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Rzymski P, Zarębska-Michaluk D, Genowska A, Tyszko P, Strukcinskiene B, Flisiak R. Trends of Hepatitis A Virus Infection in Poland: Assessing the Potential Impact of the COVID-19 Pandemic and War in Ukraine. Viruses 2024; 16:469. [PMID: 38543833 PMCID: PMC10975752 DOI: 10.3390/v16030469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 05/23/2024] Open
Abstract
Hepatitis A virus (HAV) is the most common cause of acute viral hepatitis, which is preventable by vaccination. This study analyzed trends of HAV infections in Poland according to socio-demographic features in the years 2009-2022 and assessed the potential impact of the COVID-19 pandemic (2020-2023) and the migration of war refugees from Ukraine (since February 2022). In 2009-2022, 7115 new cases of HAV infection were diagnosed in Poland, especially among men (66.4%) and in urban areas (77.4%). Infections among men were most common at the age of 25-34 (median rate 0.43 per 105) and in women aged 15-24 (median rate 0.39 per 105). Analysis of the 14-year frequency of HAV infections exhibited three trends, regardless of gender, age, and residence. The infections revealed a downward trend in 2009-2014, increased significantly in 2014-2018, and decreased again after 2018. A particularly rapid increase in HAV infections occurred between March 2017 and February 2018 (median rate 0.79 per 105). The high level of new infections persisted until the beginning of the COVID-19 pandemic, at which point it dropped significantly but did not reach the level recorded before March 2017. During the Omicron SARS-CoV-2 dominance period, the median rate of HAV infections was 0.053 per 105, with a four-fold increase being observed from February 2022 (when the migration of war refugees from Ukraine began) to August 2022. The presented results can serve as a reference point for further observations in Central Europe. The HAV epidemiological situation is unlikely to escalate in Poland but requires further monitoring.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental Medicine, Poznań University of Medical Sciences, 60-806 Poznań, Poland
| | - Dorota Zarębska-Michaluk
- Department of Infectious Diseases and Allergology, Jan Kochanowski University, 25-317 Kielce, Poland;
| | - Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, 15-295 Bialystok, Poland;
| | - Piotr Tyszko
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Institute of Rural Health, 20-090 Lublin, Poland
| | | | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland
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Ruther MH, Hsieh N. Explaining Health Disparities in the Sexual Minority Population: The Role of Neighborhood Effects. FAMILY & COMMUNITY HEALTH 2024; 47:49-58. [PMID: 37753939 DOI: 10.1097/fch.0000000000000387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Individual health is affected not only by characteristics and behaviors of the individual, but also by the environment in which the individual lives. Although neighborhood effects are well-established in the health literature, whether these effects are different for sexual minority populations is unknown. There is evidence that the neighborhoods in which sexual minorities reside are distinct from those in which heterosexuals reside, which could give rise to differential neighborhood effects. This research uses restricted data from the National Center for Health Statistics Research Data Center-which include neighborhood identifiers-to investigate health-relevant differences between the neighborhoods in which heterosexuals and sexual minorities reside. We also provide preliminary evidence on whether neighborhood effects explain any or all the disparities in health behaviors or health outcomes between sexual minority and heterosexual populations or mediate or moderate the effects of other covariates in explaining these disparities.
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Affiliation(s)
- Matthew H Ruther
- Department of Urban and Public Affairs, University of Louisville, Louisville, Kentucky (Dr Ruther); and Department of Sociology, Michigan State University, East Lansing (Dr Hsieh)
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Reid SC, Wang V, Assaf RD, Kaloper S, Murray AT, Shoptaw S, Gorbach P, Cassels S. Novel Location-Based Survey Using Cognitive Interviews to Assess Geographic Networks and Hotspots of Sex and Drug Use: Implementation and Validation Study. JMIR Form Res 2023; 7:e45188. [PMID: 37347520 DOI: 10.2196/45188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND The Ending the HIV Epidemic initiative in the United States relies on HIV hotspots to identify where to geographically target new resources, expertise, and technology. However, interventions targeted at places with high HIV transmission and infection risk, not just places with high HIV incidence, may be more effective at reducing HIV incidence and achieving health equity. OBJECTIVE We described the implementation and validation of a web-based activity space survey on HIV risk behaviors. The survey was intended to collect geographic information that will be used to map risk behavior hotspots as well as the geography of sexual networks in Los Angeles County. METHODS The survey design team developed a series of geospatial questions that follow a 3-level structure that becomes more geographically precise as participants move through the levels. The survey was validated through 9 cognitive interviews and iteratively updated based on participant feedback until the saturation of topics and technical issues was reached. RESULTS In total, 4 themes were identified through the cognitive interviews: functionality of geospatial questions, representation and accessibility, privacy, and length and understanding of the survey. The ease of use for the geospatial questions was critical as many participants were not familiar with mapping software. The inclusion of well-known places, landmarks, and road networks was critical for ease of use. The addition of a Google Maps interface, which was familiar to many participants, aided in collecting accurate and precise location information. The geospatial questions increased the length of the survey and warranted the inclusion of features to simplify it and speed it up. Using nicknames to refer to previously entered geographic locations limited the number of geospatial questions that appeared in the survey and reduced the time taken to complete it. The long-standing relationship between participants and the research team improved comfort to disclose sensitive geographic information related to drug use and sex. Participants in the cognitive interviews highlighted how trust and inclusive and validating language in the survey alleviated concerns related to privacy and representation. CONCLUSIONS This study provides promising results regarding the feasibility of using a web-based mapping survey to collect sensitive location information relevant to ending the HIV epidemic. Data collection at several geographic levels will allow for insights into spatial recall of behaviors as well as future sensitivity analysis of the spatial scale of hotspots and network characteristics. This design also promotes the privacy and comfort of participants who provide location information for sensitive topics. Key considerations for implementing this type of survey include trust from participants, community partners, or research teams to overcome concerns related to privacy and comfort. The implementation of similar surveys should consider local characteristics and knowledge when crafting the geospatial components.
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Affiliation(s)
- Sean C Reid
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Vania Wang
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Ryan D Assaf
- Benioff Homelessness and Housing Initiative, Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Sofia Kaloper
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Alan T Murray
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Steven Shoptaw
- Family Medicine and Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Pamina Gorbach
- Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Susan Cassels
- Department of Geography, University of California, Santa Barbara, Santa Barbara, CA, United States
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4
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Murphy D, Philpot S, Brown G, Prestage G. Domestic mobility and experiences of disconnection from sexual health care among gay and bisexual men in Australia: insights from a qualitative study. Sex Health 2021; 18:508-511. [PMID: 34915979 DOI: 10.1071/sh21191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/27/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Previous research on mobility and HIV acquisition among gay and bisexual men (GBM) has focused on: (1) changed sexual practices in the context of travel; and (2) the association between migration and increased HIV risk. To date, little attention has been given to continuity of sexual health and HIV-prevention services in the context of relocating between different cities or regions within the same country. METHODS Drawing on in-depth interviews with 17 GBM recently diagnosed with HIV, we explored these men's access to sexual health care in the period prior to diagnosis. RESULTS At least five of these 17 men's accounts provided examples of becoming disconnected from sexual health care because of mobility within Australia. For some men, this disconnection from care also included loss of access to pre-exposure prophylaxis (PrEP). In all these men's accounts, reconnection with services only came about at the time of seeking the HIV test associated with their diagnosis. The fact that men who had previously been well connected to sexual health services (as indicated by early uptake of PrEP, or regular HIV/STI testing) did not easily access similar services after relocating suggest that there are other factors - such as the social and physical environment - that have an important bearing on retention in sexual health care. CONCLUSIONS There is a need for more comprehensive data collection related to mobility in order to ascertain its relative importance. Regarding policy and practice, there are also opportunities for a more formalised process for interstate referral of clients of sexual health services.
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Affiliation(s)
- Dean Murphy
- The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Steven Philpot
- The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Graham Brown
- Centre for Social Impact, UNSW Sydney, Sydney, NSW 2052, Australia
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5
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Gumindega GC, Maharaj P. Factors influencing HIV-risk perception among MSM students at a university in Durban, South Africa. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2021; 20:244-253. [PMID: 34635016 DOI: 10.2989/16085906.2021.1981413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Risk perception is embedded in attitudes and beliefs that determine how one ultimately behaves. In relation to HIV-risk behaviours, risk perception is a key dimension in most health behaviour models used to construct health promotion campaigns. This study aimed to understand HIV-risk perception and associated factors among men who have sex with men (MSM). The qualitative data used in this study came from 15 in-depth interviews with MSM studying at the University of KwaZulu-Natal in Durban, South Africa. The findings show that MSM perceive themselves to be at risk for HIV due to their awareness of the main routes of infection. This perception exists because HIV has affected them through the loss of close family members. With each sexual encounter, risk perception changed based on factors such as the sexual role being assumed (insertive versus receptive), the socio-economic status of the partner, perceived level of discriminatory dating patterns, and the use of preventive measures. High levels of risk perception among the men did not translate into positive attitudes towards condoms as many of them preferred to have unprotected sex with trusted partners. Despite perceiving their risk of HIV infection to be high, MSM continue to engage in multiple sexual partnerships and high partner turnover. However, the men in this study were keen to protect their health; with time, they have developed more positive attitudes towards HIV and they understand that it is possible to protect oneself before and after infection.
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Affiliation(s)
- Geogina Charity Gumindega
- School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa
| | - Pranitha Maharaj
- School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa
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6
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Konkor I, Mkandawire P, Antabe R, Luginaah I, Husbands W, Wong J, Lawson E, Etowa J, Omorodion F, McIntosh MD. Sexual Debut Among Heterosexual Men of African and Caribbean Descent: Are the Youth Initiating Sex Earlier than the Older Generation? ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2359-2369. [PMID: 33538919 DOI: 10.1007/s10508-020-01855-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 09/18/2020] [Accepted: 09/29/2020] [Indexed: 06/12/2023]
Abstract
Although age at first sex is considered a measure of sexual risk and vulnerability for HIV infection, there is a dearth of literature on age at sexual debut in the Canadian context. This study examined time variations to first sex among heterosexual African, Caribbean, and Black (ACB) men in four Ontarian cities. A population-based retrospective survey (n = 879) on timing to first sexual intercourse was conducted between 2018 and 2019 among self-identified heterosexual ACB men 16 years or older and residing in London, Ottawa, Toronto or Windsor. We used the lognormal survival analysis technique to examine variations in time to first sexual intercourse among age cohorts and between cities. The findings showed a generational shift in the pattern of sexual initiation, with younger heterosexual ACB men initiating sexual intercourse earlier compared with those currently older than 50 years. We observed those between 16 and 19 years, 20 and 29 years, and 30 and 39 years of age to have significantly higher risk ratios of TR = 0.852, TR = 0.869, and TR = 0.855, respectively. At city level, the results show marked spatial variations, with youth in cities of Toronto, Ottawa, and London at the highest risk of early sexual debut relative to those in Windsor. Early initiation of first sexual intercourse among heterosexual ACB youth was observed with those in the larger cities being at a relatively higher risk. There is the need for programs aimed at delaying sexual debut among youth in general. It is, however, important to recognize the relative risk of those in the larger cities.
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Affiliation(s)
- Irenius Konkor
- Department of Geography, Western University, London, ON, N6A 3K7, Canada.
| | - Paul Mkandawire
- Institute of Interdisciplinary Studies, Carleton University, Ottawa, ON, Canada
| | - Roger Antabe
- Department of Geography, Western University, London, ON, N6A 3K7, Canada
| | - Isaac Luginaah
- Department of Geography, Western University, London, ON, N6A 3K7, Canada
| | | | - Josephine Wong
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, ON, Canada
| | - Erica Lawson
- Department of Women's Studies, Western University, London, ON, Canada
| | - Josephine Etowa
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | - Francisca Omorodion
- Department of Sociology, Anthropology, and Criminology, University of Windsor, Windsor, ON, Canada
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Denson DJ, Gelaude D, Saul H, Schoua-Glusberg A, Randall LA, Kenward K, Gall E, Hickson D, Schamel J, Frew PM. "To Me, Everybody Is infected": Understanding Narratives about HIV Risk among HIV-negative Black Men Who Have Sex with Men in the Deep South. JOURNAL OF HOMOSEXUALITY 2021; 68:973-992. [PMID: 31794351 PMCID: PMC7266721 DOI: 10.1080/00918369.2019.1694338] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
For black MSM living in the Deep South, the intersection of sexuality, race, and geography impacts HIV risk substantially. Between July and September 2016, we conducted a qualitative study among HIV-negative black MSM in five southern cities in the US with elevated HIV prevalence. Analysis included assessment of interrater reliability, cluster analysis, and descriptive statistics. We enrolled 99 black MSM (mean age: 33.6; SD = 12.8; range: 17-68 years). Four overarching themes emerged: harboring fear of HIV and the internalization of HIV stigma; scrutinizing potential partners to assess riskiness and HIV status; embracing distance and isolation from those perceived as a threat to HIV status; and exhibiting self-efficacy toward HIV prevention and utilizing risk reduction strategies. Future HIV prevention efforts may benefit by balancing risk and deficit based strategies with those that emphasize resilience, address disenfranchisement via structural interventions, and assess and treat inherent trauma(s).
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Affiliation(s)
- Damian J. Denson
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia, USA
| | - Deborah Gelaude
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia, USA
| | - Heather Saul
- Department of Health, Science, and Human Services, ICF International, Incorporated, Atlanta, Georgia, USA
| | | | - Laura A. Randall
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Elizabeth Gall
- Division of Health, IMPAQ International, LLC, Columbia, Maryland, USA
| | | | - Jay Schamel
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Paula M. Frew
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
- Hubert Department of Global Health, Emory Rollins School of Public Health, Atlanta, Georgia, USA
- Department of Behavioral Sciences and Health Education, Emory Rollins School of Public Health, Atlanta, Georgia, USA
- Emory Center for AIDS Research, Atlanta, Georgia, USA
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Cassels S, Meltzer D, Loustalot C, Ragsdale A, Shoptaw S, Gorbach PM. Geographic Mobility, Place Attachment, and the Changing Geography of Sex among African American and Latinx MSM Who Use Substances in Los Angeles. J Urban Health 2020; 97:609-622. [PMID: 32996024 PMCID: PMC7560688 DOI: 10.1007/s11524-020-00481-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 01/21/2023]
Abstract
The places that people go and interact with others, along with the characteristics of those places, determine degrees of sexual health risk and concomitant prevention opportunities for gay, bisexual, and other men who have sex with men (MSM). The objective of this paper is to use syndemic theory to guide analyses of 20 in-depth interviews with African American and Hispanic/Latinx MSM living in Los Angeles. We describe the places in which African American and Latinx MSM interviewees live and socialize, and how these places influence sexual behavior, drug use, and access to health care. We find common spatial patterns in mobility, incongruence in residential and sexual places, and differing geographic patterns of sex by men who use geo-social hook-up apps. Significant instability in home life and varying forms of mobility and risk-taking were a response to cumulative disadvantage and intersecting structural forces including poverty, racism, and homophobia. Our results strongly suggest that geographic mobility is a syndemic factor for HIV risk among MSM in Los Angeles, as mobility amplified negative impacts of other syndemic factors. Innovative place-interventions to reduce HIV incidence and disparities in HIV need to acknowledge the synergistic factors that drive higher HIV incidence among AA and Latinx MSM.
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Affiliation(s)
- Susan Cassels
- Department of Geography, University of California, Santa Barbara, CA, USA.
| | - Dan Meltzer
- Department of Geography, University of California, Santa Barbara, CA, USA
| | - Colin Loustalot
- Department of Geography, University of California, Santa Barbara, CA, USA
| | - Amy Ragsdale
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Steve Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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9
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Duncan DT, Sutton MY, Park SH, Callander D, Kim B, Jeffries WL, Henny KD, Harry-Hernández S, Barber S, Hickson DA. Associations Between Neighborhood Problems and Sexual Behaviors Among Black Men Who Have Sex with Men in the Deep South: The MARI Study. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:185-193. [PMID: 31950381 PMCID: PMC7410008 DOI: 10.1007/s10508-019-01619-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/05/2019] [Accepted: 12/20/2019] [Indexed: 06/10/2023]
Abstract
There is a disproportionately high HIV incidence among Black men who have sex with men (MSM) despite equal or lower levels of HIV risk behaviors compared to White MSM. Due to high levels of racial segregation in the U.S., Black MSM have an elevated likelihood of living in neighborhoods that contain psychosocial stressors, which, in turn, may increase behaviors promoting HIV infection. We examined associations between perceived neighborhood problems and sexual behaviors among Black MSM in the Deep South, a population at highest risk of HIV. Data came from the MARI Study, which included Black MSM ages 18-66 years recruited from the Jackson, MS, and Atlanta, GA, metropolitan areas (n = 377). Participants completed questions about neighborhood problems (e.g., excessive noise, heavy traffic/speeding cars and trash/litter) and sexual behaviors (e.g., condomless sex and drug use before or during sex). We used Poisson's regression model with robust standard errors to estimate the adjusted prevalence ratio (aPR; 95% confidence intervals [CI]) of neighborhood problems (coded as tertiles [tertile 1 = low neighborhood problems, tertile 2 = medium neighborhood problems, tertile 3 = high neighborhood problems] as well as continuously) with sexual behaviors, after adjustment for sociodemographic characteristics and other variables. About one-fourth of the sample reported at least one neighborhood problem, with the most common (31.6%) being no/poorly maintained sidewalks, which indicates an infrastructural problem. In multivariable models, compared to those in the lowest tertile, those reporting more neighborhood problems (tertile 2: aPR = 1.49, 95% CI = 1.04, 2.14 and tertile 3: aPR = 1.53, 95% CI = 1.05, 2.24) reported more drug use before or during sex (p for trend = .027). Neighborhood problems may promote behaviors (e.g., drug use before or during sex) conducive to HIV infection. Structural interventions could improve community infrastructure to reduce neighborhood problems (e.g., no/poorly maintained sidewalks and litter). These interventions may help to reduce HIV incidence among Black MSM in the Deep South.
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Affiliation(s)
- Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA.
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Su Hyun Park
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA
| | - Denton Callander
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA
| | - Byoungjun Kim
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA
| | - William L Jeffries
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kirk D Henny
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Salem Harry-Hernández
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 715, New York, NY, 10032, USA
| | - Sharrelle Barber
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - DeMarc A Hickson
- Center for Research, Evaluation and Environmental and Policy Change, My Brother's Keeper, Inc, Jackson, MS, USA
- Us Helping Us, People Into Living, Inc, Washington, DC, USA
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10
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Barkley-Levenson E, Xue F, Droutman V, Miller LC, Smith BJ, Jeong D, Lu ZL, Bechara A, Read SJ. Prefrontal Cortical Activity During the Stroop Task: New Insights into the Why and the Who of Real-World Risky Sexual Behavior. Ann Behav Med 2019; 52:367-379. [PMID: 29684132 DOI: 10.1093/abm/kax019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Research suggests that deficits in both executive functioning and trait impulsivity may play a role in risky sexual behavior. At the neural level, differences in regulation of the prefrontal cortex have been linked to impulsivity, measured neurocognitively and through self-report. The relationship between neurocognitive measures of executive control and trait impulsivity in predicting risky sexual behavior has not been investigated. Purpose To investigate the relationship between neural functioning during the Stroop task and risky sexual behavior, as well as the effect of individual differences in urgent (positive and negative) impulsivity on this relationship. Methods A total of 105 sexually active men who have sex with men completed the Stroop task during functional magnetic resonance imaging scanning. They also completed impulsivity inventories and self-reported their risky sexual behavior (events of condomless anal sex in the last 90 days). Results Risky participants had greater activation than safe participants during the color congruent condition of the Stroop task in anterior cingulate cortex/dorsomedial prefrontal cortex, dorsolateral prefrontal cortex, left frontal pole, and right insula. Across these regions, this neural activation mediated the link between (positive and/or negative) urgent impulsivity and risky sexual behavior. Conclusions Findings suggest that the brains of men who engage in risky sexual behavior may employ a different distribution of cognitive resources during tasks of executive functioning than men who practice safe sex, and that this may relate to differences in the prefrontal cortical/fronto-insular system responsible for impulse control.
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Affiliation(s)
- Emily Barkley-Levenson
- Department of Psychology, University of Southern California, Los Angeles, CA, USA.,Department of Psychology, Hofstra University, Hempstead, New York
| | - Feng Xue
- Department of Psychology, University of Southern California, Los Angeles, CA, USA.,Department of Radiology, University of California San Diego, San Diego, California
| | - Vita Droutman
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Lynn C Miller
- Department of Psychology, University of Southern California, Los Angeles, CA, USA.,USC Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, California
| | - Benjamin J Smith
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - David Jeong
- USC Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, California
| | - Zhong-Lin Lu
- Department of Psychology, The Ohio State University, Columbus, Ohio
| | - Antoine Bechara
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Stephen J Read
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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11
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Duncan DT, Hickson DA, Goedel WC, Callander D, Brooks B, Chen YT, Hanson H, Eavou R, Khanna AS, Chaix B, Regan SD, Wheeler DP, Mayer KH, Safren SA, Carr Melvin S, Draper C, Magee-Jackson V, Brewer R, Schneider JA. The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities: The Neighborhoods and Networks (N2) Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111922. [PMID: 31151275 PMCID: PMC6603520 DOI: 10.3390/ijerph16111922] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 01/01/2023]
Abstract
Background: In many parts of the world, stark racial disparities in human immunodeficiency virus (HIV) prevalence, incidence, prevention, and care outcomes persist among gay, bisexual, and other men who have sex with men (MSM), with Black MSM significantly impacted in the United States (U.S.). Individual-level characteristics, including sexual behaviors and socioeconomic status, do not fully account for racial/ethnic disparities in HIV among MSM. We hypothesize that neighborhood contexts and network characteristics influence risk for HIV infection as well as HIV-related prevention and care behaviors. As such, the study design includes the use of real-time geospatial methods and in-depth assessments of multiple network typologies to investigate the impact of neighborhood and network-level factors on HIV prevention and treatment among Black MSM residing in longstanding priority HIV elimination areas in the U.S., namely Chicago, Illinois and in the Deep South (Jackson, Mississippi and New Orleans, Louisiana) (n = 450, n = 50, and n = 100, respectively). We describe the design, sampling methods, data collection, data management methods, and preliminary findings of the ongoing ‘Neighborhoods and Networks (N2) Cohort Study’. Methods/Design: N2 employs a prospective longitudinal design. The sample includes Black MSM participants in Chicago recruited via respondent-driven sampling and assessed every six months over two years of follow-up. Participants enrolled in Jackson and New Orleans are being recruited through existing health and community services and assessed every six months over one year of follow-up. Mobility within and between neighborhoods is being assessed using global positioning system (GPS) technology. Social and sexual networks among Black MSM are being studied through egocentric network inventories as well as newer methods of creating meso-level networks that involve social media (Facebook) and mobile phone contacts. Key HIV prevention outcomes such as pre-exposure prophylaxis (PrEP) care engagement, and HIV/STI (sexually transmitted infections) biomarkers will be examined at baseline and follow-up. Results: As of 31 December 2018, a total of 361 men were enrolled across all study sites: 259 in Chicago and 102 in the Deep South (75 in New Orleans and 27 in Jackson). At baseline, participants ranged in age from 17 to 65 years old (mean = 34.3, standard deviation = 5.1) with 123 men (34.1%) self-reported as HIV positive. While HIV treatment levels were similar between sites, men in the Deep South reported higher rates of adherence than men in Chicago (63.3% versus 49.4%, p = 0.03). Sexual risk profiles were mainly the same between men from different study sites, with 22.9% of men in Chicago and 28.9% in the Deep South reporting consistent condom use during vaginal and anal sex (p = 0.26). Regarding their home neighborhoods, men in the Deep South were more likely than those in Chicago to characterize theirs as having a good reputation (43.1% versus 24.7%, p < 0.001) and as being safe (37.3% versus 21.2%, p = 0.002). Conclusions: The focus on Black MSM in the N2 Study will allow for a nuanced exploration of the attitudes, beliefs, behaviors, and practices of a diverse group of Black MSM. The study is also positioned to provide novel insight about neighborhood and network characteristics that influence HIV-related behaviors. A health equity framework ensures that Black MSM are not explicitly or implicitly deemed as deviant, disordered, or the non-reference group. Findings from N2 will provide guidance for the implementation of more impactful HIV prevention interventions that engage a diverse population of Black MSM as we work toward HIV elimination in the U.S.
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Affiliation(s)
- Dustin T Duncan
- NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, NY 10016, USA.
| | - DeMarc A Hickson
- Center for Research, Evaluation, and Environmental & Policy Change, My Brother's Keeper, Inc., Jackson, MS 39202, USA.
- Us Helping Us, People Into Living, Inc., Washington, DC 20010, USA.
| | - William C Goedel
- NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, NY 10016, USA.
| | - Denton Callander
- NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, NY 10016, USA.
| | - Brandon Brooks
- NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, NY 10016, USA.
| | - Yen-Tyng Chen
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
| | - Hillary Hanson
- Survey Lab, University of Chicago, Chicago, IL 60637, USA.
| | - Rebecca Eavou
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
| | - Aditya S Khanna
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.
| | - Basile Chaix
- Pierre-Louis Institute of Epidemiology Public Health (UMR-S 1136), Faculté de Médecine Saint-Antoine, Sorbonne Universités, 75012 Paris, France.
| | - Seann D Regan
- NYU Spatial Epidemiology Lab, Department of Population Health, NYU School of Medicine, New York, NY 10016, USA.
| | | | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA 02215, USA.
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
| | - Steven A Safren
- The Fenway Institute, Fenway Health, Boston, MA 02215, USA.
- Department of Psychology, College of Arts and Sciences, University of Miami, Coral Gables, FL 33124, USA.
| | - Sandra Carr Melvin
- Center for Research, Evaluation, and Environmental & Policy Change, My Brother's Keeper, Inc., Jackson, MS 39202, USA.
| | - Cordarian Draper
- Center for Research, Evaluation, and Environmental & Policy Change, My Brother's Keeper, Inc., Jackson, MS 39202, USA.
| | | | - Russell Brewer
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL 60637, USA.
- Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
- Department of Public Health Sciences, University of Chicago, Chicago, IL 60637, USA.
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12
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Mimiaga MJ, Hughto JMW, Reisner SL. A Randomized Pilot Study of a Group-Delivered HIV Risk Reduction Intervention for At-Risk Urban Men Who Have Sex with Men Who Regularly Attend Private Sex Events. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1059-1071. [PMID: 30805830 DOI: 10.1007/s10508-018-1326-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/24/2018] [Accepted: 10/04/2018] [Indexed: 06/09/2023]
Abstract
Across HIV prevention studies, as many as 25% of men who have sex with men (MSM) report meeting male partners at private sex events and attendance is associated with increased number of sexual partners, condomless anal sex (CAS), and HIV infection. Despite the need for effective HIV prevention interventions, no risk reduction interventions have been tested to reduce HIV sexual risk of MSM that regularly engage in sexual risk at private sex events. This randomized pilot study assessed the feasibility and acceptability of an HIV risk reduction intervention to reduce CAS among urban MSM (N = 14) reporting risk at a private sex event in the prior 12 months. The intervention arm received four group sessions (2 h/session) focusing on HIV risk reduction education and skills building. Both the intervention (n = 8) and control (n = 6) conditions received HIV testing and pre- and posttest risk reduction counseling and completed a sexual risk and psychosocial assessment visit at baseline and 3 months post-intervention. In addition, intervention participants completed a brief exit interview post-intervention. Mean age was 37 years, and 57% were racial/ethnic minorities. At follow-up, the intervention group reported greater reductions in sexual risk behavior in the past 3 months including number of CAS episodes, number of partners at private sex events, and CAS episodes at private sex events. The intervention group also reported reduced sexual compulsivity, increases in HIV disclosure, and reduced drug use at private sex events over study follow-up. Exit interviews revealed that participants found the intervention to be highly acceptable. Findings demonstrate feasibility of procedures, participant acceptability, and initial promise of a group-delivered HIV risk reduction intervention for MSM who attend and engage in CAS at private sex events. Further testing of this intervention in a larger pilot randomized controlled trial is warranted.
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Affiliation(s)
- Matthew J Mimiaga
- Center for Health Equity Research, Brown University, Providence, RI, USA.
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA.
| | - Jaclyn M W Hughto
- Center for Health Equity Research, Brown University, Providence, RI, USA
- Departments of Behavioral and Social Health Sciences and Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
| | - Sari L Reisner
- Department of Pediatrics, Harvard Medical School/Boston Children's Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
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13
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Koblin BA, Egan JE, Nandi V, Sang JM, Cerdá M, Tieu HV, Ompad DC, Hoover DR, Frye V. Congruence of Home, Social and Sex Neighborhoods among Men Who Have Sex with Men, NYCM2M Study. J Urban Health 2017; 94:364-374. [PMID: 27646852 PMCID: PMC5481209 DOI: 10.1007/s11524-016-0074-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Substantial literature demonstrates the influence of the neighborhood environment on health behaviors and outcomes. But limited research examines on how gay and bisexual men experience and exist in various geographic and virtual spaces and how this relates to their sexual behavior. New York City Men 2 Men (NYCM2M) was a cross-sectional study designed to identify neighborhood-level characteristics within the urban environment that influence sexual risk behaviors, substance use, and depression among men who have sex with men (MSM) living in NYC. The sample was recruited using a modified venue-based time-space sampling methodology and through select websites and mobile applications. Whether key neighborhoods of human activity, where a participant resided (termed home), socialized (termed social), or had sex most often (termed sex), were the same or different was evaluated. "Congruence" (or the sameness) of home, social, and most often sex neighborhood was reported by 17 % of men, while 30 % reported that none of their neighborhoods were the same. The largest group of men (39 %) reported that their home and sex neighborhoods were the same but their social neighborhood was different while 10 % reported that their home neighborhood was different than their social and sex neighborhood; 5 % men reported same home and social neighborhoods with a different sex neighborhood. Complete neighborhood incongruence was highest among men who were Black and/or Latino, had lower education and personal income levels, and had greater financial insecurity. In adjusted analysis, serodiscordant condomless anal intercourse and condomless anal intercourse with partners from the Internet or mobile applications were significantly associated with having the same social and sex (but not home) neighborhoods. Understanding the complexity of how different spaces and places relate to the health and sexual behavior of MSM is essential for focusing interventions to best reach various populations of interest.
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Affiliation(s)
- Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, 310 E.67th Street, New York, NY, 10065, USA.
| | - James E Egan
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vijay Nandi
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, 310 E.67th Street, New York, NY, 10065, USA
| | - Jordan M Sang
- College of Global Public Health, New York University, New York, NY, USA
| | - Magdalena Cerdá
- Department of Emergency Medicine, School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, 310 E.67th Street, New York, NY, 10065, USA.,Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Danielle C Ompad
- College of Global Public Health, New York University, New York, NY, USA.,Center for Drug Use and HIV Research, NYU Rory Meyers College of Nursing, New York, NY, USA
| | - Donald R Hoover
- Department of Statistics and Biostatistics and Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Victoria Frye
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA.,Department of Community Health and Social Medicine, City College of New York, CUNY Medical School, City University of New York, New York, NY, USA
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14
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Bauermeister JA, Connochie D, Eaton L, Demers M, Stephenson R. Geospatial Indicators of Space and Place: A Review of Multilevel Studies of HIV Prevention and Care Outcomes Among Young Men Who Have Sex With Men in the United States. JOURNAL OF SEX RESEARCH 2017; 54:446-464. [PMID: 28135857 PMCID: PMC5623108 DOI: 10.1080/00224499.2016.1271862] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Young men who have sex with men (YMSM), particularly YMSM who are racial/ethnic minorities, are disproportionately affected by the human immunodeficiency virus (HIV) epidemic in the United States. These HIV disparities have been linked to demographic, social, and physical geospatial characteristics. The objective of this scoping review was to summarize the existing evidence from multilevel studies examining how geospatial characteristics are associated with HIV prevention and care outcomes among YMSM populations. Our literature search uncovered 126 peer-reviewed articles, of which 17 were eligible for inclusion based on our review criteria. Nine studies examined geospatial characteristics as predictors of HIV prevention outcomes. Nine of the 17 studies reported HIV care outcomes. From the synthesis regarding the current state of research around geospatial correlates of behavioral and biological HIV risk, we propose strategies to move the field forward in order to inform the design of future multilevel research and intervention studies for this population.
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Affiliation(s)
| | | | - Lisa Eaton
- b Department of Psychology , University of Connecticut
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15
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Arabi-Mianrood H, Hamzehgardeshi Z, Khoori E, Moosazadeh M, Shahhosseini Z. Influencing factors on high-risk sexual behaviors in young people: an ecological perspective. Int J Adolesc Med Health 2017; 31:/j/ijamh.ahead-of-print/ijamh-2016-0162/ijamh-2016-0162.xml. [PMID: 28422704 DOI: 10.1515/ijamh-2016-0162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 02/28/2017] [Indexed: 11/15/2022]
Abstract
Background In recent years, high-risk sexual behaviors due to their negative consequences both for the individual and society have received more attention than other high-risk behaviors. Objective The aim of this study was to review the influencing factors of high-risk sexual behaviors among young people from an ecological point of view. Methods This review was conducted through searching databases including PubMed, Web of Science, Scopus, Google Scholar and the Cochrane Library with keywords such as sexual risk-taking behavior, high-risk sex, unprotected sex and unsafe sex. The relevant papers published between 1995 and 2016 were extracted. After reviewing the abstract and full text of the articles, 45 papers were used to write this article. Results From an ecological theory approach, factors which influence high-risk sexual behaviors are divided into three categories - the microsystem, the mesosystem and the macrosystem. The microsystem includes factors such as age, gender, race, marital status, place of residence, religion, level of education, personality traits, psychological problems, childhood experiences, body image and coincidence of high-risk behaviors; the mesosystem includes factors such as family structure, peers and sex education; in the macrosystem, the impact of culture and traditions of the society, economic status and the media are presented. Conclusion Given that high-risk sexual behaviors often have multiple causes, it seems that health policymakers must consider multi-dimensional interventions to influence high-risk sexual behaviors based on the ecological approach.
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Affiliation(s)
- Hoda Arabi-Mianrood
- Department of Reproductive Health and Midwifery, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zeinab Hamzehgardeshi
- Department of Reproductive Health and Midwifery, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elham Khoori
- Department of Reproductive Health and Midwifery, Counselling and Reproductive Health Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahmood Moosazadeh
- Department of Epidemiology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zohreh Shahhosseini
- Department of Reproductive Health and Midwifery, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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16
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Frye V, Nandi V, Egan JE, Cerda M, Rundle A, Quinn JW, Sheehan D, Ompad DC, Van Tieu H, Greene E, Koblin B. Associations Among Neighborhood Characteristics and Sexual Risk Behavior Among Black and White MSM Living in a Major Urban Area. AIDS Behav 2017; 21:870-890. [PMID: 27817101 DOI: 10.1007/s10461-016-1596-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Identifying neighborhood characteristics associated with sexual HIV risk behavior among gay, bisexual and other men who have sex with men (MSM) living in urban areas may inform the development of policies and programs to reduce risk and subsequently HIV prevalence in urban areas. New York City M2M was a cross-sectional study designed to identify neighborhood-level characteristics associated with sexual risk behaviors among MSM living in New York City. This paper presents results of an analysis of neighborhood-level indicators of three distinct social theories of influence of the neighborhood environment on human behavior: physical disorder, social disorganization and social norms theories. Using multilevel modeling on a sample of 766 MSM stratified by race/ethnicity, we found little support for the role of social disorganization on the sexual risk behavior of MSM, whereas different indicators of physical disorder exerted negative effects across race groups. Our results suggest that the beneficial effects of housing stock maintenance and general neighborhood physical orderliness and cleanliness may have positive effects beyond those traditionally studied for African American MSM and that the field needs novel theorizing regarding whether and how neighborhood or virtual community-level factors relate to sexual behavior among MSM.
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Affiliation(s)
- Victoria Frye
- Department of Community Health and Social Medicine, School of Medicine, City University of New York, 160 Convent Avenue, 404A Harris Hall, New York, NY, 10031, USA.
- Laboratory of Social and Behavioral Sciences, New York Blood Center, New York, NY, USA.
| | - Vijay Nandi
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - James E Egan
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Magdalena Cerda
- Department of Emergency Medicine, School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, USA
| | - James W Quinn
- Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, USA
| | - Daniel Sheehan
- Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, USA
| | - Danielle C Ompad
- New York University College of Global Public Health, New York University, New York, NY, USA
- Center for Drug Use and HIV Research, New York University Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Hong Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Emily Greene
- Laboratory of Social and Behavioral Sciences, New York Blood Center, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, USA
| | - Beryl Koblin
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
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17
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Jordan AE, Perlman DC, Neurer J, Smith DJ, Des Jarlais DC, Hagan H. Prevalence of hepatitis C virus infection among HIV+ men who have sex with men: a systematic review and meta-analysis. Int J STD AIDS 2017; 28:145-159. [PMID: 26826159 PMCID: PMC4965334 DOI: 10.1177/0956462416630910] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Since 2000, an increase in hepatitis C virus infection among HIV-infected (HIV+) men who have sex with men has been observed. Evidence points to blood exposure during sex as the medium of hepatitis C virus transmission. Hepatitis C virus prevalence among HIV + MSM overall and in relation to injection drug use is poorly characterized. In this study, a systematic review and meta-analysis examining global hepatitis C virus antibody prevalence and estimating active hepatitis C virus prevalence among HIV + MSM were conducted; 42 reports provided anti-hepatitis C virus prevalence data among HIV + MSM. Pooled prevalence produced an overall anti-hepatitis C virus prevalence among HIV + MSM of 8.1%; active HCV prevalence estimate was 5.3%-7.3%. Anti-hepatitis C virus prevalence among injection drug use and non-injection drug use HIV + MSM was 40.0% and 6.7%, respectively. Among HIV + MSM, hepatitis C virus prevalence increased significantly over time among the overall and non-injection drug use groups, and decreased significantly among injection drug use HIV + MSM. We identified a moderate prevalence of hepatitis C virus among all HIV + MSM and among non-injection drug use HIV + MSM; for both, prevalence was observed to be increasing slightly. Pooled prevalence of hepatitis C virus among HIV + MSM was higher than that observed in the 1945-1965 US birth cohort. The modest but rising hepatitis C virus prevalence among HIV + MSM suggests an opportunity to control HCV among HIV + MSM; this combined with data demonstrating a rising hepatitis C virus incidence highlights the temporal urgency to do so.
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Affiliation(s)
- Ashly E Jordan
- 1 New York University, New York, NY, USA
- 2 Center for Drug Use and HIV Research, New York, NY, USA
| | - David C Perlman
- 2 Center for Drug Use and HIV Research, New York, NY, USA
- 3 Icahn School of Medicine, Mount Sinai Beth Israel, New York, NY, USA
| | | | | | - Don C Des Jarlais
- 2 Center for Drug Use and HIV Research, New York, NY, USA
- 3 Icahn School of Medicine, Mount Sinai Beth Israel, New York, NY, USA
| | - Holly Hagan
- 1 New York University, New York, NY, USA
- 2 Center for Drug Use and HIV Research, New York, NY, USA
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18
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Vaughan AS, Kramer MR, Cooper HLF, Rosenberg ES, Sullivan PS. Activity spaces of men who have sex with men: An initial exploration of geographic variation in locations of routine, potential sexual risk, and prevention behaviors. Soc Sci Med 2016; 175:1-10. [PMID: 28040577 DOI: 10.1016/j.socscimed.2016.12.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 11/17/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
Theory and research on HIV and among men who have sex with men (MSM) have long suggested the importance of non-residential locations in defining structural exposures. Despite this, most studies within these fields define place as a residential context, neglecting the potential influence of non-residential locations on HIV-related outcomes. The concept of activity spaces, defined as a set of locations to which an individual is routinely exposed, represents one theoretical basis for addressing this potential imbalance. Using a one-time online survey to collect demographic, behavioral, and spatial data from MSM, this paper describes activity spaces and examines correlates of this spatial variation. We used latent class analysis to identify categories of activity spaces using spatial data on home, routine, potential sexual risk, and HIV prevention locations. We then assessed individual and area-level covariates for their associations with these categories. Classes were distinguished by the degree of spatial variation in routine and prevention behaviors (which were the same within each class) and in sexual risk behaviors (i.e., sex locations and locations of meeting sex partners). Partner type (e.g. casual or main) represented a key correlate of the activity space. In this early examination of activity spaces in an online sample of MSM, patterns of spatial behavior represent further evidence of significant spatial variation in locations of routine, potential HIV sexual risk, and HIV prevention behaviors among MSM. Although prevention behaviors tend to have similar geographic variation as routine behaviors, locations where men engage in potentially high-risk behaviors may be more spatially focused for some MSM than for others.
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Affiliation(s)
- Adam S Vaughan
- Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.
| | - Hannah L F Cooper
- Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA.
| | - Eli S Rosenberg
- Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, 1518 Clifton Rd NE, Emory University, Atlanta, GA 30322, USA; Laney Graduate School, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA.
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19
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Vaughan AS, Kramer MR, Cooper HL, Rosenberg ES, Sullivan PS. Completeness and Reliability of Location Data Collected on the Web: Assessing the Quality of Self-Reported Locations in an Internet Sample of Men Who Have Sex With Men. J Med Internet Res 2016; 18:e142. [PMID: 27283957 PMCID: PMC4919549 DOI: 10.2196/jmir.5701] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/22/2016] [Accepted: 05/10/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Place is critical to our understanding of human immunodeficiency virus (HIV) infections among men who have sex with men (MSM) in the United States. However, within the scientific literature, place is almost always represented by residential location, suggesting a fundamental assumption of equivalency between neighborhood of residence, place of risk, and place of prevention. However, the locations of behaviors among MSM show significant spatial variation, and theory has posited the importance of nonresidential contextual exposures. This focus on residential locations has been at least partially necessitated by the difficulties in collecting detailed geolocated data required to explore nonresidential locations. OBJECTIVE Using a Web-based map tool to collect locations, which may be relevant to the daily lives and health behaviors of MSM, this study examines the completeness and reliability of the collected data. METHODS MSM were recruited on the Web and completed a Web-based survey. Within this survey, men used a map tool embedded within a question to indicate their homes and multiple nonresidential locations, including those representing work, sex, socialization, physician, and others. We assessed data quality by examining data completeness and reliability. We used logistic regression to identify demographic, contextual, and location-specific predictors of answering all eligible map questions and answering specific map questions. We assessed data reliability by comparing selected locations with other participant-reported data. RESULTS Of 247 men completing the survey, 167 (67.6%) answered the entire set of eligible map questions. Most participants (>80%) answered specific map questions, with sex locations being the least reported (80.6%). Participants with no college education were less likely than those with a college education to answer all map questions (prevalence ratio, 0.4; 95% CI, 0.2-0.8). Participants who reported sex at their partner's home were less likely to indicate the location of that sex (prevalence ratio, 0.8; 95% CI, 0.7-1.0). Overall, 83% of participants placed their home's location within the boundaries of their reported residential ZIP code. Of locations having a specific text description, the median distance between the participant-selected location and the location determined using the specific text description was 0.29 miles (25th and 75th percentiles, 0.06-0.88). CONCLUSIONS Using this Web-based map tool, this Web-based sample of MSM was generally willing and able to provide accurate data regarding both home and nonresidential locations. This tool provides a mechanism to collect data that can be used in more nuanced studies of place and sexual risk and preventive behaviors of MSM.
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Affiliation(s)
- Adam S Vaughan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
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Nelson LE, Wilton L, Moineddin R, Zhang N, Siddiqi A, Sa T, Harawa N, Regan R, Dyer TP, Watson CC, Koblin B, Del Rio C, Buchbinder S, Wheeler DP, Mayer KH. Economic, Legal, and Social Hardships Associated with HIV Risk among Black Men who have Sex with Men in Six US Cities. J Urban Health 2016; 93:170-88. [PMID: 26830422 PMCID: PMC4794466 DOI: 10.1007/s11524-015-0020-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We assessed whether economic, legal, and social hardships were associated with human immunodeficiency virus (HIV) risk among a sample of Black men who have sex with men (MSM) and whether associations were moderated by city of residence. The study analyzed baseline and follow-up data from HIV Prevention Trials Network 061 (N = 1553). Binary logistic regression assessed associations between hardships and HIV risk indicators. Multivariate regressions were used to test if city of residence had a moderating effect for hardships and HIV risks. Adjusted analyses showed that Black MSM with recent job loss were more likely to engage in condomless insertive anal intercourse (adjusted odds ratios (AOR) = 1.37, 95% CI 1.01-1.87) and that those with recent financial crisis were more likely to have had two or more male sexual partners in the past 6 months (AOR = 1.65; 95% CI 1.18-2.29). Black MSM with recent convictions were more likely to have a sexually transmitted infection at 6 months (AOR = 3.97; 95% CI 1.58-9.94), while those who were unstably housed were more likely to have a sexually transmitted infection at 12 months (AOR = 1.71; 95%CI 1.02 = 2.86). There were no city of residence and hardship interaction effects on HIV risks. Hardships are important factors that influence HIV risk for Black MSM. Integrating strategies that address structural factors that influence HIV risk may enhance HIV prevention interventions implementation efforts.
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Affiliation(s)
- LaRon E Nelson
- School of Nursing, University of Rochester, Rochester, NY, USA.
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
| | - Leo Wilton
- College of Community and Public Affairs, State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Rahim Moineddin
- Faculty of Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Nanhua Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, Divisions of Epidemiology and Social & Behavioural Health Sciences, University of Toronto, Toronto, ON, Canada
- Gillings School of Public Health, Department of Health Behavior, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Ting Sa
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Nina Harawa
- College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- David Geffen School of Medicine, General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA, USA
| | - Rotrease Regan
- David Geffen School of Medicine, Department of Family Medicine, University of California Los Angeles, Los Angeles, CA, USA
- School of Medicine, Division of Infectious Diseases, Emory University, Atlanta, GA, USA
| | - Typhanye Penniman Dyer
- School of Public Health, Department of Epidemiology and Biostatistics, University of Maryland College Park, College Park, MD, USA
| | | | | | - Carlos Del Rio
- Rollins School of Public Health, Hubert Department of Global Health and School of Medicine, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Susan Buchbinder
- San Francisco Department of Public Health, HIV Research Section, San Francisco, CA, USA
| | - Darrell P Wheeler
- School of Social Welfare, State University of New York Albany, Albany, NY, USA
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21
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Bauermeister JA, Eaton L, Andrzejewski J, Loveluck J, VanHemert W, Pingel ES. Where You Live Matters: Structural Correlates of HIV Risk Behavior Among Young Men Who Have Sex with Men in Metro Detroit. AIDS Behav 2015; 19:2358-69. [PMID: 26334445 DOI: 10.1007/s10461-015-1180-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Structural characteristics are linked to HIV/STI risks, yet few studies have examined the mechanisms through which structural characteristics influence the HIV/STI risk of young men who have sex with men (YMSM). Using data from a cross-sectional survey of YMSM (ages 18-29) living in Detroit Metro (N = 328; 9 % HIV-positive; 49 % Black, 27 % White, 15 % Latino, 9 % Other race), we used multilevel modeling to examine the association between community-level characteristics (e.g., socioeconomic disadvantage; distance to LGBT-affirming institutions) and YMSM's HIV testing behavior and likelihood of engaging in unprotected anal intercourse with serodiscordant partner(s). We accounted for individual-level factors (race/ethnicity, poverty, homelessness, alcohol and marijuana use) and contextual factors (community acceptance and stigma regarding same-sex sexuality). YMSM in neighborhoods with greater disadvantage and nearer to an AIDS Service Organization were more likely to have tested for HIV and less likely to report serodiscordant partners. Community acceptance was associated with having tested for HIV. Efforts to address YMSM's exposure to structural barriers in Detroit Metro are needed to inform HIV prevention strategies from a socioecological perspective.
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Affiliation(s)
- José A Bauermeister
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA.
| | - Lisa Eaton
- University of Connecticut, Storrs, CT, USA
| | - Jack Andrzejewski
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | | | | | - Emily S Pingel
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
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Lama TT, Sudhinaraset M, McFarland W, Raymond HF. Migration and HIV Risk Among Men Who Have Sex With Men, San Francisco, 2011. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:538-546. [PMID: 26595266 DOI: 10.1521/aeap.2015.27.6.538] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In San Francisco, MSM account for nearly 90% of HIV infections. Studies have postulated increased risk for HIV faced by MSM who migrate, particularly to urban environments, yet empirical data are lacking. In this study we analyzed data from the National HIV Behavioral Surveillance System collected in 2011 to ascertain whether nativity (U.S. versus foreign born) was associated with HIV prevalence, risk behavior, and service use. Among 510 MSM enrolled, HIV prevalence was 23.0%. Multivariable analyses demonstrate that while nativity was not associated with increased risk for HIV infection, those who had lived in San Francisco for more than five years had higher HIV prevalence compared to those who had lived for less than a year even after adjusting for age, race, income, education, and location of birth.
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Affiliation(s)
- T T Lama
- Harvard Medical School, Boston, Massachusetts
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23
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Peacock E, Andrinopoulos K, Hembling J. Binge Drinking among Men Who Have Sex with Men and Transgender Women in San Salvador: Correlates and Sexual Health Implications. J Urban Health 2015; 92:701-16. [PMID: 25591660 PMCID: PMC4524843 DOI: 10.1007/s11524-014-9930-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
High rates of heavy alcohol use among men who have sex with men (MSM) and transgender women (TW) have been linked to increased vulnerability for HIV and poor mental health. While theories explaining elevated drinking levels among sexual minorities have been forwarded, few investigations have assessed the potential pathways using empirical data, particularly with an explicit focus on self-stigma and among MSM and TW in low- and middle-income countries. This study examined the relationship between stigma-related stress (specifically, self-stigma and concealment of one's sexual orientation) and binge drinking in a sample of MSM and TW (n = 670) in San Salvador, El Salvador, recruited using respondent-driven sampling. Levels of alcohol consumption among participants were high: only 39 % of the sample did not drink alcohol or did not binge drink, while 34 % engaged in binge drinking at least weekly. Among MSM, high self-stigma was associated with binge drinking at least weekly (adjusted relative risk ratio (aRRR) = 2.1, p < 0.05). No such relationship was found with less than weekly binge drinking. Among both MSM and TW, having a female partner was associated with binge drinking less than weekly (aRRR = 3.3, p < 0.05) and binge drinking at least weekly (aRRR = 3.4, p < 0.05), while disclosure of sexual orientation to multiple types of people was associated with binge drinking less than weekly (aRRR = 2.9 for disclosure to one-two types of people, p < 0.01; aRRR = 4.0 for disclosure to three-nine types of people, p < 0.01). No such relationship was found with at least weekly binge drinking. Binge drinking at least weekly was marginally associated with a number of sexual health outcomes, including high number of lifetime partners (adjusted odds ratio (aOR) = 1.7, p < 0.10), inconsistent condom use with a non-regular partner (aOR = 0.5, p < 0.10), and decreased intention to test for HIV in the next 12 months (aOR = 0.6, p < 0.10). With the exception of inconsistent condom use with a non-regular partner (aOR = 0.4, p < 0.05), binge drinking less than weekly was not associated with increased sexual risk behavior and was actually associated with increased intention to test for HIV in the next 12 months (aOR = 2.8, p < 0.01). These findings support multiple pathways linking stigma-related stress to alcohol use. Specifically, those with high self-stigma and identity concealment may be using alcohol as a maladaptive coping and emotion regulation strategy, while those who have disclosed their sexual orientation to multiple types of people may be more engaged with the sexual minority community, likely in bars and other venues where permissive norms for alcohol use prevail. That this frequency of binge drinking does not appear to be associated with increased sexual risk behavior (and may even be associated with increased intention to test for HIV in the next 12 months) lends further support to the suggestion that these individuals with healthy concepts of the self (as indicated by high levels of disclosure and low levels of risky sexual behavior) may engage in binge drinking because of the influence of the social environment. Further research is needed to establish the pathways linking stigma-related stress to heavy alcohol use so that points of intervention can be identified.
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Affiliation(s)
- Erin Peacock
- Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA, 70112, USA,
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Hubach RD, Dodge B, Li MJ, Schick V, Herbenick D, Ramos WD, Cola T, Reece M. Loneliness, HIV-related stigma, and condom use among a predominantly rural sample of HIV-positive men who have sex with men (MSM). AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:72-83. [PMID: 25646731 DOI: 10.1521/aeap.2015.27.1.72] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Most previous studies of the sexual behaviors of men who have sex with men (MSM) living with HIV are based on samples recruited within relatively urban and suburban areas of the United States. Using an internet-based questionnaire, we assessed HIV-related stigma, loneliness, and event-level sexual behaviors in a sample of HIV positive MSM (n = 100) residing within a largely rural area in the Midwestern United States. HIV-related stigma was correlated with loneliness (r = 0.619, p < 0.01). Loneliness was negatively associated with condom usage with the most recent partner of unknown status (p < 0.05). Namely, a 1-unit increase in the UCLA loneliness score was met with a 10% decrease in odds of condom usage. Further studies are warranted that explore loneliness, within the context of HIV-related stigma, among HIV-positive MSM residing in rural areas. More refined data will inform clinical and social service practice, as they provide much-needed information on sexual health outcomes and experiences of an often underserved and under studied population.
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25
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Bowring AL, van Gemert C, Vongsaiya K, Hughes C, Sihavong A, Phimphachanh C, Chanlivong N, Agius PA, Toole M, Hellard M. Setting the scene: locations for meeting sex partners among behaviorally bisexual men in Vientiane, Laos, and opportunities for health promotion. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2014; 26:538-553. [PMID: 25490734 DOI: 10.1521/aeap.2014.26.6.538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Behaviorally bisexual men (BBM) in Vientiane, Laos report high-risk sexual behaviors. We explore settings for meeting sex partners and associated risk behaviors among BBM in Laos. BBM and their sexual partners were recruited in Vientiane Capital using modified snowball sampling (2010). Settings for usually meeting sex partners and associations with risk behaviors were assessed. Among 88 BBM, the most common settings for men meeting male, kathoey, and female sex partners were private residences (48%, 37%, 51%, respectively) and hospitality settings (39%, 31%, 40%, respectively). Hospitality settings were more commonly reported by heterosexual-identifying BBM, and private residences more commonly reported by bisexual/homosexual-identifying BBM. Inconsistent condom use was high across partners and settings. Meeting partners in hospitality settings was associated with reporting a high number of female sex partners and frequently drinking alcohol before sex. Our results suggest that targeted health promotion initiatives in bars, clubs, and beer-shops could reach a high proportion of high-risk bisexual men, particularly heterosexual-identifying BBM.
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26
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Anderson JE, Kanters S. Lack of Sexual Minorities' Rights as a Barrier to HIV Prevention Among Men Who Have Sex with Men and Transgender Women in Asia: A Systematic Review. LGBT Health 2014; 2:16-26. [PMID: 26790014 DOI: 10.1089/lgbt.2014.0024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study set out to assess the relationship between variation in human rights for sexual minorities in Asian countries and indicators of HIV prevention among men who have sex with men (MSM) and transgender women. To quantitatively measure the relationship between variation in HIV prevention and variation in human rights for sexual minorities, this study developed the Sexual Orientation and Gender Identity (SOGI) Human Rights Index (an original index with scores ranging from 0.0 to 1.0). Subsequently, this study collected 237 epidemiological and behavioral studies from 22 Asian countries and performed a series of meta-analyses in order to calculate national averages for five indicators of HIV prevention: HIV prevalence, inconsistent condom use, recent HIV testing, adequate HIV knowledge, and exposure to HIV prevention services. A change of human rights for sexual minorities from a score of 0.0 to 1.0 as measured by the SOGI Human Rights Index was correlated with a decrease in unprotected anal intercourse by 25.5% (p=0.075), and increases in recent HIV testing by 42.9% (p=0.011), HIV knowledge by 29.5% (p=0.032), and exposure to HIV prevention services by 37.9% (p=0.119). The relationship between HIV prevalence and variation in human rights for sexual minorities was not statistically significant. Our study found correlations between human rights and indicators of HIV prevention, further supporting the need for increased rights among marginalized populations. The paucity of studies from many Asian countries as well as the disparity in how indicators of HIV prevention are measured reveals a need for increased coverage and standardization of MSM serological and behavioral data in order to better inform evidence-based policymaking.
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Affiliation(s)
- James E Anderson
- 1 Norman Paterson School of International Affairs, Carleton University , Ottawa, Canada .,2 Faculty of Law, University of Ottawa , Ottawa, Canada
| | - Steve Kanters
- 3 School of Population and Public Health, University of British Columbia , Vancouver, Canada .,4 Centre for Clinical Epidemiology and Evaluation , Vancouver, Canada
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27
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Duncan DT, Kapadia F, Halkitis PN. Examination of spatial polygamy among young gay, bisexual, and other men who have sex with men in New York City: the P18 cohort study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:8962-83. [PMID: 25170685 PMCID: PMC4199000 DOI: 10.3390/ijerph110908962] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 08/21/2014] [Accepted: 08/22/2014] [Indexed: 11/16/2022]
Abstract
The few previous studies examining the influence of the neighborhood context on health and health behavior among young gay, bisexual, and other men who have sex with men (YMSM) have predominantly focused on residential neighborhoods. No studies have examined multiple neighborhood contexts among YMSM or the relationships between sociodemographic characteristics, psychosocial factors, social support network characteristics, health behaviors, and neighborhood concordance. In this study, we assessed spatial polygamy by determining the amount of concordance between residential, social, and sex neighborhoods (defined as boroughs) in addition to examining individual-level characteristics that may be associated with neighborhood concordance. These data come from the baseline assessment of Project 18, a cohort of racially and ethnically diverse YMSM residing in the New York City metropolitan area. Participants (N = 598) provided information on their residential, social, and sex boroughs as well as information on their sociodemographic characteristics, psychosocial factors, social support network characteristics, and health behaviors (e.g., substance use and condomless sex). Descriptive analyses were conducted to examine the distribution of boroughs reported across all three contexts, i.e., residential, social, and sex boroughs. Next, concordance between: (1) residential and social boroughs; (2) residential and sex boroughs; (3) social and sex boroughs; and (4) residential, social, and sex boroughs was assessed. Finally, bivariable analyses were conducted to examine the relationships between sociodemographic characteristics, psychosocial factors, social support network characteristics, and health behaviors in relation to borough concordance. Approximately two-thirds of participants reported concordance between residential/socializing, residential/sex, and sex/socializing boroughs, whereas 25% reported concordance between all three residential/socializing/sex boroughs. Borough concordance varied by some individual-level characteristics. For example, White YMSM and YMSM reporting lower perceived socioeconomic status were significantly more likely to report residential/socializing/sex borough concordance (p < 0.001). With regard to psychosocial factors, YMSM who reported experiencing gay-related stigma in public forums were more likely to report discordant socializing/sex and residential/socializing/sex boroughs (p < 0.001). Greater frequency of communication with network members (≥weekly) was associated with less residential/social borough concordance (p < 0.05). YMSM who reported residential/socializing/sex borough concordance were more likely to report recent (last 30 days) alcohol use, recent marijuana use, and recently engaging in condomless oral sex (all p < 0.05). These findings suggest that spatial polygamy, or an individual moving across and experiencing multiple neighborhood contexts, is prevalent among urban YMSM and that spatial polygamy varies by multiple individual-level characteristics. Future research among YMSM populations should consider multiple neighborhood contexts in order to provide a more nuanced understanding of how and which neighborhood contexts influence the health and well-being of YMSM. This further examination of spatial polygamy (and individual-level characteristics associated with it) may increase understanding of the most appropriate locations for targeted disease prevention and health promotion interventions (e.g., HIV prevention interventions).
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Affiliation(s)
- Dustin T. Duncan
- Department of Population Health, School of Medicine, New York University, New York, NY 10016, USA; E-Mails: (F.K.); (P.N.K.)
- Global Institute of Public Health, New York University, New York, NY 10003, USA
- Population Center, New York University, New York, NY 10012, USA
- Center for Health, Identity, Behavior and Prevention Studies, New York University, New York, NY 10003, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-646-501-2674; Fax: + 1-646-501-2706
| | - Farzana Kapadia
- Department of Population Health, School of Medicine, New York University, New York, NY 10016, USA; E-Mails: (F.K.); (P.N.K.)
- Global Institute of Public Health, New York University, New York, NY 10003, USA
- Center for Health, Identity, Behavior and Prevention Studies, New York University, New York, NY 10003, USA
- Department of Nutrition, Food Studies and Public Health, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY 10003, USA
| | - Perry N. Halkitis
- Department of Population Health, School of Medicine, New York University, New York, NY 10016, USA; E-Mails: (F.K.); (P.N.K.)
- Global Institute of Public Health, New York University, New York, NY 10003, USA
- Population Center, New York University, New York, NY 10012, USA
- Center for Health, Identity, Behavior and Prevention Studies, New York University, New York, NY 10003, USA
- Department of Nutrition, Food Studies and Public Health, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY 10003, USA
- Department of Applied Psychology, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY 10003, USA
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Abstract
One of the most important aspects of adolescent health is sexual and reproductive health (SRH). Currently, sexually transmitted infections (STIs) threaten the health of adolescents more than any other age group, and as many as 2.2 million adolescents are living with HIV. Understanding adolescents' SRH needs and how to invest in improving their health can be best addressed by knowing more about the contexts that increase their vulnerability to poor sexual health outcomes. Recent evidence has highlighted an increasingly marginalised segment of the adolescent population--and that is the urban poor adolescent population in low and middle income countries (LMIC). Using an urban health framework, this paper examines the contextual factors within an urban community that influence the SRH of adolescents in LMIC. Findings show that while there is substantial research that has explored factors within the social environment, there is limited research that has explored factors within the physical environment, as well as research that has specifically explored urban adolescents' use of SRH services and how such services can be best provided to this vulnerable population. This paper highlights the need for further research to understand the relationships between the urban poor environment and the SRH risks that adolescents face while living in such environments.
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Affiliation(s)
- Kristin Mmari
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nan Astone
- The Urban Institute, Washington, District of Columbia, USA
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29
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Kamndaya M, Thomas L, Vearey J, Sartorius B, Kazembe L. Material deprivation affects high sexual risk behavior among young people in urban slums, South Africa. J Urban Health 2014; 91:581-91. [PMID: 24481587 PMCID: PMC4074323 DOI: 10.1007/s11524-013-9856-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Young people in urban slums adopt HIV risk behaviors influenced by their neighborhood factors. Three critical factors in urban slums of Southern and Eastern Africa--the region most affected by the HIV epidemic in the world--are unmet needs of housing, food, and health care, which are associated with HIV sexual risks. Yet, there has been limited attention on how the combination of unmet needs of housing, food, and health care--i.e., material deprivation-relates to sexual risk behavior among young people in urban slums. Cross-sectional data were extracted from the LoveLife survey in South African four provinces--KwaZulu Natal, Mpumalanga, Eastern Cape, and Gauteng, to examine the association between material deprivation and sexual risk behavior among young people aged 18-23 years (263 males, 267 females) in urban slums. Adjusted logistic regression models showed that material deprivation was significantly associated with increased odds of high sexual risk taking for young men (adjusted OR = 1.20; 95 % CI = 1.10, 5.58) and young women (adjusted OR = 1.43; 95 % CI = 1.35, 3.28). Financial difficulty--a proxy for other deprivations--was the most salient influence on young women's high sexual risk taking (adjusted OR = 2.11; 95 % CI = 1.66, 2.70). Localized behavioral HIV prevention interventions should target young people in deprived households.
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Affiliation(s)
- Mphatso Kamndaya
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa,
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30
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Frye V, Egan JE, Van Tieu H, Cerdá M, Ompad D, Koblin BA. "I didn't think I could get out of the fucking park." Gay men's retrospective accounts of neighborhood space, emerging sexuality and migrations. Soc Sci Med 2014; 104:6-14. [PMID: 24581056 PMCID: PMC4226215 DOI: 10.1016/j.socscimed.2013.12.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 08/07/2013] [Accepted: 12/05/2013] [Indexed: 11/21/2022]
Abstract
Young, African American and Latino gay, bisexual and other men who have sex with men (MSM) are disproportionately represented among new HIV cases according to the most recent national surveillance statistics. Analysts have noted that these racial/ethnic disparities in HIV among MSM exist within the wider context of sexual, mental and physical health disparities between MSM and heterosexuals. The intercorrelation of these adverse health outcomes among MSM, termed syndemics, has been theorized to be socially produced by a heterosexist social system that marginalizes lesbian, gay, bisexual, MSM and other sexual minorities. African American and Latino MSM experience overlapping systems of oppression that may increase their risk of experiencing syndemic health outcomes. In this paper, using data from twenty in-depth qualitative interviews with MSM living in four New York City (NYC) neighborhoods, we present accounts of neighborhood space, examining how space can both physically constitute and reinforce social systems of stratification and oppression, which in turn produce social disparities in sexual health outcomes. By analyzing accounts of emerging sexuality in neighborhood space, i.e. across time and space, we identify pathways to risk and contribute to our understanding of how neighborhood space is experienced by gay men, adding to our ability to support young men as they emerge in place and to shape the social topography of urban areas.
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Affiliation(s)
- Victoria Frye
- Lindsley F. Kimball Research Institute, United States; Columbia University, United States.
| | | | - Hong Van Tieu
- Lindsley F. Kimball Research Institute, United States; Columbia University, United States
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31
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Yang X. Rural-urban migration and mental and sexual health: a case study in Southwestern China. Health Psychol Behav Med 2013; 2:1-15. [PMID: 25932350 PMCID: PMC4367429 DOI: 10.1080/21642850.2013.839384] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 08/25/2013] [Indexed: 02/03/2023] Open
Abstract
Massive rural–urban temporary migration has taken place amid China's rapid economic growth and development. Much has been written about the economic causes and consequences of this massive migration; less studied are the potential health and behavioral impacts of migration on migrants. Using data from a population-based sample survey conducted in southwestern China, this paper examines the potential impact of rural–urban migration and post-migration urban living on migrants' mental health and sexual risk behavior. The results suggest that regardless of places of origin and destination temporary migrants had on average poorer mental health and riskier sexual behavior than non-migrants. Compared to living in rural areas, living in urban areas does not make statistical difference in residents' mental health; it is only marginally associated with riskier sexual behavior. Rural–urban temporary migrants' mental health and health risk sexual behavior deserve more immediate research attention. Both selectivity of temporary migrants and migration-induced psycho-socio-behavioral changes may have contributed to migrants' poorer mental health and riskier sexual behavior. However, more theory-driven research with longitudinal design is needed before firm conclusions can be drawn about the underlying mechanisms that mediate or moderate the impact of temporary migration on migrants' mental health and sexual risk behavior.
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Affiliation(s)
- Xiushi Yang
- Department of Sociology and Criminal Justice, Old Dominion University , Norfolk , VA , USA
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32
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Koblin BA, Egan JE, Rundle A, Quinn J, Tieu HV, Cerdá M, Ompad DC, Greene E, Hoover DR, Frye V. Methods to measure the impact of home, social, and sexual neighborhoods of urban gay, bisexual, and other men who have sex with men. PLoS One 2013; 8:e75878. [PMID: 24146785 PMCID: PMC3797712 DOI: 10.1371/journal.pone.0075878] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 08/16/2013] [Indexed: 11/18/2022] Open
Abstract
Men who have sex with men (MSM) accounted for 61% of new HIV diagnoses in the United States in 2010. Recent analyses indicate that socio-structural factors are important correlates of HIV infection. NYCM2M was a cross-sectional study designed to identify neighborhood-level characteristics within the urban environment that influence sexual risk behaviors, substance use and depression among MSM living in New York City. The sample was recruited using a modified venue-based time-space sampling methodology and through select websites and mobile applications. This paper describes novel methodological approaches used to improve the quality of data collected for analysis of the impact of neighborhoods on MSM health. Previous research has focused predominately on residential neighborhoods and used pre-determined administrative boundaries (e.g., census tracts) that often do not reflect authentic and meaningful neighborhoods. This study included the definition and assessment of multiple neighborhoods of influence including where men live (home neighborhood), socialize (social neighborhood) and have sex (sexual neighborhood). Furthermore, making use of technological advances in mapping, we collected geo-points of reference for each type of neighborhood and identified and constructed self-identified neighborhood boundary definitions. Finally, this study collected both perceived neighborhood characteristics and objective neighborhood conditions to create a comprehensive, flexible and rich neighborhood-level set of covariates. This research revealed that men perceived their home, social and sexual neighborhoods in different ways. Few men (15%) had the same home, social and sexual neighborhoods; for 31%, none of the neighborhoods was the same. Of the three types of neighborhoods, the number of unique social neighborhoods was the lowest; the size of sexual neighborhoods was the smallest. The resultant dataset offers the opportunity to conduct analyses that will yield context-specific and nuanced understandings of the relations among neighborhood space, and the well-being and health of urban MSM.
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Affiliation(s)
- Beryl A. Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
- * E-mail:
| | - James E. Egan
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - James Quinn
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
- Division of Infectious Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, United States of America
| | - Magdalena Cerdá
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Danielle C. Ompad
- Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS) and Department of Nutrition, Food Studies and Public Health, Steinhardt School of Culture, Education and Human Development, New York University, New York, New York, United States of America
| | - Emily Greene
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
| | - Donald R. Hoover
- Department of Statistics and Biostatistics and Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, Piscataway, New Jersey, United States of America
| | - Victoria Frye
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
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Halkitis PN, Kapadia F, Siconolfi DE, Moeller RW, Figueroa RP, Barton SC, Blachman-Forshay J. Individual, psychosocial, and social correlates of unprotected anal intercourse in a new generation of young men who have sex with men in New York City. Am J Public Health 2013; 103:889-95. [PMID: 23488487 PMCID: PMC3660046 DOI: 10.2105/ajph.2012.300963] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2012] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined associations of individual, psychosocial, and social factors with unprotected anal intercourse (UAI) among young men who have sex with men in New York City. METHODS Using baseline assessment data from 592 young men who have sex with men participating in an ongoing prospective cohort study, we conducted multivariable logistic regression analyses to examine the associations between covariates and likelihood of recently engaging in UAI with same-sex partners. RESULTS Nineteen percent reported recent UAI with a same-sex partner. In multivariable models, being in a current relationship with another man (adjusted odds ratio [AOR] = 4.87), an arrest history (AOR = 2.01), greater residential instability (AOR = 1.75), and unstable housing or homelessness (AOR = 3.10) was associated with recent UAI. Although high levels of gay community affinity and low internalized homophobia were associated with engaging in UAI in bivariate analyses, these associations did not persist in multivariable analyses. CONCLUSIONS Associations of psychosocial and socially produced conditions with UAI among a new generation of young men who have sex with men warrant that HIV prevention programs and policies address structural factors that predispose sexual risk behaviors.
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Affiliation(s)
- Perry N Halkitis
- Center for Health Identity, Behavior, and Prevention Studies, Steinhardt School of Culture, New York University, New York 10003, USA.
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Tobin KE, Cutchin M, Latkin CA, Takahashi LM. Social geographies of African American men who have sex with men (MSM): a qualitative exploration of the social, spatial and temporal context of HIV risk in Baltimore, Maryland. Health Place 2013; 22:1-6. [PMID: 23518256 DOI: 10.1016/j.healthplace.2013.02.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 02/12/2013] [Accepted: 02/17/2013] [Indexed: 11/24/2022]
Abstract
This qualitative study utilized a time-geography framework to explore the daily routines and daily paths of African American men who have sex with men (AA MSM) and how these shape HIV risk. Twenty AA MSM aged 18 years and older completed an in-depth interview. Findings revealed (1) paths and routines were differentiated by indicators of socio-economic status, namely employment and addiction, and (2) risk was situated within social and spatial processes that included dimensions of MSM disclosure and substance use. This study highlights the critical need for future research and interventions that incorporate the social and spatial dimensions of behavior to advance our ability to explain racial disparities in HIV and develop effective public health responses.
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Affiliation(s)
- K E Tobin
- Department of Health, Behavior and Society Bloomberg, School of Public Health Johns Hopkins University, 2213 McElderry Street, Second floor, Baltimore, MD 21205, USA.
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Halkitis PN, Figueroa RP. Sociodemographic characteristics explain differences in unprotected sexual behavior among young HIV-negative gay, bisexual, and other YMSM in New York City. AIDS Patient Care STDS 2013; 27:181-90. [PMID: 23442029 PMCID: PMC3595956 DOI: 10.1089/apc.2012.0415] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Young gay, bisexual, and other men who have sex with men (YMSM) under age 30 in New York City are at high risk for acquiring HIV. Using the theoretical framing of fundamental causes, this analysis examined the extent to which sociodemographic factors (race/ethnicity, perceived familial socioeconomic status [SES], U.S.-born status, and sexual orientation) explain the likelihood that HIV-negative YMSM ages 18 and 19 engage in unprotected sexual behavior, which may place them at risk for serconversion. Data were drawn from the baseline (Wave 1) assessment of a cohort study (N=592) collected between July 2009 and May 2011. The sample consisted predominantly of racial/ethnic minority YMSM (70.8%). A high level of association was demonstrated for each of the demographic factors with unprotected sexual behaviors. Multinomial logistic regression analyses were undertaken to examine associations between demographic covariates with the likelihood of engaging in unprotected sexual behaviors with male partners (any unprotected anal intercourse, as well as unprotected receptive anal, insertive anal, and receptive oral intercourse) irrespective of partner serostatus, in the month prior to assessment. U.S-born status and perceived socioeconomic status consistently were significant in differentiating risk behaviors. Being born outside the U.S. and perceiving a lower SES was associated with greater levels of risk. These findings suggest that efforts to address the disproportionate burden of HIV disease among YMSM in the United States must not focus solely on issues of race/ethnicity, but must be tailored and targeted to low SES and foreign-born young gay and bisexual men. It is posited that these demographic factors may lead to disproportionate levels of psychosocial burdens, which engender risk.
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Affiliation(s)
- Perry N Halkitis
- Center for Health, Identity, Behavior and Prevention Studies, The Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York 10003, USA.
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36
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Buttram ME, Kurtz SP. Risk and protective factors associated with gay neighborhood residence. Am J Mens Health 2012; 7:110-8. [PMID: 22948299 DOI: 10.1177/1557988312458793] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Using a sample of 482 ethnically diverse current substance using men who have sex with men who reported recent unprotected anal intercourse, this study compared health risk behaviors-substance use and sexual HIV risk-and one health protective factor-prosocial activities-between men who live in a gay neighborhood and those who do not. Data are drawn from comprehensive health and social risk assessments administered in South Florida. In a multivariate logistic regression model, methamphetamine use, high rates of receptive unprotected anal intercourse, and lower levels of prosocial engagement were found to be risk factors associated with gay neighborhood residence. Compared with living elsewhere, gay neighborhood residence appeared to be protective against cocaine use and substance dependence. Implications of the findings for prevention interventions are discussed, as is the need for further research regarding decisions about neighborhood residence and how neighborhood risk and protective factors emerge and are sustained.
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37
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Affiliation(s)
- Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F Kimball Research Institute, New York Blood Center, New York, NY 10065, USA.
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38
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Abstract
Research on the determinants of condom use in sub-Saharan Africa has focused on the personal characteristics of individuals and, more recently, on community characteristics such as levels of development and of contraceptive availability. Two additional community characteristics, however--the restraining influence exerted by social networks and traditional community institutions (both theorized to decline with population growth) and the degree of interpersonal communication concerning HIV/AIDS--should also be factored into research. This study uses data from the 2003 Zambia Sexual Behaviour Survey and other surveys to conduct multilevel analyses to assess the influence of each of these various characteristics on condom use in Zambia. The results show that condom use increases with interpersonal communication concerning HIV/ AIDS, community infrastructural development, and access to condoms, and decreases with population growth rate and density. The findings suggest that condom-promotion efforts should be attentive to community-level social norms, population trends, and informal social relationships and interpersonal communication.
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Affiliation(s)
- Kofi D Benefo
- Department of Sociology, Lehman College, City University of New York, 250 Bedford Park Boulevard West, Bronx, NY 10468, USA.
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39
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Egan JE, Frye V, Kurtz SP, Latkin C, Chen M, Tobin K, Yang C, Koblin BA. Migration, neighborhoods, and networks: approaches to understanding how urban environmental conditions affect syndemic adverse health outcomes among gay, bisexual and other men who have sex with men. AIDS Behav 2011; 15 Suppl 1:S35-50. [PMID: 21369730 PMCID: PMC3084486 DOI: 10.1007/s10461-011-9902-5] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Adopting socioecological, intersectionality, and lifecourse theoretical frameworks may enhance our understanding of the production of syndemic adverse health outcomes among gay, bisexual and other men who have sex with men (MSM). From this perspective, we present preliminary data from three related studies that suggest ways in which social contexts may influence the health of MSM. The first study, using cross-sectional data, looked at migration of MSM to the gay resort area of South Florida, and found that amount of time lived in the area was associated with risk behaviors and HIV infection. The second study, using qualitative interviews, observed complex interactions between neighborhood-level social environments and individual-level racial and sexual identity among MSM in New York City. The third study, using egocentric network analysis with a sample of African American MSM in Baltimore, found that sexual partners were more likely to be found through face-to-face means than the Internet. They also observed that those who co-resided with a sex partner had larger networks of people to depend on for social and financial support, but had the same size sexual networks as those who did not live with a partner. Overall, these findings suggest the need for further investigation into the role of macro-level social forces on the emotional, behavioral, and physical health of urban MSM.
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Affiliation(s)
- James E. Egan
- Center for Urban Epidemiologic Studies, The New York Academy of Medicine, New York, NY, USA
| | - Victoria Frye
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA, ;
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Steven P. Kurtz
- Division of Applied Interdisciplinary Studies, Nova Southeastern University, Coral Gables, FL, USA
| | - Carl Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Minxing Chen
- Division of Applied Interdisciplinary Studies, Nova Southeastern University, Coral Gables, FL, USA
| | - Karin Tobin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Cui Yang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Beryl A. Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA
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40
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Carpiano RM, Kelly BC, Easterbrook A, Parsons JT. Community and drug use among gay men: the role of neighborhoods and networks. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2011; 52:74-90. [PMID: 21362613 DOI: 10.1177/0022146510395026] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Gay neighborhoods serve as vital places for gay men's socializing, yet few studies have examined their contributions to gay men's health-either directly or indirectly via residents' social networks. Drawing from theoretical perspectives on community and networks, we test hypotheses concerning whether gay neighborhoods and social network factors are associated with patterns of recent illicit drug use among a sample of 740 urban gay men from New York City. Higher odds of drug use were observed among individuals who resided in gay neighborhoods, had networks composed predominantly of other gay men, and had increased socialization with gay men. Network factors did not mediate associations between gay neighborhoods and drug use. These findings highlight the need to better contextualize the health risks faced by gay men by accounting for both neighborhood and network structures.
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Affiliation(s)
- Richard M Carpiano
- Department of Sociology, University of British Columbia, Vancouver, British Columbia.
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41
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Abstract
Private sex parties are an emerging risk environment for HIV among men who have sex with men (MSM). In 2009, 103 participants who reported attending at least one sex party in Massachusetts in the prior 12 months completed an in-depth, interviewer-administered quantitative assessment. Multivariable logistic regression analyses were conducted to examine associations with having engaged in one or more serodiscordant unprotected anal sex (SDUAS) acts at the most recent sex party attended. Nearly one-third (32%) of the sample reported engaging in SDUAS at the most recent sex party attended. Adjusting for age, race/ethnicity, and educational attainment, variables associated with an increased odds of engaging in SDUAS at the most recent sex party were: total number of unprotected anal receptive sex acts at sex parties in the past 12 months, self-perception of being at-risk for transmitting or acquiring HIV, and sexual sensation seeking. Examined in the same model, if condoms were provided/available at the most recent sex party attended, participants were at a decreased odds of engaging in SDUAS at that sex party. The majority (80%) expressed an interest in HIV prevention activities for MSM who attend sex parties. HIV prevention interventions are needed to reach MSM who attend sex parties and should take into account individual and contextual factors that may contribute to sexual risk. Environmental factors in the sex party setting, in particular the presence and availability of condoms, may potentially mitigate individual-level factors such as unprotected anal sex.
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42
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Mimiaga MJ, Reisner SL, Bland S, Cranston K, Isenberg D, Driscoll MA, VanDerwarker R, Mayer KH. “It's a quick way to get what you want”: a formative exploration of HIV risk among urban Massachusetts men who have sex with men who attend sex parties. AIDS Patient Care STDS 2010; 24:659-74. [PMID: 20846008 DOI: 10.1089/apc.2010.0071] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Community-based studies with men who have sex with men (MSM) suggest that between 8% and 25% of MSM have met recent male sexual partners at private sex parties. Little is known about HIV sexual risk behaviors of MSM who attend sex parties and whether risk reduction interventions can be delivered in this setting. In 2008, 40 MSM who reported attending and/or hosting sex parties in Massachusetts in the past 12 months completed a qualitative interview and quantitative assessment. Participants reported attending a mean number of 10 sex parties in Massachusetts in the past 12 months. A significant percentage (43%) reported also hosting sex parties. Participants had made sexual partner connections across multiple venues, including public cruising areas, bars/clubs, and the Internet. At the most recent sex party attended, the majority had used alcohol (58%) and/or drugs (50%), and one quarter (25%) put themselves at risk of acquiring or transmitting HIV or other sexually transmitted infections (STIs) by having unprotected anal sex with a mean number of three serodiscordant male sex partners. Although many participants perceived that communicating about sexual health in the sex party context would “ruin the mood,” the majority (80%) considered some form of HIV prevention at sex parties to be appropriate and necessary, as well as acceptable. Nonintrusive prevention and education activities were especially endorsed (i.e., condoms, lubricants, and coupons for free HIV/STI testing). The majority of participants (75%) expressed some interest in “safer sex” parties. MSM attending sex parties appear to be a subpopulation at high risk for HIV and STI acquisition and transmission. Risk reduction interventions responsive to the needs of MSM who attend sex parties are warranted.
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Affiliation(s)
- Matthew J. Mimiaga
- The Fenway Institute, Fenway Health, Boston, Massachusetts
- Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts
- Harvard School of Public Health, Boston, Massachusetts
| | - Sari L. Reisner
- The Fenway Institute, Fenway Health, Boston, Massachusetts
- Harvard School of Public Health, Boston, Massachusetts
| | - Sean Bland
- The Fenway Institute, Fenway Health, Boston, Massachusetts
| | - Kevin Cranston
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Deborah Isenberg
- Massachusetts Department of Public Health, Boston, Massachusetts
| | | | | | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, Massachusetts
- Warren Alpert School of Medicine, Brown University/Miriam Hospital, Providence, Rhode Island
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43
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Frye V, Koblin B, Chin J, Beard J, Blaney S, Halkitis P, Vlahov D, Galea S. Neighborhood-level correlates of consistent condom use among men who have sex with men: a multi-level analysis. AIDS Behav 2010; 14:974-85. [PMID: 18712593 DOI: 10.1007/s10461-008-9438-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Accepted: 07/16/2008] [Indexed: 11/30/2022]
Abstract
There is growing evidence that the neighborhood environment influences sexual behavior and related outcomes, but little work has focused specifically on men who have sex with men (MSM). Using interview data from a probability sample of 385 young MSM living in New York City, recruited at public venues in 1999 and 2000 as part of the Young Men's Survey-New York City, and data on neighborhood characteristics obtained from the U.S. Census 2000, we conducted multi-level analyses of the associations between neighborhood-level characteristics and consistent condom use during anal intercourse, while controlling for individual-level sociodemographic and other factors. After adjusting for individual-level factors, neighborhood-level gay presence remained significantly and positively associated with consistent condom use during anal intercourse. This finding suggests that neighborhoods with a significant gay presence may have norms that act to discourage high risk sexual activity.
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Affiliation(s)
- Victoria Frye
- Urban Public Health Program, Hunter College, City University of New York, New York, USA.
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44
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Jerome RC, Halkitis PN, Coley MA. Methamphetamine use patterns among urban Black men who have sex with men. CULTURE, HEALTH & SEXUALITY 2009; 11:399-413. [PMID: 19301167 DOI: 10.1080/13691050902780768] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The present study investigates patterns of methamphetamine, contexts of use and sources for purchasing methamphetamine in a sample of gay, bisexual and heterosexually identified Black men who have sex with men living in New York City. Participants reported using multiple substances and used, on average, nine days within the last 30 days. They spent an average of US$159 per month on methamphetamine and a median of US$398 on all substances. Frequency of monthly methamphetamine use was related to the use of powdered cocaine and alcohol use, but not to the use of other substances. Black men who have sex with men primarily used in private venues, such as at home or in the homes of friends, and reported obtaining methamphetamine from multiple sources. Men who reported exchanging sex for methamphetamine reported greater use in public venues, such as sex clubs, sex parties and circuit parties. Findings from the present study may be critical in establishing culturally-appropriate treatment modalities for Black men who have sex with men who use methamphetamine.
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Affiliation(s)
- Roy C Jerome
- Center for Health, Identity, Behavior & Prevention Studies, New York University, USA
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45
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Jerome RC, Halkitis PN. Stigmatization, Stress, and the Search for Belonging in Black Men Who Have Sex With Men Who Use Methamphetamine. JOURNAL OF BLACK PSYCHOLOGY 2009. [DOI: 10.1177/0095798409333620] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Black men who have sex with men (BMSM) continue to be disproportionately affected by HIV. Methamphetamine use has been identified as a source of HIV risk in gay and bisexually identified men, yet the relationship between methamphetamine use and sexual risk among BMSM specifically remains unclear. The goal of this qualitative study was to investigate psychological, contextual, and developmental factors informing methamphetamine use and HIV risk behavior among a sample of heterosexual, gay, and bisexual BMSM (N = 52) in New York City. Methamphetamine use and sexual risk were associated with stress induced by stigmatization arising from and within larger dominant White gay culture, stigmatization incurred within the community, internalized homophobia, and stress induced by living under the shadow of the perceived inevitability of contracting HIV as BMSM. Methamphetamine use was associated with venues where participants could be sheltered from experiences of racism, homophobia, and dominant hegemonic images of Black masculinity, while exploring and developing same-sex desires, thereby instilling a sense of community belonging. Suggestions for culturally appropriate strategies for treating both methamphetamine use and HIV risk behaviors among BMSM are discussed.
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46
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Marshall BDL, Kerr T, Shoveller JA, Patterson TL, Buxton JA, Wood E. Homelessness and unstable housing associated with an increased risk of HIV and STI transmission among street-involved youth. Health Place 2009; 15:753-60. [PMID: 19201642 DOI: 10.1016/j.healthplace.2008.12.005] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2008] [Revised: 11/14/2008] [Accepted: 12/20/2008] [Indexed: 11/19/2022]
Abstract
The role that environmental factors play in driving HIV and STI transmission risk among street-involved youth has not been well examined. We examined factors associated with number of sex partners using quasi-Poisson regression and consistent condom use using logistic regression among participants enroled in the At Risk Youth Study (ARYS). Among 529 participants, 253 (47.8%) reported multiple partners while only 127 (24.0%) reported consistent condom use in the past 6 months. Homelessness was inversely associated with consistent condom use (adjusted odds ratio [aOR]=0.47, p=0.008), while unstable housing was positively associated with greater numbers of sex partners (adjusted incidence rate ratio [aIRR]=1.44, p=0.010). These findings indicate the need for interventions which modify environmental factors that drive risk among young street-involved populations.
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Affiliation(s)
- Brandon D L Marshall
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada V6Z 1Y6
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