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Knox JR, Dolotina B, Moline T, Matthews I, Durrell M, Hanson H, Almirol E, Hotton A, Pagkas-Bather J, Chen YT, English D, Manuzak J, Rower JE, Miles C, Millar B, Jean-Louis G, Rendina HJ, Martins SS, Grov C, Hasin DS, Carrico AW, Shoptaw S, Schneider JA, Duncan DT. HIV Prevention and Care Among Black Cisgender Sexual Minority Men and Transgender Women: Protocol for an HIV Status-Neutral Cohort Study Using an Observational-Implementation Hybrid Approach. JMIR Res Protoc 2023; 12:e48548. [PMID: 38039075 PMCID: PMC10724817 DOI: 10.2196/48548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Black cisgender gay, bisexual, and other sexual minority men (SMM) and transgender women (TW) continue to be heavily affected by HIV. Further research is needed to better understand HIV prevention and care outcomes in this population. In particular, there is a need for research examining the impact of substance use and sleep health on HIV prevention and treatment outcomes among Black SMM and TW. OBJECTIVE This paper outlines the study methods being used in the recently launched follow-up study to the Neighborhoods and Networks (N2) study, which we refer to as N2 Part 2 (N2P2). N2P2 aims to address this gap in the literature, build off the findings of the original N2 study, and identify socioenvironmental determinants of health, including whether neighborhood and network factors mediate and moderate these relationships. METHODS Building on the N2 cohort study in Chicago from 2018 to 2022, N2P2 used a prospective longitudinal cohort design and an observational-implementation hybrid approach. With sustained high levels of community engagement, we aim to recruit a new sample of 600 Black SMM and TW participants residing in the Chicago metropolitan statistical area. Participants are asked to participate in 3 study visits across an 18-month study period (1 visit every 9 months). Four different forms of data are collected per wave: (1) an in-person survey, (2) biological specimen collection, (3) a daily remote ecological momentary assessment for 14 days after each study visit, and (4) data from electronic health records. These forms of data collection continue to assess neighborhood and network factors and specifically explore substance use, sleep, immune function, obesity, and the implementation of potential interventions that address relevant constructs (eg, alcohol use and pre-exposure prophylaxis adherence). RESULTS The N2P2 study was funded in August 2021 by the National Institute of Drug Abuse (R01DA054553 and R21DA053156) and National Heart, Lung, and Blood Institute (R01HL160325). This study was launched in November 2022. Recruitment and enrollment for the first wave of data collection are currently ongoing. CONCLUSIONS The N2P2 study is applying innovative methods to comprehensively explore the impacts of substance use and sleep health on HIV-related outcomes among an HIV status-neutral cohort of Black SMM and TW in Chicago. This study is applying an observational-implementation hybrid design to help us achieve findings that support rapid translation, a critical priority among populations such as Black SMM and TW that experience long-standing inequities with regard to HIV and other health-related outcomes. N2P2 will directly build off the findings that have resulted from the original N2 study among Black SMM and TW in Chicago. These findings provide a better understanding of multilevel (eg, individual, network, and neighborhood) factors that contribute to HIV-related outcomes and viral suppression among Black SMM and TW. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48548.
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Affiliation(s)
- Justin R Knox
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brett Dolotina
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Tyrone Moline
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Isabella Matthews
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Mainza Durrell
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Hillary Hanson
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Ellen Almirol
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Anna Hotton
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Jade Pagkas-Bather
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Yen-Tyng Chen
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Devin English
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Jennifer Manuzak
- Division of Immunology, School of Medicine, Tulane University, New Orleans, LA, United States
| | - Joseph E Rower
- Center for Human Toxicology, University of Utah, Salt Lake City, UT, United States
| | - Caleb Miles
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brett Millar
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - H Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Silvia S Martins
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Christian Grov
- Einstein-CUNY-Rockefeller Center for AIDS Research, School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Deborah S Hasin
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Adam W Carrico
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Steve Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Dustin T Duncan
- Mailman School of Public Health, Columbia University, New York, NY, United States
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Robles G, Lee JJ, Reynolds A, Rodríguez-Díaz CE, Rendina HJ. Reactions to Testing HIV Negative: An Assessment of Measurement Invariance and Associations with Condomless Anal Sex among English and Spanish-speaking Latinx Sexual Minority Men in the United States. AIDS Behav 2023; 27:3661-3668. [PMID: 37195473 PMCID: PMC10777537 DOI: 10.1007/s10461-023-04081-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 05/18/2023]
Abstract
Among the many effective prevention strategies, frequent HIV testing continues to be promoted to reduce the risk of HIV transmission among sexual minority men (SMM). Testing negative for HIV can result in varied reactions that influence subsequent HIV transmission behaviors, yet the extant research has primarily been conducted in English. The current study examined measurement invariance of a Spanish-translated Inventory of Reactions to Testing HIV Negative (IRTHN). The study also examined whether the IRTHN was associated with subsequent condomless anal sex. Data were drawn from 2,170 Latinx SMM subsample of the UNITE Cohort Study. We conducted a multigroup confirmatory factor analysis to test for measurement invariance between participants who opted to take the survey in English (n = 2,024) and those who opted to take it in Spanish (n = 128). We also examined if the IRTHN is associated with subsequent CAS. The results were suggestive of partial invariance. The subscales of Luck and Invulernability were associated with CAS at the 12-month follow-up. Practice and research-based implications are discussed.
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Affiliation(s)
- Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA.
| | - Jane J Lee
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Addam Reynolds
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Carlos E Rodríguez-Díaz
- The George Washington University-Milken Institute School of Public Health, Washington, DC, USA
| | - H Jonathon Rendina
- The George Washington University-Milken Institute School of Public Health, Washington, DC, USA
- Whitman-Walker Institute, Washington, DC, USA
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Liautaud MM, Rendina HJ, Berke DS. Examining the impact of daily discrimination on alcohol use among racially diverse, trauma-exposed sexually minoritized adults: A pilot study. Psychol Trauma 2023:2024-04569-001. [PMID: 37668576 DOI: 10.1037/tra0001577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Identity-based stress and trauma are key drivers of alcohol use-related health inequities among minoritized people. Research on intersectional experiences of identity-based stress and alcohol use among trauma-exposed minoritized people is scant. This pilot study used a 30-day diary design to examine the effect of identity-based discrimination exposure on alcohol use in a racially diverse sample of trauma-exposed sexual minoritized (SM) adults (N = 47; 63.8% cisgender female; 65.2% Black, Indigenous, and People of Color [BIPOC]). METHOD Multilevel logistic regression models were used to evaluate whether days marked by any (vs. no) identity-based discrimination were concurrently or prospectively associated with increased likelihood of reporting a higher (vs. lower) level of drinking-and whether these associations differed by race/ethnicity. RESULTS Discrimination was associated with increased likelihood of reporting a higher level of same-day drinking (B = 0.91, p = .03), but did not predict next-day drinking. BIPOC (vs. White) individuals were less likely to report a higher drinking level on or following nondiscrimination days (Bs = -2.18 to -1.52, ps ≤ .005), but more likely to do so on or following discrimination days (Bs = 1.13-1.60, ps ≤ .03). CONCLUSIONS Results suggest that everyday discrimination may create insidious risk for coping-motivated alcohol use among SM BIPOC, a subgroup that otherwise exhibits resilience with respect to drinking. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Madalyn M Liautaud
- Health Psychology and Clinical Science Doctoral Program, Graduate Center, City University of New York
| | - H Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University
| | - Danielle S Berke
- Health Psychology and Clinical Science Doctoral Program, Graduate Center, City University of New York
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Moody RL, Carter JA, Talan A, Sizemore KM, Russell ST, Rendina HJ. Associations of adverse and protective childhood experiences with thwarted belongingness, perceived burdensomeness, and suicide risk among sexual minority men. Psychol Med 2023; 53:5615-5624. [PMID: 36117279 PMCID: PMC10024646 DOI: 10.1017/s0033291722002823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/04/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sexual minority men (SMM) experience higher suicidal ideation and suicide attempts than the general population. We examined the associations of adverse childhood experiences (ACES) and protective and compensatory childhood experiences (PACES) with suicidal ideation and suicide attempts in adulthood via thwarted belongingness and perceived burdensomeness among SMM. METHODS Data are from the UNITE study, a national longitudinal cohort study of HIV-negative SMM from the 50 U.S. states and Puerto Rico. Between 2017 and 2019, participants (N = 6303) completed web-based assessments at baseline and 12-month follow-up. ACES and PACES occurring before the age of 18, and current symptoms of thwarted belongingness and perceived burdensomeness were assessed at baseline. Past-week suicidal ideation and past-year suicide attempt were assessed at follow-up. RESULTS 424 (6.7%) participants reported past-week suicidal ideation and 123 (2.0%) reported a past-year suicide attempt. The results of our multivariate model suggest that each additional adverse childhood experience was prospectively associated with 14% higher odds of past-week suicidal ideation (AOR = 1.14, 95% CI 1.09-1.19) and 19% higher odds of past-year suicide attempt (AOR = 1.19, 95% CI 1.11-1.29). Each additional protective childhood experience was prospectively associated with 15% lower odds of past-week suicidal ideation (AOR = 0.85, 95% CI 0.81-0.90) and 11% lower odds of past-year suicide attempt (AOR = 0.89, 95% CI 0.82-0.98). Perceived burdensomeness partially mediated these prospective associations. CONCLUSION To reduce suicide, screening and treating perceived burdensomeness among SMM with high ACES may be warranted. PACES may decrease perceived burdensomeness and associated suicide risk.
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Affiliation(s)
- Raymond L. Moody
- Department of Epidemiology, Columbia University Mailman School of Public Health, 772 West 181st Street, New York, NY 10032, USA
| | - Joseph A. Carter
- Department of Psychology, City University of New York Graduate Center, Health Psychology and Clinical Sciences Program, New York, NY, USA
| | - Ali Talan
- Whitman-Walker Institute, Washington, DC, USA
| | - K. Marie Sizemore
- Department of Psychiatry, Rutgers University Institute for Health, Health Care Policy, and Aging, New Brunswick, NJ, USA
| | - Stephen T. Russell
- Department of Human Development and Family Sciences, University of Texas at Austin School of Human Ecology, Austin, TX, USA
| | - H. Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, and Whitman-Walker Institute, Washington, DC, USA
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Gurung S, Simpson KN, Grov C, Rendina HJ, Huang TTK, Budhwani H, Jones SS, Dark T, Naar S. Cardiovascular Risk Assessment Among Adolescents and Youths Living With HIV: Evaluation of Electronic Health Record Findings and Implications. Interact J Med Res 2023; 12:e41574. [PMID: 37585242 PMCID: PMC10468705 DOI: 10.2196/41574] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 03/27/2023] [Accepted: 04/07/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND The HIV epidemic remains a major public health concern, particularly among youths living with HIV. While the availability of antiretroviral therapy has significantly improved the health outcomes of people living with HIV, there is growing evidence that youths living with HIV may be at increased risk of cardiovascular disease. However, the underlying mechanisms linking HIV and cardiovascular disease among youths living with HIV remain poorly understood. One potential explanation is that HIV-related biomarkers, including detectable viral load (VL) and low cluster of differentiation 4 (CD4) lymphocyte counts, may contribute to increased cardiovascular risk. Despite the potential importance of these biomarkers, the relationship between HIV-related biomarkers and cardiovascular risk among youths living with HIV has been understudied. OBJECTIVE To address this gap, we examined whether detectable VL and low CD4 lymphocyte counts, both of which are indications of unsuppressed HIV, were associated with cardiovascular risk among youths living with HIV. METHODS We analyzed electronic health record data from 7 adolescent HIV clinics in the United States (813 youths living with HIV). We used multivariable linear regression to examine the relationship between detectable VL and CD4 lymphocyte counts of ≤200 and cardiovascular risk scores, which were adapted from the gender-specific Framingham algorithm. RESULTS In our study, nearly half of the participants (366/766, 47.8%) had detectable VL, indicating unsuppressed HIV, while 8.6% (51/593) of them had CD4 lymphocyte counts of ≤200, suggesting weakened immune function. We found that those with CD4 lymphocyte counts of ≤200 had significantly higher cardiovascular risk, as assessed by Cardiac Risk Score2, than those with CD4 lymphocyte counts of >200 (P=.002). After adjusting for demographic and clinical factors, we found that for every 1000-point increase in VL copies/mL, the probability of having cardiovascular risk (Cardiac Risk Score2) increased by 38%. When measuring the strength of this connection, we observed a minor effect of VL on increased cardiovascular risk (β=.134, SE 0.014; P=.006). We obtained similar results with Cardiac Risk Score1, but the effect of CD4 lymphocyte counts of ≤200 was no longer significant. Overall, our findings suggest that detectable VL is associated with increased cardiovascular risk among youths living with HIV, and that CD4 lymphocyte counts may play a role in this relationship as well. CONCLUSIONS Our study highlights a significant association between unsuppressed HIV, indicated by detectable VL, and increased cardiovascular risk in youths living with HIV. These findings emphasize the importance of implementing interventions that address both VL suppression and cardiovascular risk reduction in this population. By tailoring interventions to meet the unique needs of youths, we can promote overall well-being throughout the HIV care continuum and across the life span. Ultimately, these efforts have the potential to improve the health outcomes and quality of life of youths living with HIV. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/11185.
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Affiliation(s)
- Sitaji Gurung
- Department of Health Sciences, New York City College of Technology (City Tech), The City University of New York, Brooklyn, NY, United States
| | - Kit N Simpson
- Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, SC, United States
| | - Christian Grov
- Department of Community Health and Health Policy, The City University of New York Graduate School of Public Health and Health Policy, New York, NY, United States
| | - H Jonathon Rendina
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Terry T K Huang
- Center for Systems and Community Design, The City University of New York Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Henna Budhwani
- College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Stephen Scott Jones
- Whitman-Walker Institute, The George Washington University, Washington, DC, United States
| | - Tyra Dark
- College of Medicine, Florida State University, Tallahassee, FL, United States
| | - Sylvie Naar
- College of Medicine, Florida State University, Tallahassee, FL, United States
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Gray SS, Sizemore KM, Rendina HJ. Coping Strategies as a Moderator for the Association between Intimate Partner Violence and Depression and Anxiety Symptoms among Transgender Women. Int J Environ Res Public Health 2023; 20:5927. [PMID: 37297531 PMCID: PMC10253188 DOI: 10.3390/ijerph20115927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 06/12/2023]
Abstract
Evidence suggests that intimate partner violence (IPV) is associated with negative mental health outcomes. There is currently limited research on the impact of IPV on the outcomes of mental health for transgender women. The current study aimed to examine the relationship between intimate partner violence, coping skills, depression, and anxiety in a sample of transgender women. Hierarchical regression analyses were conducted examining the relationship of IPV and depression and anxiety symptoms, where coping skills moderate this relationship. The results suggest that those with experiences of IPV are more likely to have symptoms of depression and anxiety. For individuals with no experiences of IPV and low depression, high levels of emotional processing coping and acceptance coping buffered this relationship. For individuals with more experiences of IPV and more depressive symptoms, coping skills did not show to buffer this relationship. These same coping skills did not show evidence for buffering anxiety symptoms for transgender women with low or high levels of IPV. The results, implications, and limitations of this study and suggestions for further research are discussed.
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Affiliation(s)
- Shannon S. Gray
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, 112 Paterson St., New Brunswick, NJ 08901, USA;
| | - Kayla Marie Sizemore
- Institute for Health, Healthcare Policy, and Aging Research, Rutgers University, 112 Paterson St., New Brunswick, NJ 08901, USA;
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, 125 Paterson Street, New Brunswick, NJ 08901, USA
| | - H. Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, Washington, DC 20052, USA;
- Whitman-Walker Institute, 1377 R St., NW, Suite 200, Washington, DC 20009, USA
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Lassiter JM, O'Garro-Moore JK, Anwar K, Smallwood SW, Burnett-Zeigler IE, Stepleman L, Sizemore KM, Grov C, Rendina HJ. Spirituality, self-compassion, and anxiety among sexual minority men: a longitudinal mediation analysis. Anxiety Stress Coping 2023; 36:229-240. [PMID: 35114866 PMCID: PMC9346091 DOI: 10.1080/10615806.2022.2033235] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 01/18/2022] [Accepted: 01/18/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Research related to anxiety among sexual minority men (SMM) typically focuses on risk factors. It has seldom examined factors that may be associated with lower levels of anxiety. This gap in the literature represents an opportunity to explore positive psychological factors that may be related to lower levels of anxiety among this group. Spirituality and self-compassion are two positive psychological factors that have been associated with reduced anxiety in general samples but have been understudied among SMM. This study aimed to determine the longitudinal associations between spirituality, self-compassion, and anxiety. DESIGN AND METHODS Guided by an Afrocentric psychological framework, we conducted a secondary quantitative analysis with data from a racially and ethnically diverse sample of 697 U.S. SMM. RESULTS Utilizing Hayes PROCESS Macro Model 4, we found that spirituality at baseline was positively associated with self-compassion at baseline, which in turn was inversely associated with anxiety at 12-month follow-up. CONCLUSIONS Overall, our findings provide evidence that spirituality and self-compassion are two positive psychological factors that are inversely associated with anxiety among SMM.
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Affiliation(s)
| | - Jared K O'Garro-Moore
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Kainaat Anwar
- Department of Psychology, Rowan University, Glassboro, NJ, USA
| | - Stacy W Smallwood
- Department of Health Policy & Community Health, Georgia Southern University, Statesboro, GA, USA
| | - Inger E Burnett-Zeigler
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lara Stepleman
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta, GA, USA
| | - K Marie Sizemore
- Department of Psychiatry (RWJMS), Rutgers University, New Brunswick, NJ, USA
| | - Christian Grov
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
- CUNY Institute for Implementation Science in Population Health, New York, NY, USA
| | - H Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- Whitman-Walker Institute, Washington, DC, USA
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Berke DS, Moody RL, Grov C, Rendina HJ. Psychosocial Risk Pathways from Childhood Sexual Abuse to Intimate Partner Violence among Sexual Minority Men: A Test of the Psychological Mediation Framework of Minority Stress. J Interpers Violence 2023; 38:3321-3343. [PMID: 35652430 PMCID: PMC9841749 DOI: 10.1177/08862605221106145] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Although sexual minority men experience elevated rates of childhood sexual abuse (CSA) and equal or greater rates of intimate partner violence (IPV) victimization compared to heterosexual individuals, little research has examined mechanisms linking these forms of victimization in this high-need population. We examined general (i.e., emotion regulation difficulties) and sexual minority specific (i.e., internalized homophobia) mediational pathways between CSA and IPV victimization in a longitudinal sample of 940 sexual minority men. Path analyses revealed significant associations between CSA and internalized homophobia, between internalized homophobia and emotion regulation difficulties, and between emotion regulation difficulties and IPV victimization. No indirect effects of CSA on IPV via general or minority specific pathways were observed. Findings suggest that minority stress specific (i.e., internalized homophobia) and general psychological risk factors (i.e., emotion regulation difficulties) co-occur and may function along independent pathways to link CSA to IPV revictimization. Future work is needed to investigate how mitigation of these modifiable pathways may be targeted to inform violence prevention interventions for sexual minority men.
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Affiliation(s)
- Danielle S. Berke
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- The Graduate Center of CUNY, New York, NY, USA
| | | | - Christian Grov
- Department of Community Health and Social Science, CUNY Graduate School of Public Health and Health Policy, New York, NY
| | - H. Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- The Graduate Center of CUNY, New York, NY, USA
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Robles G, López-Matos J, Cienfuegos-Szalay J, Rodríguez-Díaz CE, Rendina HJ. The use of a Spanish-translated PrEP Stigma Scale among the Latino sample of the UNITE cohort study. Stigma and Health 2023. [DOI: 10.1037/sah0000433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Sanchez T, Sizemore KM, Jimenez RH, Jones SS, Petroll AE, Rendina HJ. The Use of HIV Pre- and Postexposure Prophylaxis Among a Web-Based Sample of HIV-Negative and Unknown Status Cisgender and Transgender Sexual Minority Men: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e31237. [PMID: 36306518 PMCID: PMC9804091 DOI: 10.2196/31237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/08/2021] [Accepted: 10/28/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND HIV disproportionately affects sexual minority men (SMM) in the United States. OBJECTIVE We sought to determine past HIV postexposure prophylaxis (PEP) use and current and prior pre-exposure prophylaxis (PrEP) use among a web-based sample of cisgender and transgender men who have sex with men. METHODS In 2019, HIV-negative and unknown status SMM (n=63,015) were recruited via geosocial networking apps, social media, and other web-based venues to participate in a brief eligibility screening survey. Individuals were asked about past PEP use and current and prior PrEP use. We examined associations of demographics, socioeconomic indicators, and recent club drug use with PEP and PrEP use, as well as the association between past PEP use and current and prior PrEP use using generalized linear models and multinomial logistic regression. Statistical significance was considered at P<.001, given the large sample size; 99.9% CIs are reported. RESULTS Prior PEP use was reported by 11.28% (7108/63,015) of the participants, with current or prior PrEP use reported by 21.95% (13,832/63,015) and 8.12% (5118/63,015), respectively. Nearly half (3268/7108, 46%) of the past PEP users were current PrEP users, and another 39.9% (2836/7108) of the participants who reported past PEP use also reported prior PrEP use. In multivariable analysis, past PEP use was associated with current (relative risk ratio [RRR] 23.53, 99.9% CI 14.03-39.46) and prior PrEP use (RRR 52.14, 99.9% CI 29.39-92.50). Compared with White men, Black men had higher prevalence of past PEP use and current PrEP use, Latino men had higher prevalence of PEP use but no significant difference in PrEP use, and those identifying as another race or ethnicity reported higher prevalence of past PEP use and lower current PrEP use. Past PEP use and current PrEP use were highest in the Northeast, with participants in the Midwest and South reporting significantly lower PEP and PrEP use. A significant interaction of Black race by past PEP use with current PrEP use was found (RRR 0.57, 99.9% CI 0.37-0.87), indicating that Black men who previously used PEP were less likely to report current PrEP use. Participants who reported recent club drug use were significantly more likely to report past PEP use and current or prior PrEP use than those without recent club drug use. CONCLUSIONS PrEP use continues to be the predominant HIV prevention strategy for SMM compared with PEP use. Higher rates of past PEP use and current PrEP use among Black SMM are noteworthy, given the disproportionate burden of HIV. Nonetheless, understanding why Black men who previously used PEP are less likely to report current PrEP use is an important avenue for future research.
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Affiliation(s)
| | - K Marie Sizemore
- Department of Psychology, Hunter College of the City University of New York, New York, NY, United States
| | - Ruben H Jimenez
- Department of Psychology, Hunter College of the City University of New York, New York, NY, United States
| | - S Scott Jones
- Department of Psychology, Hunter College of the City University of New York, New York, NY, United States
| | - Andrew E Petroll
- Health Intervention Sciences Group / Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York, New York, NY, United States
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11
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Antebi-Gruszka N, Cain D, Millar BM, Parsons JT, Rendina HJ. Stress-Related Growth Among Transgender Women: Measurement, Correlates, and Insights for Clinical Interventions. J Homosex 2022; 69:1679-1702. [PMID: 33989133 DOI: 10.1080/00918369.2021.1921511] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although transgender women (TGW), and especially TGW of color, are disproportionately exposed to discrimination and violence, many of them experience stress-related growth. However, little is known about the experience of stress-related growth and its correlates among TGW. Using data from a racially-diverse sample of 210 TGW, the short version of the Stress-Related Growth Scale was modified to assess growth as a result of coming to terms with one's transgender identity among TGW. The psychometric properties of the modified scale were examined, along with its associations with various cognitive, emotional, and social factors. A confirmatory factor analysis revealed a unidimensional factor, along with excellent reliability. A stepwise regression revealed that positive reappraisal, internal locus of control, social support, and emotional expression were associated with greater stress-related growth. Findings suggest that cognitive, emotional, and social resources are related to stress-related growth in TGW. Interventions to foster stress-related growth among TGW are discussed.
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Affiliation(s)
| | - Demetria Cain
- Department of Psychology, Hunter College of the City University of New York, New York, New York, USA
| | - Brett M Millar
- Department of Psychology, Hunter College of the City University of New York, New York, New York, USA
| | | | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York, New York, New York, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York, New York, New York, USA
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12
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Taggart T, Jonathon Rendina H, Boone CA, Burns P, Carter J, English D, Hull S, Massie JS, Mbaba M, Mena L, Río-González AMD, Shalhav O, Talan AJ, Wolfer C, Bowleg L. Stigmatizing Spaces and Places as Axes of Intersectional Stigma Among Sexual Minority Men in HIV Prevention Research. Am J Public Health 2022; 112:S371-S373. [PMID: 35763746 PMCID: PMC9241459 DOI: 10.2105/ajph.2021.306676] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 02/04/2023]
Affiliation(s)
- Tamara Taggart
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - H Jonathon Rendina
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Cheriko A Boone
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Paul Burns
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Joseph Carter
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Devin English
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Shawnika Hull
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Jenné S Massie
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Mary Mbaba
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Leandro Mena
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Ana María Del Río-González
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Ore Shalhav
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Ali J Talan
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Carly Wolfer
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
| | - Lisa Bowleg
- Tamara Taggart and H. Jonathon Rendina are with the School of Public Health, George Washington University, Washington, DC. Cheriko A. Boone, Jenné S. Massie, Mary Mbaba, Ana María del Río-González, and Lisa Bowleg are with the College of Arts and Sciences, George Washington University. Paul Burns is with the School of Public Health, University of Mississippi Medical Center, Jackson. Joseph Carter, Ore Shalhav, and Carly Wolfer are with the School of Arts and Sciences, Hunter College, New York, NY. Devin English is with the School of Public Health, Rutgers University, New Brunswick, NJ. Shawnika Hull is with the School of Communication and Information, Rutgers University. Leandro Mena is with the School of Population Health, University of Mississippi Medical Center. Ali J. Talan is with Whitman-Walker Institute, Inc., Washington, DC
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13
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Talan AJ, Shalhav O, Tilove A, Wolfer C, English D, Patel V, Jonathon Rendina H. Capturing Daily Experiences of Intersectional Stigma Among Young Sexual Minority Men in HIV Prevention Research. Am J Public Health 2022; 112:S398-S400. [PMID: 35763731 PMCID: PMC9241455 DOI: 10.2105/ajph.2022.306726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Ali J Talan
- H. Jonathon Rendina is with George Washington University Milken Institute School of Public Health and Whitman-Walker Institute, Washington, DC. Ali J. Talan and Ore Shalhav are with Whitman-Walker Institute. Aria Tilove is with Hunter College of the City University of New York (CUNY), New York, NY. Carly Wolfer is with the Graduate Center of CUNY. Devin English is with the Rutgers School of Public Health, Newark, NJ. Viraj Patel is with Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY. Note. Data collection for this study was conducted at Hunter College of CUNY, and affiliations reflect authors' institutions at the time of the most recent article submission, which were not directly involved in the human participants' portion of the research
| | - Ore Shalhav
- H. Jonathon Rendina is with George Washington University Milken Institute School of Public Health and Whitman-Walker Institute, Washington, DC. Ali J. Talan and Ore Shalhav are with Whitman-Walker Institute. Aria Tilove is with Hunter College of the City University of New York (CUNY), New York, NY. Carly Wolfer is with the Graduate Center of CUNY. Devin English is with the Rutgers School of Public Health, Newark, NJ. Viraj Patel is with Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY. Note. Data collection for this study was conducted at Hunter College of CUNY, and affiliations reflect authors' institutions at the time of the most recent article submission, which were not directly involved in the human participants' portion of the research
| | - Aria Tilove
- H. Jonathon Rendina is with George Washington University Milken Institute School of Public Health and Whitman-Walker Institute, Washington, DC. Ali J. Talan and Ore Shalhav are with Whitman-Walker Institute. Aria Tilove is with Hunter College of the City University of New York (CUNY), New York, NY. Carly Wolfer is with the Graduate Center of CUNY. Devin English is with the Rutgers School of Public Health, Newark, NJ. Viraj Patel is with Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY. Note. Data collection for this study was conducted at Hunter College of CUNY, and affiliations reflect authors' institutions at the time of the most recent article submission, which were not directly involved in the human participants' portion of the research
| | - Carly Wolfer
- H. Jonathon Rendina is with George Washington University Milken Institute School of Public Health and Whitman-Walker Institute, Washington, DC. Ali J. Talan and Ore Shalhav are with Whitman-Walker Institute. Aria Tilove is with Hunter College of the City University of New York (CUNY), New York, NY. Carly Wolfer is with the Graduate Center of CUNY. Devin English is with the Rutgers School of Public Health, Newark, NJ. Viraj Patel is with Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY. Note. Data collection for this study was conducted at Hunter College of CUNY, and affiliations reflect authors' institutions at the time of the most recent article submission, which were not directly involved in the human participants' portion of the research
| | - Devin English
- H. Jonathon Rendina is with George Washington University Milken Institute School of Public Health and Whitman-Walker Institute, Washington, DC. Ali J. Talan and Ore Shalhav are with Whitman-Walker Institute. Aria Tilove is with Hunter College of the City University of New York (CUNY), New York, NY. Carly Wolfer is with the Graduate Center of CUNY. Devin English is with the Rutgers School of Public Health, Newark, NJ. Viraj Patel is with Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY. Note. Data collection for this study was conducted at Hunter College of CUNY, and affiliations reflect authors' institutions at the time of the most recent article submission, which were not directly involved in the human participants' portion of the research
| | - Viraj Patel
- H. Jonathon Rendina is with George Washington University Milken Institute School of Public Health and Whitman-Walker Institute, Washington, DC. Ali J. Talan and Ore Shalhav are with Whitman-Walker Institute. Aria Tilove is with Hunter College of the City University of New York (CUNY), New York, NY. Carly Wolfer is with the Graduate Center of CUNY. Devin English is with the Rutgers School of Public Health, Newark, NJ. Viraj Patel is with Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY. Note. Data collection for this study was conducted at Hunter College of CUNY, and affiliations reflect authors' institutions at the time of the most recent article submission, which were not directly involved in the human participants' portion of the research
| | - H Jonathon Rendina
- H. Jonathon Rendina is with George Washington University Milken Institute School of Public Health and Whitman-Walker Institute, Washington, DC. Ali J. Talan and Ore Shalhav are with Whitman-Walker Institute. Aria Tilove is with Hunter College of the City University of New York (CUNY), New York, NY. Carly Wolfer is with the Graduate Center of CUNY. Devin English is with the Rutgers School of Public Health, Newark, NJ. Viraj Patel is with Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY. Note. Data collection for this study was conducted at Hunter College of CUNY, and affiliations reflect authors' institutions at the time of the most recent article submission, which were not directly involved in the human participants' portion of the research
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14
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Earnshaw VA, Jonathon Rendina H, Bauer GR, Bonett S, Bowleg L, Carter J, English D, Friedman MR, Hatzenbuehler ML, Johnson MO, McCree DH, Neilands TB, Quinn KG, Robles G, Scheim AI, Smith JC, Smith LR, Sprague L, Taggart T, Tsai AC, Turan B, Yang LH, Bauermeister JA, Kerrigan DL. Methods in HIV-Related Intersectional Stigma Research: Core Elements and Opportunities. Am J Public Health 2022; 112:S413-S419. [PMID: 35763749 PMCID: PMC9241464 DOI: 10.2105/ajph.2021.306710] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2021] [Indexed: 02/04/2023]
Abstract
Researchers are increasingly recognizing the importance of studying and addressing intersectional stigma within the field of HIV. Yet, researchers have, arguably, struggled to operationalize intersectional stigma. To ensure that future research and methodological innovation is guided by frameworks from which this area of inquiry has arisen, we propose a series of core elements for future HIV-related intersectional stigma research. These core elements include multidimensional, multilevel, multidirectional, and action-oriented methods that sharpen focus on, and aim to transform, interlocking and reinforcing systems of oppression. We further identify opportunities for advancing HIV-related intersectional stigma research, including reducing barriers to and strengthening investments in resources, building capacity to engage in research and implementation of interventions, and creating meaningful pathways for HIV-related intersectional stigma research to produce structural change. Ultimately, the expected payoff for incorporating these core elements is a body of HIV-related intersectional stigma research that is both better aligned with the transformative potential of intersectionality and better positioned to achieve the goals of Ending the HIV Epidemic in the United States and globally. (Am J Public Health. 2022;112(S4):S413-S419. https://doi.org/10.2105/AJPH.2021.306710).
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Affiliation(s)
- Valerie A Earnshaw
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - H Jonathon Rendina
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Greta R Bauer
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Stephen Bonett
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Lisa Bowleg
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Joseph Carter
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Devin English
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - M Reuel Friedman
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Mark L Hatzenbuehler
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Mallory O Johnson
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Donna H McCree
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Torsten B Neilands
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Katherine G Quinn
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Gabriel Robles
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Ayden I Scheim
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Justin C Smith
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Laramie R Smith
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Laurel Sprague
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Tamara Taggart
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Alexander C Tsai
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Bulent Turan
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Lawrence H Yang
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - José A Bauermeister
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Deanna L Kerrigan
- Valerie A. Earnshaw is with the Department of Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark. H. Jonathon Rendina is with the Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC. Greta R. Bauer is with the Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Stephen Bonett is with the School of Nursing, University of Pennsylvania, Philadelphia. Lisa Bowleg is an AJPH Associate Editor and is with the Department of Psychological and Brain Sciences, George Washington University. Joseph Carter is with the Department of Psychology, Hunter College, New York, NY. Devin English is with the Department of Urban-Global Public Health, School of Public Health, Rutgers University, New Brunswick, NJ. M. Reuel Friedman is with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Mark L. Hatzenbuehler is with the Department of Psychology, Harvard University, Cambridge, MA. Mallory O. Johnson and Torsten B. Neilands are with the Department of Medicine, University of California, San Francisco. Donna H. McCree is with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Katherine G. Quinn is with the Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee. Gabriel Robles is with the School of Social Work, Rutgers University, New Brunswick. Ayden I. Scheim is with the Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Justin C. Smith is with Positive Impact Health Centers, Atlanta. Laramie R. Smith is with the Division of Global Public Health and Infectious Diseases, School of Medicine, University of California, San Diego. Laurel Sprague is with the Department of Gender Equality, Human Rights, and Community Engagement, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland. Tamara Taggart and Deanna L. Kerrigan are with the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University. Alexander C. Tsai is with the Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston. Bulent Turan is with the Department of Psychology, Koc University, Istanbul, Turkey. Lawrence H. Yang is with the Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY. José A. Bauermeister is with the Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia. Note. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
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Cienfuegos-Szalay J, Moody RL, Talan A, Grov C, Rendina HJ. Sexual Shame and Emotion Dysregulation: Key Roles in the Association between Internalized Homonegativity and Sexual Compulsivity. J Sex Res 2022; 59:610-620. [PMID: 34410183 PMCID: PMC8976551 DOI: 10.1080/00224499.2021.1963649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Sexual minority men (SMM) are at increased risk for mental health problems due to effects of sexual minority stigma (e.g., internalized homonegativity (IH)). Both IH and emotion dysregulation are contributors to sexual compulsivity; however, the role of feelings of sexual shame have not been examined in this association. A sample of 982 HIV-negative SMM completed online surveys (Mage = 42.4, SD = 13.74). Path analyses indicated significant direct effects of IH on sexual shame (β = 0.44, p < .001), emotion dysregulation (β = 0.19, p < .001), and sexual compulsivity (β = 0.22, p < .001). Modeled simultaneously, the association between sexual shame and sexual compulsivity (β = 0.26, p < .001) was significant, as was the association between emotion dysregulation and sexual compulsivity (β = 0.27, p < .001). Finally, an indirect effect of IH on sexual compulsivity through both sexual shame (p < .001) and emotion dysregulation (p < .001) was significant, and the association between IH and sexual compulsivity was reduced to non-significant (β = 0.01, p = .74). Targeting feelings of sexual shame and emotion dysregulation in clinical interventions may help reduce the negative health impact of sexual compulsivity among SMM.
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Affiliation(s)
- Jorge Cienfuegos-Szalay
- Department of Psychology, Hunter College of the City University of New York (CUNY)
- Health Psychology and Clinical Science PhD Program, The Graduate Center of the City University of New York (CUNY)
| | - Raymond L Moody
- Department of Psychology, Hunter College of the City University of New York (CUNY)
- Health Psychology and Clinical Science PhD Program, The Graduate Center of the City University of New York (CUNY)
| | - Ali Talan
- Department of Psychology, Hunter College of the City University of New York (CUNY)
| | - Christian Grov
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY)
- Health Psychology and Clinical Science PhD Program, The Graduate Center of the City University of New York (CUNY)
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16
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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. J Res Adolesc 2022; 32:226-243. [PMID: 35166417 PMCID: PMC9047029 DOI: 10.1111/jora.12726] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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17
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Lee JJ, Rao DW, Robles G, Kerani RP, Naismith K, Rodriguez-Díaz CE, Rendina HJ, Katz DA. Differences in HIV Risk and Prevention Among Cisgender Latino Sexual Minority Men by Language of Online Survey Completion: Analysis of National and Washington State Data. AIDS Behav 2022; 26:662-673. [PMID: 34405303 PMCID: PMC9132616 DOI: 10.1007/s10461-021-03426-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
Internet-based surveys can be programmed and advertised in multiple languages to reach non-English-speaking individuals, but it is unclear the extent to which this enhances the diversity of participants and supports inclusion of individuals at higher risk for HIV. We sought to examine how language of survey completion (English or Spanish) was associated with sociodemographic characteristics and indicators of HIV risk and prevention among cisgender Latino sexual minority men (SMM). We analyzed national and Washington State data using the Understanding New Infections through Targeted Epidemiology (UNITE) Cohort Study (2017 and 2018) and the Washington HIV/STI Prevention Project (WHSPP) survey (2017 and 2018/2019), respectively. Latino SMM who completed online surveys in Spanish differed from those who completed surveys in English across several sociodemographic characteristics including age, education, and income. After adjusting for sociodemographic characteristics and HIV-related risk factors, Spanish language respondents in UNITE were less likely to have tested for HIV in the past year, and those in WHSPP were more likely to report a recent STI diagnosis. Findings suggest that Latino SMM who complete surveys in Spanish comprise a unique subgroup that may have a specific HIV health and risk behavior profile. Our results suggest a need for increased and tailored efforts to recruit and include Spanish-speaking Latino SMM for local and national research and public health programming.
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Affiliation(s)
- Jane J Lee
- School of Social Work, University of Washington, 4101 15th Ave NE, Seattle, WA, 98105, USA.
| | - Darcy White Rao
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Roxanne P Kerani
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Kelly Naismith
- Washington State Department of Health, Tumwater, WA, USA
| | - Carlos E Rodriguez-Díaz
- The George Washington University-Milken Institute School of Public Health, Washington, DC, USA
| | - H Jonathon Rendina
- The George Washington University-Milken Institute School of Public Health, Washington, DC, USA
| | - David A Katz
- Department of Global Health, University of Washington, Seattle, WA, USA
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Sizemore KM, Talan A, Gray S, Forbes N, Park HH, Rendina HJ. Attachment buffers against the association between childhood sexual abuse, depression, and substance use problems among transgender women: a moderated-mediation model. Psychology & Sexuality 2021. [DOI: 10.1080/19419899.2021.2019095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- K. Marie Sizemore
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NY, United States
| | - Ali Talan
- Whitman-Walker Institute, Washington, District of Columbia, United States
| | - Shannon Gray
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NY, United States
| | - Nicola Forbes
- Department of Applied Developmental Psychology, Fordham University, New York, NJ, United States
| | - Hannah Hyejin Park
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NY, United States
| | - H. Jonathon Rendina
- Whitman-Walker Institute, Washington, District of Columbia, United States
- The George Washington University- Milken Institute School of Public Health, Washington, District of Columbia, United States
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Scheer JR, Clark KA, Talan A, Cabral C, Pachankis JE, Rendina HJ. Longitudinal associations between childhood sexual abuse-related PTSD symptoms and passive and active suicidal ideation among sexual minority men. Child Abuse Negl 2021; 122:105353. [PMID: 34638046 PMCID: PMC8612966 DOI: 10.1016/j.chiabu.2021.105353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Sexual minority men report high rates of childhood sexual abuse (CSA) and adulthood suicidality. However, mechanisms (e.g., PTSD symptoms) through which CSA might drive suicidality remain unknown. OBJECTIVE In a prospective cohort of sexual minority men, we examined: (1) associations between CSA and suicidal thoughts and behaviors; (2) prospective associations between CSA-related PTSD symptoms and suicidal ideation; and (3) interpersonal moderators of these associations. PARTICIPANTS AND SETTING Participants included 6305 sexual minority men (Mage = 33.2, SD = 11.5; 82.0% gay; 53.5% White) who completed baseline and one-year follow-up at-home online surveys. METHODS Bivariate analyses were used to assess baseline demographic and suicidality differences between CSA-exposed participants and non-CSA-exposed participants. Among CSA-exposed participants, multivariable logistic regression analyses were used to regress passive and active suicidal ideation at one-year follow-up on CSA-related PTSD symptoms at baseline. Interactions were examined between CSA-related PTSD symptoms and interpersonal difficulties. RESULTS CSA-exposed sexual minority men reported two-and-a-half times the odds of suicide attempt history compared to non-CSA-exposed men (95% CI = 2.15-2.88; p < 0.001). Among CSA-exposed sexual minority men, CSA-related PTSD symptoms were prospectively associated with passive suicidal ideation (adjusted odds ratio [aOR] = 1.38; 95% CI = 1.19; 1.61). Regardless of CSA-related PTSD symptom severity, those with lower social support and greater loneliness were at elevated risk of active suicidal ideation at one-year follow-up. CONCLUSIONS CSA-related PTSD symptom severity represents a psychological mechanism contributing to CSA-exposed sexual minority men's elevated suicide risk, particularly among those who lack social support and report loneliness.
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Affiliation(s)
- Jillian R Scheer
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse NY 13244, USA.
| | - Kirsty A Clark
- Department of Medicine, Health & Society, Vanderbilt University, Nashville, TN 37212, USA
| | - Ali Talan
- Whitman-Walker Institute, Inc., Washington, DC 20009, USA
| | - Cynthia Cabral
- Counseling and Wellness Center, St. Joseph's College, Brooklyn, NY 11205, USA
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - H Jonathon Rendina
- Whitman-Walker Institute, Inc., Washington, DC 20009, USA; Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
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20
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Skeen SJ, Starks TJ, Jimenez RH, Rendina HJ, Cain D. Heterosexual Cisgender Men Partnered with Transgender Women Exhibit Higher HIV/STI Sexual Risk than Their Gay, Bisexual, and Queer Counterparts: Findings from a U.S.-Based Convenience Sample Recruited Online. AIDS Behav 2021; 25:3279-3291. [PMID: 34050403 PMCID: PMC10062375 DOI: 10.1007/s10461-021-03314-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 01/15/2023]
Abstract
Cisgender men are frequently vectors for HIV transmission among transgender women. Despite this, the correlates of sexual risk among these men remain under-examined. The purpose of the present study was to explore potential differences in relationship characteristics, sexual risk-taking, and risk-reduction strategies among cisgender men partnered with transgender women. The study utilized secondary screening data provided by adult cis men who reported being in a primary relationship with a trans woman (N = 710). Gay men (18%) were comparatively older, and most likely to report both HIV seropositivity and committed pairings. Heterosexual men (14%) were more likely to report exchange sex, briefer relationships, extra-dyadic sex, lesser serostatus awareness or PrEP uptake. Queer men (7%) were youngest, and most likely to access PrEP. Heterosexual cis men with trans women partners may be subject to unique socio-cultural drivers of sexual risk, such as heteronormative pressures and relationship stigma.
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Affiliation(s)
- Simone J Skeen
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA.
- School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA.
| | - Tyrel J Starks
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science PhD Program, The Graduate Center, CUNY, New York, NY, USA
| | - Ruben H Jimenez
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
| | - H Jonathon Rendina
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science PhD Program, The Graduate Center, CUNY, New York, NY, USA
| | - Demetria Cain
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
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21
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Rendina HJ, Talan A, Sizemore KM, Tavella NF, Salfas B, Shalhav O, Westmoreland D, Mustanski B, Rodríguez-Díaz CE. Examining inequities in rates of undiagnosed HIV and rectal STIs in a large nationwide cohort study of sexual minority men. Sex Transm Infect 2021; 98:269-276. [PMID: 34193532 PMCID: PMC9120386 DOI: 10.1136/sextrans-2021-055047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/09/2021] [Indexed: 11/25/2022] Open
Abstract
Objective Sexual minority men (SMM) of colour are disproportionately impacted by HIV and bacterial STIs (bSTIs). To better understand within-group heterogeneity and differential risk factors by race and ethnicity, we sought to examine rates of undiagnosed HIV and rectal bSTI at the intersection of racial and ethnic identity with other sociodemographic factors. Methods We examined data from 8105 SMM conducting home-based self-testing at enrolment in a nationwide cohort study collected from November 2017 to August 2018. We conducted analyses stratified by racial and ethnic groups to examine within-group (ie, subgroup) unadjusted rates of HIV and rectal bSTI infection across a range of characteristics. Results Rates of undiagnosed HIV were highest among Black (4.3%, n=39) and Latino (2.4%, n=38) SMM, with lower rates among those identified as multiracial (1.6%, n=15), white (1.3%, n=56) and other races (1.3%, n=6). Across the stratified analyses of HIV infection, 15 significant associations emerged showing that age, region, insurance type, sexual positioning and incarceration history had differential impacts across racial and ethnic groups. In particular, private and public insurance were protective against HIV for white but not Black and Latino SMM, and incarceration was associated with substantially higher rates of HIV infection for Black and Latino SMM relative to white SMM. We found significant co-occurrence of HIV and bSTI rates for participants who identified as Latino (OR=7.5, 95% CI 2.12 to 26.54), white (OR=3.19, 95% CI 1.14 to 8.98) and multiracial (OR=5.5, 95% CI 1.08 to 27.90), but not those who identified as Black (OR=0.82, 95% CI 0.10 to 6.56) or other races (OR=3.56 95% CI 0.31 to 40.80). Conclusions Stratified analyses showed differential rates of HIV infection at the intersection of racial and ethnic groups with other characteristics, particularly insurance status and incarceration history, pointing to structural inequities rather than individual behaviours underlying disproportionately high rates of HIV for Black and Latino SMM.
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Affiliation(s)
- H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
| | - Ali Talan
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
| | - K Marie Sizemore
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
| | - Nicola F Tavella
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
| | - Brian Salfas
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
| | - Ore Shalhav
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
| | - Drew Westmoreland
- Institute for Implementation Science in Population Health, CUNY Graduate School for Public Health and Health Policy, New York, New York, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Carlos E Rodríguez-Díaz
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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22
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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: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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23
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Kohn JN, Loop MS, Kim-Chang JJ, Garvie PA, Sleasman JW, Fischer B, Rendina HJ, Woods SP, Nichols SL, Hong S. Trajectories of Depressive Symptoms, Neurocognitive Function, and Viral Suppression With Antiretroviral Therapy Among Youth With HIV Over 36 months. J Acquir Immune Defic Syndr 2021; 87:851-859. [PMID: 33587499 PMCID: PMC8131211 DOI: 10.1097/qai.0000000000002653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/30/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Depression and neurocognitive impairment are highly prevalent among persons living with HIV and associated with poorer clinical outcomes; however, longitudinal studies of depression-neurocognition relationships in youth living with HIV (YLWH), and the role of antiretroviral therapy (ART), are lacking. This study tested whether (1) depressive symptomatology, across somatic, cognitive, and affective symptom domains, improved with ART and (2) more severe depressive symptoms at baseline were associated with poorer neurocognitive function and poorer HIV suppression. SETTING Data were collected from 181 YLWH (18-24 years) who were treatment-naive, a subset of whom (n = 116) initiated ART. METHODS Participants were categorized into elevated (DS) or nonelevated (non-DS) depressive symptom groups at entry (Beck Depression Inventory-II ≥14) and followed for 36 months. Neurocognition (5-domain battery) and depressive symptoms were repeatedly assessed. Longitudinal models examined depressive symptomatology, neurocognition, and odds of HIV nonsuppression by group. RESULTS Greater improvements in depressive symptoms were observed in the DS group over 36 months [beta = -0.14, (-0.24 to -0.03)], particularly within cognitive and affective domains. Verbal learning performance increased in the DS group [beta = 0.13, (0.01 to 0.24)], whereas psychomotor function improved somewhat in the non-DS group [beta = -0.10, (-0.22 to 0.00)]. Adjusted for ART adherence, odds of HIV nonsuppression did not significantly differ by group [odds ratio = 0.22, (0.04 to 1.23)]; however, greater somatic symptoms at study entry were associated with an increased risk of nonsuppression over time [odds ratio = 2.33 (1.07 to 5.68)]. CONCLUSION Depressive symptoms were associated with differential neurocognitive trajectories, and somatic depressive symptoms at baseline may predict poorer subsequent HIV suppression. Identifying and treating depressive symptoms at ART initiation may benefit neurocognitive and clinical outcomes in YLWH.
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Affiliation(s)
- Jordan N. Kohn
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Matthew Shane Loop
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina Chapel Hill, Chapel Hill, NC
| | - Julie J. Kim-Chang
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | | | - John W. Sleasman
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | - Bernard Fischer
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | | | | | - Sharon L. Nichols
- Department of Neurosciences, University of California San Diego, La Jolla, CA
| | - Suzi Hong
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA
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Schnarrs PW, Jones SS, Parsons JT, Baldwin A, Rosenberger JG, Lunn MR, Rendina HJ. Sexual Subcultures and HIV Prevention Methods: An Assessment of Condom Use, PrEP, and TasP Among Gay, Bisexual, and Other Men Who Have Sex with Men Using a Social and Sexual Networking Smartphone Application. Arch Sex Behav 2021; 50:1781-1792. [PMID: 32728870 PMCID: PMC10388693 DOI: 10.1007/s10508-020-01784-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
Abstract
Despite being grouped together in epidemiological risk categories, gay, bisexual, and other men who have sex with men (GBM) are not a homogenous group. In addition to traditional segmentation along race, ethnicity, and socioeconomic status, many GBM also identify with sexual subcultural communities. Previous research has shown differences across a variety of health outcomes between these sexual subcultural communities. The purpose of this study was to determine whether HIV prevention practices among GBM differed according to sexual subcultural community. The study was conducted in collaboration with a popular social and sexual networking smartphone application company. A total of 23,577 GBM responded to the survey. A latent class analysis identified 6 distinct classes related to sexual subcultural community identification. We found significant differences across sociodemographic characteristics, HIV prevention practices, and condomless anal sex in the past 6 months related to sexual subculture identification. Findings suggest that sexual subcultural identity is related to decision-making around HIV prevention among GBM. Differences in HIV prevention strategies are likely a function of group norms, unique shared experiences among GBM identifying with a particular sexual subculture community, and sociodemographic characteristics associated with these groups. As such, sexual subculture identity should be considered in developing interventions and social marketing campaigns to increase uptake of biomedical HIV prevention tools among GBM. Identifying group norms and shared experiences related to HIV prevention practices among sexual subcultures is necessary to understand the role these identities play in lives of GBM, especially as it relates to their sexual health and well-being.
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Affiliation(s)
- Philip W Schnarrs
- Division of Community Engagement and Health Equity, Department of Population Health, Dell Medical School, The University of Texas at Austin, Health Discovery Building 4.814, 1601 Trinity Street, Austin, TX, 78712, USA.
- The Population Research Center, The University of Texas at Austin, Austin, TX, USA.
| | - Stephen Scott Jones
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
| | - Jeffrey T Parsons
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
| | - Aleta Baldwin
- Department of Public Health, California State University at Sacramento, Sacramento, CA, USA
| | - Joshua G Rosenberger
- Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA
| | - Mitchell R Lunn
- Division of Nephrology, Department of Medicine, Stanford University, Stanford, CA, USA
- The PRIDE Study/PRIDEnet, Stanford University, Stanford, CA, USA
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
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25
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Moskowitz DA, Rendina HJ, Alvarado Avila A, Mustanski B. Demographic and social factors impacting coming out as a sexual minority among Generation-Z teenage boys. Psychology of Sexual Orientation and Gender Diversity 2021. [DOI: 10.1037/sgd0000484] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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26
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Rendina HJ, Talan AJ, Tavella NF, Matos JL, Jimenez RH, Jones SS, Salfas B, Westmoreland D. Leveraging Technology to Blend Large-Scale Epidemiologic Surveillance With Social and Behavioral Science Methods: Successes, Challenges, and Lessons Learned Implementing the UNITE Longitudinal Cohort Study of HIV Risk Factors Among Sexual Minority Men in the United States. Am J Epidemiol 2021; 190:681-695. [PMID: 33057684 PMCID: PMC8024044 DOI: 10.1093/aje/kwaa226] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 10/01/2020] [Accepted: 10/08/2020] [Indexed: 12/20/2022] Open
Abstract
The use of digital technologies to conduct large-scale research with limited interaction (i.e., no in-person contact) and objective endpoints (i.e., biological testing) has significant potential for the field of epidemiology, but limited research to date has been published on the successes and challenges of such approaches. We analyzed data from a cohort study of sexual minority men across the United States, collected using digital strategies during a 10-month period from 2017 to 2018. Overall, 113,874 individuals were screened, of whom 26,000 were invited to the study, 10,691 joined the study, and 7,957 completed all enrollment steps, including return of a human immunodeficiency virus-negative sample. We examined group differences in completion of the steps towards enrollment to inform future research and found significant differences according to several factors, including age and race. This study adds to prior work to provide further proof-of-concept for this limited-interaction, technology-mediated methodology, highlighting some of its strengths and challenges, including rapid access to more diverse populations but also potential for bias due to differential enrollment. This method has strong promise, and future implementation research is needed to better understand the roles of burden, privacy, access, and compensation, to enhance representativeness and generalizability of the data generated.
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Affiliation(s)
- H Jonathon Rendina
- Correspondence to Dr. H. Jonathon Rendina, Department of Psychology, Hunter College of the City University of New York, 695 Park Avenue, New York, NY 10065 (e-mail: )
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27
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Ventuneac A, Hecht G, Forcht E, Duah BA, Tarar S, Langenbach B, Gates J, Cain D, Rendina HJ, Aberg JA, Perlman DC. Chronic High Risk Prescription Opioid Use Among Persons With HIV. Front Sociol 2021; 6:645992. [PMID: 34095287 PMCID: PMC8176351 DOI: 10.3389/fsoc.2021.645992] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/26/2021] [Indexed: 05/07/2023]
Abstract
Persons with HIV (PWH) are a population at risk for adverse sequelae of opioid use. Yet, few studies have examined correlates of chronic high risk opioid use and its impact on HIV outcomes. Trends in prescribing patterns and identification of factors that impact the use of opioid prescriptions among PWH are crucial to determine prevention and treatment interventions. This study examined electronic medical records (EMR) of patients receiving HIV care to characterize prescribing patterns and identify risk factors for chronic high risk prescription opioid use and the impact on HIV outcomes among PWH in primary care from July 1, 2016-December 31, 2017. EMR were analyzed from 8,882 patients who were predominantly male and ethnically and racially diverse with half being 50 years of age or older. The majority of the 8,744 prescriptions (98% oral and 2% transdermal preparations) given to 1,040 (12%) patients were oxycodone (71%), 8% were morphine, 7% tramadol, 4% hydrocodone, 4% codeine, 2% fentanyl, and 4% were other opioids. The number of monthly prescriptions decreased about 14% during the study period. Bivariate analyses indicated that most demographic and clinical variables were associated with receipt of any opioid prescription. After controlling for patient socio-demographic characteristics and clinical factors, the odds of receipt of any prescription were higher among patients with pain diagnoses and opioid use and mental health disorders. In addition, the odds of receipt of high average daily morphine equivalent dose (MED) prescriptions were higher for patients with pain diagnoses. Lastly, patients with substance use disorders (SUD) had an increased likelihood of detectable viral load compared to patients with no SUD, after adjusting for known covariates. Our findings show that despite opioid prescribing guidelines and monitoring systems, additional efforts are needed to prevent chronic high risk prescriptions in patients with comorbid conditions, including pain-related, mental health and substance use disorders. Evidence about the risk for chronic high risk use based on prescribing patterns could better inform pain management and opioid prescribing practices for patients receiving HIV care.
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Affiliation(s)
- Ana Ventuneac
- Icahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United States
- *Correspondence: Ana Ventuneac,
| | - Gavriella Hecht
- Icahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United States
| | - Emily Forcht
- Icahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United States
| | - Bianca A. Duah
- Icahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United States
| | - Shafaq Tarar
- Icahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United States
| | - Blanche Langenbach
- Icahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United States
| | - Jay Gates
- Icahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United States
| | - Demetria Cain
- Department of Psychology, Hunter College, City University of New York, NY, NY, United States
| | - H. Jonathon Rendina
- Department of Psychology, Hunter College, City University of New York, NY, NY, United States
- Health Psychology and Clinical Science PhD Program, The Graduate Center, City University of New York, NY, NY, United States
| | - Judith A. Aberg
- Icahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United States
| | - David C. Perlman
- Icahn School of Medicine at Mount Sinai, Division of Infectious Diseases, NY, NY, United States
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Layland EK, Carter JA, Perry NS, Cienfuegos-Szalay J, Nelson KM, Bonner CP, Rendina HJ. A systematic review of stigma in sexual and gender minority health interventions. Transl Behav Med 2020; 10:1200-1210. [PMID: 33044540 PMCID: PMC7549413 DOI: 10.1093/tbm/ibz200] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Stigma against sexual and gender minorities is a major driver of health disparities. Psychological and behavioral interventions that do not address the stigma experienced by sexual and gender minorities may be less efficacious. We conducted a systematic review of existing psychological and behavioral health interventions for sexual and gender minorities to investigate how interventions target sexual and gender minority stigma and consider how stigma could affect intervention efficacy. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Eligible studies were peer reviewed and published in English between January 2003 and July 2019 and reported empirical results of behavioral or psychological interventions implemented among sexual and gender minorities. All interventions addressed stigma. We identified 37 eligible interventions. Most interventions targeted sexual minority men. Interventions were frequently developed or adapted for implementation among sexual and gender minorities and addressed multiple levels and types of stigma. Interventions most frequently targeted proximal stressors, including internalized and anticipated stigma. HIV and mental health were the most commonly targeted health outcomes. A limited number of studies investigated the moderating or mediating effects of stigma on intervention efficacy. The application of an intersectional framework was frequently absent and rarely amounted to addressing sources of stigma beyond sexual and gender minority identities. A growing number of interventions address sexual and gender minority stigma in an effort to prevent deleterious health effects. Future research is needed to assess whether stigma modifies the effectiveness of existing psychological and behavioral interventions among sexual and gender minorities. Further, the application of intersectional frameworks is needed to more comprehensively intervene on multiple, intersecting sources of stigma faced by the diverse sexual and gender minority community.
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Affiliation(s)
- Eric K Layland
- Human Development and Family Studies Department, The Pennsylvania State University, University Park, PA, USA,Correspondence to: E. K. Layland,
| | - Joseph A Carter
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA,Health Psychology and Clinical Science PhD Program, The Graduate Center, City University of New York, New York, NY, USA
| | - Nicholas S Perry
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Jorge Cienfuegos-Szalay
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA,Health Psychology and Clinical Science PhD Program, The Graduate Center, City University of New York, New York, NY, USA
| | | | - Courtney Peasant Bonner
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - H Jonathon Rendina
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA,Health Psychology and Clinical Science PhD Program, The Graduate Center, City University of New York, New York, NY, USA
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Rendina HJ, Talan AJ, Cienfuegos-Szalay J, Carter JA, Shalhav O. Treatment Is More Than Prevention: Perceived Personal and Social Benefits of Undetectable = Untransmittable Messaging Among Sexual Minority Men Living with HIV. AIDS Patient Care STDS 2020; 34:444-451. [PMID: 33064015 DOI: 10.1089/apc.2020.0137] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Research suggests that the science of undetectable viral load (VL) status and HIV transmission-conveyed with the slogan "Undetectable = Untransmittable" or "U = U"-has gaps in acceptance despite robust scientific evidence. Nonetheless, growing acceptance of U = U creates conditions for a shift in the sociopolitical and personal implications of viral suppression. We conducted an online survey over a 23-month period in 2018 and 2019 among 30,361 adolescent and adult (aged 13-99) sexual minority men living with HIV (SMM-LHIV) across the United States. We examined the impact of U = U on self-image, potential for changing societal HIV stigma, whether SMM-LHIV had ever spoken with a provider about viral suppression and HIV transmission, and primary sources of hearing about U = U. Approximately 80% of SMM-LHIV reported that U = U was beneficial for their self-image and societal HIV stigma, 58.6% reported it made them feel "much better" about their own HIV status, and 40.6% reporting it had the potential to make HIV stigma "much better." The most consistent factors associated with these beliefs centered around care engagement, particularly self-reported viral suppression and excellent antiretroviral therapy adherence. Two-thirds reported ever talking to a provider about VL and HIV transmission, although the primary sources for having heard about U = U were HIV and lesbian, gay, bisexual, transgender, and queer (LGBTQ) news media and personal profiles on networking apps. These findings demonstrate the significant personal and social importance of U = U for SMM-LHIV that go above-and-beyond the well-documented health benefits of viral suppression, suggesting that providers should consider routinely initiating conversations with patients around the multifaceted benefits (personal health, sexual safety and intimacy, increased self-image, and reduced social stigma) of viral suppression.
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Affiliation(s)
- H. Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
- Health Psychology and Clinical Science PhD Program, The Graduate Center of the City University of New York (CUNY), New York, New York, USA
| | - Ali J. Talan
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
| | - Jorge Cienfuegos-Szalay
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
- Health Psychology and Clinical Science PhD Program, The Graduate Center of the City University of New York (CUNY), New York, New York, USA
| | - Joseph A. Carter
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
- Health Psychology and Clinical Science PhD Program, The Graduate Center of the City University of New York (CUNY), New York, New York, USA
| | - Ore Shalhav
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, New York, USA
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Mustanski B, Moskowitz DA, Moran KO, Newcomb ME, Macapagal K, Rodriguez-Díaz C, Rendina HJ, Laber EB, Li DH, Matson M, Talan AJ, Cabral C. Evaluation of a Stepped-Care eHealth HIV Prevention Program for Diverse Adolescent Men Who Have Sex With Men: Protocol for a Hybrid Type 1 Effectiveness Implementation Trial of SMART. JMIR Res Protoc 2020; 9:e19701. [PMID: 32779573 PMCID: PMC7448177 DOI: 10.2196/19701] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/07/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Adolescent men who have sex with men (AMSM), aged 13 to 18 years, account for more than 80% of teen HIV occurrences. Despite this disproportionate burden, there is a conspicuous lack of evidence-based HIV prevention programs. Implementation issues are critical as traditional HIV prevention delivery channels (eg, community-based organizations, schools) have significant access limitations for AMSM. As such, eHealth interventions, such as our proposed SMART program, represent an excellent modality for delivering AMSM-specific intervention material where youth are. OBJECTIVE This randomized trial aimed to test the effectiveness of the SMART program in reducing condom-less anal sex and increasing condom self-efficacy, condom use intentions, and HIV testing for AMSM. We also plan to test whether SMART has differential effectiveness across important subgroups of AMSM based on race and ethnicity, urban versus rural residence, age, socioeconomic status, and participation in an English versus a Spanish version of SMART. METHODS Using a sequential multiple assignment randomized trial design, we will evaluate the impact of a stepped-care package of increasingly intensive eHealth interventions (ie, the universal, information-based SMART Sex Ed; the more intensive, selective SMART Squad; and a higher cost, indicated SMART Sessions). All intervention content is available in English and Spanish. Participants are recruited primarily from social media sources using paid and unpaid advertisements. RESULTS The trial has enrolled 1285 AMSM aged 13 to 18 years, with a target enrollment of 1878. Recruitment concluded in June 2020. Participants were recruited from 49 US states as well as Puerto Rico and the District of Columbia. Assessments of intervention outcomes at 3, 6, 9, and 12 months are ongoing. CONCLUSIONS SMART is the first web-based program for AMSM to take a stepped-care approach to sexual education and HIV prevention. This design indicates that SMART delivers resources to all adolescents, but more costly treatments (eg, video chat counseling in SMART Sessions) are conserved for individuals who need them the most. SMART has the potential to reach AMSM to provide them with a sex-positive curriculum that empowers them with the information, motivation, and skills to make better health choices. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03511131; https://clinicaltrials.gov/ct2/show/NCT03511131. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19701.
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Affiliation(s)
- Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - David A Moskowitz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kevin O Moran
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Carlos Rodriguez-Díaz
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States
| | - Eric B Laber
- Department of Statistics, North Carolina State University, Raleigh, NC, United States
| | - Dennis H Li
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Margaret Matson
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
| | - Ali J Talan
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States
| | - Cynthia Cabral
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States
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English D, Carter JA, Bowleg L, Malebranche DJ, Talan AJ, Rendina HJ. Intersectional social control: The roles of incarceration and police discrimination in psychological and HIV-related outcomes for Black sexual minority men. Soc Sci Med 2020; 258:113121. [PMID: 32590189 PMCID: PMC7506501 DOI: 10.1016/j.socscimed.2020.113121] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/14/2020] [Accepted: 06/06/2020] [Indexed: 12/17/2022]
Abstract
RATIONALE Although Black gay, bisexual, and other sexual minority men face disproportionately high levels of incarceration and police discrimination, little research examines how these stressors may drive HIV and psychological health inequities among these men. OBJECTIVE In this study we examined associations between incarceration history, police and law enforcement discrimination, and recent arrest with sexual HIV risk, Pre-Exposure Prophylaxis (PrEP) willingness, and psychological distress among Black sexual minority men. METHOD Participants were a U.S. national sample of 1172 Black sexual minority men who responded in 2017-2018 to self-report measures of incarceration history, past year police and law enforcement discrimination, recent arrests, sexual HIV risk, PrEP willingness, and psychological distress. We used structural equation modeling to examine direct and indirect pathways from incarceration, police and law enforcement discrimination, and arrests to sexual HIV risk, PrEP willingness, and psychological distress. RESULTS Past-year police and law enforcement discrimination prevalence was 43%. Incarceration history was positively associated with later police and law enforcement discrimination, which, in turn, was positively associated with recent arrest. Incarceration and recent arrest and were associated with greater sexual HIV risk; incarceration and police and law enforcement discrimination were associated with lower PrEP willingness; and police and law enforcement discrimination was associated with higher psychological distress. Mediation analyses showed that the effects of incarceration were partially mediated by police and law enforcement discrimination. CONCLUSION Findings suggest police discrimination may be a mechanism of mass incarceration and fundamental driver of health inequities among Black sexual minority men.
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Affiliation(s)
- Devin English
- Rutgers School of Public Health, Piscataway, NJ, USA
| | - Joseph A Carter
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA; Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | | | | | - Ali J Talan
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA; Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA.
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32
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John SA, López-Rios J, Starks TJ, Rendina HJ, Grov C. Willingness to Distribute HIV Self-Testing Kits to Recent Sex Partners Among HIV-Negative Gay and Bisexual Men and an Examination of Free-Response Data from Young Men Participating in the Nationwide Cohort. Arch Sex Behav 2020; 49:2081-2089. [PMID: 32495242 PMCID: PMC7366497 DOI: 10.1007/s10508-020-01752-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 06/11/2023]
Abstract
Sexual minority men (SMM)-and young SMM in particular-are disproportionately affected by HIV. Secondary distribution of HIV self-testing (HIVST) kits-wherein patients deliver kits to partners-is a novel strategy to increase HIV testing access. Using quantitative data, we assessed willingness to distribute HIVST kits to recent sex partners among a U.S. national sample of HIV-negative SMM (n = 786). A thematic analysis was then conducted to identify barriers and facilitators of kit distribution to partners among young SMM (M age = 25.75 years; range: 20-29; n = 165). Overall, 93.5% of SMM (and 97.0% of young SMM) were willing to deliver HIVST kits to recent sex partners. Among young SMM, main barriers and facilitators included concerns about their partners' reaction, availability and cost, protection beliefs for others, HIV stigma and perceived infidelity, packaging and support, communication skill needs, inability to contact partners, requests for anonymity, and dyadic self-testing with their partners. The findings highlight the need for supportive intervention strategies such as informational content for HIVST, using motivational interviewing when providing the testing kits to index clients and providing skills-based training through role-playing exercises. Secondary distribution of HIVST kits through index patients is a potentially acceptable approach that could be used to expand access to HIV testing and aid in efforts to end the HIV epidemic in the U.S.
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Affiliation(s)
- Steven A John
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Javier López-Rios
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, The CUNY Institute for Implementation Science in Population Health, 55 West 125th Street, New York, NY, 10027, USA
| | - Tyrel J Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, New York, NY, USA
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, New York, NY, USA
| | - Christian Grov
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, The CUNY Institute for Implementation Science in Population Health, 55 West 125th Street, New York, NY, 10027, USA.
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33
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Rendina HJ, Weaver L, Millar BM, López-Matos J, Parsons JT. Psychosocial Well-Being and HIV-Related Immune Health Outcomes among HIV-Positive Older Adults: Support for a Biopsychosocial Model of HIV Stigma and Health. J Int Assoc Provid AIDS Care 2020; 18:2325958219888462. [PMID: 31795813 PMCID: PMC6893929 DOI: 10.1177/2325958219888462] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Evidence suggests that psychosocial stress negatively impacts immunological health in HIV-positive individuals. However, few studies have explored this association in substance-using older adults living with HIV (OALWH). We evaluated the effect of depression, loneliness, substance use problems, and HIV stigma on primary markers of immune function in a sample of 120 OALWH with substance-related issues. HIV stigma correlated with the greatest number of factors, including depression, loneliness, and substance use problems. Older age and antiretroviral adherence were associated with viral suppression, which was in turn associated with higher percentage of CD4 count. Multivariate path analyses demonstrated that lower HIV stigma and viral suppression were the only factors independently associated with higher percentage of CD4 count, with a significant indirect effect of adherence on CD4 through viral suppression. HIV stigma emerged as the most salient factor associated with both psychosocial well-being and immune health in the current study, suggesting that it is a critical factor to consider in future interventions for the rapidly growing population of OALWH.
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Affiliation(s)
- H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Laurel Weaver
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Brett M Millar
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Jonathan López-Matos
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
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34
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Moody RL, Savarese E, Gurung S, Rendina HJ, Parsons JT. The Mediating Role of Psychological Distress in the Association between Harassment and Alcohol Use among Lesbian, Gay, and Bisexual Military Personnel. Subst Use Misuse 2020; 55:2055-2063. [PMID: 32657197 PMCID: PMC7518327 DOI: 10.1080/10826084.2020.1790007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The purpose of this study was to examine the mediating role of psychological distress on the associations between two forms of harassment, military sexual trauma (MST) and sexual orientation-based discrimination (SOBD), and alcohol use in a sample of lesbian, gay, and bisexual (LGB) military personnel. Methods: Data were analyzed from 254 LGB military service members in the United States. Bivariate associations were examined between MST, SOBD, anxiety and depression, distress in response to stressful military events, and alcohol use. A latent psychological distress factor was estimated using anxiety and depression, and distress in response to stressful military events. Path analyses were used to estimate the direct effects of MST and SOBD on alcohol use and the indirect effects of MST and SOBD on alcohol use through psychological distress. Results: All bivariate associations were positive and significant between MST, SOBD, anxiety and depression, distress in response to military events, and alcohol use. In multivariable analyses, after adjusting for demographic covariates, a significant indirect effect was observed for SOBD on alcohol use through psychological distress. MST was not directly or indirectly associated with alcohol use when SOBD was included in the path model. Conclusion: Overall, findings suggest SOBD is associated with poorer mental health, which in turn places LGB military personnel at greater risk of alcohol use and associated problems. These results affirm the need for interventions that reduce SOBD in the military and suggest that these interventions will have a positive impact on the health of LGB military personnel.
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Affiliation(s)
- Raymond L. Moody
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | | | - Sitaji Gurung
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Department of Community Health and Social Sciences, The City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY, USA
| | - H. Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
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35
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Antebi-Gruszka N, Talan AJ, Reisner SL, Rendina HJ. Sociodemographic and behavioural factors associated with testing for HIV and STIs in a US nationwide sample of transgender men who have sex with men. Sex Transm Infect 2020; 96:422-427. [PMID: 32605930 DOI: 10.1136/sextrans-2020-054474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/14/2020] [Accepted: 05/24/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Transgender men who have sex with men (TMSM) represent an understudied population in relation to screening for HIV and sexually transmitted infections (STIs). We examined HIV and STI testing prevalence among TMSM along with the factors associated with testing in a diverse US nationwide sample of TMSM. METHODS Data from a cross-sectional online convenience sample of 192 TMSM were analysed using multivariable binary logistic regression models to examine the association between sociodemographic and behavioural factors and lifetime testing for HIV, bacterial STIs and viral STIs, as well as past year testing for HIV. RESULTS More than two-thirds of TMSM reported lifetime testing for HIV (71.4%), bacterial STIs (66.7%), and viral STIs (70.8%), and 60.9% had received HIV testing in the past year. Engaging in condomless anal sex with a casual partner whose HIV status is different or unknown and having fewer than two casual partners in the past 6 months were related to lower odds of lifetime HIV, bacterial STI, viral STI and past year HIV testing. Being younger in age was related to lower probability of testing for HIV, bacterial STIs and viral STIs. Furthermore, TMSM residing in the South were less likely to be tested for HIV and viral STIs in their lifetime, and for HIV in the past year. Finally, lower odds of lifetime testing for viral STIs was found among TMSM who reported no drug use in the past 6 months. CONCLUSIONS These findings indicate that a notable percentage of TMSM had never tested for HIV and bacterial and viral STIs, though at rates only somewhat lower than among cisgender MSM despite similar patterns of risk behaviour. Efforts to increase HIV/STI testing among TMSM, especially among those who engage in condomless anal sex, are needed.
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Affiliation(s)
| | - Ali J Talan
- Department of Psychology, Hunter College of the CIty University of New York (CUNY), New York, New York, USA
| | - Sari L Reisner
- Department of Epidemiology, The Fenway Institute at Fenway Health, Boston, Massachusetts, USA.,Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the CIty University of New York (CUNY), New York, New York, USA .,Health Psychology and Clinical Science PhD Program, The Graduate Center of the City University of New York (CUNY), New York, New York, USA
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36
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Rendina HJ, Cain DN, López-Matos J, Ray M, Gurung S, Parsons JT. Measuring Experiences of Minority Stress for Transgender Women: Adaptation and Evaluation of Internalized and Anticipated Transgender Stigma Scales. Transgend Health 2020; 5:42-49. [PMID: 32322687 DOI: 10.1089/trgh.2019.0059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Transgender women (TGW) experience high rates of stigma based on their gender identity. Research has documented how transgender stigma and other discrimination negatively contribute to health inequities, including higher rates of depression compared with the general population. However, few scales measuring transgender stigma exist, even fewer that specifically assess anticipated or internalized transgender stigma. We sought to validate an adapted transgender stigma scale in a diverse sample of TGW. Methods: We adapted an existing stigma measure to capture experiences of anticipated and internalized transgender stigma for TGW. Adapted measures were completed by 213 diverse TGW. Factor analysis was completed to reduce the number of items in each scale and sociodemographic differences in each construct were explored. Results: The final nine items comprising anticipated transgender stigma and the five items for internalized transgender stigma both showed evidence of adequate model fit, unidimensionality, and internal consistency. The two constructs were moderately correlated with one another (r=0.36, p<0.001). We identified educational and HIV status differences in anticipated transgender stigma but no sociodemographic differences in internalized transgender stigma. Conclusion: We developed brief measures of internalized and anticipated transgender stigma through initial adaptation by TGW themselves and subsequent psychometric evaluation, demonstrating evidence of unidimensionality and internal consistency. These subscales were only moderately associated with one another and may provide unique insights in future research on minority stress among TGW.
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Affiliation(s)
- H Jonathon Rendina
- Department of Psychology, Hunter College, The City University of New York, New York, New York.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center, The City University of New York, New York, New York
| | - Demetria N Cain
- Department of Psychology, Hunter College, The City University of New York, New York, New York
| | - Jonathan López-Matos
- Department of Psychology, Hunter College, The City University of New York, New York, New York.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center, The City University of New York, New York, New York
| | - Marielle Ray
- Department of Psychology, Hunter College, The City University of New York, New York, New York
| | - Sitaji Gurung
- Department of Psychology, Hunter College, The City University of New York, New York, New York.,Graduate School of Public Health and Health Policy, The City University of New York, New York, New York
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Mustanski B, Moskowitz DA, Moran KO, Rendina HJ, Newcomb ME, Macapagal K. Factors Associated With HIV Testing in Teenage Men Who Have Sex With Men. Pediatrics 2020; 145:peds.2019-2322. [PMID: 32047100 PMCID: PMC7049943 DOI: 10.1542/peds.2019-2322] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Adolescent men who have sex with men (AMSM) have a high rate of HIV diagnoses. An estimated 14.5% of HIV infections in the United States are undiagnosed; but among 13- to 24-year-olds, the rate is 51.4%. We describe HIV testing rates and identifies salient individual, family, school, and health care influences among AMSM. METHODS Data were collected as part of SMART, an ongoing pragmatic trial of an online HIV prevention intervention for AMSM (N = 699). Measures included lifetime HIV testing, demographics, sexual behaviors, condom use, HIV education from school and family, sexual health communication with doctors, HIV knowledge, and risk attitudes. RESULTS Only 23.2% of participants had ever had an HIV test. Rates of testing increased with age (5.6% in 13- to 14-year-olds; 15.8% in 15- to 16-year-olds; 37.8% in 17- to 18-year-olds), and sexual experience was a strong predictor of testing (odds ratio: 6.54; 95% confidence interval: 3.95-11.49; P < .001). Most participants had a regular doctor (67.5%), but few had conversations about same-sex sexual behaviors (21.3%), HIV testing (19.2%), or sexual orientation (29.2%). Speaking to a doctor about HIV testing had a large effect (odds ratio: 25.29; confidence interval: 15.91-41.16; P < .001), with 75.4% who had such conversations having been tested, compared to only 10.8% of those who had not had such conversations. CONCLUSIONS Despite higher risk, few participants reported ever having received an HIV test. Data indicate pediatricians are an important, but largely untapped, source of testing and could be integral to achieving testing rates needed to end the epidemic.
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Affiliation(s)
- Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and .,Departments of Medical Social Sciences and
| | - David A. Moskowitz
- Departments of Medical Social Sciences and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
| | - Kevin O. Moran
- Departments of Medical Social Sciences and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
| | - H. Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York, New York, New York
| | - Michael E. Newcomb
- Departments of Medical Social Sciences and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
| | - Kathryn Macapagal
- Departments of Medical Social Sciences and,Psychiatry and Behavioral Sciences, Feinberg School of Medicine and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
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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: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Whitfield THF, Parsons JT, Rendina HJ. Rates of Pre-exposure Prophylaxis Use and Discontinuation Among a Large U.S. National Sample of Sexual Minority Men and Adolescents. Arch Sex Behav 2020; 49:103-112. [PMID: 31845148 PMCID: PMC7028359 DOI: 10.1007/s10508-019-01602-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/27/2019] [Accepted: 11/28/2019] [Indexed: 05/20/2023]
Abstract
Pre-exposure prophylaxis (PrEP) is highly effective in the prevention of HIV acquisition and was recently approved for those under 18 years of age. The primary goal of the present study was to understand the prevalence of and factors associated with PrEP use among a large sample of young and adult sexual minority men (Y/SMM). Participants came from a larger national sample of SMM. Data collected included demographics, substance use, PrEP use, and sexual risk. Participants were recruited via sexual networking/dating applications and resided in the U.S. including Puerto Rico, were at least 13 years old, self-reported being HIV-negative, and identified as male. The sample was divided into two groups: YSMM (13-24 years of age) and adult SMM (25 years of age and up). Multinomial logistic regressions examining associations with never, current, and former PrEP use were run with all variables of interest simultaneously entered into the models. Age was positively associated with both former and current PrEP use among YSMM. Additionally, YSMM who identified as gay (vs. bisexual), lived in the Northeast, Midwest, and West (vs. South), had their own health insurance (vs. those on their parent's), had recently been diagnosed with an STI, and had recently used a drug all had higher odds of being a current PrEP user compared to those that had never used PrEP. Among adult SMM, those who were older did not have higher odds of current PrEP use compared to those that had never used PrEP. Those who identified as queer (vs. gay), single, had their own or were on their partner's insurance (vs. parent's), recent condomless anal sex, recent STI diagnosis, recent drug use, and recent substance use all had higher odds of being a current PrEP user compared to those that had never used PrEP. Research is needed to address the disparities in PrEP uptake among YSMM. Interventions for PrEP access among those on their parents' insurance may also be necessary.
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Affiliation(s)
- Thomas H F Whitfield
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA
| | | | - H Jonathon Rendina
- Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York, New York, NY, USA.
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York, New York, NY, USA.
- Department of Psychology, Hunter College of the City University of New York, 695 Park Ave., New York, NY, 10065, USA.
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Grov C, Westmoreland D, Rendina HJ, Nash D. Seeing Is Believing? Unique Capabilities of Internet-Only Studies as a Tool for Implementation Research on HIV Prevention for Men Who Have Sex With Men: A Review of Studies and Methodological Considerations. J Acquir Immune Defic Syndr 2019; 82 Suppl 3:S253-S260. [PMID: 31764261 PMCID: PMC6880799 DOI: 10.1097/qai.0000000000002217] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In 2014, Grov et al published a comprehensive review cataloguing both men who have sex with men's (MSM's) sexual behavior transitions in online environments from the 1990s through 2013, as well as researchers' efforts in tandem to use the internet to engage MSM into research, treatment, and prevention. METHODS In this article, we discuss historical events and research having occurred in the half decade since the Grov et al publication. RESULTS Notable transitions include MSM's expanded use of geosocial networking apps, as well as other forms of social media accessed primarily through mobile devices, as well as the addition of biomedical prevention strategies (eg, pre-exposure prophylaxis and undetectable = untransmittable) to the proverbial HIV prevention toolkit. In tandem, researchers have rapidly expanded their employment of internet-mediated methods for the recruitment and engagement of key populations for HIV research, treatment, and prevention. In this article, we discuss methodological considerations for using the internet to conduct HIV prevention research with MSM: (1) sources of recruitment (eg, geosocial apps, Facebook, crowdsourced online panels); (2) design (eg, cross sectional, longitudinal, diaries); (3) incentives (including disincentivizing fraudulent participants and/or spam bots); (4) confidentiality; and (5) representativeness. CONCLUSION We conclude by discussing future directions in HIV prevention research in light of forthcoming technologies such as fifth generation (5G) mobile networks, combined use of self-collected biological data alongside self-report, and the utility of metadata and metaresearch to document, evaluate, and inform best practices.
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Affiliation(s)
- Christian Grov
- CUNY Graduate School of Public Health and Health Policy, New York, NY
- CUNY Institute for Implementation Science in Population Health, New York, NY
| | - Drew Westmoreland
- CUNY Institute for Implementation Science in Population Health, New York, NY
| | | | - Denis Nash
- CUNY Graduate School of Public Health and Health Policy, New York, NY
- CUNY Institute for Implementation Science in Population Health, New York, NY
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Whitfield THF, Jones SS, Wachman M, Grov C, Parsons JT, Rendina HJ. The Impact of Pre-Exposure Prophylaxis (PrEP) Use on Sexual Anxiety, Satisfaction, and Esteem Among Gay and Bisexual Men. J Sex Res 2019; 56:1128-1135. [PMID: 30777781 PMCID: PMC6699935 DOI: 10.1080/00224499.2019.1572064] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Gay and bisexual men (GBM) with heightened fears of human immunodeficiency virus (HIV) acquisition have reported high levels of sexual anxiety and low sexual self-esteem. Similarly, sexual satisfaction has been reported to be lower among some GBM who rely solely on condom use as HIV prevention. We sought to explore whether pre-exposure prophylaxis (PrEP) had an impact on the sexual satisfaction, anxiety, and esteem of GBM. As part of a longitudinal cohort study of 1,071 GBM, participants reported at three time points on PrEP use and completed the Multidimensional Sexual Self-Concept Questionnaire (MSSCQ). A total of 137 GBM began taking PrEP in the 24 months following baseline. Comparing their responses during times before initiating PrEP and after, within adjusted multilevel models, there was a significant decrease in sexual anxiety (B = -0.27, p = 0.03) but no significant changes in sexual esteem or satisfaction. Our findings indicate important psychological improvements resulting from PrEP initiation. Further research should explore the potential for other psychological benefits of PrEP use among GBM.
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Affiliation(s)
- Thomas H. F. Whitfield
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY
| | - Stephen S. Jones
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY
| | - Matthew Wachman
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY
| | - Christian Grov
- CUNY Graduate School of Public Health and Health Policy, New York, NY
| | - Jeffrey T. Parsons
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY
| | - H. Jonathon Rendina
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY
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Sizemore KM, Carter JA, Millar BM, Cain D, Parsons JT, Rendina HJ. Attachment as a Predictor of Psychological and Sexual Wellbeing Among Transgender Women in New York City. J Sex Res 2019; 56:1192-1202. [PMID: 31379205 PMCID: PMC6791782 DOI: 10.1080/00224499.2019.1644486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Transgender women are disproportionately affected by HIV and experience high rates of depression and anxiety. The importance of secure attachment in buffering against negative sexual and mental health outcomes is well established. However, few studies have examined attachment among transgender women. We recruited a community-based convenience sample of 213 transgender women in New York City (Mage =34.3; SD = 11.7). The majority were women of color (75.6%), almost half identified as heterosexual (47.4%), and 34.7% were HIV-positive. Preliminary analyses examined the sample distribution across attachment categories using the Revised Experiences in Close Relationships scale. Specifically, Brennan, Clark and Shaver's guidelines were used for categorization (43.19% fearful, 22.5% preoccupied, 21.6% dismissive, and 12.7% secure). Regression analyses examined the association of dimensional attachment anxiety, attachment avoidance, and their interaction with depression, anxiety, self-efficacy for condom use, temptations for condomless sex, and condomless sex acts. Results indicated a positive association between attachment anxiety and depression, anxiety, temptations and probability for condomless sex; and also between attachment avoidance and condomless sex probability. A significant interaction indicated that individuals with low attachment anxiety and attachment avoidance (i.e., secure) had the greatest condom use self-efficacy and the lowest probability of engaging in condomless sex.
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Affiliation(s)
- K. Marie Sizemore
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY
| | - Joseph A. Carter
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY
| | - Brett M. Millar
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY
| | - Demetria Cain
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY
| | - Jeffrey T. Parsons
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY
| | - H. Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY
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Rendina HJ, Millar BM, Dash G, Feldstein Ewing SW, Parsons JT. The Somatic Marker Hypothesis and Sexual Decision Making: Understanding the Role of Iowa Gambling Task Performance and Daily Sexual Arousal on the Sexual Behavior of Gay and Bisexual Men. Ann Behav Med 2019; 52:380-392. [PMID: 29684131 DOI: 10.1093/abm/kax006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The sexual decision-making literature suggests that sexual arousal and behavior are associated. The somatic marker hypothesis suggests that individual neuropsychological differences in decision making, as measured by the Iowa Gambling Task (IGT), may moderate these associations; however, this hypothesis has yet to be tested with event-level sexual behavior data. Purpose We hypothesized that (a) daily sexual arousal would be positively associated with likelihood of engaging in sex and condomless anal sex (CAS) and (b) IGT scores would moderate these associations such that the associations would be stronger among those with higher IGT scores. Methods We used daily diary data from 334 highly sexually active gay and bisexual men to examine the main and interaction effects of sexual arousal and IGT scores on sexual engagement and CAS. Results As hypothesized, daily sexual arousal was positively associated with greater odds of both sexual engagement and CAS with casual male partners. Individual-level IGT performance significantly moderated the day-level association between arousal and sexual engagement, which was stronger for men with higher IGT scores. There was no main effect of IGT scores on either sexual behavior outcome, nor did it moderate the association between arousal and CAS. Conclusions These findings highlight the influence of sexual arousal on sexual engagement, which differed by IGT scores; the effect of arousal on CAS was much less variable and may not be moderated by neurocognitive factors. This study supports the importance of exploring integrated behavioral/biomedical interventions to improve individual decision making to prevent HIV infection.
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Affiliation(s)
- H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), Park Avenue, New York, NY, USA.,Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Brett M Millar
- Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Genevieve Dash
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | | | - Jeffrey T Parsons
- Department of Psychology, Hunter College of the City University of New York (CUNY), Park Avenue, New York, NY, USA.,Center for HIV/AIDS Educational Studies and Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
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John SA, Cain D, Bradford-Rogers J, Rendina HJ, Grov C. Gay and bisexual men's experiences using self-testing kits for HIV and rectal and urethral bacterial sexually transmitted infections: Lessons learned from a study with home-based testing. Int J Sex Health 2019; 31:308-318. [PMID: 32983310 PMCID: PMC7518382 DOI: 10.1080/19317611.2019.1645075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/03/2019] [Accepted: 07/13/2019] [Indexed: 06/11/2023]
Abstract
This study investigated the experiences of gay, bisexual, and other men who have sex with men (GBM) conducting HIV and sexually transmitted infection (STI) self-testing procedures. We analyzed mixed-methods data from 11 GBM who self-tested HIV-positive and 1,070 HIV-negative GBM who completed the HIV self-testing and STI self-sampling procedures. Nearly all (99%) reported ease in urine-based STI self-sampling and most (90%) found rectal swab self-collection easy. Most (94%) checked their rapid-HIV self-testing results during the correct window (20-40 minutes), and nearly all (99%) trusted their HIV results. Recommendations for future self-testing procedures are provided based on findings from free-response data.
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Affiliation(s)
- Steven A. John
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Demetria Cain
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Jesse Bradford-Rogers
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - H. Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, New York, NY, USA
| | - Christian Grov
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy; The CUNY Institute for Implementation Science in Population Health, New York, NY, USA
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John SA, Starks TJ, Rendina HJ, Parsons JT, Grov C. High willingness to use novel HIV and bacterial sexually transmitted infection partner notification, testing, and treatment strategies among gay and bisexual men. Sex Transm Infect 2019; 96:173-176. [PMID: 31189548 DOI: 10.1136/sextrans-2019-053974] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/02/2019] [Accepted: 05/19/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We sought to determine willingness of gay and bisexual men (GBM) to give HIV self-testing (HIVST) kits with patient-delivered partner therapy (PDPT) and engage in geosocial sexual networking (GSN) app-based partner notification. METHODS A nationwide sample of GBM who self-tested HIV negative (n=786) were asked about their willingness to give recent sex partners (main and casual) PDPT with an HIVST kit (PDPT+HIVST) after hypothetical bacterial STI (BSTI) diagnosis. Men were also asked about their willingness to notify sexual partners met on GSN apps using an anonymous app function after BSTI diagnosis. We examined associations of relationship status and condomless anal sex with casual partners, recent BSTI diagnosis and perceived risk of HIV on PDPT+HIVST and anonymous app-based partner notification willingness (dichotomised) using binary logistic regressions, adjusting for age, race/ethnicity, education and US region. From the partner's perspective after receiving an app-based referral, frequency measures were used to report intentions for obtaining subsequent HIV/BSTI counselling and testing, engaging in HIVST if provided a free voucher, and obtaining BSTI treatment from a pharmacy with prescription voucher. RESULTS Most (90.1%) were willing to give PDPT+HIVST to recent sex partners after STI diagnosis, and nearly all (96.4%) were willing to notify sex partners met online using an anonymous function within GSN apps. Regardless of casual partner condomless anal sex engagement, partnered GBM had higher odds of reporting willingness to give PDPT+HIVST compared with single men who recently engaged in condomless anal sex with a casual partner. If anonymously notified via an app, 92.5% reported they would likely obtain counselling and testing, 92.8% would engage in HIVST if provided a free voucher, and 93.4% would obtain treatment from a pharmacy with prescription voucher. CONCLUSIONS GBM generally found novel partner notification, testing, and treatment strategies acceptable, indicating the need for feasibility and cost-effectiveness evaluations.
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Affiliation(s)
- Steven A John
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Tyrel J Starks
- Center for HIV Educational Studies and Training, Department of Pscyhology, Hunter College of the City University of New York (CUNY), New York, New York, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University ofNew York (CUNY), New York, New York, USA
| | - H Jonathon Rendina
- Center for HIV Educational Studies and Training, Department of Pscyhology, Hunter College of the City University of New York (CUNY), New York, New York, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University ofNew York (CUNY), New York, New York, USA
| | - Jeffrey T Parsons
- Center for HIV Educational Studies and Training, Department of Pscyhology, Hunter College of the City University of New York (CUNY), New York, New York, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University ofNew York (CUNY), New York, New York, USA
| | - Christian Grov
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA .,CUNY Institute for Implementation Science in Population Health, New York, New York, USA
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Mgbako O, Park SH, Callander D, Brinker DA, Kuhner C, Carrico AW, Rendina HJ, Duncan DT. Transactional sex, condomless anal sex, and HIV risk among men who have sex with men. Int J STD AIDS 2019; 30:795-801. [PMID: 31142221 DOI: 10.1177/0956462418823411] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To understand the HIV epidemic among men who have sex with men who engage in transactional sex (MSM-TS) in Paris, France, we sought to examine the association between engagement in transactional sex and HIV risk behaviors among MSM in Paris, France. Users of a geosocial-networking application in Paris were provided an anonymous web-based survey ( N = 580), which included questions about transactional sex and behavioral risk factors for HIV along with sexually transmitted infection (STI)/HIV status. Multivariate analyses showed that engagement in transactional sex was associated with condomless receptive and insertive anal intercourse (adjusted relative risk [aRR] = 1.34, 95% confidence interval [CI] = 1.04–1.72 and aRR = 1.41, 95% CI = 1.04–1.91, respectively). MSM-TS were more likely to have engaged in substance use before or during sex (aRR = 1.35, 95% CI = 1.13–1.62), to have participated in group sex (aRR = 1.37, CI = 1.13–1.62), and to have had an STI during the last year (aRR = 1.68, 95% CI = 1.16–2.45). Transactional sex was not associated with HIV status. MSM-TS in Paris engaged in higher HIV risk behaviors, however, did not have higher rates of HIV infection. Sexual health interventions should continue to target MSM-TS; however, future studies should characterize the social, cultural, and structural factors that interact with individual behaviors to elevate HIV risk for MSM-TS.
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Affiliation(s)
- Ofole Mgbako
- 1 Department of Internal Medicine, School of Medicine, Columbia University, New York, NY, USA.,2 Department of Population Health, Spatial Epidemiology Lab, School of Medicine, New York University, New York, NY, USA
| | - Su H Park
- 2 Department of Population Health, Spatial Epidemiology Lab, School of Medicine, New York University, New York, NY, USA
| | - Denton Callander
- 3 The Kirby Institute, University of New South Wales Sydney, Sydney, Australia
| | | | | | - Adam W Carrico
- 5 Department of Public Health Sciences, School of Medicine, University of Miami, Miami, FL, USA
| | - H Jonathon Rendina
- 6 Department of Psychology, Hunter College, City University of New York, New York, NY, USA
| | - Dustin T Duncan
- 2 Department of Population Health, Spatial Epidemiology Lab, School of Medicine, New York University, New York, NY, USA
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Rendina HJ, Parsons JT. Factors associated with perceived accuracy of the Undetectable = Untransmittable slogan among men who have sex with men: Implications for messaging scale-up and implementation. J Int AIDS Soc 2019; 21. [PMID: 29334178 PMCID: PMC5810313 DOI: 10.1002/jia2.25055] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 12/19/2017] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Recent research has shown high efficacy of HIV treatment for reducing the risk of HIV transmission to sexual partners. As the efficacy of treatment as prevention (TasP) has proliferated, a new messaging campaign, Undetectable = Untransmittable, has been gaining popularity. The purpose of this paper was to assess factors associated with the perceived accuracy of this TasP messaging strategy among a large and diverse sample of gay, bisexual, and other men who have sex with men (GBMSM) in order to inform subsequent efforts at large-scale and implementation of the HIV prevention message. METHODS We conducted a nationwide survey of GBMSM in the U.S. recruited from an online social networking site and a mobile sexual networking app. We analysed data from 12,222 GBMSM separately by HIV status to examine sociodemographic and behavioural factors associated with ratings of the accuracy of the Undetectable = Untransmittable message, which included the option to indicate not understanding what "undetectable" meant. RESULTS Among HIV-negative and unknown men, multivariable linear regression indicated that being on pre-exposure prophylaxis (PrEP), identifying as gay or queer (versus bisexual or straight), recent serodiscordant condomless anal sex (CAS), testing every six months or more often, less concern about sexually transmitted infection (STI) infection, and lower perceived risk of HIV infection were the factors with the largest independent effect on rating the Undetectable = Untransmittable statement as more accurate. Fewer factors emerged as associated with accuracy ratings among HIV-positive participants-reporting an undetectable viral load, a lifetime acquired immune deficiency syndrome (AIDS) diagnosis, and lower concern about STI infection were the factors most strongly associated with rating the statement as more accurate. CONCLUSIONS The findings of the current study highlight variability in the perceived accuracy of the Undetectable = Untransmittable message, suggesting potential subgroups who might benefit from targeted educational campaigns, perhaps broadcast utilizing sexual networking apps. Numerous factors, particularly among HIV-negative and unknown GBMSM, were associated with rating the message as more accurate. In particular, being on PrEP and testing regularly were two of the variables most strongly associated with higher accuracy ratings among HIV-negative GBMSM, suggesting HIV prevention services as potential points of intervention for increasing HIV knowledge and decreasing HIV stigma.
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Affiliation(s)
- H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA.,The Center for HIV Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - Jeffrey T Parsons
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA.,Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA.,The Center for HIV Educational Studies & Training (CHEST), Hunter College of the City University of New York (CUNY), New York, NY, USA
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48
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Rendina HJ, López-Matos J, Wang K, Pachankis JE, Parsons JT. The Role of Self-Conscious Emotions in the Sexual Health of Gay and Bisexual Men: Psychometric Properties and Theoretical Validation of the Sexual Shame and Pride Scale. J Sex Res 2019; 56:620-631. [PMID: 29634377 PMCID: PMC6179944 DOI: 10.1080/00224499.2018.1453042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Researchers have theorized about the role of sexual shame as a mechanism through which sexual minority stress manifests into mental health difficulties, such as sexual compulsivity for gay and bisexual men (GBM), and about the resilience-promoting effects of sexual pride. However, no validated measures to date have directly tapped into these constructs rather than using proxies for them, such as internalized homonegativity. We developed the Sexual Shame and Pride Scale (SSPS) and conducted a psychometric evaluation of it using a sample of 260 highly sexually active GBM. The scale had the expected structure in factor analysis and showed evidence of internal consistency and test-retest reliability. Correlational analyses demonstrated the convergent validity of sexual shame and sexual pride with relevant constructs. Regression analyses demonstrated the predictive validity of sexual shame in relation to sexual compulsivity, accounting for unique variability even after adjusting for previously demonstrated etiological factors, and the predictive validity of both shame and pride, which interacted to consistently predict four sexual behavior outcomes. Findings suggest the SSPS is a psychometrically valid and reliable measure that may be useful in future empirical work and highlight preliminary evidence for the role of these constructs in the sexual health of GBM.
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Affiliation(s)
- H Jonathon Rendina
- a Center for HIV/AIDS Educational Studies and Training, New York; Department of Psychology, Hunter College of the City University of New York; and Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York
| | - Jonathan López-Matos
- b Center for HIV/AIDS Educational Studies and Training, New York; and Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York
| | - Katie Wang
- c Department of Social and Behavioral Sciences , Yale School of Public Health , New Haven , CT , USA
| | - John E Pachankis
- c Department of Social and Behavioral Sciences , Yale School of Public Health , New Haven , CT , USA
| | - Jeffrey T Parsons
- a Center for HIV/AIDS Educational Studies and Training, New York; Department of Psychology, Hunter College of the City University of New York; and Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York
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49
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Grov C, Rendina HJ, John SA, Parsons JT. Determining the Roles that Club Drugs, Marijuana, and Heavy Drinking Play in PrEP Medication Adherence Among Gay and Bisexual Men: Implications for Treatment and Research. AIDS Behav 2019; 23:1277-1286. [PMID: 30306433 DOI: 10.1007/s10461-018-2309-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Researchers have established that substance use interferes with anti-retroviral medication adherence among gay and bisexual men (GBM) living with HIV. There is limited parallel examination of pre-exposure prophylaxis (PrEP) adherence among HIV-negative GBM. We conducted retrospective 30-day timeline follow-back interviews and prospective semi-weekly diary data for 10 weeks with 104 PrEP-using GBM, half of whom engaged in club drug use (ketamine, ecstasy, GHB, cocaine, or methamphetamine)-generating 9532 days of data. Participants reported their day-by-day PrEP, club drug, marijuana, and heavy alcohol use (5 + drinks in one sitting). On average, club drug users were no more likely to miss a dose of PrEP than non-club drug users (M = 1.6 doses, SD = 3.0, past 30 days). However, we found that club drug use (at the event level) increased the odds of missing a dose on the same day by 55% and the next day (e.g., a "carryover effect") by 60%. Further, missing a dose on one day increased the odds of missing a dose the following day by eightfold. We did not identify an event-level effect of marijuana use or heavy drinking on PrEP adherence. Our data suggest club drug users could have greater protective effects from daily oral or long-acting injectable PrEP compared to a time-driven PrEP regimen because of the concurrence of club drug use and PrEP non-adherence.
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50
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Neilan AM, Patel K, Agwu AL, Bassett IV, Amico KR, Crespi CM, Gaur AH, Horvath KJ, Powers KA, Rendina HJ, Hightow-Weidman LB, Li X, Naar S, Nachman S, Parsons JT, Simpson KN, Stanton BF, Freedberg KA, Bangs AC, Hudgens MG, Ciaranello AL. Model-Based Methods to Translate Adolescent Medicine Trials Network for HIV/AIDS Interventions Findings Into Policy Recommendations: Rationale and Protocol for a Modeling Core (ATN 161). JMIR Res Protoc 2019; 8:e9898. [PMID: 30990464 PMCID: PMC6488956 DOI: 10.2196/resprot.9898] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 12/12/2022] Open
Abstract
Background The United States Centers for Disease Control and Prevention estimates that approximately 60,000 US youth are living with HIV. US youth living with HIV (YLWH) have poorer outcomes compared with adults, including lower rates of diagnosis, engagement, retention, and virologic suppression. With Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) support, new trials of youth-centered interventions to improve retention in care and medication adherence among YLWH are underway. Objective This study aimed to use a computer simulation model, the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-Adolescent Model, to evaluate selected ongoing and forthcoming ATN interventions to improve viral load suppression among YLWH and to define the benchmarks for uptake, effectiveness, durability of effect, and cost that will make these interventions clinically beneficial and cost-effective. Methods This protocol, ATN 161, establishes the ATN Modeling Core. The Modeling Core leverages extensive data—already collected by successfully completed National Institutes of Health–supported studies—to develop novel approaches for modeling critical components of HIV disease and care in YLWH. As new data emerge from ongoing ATN trials during the award period about the effectiveness of novel interventions, the CEPAC-Adolescent simulation model will serve as a flexible tool to project their long-term clinical impact and cost-effectiveness. The Modeling Core will derive model input parameters and create a model structure that reflects key aspects of HIV acquisition, progression, and treatment in YLWH. The ATN Modeling Core Steering Committee, with guidance from ATN leadership and scientific experts, will select and prioritize specific model-based analyses as well as provide feedback on derivation of model input parameters and model assumptions. Project-specific teams will help frame research questions for model-based analyses as well as provide feedback regarding project-specific inputs, results, sensitivity analyses, and policy conclusions. Results This project was funded as of September 2017. Conclusions The ATN Modeling Core will provide critical information to guide the scale-up of ATN interventions and the translation of ATN data into policy recommendations for YLWH in the United States.
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Affiliation(s)
- Anne M Neilan
- Division of General Academic Pediatrics, Massachusetts General Hospital, Boston, MA, United States.,Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, United States
| | - Kunjal Patel
- Department of Epidemiology and Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Allison L Agwu
- Departments of Pediatric and Adult Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ingrid V Bassett
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, United States.,Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - K Rivet Amico
- University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Catherine M Crespi
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States
| | - Aditya H Gaur
- St. Jude's Children's Research Hospital, Memphis, TN, United States
| | - Keith J Horvath
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Kimberly A Powers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - H Jonathon Rendina
- Hunter College of the City University of New York, New York, NY, United States
| | - Lisa B Hightow-Weidman
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Xiaoming Li
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Sylvie Naar
- Center for Translational Behavioral Research, Florida State University, Tallahassee, FL, United States
| | - Sharon Nachman
- State University of New York, Stony Brook, NY, United States
| | - Jeffrey T Parsons
- Hunter College of the City University of New York, New York, NY, United States
| | - Kit N Simpson
- Medical University of South Carolina, Charleston, SC, United States
| | - Bonita F Stanton
- Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, United States
| | - Kenneth A Freedberg
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, United States.,Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.,Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Audrey C Bangs
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, United States
| | - Michael G Hudgens
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Andrea L Ciaranello
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, United States.,Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
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