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Souleymanov R, Amjad S, Moore S, Star J, McLeod A, Payne M, Ringaert L, Larcombe L, Restall G. Relationship between sociodemographics, loss of income, and mental health among two-spirit, gay, bisexual, and queer men in Manitoba during the COVID-19 pandemic. PLoS One 2022; 17:e0278382. [PMID: 36490234 PMCID: PMC9733880 DOI: 10.1371/journal.pone.0278382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022] Open
Abstract
This study examined the relationship between loss of income due to the COVID-19 pandemic and worsening mental health among a sample of 366 Two-Spirit, gay, bisexual, queer (2SGBQ+) men in Manitoba. Data were drawn from a cross-sectional online survey among 2SGBQ+ men in Manitoba. Logistic regression assessed the relationship between sociodemographics, loss of income due to COVID-19 (independent variable) and worsening of mental health (analytic outcome). Among all respondents in the sample (N = 366), 55% indicated worsening of their mental health. In logistic regression, compared to participants who did not experience any loss of income, those who experienced loss of income due to the COVID-19 pandemic were significantly more likely to report worsening mental health (Adjusted Odds Ratio [AOR] = 8.32, 95% Confidence Interval[CI] = 3.54-19.54). Compared to participants who self-identified as gay, bisexual-identifying participants were less likely to report worsening mental health (AOR = .35, 95%CI = 0.13-0.96). Finally, as compared to participants who were married or partnered, participants who were dating (AOR = 3.14, 95%CI = 1.60-6.17), single (AOR = 4.08, 95%CI = 1.75-9.52), and separated/divorced/widowed (AOR = 15.08, 95%CI = 2.22-102.51) were all significantly more likely to report experiencing a worsening of mental health due to the COVID-19 pandemic. This study highlights the need to develop robust public strategies for sub-populations of 2SGBQ+ men (non-gay identified sexual minorities and 2SGBQ+ men who may be more socially isolated). Specific targeted and tailored public health interventions designed with the unique needs of 2SGBQ+ men in Manitoba may be required to increase their access to socio-economic and mental health supports.
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Affiliation(s)
- Rusty Souleymanov
- Faculty of Social Work, University of Manitoba, Winnipeg, MB, Canada
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
- * E-mail:
| | - Sana Amjad
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Samantha Moore
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jared Star
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Albert McLeod
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
- Two-Spirit Consultants, Inc., Winnipeg, MB, Canada
| | - Michael Payne
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
- Nine Circles Community Health Centre, Winnipeg, MB, Canada
| | - Laurie Ringaert
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
| | - Linda Larcombe
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
- Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Gayle Restall
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, MB, Canada
- Department of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Moskowitz DA, Alvarado Avila A, Kraus A, Birnholtz J, Macapagal K. Top, Bottom, and Versatile Orientations among Adolescent Sexual Minority Men. JOURNAL OF SEX RESEARCH 2022; 59:643-651. [PMID: 34309441 DOI: 10.1080/00224499.2021.1954583] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sexual role preference or self-label (i.e., top, versatile, or bottom) has been well studied in samples of sexual minority men (SMM) but lacks research among adolescent sexual minority men (ASMM). In response, data were collected from 302 ASMM (15-18 years old), measuring sexual self-label, relationship and sexual experience, sexually explicit media use, use of geosocial networking applications, penis size satisfaction, and gender atypicality. Results showed there was no significant difference in the distribution of sexual position self-identity in ASMM when compared with data from published, adult samples. A model that associated sexual socialization factors with adopting any self-label was significant, with greater number of partners, previous geosocial networking app use, and more relationship experience being positive predictors of having a label. Additionally, a model that tested the convergent validity between self-label and enacted sexual behaviors was significant. Both receptive and insertive sex enactments were highly correlated with corresponding labels. Lastly, gender atypicality and penis size satisfaction were significant predictors of sexual position self-identity. Data from our study supports sexual self-labeling occurring before adulthood, during adolescence for SMM. Furthermore, it shows that socialization factors (e.g., partner frequency, using apps) are important in the development of sexual position self-identity in this population.
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Affiliation(s)
| | - Andrés Alvarado Avila
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Ashley Kraus
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Jeremy Birnholtz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Communication Studies, Northwestern University
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
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Souleymanov R, Star J, McLeod A, Amjad S, Moore S, Campbell C, Lorway R, Payne M, Ringaert L, Larcombe L, Restall G, Migliardi P, Magwood B, Lachowsky NJ, Brennan DJ, Sharma UN. Relationship between sociodemographics, healthcare providers' competence and healthcare access among two-spirit, gay, bisexual, queer and other men who have sex with men in Manitoba: results from a community-based cross-sectional study. BMJ Open 2022; 12:e054596. [PMID: 35105639 PMCID: PMC8804644 DOI: 10.1136/bmjopen-2021-054596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Little is known about barriers to healthcare access for two-spirit, gay, bisexual and queer (2SGBQ+) men in Manitoba. DESIGN Data were drawn from a community-based, cross-sectional survey designed to examine health and healthcare access among 2SGBQ+ men. SETTING Community-based cross-sectional study in Manitoba, Canada. PARTICIPANTS Community-based sample of 368 2SGBQ+ men. OUTCOMES Logistic regression analyses assessed the relationship between sociodemographics, healthcare discrimination, perceived healthcare providers' 2SGBQ+ competence/knowledge and two indicators of healthcare access (analytic outcome variables): (1) having a regular healthcare provider and (2) having had a healthcare visit in the past 12 months. RESULTS In multivariate analyses, living in Brandon (adjusted OR (AOR)=0.08, 95% CI 0.03 to 0.22), small cities (AOR=0.20, 95% CI 0.04 to 0.98) and smaller towns (AOR=0.26, 95% CI 0.08 o 0.81) in Manitoba (compared with living in Winnipeg), as well as having a healthcare provider with poor (AOR=0.19, 95% CI 0.04 to 0.90) or very poor competence/knowledge (AOR=0.03, 95% CI 0.03 to 0.25) of 2SGBQ+ men's issues (compared with very good competence) was associated with lower odds of having a regular healthcare provider. Living in Brandon (AOR=0.05, 95% CI 0.02 to 0.17) and smaller towns (AOR=0.25, 95% CI 0.67 to 0.90) in Manitoba (compared with living in Winnipeg) was associated with lower odds of having a healthcare visit in the past 12 months, while identifying as a gay man compared with bisexual (AOR=12.57, 95% CI 1.88 to 83.97) was associated with higher odds of having a healthcare visit in the past 12 months. CONCLUSIONS These findings underscore the importance of reducing the gap between the healthcare access of rural and urban 2SGBQ+ men, improving healthcare providers' cultural competence and addressing their lack of knowledge of 2SGBQ+ men's issues.
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Affiliation(s)
- Rusty Souleymanov
- Faculty of Social Work, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jared Star
- Department of Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Albert McLeod
- Two-Spirited People of Manitoba, Winnipeg, Manitoba, Canada
| | - Sana Amjad
- Department of Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Samantha Moore
- Department of Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Robert Lorway
- Department of Community Health Sciences, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michael Payne
- Nine Circles Community Health Centre, Winnipeg, Manitoba, Canada
| | - Laurie Ringaert
- Manitoba HIV-STBBI Collective Impact Network, Winnipeg, Manitoba, Canada
| | - Linda Larcombe
- Department of Internal Medicine, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gayle Restall
- Department of Occupational Therapy, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Paula Migliardi
- Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | | | - Nathan J Lachowsky
- Community-Based Research Centre, Victoria, British Columbia, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - David J Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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Breslow AS, Sandil R, Brewster ME, Parent MC, Chan A, Yucel A, Bensmiller N, Glaeser E. Adonis on the Apps: Online Objectification, Self-Esteem, and Sexual Minority Men. PSYCHOLOGY OF MEN & MASCULINITY 2020; 21:25-35. [PMID: 38827385 PMCID: PMC11142472 DOI: 10.1037/men0000202] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
The recent proliferation of mobile dating applications ("apps") has led to profound shifts in the ways sexual minority men (SMM) connect with others and themselves (Anderson, Holland, Koc, & Haslam, 2018). These apps, which often categorize users by factors such as body build, may promote sexual harassment and objectification (Griffiths, Murray, Krug, & McLean, 2018), potentially compounding already disproportionate body image concerns among this population (Daniel & Bridges, 2010). To test relations of app use and online objectification, we examined a path model testing tenets of objectification theory (Fredrickson & Roberts, 1997) among a national sample of 230 SMM. We measured direct and indirect relations between patterns of app use (i.e., number of apps used, app use frequency), online objectification, internalization of sociocultural standards of attractiveness, two psychological reactions (i.e., body surveillance, body satisfaction), and self-esteem, a mental health risk particularly salient among SMM. The present study demonstrated support for expansions of objectification theory both online and among SMM. Regarding direct relations, number of apps used (though not app use frequency) was positively related with objectification, internalization, and body surveillance, and negatively related with body satisfaction and self-esteem. Variables yielded indirect relations via internalization, body surveillance, and body satisfaction. Implications of our findings, as well as limitations and implications for future research and practice, are discussed.
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Affiliation(s)
- Aaron S Breslow
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Riddhi Sandil
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Melanie E Brewster
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Mike C Parent
- Department of Educational Psychology, College of Education, University of Texas at Austin
| | - Anthea Chan
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Aysegul Yucel
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
- Department of Psychiatry, Mount Sinai St. Luke's Hospital. Nicholas Bensmiller is now at the Institute for Human Identity
| | - Nicholas Bensmiller
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Elizabeth Glaeser
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
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Ferlatte O, Salway T, Trussler T, Oliffe JL, Gilbert M. Combining intersectionality and syndemic theory to advance understandings of health inequities among Canadian gay, bisexual and other men who have sex with men. CRITICAL PUBLIC HEALTH 2017. [DOI: 10.1080/09581596.2017.1380298] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Olivier Ferlatte
- Men’s Health Research Program, University of British Columbia , Vancouver, Canada
- Community-Based Research Centre for Gay Men’s Health , Vancouver, Canada
| | - Travis Salway
- Community-Based Research Centre for Gay Men’s Health , Vancouver, Canada
- Dalla Lana School of Public Health, University of Toronto , Toronto, Canada
| | - Terry Trussler
- Community-Based Research Centre for Gay Men’s Health , Vancouver, Canada
| | - John L. Oliffe
- Men’s Health Research Program, University of British Columbia , Vancouver, Canada
| | - Mark Gilbert
- British Columbia Centre for Disease Control , Vancouver, Canada
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Whitfield DL, Kattari SK, Walls NE, Al-Tayyib A. Grindr, Scruff, and on the Hunt: Predictors of Condomless Anal Sex, Internet Use, and Mobile Application Use Among Men Who Have Sex With Men. Am J Mens Health 2017; 11:775-784. [PMID: 28134002 PMCID: PMC5675229 DOI: 10.1177/1557988316687843] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 11/30/2016] [Accepted: 12/12/2016] [Indexed: 11/16/2022] Open
Abstract
In 2016, gay, bisexual, and other men who have sex with men (MSM) comprise more than half of all new HIV diagnoses in the United States, with the primary mode of infection being condomless anal sex (CAS). While studies report an association between use of Internet-based social networking sites and increased CAS, the research on the relationship between cell phone mobile applications (e.g., Grindr, Scruff, Jack'd) and CAS is much less developed. The present study examines whether the manner in which gay, bisexual, and other MSM find sexual partners predicts an increase in likelihood of engaging in CAS in an urban, noncoastal U.S. city. Conducting a secondary data analysis of the 2011 National HIV Behavioral Surveillance survey for Denver ( N = 546), the authors performed binary logistic regression analyses to assess the models that predict how MSM find sexual partners, and the odds of engaging in CAS. While the results suggest that age and race are associated with the mode of finding sexual partners, using the Internet or a mobile app to find sexual partners was not predictive of CAS ( ZWald = .41, p = .52; ZWald = .80, p = .37). In terms of HIV prevention, these findings suggest a need for intervention to address HIV prevention on multiple levels (e.g., individual, group, community).
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Klein H. Early life emotional neglect and HIV risk taking among men using the Internet to find other men for unprotected sex. CHILD ABUSE & NEGLECT 2014; 38:434-44. [PMID: 24456742 PMCID: PMC6130256 DOI: 10.1016/j.chiabu.2013.12.006] [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: 03/29/2013] [Revised: 12/14/2013] [Accepted: 12/17/2013] [Indexed: 06/03/2023]
Abstract
PURPOSE Using a Syndemics Theory conceptual model, this study examines the relationship between emotional neglect experiences during childhood and/or adolescence and involvement in HIV risk taking in a sample of adult men who actively seek partners for unprotected sex via the Internet. METHODS The study was based on a national random sample of 332 MSM who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Structural equation analysis was undertaken to examine the specific nature of the relationships involved in understanding HIV risk practices. RESULTS Emotional neglect was highly prevalent among the men participating in this study. Emotional neglect experiences were not found to be related directly to involvement in HIV risk taking in adulthood. Emotional neglect, was found to be an important variable in the overall structural equation. Its effect on HIV risk taking was indirect, operating principally by having a negative impact upon self-esteem, which in turn had a negative effect on attitudes toward condom use, which in turn were related strongly and directly to risk taking. CONCLUSIONS Childhood experiences with emotional neglect are relevant to understanding HIV risk practices among MSM in adulthood, but the relationship is not as simple as usually conceptualized. Rather, emotional neglect appears to impact risk taking indirectly, through its effects on mental health functioning, which in turn affects risk-related attitudes.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, Silver Spring, MD 20910, USA
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Robinson BA, Moskowitz DA. The eroticism of Internet cruising as a self-contained behaviour: a multivariate analysis of men seeking men demographics and getting off online. CULTURE, HEALTH & SEXUALITY 2013; 15:555-69. [PMID: 23565985 PMCID: PMC3715033 DOI: 10.1080/13691058.2013.774050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Most studies on men seeking men and who use the Internet for sexual purposes have focused on the epidemiological outcomes of Internet cruising. Other research has only focused on online sexual behaviours such as cybersex. The present study examines men who find the acts of Internet cruising and emailing to be erotic as self-contained behaviours. We surveyed 499 men who used craigslist.org for sexually-oriented purposes, and ran an ordinary least squares multiple regression model to determine the demographic characteristics of men seeking men who found Internet cruising erotic. Our results showed that younger compared to older men seeking men found the acts erotic. Likewise, men seeking men from mid-sized cities and large cities compared to men from smaller cities found Internet cruising and emailing to be erotic. Most notably, bisexual- and heterosexual-identifying men seeking men compared to gay-identifying men found these acts to be more erotic. Our results suggested that self-contained Internet cruising might provide dual functions. For some men (e.g., heterosexual-identifying men), the behaviour provides a sexual outlet in which fantasy and experimentation may be explored without risking stigmatization. For other men (e.g., those from large cities), the behaviour may be an alternative to offset sexual risk while still being able to 'get off'.
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Klein H. Involvement in Specific HIV Risk Practices among Men Who Use the Internet to Find Male Partners for Unprotected Sex. JOURNAL OF ADDICTION 2013; 2013:826039. [PMID: 24826369 PMCID: PMC4008398 DOI: 10.1155/2013/826039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 02/21/2013] [Indexed: 11/17/2022]
Abstract
Purpose. Men who have sex with other men (MSM) account for more than one-half of all new HIV infections in the USA. This study reports on the prevalence of a variety of HIV risk behaviors in one specific subpopulation of risk-seeking MSM. Methods. The study was based on a national sample of 332 MSM who use the Internet to find partners for unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Results. Unprotected oral and anal sex was commonplace among study participants. Men engaged in a large number of other risky behaviors as well, including having had multiple recent sex partners (mean number = 11), simultaneous double-penile penetration of the anus (16%), eating semen out of another man's anus (17%), engaging in multiple-partner sexual encounters (47%), engaging in anonymous sex (51%), and having sex while "under the influence" (52%). Conclusions. HIV intervention and prevention programs need to address numerous behaviors that place MSM at risk for contracting/transmitting HIV. Merely focusing on unprotected anal sex does a disservice to members of this community, who typically engage in many types of behavioral risks, each of which requires addressing if HIV transmission rates are to be reduced.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, 401 Schuyler Road, Silver Spring, MD 20910, USA
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Abstract
The current study examines the risk perceptions of HIV-negative men who have sex with men (MSM) who use the Internet to seek unprotected sex. The research questions include the following: How great do these men perceive their HIV risk to be? Are their perceptions based on HIV knowledge or related to their risk behaviors? What factors are associated with greater/lesser perceived risk? Results revealed that more than half of the men believed that they had no or only a slight chance of contracting HIV. Risk perceptions were not related to HIV knowledge or to involvement in HIV risk practices. Four factors were identified as being associated with greater perception of HIV risk: self-identity as a sexual "bottom," having sex while high, greater use of bareback-focused websites, and younger age. Internet-using HIV-negative men who have sex with men tend to underestimate their risk for acquiring HIV, and interventions need to help them accurately assess their risk.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, Silver Spring, MD 20910, USA.
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Klein H. Using a syndemics theory approach to study HIV risk taking in a population of men who use the internet to find partners for unprotected sex. Am J Mens Health 2011; 5:466-76. [PMID: 21406487 PMCID: PMC6192255 DOI: 10.1177/1557988311398472] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examines the value of using syndemics theory as a model for understanding HIV risk taking in a population of men who are at great risk for acquiring and/or transmitting HIV. The principal aim is to provide an empirical test of the applicability of the theory to sexual risk behaviors in this particular research population. The study was based on a national random sample of 332 men who have sex with men, or MSM, who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. As hypothesized in the syndemics theory model, attitudes toward condom use were central to understanding men's involvement in risky sex. As hypothesized, these attitudes depended on various demographic, psychological/psychosocial functioning, and sex-related preference measures. Also as hypothesized, psychological and psychosocial functioning were found to be very important to the overall model, and as expected, these factors were shaped greatly by factors such as demographic characteristics and childhood maltreatment experiences. The structural equation assessing the fit of the overall model indicated solid support for the syndemics theory approach. Overall, syndemics theory seems to apply fairly well to understanding the complexity of the factors that underlie men's risk-taking practices. The complicated interplay among factors such as attitudes toward condom use, childhood maltreatment experiences, psychological and psychosocial functioning, and substance use and abuse-all of which are central to a syndemics theory approach to studying risk-was demonstrated.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, Silver Spring, MD 20910, USA.
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