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Cain D, Scales D, Castiblanco J, Gorman J, Starks TJ. Collective efficacy: A protective factor for sexual minority men during the U.S. mpox outbreak. Health Psychol 2025; 44:211-222. [PMID: 39992767 PMCID: PMC12036798 DOI: 10.1037/hea0001472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2025]
Abstract
OBJECTIVES Collective efficacy is an understudied potential protective factor for health behavior change. This study extends previous research on HIV and COVID-19 infection to test associations with mpox vaccination and symptoms of depression and anxiety among sexual minority men during the mpox outbreak. METHOD Between July 28, 2022 and September 22, 2022, adult cisgender sexual minority men (n = 2,614) were recruited from social networking applications and completed a cross-sectional online survey that assessed collective efficacy (united action), mpox vaccination, and symptoms of anxiety and depression. RESULTS In multivariable regression models, united action was positively associated with having received at least one dose of the mpox vaccine (OR = 1.025, p = .04) and negatively associated with anxiety (β = -.055, p < .004) and depression (β = -.037, p = .05) above and beyond disease-related cognition and behavioral risk factors (sex with casual partners and substance use). CONCLUSION These findings suggest that perceptions of community agency to overcome health threats may be associated with individual health benefits. Clinically, these results suggest interventions that activate or develop community-level capacity to cope or respond to disease outbreaks may be useful public health strategies to mitigate infection risk as well as some mental health challenges among members of communities at high risk of infection. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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Affiliation(s)
- Demetria Cain
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | - David Scales
- Division of General Internal Medicine, Department of Internal Medicine, Weill Cornell Medicine, New York, NY, USA
- Critica, The Bronx, NY, USA
| | - Juan Castiblanco
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
| | | | - Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Doctoral Program in Health Psychology and Clinical Science, Graduate Center of CUNY, New York, NY, USA
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Lewczuk K, Wizła M, Glica A, Dwulit AD. Compulsive Sexual Behavior Disorder and Problematic Pornography Use in Cisgender Sexual Minority Individuals: The Associations with Minority Stress, Social Support, and Sexualized Drug Use. JOURNAL OF SEX RESEARCH 2024; 61:1246-1260. [PMID: 37676791 DOI: 10.1080/00224499.2023.2245399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Compulsive Sexual Behavior Disorder (CSBD), recently recognized in the ICD-11 as an independent disorder, has been shown to be more prevalent in sexual minorities. However, we still lack studies investigating which factors contribute to CSBD and related behaviors in this group. In our cross-sectional study, we investigated the relationships between characteristics potentially contributing to CSBD and problematic pornography use (PPU) in sexual minority individuals: sexual minority stress (internalized sexual stigma, discrimination experiences, and openness about one's sexual orientation), perceived social support, and sexualized drug use (also more prevalent in sexual minorities). We adjusted for gender, age, sexual orientation, and the frequency of sexual behaviors. Cisgender sexual minority participants (n = 198, 72.7% men, 27.3% women; Mage = 27.13, SD = 7.78) completed an online survey. We conducted a two-step linear regression. In the first step, we introduced sociodemographic variables and the frequency of sexual activities. In the second step, we placed the predictors of main interest: perceived social support, minority stress measures, and the frequency of sexualized drug use. Our results showed that social support was negatively related to CSBD, while experiences of discrimination due to sexual orientation and engagement in sexualized drug use were associated with higher CSBD symptom severity. Internalized sexual stigma related to greater PPU severity. The discussed relationships were weak to moderate in strength. Implications of current results for therapy and diagnosis of CSBD in sexual minorities are discussed. The role of minority stressors and other factors specific to sexual minorities requires further exploration to design well-suited therapeutic interventions.
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Affiliation(s)
- Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University
| | - Magdalena Wizła
- Institute of Psychology, Cardinal Stefan Wyszynski University
| | - Agnieszka Glica
- Institute of Psychology, Cardinal Stefan Wyszynski University
- Laboratory of Language Neurobiology, Nencki Institute of Experimental Biology, Polish Academy of Sciences
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3
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Brown MJ, Osinubi MO, Amoatika D, Haider MR, Kirklewski S, Wilson P, Hansen NB. Childhood Sexual Abuse and Compulsive Sexual Behavior Among Men Who Have Sex with Men Newly Diagnosed with HIV. AIDS Behav 2024; 28:3421-3429. [PMID: 38992227 PMCID: PMC11427551 DOI: 10.1007/s10461-024-04438-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
Childhood sexual abuse (CSA) continues to be a public health challenge. The prevalence of experiencing CSA is higher among men who have sex with men (MSM) than the general population. CSA has been linked to compulsive sexual behavior (CSB) among varying populations but has not been examined among MSM who were newly diagnosed with HIV. Therefore, the aims of this study were to assess the direct association between CSA and CSB among newly diagnosed MSM living with HIV, and to identify the potential mediating roles of depressive symptoms and emotion regulation in the association between CSA and CSB. The study was a secondary data analysis using data obtained from 2012 to 2017 from two community HIV clinics in New York City (n = 202). CSA was operationalized with questions asking about sexual abuse during childhood/adolescence. CSB was measured using the 13-item Compulsive Sexual Behavior Inventory (CSBI). Depressive symptoms were measured using the 20-item Centers for Epidemiologic Studies Depression (CES-D) scale and emotion regulation was measured using a 36-item Difficulties in Emotion Regulation Scale (DERS). Path analysis was conducted to determine the mediating role of depressive symptoms and emotion regulation in the association between CSA and CSB. There was a statistically significant association between CSA and CSB (β = 0.160; p = 0.019). There were statistically significant indirect associations between CSA, depressive symptoms, emotion regulation, and CSB (depressive symptoms β = 0.0.071; p = 0.010; DERS: β = 0.080; p = 0.006). Depressive symptoms were also correlated with emotion regulation (r = 0.596; p < 0.001). The relationship between CSA and CSB was significantly mediated by depressive symptoms and emotion regulation. Trauma-informed interventions addressing depressive symptoms and difficulties in emotion regulation may help to reduce CSB among MSM living with HIV.
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Affiliation(s)
- Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, South Carolina, USA.
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, South Carolina, USA.
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
| | - Medinat Omobola Osinubi
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, South Carolina, USA
| | - Daniel Amoatika
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, South Carolina, USA
| | - Mohammad Rifat Haider
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Sally Kirklewski
- ENRICH Lab, Yale School of Public Health, New Haven, Connecticut, USA
| | - Patrick Wilson
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Nathan B Hansen
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia
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4
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Berlin GW, Dermody SS, Noor SW, Skakoon-Sparling S, Ghauri Y, Zahran A, Card KG, Lachowsky NJ, Cox J, Moore DM, Lambert G, Jollimore J, Grace D, Zhang H, Apelian H, Sang JM, Dvorakova M, Lal A, Hart TA. Minority Stress, Psychological Distress, Sexual Compulsivity, and Avoidance-Based Motivations Associated with Methamphetamine Use Among Sexual Minority Men Living with HIV: Examining Direct and Indirect Associations Using Cross-Sectional Structural Equation Modeling. Subst Use Misuse 2024; 59:1629-1639. [PMID: 38950280 DOI: 10.1080/10826084.2024.2369159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
OBJECTIVE Sexual minority men (SMM) living with HIV report significantly greater methamphetamine use compared with heterosexual and HIV-negative peers. Greater use may be related to stressors (e.g., HIV-related stigma) faced by SMM living with HIV and subsequent psychological and behavioral sequelae. We tested an integrated theoretical model comprised of pathways between stigma, discrimination, childhood sexual abuse, psychological distress, sexual compulsivity, and cognitive escape in predicting methamphetamine use among SMM living with HIV. METHODS Among 423 SMM living with HIV, we tested a structural equation model examining factors hypothesized to be directly and indirectly associated with methamphetamine use. Analyses were adjusted for demographic covariates and sampling bias. RESULTS The model showed good fit (CFI = 0.96, RMSEA = 0.01). Heterosexist discrimination was associated with psychological distress (β = 0.39, p < 0.001) and psychological distress was associated with sexual compulsivity (β = 0.33, p < 0.001). Sexual compulsivity was associated with cognitive escape (β = 0.31, p < 0.001), which was associated with methamphetamine use (β = 0.51, p < 0.001). Psychological distress was associated with methamphetamine use via serial indirect effects of sexual compulsivity and cognitive escape (β = 0.05, p < 0.05). CONCLUSIONS Heterosexist discrimination contributed to psychological distress among SMM living with HIV. Psychological distress is linked to methamphetamine use via sexual compulsivity and cognitive avoidance. Interventions seeking to reduce the likelihood that SMM living with HIV use methamphetamine should include coping strategies specific to heterosexism and related psychological distress.
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Affiliation(s)
| | | | - Syed W Noor
- Toronto Metropolitan University, Toronto, Canada
- Louisiana State University Shreveport, Shreveport, Louisiana, USA
| | | | - Yusuf Ghauri
- Toronto Metropolitan University, Toronto, Canada
| | - Adhm Zahran
- Toronto Metropolitan University, Toronto, Canada
| | - Kiffer G Card
- University of Victoria, Victoria, Canada
- Simon Fraser University, Vancouver, Canada
| | | | - Joseph Cox
- McGill University, Montreal, Canada
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Gilles Lambert
- Research Institute of the McGill University Health Centre, Montreal, Canada
- Institute National de Santé Publique du Québec, Montreal, Canada
| | - Jody Jollimore
- Canadian AIDS Treatment Information Exchange (CATIE), Toronto, Canada
| | | | | | - Herak Apelian
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Jordan M Sang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Milada Dvorakova
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Trevor A Hart
- Toronto Metropolitan University, Toronto, Canada
- University of Toronto, Toronto, Canada
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5
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Starks TJ, Hillesheim JR, Castiblanco J, Cain D, Stephenson R. Drug use during the second year of the COVID-19 pandemic: observations from repeated cross-sectional surveys of sexual minority men in the US active on social networking applications. AIDS Care 2024; 36:145-153. [PMID: 38289592 PMCID: PMC11283985 DOI: 10.1080/09540121.2024.2308738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/10/2024] [Indexed: 07/28/2024]
Abstract
Studies conducted early in the COVID-19 pandemic - before vaccines were widely available - indicated that drug use may have declined among sexual minority men (SMM). This study evaluated drug use trends in the second year of the pandemic. Cross-sectional responses from cisgender SMM living in the US and recruited online (n = 15,897) were grouped for analyses: Time 1: 3/1/2021-5/30/2021; Time 2: 6/1/2021-8/31/2021; Time 3: 9/1/2021-11/30/2021; and Time 4: 12/1 2021-2/28/2022. Results of multivariable models indicated that illicit drug use (excluding cannabis) increased at Times 2 (OR = 1.249, p < .001), 3 (OR = 1.668, p < .001), and 4 (OR = 1.674, p < .001) compared to Time 1. In contrast, cannabis use was relatively stable over time. Rates did not differ significantly among Times 1, 2, and 4. While rates of COVID-19 vaccination increased over time, illicit drug use was negatively associated with the odds of vaccination (OR = 0.361, p < .001). These findings highlight the need for ongoing attention to the risks drug use poses among SMM. Illicit drug use - a long-standing health disparity among SMM - increased significantly across the second year of the pandemic. Because they are less likely to be vaccinated, SMM who use illicit drugs may be at greater risk of COVID-19 infection or complications.
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Affiliation(s)
- Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
- Doctoral Program in Health Psychology and Clinical Science, Graduate Center of the City University of New York, New York, NY, USA
| | - Joseph R. Hillesheim
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
| | - Juan Castiblanco
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
| | - Demetria Cain
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
| | - Rob Stephenson
- The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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6
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Rutledge SE, Zhang J, Icard LD, Jemmott JB. Do syndemic conditions predict HIV medication adherence among urban African American men? AIDS Care 2024; 36:781-789. [PMID: 38387445 DOI: 10.1080/09540121.2024.2305149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 01/09/2024] [Indexed: 02/24/2024]
Abstract
Much progress has been made in advancing antiretroviral (ART) adherence, yet disparities remain. To explore relationships of syndemic conditions - co-occurring health conditions caused by combinations of biological, social, and structural factors - to ART adherence among African American men, we used data from longitudinal assessments of 302 African American men enrolled in a study designed to increase physical activity and healthy eating. Syndemic conditions included alcohol dependency, drug dependency, depression, post-traumatic stress disorder, and unstable housing. A syndemic conditions variable was operationalized to indicate the presence of 0-5 conditions. About 55% of participants had 1 or more syndemic conditions. Age and marriage were positively associated with ART adherence, whereas number of syndemic conditions was negatively associated with adherence during the 12-month period. The interaction of being married and the syndemic conditions variable significantly predicted greater adherence. Similarly, the interaction of more education and the syndemic conditions variable predicted greater adherence. In multiple regression models, the syndemic conditions variable remained significant (-0.018) in predicting adherence; however, there was no significant interaction among the 5 conditions. This study lends evidence to syndemics literature indicating deleterious consequences of negative life experiences on health outcomes.
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Affiliation(s)
| | - Jingwen Zhang
- Department of Communication, University of California, Davis, CA, USA
| | - Larry D Icard
- School of Social Work, Temple University, Philadelphia, PA, USA
- Centre for Community Technologies, Nelson Mandela University, Port Elizabeth, South Africa
| | - John B Jemmott
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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7
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Bulled N, Singer M. Conceptualizing COVID-19 syndemics: A scoping review. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2024; 14:26335565241249835. [PMID: 38682155 PMCID: PMC11055430 DOI: 10.1177/26335565241249835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 04/10/2024] [Indexed: 05/01/2024]
Abstract
Background COVID-19's heavy toll on human health, and its concentration within specific at-risk groups including the socially vulnerable and individuals with comorbidities, has made it the focus of much syndemic discourse. Syndemic theory recognizes that social factors create the conditions that support the clustering of diseases and that these diseases interact in a manner that worsens health outcomes. Syndemics theory has helped to facilitate systems-level approaches to disease as a biosocial phenomenon and guide prevention and treatment efforts. Despite its recognized value, reviews of syndemics literature have noted frequent misuse of the concept limiting its potential in guiding appropriate interventions. Objective To review how the term 'syndemic' is defined and applied within peer-reviewed literature in relation to COVID-19. Design A scoping review of definitions within COVID-19 literature published between January 1, 2020 to May 15, 2023 was conducted. Searches took place across six databases: Academic Search Premier, CINAHL, JSTOR, MEDLINE/Pubmed, PsycINFO and Scopus. PRISMA-ScR guidelines were followed. Results Content analysis revealed that COVID-19 has varied clustered configurations of communicable-non-communicable diseases and novel communicable disease interactions. Spatial analysis was presented as a new strategy to evidence syndemic arrangements. However, syndemics continue to be regarded as universal, with continued misunderstanding and misapplication of the concept. Conclusion This review found that current applications of syndemics remain problematic. Recommendations are made on the design of syndemic studies. A syndemic framework offers an opportunity for systems-level thinking that considers the full complexity of human-disease interactions and is useful to inform future pandemic preparations and responses.
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Affiliation(s)
| | - Merrill Singer
- Anthropology, University of Connecticut, Storrs, CT, USA
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8
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Mesías-Gazmuri J, Folch C, Ferrer L, Reyes-Urueña J, Egea-Cortés L, Morales A, Villegas L, Casabona J. Syndemic Conditions and Their Association with HIV/STI Sexual Risk Behaviors Among Transgender Women and Cisgender Men Sex Workers in Catalonia: The SexCohort Project. Int J Behav Med 2023; 30:824-835. [PMID: 36333554 DOI: 10.1007/s12529-022-10138-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Transgender women and cisgender men sex workers are vulnerable to HIV and sexually transmitted infections (STIs). This study aimed to explore in depth the prevalence of syndemic conditions and their association with the sexual risk behaviors for HIV/STI acquisition in cis men and trans women sex workers in Barcelona (Catalonia, Spain). METHOD We conducted a study between 2014 and 2018 to determine whether syndemic conditions (frequent alcohol consumption and polydrug use (> 2) during sex with clients; experience of violence; and lack of healthcare access) are associated with HIV/STI sexual risk behaviors. A "syndemic index" was calculated based on the cumulative number of syndemic conditions (0 to 4). RESULTS In the last year (2018), 78.8% of cisgender men and 68.1% of transgender women reported at least one syndemic condition. The most prevalent syndemic factor in both cisgender men and transgender women was violence (38.8% and 43.6% respectively). In multivariable analysis, an association was found between condomless anal sex and violence (aOR = 1.81), and frequent alcohol consumption and violence with reporting > 10 clients/week (aOR = 2.73 and 1.88, respectively). The higher the number of syndemic factors, the greater probability of having > 10 clients/week and reporting condomless anal sex with clients. CONCLUSION Psychosocial conditions have a syndemic effect on risky sexual behaviors highlighting the need for a more holistic approach to HIV/STI prevention targeting these populations.
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Affiliation(s)
- Jocelyn Mesías-Gazmuri
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, Badalona, Spain
- Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Edifici MuntanyaCamí de Les Escoles S/N, 08916, Badalona (Barcelona), Spain
- Doctorat Metodologia de La Recerca Biomèdica I Salut Publica, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Cinta Folch
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, Badalona, Spain.
- Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Edifici MuntanyaCamí de Les Escoles S/N, 08916, Badalona (Barcelona), Spain.
| | - Laia Ferrer
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, Badalona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Juliana Reyes-Urueña
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, Badalona, Spain
- Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Edifici MuntanyaCamí de Les Escoles S/N, 08916, Badalona (Barcelona), Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Laia Egea-Cortés
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, Badalona, Spain
- Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Edifici MuntanyaCamí de Les Escoles S/N, 08916, Badalona (Barcelona), Spain
| | | | | | - Jordi Casabona
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, Badalona, Spain
- Institut d'Investigació Germans Trias I Pujol, Carretera de Can Ruti, Edifici MuntanyaCamí de Les Escoles S/N, 08916, Badalona (Barcelona), Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, Badalona, Spain
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Kirwan M, Stewart R, Chen W, Hammett JF, Davis KC. Sexual Compulsivity Mediates the Association Between Childhood Sexual Abuse and Condom Use Resistance Among Men Who Have Sex with Men and Women. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3457-3469. [PMID: 37697092 DOI: 10.1007/s10508-023-02681-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 09/13/2023]
Abstract
Despite the continued prevalence of HIV and condoms' proven effectiveness in HIV prevention, many young men continue to engage in condom use resistance (CUR). Research shows that sexual compulsivity and childhood sexual abuse (CSA) victimization are risk factors for CUR. Given that sexual activity between men is the most common method through which HIV is transmitted, and that men who have sex with men and women (MSMW) are up to five times as likely to contract or transmit HIV as men who have sex with women only (MSWO), understanding the CUR behaviors of MSMW is uniquely important. Young, single men who had had sex with a woman in the past year (N = 623) completed questionnaires assessing their previous sexual experiences with men and women, history of CSA, sexual compulsivity, and CUR to determine how MSMW classification may moderate the associations between these variables. Results revealed full, moderated mediation, such that CSA was significantly associated with sexual compulsivity among MSMW, but not MSWO. Furthermore, sexual compulsivity was subsequently associated with CUR, in a model accounting for 5.35% of CUR variance. Such findings suggest that exposure to CSA may render MSMW especially susceptible to maladaptive, sexually compulsive desires and behaviors. As a result, MSMW may be more likely to disregard the inherent risks associated with condomless sexual activity and engage in CUR. Thus, intervention programs seeking to reduce the transmission of HIV and other STIs should prioritize targeting MSMW who experienced CSA to reduce sexual compulsivity and increase condom use.
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Affiliation(s)
- Mitchell Kirwan
- Department of Psychology, University of Texas at El Paso, 500 W University Ave., El Paso, TX, 79968, USA.
| | - Robin Stewart
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Weiqi Chen
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Julia F Hammett
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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10
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Storholm ED, Reynolds HE, Muthuramalingam S, Nacht CL, Felner JK, Wagner GJ, Stephenson R, Siconolfi DE. Intimate Partner Violence and the Sexual Health of Sexual Minority Men. LGBT Health 2023; 10:S39-S48. [PMID: 37754928 PMCID: PMC10623463 DOI: 10.1089/lgbt.2023.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Purpose: This qualitative study explores the pathways by which various forms of intimate partner violence (IPV) impact the sexual health behaviors of cisgender identified sexual minority men (SMM). Methods: Semi-structured interviews were conducted with 23 racially and ethnically diverse SMM who recently experienced IPV and 10 clinical and social service providers focused on how experiences of IPV directly or indirectly influences sexual risk as well as engagement in HIV prevention behaviors (e.g., pre-exposure prophylaxis [PrEP] use). Applied thematic analysis, including cycles of analytic memo writing and coding, aided the identification of patterns across the data. Results: Analyses yielded three overarching themes: use of condoms, use of PrEP, and HIV and sexually transmitted infections (STIs). Participants described different ways condom use or nonuse was a mechanism by which power and/or control might be asserted by one partner over the other partner. A range of responses to questions about PrEP were identified, including partners encouraging PrEP use, as well as avoidance of conversations about PrEP or actual PrEP use, to prevent experiencing aggression or IPV from partners. Responses regarding HIV/STIs included those ranging from a new diagnosis being a potential trigger for violence to the exploitation of status to control partners. Conclusion: These findings suggest that in relationships with IPV, HIV prevention strategies can be sources of relationship control and trigger abuse. Addressing IPV may help to prevent HIV/STI transmission and promote the health of SMM. In addition, long-acting formulations of PrEP may be a promising strategy for SMM experiencing IPV when oral PrEP medications may be a risk factor for violence.
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Affiliation(s)
- Erik D. Storholm
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Hannah E. Reynolds
- School of Public Health, San Diego State University, San Diego, California, USA
| | | | - Carrie L. Nacht
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Jennifer K. Felner
- School of Public Health, San Diego State University, San Diego, California, USA
| | | | - Rob Stephenson
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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11
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Reis SC, Park KE, Dionne MM, Kim HS, Scanavino MDT. Symptoms of depression (not anxiety) mediate the relationship between childhood sexual abuse and compulsive sexual behaviors in men. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2023; 45:38-45. [PMID: 36379052 PMCID: PMC9976921 DOI: 10.47626/1516-4446-2022-2584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Childhood sexual abuse is associated with compulsive sexual behavior, depression, and anxiety in men. Furthermore, both depression and anxiety have been linked to compulsive sexual behaviors. However, whether anxiety and depression mediate the relationship between childhood sexual abuse and compulsive sexual behaviors has yet to be tested. We investigated whether symptoms of depression and anxiety mediate the relationship between childhood sexual abuse and compulsive sexual behaviors in 222 men seeking treatment for such behaviors. METHODS Participants completed the Sexual Compulsivity Scale, Childhood Trauma Questionnaire, Beck Depression Inventory, and Beck Anxiety Inventory. A cross-sectional parallel mediation analysis was conducted. RESULTS The prevalence of childhood sexual abuse in our sample was 57%. Significant correlations were found between childhood sexual abuse and compulsive sexual behaviors, depression, and anxiety. The results of the mediation analyses suggested that depression (B = 0.07, standard error [SE] = 0.03, 95%CI 0.02 to 0.15), but not anxiety (B = 0.02, SE = 0.02, 95%CI -0.2 to 0.07), mediated the link between childhood sexual abuse and compulsive sexual behaviors. The pattern of our results remained the same when controlling for other types of childhood trauma. CONCLUSIONS Depression, not anxiety, appears to mediate the relationship between childhood sexual abuse and compulsive sexual behaviors in men. Future research that tests our mediation analyses using a prospective longitudinal study would be highly informative.
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Affiliation(s)
- Sirlene C Reis
- Ambulatório de Impulso Sexual Excessivo e de Prevenção aos Desfechos Negativos Associados ao Comportamento Sexual, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil. Departamento de Psiquiatria, Faculdade de Medicina, USP, São Paulo, SP, Brazil. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, São Paulo, SP, Brazil
| | - Katey E Park
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Michelle M Dionne
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Hyoun S Kim
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada. University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, Canada
| | - Marco D T Scanavino
- Ambulatório de Impulso Sexual Excessivo e de Prevenção aos Desfechos Negativos Associados ao Comportamento Sexual, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil. Programa de Aperfeiçoamento de Ensino, São Paulo, SP, Brazil
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12
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Storholm ED, Huang W, Ogunbajo A, Horvath KJ, Reback CJ, Blumenthal J, Moore DJ, Flynn RP, Bolan RK, Corado KC, Morris SR. Gender-Based Violence and Post-traumatic Stress Disorder Symptoms Predict HIV PrEP Uptake and Persistence Failure Among Transgender and Non-binary Persons Participating in a PrEP Demonstration Project in Southern California. AIDS Behav 2023; 27:745-759. [PMID: 36053404 PMCID: PMC9908815 DOI: 10.1007/s10461-022-03807-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
Gender-based violence (GBV) against transgender and nonbinary (TGNB) persons is a pervasive public health issue. GBV has been linked to mental health problems such as depression and posttraumatic stress disorder (PTSD), as well has risk for HIV seroconversion and HIV treatment nonadherence. However, the impact of GBV on HIV pre-exposure prophylaxis (PrEP) use among TGNB persons has yet to be investigated. In the current study we assessed longitudinal PrEP persistence data from dried blood spots (DBS) collected from 172 racially and ethnically diverse TGNB participants during a 48-week PrEP demonstration project in Southern California from June 2017 to September 2020. Participants were categorized into three levels of PrEP uptake and persistence based on their PrEP levels at the start and end of the study: low-low, high-low, and high-high. Individual-, social-, and structural-level variables were then entered into multinomial logistic regression models to predict levels of PrEP uptake and persistence based on hypotheses informed by syndemic and minority stress theories. The models demonstrated that experience of GBV predicted significantly lower odds of PrEP uptake and persistence and greater PTSD symptoms predicted significantly greater odds of early PrEP discontinuation. Higher levels of coping skills, already being on PrEP at baseline, and being in a steady relationship were associated with greater odds of PrEP uptake and persistence. Implications for future GBV research, advocacy, interventions, and much needed structural changes focused on improving the health and safety of TGNB individuals are discussed.
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Affiliation(s)
- Erik D Storholm
- School of Public Health, San Diego State University, San Diego, CA, USA.
- RAND Corporation, Santa Monica, CA, USA.
- Center for HIV Identification, Prevention and Treatment Services, Department of Family Medicine, University of California Los Angeles, Los Angeles, CA, USA.
| | | | - Adedotun Ogunbajo
- RAND Corporation, Santa Monica, CA, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Cathy J Reback
- Center for HIV Identification, Prevention and Treatment Services, Department of Family Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Friends Research Institute, Los Angeles, CA, USA
| | - Jill Blumenthal
- AntiViral Research Center, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - David J Moore
- AntiViral Research Center, University of California, San Diego School of Medicine, San Diego, CA, USA
| | | | | | | | - Sheldon R Morris
- AntiViral Research Center, University of California, San Diego School of Medicine, San Diego, CA, USA
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13
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Houang ST, Kafka JM, Choi SK, Meanley SP, Muessig KE, Bauermeister JA, Hightow-Weidman LB. Co-occurring Epidemic Conditions Among Southern U.S. Black Men Who Have Sex with Men in an Online eHealth Intervention. AIDS Behav 2023; 27:641-650. [PMID: 35986818 PMCID: PMC9391640 DOI: 10.1007/s10461-022-03799-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/09/2022]
Abstract
Black men who have sex with men (BMSM) face disproportionately higher risks for adverse sexual health outcomes compared to their non-Hispanic White counterparts. This disparity can be attributable to overlapping and intersecting risk factors at the individual and structural levels and can be understood through syndemic theory. Using longitudinal data from the HealthMPowerment trial (n = 363), six conditions related to stigma syndemics were indexed as a cumulative risk score: high alcohol use, polydrug use, depression and anxiety symptomology, and experiences of racism and sexual minority stigma. Using Poisson regression, we found a positive association between baseline risk scores and sexual risk behavior (b: 0.32, SE: 0.03, p < 0.001). Using a Generalized Estimating Equation, we also found a 0.23 decrease in the within-participant risk scores at 3-month follow-up (SE: 0.10, p < 0.020). Future work examining how care and prevention trials improve health outcomes in this population is needed.
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Affiliation(s)
- Steven T Houang
- Department of Health Behavior, University of North Carolina Chapel Hill, 170 Rosenau Hall, CB #7400, Chapel Hill, NC, 27599, USA.
| | - Julie M Kafka
- Department of Health Behavior, University of North Carolina Chapel Hill, 170 Rosenau Hall, CB #7400, Chapel Hill, NC, 27599, USA
| | - Seul Ki Choi
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, USA
| | - Steven P Meanley
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, USA
| | - Kathryn E Muessig
- Department of Health Behavior, University of North Carolina Chapel Hill, 170 Rosenau Hall, CB #7400, Chapel Hill, NC, 27599, USA
| | - Jose A Bauermeister
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, USA
| | - Lisa B Hightow-Weidman
- Department of Health Behavior, University of North Carolina Chapel Hill, 170 Rosenau Hall, CB #7400, Chapel Hill, NC, 27599, USA
- Institute for Global Health and Infectious Diseases, University North Carolina Chapel Hill, Chapel Hill, USA
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14
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Berke DS, Moody RL, Grov C, Rendina HJ. Psychosocial Risk Pathways from Childhood Sexual Abuse to Intimate Partner Violence among Sexual Minority Men: A Test of the Psychological Mediation Framework of Minority Stress. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3321-3343. [PMID: 35652430 PMCID: PMC9841749 DOI: 10.1177/08862605221106145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Although sexual minority men experience elevated rates of childhood sexual abuse (CSA) and equal or greater rates of intimate partner violence (IPV) victimization compared to heterosexual individuals, little research has examined mechanisms linking these forms of victimization in this high-need population. We examined general (i.e., emotion regulation difficulties) and sexual minority specific (i.e., internalized homophobia) mediational pathways between CSA and IPV victimization in a longitudinal sample of 940 sexual minority men. Path analyses revealed significant associations between CSA and internalized homophobia, between internalized homophobia and emotion regulation difficulties, and between emotion regulation difficulties and IPV victimization. No indirect effects of CSA on IPV via general or minority specific pathways were observed. Findings suggest that minority stress specific (i.e., internalized homophobia) and general psychological risk factors (i.e., emotion regulation difficulties) co-occur and may function along independent pathways to link CSA to IPV revictimization. Future work is needed to investigate how mitigation of these modifiable pathways may be targeted to inform violence prevention interventions for sexual minority men.
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Affiliation(s)
- Danielle S. Berke
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- The Graduate Center of CUNY, New York, NY, USA
| | | | - Christian Grov
- Department of Community Health and Social Science, CUNY Graduate School of Public Health and Health Policy, New York, NY
| | - H. Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
- The Graduate Center of CUNY, New York, NY, USA
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15
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Closson K, Nicholson V, Lee M, McLinden T, Cassidy-Matthews C, G Card K, E Marziali M, Trigg J, Wang L, Parashar S, S G Montaner J, Gibbs A, Hart TA, Kaida A, Hogg RS. Associations between psychosocial factors and antiretroviral therapy outcomes differ by gender and sexual orientation among people living with HIV in British Columbia, Canada. AIDS Care 2023; 35:296-305. [PMID: 36169492 DOI: 10.1080/09540121.2022.2126959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Little is known about how the co-occurrence of psychosocial factors affect sub-populations of people living with HIV (PLWH). We used cross-sectional data from 999 PLWH, aged ≥19, accessing antiretroviral therapy (ART) in British Columbia, Canada (2007-2010) to examine associations between psychosocial factors and ART-related outcomes separately for trans/cis inclusive women; heterosexual men; and gay, bisexual, and other men who have sex with men (gbMSM). Multivariable logistic regression examined associations between psychosocial factors (0-3): any violence in the past 6 months, depressive symptoms in the past week, and current street drug use (heroin, crack, meth or speedball) with sub-optimal adherence (outcome 1: average annual ART adherence <95% from interview until end of follow-up, death, or December 31st, 2018) and ever viral rebound (outcome 2) adjusting for potential confounders. Of 999 PLWH (264 women, 382 heterosexual men, and 353 gbMSM), women and heterosexual men had significantly higher median counts than gbMSM. Overall, higher counts were associated with sub-optimal adherence (adjusted odds ratio [aOR] = 1.26/1-unit increase, 95%CI = 1.07-1.49). All effect estimates were of a greater magnitude among gbMSM, but not significant for women or heterosexual men, highlighting the need for population (e.g., gender and sexual orientation)-centered care and research.
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Affiliation(s)
- Kalysha Closson
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Valerie Nicholson
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Melanie Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Taylor McLinden
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | | | - Kiffer G Card
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Megan E Marziali
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jason Trigg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Surita Parashar
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | | | - Andrew Gibbs
- South African Medical Research Council, Gender and Health Unit, Durban, South Africa
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal (UKZN), Durban, South Africa
| | - Trevor A Hart
- Department of Psychology, Ryerson University, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Robert S Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
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16
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Li Y, Xiao X, Zhou Y, Su X, Wang H. The mediating role of executive function in the relationship between self-stigma and self-injury or suicidal ideation among men who have sex with men living with HIV. Front Public Health 2023; 10:1066781. [PMID: 36699888 PMCID: PMC9869120 DOI: 10.3389/fpubh.2022.1066781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Background Men who have sex with men (MSM) living with HIV suffer from psychosocial pressures and marginalization as a result of being HIV-positive and belonging to a sexual minority group, and self-injury or suicidal ideation are prevalent among this group. Studies have found that both perceived self-stigma and altered executive function is related to self-injury or suicidal ideation. However, the combined contribution of self-stigma and executive function to self-injury or suicidal ideation remains unclear, especially in MSM living with HIV. Therefore, this study is conducted to explore the mechanism of self-injury or suicidal ideation by hypothesizing that executive function plays a mediating role in the relationship between self-stigma and self-injury or suicidal ideation. Methods We conducted a cross-sectional survey among 448 MSM living with HIV who were recruited in the HIV clinic of a tertiary general hospital in Changsha, China, from November 2021 to February 2022. A questionnaires survey was adopted to collect sociodemographic and disease-related information and data related to executive function (including working memory, inhibition, and task monitoring), self-stigma, and self-injury or suicidal ideation. Structural equation modeling and bootstrap testing were used to investigate the potential mediating role of executive function in the relationship between self-stigma and suicidal ideation. Results The participants were aged 18-76 years. Those who had ever had self-injury or suicidal ideation accounted for 32.8% of the total. A higher level of self-stigma and poorer executive function were associated with more frequent self-injury or suicidal ideation (p < 0.01). The mediation model analysis showed a good fit (x 2/df = 1.07, p = 0.381). The direct effect of self-stigma on self-injury or suicidal ideation (β = 0.346, p < 0.001) and the indirect effect of self-stigma via executive function (β = 0.132, p < 0.001) were significant, with the indirect effect accounting for 27.6% of the total effect. Conclusions This study demonstrates that executive function mediates the relationship between self-stigma and self-injury or suicidal ideation among MSM living with HIV. It suggests that future studies targeting enhancing executive function and decreasing self-stigma may reduce self-injury or suicidal ideation among MSM living with HIV.
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17
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Kamolova M, Chen YL, Etuk R, Sacco SJ, Kraus SW. Differences within: Hypersexuality, Sensation Seeking and Pornography Viewing Behaviors in a Sample of Heterosexual, Gay, Bisexual, and Uncertain Men. SEXUAL HEALTH & COMPULSIVITY 2022. [DOI: 10.1080/26929953.2022.2162652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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18
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Mancera BM, Provencio-Vasquez E, Loza O, De Santis JP. Impulsivity, Sexual Compulsivity, and Sexual Risk Behaviors among Hispanic Men Who Have Sex with Men in a US-Mexico Border City. Issues Ment Health Nurs 2022; 43:1107-1113. [PMID: 36368928 DOI: 10.1080/01612840.2022.2134530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hispanic men who have sex with men (HMSM) experience HIV risk-related and mental health disparities. The relationship of mental health (i.e., depressive symptoms and anxiety) on sexual risk behaviors of HMSM has been reported. However, little is known about the influence of impulsivity and compulsivity on sexual risk behaviors. A cross-sectional study explored these factors among 150 HMSM in the El Paso, Texas area utilizing standardized measures, in a cross-sectional study. Regression analysis determined the influence of sexual impulsivity and compulsivity, and demographic variables on sexual risk behaviors, indicating interventions should target these behaviors to mitigate sexual risk among HMSM.
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Affiliation(s)
- Bibiana M Mancera
- Director of Community Engagement, Border Biomedical Research Center (BBRC), University of Texas at El Paso, El Paso, TX, USA
| | | | - Oralia Loza
- College of Health Sciences, Department of Public Health Sciences, University of Texas at El Paso, El Paso, TX, USA
| | - Joseph P De Santis
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
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19
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Lambert G, Cox J, Fourmigue A, Dvorakova M, Apelian H, Moodie EEM, Grace D, Skakoon-Sparling S, Moore DM, Lachowsky N, Jollimore J, Lal A, Parlette A, Hart TA. HIV incidence and related risks among gay, bisexual, and other men who have sex with men in Montreal, Toronto, and Vancouver: Informing blood donor selection criteria in Canada. Transfusion 2022; 62:2555-2567. [PMID: 36197064 PMCID: PMC10092181 DOI: 10.1111/trf.17127] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/25/2022] [Accepted: 09/06/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND An individualized behavior-based selection approach has potential to allow for a more equitable blood donor eligibility process. We collected biological and behavioral data from urban gay, bisexual, and other men who have sex with men (GBM) to inform the use of this approach in Canada. STUDY DESIGN AND METHODS Engage is a closed prospective cohort of sexually active GBM, aged 16+ years, recruited via respondent-driven-sampling (RDS) in Montreal, Toronto, and Vancouver, Canada. Participants completed a questionnaire on behaviors (past 6 months) and tested for HIV and sexually transmitted and blood-borne infections at each visit. Rate ratios for HIV infection and predictive values for blood donation eligibility criteria were estimated by RDS-adjusted Poisson regression. RESULTS Data on 2008 (study visits 2017-02 to 2021-08) HIV-negative participants were used. The HIV incidence rate for the three cities was 0.4|100 person-years [95%CI:0.3, 0.6]. HIV seroconversion was associated with age <30 years: adjusted rate ratio (aRR) 9.1 [95%CI:3.2, 26.2], 6-10 and >10 anal sex partners versus 1-6 aRR: 5.3 [2.1,13.5] and 8.4 [3.4, 20.9], and use of crystal methamphetamine during sex: 4.2 [1.5, 11.6]. Applying the combined selection criteria: drug injection, ≥2 anal sex partners, and a new anal sex partner, detected all participants who seroconverted (100% sensitivity, 100% negative predictive value), and would defer 63% of study participants from donating. CONCLUSION Using three screening questions regarding drug injection and sexual behaviors in the past 6 months would correctly identify potential GBM donors at high risk of having recently contracted HIV. Doing so would reduce the proportion of deferred sexually active GBM by one-third.
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Affiliation(s)
- Gilles Lambert
- Direction Régionale de Santé Publique de Montréal, Montréal, Québec, Canada.,Institut National de Santé Publique du Québec, Montréal, Québec, Canada
| | - Joseph Cox
- Direction Régionale de Santé Publique de Montréal, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Alain Fourmigue
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Milada Dvorakova
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Herak Apelian
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Erica E M Moodie
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathan Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada.,Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Jody Jollimore
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Abbie Parlette
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Trevor A Hart
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
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20
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Rosansky JA, Borgogna NC, Kraus SW, Grubbs JB. Cross-Sectional and Longitudinal Associations Between Posttraumatic Stress Symptoms and Hypersexual Behaviors Among Individuals Who have Gambled in Their Lifetimes. J Sex Med 2022; 19:1813-1823. [PMID: 36216746 DOI: 10.1016/j.jsxm.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/12/2022] [Accepted: 09/05/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Exposure to traumatic experiences represent one factor that may contribute to the development of hypersexual behaviors. AIM We investigated the associations between posttraumatic stress symptoms and hypersexual behaviors by analyzing survey data from 2 samples. METHOD The first sample consisted of n = 585 college students, and the second consisted of n = 786 adults recruited via Amazon's Mechanical Turk (MTurk), n = 337 of whom completed a 6-month follow-up survey. We conducted 3 hierarchical regression analyses adjusting for age, gender, sexual orientation, impulsivity, drug use, alcohol use, and gambling. OUTCOMES The primary outcomes for this investigation were associations between posttraumatic stress symptoms, measured using the PTSD Checklist for DSM-IV and DSM-5 (PCL-C and PCL-5), and hypersexual behaviors, measured using the Hypersexual Behavior Inventory (HBI). RESULTS A significant regression, R2 = 0.230, R2adjusted = 0.211, F (14,570) = 12.17, P < .001, revealed posttraumatic stress symptoms were associated with hypersexual behaviors in the university student sample (β = 0.154). A significant regression using the MTurk sample, R2 = 0.403, R2adjusted = 0.392, F (14,771) = 37.13, P < .001, confirmed this finding (β = 0.259). In addition, a significant regression, R2 = 0.562, R2adjusted = 0.541, F (15,321) = 27.42, P < .001, indicated that posttraumatic stress symptoms were longitudinally associated with increased hypersexual behaviors (β = .190) after adjusting for all variables, including baseline hypersexuality. CLINICAL TRANSLATION Results suggest that individuals experiencing posttraumatic stress symptoms are at increased risk for current and future hypersexual behaviors. STRENGTHS & LIMITATIONS This investigation involved secondary analyses of adults who had gambled at least once in their lives and findings may not generalize to those who have never gambled. Furthermore, longitudinal findings may be impacted by selection bias (42% completion rate) and may not generalize to follow up periods longer than 6-months. CONCLUSION This study provides support for the hypothesis that posttraumatic stress symptoms are associated with increased hypersexual behavior, and further research is indicated to explore the etiology and directionality of this relationship. Rosansky JA, Borgogna NC, Kraus SW, et al. Cross-Sectional and Longitudinal Associations Between Posttraumatic Stress Symptoms and Hypersexual Behaviors Among Individuals Who have Gambled in Their Lifetimes. J Sex Med 2022;19:1813-1823.
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Affiliation(s)
- Joseph A Rosansky
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychology, Bowling Green State University, Bowling Green, OH, USA.
| | - Nicholas C Borgogna
- Department of Psychological Science, Texas Tech University, Lubbock, TX, USA
| | - Shane W Kraus
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Joshua B Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
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21
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Storholm ED, Siconolfi DE, Wagner GJ, Huang W, Nacht CL, Sallabank G, Felner JK, Wolf J, Lee SD, Stephenson R. Intimate Partner Violence and HIV Prevention Among Sexual Minority Men: Protocol for a Prospective Mixed Methods Cohort Study. JMIR Res Protoc 2022; 11:e41453. [PMID: 36378519 PMCID: PMC9709678 DOI: 10.2196/41453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Sexual minority men experience intimate partner violence (IPV) at rates similar to those reported by heterosexual women in the United States. Previous studies linked both IPV victimization and perpetration to HIV risk and seroconversion; however, less is known about the impact of IPV on HIV testing, sexually transmitted infection (STI) testing, pre-exposure prophylaxis (PrEP) uptake, and the persistence of PrEP use among sexual minority men experiencing IPV. Although prior work suggests that IPV may influence HIV prevention behavior, experiences of IPV are so highly varied among sexual minority men (eg, forms, frequency, and severity; steady vs casual partnerships; perpetration vs receipt; and sexual vs physical vs psychological violence) that additional research is needed to better understand the impact that IPV has on HIV risk and protective behaviors to develop more effective interventions for sexual minority men. OBJECTIVE This study aims to contribute to our understanding of the antecedents of IPV and the direct and indirect pathways between perpetration and receipt of IPV and HIV or STI risk behavior, STIs, and use of PrEP among sexual minority men experiencing IPV. METHODS This mixed methods study has 2 phases: phase 1 involved formative qualitative interviews with 23 sexual minority men experiencing IPV and 10 key stakeholders or providers of services to sexual minority men experiencing IPV to inform the content of a subsequent web-based cohort study, and phase 2 involves the recruitment of a web-based cohort study of 500 currently partnered HIV-negative sexual minority men who reside in Centers for Disease Control and Prevention-identified Ending the HIV Epidemic priority jurisdictions across the United States. Participants will be followed for 24 months. They will be assessed through a full survey and asked to self-collect and return biospecimen kits assessing HIV, STIs, and PrEP use at 0, 6, 12, 18, and 24 months. They will also be asked to complete abbreviated surveys to assess for self-reported changes in key study variables at 3, 9, 15, and 21 months. RESULTS Phase 1 was launched in May 2021, and the phase 1 qualitative interviews began in December 2021 and were concluded in March 2022 after a diversity of experiences and perceptions were gathered and no new ideas emerged in the interviews. Rapid analysis of the qualitative interviews took place between March 2022 and June 2022. Phase 2 recruitment of the full cohort began in August 2022 and is planned to continue through February 2024. CONCLUSIONS This mixed methods study will contribute valuable insights into the association that IPV has with HIV risk and protective behaviors among sexual minority men. The findings from this study will be used to inform the development or adaptation of HIV and IPV prevention interventions for sexual minority men experiencing IPV. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41453.
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Affiliation(s)
- Erik D Storholm
- School of Public Health, San Diego State University, San Diego, CA, United States
- RAND Corporation, Santa Monica, CA, United States
| | | | | | | | - Carrie L Nacht
- School of Public Health, San Diego State University, San Diego, CA, United States
| | - Greg Sallabank
- School of Nursing, University or Michigan, Ann Arbor, MI, United States
| | - Jennifer K Felner
- School of Public Health, San Diego State University, San Diego, CA, United States
| | - Joshua Wolf
- RAND Corporation, Santa Monica, CA, United States
| | - Sarita D Lee
- RAND Corporation, Santa Monica, CA, United States
| | - Rob Stephenson
- School of Nursing, University or Michigan, Ann Arbor, MI, United States
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22
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Garner AR, Brem MJ, Shorey RC, Hamlin J, Stuart GL. Negative urgency moderates the association between compulsive sexual behaviors and sending unsolicited sexts among men in residential treatment for substance use disorders. COMPUTERS IN HUMAN BEHAVIOR 2022; 136:107385. [PMID: 40443957 PMCID: PMC12122005 DOI: 10.1016/j.chb.2022.107385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Compulsive sexual behaviors (CSB; i.e., recurrent, excessive, and impairing sexual thoughts and behaviors) is prevalent among populations affected by substance use disorder (SUD) and was linked to harmful sexual behaviors. However, less is known about the association between CSB and potentially harmful sexual behaviors that occur in digital contexts (e.g., unsolicited sexting defined as sending sexually-explicit images or messages without the recipient's permission). The present study reviewed medical records for 253 men in residential treatment for SUD to examine the association between CSB and unsolicited sexting and the moderating effect of negative urgency (i.e., the tendency to act impulsively when negative affect is high) on this association. We conducted hierarchical multiple regression analyses using PROCESS. Results revealed a significant positive association between CSB and unsolicited sexting among men who endorsed high and average, but not low, levels of negative urgency. These results suggest that negative urgency may serve as a point of intervention in the relationship between CSB and unsolicited sexting among male residential SUD patients.
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Affiliation(s)
- Alisa R. Garner
- Univeristy of Tennessee-Knoxville, Department of Psychology, Knoxville, TN, 37996, USA
| | - Meagan J. Brem
- Virginia Polytechnic Institute and State University, Department of Psychology, Blacksburg, VA, 24060, USA
| | - Ryan C. Shorey
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, 53211, USA
| | - Julie Hamlin
- Cornerstone of Recovery a Bradford Health Service, Louisville, TN, 37777, USA
| | - Gregory L. Stuart
- Univeristy of Tennessee-Knoxville, Department of Psychology, Knoxville, TN, 37996, USA
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23
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Liu S, Xia D, Wang Y, Xu H, Xu L, Yuan D, Liang A, Chang R, Wang R, Liu Y, Chen H, Hu F, Cai Y, Wang Y. Predicting the risk of HIV infection among internal migrant MSM in China: An optimal model based on three variable selection methods. Front Public Health 2022; 10:1015699. [PMID: 36388367 PMCID: PMC9641070 DOI: 10.3389/fpubh.2022.1015699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/04/2022] [Indexed: 01/27/2023] Open
Abstract
Introduction Internal migrant Men who have sex with men (IMMSM), which has the dual identity of MSM and floating population, should be more concerned among the vulnerable groups for HIV in society. Establishing appropriate prediction models to assess the risk of HIV infection among IMMSM is of great significance to against HIV infection and transmission. Methods HIV and syphilis infection were detected using rapid test kits, and other 30 variables were collected among IMMSM through questionnaire. Taking HIV infection status as the dependent variable, three methods were used to screen predictors and three prediction models were developed respectively. The Hosmer-Lemeshow test was performed to verify the fit of the models, and the net classification improvement and integrated discrimination improvement were used to compare these models to determine the optimal model. Based on the optimal model, a prediction nomogram was developed as an instrument to assess the risk of HIV infection among IMMSM. To quantify the predictive ability of the nomogram, the C-index measurement was performed, and internal validation was performed using bootstrap method. The receiver operating characteristic (ROC) curve, calibration plot and dynamic component analysis (DCA) were respectively performed to assess the efficacy, accuracy and clinical utility of the prediction nomogram. Results In this study, 12.52% IMMSMs were tested HIV-positive and 8.0% IMMSMs were tested syphilis-positive. Model A, model B, and model C fitted well, and model B was the optimal model. A nomogram was developed based on the model B. The C-index of the nomogram was 0.757 (95% CI: 0.701-0.812), and the C-index of internal verification was 0.705. Conclusions The model established by stepwise selection methods incorporating 11 risk factors (age, education, marriage, monthly income, verbal violence, syphilis, score of CUSS, score of RSES, score of ULS, score of ES and score of DS) was the optimal model that achieved the best predictive power. The risk nomogram based on the optimal model had relatively good efficacy, accuracy and clinical utility in identifying internal migrant MSM at high-risk for HIV infection, which is helpful for developing targeted intervention for them.
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Affiliation(s)
- Shangbin Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danni Xia
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuxuan Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huifang Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lulu Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Yuan
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ajuan Liang
- Renji Hospital, Affiliated With the School of Medicine Shanghai Jiao Tong University, Shanghai, China
| | - Ruijie Chang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongxi Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujie Liu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Hu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,*Correspondence: Fan Hu
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Yong Cai
| | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Ying Wang
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24
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Helminen EC, Cascalheira CJ, Shaw TJ, Zollweg S, Hughes TL, Scheer JR. A latent class analysis of tailored substance use treatment programs: Implications for treating syndemic conditions facing sexual and gender minority populations. Drug Alcohol Depend 2022; 238:109550. [PMID: 35820291 PMCID: PMC9444885 DOI: 10.1016/j.drugalcdep.2022.109550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Syndemics (i.e., multiple, co-occurring, and synergistic conditions) contribute to elevated substance use among sexual and gender minority (SGM) people relative to heterosexual, cisgender people. Research suggests that syndemic-informed and SGM-tailored treatments are effective in substance use treatment among SGM people. However, few studies have examined 1) the proportion of substance use treatment facilities offering syndemic-informed, SGM-tailored treatment programming; and 2) the availability and accessibility of syndemic-informed, SGM-tailored treatment programs across the U.S. METHODS We used the 2020 National Survey of Substance Abuse Treatment Services (N-SSATS) dataset to perform a latent class analysis examining whether substance use treatment facilities' tailored treatment programs cluster together to form distinct classes indicating whether facilities offer syndemic-informed and SGM-tailored programming. We then used multinomial logistic regression to examine associations between class membership and facility availability and accessibility. RESULTS Analyses revealed four classes of substance use treatment facilities' tailored programs. Facilities with syndemic-informed and SGM-tailored treatment programs compared to facilities with no tailored programs were more likely to be in the Northeast compared to the Midwest and South; to offer payment assistance versus not offer payment assistance; and to be private, for-profit facilities versus public or non-profit facilities. CONCLUSIONS This study's findings identify the need for more facilities with syndemic-informed and SGM-tailored treatment, particularly in the Midwestern and Southern U.S. regions. Facilities offering syndemic-informed and SGM-tailored treatment might present accessibility barriers for low-income SGM people, as they were more likely to be private, for-profit facilities; however, they were more likely to offer payment assistance.
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Affiliation(s)
- Emily C Helminen
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Cory J Cascalheira
- Department of Psychology, Syracuse University, Syracuse, NY, USA; Department of Counseling and Educational Psychology, New Mexico State University, Las Cruces, NM, USA
| | - Thomas J Shaw
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Sarah Zollweg
- School of Nursing, Columbia University, New York, NY, USA
| | - Tonda L Hughes
- School of Nursing, Columbia University, New York, NY, USA; Department of Psychiatry, Columbia University, New York, NY, USA
| | - Jillian R Scheer
- Department of Psychology, Syracuse University, Syracuse, NY, USA.
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25
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Cascalheira CJ, Morrison C, D’Angelo AB, Villanueva OG, Grov C. The Impact of the COVID-19 Pandemic on HIV-Positive Men Who Have Sex With Men: (Dis)connection to Social, Sexual, and Health Networks. PSYCHOLOGY & SEXUALITY 2022; 14:306-320. [PMID: 36743519 PMCID: PMC9897219 DOI: 10.1080/19419899.2022.2112745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/08/2022] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has disproportionately affected HIV-positive cisgender men who have sex with men (MSM). Between May and June in 2020, we conducted one-on-one semi-structured qualitative interviews with 20 HIV-positive MSM aiming to describe their (dis)connection to social, sexual, and health networks during the COVID-19 pandemic. All participants relied on social support networks to manage pandemic-based distress, using computer-mediated communication as well as physical proximity. To connect to sexual networks, this sample described adaptations to their partner selection strategies, such as enumerating harm reduction approaches. To connect to health networks, participants depended on reassuring providers, resourceful case managers, telehealth, and streamlined access to their antiretroviral therapy (ART) medications. Nonetheless, stay-at-home recommendations reduced community connection, sexual activity, and healthcare access for many participants, and perceptions of these losses were shaped by psychosocial burdens (e.g., loneliness), structural burdens (e.g., environmental barriers, financial difficulties), and health-protective factors (e.g., hopeful outlook, adherence to a regular routine). The COVID-19 pandemic appears to have exacerbated health-related issues for HIV-positive MSM. Given the ongoing COVID-19 mutations, community-based organizations, clinicians, and researchers might use these findings to modify HIV prevention and intervention efforts.
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Affiliation(s)
| | - Corey Morrison
- City University of New York (CUNY) Institute for Implementation Science in Population Health
| | - Alexa B. D’Angelo
- City University of New York (CUNY) Institute for Implementation Science in Population Health
- CUNY Graduate School of Public Health and Health Policy
| | | | - Christian Grov
- City University of New York (CUNY) Institute for Implementation Science in Population Health
- CUNY Graduate School of Public Health and Health Policy
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26
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Viamonte M, Ghanooni D, Reynolds JM, Grov C, Carrico AW. Running with Scissors: a Systematic Review of Substance Use and the Pre-exposure Prophylaxis Care Continuum Among Sexual Minority Men. Curr HIV/AIDS Rep 2022; 19:235-250. [PMID: 35701713 PMCID: PMC9279195 DOI: 10.1007/s11904-022-00608-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 11/26/2022]
Abstract
Purpose of Review Patterns of sexualized drug use, including stimulants (e.g., methamphetamine) and chemsex drugs, are key drivers of HIV incidence among sexual minority men (SMM). Although pre-exposure prophylaxis (PrEP) mitigates HIV risk, there is no consensus regarding the associations of substance use with the PrEP care continuum. Recent Findings SMM who use substances are as likely or more likely to use PrEP. Although SMM who use stimulants experience greater difficulties with daily oral PrEP adherence, some evidence shows that SMM who use stimulants or chemsex drugs may achieve better adherence in the context of recent condomless anal sex. Finally, SMM who use substances may experience greater difficulties with PrEP persistence (including retention in PrEP care). Summary SMM who use stimulants and other substances would benefit from more comprehensive efforts to support PrEP re-uptake, adherence, and persistence, including delivering behavioral interventions, considering event-based dosing, and providing injectable PrEP.
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Affiliation(s)
- Michael Viamonte
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Office 1010, Miami, FL, 33136, USA
| | - Delaram Ghanooni
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Office 1010, Miami, FL, 33136, USA
| | - John M Reynolds
- Calder Memorial Library, University of Miami, FL, Miami, USA
| | - Christian Grov
- City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Office 1010, Miami, FL, 33136, USA.
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27
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Calvetti S, Rusow JA, Lewis J, Martinez A, Slay L, Bray BC, Goldbach JT, Kipke MD. A Trans Youth of Color Study (TRUTH) to Measure Health and Wellness: Protocol for a Longitudinal Observation Study (Preprint). JMIR Res Protoc 2022; 11:e39207. [PMID: 36342757 PMCID: PMC9679929 DOI: 10.2196/39207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/29/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Growing research on transgender youth is accounting for the variety of ways in which young people define their genders and sexualities. Because of this growing representation, more research is needed to understand how intersectional identities and stigma affect risk for HIV acquisition along the HIV care continuum and engagement in mental and physical health care. Little is known about accessibility to HIV-related prevention services of nonbinary and transmasculine youth, and further understanding of the impacts on transfeminine people-those who have historically faced the highest prevalence of HIV positivity-is crucial. OBJECTIVE The overarching aims of the Trans Youth of Color Study are to conduct longitudinal research with a cohort of transgender minority youth (TGMY), explore factors that aid in the prevention of new HIV infection and transmission, and reduce HIV- and AIDS-related disparities by focusing on successful engagement in care. Findings from this research will be used to inform the development of new interventions designed to engage TGMY in the HIV prevention and care continua. METHODS Longitudinal research (baseline and follow-up assessments every 6 months for 3 waves of data collection) followed a cohort (N=108) of transgender youth of color recruited in Los Angeles, California, United States. Participants were recruited using multiple community-informed strategies, such as from local venues, social media, and participant referral. In addition to self-report surveys, urine was collected to assess recent use of illicit drugs, and blood, rectal, and throat swabs were collected to test for current sexually transmitted infection and HIV infection. Additional blood and plasma samples (10 mL for 4 aliquots and 1 pellet) were collected and stored for future research. RESULTS Participants in the Trans Youth of Color Study were recruited between May 25, 2018, and December 7, 2018. Baseline and longitudinal data are being analyzed as of August 2022. CONCLUSIONS The findings from this research will inform adaptations to existing evidence-based HIV prevention interventions and help to guide new interventions designed to engage TGMY, especially those who are Black, Indigenous, or people of color, in the HIV prevention and care continua. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39207.
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Affiliation(s)
- Sam Calvetti
- Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Joshua A Rusow
- The Brown School, Washington University in St Louis, St Louis, MO, United States
| | - Jacqueline Lewis
- Health Services, Los Angeles LGBT Center, Los Angeles, CA, United States
| | - Amarah Martinez
- HIV & Biomedical Department, Wesley Health Centers, JWCH Institute, Palmdale, CA, United States
| | - Lindsay Slay
- Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Bethany C Bray
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - Jeremy T Goldbach
- The Brown School, Washington University in St Louis, St Louis, MO, United States
| | - Michele D Kipke
- Children's Hospital Los Angeles, Los Angeles, CA, United States
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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28
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Cienfuegos-Szalay J, Moody RL, Talan A, Grov C, Rendina HJ. Sexual Shame and Emotion Dysregulation: Key Roles in the Association between Internalized Homonegativity and Sexual Compulsivity. JOURNAL OF SEX RESEARCH 2022; 59:610-620. [PMID: 34410183 PMCID: PMC8976551 DOI: 10.1080/00224499.2021.1963649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Sexual minority men (SMM) are at increased risk for mental health problems due to effects of sexual minority stigma (e.g., internalized homonegativity (IH)). Both IH and emotion dysregulation are contributors to sexual compulsivity; however, the role of feelings of sexual shame have not been examined in this association. A sample of 982 HIV-negative SMM completed online surveys (Mage = 42.4, SD = 13.74). Path analyses indicated significant direct effects of IH on sexual shame (β = 0.44, p < .001), emotion dysregulation (β = 0.19, p < .001), and sexual compulsivity (β = 0.22, p < .001). Modeled simultaneously, the association between sexual shame and sexual compulsivity (β = 0.26, p < .001) was significant, as was the association between emotion dysregulation and sexual compulsivity (β = 0.27, p < .001). Finally, an indirect effect of IH on sexual compulsivity through both sexual shame (p < .001) and emotion dysregulation (p < .001) was significant, and the association between IH and sexual compulsivity was reduced to non-significant (β = 0.01, p = .74). Targeting feelings of sexual shame and emotion dysregulation in clinical interventions may help reduce the negative health impact of sexual compulsivity among SMM.
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Affiliation(s)
- Jorge Cienfuegos-Szalay
- Department of Psychology, Hunter College of the City University of New York (CUNY)
- Health Psychology and Clinical Science PhD Program, The Graduate Center of the City University of New York (CUNY)
| | - Raymond L Moody
- Department of Psychology, Hunter College of the City University of New York (CUNY)
- Health Psychology and Clinical Science PhD Program, The Graduate Center of the City University of New York (CUNY)
| | - Ali Talan
- Department of Psychology, Hunter College of the City University of New York (CUNY)
| | - Christian Grov
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY)
- Health Psychology and Clinical Science PhD Program, The Graduate Center of the City University of New York (CUNY)
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29
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Coleman JN, Batchelder AW, Kirakosian N, Choi KW, Shipherd JC, Bedoya CA, Safren SA, Ironson G, O'Cleirigh C. Indirect effects of dissociation on the relationship between lifetime PTSD symptoms and condomless sex among men who have sex with men with a history of childhood sexual abuse. J Trauma Dissociation 2022; 23:279-295. [PMID: 34678135 PMCID: PMC9023598 DOI: 10.1080/15299732.2021.1989118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Posttraumatic stress disorder (PTSD) symptoms may interfere with gay, bisexual and other men who have sex with men's (MSM) ability to engage in safe sex practices. An indirect relationship with dissociation may help to elucidate the relationship between PTSD symptom severity and condomless sex among MSM with childhood sexual abuse (CSA) histories. These relationships have not previously been examined in this group, which has a unique vulnerability for HIV acquisition. A cross-sectional sample of MSM with histories of CSA (N=290) was recruited at study sites in Boston, MA, and Miami, FL. Participants had a mean age of 37.95 years (SD=11.68), 22% were African American and 29.4% identified as Latino. The sample reported a mean of 10.47 (SD=4.38) lifetime PTSD symptoms and 26.4% met the clinical threshold for dissociation. Logistic regression models (adjusted for age, education, and substance use disorder) were used to assess indirect effects of dissociation on the relationship between lifetime PTSD symptoms and condomless anal/vaginal sex episodes with serodiscordant or unknown status partners in the past 3 months. Dissociation accounted for the association between lifetime PTSD symptom severity and condomless sex episodes. The Sobel test (Sobel = 2.04, p= .042; CI 95% bias-corrected bootstrap) suggested significant indirect effects for dissociation. Dissociation among MSM with CSA histories may compromise accurate appraisals of sexual risk and safety and increase vulnerability for HIV acquisition. Further research is warranted to address HIV prevention in the context of PTSD symptom severity to improve the mental health of MSM and increase the effectiveness of HIV prevention interventions.
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Affiliation(s)
- Jessica N Coleman
- Department of Psychology & Neuroscience, Duke University, Durham, North Carolina, United States.,Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, United States
| | - Abigail W Batchelder
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States.,The Fenway Institute, Fenway Health, Boston, Massachusetts, United States
| | - Norik Kirakosian
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States
| | - Karmel W Choi
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, United States.,Department of Epidemiology, Harvard T.h. Chan School of Public Health, Boston, Massachusetts, United States
| | - Jillian C Shipherd
- School of Medicine, Boston University, Boston, Massachusetts, United States.,Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, United States.,Office of Patient Care Services, LGBT Health Program, Veterans Health Administration, Washington, District of Columbia, United States
| | - C Andres Bedoya
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, Florida, United States
| | - Gail Ironson
- Department of Psychology, University of Miami, Coral Gables, Florida, United States
| | - Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States.,The Fenway Institute, Fenway Health, Boston, Massachusetts, United States
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30
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Interpersonal Stigma, Mental Health, and Sexual Compulsivity Among an Online U.S. Sample of Men Who Have Sex with Men Living with HIV. AIDS Behav 2022; 26:1321-1331. [PMID: 34698953 DOI: 10.1007/s10461-021-03489-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 10/20/2022]
Abstract
This cross-sectional study sought to determine whether HIV-related interpersonal stigma was associated with the presence of sexual compulsivity (SC) in a national online sample of 936 men who have sex with men (MSM) living with HIV who reported recent suboptimal adherence to their antiretroviral therapy (ART) or virologic non-suppression. A modest association was found between perceptions of HIV-related interpersonal stigma and SC that was partially mediated by current mental health symptoms. White MSM were significantly more likely than Black MSM to report SC or HIV-related interpersonal stigma. Findings signal the need for therapeutic interventions that include behavioral and/or pharmacologic therapy to address overlapping intervention targets, including mental health, substance use, and sexual health. Future research should assess temporality of HIV-related interpersonal stigma and SC, as well as racial differences in relation to these constructs.
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31
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Ewart LD, Johnson A, Bainter S, Brown EC, Grov C, Harkness A, Roth AM, Paul R, Neilands TB, Dilworth SE, Carrico AW. Tina's ParTy line: Polysubstance use patterns in sexual minority men living with HIV who use methamphetamine. Drug Alcohol Rev 2022; 41:338-346. [PMID: 34806244 PMCID: PMC11215554 DOI: 10.1111/dar.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/25/2021] [Accepted: 10/17/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This cross-sectional study examined the associations of demographic, structural and psychological factors with distinct typologies of polysubstance use in sexual minority men (SMM) living with HIV who use methamphetamine. METHODS In total, 161 SMM living with HIV who reported methamphetamine use in the past 3 months were recruited in San Francisco from 2013 to 2017 for a randomised controlled trial. A latent class analysis was conducted by leveraging baseline measures of self-reported use of 15 substances in the past 3 months as well as validated screening measures of hazardous alcohol and cannabis use. Correlates of latent class membership were examined using a three-step categorical latent variable logistic regression. RESULTS Four typologies of substance use were identified: (i) methamphetamine use only (43%); (ii) methamphetamine and crack-cocaine use (22%); (iii) party and play use-methamphetamine, gamma-hydroxybutyrate and amyl nitrites (i.e. poppers) with erectile dysfunction drugs (31%); and (iv) high polysubstance use (4%). SMM of colour and those with a history of incarceration were more commonly classified as engaging in methamphetamine and crack-cocaine use compared to party and play use. Men with higher sexual compulsivity scores were more commonly classified as engaging in party and play use and polysubstance use. DISCUSSION AND CONCLUSIONS There is substantial heterogeneity in polysubstance use patterns among SMM living with HIV who use methamphetamine. This will inform the development of tailored substance use interventions addressing the unique needs of SMM of colour and targeting sexual compulsivity as a prominent comorbidity for some men.
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Affiliation(s)
| | - Ariana Johnson
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sierra Bainter
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eric C. Brown
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Christian Grov
- City University of New York, Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Audrey Harkness
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alexis M. Roth
- Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Robert Paul
- University of Missouri St. Louis, Department of Psychological Sciences, St. Louis, MO, USA
| | - Torsten B. Neilands
- University of California, San Francisco Center for AIDS Prevention Studies, San Francisco, CA USA
| | - Samantha E. Dilworth
- University of California, San Francisco Center for AIDS Prevention Studies, San Francisco, CA USA
| | - Adam W. Carrico
- University of Miami Miller School of Medicine, Miami, FL, USA
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Prediction Model for the Risk of HIV Infection among MSM in China: Validation and Stability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19021010. [PMID: 35055826 PMCID: PMC8776241 DOI: 10.3390/ijerph19021010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/08/2022] [Accepted: 01/11/2022] [Indexed: 12/04/2022]
Abstract
The impact of psychosocial factors on increasing the risk of HIV infection among men who have sex with men (MSM) has attracted increasing attention. We aimed to develop and validate an integrated prediction model, especially incorporating emerging psychosocial variables, for predicting the risk of HIV infection among MSM. We surveyed and collected sociodemographic, psychosocial, and behavioral information from 547 MSM in China. The participants were split into a training set and a testing set in a 3:1 theoretical ratio. The prediction model was constructed by introducing the important variables selected with the least absolute shrinkage and selection operator (LASSO) regression, applying multivariate logistic regression, and visually assessing the risk of HIV infection through the nomogram. Receiver operating characteristic curves (ROC), Kolmogorov–Smirnov test, calibration plots, Hosmer–Lemeshow test and population stability index (PSI) were performed to test validity and stability of the model. Four of the 15 selected variables—unprotected anal intercourse, multiple sexual partners, involuntary subordination and drug use before sex—were included in the prediction model. The results indicated that the comprehensive prediction model we developed had relatively good predictive performance and stability in identifying MSM at high-risk for HIV infection, thus providing targeted interventions for high-risk MSM.
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The Impact of COVID-19 on Sexual Behavior and Psychosocial Functioning in a Clinical Sample of Men who have Sex with Men Using HIV Pre-exposure Prophylaxis. AIDS Behav 2022; 26:69-75. [PMID: 34114165 PMCID: PMC8191709 DOI: 10.1007/s10461-021-03334-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 01/04/2023]
Abstract
The purpose of this study was to evaluate the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on sexual behavior, mental health, and substance use among men who have sex with men (MSM) engaged in pre-exposure prophylaxis (PrEP) care. Generalized linear mixed models and logistic mixed-effect models examined change over time for number of sexual partners, mood, and alcohol consumption. From February 29, 2020 to July 31, 2020, 177 MSM actively engaged in PrEP care were evaluated. The median age was 37 [interquartile range (IQR 30, 51]. Patients in the sample were largely representative of the clinic population and identified as White (73.0%), Black/African American (9.2%), and other race (17.2%), and 11.8% identified as Hispanic/Latino ethnicity. Men reported an average of 2.60 fewer sexual partners (95% CI −4.04, −1.40) during the pandemic compared to pre-COVID-19. Rates of depressive symptoms and alcohol use remained stable and few patients reported substance use. The reduced number of sexual partners may be explained by patients’ efforts to reduce risk of exposure to COVID-19 and low rates of psychosocial symptoms may be indicative of only the highest functioning patients continuing to engage in care. Reductions in sexual partners may offset reduced engagement in care and help mitigate risk of HIV and other sexually transmitted infections (STIs).
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Shrader CH, Arroyo-Flores J, Stoler J, Skvoretz J, Carrico A, Doblecki-Lewis S, Kanamori M. The Association Between Social and Spatial Closeness With PrEP Conversations Among Latino Men Who Have Sex With Men. J Acquir Immune Defic Syndr 2021; 88:366-375. [PMID: 34342298 PMCID: PMC8556301 DOI: 10.1097/qai.0000000000002777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/22/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND US Latino men who have sex with men (LMSM) are a group at highest risk for HIV. One driver of HIV among LMSM is inadequate access to pre-exposure prophylaxis (PrEP) information. The social network theory of homophily suggests that sharing similar sociodemographic factors could influence PrEP conversations within networks. This study aimed to determine how the effects of homophily across sociodemographic, immigration, cultural, and PrEP-related factors are associated with PrEP-related communication. SETTING This study was conducted in Miami-Dade County, FL. METHODS Data collected between August 2018 and October 2019 included 10 sociocentric friendship groups of 13 LMSM (N = 130). Participants were recruited using respondent-driven sampling by a community-based organization in Miami. We used the multiple regression quadratic assignment procedure to identify the effects of homophily and relationship characteristics on PrEP-related conversations using R software. RESULTS More frequent PrEP-related conversations were associated with dyadic friendships characterized by homophily on knowledge of PrEP effectiveness, heterophily on depressive symptom severity, home addresses proximity, friend closeness, and interaction frequency. Past PrEP-related conversation frequency also increased based on heterophily on the Latino cultural value of familism (ie, emotional support to family). Racial homophily, heterophily on severity of depressive symptoms, home addresses proximity, friendship closeness, and frequency of interactions increased likelihood to encourage a friend to use PrEP. DISCUSSION Social and spatial closeness and homophily play a role in PrEP-related conversations. Information from social networks contextualized in geographic settings can be elucidated to contribute toward the design of novel opportunities to end HIV.
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Affiliation(s)
- Cho-Hee Shrader
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Juan Arroyo-Flores
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Justin Stoler
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Geography, College of Arts and Sciences, University of Miami, Coral Gables, FL, USA
| | - John Skvoretz
- Department of Sociology, University of South Florida, Tampa, FL, USA
| | - Adam Carrico
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Mariano Kanamori
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Liu M, Cai X, Hao G, Li W, Chen Q, Chen Y, Xiong P. Prevalence of Intimate Partner Violence Among Men Who Have Sex With Men: An Updated Systematic Review and Meta-Analysis. Sex Med 2021; 9:100433. [PMID: 34571326 PMCID: PMC8766270 DOI: 10.1016/j.esxm.2021.100433] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/03/2021] [Accepted: 08/10/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Intimate partner violence (IPV) among men who have sex with men (MSM) has become a serious and widespread public health issue, which might result in low quality of life and increase the global burden of diseases. AIM To quantitatively estimate the pooled prevalence of IPV and its specific forms (physical violence, sexual violence and emotional violence) among MSM. METHODS Databases of PubMed, Cochrane Library, CINAHL, MEDLINE, PsycINFO, CNKI, WANFANG Data, and Weipu (CQVIP) Data were searched for identified studies published between January 1990 and August 2020. Random effect meta-analyses were used to synthesize the pooled prevalence and 95% CIs of IPV. MAIN OUTCOME MEASURES The pooled prevalence of IPV in victimization and in perpetration among MSM. RESULTS A total of 52 studies with 32,048 participants were included for final analysis. The pooled prevalence of IPV was 33% (6,342 of 19,873; 95%CI, 28-39%) in victimization and 29% (1,491 of 5,983; 95%CI, 17 -40%) in perpetration across all recall periods among MSM population. Furthermore, the pooled prevalence of physical violence was 17% (3,979 of 22,928; 95%CI, 14 -20%) and 12% (942 of 9,236; 95%CI, 10 -15%), of sexual violence was 9% (1,527 of 19,511; 95%CI, 8 -11%) and 4% (324 of 8,044; 95%CI, 3 -5%), of emotional violence was 33% (5,147 of 17,994; 95%CI, 25 -40%) and 41% (1,317 of 3,811; 95%CI, 17 -65%) in victimization and perpetration, respectively. Out of all the IPV identified, emotional violence was estimated at the highest level. CONCLUSION This study demonstrated a high prevalence of IPV both in victimization and perpetration among MSM, and emotional violence was estimated at the highest level out of all IPV forms. Efforts are needed to develop corresponding prevention programs for victims with an intent to increase the accessible availability of health services, and ultimately improve their life quality. Liu M., Cai X., Hao G. et al., Prevalence of Intimate Partner Violence Among Men Who Have Sex With Men: An Updated Systematic Review and Meta-Analysis. Sex Med 2021;9:100433.
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Affiliation(s)
- Min Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xianghao Cai
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Guang Hao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Wenhao Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Qingshan Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Yuhan Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China; International School, Jinan University, Guangzhou, China
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
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Chuang DM, Newman PA, Fang L, Lai MC. Syndemic Conditions, Sexual Risk Behavior, and HIV Infection Among Men Who Have Sex with Men in Taiwan. AIDS Behav 2021; 25:3503-3518. [PMID: 33950337 DOI: 10.1007/s10461-021-03269-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 11/29/2022]
Abstract
Men who have sex with men (MSM) continue to constitute the majority of HIV incidence in Taiwan. This study examined the associations between five co-occurring psychosocial health conditions (PHCs)-childhood physical abuse (CPA), childhood sexual abuse (CSA), intimate partner violence (IPV), internalized homophobia (IH), and methamphetamine use (MU), and two outcomes (HIV infection and condomless anal sex) among a community sample of 1,000 Taiwanese MSM (mean age 28.5 years). Compared to MSM who had never experienced any PHC, MSM with one or more PHCs had greater than twofold higher odds of being HIV-positive, and those with three or more PHCs had twofold higher odds of having condomless anal sex. Interactive effects on HIV infection were identified from CPA + CSA + MU and CPA + IPV + MU. An interactive effect on condomless anal sex was detected between IH and MU. In order to control the escalating HIV epidemic among MSM in Taiwan, interventions are needed to address syndemic psychosocial health conditions.
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Affiliation(s)
- Deng-Min Chuang
- Graduate Institute of Social Work, National Taiwan Normal University, No. 162, Sec. 1, Heping E. Rd., Da'an Dist., Taipei, 106, Taiwan, ROC.
| | - Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Lin Fang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Meng-Chuan Lai
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Azrieli Adult Neurodevelopmental Centre, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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Numer M, Holmes D, Hammond C, Joy P, Sinno J. Assemblages of excess and pleasures: The sociosexual uses of online and chemical technologies among men who have sex with men. Nurs Philos 2021; 23:e12370. [PMID: 34617377 DOI: 10.1111/nup.12370] [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: 06/29/2021] [Revised: 09/01/2021] [Accepted: 09/11/2021] [Indexed: 11/27/2022]
Abstract
Chemicals have penetrated everyday lives of men who have sex with men as never before, along with new online and mobile technologies used to seek pleasures and connections. Poststructuralist (including queer) explorations of these new intensities show how bodies exist in the form of (political) surfaces able to connect with other bodies and with other objects where they may find/create a function (e.g., reproduce or disrupt hegemonies). This federally funded netnographic study explored how a variety of chemicals such as recreational drugs, pharmaceuticals and steroids are contributing to the construction of gay, bisexual and other men having sex with men (GBMSM) communities and their interactions with idealized masculinities in the age of increasing technology. Five major thematic categories emerged from our analysis: (1) assembling bodies and technologies, (2) becoming orgiastic, (3) experiencing stigma, (4) becoming machinic and (5) negotiating practices. Our analysis explores how and why GBMSM pursue excesses of pleasure and connection through the assemblages they make with sexualized drug use, online platforms and other men.
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Affiliation(s)
- Matthew Numer
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Dave Holmes
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Chad Hammond
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Phillip Joy
- Applied Nutrition Department, Mount Saint-Vincent University, Halifax, Nova Scotia, Canada
| | - Jad Sinno
- Faculty of Health, School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
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Scheer JR, Clark KA, Maiolatesi AJ, Pachankis JE. Syndemic Profiles and Sexual Minority Men's HIV-Risk Behavior: A Latent Class Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2825-2841. [PMID: 33483851 PMCID: PMC8295412 DOI: 10.1007/s10508-020-01850-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 09/14/2020] [Accepted: 09/23/2020] [Indexed: 05/10/2023]
Abstract
Syndemic theory posits that "syndemic conditions" (e.g., alcohol misuse, polydrug use, suicidality) co-occur among sexual minority men and influence HIV-risk behavior, namely HIV acquisition and transmission risk. To examine how four syndemic conditions cluster among sexual minority men and contribute to HIV-risk behavior, we conducted latent class analysis (LCA) to: (1) classify sexual minority men (n = 937) into subgroups based on their probability of experiencing each syndemic condition; (2) examine the demographic (e.g., race/ethnicity) and social status (e.g., level of socioeconomic distress) characteristics of the most optimally fitting four syndemic classes; (3) examine between-group differences in HIV-risk behavior across classes; and (4) use syndemic class membership to predict HIV-risk behavior with sexual minority men reporting no syndemic conditions as the reference group. The four classes were: (1) no syndemic, (2) alcohol misuse and polydrug use syndemic, (3) polydrug use and HIV syndemic, and (4) alcohol misuse. HIV-risk behavior differed across these latent classes. Demographic and social status characteristics predicted class membership, suggesting that syndemic conditions disproportionately co-occur in vulnerable subpopulations of sexual minority men, such as those experiencing high socioeconomic distress. When predicting HIV-risk behavior, men in the polydrug use and HIV syndemic class were more likely (Adjusted Risk Ratio [ARR] = 2.93, 95% CI: 1.05, 8.21) and men in the alcohol misuse class were less likely (ARR = 0.17, 95% CI: 0.07, 0.44) to report HIV-risk behavior than were men in the no syndemic class. LCA represents a promising methodology to inform the development and delivery of tailored interventions targeting distinct combinations of syndemic conditions to reduce sexual minority men's HIV-risk behavior.
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Affiliation(s)
- Jillian R Scheer
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY, 13244, USA.
| | - Kirsty A Clark
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Anthony J Maiolatesi
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
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Egan JE, Haberlen SA, Meanley S, Ware D, Brown AL, Siconolfi D, Brennan-Ing M, Stall R, Plankey MW, Friedman MR. Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men: Protocol for an Observational Cohort Study. JMIR Res Protoc 2021; 10:e25750. [PMID: 34554100 PMCID: PMC8498890 DOI: 10.2196/25750] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/23/2021] [Accepted: 05/25/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND With the graying of sexual and gender minority communities and the growing number of people aged ≥50 years living with HIV, it is increasingly important to understand resilience in the context of the psychosocial aspects of aging and aging well. OBJECTIVE This paper aims to describe the methods and sample for the Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men study. METHODS This observational cohort study was conducted within the Multisite AIDS Cohort Study (MACS) and was designed to explore resiliencies to explain patterns of health and illness among middle-aged and older sexual minority men. To be eligible, a participant had to be an active participant in the MACS, be at least 40 years of age as of April 1, 2016, and report any sex with another man since enrollment in the MACS. RESULTS Eligible participants (N=1318) completed six biannual surveys between April 2016 and April 2019. The mean age of the sample was 59.6 years (range 40-91 years). The sample was mostly White, educated, gay-identified, and included both HIV-positive (656/1318, 49.77%) and HIV-negative (662/1318, 50.23%) men. CONCLUSIONS Understanding resiliencies in aging is a critical springboard for the development of more holistic public health theories and interventions that support healthy aging among older sexual minority men. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/25750.
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Affiliation(s)
- James E Egan
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Center for LGBT Health Research, Graduate School for Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sabina A Haberlen
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Steven Meanley
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
| | - Deanna Ware
- Department of Medicine, Division of General Internal Medicine, Georgetown University Medical Center, Washington, DC, United States
| | - Andre L Brown
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Center for LGBT Health Research, Graduate School for Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, New York, NY, United States
| | - Ron Stall
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Center for LGBT Health Research, Graduate School for Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Michael W Plankey
- Department of Medicine, Division of General Internal Medicine, Georgetown University Medical Center, Washington, DC, United States
| | - M Reuel Friedman
- Center for LGBT Health Research, Graduate School for Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
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Gleason N, Finotelli I, Miner MH, Herbenick D, Coleman E. Estimated Prevalence and Demographic Correlates of Compulsive Sexual Behavior Among Gay Men in the United States. J Sex Med 2021; 18:1545-1554. [PMID: 37057439 DOI: 10.1016/j.jsxm.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/29/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Compulsive sexual behavior (CSB) is a clinical syndrome that causes significant distress and impairment for many individuals in the United States. Gay men are thought to have a higher prevalence of CSB, and it is associated with many relevant health outcomes including HIV risk behavior. AIM To estimate the prevalence and examine demographic correlates of CSB among gay men in the United States. METHODS A U.S. national probability sample of 227 gay-identified men were collected as part of the 2015 National Survey of Sexual Health and Behavior (NSSHB). OUTCOMES Participants completed the Compulsive Sexual Behavior Inventory (CSBI-13) and demographic measures. RESULTS Eighteen participants (7.93%) scored above the CSBI-13 clinical cut point, indicating they would likely meet criteria for clinically significant compulsive sexual behavior. To assess demographic correlates of CSB, demographic variables were entered into a logistic regression. Results of the logistic regression indicated that participant age, education, and religious affiliation were significant predictors of CSB status. Individuals scoring above the cut point were younger on average (M = 39.17; SD = 14.84) than those scoring below the cut point (M = 47.52; SD = 14.62; P = .02). Odds of scoring above the cut point were about six times greater for religiously affiliated participants compared to non-religiously affiliated participants (P = .005), and four times greater for those who had attended college compared to those who had not (P = .03). CLINICAL IMPLICATIONS These results indicate the prevalence of CSB in gay men is more modest than previously estimated, and is similar to the general population prevalence estimated in a previous study. The strongest predictor of CSB in this sample was religious affiliation, which underscores the importance of evaluating the role of religiosity in the etiology and/or identification of this clinical syndrome. STRENGTHS AND LIMITATIONS These findings are strengthened by the national probability sampling methodology and the use of the empirically validated CSBI-13 cut point. However, this sample was also older and had higher income and educational attainment than the larger population of gay men in the U.S. CONCLUSION These results indicate gay men may have a CSB prevalence rate similar to the general population, which contradicts previous research suggesting they are at greater risk for CSB. Gleason N, Finotelli I, Miner MH, et al. Estimated Prevalence and Demographic Correlates of Compulsive Sexual Behavior Among Gay Men in the United States. J Sex Med 2021;18:1545-1554.
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Affiliation(s)
- Neil Gleason
- Department of Psychology, University of Washington, Seattle, WA, USA.
| | - Itor Finotelli
- Program in Human Sexuality, University of Minnesota, Minneapolis, MN, USA
| | - Michael H Miner
- Program in Human Sexuality, University of Minnesota, Minneapolis, MN, USA
| | - Debra Herbenick
- The Kinsey Institute for Research in Sex, Gender and Reproduction, Indiana University, Bloomington, IN, USA
| | - Eli Coleman
- Program in Human Sexuality, University of Minnesota, Minneapolis, MN, USA
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Stults CB, Javdani S, Kapadia F, Halkitis PN. Determinants of Intimate Partner Violence Among Young Men Who Have Sex With Men: The P18 Cohort Study. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:7018-7042. [PMID: 30819047 PMCID: PMC8480546 DOI: 10.1177/0886260519831374] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Intimate Partner Violence (IPV) is an understudied health problem among young gay, bisexual, and other non-identified young men who have sex with men (YMSM). According to cross-sectional studies, IPV is associated with psychosocial and mental health problems, such as stigma and depression, among YMSM. IPV is also associated with health-risk behaviors, such as substance use, among this population. Yet, to date, no studies have used longitudinal data to examine determinants of IPV among YMSM. This gap in the extant literature is problematic, as it limits our understanding of how to intervene to interrupt cycles of violence. The aim of the present study was to examine longitudinal determinants of IPV among a sample of (N = 526) YMSM living in the New York City area. Longitudinal analyses using Generalized Estimating Equations (GEE) were used to examine individual, relationship, mental health, psychosocial, and substance use factors in relation to IPV victimization and perpetration. Most notably, early experiences of IPV were a robust predictor of later experiences of IPV victimization and perpetration. Relationship status, depression, public gay-related stigma, and illicit substance use were associated with IPV victimization over time. Similarly, relationship status, depression, public gay-related stigma, marijuana, and other illicit substance were associated with IPV perpetration. These findings suggest that prevention programs and awareness campaigns should aim to reach YMSM before their first experiences of relationship violence, as these early experiences of violence are strongly linked to later experiences of violence. Also, IPV interventions should be tailored to the needs of YMSM and should target depressive symptoms, gay-related stigma, and substance use behaviors. Additionally, substance use interventions may be improved by addressing IPV. Finally, policymakers should support policies that improve the social climate for LGBTQ people, thereby reducing gay-related stigma, and potentially stemming violence against and among YMSM.
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Affiliation(s)
- Wilson M Compton
- From the National Institute on Drug Abuse, Bethesda, MD (W.M.C.); and the Centers for Disease Control and Prevention, Atlanta (C.M.J.)
| | - Christopher M Jones
- From the National Institute on Drug Abuse, Bethesda, MD (W.M.C.); and the Centers for Disease Control and Prevention, Atlanta (C.M.J.)
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Harkness A, Rogers BG, Balise R, Mayo D, Weinstein ER, Safren SA, Pachankis JE. Who Aren't We Reaching? Young Sexual Minority Men's Non-participation in an HIV-Prevention and Mental Health Clinical Trial. AIDS Behav 2021; 25:2195-2209. [PMID: 33483898 PMCID: PMC8169533 DOI: 10.1007/s10461-020-03148-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 11/29/2022]
Abstract
Despite many successful clinical trials to test HIV-prevention interventions for sexual minority men (SMM), not all SMM are reached by these trials. Identifying factors associated with non-participation in these trials could help to ensure the benefits of research extend to all SMM. Prospective participants in New York City and Miami were screened to determine eligibility for a baseline assessment for a mental health/HIV-prevention trial (N = 633 eligible on screen). Logistic regression and classification and regression tree (CART) analysis identified predictors of non-participation in the baseline, among those who were screened as eligible and invited to participate. Individuals who reported unknown HIV status were more likely to be non-participators than those who reported being HIV-negative (OR = 2.39; 95% CI 1.41, 4.04). In New York City, Latinx SMM were more likely to be non-participators than non-Latinx white SMM (OR = 1.81; 95% CI, 1.09, 2.98). A CART model pruned two predictors of non-participation: knowledge of HIV status and age, such that SMM with unknown HIV status and SMM ages 18-19 were less likely to participate. Young SMM who did not know their HIV status, and thus are more likely to acquire and transmit HIV, were less likely to participate. Additionally, younger SMM (18-19 years) and Latinx SMM in New York City were less likely to participate. The findings suggest the importance of tailored recruitment to ensure HIV-prevention/mental health trials reach all SMM.
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Affiliation(s)
- Audrey Harkness
- Department of Public Health Sciences, University of Miami, Clinical Research Building, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA.
| | - Brooke G Rogers
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Raymond Balise
- Department of Public Health Sciences, University of Miami, Clinical Research Building, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
| | - Daniel Mayo
- Department of Psychology, University of Miami, Miami, FL, USA
| | | | - Steven A Safren
- Department of Psychology, University of Miami, Miami, FL, USA
| | - John E Pachankis
- Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, Yale School of Public Health, Yale University, New Haven, CT, USA
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Martins A, Canavarro MC, Pereira M. Multidimensional factors associated with perceived risk of HIV among sexually experienced individuals in Portugal. PSYCHOLOGY & SEXUALITY 2021. [DOI: 10.1080/19419899.2021.1933146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Alexandra Martins
- Faculty of Psychology and Educational Sciences, University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Maria Cristina Canavarro
- Faculty of Psychology and Educational Sciences, University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Marco Pereira
- Faculty of Psychology and Educational Sciences, University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Coimbra, Portugal
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Satyanarayana S, Rogers BG, Bainter SA, Christopoulos KA, Fredericksen RJ, Mathews WC, Moore RD, Mugavero MJ, Napravnik S, Carrico AW, Mimiaga MJ, Mayer KH, Crane HM, Safren SA. Longitudinal Associations of Syndemic Conditions with Antiretroviral Therapy Adherence and HIV Viral Suppression Among HIV-Infected Patients in Primary Care. AIDS Patient Care STDS 2021; 35:220-230. [PMID: 34097465 PMCID: PMC8336208 DOI: 10.1089/apc.2021.0004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Psychosocial syndemic conditions have received more attention regarding their deleterious effects on HIV acquisition risk than for their potential impact on HIV treatment and viral suppression. To examine syndemic conditions' impact on the HIV care continuum, we analyzed data collected from people living with HIV (N = 14,261) receiving care through The Centers for AIDS Research Network of Integrated Clinical Systems at seven sites from 2007 to 2017 who provided patient-reported outcomes ∼4-6 months apart. Syndemic condition count (depression, anxiety, substance use, and hazardous drinking), sexual risk group, and time in care were modeled to predict antiretroviral therapy (ART) adherence and viral suppression (HIV RNA <400 copies/mL) using multilevel logistic regression. Comparing patients with each other, odds of ART adherence were 61.6% lower per between-patient syndemic condition [adjusted odds ratio (AOR) = 0.384; 95% confidence interval (CI), 0.362-0.408]; comparing patients with themselves, odds of ART adherence were 36.4% lower per within-patient syndemic condition (AOR = 0.636 95% CI, 0.606-0.667). Odds of viral suppression were 29.3% lower per between-patient syndemic condition (AOR = 0.707; 95% CI, 0.644-0.778) and 27.7% lower per within-patient syndemic condition (AOR = 0.723; 95% CI, 0.671-0.780). Controlling for the effects of adherence (AOR = 5.522; 95% CI, 4.67-6.53), each additional clinic visit was associated with 1.296 times higher odds of viral suppression (AOR = 1.296; 95% CI, 1.22-1.38), but syndemic conditions were not significant. Deploying effective interventions within clinics to identify and treat syndemic conditions and bolster ART adherence and continued engagement in care can help control the HIV epidemic, even within academic medical settings in the era of increasingly potent ART.
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Affiliation(s)
- Satyanand Satyanarayana
- Department of Psychology, University of Miami, Coral Gables, Florida, USA.,Address correspondence to: Satyanand Satyanarayana, JD, MS, Department of Psychology, University of Miami, Coral Gables, FL 33124, USA
| | - Brooke G. Rogers
- Department of Psychology, University of Miami, Coral Gables, Florida, USA.,Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sierra A. Bainter
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | | | - Rob J. Fredericksen
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - William C. Mathews
- Department of Medicine, UCSD School of Medicine, San Diego, California, USA
| | - Richard D. Moore
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael J. Mugavero
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Department of Medicine, UAB School of Medicine, Birmingham, Alabama, USA
| | - Sonia Napravnik
- Department of Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Adam W. Carrico
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida, USA
| | - Matthew J. Mimiaga
- UCLA Center for LGBTQ Advocacy, Research, and Health (C-LARAH), Los Angeles, California, USA.,Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, California, USA.,The Fenway Institute at Fenway Health, Boston, Massachusetts, USA
| | - Kenneth H. Mayer
- The Fenway Institute at Fenway Health, Boston, Massachusetts, USA.,Massachusetts General Hospital Center for Global Health, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Heidi M. Crane
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Steven A. Safren
- Department of Psychology, University of Miami, Coral Gables, Florida, USA.,The Fenway Institute at Fenway Health, Boston, Massachusetts, USA
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46
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Gutierrez JI, Dubov A, Altice FL, Vlahov D. Preferences for pre-exposure prophylaxis among U.S. military men who have sex with men: results of an adaptive choice based conjoint analysis study. Mil Med Res 2021; 8:32. [PMID: 34006328 PMCID: PMC8132436 DOI: 10.1186/s40779-021-00323-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 04/26/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Pre-exposure prophylaxis (PrEP) prevents human immunodeficiency virus (HIV) infection, but its use remains low among U.S. military men who have sex with men (MSM), likely due to mis-matching with personal preferences. We conducted a study to characterize preferences to PrEP measures within this population. METHODS HIV-negative military MSM were recruited through a closed, Lesbian, Gay, Bisexual, and Transgendered (LGBT) military social media group. The survey was anonymous, and consisted of five experimentally varied attributes in service delivery: dosing method, provider type, visit location, lab work evaluation location, and dispensing venue. Relative importance and part-worth utility scores were generated using hierarchical bayes (HB) estimation, and the randomized first choice model was used to examine participation interest across eight possible PrEP program scenarios. RESULTS A total of 429 participants completed the survey. Among the eight scenarios with varying attributes, the most preferred scenario featured a daily tablet, PrEP injection or implant, along with a military provider, smartphone/telehealth visit, and on-base locations for lab evaluation and medication pick-up. The results also emphasized the importance for providers to be familiar with PrEP prescription knowledge, and to provide interactions sensitive to sexual identity and mental health. CONCLUSION A PrEP program consisting of daily tablet is preferred in military healthcare settings is preferred. Long-acting implants and injections are also desired.
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Affiliation(s)
- José I Gutierrez
- Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA. .,Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 3333 California St, San Francisco, CA, 94118, USA.
| | - Alex Dubov
- Loma Linda University, Griggs Hall 11065, Loma Linda, CA, 92350, USA
| | - Frederick L Altice
- Yale School of Medicine, Section of Infectious Diseases, 135 College Street, Suite 323, New Haven, CT, 06510, USA.,Department of Epidemiology-Microbial Diseases, Yale School of Public Health, 60 College St, New Haven, CT, 06510, USA
| | - David Vlahov
- Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA.,Department of Epidemiology-Microbial Diseases, Yale School of Public Health, 60 College St, New Haven, CT, 06510, USA
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Chandler CJ, Meunier É, Eaton LA, Andrade E, Bukowski LA, Matthews DD, Raymond HF, Stall RD, Friedman MR. Syndemic Health Disparities and Sexually Transmitted Infection Burden Among Black Men Who Have Sex with Men Engaged in Sex Work in the U.S. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1627-1640. [PMID: 33159237 PMCID: PMC8099930 DOI: 10.1007/s10508-020-01828-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 07/17/2020] [Accepted: 08/21/2020] [Indexed: 06/11/2023]
Abstract
Black men who have sex with men (MSM) engaged in sex work (BMSM-SW) experience elevated HIV and sexually transmitted infection (STI) prevalence. Further, BMSM-SW have been shown to have higher rates of syndemic psychosocial health conditions which contribute to HIV risk behavior and incidence, and poorer care outcomes than other groups of men who have sex with men. However, syndemic perspectives have not been applied to understanding past-year STI burden among BMSM-SW in the U.S. Sexually active Black MSM ≥ 18 years old were recruited from Black Pride events in six U.S. cities (n = 4421) between 2014 and 2017. Multivariable logistic regressions assessed correlates of past-year sex work engagement; whether BMSM-SW had higher odds of syndemic conditions; and whether BMSM-SW had higher odds of self-reported, past-year STI diagnoses. Structural equation models assessed relationships between sex work engagement, syndemic conditions, and STI controlled for sociodemographics and number of sexual partners. A total of 254 (5.7%) Black MSM reported past-year sex work, of whom 45.3% were HIV positive. BMSM-SW were significantly more likely to be Hispanic, to report past-year bisexual behavior, and to report annual income < $10,000. In multivariable models, BMSM-SW were significantly more likely to report intimate partner violence, assault victimization, polydrug use, and depression symptoms; they were also more likely to report past-year gonorrhea, chlamydia, and syphilis. Syndemic conditions mediated the relationship between past-year sex work and past-year STI burden, constituting a significant indirect effect. BMSM-SW in the U.S. face severe biopsychosocial health disparities. Interventions developed for BMSM engaged in sex work are lacking. Our results suggest that interventions containing safer sex work education and sex-positive biobehavioral HIV/STI prevention alongside substance use, mental health, employment, and education components will be most effective.
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Affiliation(s)
- Cristian J Chandler
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Étienne Meunier
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Elí Andrade
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Leigh A Bukowski
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Derrick D Matthews
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Henry F Raymond
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Ronald D Stall
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - M Reuel Friedman
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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48
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Kiss MJ, McDonagh LK, Sparks B, Hamp T, Morrison TG. Accurately Assessing Gay Men's Erectile Functioning: A Critique of the International Index of Erectile Function (IIEF) Use with Gay Men. JOURNAL OF SEX RESEARCH 2021; 58:589-598. [PMID: 33044087 DOI: 10.1080/00224499.2020.1811195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The International Index of Erectile Functioning (IIEF) has been widely used to measure gay men's erectile functioning. However, the IIEF was initially developed using a sample of men whose sexual orientation was unspecified. Using scales not validated for specific populations can result in inaccurate assessments. The purpose of the current study was to evaluate the dimensionality, reliability, and validity of the IIEF with a large sample of gay men. One thousand and eighteen men self-identifying as "exclusively gay" completed an online survey consisting of demographics, the IIEF, the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale 4 (PSS4), and the Gay Male Sexual Difficulties (GMSD) erectile difficulties sub-scale. The replicability of the IIEF factor structure with a gay male sample was determined using exploratory and confirmatory factor analyses. Additionally, the HADS, PSS4, and GMSD were used to determine the validity of the IIEF. The current study was unable to replicate the IIEF factor structure. Four items required deletion and the factor solution differed from the original. Thus, reinterpretation of the latent variables was deemed necessary. Although the resultant 12-item IIEF evidenced model fit, validity, and reliability, it is not recommended for use with gay men. The revised IIEF is unable to accurately measure gay men's erectile functioning as the content of the items fail to capture their sexual behaviors (i.e., insertive and receptive anal sex).
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Affiliation(s)
- Mark J Kiss
- Department of Psychology, University of Saskatchewan
| | - Lorraine K McDonagh
- Research Department of Primary Care and Population Health, University College London
| | | | - Thomas Hamp
- Department of Psychology, University of Saskatchewan
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Mayer KH, Nelson L, Hightow-Weidman L, Mimiaga MJ, Mena L, Reisner S, Daskalakis D, Safren SA, Beyrer C, Sullivan PS. The persistent and evolving HIV epidemic in American men who have sex with men. Lancet 2021; 397:1116-1126. [PMID: 33617771 PMCID: PMC9639667 DOI: 10.1016/s0140-6736(21)00321-4] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/03/2020] [Accepted: 09/25/2020] [Indexed: 01/06/2023]
Abstract
Men who have sex with men (MSM) in the USA were the first population to be identified with AIDS and continue to be at very high risk of HIV acquisition. We did a systematic literature search to identify the factors that explain the reasons for the ongoing epidemic in this population, using a social-ecological perspective. Common features of the HIV epidemic in American MSM include role versatility and biological, individual, and social and structural factors. The high-prevalence networks of some racial and ethnic minority men are further concentrated because of assortative mixing, adverse life experiences (including high rates of incarceration), and avoidant behaviour because of negative interactions with the health-care system. Young MSM have additional risks for HIV because their impulse control is less developed and they are less familiar with serostatus and other risk mitigation discussions. They might benefit from prevention efforts that use digital technologies, which they often use to meet partners and obtain health-related information. Older MSM remain at risk of HIV and are the largest population of US residents with chronic HIV, requiring culturally responsive programmes that address longer-term comorbidities. Transgender MSM are an understudied population, but emerging data suggest that some are at great risk of HIV and require specifically tailored information on HIV prevention. In the current era of pre-exposure prophylaxis and the undetectable equals untransmittable campaign, training of health-care providers to create culturally competent programmes for all MSM is crucial, since the use of antiretrovirals is foundational to optimising HIV care and prevention. Effective control of the HIV epidemic among all American MSM will require scaling up programmes that address their common vulnerabilities, but are sufficiently nuanced to address the specific sociocultural, structural, and behavioural issues of diverse subgroups.
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Affiliation(s)
- Kenneth H Mayer
- Beth Israel Deaconess Medical Center, Harvard Medical School, Fenway Health, Boston, MA, USA.
| | - LaRon Nelson
- School of Nursing, Yale University, New Haven, CT, USA
| | | | - Matthew J Mimiaga
- Fielding School of Public Health and David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Leandro Mena
- Medical Center, University of Mississippi, Jackson, MS, USA
| | - Sari Reisner
- Boston Children's Hospital, Fenway Health, Boston, MA, USA
| | | | | | - Chris Beyrer
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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50
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Noor SW, Hart TA, Okafor CN, Ware D, Chew KW, D’Souza G, Ho K, Friedman MR, Plankey M. Staying or moving: Results of a latent transition analysis examining intra-individual stability of recreational substance use among MSM in the Multicenter AIDS Cohort Study from 2004 to 2016. Drug Alcohol Depend 2021; 220:108516. [PMID: 33485009 PMCID: PMC7901540 DOI: 10.1016/j.drugalcdep.2021.108516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Studies have examined patterns of substance use among Men who have Sex with Men (MSM), but few have examined factors predicting transitioning from one substance use pattern to another. We investigated transitioning from one substance use pattern to another over a 12-year period (2004-2016) among the Multicenter AIDS Cohort Study participants. METHOD Alcohol, marijuana, heroin, cocaine, poppers, uppers (e.g., methamphetamines) and erectile dysfunction(ED) medications use in the last 6 months from 3568 US MSM was dichotomized (no/yes) to classify participants into substance use classes at each follow up visit. We fit latent transition models to calculate transition probabilities of moving from one substance use class to another over a 3, 4 and 6-year time period. Then fit regression models to identify factors associated with the probability of each participant staying in or moving from the same substance use class. RESULTS Overall, cocaine and ED medication use declined but marijuana and heroin use increased over 2004-2016. We observed most participants (84.6 %-100 %) stayed in the same class. Increased age was associated with transition from the Minimal-use class to the Alcohol-only class (aOR = 1.06,95 %CI:1.01-1.13;p < 0.01) and non-White MSM reported lower odds of moving from the Alcohol-only class to the Alcohol-Popper class (aOR = 0.50,95 %CI:0.30-0.82;p <0.01). There were no difference in the transition probabilities by HIV-status. CONCLUSION Despite decline in substance use in general, participants are highly stable in their choice of substances. However, treating MSM as a homogeneous group can lead to an under-appreciation of the diversity of prevention needs and treatment of substance using MSM.
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Affiliation(s)
- Syed W. Noor
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada,Department of Kinesiology and Health Science, Louisiana State University Shreveport, One University Place, Shreveport, LA 71115, USA
| | - Trevor A. Hart
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
| | - Chukwuemeka N. Okafor
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, 1311 S 5th St, Waco, TX 76706, USA
| | - Deanna Ware
- Georgetown University Medical Center, 4000 Reservoir Road, NW, Suite 120 Washington, D.C. 20057, USA
| | - Kara W. Chew
- David Geffen School of Medicine at UCLA, 11075 Santa Monica Blvd, Suite 100, Los Angeles, CA 90025, USA
| | - Gypsyamber D’Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Ken Ho
- Division of Infectious Diseases, University of Pittsburgh, 3520 Fifth Avenue, Suite 533, Pittsburgh, PA 15213, USA
| | - M. Reuel Friedman
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, 130 De Soto St, Pittsburgh, PA 15261, USA
| | - Michael Plankey
- Georgetown University Medical Center, 4000 Reservoir Road, NW, Suite 120 Washington, D.C. 20057, USA
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