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Chang K, D'Anna LH, Owens J, Wood J. The Effects of Previous Experiences of Healthcare Discrimination on HIV Intervention Outcomes. AIDS Behav 2024; 28:1741-1751. [PMID: 38367163 DOI: 10.1007/s10461-024-04267-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 02/19/2024]
Abstract
Although several healthcare interventions have been developed to address HIV among young Black/African American men who have sex with men (YBMSM), the HIV epidemic in the United States continues to disproportionately burden this population. The current study examines previous healthcare discrimination and how it affects HIV intervention delivery. One hundred seventy-two YBMSM participated in the Peer Promotion of Wellness and Enhanced Linkage to Resources (PPOWER) project, which used a short, multi-faceted, community-level intervention based on Community Peers Reaching Out and Modeling Intervention Strategies (Community PROMISE). Data were collected at baseline, a 45-day follow up, and a 90-day follow up. Generalized Estimating Equations (GEE) were used to examine the effects of previous healthcare discrimination on outcomes related to HIV testing, alcohol and drug use, and sexual behaviors. Previous healthcare discrimination was found to moderate the relationship between time and intentions to test for HIV, perceptions of sexual risk, problem marijuana use, and problem other drug use, such that those who had experienced more healthcare discrimination showed greater improvements over time compared to those who had experienced less healthcare discrimination. The results of the current study suggest that a community-level peer intervention, in combination with a component to promote cultural competency and address prior experiences of discrimination in healthcare settings, may be highly effective for people who have experienced a barrier in their continuum of care as a result of racial discrimination.
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Affiliation(s)
- Kyle Chang
- Center for Health Equity Research, California State University Long Beach, 1250 Bellflower Blvd., FO5 Rm. 120, Long Beach, CA, 90840, USA.
| | - Laura Hoyt D'Anna
- Center for Health Equity Research, California State University Long Beach, 1250 Bellflower Blvd., FO5 Rm. 120, Long Beach, CA, 90840, USA
| | - Jaelen Owens
- Center for Health Equity Research, California State University Long Beach, 1250 Bellflower Blvd., FO5 Rm. 120, Long Beach, CA, 90840, USA
| | - Jefferson Wood
- Center for Health Equity Research, California State University Long Beach, 1250 Bellflower Blvd., FO5 Rm. 120, Long Beach, CA, 90840, USA
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Mostafa T, Alghobary M. Substance abuse and male sexual dysfunction: what lies beneath? Sex Med Rev 2023; 11:395-411. [PMID: 37085960 DOI: 10.1093/sxmrev/qead011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Substance abuse has become a worldwide health problem, leading to numerous consequences such as social problems among family members, abnormal behavior, adverse health effects, and psychological problems as well as economic consequences. OBJECTIVES We sought to assess the relationship between substance abuse and male sexual health. METHODS A search was carried out in the following databases: PubMed, MeSH (Medical Subject Headings), Science Direct, Scopus, Cochrane Library, EMBASE, CINAHL, Academic Search Complete, and the Egyptian Knowledge Bank. The following keywords were used to assess the outcomes for relevant associations: illicit drugs, addiction, substance abuse, sexual health, erectile dysfunction, ejaculatory disorders, impotence, orgasm disorders, and sexual performance. RESULTS The initial literature search identified a total of 148 articles in all searched databases. After removal of duplicate studies and application of inclusion/exclusion criteria, 75 reported studies were retained for review, including 38 case-control studies and 37 cross-sectional studies. These articles were classified into the following categories according to the type of abused substance addressed: cannabis/marihuana, 16 articles; opioids, 13 articles; heroin, 11 articles; cocaine, 5 articles; tramadol, 6 articles; ketamine, 2 articles; ecstasy, 4 articles; amphetamine, 2 articles; khat, 7 articles; androgen anabolic steroids, 2 articles; and polydrugs, 7 articles. Most of these recruited articles demonstrated a negative impact of the addressed substance on male sexual health, with variable levels. CONCLUSION Substance abuse has negative impacts on male sexual health that should be addressed. More studies conducted with proper methodological and statistical approaches, including logistic regression analysis, are needed to predict the effects of specific substances, considering the rapidly growing effects of non-substance-use disorders on male sexual health.
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Affiliation(s)
- Taymour Mostafa
- Department of Andrology, Sexology, & STIs, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Moheiddin Alghobary
- Department of Dermatology, Andrology & STIs, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
- Department of Clinical Science, Fakeeh College of Medical Sciences, Jeddah, KSA
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Gómez-Núñez MI, Molla-Esparza C, Gandia Carbonell N, Badenes Ribera L. Prevalence of Intoxicating Substance Use Before or During Sex Among Young Adults: A Systematic Review and Meta-Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2503-2526. [PMID: 36897426 PMCID: PMC10501956 DOI: 10.1007/s10508-023-02572-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Drug use before or during sex is a high-risk sexual behavior associated with adverse health risks and outcomes, such as increasing the likelihood of overdoses and of acquiring sexually-transmitted diseases. This systematic review and meta-analysis of three scientific databases examined the prevalence of the use of intoxicating substances, those tending to excite or stupefy the user on a psychoactive level, before or during sex, among young adults (18-29 years old). A total of 55 unique empirical studies met the inclusion criteria (48,145 individuals; 39% males), were assessed for risk of bias using the tools of Hoy et al. (2012), and were analyzed via a generalized linear mixed-effects model. The results produced a global mean prevalence of this sexual risk behavior of 36.98% (95% CI: 28.28%, 46.63%). Nonetheless, significant differences were identified between different intoxicating substances, with the use of alcohol (35.10%; 95% CI: 27.68%, 43.31%), marijuana (27.80%; 95% CI: 18.24%, 39.92%), and ecstasy (20.90%; 95% CI: 14.34%, 29.45%) significantly more prevalent than that of cocaine (4.32%; 95% CI: 3.64%, 5.11%), heroin (.67%; 95% CI: .09%, 4.65%), methamphetamine (7.10%; 95% CI: 4.57%, 10.88%), and GHB (6.55%; 95% CI: 4.21%, 10.05%). Moderator analyses showed that the prevalence of alcohol use before or during sex differed according to geographical sample origin, and increased as the proportion of ethnic whites in samples increased. The remaining demographic (e.g., gender, age, reference population), sexual (e.g., sexual orientation, sexual activity), health (e.g., drug consumption, STI/STD status), methodological (e.g., sampling technique), and measurement (e.g., timeframe) variables that were examined did not moderate prevalence estimates. Implications for sexual development interventions were discussed.
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Affiliation(s)
- María Isabel Gómez-Núñez
- Department of Research Methods and Diagnostics in Education, International University of La Rioja, UNIR, Logroño, La Rioja, Spain
| | - Cristian Molla-Esparza
- Department of Research Methods and Diagnostics in Education, University of Valencia, UVEG, Av. de Blasco Ibáñez, 30, 46010, Valencia, Spain.
| | - Natalia Gandia Carbonell
- Llaurant la Llum Therapeutic Community, Center for the Treatment, Withdrawal and Detoxification of Addictions and Other Associated Disorders, Valencia, Spain
- Department of Psychobiology and Health Sciences Methodology, Autonomous University of Barcelona, UAB, Bellaterra, Spain
| | - Laura Badenes Ribera
- Department of Methodology of the Behavioural Sciences, University of Valencia, UVEG, Valencia, Spain
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Flores R, Kerman J, Schneider J, Harawa N. "I feel like marijuana is the only drug that wouldn't kill me": perceptions of cannabis use in previously incarcerated Black men who have sex with other men. Harm Reduct J 2023; 20:13. [PMID: 36737793 PMCID: PMC9896444 DOI: 10.1186/s12954-023-00744-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/25/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Fragmented state laws have impacted cannabis uptake and perceptions in the USA. Little research has explored the attitudes, beliefs, and social network influences of young Black men who have sex with men (BMSM) who have experienced incarceration and use cannabis. While problematic cannabis use is not well defined and understudied, scholars have found that a person's social network can mediate problematic substance use and reduce recidivism rates by providing both tangible and emotional support. This analysis examines how social networks contribute to cannabis perceptions and use among BMSM with criminal legal system involvement in Chicago, IL, and Houston TX. METHODS Researchers conducted interviews with 25 cis gender Black men informed by life course theory, with a focus on the role of social networks, incarceration, and other life experiences in substance use. All interviews were audio-recorded, de-identified, and transcribed; participants were compensated $50. A deductive-inductive thematic analysis was used to analyze all qualitative data collected. RESULTS Twelve BMSM in Chicago and 13 BMSM in Houston (M = 26.6 years old, SD = 3.7) were interviewed. A majority identified as gay (56%), with 12 participants (48%) reporting having a high school diploma or equivalent; their average age of first substance use was 15.2 (SD = 2.9). Participants perceived cannabis usage to be categorically distinct from other intoxicating substance usage, with many describing it as not harmful and potentially beneficial. Three themes shaped their choices and attitudes regarding cannabis and "hard" drugs-social networks, need fulfillment, and knowledge of risk. CONCLUSION Participant descriptions of cannabis use emphasize their drug-use behavior as being produced by agent decision-making and risk assessment. Future work should expand on how these decisions are made, and how social networks can be leveraged to encourage non-harmful drug consumption behaviors.
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Affiliation(s)
- Rey Flores
- University of Chicago, 5801 S Ellis Ave, Chicago, IL, 60637, USA. .,Chicago Center for HIV Elimination, 1525 E. 55th St. Suite 205, Chicago, IL, 60637, USA. .,University of Illinois at Chicago, 750 S Halsted St., Chicago, IL, 60607, USA.
| | - Jared Kerman
- University of Chicago, 5801 S Ellis Ave, Chicago, IL, 60637, USA.,Chicago Center for HIV Elimination, 1525 E. 55th St. Suite 205, Chicago, IL, 60637, USA
| | - John Schneider
- University of Chicago, 5801 S Ellis Ave, Chicago, IL, 60637, USA.,Chicago Center for HIV Elimination, 1525 E. 55th St. Suite 205, Chicago, IL, 60637, USA
| | - Nina Harawa
- David Geffen School of Medicine at UCLA, 1100 Glendon Ave. Suite 850, Los Angeles, CA, 90024, USA.,Charles Drew University of Medicine and Science, 1731 E. 120th St., Los Angeles, CA, 90059, USA
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Javanbakht M, Rosen A, Ragsdale A, Richter EI, Shoptaw S, Gorbach PM. Interruptions in Mental Health Care, Cannabis Use, Depression, and Anxiety during the COVID-19 Pandemic: Findings from a Cohort of HIV-Positive and HIV-Negative MSM in Los Angeles, California. J Urban Health 2022; 99:305-315. [PMID: 35235134 PMCID: PMC8890012 DOI: 10.1007/s11524-022-00607-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 11/28/2022]
Abstract
The objective was to examine the impact of the COVID-19 pandemic on mental health care, cannabis use, and behaviors that increase the risk of STIs among men living with or at high risk for HIV. Data were from mSTUDY - a cohort of men who have sex with men in Los Angeles, California. Participants who were 18 to 45 years and a half were HIV-positive. mSTUDY started in 2014, and at baseline and semiannual visits, information was collected on substance use, mental health, and sexual behaviors. We analyzed data from 737 study visits from March 2020 through August 2021. Compared to visits prior to the COVID-19 pandemic, there were significant increases in depressive symptomatology (CES-D ≥ 16) and anxiety (GAD-7 ≥ 10). These increases were highest immediately following the start of the pandemic and reverted to pre-pandemic levels within 17 months. Interruptions in mental health care were associated with higher substance use (especially cannabis) for managing anxiety/depression related to the pandemic (50% vs. 31%; p-value < .01). Cannabis use for managing pandemic-related anxiety/depression was higher among those reporting changes in sexual activity (53% vs. 36%; p-value = 0.01) and was independently associated with having more than one sex partner in the prior 2 weeks (adjusted OR = 1.5; 95% CI 1.0-2.4). Our findings indicate increases in substance use, in particular cannabis, linked directly to experiences resulting from the COVID-19 pandemic and the associated interruptions in mental health care. Strategies that deliver services without direct client contact are essential for populations at high risk for negative sexual and mental health outcomes.
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Affiliation(s)
- Marjan Javanbakht
- Department of Epidemiology, UCLA Fielding School of Public Health, CHS 46-082, Box 951772, Los Angeles, CA, 90095-1772, USA.
| | - Allison Rosen
- Department of Epidemiology, UCLA Fielding School of Public Health, CHS 46-082, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Amy Ragsdale
- Department of Epidemiology, UCLA Fielding School of Public Health, CHS 46-082, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - E India Richter
- Department of Epidemiology, UCLA Fielding School of Public Health, CHS 46-082, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Steven Shoptaw
- Department of Family Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Pamina M Gorbach
- Department of Epidemiology, UCLA Fielding School of Public Health, CHS 46-082, Box 951772, Los Angeles, CA, 90095-1772, USA
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