Young African American Male-Male Relationships: Experiences, Expectations, and Condom Use

Condom stigma among men who have sex with men population: Concept synthesis

OBJECTIVES

The epidemic of acquired immune deficiency syndrome (AIDS) among men who have sex with men (MSM) is severe in China. And MSM has now become a key population for the infection and transmission of AIDS. At present, the bottleneck of AIDS prevention and control among MSM population is low rate of continuous condom use and high incidence of unsafe sexual behavior. Inductive summarization of the literature revealed that the most critical reason for low rate of continuous condom use among the MSM population was condom-related stigma. Although many studies mentioned condom-related stigma among MSM populations, there has been no any definition of MSM-related condom stigma and no measurement for it. Therefore, the paper aims to explore barriers to condom use among MSM, then construct the conceptual and operational definition of "MSM-related condom stigma" through Meta synthesis and concept synthesis, and provide a new perspective for AIDS prevention and control among MSM.

METHODS

Based on evidence-based method, "PICoS" framework and Meta-synthesis was used to include the literatures. Then, we used synthesized qualitative evidence from included studies to construct the concept and operational definition of MSM-related condom stigma by the means of thematic analysis and concept synthesis.

RESULTS

According to the results of the concept synthesis, MSM-related condom stigma refers to any taboos or misbeliefs about condom use or feeling ashamed or embarrassed to talk about using condoms which perceived by individuals at the individual, interpersonal, and social levels.It was demonstrated through 4 sub-themes at operational level: a symbol of distrust, a symbol of HIV/sexual transmitted infections (STIs) prevention, a symbol of an embarrassing topic, and a symbol of violating the traditional cognition of sexual intercourse. According to the Social-ecological Model (SEM), a symbol of distrust refers to that the MSM population believes that not using condoms represents mutual trust between sexual partners, while using condoms is difficult to express intimacy, trust and loyalty between sexual partners. A symbol of HIV/STIs prevention at the interpersonal level refers to that the MSM population believes that condom use is a "symbol" for the prevention or infection of AIDS; on the one hand, if someone proposes to use condoms, he may be considered infected with HIV or have unsafe sex experiences, thus, making it difficult to propose condom use; on the other hand, if they believe that sexual partners are "AIDS free" (often a wrong perception, such as sexual partners may have the risk of AIDS infection although they do not have AIDS), it is considered that condom use is completely unnecessary. The environmental level includes a symbol of an embarrassing topic and a symbol of violating the traditional cognition of sexual intercourse. A symbol of an embarrassing topic refers to the MSM population feels shame about topics related to sexual behavior and is embarrassed to carry/buy/propose condom use or be ashamed to engage in conversations about whether to use condoms during sexual behavior. And a symbol of violating the traditional cognition of sexual intercourse: The MSM population have limitations in their perception of "sex" or "sexual behavior" and believe that real sex (behavior) is unobstructed contact between the bodies and exchange between all body fluids.

CONCLUSIONS

The concept of MSM-related condom stigma is proposed for the first time, and its operational definition is given. The concept includes 3 levels and 4 dimensions. It is helpful to understand MSM people's attitude and cognition towards condoms, and adds indicators with cultural sensitivity and behavioral sensitivity to the behavioral intervention for AIDS in the future.

Dismantling Barriers and Transforming the Future of Pre-Exposure Prophylaxis Uptake in Young Black and Latinx Sexual Minority Men and Transgender Women

Pre-exposure prophylaxis (PrEP) has the potential to transform HIV in young Black and Latinx sexual minority men (SMM) and transgender women (TW). Addressing low PrEP uptake in this population depends on the better understanding of barriers to PrEP use. This article uses an ecological framework to explore barriers to daily oral PrEP in a sample of young Black and Latinx SMM and TW in three geographically prioritized cities in the United States. In-depth interviews were completed with 33 young Black and Latinx SMM and TW (22 at risk for and 11 recently diagnosed with HIV), aged 17-24, participating in a randomized trial aimed at increasing PrEP and antiretroviral therapy (ART) uptake and adherence. Interviews were recorded and transcribed, and then analyzed using inductive and deductive coding. Coded transcripts were organized into individual, interpersonal, community, and structural categories, by PrEP use and HIV status. Among participants, nine reported having been prescribed PrEP, with five actively or recently taking PrEP, whereas only one participant diagnosed with HIV had been prescribed PrEP. Major themes related to barriers emerged across the individual, family, community, and structural level. Limited barriers related to partners, instead partners with HIV encouraged PrEP use. Participants commonly reported low perceived HIV risk, fear of disclosure, barriers relating to insurance/cost, and medication use as reasons for nonuse of PrEP. For youth to remain on a healthy life course, HIV preventative measures will need to be adopted early in adolescence for those at risk of HIV acquisition. Interventions need to simultaneously address multilevel barriers that contribute to nonuse in adolescents. Clinical trials registry site and number: ClinicalTrials.gov Identifier: NCT03194477.

Partnerbeziehungen bei jungen Erwachsenen: Flucht vor der Intimität?

Hintergrund

Junge Erwachsene kommen häufig mit Partnerproblemen in die Behandlung; die Abgrenzung zwischen Bindungsstörungen bzw. narzisstischen Persönlichkeitsstörungen und normalen Entwicklungsphänomenen ist oftmals schwer.

Ziel der Arbeit

Es wird ein Überblick über Forschungsbefunde zu Partnerbeziehungen der 20- bis 30-Jährigen, den „emerging adults“, gegeben. Diese befinden sich in einer spezifischen, neu entdeckten Entwicklungsphase mit viel Exploration und wenig „commitment“.

Ergebnisse

Internationale Forschungsarbeiten, aber auch Arbeiten im deutschsprachigen Raum, belegen einheitlich eine Form von „Nichtbeziehungen“, in denen Sexualität gelebt, aber definitiv keine Partnerbeziehung gewünscht wird. Die Beziehungsqualitäten und die Form der Nichtbeziehungen sind bei allen Geschlechtern gleich. Längsschnittstudien belegen, dass eine Entwicklung zur Paarbindung, die im Jugendalter eingesetzt hatte, unterbrochen wird und erst Jahre später wieder länger dauernde, bezogene Paarbeziehungen bei den meisten jungen Menschen nachweisbar sind.

Diskussion

Es wird diskutiert, inwieweit zu enge, intrusive und zu unterstützende Elternbeziehungen zur „Flucht vor der Intimität“ beitragen, und welchen Einfluss neue Medien und Dating-Portale, aber auch der zunehmende Optimierungswahn und narzisstische gesamtgesellschaftliche Entwicklungen haben. Für diese Einflussfaktoren gibt es auch empirische Belege.

Brief report: Identified barriers and proposed solutions for recruiting young Black sexual minority men in HIV-related research

INTRODUCTION

Young Black sexual minority men represent a high priority population for HIV prevention research yet the existing literature is not proportional to the current health disparity observed. The challenge of engaging this intersectional population in research on a stigmatized topic likely contributes to the dearth of literature.

METHODS

This brief report examines the current recruitment strategies for engaging sexual minority men in HIV-related research and identifies individual and system-level barriers that contribute to the underrepresentation of Black sexual minority men in HIV-related research. Qualitative data is integrated from Project HATCH (Helping African American Teens Combat HIV), an ongoing recruitment effort of 14-21-year-old Black sexual minority men in Washington D.C., United States.

RESULTS

Identified barriers to recruiting young Black sexual minority men include cultural stigma, mistrust of research institutions, the 'coming out' process for queer youth, assent procedures for youth, and others.

CONCLUSIONS

We propose several solutions for recruitment including geospatial technology, social media, and community spaces of trust (i.e., churches and schools). Additional larger scale solutions include destigmatizing youths' sexuality and prioritizing the advancement of Black scholars in academia and research endeavors.