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Wade RM, Piasecki M. Whose Role is It Anyway? Sexual Racism and Sexual Positioning Among Young Sexual Minority Black Men. JOURNAL OF SEX RESEARCH 2024:1-12. [PMID: 38270958 DOI: 10.1080/00224499.2024.2305823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Racialized Sexual Discrimination (RSD), also referred to as "sexual racism," is widely reported among young sexual minority Black men (YSMBM). Though RSD is driven in part by sexual scripts and racial stereotypes, little is known about YSMBM's experiences with RSD with respect to their sexual positioning roles. Using data from a cross-sectional web-survey of YSMBM (N = 726), a multivariate Kruskal Wallis test was conducted comparing YSMBM who identified as mostly bottom, versatile, or mostly top, on the degree to which they were affected by four RSD experiences, as well as the frequency with which they encountered these experiences. Men identifying as mostly bottom reported significantly stronger negative reactions to same-race rejection and encountering sexual role assumptions than men identifying as mostly top. Men identifying as versatile encountered same-race rejection significantly more frequently than men identifying as mostly top. Men identifying as mostly bottom encountered White superiority significantly more frequently than men identifying as mostly top. RSD may impact YSMBM differentially based on sexual position. These findings may have implications for culturally competent clinical practice, as well as analytic implications (e.g., estimating more complex statistical models) for sexual racism research, which remains an important yet underexamined field in the health sciences.
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Affiliation(s)
- Ryan M Wade
- School of Social Work, University of Illinois at Urbana-Champaign
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2
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Harper GW, Cherenack EM, Slye N, Jadwin-Cakmak L, Hudgens M. Pilot Trial of a Critical Consciousness-Based Intervention for Black Young Gay and Bisexual Men Living with HIV: Mobilizing Our Voices for Empowerment (MOVE). J Racial Ethn Health Disparities 2023; 10:64-82. [PMID: 35048310 PMCID: PMC9296697 DOI: 10.1007/s40615-021-01197-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 02/03/2023]
Abstract
HIV in the USA disproportionately affects Black young gay and bisexual men (Y-GBM). This article presents outcomes of a pilot randomized controlled trial comparing Mobilizing our Voices for Empowerment (MOVE), a culturally and developmentally tailored critical consciousness-based intervention for Black Y-GBM living with HIV (ages 16-24), with a comparison health promotion intervention. Black Y-GBM (n = 54) from four cities participated. Mixed effects models across four assessment points revealed participants in MOVE showed greater increases over time in perceived stress of HIV disclosure, self-efficacy for limiting HIV risk behavior, and condom use self-efficacy. Examining mean difference scores separately, participants in MOVE demonstrated increases in self-efficacy for HIV disclosure, perceived policy control, and self-efficacy for limiting HIV risk behavior. Immediately post-intervention, MOVE participants reported greater decreases in condomless intercourse with negative/unknown partners. MOVE may have potential to improve the health of Black Y-GBM living with HIV and reduce further transmission.
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Affiliation(s)
- Gary W Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Emily M Cherenack
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Nicole Slye
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Laura Jadwin-Cakmak
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Michael Hudgens
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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3
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López DJ, Chandler C, Whitfield DL, Adams B, Burdick J, Friedman MR. "Take It Out on the Floor": Experiences of Violence Among Black LGBT House and Ball Community Youth in a Rust Belt City. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3950-3978. [PMID: 36004529 PMCID: PMC10105583 DOI: 10.1177/08862605221113025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Black, lesbian, gay, bisexual, and transgender (LGBT), individuals experience higher rates of violent victimization compared to their cisgender heterosexual counterparts over their life course. Among Black LGBT people, witnessing and experiencing violence have been related to poor health outcomes, including depression, risky sexual behavior, substance use, and lower engagement in healthcare services. We engaged in research to better understand the effects of violence experienced by the Black LGBT youth community. We conducted a qualitative, phenomenological study focused on the causes of violence occurring in the lives of Black LGBT youth engaged in a recreation-based community health program. The study consisted of four focus groups with Black LGBT youth (N = 24) and in-depth individual interviews with medical and social service providers who work with Black LGBT youth (N = 4). Data analysis presented three themes: (1) causes of violence, (2) the context of intracommunity violence, and (3) solutions to violence. The first theme describes the reasoning, motivation, or explanation for violence experienced by the Black LGBT youth community. The second theme, the context of intracommunity violence, describes how violence occurs specifically within Black LGBT young adult communities. The third theme, solutions to violence, describes the recommendations for addressing, reducing, and/or eliminating violence within the Black LGBT youth community. Our findings highlight the need for safe spaces, culturally-relevant services, and trusted figures for Black LGBT young adults, which can serve as mechanisms for mitigating violence.
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Affiliation(s)
| | | | | | | | - Jessica Burdick
- Project Silk, Community Health Services, Pittsburgh, PA, USA
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4
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Boyd DT, Abu-Ba’are GR, LoVette A, Whitfield DL, Turpin RE, Ramos SR, Quinn CR, Hickson DA. Assessing the Influence of Child Sexual Behavior on Depression among Black SMM in the Southeastern United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13930. [PMID: 36360808 PMCID: PMC9658341 DOI: 10.3390/ijerph192113930] [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: 07/09/2022] [Revised: 10/10/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Limited studies have examined the associations between child sexual abuse (CSA) and depression among Black sexual minority men (SMM) in the Southeastern United States (US). As, such, the current study examined the critical gap in understanding the impact of CSA on Black SMM's mental health. Specifically, we tested the associations between contextual CSA factors and depression among a large population-based sample of Black SMM living in two cities in the Southern US. Data were obtained from the MARI Study, a sample of Black SMM ages 18-66 years, recruited from the Jackson, MS and Atlanta, GA metropolitan areas (n = 507). Depression was assessed using the 9-item CES-D scale. We conducted multivariable regression analyses to examine the association between depression with history of CSA and other child sexual-related variables (i.e., age of perpetrator and age of sexual abuse), controlling for key confounders. Our results indicated that CSA (β = 0.14, p < 0.001) was positively associated with depression. Our results also indicated that Black SMM who reported being sexually abused at the ages of 6 to 10 (β = 0.30, p < 0.01) and 16 to 18 (β = 0.25, p < 0.05) were positively associated with depression. These findings suggest that there is a need to provide culturally and safe mental health services in the Southeastern US for CSA survivors.
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Affiliation(s)
- Donte Travon Boyd
- College of Social Work, Ohio State University, Columbus, OH 43210, USA
- Us Helping Us, People into Living, Inc., Washington, DC 20010, USA
| | - Gamji Rabiu Abu-Ba’are
- Department of Public Health Sciences, University of Rochester, Rochester, NY 14642, USA
- School of Nursing, University of Rochester, Rochester, NY 14642, USA
- Center for Interdisciplinary Research on AIDS, New Haven, CT 06511, USA
| | - Ashleigh LoVette
- Us Helping Us, People into Living, Inc., Washington, DC 20010, USA
- College of Public Health, Ohio State University, Columbus, OH 43210, USA
| | | | - Rodman E. Turpin
- Department of Global & Community Health, College of Health and Human Services, George Mason University, College Park, MD 20742, USA
| | - S. Raquel Ramos
- Us Helping Us, People into Living, Inc., Washington, DC 20010, USA
- School of Nursing, Yale University, West Haven, CT 06477, USA
| | - Camille R. Quinn
- Center for Equitable Family and Community Well-Being, School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA
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Woo H, Jang H, Byrd JA, Walker TL. Black American Scholarship in ACA-affiliated journals: a content analysis. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2022. [DOI: 10.1080/03069885.2022.2076066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Hongryun Woo
- Department of Counseling and Human Development, University of Louisville, Louisville, KY, USA
| | - Hansori Jang
- Graduate School of Education, Hankuk University of Foreign Studies, Seoul, South Korea
| | - Janice A. Byrd
- Department of Educational Psychology, Counseling, and Special Education, Penn State University, State College, PA, USA
| | - Tanesha L. Walker
- School of Intervention and Wellness, University of Toledo, Toledo, OH, USA
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English D, Boone CA, Carter JA, Talan AJ, Busby DR, Moody RL, Cunningham DJ, Bowleg L, Rendina HJ. Intersecting Structural Oppression and Suicidality Among Black Sexual Minority Male Adolescents and Emerging Adults. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2022; 32:226-243. [PMID: 35166417 PMCID: PMC9047029 DOI: 10.1111/jora.12726] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/30/2021] [Accepted: 12/30/2021] [Indexed: 05/02/2023]
Abstract
This study examined associations between structural racism, anti-LGBTQ policies, and suicide risk among young sexual minority men (SMM). Participants were a 2017-2018 Internet-based U.S. national sample of 497 Black and 1536 White SMM (ages 16-25). Structural equation modeling tested associations from indicators of structural racism, anti-LGBTQ policies, and their interaction to suicide risk factors. For Black participants, structural racism and anti-LGBTQ policies were significantly positively associated with depressive symptoms, heavy drinking, perceived burdensomeness, thwarted belongingness, self-harm, and suicide attempt. There were significant interaction effects: Positive associations between structural racism and several outcomes were stronger for Black participants in high anti-LGBTQ policy states. Structural racism, anti-LGBTQ policies, and their interaction were not significantly associated with suicide risk for White SMM.
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Affiliation(s)
| | | | - Joseph A. Carter
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY)
| | | | | | | | | | | | - H. Jonathon Rendina
- Whitman-Walker Institute
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University
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Siconolfi D, Storholm ED, Vincent W, Pollack L, Rebchook GM, Huebner DM, Peterson JL, Kegeles SM. Prevalence and Correlates of Sexual Violence Experienced by Young Adult Black Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3621-3636. [PMID: 34725750 PMCID: PMC9473496 DOI: 10.1007/s10508-021-02011-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/27/2021] [Accepted: 04/09/2021] [Indexed: 05/06/2023]
Abstract
Men who have sex with men (MSM) experience high prevalence of sexual violence (SV), and SV has well-documented effects on health. Research gaps are especially evident for young Black MSM (YBMSM), who experience significant HIV disparities and syndemics, including multiple forms of violence victimization. We examined lifetime prevalence of SV (having been forced or frightened into sexual activity) in a cross-sectional sample of YBMSM (N = 1732), and tested associations of demographic, psychosocial, and structural factors using multivariable regression. YBMSM were recruited between 2013 and 2015 using modified venue-based time-location sampling (e.g., at bars and clubs) in Dallas and Houston, Texas. Approximately 17% of YBMSM experienced any SV in their lifetimes. SV was associated with high school non-completion (OR 1.78; 95% CI 1.15-2.77), lower psychological resilience (OR 0.84; 95% CI 0.71-0.98), lifetime history of homelessness (OR 5.52; 95% CI 3.80-8.02), recent financial hardship (OR 2.16; 95% CI 1.48-3.14), and recent transactional sex (OR 3.87; 95% CI 2.43-6.15). We also examined differences by age of SV onset (childhood versus adulthood). YBMSM with adolescent/emerging adult-onset SV may have been more ambivalent in reporting lifetime SV experience, compared to men with childhood-onset SV, and correlates differed by age of onset. Childhood-onset SV was associated with high school non-completion, lower levels of psychological resilience, history of homelessness, recent financial hardship, and recent transactional sex. Adolescent/emerging adult-onset SV was associated with greater depressive symptoms, history of homelessness, and recent financial hardship. There is a need for multi-level approaches to SV prevention and treatment, including services and supports that are culturally-relevant and responsive to the needs of YBMSM.
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Affiliation(s)
| | - Erik D Storholm
- RAND, Santa Monica, CA, USA
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
| | - Wilson Vincent
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Lance Pollack
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Gregory M Rebchook
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - David M Huebner
- Department of Prevention and Community Health, George Washington University, Washington, DC, USA
| | - John L Peterson
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Susan M Kegeles
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Wade RM, Harper GW. Racialized Sexual Discrimination (RSD) in Online Sexual Networking: Moving from Discourse to Measurement. JOURNAL OF SEX RESEARCH 2021; 58:795-807. [PMID: 32877277 DOI: 10.1080/00224499.2020.1808945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Young Black gay/bisexual men (YBGBM) are at disproportionate risk for poor health outcomes due to multilevel stressors, such as community- and individual-level discrimination. Racialized Sexual Discrimination (RSD) is an under-examined type of discrimination experienced by gay/bisexual men of color when seeking partners online. RSD may be a driving force behind sexual network restriction (which elevates YBGBM's risk for HIV infection) and may have an adverse impact on YBGBM's psychological wellbeing. Thus, adequate measurement of this phenomenon is essential. Focus groups with young gay/bisexual men of color were conducted to generate survey content that captured RSD experiences; the resultant information was used to develop an RSD scale. The scale, along with other sociodemographic measures, was administered to a sample of 634 YBGBM. An exploratory factor analysis was conducted on the scale. Results revealed an 8-factor structure: 1-White superiority; 2-White inferiority; 3-White rejection; 4-same-race rejection; 5-White physical objectification; 6-same-race physical objectification); 7-degradation; and 8-role assumptions. The scale was psychometrically sound and demonstrated good reliability, providing preliminary support for the scale's utility in social science research. Future research should further refine the scale and examine the association between RSD and sexual/mental health outcomes among YBGBM.
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Affiliation(s)
- Ryan M Wade
- University of Illinois at Urbana-Champaign School of Social Work
| | - Gary W Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health
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9
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English D, Carter JA, Boone CA, Forbes N, Bowleg L, Malebranche DJ, Talan AJ, Rendina HJ. Intersecting Structural Oppression and Black Sexual Minority Men's Health. Am J Prev Med 2021; 60:781-791. [PMID: 33840546 PMCID: PMC8274250 DOI: 10.1016/j.amepre.2020.12.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/08/2020] [Accepted: 12/15/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Although evidence indicates that Black gay, bisexual, and other sexual minority men experience vast psychological and behavioral health inequities, most research has focused on individual rather than structural drivers of these inequities. This study examines the associations between structural racism and anti-lesbian, gay, bisexual, transgender, and queer policies and the psychological and behavioral health of Black and White sexual minority men. METHODS Participants were an Internet-based U.S. national sample of 1,379 Black and 5,537 White sexual minority men during 2017-2018. Analysis occurred in 2019-2020. Structural equation modeling tested the associations from indicators of structural racism, anti‒lesbian, gay, bisexual, transgender, and queer policies, and their interaction to anxiety symptoms, depressive symptoms, perceived burdensomeness, heavy drinking, and HIV testing frequency. Separate models for Black and White sexual minority men adjusted for contextual and individual covariates. RESULTS For Black participants, structural racism was positively associated with anxiety symptoms (β=0.20, SE=0.10, p=0.04), perceived burdensomeness (β=0.42, SE=0.09, p<0.001), and heavy drinking (β=0.23, SE=0.10, p=0.01). Anti‒lesbian, gay, bisexual, transgender, and queer policies were positively associated with anxiety symptoms (β=0.08, SE=0.04, p=0.03), perceived burdensomeness (β=0.20, SE=0.04, p<0.001), and heavy drinking (β=0.10, SE=0.04, p=0.01) and were negatively associated with HIV testing frequency (β= -0.14, SE=0.07, p=0.04). Results showed significant interaction effects, such that the positive associations between structural racism and both perceived burdensomeness (β=0.38, SE=0.08, p≤0.001) and heavy drinking (β=0.22, SE=0.07, p=0.003) were stronger for individuals living in states with high levels of anti‒lesbian, gay, bisexual, transgender, and queer policies. Neither of the oppression variables nor their interaction was significantly associated with outcomes for White sexual minority men. CONCLUSIONS Results highlight the intersectional nature of structural oppression and suggest that racist and anti-lesbian, gay, bisexual, transgender, and queer policies must be repealed to rectify health inequities facing Black sexual minority men.
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Affiliation(s)
| | - Joseph A Carter
- Department of Psychology, Hunter College of City University of New York, New York, New York; Health Psychology and Clinical Science Doctoral Program, The Graduate Center, City University of New York, New York, New York
| | - Cheriko A Boone
- Department of Psychology, The George Washington University, Washington, District of Columbia
| | - Nicola Forbes
- Department of Psychology, Fordham University, Bronx, New York
| | - Lisa Bowleg
- Department of Psychology, The George Washington University, Washington, District of Columbia
| | | | - Ali J Talan
- Department of Psychology, Hunter College of City University of New York, New York, New York
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of City University of New York, New York, New York; Health Psychology and Clinical Science Doctoral Program, The Graduate Center, City University of New York, New York, New York.
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10
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Keene LC, Heath RD, Bouris A. Disclosure of Sexual Identities Across Social-Relational Contexts: Findings from a National Sample of Black Sexual Minority Men. J Racial Ethn Health Disparities 2021; 9:201-214. [PMID: 33415706 DOI: 10.1007/s40615-020-00944-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/30/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
Black sexual minority men (BSMM) in the USA navigate a range of factors that may influence the extent to which they disclose or conceal their sexual identity in various social contexts. To date, few studies have investigated the correlates of sexual identity disclosure or concealment among BSMM across multiple life domains. Guided by a minority stress perspective and intersectionality, we analyzed data from N = 809 BSMM who participated in the Social Justice Sexuality Survey. We conducted ordinary least squares regression to examine the relative weight of perceptions of homophobia, religiosity, LGBT community connectedness, racial identity salience, and sexual identity salience on disclosure of sexual identity in six social-relational contexts: (1) family, (2) friends, (3) neighbors, (4) religious community, (5) work, and (6) online. Findings indicate that BSMM disclosed their sexual identity unevenly across social-relational contexts. Notably, LGBTQ community connectedness and sexual identity importance were consistent predictors of sexual identity disclosure across contexts. In contrast, perceptions of homophobia were not related to sexual identity disclosure, suggesting that other factors may be more salient for BSMM when deciding to disclose their sexual identity. Finally, bisexual men consistently reported lower levels of sexual identity disclosure relative to gay men in all six contexts. Study findings have important implications for future research on sexual identity disclosure with diverse samples of BSMM.
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Affiliation(s)
- Lance C Keene
- New York University Center for Latino Adolescent and Family Health, 15 Washington Pl, New York, NY, 10003, USA.
| | - Ryan D Heath
- Syracuse University School of Social Work, Syracuse, NY, USA
| | - Alida Bouris
- University of Chicago School of Social Service Administration, Chicago, IL, USA
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Harper GW, LaBoy R, Castillo M, Johnson GL, Hosek SG, Jadwin-Cakmak L. It's a Kiki!: Developmental benefits of the Kiki scene for Black gay/bisexual/transgender adolescents/emerging adults. JOURNAL OF LGBT YOUTH 2020; 19:31-52. [PMID: 35003510 PMCID: PMC8735768 DOI: 10.1080/19361653.2020.1813672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 06/14/2023]
Abstract
Younger members of the House and Ball Community (HBC) have created an emerging social scene called "Kiki" that has shared elements with the HBC. Given the growing popularity of the Kiki scene in urban communities with large numbers of Black gay, bisexual, and transgender (GBT) adolescents and emerging adults, it is important to understand the developmental benefits of the Kiki scene. We conducted individual in-depth interviews with 30 GBT adolescents and emerging adults (ages 15-24) who attended Kiki-related events and 15 older opinion leaders affiliated with the HBC. Participants described how the Kiki scene provides them with a range of supportive and affirming functions and offers a place where they can achieve important developmental milestones. The results clustered into three primary thematic areas of development: Executive Functioning Development, Social-Emotional Development, and Physical and Emotional Safety during Development. Within each of these thematic areas are sub-themes that further explicate the ways in which these functions are supported. We believe this to be one of the first papers exclusively focused on the positive aspects of the Kiki scene for adolescent and emerging adult development, and we encourage other researchers to further explore this emerging socializing force and its potential benefits to development.
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Affiliation(s)
- Gary W. Harper
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Richard LaBoy
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Marne Castillo
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Gabriel L. Johnson
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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12
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Wade RM, Harper GW. Racialized Sexual Discrimination (RSD) in the Age of Online Sexual Networking: Are Young Black Gay/Bisexual Men (YBGBM) at Elevated Risk for Adverse Psychological Health? AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 65:504-523. [PMID: 31587325 DOI: 10.1002/ajcp.12401] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Young Black gay/bisexual men (YBGBM) are a highly marginalized population across multiple health outcomes. Most research on YBGBM health has focused on HIV/sexual health, but there is a demonstrable need for research examining racism and psychosocial functioning among this population. Racialized Sexual Discrimination (RSD), also known as sexual racism, is an important but under-investigated phenomenon that may have implications for the psychological health and well-being of YBGBM. This paper provides an overview of empirical research on RSD as experienced by gay/bisexual men of color in online partner-seeking venues. First, the researchers discuss how racialized experiences are a documented online phenomenon, with a variety of manifestations, and identify the potential effects that this phenomenon may have on the psychosocial health of YBGBM, and gay/bisexual men of color as a whole. Second, the researchers synthesize the RSD literature with a broader literature examining psychological well-being across race and sexual orientation. Third, the researchers present a theoretically grounded conceptual model detailing the pathways between RSD and psychological well-being using a stress and coping framework. The paper concludes with recommendations for future research on this topic, including scale development and hypothesis testing.
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Affiliation(s)
- Ryan M Wade
- University of Illinois at Urbana-Champaign School of Social Work, Urbana, IL, USA
| | - Gary W Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
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13
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VandeVusse A, Rosentel K, Coldon L, Schneider J, Hill BJ. Parenting and child-caretaking among black men who have sex with men and associated sexual and reproductive health factors: A brief report. JOURNAL OF GAY & LESBIAN SOCIAL SERVICES 2020; 32:283-296. [PMID: 38773990 PMCID: PMC11107801 DOI: 10.1080/10538720.2020.1728462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
The purpose of this exploratory study was to examine the prevalence of parenting and child-caretaking among a sample of black men who have sex with men (MSM), as well as associations between parenting roles and sexual and reproductive health (SRH) factors. Parenting and SRH data were derived from a survey of 199 black MSM. Nearly half of the sample reported being a father or father-figure (44.4%), almost a third indicated serving as caretaker of a child (29.1%), and one in five have a biological child (20.1%). Over half of the sample reported at least one of these three parenting/child-caretaking roles (52.5%). Two significant differences were observed for sexual health variables: men with biological children were significantly more likely to report using condoms inconsistently (55.0% vs. 35.7%, p=.026) and engaging in transactional sex work (36.8% vs. 21.0%, p=.041). Given the observed prevalence, parenting and child-caretaking among black MSM warrant further inquiry as factors that may influence SRH outcomes and care utilization. Services and interventions tailored to black MSM should consider these men's potential roles and responsibilities as parents and caretakers of children.
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Affiliation(s)
| | - Kris Rosentel
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Lawrence Coldon
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
| | - John Schneider
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Brandon J. Hill
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
- Planned Parenthood Great Plains
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Busby DR, Horwitz AG, Zheng K, Eisenberg D, Harper GW, Albucher RC, Roberts LW, Coryell W, Pistorello J, King CA. Suicide risk among gender and sexual minority college students: The roles of victimization, discrimination, connectedness, and identity affirmation. J Psychiatr Res 2020; 121:182-188. [PMID: 31837538 PMCID: PMC7008002 DOI: 10.1016/j.jpsychires.2019.11.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/15/2019] [Accepted: 11/21/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Little is known about how victimization and discrimination relate to suicide risk among sexual and gender minority (SGM) college students, or what is protective for these students. The current study will: 1.) determine the extent to which interpersonal victimization, discrimination, identity affirmation, and social connectedness are associated with suicide risk characteristics, and if race and/or ethnicity moderates this association; 2.) examine whether identity affirmation and social connectedness are protective against associations between victimization or discrimination and suicide risk characteristics. METHOD Participants were 868 students (63.6% female) from four United States universities who completed an online screening survey and met the following study inclusion criteria: self-identification as gender and/or sexual minority, endorsement of at least one suicide risk characteristic and no current use of mental health services. Participants also completed measures that assessed demographics, non-suicidal self-injury (NSSI), victimization, discrimination, connectedness, and LGBTQ identity affirmation. RESULTS Victimization was positively associated with depression severity, suicidal ideation, alcohol misuse, suicide attempt history, and NSSI. Discrimination was positively associated with depression severity, suicide attempt history, and NSSI. Connectedness was inversely associated with depression severity, suicidal ideation severity, suicide attempt history, and NSSI, and moderated the association between victimization and suicide attempt history. LGBTQ identity affirmation moderated the link between victimization and depression. CONCLUSIONS Results suggest efforts to decrease victimization and discrimination and increase connectedness may decrease depressive morbidity and risks for self-harm among SGM college students. Further, increasing LGBTQ identity affirmation may buffer the impact of victimization on depression.
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Affiliation(s)
| | | | - Kai Zheng
- University of California, Irvine, CA, USA
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15
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English D, Carter JA, Forbes N, Bowleg L, Malebranche DJ, Talan AJ, Rendina HJ. Intersectional discrimination, positive feelings, and health indicators among Black sexual minority men. Health Psychol 2020; 39:220-229. [PMID: 31944799 DOI: 10.1037/hea0000837] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study examined psychological and sexual health indicators associated with positive feelings and discrimination at the intersection of race and gender among Black gay, bisexual, and other sexual minority men (SMM). METHOD Participants were a national sample of 1,064 Black SMM (Mdn age = 28) who responded to self-report measures of positive feelings and discrimination associated with being a Black man, psychological distress, self-efficacy, emotional awareness, and sexual HIV risk and protective behavior. Using structural equation modeling, we examined associations between the positive feelings and discrimination scales and the psychological and sexual health indicators. We also tested age as a moderator of these associations. RESULTS Our results indicated that positive feelings about being a Black man were significantly positively associated with self-efficacy (b = 0.33), emotional awareness (b = 0.16), and sexual protective behavior (b = 0.93) and negatively associated with psychological distress (b = -0.26) and sexual risk behavior (b = -0.93). Except for emotional awareness and sexual protective behavior, discrimination as a Black man was also associated with these variables, though to a lesser magnitude for positive health indicators. Moderation results showed that, except for the association between positive feelings and emotional awareness, younger men generally had stronger associations between health indicators and the positive feelings and discrimination scales. CONCLUSIONS These results suggest that positive feelings, in addition to discrimination, at the intersection of race and gender play an important role in the psychological and sexual health of Black SMM, especially earlier in their lives. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Feinstein BA, Dodge B. Meeting the Sexual Health Needs of Bisexual Men in the Age of Biomedical HIV Prevention: Gaps and Priorities. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:217-232. [PMID: 31691076 DOI: 10.1007/s10508-019-1428-3)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 05/09/2019] [Accepted: 05/14/2019] [Indexed: 05/24/2023]
Abstract
The field of HIV/STI prevention has primarily focused on gay men (or "men who have sex with men" [MSM] as a broad category) with limited attention to bisexual men in particular. Although bisexual men are also at increased risk for HIV and other STI, they are less likely to utilize HIV/STI prevention services than gay men, and very few interventions have been developed to address their unique needs. Further, while biomedical advances are changing the field of HIV prevention, bisexual men are also less likely to use biomedical HIV prevention strategies (e.g., pre-exposure prophylaxis [PrEP]) than gay men. In an effort to advance research on bisexual men and their sexual health needs, the goals of this commentary are: (1) to review the empirical literature on the prevalence of HIV/STI among bisexual men, the few existing HIV/STI prevention interventions developed for bisexual men, and the use of biomedical HIV prevention among bisexual men; (2) to describe the ways in which the field of HIV/STI prevention has largely overlooked bisexual men as a population in need of targeted services; and (3) to discuss how researchers can better address the sexual health needs of bisexual men in the age of biomedical HIV prevention.
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Affiliation(s)
- Brian A Feinstein
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., #14-047, Chicago, IL, 60611, USA.
| | - Brian Dodge
- Indiana University School of Public Health, Bloomington, IN, USA
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Feinstein BA, Dodge B. Meeting the Sexual Health Needs of Bisexual Men in the Age of Biomedical HIV Prevention: Gaps and Priorities. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:217-232. [PMID: 31691076 PMCID: PMC7018582 DOI: 10.1007/s10508-019-01468-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 05/09/2019] [Accepted: 05/14/2019] [Indexed: 05/02/2023]
Abstract
The field of HIV/STI prevention has primarily focused on gay men (or "men who have sex with men" [MSM] as a broad category) with limited attention to bisexual men in particular. Although bisexual men are also at increased risk for HIV and other STI, they are less likely to utilize HIV/STI prevention services than gay men, and very few interventions have been developed to address their unique needs. Further, while biomedical advances are changing the field of HIV prevention, bisexual men are also less likely to use biomedical HIV prevention strategies (e.g., pre-exposure prophylaxis [PrEP]) than gay men. In an effort to advance research on bisexual men and their sexual health needs, the goals of this commentary are: (1) to review the empirical literature on the prevalence of HIV/STI among bisexual men, the few existing HIV/STI prevention interventions developed for bisexual men, and the use of biomedical HIV prevention among bisexual men; (2) to describe the ways in which the field of HIV/STI prevention has largely overlooked bisexual men as a population in need of targeted services; and (3) to discuss how researchers can better address the sexual health needs of bisexual men in the age of biomedical HIV prevention.
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Affiliation(s)
- Brian A Feinstein
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., #14-047, Chicago, IL, 60611, USA.
| | - Brian Dodge
- Indiana University School of Public Health, Bloomington, IN, USA
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18
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Individual and Network Factors Associated With Racial Disparities in HIV Among Young Men Who Have Sex With Men: Results From the RADAR Cohort Study. J Acquir Immune Defic Syndr 2019; 80:24-30. [PMID: 30365451 DOI: 10.1097/qai.0000000000001886] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Individual sexual risk behaviors have failed to explain the observed racial disparity in HIV acquisition. To increase understanding of potential drivers in disparities, we assessed differences across individual, network, and social determinants. METHODS Data come from RADAR (N = 1015), a longitudinal cohort study of multilevel HIV-risk factors among young men who have sex with men (YMSM) aged 16-29 years in Chicago, IL. Data collection includes biological specimens; network data, including detailed information about social, sexual, and drug-use networks; and psychosocial characteristics of YMSM. RESULTS Compared to white YMSM (24.8%) and Hispanic YMSM (30.0%), black YMSM (33.9%) had a higher prevalence of both HIV (32%; P < 0.001) and rectal sexually transmitted infections (26.5%; P = 0.011) with no observed differences in pre-exposure prophylaxis use. Black YMSM reported lower rates of sexual risk behaviors and more lifetime HIV tests (P < 0.001) compared with all other YMSM; however, they were also significantly less likely to achieve viral suppression (P = 0.01). Black YMSM reported the highest rate of cannabis use (P = 0.03) as well as greater levels of stigma (P < 0.001), victimization (P = 0.04), trauma (P < 0.001), and childhood sexual abuse (P < 0.001). White YMSM reported higher rates of depression (P < 0.001) and alcohol use (P < 0.001). In network analyses, significant differences existed across network characteristics with black YMSM having the lowest transitivity (P = 0.002), the highest density (P < 0.001), and the highest homophily (P < 0.001). CONCLUSIONS Black YMSM do not report higher rates of HIV-risk behaviors, but social and network determinants are aligned toward increased HIV risk. These results suggest that network interventions and those addressing social determinants may help reduce disparities.
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19
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Wilson BDM, Neubauer LC, Park A, Abuor P, Harper GW. The sexual health needs of sexual minority women in Western Kenya: An exploratory community assessment and public policy analysis. Glob Public Health 2019; 14:1495-1508. [DOI: 10.1080/17441692.2019.1611895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Bianca D. M. Wilson
- Williams Institute, School of Law, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Andrew Park
- Williams Institute, School of Law, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Paula Abuor
- Women Working with Women (3W), Kisumu, Kenya
| | - Gary W. Harper
- Global Public Health School, University of Michigan, Ann Arbor, MI, USA
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20
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Cook SH, Valera P, Wood EP, Calebs BJ, Wilson PA. Understanding Attachment Transitions Through the Lived Experiences of Young Black Gay and Bisexual Men. JOURNAL OF SEX RESEARCH 2019; 56:604-619. [PMID: 29578810 PMCID: PMC6158107 DOI: 10.1080/00224499.2018.1440280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
We conducted a mixed-methods study to identify factors that influence transitions in attachment style between childhood and adulthood among 28 young Black gay and bisexual men (YBGBM) in the United States. We used a phenomenological approach to data integration, with the major component to the results being garnered from the qualitative interviews. We organized our results by four attachment transition groups: stable secure (secure attachment in childhood and young adulthood), stable insecure (insecure attachment in childhood and young adulthood), secure to insecure (secure in childhood and insecure in adulthood) and insecure to secure (insecure in childhood and secure in adulthood). Within each of the typologies, two major themes emerged: social support and religion. Generally, transitions from secure to insecure attachment were related to experiences of perceived rejection by a parental figure during adolescence that corresponded with sexual orientation disclosure. Transitions from insecure to secure attachment appeared to be related to the absence of an attachment figure early in life, but with the acquisition of an attachment figure during early to late adolescence. The findings from our study suggest a need for attachment-based approaches to social support interventions, as well as for an increased understanding of social and cultural factors that impact attachment changes among practitioners who use attachment-based therapy models for YBGBM.
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Affiliation(s)
- Stephanie H. Cook
- College of Global Public Health, Department of Biostatistics and Department of Social and Behavioral Sciences, New York University, New York, NY, 715 Broadway, Room 1014
- Corresponding Author: Phone: 212-998-5635,
| | - Pamela Valera
- Rutegers School of Public Health, Rutgers University
| | - Erica P. Wood
- College of Global Public Health, Department of Biostatistics and Department of Social and Behavioral Sciences, New York University, New York, NY, 715 Broadway, Room 1014
| | - Benjamin J. Calebs
- Department of Psychological and Brain Sciences, University of Louisville
| | - Patrick A. Wilson
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health
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21
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Harper GW, Jadwin-Cakmak L, Cherenak E, Wilson P. Critical Consciousness-Based HIV Prevention Interventions for Black Gay and Bisexual Male Youth. AMERICAN JOURNAL OF SEXUALITY EDUCATION 2018; 14:109-133. [PMID: 30956625 PMCID: PMC6448792 DOI: 10.1080/15546128.2018.1479668] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/01/2018] [Accepted: 05/18/2018] [Indexed: 06/09/2023]
Abstract
Black gay/bisexual male youth are one of the groups most affected by HIV in the U.S., but few behavioral interventions have been created specifically to address this health inequity. Oppression related to these youths' multiple social identities - including racism, heterosexism, and HIV stigma - contribute to increased health risks. Primary and secondary HIV prevention interventions created specifically for Black gay/bisexual male youth that address the negative impact of oppression are urgently needed. We present empowerment as a framework for understanding how oppression affects health, and critical consciousness as a tool to be utilized in behavioral interventions. This approach helps to move Black gay/bisexual male youth from a place of oppression and powerlessness that leads to elevated health risks to a position of empowerment that promotes feelings of control and participation in healthy behaviors. Finally, we present a case example of our own critical consciousness-based secondary HIV prevention intervention created specifically for Black gay/bisexual male youth.
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Affiliation(s)
- Gary W Harper
- University of Michigan School of Public Health, Department of Health Behavior and Health Education, 1415 Washington Heights, School of Public Health I, Room 2272, Ann Arbor, MI 48109, ; 734-647-9778
| | - Laura Jadwin-Cakmak
- University of Michigan School of Public Health, Department of Health Behavior and Health Education, Center for Sexuality & Health Disparities, 400 North Ingalls St., Ann Arbor, MI 48109, ; 734-763-2884
| | - Emily Cherenak
- Columbia University, Mailman School of Public Health, Department of Sociomedical Sciences, 722 W. 168th Street, 5th Floor, New York NY USA 10032, ; 908-303-0786
| | - Patrick Wilson
- Columbia University, Mailman School of Public Health, Department of Sociomedical Sciences, 722 W. 168th Street, 5th Floor, New York NY USA 10032, ; 212-305-1852
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22
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Yıldız E. Suicide in sexual minority populations: A systematic review of evidence-based studies. Arch Psychiatr Nurs 2018; 32:650-659. [PMID: 30029759 DOI: 10.1016/j.apnu.2018.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 12/13/2017] [Accepted: 03/06/2018] [Indexed: 02/05/2023]
Abstract
Sexual minority populations are exposed to more forms of distress than heterosexual individuals, thereby increasing the risk of suicidal behavior. It therefore seems surprising that suicidal behavior in sexual minorities is not sufficiently addressed in the nursing literature.The aim of this review was to integrate evidence-based knowledge and experiences related to suicide in sexual minorities into the nursing literature. This study has been conducted according to PRISMA guidelines, which contains a basic systematic screening process. Fourteen articles met the research criteria. The evaluation encompassed 4 themes: 1) Suicide attempts; 2) Thoughts of suicide; 3) Suicide attempts and completed suicide; 4) Suicidal thoughts and suicide attempts. Most studies focused on the dimensions of attempted suicide. The key finding was that young people in sexual minority groups exhibit more suicidal ideation, more suicide attempts and are more at risk of completed suicide than heterosexual individuals. Family-centered care for young people can therefore be one of the basic principles of nursing practice. Nurses can routinely ask adolescents about their sexual orientation and identity to provide appropriate assessment and care. Additionally, nurses can use educational, counseling, case manager and therapist roles to avoid negative experiences such as homophobia, stigmatization and the discrimination of sexual minorities.
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Affiliation(s)
- Erman Yıldız
- Department of Psychiatric Nursing, Faculty of Health Sciences, Inonu University, Malatya 44280, Turkey.
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23
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Morgan A, Saunders B, Dodge B, Harper G, Arrington Sanders R. Exploring the Sexual Development Experiences of Black Bisexual Male Adolescents Over Time. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1839-1851. [PMID: 29299791 PMCID: PMC6123617 DOI: 10.1007/s10508-017-1084-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 09/08/2017] [Accepted: 09/16/2017] [Indexed: 06/07/2023]
Abstract
Scant research has sought to explore the development of dimensions of sexual orientation among Black bisexual male adolescents (BBMA). Understanding how sexual attractions, behaviors, and identities evolve among BBMA over time is crucial to understanding the most appropriate support strategies to provide during this developmental period. We sought to understand and describe the sexual orientation development experiences in a sample of BBMA over the course of 1 year. We further sought to understand the sociocontextual factors that may play a role during this development process. Fifteen BBMA, aged 15-19 years, were interviewed about sexual debut experiences (baseline) and were re-interviewed three times over a 1-year period about sexual attractions, behaviors, and identity at each follow-up point. A three-person team used inductive open coding to analyze each participant's data set. The mean Kinsey scale score for the sample was 2.93 (SD = 1.2) most closely translating to "heterosexual/gay-equally." A case study analysis was used to identify themes related to sexual attractions, behavior, and identity over time, within and across participants. Among the sample of young men, two unique groups were identified based on self-reported sexual identity and experiences of same- and other-sex sexual attractions and behaviors over time. The first group consisted of seven young men who consistently described their sexual identity as bisexual from baseline to the final follow-up. These young men also described similar experiences related to same- and other-sex sexual and romantic attractions and more consistently described same- and other-sex sexual behaviors. The second group consisted of eight young men that described changing sexual identity and same- and other-sex sexual romantic attractions over time. Participants described sociocontextual factors such as religion, masculinity, and homophobia played during their development. Findings from this study underscore the complexity of sexual orientation development and sociocultural factors and expectations that may influence sexual identity and behavior among BBMA.
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Affiliation(s)
- Anthony Morgan
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, 200 North Wolfe Street, 2063, Baltimore, MD, 21287, USA.
| | - Brianna Saunders
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, 200 North Wolfe Street, 2063, Baltimore, MD, 21287, USA
| | - Brian Dodge
- Indiana University School of Public Health, Bloomington, IN, USA
| | - Gary Harper
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Renata Arrington Sanders
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, 200 North Wolfe Street, 2063, Baltimore, MD, 21287, USA
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24
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Marcell AV, Gibbs SE, Pilgrim NA, Page KR, Arrington-Sanders R, Jennings JM, Loosier PS, Dittus PJ. Sexual and Reproductive Health Care Receipt Among Young Males Aged 15-24. J Adolesc Health 2018; 62:382-389. [PMID: 29128296 PMCID: PMC6080721 DOI: 10.1016/j.jadohealth.2017.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/01/2017] [Accepted: 08/24/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to describe young men's sexual and reproductive health care (SRHC) receipt by sexual behavior and factors associated with greater SRHC receipt. METHODS There were 427 male patients aged 15-24 who were recruited from 3 primary care and 2 sexually transmitted disease (STD) clinics in 1 urban city. Immediately after the visit, the survey assessed receipt of 18 recommended SRHC services across four domains: screening history (sexual health, STD/HIV test, family planning); laboratories (STDs/HIV); condom products (condoms/lubrication); and counseling (STD/HIV risk reduction, family planning, condoms); in addition, demographic, sexual behavior, and visit characteristics were examined. Multivariable Poisson regressions examined factors associated with each SRHC subdomain adjusting for participant clustering within clinics. RESULTS Of the participants, 90% were non-Hispanic black, 61% were aged 20-24, 90% were sexually active, 71% had female partners (FPs), and 20% had male or male and female partners (M/MFPs). Among sexually active males, 1 in 10 received all services. Half or more were asked about sexual health and STD/HIV tests, tested for STDs/HIV, and were counseled on STD/HIV risk reduction and correct condom use. Fewer were asked about family planning (23%), were provided condom products (32%), and were counseled about family planning (35%). Overall and for each subdomain, never sexually active males reported fewer services than sexually active males. Factors consistently associated with greater SRHC receipt across subdomains included having M/MFPs versus FPs, routine versus non-STD-acute visit, time alone with provider without parent, and seen at STD versus primary care clinic. Males having FPs versus M/MFPs reported greater family planning counseling. CONCLUSIONS Findings have implications for improving young men's SRHC delivery beyond the narrow scope of STD/HIV care.
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Affiliation(s)
- Arik V Marcell
- Department of Pediatrics, The Johns Hopkins University, School of Medicine, Baltimore, Maryland; Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland.
| | - Susannah E Gibbs
- Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Nanlesta A Pilgrim
- Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Kathleen R Page
- Department of Medicine, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | | | - Jacky M Jennings
- Department of Pediatrics, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Penny S Loosier
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patricia J Dittus
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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25
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Wade R, Harper GW, Bauermeister JA. Psychosocial Functioning and Decisional Balance to Use Condoms in a Racially/Ethnically Diverse Sample of Young Gay/Bisexual Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:195-204. [PMID: 28233112 PMCID: PMC5569003 DOI: 10.1007/s10508-016-0912-2] [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] [Received: 04/28/2016] [Revised: 10/19/2016] [Accepted: 11/25/2016] [Indexed: 06/06/2023]
Abstract
Young gay/bisexual and other men who have sex with men (YGBMSM; ages 18-24) are experiencing an increase in HIV infection rates, particularly if they are Black or Latino. Psychosocial functioning is consistently implicated in HIV risk behaviors; however, less is known about the role of these factors in YGBMSM's decision-making process to use condoms (i.e., decisional balance to use condoms; DBC). We examined whether YGBMSM's psychological functioning was associated differentially with their DBC across racial/ethnic groups. Using data from a cross-sectional web-survey of single YGBMSM (N = 1380; 9.9% Black; 18.6% Latino; 71.5% White), we performed racial/ethnic-specific multivariable regression models to explore the association between DBC and psychological factors (e.g., depression, anxiety), demographics (e.g., age, education, HIV status, prior STI diagnosis), and perceived difficulty implementing safer sex strategies. Black YGBMSM reported lower DBC if they reported higher depression symptoms (β = -.31, p < .05), were HIV-negative (β = -.20, p < .05), and had greater difficulty implementing safer sex strategies (β = -.32, p < .001). Latino participants reported greater DBC to use condoms if they reported greater anxiety symptoms (β = .21, p < .05). White participants reported greater DBC if they were younger (β = -.09, p < .01), did not report a prior STI (β = .10, p < .001), and had fewer difficulties implementing safer sex strategies (β = -.27, p < .001); DBC had no association to psychological well-being among White participants. Psychological factors may be differentially associated with DBC across racial/ethnic group categories. Health promotion initiatives targeting condom use may benefit from culturally tailored interventions that address psychosocial functioning and its role in YGBMSM's condom use decision-making.
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Affiliation(s)
- Ryan Wade
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Gary W Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - José A Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, 19104, USA.
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Harper GW, Tyler AT, Bruce D, Graham L, Wade RM. Drugs, Sex, and Condoms: Identification and Interpretation of Race-Specific Cultural Messages Influencing Black Gay and Bisexual Young Men Living with HIV. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2016; 58:463-476. [PMID: 27883219 PMCID: PMC5161543 DOI: 10.1002/ajcp.12109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Black gay and bisexual young men carry a disproportionate burden of HIV in the United States. This study explored Black gay and bisexual young men living with HIV's identification and interpretation of race-specific cultural messages regarding substance use, sexual activity, and condom use. A total of 36 Black gay and bisexual young men living with HIV (ages 16-24, mean = 20.6 years) from four geographically diverse regions of the United States participated in qualitative in-depth interviews. Results from this study elucidate the ways in which these young men interpret various forms of race-specific cultural messages and experiences regarding substance use, sexual activity, and condom use. Participants discussed cultural messages and experiences promoting and discouraging condoms and substance use. Regarding sexual activity, only messages and experiences promoting sex were reported. Across all three categories, messages and experiences promoting risk were predominant. Data further revealed that socially transmitted cultural messages received by young men emanated from multiple sources, such as family, peers, sexual partners, community/neighborhood, and the broader society. Race-specific cultural messages and experiences should be addressed in interventions for this population, and programs should assist young men in developing a critical consciousness regarding these messages and experiences in order to promote health and well-being.
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Affiliation(s)
| | - April Timmons Tyler
- Michael Reese Research and Education Foundation Care Program at Mercy Hospital, Chicago, IL, USA
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