sex with men. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2019. [DOI: 10.1080/19359705.2019.1688216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Robert W. Moeller
- Department of Psychology, Middlebury College, Middlebury, Vermont, USA
| | - Martin Seehuus
- Department of Psychology, Middlebury College, Middlebury, Vermont, USA
- Department of Psychological Science, University of Vermont, Burlington, Vermont, USA
| | - Logan Wahl
- Department of Psychology, Middlebury College, Middlebury, Vermont, USA
| | - Ilana Gratch
- Department of Psychology, Middlebury College, Middlebury, Vermont, USA
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Nosrat S, Velez BL, Ciccolo JT. Psychological Distress and Risky Sexual Behavior in a Sample of Men Who Have Sex with Men in the United States. J Assoc Nurses AIDS Care 2019; 30:691-698. [PMID: 31633631 DOI: 10.1097/jnc.0000000000000035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liu J, Yi Z, Zhao Y, Qu B, Zhu Y. The psychological health and associated factors of men who have sex with men in China: A cross-sectional survey. PLoS One 2018; 13:e0197481. [PMID: 29813076 PMCID: PMC5973584 DOI: 10.1371/journal.pone.0197481] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/03/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives The psychological health of men who have sex with men (MSM) has received increased attention in recent years. We thus investigated the psychological status and associated factors among MSM in China. Methods A cross-sectional survey of 248 MSM was conducted from April to September 2015 using Symptom Checklist 90 (SCL-90) in Huludao and Zhengzhou, China. Statistical analyses utilized SPSS version 19.0 for Windows. Results All Cronbach’s α coefficients of the SCL-90 subscales exceeded 0.7, suggesting acceptable reliability. The coefficient range of the collective validity for all the subscales was >0.4. For the divisional validity, each item correlated better with the hypothetical subscale than with other subscales. Collective validity and divisional validity were both acceptable. The four most frequent types of psychological distress among MSM were depression, obsessive-compulsive behavior, interpersonal sensitivity, and anxiety. Results of the univariate analysis revealed that the following groups had significantly higher SCL-90 scores (P < 0.05): peasantry, married MSM, respondents who reported condomless anal intercourse and a greater number of male partners, and respondents who had not undergone psychosocial counseling and whose family or friends did not know about their sexual identity. In a multivariate logistic regression model, the following parameters were independently associated with higher SCL-90 scores: being married (AOR [adjusted odds ratio] = 3.19; 95% CI [confidence interval]: 1.96 to 5.93), condomless anal intercourse (AOR = 1.16; 95% CI: 1.02 to 1.31), number of male partners (AOR = 1.66 and 1.81; 95% CI: 1.08 to 2.34 and 1.32 to 2.69), family or friends not knowing about sexual identity (AOR = 2.13; 95% CI: 1.17 to 4.92), and lack of psychosocial counseling (AOR = 2.09; 95% CI: 1.06 to 4.09). Conclusions Our results indicate that psychological health problems among MSM in China are of concern. It is thus necessary to strengthen intervention efforts, with more emphasis on intervention programs to improve psychological health among Chinese MSM.
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Affiliation(s)
- Jie Liu
- Department of Health Statistics, School of public health, China Medical University, Shenyang, Liaoning Province, P.R. China
| | - Zhe Yi
- Department of Prothodontics, School of Stomatology, China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Yang Zhao
- Department of Health Statistics, School of public health, China Medical University, Shenyang, Liaoning Province, P.R. China
| | - Bo Qu
- Department of Health Statistics, School of public health, China Medical University, Shenyang, Liaoning Province, P.R. China
- * E-mail:
| | - Yaxin Zhu
- Department of Health Statistics, School of public health, China Medical University, Shenyang, Liaoning Province, P.R. China
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Abstract
While negative emotions are associated with risk behaviors and risk avoidance among people with HIV, emerging evidence indicates that negative self-conscious emotions, those evoked by self-reflection or self-evaluation (e.g., shame, guilt, and embarrassment), may differentially influence health-risk behaviors by producing avoidance or, conversely, pro-social behaviors. Positive emotions are associated with beneficial health behaviors, and may account for inconsistent findings related to negative self-conscious emotions. Using multinomial logistic regression, we tested whether positive emotion moderated the relationships between negative emotion and negative self-conscious emotions and level of condomless sex risk: (1) seroconcordant; (2) serodiscordant with undetectable viral load; and (3) serodiscordant with detectable viral load [potentially amplified transmission (PAT)] among people recently diagnosed with HIV (n = 276). While positive emotion did not moderate the relationship between negative emotion and condomless sex, it did moderate the relationship between negative self-conscious emotion and PAT (AOR = 0.60; 95% CI 0.41, 0.87); high negative self-conscious and high positive emotion were associated with lower PAT risk. Acknowledgment of both positive and negative self-conscious emotion may reduce transmission risk behavior among people with HIV.
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Brisson J. Reflections on the history of bareback sex through ethnography: the works of subjectivity and PrEP. Anthropol Med 2017; 26:345-359. [PMID: 29172667 DOI: 10.1080/13648470.2017.1365430] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Throughout the history of bareback sex (condomless sex between men), 'subjects' have been created, particularly through scientific literature, to characterise the men who engage in the sexual practice. For example, a gay man who does not use a condom may be framed as a pathologised subject. This paper first presents this history. Afterwards, by relying upon ethnographic data such as interviews collected from fieldwork research done in Toronto in 2014 with young gay men who have bareback sex, it shows exactly how these young gay men related themselves to those subjects. Then, it focuses on the pre-exposure prophylaxis (PrEP) Truvada as a new HIV prevention technology. Although PrEP can allow condomless sex to occur while diminishing the risk of HIV transmission, at the time of the research, none of the young gay men were interested in using this tool despite being the subjects for whom the drug is tailored. This paper argues that PrEP and subjectivity are coproduced and can have conflicting meanings. This contradiction of meanings is a result of the various representations and symbols of bareback sex and the men who engage in the practice that have been produced throughout the history of bareback sex.
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Affiliation(s)
- Julien Brisson
- Department of Social and Preventative Medicine, School of Public Health, University of Montreal, Montreal, Canada
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14
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Mitrani VB, De Santis JP, McCabe BE, Deleon DA, Gattamorta KA, Leblanc NM. The Impact of Parental Reaction to Sexual Orientation on Depressive Symptoms and Sexual Risk Behavior Among Hispanic Men Who Have Sex with Men. Arch Psychiatr Nurs 2017; 31:352-358. [PMID: 28693870 PMCID: PMC5721521 DOI: 10.1016/j.apnu.2017.04.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/15/2017] [Accepted: 04/09/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE This study examined the relationship of parent reaction to sexual orientation with depressive symptoms and safer sex among Hispanic adult men who have sex with men (MSM). We also examined men's acculturation to the U.S. (Americanism) in relation with these variables. METHOD Cross-sectional data collected from July 2011 to December 2012, from 125 MSM with a mean age of 43.02years. Instruments included the Perceived Parent Reaction Scale, the Centers for Epidemiological Studies Depression Scale, the Safer Sex Behavior Questionnaire and the Bidimensional Acculturation Scale. Data was analyzed using Hierarchical generalized linear models (GZLM). RESULTS Among men whose parents knew of their sexual orientation, rejection of son's sexual orientation from mother (p=0.032) and from father (p=0.004) was related to higher number of depressive symptoms. Parent reactions were not directly related to safer sex behaviors. Americanism was associated with lower depressive symptoms (p=0.001) but was not related to safer sex behaviors. CONCLUSIONS Current parent attitudes about their sons' sexual orientation had an effect on the sons' emotional wellbeing and acculturation may play a protective role. Mental health and primary care clinicians working with Hispanic MSM should assess for level of family support and provide resources to assist with disclosure and family acceptance of sexual orientation as indicated, particularly among recently immigrated men who may be at higher risk.
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Affiliation(s)
- Victoria B Mitrani
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA
| | - Joseph P De Santis
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA.
| | - Brian E McCabe
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA
| | - Diego A Deleon
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA
| | - Karina A Gattamorta
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA
| | - Natalie M Leblanc
- University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146, USA
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Morgan E, Nyaku AN, D’Aquila RT, Schneider JA. Determinants of HIV Phylogenetic Clustering in Chicago Among Young Black Men Who Have Sex With Men From the uConnect Cohort. J Acquir Immune Defic Syndr 2017; 75:265-270. [PMID: 28328553 PMCID: PMC5472497 DOI: 10.1097/qai.0000000000001379] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Phylogenetic analysis determines similarities among HIV genetic sequences from persons infected with HIV, identifying clusters of transmission. We determined characteristics associated with both membership in an HIV transmission cluster and the number of clustered sequences among a cohort of young black men who have sex with men (YBMSM) in Chicago. METHODS Pairwise genetic distances of HIV-1 pol sequences were collected during 2013-2016. Potential transmission ties were identified among HIV-infected persons whose sequences were ≤1.5% genetically distant. Putative transmission pairs were defined as ≥1 tie to another sequence. We then determined demographic and risk attributes associated with both membership in an HIV transmission cluster and the number of ties to the sequences from other persons in the cluster. RESULTS Of 86 available sequences, 31 (36.0%) were tied to ≥1 other sequence. Through multivariable analyses, we determined that those who reported symptoms of depression and those who had a higher number of confidants in their network had significantly decreased odds of membership in transmission clusters. We found that those who had unstable housing and who reported heavy marijuana use had significantly more ties to other individuals within transmission clusters, whereas those identifying as bisexual, those participating in group sex, and those with higher numbers of sexual partners had significantly fewer ties. CONCLUSIONS This study demonstrates the potential for combining phylogenetic and individual and network attributes to target HIV control efforts to persons with potentially higher transmission risk, as well as suggesting some unappreciated specific predictors of transmission risk among YBMSM in Chicago for future study.
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Affiliation(s)
- Ethan Morgan
- Department of Public Health Sciences, University of Chicago, Chicago, USA
| | - Amesika N Nyaku
- Department of Medicine, Northwestern University, Chicago, USA
| | | | - John A Schneider
- Department of Public Health Sciences, University of Chicago, Chicago, USA
- Department of Medicine, University of Chicago, Chicago, USA
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16
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Gasch Gallén Á, Tomás Aznar C, Rubio Aranda E. Assessing gender stereotypes and sexual risk practices in men who have sex with men. GACETA SANITARIA 2017. [PMID: 28648255 DOI: 10.1016/j.gaceta.2017.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To analyze the construct validity and the internal consistency of the 12-item Bem Sex Role Inventory (BSRI-12) questionnaire and to study the association between gender stereotypes and sexual risk practices in men who have sex with men (MSM). METHODS Cross-sectional study of 601 MSM who voluntarily and anonymously responded to an online survey on risk practices and gender stereotypes. The BSRI-12 was used to obtain gender stereotypes (masculine, feminine, undifferentiated and androgynous). For data analysis, exploratory factor analysis (EFA) of the BSRI-12 and logistic regression were performed. RESULTS Two main factors (Cronbach alpha 0.95 and 0.81) were obtained from the EFA. Using the androgynous roles as the reference category, we found lower odds of engaging in unprotected anal intercourse (UAI) among those who endorse feminine roles (OR: 0.53; 95%CI: 0.29-0.95). Endorsing masculine roles with alcohol consumption (OR: 1.92; 95%CI: 1.15-3.20) or the undifferentiated when not knowing the partner's serological status (OR: 1.55; 95%CI: 1.02-2.35) were associated with higher odds of UAI compared to those endorsing the androgynous roles. Undifferentiated participants also perform receptive UAI using poppers (OR: 2.19; 95%CI: 1.24-3.87), and insertive UAI not knowing the serological status of the sexual partner (OR: 1.69; 95%CI: 1.04-2.76) compared to androgynous participants. CONCLUSION The BSRI is a valid and consistent instrument for identifying gender stereotypes in MSM. A greater proportion of participants within the undifferentiated and the masculine category engage in risk practices with the influence of substance consumption and unawareness of their sexual partner's serological status. The information obtained may be useful to define intervention and prevention programs.
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Affiliation(s)
- Ángel Gasch Gallén
- Pyschiatry and Nursing Department, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
| | - Concepción Tomás Aznar
- Pyschiatry and Nursing Department, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Encarnación Rubio Aranda
- Microbiology, Preventive Medicine and Public Health Department, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
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17
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Millar BM, Starks TJ, Grov C, Parsons JT. Sexual Risk-Taking in HIV-Negative Gay and Bisexual Men Increases with Depression: Results from a U.S. National Study. AIDS Behav 2017; 21:1665-1675. [PMID: 27475943 PMCID: PMC5323369 DOI: 10.1007/s10461-016-1507-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The link between depression and sexual risk-taking has received mixed findings in the literature. The current study analyzed the links between depression and recent condomless anal sex (CAS) with casual partners among 1033 HIV-negative, non-PrEP-using, gay and bisexual men. When CAS was dichotomized as either none or some, depression was not associated with the odds of CAS (with receptive and insertive combined) or insertive CAS only, but was positively associated with the odds of receptive CAS. When CAS was tallied as a count variable of events, depression was positively associated with total CAS, receptive CAS, and insertive CAS. With the addition of a quadratic term for depression, a positive quadratic effect was only found for total CAS and receptive CAS, but not for insertive CAS. These findings highlight the utility of using count data for CAS events and treating CAS separately with regard to receptive and insertive positioning when considering the role of depression among gay and bisexual men.
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Affiliation(s)
- Brett M Millar
- Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center (CUNY), New York, NY, USA
| | - Tyrel J Starks
- Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center (CUNY), New York, NY, USA
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave., New York, NY, 10065, USA
| | - Christian Grov
- Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Jeffrey T Parsons
- Center for HIV/AIDS Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center (CUNY), New York, NY, USA.
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave., New York, NY, 10065, USA.
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Miltz AR, Rodger AJ, Sewell J, Speakman A, Phillips AN, Sherr L, Gilson RJ, Asboe D, Nwokolo NC, Clarke A, Gompels MM, Allan S, Collins S, Lampe FC. Clinically significant depressive symptoms and sexual behaviour among men who have sex with men. BJPsych Open 2017; 3:127-137. [PMID: 28507772 PMCID: PMC5421094 DOI: 10.1192/bjpo.bp.116.003574] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 01/13/2017] [Accepted: 03/06/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The relationship between depression and sexual behaviour among men who have sex with men (MSM) is poorly understood. AIMS To investigate prevalence and correlates of depressive symptoms (Patient Health Questionnaire-9 score ≥10) and the relationship between depressive symptoms and sexual behaviour among MSM reporting recent sex. METHOD The Attitudes to and Understanding of Risk of Acquisition of HIV (AURAH) is a cross-sectional study of UK genitourinary medicine clinic attendees without diagnosed HIV (2013-2014). RESULTS Among 1340 MSM, depressive symptoms (12.4%) were strongly associated with socioeconomic disadvantage and lower supportive network. Adjusted for key sociodemographic factors, depressive symptoms were associated with measures of condomless sex partners in the past 3 months (≥2 (prevalence ratio (PR) 1.42, 95% CI 1.17-1.74; P=0.001), unknown or HIV-positive status (PR 1.43, 95% CI 1.20-1.71; P<0.001)), sexually transmitted infection (STI) diagnosis (PR 1.46, 95% CI 1.19-1.79; P<0.001) and post-exposure prophylaxis use in the past year (PR 1.83, 95% CI 1.33-2.50; P<0.001). CONCLUSIONS Management of mental health may play a role in HIV and STI prevention. DECLARATION OF INTEREST A.N.P. has received payments for presentations made at meetings sponsored by Gilead in spring 2015. N.C.N. has received support for attendance at conferences, speaker fees and payments for attendance at advisory boards from Gilead Sciences, Viiv Healthcare, Janssen Pharmaceuticals and Bristol-Myers Squibb and a research grant from Gilead Sciences. D.A. served on the advisory board for Gilead in January 2016. M.M.G. has had sponsorship to attend conferences by Bristol-Myers Squibb, been on the BioCryst advisory board and run trials for Merck, Gilead, SSAT, BioCryst and Novartis. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
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Affiliation(s)
- Ada R. Miltz
- Ada R. Miltz, MSc, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Alison J. Rodger
- Alison J. Rodger, MD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Janey Sewell
- Janey Sewell, BNurs, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Andrew Speakman
- Andrew Speakman, PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Andrew N. Phillips
- Andrew N. Phillips, PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Lorraine Sherr
- Lorraine Sherr, PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Richard J. Gilson
- Richard J. Gilson, MBBS, Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, Mortimer Market Centre, University College London, London, UK
| | - David Asboe
- David Asboe, MBBS, John Hunter Clinic, London, UK
| | | | - Amanda Clarke
- Amanda Clarke, BM, Royal Sussex County Hospital, Brighton, UK
| | | | - Sris Allan
- Sris Allan, MBBS, City of Coventry Healthcare Centre, Coventry, UK
| | | | - Fiona C. Lampe
- Fiona C. Lampe, PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK, for the AURAH Study Group
| | - for the AURAH Study Group
- Ada R. Miltz, MSc, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
- Alison J. Rodger, MD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
- Janey Sewell, BNurs, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
- Andrew Speakman, PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
- Andrew N. Phillips, PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
- Lorraine Sherr, PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
- Richard J. Gilson, MBBS, Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, Mortimer Market Centre, University College London, London, UK
- David Asboe, MBBS, John Hunter Clinic, London, UK
- Nneka C. Nwokolo, MBBS, 56 Dean Street, London, UK
- Amanda Clarke, BM, Royal Sussex County Hospital, Brighton, UK
- Mark M. Gompels, MBBS, Southmead Hospital, Bristol, UK
- Sris Allan, MBBS, City of Coventry Healthcare Centre, Coventry, UK
- Simon Collins, advocate, HIV i-Base, London, UK
- Fiona C. Lampe, PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK, for the AURAH Study Group
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Latkin CA, Van Tieu H, Fields S, Hanscom BS, Connor M, Hanscom B, Hussen SA, Scott HM, Mimiaga MJ, Wilton L, Magnus M, Chen I, Koblin BA. Social Network Factors as Correlates and Predictors of High Depressive Symptoms Among Black Men Who Have Sex with Men in HPTN 061. AIDS Behav 2017; 21:1163-1170. [PMID: 27480454 PMCID: PMC5288401 DOI: 10.1007/s10461-016-1493-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Depression is linked to a range of poor HIV-related health outcomes. Minorities and men who have sex with men (MSM), suffer from high rates of depression. The current study examined the relationship between depressive symptoms and social network characteristics among community-recruited Black MSM in HPTN 061 from 6 US cities. A social network inventory was administer at baseline and depression was assessed with the CES-D at baseline, 6, and 12-months. At baseline, which included 1167 HIV negative and 348 HIV positive participants, size of emotional, financial, and medical support networks were significantly associated with fewer depressive symptoms. In longitudinal mixed models, size of emotional, financial, and medical support networks were significantly associated with fewer depressive symptoms as was the number of network members seen weekly. In the multivariate analyses, size of medical appointment network remained statistically significant (aOR 0.89, CI 0.81-0.98). These findings highlight the importance of network support of medical care on depression and suggest the value of support mobilization.
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Affiliation(s)
- Carl A Latkin
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 737 Hampton House, Baltimore, MD, 21205, USA.
| | - Hong Van Tieu
- School of Medicine, Columbia University, New York, NY, USA
| | - Sheldon Fields
- Mervyn M. Dymally School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Brett S Hanscom
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Matt Connor
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Brett Hanscom
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sophia A Hussen
- Hubert Department of Global Health, Rollins School of Public Health Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA
| | - Hyman M Scott
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Matthew J Mimiaga
- Department of Behavioral & Social Health Sciences and Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
| | - Manya Magnus
- Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, USA
| | - Iris Chen
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention Member, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
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The Road Less Travelled: Exploring Gay and Bisexual Men's Explanations of 'Uncommon' Routes of HIV Transmission. AIDS Behav 2016; 20:2266-2274. [PMID: 26781867 DOI: 10.1007/s10461-016-1289-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although there are practices other than condomless anal intercourse that may result in HIV transmission among gay and bisexual men, very little is known about these 'uncommon' transmission explanations. To address this topic, the free text survey responses from 465 HIV positive gay men in Australia were thematically analysed; 123 participants offered uncommon explanations for their seroconversion. Men described several sexual acts they believed led to infection, categorised as adventurous sex (e.g., fisting) and foreplay (e.g., oral sex). Participants also identified mediating factors associated with their seroconversion, either internal (e.g., cum/pre-cum) or external (e.g., sores, illness) to sex. Finally, contextual forces associated with infection were also explored, namely physical spaces (e.g., sex on premises venues) or mental states (e.g., depression). While some uncommon explanations are unlikely to have resulted in HIV transmission, these accounts reveal the diverse and intersecting ways that men attempt to make sense of their seroconversion.
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21
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Rasmussen LD, Kronborg G, Larsen CS, Pedersen C, Gerstoft J, Obel N, Pottegård A. Use of non-antiretroviral drugs among individuals with and without HIV-infection: a Danish nationwide study. Infect Dis (Lond) 2016; 49:42-54. [PMID: 27686116 DOI: 10.1080/23744235.2016.1212168] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AIM We investigated the use of non-antiretroviral drugs in the HIV-infected compared to the general population. METHODS From the Danish HIV Cohort Study, we identified all HIV-infected individuals older than 18 years at HIV diagnosis who received care in Denmark through 1995-2013 and reported no injection drug abuse or hepatitis C infection. Population controls were identified from The Danish Civil Registration System and matched on age and gender (5:1). We analyzed the proportion of individuals who redeemed 0-1, 2-4, 5-9, or 10 or more non-antiretroviral drugs. Data were analyzed according to calendar time, age, time from initiation of combination antiretroviral therapy (cART) and stratified by gender, geographical origin and route of HIV transmission. We further analyzed the use of the 25 most used non-antiretroviral drug classes. RESULTS We identified 4,928 HIV-infected individuals (median age: 37; 76.4% males). Overall, the HIV-infected population had a higher use of non-antiretroviral drugs compared to the background population. Whereas, the use of non-antiretroviral drugs in the HIV-infected population only changed marginally with time, the use in the background population increased considerably. Thus, use in the HIV-infected population only differed marginally from that of the background population in recent years. This difference was most pronounced in men who have sex with men (MSM). CONCLUSION Compared to the background population, HIV infected individuals have increased use of non-antiretroviral drugs. The excess use is mainly observed in MSM and has decreased with calendar time, why it in recent years only differs marginally from that observed in the background population.
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Affiliation(s)
- Line D Rasmussen
- a Department of Infectious Diseases , Odense University Hospital , Odense , Denmark
| | - Gitte Kronborg
- b Department of Infectious Diseases , Copenhagen University Hospital , Hvidovre , Denmark
| | - Carsten S Larsen
- c Department of Infectious Diseases , Aarhus University Hospital , Skejby , Denmark
| | - Court Pedersen
- a Department of Infectious Diseases , Odense University Hospital , Odense , Denmark
| | - Jan Gerstoft
- d Department of Infectious Diseases , Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark
| | - Niels Obel
- d Department of Infectious Diseases , Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark
| | - Anton Pottegård
- e Clinical Pharmacology, Department of Public Health , University of Southern Denmark , Odense , Denmark
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Yi S, Tuot S, Chhoun P, Pal K, Choub SC, Mburu G. Mental health among men who have sex with men in Cambodia: Implications for integration of mental health services within HIV programmes. Int J Equity Health 2016; 15:53. [PMID: 27009628 PMCID: PMC4806506 DOI: 10.1186/s12939-016-0342-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 03/15/2016] [Indexed: 01/09/2023] Open
Abstract
Background Poor mental health contributes to poor HIV prevention, treatment and care outcomes. This paper documents factors associated with psychological distress among men who have sex with men (MSM) in Cambodia and discusses potential ways in which routine mental health management could be integrated into HIV services. Methods A cross-sectional study was conducted in 2014 among 394 MSM randomly selected from two provinces using a two-stage cluster sampling method. A structured questionnaire was used to assess psychological distress, sexual behaviors, substance use, adverse childhood experiences and family dysfunction. Multivariate logistic regression analysis was performed to explore factors associated with levels of psychological distress. Results In total, 10.7 % of the respondents reported having suicidal thoughts and 6.6 % reported having attempted to commit suicide in the past three months, while 38.8 % had a higher level of psychological distress (GHQ-12 > 3), which indicates poor mental health. Higher levels of psychological distress were independently associated with older age (AOR = 1.09, 95 % CI 1.03–1.14), alcohol use (AOR = 3.3, 95 % CI 1.36–7.83), illicit drug use (AOR = 3.53, 95 % CI 1.12–11.18), poor self-reported quality of life (AOR = 7.45, 95 % CI 1.79–3.04), and reduced condom use at last sex (AOR = 0.40, 95 % CI 0.21–0.73). MSM with higher levels of psychological distress were significantly more likely to report that a family member said hurtful things to them (AOR = 1.80, 95 % CI 1.10–2.97), a parent or guardian had been physically abused (AOR = 3.51, 95 % CI 1.86–6.62), and a family member had been mentally ill (AOR = 4.01, 95 % CI 2.06–7.81) when they were growing up. Conclusions In order to mitigate psychological distress among MSM in Cambodia, integration of mental health interventions within HIV programmes should be strengthened. To achieve optimal impact, these interventions should also address alcohol and other substance use, and low condom use among distressed MSM. In addition, training of clinical and non-clinical HIV service providers to screen for mental health symptoms, and subsequent provision of peer-based outreach and social support for MSM identified with psychological distress is required.
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Affiliation(s)
- Siyan Yi
- Research Department, KHANA, Phnom Penh, Cambodia
| | | | - Pheak Chhoun
- Programs Department, KHANA, Phnom Penh, Cambodia
| | | | | | - Gitau Mburu
- Program Impact Unit, International HIV/AIDS Alliance, Brighton, UK. .,Department of Health Research, Lancaster University, Lancaster, UK.
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23
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Williams JK, Wilton L, Magnus M, Wang L, Wang J, Dyer TP, Koblin BA, Hucks-Ortiz C, Fields SD, Shoptaw S, Stephenson R, O'Cleirigh C, Cummings V. Relation of Childhood Sexual Abuse, Intimate Partner Violence, and Depression to Risk Factors for HIV Among Black Men Who Have Sex With Men in 6 US Cities. Am J Public Health 2015; 105:2473-81. [PMID: 26469666 DOI: 10.2105/ajph.2015.302878] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed the relation of childhood sexual abuse (CSA), intimate partner violence (IPV), and depression to HIV sexual risk behaviors among Black men who have sex with men (MSM). METHODS Participants were 1522 Black MSM recruited from 6 US cities between July 2009 and December 2011. Univariate and multivariable logistic regression models were used. RESULTS Participants reported sex before age 12 years with someone at least 5 years older (31.1%), unwanted sex when aged 12 to 16 years (30%), IPV (51.8%), and depression (43.8%). Experiencing CSA when aged 12 to 16 years was inversely associated with any receptive condomless anal sex with a male partner (adjusted odds ratio [AOR] = 0.50; 95% confidence interval [CI] = 0.29, 0.86). Pressured or forced sex was positively associated with any receptive anal sex (AOR = 2.24; 95% CI = 1.57, 3.20). Experiencing CSA when younger than 12 years, physical abuse, emotional abuse, having been stalked, and pressured or forced sex were positively associated with having more than 3 male partners in the past 6 months. Among HIV-positive MSM (n = 337), CSA between ages 12 and 16 years was positively associated with having more than 3 male partners in the past 6 months. CONCLUSIONS Rates of CSA, IPV, and depression were high, but associations with HIV sexual risk outcomes were modest.
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Affiliation(s)
- John K Williams
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Leo Wilton
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Manya Magnus
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Lei Wang
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Jing Wang
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Typhanye Penniman Dyer
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Beryl A Koblin
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Christopher Hucks-Ortiz
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Sheldon D Fields
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Steve Shoptaw
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Rob Stephenson
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Conall O'Cleirigh
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Vanessa Cummings
- John K. Williams is with the Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Leo Wilton is with College of Community and Public Affairs, Department of Human Development, Binghamton University, Binghamton, NY. Manya Magnus is with the Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington, DC. Lei Wang and Jing Wang are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Typhanye Penniman Dyer is with the Department of Epidemiology and Biostatistics, University of Maryland, College Park. Beryl A. Koblin is with New York Blood Center, Laboratory of Infectious Disease Prevention, New York, NY. Christopher Hucks-Ortiz is with the Department of Family Medicine, UCLA. Sheldon D. Fields is with the Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami. Steve Shoptaw is with the departments of Family Medicine and Psychiatry and Biobehavioral Sciences, UCLA. Rob Stephenson is with the Rollins School of Public Health, Emory University, Atlanta, GA. Conall O'Cleirigh is with Fenway Institute HIV Clinical Research Support (CRS), Fenway Community Health Center, Boston, MA. Vanessa Cummings is with the Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD
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Stahlman S, Grosso A, Ketende S, Sweitzer S, Mothopeng T, Taruberekera N, Nkonyana J, Baral S. Depression and Social Stigma Among MSM in Lesotho: Implications for HIV and Sexually Transmitted Infection Prevention. AIDS Behav 2015; 19:1460-9. [PMID: 25969182 PMCID: PMC4858167 DOI: 10.1007/s10461-015-1094-y] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Social stigma is common among men who have sex with men (MSM) across Sub-Saharan Africa, and may influence risks for HIV and sexually transmitted infections (STIs) via its association with depression. We conducted a cross-sectional study of 530 MSM in Lesotho accrued via respondent-driven sampling. Using generalized structural equation models we examined associations between stigma, social capital, and depression with condom use and testing positive for HIV/STIs. Depression was positively associated with social stigma experienced or perceived as a result of being MSM. In contrast, increasing levels of social cohesion were negatively associated with depression. Social stigma was associated with testing positive for HIV; however, this association did not appear to be mediated by depression or condom use. These data suggest a need for integrated HIV and mental health care that addresses stigma and discrimination and facilitates positive social support for MSM.
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Affiliation(s)
- Shauna Stahlman
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, E7133, 615 N. Washington St., Baltimore, MD, 21205, USA,
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25
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Downing MJ, Chiasson MA, Hirshfield S. Recent anxiety symptoms and drug use associated with sexually transmitted infection diagnosis among an online US sample of men who have sex with men. J Health Psychol 2015; 21:2799-2812. [PMID: 26063210 DOI: 10.1177/1359105315587135] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The extent to which mental health problems, including current anxiety and depressive symptoms, may co-occur, or are associated, with the acquisition of sexually transmitted infections other than HIV remains largely unexplored among men who have sex with men. In a cross-sectional survey of 8,381 US men who have sex with men recruited from a sexual networking website, 15 percent reported a past 60-day sexually transmitted infection diagnosis. Among HIV-negative men, increased odds of reporting a sexually transmitted infection were associated with current anxiety symptoms and past 60-day drug use. Findings underscore the need to better understand causal pathways among anxiety, drug use, and sexually transmitted infection acquisition and transmission among men who have sex with men.
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Halkitis PN, Kapadia F, Bub KL, Barton S, Moreira AD, Stults CB. A Longitudinal Investigation of Syndemic Conditions Among Young Gay, Bisexual, and Other MSM: The P18 Cohort Study. AIDS Behav 2015; 19:970-80. [PMID: 25192900 DOI: 10.1007/s10461-014-0892-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The persistence of disparities in STI/HIV risk among a new generation of emerging adult gay, bisexual, and other men who have sex with men (YMSM) warrant holistic frameworks and new methodologies for investigating the behaviors related to STI/HIV in this group. In order to better understand the continued existence of these disparities in STI/HIV risk among YMSM, the present study evaluated the presence and persistence of syndemic conditions among YMSM by examining the co-occurrence of alcohol and drug use, unprotected sexual behavior, and mental health burden over time. Four waves of data, collected over the first 18 months of a 7 wave, 36-month prospective cohort study of YMSM (n=600) were used to examine the extent to which measurement models of drug use, unprotected sexual behavior, and mental health burden remained consistent across time using latent class modeling. Health challenges persisted across time as these YMSM emerged into young adulthood and the measurement models for the latent constructs of drug use and unprotected sexual behavior were essentially consistent across time whereas models for mental health burden varied over time. In addition to confirming the the robustness of our measurement models which capture a more holistic understandings of the health conditions of drug use, unprotected sex, and mental health burden, these findings underscore the ongoing health challenges YMSM face as they mature into young adulthood. These ongoing health challenges, which have been understood as forming a syndemic, persist over time, and add further evidence to support ongoing and vigilant comprehensive health programming for sexual minority men that move beyond a sole focus on HIV.
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The gap of masculinity in the research on HIV among men who have sex with men: A review of quantitative literature and theoretical contributions on gender and masculinity approaches. SOCIAL THEORY & HEALTH 2015. [DOI: 10.1057/sth.2015.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Hightow-Weidman LB, Muessig KE, Pike EC, LeGrand S, Baltierra N, Rucker AJ, Wilson P. HealthMpowerment.org: Building Community Through a Mobile-Optimized, Online Health Promotion Intervention. HEALTH EDUCATION & BEHAVIOR 2015; 42:493-9. [PMID: 25588932 DOI: 10.1177/1090198114562043] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Both young Black men who have sex with men as well as young Black transgender women (YBMSM/TW) continue to experience a significant increase in HIV incidence. HealthMpowerment.org (HMP) is a mobile phone-optimized, online intervention for both YBMSM/TW to build community and facilitate supportive relationships. METHODS To assess the feasibility, acceptability, and preliminary outcomes, a 1-month pilot trial of HMP among 15 YBMSM/TW was conducted. RESULTS Retention was 100%. Mean age was 26 years, 60% were HIV-infected, 87% earned <$21,000, and 67% were uninsured. Despite the small sample size and limited intervention length, statistically significant improvements were seen in social support (p = .012), social isolation (p = .050), and depressive symptoms (p = .045). CONCLUSION The HMP pilot trial demonstrated feasibility and acceptability. Given the burden of the epidemic among YBMSM/TW, there is an imperative to develop, test, and scale up culturally appropriate interventions to both prevent HIV acquisition and limit onward transmission.
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Affiliation(s)
| | | | - Emily C Pike
- University of North Carolina at Chapel Hill, NC, USA
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29
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Patel SK, Prabhakar P, Saggurti N. Factors Associated with Mental Depression among Men Who Have Sex with Men in Southern India. Health (London) 2015. [DOI: 10.4236/health.2015.79127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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30
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Shiu C, Chen Y, Tseng P, Chung A, Wu M, Hsu S, Ko N. Curvilinear Relationship Between Depression and Unprotected Sexual Behaviors among Men Who Have Sex with Men. J Sex Med 2014; 11:2466-73. [DOI: 10.1111/jsm.12638] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Rasmussen LD, Obel D, Kronborg G, Larsen CS, Pedersen C, Gerstoft J, Obel N. Utilization of psychotropic drugs prescribed to persons with and without HIV infection: a Danish nationwide population-based cohort study. HIV Med 2014; 15:458-69. [DOI: 10.1111/hiv.12135] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2014] [Indexed: 11/30/2022]
Affiliation(s)
- LD Rasmussen
- Department of Infectious Diseases; Odense University Hospital; Odense Denmark
| | - D Obel
- Private Clinic of Child and Adolescent Psychiatry; Aarhus Denmark
| | - G Kronborg
- Department of Infectious Diseases; Copenhagen University Hospital; Hvidovre Denmark
| | - CS Larsen
- Department of Infectious Diseases; Aarhus University Hospital; Skejby Denmark
| | - C Pedersen
- Department of Infectious Diseases; Odense University Hospital; Odense Denmark
| | - J Gerstoft
- Department of Infectious Diseases; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
| | - N Obel
- Department of Infectious Diseases; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
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Klein H. Depression and HIV Risk Taking among Men Who Have Sex with Other Men (MSM) and Who Use the Internet to Find Partners for Unprotected Sex. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2013; 18:164-189. [PMID: 26877831 DOI: 10.1080/19359705.2013.834858] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE This study examines the prevalence of depression in a sample of MSM who are at high risk for HIV. It examines the relationship between depressive symptomatology and involvement in HIV risk behaviors, and the factors associated with greater depressive symptomatology. METHODS The data come from a national random sample of 332 MSM who used any of 16 websites to identify men with whom they could engage in unprotected sex. Data were collected via telephone interviews. RESULTS Depression was more prevalent in this population (26.7%) than among men in the general population. Depression was not related directly to any of the HIV risk behaviors examined, but it was related to men's attitudes toward condom use, which was the strongest predictor of their involvement in risky behaviors. Five factors were identified as being associated with greater depression: lower educational attainment, greater discrimination based on sexual orientation, greater eroticizing of ejaculatory fluids, experiencing more substance abuse problems, and greater childhood maltreatment. CONCLUSIONS Depression is a consequential problem in this population. Although depression does not appear to be related directly to HIV risk practices in this population, its influence cannot be discounted because of its effects on other key predictors of risk involvement.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, 401 Schuyler Road, Silver Spring, MD 20910,
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Sexual partnership types as determinant of HIV risk in South African MSM: an event-level cluster analysis. AIDS Behav 2013; 17 Suppl 1:S23-32. [PMID: 22956229 DOI: 10.1007/s10461-012-0294-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
While individual determinants of HIV risk among MSM have been widely studied, there is limited understanding of how relational characteristics determine sexual risk. Based on data collected among 300 South African men who have sex with men (MSM) and using cluster analysis, this study developed a typology of four partnership types: the "Race-Economic Similar," "Age-Race-Economic Discordant," "Non-regular Neighbourhood," and "Familiar" partnership types. Support for the meaningfulness of these types was found through associations of these partnership types with participant characteristics and characteristics of the last anal sex event. Furthermore, in a multivariate analysis, only partnership type independently predicted whether the last anal sex event was unprotected. Findings of the study illustrate the importance of taking into account the relational context in understanding unprotected sexual practices and present ways to target intervention efforts as well as identify relationship specific determinants of unprotected sex.
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Klein H. Mental Health Functioning Among Men who Use the Internet Specifically to Find Partners for Unprotected Sex. Ment Illn 2013; 5:e6. [PMID: 25478130 PMCID: PMC4253389 DOI: 10.4081/mi.2013.e6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 03/15/2013] [Indexed: 11/23/2022] Open
Abstract
Previous studies have shown a link between mental health functioning and involvement in HIV risk practices. The present research examines how well one specific group of men who have sex with other men (MSM) fare in terms of their mental health functioning, and then focuses on how mental health functioning relates to HIV risk practices in this population. The study was based on a national random sample of 332 MSM who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Depression is more common among men in this population than in the adult male population-at-large. All other measures of mental health functioning that were examined (self-esteem, impulsivity, current life satisfaction, optimism about the future) indicated low rates of mental health problem. Contrary to expectations, in nearly all instances, mental health functioning was not related to HIV risk practices. More work needs to be done to understand the causes of depression among these men, and to assess how, if at all, depression relates to risk practices in this population. These findings suggest that factors other than mental health problems must be considered if one wishes to understand HIV risk taking in this population.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, Silver Spring, MD, USA
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