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Dickstein DR, Amarasekera C, Chen RC, Nguyen PL, Hoffman KE. Clinical considerations for sexual and gender minorities with prostate cancer. Urol Oncol 2024; 42:345-351. [PMID: 38987120 DOI: 10.1016/j.urolonc.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/28/2024] [Accepted: 06/04/2024] [Indexed: 07/12/2024]
Abstract
At every stage of the cancer continuum, the management of sexual and gender minorities with prostate cancer requires a thoughtful and multidisciplinary approach. For example, it is important to recognize that receptive anal intercourse, common among sexual minority men-i.e. gay and bisexual men-can potentially elevate prostate-specific antigen (PSA) leading to overdiagnosis and overtreatment. Additionally, it is important to understand that sexual minority men with prostate cancer might engage in insertive and/or receptive anal intercourse, as opposed to insertive vaginal intercourse, requiring a treatment conversation that expands beyond the usual discussion of sexual health in prostate cancer patients. For gender minorities-i.e. transgender women or trans feminine individuals (those recorded male at birth with feminine gender identities)-it is important to consider gender affirming hormones and pelvic surgeries as they can cause diagnostic and treatment challenges, including PSA suppression, more aggressive disease, and anatomical changes. Furthermore, it is essential to recognize that gender minorities are a diverse cohort and may or may not be on gender affirming hormone therapy and may or may not have received or intend to receive pelvic affirming surgery. In this seminar article, we highlight considerations for personalized management of prostate cancer in sexual and gender minorities to improve care for this understudied cohort and enhance health equity.
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Affiliation(s)
- Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York City, NY.
| | - Channa Amarasekera
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Ronald C Chen
- Department of Radiation Oncology, The University of Kansas Medical Center, Kansas City, KS
| | - Paul L Nguyen
- Department of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA
| | - Karen E Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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2
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Yu Y, Qin K, Tang S, Xian Y. Anal Sexual Roles and Impacts on HIV Infection and Psychological Distress Among Men Who Have Sex With Men in China: A 14-Year Longitudinal Study. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:3573-3582. [PMID: 39152319 DOI: 10.1007/s10508-024-02964-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/06/2024] [Accepted: 07/18/2024] [Indexed: 08/19/2024]
Abstract
Previous studies have shown that men who have sex with men (MSM) with different anal sexual roles, namely bottom, versatile, and top, are at different risk of HIV infection and psychological distress. However, the evidence was primarily derived from cross-sectional designs from Western countries, and it remains unclear how anal sexual roles change over a long time and their health impacts among MSM from Eastern countries. We aimed to describe the changes in anal sexual roles among a Chinese sample of MSM over 14 years and explore their effects on HIV infection, depression, anxiety, and suicidal ideation. Between 2009 and 2023, a longitudinal study was conducted on 373 MSM in Changsha, China, to assess their anal sexual roles, HIV infection, and psychological distress, including depression, anxiety, and suicidal ideation. Generalized linear models with a binomial probability was used to analyze the predictive effect of anal sexual roles on HIV infection and psychological distress. At baseline, 30.3% of MSM self-identified as bottom, 32.2% as versatile, and 37.5% as top, and these numbers changed slightly to 35.9%, 33.0%, and 31.1%, respectively, at follow-up (p = 0.131). From baseline to follow-up, 48 (12.9%) new HIV cases were identified. The prevalence of depression increased from 23.1 to 38.1% (p < 0.001), anxiety increased from 25.5% to 35.4% (p = 0.003), and suicidal ideation increased from 30.8 to 38.9% (p = 0.021). MSM with bottom and versatile roles were more likely to have HIV infection, depression, anxiety, and suicidal ideation than those with top roles. MSM's risk of HIV infection and psychological distress varies according to their anal sexual roles, suggesting that future HIV prevention and mental health improvement programs for MSM may benefit from providing targeted and individualized support based on their anal sexual roles, with a particular focus on those with bottom and versatile roles.
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Affiliation(s)
- Yong Yu
- School of Politics and Public Administration, Guangxi Normal University, Guilin, 541006, Guangxi, China.
| | - Keke Qin
- School of Politics and Public Administration, Guangxi Normal University, Guilin, 541006, Guangxi, China
| | - Shishi Tang
- School of Politics and Public Administration, Guangxi Normal University, Guilin, 541006, Guangxi, China
| | - Yedong Xian
- School of Politics and Public Administration, Guangxi Normal University, Guilin, 541006, Guangxi, China
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3
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Mapingure MP, Chingombe I, Dzinamarira T, Cuadros D, Murewanhema G, Moyo B, Samba C, Mpofu A, Mugurungi O, Herrera H, Musuka G. Condomless anal intercourse among HIV-positive and HIV-negative men who have sex with men in Zimbabwe. South Afr J HIV Med 2024; 25:1583. [PMID: 39364387 PMCID: PMC11447604 DOI: 10.4102/sajhivmed.v25i1.1583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/27/2024] [Indexed: 10/05/2024] Open
Abstract
Background Men who have sex with men (MSM) are disproportionately impacted by HIV in sub-Saharan Africa (SSA), where condomless anal intercourse (CAI) is a major driver of HIV transmission among this hidden subpopulation. Objectives To determine CAI drivers and prevalence among HIV-positive and HIV-negative MSM. Method Data from 1538 MSM who participated in a biobehavioural survey in Zimbabwe were used. Secondary statistical data analysis methods were used to determine prevalences and drivers of CAI. Results A high prevalence of CAI, of at least 30%, among HIV-positive and HIV-negative MSM was found. Factors that led to a statistically significant higher CAI among HIV-positives compared to HIV-negatives included drunkenness (35% vs. 25%, P = 0.01), fear of partner (13% vs. 9%, P = 0.017), trusting the partner (10% vs. 6%, P = 0.008), and being offered more money (10% vs. 6%, P = 0.003). Conclusion Our findings indicate that economic, socio-behavioural and perceptual dimensions increase men's likelihood to engage in risky sexual behaviour, suggesting the need for HIV prevention efforts that provide tailored education regarding HIV risk among MSM in SSA. This is the first large biobehavioural survey that generated valuable information useful for analysing condomless anal sex among MSM in Zimbabwe.
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Affiliation(s)
| | | | | | - Diego Cuadros
- Digital Epidemiology Laboratory, Digital Futures, University of Cincinnati, Cincinnati, United States of America
| | - Grant Murewanhema
- Unit of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Brian Moyo
- AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe
| | | | | | - Owen Mugurungi
- AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Helena Herrera
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Godfrey Musuka
- International Initiative for Impact Evaluation, Harare, Zimbabwe
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4
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Weng RX, Ning N, Luo YT, Zhang CL, Wen LZ, Ye JB, Li J, Chen XS, Cai YM. Using Self-Reported Sexual Positioning as an Indicator for Rectal Chlamydia and Gonorrhea Screening Among Men Who Have Sex With Men in China: A Missed Opportunity. Sex Transm Dis 2024; 51:400-406. [PMID: 38403298 DOI: 10.1097/olq.0000000000001954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
BACKGROUND Rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) are escalating public health concerns. This study aimed to explore (1) the reliability of self-reported sexual positioning as an indicator for rectal CT and NG screening, and (2) factors associated with rectal CT and NG infections in Shenzhen, China. METHODS A cross-sectional study was conducted in 2 settings in Shenzhen, China, from April 1, 2021, to March 31, 2022. Data on sociodemographic characteristics, sexual behaviors, and basic CT knowledge were collected. Urine and self-collected rectal swabs were collected for CT and NG testing. RESULTS In total, 195 MSM participated in the study, and 5.1% tested positive for urogenital CT, 29.2% for rectal CT, 1.0% for urogenital NG, and 8.2% for rectal NG. Among those who reported exclusively insertive anal sex, 69.2% of CT infections and 85.7% of NG infections would have remained undetected with urine testing alone. Risk factors for rectal CT infection included engaging in both insertive and receptive anal sex, with a significant association found for coinfection with rectal NG. CONCLUSIONS Self-reported sexual positioning was found to be an unreliable indicator for CT and NG screening, as a substantial proportion of infections would have remained undetected. The findings suggest that CT and NG screening in China should be offered to all MSM regardless of self-reported sexual positioning, and that the dual CT/NG testing is recommended.
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Affiliation(s)
| | - Ning Ning
- From the Shenzhen Center for Chronic Disease Control, Shenzhen Institute of Dermatology, Shenzhen, Guangdong Province, China
| | - Yi-Ting Luo
- From the Shenzhen Center for Chronic Disease Control, Shenzhen Institute of Dermatology, Shenzhen, Guangdong Province, China
| | - Chun-Lai Zhang
- From the Shenzhen Center for Chronic Disease Control, Shenzhen Institute of Dermatology, Shenzhen, Guangdong Province, China
| | - Li-Zhang Wen
- From the Shenzhen Center for Chronic Disease Control, Shenzhen Institute of Dermatology, Shenzhen, Guangdong Province, China
| | - Jian-Bin Ye
- From the Shenzhen Center for Chronic Disease Control, Shenzhen Institute of Dermatology, Shenzhen, Guangdong Province, China
| | - Jing Li
- From the Shenzhen Center for Chronic Disease Control, Shenzhen Institute of Dermatology, Shenzhen, Guangdong Province, China
| | | | - Yu-Mao Cai
- From the Shenzhen Center for Chronic Disease Control, Shenzhen Institute of Dermatology, Shenzhen, Guangdong Province, China
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5
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Dickstein DR, Edwards CR, Rowan CR, Avanessian B, Chubak BM, Wheldon CW, Simoes PK, Buckstein MH, Keefer LA, Safer JD, Sigel K, Goodman KA, Rosser BRS, Goldstone SE, Wong SY, Marshall DC. Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus. Nat Rev Gastroenterol Hepatol 2024; 21:377-405. [PMID: 38763974 DOI: 10.1038/s41575-024-00932-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/21/2024]
Abstract
The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI - encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.
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Affiliation(s)
- Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Collin R Edwards
- Department of Radiology, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Catherine R Rowan
- Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Bella Avanessian
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara M Chubak
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health at Temple University, Philadelphia, PA, USA
| | - Priya K Simoes
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael H Buckstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laurie A Keefer
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua D Safer
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Keith Sigel
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karyn A Goodman
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health at University of Minnesota, Minneapolis, MN, USA
| | - Stephen E Goldstone
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Serre-Yu Wong
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah C Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Silva T. Self-Rated Masculinity and Femininity and Reported Number of Lifetime Sexual Partners Among Cisgender Heterosexual and LGBQ Men and Women. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1633-1644. [PMID: 38097871 DOI: 10.1007/s10508-023-02756-7] [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: 06/08/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 05/21/2024]
Abstract
Prior research has quantitatively examined why heterosexual men and women report different numbers of lifetime different-sex sexual partners, whereas qualitative work has analyzed how men's masculinity-and to a lesser extent, women's femininity-is tied to gender norms about sexual activity. Less research, however, has quantitatively examined the associations between self-rated masculinity and femininity and reported number of lifetime sexual partners. This brief report uses a large sample of Canadians (n = 2117) to examine how self-rated masculinity and femininity relate to reported numbers of sexual partners among four groups of cisgender people: (1) heterosexual men (n = 972), (2) heterosexual women (n = 979), (3) gay and bisexual/pansexual men (n = 99), and (4) lesbian and bisexual/pansexual women (n = 67). Results demonstrate that self-rated femininity was negatively, and masculinity positively, associated with reported numbers of lifetime different-sex sexual partners among heterosexual women. No significant associations emerged for other groups. The lack of significant associations among heterosexual men may be attributable to the fact that most rated themselves as very masculine and not very feminine, whereas there was more variation among heterosexual women. In contrast, the non-significance among LGBQ women and men could reflect that subcultural norms and practices more strongly shape the number of sexual partners individuals report having in these communities. These results demonstrate that it would be beneficial for researchers to measure self-rated masculinity and femininity in future studies about sexual partnering practices, especially among heterosexual cisgender women.
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Affiliation(s)
- Tony Silva
- Department of Sociology, University of British Columbia, 6303 NW Marine Drive, Vancouver, BC, V6T 1Z1, Canada.
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7
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Wade RM, Piasecki M. Whose Role is It Anyway? Sexual Racism and Sexual Positioning Among Young Sexual Minority Black Men. JOURNAL OF SEX RESEARCH 2024:1-12. [PMID: 38270958 DOI: 10.1080/00224499.2024.2305823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Racialized Sexual Discrimination (RSD), also referred to as "sexual racism," is widely reported among young sexual minority Black men (YSMBM). Though RSD is driven in part by sexual scripts and racial stereotypes, little is known about YSMBM's experiences with RSD with respect to their sexual positioning roles. Using data from a cross-sectional web-survey of YSMBM (N = 726), a multivariate Kruskal Wallis test was conducted comparing YSMBM who identified as mostly bottom, versatile, or mostly top, on the degree to which they were affected by four RSD experiences, as well as the frequency with which they encountered these experiences. Men identifying as mostly bottom reported significantly stronger negative reactions to same-race rejection and encountering sexual role assumptions than men identifying as mostly top. Men identifying as versatile encountered same-race rejection significantly more frequently than men identifying as mostly top. Men identifying as mostly bottom encountered White superiority significantly more frequently than men identifying as mostly top. RSD may impact YSMBM differentially based on sexual position. These findings may have implications for culturally competent clinical practice, as well as analytic implications (e.g., estimating more complex statistical models) for sexual racism research, which remains an important yet underexamined field in the health sciences.
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Affiliation(s)
- Ryan M Wade
- School of Social Work, University of Illinois at Urbana-Champaign
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8
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Rubini E, Valente M, Trentin M, Facci G, Ragazzoni L, Gino S. Negative consequences of conflict-related sexual violence on survivors: a systematic review of qualitative evidence. Int J Equity Health 2023; 22:227. [PMID: 37891663 PMCID: PMC10612192 DOI: 10.1186/s12939-023-02038-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Conflicts exacerbate dynamics of power and inequalities through violence normalization, which acts as a facilitator for conflict-related sexual violence. Literature addressing its negative outcomes on survivors is scant. The aim of this systematic review was to analyze the qualitative evidence reported in scientific literature and focusing on the negative consequences of conflict-related sexual violence on victims' physical, psychological, and social dimensions of health in a gender-inclusive and disaggregated form. METHODS A literature search was conducted on January 13, 2023 on Pubmed, Scopus, and PsychArticles. The search strings combined two blocks of terms related to sexual violence and conflict. A time filter was applied, limiting the search to studies published in the last ten years. Information regarding the main characteristics and design of the study, survivors and their experience, and about conflict-related sexual violence was collected. The negative consequences of conflict-related sexual violence on the physical, psychological, and social dimension of victims were extracted according to the Biopsychosocial model of health. The review followed the Joanna Briggs Institute methodology for systematic reviews and relied on the Preferred Reporting Items for Systematic reviews and Meta-Analyses. RESULTS After full text review, 23 articles met the inclusion criteria, with 18 of them reporting negative repercussions on physical health, all of them highlighting adverse psychological outcomes, and 21 disclosing unfavorable social consequences. The negative outcomes described in multiple studies were sexual and reproductive health issues, the most mentioned being pregnancy, manifestations of symptoms attributable to post-traumatic stress disorder, and stigma. A number of barriers to access to care were presented as emerging findings. CONCLUSIONS This review provided an analysis of the negative consequences of conflict-related sexual violence on survivors, thus highlighting the importance of qualitative evidence in understanding these outcomes and addressing barriers to access to care. Conflict-related sexual violence is a sexual and reproductive health issue. Sexuality education is needed at individual, community, and provider level, challenging gender norms and roles and encompassing gender-based violence. Gender-inclusive protocols and services need to be implemented to address the specific needs of all victims. Governments should advocate for SRHRs and translate health policies into services targeting survivors of CRSV.
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Affiliation(s)
- Elena Rubini
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy.
| | - Martina Valente
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, 13100, Vercelli, Italy
| | - Monica Trentin
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, 28100, Novara, Italy
| | - Giulia Facci
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, 28100, Novara, Italy
| | - Luca Ragazzoni
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, 13100, Vercelli, Italy
| | - Sarah Gino
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
- Department of Health Sciences, Università del Piemonte Orientale, 28100, Novara, Italy
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VanderLaan DP, Skorska MN, Peragine DE, Coome LA. Carving the Biodevelopment of Same-Sex Sexual Orientation at Its Joints. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2939-2962. [PMID: 35960401 DOI: 10.1007/s10508-022-02360-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/30/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
Sexual orientation is a core aspect of human experience and understanding its development is fundamental to psychology as a scientific discipline. Biological perspectives have played an important role in uncovering the processes that contribute to sexual orientation development. Research in this field has relied on a variety of populations, including community, clinical, and cross-cultural samples, and has commonly focused on female gynephilia (i.e., female sexual attraction to adult females) and male androphilia (i.e., male sexual attraction to adult males). Genetic, hormonal, and immunological processes all appear to influence sexual orientation. Consistent with biological perspectives, there are sexual orientation differences in brain development and evidence indicates that similar biological influences apply across cultures. An outstanding question in the field is whether the hypothesized biological influences are all part of the same process or represent different developmental pathways leading to same-sex sexual orientation. Some studies indicate that same-sex sexually oriented people can be divided into subgroups who likely experienced different biological influences. Consideration of gender expression in addition to sexual orientation might help delineate such subgroups. Thus, future research on the possible existence of such subgroups could prove to be valuable for uncovering the biological development of sexual orientation. Recommendations for such future research are discussed.
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Affiliation(s)
- Doug P VanderLaan
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada.
- Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Malvina N Skorska
- Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Diana E Peragine
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada
| | - Lindsay A Coome
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada
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10
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Dickstein DR, Edwards CR, Lehrer EJ, Tarras ES, Gallitto M, Sfakianos J, Galsky MD, Stock R, Safer JD, Rosser BRS, Marshall DC. Sexual health and treatment-related sexual dysfunction in sexual and gender minorities with prostate cancer. Nat Rev Urol 2023; 20:332-355. [PMID: 37217695 PMCID: PMC10389287 DOI: 10.1038/s41585-023-00778-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 05/24/2023]
Abstract
Prostate cancer treatment has substantial effects on sexual health and function. Sexual function is a vital aspect of human health and a critical component of cancer survivorship, and understanding the potential effects of different treatment modalities on sexual health is crucial. Existing research has extensively described the effects of treatment on male erectile tissues necessary for heterosexual intercourse; however, evidence regarding their effects on sexual health and function in sexual and gender minority populations is minimal. These groups include sexual minority - gay and bisexual - men, and transgender women or trans feminine people in general. Such unique effects in these groups might include altered sexual function in relation to receptive anal and neovaginal intercourse and changes to patients' role-in-sex. Sexual dysfunctions following prostate cancer treatment affecting quality of life in sexual minority men include climacturia, anejaculation, decreased penile length, erectile dysfunction, and problematic receptive anal intercourse, including anodyspareunia and altered pleasurable sensation. Notably, clinical trials investigating sexual outcomes after prostate cancer treatment do not collect sexual orientation and gender identity demographic data or outcomes specific to members of these populations, which perpetuates the uncertainty regarding optimal management. Providing clinicians with a solid evidence base is essential to communicate recommendations and tailor interventions for sexual and gender minority patients with prostate cancer.
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Affiliation(s)
- Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Collin R Edwards
- Department of Radiology, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Eric J Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elizabeth S Tarras
- Department of Pulmonology, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Matthew Gallitto
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - John Sfakianos
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew D Galsky
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Richard Stock
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua D Safer
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health at University of Minnesota, Minneapolis, MN, USA
| | - Deborah C Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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11
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Song L, Yu X, Su B, Geng WK, Lan G, Zhang X. HIV Prevalence and Risk Factors Among Young Men Who Have Sex With Men in Southwest China: Cross-sectional Questionnaire Study. JMIR Form Res 2023; 7:e37344. [PMID: 36630166 PMCID: PMC9893886 DOI: 10.2196/37344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 09/06/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Previous studies showed an increase in HIV prevalence among young men who have sex with men aged 25 years or younger in China. OBJECTIVE This study aimed to assess HIV prevalence and associated factors among young men who have sex with men in the Guangxi Zhuang Autonomous Region. METHODS This study was conducted in 4 cities (Guilin, Liuzhou, Beihai, and Nanning) in the Guangxi Zhuang Autonomous Region between June 2014 and May 2016. Participants were reached through web-based and site recruitment approaches. Laboratory tests were performed to detect HIV and syphilis infections. A self-administered questionnaire was used to collect data from 632 eligible young men who have sex with men. RESULTS The prevalence of HIV and syphilis was 9.3% (59/632) and 11.4% (72/632), respectively. Multivariable logistic analysis showed that ethnic minority (adjusted odds ratio [AOR] for Han Chinese vs other minorities 0.28, 95% CI 0.11-0.71, P=.007), receptive sexual positioning in the past 6 months (AOR 2.94, 95% CI 1.32-6.53, P=.008), current syphilis infection (AOR for individuals without vs those with infection 0.38, 95% CI 0.19-0.75, P=.005), inconsistent condom use in the past 6 months (AOR 1.91, 95% CI 1.06-3.45, P=.03), and psychotropic drug use before last anal intercourse (AOR 16.70, 95% CI 2.34-119.18, P=.005) were independently associated with HIV infection. CONCLUSIONS There is an urgent need to scale up HIV and syphilis interventions in young men who have sex with men. Some subgroups might need specific attention for HIV prevention, including ethnic minority men, individuals with a history of sexually transmitted infections, and individuals who have been engaging in receptive anal sex.
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Affiliation(s)
- Liping Song
- School of Public Health, Guilin Medical University, Guilin, China
| | - Xiangyuan Yu
- School of Public Health, Guilin Medical University, Guilin, China
| | - Bing Su
- Department of Clinical Psychology, Qingdao Mental Health Center, Qingdao, China
| | - Wen Kui Geng
- Guangxi Zhuang Autonomous Region Health and Family Planning Commission, Nanning, China
| | - Guanghua Lan
- Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Xiangjun Zhang
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, United States
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12
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Zambrano Sánchez PG, Mosquera Moyano F. A case of monkeypox coinfection with syphilis in an Ecuadorian HIV positive young male. Travel Med Infect Dis 2022; 52:102516. [PMID: 36581142 PMCID: PMC9791796 DOI: 10.1016/j.tmaid.2022.102516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/07/2022] [Accepted: 12/05/2022] [Indexed: 12/27/2022]
Abstract
The current Monkeypox (MPXV) outbreak has put evidence the worrisome trend of an increased prevalence of other sexually transmitted infections (STDs) particularly in the group of Men who have sex with men (MSM). This phenomenon is illustrated through the case of a 24-year-old male living with HIV that after attending a party where potentially unprotected sex was performed developed a painful popular perianal rash. Laboratory examinations performed confirmed the presence of an acute MPXV infection and primary syphilis, receiving pain relief medication and antibiotics with a rapid control of both illnesses. As in many cases during this outbreak, his HIV status was well controlled and thus a further understanding of the sexual practices in the MSM should help design more adequate interventions to prevent the spread of this and other more conventional STIs.
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13
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Hernandez AL, Weatherly CS, Burrowes S, Jimenez JL, Gonzalez R, Palefsky JM. "The problem is that our culture is just so messed up about aging." Recruiting older men who have sex with men (MSM) into research studies: an example from a study of aging, HIV, and anal HPV. BMC Med Res Methodol 2022; 22:296. [PMID: 36401159 PMCID: PMC9675202 DOI: 10.1186/s12874-022-01752-0] [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] [Received: 08/14/2021] [Revised: 07/11/2022] [Accepted: 10/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Anal human papillomavirus (HPV) disproportionately affects men who have sex with men (MSM), particularly those who are older and those living with HIV. After experiencing difficulty recruiting older MSM into a study on aging and anal HPV, we conducted a sub-study to gain feedback on our recruitment methods and explore barriers and facilitators to participating in anal HPV research. METHODS We conducted focus groups with 30 men who have sex with men (MSM), both HIV-negative and MSM living with HIV, ages 50-75. RESULTS We identified multiple themes that were barriers to participation including: (1) lack of knowledge about human papillomavirus and anal cancer; (2) research focused on anal cancer or discomfort with topics or procedures concerning the anus; (3) stigma including stigma associated with being men who have sex with men, being out, being a receptive partner, and being considered "older" in the gay community; and (4) confidentiality concerns including a fear of breach of confidentiality. Facilitators to participation were also identified; these motivational factors include altruism, wanting recommendations from a doctor, and desire to receive the best available care. CONCLUSION Researchers seeking to enroll older men who have sex with men should be aware of these barriers and facilitators to participation in order to maximize recruitment.
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Affiliation(s)
- Alexandra L Hernandez
- Department of Medicine Division of Infectious Diseases, University of California, San Francisco (UCSF), 513 Parnassus Ave, Room S420, Box 0654, 94143, San Francisco, CA, USA.
- Public Health Program, College of Education and Health Sciences, Touro University, Vallejo, CA, USA.
| | - Christopher Scott Weatherly
- Department of Medicine Division of Infectious Diseases, University of California, San Francisco (UCSF), 513 Parnassus Ave, Room S420, Box 0654, 94143, San Francisco, CA, USA
- College of Osteopathic Medicine, Touro University Nevada, Henderson, NV, USA
| | - Sahai Burrowes
- Public Health Program, College of Education and Health Sciences, Touro University, Vallejo, CA, USA
| | - Jessica Lopez Jimenez
- Public Health Program, College of Education and Health Sciences, Touro University, Vallejo, CA, USA
| | - Ryan Gonzalez
- Department of Medicine Division of Infectious Diseases, University of California, San Francisco (UCSF), 513 Parnassus Ave, Room S420, Box 0654, 94143, San Francisco, CA, USA
| | - Joel M Palefsky
- Department of Medicine Division of Infectious Diseases, University of California, San Francisco (UCSF), 513 Parnassus Ave, Room S420, Box 0654, 94143, San Francisco, CA, USA
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14
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Silva T. Subcultural Identification, Penetration Practices, Masculinity, and Gender Labels within a Nationally Representative Sample of Three Cohorts of American Black, White, and Latina/o LGBQ People. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3467-3483. [PMID: 35997907 DOI: 10.1007/s10508-022-02285-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 06/15/2023]
Abstract
Most quantitative research about lesbian, gay, bisexual, and queer (LGBQ) people's sexual subcultures and sexual practices has used non-probability samples due to data limitations. This paper used the Generations study, a national probability sample of LGBQ Americans in three age cohorts, 18-25 (n = 510), 34-41 (n = 294), and 52-59 (n = 425), who also identified as Black, white, or Latina/o. This paper analyzed men (n = 590) and women (n = 639) to answer the following sets of research questions: (1) What is the prevalence of subcultural identification as bear, leather/kink, twink, and jock among men, and how does it differ by cohort, race/ethnicity, and sexual identity? (2) What is the prevalence of men who describe themselves as a top, versatile top, versatile, versatile bottom, and bottom? What is the relationship between penetration practices and masculinity? (3) What is the prevalence of gender labels among women as femme, androgynous, and butch? How does the prevalence differ by cohort, race/ethnicity, and sexual identity? (4) What is the relationship between women's gender labels and masculinity? Penetration practices were fairly evenly distributed among men, and there were few differences in masculinity based on penetration practices after controlling for demographics and subcultural identification. Most women did not use gender labels, but butch identities were more common among lesbians and femme labels were more common among Black women and Latinas.
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Affiliation(s)
- Tony Silva
- Department of Sociology, University of British Columbia, 6303 NW Marine Drive, Vancouver, BC, V6T 1Z1, Canada.
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15
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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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16
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Dangerfield Ii DT, Anderson JN, Wylie C, Arrington-Sanders R, Bluthenthal RN, Beyrer C, Farley JE. Refining a Multicomponent Intervention to Increase Perceived HIV Risk and PrEP Initiation: Focus Group Study Among Black Sexual Minority Men. JMIR Form Res 2022; 6:e34181. [PMID: 35947442 PMCID: PMC9403828 DOI: 10.2196/34181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 04/28/2022] [Accepted: 07/08/2022] [Indexed: 11/26/2022] Open
Abstract
Background Increased preexposure prophylaxis (PrEP) initiation is needed to substantially decrease HIV incidence among Black sexual minority men (BSMM). However, BSMM perceive others as PrEP candidates instead of themselves and are less likely than other groups to use PrEP if prescribed. Peers and smartphone apps are popular HIV prevention intervention tools typically used independently. However, they could be useful together in a multicomponent strategy to improve perceived HIV risk and PrEP initiation for this group. Information regarding attitudes and preferences toward this multicomponent strategy is limited. Objective The goal of this study is to obtain attitudes and perspectives regarding the design of a multicomponent intervention that uses a smartphone app and a peer change agent (PCA) to increase perceived HIV risk and PrEP initiation. The intervention will be refined based on thematic findings for a culturally responsive approach. Methods Data were obtained guided by life course theory and the health belief model using 12 focus groups and 1 in-depth interview among HIV-negative BSMM from Baltimore, MD, between October 2019 and May 2020 (n=39). Groups were stratified by the following ages: 18 to 24 years, 25 to 34 years, and 35 years and older. Participants were provided details regarding an existing mobile app diary to self-monitor sexual behaviors and a hypothetical PCA with whom to review the app. Facilitators posed questions regarding perceived HIV risk, attitudes toward the app, working with a PCA, and preferences for PCA characteristics and approaches. Results Most participants identified as homosexual, gay, or same gender-loving (26/38, 68%), were employed (26/38, 69%), single (25/38, 66%), and interested in self-monitoring sexual behaviors (28/38, 68%). However, themes suggested that participants had low perceived HIV risk, that self-monitoring sexual behaviors using a mobile app diary was feasible but could trigger internalized stigma, and that an acceptable PCA should be a possible self for BSMM to aspire to but they still wanted clinicians to “do their job.” Conclusions HIV-negative BSMM have dissonant attitudes regarding perceived HIV risk and the utility of a mobile app and PCA to increase perceived HIV risk and PrEP initiation. Future research will explore the feasibility, acceptability, and preliminary impact of implementing the multicomponent intervention on perceived HIV risk and PrEP initiation among BSMM in a pilot study.
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Affiliation(s)
- Derek T Dangerfield Ii
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Us Helping Us, People Into Living, Inc, Washington, DC, United States
| | - Janeane N Anderson
- University of Tennessee Health Science Center, Memphis, TN, United States
| | - Charleen Wylie
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | - Ricky N Bluthenthal
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| | - Christopher Beyrer
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jason E Farley
- Johns Hopkins School of Nursing, Baltimore, MD, United States
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17
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Parchem B, Aguayo-Romero RA, Alizaga NM, Poppen PJ, Cecilia Zea M. Sexual Role Identity and Anal Sex Positioning among Brazilian, Colombian, and Dominican Immigrant Sexual Minority Men. JOURNAL OF SEX RESEARCH 2022; 59:632-642. [PMID: 34080929 PMCID: PMC8639841 DOI: 10.1080/00224499.2021.1922574] [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: 05/03/2023]
Abstract
Sexual role identities for anal sex and anal sex positionings are often conflated in research. This study aimed to identify profiles of sexual minority men based on sexual role identity and anal sex positioning and determine correlates of these profiles, including individual (i.e., HIV-status identity, condom use, partner type, sexual orientation) and cultural (i.e., same-race partnering, country of birth, acculturation) factors. A sample of Brazilian, Colombian, and Dominican immigrant sexual minority men (n = 480) living in New York City were surveyed about identity and positioning at the two most recent encounters. Individual and cultural factors were examined as correlates of profiles identified through latent class analysis. Four latent classes were identified: No Labels (12%), Receptive Bottoms (16%), Insertive Tops (23%), Insertive and Receptive Versatiles (49%). We found a concordance rate of ~70% between identity and behavior. A proportion (12%) of behaviorally versatile men chose not to use sexual role labels. Living with HIV was associated with receptive and versatile classes, sex with main partners was associated with versatility, and sexual orientation differed across classes. Identity and behavior should not be used interchangeably in research or applied domains, particularly given the complexities of versatility and men who prefer to not use labels.
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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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18
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Moskowitz DA, Alvarado Avila A, Kraus A, Birnholtz J, Macapagal K. Top, Bottom, and Versatile Orientations among Adolescent Sexual Minority Men. JOURNAL OF SEX RESEARCH 2022; 59:643-651. [PMID: 34309441 DOI: 10.1080/00224499.2021.1954583] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sexual role preference or self-label (i.e., top, versatile, or bottom) has been well studied in samples of sexual minority men (SMM) but lacks research among adolescent sexual minority men (ASMM). In response, data were collected from 302 ASMM (15-18 years old), measuring sexual self-label, relationship and sexual experience, sexually explicit media use, use of geosocial networking applications, penis size satisfaction, and gender atypicality. Results showed there was no significant difference in the distribution of sexual position self-identity in ASMM when compared with data from published, adult samples. A model that associated sexual socialization factors with adopting any self-label was significant, with greater number of partners, previous geosocial networking app use, and more relationship experience being positive predictors of having a label. Additionally, a model that tested the convergent validity between self-label and enacted sexual behaviors was significant. Both receptive and insertive sex enactments were highly correlated with corresponding labels. Lastly, gender atypicality and penis size satisfaction were significant predictors of sexual position self-identity. Data from our study supports sexual self-labeling occurring before adulthood, during adolescence for SMM. Furthermore, it shows that socialization factors (e.g., partner frequency, using apps) are important in the development of sexual position self-identity in this population.
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Affiliation(s)
| | - Andrés Alvarado Avila
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Ashley Kraus
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Jeremy Birnholtz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Communication Studies, Northwestern University
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
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19
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Swift-Gallant A, Coome LA, Monks DA, VanderLaan DP. Recalled Childhood Separation Anxiety Differs by Anal Sex Role among Gay Men. JOURNAL OF SEX RESEARCH 2022; 59:546-554. [PMID: 33821703 DOI: 10.1080/00224499.2021.1903378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Male androphilia (i.e., male sexual attraction to adult males) is considered an evolutionary paradox because it is partially influenced by genes and associated with decreased reproduction. Traits associated with attachment to genetic relatives (i.e., kin) could prompt increased kin-directed altruism, thereby offsetting decreased reproduction by helping kin reproduce. These traits include childhood separation anxiety and adulthood neuroticism, which have been associated with feminine gender expression. In prior research, gay men with a receptive (Bottom or Versatile) anal sex role (ASR) reported greater childhood gender nonconformity (GNC) than those with an insertive (Top) ASR. We examined whether ASR groups also differed on recalled childhood separation anxiety and adulthood neuroticism. The Separation Anxiety Scale-Revised and Big-Five Personality Inventory - short form were completed by 350 gay and 146 heterosexual men. For neuroticism, ASR preference groups differed from heterosexual men but not from one another. Gay men who preferred a Bottom or Versatile ASR reported higher recalled childhood separation anxiety than Tops and heterosexual men. Recalled childhood GNC mediated ASR group differences with heterosexual men on childhood separation anxiety. These results indicate that subgroups of gay men delineated by ASR differ on an evolutionarily relevant developmental trait, childhood separation anxiety.
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Affiliation(s)
- Ashlyn Swift-Gallant
- Department of Psychology, University of Toronto Mississauga
- Department of Psychology, Memorial University of Newfoundland
| | | | - D Ashley Monks
- Department of Psychology, University of Toronto Mississauga
- Department of Cells and Systems Biology, University of Toronto
| | - Doug P VanderLaan
- Department of Psychology, University of Toronto Mississauga
- Child and Youth Psychiatry, Centre for Addiction and Mental Health
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20
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Schmid AT, Payam S. "I Don't Want to Have Sex as a Woman": A Qualitative Study Exploring Sexuality and Sexual Practices of Drag Queens in Germany. JOURNAL OF HOMOSEXUALITY 2022:1-21. [PMID: 35285775 DOI: 10.1080/00918369.2022.2051117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Drag queens are typically gay men who perform as caricature-like women. They thereby publicly challenge "naturally" binary gender role categories, though it remains unclear how that interplays with their private (e.g., sexual) lives. This study seeks to answer this question by exploring the sexuality and sexual practices of drag queens. Employing a critical realist approach, ten semi-structured interviews were conducted in Germany, with questions focusing on the drag queens' views on sexuality and sexual positioning. By adopting a thematic analysis, three main themes were identified: natural versus artificial identity; advocacy for sexuality; and rejection of heteronormativity. Results suggest that the primary intention of drag queens is to challenge heteronorms, while they regularly adhered to these privately. This illustrates the distinction made by the participants between their "public" persona, an artificial character that lacks sexuality, and their "private" life (e.g., sexual practices), shaped by an "inborn" sexuality.
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Affiliation(s)
- Anna Theresa Schmid
- Chair of Sociology of Diversity, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Shahin Payam
- Chair of Sociology of Diversity, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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21
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Walsh AR, Sullivan S, Stephenson R. Inter-partner Agreement of Condom Use and Sexual Positioning in Male Couples. JOURNAL OF SEX RESEARCH 2022; 59:212-223. [PMID: 33983091 DOI: 10.1080/00224499.2021.1924606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Accurate, reliable self-reports of sexual behavior are a crucial component of valid HIV risk-estimation and behavioral intervention evaluation, yet this data's reliability remains understudied. The goal of this study was to describe interpartner agreement on recent receptive anal intercourse (AI) and condomless receptive AI frequencies, among a sample of male couples. We quantified interpartner agreement on self-reported receptive AI and condomless receptive AI (absolute and relative to AI frequency), and position and condom use during a couple's most recent AI, using cross-sectional data from male partners (US, 2016-2017; N = 718 individuals). Proportional and statistical agreement (intraclass correlation coefficients (ICC), kappa (k)) were assessed. Observed agreement for receptive AI frequency was 49.44% (ICC (95% CI): 0.82(0.79, 0.84)) and for relative receptive frequency, 59.05% (ICC: 0.96 (0.85, 0.96). Agreement on condomless receptive AI was 90.21% (ICC: 0.78 (0.75, 0.82), and for relative condomless receptive AI, 91.15% (ICC: 0.80 (0.77, 0.83). Most recent AI position agreement was 89.42% (k (95% CI): 0.84 (0.80, 0.88)), and condom use, 98.89% (k: 0.82 (0.87, 0.98)). Observed agreement was higher among those who reported consistent positioning and condom use. Further research on self-reported sexual behavior data is needed to improve research validity and intervention effectiveness.
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Affiliation(s)
- Alison R Walsh
- Center for Sexuality and Health Disparities, University of Michigan
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing
| | - Stephen Sullivan
- Center for Sexuality and Health Disparities, University of Michigan
| | - Rob Stephenson
- Center for Sexuality and Health Disparities, University of Michigan
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing
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22
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Grov C, Westmoreland D, Carneiro PB, Bauermeister JA, Carrico AW. Getting Clear About Rectal Douching Among Men Who Have Sex With Men. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2911-2920. [PMID: 34590220 PMCID: PMC9753552 DOI: 10.1007/s10508-021-01933-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 08/26/2020] [Accepted: 01/22/2021] [Indexed: 06/13/2023]
Abstract
Receptive anal sex is the primary means through which HIV is transmitted among men who have sex with men (MSM). Recently, researchers have begun investigating the role that rectal douching may play in amplifying risk for transmission. Yet, there is limited research on the frequency with which MSM douche, the products they use, and how this may vary across sociodemographic characteristics. A U.S. national sample of 4745 MSM completed an online survey that assessed their douching behavior, demographic characteristics, sexual behavior, and their anal sexual positioning (i.e., top, bottom, versatile). Nearly two-thirds (65.8%) had engaged in rectal douching in the last three months. Among those who douched, water was commonly reported (84.2%) and 20.1% reported using commercial enemas (e.g., Fleet), as well as water and soap (15.0%)-numbers exceed 100% as some participants reported more than one. Men who douched reported significantly more receptive and insertive condomless anal sex acts in the prior 3 months. One-in-ten men reported rectal bleeding after douching. Compared to HIV-negative participants who had not taken PrEP, participants had higher odds of reporting douching in the past 3 months if they were HIV-negative and currently on PrEP (AOR = 1.82), HIV-negative and previously used PrEP (AOR = 1.58), and HIV-positive (AOR = 1.83). Douching was common in this sample. Given that douching could amplify risk for HIV transmission, healthcare providers should discuss douching safety with their patients, with a focus on harm reduction (e.g., reduce risk of bleeding, as opposed to abstinence from douching).
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Affiliation(s)
- Christian Grov
- CUNY Institute for Implementation Science in Population Health, New York, NY, USA.
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, 55 W. 125th St., 7th Floor mailroom, New York, NY, 10027, USA.
| | - Drew Westmoreland
- CUNY Institute for Implementation Science in Population Health, New York, NY, USA
| | - Pedro B Carneiro
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, 55 W. 125th St., 7th Floor mailroom, New York, NY, 10027, USA
| | - Jose A Bauermeister
- Department of Family & Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
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23
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Dangerfield DT, Kuo I, Magnus M, Beauchamp G, Fields SD, Nelson L, Shoptaw S, Wilton L, Wheeler DP. Sexual Risk Profiles Among Black Sexual Minority Men: Implications for Targeted PrEP Messaging. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2947-2954. [PMID: 34590218 PMCID: PMC9529079 DOI: 10.1007/s10508-021-02066-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/20/2021] [Accepted: 06/02/2021] [Indexed: 06/13/2023]
Abstract
Black gay, bisexual, and other Black sexual minority men (BSMM) continue to experience some of the largest sexual health disparities in the U.S. Engaging BSMM in PrEP is crucial to improving sexual health outcomes and reducing disparities. However, knowledge of the profiles of sexual risk and PrEP initiation among this group is limited. This study used latent class analysis to identify HIV risk and PrEP initiation patterns among BSMM in the HPTN 073 Study (n = 226). Guided by current Centers for Disease Control screening guidelines, latent class indicators included relationship status, condom use, number of sexual partners, substance use, sexually transmitted infection (STI) history, and partner HIV status. Age and PrEP initiation were used in a multinomial regression to identify correlates of class membership. Three latent classes were identified: Single, Condomless Partners, Single, Multiple Partners, and Serodiscordant Partners. Single, Condomless Partners had the highest conditional probabilities of having greater than three male partners, substance use before sex, and receiving an STI diagnosis. Serodiscordant Partners had a 100% conditional probability of condomless sex and having a male partner living with HIV. BSMM who initiated PrEP were less likely to be classified as Single, Condomless Partners than Serodiscordant Partners (AOR = 0.07, 95% CI = 0.02, 0.66). Findings support the need for culturally relevant tailored and targeted messaging for BSMM with multiple sexual risk indicators.
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Affiliation(s)
- Derek T Dangerfield
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205, USA.
| | - Irene Kuo
- George Washington University Milken School of Public Health, Washington, DC, USA
| | - Manya Magnus
- George Washington University Milken School of Public Health, Washington, DC, USA
| | | | - Sheldon D Fields
- School of Health Professions, New York Institute of Technology, Old Westbury, NY, USA
| | | | - Steven Shoptaw
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Leo Wilton
- College of Community and Public Affairs, State University of New York at Binghamton, Binghamton, NY, USA
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24
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Morgan E, Meites E, Markowitz LE, Xavier Hall CD, Querec TD, Unger ER, Crosby RA, Newcomb ME, Mustanski B. Sexual Positioning Practices and Anal Human Papillomavirus Infection Among Young Men Who Have Sex with Men and Transgender Women-Chicago, Illinois, 2016-2018. Sex Transm Dis 2021; 48:709-713. [PMID: 34110734 PMCID: PMC8459672 DOI: 10.1097/olq.0000000000001433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; men who have sex with men (MSM) have higher prevalence of infection and related disease compared with other men. We assessed whether differences in HPV acquisition exist among MSM according to their sexual positioning practices, as well as self-reported receipt of HPV vaccination. METHODS We enrolled young MSM and transgender women aged 18 to 26 years in Chicago, IL (N = 666). Participants self-reported their history of HPV vaccination and submitted self-collected anal swab specimens for type-specific HPV detection using an L1-consensus PCR assay. Multivariable logistic regression analyses were used to assess relationships between sexual positioning practices and detection of any HPV or quadrivalent HPV vaccine (4vHPV) types by vaccination status, defined as self-reported receipt of ≥1 HPV vaccine dose versus none. RESULTS Among 666 participants, 400 (60.1%) had any anal HPV, and 146 (21.9%) had a 4vHPV type. Among vaccinated participants, 18, 36, and 177 reported exclusively insertive, exclusively receptive, or both sexual positioning practices, respectively. Compared with participants reporting exclusively insertive anal sex, odds of any HPV were significantly higher among participants engaging exclusively in receptive anal sex (adjusted odds ratio [aOR], 5.90; 95% confidence interval [CI], 2.52-13.78), as well as those engaging in both (aOR, 3.32; 95% CI, 1.71-6.44). Vaccinated participants, compared with unvaccinated participants, had lower odds of 4vHPV-type HPV regardless of sexual positioning practices (aOR, 0.56; 95% CI, 0.34-0.92). CONCLUSIONS Adult men and transgender women who practice anal receptive sex have high prevalence of infection with any HPV. Routine vaccination of all adolescents is expected to reduce HPV-related disease incidence among adult MSM and transgender women as vaccinated cohorts age.
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Affiliation(s)
- Ethan Morgan
- Infectious Disease Institute and College of Nursing, The Ohio State University, Columbus, OH
| | - Elissa Meites
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lauri E. Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - Troy D. Querec
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Elizabeth R. Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Michael E. Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
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25
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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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26
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Zheng L, Fu C. Gender beliefs and internalized homophobia shape sexual self-labeling and partner choice in gay and bisexual men in China. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1957091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lijun Zheng
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Chengyao Fu
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- Faculty of Psychology, Southwest University, Chongqing, China
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27
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Poteat T, Cooney E, Malik M, Restar A, Dangerfield DT, White J. HIV Prevention Among Cisgender Men Who have Sex with Transgender Women. AIDS Behav 2021; 25:2325-2335. [PMID: 33634354 PMCID: PMC8222096 DOI: 10.1007/s10461-021-03194-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
Cisgender men who have sex with transgender women face elevated risk for HIV, yet are understudied in prevention research. We conducted in-depth interviews with 19 men who have sex with transgender women in Baltimore, Maryland and Atlanta, Georgia to explore perspectives on HIV prevention. Participants used several strategies to reduce HIV risk: condoms, frequent HIV testing, communication about HIV status with partners, and limiting the types of sex acts performed. While condom use was inconsistent, it was preferred over pre-exposure prophylaxis, in part due to medical distrust. HIV self-testing was generally viewed unfavorably. Although most participants were referred to the study by their transgender women partners, they recommended reaching other men who have sex with transgender women in bars, nightclubs, online, and through social media. HIV prevention interventions should be inclusive of the needs and experiences of men who have sex with transgender women.
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Affiliation(s)
- Tonia Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, 333 S. Columbia Street, CB #7240, Chapel Hill, NC, 27599, USA.
- Department of Health Behavior, Gillings School of Public Health, Chapel Hill, NC, USA.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Erin Cooney
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mannat Malik
- Department of Health Behavior, Gillings School of Public Health, Chapel Hill, NC, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Arjee Restar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Derek T Dangerfield
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Us Helping Us, People into Living, Inc., Washington DC, USA
| | - Jordan White
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Bachelors of Social Work Department, Morgan State University, Baltimore, MD, USA
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28
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Smith JG, Amaro G. "No Fats, No Femmes, and No Blacks or Asians": The Role of Body-type, Sex Position, and Race on Condom Use Online. AIDS Behav 2021; 25:2166-2176. [PMID: 33389375 DOI: 10.1007/s10461-020-03146-z] [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: 12/21/2020] [Indexed: 10/22/2022]
Abstract
Despite the promises to end HIV infection rates by 2030, several factors continue to contribute to rising HIV infection rates in sexual minority communities. In fact, the CDC predicts that more than half of gay and bisexual men of color will be infected in the coming years if an intervention is not staged. While much focus has been placed on PrEP access, less has been given to the social environment online, which many men who have sex with men use to find sexual partners. This environment, facilitated by the anonymity afforded to men online, is infected with anti-fat, anti-femme, anti-Black bias aimed at men constructed as less desirable and summed up in the phrase, "No fats, No femmes, and No Blacks or Asians." Considering this online environment and the fact that past research suggests a relationship between weight and condom use, sex position and condom use and race and condom use, the researchers test all three pairings as well as a fourth hypothesis predicting if men who embody all three variables are also more likely to go condom-less. Findings from the analysis were mixed with men with "ideal body types" (slim, athletic and muscular built) and bottom men being more likely to have bareback on their profiles for sex behavior while men of color were more likely than Whites to have safe sex only. Most strikingly, regardless of body-type, sex position, or HIV status, Whites were more likely to have bareback on their profiles.
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29
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Ramos SR, Lardier DT, Boyd DT, Gutierrez JI, Carasso E, Houng D, Kershaw T. Profiles of HIV Risk, Sexual Power, and Decision-Making among Sexual Minority Men of Color Who Engage in Transactional Sex: A Latent Profile Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4961. [PMID: 34066948 PMCID: PMC8125585 DOI: 10.3390/ijerph18094961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 11/17/2022]
Abstract
Though the transmission of HIV is preventable, there were still 37,968 new documented cases in the United States in 2018. HIV incidence is disproportionate in sexual minority men of color. The purpose of this study was to examine sexual relationship power risk profiles to identify distinct subgroups within the profiles who carry the highest HIV risk. Latent class profile analysis was used to identify subgroups of sexual minority men of color at the highest risk for contracting HIV based on their sexual power profiles. Among 322 sexual minority men, we identified four latent profiles. Profile 1: Low transactional sex and high power (n = 133; 14.3%); Profile 2: Transactional sex, high decision-making in sexual relationships, and low control in sexual relationship (n = 99; 30.7%); Profile 3: Low transactional sex, low decision-making, and moderate control (n = 43; 13.4%); Profile 4: High transactional sex and low power (n = 47; 14.6%). LPA was useful to identify distinct subgroups based on measures of sexual risk and relationship sexual power. Findings carry significant implications for developing tailored strategies to increase HIV knowledge and related HIV prevention and risk reduction services for sexual minority men of color who engage in transactional sex.
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Affiliation(s)
- S. Raquel Ramos
- Rory Meyers College of Nursing, New York University, New York, NY 10016, USA; (E.C.); (D.H.)
| | - David T. Lardier
- Department of Individual, Family, and Community Studies, College of Education and Human Sciences, University of New Mexico, Albuquerque, NM 87131, USA;
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Donte T. Boyd
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA;
| | - José I. Gutierrez
- National Clinician Scholar, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA 94118, USA;
| | - Eliana Carasso
- Rory Meyers College of Nursing, New York University, New York, NY 10016, USA; (E.C.); (D.H.)
| | - David Houng
- Rory Meyers College of Nursing, New York University, New York, NY 10016, USA; (E.C.); (D.H.)
| | - Trace Kershaw
- School of Public Health, Yale University, New Haven, CT 06520, USA;
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT 06520, USA
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30
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Differences in digit ratios between gay men who prefer receptive versus insertive sex roles indicate a role for prenatal androgen. Sci Rep 2021; 11:8102. [PMID: 33854100 PMCID: PMC8046970 DOI: 10.1038/s41598-021-87338-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 03/26/2021] [Indexed: 12/14/2022] Open
Abstract
Among non-human mammals, exposure to androgens during critical periods of development leads to gynephilia (attraction to females), whereas the absence or low levels of prenatal androgens leads to androphilia (attraction to males). However, in humans, retrospective markers of prenatal androgens have only been associated with gynephilia among women, but not with androphilia among men. Here, we asked whether an indirect indication of prenatal androgen exposure, 2D:4D, differs between subsets of gay men delineated by anal sex role (ASR). ASR was used as a proxy for subgroups because ASR groups tend to differ in other measures affected by brain sexual differentiation, such as gender conformity. First, we replicated the finding that gay men with a receptive ASR preference (bottoms) report greater gender nonconformity (GNC) compared to gay men with an insertive ASR preference (tops). We then found that Tops have a lower (male-typical) average right-hand digit ratio than Bottoms, and that among all gay men the right-hand 2D:4D correlated with GNC, indicating that a higher (female-typical) 2D:4D is associated with increased GNC. Differences were found between non-exclusive and exclusive same-sex attraction and GNC, and ASR group differences on digit ratios do not reach significance when all non-heterosexual men are included in the analyses, suggesting greater heterogeneity in the development of non-exclusive same-sex sexual orientations. Overall, results support a role for prenatal androgens, as approximated by digit ratios, in influencing the sexual orientation and GNC of a subset of gay men.
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31
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Seida K, Shor E. Aggression and Pleasure in Opposite-Sex and Same-Sex Mainstream Online Pornography: A Comparative Content Analysis of Dyadic Scenes. JOURNAL OF SEX RESEARCH 2021; 58:292-304. [PMID: 31809207 DOI: 10.1080/00224499.2019.1696275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Existing research on aggression in online pornography is almost exclusively based on pornography featuring heterosexual sex. Pornography featuring sex between two men or between two women has received comparatively little scholarly attention, despite its growing industry presence and revenue. To our knowledge, no study has focused on comparing the aggressive content of different-sex and same-sex mainstream online pornography. To address this gap, we utilized a sample of 210 popular videos uploaded to Pornhub over the last decade. This sample consisted of three major categories: "gay" (male/male; n = 70), "lesbian" (female/female; n = 70), and "most-watched of all time" (male/female; n = 70). Our findings show that there are both more displays of aggression and more displays of affection and pleasure in same-sex online pornographic videos, relative to different-sex videos. We discuss the relevance and limits of dominant sexual and gender scripts when analyzing across subgenres of mainstream online pornography.
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Affiliation(s)
| | - Eran Shor
- Department of Sociology, McGill University
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32
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Newcomb ME, Swann G, Ma J, Moskowitz D, Bettin E, Macapagal K, Whitton SW. Interpersonal and Intrapersonal Influences on Sexual Satisfaction in Young Male Couples: Analyses of Actor-Partner Interdependence Models. JOURNAL OF SEX RESEARCH 2021; 58:183-194. [PMID: 32955948 PMCID: PMC7855530 DOI: 10.1080/00224499.2020.1820933] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Very little research has examined sexual satisfaction in young gay, bisexual, queer, and other men who have sex with men (YMSM). Sexual satisfaction has important implications for individual wellbeing and is a central component of romantic relationship functioning and satisfaction. In order to fill this gap, this study examined interpersonal and intrapersonal factors associated with sexual satisfaction in a large sample of young male couples. Data for these analyses came from the baseline visits of two ongoing randomized controlled trials of 2GETHER, a relationship education and HIV prevention program for young male couples. Participants for the current analytic sample were 419 couples (individual N = 838) from across the United States who were diverse in terms of race/ethnicity, HIV status, and geographic region. Analyses found that relationship functioning (i.e., relationship satisfaction, communication) was positively associated with sexual satisfaction, while not having a specified relationship agreement (i.e., monogamy/non-monogamy agreement) was associated with less sexual satisfaction. Intrapersonal factors (i.e., depression, substance use) were associated with sexual satisfaction, but most of these effects became non-significant in a full multivariate model. Relationship functioning plays a central role in sexual satisfaction and should be addressed in couple-based programs to optimize relationship functioning and sexual health.
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Affiliation(s)
- Michael E. Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Gregory Swann
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Junye Ma
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - David Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Emily Bettin
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Sarah W. Whitton
- Department of Psychology, University of Cincinnati, Cincinnati, OH
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33
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Gianotten WL. Prostate cancer: impact of the diagnosis on sexuality and the role of the HCP. Int J Impot Res 2021; 33:393-396. [PMID: 33462374 DOI: 10.1038/s41443-020-00403-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/17/2020] [Indexed: 11/09/2022]
Abstract
Sexuality is frequently disturbed in prostate cancer (PC), the most common cancer in men. This article addresses aspects of sexuality in the diagnostic phase of PC. Combined with this information, the role of health care professionals (HCPs) is elucidated, with particular attention to assessment, information and education.
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Affiliation(s)
- Woet L Gianotten
- Erasmus University Medical Centre Rotterdam, Rotterdam, the Netherlands.
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34
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Doyle CM, Maheu-Giroux M, Lambert G, Mishra S, Apelian H, Messier-Peet M, Otis J, Grace D, Hart TA, Moore DM, Lachowsky NJ, Cox J. Combination HIV Prevention Strategies Among Montreal Gay, Bisexual, and Other Men Who Have Sex with Men in the PrEP Era: A Latent Class Analysis. AIDS Behav 2021; 25:269-283. [PMID: 32648063 PMCID: PMC7846508 DOI: 10.1007/s10461-020-02965-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Pre-exposure prophylaxis (PrEP) became publicly available in Quebec for gay, bisexual and other men who have sex with men (GBM) in 2013. We used baseline data from Engage, a cohort of GBM recruited by respondent-driven sampling, to examine patterns of combination HIV prevention use among Montreal GBM since PrEP became available. Latent class analysis, stratified by HIV status, was used to categorize GBM by self-reported use of biomedical and behavioural prevention strategies. Correlates of resulting classes were identified using multinomial logistic regression. Among HIV-negative/unknown GBM (n = 968), we identified four classes: low use of prevention (32%), condoms (40%), seroadaptive behaviour (21%), and biomedical (including PrEP; 7%). Those using prevention (condoms, seroadaptive behaviour, and biomedical) had a higher number of anal sex partners and were more likely to report a recent sexually transmitted infection diagnosis. GBM using biomedical prevention also had a higher level of formal education. Among GBM living with HIV (n = 200), we identified three classes: mainly antiretroviral treatment (ART) with viral suppression (53%), ART with viral suppression and condoms (19%), and ART with viral suppression and seroadaptive behaviour (18%). Again, the number of anal sex partners was higher among those using condoms and seroadaptive behaviours. Our findings show antiretroviral-based prevention, either alone or in combination with other strategies, is clearly a component of the HIV prevention landscape for GBM in Montreal. Nevertheless, PrEP uptake remains low, and there is a need to promote its availability more widely.
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Affiliation(s)
- Carla M Doyle
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Mathieu Maheu-Giroux
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Gilles Lambert
- Direction Régionale de Santé Publique de Montréal, Montreal, QC, Canada
| | - Sharmistha Mishra
- Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Herak Apelian
- Direction Régionale de Santé Publique de Montréal, Montreal, QC, Canada
| | - Marc Messier-Peet
- Direction Régionale de Santé Publique de Montréal, Montreal, QC, Canada
| | - Joanne Otis
- Département de Sexologie, Université du Québec à Montréal, Montreal, QC, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Trevor A Hart
- Department of Psychology, Ryerson University, Toronto, ON, Canada
- Division of Social & Behavioural Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - David M Moore
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Nathan J Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Joseph Cox
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.
- Direction Régionale de Santé Publique de Montréal, Montreal, QC, Canada.
- Clinical Outcomes Research and Evaluation, Research Institute - McGill University Health Centre, Montreal, QC, Canada.
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35
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Zheng L. The Dyadic Effects of Top/Bottom Sexual Self-Labels and Partner Sexual Role Requirements on Facial Masculinity Preferences Among Gay and Bisexual Men in China. JOURNAL OF SEX RESEARCH 2021; 58:122-128. [PMID: 31663784 DOI: 10.1080/00224499.2019.1680596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sexual position preferences in male same-sex relationships are reflected in individuals' top/bottom sexual self-labels and requirements for their partners' sexual positions. Previous studies revealed significant differences in facial masculinity preferences among sexual self-label groups among gay and bisexual men. This study examined the moderating effect of requirements for partners' sexual positions on the relationship between facial masculinity preferences and sexual self-labels. Participants (N = 1,628, data were collected in 2019) were shown 10 pairs of male faces sequentially, with each pair consisting of a masculinized and feminized version of the same base face. "Bottoms" and "versatiles" preferred masculinized faces over feminized faces, whereas "tops" showed no significant preference for masculinized or feminized faces. "Tops" preferred more feminized faces than did "bottoms" and "versatiles." There were significant interactions between sexual self-labels and requirements for partners' positions. "Tops" who required a complementary partner preferred more feminized faces than did those having no requirement. "Bottoms" who required a complementary partner preferred more masculinized faces than did those having no requirement. "Versatiles" requiring a "top" as a romantic partner preferred more masculinized faces than did those requiring "bottoms" or those having no requirement. The findings highlighted the correlation between sexual preferences and partner choices among gay and bisexual men. Stereotypes about gender and masculinity may account for the links between sexual self-labels and partner choice in both sexual self-labeling and preferred labeling of partners based on masculinity.
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Affiliation(s)
- Lijun Zheng
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University
- Faculty of Psychology, Southwest University
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Wongsomboon V, Sietins E, Webster GD. Attractiveness, profile-picture face visibility and unprotected receptive anal intercourse in young men who have sex with men using online dating applications. Sex Health 2021; 18:212-220. [PMID: 34006347 DOI: 10.1071/sh20190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/19/2021] [Indexed: 11/23/2022]
Abstract
Background We examined links among face visibility on dating-profile pictures, self-perceived attractiveness, condom use self-efficacy, and unprotected receptive anal intercourse (URAI) in 223 young men who have sex with men (YMSM; ages 18-24 years) using online dating applications (e.g. Grindr). METHODS Participants reported their face visibility on their main dating-profile picture, attractiveness, condom use self-efficacy, and frequency of URAI in the past 3 months. Number of casual sex partners and pre-exposure prophylaxis (PrEP) use were statistically controlled in all analyses. RESULTS Using a mediated moderation model, we found that a significant attractiveness-by-face-visibility interaction for URAI was fully mediated by condom use self-efficacy. Specifically, lower face visibility on profile pictures related to lower condom use self-efficacy, which in turn related to higher URAI, but only among highly attractive YMSM. CONCLUSIONS Our findings suggest that attractive YMSM who show less-visible faces on their dating profiles could be at particularly high risk for sexually transmissible infections. This study has potentially important clinical implications because dating applications have become one of the most common ways for YMSM to find sexual partners.
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Affiliation(s)
- Val Wongsomboon
- Department of Psychology, University of Florida, 945 Center Drive, Gainesville, FL 32603, USA; and Corresponding author.
| | - Emils Sietins
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Gregory D Webster
- Department of Psychology, University of Florida, 945 Center Drive, Gainesville, FL 32603, USA
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He Y, Dangerfield Ii DT, Fields EL, Dawkins MR, Turpin RE, Johnson D, Browne DC, Hickson DA. Health care access, health care utilisation and sexual orientation disclosure among Black sexual minority men in the Deep South. Sex Health 2020; 17:421-428. [PMID: 33176906 DOI: 10.1071/sh20051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 09/01/2020] [Indexed: 11/23/2022]
Abstract
Background Black gay, bisexual, and other sexual minority men (BSMM) account for 39.1% of new HIV infections among men who have sex with men and 78.9% of newly diagnosed cases among Black men. Health care access, health care utilisation and disclosing sexuality to providers are important factors in HIV prevention and treatment. This study explored the associations among sexual orientation disclosure, health care access and health care utilisation among BSMM in the Deep South. METHODS Secondary analysis of existing data of a population-based study in Jackson, Mississippi, and Atlanta, Georgia, was conducted among 386 BSMM. Poisson regression models were used to estimate prevalence ratios (PR) between sexual orientation disclosure to healthcare providers, health care access and health care utilisation. RESULTS The mean (±s.d.) age of participants was 30.5 ± 11.2 years; 35.3% were previously diagnosed with HIV and 3.7% were newly diagnosed with HIV. Two-thirds (67.2%) self-identified as homosexual or gay; 70.6% reported being very open about their sexual orientation with their healthcare providers. After adjustment, BSMM who were not open about their sexual orientation had a lower prevalence of visiting a healthcare provider in the previous 12 months than those who were very open with their healthcare provider (PR 0.42; 95% confidence interval 0.18-0.97). CONCLUSION Clinics, hospitals and other healthcare settings should promote affirming environments that support sexuality disclosure for BSMM.
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Affiliation(s)
- Ying He
- My Brother's Keeper, Inc., 407 Orchard Park, Ridgeland, MS 39157, USA
| | - Derek T Dangerfield Ii
- Johns Hopkins School of Nursing, 525 N Wolfe Street, Baltimore, MD 21205, USA; and Us Helping Us, People Into Living, Inc., 3636 Georgia Avenue NW, Washington, DC 20010, USA; and Corresponding author.
| | - Errol L Fields
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N Wolfe Street, Baltimore, MD 21287, USA
| | - Milton R Dawkins
- My Brother's Keeper, Inc., 407 Orchard Park, Ridgeland, MS 39157, USA; and Department of Psychology, Jackson State University, Jackson, MS 39213, USA
| | - Rodman E Turpin
- School of Public Health, University of Maryland, 4200 Valley Drive #2242, College Park, MD 20742, USA
| | - Damon Johnson
- USA National AIDS and Education Services for Minorities, Inc., 2140 Martin Luther King Jr Drive SW, Atlanta, GA 30310, USA
| | - Dorothy C Browne
- Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; and University of Duy Tan, 254 Nguyen Van Linh, Thanh Khe District, Da Nang, Vietnam
| | - DeMarc A Hickson
- My Brother's Keeper, Inc., 407 Orchard Park, Ridgeland, MS 39157, USA; and Us Helping Us, People Into Living, Inc., 3636 Georgia Avenue NW, Washington, DC 20010, USA
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Macapagal K, Kraus A, Moskowitz DA, Birnholtz J. Geosocial Networking Application Use, Characteristics of App-Met Sexual Partners, and Sexual Behavior Among Sexual and Gender Minority Adolescents Assigned Male at Birth. JOURNAL OF SEX RESEARCH 2020; 57:1078-1087. [PMID: 31846592 PMCID: PMC7297657 DOI: 10.1080/00224499.2019.1698004] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Although many sexual and gender minorities (SGM) assigned male at birth (AMAB) use sexual networking applications intended for adult sexual minority men, little is known about adolescents' use of these technologies and characteristics of their online-met partners. We conducted an online survey of 219 sexually experienced SGM AMAB adolescents in the USA aged 15-17 (39.3% racial/ethnic minority; 74.9% gay; 94.1% cisgender male). Questions assessed app use patterns, partner-seeking behaviors on sexual minority male-specific apps vs. social media/other dating apps, app-met partner characteristics, and sexual behavior with app-met partners. Most (70.3%) used apps for sexual minority men, 14.6% used social media/other apps to meet partners, and 15.1% used neither. Nearly 60% of adolescents who used any type of app reported having met people from the apps in person, and nearly 90% of these reported at least one online-met sexual partner. Most partners were reportedly older than participants, and participants were more likely to report condomless receptive anal sex with older (vs. younger) online-met partners. Although partnerships were primarily sexual in nature, a minority reported friendships or serious partnerships. Meeting same-sex/gender partners via applications for adults may be common among SGM AMAB adolescents, which has implications for their sexual health and well-being.
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Affiliation(s)
- Kathryn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, USA
| | - Ashley Kraus
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, USA
| | - David A. Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, USA
| | - Jeremy Birnholtz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, USA
- Department of Communication Studies, Northwestern University, 2240 Campus Dr., Evanston, IL 60208, USA
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Sullivan MC, Cruess DG, Huedo-Medina TB, Kalichman SC. Substance Use, HIV Serostatus Disclosure, and Sexual Risk Behavior in People Living with HIV: An Event-Level Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2005-2018. [PMID: 31863314 DOI: 10.1007/s10508-019-01531-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/21/2019] [Accepted: 07/31/2019] [Indexed: 05/22/2023]
Abstract
People living with HIV (PLWH) face difficult decisions about disclosing their HIV status to new sexual partners. Alcohol and other drug use could impact these decision-making processes and subsequent sexual risk behavior. We sought to examine the event-level relationships between substance use, HIV disclosure, and condom use in PLWH and their first-time HIV-negative or unknown status sexual partners. Adult PLWH were recruited from care settings in a southeastern U.S. city. Participants reported their sexual behavior for 28 consecutive days via text message prompts. We employed multilevel covariation in a causal system to examine the event-level relations between substance use and condom use. We proposed that this relationship would be mediated by HIV disclosure and moderated by viral suppression status. A total of 243 participants (83% male, 93% Black) reported 509 sexual events with first-time HIV-negative/unknown status sexual partners. Substance use at the time of sex was negatively associated with disclosure in PLWH with suppressed viral load (OR 0.29, β = - 1.22, 95% CI [- 2.42, - 0.03], p = .045), but differentially associated with condom use in PLWH with detectable versus undetectable viral load. In PLWH with viral suppression, participants who always disclosed versus who never disclosed their HIV status were more likely to use condoms (β = 1.84, 95% CI [0.35, 3.53], p = .017), but inconsistent disclosers were less likely to use a condom after disclosing (OR 0.22, 95% CI [0.07, 0.68], p = .008). Event-level analysis offers a more nuanced understanding of the proximal (substance use, HIV disclosure) and person-level (substance use, viral load) determinants of HIV transmission risk behavior in PLWH.
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Affiliation(s)
- Matthew C Sullivan
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA.
- Institute for Collaboration for Health, Intervention, and Prevention, University of Connecticut, Storrs, CT, USA.
| | - Dean G Cruess
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
- Institute for Collaboration for Health, Intervention, and Prevention, University of Connecticut, Storrs, CT, USA
| | - Tania B Huedo-Medina
- Institute for Collaboration for Health, Intervention, and Prevention, University of Connecticut, Storrs, CT, USA
- Allied Health Sciences Department, University of Connecticut, Storrs, CT, USA
| | - Seth C Kalichman
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
- Institute for Collaboration for Health, Intervention, and Prevention, University of Connecticut, Storrs, CT, USA
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40
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Dangerfield DT, Johnson D, Hamlin-Palmer S, Browne DC, Mayer KH, Hickson DA. Prevalence and Correlates of Rectal Douching and Enema Use Among Black Sexual Minority Men and Black Transwomen in the Deep South. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1915-1922. [PMID: 32086643 DOI: 10.1007/s10508-019-01605-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 11/30/2019] [Accepted: 12/03/2019] [Indexed: 06/10/2023]
Abstract
HIV/STI disparities are highest among Black sexual minority men (BSMM) and Black transwomen (BTW) in the Deep South. Exploring the prevalence and correlates of rectal douching and enema use could provide insights into risk factors and HIV/STI prevention opportunities among these groups. This study explored the prevalence and correlates of rectal douching and enema using Poisson regression models among 375 BSMM and BTW in Jackson, MS, and Atlanta GA. Approximately 95% reported their gender as male/man; 5.6% self-identified as transwomen. Most reported being single (73.1%) and were unemployed (56.0%); 36.1% were previously diagnosed with HIV. In multivariable models, BSMM and BTW who reported that their typical sexual position during anal sex was "bottom" (aPR = 2.39, 95% CI = 1.48, 3.84) or "versatile" (aPR = 2.46, 95% CI = 1.44, 4.17) had a higher prevalence of rectal douching and enema use than those who reported "top." Deeper understanding of the contexts of rectal douching, enema use, and sexual positioning practices is needed.
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Affiliation(s)
| | | | | | - Dorothy C Browne
- Department of Maternal and Child Health, University of North Carolina, Durham, NC, USA
| | - Kenneth H Mayer
- The Fenway Institute of Fenway Health and the Infectious Disease Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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41
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Dangerfield DT, Carmack CC, Gilreath TD, Duncan DT. Latent classes of partner-seeking venues and sexual risk among men who have sex with men in Paris, France. Int J STD AIDS 2020; 31:502-509. [PMID: 32295477 DOI: 10.1177/0956462419899012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In France, men who have sex with men (MSM) experience the highest HIV incidence. MSM who use multiple venues such as bars and smartphone apps to find sexual partners have greater HIV and sexually transmitted infection risk than those who use a single physical or online venue. To explore the role of venues and sexual behavior on HIV risk, we used latent class analysis to highlight underlying profiles of 580 MSM in Paris, France. Three latent classes emerged: Multi-venue Users (19%), Non-serosorting App Users (49%), and Serosorting App Users (32%). Multi-venue Users had the highest probabilities of condomless receptive anal intercourse (CRAI) and condomless insertive anal intercourse (CIAI), group sex, and meeting partners at venues such as bars or online. Non-serosorting App Users had the lowest probabilities of CRAI, CIAI, and condomless serosorting. Serosorting App Users had an 87% chance of condomless serosorting. MSM reporting a pre-exposure prophylaxis history had 14 and 5 times the odds of being classified as Multi-venue Users and Serosorting App Users than Non-serosorting App Users. MSM were 3% more likely to be Multi-venue Users than Non-serosorting App Users for every one-year increase in age. Interventions addressing sexual risk behaviors among MSM in France should consider tailored risk-reduction and prevention messaging.
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Affiliation(s)
| | - Chakema C Carmack
- Department of Psychological Health and Learning Sciences, University of Houston, Houston, TX, USA
| | - Tamika D Gilreath
- Department of Health and Kinesiology, Texas A&M University, Houston, TX, USA
| | - Dustin T Duncan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, NY, USA
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42
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Higa DH, Crepaz N, McDonald CM, Adegbite-Johnson A, DeLuca JB, Kamitani E, Sipe TA. HIV Prevention Research on Men Who Have Sex With Men: A Scoping Review of Systematic Reviews, 1988-2017. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:1-S7. [PMID: 32073309 DOI: 10.1521/aeap.2020.32.1.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In the United States, men who have sex with men (MSM) are disproportionately affected by HIV. To identify research gaps and inform HIV prevention for MSM, we conducted a scoping review of systematic reviews using CDC's Prevention Research Synthesis database. Eligibility criteria comprised English-language systematic reviews focused on HIV prevention for MSM, published during 1988-2017, and included at least one U.S. primary study. We coded data type, subpopulations, topics, and key findings. To assess study quality, we used the Assessment of Multiple Systematic Reviews (AMSTAR). Among 129 relevant systematic reviews, study quality was high or moderate for 63%. Most common topics were sexual behavior and disease vulnerability. The most frequently mentioned MSM subgroups were HIV-positive, Black or African American, and young. Research gaps include Hispanic/Latino MSM, pre-exposure prophylaxis (PrEP), treatment as prevention, social determinants of health, health disparities, syndemics, and protective factors for sexual health.
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Affiliation(s)
- Darrel H Higa
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Nicole Crepaz
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Christina M McDonald
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | | | - Julia B DeLuca
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Emiko Kamitani
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Theresa Ann Sipe
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
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Granderson RM, Harper GW, Wade R, Odero W, Onyango Olwango DP, Fields EL. Gender Role Strain and the Precarious Manhood of Sexual Minority Kenyan Men. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2019; 6:420-432. [PMID: 33620336 PMCID: PMC7897423 DOI: 10.1037/sgd0000340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Examining the impact of precarious manhood on the mental health of sexual minority men living in Kenya, we hypothesized that (a) men who have sex with men exclusively (MSME) and men who have sex with men and women (MSMW) would display differential patterns of conformity to norms of masculinity; (b) these differences would result in distinct patterns of association between masculine conformity and symptoms of psychological distress for MSME and MSMW; and (c) conformity to norms of masculinity would be bidirectionally associated with symptoms of depression and anxiety. Using data collected from 391 young men who participated in a community-based, cross-sectional study of HIV-related risk and resilience among young sexual minority men in western Kenya, we ran a multivariate analysis of variance (MANOVA) to assess differences in conformity to masculine norms and four hierarchical linear regression models to examine the associations between conformity to masculine norms and symptoms of anxiety and depression for MSME and MSMW. MANOVA results revealed no significant differences between MSME and MSMW in overall conformity to masculinity, although MSMW were significantly more likely to conform to the masculine norm of power over women. Regression results revealed that conformity to norms of masculinity was bidirectionally associated with psychological distress and that these patterns of association were distinct for MSME and MSMW. The discussion explores possible explanations for revealed differences between MSME and MSMW using existing research. Clinical implications, limitations, and opportunities for future research are also discussed.
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Affiliation(s)
| | | | - Ryan Wade
- University of Illinois at Urbana-Champaign
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Shaw L, Wang L, Cui Z, Rich AJ, Armstrong HL, Lachowsky NJ, Sereda P, Card KG, Olarewaju G, Moore D, Hogg R, Roth EA. Longitudinal Event-Level Analysis of Gay and Bisexual Men's Anal Sex Versatility: Behavior, Roles, and Substance Use. JOURNAL OF SEX RESEARCH 2019; 56:1136-1146. [PMID: 31461383 PMCID: PMC6791743 DOI: 10.1080/00224499.2019.1652238] [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: 06/10/2023]
Abstract
Gay and bisexual Men Who Have Sex with Men (GBM) are sexually unique in that they can practice penile-anal sex versatility, i.e. engage in insertive and receptive anal sex. Individual-level versatility is extensively researched both as a sexual behavior linked to HIV/STI transmission, and as a GBM identity that can change over time. However, there is a dearth of research on event-level versatility (ELV), defined as taking the receptive and insertive role in the same sexual encounter. We analyzed event-level data from 644 GBM in the Momentum Health Study from February 2012-February 2017 to identify factors associated with ELV prevalence, the relationship between ELV and anal sex role preference, and sero-adaptive and sexualized drug use strategies. Univariate analysis revealed ELV prevalence rates between 15% and 20%. A multivariate generalized linear mixed model indicated ELV significantly (p < .05) associated with versatile role preference and condomless sex. However, the majority of ELV came from GBM reporting insertive or receptive role preferences, and there was significantly higher condom use among sero-discordant partners, indicating sero-adaptation. Multivariate log-linear modeling identified multiple polysubstance combinations significantly associated with ELV. Results provide insights into GBM sexual behavior and constitute empirical data useful for future HIV/STI transmission pattern modeling.
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Affiliation(s)
- Lindsay Shaw
- Canadian Institute for Substance Use Research, University of Victoria
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS
| | - Zishan Cui
- British Columbia Centre for Excellence in HIV/AIDS
| | - Ashleigh J Rich
- British Columbia Centre for Excellence in HIV/AIDS
- Faculty of Medicine, University of British Columbia
| | - Heather L Armstrong
- British Columbia Centre for Excellence in HIV/AIDS
- Faculty of Medicine, University of British Columbia
| | - Nathan J Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS
- School of Public Health and Social Policy, University of Victoria
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS
| | | | | | - David Moore
- British Columbia Centre for Excellence in HIV/AIDS
- Faculty of Medicine, University of British Columbia
| | - Robert Hogg
- British Columbia Centre for Excellence in HIV/AIDS
- Faculty of Health Sciences, Simon Fraser University
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Dangerfield DT, Williams JE, Bass AS, Wynter T, Bluthenthal RN. Exploring Religiosity and Spirituality in the Sexual Decision-Making of Black Gay and Bisexual Men. JOURNAL OF RELIGION AND HEALTH 2019; 58:1792-1802. [PMID: 31161470 DOI: 10.1007/s10943-019-00845-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Many Black gay and bisexual men (BGBM) practice consistent religious worship and spirituality in order to cope with social challenges. This study utilized data from in-depth qualitative interviews conducted to explore personal meanings of religiosity and spirituality and how these constructs affect partner choices and sexual behaviors among BGBM. Interviews were conducted with 26 BGBM in Los Angeles, California, from September to November 2015. In-depth interviews yielded themes related to BGBM's understanding of religiosity and spirituality and how their personal beliefs influenced their partner choices and sexual risks. Implications for church-based and community-based interventions are discussed.
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Affiliation(s)
- Derek T Dangerfield
- Johns Hopkins School of Nursing, 855 N. Wolfe St Suite 601, Baltimore, MD, 21205, USA.
| | - Jeffery E Williams
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alágra S Bass
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - Timothy Wynter
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ricky N Bluthenthal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Queiroz AAFLN, Sousa AFLD, Brignol S, Araújo TME, Reis RK. Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil. Braz J Infect Dis 2019; 23:298-306. [PMID: 31472125 PMCID: PMC9427977 DOI: 10.1016/j.bjid.2019.07.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/21/2019] [Accepted: 07/28/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction The elderly population is increasingly benefiting from recent technological advances. In this scenario, geolocation-based dating applications provide a viable alternative for finding partners in a practical and timely manner, but may be accompanied by certain risk behaviors for HIV infection. Although there are considerable number of users over 50 on these applications, no studies have addressed this problem. The aim of the present study was to analyze factors of vulnerability to HIV/Aids among the population of men who have sex with men (MSM) age 50 years or older who use dating apps. Methods This was a cross-sectional, population-survey-based, analytical study, conducted exclusively online with a sample of 412 MSM. The data was collected from the following apps: Grindr®, Hornet®, Scruff® and Daddy Hunter®. Results Factors associated with a higher chance of having HIV were: sexual relations with an HIV-infected partner (ORa = 5.53; 95%CI = 2.23–13.73); chemsex (ORa = 3.97; 95%CI = 1.72–8.92); and, above all, having an HIV-infected partner (ORa = 8.02; 95%CI = 2.01–32.01). The belief that apps increase protection against sexually transmitted infections (ORa = 0.43; 95%CI = 0.19–0.95) and not being familiar with post-exposure prophylaxis (ORa = 0.43; 95%CI = 0.19–0.95) were associated with decreased chances of having HIV. Conclusions We highlight some important factors that structure the vulnerability of the MSM surveyed in relation to HIV infection. The findings should be used to customize care for this population, which could bring them in more for health care services.
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Affiliation(s)
| | - Alvaro Francisco Lopes de Sousa
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil; Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.
| | - Sandra Brignol
- Universidade Federal Fluminense, Departamento de Saúde Pública, Rio de Janeiro, RJ, Brazil.
| | | | - Renata K Reis
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil.
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Rios LF, Albuquerque APD, Santana WJD, Pereira AF, Oliveira Júnior CJD. [Sexual positions, body styles and HIV risk among men who have sex with men in Recife (Brazil)]. CIENCIA & SAUDE COLETIVA 2019; 24:973-982. [PMID: 30892518 DOI: 10.1590/1413-81232018243.34092016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 03/18/2017] [Indexed: 11/22/2022] Open
Abstract
The article presents the results of an ethnographic study of the gay community in Recife (PE), conducted via participant observation and interviews. It seeks to understand sexual risk conduct among men who have sex with men (MSM) and HIV, focusing on the significance of sexual positions during anal-receptive intercourse (ARI) and anal-insertive intercourse (AII). Those who practice unprotected ARI are subject to a greater risk of infection than those who practice AII. Those who practice both, ARI and AII, are amplifiers (greater chances of receiving and passing on the virus) in the transmission chains. The text addresses the emic categories related with gender identities - pintosa (female gay), boy (male gay), and cafuçu (MSM and with women, non-gay, male, lower social class) - and with gender identities - active (AII), passive (ARI), and versatile (AII and ARI) - in the ways they result in sexual positions and produce sexual attraction. Masculine men are the most sexually desirable. Boys tend to relate with boys, and pintosas with cafuçus. There is a significant number of versatiles, which increases the collective risk within the gay community. By means of the relations between pintosas and cafuçus, there is increased danger for the virus to circulate more among the gay community and society in general.
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Affiliation(s)
- Luís Felipe Rios
- Departamento de Psicologia, Centro de Filosofia e Ciências Humanas,Universidade Federal de Pernambuco. Av. Acadêmico Helio Ramos CFCH/7º, Cidade Universitária. 50670-901 Recife PE Brasil.
| | - Amanda Pereira de Albuquerque
- Departamento de Psicologia, Centro de Filosofia e Ciências Humanas,Universidade Federal de Pernambuco. Av. Acadêmico Helio Ramos CFCH/7º, Cidade Universitária. 50670-901 Recife PE Brasil.
| | - Warlley Joaquim de Santana
- Departamento de Psicologia, Centro de Filosofia e Ciências Humanas,Universidade Federal de Pernambuco. Av. Acadêmico Helio Ramos CFCH/7º, Cidade Universitária. 50670-901 Recife PE Brasil.
| | - Amanda França Pereira
- Departamento de Psicologia, Centro de Filosofia e Ciências Humanas,Universidade Federal de Pernambuco. Av. Acadêmico Helio Ramos CFCH/7º, Cidade Universitária. 50670-901 Recife PE Brasil.
| | - Cristiano José de Oliveira Júnior
- Departamento de Psicologia, Centro de Filosofia e Ciências Humanas,Universidade Federal de Pernambuco. Av. Acadêmico Helio Ramos CFCH/7º, Cidade Universitária. 50670-901 Recife PE Brasil.
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Hermanstyne KA, Green HD, Tieu HV, Hucks-Ortiz C, Wilton L, Shoptaw S. The Association Between Condomless Anal Sex and Social Support Among Black Men Who Have Sex With Men (MSM) in Six U.S. Cities: A Study Using Data from the HIV Prevention Trials Network BROTHERS Study (HPTN 061). AIDS Behav 2019; 23:1387-1395. [PMID: 30377980 DOI: 10.1007/s10461-018-2315-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We assessed how egocentric (i.e., self-generated descriptions of a person's social contacts) network structure and composition corresponded with reported instances of condomless receptive and insertive anal intercourse with men who were reportedly HIV-infected or of unknown HIV serostatus in a sample of black men who have sex with men (MSM) in six U.S. cities. Ratings showing a higher percentage of network members who provided social participation and medical support were positively associated with reporting condomless sex. There were also significant positive associations between stimulant use and condomless insertive and receptive anal sex. Future research should examine the social processes that underlie these associations and explore ways that social support can affect HIV prevention efforts for black MSM.
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Affiliation(s)
- Keith A Hermanstyne
- Department of Psychiatry, UCSF Weil Institute for Neurosciences, University of California, 1930 Market Street, San Francisco, CA, 94102, USA.
| | - Harold D Green
- Indiana University Network Science Institute, Bloomington, IN, USA
- Center for Applied Network Analysis and Systems Science, RAND Corporation, Santa Monica, CA, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | | | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles, CA, USA
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Rios LF, Paiva V, Brignol S. Passivos, ativos and versáteis: men who have sex with men, sexual positions and vulnerability to HIV infection in the northeast of Brazil. CULTURE, HEALTH & SEXUALITY 2019; 21:510-525. [PMID: 30422062 DOI: 10.1080/13691058.2018.1491063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 06/17/2018] [Indexed: 06/09/2023]
Abstract
In Brazil, men who practise receptive anal sex (passivos) and both insertive and receptive anal sex (versáteis) are at greater risk of HIV infection than men who practise only insertive anal sex (ativos). In this study, which combined participant observation, 25 biographical interviews and a behavioural survey of 380 self-identified men who had sex with men in the metropolitan region of Recife (Brazil), we investigated how the sex-gender system, through body stylisation (masculine and effeminate) engenders desire and sexual positioning in men's sexual scenes. The analysis indicated that the sex-gender system tends to reinforce images that portray masculine men as ativos and effeminate men as passivos. However, regarding sexual positioning, sexual versatility is most common (83.3%), which can increase the likelihood of HIV infection and transmission. Stylisations also engender differences in violence related to sexual orientation (e.g. effeminate men were 1.9 times more likely to have experienced violence than masculine men) and desirability (e.g. effeminate men are 6.1 times more likely to be rejected erotically than masculine men). Sexual positioning and stylisation jointly enable community sexual scripts and pathways for HIV to circulate, producing individual and social vulnerability to the epidemic.
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Affiliation(s)
- Luis Felipe Rios
- a Department of Psychology , Federal University of Pernambuco , Recife , Pernambuco , Brazil
| | - Vera Paiva
- b NEPAIDS, Institute of Psychology, São Paulo University , Sao Paulo , Brazil
| | - Sandra Brignol
- c Institute of Collective Health, Federal University Fluminense , Rio de Janeiro , Brazil
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Moskowitz DA, Garcia CP. Top, Bottom, and Versatile Anal Sex Roles in Same-Sex Male Relationships: Implications for Relationship and Sexual Satisfaction. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1217-1225. [PMID: 29858726 DOI: 10.1007/s10508-018-1240-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 02/17/2018] [Accepted: 05/22/2018] [Indexed: 06/08/2023]
Abstract
Across much of the gay and bisexual male research on sexual position self-label (i.e., calling oneself a top, bottom, or versatile), there exist two commonalities: (1) studies tend to focus almost entirely on individual, relationally single androphilic men; (2) studies rarely account for relationships and relationship dynamics. In response, we explored the role of self-label over sexual and relationship satisfaction among gay and bisexual partnered men. Specifically, we looked at whether adopted sexual position identities were consonant or dissonant (i.e., matching or mismatching) with enacted behavior in relationships and how that impacted men's attitudes toward different relational attributes. Through an online survey, we sampled 169 men in same-sex relationships, asking them questions about their ideal penetrative role identities and their reality penetrative roles with their partner. We then asked them to rate their relationship on 10 sexual and interpersonal attributes. Multiple regression modeling suggested ideal-reality penetrative role dissonance was predictive of sexual dissatisfaction among tops who bottomed in their relationships and, to a lesser extent, bottoms who topped. In contrast, penetrative role dissonance was predictive of relationship satisfaction among tops who bottomed in their relationship, but not bottoms who topped. We conclude that a potential reason for this paradox among tops who bottom may be sexual altruism. That is, men may be satisfied with other aspects within their relationships, understand their partner's anal sex preferences, and accommodate that position in response to their initial relationship satisfaction.
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Affiliation(s)
- David A Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Ste. 14-051, Chicago, IL, 60611, USA.
| | - Christopher P Garcia
- Department of Medical Social Sciences, Feinberg School of Medicine, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Ste. 14-051, Chicago, IL, 60611, USA
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