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Bragard E, Macapagal K, Mustanski B, Fisher CB. Association of CAI Vulnerability and Sexual Minority Victimization Distress Among Adolescent Men Who Have Sex With Men. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2021; 8:496-505. [PMID: 34957315 DOI: 10.1037/sgd0000436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Adolescent men who have sex with men (AMSM) are at high HIV risk. Condomless anal intercourse (CAI) increases HIV risk and has been associated with interpersonal power imbalances, such as asymmetries in decision-making authority, social status, and emotional dependence, between male sexual partners. AMSM experience high levels of psychological and physical victimization due to their sexual minority status. Sexual minority victimization (SMV) is similarly associated with low interpersonal power and may relate to the extent to which AMSM are vulnerable to partner influences to engage in CAI. This online survey study of AMSM 14-17 years (N = 143) tested the hypothesis that experiences and attitudes reflecting vulnerability to partner CAI influence (CAI Vulnerability) and distress in response to experienced sexual minority victimization (SMV Distress) would be positively associated with participant and partner condom non-use during anal sex (CAI frequency). Approximately 35% reported they or their partner(s) had never or rarely used a condom. Positive correlations were found among partners' CAI frequency during sex with the participant, CAI Vulnerability, and SMV Distress. Multiple regression indicated CAI Vulnerability significantly accounted for the relation between SMV Distress and partner's CAI frequency. Findings suggest that distress in response to SMV may be associated with a diminished sense of interpersonal control resulting in CAI Vulnerability and subsequent more frequent instances of partner CAI. HIV prevention strategies designed to increase condom use among AMSM have the potential to benefit from procedures aimed at increasing interpersonal sexual assertiveness and decreasing distress associated with sexual minority victimization.
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Affiliation(s)
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Feinberg School of Medicine, and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Celia B Fisher
- Department of Psychology, Fordham University.,Center for Ethics Education, Fordham University
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Parchem B, Aguayo-Romero RA, del Río-González AM, Calabrese SK, Poppen PJ, Zea MC. Perceptions of power and sexual pleasure associated with sexual behaviour profiles among Latino sexual minority men. CULTURE, HEALTH & SEXUALITY 2021; 23:1344-1360. [PMID: 32744462 PMCID: PMC7855680 DOI: 10.1080/13691058.2020.1781263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
In a body of research typically focused on risk reduction and disease prevention, other factors motivating the sexual behaviours of Latino sexual minority men, such as resource-based power and sexual pleasure, are less well understood. To this end, Latino immigrant sexual minority men living in New York City were surveyed about their sexual behaviours, perceived power differentials, and pleasure from insertive and receptive anal intercourse. Power and pleasure were examined as associations with behavioural profiles identified through latent class analysis, adjusting for age and partner type. Four latent classes of Latino sexual minority men were identified based on behaviours reported during the most recent sexual event: behaviourally insertive (14.2%), behaviourally versatile (25.9%), behaviourally receptive (29.2%), and limited penetrative behaviour (30.7%). Participants who derived pleasure from insertive and receptive anal intercourse had higher odds of belonging in the behaviourally insertive and behaviourally receptive class, respectively. Perceptions of resource-based power were not associated with class membership. Findings highlight the importance of sexual pleasure as a driver of sexual behaviour, irrespective of power dynamics. Sexual health curricula and interventions for sexual minority men should consider sexual pleasure and sex-affirmative frameworks when providing sexuality education and promoting sexual wellbeing.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Rodrigo A. Aguayo-Romero
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
- Brigham and Women’s Hospital, Harvard Medical School, The Fenway Institute, Boston, MA, USA
| | | | - Sarah K. Calabrese
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
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Profiles of HIV Risk, Sexual Power, and Decision-Making among Sexual Minority Men of Color Who Engage in Transactional Sex: A Latent Profile Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094961. [PMID: 34066948 PMCID: PMC8125585 DOI: 10.3390/ijerph18094961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 11/17/2022]
Abstract
Though the transmission of HIV is preventable, there were still 37,968 new documented cases in the United States in 2018. HIV incidence is disproportionate in sexual minority men of color. The purpose of this study was to examine sexual relationship power risk profiles to identify distinct subgroups within the profiles who carry the highest HIV risk. Latent class profile analysis was used to identify subgroups of sexual minority men of color at the highest risk for contracting HIV based on their sexual power profiles. Among 322 sexual minority men, we identified four latent profiles. Profile 1: Low transactional sex and high power (n = 133; 14.3%); Profile 2: Transactional sex, high decision-making in sexual relationships, and low control in sexual relationship (n = 99; 30.7%); Profile 3: Low transactional sex, low decision-making, and moderate control (n = 43; 13.4%); Profile 4: High transactional sex and low power (n = 47; 14.6%). LPA was useful to identify distinct subgroups based on measures of sexual risk and relationship sexual power. Findings carry significant implications for developing tailored strategies to increase HIV knowledge and related HIV prevention and risk reduction services for sexual minority men of color who engage in transactional sex.
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Griner SB, Kline N, Monroy E, Thompson EL. Sexual Consent Communication among Sexual and Gender Minority College Students. JOURNAL OF SEX RESEARCH 2021; 58:462-468. [PMID: 33595408 DOI: 10.1080/00224499.2021.1882929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sexual scripts and consent communication methods are seldom explored outside of heterosexual, cisgender relationships. To date, little research has been conducted to determine how sexual and gender minority (SGM) students conceptualize and communicate consent. This study explored SGM undergraduate students' (n = 81) sexual consent communication scripts using open-ended survey items. We conducted a thematic freelisting analysis to assess the domains of consent and non-consent scripts using Smith's Salience Score (S). Salient indicators of consent were verbal communication (S = .31; 38%); however, more specific forms of verbal communication were listed as a spectrum, including: asking (a request, S = .16; 23%), saying (a statement, S = .16; 20%), and telling (a command, S = .10; 13%). The most salient indicators of verbal non-consent were on a similar spectrum: saying no (S = .42; 9%), verbal communication broadly (S = .23; 27%), and telling no (S = .06; 7%). Salient physical indicators of both consent and non-consent also followed a spectrum in their descriptions. Future research among SGM college students should explore the meanings, patterns, and differences in consent communication and sexual scripts.
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Affiliation(s)
- Stacey B Griner
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center
| | | | - Edward Monroy
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center
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Carmack C, Roncancio AM, Gerecht L, Ansari M. Perceived partner beliefs about condoms and self-efficacy communication within the context of the theory of gender and power. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:1424-1437. [PMID: 32168397 DOI: 10.1002/jcop.22337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 05/25/2023]
Abstract
The theory of gender and power provides a unique framework for understanding condom use by accounting for distinct challenges faced by minority women in particular. This study examined whether self-efficacy about condom use communication (SECC) and perceived partner's beliefs about condom (PPBC) use had an influence on condom use frequency; and whether these associations varied by gender. A sample of 252 African-American college students (101 males and 151 females) completed a confidential online survey assessing SECC, PPBC, and condom use behavior. SECC and PPBC showed significant associations with condom use behavior. Furthermore, there was a gender interaction effect with PPBC on condom use behavior. As PPBC increases toward positive associations about condom use, condom use behavior increased significantly more for females (B = 0.42; p = .02) as compared to males (B = 0.26; p = .19). This study supports the need to teach young women effective communication skills in order for them to accurately assess what their partner thinks about condom-related behaviors; and ultimately not allow partner discouragement to influence their decisions to use condoms. Interventions aimed at reducing risky sexual behavior on predominantly Black college campuses, in particular, may benefit from directly addressing relationship power and focusing on building self-efficacy in communicating condom use.
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Affiliation(s)
- Chakema Carmack
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, Texas
| | - Angelica M Roncancio
- Health and Behavioral Science, College of Humanities and Social Sciences, Houston, Texas
| | - Lena Gerecht
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, Texas
| | - Mohammed Ansari
- Department of Psychological, Health, and Learning Sciences, College of Education, University of Houston, Houston, Texas
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Braksmajer A, Zhang C, McMahon JM. Associations Between Relationship Power and Pre-Exposure Prophylaxis (PrEP) Use Among Men Who Have Sex With Men. AIDS Behav 2020; 24:1358-1364. [PMID: 31732829 DOI: 10.1007/s10461-019-02731-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Few studies have attempted to understand relationship-level factors impacting PrEP utilization among men who have sex with men (MSM). This study examined associations between relationship power and PrEP use among 826 MSM participating in a cross-sectional, Internet-based survey. The results of our analysis indicate that decision-making dominance was positively associated with PrEP use among MSM, but the association between relationship control/overall relationship power and PrEP use was inconclusive. Furthermore, when examining specific types of decision-making dominance, equal and greater dominance compared to one's partner regarding types of sexual activity engaged in, as well as dominance more generally, were positively associated with PrEP use. However, the relationships between decision-making dominance related to condom use/sexual initiation and PrEP use were inconclusive. This study suggests that the promotion of egalitarian relationships-as well as other relationship-level determinants-should be an essential component of biobehavioral interventions targeting this population.
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Neilands TB, Dworkin SL, Chakravarty D, Campbell CK, Wilson PA, Gomez AM, Grisham KK, Hoff CC. Development and Validation of the Power Imbalance in Couples Scale. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:763-779. [PMID: 29850977 PMCID: PMC6269212 DOI: 10.1007/s10508-018-1190-y] [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: 02/15/2017] [Revised: 02/28/2018] [Accepted: 03/03/2018] [Indexed: 05/03/2023]
Abstract
Few researchers have quantitatively explored the relationship power-HIV risk nexus in same-sex male couples. We developed and validated the Power Imbalance in Couples Scale (PICS) to measure relationship power among men in same-sex, committed relationships and its association with sexual risk behaviors. We recruited three independent and diverse samples of male couples in the greater San Francisco and New York City metropolitan areas and conducted qualitative interviews (N1 = 96) to inform item development, followed by two quantitative surveys (N2 = 341; N3 = 434) to assess the construct, predictive, convergent, and discriminant validity of the PICS. Exploratory factor analysis of the first survey's data yielded four factors-overtly controlling partner, supportive partner, conflict avoidant actor, and overtly controlling actor-that accounted for more than 50% of the shared variance among the PICS items. Confirmatory factor analysis (CFA) of the second survey's data supported these four factors: χ2(1823) = 2493.40, p < .001; CFI = .96, RMSEA = .03 and WRMR = 1.33. Strong interfactor correlations suggested the presence of a higher-order general perception of power imbalance factor; a higher-order factor CFA model was comparable in fit to the correlated lower-order factors' CFA: χ2(2) = 2.00, p = .37. Internal reliability of the PICS scale was strong: α = .94. Men perceiving greater power imbalances in their relationships had higher odds of engaging in condomless anal intercourse with outside partners of discordant or unknown HIV status (OR 1.27; 95% CI 1.01-1.60; p = .04). The PICS is an important contribution to measuring relationship power imbalance and its sequelae among male couples; it is applicable to research on relationships, sexuality, couples, and HIV prevention.
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Affiliation(s)
- Torsten B Neilands
- Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA
| | - Shari L Dworkin
- Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA
- Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- School of Nursing and Health Studies, University of Washington, Bothell, WA, USA
| | - Deepalika Chakravarty
- Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA
- Center for Research and Education on Gender and Sexuality, San Francisco State University, 835 Marker St., #523, San Francisco, CA, 94103, USA
| | - Chadwick K Campbell
- Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA
- Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Patrick A Wilson
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Anu Manchikanti Gomez
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, CA, USA
| | - Kirk K Grisham
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Colleen C Hoff
- Center for Research and Education on Gender and Sexuality, San Francisco State University, 835 Marker St., #523, San Francisco, CA, 94103, USA.
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Dangerfield DT, Ober AJ, Smith LR, Shoptaw S, Bluthenthal R. Exploring and Adapting a Conceptual Model of Sexual Positioning Practices and Sexual Risk Among HIV-Negative Black Men Who Have Sex With Men. JOURNAL OF SEX RESEARCH 2018; 55:1022-1032. [PMID: 29466064 PMCID: PMC6105556 DOI: 10.1080/00224499.2018.1433287] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Estimates show a 50% lifetime human immunodeficiency virus (HIV) risk among Black men who have sex with men (BMSM) in the United States(U.S.). Studying the dynamics of sexual positioning practices among BMSM could provide insights into the disparities observed among U.S. groups of men who have sex with men (MSM). This study explored sexual positioning dynamics among HIV-negative BMSM and how they aligned with a theoretical model of sexual positioning and HIV/sexually transmitted infection (STI) risk among MSM. In-depth qualitative interviews were conducted with 29 HIV-negative BMSM between ages 25 and 35 in Los Angeles. Comments related to sexual behaviors were reviewed for relevance regarding oral or anal sexual positioning practices. Data presented represent the range of themes related to decision making regarding sexual positioning. Personal preference, partner attraction, HIV avoidance, and feeling obligated to practice partner preferences influenced sexual positioning. Drug use also affected decision making and was sometimes preferred in order to practice receptive anal intercourse. These variables build on the conceptual model of sexual positioning practices and sexual risk, and add understanding to the relationship between preferences, practices, and risk management. Future research on risk among HIV-negative BMSM should quantify the relative impact of personal preferences, partner attraction, partner type, compromise, and substance use on sexual positioning practices and risk.
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Affiliation(s)
| | | | - Laramie R. Smith
- University of California, San Diego, Division of Global Public Health, La Jolla, CA
| | - Steven Shoptaw
- University of California, Los Angeles, Department of Family Medicine, Los Angeles, CA
| | - Ricky Bluthenthal
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA
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Dangerfield DT, Smith LR, Anderson JN, Bruce OJ, Farley J, Bluthenthal R. Sexual Positioning Practices and Sexual Risk Among Black Gay and Bisexual Men: A Life Course Perspective. AIDS Behav 2018; 22:1919-1931. [PMID: 29079948 PMCID: PMC5924576 DOI: 10.1007/s10461-017-1948-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Increased attention has highlighted the role of age and sexual development on HIV risk among Black MSM (BMSM); limited focus has been given to the relationship of sexual positioning to HIV risk along the life course. This study examined BMSM's life course sexual positioning practices and accompanying HIV/STI risks. Twenty-six Black gay and bisexual men ages 24-61 completed life history interviews in Los Angeles, California, between September and November 2015. Thematic analysis evaluated domains including major life events, substance use, social support, and partner selection. Varying exposure to HIV treatment and prevention options and venues to meet male partners revealed generational differences in sexual risks. Childhood sexual abuse and internalized homonegativity impacted personal development, sexual positioning, and condom negotiation. BMSM also assumed sexual positioning using masculinity stereotypes and body language. Clarifying the sexual development and HIV/STI risk contexts among BMSM could better inform current treatment and prevention needs.
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Affiliation(s)
- Derek T Dangerfield
- The REACH Initiative, Johns Hopkins School of Nursing, Baltimore, MD, 2120532, USA.
| | - Laramie R Smith
- Division of Global Public Health, University of California, La Jolla, San Diego, CA, USA
| | - Janeane N Anderson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Omar J Bruce
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Jason Farley
- The REACH Initiative, Johns Hopkins School of Nursing, Baltimore, MD, 2120532, USA
- Department of Community Public Health, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Ricky Bluthenthal
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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