1
|
Wheldon CW, Polter E, Rosser BRS, Bates AJ, Haggart R, Wright M, Mitteldorf D, Ross MW, Konety BR, Kohli N, Talley KMC, West W, Tatum AK. Prevalence and Risk Factors for Sexually Transmitted Infections in Gay and Bisexual Prostate Cancer Survivors: Results From the Restore-2 Study. Front Oncol 2022; 12:832508. [PMID: 35600390 PMCID: PMC9117614 DOI: 10.3389/fonc.2022.832508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background Equitable cancer survivorship care for gay and bisexual male (GBM) prostate cancer survivors should be responsive to their sexual health needs. Rates of sexually transmitted infections (STIs) are higher among GBM compared to heterosexual men across the lifespan. In addition, evidence suggests that GBM will use a variety of strategies to cope with sexual dysfunction that may increase risk for STIs. The purpose of this study was to determine the prevalence of STIs following prostate cancer treatment among GBM and identify risk factors. Methods In 2019, 401 GBM previously treated for prostate cancer were recruited into the Restore-2 Study. They completed a baseline online questionnaire with items assessing STIs diagnosed since being treated for prostate cancer. Any STI diagnoses was regressed on demographic, clinical, and relationship related variables using binary logistic regression. Results Forty-five participants (11.4%) were diagnosed with an STI during or following their prostate cancer treatment. The mostly commonly diagnosed STI was syphilis (4.3%), followed by gonorrhoea (2.8%), and chlamydia (2.5%). Four participants were infected with HIV following their prostate cancer treatment. Independent risk factors for STI diagnosis included time since prostate cancer diagnosis (aOR = 1.18; 95% CI: 1.10-1.26), nonmonogamous sexual relationship (aOR = 11.23; 95% CI: 2.11-59.73), better sexual function (aOR = 1.02; 95% CI: 1.01-1.04), penile injection treatment (aOR = 3.28; 95% CI: 1.48-7.29), and multiple sex partners (aOR = 5.57; 95% CI: 1.64-18.96). Conclusions GBM prostate cancer survivors are at risk for STIs. Culturally responsive STI prevention should be incorporated into cancer survivorship plans, particularly as men are treated for and regain sexual function over time.
Collapse
Affiliation(s)
- Christopher W. Wheldon
- Cancer Health Equity, Education and Research Lab, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
- *Correspondence: Christopher W. Wheldon,
| | - Elizabeth Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - B. R. Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Alex J. Bates
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Ryan Haggart
- Department of Urology, University of Minnesota, Minneapolis, MN, United States
| | - Morgan Wright
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | | | - Michael W. Ross
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | | | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Kristine M. C. Talley
- Adult and Geriatric Health, University of Minnesota School of Nursing, Minneapolis, MN, United States
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, United States
| | - Alexander K. Tatum
- Department of Counseling Psychology, Social Psychology, and Counseling, College of Health, Ball State University, Muncie, IN, United States
| |
Collapse
|
2
|
Robles G, Bosco SC, Sauermilch D, Starks TJ. Population-Specific Correlates of Sexual Arrangements and Communication in a National Sample of Latinx Sexual Minority Men. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1449-1460. [PMID: 34080072 PMCID: PMC8272519 DOI: 10.1007/s10508-021-02009-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/23/2021] [Accepted: 04/09/2021] [Indexed: 05/25/2023]
Abstract
While the literature on sexual arrangements has expanded considerably, less is known about sexual arrangements among ethnically diverse populations, particularly Latinx sexual minority men (LSMM). Relationship research may overlook culturally salient correlates (e.g., ideals of masculinity or immigration-related factors) of sexual arrangements. The current study explored relationship-related factors (i.e., sexual arrangements, sexual communication, and relationship functioning) as well as Latino-specific factors, including dominant cultural views of masculinity (machismo/caballerismo) and immigration among partnered LSMM. Participants were recruited nationwide through social media and geo-location dating apps. All participants were aged 18 or older, cisgender male, lived in the U.S., including Puerto Rico, were able to read in either English or Spanish, and indicated they were currently in a relationship with a cismale partner. Multinomial regression was used to calculate the odds of being in an open or monogamish arrangement relative to a monogamous arrangement. Multivariable linear regression analysis was conducted to examine factors related to sexual communication. Language spoken with partner, adherence to more general heteronormative beliefs (genderism), and substance use were associated with specific sexual arrangement groups. The findings also suggested that birthplace, language spoken with partner variables, and machismo were associated with specific sexual arrangements and with sexual communication. This study highlights that factors associated with sexual arrangements and sexual communication may be population specific. The current study points to a complex interplay between culturally relevant ideals of masculinity and sexual arrangements as well as sexual communication among partnered Latinx sexual minority men.
Collapse
Affiliation(s)
- Gabriel Robles
- School of Social Work, Rutgers University, 390 George Street, New Brunswick, NJ, 08901, USA.
| | - Stephen C Bosco
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of the City University of New York, New York, NY, USA
| | - Daniel Sauermilch
- Department of Counseling and Clinical Psychology, Teachers College of Columbia University, New York, New York, NY, USA
| | - Tyrel J Starks
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of the City University of New York, New York, NY, USA
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
| |
Collapse
|
3
|
Philpot SP, Bavinton BR, Prestage G, Grierson J, Ellard J, Duncan D. Exploring Diversity in HIV Research in the Sexual Partnerships of Australian Gay and Bisexual Men. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2069-2080. [PMID: 31863315 DOI: 10.1007/s10508-019-01540-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 08/18/2019] [Accepted: 08/22/2019] [Indexed: 06/10/2023]
Abstract
Gay and bisexual men engage in a variety of sexual partnerships, but the most common distinction made in HIV research and behavioral surveillance is a binary between "regular" and "casual" partners. The "regular partner" category is often perceived as pertaining to ongoing coupled "boyfriend" relationships, with the literature to date rarely troubling what actually constitutes a "regular partner." Some emerging literature has identified "fuckbuddy" partnerships as a type of regular partnership requiring attention, but it is relatively new and not well understood. Currently, assumptions of the regular partner category do not capture how men perceive and conduct commitment in different sexual partnerships that could also be considered "regular," and the implications this has for HIV prevention. Drawing on in-depth interviews with a sample of 61 Australian gay-identified men, we explore a diversity of partnership types that represent unique ways of enacting commitment. We identify three sexual partnerships: "fuckbuddies," dating, and serial monogamy, each with specific issues for HIV risk and prevention. These partnerships suggest important differences in the way men conceive of and practice intimacy and sex.
Collapse
Affiliation(s)
- Steven P Philpot
- Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, NSW, 2052, Australia.
| | - Benjamin R Bavinton
- Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Garrett Prestage
- Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Jeffrey Grierson
- Health, Social Care and Education, Anglia Ruskin University, Cambridge Campus, Cambridge, UK
| | - Jeanne Ellard
- Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Duane Duncan
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, VIC, Australia
- School of Humanities, Arts and Social Sciences, University of New England, Armidale, NSW, Australia
| |
Collapse
|
4
|
Abstract
A sexual agreement is a mutual understanding between two partners regarding sexual and relational behaviors both within and outside of their relationship. Sexual agreements have been central to research and programming efforts around HIV prevention, primarily for male couples. A comprehensive scoping review of the primary literature on sexual agreements, including negotiated safety, was performed to identify what is known about sexual agreements among couples (n = 66). Results indicate a wide range of prevalence of agreements and measurements used to characterize sexual agreements. Findings also report associations between sexual agreements and health and relational outcomes. Several knowledge gaps were identified; specifically, the need to expand sexual agreements research beyond MSM populations and the need to better understand agreement breaks, break disclosure, and how variation in agreement categorization may impact reported prevalence. This review demonstrates the importance of broadening the evidence-base of sexual agreements research and programmatic focus.
Collapse
|
5
|
Meanley S, Egan JE, Bauermeister JA. Policing Heteronormativity and Sexual Risk-Taking Among Young Adult Men Who Have Sex with Men in the Detroit Metro Area. AIDS Behav 2018; 22:3991-4000. [PMID: 30141149 DOI: 10.1007/s10461-018-2257-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Policing gender and sexuality can have enduring health implications for the well-being of young men who have sex with men (YMSM). Using data from a community-based sample of YMSM in the Detroit Metro Area (N = 364), we examined the prevalence of lifetime heteronormative policing by gender (e.g., punished/restricted for femininity) and sexuality (e.g., attempts to alter same-sex attractions). We examined the associations of heteronormative policing attempts and the number of condomless insertive and receptive anal intercourse partners, respectively. We also tested whether internalized homophobia moderated the association between sexuality policing and sexual risk. Multivariable models demonstrated that policing sexuality, but not gender, was associated with a greater number of partners in which participants engaged in condomless intercourse as the receptive partner. We observed no interaction between policing sexuality and internalized homophobia. Multilevel efforts are needed to reduce the contribution of heteronormative policing on YMSM's HIV risk.
Collapse
Affiliation(s)
- Steven Meanley
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
- Program on Sexuality, Technology & Action Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
| | - James E Egan
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
- The Center for LGBT Health Research, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - José A Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Program on Sexuality, Technology & Action Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| |
Collapse
|
6
|
Feinstein BA, Dellucci TV, Sullivan PS, Mustanski B. Characterizing Sexual Agreements With One's Most Recent Sexual Partner Among Young Men Who Have Sex With Men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2018; 30:335-349. [PMID: 30148672 PMCID: PMC6311095 DOI: 10.1521/aeap.2018.30.4.335] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Men who have sex with men (MSM) often create sexual agreements with their partners, but little is known about agreements with serious versus causal partners. We used data from 472 young MSM to examine agreements with one's most recent partner, individual differences across types of partnerships and agreements, and predictors of condomless anal sex (CAS). Two-thirds of participants did not have agreements. Monogamous agreements were most common among those who were seriously dating their partner, but also present among those who were casually dating their partner and those who were not dating their partner. Participants who were seriously dating their partner reported the most frequent sexual health communication. Participants without agreements reported the lowest frequency of and comfort with sexual health communication. Participants who were seriously dating their partner and those with monogamous agreements were most likely to report CAS. HIV prevention should address communication with serious and casual partners.
Collapse
Affiliation(s)
- Brian A. Feinstein
- Northwestern University, Institute for Sexual and Gender Minority Health and Wellbeing
| | - Trey V. Dellucci
- Center for HIV Educational Studies & Training, Hunter College of the City University of New York
- Health Psychology and Clinical Science Doctoral Training Program, Graduate Center of the City University of New York
| | | | - Brian Mustanski
- Northwestern University, Institute for Sexual and Gender Minority Health and Wellbeing
- Northwestern University, Feinberg School of Medicine, Department of Medical Social Sciences
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Pathak EB, Wieten SE, Wheldon CW. Stoic beliefs and health: development and preliminary validation of the Pathak-Wieten Stoicism Ideology Scale. BMJ Open 2017; 7:e015137. [PMID: 29138193 PMCID: PMC5695468 DOI: 10.1136/bmjopen-2016-015137] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION We developed and validated a new parsimonious scale to measure stoic beliefs. Key domains of stoicism are imperviousness to strong emotions, indifference to death, taciturnity and self-sufficiency. In the context of illness and disease, a personal ideology of stoicism may create an internal resistance to objective needs, which can lead to negative consequences. Stoicism has been linked to help-seeking delays, inadequate pain treatment, caregiver strain and suicide after economic stress. METHODS During 2013-2014, 390 adults aged 18+ years completed a brief anonymous paper questionnaire containing the preliminary 24-item Pathak-Wieten Stoicism Ideology Scale (PW-SIS). Confirmatory factor analysis (CFA) was used to test an a priori multidomain theoretical model. Content validity and response distributions were examined. Sociodemographic predictors of strong endorsement of stoicism were explored with logistic regression. RESULTS The final PW-SIS contains four conceptual domains and 12 items. CFA showed very good model fit: root mean square error of approximation (RMSEA)=0.05 (95% CI 0.04 to 0.07), goodness-of-fit index=0.96 and Tucker-Lewis Index=0.93. Cronbach's alpha was 0.78 and ranged from 0.64 to 0.71 for the subscales. Content validity analysis showed a statistically significant trend, with respondents who reported trying to be a stoic 'all of the time' having the highest PW-SIS scores. Men were over two times as likely as women to fall into the top quartile of responses (OR=2.30, 95% CI 1.44 to 3.68, P<0.001). ORs showing stronger endorsement of stoicism by Hispanics, Blacks and biracial persons were not statistically significant. DISCUSSION The PW-SIS is a valid and theoretically coherent scale which is brief and practical for integration into a wide range of health behaviour and outcomes research studies.
Collapse
Affiliation(s)
- Elizabeth B Pathak
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Sarah E Wieten
- Departments of Philosophy and Internal Medicine, University of South Florida, Tampa, Florida, USA
| | - Christopher W Wheldon
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida, USA
| |
Collapse
|
9
|
Carter A, Lachowsky N, Forrest JI, Cui Z, Sereda P, Kaida A, Armstrong HL, Card KG, Montaner JS, Moore D, Roth EA, Hogg RS. A latent class analysis of sexual and romantic relationships among HIV-positive and HIV-negative gay and bisexual men in Vancouver. CANADIAN JOURNAL OF HUMAN SEXUALITY 2017. [DOI: 10.3138/cjhs.262.a1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Allison Carter
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Nathan Lachowsky
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- School of Public Health and Social Policy, University of Victoria, Victoria, BC
| | - Jamie I. Forrest
- School of Population and Public Health, University of British Columbia, Vancouver, BC
| | - Zishan Cui
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Paul Sereda
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
| | - Heather L. Armstrong
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- Department of Medicine, University of British Columbia, Vancouver, BC
| | - Kiffer G. Card
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Julio S.G. Montaner
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- Department of Medicine, University of British Columbia, Vancouver, BC
| | - David Moore
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- Department of Medicine, University of British Columbia, Vancouver, BC
| | - Eric A. Roth
- Department of Anthropology, University of Victoria, Victoria, BC
| | - Robert S. Hogg
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| |
Collapse
|
10
|
Martinez O, Wu E, Frasca T, Shultz AZ, Fernandez MI, López Rios J, Ovejero H, Moya E, Chavez Baray S, Capote J, Manusov J, Anyamele CO, López Matos J, Page JSH, Carballo-Diéguez A, Sandfort TGM. Adaptation of a Couple-Based HIV/STI Prevention Intervention for Latino Men Who Have Sex With Men in New York City. Am J Mens Health 2016; 11:181-195. [PMID: 25846772 DOI: 10.1177/1557988315579195] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Predominantly Spanish-speaking Latino men who have sex with men (MSM) and their same-sex partners continue to be at high risk for HIV and STIs. Behavioral research has identified how relationship dynamics for male couples are associated with sexual risk behavior. Connect 'n Unite (CNU), an evidence-based HIV/STI prevention intervention originally created for Black MSM and their same-sex partners, was adapted for predominantly Spanish-speaking Latino MSM and their same-sex partners on the assumption that its key elements would be translatable while its efficacy would be retained. A systematic adaptation process utilizing qualitative methods was used, including intervention adaptation sessions with 20 predominantly Spanish-speaking Latino gay couples and 10 health service providers. The process included five steps: (1) engaging community stakeholders, (2) capturing the lived experiences of Latino gay couples, (3) identifying intervention priorities, (4) integrating the original intervention's social cognitive theory into a relationship-oriented, ecological framework for Latino gay couples, and (5) adapting intervention activities and materials. The adapted intervention, which we called Latinos en Pareja or Latinos in a Relationship, incorporates elements that effective HIV prevention interventions share, including: a solid theoretical foundation; emphasis on increasing risk reduction norms, sexual communication skills and social support for protection; and guidance on how to utilize available, culturally and linguistically appropriate services. The systematic adaptation approach used for a couples-based HIV prevention intervention also can be employed by other researchers and community stakeholders to adapt evidence-based interventions that promote wellness, linkage to care, and disease prevention for populations not originally targeted.
Collapse
Affiliation(s)
- Omar Martinez
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | - Elwin Wu
- 2 Columbia University, New York, NY, USA
| | - Timothy Frasca
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | - Andrew Zach Shultz
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | | | - Javier López Rios
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | | | - Eva Moya
- 5 University of Texas at El Paso, El Paso, TX, USA
| | | | | | | | - Chukwuemeka O Anyamele
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | | | | | - Alex Carballo-Diéguez
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| | - Theo G M Sandfort
- 1 New York State Psychiatric Institute, New York, NY, USA.,2 Columbia University, New York, NY, USA
| |
Collapse
|
11
|
Lee TK, Handy AB, Kwan W, Oliffe JL, Brotto LA, Wassersug RJ, Dowsett GW. Impact of Prostate Cancer Treatment on the Sexual Quality of Life for Men-Who-Have-Sex-with-Men. J Sex Med 2015; 12:2378-86. [PMID: 26537853 DOI: 10.1111/jsm.13030] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION With earlier prostate cancer (PCa) diagnosis and an increased focus on survivorship, post-treatment sexual quality of life (QoL) has become increasingly important. Research and validated instruments for sexual QoL assessment based on heterosexual samples have limited applicability for men-who-have-sex-with-men (MSM). AIM We aimed to create a validated instrument for assessing sexual needs and concerns of MSM post-PCa treatment. Here we explore post-PCa treatment sexual concerns for a sample of MSM, as the first part of this multi-phase project. METHODS Individual semi-structured interviews were conducted with 16 MSM face-to-face or via Internet-based video conferencing. Participants were asked open-ended questions about their experiences of sexual QoL following PCa. Interviews were recorded, transcribed verbatim, uploaded to NVivo 8(TM) , and analyzed using qualitative methodology. MAIN OUTCOME MEASURE We have conducted semi-structure qualitative interviews on 16 MSM who were treated for PCa. Focus was on post-treatment sexual concerns. RESULTS The following themes were inductively derived: (i) erectile, urinary, ejaculation, and orgasmic dysfunctions; (ii) challenges to intimate relationships; and (iii) lack of MSM-specific oncological and psychosocial support for PCa survivorship. Sexual practices pre-treatment ranked in order of frequency were masturbation, oral sex, and anal sex, an ordering that prevailed post-treatment. Sexual QoL decreased with erectile, urinary, and ejaculation dysfunctions. Post-treatment orgasms were compromised. Some single men and men in non-monogamous relationships reported a loss of confidence or difficulty meeting other men post-treatment. Limited access to targeted oncological and psychosocial supports posed difficulties in coping with PCa for MSM. CONCLUSIONS The negative impact on sexual QoL can be severe for MSM and requires targeted attention. Penile-vaginal intercourse and erectile function have been the primary focus of sexual research and rehabilitation for men with PCa, and do not adequately reflect the sexual practices of MSM. Our findings suggest that future research dedicated to MSM with PCa is needed to incorporate their sexual practices and preferences specifically into treatment decisions, and that targeted oncological and psychosocial support services are also warranted.
Collapse
Affiliation(s)
- Tsz Kin Lee
- British Columbia Cancer Agency, Fraser Valley Cancer Centre, Surrey, BC, Canada
| | - Ariel Baker Handy
- Department of Obstetrics and Gynaecology, Diamond Health Care Centre, University of British Columbia, Vancouver, BC, Canada
| | - Winkle Kwan
- British Columbia Cancer Agency, Fraser Valley Cancer Centre, Surrey, BC, Canada
| | - John Lindsay Oliffe
- Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Lori Anne Brotto
- Department of Obstetrics and Gynaecology, Diamond Health Care Centre, University of British Columbia, Vancouver, BC, Canada
| | - Richard Joel Wassersug
- Department of Urologic Sciences, Gordon and Leslie Diamond Health Care Centre, University of British Columbia, Vancouver, BC, Canada
| | - Gary Wayne Dowsett
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| |
Collapse
|
12
|
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]
|
13
|
Applewhite S, Littlefield MB. The Role of Resilience and Anti-Resilience Behaviors in the Romantic Lives of Black Same Gender Loving (sgl) Men. JOURNAL OF BLACK SEXUALITY AND RELATIONSHIPS 2015; 2:1-38. [PMID: 28042598 PMCID: PMC5198898 DOI: 10.1353/bsr.2016.0005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study examines the role of resilience in the romantic lives of Black same gender loving romantic male couples in the nyc metropolitan area. Twenty in-depth interviews (N=40) were conducted, ranging in age from 18 to 67, and were predominately low income and moderately educated. Research questions were: 1) What strategies do Black sgl couples use to preserve and improve their relationships and (2) What are the potential problems or barriers your relationship experiences? The data from interviews were aggregated and three major themes emerged: direct communication strategies, relationship support, and intentional and thoughtful decision making. Additional themes identified as anti-resilient to Black sgl couples were relationship discord, hostile neighborhood climate, poor communication, and lack of support. Findings show that additional research Black gay couples is needed to identify the contextual factors that influence their romantic relationships and the resilient strategies that they uses to support their romantic relationships.
Collapse
|
14
|
Mitchell JW. Between and within couple-level factors associated with gay male couples' investment in a sexual agreement. AIDS Behav 2014; 18:1454-65. [PMID: 24327185 PMCID: PMC4397649 DOI: 10.1007/s10461-013-0673-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Sexual agreements are common among gay male couples, and between one-third and two-thirds of gay men acquire HIV while in a same-sex relationship. Studies have assessed whether agreements could be used for HIV prevention yet additional research is needed. By using dyadic data collected from 361 U.S. gay male couples, the present cross-sectional study sought to assess whether certain between and within couple-level relationship characteristics predict a partner's value in, commitment to, and satisfaction with an agreement. On average, couples with higher levels of constructive communication and relationship satisfaction and commitment were associated with partners who had higher levels of investment in the agreement. Within the couple, differences in commitment and investment of the relationship were also found to be negatively associated with partners' investment toward an agreement. Implications are discussed for how sexual agreements may be used to develop new HIV prevention efforts for gay male couples.
Collapse
Affiliation(s)
- Jason W Mitchell
- Health Promotion and Risk Reduction Programs, University of Michigan School of Nursing, 400 N. Ingalls, Office 3343, Ann Arbor, MI, 48109-5482, USA,
| |
Collapse
|
15
|
Mitchell JW, Boyd C, McCabe S, Stephenson R. A cause for concern: male couples' sexual agreements and their use of substances with sex. AIDS Behav 2014; 18:1401-11. [PMID: 24584415 DOI: 10.1007/s10461-014-0736-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Substance use is strongly associated with HIV risk among gay men. Many gay couples establish sexual agreements. However, little is known about gay couples' use of substances with sex, and whether substance use is associated with couples' agreements. The present study assessed whether gay couples' use of substances with sex was associated with their establishment of, type of, and adherence to, a sexual agreement. Dyadic data from 275 HIV-negative US gay couples were collected online in a nation-wide, cross-sectional study, and analyzed at the couple-level. Findings revealed that couples with an established agreement, and a recently broken agreement, were more likely to have used amyl nitrates and marijuana with sex within their relationship. This same trend was also noted, but for alcohol use with sex outside of couples' relationships. Further research is urgently needed to examine the fluidity of HIV-negative gay male couples' sexual agreements and substance use with sex.
Collapse
Affiliation(s)
- Jason W Mitchell
- School of Nursing, University of Michigan, 400 N. Ingalls, Office 3343, Ann Arbor, MI, 48109-5482, USA,
| | | | | | | |
Collapse
|
16
|
Abstract
Few HIV-preventing interventions exist for gay male couples in the USA, yet estimates indicate that between one- and two-thirds of US men who have sex with men acquire HIV while in a primary relationship (e.g., gay male couples). In response to these statistics, research has been conducted to better understand gay male couples' relationships, including their sexual agreements. Many gay male couples in the USA establish a sexual agreement, which is an explicit mutual understanding between two main partners about what sexual and other behaviors they agree to engage in and with whom while in the relationship. Although some research about sexual agreements has been conducted, little is known on whether aspects of gay male couples' sexual agreements (e.g., establishment, type, and adherence) vary as a function of their relationship length. The present study aimed to fulfill this gap of knowledge, which may lead to a better understanding of how agreements can be used for developing HIV/sexually transmitted infection (STI) prevention interventions. A national, cross-sectional, Internet-based study was used to collect dyadic data from 361 US gay male couples. Men in each couple completed the questionnaire independently. All analyses were employed at the couple level. Our findings showed that the longer the couples had been in their relationship, the more likely they would concur about having a sexual agreement. As relationship length increased, the proportion of couples who disagreed about their current agreement type increased. No direct trend was found for recent adherence to an agreement; however, the likelihood of ever breaking an agreement increased as relationship length increased. Findings from this study indicate there is a need to help gay male couples' establish and maintain their agreements, particularly for those who are in their early formative stages, as well as, for those who are experiencing challenges and/or changes in their relationships.
Collapse
Affiliation(s)
- Jason W Mitchell
- a Health Promotion and Risk Reduction Programs , University of Michigan School of Nursing , Ann Arbor , MI , USA
| |
Collapse
|
17
|
Blashill AJ, Wilson JM, O'Cleirigh CM, Mayer KH, Safren SA. Examining the correspondence between relationship identity and actual sexual risk behavior among HIV-positive men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:129-37. [PMID: 24198170 PMCID: PMC3947093 DOI: 10.1007/s10508-013-0209-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Sexual behavior of men who have sex with men (MSM), within and outside of one's primary relationship, may contribute to increased risk of HIV transmission among those living with HIV. The current study sought to understand how HIV-infected MSM report their relationship status and the degree to which this corresponds with their sexual behavior. Further, we examined rates and psychosocial associations with sexual HIV transmission risk behavior (TRB) across relationship categories. In a sample of 503 HIV-infected MSM in HIV care, 200 (39.8 %) reported having a primary partner. Of these, 115 reported that their relationship was open and 85 reported that it was monogamous. Of the 85 who reported a monogamous relationship, 23 (27 %) reported more than one sexual partner in the prior 3 months, 53 (62 %) reported only one partner, and nine did not report on the number of partners in the past 3 months. Hence, there were three categories of relationships: (1) "monogamous with one sexual partner," (2) "monogamous with more than one sexual partner," and (3) "open relationship." The "monogamous with more than one sexual partner" group reported higher TRB and crystal methamphetamine use compared to the "monogamous with one sexual partner" group and different patterns of relationships with TRB emerged across the three groups. Couples-based HIV prevention interventions for MSM may be enhanced by considering that there may be different definitions of monogamy among MSM, and that the context of relationship status may require tailoring interventions to meet the needs of specific subgroups of MSM couples.
Collapse
Affiliation(s)
- Aaron J Blashill
- Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA,
| | | | | | | | | |
Collapse
|
18
|
Grov C, Starks TJ, Rendina HJ, Parsons J. Rules about casual sex partners, relationship satisfaction, and HIV risk in partnered gay and bisexual men. JOURNAL OF SEX & MARITAL THERAPY 2013; 40:105-22. [PMID: 23768194 DOI: 10.1080/0092623x.2012.691948] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The authors used latent class analysis to investigate rules guiding nonmonogamy in partnered gay and bisexual men. Data are from a 2010 survey (N = 463) from which those in relationships (n = 191) were analyzed. More than half (56%) were nonmonogamous, and these men responded to 13 rules about sex outside of their relationship. The safe anonymous sex group (34%) included men who indicated that they must use condoms for anal sex and not have sex with people they know. The communication mandate group (19%) included men who indicated that they must talk about outside partners before sex occurs, disclose their relationship status to outside partners, and use condoms for anal sex. The play together group (9%) included men who indicated that they must play with others as a couple, not have anal sex with outside partners, and not spend the night with outside partners. Those in the no salient rule group (37%) were individuals who did not endorse a clear set of rules. These 4 groups (and compared with monogamous men) differed in age, agreement formality and flexibility, relationship satisfaction, and whether anal sex recently occurred with casual partners. This study provides a novel approach for understanding nonmonogamous same-sex relationships and highlights their complexity.
Collapse
Affiliation(s)
- Christian Grov
- a Brooklyn College of the City University of New York (CUNY) , New York , New York , USA
| | | | | | | |
Collapse
|
19
|
Beougher SC, Chakravarty D, Garcia CC, Darbes LA, Neilands TB, Hoff CC. Risks worth taking: safety agreements among discordant gay couples. AIDS Care 2012; 24:1071-7. [PMID: 22292838 DOI: 10.1080/09540121.2011.648603] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
As HIV research and prevention efforts increasingly target gay men in relationships, situational factors such as couple serostatus and agreements about sex become central to examinations of risk. Discordant gay couples are of particular interest because the risk of HIV infection is seemingly near-at-hand. Yet, little is known about their sexual behaviors, agreements about sex, and safer sex efforts. The present study utilized longitudinal semi-structured, qualitative interviews to explore these issues among 12 discordant couples. Findings show that nearly every couple had agreements about reducing the likelihood of HIV transmission from one partner to the other. Negotiating these agreements involved establishing a level of acceptable risk, determining condom use, and employing other risk-reduction techniques, such as seropositioning and withdrawal. For half of the couples, these agreements did not involve using condoms; only two couples reported consistent condom use. Despite forgoing condoms, however, none reported seroconversion over the course of data collection. Additional issues are raised where long-term HIV prevention is concerned. Future prevention efforts with discordant couples should work with, rather than fight against, the couple's decision to use condoms and endeavor to complement and accentuate their other safer sex efforts.
Collapse
Affiliation(s)
- Sean C Beougher
- Center for Research on Gender and Sexuality, San Francisco State University, San Francisco, CA, USA.
| | | | | | | | | | | |
Collapse
|