Prevalence and Correlates of Sexual Violence Experienced by Young Adult Black Men Who Have Sex with Men

Exploring determinants of pre-exposure prophylaxis awareness and willingness among sexual minority men in Taiwan: a stochastic search variable selection approach

Since the introduction of pre-exposure prophylaxis (PrEP) in Taiwan in 2016, understanding factors influencing awareness and willingness among sexual minority men (SMM) remains critical. This study investigated predictors of PrEP awareness and willingness among SMM in Taiwan. A cross-sectional online survey conducted between April and May 2023 included 379 HIV-negative or status-unknown cisgender men identifying as gay, bisexual, or men who have sex with men, aged 18-59. Using stochastic search variable selection (SSVS), regression models identified key factors associated with PrEP awareness and willingness. Results revealed high awareness (96.9%) but moderate willingness (75.5%) to use PrEP. Regular HIV/STI testing, using apps to find sex partners, and community affinity significantly predicted both awareness and willingness. Additionally, internalized stigma, higher education, financial stress, and sexualized substance use were linked to awareness, while enacted stigma and PrEP awareness were associated with willingness. These findings highlight the need for targeted strategies to address stigma and barriers to awareness and willingness. Leveraging digital platforms and fostering community engagement are essential for strengthening these critical precursors in HIV prevention among SMM in Taiwan.

The Role of Substance Misuse and Sexual Victimization History on Sexual Violence Risk Perception in Men Who Have Sex With Men: A Novel Paradigm

OBJECTIVE

Sexual victimization (SV) is common among men who have sex with men (MSM), as is dating and sexual networking (DSN) app use. We developed a novel laboratory paradigm ("G-Date") of sexual violence risk perception in DSN app environments and explored its validity and the role of substance misuse and SV history on sexual violence risk perception.

METHOD

Using convenience sampling, we recruited 145 MSM to use G-Date to interact with two bogus speed dates whose responses were scripted to be risky or nonrisky. Risky dates displayed several cues indicating risk for sexual violence perpetration. Dependent variables included pre/post changes in ratings of their dating partner's appeal, ratings of the presence of each embedded risk cue, and the duration of the speed dates.

RESULTS

Compared with nonrisky dates, participants terminated risky dates significantly sooner, rated them higher in each risk cue, and gave them pre- to postdate ratings of partner appeal that declined significantly more. Participants' drug misuse was associated with reduced interest in the nonrisky date but not the risky date and predicted shorter speed date length and lower partner appeal ratings across date types. Substance-facilitated SV history interacted with alcohol misuse and date type to predict sexual violence risk perception.

CONCLUSIONS

Results provide evidence for the paradigm's validity and suggest that drug misuse and substance-facilitated SV history shape MSM's risk perception in DSN apps. Efforts to prevent SV among MSM should consider individual characteristics, including substance misuse, in risk perception.

Financial strain measures and associations with adult health: A systematic literature review

Despite growing attention to other social needs like food and housing insecurity, financial strain, defined as having difficulty making ends meet or lacking money for basic needs, is under-recognized. Inconsistent labels and measures have made the literature difficult to unify. We used many synonyms for financial strain to systematically identify 199 U.S. studies (316 papers) that used financial strain measures that were operationally consistent with our definition as predictors of health among adults. We thematically coded financial strain measures for content and synthesized evidence based on measure and methods. Financial strain was measured by self-reported lacking money for basic needs (119 studies) and/or difficulty making ends meet (n = 132), and less commonly additionally based on coping strategies (n = 23), satisfaction with finances (n = 14), worry about finances (n = 22), the anticipation of strain (n = 14), and/or lacking money for leisure (n = 29). Regardless of measure, financial strain was associated with poorer mental, physical, biological, and functional health, worse health behaviors and more social needs. Associations were found across diverse and population-based samples and when accounting for other socioeconomic factors and even intermediating health factors. Results demonstrate predictive validity for two different one-item screening tools. Furthermore, the vast evidence linking financial strain to health highlights an urgent need for policy action addressing financial strain to advance health equity.

Differential Associations of Depressive Symptomology to HIV Care Engagement Among Young Black Sexual Minority Men with HIV (YBSMM+) in the US South: A Multi-Group Analysis of Mood, Intimate Partner Violence, and Alcohol Use

Young Black Sexual Minority Men with HIV (YBSMM+) in the US South encounter multiple socio-structural challenges that contribute to disproportionately poor HIV-related outcomes across the care continuum. Depression, anxiety, intimate partner violence (IPV), and alcohol use are prominent factors that negatively impact engagement with HIV care. Syndemic theory posits that these multiple factors interact synergistically to promote poor outcomes; however, depression itself is highly heterogeneous in presentation, which may pose issues when examining associations to HIV care engagement. This study sought to better understand the associations of specific depressive symptomology subtypes, generalized anxiety, experienced IPV, and alcohol use on HIV care engagement for YBSMM+. Results showed that interpersonally oriented depressive symptomatology was associated with increased HIV care engagement among YBSMM + who abstained from alcohol. On the other hand, among YBSMM + who frequently binge drank, combined negative affect and somatic components of depressive symptomatology and frequency of IPV experiences were associated with decreased HIV care engagement while generalized anxiety was associated with increased HIV care engagement. The findings suggest that the negative affect and somatic components of depression may be particularly salient for HIV care engagement among YBSMM + who binge drink frequently. Developing targeted interventions that address these specific conditions while accounting for the nuances of mood-based symptomatology could improve intervention efforts geared towards improving HIV care engagement among YBSMM+.

History of Incarceration is Associated with Unmet Socioeconomic Needs and Structural Discrimination among Young Black Sexual Minority Men (SMM) in the United States

There is a dearth of research on incarceration among young Black sexual minority men (SMM). The current study aimed to assess the prevalence and association between unmet socioeconomic and structural needs and history of incarceration among young Black SMM. Between 2009 and 2015, young Black SMM (N = 1,774) in Dallas and Houston Texas were recruited to participate in an annual, venue-based, cross-sectional survey. We found that 26% of the sample reported any lifetime history of incarceration. Additionally, participants with unmet socioeconomic and structural needs (unemployment, homelessness, financial insecurity and limited educational attainment) were more likely to have a history of incarceration. It is imperative that interventions are developed to address the basic, social, and economic needs of young Black SMM with a history of incarceration or who are at risk for incarceration.

Violence, Discrimination, Psychological Distress, and HIV Vulnerability Among Men Who Have Sex With Men in Memphis, Tennessee

Gay, bisexual, and other men who have sex with men (MSM) are disproportionally impacted by HIV. Discrimination, violence, and psychological distress (PD) may influence engagement with HIV prevention services and amplify HIV vulnerability among this priority population. These dynamics are understudied in the Southern United States. Understanding how these relationships interact is critical to designing effective HIV programs. We examined associations between MSM-related discrimination, MSM-related violence, and severe PD with HIV status among 2017 National HIV Behavioral Surveillance study participants in Memphis, Tennessee. Eligible participants were aged ≥18 years, born and identified as male, and reported having sex with another man in their lifetime. Participants completed a Centers for Disease Control and Prevention-designed anonymous survey and self-reported discrimination and violence across their lifetime, and PD symptoms within the past month, scored on the Kessler-6 Scale. Optional HIV rapid tests were performed on-site. Logistic regressions examined the associations between the exposure variables and HIV antibody-positive results. Among 356 respondents, 66.9% were aged <35 years and 79.5% identified as non-Hispanic Black; 13.2% reported experiencing violence, 47.8% reported discrimination, and 10.7% experienced PD. Of the 297 participants who tested, 33.33% were living with HIV. Discrimination, violence, and PD were significantly associated with each other (p < .0001). HIV antibody-positive test results were associated with violence (p < .01). Memphis-based MSM face a complex array of social experiences, which may increase vulnerability to HIV. On-site testing at community-based organizations and clinical settings among MSM may be an opportunity to screen for violence and incorporate strategies when designing HIV programs.

Sexual violence experiences among adolescent and young adult males: a review to empower healthcare providers

PURPOSE OF REVIEW

Despite 3-17% of adolescent and young adult males (AYAMs) experiencing sexual violence, there is a paucity of information regarding their sexual violence experiences leaving them vulnerable to dangerous and detrimental sequelae.

RECENT FINDINGS

There is underreporting and under-discussion of AYAMs' experiences of sexual violence, with disclosure influenced by societal perceptions of male sexuality, shame, and fear of discrimination. AYAMs experience sexual violence from individuals known to them, with many experiencing physical violence, threats, coercion, and electronic harassment. Intersectionality, previous traumas, inappropriate childhood exposures to sexually explicit situations, select online media consumption, and adverse childhood experiences (ACEs) increase the risk of sexual violence. AYAMs who experience sexual violence are at increased risk of re-victimization, perpetrating sexual violence, experiencing bodily harm, contracting sexually transmitted infections (STIs), and experiencing internalizing and externalizing symptoms, which can lead to significant morbidity and mortality. Research on male-specific protective and resilience factors is scarce and represents an ongoing need.

SUMMARY

After reviewing AYAMs' experiences of sexual violence, including risk and protective factors, media influences, detrimental sequelae, and resilience factors, we provide a screening framework to empower the healthcare provider (HCP) to champion tailored prevention, screening, intervention, and advocacy efforts to support AYAMs.