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Wetzel GM, Sanchez DT, Gesselman AN, Adams OR, Campbell JT, Garcia JR. Exploring the Orgasm Gap Across Racial/Ethnic Groups: A Descriptive Analysis. JOURNAL OF SEX RESEARCH 2024:1-10. [PMID: 38329940 DOI: 10.1080/00224499.2024.2308044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Orgasm gaps between heterosexual men and women, and for women across sexual orientations, are well-established in research. However, no large-scale assessments of orgasm frequency by race/ethnicity exist. Here, we analyzed 10 years of cross-sectional Singles in America survey data between 2011 and 2021 to investigate the orgasm gap at the intersection of gender and racial/ethnic identity (i.e. White, Black, Hispanic/Latino, and Asian) for heterosexual participants (N = 27,347). White and Hispanic/Latino men reported greater orgasm frequency than Black and Asian men. Hispanic/Latino women reported the greatest orgasm frequency, and Asian women reported the lowest, with White and Black women's frequencies in between. The orgasm gap between men and women was largest for White (d = 0.89) and Asian (d = 0.86) groups, although Asian participants reported a lower orgasm frequency than White participants overall. The orgasm gap was smaller for Hispanic/Latino participants (d = 0.66), because Hispanic/Latino women reported a greater orgasm frequency than other racial/ethnic groups of women. The orgasm gap was smaller for Black participants (d = 0.61), because Black men reported a lower orgasm frequency than some other racial/ethnic groups of men. This descriptive study serves as an important starting point for future research on orgasm experiences across racial/ethnic groups.
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Affiliation(s)
| | | | | | - Olivia R Adams
- The Kinsey Institute, Indiana University
- Department of Gender, Women's, and Sexuality Studies, University of Florida
| | | | - Justin R Garcia
- The Kinsey Institute, Indiana University
- Department of Gender Studies, Indiana University
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2
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Wade RM, Pear MM. Online Dating and Mental Health among Young Sexual Minority Black Men: Is Ethnic Identity Protective in the Face of Sexual Racism? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114263. [PMID: 36361143 PMCID: PMC9656016 DOI: 10.3390/ijerph192114263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/22/2022] [Accepted: 10/27/2022] [Indexed: 05/29/2023]
Abstract
Racialized Sexual Discrimination (RSD), also known as 'sexual racism,' is pervasive within online dating venues. RSD is associated with poor mental health outcomes among young sexual minority Black men (YSMBM), and there is limited research on factors that may mitigate this association. Ethnic identity has been identified as a potential protective factor for racial/ethnic minorities who encounter racialized stressors, though some evidence suggests that ethnic identity may also intensify the negative effects of racial discrimination. Using data from a cross-sectional web-survey of YSMBM (n = 690), a series of linear regression models were estimated to examine the moderating effect of ethnic identity search and ethnic identity commitment on the relationship between RSD and depressive symptoms/feeling of self-worth. Results indicated that having moderate-to-high scores on commitment attenuated the association between being physically objectified by White men and higher depressive symptoms. However, having high scores on commitment intensified the association between being rejected by Black men and lower feelings of self-worth. Stronger identity commitment may be protective against objectification from White men, though it may also exacerbate negative outcomes related to in-group discrimination. These findings may have important implications for the development of individual and group-level interventions addressing ethnic identity among YSMBM.
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Parchem B, Aguayo-Romero RA, Alizaga NM, del Río-González AM, Poppen PJ, Zea MC. Identity and Relational Factors Associated with Sexual Role and Positioning for Anal Sex among Colombian Sexual Minority Men. JOURNAL OF SEX RESEARCH 2022; 59:911-919. [PMID: 35080994 PMCID: PMC9314459 DOI: 10.1080/00224499.2022.2026287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study aimed to identify Top, Bottom, and Versatile sexual role identities and anal sex behavior profiles using latent class analysis in a sample of 942 sexual minority men living in Bogotá. A Versatile-insertive and receptive class (52.2%) was the most prevalent of the four resulting classes, whereas the least common was a class (1.7%) that did not use labels and had a low probability of anal sex. We examined whether identity and relational factors (i.e., sexual orientation, LGBT collective identity, and partner type) were associated with profiles. Gay identity was associated with versatile and receptive classes and bisexual identity was associated with insertive and versatile classes. LGBT collective identity was associated with the class characterized by Bottom identity and receptive positioning. Partner type was not associated with class membership, but versatile behaviors were more common among encounters with a main partner. Models using data at different timescales offered consistent patterns of behavior between the last encounter and the past three months, though the versatile class in the three-month model split into two classes based on frequency of versatile positioning. Findings highlight the relationship between sexual identity and positioning and can inform interventions for sexual health education and identity development.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
| | - Rodrigo A. Aguayo-Romero
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
- Brigham and Women’s Hospital/ Harvard Medical School/ The Fenway Institute, Boston, MA
| | | | | | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
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4
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Wade RM, Pear MM. A Good App Is Hard to Find: Examining Differences in Racialized Sexual Discrimination across Online Intimate Partner-Seeking Venues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148727. [PMID: 35886579 PMCID: PMC9316549 DOI: 10.3390/ijerph19148727] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/30/2022] [Accepted: 07/15/2022] [Indexed: 02/04/2023]
Abstract
Young sexual minority Black men (YSMBM) report widespread instances of Racialized Sexual Discrimination (RSD) when seeking intimate partners online. RSD is associated with negative psychological health outcomes; however, little is known about the differences between virtual environments, and whether users are exposed to differential types/frequencies of RSD across different virtual environments. Using data from a cross-sectional web survey of YSMBM (N = 548), a multivariate Kruskal–Wallis test was conducted comparing those who primarily used Jack’d and those who primarily used Grindr to meet intimate partners; the frequency with which these two groups encountered six RSD domains was compared. Men who primarily used Grindr reported more frequent instances of White superiority and rejection from White men compared with men who primarily used Jack’d. Men who primarily used Jack’d reported more frequent instances of physical objectification from Black men compared with men who primarily used Grindr. RSD may manifest differentially based on the specific venue that YSMBM use. Such differences may reflect the sociodemographic makeup of these spaces, as well as differences in acceptability/normalization of different forms of RSD. These findings have implications for the development of anti-RSD initiatives that target the specific sociocultural norms that are unique to different virtual environments.
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5
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Wiginton JM, Eaton LA, Watson RJ, Maksut JL, Earnshaw VA, Berman M. Sex-Positivity, Medical Mistrust, and PrEP Conspiracy Beliefs Among HIV-Negative Cisgender Black Sexual Minority Men in Atlanta, Georgia. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2571-2581. [PMID: 34761347 PMCID: PMC9085967 DOI: 10.1007/s10508-021-02174-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 08/18/2021] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
Because the public health response to the disproportionate HIV burden faced by Black sexual minority men (BSMMM) has focused on sexual risk reduction and disease prevention, other vital components of sexual health (e.g., intimacy, pleasure, benefits of sex) have been often overlooked. Sex-positive describes a more open, holistic approach toward sex and sexuality that prioritizes these other components, though such an approach is rarely applied to BSMM's sexual health. For sex-positive BSMM, risk/preventive discourse may foster or exacerbate medical mistrust as a reaction to the dissonance between how these men view sexual health and how the medical establishment views it, which may discourage sexual healthcare-seeking. We assessed sex-positivity and its association with medical mistrust and PrEP conspiracy beliefs among 206 HIV-negative cisgender BSMM in Atlanta, Georgia. We performed exploratory factor analytic procedures on responses to a sex-positivity scale, followed by multivariable linear regressions to determine sex-positivity's associations with medical mistrust and PrEP conspiracy beliefs. We extracted two sex-positivity factors: sexual freedom (α = 0.90), reflecting openness toward casual sex and rejection of sexual mores, and essence of sex (α = 0.77), reflecting the intimate, relational, and pleasurable qualities of sex. Sexual freedom was independently associated with perceived provider deception (β = 0.19, CI = 0.04, 0.34). Essence of sex was independently associated with PrEP conspiracy beliefs (β = 0.16, CI = 0.02, 0.31) and marginally associated with perceived provider deception (β = 0.14, CI = - 0.00, 0.29). Healthcare providers and public health practitioners may cultivate greater trust with BSMM by incorporating a sex-positive approach into patient/participant interactions, clinical decision-making, and interventions. Improving access to sexual pleasure acknowledges BSMM's right to optimal, holistic sexual health.
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Affiliation(s)
- John Mark Wiginton
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway Street, Baltimore, MD, 21205, USA.
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Jessica L Maksut
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Valerie A Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, USA
| | - Marcie Berman
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
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6
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Eschliman EL, Uzzi M, White JJ, Mathews A, Henry M, Moran MB, Page K, Latkin CA, Tucker JD, Yang C. Crowdsourced PrEP Promotion Messages for an HIV High-Burden Area: A Framework-Based Content Analysis. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:69-81. [PMID: 35192395 PMCID: PMC10839679 DOI: 10.1521/aeap.2022.34.1.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pre-exposure prophylaxis (PrEP) is an important and highly effective HIV prevention strategy, but its uptake remains low, particularly among marginalized populations at high risk of HIV. Innovative and community-driven promotion strategies, such as open contests, are needed to address disparities. This directed content analysis uses a PrEP-specific adaptation of the Information-Motivation-Behavioral Skills (IMB) model to identify themes related to PrEP use reflected in community-generated submissions (n = 73) from an open contest conducted to elicit crowdsourced health promotion messages on PrEP in Baltimore, Maryland. In addition to identifying eight of the themes from the adapted IMB model, this analysis also identified two novel salient themes in the motivation category: self-worth/self-love and self-care practice. Findings from this analysis can inform PrEP promotion efforts by pointing to salient themes identified from a community-driven approach that are less well represented in existing research.
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Affiliation(s)
- Evan L. Eschliman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Mudia Uzzi
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jordan J. White
- Morgan State University, School of Social Work, Baltimore, Maryland
| | | | - Marcus Henry
- Know Your Place Movement & J.O.Y. Baltimore, Baltimore, Maryland
| | - Meghan B. Moran
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kathleen Page
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Carl A. Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Joseph D. Tucker
- University of North Carolina-Chapel Hill, School of Medicine, Chapel Hill, North Carolina
| | - Cui Yang
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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7
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Dennermalm N, Persson KI, Thomsen S, Forsberg BC, Alvesson HM. Conceptualizing safer sex in a new era: Risk perception and decision-making process among highly sexually active men who have sex with men. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000159. [PMID: 36962224 PMCID: PMC10022342 DOI: 10.1371/journal.pgph.0000159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/06/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) are at the epicenter of the HIV epidemic. Efforts to prevent sexually transmitted infections (STIs) and HIV transmission have traditionally focused on condoms and abstinence from high risk sexual practices. Recently, additional methods such as pre-exposure prophylaxis (PrEP) and viral load sorting have been introduced. The aim of this study was to gain understanding about risk management and risk perception strategies for HIV among highly sexually active Swedish MSM with men in Berlin. METHODS Eighteen sexually active Swedish MSM who travelled to or lived in Berlin were recruited and interviewed in this study. The data were analyzed using content analysis. RESULTS AND DISCUSSION These men represent a group of knowledgeable MSM in terms of HIV. They acknowledged that having sex with men in Berlin was linked to high sexual risk taking due to the higher prevalence of HIV/STIs than in Sweden, but reported that they nevertheless did not alter their risk management strategies. The analysis resulted in a conceptual model of risk assessment that allows for a deeper understanding of the complexity of the risk reduction decision-making process. Three ontological perceptions of risk were identified: accepting, minimizing and rejecting risk. Seven practiced risk reduction methods were described. Some informants applied their preferred method or set of methods to all settings and partners, while others faced complex decision-making processes. CONCLUSION HIV is integrated into the core of MSM's sexuality, independently of how they ontologically related to the idea of risk. A constant navigation between pleasure, risk and safety, alongside having to relate to risk created a complex process. Efforts were made to remove HIV from their lives by rejecting the idea of risk, and thereby reject the idea of the homosexual body being a possible vessel for a virus and an epidemic.
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Affiliation(s)
- Nicklas Dennermalm
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | | | - Sarah Thomsen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Birger C Forsberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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8
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Parchem B, Aguayo-Romero RA, del Río-González AM, Calabrese SK, Poppen PJ, Zea MC. Perceptions of power and sexual pleasure associated with sexual behaviour profiles among Latino sexual minority men. CULTURE, HEALTH & SEXUALITY 2021; 23:1344-1360. [PMID: 32744462 PMCID: PMC7855680 DOI: 10.1080/13691058.2020.1781263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
In a body of research typically focused on risk reduction and disease prevention, other factors motivating the sexual behaviours of Latino sexual minority men, such as resource-based power and sexual pleasure, are less well understood. To this end, Latino immigrant sexual minority men living in New York City were surveyed about their sexual behaviours, perceived power differentials, and pleasure from insertive and receptive anal intercourse. Power and pleasure were examined as associations with behavioural profiles identified through latent class analysis, adjusting for age and partner type. Four latent classes of Latino sexual minority men were identified based on behaviours reported during the most recent sexual event: behaviourally insertive (14.2%), behaviourally versatile (25.9%), behaviourally receptive (29.2%), and limited penetrative behaviour (30.7%). Participants who derived pleasure from insertive and receptive anal intercourse had higher odds of belonging in the behaviourally insertive and behaviourally receptive class, respectively. Perceptions of resource-based power were not associated with class membership. Findings highlight the importance of sexual pleasure as a driver of sexual behaviour, irrespective of power dynamics. Sexual health curricula and interventions for sexual minority men should consider sexual pleasure and sex-affirmative frameworks when providing sexuality education and promoting sexual wellbeing.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Rodrigo A. Aguayo-Romero
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
- Brigham and Women’s Hospital, Harvard Medical School, The Fenway Institute, Boston, MA, USA
| | | | - Sarah K. Calabrese
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
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9
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Laan ETM, Klein V, Werner MA, van Lunsen RHW, Janssen E. In Pursuit of Pleasure: A Biopsychosocial Perspective on Sexual Pleasure and Gender. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 33:516-536. [PMID: 38595780 PMCID: PMC10903695 DOI: 10.1080/19317611.2021.1965689] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/23/2021] [Accepted: 07/31/2021] [Indexed: 04/11/2024]
Abstract
Objective: Various sources of evidence suggest that men and women differ in their experience of sexual pleasure. Such gender differences have been attributed to men's higher innate sex drive, supported by evolutionary psychology perspectives and gender differences in reproductive strategies. Method: This paper presents biopsychosocial evidence for gender similarities in the capacity to experience pleasure, and for substantial gender differences in opportunities for sexual pleasure. Results: We conclude that sexual activity, in most cultures, is less pleasurable and associated with greater cost for heterosexual women than for heterosexual men, even though they do not differ in the capacity for sexual pleasure. Conclusion: Since gender differences in experienced sexual pleasure are not a biological given, a more critical discourse of sexual pleasure might create awareness of current inequalities, help lift restrictions for women's opportunities for pleasure, and could reduce gender differences in the cost of sex. That would truly serve sexual justice around the globe.
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Affiliation(s)
- Ellen T. M. Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Verena Klein
- Institute for Sex Research and Forensic Psychiatry, University of Hamburg, Hamburg, Germany
| | - Marlene A. Werner
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Rik H. W. van Lunsen
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Erick Janssen
- Department of Neurosciences, Institute for Family and Sexuality Studies, University of Leuven, Leuven, Belgium
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10
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Wade RM, Harper GW. Racialized Sexual Discrimination (RSD) in Online Sexual Networking: Moving from Discourse to Measurement. JOURNAL OF SEX RESEARCH 2021; 58:795-807. [PMID: 32877277 DOI: 10.1080/00224499.2020.1808945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Young Black gay/bisexual men (YBGBM) are at disproportionate risk for poor health outcomes due to multilevel stressors, such as community- and individual-level discrimination. Racialized Sexual Discrimination (RSD) is an under-examined type of discrimination experienced by gay/bisexual men of color when seeking partners online. RSD may be a driving force behind sexual network restriction (which elevates YBGBM's risk for HIV infection) and may have an adverse impact on YBGBM's psychological wellbeing. Thus, adequate measurement of this phenomenon is essential. Focus groups with young gay/bisexual men of color were conducted to generate survey content that captured RSD experiences; the resultant information was used to develop an RSD scale. The scale, along with other sociodemographic measures, was administered to a sample of 634 YBGBM. An exploratory factor analysis was conducted on the scale. Results revealed an 8-factor structure: 1-White superiority; 2-White inferiority; 3-White rejection; 4-same-race rejection; 5-White physical objectification; 6-same-race physical objectification); 7-degradation; and 8-role assumptions. The scale was psychometrically sound and demonstrated good reliability, providing preliminary support for the scale's utility in social science research. Future research should further refine the scale and examine the association between RSD and sexual/mental health outcomes among YBGBM.
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Affiliation(s)
- Ryan M Wade
- University of Illinois at Urbana-Champaign School of Social Work
| | - Gary W Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health
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11
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English D, Hickson DA, Callander D, Goodman MS, Duncan DT. Racial Discrimination, Sexual Partner Race/Ethnicity, and Depressive Symptoms Among Black Sexual Minority Men. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1799-1809. [PMID: 32222852 PMCID: PMC7340340 DOI: 10.1007/s10508-020-01647-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 06/01/2023]
Abstract
Although racial sexual exclusivity among Black gay, bisexual, and other sexual minority men (SMM) is frequently framed as a cause of HIV inequities, little research has examined how these sexual relationships may be driven by and protective against racism. This study examined associations between general racial discrimination, Black sexual exclusivity, sexual racial discrimination, and depressive symptoms among Black SMM. We conducted analyses on cross-sectional self-report data from 312 cisgender Black SMM in the U.S. Deep South who participated in the MARI study. Measures included general racial and sexual identity discrimination, race/ethnicity of sexual partners, sexual racial discrimination, and depressive symptoms. We estimated a moderated-mediation model with associations from discrimination to Black sexual exclusivity, moderated by discrimination target, from Black sexual exclusivity to sexual racial discrimination, and from sexual racial discrimination to depressive symptoms. We tested an indirect effect from racial discrimination to depressive symptoms to examine whether Black sexual exclusivity functioned as an intervening variable in the associations between racial discrimination and depressive symptoms. Results indicated that participants who experienced racial discrimination were more likely to exclusively have sex with Black men. Men with higher Black sexual exclusivity were less likely to experience sexual racial discrimination and, in turn, reported lower depressive symptoms. The indirect pathway from racial discrimination to depressive symptoms through Black sexual exclusivity and sexual racial discrimination was significant. Our results suggest that one of the drivers of sexual exclusivity among Black SMM may be that it helps to protect against the caustic psychological effects of racial discrimination.
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Affiliation(s)
- Devin English
- Rutgers School of Public Health, One Riverfront Plaza, Suite 1020 (10th Floor), Newark, NJ, 07102-0301, USA.
| | | | | | - Melody S Goodman
- New York University College of Global Public Health, New York, NY, USA
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12
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Wade RM, Harper GW. Racialized Sexual Discrimination (RSD) in the Age of Online Sexual Networking: Are Young Black Gay/Bisexual Men (YBGBM) at Elevated Risk for Adverse Psychological Health? AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 65:504-523. [PMID: 31587325 DOI: 10.1002/ajcp.12401] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Young Black gay/bisexual men (YBGBM) are a highly marginalized population across multiple health outcomes. Most research on YBGBM health has focused on HIV/sexual health, but there is a demonstrable need for research examining racism and psychosocial functioning among this population. Racialized Sexual Discrimination (RSD), also known as sexual racism, is an important but under-investigated phenomenon that may have implications for the psychological health and well-being of YBGBM. This paper provides an overview of empirical research on RSD as experienced by gay/bisexual men of color in online partner-seeking venues. First, the researchers discuss how racialized experiences are a documented online phenomenon, with a variety of manifestations, and identify the potential effects that this phenomenon may have on the psychosocial health of YBGBM, and gay/bisexual men of color as a whole. Second, the researchers synthesize the RSD literature with a broader literature examining psychological well-being across race and sexual orientation. Third, the researchers present a theoretically grounded conceptual model detailing the pathways between RSD and psychological well-being using a stress and coping framework. The paper concludes with recommendations for future research on this topic, including scale development and hypothesis testing.
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Affiliation(s)
- Ryan M Wade
- University of Illinois at Urbana-Champaign School of Social Work, Urbana, IL, USA
| | - Gary W Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
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13
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Vasilenko SA, Espinosa-Hernández G, Rice CE, Biello KB, Novak DS, Mayer KH, Mimiaga MJ, Rosenberger JG. Patterns of Sexual Behaviors in Young Men Who Have Sex With Men in Mexico. JOURNAL OF SEX RESEARCH 2019; 56:1168-1178. [PMID: 30638395 PMCID: PMC6626694 DOI: 10.1080/00224499.2018.1563667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recent research has documented the importance of understanding the multidimensional nature of sexual risk behavior. However, little is known about patterns of sexual behavior among men who have sex with men (MSM) in Mexico, men who are at greatest risk for HIV and sexually transmitted infections compared to other subpopulations in the country. This study applied latent class analysis to data from a large, HIV-negative sample of 18- to 25-year-old Mexican MSM recruited from a social and sexual networking website (N = 3,722) to uncover multidimensional patterns of sexual behaviors, partner factors, and protective behaviors, and examine how these were associated with health and well-being correlates. We selected a model with seven classes. The most common class included those who reported both insertive and receptive behaviors with more than one partner, but smaller groups of individuals were in classes marked by only insertive or receptive anal sex, romantic relationships, or sexual inactivity. Class membership differed by sexual orientation, age, depressive symptoms, alcohol problems, and self-acceptance, with individuals in a class marked by same-sex relationships generally reporting more positive outcomes. Findings suggest heterogeneity of behaviors among Mexican MSM and the possible efficacy of prevention messages tailored to individuals' specific patterns of sexual behavior.
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Affiliation(s)
- Sara A Vasilenko
- Department of Human Development and Family Science, Syracuse University
| | | | - Cara E Rice
- The Methodology Center, Pennsylvania State University
| | - Katie B Biello
- Departments of Behavioral and Social Sciences and Epidemiology, Brown University, and The Fenway Institute
| | | | - Kenneth H Mayer
- The Fenway Institute and Department of Global Health and Population, Harvard University
| | - Matthew J Mimiaga
- Departments of Behavioral & Social Health Sciences and Epidemiology, Brown University and The Fenway Institute
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14
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Elion RA, Kabiri M, Mayer KH, Wohl DA, Cohen J, Beaubrun AC, Altice FL. Estimated Impact of Targeted Pre-Exposure Prophylaxis: Strategies for Men Who Have Sex with Men in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1592. [PMID: 31067679 PMCID: PMC6539923 DOI: 10.3390/ijerph16091592] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/04/2019] [Accepted: 05/04/2019] [Indexed: 01/17/2023]
Abstract
Pre-exposure prophylaxis (PrEP) effectively reduces human immunodeficiency virus (HIV) transmission. We aimed to estimate the impact of different PrEP prioritization strategies among Black and Latino men who have sex with men (MSM) in the United States, populations most disproportionately affected by HIV. We developed an agent-based simulation to model the HIV epidemic among MSM. Individuals were assigned an HIV incidence risk index (HIRI-MSM) based on their sexual behavior. Prioritization strategies included PrEP use for individuals with HIRI-MSM ≥10 among all MSM, all Black MSM, young (≤25 years) Black MSM, Latino MSM, and young Latino MSM. We estimated the number needed to treat (NNT) to prevent one HIV infection, reductions in prevalence and incidence, and subsequent infections in non-PrEP users avoided under these strategies over 5 years (2016-2020). Young Black MSM eligible for PrEP had the lowest NNT (NNT = 10) followed by all Black MSM (NNT = 33) and young Latino MSM (NNT = 35). All Latino MSM and all MSM had NNT values of 63 and 70, respectively. Secondary infection reduction with PrEP was the highest among young Latino MSM (53.2%) followed by young Black MSM (37.8%). Targeting all MSM had the greatest reduction in prevalence (14.7% versus 2.9%-3.9% in other strategies) and incidence (49.4% versus 9.4%-13.9% in other groups). Using data representative of the United States MSM population, we found that a strategy of universal PrEP use by MSM was most effective in reducing HIV prevalence and incidence of MSM. Targeted use of PrEP by Black and Latino MSM, however, especially those ≤25 years, had the greatest impact on HIV prevention.
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Affiliation(s)
- Richard A Elion
- George Washington University School of Medicine, Washington, DC 20009, USA.
| | - Mina Kabiri
- Precision Health Economics, Los Angeles, CA 90025, USA.
| | - Kenneth H Mayer
- The Fenway Institute, Harvard Medical School, Boston, MA 02215, USA.
| | - David A Wohl
- Chapel Hill School of Medicine, The University of North Carolina, Chapel Hill, NC 27514, USA.
| | - Joshua Cohen
- Tufts University Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA 02111, USA.
| | | | - Frederick L Altice
- Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT 06510, USA.
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15
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Patterns of Sexual Behavior and Sexually Transmitted Infections in Young Men Who Have Sex With Men. Sex Transm Dis 2019; 45:387-393. [PMID: 29465677 DOI: 10.1097/olq.0000000000000767] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Young men who have sex with men (MSM) are at an increased risk for sexually transmitted infections (STIs). Recent research has documented the importance of understanding the multidimensional nature of sexual risk behavior; however, little is known about how multidimensional patterns of sexual behavior among MSM may be associated with STIs. METHOD This study applies latent class analysis to data from a large, HIV- sample of 18- to 25-year-old MSM recruited from social and sexual networking Web sites (N = 5965; 76% white, 11% Latino, 5% black, 4% Asian, 4% other; 74% homosexual, 21% bisexual, 1% heterosexual, 3%, unsure/questioning 1% other) to uncover multidimensional patterns of past-year sexual behaviors, partner factors, and protective behavior and their associations with self-reported STI diagnosis. RESULTS We selected a model with 8 classes, with nearly half of participants belonging to a class marked by multiple behaviors with more than 1 partner, and smaller numbers of individuals in classes with a smaller number of behaviors, romantic relationships, and sexual inactivity. Class membership was associated with recent STI diagnosis, with classes marked by no penetrative sex or receptive anal sex with consistent condom use having lower prevalence than those with inconsistent condom use, including those engaging in only insertive anal sex. CONCLUSIONS Findings suggest heterogeneity of behaviors within MSM and that prevention messages may be more effective if they are tailored to individuals' patterns of sexual behavior, as well as demographic and sociocontextual factors.
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16
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Herbenick D, Fu TCJ, Owens C, Bartelt E, Dodge B, Reece M, Fortenberry JD. Kissing, Cuddling, and Massage at Most Recent Sexual Event: Findings From a U.S. Nationally Representative Probability Sample. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:159-172. [PMID: 30040548 DOI: 10.1080/0092623x.2018.1494648] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Using data from the 2014 National Survey of Sexual Health and Behavior, a probability survey of Americans aged 14+, we assessed the prevalence and correlates of kissing, cuddling, and massage during 1,493 individuals' most recent sexual event from the past year. Most respondents reported kissing (87%) and cuddling (70%); fewer (23%) reported massage. Each was significantly associated with age, education, and relationship structure. Respondents younger than 30 were significantly more likely to indicate they did not kiss because kissing would have been too intimate with their partner. Only cuddling was significantly associated with event-level emotional intimacy and sexual pleasure.
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Affiliation(s)
- Debby Herbenick
- a School of Public Health-Bloomington, Department of Applied Health Sciences , Indiana University , Bloomington , Indiana , USA
- b Center for Sexual Health Promotion, School of Public Health-Bloomington , Indiana University , Bloomington , Indiana , USA
| | - Tsung-Chieh Jane Fu
- a School of Public Health-Bloomington, Department of Applied Health Sciences , Indiana University , Bloomington , Indiana , USA
- b Center for Sexual Health Promotion, School of Public Health-Bloomington , Indiana University , Bloomington , Indiana , USA
| | - Christopher Owens
- a School of Public Health-Bloomington, Department of Applied Health Sciences , Indiana University , Bloomington , Indiana , USA
- b Center for Sexual Health Promotion, School of Public Health-Bloomington , Indiana University , Bloomington , Indiana , USA
| | - Elizabeth Bartelt
- a School of Public Health-Bloomington, Department of Applied Health Sciences , Indiana University , Bloomington , Indiana , USA
- b Center for Sexual Health Promotion, School of Public Health-Bloomington , Indiana University , Bloomington , Indiana , USA
| | - Brian Dodge
- a School of Public Health-Bloomington, Department of Applied Health Sciences , Indiana University , Bloomington , Indiana , USA
- b Center for Sexual Health Promotion, School of Public Health-Bloomington , Indiana University , Bloomington , Indiana , USA
| | - Michael Reece
- a School of Public Health-Bloomington, Department of Applied Health Sciences , Indiana University , Bloomington , Indiana , USA
- b Center for Sexual Health Promotion, School of Public Health-Bloomington , Indiana University , Bloomington , Indiana , USA
| | - J Dennis Fortenberry
- c Indiana University School of Medicine, Indiana University , Indianapolis , Indiana , USA
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17
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Chittamuru D, Icard LD, Jemmott JB, O'Leary A. Prospective Predictors of Multiple Sexual Partners Among African American Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2081-2090. [PMID: 29926260 DOI: 10.1007/s10508-018-1207-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 02/16/2018] [Accepted: 03/23/2018] [Indexed: 06/08/2023]
Abstract
Studies show that having sex with multiple partners increases the risk of acquiring and transmitting sexually transmitted diseases, including HIV. The present article reports prospective predictors of having multiple sexual partners among 505 African American men in Philadelphia who have sex with men (MSM) who participated in an intervention trial and attended a 6-month follow-up. Participants completed audio computer-assisted surveys of demographics, sexual behavior, and Reasoned Action Approach and Social Cognitive Theory mediators concerning multiple partners. We analyzed the incidence of self-reported multiple partners at the 6-month follow-up, controlling for treatment condition and baseline levels of the theoretical variables. The odds of having multiple partners decreased with increasing age (p < .03). Participants who said they were HIV positive had lower odds of having multiple partners (p < .009). The more pride participants reported in their identities as black or African American men, the lower the odds that they reported having multiple partners (p < .02). Adverse outcome expectancies accruing to multiple partners fully mediated the effect of black pride and partially mediated the effects of age on the odds of having multiple partners. Modifiable factors such as perceived negative outcome expectancies regarding having multiple sex partners should be addressed in designing interventions and prevention programs with the goal of decreasing the number of sexual partners among African American MSM.
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Affiliation(s)
- Deepti Chittamuru
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Larry D Icard
- College of Public Health, School of Social Work, Temple University, 1301 Cecil B. Moore Ave., Suite 543, RA, Philadelphia, PA, 19121, USA.
| | - John B Jemmott
- Annenberg School of Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Ann O'Leary
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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18
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Philbin MM, Parker CM, Parker RG, Wilson PA, Garcia J, Hirsch JS. Gendered Social Institutions and Preventive Healthcare Seeking for Black Men Who Have Sex with Men: The Promise of Biomedical HIV Prevention. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:2091-2100. [PMID: 29926263 PMCID: PMC6309278 DOI: 10.1007/s10508-018-1211-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 03/23/2018] [Accepted: 04/02/2018] [Indexed: 06/01/2023]
Abstract
Research on gender and health, including research conducted among Black men who have sex with men (BMSM), has primarily focused on how gender norms and roles shape healthcare engagement. Here we advance that work by demonstrating how a broader theorization of gender, particularly one that moves beyond gender norms and performance to incorporate structures such as the healthcare system and the labor market, can facilitate an understanding of how gender affects preventive healthcare seeking among BMSM, particularly the uptake of pre-exposure prophylaxis (PrEP), a promising approach to alleviate HIV disparities. This article is based on a year-long ethnographic study conducted in New York City with BMSM (n = 31; three interviews each) and community stakeholders (n = 17). Two primary findings emerged: (1) the labor market systematically excluded the men in our sample, which limited their ability to access employer-sponsored healthcare. Such discrimination may promote overt demonstrations of masculinity that increase their HIV vulnerability and decrease healthcare seeking, and (2) healthcare systems are not structured to promote preventive healthcare for men, particularly BMSM. In fact, they constrained men's access to primary providers and were usually tailored to women. Applying a structural, gendered lens to men's health-in addition to the more frequently researched individual or interpersonal levels-provides insight into factors that affect healthcare seeking and HIV prevention for BMSM. These findings have implications for the design of policies and institutional reforms that could enhance the impact of PrEP among BMSM. Findings are also relevant to the management of chronic disease among men more broadly.
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Affiliation(s)
- Morgan M Philbin
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, Floor 5, Room 536, New York, NY, 10032, USA.
| | - Caroline M Parker
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, Floor 5, Room 536, New York, NY, 10032, USA
| | - Richard G Parker
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, Floor 5, Room 536, New York, NY, 10032, USA
| | - Patrick A Wilson
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, Floor 5, Room 536, New York, NY, 10032, USA
| | - Jonathan Garcia
- College of Public Health and Human Science, Oregon State University, Corvallis, OR, USA
| | - Jennifer S Hirsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, Floor 5, Room 536, New York, NY, 10032, USA
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19
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Carter A, Lachowsky N, Forrest JI, Cui Z, Sereda P, Kaida A, Armstrong HL, Card KG, Montaner JS, Moore D, Roth EA, Hogg RS. A latent class analysis of sexual and romantic relationships among HIV-positive and HIV-negative gay and bisexual men in Vancouver. CANADIAN JOURNAL OF HUMAN SEXUALITY 2017. [DOI: 10.3138/cjhs.262.a1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Allison Carter
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Nathan Lachowsky
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- School of Public Health and Social Policy, University of Victoria, Victoria, BC
| | - Jamie I. Forrest
- School of Population and Public Health, University of British Columbia, Vancouver, BC
| | - Zishan Cui
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Paul Sereda
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
| | - Heather L. Armstrong
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- Department of Medicine, University of British Columbia, Vancouver, BC
| | - Kiffer G. Card
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Julio S.G. Montaner
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- Department of Medicine, University of British Columbia, Vancouver, BC
| | - David Moore
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- Department of Medicine, University of British Columbia, Vancouver, BC
| | - Eric A. Roth
- Department of Anthropology, University of Victoria, Victoria, BC
| | - Robert S. Hogg
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
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20
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Bowleg L, Del Río-González AM, Holt SL, Pérez C, Massie JS, Mandell JE, A Boone C. Intersectional Epistemologies of Ignorance: How Behavioral and Social Science Research Shapes What We Know, Think We Know, and Don't Know About U.S. Black Men's Sexualities. JOURNAL OF SEX RESEARCH 2017; 54:577-603. [PMID: 28287844 DOI: 10.1080/00224499.2017.1295300] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Epistemologies of ignorance describe how ignorance influences the production of knowledge. Advancing an intersectional epistemologies of ignorance approach that examines how conscious (or unconscious) ignorance about racism, heterosexism, and classism shapes empirical knowledge about Black men's sexualities, we conducted a critical review of the behavioral and social science research on U.S. Black men, ages 18 and older, for two time frames: pre-1981 and the most recent decade, 2006-2016. Our search yielded 668 articles, which we classified into five categories: sexual violence, sexual experiences and expressions, sexual identities, cultural and social-structural influences, and sexual health and sexual risk. We found that most of the research, particularly pre-1981, centered the experiences of White heterosexual men as normative and implicitly constructed Black men as hypersexual or deviant. Most of the research also color-blinded White privilege and ignored how racism, heterosexism, and classism structured Black men's inequities. We also found notable exceptions to these trends. Black men who are gay, bisexual, or who have sex with men, and research on HIV risk were prominent in the past decade, as was research that emphasized the social-structural (e.g., poverty, heterosexism, racism) and cultural (e.g., masculinity, religion) contexts of Black men's lives and sexualities. We provide 10 recommendations to avoid intersectional epistemic ignorance in future research.
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Affiliation(s)
- Lisa Bowleg
- a Department of Psychology , The George Washington University
| | | | - Sidney L Holt
- a Department of Psychology , The George Washington University
| | - Carolin Pérez
- a Department of Psychology , The George Washington University
| | - Jenné S Massie
- a Department of Psychology , The George Washington University
| | | | - Cheriko A Boone
- a Department of Psychology , The George Washington University
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21
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Klein C, Lomonaco C. Real Talk: Developing a Computer-Delivered Sexual Health Program for Black Men Who Have Sex With Men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:455-471. [PMID: 27925486 PMCID: PMC6261286 DOI: 10.1521/aeap.2016.28.6.455] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
HIV disproportionately affects Black men who have sex with men (MSM), yet there are few evidence-based programs that respond to the diverse realities of Black MSM communities. This article examines the development of Real Talk, a new harm reduction-based, sexual health intervention for Black MSM. We first analyze the key themes from our formative research: (1) stigma, discrimination, and intersectionalities in the lives of Black MSM, (2) the importance of safe spaces and community provided by health promotion programs, and (3) moving beyond condoms in sexual health messaging. We then describe our agile design product development process and present an overview of the intervention's components and how they respond to the issues identified in the formative research. In conclusion, we discuss dissemination opportunities and challenges in an age of decreased prevention funding, pre-exposure prophylaxis (PrEP), and the increased use of e-health promotion modalities.
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Affiliation(s)
| | - Carmela Lomonaco
- Office of the President, University of California, Oakland, California
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22
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Tan JY, Xu LJ, Lopez FY, Jia JL, Pho MT, Kim KE, Chin MH. Shared Decision Making Among Clinicians and Asian American and Pacific Islander Sexual and Gender Minorities: An Intersectional Approach to Address a Critical Care Gap. LGBT Health 2016; 3:327-34. [PMID: 27158858 DOI: 10.1089/lgbt.2015.0143] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Shared decision making (SDM) is a model of patient-provider communication. Little is known about the role of SDM in health disparities among Asian American and Pacific Islander (AAPI) sexual and gender minorities (SGM). We illustrate how issues at the intersection of AAPI and SGM identities affect SDM processes and health outcomes. We discuss experiences of AAPI SGM that are affected by AAPI heterogeneity, SGM stigma, multiple minority group identities, and sources of discrimination. Recommendations for clinical practice, research, policy, community development, and education are offered.
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Affiliation(s)
- Judy Y Tan
- 1 Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, California
| | - Lucy J Xu
- 2 Section of General Internal Medicine, Department of Medicine, University of Chicago , Chicago, Illinois.,3 Pritzker School of Medicine, University of Chicago , Chicago, Illinois
| | - Fanny Y Lopez
- 2 Section of General Internal Medicine, Department of Medicine, University of Chicago , Chicago, Illinois
| | - Justin L Jia
- 2 Section of General Internal Medicine, Department of Medicine, University of Chicago , Chicago, Illinois.,4 The College, University of Chicago , Chicago, Illinois
| | - Mai T Pho
- 5 Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago , Chicago, Illinois
| | - Karen E Kim
- 6 Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago , Chicago, Illinois.,7 Center for Asian Health Equity, University of Chicago , Chicago, Illinois
| | - Marshall H Chin
- 2 Section of General Internal Medicine, Department of Medicine, University of Chicago , Chicago, Illinois.,8 Robert Wood Johnson Foundation Finding Answers: Solving Disparities through Payment and Delivery System Reform Program Office, University of Chicago , Chicago, Illinois
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23
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Matthews DD, Smith JC, Brown AL, Malebranche DJ. Reconciling Epidemiology and Social Justice in the Public Health Discourse Around the Sexual Networks of Black Men Who Have Sex With Men. Am J Public Health 2016; 106:808-14. [PMID: 26890175 DOI: 10.2105/ajph.2015.303031] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Several studies have implicated the sexual networks of Black men who have sex with men (MSM) as facilitating disproportionally high rates of new HIV infections within this community. Although structural disparities place these networks at heightened risk for infection, HIV prevention science continues to describe networks as the cause for HIV disparities, rather than an effect of structures that pattern infection. We explore the historical relationship between public health and Black MSM, arguing that the current articulation of Black MSM networks is too often incomplete and counterproductive. Public health can offer a counternarrative that reconciles epidemiology with the social justice that informs our discipline, and that is required for an effective response to the epidemic among Black MSM.
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Affiliation(s)
- Derrick D Matthews
- Derrick D. Matthews is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Justin C. Smith is with the Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Andre L. Brown is with the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. David J. Malebranche is with Student Health Service, University of Pennsylvania, Philadelphia
| | - Justin C Smith
- Derrick D. Matthews is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Justin C. Smith is with the Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Andre L. Brown is with the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. David J. Malebranche is with Student Health Service, University of Pennsylvania, Philadelphia
| | - Andre L Brown
- Derrick D. Matthews is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Justin C. Smith is with the Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Andre L. Brown is with the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. David J. Malebranche is with Student Health Service, University of Pennsylvania, Philadelphia
| | - David J Malebranche
- Derrick D. Matthews is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Justin C. Smith is with the Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Andre L. Brown is with the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. David J. Malebranche is with Student Health Service, University of Pennsylvania, Philadelphia
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