1
|
Frank K. Rethinking Risk, Culture, and Intervention in Collective Sex Environments. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:3-30. [PMID: 29748787 DOI: 10.1007/s10508-018-1153-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 11/28/2017] [Accepted: 01/11/2018] [Indexed: 05/16/2023]
Abstract
This article provides a narrative overview of research on HIV/STI risk and collective sexual behavior based on an inclusive analysis of research on environments where people gather for sexual activity-sex clubs, swingers' clubs, bathhouses, parks, private sex parties, etc. The aim is to analyze how collective sex has been approached across disciplines to promote conversation across paradigms and suggest new lines of inquiry. Attention to context-such as the location of sex-was a necessary redress to universalizing models of sexual risk-taking behavior, leading to insights rooted in the particularities of each environment and its users. However, the identification of ever more precise risk groups or environmental idiosyncrasies eventually becomes theoretically restrictive, leading to an overestimation of the uniqueness of sexual enclaves, and of the difference between any given enclave and the broader social milieu. Using a theoretical framework of transgression to interpret the interdisciplinary literature, similarities in the spatial and social organization of collective sex environments are identified. Insights generated from this complementary perspective are then applied to understandings of collective sex: first, the example of male-female (MF) "swingers" is used to illustrate the need to establish, rather than assume, the distinctiveness of each non-normative sexual enclave, and to broaden the conceptualization of context; second, questions are raised about the practicality of interventions in collective sex environments. Finally, new lines of intellectual inquiry are suggested to shed light not just on collective sex but on sociosexual issues more generally, such as increasing protective sexual health behavior or negotiating consent in sexual encounters.
Collapse
Affiliation(s)
- Katherine Frank
- Department of Sociology, University of Nevada, Las Vegas, Las Vegas, NV, 89557, USA.
| |
Collapse
|
2
|
Wilkerson JM, Noor SW, Rhoton JM, Li D, Rosser BRS. Differentially classified methamphetamine-using men who have sex with men: A latent class analysis. Drug Alcohol Depend 2018; 192:129-136. [PMID: 30248559 PMCID: PMC6746229 DOI: 10.1016/j.drugalcdep.2018.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 06/30/2018] [Accepted: 07/03/2018] [Indexed: 12/19/2022]
Abstract
CONTEXT Substance use interventions for methamphetamine-using men who have sex with men (MSM) are limited by the assumption that they are a uniform group. We hypothesized that an LCA would identify distinct patterns of substance use and demographic and psychosocial variables associated with different substance-using groups would aid in understanding distinctions. Using cross-sectional data from 343 methamphetamine-using MSM, we conducted an LCA to model the patterns of polysubstance use then examined how the classes varied on psychosocial variables defined by the Information-Motivation-Behavioral Skills (IMB) model. FINDINGS Because we were interested in identifying patterns of polysubstance use (PSU) among our sample, we identified four classes: minimal PSU, marijuana PSU, cocaine/hallucinogens PSU, and designer drugs/heroin PSU. Men in the marijuana PSU class were less likely to have positive attitudes towards methamphetamine than participants in the other three classes. Men in the Cocaine and Hallucinogens PSU class were more likely to have higher PANAS scores (OR = 13.00 [3.25, 52.07]) compared to the other classes, and they were more likely to have higher self-efficacy to enact safer substance use strategies (OR = 10.72 [3.23, 35.47]). MSM in the Designer Drug and Heroin PSU class were more likely to have a diagnosis of Hepatitis B (OR = 4.07 [0.86, 19.36] despite having higher knowledge of sexual health practices (OR = 0.55 [0.36, 0.84]. CONCLUSIONS Differential classification for methamphetamine-using MSM suggests an opportunity for tailored interventions and secondary prevention programs. By understanding how men vary on illicit substance use, interventionists can routinely screen and link men before they potentially progress to another classification.
Collapse
Affiliation(s)
- J. Michael Wilkerson
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 7000 Fannin St #1200, Houston, TX, 77030, USA
| | - Syed W. Noor
- Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada
| | - Jayson M. Rhoton
- The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 7000 Fannin St #1200, Houston, TX, 77030, USA
| | - Dennis Li
- Northwestern University, 633 Clark St., Evanston, IL, 60208, USA
| | - B. R. Simon Rosser
- University of Minnesota School of Public Health, 420 Delaware St. SE, Minneapolis, MN 55455, USA
| |
Collapse
|
3
|
Jeffries WL, Greene KM, Paz-Bailey G, McCree DH, Scales L, Dunville R, Whitmore S. Determinants of HIV Incidence Disparities Among Young and Older Men Who Have Sex with Men in the United States. AIDS Behav 2018; 22:2199-2213. [PMID: 29633094 DOI: 10.1007/s10461-018-2088-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This study sought to determine why young men who have sex with men (MSM) have higher HIV incidence rates than older MSM in the United States. We developed hypotheses that may explain this disparity. Data came from peer-reviewed studies published during 1996-2016. We compared young and older MSM with respect to behavioral, clinical, psychosocial, and structural factors that promote HIV vulnerability. Compared with older MSM, young MSM were more likely to have HIV-discordant condomless receptive intercourse. Young MSM also were more likely to have "any" sexually transmitted infection and gonorrhea. Among HIV-positive MSM, young MSM were less likely to be virally suppressed, use antiretroviral therapy, and be aware of their infection. Moreover, young MSM were more likely than older MSM to experience depression, polysubstance use, low income, decreased health care access, and early ages of sexual expression. These factors likely converge to exacerbate age-associated HIV incidence disparities among MSM.
Collapse
Affiliation(s)
- William L Jeffries
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA.
- Centers for Disease Control and Prevention, 1600 Clifton Road, MS E40, Atlanta, GA, 30333, USA.
| | - Kevin M Greene
- Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Gabriela Paz-Bailey
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Donna Hubbard McCree
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Lamont Scales
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Richard Dunville
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Suzanne Whitmore
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| |
Collapse
|
4
|
Coleman CL. Qualitative Perspectives about Living with HIV from Seropositive African American MSM Aged 50 years and Older. Issues Ment Health Nurs 2017; 38:486-492. [PMID: 28605244 DOI: 10.1080/01612840.2017.1284969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
It has nearly been more than three decades; yet, the research on aging seropositive African American men who have sex with men (MSM) is scarce. Exploring issues for an aging population of seropositive MSM is critical given that earlier epidemiological data suggested that by 2015, half of the AIDS cases will be in adults aged 50 years and older. A qualitative approach with the aim to examine perspectives about HIV risk from a group of seropositive African American MSM 50 years of age and older was conducted. Two separate focus groups with a total N = 30 were conducted. Four themes emerged: feeling left out, no place to call home, not a priority, and no one to grow older with.
Collapse
Affiliation(s)
- Christopher Lance Coleman
- a Institute on Aging, University of Pennsylvania School of Nursing , Philadelphia , Pennsylvania , USA
| |
Collapse
|
5
|
Viswanath H, Wilkerson JM, Breckenridge E, Selwyn BJ. Life Chaos and Perceived Social Support Among Methamphetamine-Using Men Who Have Sex With Men Engaging in Transactional Sexual Encounters. Subst Use Misuse 2017; 52:100-107. [PMID: 27679931 PMCID: PMC5344650 DOI: 10.1080/10826084.2016.1222620] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Social support and life chaos have been inversely associated with increased risk of HIV infection. The purpose of this study was to explore among a sample of HIV-negative methamphetamine-using men who have sex with men (MSM) the association between engaging in transactional sex, life chaos, and low social support. METHODS HIV-negative methamphetamine-using MSM completed an online questionnaire between July and October 2012 about recent substance use and sexual behavior. Bivariate and multivariate tests were used to obtain statistically significant associations between demographic characteristics, engaging in transactional sex, life chaos, and the participants' perception of their social support. RESULTS Of the 325 participants, 23.7% reported engaging in transactional sex, 45.2% reported high life chaos, and 53.5% reported low perceived social support. Participants who engaged in transactional sex were more likely to have high life chaos than participants who did not (aOR = 1.70, 95% CI = [1.01, 2.84]); transactional sex was not associated with social support. Participants with high life chaos were more out about their sexual orientation (aOR = 2.29, 95% CI = [1.18, 4.42]) and more likely to perceive they had low social support (aOR = 3.78, 95% CI = [2.31, 6.22]) than participants with low life chaos. Non-Latinos perceived they had less social support than Latinos (aOR = 0.48, 95% CI = [0.25, 0.92]). CONCLUSIONS Methamphetamine-using MSM engaging in transactional sex experience more life chaos than those who do not engage in transactional sex. Outness, perceived social support, and ethnicity are associated with life chaos.
Collapse
Affiliation(s)
- Humsini Viswanath
- a Center for Health Promotion and Prevention Research , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - J Michael Wilkerson
- a Center for Health Promotion and Prevention Research , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Ellen Breckenridge
- a Center for Health Promotion and Prevention Research , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Beatrice J Selwyn
- a Center for Health Promotion and Prevention Research , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| |
Collapse
|
6
|
Underhill K, Morrow KM, Colleran C, Calabrese SK, Operario D, Salovey P, Mayer KH. Explaining the Efficacy of Pre-exposure Prophylaxis (PrEP) for HIV Prevention: A Qualitative Study of Message Framing and Messaging Preferences Among US Men Who have Sex with Men. AIDS Behav 2016; 20:1514-26. [PMID: 25963772 PMCID: PMC4643421 DOI: 10.1007/s10461-015-1088-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We investigated message comprehension and message framing preferences for communicating about PrEP efficacy with US MSM. We conducted eight focus groups (n = 38) and n = 56 individual interviews with MSM in Providence, RI. Facilitators probed comprehension, credibility, and acceptability of efficacy messages, including percentages, non-numerical paraphrases, efficacy ranges versus point estimates, and success- versus failure-framed messages. Our findings indicated a range of comprehension and operational understandings of efficacy messages. Participants tended to prefer percentage-based and success-framed messages, although preferences varied for communicating about efficacy using a single percentage versus a range. Participants reported uncertainty about how to interpret numerical estimates, and many questioned whether trial results would predict personal effectiveness. These results suggest that providers and researchers implementing PrEP may face challenges in communicating with users about efficacy. Efforts to educate MSM about PrEP should incorporate percentage-based information, and message framing decisions may influence message credibility and overall PrEP acceptability.
Collapse
Affiliation(s)
- Kristen Underhill
- Yale Center for Interdisciplinary Research on AIDS, Yale University, 135 College St, Suite 200, New Haven, CT, 06510, USA.
- Yale Law School, Yale University, P.O. Box 208215, New Haven, CT, 06520, USA.
| | - Kathleen M Morrow
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Christopher Colleran
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Sarah K Calabrese
- Yale Center for Interdisciplinary Research on AIDS, Yale University, 135 College St, Suite 200, New Haven, CT, 06510, USA
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Don Operario
- Program in Public Health, Brown University, Providence, RI, USA
| | - Peter Salovey
- Department of Psychology, Yale University, New Haven, CT, USA
| | | |
Collapse
|
7
|
Rönn M, White PJ, Hughes G, Ward H. Developing a conceptual framework of seroadaptive behaviors in HIV-diagnosed men who have sex with men. J Infect Dis 2015; 210 Suppl 2:S586-93. [PMID: 25381379 PMCID: PMC4231642 DOI: 10.1093/infdis/jiu482] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Seroadaptive behaviors are strategies employed by men who have sex with men (MSM) to reduce the transmission risk for human immunodeficiency virus (HIV). It has been suggested that they contribute to the increasing diagnoses of sexually transmitted infections in HIV-diagnosed MSM. To understand the context in which the reemerging sexually transmitted infections appear, we developed a social epidemiological model incorporating the multiple factors influencing seroadaptive behaviors. METHODS A literature review of seroadaptive behaviors in HIV-diagnosed MSM was conducted. The literature was synthesized using a social epidemiological perspective. RESULTS Seroadaptive behaviors are adopted by MSM in high-income countries and are a way for HIV-diagnosed men to manage and enjoy their sexual lives. Influences are apparent at structural, community, interpersonal, and intrapersonal levels. There is little evidence of whether and when the behavior forms part of a premeditated strategy; it seems dependent on the social context and on time since HIV diagnosis. Social rules of HIV disclosure and perception of risk depend on the setting where partners are encountered. CONCLUSIONS Seroadaptive behaviors are strongly context dependent and can reduce or increase transmission risk for different infectious diseases. Further data collection and mathematical modeling can help us explore the specific conditions in more detail.
Collapse
Affiliation(s)
- Minttu Rönn
- Department of Infectious Disease Epidemiology
| | - Peter J White
- MRC Centre for Outbreak Analysis and Modelling and NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control
| | - Gwenda Hughes
- STI Section, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
| | - Helen Ward
- Department of Infectious Disease Epidemiology
| |
Collapse
|
8
|
Reback CJ, Fletcher JB. Reductions in HIV prevalence rates among substance-using men who have sex with men in Los Angeles County, 2008-2011. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2014; 26:459-470. [PMID: 25299809 PMCID: PMC7685050 DOI: 10.1521/aeap.2014.26.5.459] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
An outreach program performed street encounters with 5,599 unique substance-using MSM from January 2008 through December 2011. HIV prevalence reduced from 20.2% in the first half of 2008 to 8.1% in the second half of 2011. Older, gay-identified, non-Hispanic/Latino participants were each more likely to report a HIV-positive serostatus. When controlling for these cofactors, robust log-Poisson analysis revealed that each additional day of methamphetamine (RRR = 1.03; 95% CI [1.02, 1.03]) and/or marijuana (RRR = 1.01; 95% CI [1.01, 1.02]) use in the previous 30 days, injection drug use at any point in their lifetime (RRR = 2.01; 95% CI [1.70, 2.37]), and/or unprotected anal intercourse with another male in the previous 30 days (RRR = 1.48; 95% CI [1.29, 1.71]) were associated with HIV-positive status. When controlling for all these cofactors, the probability of reporting a HIV-positive status reduced an estimated 9% (95% CI [6%, 12%]) every six months throughout the reporting period. Self-reported HIV prevalence decreased among this sample of substance-using MSM in LAC from 2008 to 2011.
Collapse
Affiliation(s)
- Cathy J. Reback
- Friends Research Institute, Inc
- UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles
| | | |
Collapse
|
9
|
Tensions between the epidemiology and psychology of HIV risk: implications for pre-exposure prophylaxis. AIDS Behav 2014; 18:1686-93. [PMID: 24719201 DOI: 10.1007/s10461-014-0770-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study focuses on psychological differences in risk-taking patterns and their association with risk compensation motivations in the context of pre-exposure prophylaxis (PrEP). Participants were 257 HIV-negative MSM and transgender women recruited in New York City. The majority of participants (89.5 %, n = 230), could be classified as either: Intimates (40 %), who report unprotected anal intercourse (UAI) only with a main partner believed to be HIV-negative; Trusters (34 %), who engaged in UAI only with casual partners believed to be HIV-negative; and Gamblers (26 %) who report UAI with partners of unknown serostatus. Partner-based classifications were better predictors of HIV risk perception and other traditional correlates of risk-taking (e.g. impulsivity, sexual compulsivity) than rates of UAI. The three groups differed significantly in PrEP-related risk compensation motivations: sexual pleasure (Gamblers), intimacy (Trusters) and partner pressure (Intimates). These data underscore the importance of focusing the psychological dynamics of risk perception and sexual decision-making.
Collapse
|
10
|
Correlates of group sex among a community-based sample of men who have sex with men (MSM) in Washington, DC. AIDS Behav 2014; 18:1413-9. [PMID: 23700223 DOI: 10.1007/s10461-013-0527-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Participation of MSM in group sex events (GSEs) is an understudied phenomenon. Studies on GSEs identified significant proportions of MSM engaging in unprotected anal intercourse (UAI). We sought to identify the prevalence of group sex participation among MSM in Washington, DC and to characterize these experiences. Data were collected for NHBS-MSM-3 in 2011. More than one-quarter of MSM (27.2 %) reported engaging in group sex in the prior year, with one-third reporting no condom use with their sex partners (33.0 %). In multivariable logistic regression, men who participated in a GSE in the prior year were significantly younger, more likely to be white, and to have used crystal meth, poppers, and downers in the past year. The high prevalence of UAI during GSEs, especially in view of the fact that HIV-positive MSM were significantly less likely to report condom use, offers an opportunity to develop risk reduction interventions specific to GSE attendees.
Collapse
|
11
|
Nitrite inhalants use and HIV infection among men who have sex with men in China. BIOMED RESEARCH INTERNATIONAL 2014; 2014:365261. [PMID: 24800219 PMCID: PMC3985158 DOI: 10.1155/2014/365261] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 03/02/2014] [Indexed: 12/04/2022]
Abstract
Objective. This is the first study in China to examine the use of nitrite inhalants and its correlates among men who have sex with men (MSM) in Beijing, China. Methods. A cross-sectional survey was conducted in 2012. Structured interviews collected data on demographics, sexual and drug use behaviors, and the use of HIV services. Blood specimens were collected and tested for HIV and syphilis. Results. A total of 400 MSM eligible for the study were between 19 and 63 years of age and overall HIV prevalence was 6.0% (9.0% among nitrite inhalant users and 3.3% among nonusers). Nearly half (47.3%) of them reported ever using nitrite inhalants and 42.3% admitted using nitrite inhalants in the past year. Multivariable logistic analysis revealed that ever using nitrite inhalants in the past was independently associated with being aged ≤25 years, having higher education attainment, seeking sex via Internet, having casual partners in the past three months, and being HIV positive. Conclusion. The use of nitrite inhalants was alarmingly prevalent among MSM in Beijing. The independent association of the nitrite inhalant use with more casual sex partners and HIV infection underscored the need for intervention and prevention of nitrite inhalant use.
Collapse
|
12
|
Anema A, Marshall BD, Stevenson B, Gurm J, Montaner G, Small W, Roth EA, Lima VD, Montaner JS, Moore D, Hogg RS. Intergenerational sex as a risk factor for HIV among young men who have sex with men: a scoping review. Curr HIV/AIDS Rep 2013; 10:398-407. [PMID: 24272070 PMCID: PMC4727934 DOI: 10.1007/s11904-013-0187-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An emerging body of evidence suggests that intergenerational sexual partnerships may increase risk of HIV acquisition among young men who have sex with men (YMSM). However, no studies have comprehensively evaluated literature in this area. We applied a scoping review methodology to explore the relationships between age mixing, HIV risk behavior, and HIV seroconversion among YMSM. This study identified several individual, micro-, and meso-system factors influencing HIV risk among YMSM in the context of intergenerational relationships: childhood maltreatment, coming of age and sexual identity, and substance use (individual-level factors); family and social support, partner characteristics, intimate partner violence, connectedness to gay community (micro-system factors); and race/ethnicity, economic disparity, and use of the Internet (meso-system factors). These thematic groups can be used to frame future research on the role of age-discrepant relationships on HIV risk among YMSM, and to enhance public health HIV education and prevention strategies targeting this vulnerable population.
Collapse
Affiliation(s)
- Aranka Anema
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital; 608-1081 Burrard St. Vancouver, British Columbia (BC), V6Z 1Y6, Canada; t: 604-6068477; f: 604-806-9044
| | - Brandon D.L. Marshall
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-2 Providence, Rhode Island, 02909 USA; t: 401-863-6427; f: 401-863-3713
| | - Benjamin Stevenson
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital; 608-1081 Burrard St. Vancouver, British Columbia (BC), V6Z 1Y6, Canada; t: 604-6068477; f: 604-806-9044
| | - Jasmine Gurm
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital; 608-1081 Burrard St. Vancouver, British Columbia (BC), V6Z 1Y6, Canada; t: 604-6068477; f: 604-806-9044
| | - Gabriela Montaner
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital; 608-1081 Burrard St. Vancouver, British Columbia (BC), V6Z 1Y6, Canada; t: 604-6068477; f: 604-806-9044
| | - Will Small
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital; 608-1081 Burrard St. Vancouver, British Columbia (BC), V6Z 1Y6, Canada; t: 604-6068477; f: 604-806-9044
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive; Burnaby, BC, V5A 1S6; Canada; t:778-7824821;778-782-5927
| | - Eric A. Roth
- Department of Anthropology, University of Victoria, PO Box 1700 STN CSC Victoria, BC; V8W 2Y2; Canada; t: 250-721-7046; f: N/A
| | - Viviane D. Lima
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital; 608-1081 Burrard St. Vancouver, British Columbia (BC), V6Z 1Y6, Canada; t: 604-6068477; f: 604-806-9044
- Faculty of Medicine, University of British Columbia, Experimental Medicine Program Department of Medicine; 10th Floor, Room 10203; Gordon and Leslie Diamond Health Care Centre; 2775 Laurel Street; Vancouver, BC V5Z 1M9. t: N/A; f: N/A
| | - Julio S.G. Montaner
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital; 608-1081 Burrard St. Vancouver, British Columbia (BC), V6Z 1Y6, Canada; t: 604-6068477; f: 604-806-9044
- Faculty of Medicine, University of British Columbia, Experimental Medicine Program Department of Medicine; 10th Floor, Room 10203; Gordon and Leslie Diamond Health Care Centre; 2775 Laurel Street; Vancouver, BC V5Z 1M9. t: N/A; f: N/A
| | - David Moore
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital; 608-1081 Burrard St. Vancouver, British Columbia (BC), V6Z 1Y6, Canada; t: 604-6068477; f: 604-806-9044
- Faculty of Medicine, University of British Columbia, Experimental Medicine Program Department of Medicine; 10th Floor, Room 10203; Gordon and Leslie Diamond Health Care Centre; 2775 Laurel Street; Vancouver, BC V5Z 1M9. t: N/A; f: N/A
| | - Robert S. Hogg
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital; 608-1081 Burrard St. Vancouver, British Columbia (BC), V6Z 1Y6, Canada; t: 604-6068477; f: 604-806-9044
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive; Burnaby, BC, V5A 1S6; Canada; t:778-7824821;778-782-5927
| |
Collapse
|