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Liu Y, Mitchell JW, Brown L, Chandler C, Zhang C. Associations of Minority Stressors, Alcohol Use Disorder, Resilience, and HIV Testing Self-Efficacy Among Community-Based Black Men Who Have Sex with Men in a Southern U.S. City: A Causal Mediation and Moderation Analysis. Subst Use Misuse 2024:1-10. [PMID: 39358912 DOI: 10.1080/10826084.2024.2409770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
Background: Black men who have sex with men (BMSM) face multiple minority stressors (e.g., homophobia, racism, and presumed HIV status) that may indirectly erode their confidence in pursuing HIV testing uptake through exacerbating alcohol use disorder (AUD). Objectives: Using cross-sectional data from 203 community-based BMSM (71.4% as homosexual with a mean age of 26 years) living in a Southern US city, we conducted a causal mediation and moderation analysis to investigate in/direct pathways linking minority stressors, AUD risk, and self-efficacy of HIV testing, including how resilience may moderate these associations. Results: Our mediation analysis revealed that AUD risk accounted for 32.1% of the total effect of internalized homonegativity (βtotal effect = -0.424; SE=0.071; p<0.001), 28.6% of the total effect of experienced homophobia (βtotal effect = -0.684; SE=0.122; p<0.001), and 15.3% of the total effect of perceived HIV stigma (βtotal effect = -0.361; SE=0.164; p<0.05) on HIV testing self-efficacy. Resilience significantly moderated the associations of experienced homophobia (β = -0.049; SE=0.011; p<0.001), internalized homonegativity (β = -0.065; SE=0.027; p<0.01), and perceived HIV stigma (β = -0.034; SE=0.013; p<0.05) with AUD risk. Resilience also significantly moderated the associations of experienced homophobia (β = -0.073; SE=0.021; p<0.01), internalized homonegativity (β = -0.082; SE=0.012; p<0.001), perceived HIV stigma (β = -0.037; SE=0.039; p<0.05), and AUD risk (β = -0.021; SE=0.015; p<0.05) with HIV testing self-efficacy. Conclusions: Our study provides important implications in identifying multilevel sources for building resilience among BMSM to buffer the effects of minority stress on AUD risk and improve HIV testing outcomes.
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Affiliation(s)
- Yu Liu
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Jason W Mitchell
- Department of Health Promotion and Disease Prevention, Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Lauren Brown
- Meharry Medical College, Nashville, Tennessee, USA
| | - Cristian Chandler
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Chen Zhang
- School of Nursing, University of Rochester, Rochester, New York, USA
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Boyd DT, Jones KV, Quinn CR, Hill M, Nelson LE, Beauchamp G, Emel L, Hightow-Weidman L, Shoptaw S, Magnus M, Piwowar-Manning E, Mayer KH, Fields SD, Wheeler DP, Dyer TV, Wilton L. Ethnic identity and social support as mediators between childhood sexual abuse and depression among black men who have sex with men. CHILD ABUSE & NEGLECT 2024; 157:107064. [PMID: 39303435 DOI: 10.1016/j.chiabu.2024.107064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 09/09/2024] [Accepted: 09/16/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Survivors of childhood sexual abuse (CSA) often experience long-term adverse mental health effects, a trend that has been observed in research focusing on men who have sex with men (MSM), especially Black MSM. OBJECTIVE The aim of this study was to investigate the direct and indirect effects of childhood sexual abuse on depression symptoms among Black MSM through early sexual debut, histories of incarceration, ethnic identity, and social support. In addition, we examine the role of social support and ethnic identity as mediators of depression symptoms. PARTICIPANTS AND SETTING The HPTN 073 study enrolled and followed 226 HIV-uninfected Black MSM in three US cities (Los Angeles; Washington, DC; and Chapel Hill, North Carolina) from February 2013 to September 2015. Study participants were offered once-daily oral emtricitabine/tenofovir preexposure prophylaxis combined with counseling and followed for 52 weeks. METHODS A path analysis was used to examine direct and indirect effects of CSA experiences on depression symptoms through incarceration, early sexual debut ethnic identity, and social support, and to see whether social support and ethnic identity mediated the relationship between incarceration and depression symptoms. RESULTS Our results indicate that childhood sexual abuse was direct and positively associated with early sexual debut (β = 0.21, p < .001). Both ethnic identity (β = -0.14, p < .001) and social support (β = -0.82, p < .001) were direct and negatively associated with depressive symptoms. CONCLUSION Our research underscores the significant impact of CSA factors on the life trajectories of some Black MSM, including experiences such as incarceration, sexual debut, and depression symptoms.
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Affiliation(s)
- Donte T Boyd
- The Ohio State University, College of Social Work, Columbus, OH, USA; Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, USA.
| | - Kristian V Jones
- University of Washington, School of Social Work, Seattle, WA, USA
| | - Camille R Quinn
- University of Michigan, School of Social Work, Ann Arbor, MI, USA
| | - Mandy Hill
- University of Texas, McGovern Medical School, Houston, TX, USA
| | - LaRon E Nelson
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, USA; Yale School of Nursing, New Haven, CT, USA
| | - Geetha Beauchamp
- Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Lynda Emel
- Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | | | - Steve Shoptaw
- University of California Los Angeles, David Geffen School of Medicine, Division of Family Medicine, Los Angeles, California, USA
| | - Manya Magnus
- George Washington University, Milken Institute School of Public Health, Department of Epidemiology, DC, USA
| | | | | | - Sheldon D Fields
- Pennsylvania State University, Ross and Carl Nese College of Nursing, University Park, PA, USA
| | | | - Typhanye V Dyer
- University of Maryland, Department of Epidemiology and Biostatistics, College Park, MD, USA
| | - Leo Wilton
- State University of New York at Binghamton, Department of Human Development, Binghamton, NY, USA; University of Johannesburg, Department of Humanities, South Africa
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Scanlon F, Remch M, Scheidell JD, Brewer R, Dyer TV, Albis-Burdige B, Irvine N, Turpin R, Parker S, Cleland CM, Hucks-Ortiz C, Gaydos CA, Mayer KH, Khan MR. Posttraumatic Stress Disorder Symptoms and Incarceration: The Impact on Sexual Risk-Taking, Sexually Transmitted Infections, and Depression Among Black Sexual Minority Men in HIV Prevention Trials Network (HPTN) 061. PSYCHOLOGY OF MEN & MASCULINITY 2024; 25:44-56. [PMID: 38854997 PMCID: PMC11156418 DOI: 10.1037/men0000458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Black men and people belonging to sexual minority groups are disproportionately impacted by criminal legal involvement and sexually transmitted infections (STIs). Traumatic experiences are often associated with later criminal legal involvement, depression symptoms, sexual risk behavior, and STIs. Research on the joint influence of trauma and incarceration on STI risk among racial and/or sexual minority people is limited. This study tested the association between post-traumatic stress disorder (PTSD) symptoms and incarceration on sexual risk behavior and STI among Black sexual minority men, a population that may be at higher risk for contracting STIs. Using data from the HIV Prevention Trials Network 061 Study, a longitudinal study of adult Black sexual minority men in six U.S. cities (N = 855), we tested associations between past six-month incarceration and subsequent sexual risk behavior, STI, and depression symptoms, for those with and without pre-incarceration PTSD symptoms. PTSD symptoms were elevated among participants who reported Hispanic ethnicity, having sex with both men and women, and previous incarceration. Although there were not significant differences between recent incarceration and sexual risk for those with and without PTSD, incarceration was linked to some sexual risk behaviors regardless of PTSD symptoms. Among people with PTSD symptoms, there was a higher prevalence of sexual risk and depression symptoms, regardless of incarceration. These findings suggest a potentially compounding influence of PTSD symptoms and incarceration on sexual risk and infection among Black sexual minority men.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sharon Parker
- North Carolina Agricultural and Technical State University
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4
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Remch M, Scheidell JD, Cleland CM, Turpin R, Duncan DT, Dyer TT, Kaufman JS, Mazumdar M, Brewer R, Feelemyer J, Mayer KH, Khan MR. Mediation of the Effect of Incarceration on Selling Sex Among Black Sexual Minority Men and Black Transgender Women in the HPTN 061 Study. AIDS Behav 2023; 27:2791-2802. [PMID: 36746876 DOI: 10.1007/s10461-023-04003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/08/2023]
Abstract
Incarceration among Black sexual minority men and Black transgender women (BSMM/BTW) is disproportionately high in the United States. Limited research has documented the disruptive effect of incarceration on sexual networks and sexual partnership exchange among BSMM/BTW. We estimate the influence of incarceration on selling sex and mediating pathways among 1169 BSMM/BTW enrolled in the HIV Prevention Trials Network (HPTN) 061 cohort to assess this relationship. Mediators investigated were social support, violence, illicit drug use, and distress due to experienced racism and homophobia. During the 6 months following baseline, 14% of the cohort was incarcerated, including 24% of BTW. After adjustment, recent incarceration was associated with 1.57 (95% CI 1.02, 2.42) times the risk of subsequently selling sex. The hypothesized mediators together explained 25% of the relationship, with an indirect effect risk ratio of 1.09 (95% CI 0.97, 1.24). Our results document an association and call for more research investigating mechanisms.
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Affiliation(s)
- Molly Remch
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, CB 7435, McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA.
| | - Joy D Scheidell
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
| | - Charles M Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Rodman Turpin
- Department of Global and Community Health, George Mason University College of Public Health, Fairfax, VA, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Typhanye T Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics, & Occupational Health, McGill University, Montreal, QC, Canada
| | - Medha Mazumdar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Russell Brewer
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Jonathan Feelemyer
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Kenneth H Mayer
- Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Maria R Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Ogunbajo A, Siconolfi D, Storholm E, Vincent W, Pollack L, Rebchook G, Tan J, Huebner D, Kegeles S. History of Incarceration is Associated with Unmet Socioeconomic Needs and Structural Discrimination among Young Black Sexual Minority Men (SMM) in the United States. J Urban Health 2023; 100:447-458. [PMID: 37204646 PMCID: PMC10323066 DOI: 10.1007/s11524-023-00737-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
There is a dearth of research on incarceration among young Black sexual minority men (SMM). The current study aimed to assess the prevalence and association between unmet socioeconomic and structural needs and history of incarceration among young Black SMM. Between 2009 and 2015, young Black SMM (N = 1,774) in Dallas and Houston Texas were recruited to participate in an annual, venue-based, cross-sectional survey. We found that 26% of the sample reported any lifetime history of incarceration. Additionally, participants with unmet socioeconomic and structural needs (unemployment, homelessness, financial insecurity and limited educational attainment) were more likely to have a history of incarceration. It is imperative that interventions are developed to address the basic, social, and economic needs of young Black SMM with a history of incarceration or who are at risk for incarceration.
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Affiliation(s)
| | | | - Erik Storholm
- San Diego State University, School of Public Health, San Diego, CA, USA
| | - Wilson Vincent
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Lance Pollack
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Greg Rebchook
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Judy Tan
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - David Huebner
- George Washington University, Milken School of Public Health, Washington, DC, USA
| | - Susan Kegeles
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
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Wilson K, Przybyla S, Bleasdale J, Gabriel S, Leblanc N, St Vil N. Factors correlated with pre-exposure prophylaxis (PrEP) awareness and use among black adults in the United States: implications for improving HIV prevention. AIDS Care 2022; 34:1481-1488. [PMID: 35981242 DOI: 10.1080/09540121.2022.2113027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
HIV remains a significant public health concern for Black adults (BA) in the United States. Pre-exposure prophylaxis (PrEP) is a highly effective prevention tool prescribed to protect the health of HIV-uninfected individuals. Yet, low rates of PrEP awareness and utilization persist among BA. Less is understood about the pathways that may promote PrEP uptake. The present study explored factors associated with PrEP awareness and use among BA. Using a cross-sectional sample of 666 BA, we employed multivariable logistic regression models to examine the relationship between PrEP and several covariates. Most participants were unaware of PrEP (71%). Reporting history of incarceration and lifetime sexually transmitted infection testing [aOR 1.76 (1.19, 2.59), p < 0.05] had greater odds of PrEP awareness. Only 6% of respondents had ever taken PrEP. Reports of incarceration history [aOR 9.96 (2.82, 35.14), p < 0.05], concurrent sexual partners [aOR 1.09 (1.00, 1.18), p < 0.05], and substance use during sex [aOR 4.23 (1.02, 17.48), p < 0.05] had greater odds of PrEP use. Interventions aiming to improve PrEP uptake among BA must consider the individual, social, and structural contexts associated with its awareness and use. Enhanced efforts by healthcare providers and institutions may better facilitate access to PrEP for HIV prevention and control transmission.
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Affiliation(s)
- Kennethea Wilson
- Department of Community Health and Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Sarahmona Przybyla
- Department of Community Health and Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Jacob Bleasdale
- Department of Community Health and Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Steven Gabriel
- Department of Community Health and Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Natalie Leblanc
- School of Nursing, University of Rochester, Rochester, NY, USA
| | - Noelle St Vil
- School of Social Work, University at Buffalo, Buffalo, NY, USA
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7
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Sleep Disturbance is Associated with Missing PrEP Doses Among Young Black Sexual Minority Men in The N2 study. AIDS Behav 2022; 26:3827-3833. [PMID: 35661017 PMCID: PMC10109514 DOI: 10.1007/s10461-022-03711-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 11/01/2022]
Abstract
PrEP uptake and adherence among young Black sexual minority men (YBSMM), has been sub-optimal. Multiple studies identified sleep as an important determinant of medication adherence, although it has not been examined with regard to PrEP among YBSMM. This study utilized data collected from HIV-negative cisgender YBSMM in the Neighborhoods and Networks (N2) study in Chicago using PrEP (N = 70). Sleep quality was measured using the PHQ-9 and PrEP adherence questions were adapted from Reynolds et al., 2004. Bivariate and multivariable regression analyses were used to estimate associations between sleep and missing PrEP doses, controlling for relevant demographic and behavioral factors. YBSMM who reported sleep disturbance a moderate amount of time (aOR 7.59 [1.05 to 54.57]) were more likely to miss taking PrEP because they had too many pills to take. Sleep quality is an overlooked determinant of medication adherence, and may negatively impact YBSMM's ability to consistently take PrEP.
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8
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Role of the Intersections of Gender, Race and Sexual Orientation in the Association between Substance Use Behaviors and Sexually Transmitted Infections in a National Sample of Adults with Recent Criminal Legal Involvement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074100. [PMID: 35409785 PMCID: PMC8998534 DOI: 10.3390/ijerph19074100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023]
Abstract
Limited research has focused on how substance use and sexual risk behaviors differ among individuals impacted by the criminal legal system based on social identities. Using the National Survey on Drug Use and Health, we estimated relative risk for reporting a sexually transmitted infection (STI) among intersectional social groups with criminal legal involvement using a modified Poisson regression. We then utilized multivariate logistic regression and marginal effects to measure associations between substance use behaviors and STIs and to estimate whether these varied among the intersectional social groups with elevated STI rates. Three groups had elevated risk of reporting an STI compared to white, heterosexual men: white, heterosexual women (1.53, 95% CI: 1.05-2.20); Black, heterosexual women (2.03, 95% CI: 1.18-3.49); and white, gay or bisexual men (5.65, 95% CI: 2.61-12.20). Considering the intersections of gender, race, and sexual orientation, elevated risks for STIs among white and Black heterosexual women were mitigated after adjusting for substance use alongside other confounders. Only those who identified as white, gay or bisexual, and male had increased STI risk after controlling for substance use. Interventions targeting Black and white heterosexual women's sexual health following incarceration should focus on substance use and interventions targeting white, gay or bisexual men should focus on healthy sexual behaviors, HIV/STI screening, and care continuum efforts.
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9
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Social Determinants of Transactional Sex in a Sample of Young Black and Latinx Sexual Minority Cisgender Men and Transgender Women. J Adolesc Health 2022; 70:275-281. [PMID: 34580030 PMCID: PMC8915132 DOI: 10.1016/j.jadohealth.2021.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE We sought to explore characteristics and risk factors associated with transactional sex in a sample of young black and Latinx sexual minority cisgender men and transgender women of age 15 to 24 years who were living with or at high risk for HIV infection and whether these associations vary by gender identity and HIV status. METHODS A total of 454 black and Latinx sexual minority cisgender men and transgender women from Baltimore, MD; Philadelphia, PA; Washington, DC; and St. Petersburg/Tampa, Fl, were recruited to participate in a multisite study that included a 45-minute baseline Web-based survey and HIV-1 rapid testing. Bivariate analysis was used to explore factors associated with transactional sex. Factors significant at p-value <.20 in bivariate analysis were entered into a final logistic regression models; and models were further stratified by gender identity and HIV status. RESULTS The mean age was 21.3 (standard deviation = 2.5), with 14.7% (n = 65) identifying as transgender, and 103 youth (22.7%) reporting lifetime transactional sex. Transactional sex was associated with transgender identity, recent unstable housing in the last 12 months, poorer perceived financial well-being, coerced sex, and marijuana use. Differences were noted by gender identity and HIV status, with marijuana use associated with transactional sex in cisgender men and unstable housing and sexual coercion in youth living with HIV. CONCLUSIONS Young black and Latinx cisgender men and transgender women are at a high risk for engaging in transactional sex. Transactional sex may create a syndemic for HIV risk exposure through co-occurring and reinforcing conditions of unstable housing, violence, and substance use.
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Harawa NT, Schrode KM, Daniels J, Javanbakht M, Hotton A, Makgoeng S, Ragsdale A, Schneider J, Fujimoto K, Bolan R, Gorbach P. Factors predicting incarceration history and incidence among Black and Latino men who have sex with men (MSM) residing in a major urban center. PLoS One 2022; 17:e0265034. [PMID: 35259198 PMCID: PMC8903243 DOI: 10.1371/journal.pone.0265034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/22/2022] [Indexed: 11/18/2022] Open
Abstract
We analyzed data from a cohort of Black and Latino men who have sex with men (MSM) in order to identify correlates of prevalent and incident incarceration, including potential predictors related to their status as sexual and gender minorities (SGMs). Baseline and follow-up self-administered survey data were examined from Los Angeles County participants' ages 18-45 years at enrollment who were either HIV negative or living with HIV, but recruited to over represent men who used drugs and men with unsuppressed HIV infection. Multivariable logistic regression models were developed to identify predictors of baseline incarceration history and of incident incarceration over study follow-up among 440 and 338 participants, respectively. Older age, Black race, low socioeconomic status, homelessness, stimulant use, and depression symptoms were associated with baseline incarceration history. The only SGM-related factor associated with baseline incarceration history was having experienced violence based on sexual orientation identity. Just one statistically significant, independent positive predictor of incident incarceration was identified: prior incarceration, whereas having four or more friends that could lend money was a statistically significant protective factor against incident incarceration. Fundamental Cause Theory provides a useful framework to explain identified predictors of incarceration. Addressing poverty, housing instability, inadequate access to health care, and their root causes is critical to reducing incarceration rates in this population, as is expanded access to both diversion and anti-recidivism programs and to evidence-based treatment for stimulant use disorders.
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Affiliation(s)
- Nina T. Harawa
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
- Department of Psychiatry and Human Behaviors, College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States of America
- * E-mail:
| | - Katrina M. Schrode
- Department of Psychiatry and Human Behaviors, College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States of America
| | - Joseph Daniels
- Department of Psychiatry and Human Behaviors, College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States of America
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Anna Hotton
- Department of Medicine, University of Chicago, Chicago, IL, United States of America
| | - Solomon Makgoeng
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Amy Ragsdale
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
| | - John Schneider
- Department of Medicine, University of Chicago, Chicago, IL, United States of America
- Chicago Center for HIV Elimination, Chicago, IL, United States of America
| | - Kayo Fujimoto
- Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Robert Bolan
- Department of Health Services, Los Angeles LGBT Center, Los Angeles, CA, United States of America
| | - Pamina Gorbach
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
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11
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Scheidell JD, Dyer TV, Hucks-Ortiz C, Abrams J, Mazumdar M, Cleland C, Irvine N, Turpin RE, Severe M, Mayer K, Khan M. Characterisation of social support following incarceration among black sexual minority men and transgender women in the HPTN 061 cohort study. BMJ Open 2021; 11:e053334. [PMID: 34588263 PMCID: PMC8483031 DOI: 10.1136/bmjopen-2021-053334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To examine longitudinal associations between recent incarceration and subsequent social support among black sexual minority men and transgender women, and whether associations differed between those who did and did not have support prior to incarceration. DESIGN A secondary analysis in 2020 of data from the HIV Prevention Trials Network 061, a cohort study of black sexual minority men and transgender women recruited in 2009-2010 and followed for 12 months. SETTING Six US cities (Atlanta, Boston, Los Angeles, New York City, San Francisco and Washington DC). PARTICIPANTS Individuals ≥18 years of age who identified as black, reported being male or assigned male at birth, reported ≥1 unprotected anal intercourse event with a male partner in the past 6 months, and reported on incarceration at the 6-month follow-up visit. EXPOSURE Having spent ≥1 night in jail/prison in the past 6 months reported at the 6-month follow-up visit. OUTCOME Social support measured using a six-item scale assessing frequency of emotional/informational, affectionate and tangible support (range 6-30); and dichotomous indicators of low support for each item (ie, receiving that form of support none/little of the time). RESULTS Among participants who returned for the 6-month visit (N=1169), 14% had experienced incarceration in the past 6 months. Mean support score was 20.9; 18.9 among those with recent incarceration versus 21.2 among those without. Recent incarceration predicted lower support (adjusted β -2.40, 95% CI -3.94 to -0.85). Those recently incarcerated had increased risk of lacking emotional/informational (eg, no one to talk to adjusted risk ratio (aRR) 1.55, 95% CI 1.13 to 2.13) and affectionate (aRR 1.51, 95% CI 1.11 to 2.04) but not tangible support. Effects appeared somewhat stronger among those who had support at baseline. CONCLUSIONS Incarceration may reduce support on re-entry among black sexual minority men and transgender women, populations unequally targeted for incarceration and at risk for low support.
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Affiliation(s)
- Joy D Scheidell
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Typhanye V Dyer
- School of Public Health, Epidemiology and Biostatistics, University of Maryland at College Park, College Park, Maryland, USA
| | | | - Jasmyn Abrams
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Medha Mazumdar
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Charles Cleland
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Natalia Irvine
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Rodman E Turpin
- School of Public Health, Epidemiology and Biostatistics, University of Maryland at College Park, College Park, Maryland, USA
| | - MacRegga Severe
- Population Health, New York University School of Medicine, New York, New York, USA
| | - Kenneth Mayer
- Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Maria Khan
- Population Health, New York University School of Medicine, New York, New York, USA
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Quinn KG, Spector A, Takahashi L, Voisin DR. Conceptualizing the Effects of Continuous Traumatic Violence on HIV Continuum of Care Outcomes for Young Black Men Who Have Sex with Men in the United States. AIDS Behav 2021; 25:758-772. [PMID: 32944841 PMCID: PMC7886964 DOI: 10.1007/s10461-020-03040-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 01/06/2023]
Abstract
The United States (US) is on track to achieve the 90-90-90 targets set forth by UNAIDS and the National HIV/AIDS strategy, yet significant racial disparities in HIV care outcomes remain, particularly for young Black men who have sex with men (YBMSM). Research has demonstrated that various types of violence are key aspects of syndemics that contribute to disparities in HIV risk. However, little research has looked collectively at cumulative violent experiences and how those might affect HIV treatment and care outcomes. Drawing on extant literature and theoretical underpinnings of syndemics, we provide a conceptual model that highlights how continuous traumatic violence experienced by YBMSM may affect HIV outcomes and contribute to racial disparities in HIV outcomes. The findings of this focused review suggest a need for research on how continuous exposure to various types of violence influence HIV prevention and treatment outcomes for young Black MSM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, 2071 N. Summit Ave., Milwaukee, WI, 53202, USA.
| | - Antoinette Spector
- Medical College of Wisconsin, Institute for Health Equity, Milwaukee, USA
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