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Parchem B, Aguayo-Romero RA, Alizaga NM, del Río-González AM, Poppen PJ, Zea MC. Identity and Relational Factors Associated with Sexual Role and Positioning for Anal Sex among Colombian Sexual Minority Men. J Sex Res 2022; 59:911-919. [PMID: 35080994 PMCID: PMC9314459 DOI: 10.1080/00224499.2022.2026287] [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: 06/14/2023]
Abstract
This study aimed to identify Top, Bottom, and Versatile sexual role identities and anal sex behavior profiles using latent class analysis in a sample of 942 sexual minority men living in Bogotá. A Versatile-insertive and receptive class (52.2%) was the most prevalent of the four resulting classes, whereas the least common was a class (1.7%) that did not use labels and had a low probability of anal sex. We examined whether identity and relational factors (i.e., sexual orientation, LGBT collective identity, and partner type) were associated with profiles. Gay identity was associated with versatile and receptive classes and bisexual identity was associated with insertive and versatile classes. LGBT collective identity was associated with the class characterized by Bottom identity and receptive positioning. Partner type was not associated with class membership, but versatile behaviors were more common among encounters with a main partner. Models using data at different timescales offered consistent patterns of behavior between the last encounter and the past three months, though the versatile class in the three-month model split into two classes based on frequency of versatile positioning. Findings highlight the relationship between sexual identity and positioning and can inform interventions for sexual health education and identity development.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
| | - Rodrigo A. Aguayo-Romero
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
- Brigham and Women’s Hospital/ Harvard Medical School/ The Fenway Institute, Boston, MA
| | | | | | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
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Zea MC, Barnett AP, del Río-González AM, Parchem B, Pinho V, Le HN, Poppen PJ. Experiences of Violence and Mental Health Outcomes among Colombian Men who have Sex with Men (MSM) and Transgender Women. J Interpers Violence 2022; 37:NP11991-NP12013. [PMID: 33663239 PMCID: PMC8887868 DOI: 10.1177/0886260521997445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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
Colombia endured 70 years of internal conflict, but despite a peace agreement, violence continues to be significant in the post-conflict era. Violence degrades the health and well-being of affected populations and it engenders psychological distress. Little is known about the impact of violence on the mental health of sexual and gender minority populations in Colombia. This study aimed to examine the frequency and sources of violence among cisgender men who have sex with men (MSM) and transgender women and their association with depressive symptoms and substance use. We administered a survey to 942 MSM and 58 transgender women recruited using respondent-driven sampling. We estimated the relationship between mental health indicators and experiences of violence using stepwise logistic and linear regressions, controlling for income, education, age, race, and mistreatment for being effeminate when younger. Respondent-driven sampling adjusted prevalence of any type of violence was 60.9% for the total sample, 59.8% for MSM, and 75.1% for transgender women. Experiences of violence were significantly related to depressive symptoms, binge drinking and drug use for the MSM sample. Violence perpetrated by family members or acquaintances was associated with greater depressive symptoms, and violence perpetrated by partners and strangers was associated with increased binge drinking and drug use. These results provide significant evidence of the negative association of experiences of violence and the mental health of sexual and gender minority people, a vulnerable population in Colombia. This study addresses issues of diversity regarding sexual orientation and gender identity in a Latin American middle-income country.
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Affiliation(s)
| | | | | | | | | | - Huynh-Nhu Le
- The George Washington University, Washington DC, USA
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3
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Xie T, Wen J, Liu X, Wang J, Poppen PJ. Utilizing network analysis to understand the structure of depression in Chinese adolescents: Replication with three depression scales. Curr Psychol 2022; 42:1-12. [PMID: 35669214 PMCID: PMC9157480 DOI: 10.1007/s12144-022-03201-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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] [Accepted: 05/06/2022] [Indexed: 12/15/2022]
Abstract
Depression involves a heterogenous collection of symptoms. Network perspective views depressive symptoms as an interrelated network. The current study aimed to replicate network analyses on adolescent depression in three samples assessed with three instruments to examine the consistency of network structures and also examine the variance of networks between genders. Three samples of adolescents (total N = 4375, mean age = 15, 49.1% boys) were assessed with PHQ-9, SMFQ and CDI, respectively. Network analyses were carried out on depression symptoms. Network stability, node centrality and network comparisons between genders were examined. Three networks were reliably stable. Sadness and self-hatred were unanimously identified to be central symptoms of adolescent depression in three networks. In addition, fatigue, no good, everything wrong and loneliness also appeared to be central in specific networks. Among three depression networks, PHQ-9 network demonstrated gender difference in network structure. The current study is exploratory in nature. The differences in three networks can be due to various samples or different node inclusions. Further, the study is cross-sectional precluding causal interpretation and the samples are nonclinical. Besides "hallmark" symptom sadness, self-hatred was also identified unanimously in three networks, which demonstrated the significant role self-worth played in adolescent depression. The results also suggested that differences in node inclusion may have influence on the network structure. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-03201-z.
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Affiliation(s)
- Tong Xie
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
| | - Jun Wen
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
- Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Xiaoyan Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
| | - Jianping Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
| | - Paul J. Poppen
- Psychological and Brain Sciences, George Washington University, Washington, DC USA
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4
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Parchem B, Aguayo-Romero RA, Alizaga NM, Poppen PJ, Cecilia Zea M. Sexual Role Identity and Anal Sex Positioning among Brazilian, Colombian, and Dominican Immigrant Sexual Minority Men. J Sex Res 2022; 59:632-642. [PMID: 34080929 PMCID: PMC8639841 DOI: 10.1080/00224499.2021.1922574] [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 role identities for anal sex and anal sex positionings are often conflated in research. This study aimed to identify profiles of sexual minority men based on sexual role identity and anal sex positioning and determine correlates of these profiles, including individual (i.e., HIV-status identity, condom use, partner type, sexual orientation) and cultural (i.e., same-race partnering, country of birth, acculturation) factors. A sample of Brazilian, Colombian, and Dominican immigrant sexual minority men (n = 480) living in New York City were surveyed about identity and positioning at the two most recent encounters. Individual and cultural factors were examined as correlates of profiles identified through latent class analysis. Four latent classes were identified: No Labels (12%), Receptive Bottoms (16%), Insertive Tops (23%), Insertive and Receptive Versatiles (49%). We found a concordance rate of ~70% between identity and behavior. A proportion (12%) of behaviorally versatile men chose not to use sexual role labels. Living with HIV was associated with receptive and versatile classes, sex with main partners was associated with versatility, and sexual orientation differed across classes. Identity and behavior should not be used interchangeably in research or applied domains, particularly given the complexities of versatility and men who prefer to not use labels.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
| | - Rodrigo A. Aguayo-Romero
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
- Brigham and Women’s Hospital/ Harvard Medical School/ The Fenway Institute, Boston, MA
| | | | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC
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Xu X, Xie T, Zhou N, Shi G, Wen J, Wang J, Li X, Poppen PJ. Network analysis of PGD, PTSD and insomnia symptoms in Chinese shidu parents with PGD. Eur J Psychotraumatol 2022; 13:2057674. [PMID: 35401947 PMCID: PMC8986251 DOI: 10.1080/20008198.2022.2057674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/17/2022] [Indexed: 12/31/2022] Open
Abstract
Background Chinese shidu parents (bereaved parents over the age of 49 who have lost their only child) are potentially at a high risk of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD) and insomnia. Objective The current study aimed to estimate three network models in 310 shidu parents who met the ICD-11 criteria for PGD: (1) a PGD network to identify central symptoms; (2) a comorbidity network to explore bridge symptoms between PGD and PTSD; (3) a comorbidity network to examine the associations between PGD and insomnia symptoms. Methods The R-packages bootnet, qgraph and networktools were used to investigate the structure of network models and centrality indices of symptoms. In addition, robustness and significance analyses for the edge weights and the order of centrality were performed. Results Emotional pain and numbness emerged as the most central symptoms in the PGD network. In the PGD-PTSD comorbidity network, the highest bridge strength symptoms were inability to trust others (PGD) and feeling upset (PTSD). Inability to trust others (PGD), avoidance (PGD), and impairment of life quality (insomnia) were possible bridge symptoms connecting PGD and insomnia. Conclusions Reducing emotional pain and numbness may be a viable target in PGD interventions for shidu parents. Additionally, findings suggest that future studies could examine the role of inability to trust others and avoidance in PGD comorbidities. HIGHLIGHTS • Emotional pain and numbness were the most influential symptoms in shidu parents with PGD. The role of PGD symptoms of inability to trust others and avoidance in the comorbidities of PGD with PTSD and insomnia might be worthy of further study.
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Affiliation(s)
- Xin Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
| | - Tong Xie
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
| | - Ningning Zhou
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, People’s Republic of China
| | - Guangyuan Shi
- Center for psychological development, Tsinghua University, Beijing, People’s Republic of China
| | - Jun Wen
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
| | - Jianping Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People’s Republic of China
| | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
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Parchem B, Aguayo-Romero RA, del Río-González AM, Calabrese SK, Poppen PJ, Zea MC. Perceptions of power and sexual pleasure associated with sexual behaviour profiles among Latino sexual minority men. Cult Health Sex 2021; 23:1344-1360. [PMID: 32744462 PMCID: PMC7855680 DOI: 10.1080/13691058.2020.1781263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
In a body of research typically focused on risk reduction and disease prevention, other factors motivating the sexual behaviours of Latino sexual minority men, such as resource-based power and sexual pleasure, are less well understood. To this end, Latino immigrant sexual minority men living in New York City were surveyed about their sexual behaviours, perceived power differentials, and pleasure from insertive and receptive anal intercourse. Power and pleasure were examined as associations with behavioural profiles identified through latent class analysis, adjusting for age and partner type. Four latent classes of Latino sexual minority men were identified based on behaviours reported during the most recent sexual event: behaviourally insertive (14.2%), behaviourally versatile (25.9%), behaviourally receptive (29.2%), and limited penetrative behaviour (30.7%). Participants who derived pleasure from insertive and receptive anal intercourse had higher odds of belonging in the behaviourally insertive and behaviourally receptive class, respectively. Perceptions of resource-based power were not associated with class membership. Findings highlight the importance of sexual pleasure as a driver of sexual behaviour, irrespective of power dynamics. Sexual health curricula and interventions for sexual minority men should consider sexual pleasure and sex-affirmative frameworks when providing sexuality education and promoting sexual wellbeing.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Rodrigo A. Aguayo-Romero
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
- Brigham and Women’s Hospital, Harvard Medical School, The Fenway Institute, Boston, MA, USA
| | | | - Sarah K. Calabrese
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Paul J. Poppen
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | - Maria Cecilia Zea
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
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7
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Barnett AP, Del Río-González AM, Parchem B, Pinho V, Aguayo-Romero R, Nakamura N, Calabrese SK, Poppen PJ, Zea MC. Content analysis of psychological research with lesbian, gay, bisexual, and transgender people of color in the United States: 1969-2018. Am Psychol 2019; 74:898-911. [PMID: 31697126 PMCID: PMC8243565 DOI: 10.1037/amp0000562] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This article updates previous content analyses that identified a relative paucity of U.S.-based psychological research on lesbian, gay, bisexual, and transgender (LGBT) people of color by extending the period covered to 2018. In addition to documenting how many such studies occurred and when, it considers the research questions asked, funding sources, impact, and journal outlets. This richer description of this research area allowed us to describe historically not only when LGBT people of color in the United States were studied but why they were studied, which journals published this work, and which published studies were most influential. We found that the literature starts in 1988 for LGB people of color and in 2009 for transgender people of color and that a significant shift occurred in 2009, with the majority of the articles being published in the last 10 years. Findings suggest that U.S. federal funding and support for LGBT research as well as divisions of the American Psychological Association focused on minoritized identities and their journals played a role in the recent increase. Half of the studies investigated psychological symptoms, and more than a third of studied experiences and psychological processes related to holding multiple minority statuses, many of which focused on potentially deleterious aspects of these identities. These findings indicate that this literature has a significant focus on pathology. Underrepresented groups included cisgender and transgender women; transgender men; older individuals; Asian Americans, Native Hawaiians, and Pacific Islanders; American Indians and Alaska Natives; and multiracial individuals. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | | | - Paul J Poppen
- Department of Psychology, George Washington University
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8
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Zeglin RJ, Hergenrather KC, Poppen PJ, Choi J, Reisen C, Zea MC. Latino Sexual Beliefs Scale: An Exploratory Factor Analysis of Latino Men Who Have Sex With Men. Arch Sex Behav 2018; 47:299-308. [PMID: 28585155 DOI: 10.1007/s10508-017-0988-3] [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: 12/20/2016] [Revised: 02/28/2017] [Accepted: 04/03/2017] [Indexed: 06/07/2023]
Abstract
The catalyzing forces behind risky sexual behavior are a rich area of interest for public health researchers concerned with reducing HIV risk. Social cognitive theory would suggest that sexual beliefs are a viable example of one such influential agent. Recognizing that culture plays an important role in forming such sexual beliefs, and seeking to understand the unique HIV risks present for Latino men who have sex with men (MSM), this article presents an exploratory factor analysis of the 13-item Latino Sexual Beliefs Scale (LSBS) created as part of a larger study to investigate predictors of condom use among a sample of 482 MSM born in Brazil, Colombia, and the Dominican Republic and living in the U.S. The current analysis identified two psychometric factors in the LSBS as Romantic Exigency (containing six items with a mean loading of .62) and Sexual Acquiescence (containing seven items with a mean loading of .57). This is the first factor analysis conducted on the 13-item LSBS and represents the first known quantitative measure of Latino cultural sexual beliefs related to condom use for Latino MSM. Implications for future research include further validation, use in studies exploring the role of sexual beliefs on condom use, and possible thematic targets in HIV risk reduction interventions.
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Affiliation(s)
- Robert J Zeglin
- Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, FL, 32224, USA.
| | - Kenneth C Hergenrather
- Department of Counseling and Human Development, The George Washington University, Washington, DC, 20037, USA
| | - Paul J Poppen
- Department of Psychology, The George Washington University, Washington, DC, 20037, USA
| | - Jaehwa Choi
- Department of Educational Leadership, The George Washington University, Washington, DC, 20037, USA
| | - Carol Reisen
- Department of Psychology, The George Washington University, Washington, DC, 20037, USA
| | - Maria Cecilia Zea
- Department of Psychology, The George Washington University, Washington, DC, 20037, USA
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Abstract
We examined recency of infection in serum samples obtained from 69 newly identified HIV-positive cases in a sample of 1000 men who have sex with men (MSM) in Bogotá. HIV antibody avidity assays were performed using the Architect HIV Ag/AB combo. Avidity indices ranged from 0.62 to 1.22, with a cut-off score below 0.80 indicative of recent infection. Two samples were classified as recent, six fell within the gray zone (0.75 to 0.85), and the remaining 61 were considered established infections. Results provided evidence of widespread, long-term, undiagnosed HIV infection, as well as an estimate of one-year incidence at .25 in the population of MSM in Bogotá. This incidence rate is approximately 8.5 times the rate estimated for the general adult population in Colombia. The large proportion of newly diagnosed cases found among individuals with established infections indicates that many MSM in Bogotá are living with HIV for extended periods without being diagnosed and treated. Greater efforts to detect and treat undiagnosed infections are crucial to decrease HIV incidence and increase maximum effectiveness of medical intervention. Given the over-representation of MSM and transgender women in the HIV epidemic in Colombia, such efforts should specifically target this population.
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Ramirez-Valles J, Fergus S, Reisen CA, Poppen PJ, Zea MC. Confronting Stigma: Community Involvement and Psychological Well-Being Among HIV-Positive Latino Gay Men. Hispanic Journal of Behavioral Sciences 2016. [DOI: 10.1177/0739986304270232] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Theories of social integration and stress process posit that community involvement may buffer or may compensate the adverse effects of stigma on psychological well-being. In this article, the authors explore this thesis in a stigmatized and seldom studied group of HIV-positive Latino gay men. Specifically, they examine the effects of community involvement in AIDS and gay-related organizations (e.g., volunteerism and activism) and experienced homosexual stigma on three psychological well-being indicators (i.e., self-esteem, depression, and loneliness). The cross-sectional sample includes 155 HIV-positive men living in New York City and Washington, DC. Results suggest that experienced stigma attributed to homosexuality is associated with psychological well-being. Community involvement, however, seems to compensate the association between stigma and depression and loneliness, while buffering the association with self-esteem. Furthermore, community involvement appears to also heighten the perception of stigma.
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Bianchi FT, Reisen CA, Zea MC, Poppen PJ, Echeverry JJ. A Comparison of HIV-Related Factors Among Seropositive Brazilian, South American, and Puerto Rican Gay Men in the United States. Hispanic Journal of Behavioral Sciences 2016. [DOI: 10.1177/0739986306291127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Latino men who have sex with men are a group at high risk for HIV infection. Much of the research addressing attitudes and behaviors related to HIV among Latinos in the United States has overlooked differences based on nationality. Brazilian immigrants, in particular, are an understudied subgroup of Latinos. This study compared HIV-positive Brazilian gay men ( n = 75) with their Spanish-speaking counterparts from South America ( n = 103) and Puerto Rico ( n = 61) on a variety of HIV-related factors. Results failed to reveal any significant group differences in disclosure of serostatus or in behaviors relevant to sexual risk. Some differences in demographic characteristics, reasons for immigration, and acculturation, however, did emerge among the three groups. Implications for aggregation of Latino subgroups in HIV-related programs are discussed.
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12
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Aguayo-Romero RA, Reisen CA, Zea MC, Bianchi FT, Poppen PJ. Gender Affirmation and Body Modification Among Transgender Persons in Bogotá, Colombia. Int J Transgend 2015; 16:103-115. [PMID: 26839525 DOI: 10.1080/15532739.2015.1075930] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 10/22/2022] Open
Abstract
This paper examined structural, social, and personal characteristics that shape the processes of gender affirmation and body modification among transgender persons (assigned male at birth) in Bogotá, Colombia. Qualitative data from life-history interviews (N=14) and a focus group (N=11) explored research questions concerning the ways in which the internal psychological and external contextual processes influence individuals' decisions and behaviors concerning hormonal treatment, injections, or surgery. Research questions concerning practices and consequences of treatment performed without medical supervision were addressed through qualitative data, as well as quantitative data from 58 transgender participants. Findings indicated variation in ways participants conceptualized gender (e.g., binary or fluid), but an increased feminine presentation was a strong personal desire expressed by many and often encouraged by romantic partners and transgender friends. Transgender individuals within participants' social networks were frequently instrumental not only in providing information about hormones and contouring injections, but also in carrying out procedures-sometimes with negative consequences. Body modification procedures occurred primarily outside the health care system, due to limited access to or awareness of medical care, societal stigma, social norms within the transgender community, and personal decision-making. Public health approaches to protect the health of transgender persons undergoing body modification were suggested.
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Affiliation(s)
| | - Carol A Reisen
- Department of Psychology, The George Washington University, Washington, DC
| | - Maria Cecilia Zea
- Department of Psychology, The George Washington University, Washington, DC
| | - Fernanda T Bianchi
- Department of Psychology, The George Washington University, Washington, DC
| | - Paul J Poppen
- Department of Psychology, The George Washington University, Washington, DC
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13
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Zea MC, Reisen CA, del Río-González AM, Bianchi FT, Ramirez-Valles J, Poppen PJ. HIV Prevalence and Awareness of Positive Serostatus Among Men Who Have Sex With Men and Transgender Women in Bogotá, Colombia. Am J Public Health 2015; 105:1588-95. [PMID: 25602899 DOI: 10.2105/ajph.2014.302307] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We estimated HIV prevalence among men who have sex with men (MSM) and transgender women in Bogotá, Colombia, and explored differences between HIV-positive individuals who are aware and unaware of their serostatus. METHODS In this cross-sectional 2011 study, we used respondent-driven sampling (RDS) to recruit 1000 MSM and transgender women, who completed a computerized questionnaire and received an HIV test. RESULTS The RDS-adjusted prevalence was 12.1% (95% confidence interval [CI] = 8.7, 15.8), comparable to a previous RDS-derived estimate. Among HIV-positive participants, 39.7% (95% CI = 25.0, 54.8) were aware of their serostatus and 60.3% (95% CI = 45.2, 75.5) were unaware before this study. HIV-positive-unaware individuals were more likely to report inadequate insurance coverage, exchange sex (i.e., sexual intercourse in exchange for money, goods, or services), and substance use than other participants. HIV-positive-aware participants were least likely to have had condomless anal intercourse in the previous 3 months. Regardless of awareness, HIV-positive participants reported more violence and forced relocation experiences than HIV-negative participants. CONCLUSIONS There is an urgent need to increase HIV detection among MSM and transgender women in Bogotá. HIV-positive-unaware group characteristics suggest an important role for structural, social, and individual interventions.
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Affiliation(s)
- Maria Cecilia Zea
- Maria Cecilia Zea, Carol A. Reisen, Ana María del Río-González, Fernanda T. Biachi, and Paul J. Poppen are with George Washington University, Washington, DC. Jesus Ramirez-Valles is with the University of Illinois, Chicago
| | - Carol A Reisen
- Maria Cecilia Zea, Carol A. Reisen, Ana María del Río-González, Fernanda T. Biachi, and Paul J. Poppen are with George Washington University, Washington, DC. Jesus Ramirez-Valles is with the University of Illinois, Chicago
| | - Ana María del Río-González
- Maria Cecilia Zea, Carol A. Reisen, Ana María del Río-González, Fernanda T. Biachi, and Paul J. Poppen are with George Washington University, Washington, DC. Jesus Ramirez-Valles is with the University of Illinois, Chicago
| | - Fernanda T Bianchi
- Maria Cecilia Zea, Carol A. Reisen, Ana María del Río-González, Fernanda T. Biachi, and Paul J. Poppen are with George Washington University, Washington, DC. Jesus Ramirez-Valles is with the University of Illinois, Chicago
| | - Jesus Ramirez-Valles
- Maria Cecilia Zea, Carol A. Reisen, Ana María del Río-González, Fernanda T. Biachi, and Paul J. Poppen are with George Washington University, Washington, DC. Jesus Ramirez-Valles is with the University of Illinois, Chicago
| | - Paul J Poppen
- Maria Cecilia Zea, Carol A. Reisen, Ana María del Río-González, Fernanda T. Biachi, and Paul J. Poppen are with George Washington University, Washington, DC. Jesus Ramirez-Valles is with the University of Illinois, Chicago
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Bianchi FT, Reisen CA, Zea MC, Vidal-Ortiz S, Gonzales FA, Betancourt F, Aguilar M, Poppen PJ. Sex work among men who have sex with men and transgender women in Bogotá. Arch Sex Behav 2014; 43:1637-1650. [PMID: 24464550 PMCID: PMC4110190 DOI: 10.1007/s10508-014-0260-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 08/08/2013] [Revised: 11/18/2013] [Accepted: 11/30/2013] [Indexed: 06/03/2023]
Abstract
This qualitative study examined sex work among internally displaced male and transgender female sex workers in Bogotá, Colombia. Internal displacement has occurred in Colombia as a result of decades of conflict among armed groups and has created large-scale migration from rural to urban areas. Informed by the polymorphous model of sex work, which posits that contextual conditions shape the experience of sex work, we examined three main research questions. The first dealt with how internal displacement was related to the initiation of sex work; the second concerned the effect of agency on sex worker satisfaction; and the third examined how sex work in this context was related to HIV and other risks. Life history interviews were conducted with 26 displaced individuals who had done sex work: 14 were men who have sex with men and 12 were transgender women (natal males). Findings revealed that many participants began doing sex work in the period immediately after displacement, because of a lack of money, housing, and social support. HIV risk was greater during this time due to limited knowledge of HIV and inexperience negotiating safer sex with clients. Other findings indicated that sex workers who exerted more control and choice in the circumstances of their work reported greater satisfaction. In addition, we found that although many sex workers insisted on condom use with clients, several noted that they would sometimes have unprotected sex for additional money. Specific characteristics affecting the experience of sex work among the transgender women were also discussed.
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Affiliation(s)
- Fernanda T Bianchi
- Global Women's Institute, The George Washington University, 714 21st Street NW, 2nd Floor, Washington, DC, 20052, USA,
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Reisen CA, Zea MC, Bianchi FT, Poppen PJ, del Río González AM, Romero RAA, Pérez C. HIV testing among MSM in Bogotá, Colombia: the role of structural and individual characteristics. AIDS Educ Prev 2014; 26:328-344. [PMID: 25068180 PMCID: PMC4121962 DOI: 10.1521/aeap.2014.26.4.328] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study used mixed methods to examine characteristics related to HIV testing among men who have sex with men (MSM) in Bogotá, Colombia. A sample of 890 MSM responded to a computerized quantitative survey. Follow-up qualitative data included 20 in-depth interviews with MSM and 12 key informant interviews. Hierarchical logistic set regression indicated that sequential sets of variables reflecting demographic characteristics, insurance coverage, risk appraisal, and social context each added to the explanation of HIV testing. Follow-up logistic regression showed that individuals who were older, had higher income, paid for their own insurance, had had a sexually transmitted infection, knew more people living with HIV, and had greater social support were more likely to have been tested for HIV at least once. Qualitative findings provided details of personal and structural barriers to testing, as well as inter-relationships among these factors. Recommendations to increase HIV testing among Colombian MSM are offered.
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Bianchi FT, Reisen CA, Gonzales FA, Arroyo JC, Zea MC, Poppen PJ. Sex with sex workers among latino day laborers in Suburban Maryland. Arch Sex Behav 2013; 42:835-849. [PMID: 23070528 PMCID: PMC4745421 DOI: 10.1007/s10508-012-0010-z] [Citation(s) in RCA: 3] [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: 05/21/2011] [Revised: 02/04/2012] [Accepted: 05/29/2012] [Indexed: 06/01/2023]
Abstract
Using the structural-environmental conceptual framework, this study employed mixed methods to address the question of whether sex with female sex workers contributes to HIV risk among male immigrant Latino day laborers in suburban Maryland. Because contextual factors can greatly affect HIV risk for both sex workers and their clients, this study investigated the organizational structure of sex work, factors that predicted men's hiring of sex workers, sexual behaviors performed with sex workers, and the use of condoms. Qualitative research was conducted to inform the development of a quantitative survey, but also provided crucial descriptions about the motivations, locations, arrangements, and sexual activities related to sex work. Key informant interviews (N = 10), in-depth interviews with day laborers (N = 10) and Latina female sex workers (N = 4), and two focus groups with day laborers (N = 11) were conducted, and a quantitative survey administered via Audio-enhanced Computer-assisted Self-interviewing (N = 174). Condom use was nearly universal in encounters with female sex workers, thus indicating that the sex workers were not an important source of HIV transmission in this context. Logistic regression was performed to test a model predicting sex with sex workers. Latino day laborers who reported more immigrant stress and who did not have a partner in the U.S. were more likely to have had sex with a sex worker, as were men who reported binge drinking. Structural and social conditions influenced the hiring of sex workers. Further research is warranted to better understand the interrelationships among these circumstances and to inform the development of programs to address them.
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Affiliation(s)
- Fernanda T Bianchi
- Department of Psychology, George Washington University, 2125 G St. NW, Washington, DC, 20052, USA.
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Zea MC, Reisen CA, Bianchi FT, Gonzales FA, Betancourt F, Aguilar M, Poppen PJ. Armed conflict, homonegativity and forced internal displacement: implications for HIV among Colombian gay, bisexual and transgender individuals. Cult Health Sex 2013; 15:788-803. [PMID: 23586420 PMCID: PMC3732551 DOI: 10.1080/13691058.2013.779028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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: 06/01/2023]
Abstract
Colombia has endured six decades of civil unrest, population displacement and violence. We examined the relationships between contextual conditions, displacement and HIV among gay, bisexual and transgender individuals in Bogotá, Colombia. A total of 19 key informants provided information about internal displacement of sexual minorities. Life-history interviews were conducted with 42 participants aged 18 to 48 years and included questions about displacement experiences, sexual behaviour, life prior to displacement and participants' economic and social situation in Bogotá. The interplay of a variety of factors - including internal conflict and violence, homonegativity and 'social cleansing', gender and sexual identity and poverty - strongly shaped the varied experiences of displacement. Migration, sexual violence, exchange sex and low rates of HIV testing were risk factors that increased vulnerability for HIV in this displaced sample. Although displacement and HIV in Colombia are major problems, both are understudied.
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Affiliation(s)
- Maria Cecilia Zea
- Department of Psychology, George Washington University, Washington, USA.
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Reisen CA, Brooks KD, Zea MC, Poppen PJ, Bianchi FT. Can additive measures add to an intersectional understanding? Experiences of gay and ethnic discrimination among HIV-positive Latino gay men. Cultur Divers Ethnic Minor Psychol 2013; 19:208-217. [PMID: 23647331 PMCID: PMC3823050 DOI: 10.1037/a0031906] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [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: 06/02/2023]
Abstract
The current study investigated a methodological question of whether traditional, additive, quantitative data can be used to address intersectional issues, and illustrated such an approach with a sample of 301 HIV-positive, Latino gay men in the United States. Participants were surveyed using A-CASI. Hierarchical logistic set regression investigated the role of sets of variables reflecting demographic characteristics, gender nonconformity, and gay and ethnic discrimination in relation to depression and gay collective identity. Results showed the discrimination set was related to depression and to gay collective identity, as was gender nonconformity. Follow-up logistic regression showed that both types of discrimination were associated with greater depression, but gender nonconformity was not. Gay discrimination and gender nonconformity were positively associated with gay collective identity, whereas ethnic discrimination was negatively associated. Results are discussed in terms of the use of traditional quantitative data as a potential means of understanding intersectional issues, as well as of contributing to knowledge about individuals facing multiple structural inequalities.
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Affiliation(s)
- Carol A Reisen
- Department of Psychology, George Washington University, 2125 G. St. NW, Washington, DC 20052, USA.
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Gonzales FA, Zea MC, Reisen CA, Bianchi FT, Betancourt Rodríguez CF, Aguilar Pardo M, Poppen PJ. Popular perceptions of circumcision among Colombian men who have sex with men. Cult Health Sex 2012; 14:991-1005. [PMID: 22917475 PMCID: PMC3463718 DOI: 10.1080/13691058.2012.712719] [Citation(s) in RCA: 3] [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] [Indexed: 06/01/2023]
Abstract
Male circumcision has received increased attention for its potential to reduce sexual transmission of HIV. Research on the acceptability of circumcision as a means of HIV prevention among men who have sex with men is limited. Men who have sex with men in Bogotá, Colombia, either participated in a focus group in which they shared information regarding their perceptions of circumcision or completed a survey that assessed circumcision experiences, attitudes, beliefs and willingness. Few participants reported they were circumcised, yet most participants reported knowing something about the procedure. Overall, attitudes towards circumcision were mixed: although circumcision was viewed as safe, it was also viewed as unnatural and cruel to babies. Beliefs that circumcision could improve sexual functioning and protect against STIs and HIV were not widely endorsed by survey participants, although focus-group participants discussed the potential impacts of circumcision on the availability of sexual partners and sexual performance. Some focus-group participants and many survey participants reported a hypothetical willingness to get circumcised if strong evidence of its effectiveness could be provided, barriers removed and recovery time minimised.
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Affiliation(s)
- Felisa A Gonzales
- Department of Psychology, The George Washington University, Washington, USA.
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Calabrese SK, Reisen CA, Zea MC, Poppen PJ, Bianchi FT. The pleasure principle: the effect of perceived pleasure loss associated with condoms on unprotected anal intercourse among immigrant Latino men who have sex with men. AIDS Patient Care STDS 2012; 26:430-5. [PMID: 22663165 DOI: 10.1089/apc.2011.0428] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Sexual pleasure has been identified as an important consideration in decision-making surrounding condom use. We examined the impact of perceived pleasure loss associated with condom use on recent history of insertive and receptive unprotected anal intercourse (UAI) among Latino men who have sex with men (MSM) living in the United States. A total of 482 Dominican, Colombian, and Brazilian immigrant MSM were surveyed regarding sexual attitudes and practices via computer-assisted self-interviewing technology with audio enhancement (ACASI). Participants rated the pleasure they derived from protected and unprotected anal intercourse in each position (insertive and receptive) and also reported their HIV status, relationship status, and recent sexual history. Men who had engaged in both positions, with and without condoms (n=268), perceived a greater pleasure loss associated with condoms during anal intercourse in the insertive versus receptive position. Logistic regression analyses controlling for HIV status, relationship status, and age revealed that men who perceived greater pleasure loss from condoms were more likely to have engaged in UAI over the past 3 months (n[insertive]=297; n[receptive]=284). Findings indicate that the pleasure loss associated with condoms may be a key deterrent for their use in either sex position among Latino MSM. Therefore, pleasure needs to be prioritized in the development of condoms and other sexual safety measures as well as in the promotion of their use.
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Affiliation(s)
| | - Carol A. Reisen
- The George Washington University, Washington, District of Columbia
| | | | - Paul J. Poppen
- The George Washington University, Washington, District of Columbia
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Abstract
Many men who have sex with men (MSM) have sexual encounters in public places, and some data suggest that this behavior is more common among Latino than non-Hispanic white MSM in the USA. In a sample of 482 Latino MSM born in Brazil, Colombia, and the Dominican Republic, and living in the New York City metropolitan area, we examined how demographic and psychosocial characteristics are related to having sex in public venues. Logistic regression was performed with the dichotomous outcome of sex in a public place in the previous six months. Demographic variables included education, HIV-positive serostatus, unknown HIV serostatus, and years in the USA; psychosocial variables included self-efficacy for safer sex, depression, and gay community involvement. Results indicated that those individuals with unknown serostatus were more likely than those with HIV-negative serostatus to have had sex in a public setting, as were men with lower self-efficacy for safer sex. These findings suggest that the partner pool may pose some risk to men who have sex in public sex venues, and therefore, low-risk sexual practices and condom use should be promoted in such settings. Contrary to expectations, higher education was related to sex in public settings, but neither depression nor more recent immigration was. Greater involvement in the gay community was also associated with having sex in public places, which may reflect the larger social function served by gay venues such as bathhouses and bars.
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Affiliation(s)
- Carol A Reisen
- Department of Psychology, George Washington University, Washington, DC, USA.
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Abstract
This study examined factors associated with communication about condom use and unprotected anal intercourse (UAI) in a U.S. sample of immigrant Latino MSM (N = 356), with a focus on culturally based beliefs. Logistic regression analysis revealed that communication about condom use at participants' most recent encounter was associated with a lower likelihood of UAI during that encounter. UAI was more likely when the partner was a main partner and there was seroconcordance. A separate logistic regression indicated that communication about condom use was less likely when the most recent encounter involved a main partner, greater sexual desire, and intoxication due to substance use. Although cultural beliefs were not predictive of communication about condom use or UAI at the most recent encounter, they were related to the occurrence of UAI in the previous three months. There is a need for more research on the interplay of culture, safer sex communication, and sexual risk.
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Affiliation(s)
- Serena C Lo
- Department of Psychology, George Washington University, NW, DC 20052, USA.
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Reisen CA, Bianchi FT, Cohen-Blair H, Liappis AP, Poppen PJ, Zea MC, Benator DA, Labriola AM. Present and past influences on current smoking among HIV-positive male veterans. Nicotine Tob Res 2011; 13:638-45. [PMID: 21436293 DOI: 10.1093/ntr/ntr050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Cigarette smoking has become an important influence of morbidity and mortality for HIV-positive individuals in the era of highly active antiretroviral therapy. Although smoking is common among military personnel and veterans, the lasting impact of military service on smoking at a later stage of life has not been examined. The current study investigated present and past influences on current smoking among HIV-positive male veterans. METHODS Participants were 200 HIV-positive men served by the Veterans Affairs Medical Center. A survey was administered via audio-enhanced computer-assisted self-interview, and additional information was extracted from the computerized patient record system. RESULTS Logistic regression was performed to test hypotheses concerning the participants' current situations as well as characteristics of their past military service. Having smokers in one's environment, being more depressed, and having used alcohol or drugs were associated with having smoked in the previous 30 days, whereas stronger endorsement of attitudes stating adverse effects of smoking was linked to lower likelihood of smoking. Neither having been in a military conflict nor the length of the military service was significantly related to current smoking. CONCLUSIONS Remote experiences in the military did not have a sustained effect on smoking behavior years later. Implications of this study for the development of smoking cessation programs targeting HIV-positive veterans include the importance of altering attitudes about tobacco, treating underlying depression, addressing social influence, decreasing substance use, and increasing awareness of the heightened vulnerability to a variety of negative consequences of smoking among infected individuals.
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Affiliation(s)
- Carol A Reisen
- Department of Psychology, George Washington University, 2125 G St. NW, Washington, DC 20052, USA.
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Bianchi FT, Shedlin MG, Brooks KD, Montes Penha M, Reisen CA, Zea MC, Poppen PJ. Partner selection among Latino immigrant men who have sex with men. Arch Sex Behav 2010; 39:1321-30. [PMID: 19688592 PMCID: PMC2992808 DOI: 10.1007/s10508-009-9510-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 10/22/2008] [Revised: 05/26/2009] [Accepted: 05/26/2009] [Indexed: 05/13/2023]
Abstract
This qualitative study explored partner selection in a sample of immigrant Latino men who have sex with men (MSM). In-depth interviews were conducted with men living in the greater New York metropolitan area who had been born in Brazil (n = 10), Colombia (n = 14), or the Dominican Republic (n = 9). One focus group was conducted with MSM from each of the three countries (9 Brazilian, 11 Colombian, and 5 Dominican participants). A grounded theory approach revealed three main themes relating to partner selection. The first concerned stereotypes of how Latino and Anglo-American men tend to behave in their sexual encounters and relationships. The participants perceived Latinos to be more affectionate and passionate, whereas they saw Anglo-American men as more independent and practical. These cultural discrepancies sometimes resulted in a preference for Latino partners. A second theme concerned stereotypes of the national groups, including expectations that Brazilians would be sexy and sensual and that Dominicans would have large penises. As found in other research on MSM of color, ethnic and national stereotypes were associated with experiences of sexual objectification. The third theme addressed the importance of masculine characteristics in sexual attraction and partner selection. Negative feelings towards effeminate men who did not conform to normative male physical or behavioral presentation reflect a stigma found inside and outside of the gay community. These findings suggest that gender and ethnic stereotypes play an important role in shaping partner choice and have implications for sexual risk and relationship formation.
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Affiliation(s)
- Fernanda T Bianchi
- Department of Psychology, George Washington University, 2125 G Street NW, Washington, DC 20052, USA.
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25
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Meade CS, Wang J, Lin X, Wu H, Poppen PJ. Stress and coping in HIV-positive former plasma/blood donors in China: a test of cognitive appraisal theory. AIDS Behav 2010; 14:328-38. [PMID: 19127424 DOI: 10.1007/s10461-008-9494-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [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] [Received: 06/12/2008] [Accepted: 11/06/2008] [Indexed: 11/27/2022]
Abstract
Throughout the 1990s, many villagers in rural China were infected with HIV through commercial plasma/blood donation. These former plasma/blood donors (FPDs) experienced many HIV-related stressors. This study tested a cognitive appraisal model of stress and coping in a sample of HIV-positive adult FPDs. Participants (N = 207) from multiple villages completed a battery of questionnaires assessing HIV-related stress, HIV symptoms, cognitive appraisal, coping behaviors, and psychological distress. Participants reported high levels of HIV-related stress, depression, and anxiety. In a structural equation model, greater HIV-related stress, HIV symptoms, and threat appraisal were directly associated with psychological distress. HIV-related stress was also indirectly associated with psychological distress through threat appraisal. In a second model, coping was found to mediate the relationship between challenge appraisal and psychological distress. Results support the utility of cognitive appraisal theory. Stress management interventions targeting HIV-positive FPDs in China are indicated.
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Affiliation(s)
- Christina S Meade
- Department of Psychiatry, McLean Hospital/Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA.
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26
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Reisen CA, Zea MC, Bianchi FT, Poppen PJ, Shedlin MG, Penha MM. Latino gay and bisexual men's relationships with non-gay-identified men who have sex with men. J Homosex 2010; 57:1004-21. [PMID: 20818527 PMCID: PMC3467943 DOI: 10.1080/00918369.2010.503510] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This study investigated relationships between Latino gay-identified men in metropolitan New York City and their non-gay-identified male partners. Phase 1 consisted of in-depth interviews (N = 33), and Phase 2 consisted of quantitative surveys (N = 120) with Brazilian, Colombian, and Dominican men who have sex with men (MSM). A majority of participants reported having had sex with heterosexually identified men, and in many cases, the relationship was sustained over time. We found mixed results concerning an attitude sometimes attributed to Latinos that sexual orientation is defined by sexual role, with receptive MSM seen as gay and insertive MSM seen as straight. Although there were no significant associations between partner sexual orientation and unprotected anal intercourse, gay men were less likely to take the insertive role in oral or anal sex with straight-identified male partners than with gay partners.
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Affiliation(s)
- Carol A Reisen
- Department of Psychology, George Washington University, Washington, DC 20052, USA.
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Zea MC, Reisen CA, Poppen PJ, Bianchi FT. Unprotected anal intercourse among immigrant Latino MSM: the role of characteristics of the person and the sexual encounter. AIDS Behav 2009; 13:700-15. [PMID: 19030982 DOI: 10.1007/s10461-008-9488-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [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] [Received: 06/17/2008] [Accepted: 10/23/2008] [Indexed: 11/26/2022]
Abstract
Theoretical models of sexual risk-taking have traditionally focused on personal characteristics, but conceptual approaches emphasizing the social and situational context have also been proposed. This study examined the impact of characteristics of the person and of the sexual encounter on unprotected anal intercourse (UAI) among 482 immigrant Latino MSM. Analyses included logistic regression and hierarchical linear modeling. The personal characteristic of self-efficacy for safer sex was negatively associated with UAI over the previous three months, at the most recent encounter, and over multiple encounters reported by each participant. In addition, a cross-level interaction of self-efficacy at the person-level and sexual desire at the encounter-level showed that increased sexual desire was associated with greater likelihood of UAI for those with low self-efficacy, but not those with high self-efficacy. Likelihood of UAI was also linked to the situational characteristics of closeness to the partner, seroconcordance, and concern about STIs in the encounter.
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Affiliation(s)
- Maria Cecilia Zea
- Department of Psychology, George Washington University, 2125 G. St., NW, Washington, DC 20052, USA.
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Abstract
This study investigated protective effects of circumcision in a sample of immigrant Latino men who have sex with men (MSM). A survey in Portuguese, Spanish, or English was administered with computer-assisted self-interview technology with audio enhancement (A-CASI) to 482 MSM from Brazil (n=146), Colombia (n=169), and the Dominican Republic (n=167), living in the New York metropolitan area. Logistic regression revealed that after controlling for age, income, education, having had syphilis, having done sex work, and preferring the receptive role in anal intercourse, uncircumcised men were almost twice as likely to be HIV-positive as circumcised men. Follow-up analyses revealed, however, that the protective effects occurred only among the group of Colombian men.
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Affiliation(s)
- Carol A Reisen
- Department of Psychology, George Washingtoin University, 2125 G Street NW, Washington, DC 20052, USA.
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Zea MC, Reisen CA, Poppen PJ, Bianchi FT, Echeverry JJ. Predictors of disclosure of human immunovirus-positive serostatus among Latino gay men. Cultur Divers Ethnic Minor Psychol 2007; 13:304-312. [PMID: 17967098 DOI: 10.1037/1099-9809.13.4.304] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
To test a theoretical approach to disclosure of human immunovirus (HIV) status, 301 HIV-positive Latino gay men were interviewed using Audio-CASI (Computer Assisted Self-Interview technology with Audio enhancement). Consequence theory and social influence theory were combined to create a model of antecedents of disclosure. Results provided support for both theories. Perceived positive consequences were associated with greater disclosure to casual partners, families, and friends, whereas perceived negative consequences were associated with less disclosure to friends and family members. Social influence of peer behavioral norms was predictive of disclosure to all three target groups. Gay community social influence produced different effects on disclosure of HIV-positive status: a negative association for casual partners, a positive association for close friends, and no relationship for family members. Time since diagnosis was also predictive of disclosure.
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Affiliation(s)
- Maria Cecilia Zea
- Department of Psychology, George Washington University, Washington, DC 20052, USA.
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Bianchi FT, Reisen CA, Zea MC, Poppen PJ, Shedlin MG, Penha MM. The sexual experiences of Latino men who have sex with men who migrated to a gay epicentre in the USA. Cult Health Sex 2007; 9:505-18. [PMID: 17687675 PMCID: PMC3467945 DOI: 10.1080/13691050701243547] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [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: 05/08/2023]
Abstract
Key informant interviews, in-depth interviews and focus groups were conducted to examine ways in which social context influenced the behavior of Brazilian, Colombian and Dominican men who have sex with men. First, we investigated how the social context in the home country affected motivation for migration. Findings suggest that Latino men who have sex with men frequently reported coming to the USA to escape homo-negativity and to achieve greater sexual freedom. The study also examined how the social context encountered in the early years after migration shaped sexual behavior and risk. A majority of the participants reported easy access to sex partners and frequent sexual encounters. The anonymity of living in a gay epicentre such as New York City, often without social connections from the past, was experienced as liberating and conducive to sexual exploration. Moreover, sex in public venues, such as parks and sex cabins, was readily available to those who do not speak English. The tendency to engage in high levels of sexual activity during the early period after arrival in New York City was particularly evident among younger men. Implications for future programme development are discussed alongside prevention efforts targeting migrants during this critical period.
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Jarama SL, Kennamer JD, Poppen PJ, Hendricks M, Bradford J. Psychosocial, behavioral, and cultural predictors of sexual risk for HIV infection among Latino men who have sex with men. AIDS Behav 2005; 9:513-23. [PMID: 16328712 DOI: 10.1007/s10461-005-9022-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study sought to replicate and extend an investigation by Diaz et al. (1999) on determinants of HIV risk among Latino gay and bisexual men living in San Francisco who were predominantly English-speaking. Compared to the Diaz et al. study, the current study sample consisted of predominantly Spanish-speaking MSM, who resided outside of HIV/AIDS epicenters and whose countries of origin were primarily Central & South American. The relationships of unprotected anal sex and multiple sexual partners with demographic, developmental, behavioral, cultural and psychosocial variables were examined. Data were collected in a convenience sample of 250 participants (primarily immigrants from El Salvador) residing in Virginia. Most men in the sample had more than one sexual partner in the last 3 months (62%) and more than a third had unprotected anal sex with a casual partner in the same time period. Communication about HIV, sexual attraction, machismo, and experiences of discrimination based on homosexual behavior were predictive of HIV risk behaviors. The findings support an integrative approach to investigating HIV risk among Latino MSM. Implications for prevention programs are discussed.
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Affiliation(s)
- S Lisbeth Jarama
- Department of Psychology, George Washington University, Washington, DC 20052, USA
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Abstract
The purpose of this study was to examine the degree to which HIV-positive Latino gay and bisexual men utilized complementary and alternative medicine (CAM), and to explore the relationship between CAM use and adherence to treatment. The sample consisted of 152 HIV-positive Latino gay and bisexual men. Eighty percent of participants reported use of some form of CAM. Asian CAM was most commonly used, followed by herbal remedies and Latino CAM. Adherence to Western medical care was also explored, with more than two-thirds of the sample adhering completely to recommendations concerning seeing the doctor, taking medications and following instructions. The relationships between CAM use and Western medical care were examined with logistic regressions. Those who used Latino CAM were less likely to keep doctors' appointments, follow physicians' recommendations and adhere to the prescribed medication regimen in the past three days. Plant-based CAM was also significantly related to non-adherence to Western medicine.
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Affiliation(s)
- N Jernewall
- The George Washington University, Washington, DC 20052, USA
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Poppen PJ, Reisen CA, Zea MC, Bianchi FT, Echeverry JJ. Serostatus disclosure, seroconcordance, partner relationship, and unprotected anal intercourse among HIV-positive Latino men who have sex with men. AIDS Educ Prev 2005; 17:227-37. [PMID: 16006209 DOI: 10.1521/aeap.17.4.227.66530] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This article examined, in a sample of 219 HIV-positive Latino men who have sex with men (MSM), a set of three variables that can shape the context of sexual encounters between men and influence sexual risk behaviors: disclosure of positive HIV serostatus, seroconcordance of partners, and relationship between partners. Participants from Boston, New York, and Washington completed a survey in English or Spanish using computer-assisted self-interview technology with audio enhancement. At the bivariate level, disclosure, seroconcordance, and partner relationship were all interrelated, as well as associated with the likelihood of unprotected intercourse. Unprotected anal intercourse with the most recent partner was more likely when the partner (a) knew that the participant was HIV-positive, (b) was the participant's main partner, and (c) was himself also HIV-positive. A logistic set regression revealed that the set of three variables added significantly to the prediction of unprotected anal intercourse, beyond demographic variables of income, education, and age. In the multivariate model, however, of the three, only seroconcordance achieved significance. The importance of a contextual approach to understanding sexual risk behavior was discussed.
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Affiliation(s)
- Paul J Poppen
- Department of Psychology, George Washington University, Washington, DC 20052, USA.
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Zea MC, Reisen CA, Poppen PJ, Bianchi FT, Echeverry JJ. Disclosure of HIV status and psychological well-being among Latino gay and bisexual men. AIDS Behav 2005; 9:15-26. [PMID: 15812610 DOI: 10.1007/s10461-005-1678-z] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.2] [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] [Received: 11/08/2003] [Revised: 03/02/2004] [Accepted: 04/12/2004] [Indexed: 11/30/2022]
Abstract
This study examined disclosure of HIV-positive serostatus by 301 Latino gay and bisexual men to members of their social networks and the mental health consequences of such disclosure. The sample was recruited from clinics, hospitals, and community agencies in New York City, Washington, DC, and Boston. Proportions disclosing differed depending on the target, with 85% having disclosed to closest friend, 78% to male main partner, 37% to mother, and 23% to father. Although there were differences depending on the target, disclosure was related to greater quality of social support, greater self-esteem, and lower levels of depression. Moreover, findings indicated that social support mediated the relationship between disclosure of serostatus and both self-esteem and depression. Thus, disclosure resulted in greater social support, which in turn had positive effects on psychological well-being. Findings demonstrate that generally Latino gay men are selective in choosing people to whom they disclose their serostatus and that disclosure tends to be associated with positive outcomes.
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Affiliation(s)
- María Cecilia Zea
- Department of Psychology, George Washington University, Washington, District of Columbia 20052, USA.
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Abstract
This study examined sexual behaviors in a sample of 155 HIV-positive Latino gay and bisexual men. Nearly half the sample had engaged in unprotected anal intercourse in the past 12 months; unprotected anal intercourse was more likely when the partner was also HIV-positive. Separate regression models predicted the number of receptive and insertive partners for unprotected anal intercourse. Participants reported both more unprotected insertive and receptive partners if they had sex under the influence of alcohol or drugs. Older participants and those with lower levels of Latino acculturation reported having more partners with whom they took the receptive role during unprotected anal intercourse, whereas those with higher levels of depression reported having more partners with whom they took the insertive role. Hierarchical set logistic regression revealed that the dyadic variable of seroconcordance added to the prediction of unprotected anal sex with the most recent male partner, beyond the individual characteristics. Results show the importance of examining both individual and dyadic characteristics in the study of sexual behavior.
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Affiliation(s)
- Paul J Poppen
- George Washington University, Washington, District of Columbia 20052, USA.
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Abstract
This study explored disclosure of serostatus in a sample of 155 HIV-positive Latino gay men from New York City and Washington, DC. We examined rates of disclosure to different members of the social network: mothers, fathers, close friends, and primary sexual partners. There were high rates of disclosure of HIV-positive serostatus to main partners and closest friends and lower rates to fathers and mothers. We examined the role of 3 contextual target-dependent factors (emotional closeness to target, anticipated reactions from target, and target's knowledge of sexual orientation), as well as acculturation and time since diagnosis. Three separate logistic regression models were performed to predict disclosure of HIV-positive status to 3 targets: mothers, fathers, and closest friends. We found that disclosure was not a generalized tendency, but rather different factors were influential depending on the target. Whether the target was aware of participant's sexual orientation was associated with disclosure in all 3 models. Greater emotional closeness also predicted disclosure to mother and father; greater U.S. acculturation was associated with disclosure to father and marginally to mother. A longer time since diagnosis was associated with disclosure to the closest friend. These findings highlight the importance of taking into account roles and relationships, and their effect on disclosure.
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Affiliation(s)
- María Cecilia Zea
- Department of Psychology, George Washington University, Washington, District of Columbia 20052, USA.
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Bianchi FT, Zea MC, Poppen PJ, Reisen CA, Echeverry JJ. Coping as a mediator of the impact of sociocultural factors on health behavior among HIV-positive latino gay men. Psychol Health 2004. [DOI: 10.1080/08870440410001655340] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Communication about HIV status--that is, asking about a sex partner's status as well as disclosing one's own status--was examined in a sample of 129 Latino HIV-positive gay men interviewed as part of a larger study conducted in New York, Miami, and Los Angeles. Asking and telling were strongly related to each other; however, participants were more likely to disclose their positive serostatus to sex partners than to solicit information about their partners' serostatus. Region of birth was associated with both asking and telling. Participants with bilingual friendship networks reported more communication with partners. Higher levels of social isolation were related to lower levels of communication, and perceived negative consequences--beliefs that disclosure would result in negative consequences or rejection--were related to less telling. Contrary to expectations, reported experiences of gay discrimination were positively associated with communication of serostatus.
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Affiliation(s)
- María Cecilia Zea
- Department of Psychology, George Washington University, Washington, D.C. 20052, USA.
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Abstract
In a sample of college women at two private universities, this study examined dual use of self-protective measures, i.e., simultaneous use of condoms for disease prevention and birth control pills for contraception. Those who were dual users of condoms and birth control pills were in newer relationships, were less committed to their current relationships, and perceived their partners as more likely to have HIV or other STDs, as compared to college women using condoms only, birth control pills only, or no method. Dual use was unrelated to personality or health and risk behavior. Rather, dual use reflected a pattern of sexual self-protection based on risk management associated with concerns about consequences of sexual activity, that is STDs and conception, and not with more distal factors.
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Affiliation(s)
- P J Poppen
- Department of Psychology, George Washington University, Washington, DC 20052, USA
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Poppen PJ, Reisen CA. Perception of risk and sexual self-protective behavior: a methodological critique. AIDS Educ Prev 1997; 9:373-390. [PMID: 9376210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Although several theories suggest that perceptions of the risk of transmission of sexually transmitted diseases, including HIV, motivate individuals to adopt or maintain self-protective behaviors, the research literature has generally failed to demonstrate this relationship. Because many HIV prevention interventions are based on the presumption of this relationship and because there is support for the effects of risk perception on self-protective behaviors in other health domains, a closer examination of the research concerning HIV risk perception is warranted. Therefore, a critical review of methodological features of research in this area was conducted. Issues considered were measurement; research design; the distinctive characteristics of HIV risk; the sexual and social nature of HIV transmission; and ecological, construct, and statistical conclusion validity. Methodological and design recommendations were made for testing the effects of HIV risk perception more adequately.
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Affiliation(s)
- P J Poppen
- George Washington University, Washington, DC 20052, USA
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Abstract
Representative community mental health center (CMHC) survey data showed that psychiatrists differed from other CMHC providers of mental health services by serving the more seriously impaired patients who are admitted and readmitted to outpatient services. Psychiatrists also shared more outpatients with providers from other disciplines than providers in other disciplines shared with one another. The results are consistent with previous research on differences between disciplines and with the flight of psychiatrists from CMHCs but cast doubt on the hypothesis that psychiatrists see sicker patients than psychologists see because of differences in reimbursement between the two disciplines.
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