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Higa DH, Crepaz N, McDonald CM, Adegbite-Johnson A, DeLuca JB, Kamitani E, Sipe TA. HIV Prevention Research on Men Who Have Sex With Men: A Scoping Review of Systematic Reviews, 1988-2017. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:1-S7. [PMID: 32073309 DOI: 10.1521/aeap.2020.32.1.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In the United States, men who have sex with men (MSM) are disproportionately affected by HIV. To identify research gaps and inform HIV prevention for MSM, we conducted a scoping review of systematic reviews using CDC's Prevention Research Synthesis database. Eligibility criteria comprised English-language systematic reviews focused on HIV prevention for MSM, published during 1988-2017, and included at least one U.S. primary study. We coded data type, subpopulations, topics, and key findings. To assess study quality, we used the Assessment of Multiple Systematic Reviews (AMSTAR). Among 129 relevant systematic reviews, study quality was high or moderate for 63%. Most common topics were sexual behavior and disease vulnerability. The most frequently mentioned MSM subgroups were HIV-positive, Black or African American, and young. Research gaps include Hispanic/Latino MSM, pre-exposure prophylaxis (PrEP), treatment as prevention, social determinants of health, health disparities, syndemics, and protective factors for sexual health.
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Affiliation(s)
- Darrel H Higa
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Nicole Crepaz
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Christina M McDonald
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | | | - Julia B DeLuca
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Emiko Kamitani
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
| | - Theresa Ann Sipe
- Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia
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A wager on the future: a practicable response to HIV pre-exposure prophylaxis (PrEP) and the stubborn fact of process. SOCIAL THEORY & HEALTH 2019. [DOI: 10.1057/s41285-019-00115-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
This article outlines the importance of conceptualizing ‘sexual health’ as a pluralistic and context-bound phenomenon. It explores gay men's sexual decision making in the particular context of public parks. Twenty gay men from Glasgow, Scotland, took part in semi-structured, in-depth interviews. Interpretative Phenomenological Analysis (IPA) was employed to analyse transcripts for recurrent themes—these represent shared understandings across participants. Risk reduction, danger and safety figured frequently in men's accounts of sex and sexual decision making. However, the risks men reported related more directly to the threat of attack or arrest rather than the avoidance of sexually transmitted infections. Indeed, danger itself was occasionally something to be sought and enjoyed. Given these findings, we discuss the appropriateness of traditional health psychological approaches to understanding sexual health. It is hoped that this approach can highlight some issues that a true psychology of sexual health must address in order to represent sexual decision making more accurately and to be useful with respect to both service provision and theoretical development.
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Affiliation(s)
| | - Graham Hart
- MRC Medical Sociology Unit, University of Glasgow, Glasgow, UK
| | - Claire Marriott
- Department of Public Health, University of Glasgow, Glasgow, UK
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Frankis J, Young I, Flowers P, McDaid L. Who Will Use Pre-Exposure Prophylaxis (PrEP) and Why?: Understanding PrEP Awareness and Acceptability amongst Men Who Have Sex with Men in the UK--A Mixed Methods Study. PLoS One 2016; 11:e0151385. [PMID: 27093430 PMCID: PMC4836740 DOI: 10.1371/journal.pone.0151385] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 02/27/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Recent clinical trials suggest that pre-exposure prophylaxis (PrEP) may reduce HIV transmission by up to 86% for men who have sex with men (MSM), whilst relatively high levels of PrEP acceptability have been reported to date. This study examines PrEP awareness amongst sub-groups of MSM communities and acceptability amongst MSM in a low prevalence region (Scotland, UK), using a mixed methods design. METHODS Quantitative surveys of n = 690 MSM recruited online via social and sociosexual media were analysed using descriptive statistics and multivariate logistic regression. In addition, n = 10 in-depth qualitative interviews with MSM were analysed thematically. RESULTS Under one third (29.7%) of MSM had heard of PrEP, with awareness related to living in large cities, degree level education, commercial gay scene use and reporting an HIV test in the last year. Just under half of participants (47.8%) were likely to use PrEP if it were available but there was no relationship between PrEP acceptability and previous PrEP awareness. Younger men (18-25 years) and those who report higher risk UAI were significantly more likely to say they would use PrEP. Qualitative data described specific PrEP scenarios, illustrating how risk, patterns of sexual practice and social relationships could affect motivation for and nature of PrEP use. CONCLUSION These findings suggest substantial interest PrEP amongst MSM reporting HIV risk behaviours in Scotland. Given the Proud results, there is a strong case to investigate PrEP implementation within the UK. However, it appears that disparities in awareness have already emerged along traditional indicators of inequality. Our research identifies the need for comprehensive support when PrEP is introduced, including a key online component, to ensure equity of awareness across diverse MSM communities (e.g. by geography, education, gay scene use and HIV proximity), as well as to responding to the diverse informational and sexual health needs of all MSM communities.
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Affiliation(s)
- Jamie Frankis
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Ingrid Young
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Paul Flowers
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Lisa McDaid
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
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Lacefield K, Negy C, Schrader RM, Kuhlman C. Comparing Psychosocial Correlates of Condomless Anal Sex in HIV-Diagnosed and HIV-Nondiagnosed Men Who Have Sex with Men: A Series of Meta-Analyses of Studies from 1993-2013. LGBT Health 2015; 2:200-20. [PMID: 26788669 DOI: 10.1089/lgbt.2014.0069] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Men who have sex with men (MSM) continue to be overrepresented in rates of incidence and prevalence of human immunodeficiency virus (HIV). Both HIV-diagnosed (HIV-D) and HIV-nondiagnosed (HIV-N) MSM report a variety of reasons for intentional and unintentional nonuse of condoms. Elucidating and comparing reasons for continued engagement in condomless anal sex specific to both HIV-D and HIV-N MSM likely is important to identifying effective prevention. METHODS This study employed meta-analytic methods to evaluate and compare correlates to condomless anal sex in both HIV-D and HIV-N MSM from primary studies from 1993 to February 2013. RESULTS Of the 19 individual correlates assessed within the subgroup of HIV-D MSM, variables that achieved significant effect were alcohol, mind-altering substance use, sexual-enhancement medication, intentional condom nonuse, self-efficacy, attitudes toward condom use, social support, gay identity, compulsivity, trading sex, and number of sex partners. Those that were statistically non-significant were intention to use a condom, perceived risk, perceived norms, perceived responsibility, HIV medical management, treatment optimism, mental health, and setting. Of the 12 correlates assessed within the subgroup of HIV-N MSM, variables that achieved significant effect were alcohol, mind-altering substance use, intentional condom nonuse, attitudes toward condom use, perceived risk, and setting. Those observed as statistically non-significant were perceived norms, social support, gay identity, mental health, trading sex, and number of sex partners. CONCLUSION Study results have clinical implications that may guide future prevention research and practice by highlighting risk variables shared between HIV-N and HIV-D MSM, as well as variables observed to be unique to each group that may warrant more tailored intervention. Further investigation is recommended to elucidate the relationships among these variables such that optimal intervention can be determined.
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Affiliation(s)
- Katharine Lacefield
- 1 Department of Psychology, VA Maryland Healthcare System , Baltimore, Maryland.,2 Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Charles Negy
- 3 Department of Psychology, University of Central Florida , Orlando, Florida
| | - Ronald M Schrader
- 4 Department of Dialysis, DCI Corporate Quality Management , Albuquerque, New Mexico
| | - Christina Kuhlman
- 3 Department of Psychology, University of Central Florida , Orlando, Florida
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Martin AM, Benotsch EG, Perschbacher Lance S, Green M. Transmission risk behaviors in a subset of HIV-positive individuals: The role of narcissistic personality features. PERSONALITY AND INDIVIDUAL DIFFERENCES 2013. [DOI: 10.1016/j.paid.2012.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Frankis JS, Flowers P. Public sexual cultures: a systematic review of qualitative research investigating men's sexual behaviors with men in public spaces. JOURNAL OF HOMOSEXUALITY 2009; 56:861-93. [PMID: 19802761 DOI: 10.1080/00918360903187846] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Resurgent HIV and sexually transmitted infection incidence among men who have sex with men (MSM) requires an urgent re-examination of sexual transmission sites. To these ends, we systematically review qualitative literature concerning men's sexual behaviors within public sex environments (PSEs). Sex, therein, is negotiated by the highly codified, largely nonverbal practice of "cruising." A generic, shared PSE sexual culture emerges from the literature-across locations, countries, and decades-because of the importance of concealment and common structural constraints on sexual encounters in PSEs. However, differences in local geography and facilities may transform key features of this, resulting in specific, local sexual cultures emerging for each locale. We argue that, although sexual cultures developed to minimize nonsexual cruising risks, they may be exploited to improve contemporary in situ outreach work.
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Affiliation(s)
- Jamie S Frankis
- The School of Health, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom.
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Jacobson J. Informing our psychosexual practice for treating erectile dysfunction in gay and bisexual men living with HIV: a response to the 2006 NHS Greater Glasgow HIV needs assessment report. SEXUAL AND RELATIONSHIP THERAPY 2007. [DOI: 10.1080/14681990701391277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Duncan C, Harrison MG, Toldson IA, Malaka D, Sithole S. Social Stigma, HIV/AIDS Knowledge, and Sexual Risk: A Cross-Cultural Analysis1. ACTA ACUST UNITED AC 2007. [DOI: 10.1111/j.1751-9861.2005.tb00001.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Noar SM, Cole C, Carlyle K. Condom use measurement in 56 studies of sexual risk behavior: review and recommendations. ARCHIVES OF SEXUAL BEHAVIOR 2006; 35:327-45. [PMID: 16799837 DOI: 10.1007/s10508-006-9028-4] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2004] [Revised: 02/24/2005] [Accepted: 05/01/2005] [Indexed: 05/08/2023]
Abstract
Despite numerous studies that measure self-reported condom use, there is currently no agreed upon "gold standard" in terms of the best way to assess condom use. The purpose of the current study was to review measures of self-reported condom use within correlational studies of sexual risk behavior, and to evaluate such measures on the basis of suggestions from the methodological literature. An additional purpose was to examine specifically whether measures published in the correlational literature have improved over time. A systematic review of studies was undertaken and specific review criteria were used to guide the inclusion of studies. A final set of 56 studies that contained 72 measures of self-reported condom use were included in the review. These measures were coded and evaluated on 12 dimensions, including measure type, number of response categories, recall period, sex partner specificity, and sex act specificity. Results indicated a great amount of diversity in terms of how condom use has been measured in the literature. Although results indicated that measures published between 1996 and 2003 were of higher quality on a number of dimensions as compared to 1989-1995, a number of these gains were minimal and in some cases measures have decreased in quality. The overall conclusion is that the sexual risk behavior literature should implement more of the recommendations made by methodological scholars in this area. Specific recommendations are summarized and presented in a way that may be helpful in guiding the development of future measures of self-reported condom use.
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Affiliation(s)
- Seth M Noar
- Department of Communication, University of Kentucky, Lexington, Kentucky 40506-0042, USA.
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Noar SM, Carlyle K, Cole C. Why communication is crucial: meta-analysis of the relationship between safer sexual communication and condom use. JOURNAL OF HEALTH COMMUNICATION 2006; 11:365-90. [PMID: 16720536 DOI: 10.1080/10810730600671862] [Citation(s) in RCA: 192] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The purpose of this study was to quantitatively synthesize the growing literature on the relationship between safer sexual communication (SSC) among sexual partners and condom use, and to systematically examine a number of conceptual and methodological moderators of this relationship. Data from 53 articles published in 27 journals met criteria for the study. Fifty-five independent effect sizes coded from samples totaling N=18,529 were meta-analyzed. Results indicate that the mean sample-size weighted effect size of the SSC-condom use relation was r=.22, and a number of conceptual variables were found to moderate this relationship. Specifically, communication about condom use (r=.25) and sexual history (r=.23) had significantly (p<.05) larger effect sizes than communication about safer sex (r=.18). In addition, SSC measures operationalized differently had significantly (p<.05) different effect sizes. From largest to smallest, these were behavioral format (r=.29), intentional format (r=.18), and self-efficacy format (r=.13). Measures that tried to assess persuasion attempts as compared with informational exchanges were not found to have significantly different effect sizes (p>.05). Further, methodological moderators tended to be unrelated to effect size. Implications for the future study of safer sexual communication as well as the importance of emphasizing communication skills in HIV preventive interventions are discussed.
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Affiliation(s)
- Seth M Noar
- Department of Communication, University of Kentucky, Lexington, Kentucky 40506-0042, USA.
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Norton TR, Bogart LM, Cecil H, Pinkerton SD. Primacy of Affect Over Cognition in Determining Adult Men's Condom–Use Behavior: A Review1. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2005. [DOI: 10.1111/j.1559-1816.2005.tb02112.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Poppen PJ, Reisen CA, Zea MC, Bianchi FT, Echeverry JJ. Serostatus disclosure, seroconcordance, partner relationship, and unprotected anal intercourse among HIV-positive Latino men who have sex with men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2005; 17:227-37. [PMID: 16006209 DOI: 10.1521/aeap.17.4.227.66530] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This article examined, in a sample of 219 HIV-positive Latino men who have sex with men (MSM), a set of three variables that can shape the context of sexual encounters between men and influence sexual risk behaviors: disclosure of positive HIV serostatus, seroconcordance of partners, and relationship between partners. Participants from Boston, New York, and Washington completed a survey in English or Spanish using computer-assisted self-interview technology with audio enhancement. At the bivariate level, disclosure, seroconcordance, and partner relationship were all interrelated, as well as associated with the likelihood of unprotected intercourse. Unprotected anal intercourse with the most recent partner was more likely when the partner (a) knew that the participant was HIV-positive, (b) was the participant's main partner, and (c) was himself also HIV-positive. A logistic set regression revealed that the set of three variables added significantly to the prediction of unprotected anal intercourse, beyond demographic variables of income, education, and age. In the multivariate model, however, of the three, only seroconcordance achieved significance. The importance of a contextual approach to understanding sexual risk behavior was discussed.
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Affiliation(s)
- Paul J Poppen
- Department of Psychology, George Washington University, Washington, DC 20052, USA.
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van Kesteren NMC, Hospers HJ, Kok G, van Empelen P. Sexuality and sexual risk behavior in HIV-positive men who have sex with men. QUALITATIVE HEALTH RESEARCH 2005; 15:145-168. [PMID: 15611201 DOI: 10.1177/1049732304270817] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The purpose of this study was to examine the psychological processes pertaining to sexuality and sexual risk behavior among HIV-positive men who have sex with men (MSM). The authors analyzed transcripts of 30 semistructured interviews. Findings suggest that sexual problems in HIV-positive MSM might be primarily caused by the perceived risk of transmitting HIV to others. Furthermore, safer sexual behavior seems to be related to feelings of personal responsibility for safer sex. This study illustrates that although some men might have a clear notion of personal responsibility for safer sex, contextual factors can influence whether behavior is consistent with their norms of personal responsibility. The implications of the study are discussed for the practice of HIV prevention for HIV-positive MSM.
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Poppen PJ, Reisen CA, Zea MC, Bianchi FT, Echeverry JJ. Predictors of unprotected anal intercourse among HIV-positive Latino gay and bisexual men. AIDS Behav 2004; 8:379-89. [PMID: 15690111 DOI: 10.1007/s10461-004-7322-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study examined sexual behaviors in a sample of 155 HIV-positive Latino gay and bisexual men. Nearly half the sample had engaged in unprotected anal intercourse in the past 12 months; unprotected anal intercourse was more likely when the partner was also HIV-positive. Separate regression models predicted the number of receptive and insertive partners for unprotected anal intercourse. Participants reported both more unprotected insertive and receptive partners if they had sex under the influence of alcohol or drugs. Older participants and those with lower levels of Latino acculturation reported having more partners with whom they took the receptive role during unprotected anal intercourse, whereas those with higher levels of depression reported having more partners with whom they took the insertive role. Hierarchical set logistic regression revealed that the dyadic variable of seroconcordance added to the prediction of unprotected anal sex with the most recent male partner, beyond the individual characteristics. Results show the importance of examining both individual and dyadic characteristics in the study of sexual behavior.
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Affiliation(s)
- Paul J Poppen
- George Washington University, Washington, District of Columbia 20052, USA.
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van Empelen P, Kok G, van Kesteren NMC, van den Borne B, Bos AER, Schaalma HP. Effective methods to change sex-risk among drug users: a review of psychosocial interventions. Soc Sci Med 2003; 57:1593-608. [PMID: 12948569 DOI: 10.1016/s0277-9536(02)00557-9] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This review examines the current state of knowledge on the effectiveness of HIV prevention interventions with respect to sexual behavior among the population of drug users. The review focuses specifically on the relation between intervention methods found to be effective and the underlying theory. Electronic searches were conducted and supplemented by publications gathered through other channels. The studies were reviewed for (1) study design, (2) evident use of theory in intervention development, (3) clear targeting of determinants, (4) description of the study or studies, and (5) evaluation of the behavioral goals and targeted determinants. For each study, a description is given of: (1) the size and nature of the sample; (2) the retention rate; (3) the study design; (4) the nature of the intervention programs, including theoretical methods, practical strategies and theoretical background; (4) the measures of variability. The results show that a limited number of interventions were effective in changing sexual risk behavior among drug users. More successful programs featured several of the following elements: use of multiple theories and methods, inclusion of peers and rehearsal of skills. Moreover, the community-level interventions showed the importance of sustainability. The most successful intervention methods were modeling, skill building and social support enhancement. These methods are generally derived from the Social-Cognitive Theory or the Diffusion of Innovations Theory. Future HIV/AIDS interventions should build on the strengths discussed. Evaluations of interventions should be designed to facilitate comparison, using standardized and specific behavioral outcomes as well as standardized and preferably long-term follow-up levels, and should also evaluate the impact of programs at a psychosocial level to examine whether or not the theoretical methods on which a program was based were actually effective in changing the psychosocial factors targeted and why.
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Affiliation(s)
- Pepijn van Empelen
- Department of Experimental Psychology, RESHAPE, Universiteit Maastricht, P.O. Box 616, 6200 MD Maastricht, Netherlands.
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Hafer CL, Bogaert AF, McMullen SL. Belief in a Just World and Condom Use in a Sample of Gay and Bisexual Men1. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2001. [DOI: 10.1111/j.1559-1816.2001.tb00209.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Paul JP, Catania J, Pollack L, Stall R. Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: The Urban Men's Health Study. CHILD ABUSE & NEGLECT 2001; 25:557-84. [PMID: 11370726 DOI: 10.1016/s0145-2134(01)00226-5] [Citation(s) in RCA: 132] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE The prevalence and characteristics of childhood sexual abuse (CSA) among men who have sex with men (MSM), and links with sexual risk are explored. A model linking CSA and sexual risk among MSM is proposed. METHOD A telephone probability sample of urban MSM (n = 2881) was recruited and interviewed between November 1996 and February 1998. The interview covered numerous health issues, including history of sexual victimization. RESULTS One-fifth reported CSA, primarily by non-family perpetrators. Initial CSA experiences are characterized by high levels of force (43% involved physical force/weapons), and penetrative sex (78%; 46% reported attempted or actual anal intercourse). Such men are more likely than nevercoerced men to engage in high risk sex (unprotected anal intercourse with a non-primary partner or with a serodiscordant male). In multivariate analyses, the effect of childhood sexual coercion on sexual risk is mediated by substance use, patterns of sexual contacts, and partner violence, but not by adult sexual revictimization or by depression. CONCLUSIONS Findings are interpreted within the context of social learning theory and prior research on sexual risk-taking. The high risk for CSA among MSM, which can predispose such men to patterns of HIV sexual risk, warrants new approaches in HIV prevention.
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Affiliation(s)
- J P Paul
- University of California, San Francisco, Center for AIDS Prevention Studies, 94105, USA
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Theoretical Approaches to Individual-Level Change in HIV Risk Behavior. HANDBOOK OF HIV PREVENTION 2000. [DOI: 10.1007/978-1-4615-4137-0_1] [Citation(s) in RCA: 225] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Sheeran P, Taylor S. Predicting Intentions to Use Condoms: A Meta-Analysis and Comparison of the Theories of Reasoned Action and Planned Behavior1. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 1999. [DOI: 10.1111/j.1559-1816.1999.tb02045.x] [Citation(s) in RCA: 302] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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