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Cénat JM, Kogan CS, Kebedom P, Ukwu G, Moshirian Farahi SMM, Darius WP, Mulopo Bakombo S, Dalexis RD, Ndengeyingoma A, Noorishad PG, Labelle PR. Prevalence and risk factors associated with psychostimulant use among Black individuals: A meta-analysis and systematic review. Addict Behav 2023; 138:107567. [PMID: 36521424 DOI: 10.1016/j.addbeh.2022.107567] [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: 07/21/2022] [Revised: 11/16/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Psychostimulants (e.g., cocaine, amphetamine) are among the most widely used drugs globally with detrimental short and long-term physical, psychological and social consequences. There is limited data on psychostimulant use for various racial and ethnic groups, including Black people, and the challenges they face living as minorities overcoming historical challenges including increased incarceration associated with drug possession. METHODS Peer-reviewed articles were identified in five databases (APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, MEDLINE). Eligible studies were published in French or English, provided empiral data on psychostimulant use in Black individuals living in a minority context. The PRISMA guideline was used for structuring the review. Random-effects meta-analyses were generated to estimate the pooled prevalence of lifetime and periodic psychostimulant use among Black individuals using STATA 16. RESULTS Sixty-three studies published from 1991 to 2022 with a sample size of 139,683 Black individuals were included in the current meta-analysis. Results indicate a pooled prevalence estimate of 11.4% for any form of psychostimulant use among Black individuals. The pooled prevalence estimates were 12.4% (95% CI, 8.4% - 16.4%) for cocaine, 8.3% (95% CI, 0% - 19.1%) for amphetamines, and 11.4% (95% CI, 4.6% - 18.1%) for other stimulants. Prediction intervals for all psychostimulant types were highly heterogenous ranging from 0% to as high as 51.2% for amphetamine suggesting prevalence of use in some studies of Black people could be found to be as low as zero. Subgroup analyses were conducted to examine differences between age groups, gender, reference period, and type of assessment. CONCLUSIONS High prevalence rates of psychostimulant use among Black people argues for greater access to evidence-based treatments. However, current psychosocial interventions are suboptimal, warranting further study. Consideration needs to be given to the challenges of the large range of prediction intervals, living in urban areas, racial discrimination experiences, race-based stress, and sociodemographic characteristics, including poverty, education level, age, gender.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | - Cary S Kogan
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Philmona Kebedom
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Gloria Ukwu
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | - Assumpta Ndengeyingoma
- Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Nursing, Université du Québec en Outaouais, Quebec, Canada
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Cherenack EM, Stein MD, Abrantes AM, Busch A, Pinkston MM, Baker JV, Uebelacker LA. The relationship between substance use and physical activity among people living with HIV, chronic pain, and symptoms of depression: a cross-sectional analysis. AIDS Care 2023; 35:170-181. [PMID: 36260055 PMCID: PMC10038820 DOI: 10.1080/09540121.2022.2136349] [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: 07/23/2021] [Accepted: 10/11/2022] [Indexed: 10/24/2022]
Abstract
ABSTRACTChronic pain, depression, and substance use are common among people living with HIV (PLWH). Physical activity can improve pain and mental health. Some substances such as cannabis may alleviate pain, which may allow PLWH to participate in more physical activity. However, risks of substance use include poorer mental health and HIV clinical outcomes. This cross-sectional analysis examined the relationships of self-reported substance use (alcohol, cannabis, and nicotine use), gender, and age with self-reports of walking, moderate physical activity, and vigorous physical activity, converted to Metabolic Equivalent of Task Units (METs), among 187 adults living with HIV, chronic pain, and depressive symptoms in the United States. Women reported less walking, vigorous activity, and total physical activity compared to men. Individuals who used cannabis reported more vigorous physical activity relative to those who did not use cannabis. These findings were partially accounted for by substance use*gender interactions: men using cannabis reported more vigorous activity than all other groups, and women with alcohol use reported less walking than men with and without alcohol use. Research is needed to increase physical activity among women who use substances and to evaluate reasons for the relationship between substance use and physical activity among men.
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Affiliation(s)
- Emily M. Cherenack
- Alpert Medical School of Brown University, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | - Michael D. Stein
- Alpert Medical School of Brown University, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
- Boston University School of Public Health, Boston, MA, USA
| | - Ana M. Abrantes
- Alpert Medical School of Brown University, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | - Andrew Busch
- Hennepin Healthcare, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Megan M. Pinkston
- Alpert Medical School of Brown University, Providence, RI, USA
- Lifespan Physicians Group, Miriam Hospital, Providence, RI, USA
| | - Jason V. Baker
- Hennepin Healthcare, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Lisa A. Uebelacker
- Alpert Medical School of Brown University, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
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3
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Event-level patterns of methamphetamine and poly-drug use among millennial sexual minority men: The P18 Cohort Study. Addict Behav 2021; 117:106831. [PMID: 33588290 DOI: 10.1016/j.addbeh.2021.106831] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Knowledge on methamphetamine use among a new generation of sexual minority men (SMM) is limited. This study describes the event-level patterns of methamphetamine use and characteristics of methamphetamine users across time among Millennial SMM emerging into adulthood. METHODS A prospective cohort study was conducted in two waves: 2009-2014 (Wave I) and 2014-2019 (Wave II) in the New York City metropolitan area. A total of 600 Millennial SMM ages 18-19 years were recruited for Wave I. A total of 665 SMM ages 22-23 years were recruited for Wave II, of which 41.2% (n = 274) were retained from Wave I. The Timeline Followback assessment was conducted every six months to record event-level drug use in the 30 days prior to the visit. RESULTS A total of 5.4% of participants of between the ages of 18-27 reported methamphetamine use throughout the study period. The average number of days of methamphetamine use was significantly higher among racial/ethnic minority men in Wave II (F = 4.34, p = 0.0029). We found methamphetamine use occurred more often on weekend days and same-day use of methamphetamine occurred most often with cannabis and gamma-hydroxybutyrate. Usage of methamphetamine was significantly greater among SMM in Wave II who by design were older than Wave I. CONCLUSION We have identified differences in methamphetamine use by race/ethnicity. Weekend use and poly-drug use were common among methamphetamine-using SMM. Data indicate differential use in the population and that attempts to address this addictive behavior must be linked to other drug use and socialization among young SMM.
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4
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Tam CC, Benotsch EG, Li X. Sexual enhancement expectancy, non-medical use of prescription drugs, and sexual risk behaviors in college students. Subst Abus 2020; 42:577-586. [DOI: 10.1080/08897077.2020.1803177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Cheuk Chi Tam
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Eric G. Benotsch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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5
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Colyer SP, Moore DM, Cui Z, Zhu J, Armstrong HL, Taylor M, Edward J, Howard T, Dickie C, Olarewaju G, Montaner JSG, Hogg RS, Roth EA, Lachowsky NJ. Crystal Methamphetamine Use and Initiation among Gay, Bisexual, and Other Men Who Have Sex with Men Living with HIV in a Treatment as Prevention Environment. Subst Use Misuse 2020; 55:2428-2437. [PMID: 33059493 PMCID: PMC7657389 DOI: 10.1080/10826084.2020.1833925] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Risk compensation in an HIV Treatment as Prevention (TasP) environment may increase high-risk sexual and substance use behaviors among people living with HIV. Objective: To examine recent crystal methamphetamine (CM) use/initiation in a longitudinal cohort of gay, bisexual, and other men who have sex with men (GBMSM) living with HIV in Metro Vancouver, Canada. Methods: Eligible participants were GBMSM aged >15 years who reported sex with another man in the past six months. Participants were recruited using respondent-driven sampling and self-completed a computer questionnaire every six months. We used multi-level generalized mixed-effect models to evaluate trends in recent CM use (past six months), multivariable logistic regression to identify covariates of recent CM use, and multivariable survival analysis to identify predictors of CM initiation. Results: Of 207 GBMSM living with HIV at enrollment, 44.3% reported recent CM use; there was a statistically non-significant decrease over the study period (41% in first period to 25% in final period, p = 0.087). HIV treatment optimism was not associated with CM use/initiation. CM use was positively associated with depressive symptomology, sexual escape motivation, transactional sex, number of anal sex partners, condomless anal sex with seroconcordant partners, STIs, and other substance use. Recent CM use was negatively associated with viral load sorting. CM initiation was predicted by escape motivation, transactional sex, and group sex participation. Conclusion: Results suggest that CM use among GBMSM living with HIV is prevalent and increased CM use/initiation is not a consequence of TasP public policy.
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Affiliation(s)
- Sean P Colyer
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Medicine, McGill University, Montreal, Canada
| | - David M Moore
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Zishan Cui
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Julia Zhu
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Heather L Armstrong
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada.,Department of Psychology, University of Southampton, Southampton, UK
| | | | - Joshua Edward
- Health Initiative for Men Society, Vancouver, Canada
| | - Terry Howard
- Community Advisory Board, Momentum Health Study, Vancouver, Canada
| | - Chad Dickie
- Community Advisory Board, Momentum Health Study, Vancouver, Canada
| | - Gbolahan Olarewaju
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Julio S G Montaner
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Robert S Hogg
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria, Victoria, Canada
| | - Nathan J Lachowsky
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, Canada.,Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
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Mimiaga MJ, Pantalone DW, Biello KB, White Hughto JM, Frank J, O’Cleirigh C, Reisner SL, Restar A, Mayer KH, Safren SA. An initial randomized controlled trial of behavioral activation for treatment of concurrent crystal methamphetamine dependence and sexual risk for HIV acquisition among men who have sex with men. AIDS Care 2019; 31:1083-1095. [PMID: 30887824 PMCID: PMC6625920 DOI: 10.1080/09540121.2019.1595518] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/25/2019] [Indexed: 10/27/2022]
Abstract
Men who have sex with men (MSM) continue to be the largest risk group for HIV infections in the U.S., where crystal methamphetamine abuse heightens risk for HIV infection through greater engagement in condomless anal sex (CAS). Existing treatments lack attention to replacement activities or the role of depressed mood. Behavioral activation (BA) is an evidence-based approach for depression that involves identifying and participating in pleasurable, goal-directed activities. We hypothesize, for MSM abusing crystal methamphetamine, re-learning how to engage in non-drug-using aspects of life would facilitate their ability to benefit from sexual risk reduction (SRR) counseling. Project IMPACT was a pilot randomized-controlled-trial. Forty-six MSM at sexual risk of acquiring HIV who met DSM-IV criteria for crystal methamphetamine dependence were enrolled. Of those MSM, 41 were randomized: 21 were assigned to the intervention, two sessions of SRR, ten sessions of BA with SRR, and one session of relapse prevention; 20 participants were assigned to a control condition (two sessions of SRR). At the acute post-intervention visit, intervention participants reported an average of 3.2 CAS acts with men who were HIV-infected or whose status they did not know, compared to 4.5 among control participants (β = -0.36; 95% CI: -0.69, -0.02; p = 0.035). At the 6-month post-intervention visit, intervention participants reported 1.1 CAS acts with men who were HIV-infected or whose status they did not know compared to 2.8 among control participants (β = -0.95; 95% CI: -1.44, -0.46; p < 0.0001). Similarly, intervention participants reported 1.0 CAS acts under the influence of crystal methamphetamine with men who were HIV-infected or whose status they did not know compared to 2.5 among control participants (β = -0.87; 95% CI: -1.38, -0.36; p = 0.0005). Lastly, intervention participants reported more continuous days abstaining from crystal methamphetamine compared to control (50.1 vs. 39.0, respectively) (β = 0.25; 95% CI: 0.16, 0.34; p < 0.0001). Findings are encouraging, provide evidence of feasibility and acceptability, and demonstrate initial efficacy for reducing sexual risk for HIV and crystal methamphetamine use.
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Affiliation(s)
- Matthew J. Mimiaga
- Center for Health Equity Research, Brown University, Providence, RI, USA
- Departments of Behavioral & Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - David W. Pantalone
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychology, University of Massachusetts, Boston, MA, USA
| | - Katie B. Biello
- Center for Health Equity Research, Brown University, Providence, RI, USA
- Departments of Behavioral & Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Jackie M. White Hughto
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Epidemiology, Yale University School of Public Health, New Haven, CT, USA
| | - John Frank
- Center for Health Equity Research, Brown University, Providence, RI, USA
- Departments of Behavioral & Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
| | - Conall O’Cleirigh
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychiatry, Behavioral Medicine Service, Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA
| | - Sari L. Reisner
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Division of General Pediatrics, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Arjee Restar
- Center for Health Equity Research, Brown University, Providence, RI, USA
- Departments of Behavioral & Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Infectious Diseases, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Steven A. Safren
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychology, University of Miami, Coral Gables, FL, USA
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7
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Mimiaga MJ, Suarez N, Garofalo R, Frank J, Ogunbajo A, Brown E, Bratcher A, Pardee D, Hidalgo MA, Hoehnle S, Restar A, Wimbly T, Thai J, Sullivan PS, Stephenson R. Relationship Dynamics in the Context of Binge Drinking and Polydrug Use Among Same-Sex Male Couples in Atlanta, Boston, and Chicago. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1171-1184. [PMID: 30806868 PMCID: PMC6458086 DOI: 10.1007/s10508-018-1324-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 09/05/2018] [Accepted: 10/03/2018] [Indexed: 06/09/2023]
Abstract
An estimated one- to two-thirds of incident HIV infections among U.S. men who have sex with men (MSM) occur within the context of a primary relationship. The existing, yet limited, literature on sexual risk behavior among same-sex couples suggests that MSM with main partners are more often to report having lower perceived HIV risk, higher unrecognized HIV infection, and increased frequency of condomless anal intercourse with their primary partner. Furthermore, numerous studies document the strong relationship between polydrug use and binge drinking with HIV infection among MSM. However, more research is needed that identifies how individual- and relationship-level factors are related to polydrug use and binge drinking in the context of same-sex male relationships. We used baseline data collected as part of a prospective randomized controlled trial of 160 same-sex male couples (total N = 320 individuals). In 2015, recruitment commenced in three U.S. cities: Atlanta, GA, Boston, MA, and Chicago, IL. Participants completed a self-report assessment using an audio-computer-assisted self-interview system during their baseline enrollment visit. We collected information on participants' sociodemographic characteristics, drug and alcohol use, individual- and relationship-level variables of interest, as well as relationship quality. Multinomial logistic regression models were fit for three different categories of polydrug use and of binge drinking for which (1) both partners exhibited the behavior, (2) only the respondent exhibited the behavior, or (3) only the partner exhibited the behavior. Participants' age ranged from 18 to 69 (M = 35.9). The sample majority (77.5%) was White (248/320), with 12.2% Black (39/320) and 10.3% Multiracial (33/320); 68.4% had completed a college degree; and 9.6% were unemployed. A high proportion (62.2%) reported any drug use, including marijuana; 45% reported using drugs other than marijuana; and 18.1% reported polydrug use. Overall, 22.2% reported current binge drinking. Age discordance and being in a long-term relationship (6 or more years) were associated with a decreased odds of polydrug use among couples; being in an interracial dyad, recent history of arrest, living with HIV, and self-reported clinically significant depressive symptoms were associated with an increased odds of polydrug use. Additionally, being the older partner and reporting higher levels of internalized homophobia decreased odds for binge drinking, while recent history of arrest, living with HIV, and feeling more loved in their relationship were associated with an increased odds of binge drinking. Findings have implications for developing interventions to reduce substance use and promote health among same-sex male couples. Future research would benefit by using longitudinal study designs to understand the individual-, relationship-, and structural-level factors that potentiate polydrug use and binge drinking among same-sex male couples.
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Affiliation(s)
- Matthew J Mimiaga
- Center for Health Equity Research, Brown University, 121 South Main Street, Floor 8, Providence, RI, 02903, USA.
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA.
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA.
- The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA.
| | - Nicolas Suarez
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Robert Garofalo
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - John Frank
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Adedotun Ogunbajo
- Center for Health Equity Research, Brown University, 121 South Main Street, Floor 8, Providence, RI, 02903, USA
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Emily Brown
- The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA
| | - Anna Bratcher
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dana Pardee
- The Fenway Institute, Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA
| | - Marco A Hidalgo
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Sam Hoehnle
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Arjee Restar
- Center for Health Equity Research, Brown University, 121 South Main Street, Floor 8, Providence, RI, 02903, USA
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Taylor Wimbly
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennie Thai
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rob Stephenson
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA
- Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
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Currin JM, Hubach RD, Croff JM. Sex, drugs, & rurality: A brief qualitative analysis of rural gay and bisexual men’s substance use sex expectancies. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1581284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Joseph M. Currin
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Randolph D. Hubach
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Julie M. Croff
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Mimiaga MJ, Pantalone DW, Biello KB, Glynn TR, Santostefano CM, Olson J, Pardee DJ, Hughto JMW, Garcia Valles J, Carrico AW, Mayer KH, Safren SA. A randomized controlled efficacy trial of behavioral activation for concurrent stimulant use and sexual risk for HIV acquisition among MSM: project IMPACT study protocol. BMC Public Health 2018; 18:914. [PMID: 30045702 PMCID: PMC6060452 DOI: 10.1186/s12889-018-5856-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 07/17/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In the United States, problematic stimulant use is a prevalent and difficult to treat problem among men who have sex with men (MSM), as well as a major driver of HIV transmission through the large number of sexual partners and concomitant condomless anal sex (CAS). Evidence-based behavioral studies that address problematic stimulant use in MSM at risk for HIV infection are also lacking. In this paper, we describe the design of a behavioral intervention trial to reduce sexual risk behavior and stimulant use in HIV-uninfected MSM. METHODS This study, funded by the National Institute on Drug Abuse (NIDA), is a randomized controlled trial (RCT) testing an integrated HIV risk reduction and behavioral activation counseling intervention (IMPACT) for HIV-uninfected, stimulant using MSM in Boston, MA, and Miami, FL. Participants are randomized (2:2:1) to either (1) the IMPACT intervention; (2) a relaxation condition, an active therapy time- and intensity-matched control; or (3) a standard of care risk reduction counseling comparison. At enrollment, all participants receive an HIV test and pre- and post-test counseling. The primary outcome is the difference in the rate of change in the number of self-reported condomless anal sex acts without the protection of consistent Pre-Exposure Prophylaxis (PrEP) use, as well as reductions in stimulant use during the prior 4-months. Major assessments are conducted at baseline, 4-, 8-, and 12-month follow-up visits. DISCUSSION Effective and sustainable behavioral interventions are sorely needed to reduce HIV acquisition in stimulant using MSM at risk for HIV infection. In this study, we will evaluate the evidence of efficacy of the IMPACT intervention to reduce HIV acquisition in HIV-uninfected, stimulant-using MSM. If found effective, the intervention tested here holds promise for being readily integrated into real-world clinical settings. TRIAL REGISTRATION ClinicalTrials.gov number NCT03175159 , registered June 5, 2017.
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Affiliation(s)
- Matthew J. Mimiaga
- Center for Health Equity Research, Brown University, 121 South Main Street, Providence, RI 02903 USA
- Departments of Behavioral & Social Health Sciences and Epidemiology, Brown University, School of Public Health, Providence, RI USA
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI USA
- The Fenway Institute, Fenway Health, Boston, MA USA
| | - David W. Pantalone
- The Fenway Institute, Fenway Health, Boston, MA USA
- Department of Psychology, University of Massachusetts, Boston, MA USA
| | - Katie B. Biello
- Center for Health Equity Research, Brown University, 121 South Main Street, Providence, RI 02903 USA
- Departments of Behavioral & Social Health Sciences and Epidemiology, Brown University, School of Public Health, Providence, RI USA
- The Fenway Institute, Fenway Health, Boston, MA USA
| | | | - Christopher M. Santostefano
- Center for Health Equity Research, Brown University, 121 South Main Street, Providence, RI 02903 USA
- Departments of Behavioral & Social Health Sciences and Epidemiology, Brown University, School of Public Health, Providence, RI USA
| | - Jennifer Olson
- Center for Health Equity Research, Brown University, 121 South Main Street, Providence, RI 02903 USA
| | | | - Jaclyn M. W. Hughto
- Center for Health Equity Research, Brown University, 121 South Main Street, Providence, RI 02903 USA
- Departments of Behavioral & Social Health Sciences and Epidemiology, Brown University, School of Public Health, Providence, RI USA
- The Fenway Institute, Fenway Health, Boston, MA USA
| | | | - Adam W. Carrico
- Department of Public Health Sciences, University of Miami Medical School, Coral Gables, FL USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA USA
- Department of Infectious Diseases, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, MA USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Steven A. Safren
- The Fenway Institute, Fenway Health, Boston, MA USA
- Department of Psychology, University of Miami, Coral Gables, FL USA
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Dutta RR, Taffe MA, Mandyam CD. Chronic administration of amphetamines disturbs development of neural progenitor cells in young adult nonhuman primates. Prog Neuropsychopharmacol Biol Psychiatry 2018; 85:46-53. [PMID: 29601895 PMCID: PMC5962428 DOI: 10.1016/j.pnpbp.2018.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 03/24/2018] [Accepted: 03/25/2018] [Indexed: 02/07/2023]
Abstract
The detrimental effects of amphetamines on developmental stages of NPCs are limited to rodent brain and it is not known if these effects occur in nonhuman primates which are the focus of the current investigation. Young adult rhesus macaques either experienced MDMA only, a combination of amphetamines (MDMA, MDA and methamphetamine) or no amphetamines (controls) and hippocampal tissue was processed for immunohistochemical analysis.Quantitative stereological analysis showed that intermittent exposure to MDMA or the three amphetamines over 9.6 months causes >80% decrease in the number of Ki-67 cells (actively dividing NPCs) and >50% decrease in the number of NeuroD1 cells (NPCs that have attained a neuronal phenotype). Co-labeling analysis revealed distinct, actively dividing hippocampal NPCs in the subgranular zone of the dentate gyrus that were in transition from stem-like radial glia-like cells (type-1) to immature transiently amplifying neuroblasts (type-2a, type-2b, and type-3).MDMA-alone and the combination reduced the number of dividing type-1 and type-3 NPCs and cells that were not NPCs. These data indicate that amphetamines interfere with the division and migration of NPCs. Notably, the reduction in the number of NPCs and immature neurons were not associated with changes in cell death (via apoptosis) or granule cell neuron numbers, indicating that amphetamines selectively affected the generation and maturation of newly born granule cell neurons. In sum, our findings suggest that alterations in the cellular composition in the dentate gyrus during chronic exposure to amphetamines can effect neuroplasticity in the hippocampus and influence functional properties of hippocampal neurons.
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Affiliation(s)
- Rahul R Dutta
- Department of Neuroscience, The Scripps Research Institute,USA
| | - Michael A Taffe
- Department of Neuroscience, The Scripps Research Institute,USA
| | - Chitra D Mandyam
- Department of Neuroscience, The Scripps Research Institute,USA; VA San Diego Healthcare System, USA; Department of Anesthesiology, University of California San Diego, San Diego, CA, USA.
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11
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Jacques-Aviñó C, García de Olalla P, González Antelo A, Fernández Quevedo M, Romaní O, Caylà JA. The theory of masculinity in studies on HIV. A systematic review. Glob Public Health 2018; 14:601-620. [PMID: 29972098 DOI: 10.1080/17441692.2018.1493133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study aimed to describe the methodological characteristics of publications on HIV and masculinity, to identify possible information gaps and determine the main thematic areas. A systematic review was conducted of gender, masculinity, HIV infection and other sexually-transmitted infections in original articles published between 1992 and 2015. Original studies published from Pubmed and Scopus were included. A total of 303 articles were identified, of which 187 were selected. Most of the studies were qualitative and the most widely used technique was the interview. Twenty-nine-point five percent of studies were performed in South Africa, 20.8% in the USA, and 3.2% in Europe. Fifteen percent of the studies were performed in heterosexuals, 12.8% in men who have sex with men, and 60% did not specify the sexual orientation of the population. Eight thematic areas were defined, the most frequent being sexuality and risk behaviours, defined by men's need to demonstrate they were sexually active and a breadwinner. Most studies on HIV and masculinity show a gender bias by not specifying the sexual identity of the population. Studies should consider diversity in sexual and cultural identity in different contexts, including in Europe, to carry out more effective HIV interventions from a masculinity perspective.
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Affiliation(s)
- Constanza Jacques-Aviñó
- a Servicio de Epidemiología , Agència de Salud Pública de Barcelona , Barcelona , Spain.,b Universitat Rovira i Virgili (URV) , Tarragona , Spain
| | - Patricia García de Olalla
- a Servicio de Epidemiología , Agència de Salud Pública de Barcelona , Barcelona , Spain.,c Epidemiología y Salud Pública , CIBER , Spain
| | - Alicia González Antelo
- d Servicio Medicina Preventiva y Epidemiología , Hospital Vall d'Hebrón , Barcelona , Spain
| | | | - Oriol Romaní
- c Epidemiología y Salud Pública , CIBER , Spain.,e Medical Anthropology Research Center (MARC- URV) , Tarragona , Spain
| | - Joan A Caylà
- a Servicio de Epidemiología , Agència de Salud Pública de Barcelona , Barcelona , Spain.,c Epidemiología y Salud Pública , CIBER , Spain
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12
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Optimizing Contingency Management with Methamphetamine-Using Men who Have Sex with Men. COGNITIVE AND BEHAVIORAL PRACTICE 2017; 25:286-295. [PMID: 32461714 DOI: 10.1016/j.cbpra.2017.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Among men who have sex with men (MSM), methamphetamine use is associated with multiple, overlapping syndemic conditions including increased risk for HIV seroconversion and onward HIV transmission. Contingency management (CM) is an evidence-based, behavioral intervention implemented to curb methamphetamine use and optimize HIV/AIDS prevention among MSM in San Francisco since 2003. We conducted a program evaluation to document the evolution of this 12-week CM program to include delivery of brief, individual counseling incorporating motivational interviewing and behavioral skills. A drop-in group delivered concurrently with CM urine-screening visits also provides peer support as well as referrals for other social and medical services. From December 2011-October 2013, a total of 131 clients enrolled in the CM program and provided a median of 22 urine samples (Interquartile Range = 10-34) that were non-reactive for methamphetamine. Findings support the feasibility and acceptability of integrating individual and group counseling with community-based CM for methamphetamine-using MSM.
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Molero Y, Bakshi AS, Gripenberg J. Illicit Drug Use Among Gym-Goers: a Cross-sectional Study of Gym-Goers in Sweden. SPORTS MEDICINE - OPEN 2017; 3:31. [PMID: 28853020 PMCID: PMC5574837 DOI: 10.1186/s40798-017-0098-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/11/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The use of anabolic-androgenic steroids has increased among gym-goers, and it has been proposed that this may be part of a polysubstance use pattern that includes the use of illicit drugs. Still, epidemiological data on illicit drug use among gym-goers of both genders are meager. The aim of the present study was thus to examine the use of illicit drugs and its correlates in a large sample of men and women who engaged in weight training at gyms across Sweden. METHODS In this cross-sectional study, a total of 1969 gym-goers who engaged in weight training in 54 gyms across Sweden were invited to fill in a questionnaire. The questionnaire included 25 items on background variables, weight training frequency, use of illicit drugs and doping substances, and non-medical use of benzodiazepines. RESULTS Of the gym-goers, 19.6% reported having ever used illicit drugs, 6.5% reported use during the past 12 months, and 2.1% during the past 30 days. The most commonly used drug was cannabis, followed by cocaine, amphetamine, and ecstasy. Almost 40% of those who reported drug use had used more than one drug. Male participants and participants between 20 and 39 years of age made up the majority of users. Furthermore, 5.1% of the reported drug users had ever used a doping substance. There was an almost threefold higher odds (OR = 2.99, 95% CI = 1.16-7.66, p < 0.023) of doping use among people who had reported drug use as compared to non-users. CONCLUSIONS Training at gyms is typically considered a health-promoting behavior. However, our results revealed a slightly higher prevalence of illicit drug use among gym attendees as compared to the general population. Our findings may have captured an underrecognized group of young adult males who engage in weightlifting and use illicit drugs recreationally and/or as training aids. Developing knowledge is imperative in orientating preventive efforts among at-risk gym-goers. TRIAL REGISTRATION ISRCTN11655041.
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Affiliation(s)
- Yasmina Molero
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Norra Stationsgatan 69, SE-1113-64, Stockholm, Sweden.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Ann-Sofie Bakshi
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Norra Stationsgatan 69, SE-1113-64, Stockholm, Sweden
| | - Johanna Gripenberg
- STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Norra Stationsgatan 69, SE-1113-64, Stockholm, Sweden
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14
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Gordon AR, Krieger N, Okechukwu CA, Haneuse S, Samnaliev M, Charlton BM, Austin SB. Decrements in health-related quality of life associated with gender nonconformity among U.S. adolescents and young adults. Qual Life Res 2017; 26:2129-2138. [PMID: 28315179 PMCID: PMC5511094 DOI: 10.1007/s11136-017-1545-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE Gender nonconformity, that is, transgressing conventionally "masculine" vs. "feminine" characteristics, is often stigmatized. Stigmatization and discrimination are social stressors that raise risk of adverse mental and physical health outcomes and may drive health inequities. However, little is known about the relationship between such social stressors and health-related quality of life (HRQOL). This paper aimed to examine associations between perceived gender nonconformity and HRQOL in a cohort of U.S. adolescents and young adults. METHODS Using data from 8408 participants (18-31 years) in the U.S. Growing Up Today Study (93% white, 88% middle-to-high income), we estimated risk ratios (RRs) for the association of gender nonconformity (three levels: highly gender conforming, moderately conforming, and gender nonconforming) and HRQOL using the EuroQol questionnaire (EQ-5D-5L). Models were adjusted for demographic characteristics, including sexual orientation identity. RESULTS Gender nonconformity was independently associated with increased risk of having problems with mobility [RR (95% confidence interval): 1.76 (1.16, 2.68)], usual activities [2.29 (1.67, 3.13)], pain or discomfort [1.59, (1.38, 1.83)], and anxiety or depression [1.72 (1.39, 2.13)], after adjusting for sexual orientation and demographic characteristics. Decrements in health utility by gender nonconformity were observed: compared to persons who were highly gender conforming, mean health utility was lower for the moderately gender conforming [beta (SE): -0.011 (.002)] and lowest for the most gender nonconforming [-0.034 (.005)]. CONCLUSIONS In our study, HRQOL exhibited inequities by gender nonconformity. Future studies, including in more diverse populations, should measure the effect of gender-related harassment, discrimination, and violence victimization on health and HRQOL.
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Affiliation(s)
- Allegra R Gordon
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave. (AU-Box 17, BCH 3189), Boston, MA, 02115, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Cassandra A Okechukwu
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Mihail Samnaliev
- Department of Clinical Research Center, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, USA
| | - Brittany M Charlton
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave. (AU-Box 17, BCH 3189), Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave. (AU-Box 17, BCH 3189), Boston, MA, 02115, USA
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
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15
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Rusow JA, Fletcher JB, Reback CJ. Sexual Venue Choice and Sexual Risk-Taking Among Substance-Using Men Who have Sex with Men. AIDS Behav 2017; 21:1149-1162. [PMID: 27905014 PMCID: PMC5370583 DOI: 10.1007/s10461-016-1630-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Commercial sex venues (CSVs) and public sex environments (PSEs) offer men who have sex with men (MSM) sexual privacy and anonymity. Sociodemographic characteristics (e.g., race/ethnicity, sexual identity, age, HIV status) are correlated with individuals' choice of sexual venue, potentially suggesting environmental associations with both sociodemographics and sexual risk. From March 2005 through March 2012, 1298 substance-using MSM provided information on their most recent sexual encounter; iterative logit models estimated associations between sociodemographics and sexual venue, and/or whether sexual venue was associated with sexual risk-taking while controlling for sociodemographics. More than a third of participants' most recent sexual encounters took place in either a PSE (23.0%) or a CSV (11.3%); anonymous, HIV-serodiscordant, and/or sex while on methamphetamine and/or marijuana was significantly more likely to occur in CSVs/PSEs than in a private location, even when controlling for sociodemographics. Findings demonstrate that socioenvironmental factors were associated with sexual risk-taking among high-risk, urban MSM.
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Affiliation(s)
- Joshua A Rusow
- Friends Research Institute, Inc., 1419 N. La Brea Ave, Los Angeles, CA, 90028, USA.
| | - Jesse B Fletcher
- Friends Research Institute, Inc., 1419 N. La Brea Ave, Los Angeles, CA, 90028, USA
| | - Cathy J Reback
- Friends Research Institute, Inc., 1419 N. La Brea Ave, Los Angeles, CA, 90028, USA
- David Geffen School of Medicine, Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, 90095, USA
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16
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Mitchell JW. Differences in Relationship Characteristics Between HIV-Negative Male Couples Who Used and Did Not Use Substances with Sex. AIDS Behav 2016; 20:667-78. [PMID: 26223222 PMCID: PMC4733439 DOI: 10.1007/s10461-015-1148-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Although substance use is linked to HIV seroconversion, little is known about male couples substance use with sex. The present study sought to: describe whether neither, one, or both partners in the couple used a particular substance with sex within or outside their relationship; assess, by substance type used with sex, whether relationship factors differed between these groups of couples. Dyadic data from 83 behaviorally non-monogamous HIV-negative male couples were used with multinomial regression models. Those who used with sex within the relationship varied by substance type; outside the relationship, most only had one partner who used with sex. Couples with one or both partners who used substances with sex within or outside the relationship were more likely to have higher commitment to their relationship yet less likely to trust their main partner; mixed results were found regarding communication. Further research is warranted toward the need for preventive intervention development.
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Affiliation(s)
- Jason W Mitchell
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1021, Miami, FL, 33136, USA.
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17
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Zeglin RJ. Assessing the role of masculinity in the transmission of HIV: a systematic review to inform HIV risk reduction counseling interventions for men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1979-1990. [PMID: 25917411 PMCID: PMC5502076 DOI: 10.1007/s10508-015-0501-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 01/24/2015] [Accepted: 01/28/2015] [Indexed: 05/31/2023]
Abstract
HIV affects over 1.2 million people in the United States; a substantial number are men who have sex with men (MSM). Despite an abundance of literature evaluating numerous social/structural and individual risk factors associated with HIV for this population, relatively little is known regarding the individual-level role of masculinity in community-level HIV transmission risk. To address this gap, the current analysis systematically reviewed the masculinity and HIV literature for MSM. The findings of 31 sources were included. Seven themes were identified: (1) number of partners, (2) attitudes toward condoms, (3) drug use, (4) sexual positioning, (5) condom decision-making, (6) attitudes toward testing, and (7) treatment compliance. These factors, representing the enactment of masculine norms, potentiate the spread of HIV. The current article aligns these factors into a masculinity model of community HIV transmission. Opportunities for counseling interventions include identifying how masculinity informs a client's cognitions, emotions, and behaviors as well as adapting gender-transformative interventions to help create new conceptualizations of masculinity for MSM clients. This approach could reduce community-level HIV incidence.
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Affiliation(s)
- Robert J Zeglin
- Department of Counseling and Human Development, George Washington University, 2134 G St. NW, 3rd Floor, Washington, DC, 20037, USA,
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18
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Lelutiu-Weinberger C, Pachankis JE, Gamarel KE, Surace A, Golub SA, Parsons JT. Feasibility, Acceptability, and Preliminary Efficacy of a Live-Chat Social Media Intervention to Reduce HIV Risk Among Young Men Who Have Sex With Men. AIDS Behav 2015; 19:1214-27. [PMID: 25256808 PMCID: PMC4375068 DOI: 10.1007/s10461-014-0911-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Given the popularity of social media among young men who have sex with men (YMSM), and in light of YMSM's elevated and increasing HIV rates, we tested the feasibility, acceptability and preliminary efficacy of a live chat intervention delivered on Facebook in reducing condomless anal sex and substance use within a group of high risk YMSM in a pre-post design with no control group. Participants (N = 41; 18-29 years old) completed up to eight one-hour motivational interviewing and cognitive behavioral skills-based online live chat intervention sessions, and reported on demographic, psychosocial, and behavioral characteristics at baseline and immediately post-intervention. Analyses indicated that participation in the intervention (n = 31) was associated with reductions of days of drug and alcohol use in the past month and instances of anal sex without a condom (including under the influence of substances), as well as increases in knowledge of HIV-related risks at 3-month follow-up. This pilot study argues for the potential of this social media-delivered intervention to reduce HIV risk among a most vulnerable group in the United States, in a manner that was highly acceptable to receive and feasible to execute. A future randomized controlled trial could generate an intervention blueprint for providers to support YMSM's wellbeing by reaching them regardless of their geographical location, at a low cost.
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Affiliation(s)
- Corina Lelutiu-Weinberger
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA, URL: http://cunyhart.org/
| | - John E. Pachankis
- Chronic Disease Epidemiology, Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
| | - Kristi E. Gamarel
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
- Alpert Medical School of Brown University, 167 Point Street, Providence, RI 023093, USA
| | - Anthony Surace
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
| | - Sarit A. Golub
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
- Health Psychology and Basic and Applied Social Psychology Doctoral Programs, the Graduate Center, CUNY, 365 Fifth Avenue, New York, NY 10016, USA
| | - Jeffrey T. Parsons
- Department of Psychology, Hunter AIDS Research Team (HART), Hunter College, City University of New York (CUNY), 695 Park Avenue, HN Room 1209, New York, NY 10065, USA
- Health Psychology and Basic and Applied Social Psychology Doctoral Programs, the Graduate Center, CUNY, 365 Fifth Avenue, New York, NY 10016, USA
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36th Street, 9th Floor, New York, NY 10018, USA
- CUNY School of Public Health at Hunter College, 2180 Third Avenue, New York, NY 10035, USA
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Exposure to Theory-Driven Text Messages is Associated with HIV Risk Reduction Among Methamphetamine-Using Men Who have Sex with Men. AIDS Behav 2015; 19 Suppl 2:130-41. [PMID: 25563501 DOI: 10.1007/s10461-014-0985-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Fifty-two non-treatment-seeking methamphetamine-using men who have sex with men were enrolled in Project Tech Support, an open-label pilot study to evaluate whether exposure to theory-based [social support theory (SST), social cognitive theory (SCT), and health belief model (HBM)] text messages could promote reductions in HIV sexual risk behaviors and/or methamphetamine use. Multivariable analyses revealed that increased relative exposure to HBM or SCT (vs. SST) text messages was associated with significant reductions in the number of HIV serodiscordant unprotected (i.e., without a condom) anal sex partners, engagement in sex for money and/or drugs, and frequency of recent methamphetamine use; additionally, increased relative exposure to HBM (vs. SCT or SST) messages was uniquely associated with reductions in the overall number of non-primary anal sex partners (all p ≤ 0.05, two-tailed). Pilot data demonstrated that text messages based on the principles of HBM and SCT reduced sentinel HIV risk and drug use behaviors in active methamphetamine users.
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20
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The gap of masculinity in the research on HIV among men who have sex with men: A review of quantitative literature and theoretical contributions on gender and masculinity approaches. SOCIAL THEORY & HEALTH 2015. [DOI: 10.1057/sth.2015.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Mitchell JW. Relationship characteristics differ based on use of substances with sex among an urban internet sample of HIV-discordant and HIV-positive male couples. J Urban Health 2015; 92:136-50. [PMID: 25559366 PMCID: PMC4338121 DOI: 10.1007/s11524-014-9926-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Previous research with men who have sex with men (MSM) has found that substance use with sex is strongly associated with HIV acquisition and poor adherence to HIV treatments. Although some studies have assessed male couples' use of substances with unprotected anal sex, little is known on whether differences in their relationship dynamics are associated with their usage. Current HIV prevention initiatives underscore the importance of studying male couples' relationship dynamics. Using dyadic data from 28 HIV-positive and 58 HIV-discordant male couples, this analysis sought to: (1) describe, by substance type, whether neither, one, or both partners in the couple used a particular substance with sex within their relationship or outside of the relationship, respectively, and (2) assess, by substance type, whether relationship characteristic differences existed between these three groups of couples with respect to substance use with sex within and outside the relationship. Data from 86 dyads came from a cross-sectional, Internet study. Multivariate multinomial regression models were employed to achieve the aims. Except for alcohol, most did not use substances with sex. Within the relationship, those who used with sex varied by substance type; outside the relationship, most couples had only one partner who used with sex regardless of substance type. Several relationship characteristic differences were noted between the groups of couples. Within the relationship, marijuana and erectile dysfunction medication (EDM) use with sex was associated with having less tangible resources; for outside the relationship, these were associated with perceiving to have greater quality of alternatives. In general, amyl nitrates and party drug use with sex were associated with viewing the main partner as being less dependable for trustworthiness. Marijuana and party drug use with sex within the relationship and EDM use with sex outside the relationship were negatively associated with being able to communicate constructively. Mixed results were noted for relationship satisfaction. Additional research is urgently needed for prevention and promotion of healthy relationships for male couples who use substances with sex.
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Affiliation(s)
- Jason W Mitchell
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1021, Miami, FL, 33136, USA,
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22
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Mitchell JW. Differences in Gay Male Couples' Use of Drugs and Alcohol With Sex by Relationship HIV Status. Am J Mens Health 2014; 10:262-9. [PMID: 25424504 DOI: 10.1177/1557988314559243] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Prior studies with men who have sex with men have documented a strong association between substance use with sex and risk for acquisition of HIV. However, few studies have been conducted about gay male couples' use of substances with sex, despite the fact that between one third and two thirds of men who have sex with men acquire HIV from their relationship partners. The present study sought to (1) describe whether one or both partners in the male couple uses substances with sex-by substance type-within and/or outside of their relationship, and (2) assess whether differences exist in those who use substances with sex within and outside the relationship by the couples' HIV status. Dyadic data for this analysis were collected in the United States from a nation-wide cross-sectional Internet study about male couples' relationships and behaviors. Couple-level descriptive and comparative analyses were employed with 361 male couples. Except for alcohol, most couples did not use substances with sex. Of those who did, rates of who used it with sex and substance type within the relationship varied; most couples only had one partner who used substances with sex outside the relationship. Significantly higher proportions of concordantly HIV-negative and HIV-positive couples had both partners who used substances (all types) with sex within their relationship over discordant couples. Most couples had one partner who used outside the relationship; only marijuana and erectile dysfunction medication use with sex significantly differed by couples' HIV status. Findings indicate the need to conduct additional research for prevention development.
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24
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Buttram ME, Kurtz SP, Surratt HL, Levi-Minzi MA. Health and social problems associated with prescription opioid misuse among a diverse sample of substance-using MSM. Subst Use Misuse 2014; 49:277-84. [PMID: 23971894 PMCID: PMC3947231 DOI: 10.3109/10826084.2013.828754] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2013] [Indexed: 11/13/2022]
Abstract
This study examines associations between prescription opioid misuse and demographics, substance use, sexual behavior, and related health and social problems. Baseline data were collected between 2008 and 2010 from 515 high risk men who have sex with men, ages 18-55, in the Miami-Ft. Lauderdale metropolitan area who reported heavy substance use and HIV risk in the past 90 days. Prescription opioid misuse was associated with other substance use, drug injection, substance dependence, and history of arrest. Implications, limitations, and directions for future study are discussed.
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Affiliation(s)
- Mance E. Buttram
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida
| | - Steven P. Kurtz
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida
| | - Hilary L. Surratt
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida
| | - Maria A. Levi-Minzi
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, Florida
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Wim VB, Christiana N, Marie L. Syndemic and other risk factors for unprotected anal intercourse among an online sample of Belgian HIV negative men who have sex with men. AIDS Behav 2014; 18:50-8. [PMID: 23681697 DOI: 10.1007/s10461-013-0516-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Men who have sex with men (MSM) are confronted with different health problems. Next to a higher HIV prevalence and a higher reporting of depressive symptoms and other mental health problems, there is also evidence of substance dependence and sexual compulsivity occurring simultaneously. Using a sample of 591 HIV-negative Belgian MSM, we examine the relationships between depressive symptoms and other risk factors of unprotected anal intercourse (UAI) practice with casual partners. These risk factors include depressive symptoms, sexual behavioural indicators, individual risk perception of UAI, intrapersonal factors measured by the sexual sensation seeking scale, substance use, sources of social support and social norming regarding condom use and finally the location where or media through which men find sex partners. Our findings show that multifactorial, intertwined factors contribute to the explanation of UAI among MSM at risk for HIV infection. These findings underline the need for an integrated sexual health approach for MSM.
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26
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Benotsch EG, Lance SP, Nettles CD, Koester S. Attitudes toward methamphetamine use and HIV risk behavior in men who have sex with men. Am J Addict 2013; 21 Suppl 1:S35-42. [PMID: 23786508 DOI: 10.1111/j.1521-0391.2012.00294.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Methamphetamine use has been strongly associated with high-risk sexual behaviors, and its use has been increasing among men who have sex with men (MSM). Although the behavioral implications of methamphetamine use and sexual risk have been broadly examined, fewer studies have examined attitudes about methamphetamine use. METHODS This study investigates the relationship between personal beliefs regarding methamphetamine use, patterns of use, and sexual risk behaviors within a sample of MSM attending a gay pride event (N= 342). RESULTS A minority of MSM reported lifetime (27%) or recent (7%) methamphetamine use. Only a minority of MSM who had used methamphetamine believed that it enhanced sexual pleasure (32%) or incorporated methamphetamine use into their sexual activity (31%). Individuals who used methamphetamine during sexual activity were more likely to be recent users of the drug and more likely to engage in high-risk behaviors. A significant minority of participants endorsed items assessing the disinhibiting effects of methamphetamine including being less likely to use a condom (35%) and less selective in their choice of partners (26%). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Results suggest that prevention efforts may benefit from targeting the minority of methamphetamine users who perceive methamphetamine as enhancing sexual activity and use it for this purpose.
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Affiliation(s)
- Eric G Benotsch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA.
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Klein H. Depression and HIV Risk Taking among Men Who Have Sex with Other Men (MSM) and Who Use the Internet to Find Partners for Unprotected Sex. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2013; 18:164-189. [PMID: 26877831 DOI: 10.1080/19359705.2013.834858] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE This study examines the prevalence of depression in a sample of MSM who are at high risk for HIV. It examines the relationship between depressive symptomatology and involvement in HIV risk behaviors, and the factors associated with greater depressive symptomatology. METHODS The data come from a national random sample of 332 MSM who used any of 16 websites to identify men with whom they could engage in unprotected sex. Data were collected via telephone interviews. RESULTS Depression was more prevalent in this population (26.7%) than among men in the general population. Depression was not related directly to any of the HIV risk behaviors examined, but it was related to men's attitudes toward condom use, which was the strongest predictor of their involvement in risky behaviors. Five factors were identified as being associated with greater depression: lower educational attainment, greater discrimination based on sexual orientation, greater eroticizing of ejaculatory fluids, experiencing more substance abuse problems, and greater childhood maltreatment. CONCLUSIONS Depression is a consequential problem in this population. Although depression does not appear to be related directly to HIV risk practices in this population, its influence cannot be discounted because of its effects on other key predictors of risk involvement.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, 401 Schuyler Road, Silver Spring, MD 20910,
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Kapadia F, Siconolfi DE, Barton S, Olivieri B, Lombardo L, Halkitis PN. Social support network characteristics and sexual risk taking among a racially/ethnically diverse sample of young, urban men who have sex with men. AIDS Behav 2013; 17:1819-28. [PMID: 23553346 PMCID: PMC3761803 DOI: 10.1007/s10461-013-0468-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Associations between social support network characteristics and sexual risk among racially/ethnically diverse young men who have sex with men (YMSM) were examined using egocentric network data from a prospective cohort study of YMSM (n = 501) recruited in New York City. Bivariate and multivariable logistic regression analyses examined associations between social support network characteristics and sexual risk taking behaviors in Black, Hispanic/Latino, and White YMSM. Bivariate analyses indicated key differences in network size, composition, communication frequency and average relationship duration by race/ethnicity. In multivariable analyses, controlling for individual level sociodemographic, psychosocial and relationship factors, having a sexual partner in one's social support network was associated with unprotected sexual behavior for both Hispanic/Latino (AOR = 3.90) and White YMSM (AOR = 4.93). Further examination of key network characteristics across racial/ethnic groups are warranted in order to better understand the extant mechanisms for provision of HIV prevention programming to racially/ethnically diverse YMSM at risk for HIV.
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Affiliation(s)
- F Kapadia
- Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY 10016, USA.
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29
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Parsons JT, Lelutiu-Weinberger C, Botsko M, Golub SA. Predictors of day-level sexual risk for young gay and bisexual men. AIDS Behav 2013; 17:1465-77. [PMID: 22614745 PMCID: PMC3463644 DOI: 10.1007/s10461-012-0206-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
As HIV infection rates remain high among young gay and bisexual men, investigations into determinants of sexual risk are paramount. This study examined independent and interactive effects of substance use, mental health, perceived benefits of unprotected sex, and type of sex partner on odds of not using condoms. Analyses included 188 high-risk substance using HIV-negative and unknown status young gay and bisexual men (ages 18-29). Substance use and endorsing favorable attitudes towards unprotected sex strongly predicted sexual risk. Mental health moderated the relationship between partner type (main vs. casual) and condom use such that increased anxiety and depression were associated with increased odds of using condoms with main partners and not using condoms with casual partners. Understanding how these determinants of HIV risk converge to predict unprotected anal sex can identify essential risk relationships for prevention, obtain effects sizes of greater magnitude and prolonged sustainability, and build robust couples-based interventions.
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Affiliation(s)
- Jeffrey T Parsons
- Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York, 142 West 36th Street, 9th Floor, New York, NY 10018, USA.
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30
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Mimiaga MJ, Reisner SL, Pantalone DW, O'Cleirigh C, Mayer KH, Safren SA. A pilot trial of integrated behavioral activation and sexual risk reduction counseling for HIV-uninfected men who have sex with men abusing crystal methamphetamine. AIDS Patient Care STDS 2012; 26:681-93. [PMID: 23030605 PMCID: PMC3495110 DOI: 10.1089/apc.2012.0216] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Crystal methamphetamine use is a major driver behind high-risk sexual behavior among men who have sex with men (MSM). Prior work suggests a cycle of continued crystal methamphetamine use and high-risk sex due to loss of the ability to enjoy other activities, which appears to be a side effect of this drug. Behavioral activation (BA) is a treatment for depression that involves learning to reengage in life's activities. We evaluated a novel intervention for crystal methamphetamine abuse and high-risk sex in MSM, incorporating 10 sessions of BA with integrated HIV risk reduction counseling (RR). Forty-four subjects were screened, of whom 21 met initial entry criteria. A total of 19 participants enrolled; 16 completed an open-phase study of the intervention. Behavioral assessments were conducted at baseline, 3 months postbaseline, and 6 months postbaseline. Linear mixed effects regression models were fit to assess change over time. Mean unprotected anal intercourse (UAI) episodes decreased significantly from baseline to acute postintervention (β=-4.86; 95% confidence interval [CI]=-7.48, -2.24; p=0.0015) and from baseline to 6 months postbaseline (β=-5.07; 95% CI=-7.85, -2.29; p=0.0017; test of fixed effects χ(2)=16.59; df=2,13; p=0.0002). On average, there was a significant decrease over time in the number of crystal methamphetamine episodes in the past 3 months (χ(2)=22.43; df=2,15; p<0.0001), and the number of days of crystal methamphetamine use in the past 30 days (χ(2)=9.21; df=2,15; p=0.010). Statistically significant reductions in depressive symptoms and poly-substance use were also maintained. Adding behavioral activation to risk reduction counseling for MSM with problematic crystal methamphetamine use may augment the potency of a risk reduction intervention for this population. Due to the small sample size and time intensive intervention, future testing in a randomized design is necessary to determine efficacy, with subsequent effectiveness testing.
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Affiliation(s)
- Matthew J Mimiaga
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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31
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Galindo GR, Casey AJ, Yeung A, Weiss D, Marx MA. Community associated methicillin resistant Staphylococcus aureus among New York City men who have sex with men: qualitative research findings and implications for public health practice. J Community Health 2012; 37:458-67. [PMID: 21874581 DOI: 10.1007/s10900-011-9463-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Academic literature has recorded increased microbial resistance in the United States and recent news media has adversely portrayed men who have sex with men (MSM) at increased risk for community associated methicillin resistant Staphylococcus aureus (CA-MRSA) transmission. CA-MRSA is a specific type of bacteria resistant to certain antibiotics, which limits treatment options for those needing clinical care. Infection can manifest as painful abscesses and can cause severe illness. With increased CA-MRSA infections overall, and attention given to MSM populations regarding CA-MRSA, as well as the fact that limited data on sociocultural factors that may facilitate transmission, we undertook a qualitative study to explore contextual influences that may fuel infection among MSM in New York City so that public health professionals can better recognize, and respond appropriately to, potential future outbreaks. In-depth interviews were used to qualitatively investigate perceptions and beliefs regarding transmission, as well as community understandings of treatment options. Participants included thirteen MSM who reported a previous CA-MRSA infection and nine community practitioners. A thematic content analysis of these interviews was conducted and data suggests that behaviors and exposures associated with transmission of CA-MRSA are common in certain MSM networks. Specifically, sociocultural influences and methamphetamine use activities were found to contribute to CA-MRSA transmission. We underscore the role of public health and health services practitioners in providing appropriate CA-MRSA awareness and education to MSM populations.
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Affiliation(s)
- Gabriel R Galindo
- Center for AIDS Prevention Studies, University of California at San Francisco, 50 Beale St, Suite 1300, San Francisco, CA 94105, USA.
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32
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Patterns of Alcohol and Other Drug Use Associated with Major Depression Among Gay Men Attending General Practices in Australia. Int J Ment Health Addict 2011. [DOI: 10.1007/s11469-011-9330-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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33
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Santos GM, Das M, Colfax GN. Interventions for non-injection substance use among US men who have sex with men: what is needed. AIDS Behav 2011; 15 Suppl 1:S51-6. [PMID: 21404011 PMCID: PMC3064889 DOI: 10.1007/s10461-011-9923-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Glenn-Milo Santos
- San Francisco Department of Public Health, HIV Prevention Section, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102 USA
| | - Moupali Das
- San Francisco Department of Public Health, HIV Prevention Section, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102 USA
| | - Grant Nash Colfax
- San Francisco Department of Public Health, HIV Prevention Section, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102 USA
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34
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Wei C, Raymond HF, Wong FY, Silvestre AJ, Friedman MS, Documét P, McFarland W, Stall R. Lower HIV prevalence among Asian/Pacific Islander men who have sex with men: a critical review for possible reasons. AIDS Behav 2011; 15:535-49. [PMID: 21153049 DOI: 10.1007/s10461-010-9855-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We conducted a critical literature review for possible reasons that may explain the lower HIV prevalence observed among API MSM compared to MSM of other races/ethnicities. Trends emerging from the literature suggest that traditional individual-level factors-unprotected anal intercourse, substance use, STD prevalence, rates and frequency of HIV testing, and utilization of HIV prevention services-do not appear to be related to the lower HIV prevalence among API MSM. Some evidence suggests that socio-cultural and structural factors might be the more critical forces in determining racial/ethnic disparities of HIV among MSM. For API MSM, these factors include structures of sexual networks, access to and reception of medical care and treatment among HIV-positive MSM, and influences of different levels and types of acculturation. Moreover, emerging risk reduction strategies, such as seroadaptive behaviors, could play a role. Future research should address these factors in intervention design. In addition, better theories of resilience and measurement of strengths and protective factors are needed to enhance the efficacy of HIV interventions.
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Affiliation(s)
- Chongyi Wei
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA.
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35
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Nonmedical Use of Prescription Drugs and HIV Risk Behavior in Gay and Bisexual Men. Sex Transm Dis 2011; 38:105-10. [DOI: 10.1097/olq.0b013e3181f0bc4b] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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36
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Halkitis PN, Pollock JA, Pappas MK, Dayton A, Moeller RW, Siconolfi D, Solomon T. Substance use in the MSM population of New York City during the era of HIV/AIDS. Subst Use Misuse 2011; 46:264-73. [PMID: 21303246 DOI: 10.3109/10826084.2011.523265] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This literature review considers the historical significance, emergence of, and interplay between the HIV and illicit drug use epidemics among gay, bisexual, and other men who have sex with men (MSM) in New York City (NYC). The continual rise in HIV infections in recent years among MSM, particularly among young MSM (YMSM), commands a need for the examination of the effectiveness of current HIV prevention strategies and a more comprehensive understanding of the complex biopsychosocial influences that place YMSM at risk. A chronological perspective of both the HIV and illicit drug use epidemics affecting NYC MSM is presented, followed by a review of the existing research on the synergistic relation between the two. Special consideration is given to the patterns and interconnectivity between HIV, substance use, and housing instability specific to YMSM, as they represent the demographic currently at greatest risk for HIV transmission in NYC. Thereafter, an overview of treatment research is provided. We conclude by offering recommendations for future research and best practices as we move forward in an attempt to reduce the incidence of HIV transmission.
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Affiliation(s)
- Perry N Halkitis
- Center for Health, Identity, Behavior, & Prevention Studies, The Steinhardt School of Culture, Education, and Human Development, New York University, New York, USA.
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37
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Hampton MC, Halkitis PN, Mattis JS. Coping, drug use, and religiosity/spirituality in relation to HIV serostatus among gay and bisexual men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2010; 22:417-429. [PMID: 20973662 DOI: 10.1521/aeap.2010.22.5.417] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Cross-sectional data were collected on a sample of 259 gay and bisexual, male-identified individuals as part of a larger study of the psychosocial functioning of lesbian, gay, bisexual, and transgender persons. Analyses considered differences between HIV-positive and HIV-negative men in relation to active and religious coping strategies; avoidant coping strategies (specifically, illicit drug use); and the psychosocial states of anxiety, hostility, and depression in relation to self-reported HIV-status of the participants. As compared with HIV-negative men, the HIV positive participants indicated a greater likelihood of engaging in illicit substance use within the previous 3 months, as well as higher levels of both active and religious coping strategies. Illicit substance use also was found to be related to higher levels of depression, anxiety, and hostility. A multivariate model indicated a significant difference in substance-based and active coping strategies among the men surveyed, with persons with a self-reported HIV-positive serostatus endorsing higher levels of both strategies. These results and their implications for prevention and future research are discussed, rooted in the understanding that a complex reality for coping is often enacted by HIV-positive men.
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Affiliation(s)
- Melvin C Hampton
- Center for Health, Identity, Behavior, and Prevention Studies, Department of Applied Psychology, New York University, New York, USA
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38
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Carrico AW, Johnson MO, Colfax GN, Moskowitz JT. Affective correlates of stimulant use and adherence to anti-retroviral therapy among HIV-positive methamphetamine users. AIDS Behav 2010; 14:769-77. [PMID: 19125321 PMCID: PMC2891867 DOI: 10.1007/s10461-008-9513-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Accepted: 12/09/2008] [Indexed: 11/12/2022]
Abstract
The use of stimulants has important implications for HIV prevention and care. However, few investigations have examined psychological correlates of substance use and adherence to anti-retroviral therapy (ART) among HIV-positive stimulant users. This cross-sectional investigation examined affective correlates of stimulant use and ART adherence among HIV-positive methamphetamine users. In total, 122 HIV-positive men who have sex with men or transgendered individuals on ART who reported using methamphetamine in the past 30 days were recruited from the community. HIV-specific traumatic stress was consistently and independently associated with more frequent cocaine/crack use (but not with methamphetamine use). Positive affect was independently associated with a decreased likelihood of reporting any injection drug use and an increased likelihood of reporting perfect ART adherence. HIV-specific traumatic stress may be an important determinant of increased cocaine/crack use in this population. Positive affect may increase the likelihood that individuals will refrain from injection drug use and achieve high levels of ART adherence.
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39
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Brown RA. Crystal methamphetamine use among American Indian and White youth in Appalachia: Social context, masculinity, and desistance. ADDICTION RESEARCH & THEORY 2010; 18:250-269. [PMID: 21637733 PMCID: PMC3104682 DOI: 10.3109/16066350902802319] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Rural areas and American Indian reservations are hotspots for the use of crystal methamphetamine ("meth") in the United States, yet there is little ethnographic data describing meth use in these areas. This study draws upon three years of ethnographic work conducted with American Indian and White youth in Appalachia during the height of the meth epidemic. It describes how historical, cultural, and socioeconomic processes influence vulnerability to meth use in Appalachia, and highlights the role of social relationships and meaning-making in facilitating desistance and recovery from meth use. The first section shows how crystal meth filled a particular functional niche in the lives of many young men, alleviating boredom and anomie linked to recent socioeconomic changes and labor opportunities in the region, and intersecting with local understandings of masculinity and forms of military identity. Here, ethnographic and interview data converge to illustrate how social role expectations, recent socioeconomic change, and meth's pharmacological properties converge to create vulnerability to meth use in Appalachia. The second section draws upon two American Indian narratives of desistance. These youth described recently severed social relationships and acute feelings of social isolation during the initiation of meth use. Both also described dramatic close calls with death that facilitated their eventual desistance from use, involving repaired social relationships and the establishment of new lives and hope. These interviews illustrate how changes in social relationships were linked with both initiation and desistance from meth use, and how religious interpretations of near-death experiences structured narratives of cessation and redemption.
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Affiliation(s)
- Ryan A Brown
- School of Education and Social Policy, Human Development and Social Policy, Northwestern University, Walter Annenberg Hall, 2120 Campus Drive, Evanston, IL 60208, USA
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40
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Siconolfi D, Halkitis PN, Allomong TW, Burton CL. Body Dissatisfaction and Eating Disorders in a Sample of Gay and Bisexual Men. ACTA ACUST UNITED AC 2009. [DOI: 10.3149/jmh.0803.254] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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41
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Halkitis PN, Mukherjee PP, Palamar JJ. Longitudinal modeling of methamphetamine use and sexual risk behaviors in gay and bisexual men. AIDS Behav 2009; 13:783-91. [PMID: 18661225 DOI: 10.1007/s10461-008-9432-y] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Accepted: 07/08/2008] [Indexed: 12/21/2022]
Abstract
The purpose of the analyses was to examine the associations between methamphetamine and other club drug use with sexual risk taking across time in cohort of gay and bisexual men. Data were collected from a community-based sample. Assessments of unprotected anal intercourse with casual partners, and use of methamphetamine and other illicit drugs, were assessed at baseline, and at 4-month intervals over the course of a year, and were analyzed using hierarchical linear modeling. Methamphetamine use was related to the frequency of unprotected insertive and receptive intercourse with both HIV-positive and status unknown casual partners across time. The association between methamphetamine use and unprotected acts also was more pronounced for HIV-positive participants. These findings suggest that methamphetamine, and unprotected anal intercourse are co-occurring risk behaviors, that potentially heighten the risk of HIV transmission among gay and bisexual men. HIV prevention and intervention should concurrently target both these behaviors.
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Affiliation(s)
- Perry N Halkitis
- Center for Health, Identity, Behavior & Prevention Studies, Department of Applied Psychology, The Steinhardt School, New York University, 82 Washington Square East, Pless 555, New York, NY 10003, USA.
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42
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Halkitis PN, Solomon TM, Moeller RW, Doig SAR, Espinosa LS, Siconolfi D, Homer BD. Methamphetamine use among gay, bisexual and non-identified men-who-have-sex-with-men: an analysis of daily patterns. J Health Psychol 2009; 14:222-31. [PMID: 19237489 DOI: 10.1177/1359105308100206] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study sought to understand the patterns, methods of administration and contexts for methamphetamine use (MA) in a sample of racially diverse men who have sex with men (MSM). Inclusion into the study required participants to be classified as clinically dependent on MA, but indicate no other illicit substance use. Use was assessed using Timeline Followback for a period of 30 days. Of the 900 assessed days, MA use was reported on 217. Participants reported an average of seven days of use, with the majority of use occurring on the weekend. The weekend usage pattern suggests an incorporation of drugs into the lives of gay men as a means of socialization and recreation.
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43
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Halkitis PN, Moeller RW, Pollock JA. Sexual practices of gay, bisexual, and other nonidentified MSM attending New York City gyms: patterns of serosorting, strategic positioning, and context selection. JOURNAL OF SEX RESEARCH 2008; 45:253-261. [PMID: 18686154 DOI: 10.1080/00224490802204456] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This descriptive paper characterizes the sexual behaviors of a diverse sample (N=311) of gay, bisexual, and other nonidentified men who have sex with men (MSM) who regularly attended gyms in New York City. Approximately 50% of the sample indicated sex with primary male partners, while 88% of the men had sexual relations with male casual partners in the 6 months prior to assessment. The participants met their casual partners in a variety of different venues, including the Internet. Differences were noted along key demographic factors with regard to the contexts in which men met their partners. The data indicate that the men use serosorting, strategic positioning, and contexts in which they meet other men, to influence choices concerning sexual partners and practices as a form of health protection. It is proposed that these patterns of sexual behavior are representative of the totality of the lives of gay, bisexual, and other MSM, because despite engaging in gym behaviors, which might be considered health promoting, these men are simultaneously taking risks. Such findings point to varying motivations as to why gay, bisexual, and other MSM actually attend the gym.
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Affiliation(s)
- Perry N Halkitis
- Center for Health, Identity, Behavior & Prevention Studies (CHIBPS), Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY 10003, USA.
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