Vengeance, Condomless Sex and HIV Disclosure Among Men Who Have Sex with Men Living with HIV

Behavioral and psychosocial predictors of self-efficacy for managing chronic disease among people living with HIV: forgiveness, life perspective, and social support

HIV medication can help people living with HIV (PLWH) live longer, but many PLWH still report difficulty managing their disease and report engaging in harmful behaviors to themselves and others, which have adverse downstream consequences. Self-efficacy is predictive of positive health behaviors and outcomes, and it is modifiable through interventions. While existing studies overwhelmingly examine self-efficacy among PLWH, much fewer studies focus on self-efficacy for managing HIV, including self-efficacy for managing physical and psychological health problems caused by HIV-common problems that PLWH experience. Additionally, only limited literature on other-forgiveness and life perspective among PLWH exists. Thus, we further examine predictors of self-efficacy for managing HIV. We hypothesize that other-forgiveness, positive life perspective, and social support significantly predict self-efficacy for managing HIV after controlling for demographic variables. The results show that the overall multiple linear regression model significantly accounted for 38% of the variance in self-efficacy for managing HIV. Additionally, other-forgiveness was as powerful at predicting self-efficacy as social support; moreover, positive life perspective was a significant and the most powerful predictor of self-efficacy. These findings indicate that other-forgiveness and positive life regard may be as important, if not more so, than social support to chronic disease management.

Family acceptance, peer support, and HIV serostatus disclosure of MSM-PLWHA in Medan, Indonesia

OBJECTIVE

This study was conducted to determine the correlation between family acceptance and HIV serostatus disclosure, and the correlation between peer support and HIV serostatus disclosure.

METHODS

This was a quantitative study with a cross-sectional design involving 176 MSM-PLWHA (Men who have sex with men-people living with HIV and AIDS). Instruments used in this study is Brief Scale of HIV disclosure, perceived acceptance scale, and peer group caring interaction scale.

RESULTS

The analysis showed a significant correlation between peer support and HIV serostatus disclosure (p-value 0.011), but there was no significant correlation between family acceptance and HIV serostatus disclosure (p-value 0.979).

CONCLUSION

Peer support affects HIV serostatus disclosure in MSM-PLWHA. Peer group interventions need to be improved. Providing systematic peer group support for MSM-PLWHA and integrating intervention with peer support might need to be done for the next care plan for MSM-PLWHA in Medan, Indonesia.

Age and racial disparities in substance use and self-reported viral suppression among men who have sex with men with HIV

HIV disproportionately affects men who have sex with men (MSM). Substance use is common among people living with HIV and may affect antiretroviral therapy adherence. Nevertheless, research examining the association between substance use and viral suppression is lacking. The aims of this study were to determine the association between substance use and self-reported viral suppression, and by age and race among MSM living with HIV. Data were obtained from 309 HIV-positive MSM. Logistic regression was used to determine the association between substance use and self-reported viral suppression at baseline, and by age and race. Approximately 67% of participants reported they were virally suppressed. After adjusting for sociodemographics, every increase in substance use score was associated with a 7% decrease in the odds of reporting viral suppression (odds ratio [OR]: 0.93; 95% confidence interval [CI]: 0.89-0.98; p = 0.003). The negative association between substance use and self-reported viral suppression remained statistically significant among MSM aged 25-34 years (OR = 0.89; 95% CI: 0.79-1.00; p = 0.041) and statistically significant for Black MSM (OR = 0.92; 95% CI: 0.86-0.98; p = 0.009). Intervention programs for MSM living with HIV aimed at improving viral suppression should address substance use and consider the differences by age and race.

Vengeance, sexual compulsivity and self-efficacy among men who have sex with men living with HIV

Vengeance is defined as a continuum of thoughts and/or actions ranging from harmless thoughts to destruction or death, due to feelings of hurt or anger, as a result of a perceived personal attack. Studies assessing the association between vengeance and HIV risk behavior are extremely lacking. The primary aims of this study were to examine the associations between vengeance and sexual compulsivity (SC), and self-efficacies (SEs) for condom use, HIV disclosure, and negotiation of safer sex practices. Data were obtained from 266 men who have sex with men (MSM) living with HIV. Simple and multiple linear regression were used to explore the associations between vengeance, SC and SE. After adjusting for sociodemographic and HIV-related factors, there was a negative association between vengeance and SE for HIV disclosure: (most vengeful: β = -1.49; 95% CI: -2.40, -0.58; more vengeful: β = -1.17; 95% CI: -2.12, -0.22; vengeance (continuous: β = -0.03; 95% CI: -0.05, -0.01). Intervention programs geared towards improving SE for HIV disclosure among MSM living with HIV should endeavor to reduce vengeful feelings.