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Lu W, Vu TT, Wilton L, Paige M, Nandi V, Greene E, Frye V. Patterns and Factors Associated With Alcohol Misuse Among Young Black Men Who Have Sex With Men in New York City. Am J Mens Health 2024; 18:15579883231218580. [PMID: 38700239 PMCID: PMC11069334 DOI: 10.1177/15579883231218580] [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: 04/22/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 05/05/2024] Open
Abstract
Alcohol misuse is a significant health concern among gay, bisexual, same-gender-loving, and other men who have sex with men (MSM). Yet, little is known about the severity and predictors of alcohol misuse among self-reported young Black MSM. This study aimed to identify patterns of and factors associated with alcohol misuse in a sample of young Black MSM living in New York City. Baseline data from a randomized controlled trial aimed at improving the uptake of HIV testing among 250 MSM aged 18 to 29 were analyzed. Log-binominal regression analyses were conducted to assess the association of demographic and psychosocial factors with alcohol misuse in the past year and past 3 months among young Black MSM. Overall, 33.2% and 28.0% of young Black MSM in the study experienced alcohol misuse in the past year and past 3 months, respectively. In the adjusted model, factors positively associated with past-year alcohol misuse included marijuana use, a history of drug use, and having one-two or more than two male sex partners. Likewise, participants who used marijuana and those with one-two or more than two male partners were more likely to report past 3-month alcohol misuse. No significant association was found between positive screening for depressive symptoms, chemsex, internalized homophobia, and the likelihood of having alcohol misuse. The high prevalence of alcohol misuse underscores the importance of raising awareness of alcohol misuse and designing alcohol risk reduction programs that jointly address HIV risk among young Black MSM.
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Affiliation(s)
- Wenhua Lu
- Department of Community Health and Social Medicine, School of Medicine, The City University of New York, New York, NY, USA
| | - Thinh Toan Vu
- Center for Innovation in Mental Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
| | - Leo Wilton
- Department of Human Development, College of Community and Public Affairs, State University of New York at Binghamton, Binghamton, NY, USA
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Mark Paige
- Department of Community Health and Social Medicine, School of Medicine, The City University of New York, New York, NY, USA
| | - Vijay Nandi
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Emily Greene
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - Victoria Frye
- School of Social Work, Columbia University, New York, NY, USA
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Opozda MJ, Galdas PM, Watkins DC, Smith JA. Intersecting identities, diverse masculinities, and collaborative development: Considerations in creating online mental health interventions that work for men. Compr Psychiatry 2024; 129:152443. [PMID: 38113813 DOI: 10.1016/j.comppsych.2023.152443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/02/2023] [Accepted: 12/07/2023] [Indexed: 12/21/2023] Open
Abstract
Online mental health interventions have received attention for their potential to bypass barriers that stop men from seeking mental health help from a health professional. However, emerging data suggest that men's use of online mental health interventions is low, and when used, early attrition is common. In this commentary, we hypothesise that men's common lack of engagement with online mental health interventions may reflect limited attention being paid to the needs and preferences of potential users during their development. We outline a series of considerations that we believe are important to advance the development of acceptable, effective online mental health interventions for men: (1) men's diverse and intersecting characteristics, circumstances, and needs; (2) centring positive, progressive masculinities; and (3) listening to, learning from, and working in partnership with men to develop interventions. We also examine how existing online mental health interventions targeting men have engaged with these considerations. Keywords: men, male, mental health, e-mental health, digital health, online interventions.
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Affiliation(s)
- Melissa J Opozda
- College of Medicine and Public Health, Flinders University, Darwin, Australia; Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia.
| | - Paul M Galdas
- Department of Health Sciences, University of York, York, UK
| | - Daphne C Watkins
- School of Social Work, National Centre for Institutional Diversity, University of Michigan, Ann Arbor, USA
| | - James A Smith
- College of Medicine and Public Health, Flinders University, Darwin, Australia
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Lisboa C, Stuardo V, Folch C. Sexualized drug use among gay men and other men who have sex with men in Latin America: A description of the phenomenon based on the results of LAMIS-2018. PLoS One 2023; 18:e0287683. [PMID: 37856552 PMCID: PMC10586662 DOI: 10.1371/journal.pone.0287683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/08/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Sexualized drug use (SDU) to enhance and extend sexual relations may involve risks of substances abuse (intoxication, interactions and overdose) and higher exposure to HIV and other sexually transmitted infections. There are inconsistencies in the methodology and findings of previous research on SDU in Latin America (LA), and more studies are required. The purpose of this research was to characterize SDU in gay men and other men who have sex with men from 18 LA countries, and describe the aspects by comparing people who practice and do not practice SDU, at the general and country levels. MATERIAL AND METHODS Cross-sectional study based on the data collected by LAMIS-2018. Dependent variable was SDU (last 12 months), and the independent variables were: drug use (in any context/in sexual context), sociodemographic, socioepidemiological, and psychosocial aspects. A descriptive analysis was carried out, comparing those who practiced and did not practice SDU. RESULTS LAMIS-2018 included 64,655 participants, averaging 30 years of age. 13.6% declared having practiced SDU (6.6% with multiple partners). In the last sexual encounter the most commonly used drugs were cannabis (9.3%), poppers (6%), and Viagra (5.4%), and in the last encounter with multiple partners, poppers (19.7%), cannabis (17%), and Viagra (13.2%). HIV diagnosis was reported by 27% of people practicing SDU, vs. 14.3% in the other group. Severe anxiety-depression symptoms were more common among people practicing SDU (9.2% vs. 7%), as were the episodes of homophobic intimidation (52.6% vs. 48.2%), insults (34.4% vs. 28.6%), and aggression (4.1% vs. 3.0%). CONCLUSIONS SDU was reported by a high percentage of people, with a predominance of the use of drugs related to sexual practice, and others for recreational use. Aspects described as the higher proportion of self-reported HIV diagnosis and severe symptoms of anxiety-depression among those who practiced SDU, show that is necessary to implement preventive strategies to reduce the harmful impacts that can sometimes result from this practice, including harm reduction policies, promote access to mental health services and support in situations of homophobia and stigma.
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Affiliation(s)
- Cristian Lisboa
- Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - Valeria Stuardo
- Instituto de Salud Pública, Universidad Andrés Bello, Santiago, Chile
| | - Cinta Folch
- Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y SIDA de Cataluña (CEEISCAT), Cataluña, España
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España
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Flores Anato JL, Panagiotoglou D, Greenwald ZR, Blanchette M, Trottier C, Vaziri M, Charest L, Szabo J, Thomas R, Maheu-Giroux M. Chemsex and incidence of sexually transmitted infections among Canadian pre-exposure prophylaxis (PrEP) users in the l'Actuel PrEP Cohort (2013-2020). Sex Transm Infect 2022; 98:549-556. [PMID: 35039437 PMCID: PMC9685712 DOI: 10.1136/sextrans-2021-055215] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/23/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Use of illicit substances during sex (chemsex) may increase transmission of HIV and other STIs. Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV transmission, providing an important prevention tool for those who practise chemsex. However, it does not prevent acquisition of other STIs. We aim to examine the impact of chemsex on STI incidence among gay, bisexual and other men who have sex with men (gbMSM), and transgender women using PrEP in Montréal, Canada. METHODS We linked baseline sociodemographic and behavioural data with follow-up STI testing from 2013 to 2020 among PrEP users in the l'Actuel PrEP Cohort (Canada). Focusing on the 24 months following PrEP initiation, we estimated the effect of chemsex reported at baseline on cumulative incidence of gonorrhoea and chlamydia using Kaplan-Meier curves and survival analyses. We investigated the role of polysubstance use and effect modification by sociodemographic factors. RESULTS There were 2086 clients (2079 cisgender gbMSM, 3 transgender gbMSM, 4 transgender women) who initiated PrEP, contributing 1477 years of follow-up. There were no incident HIV infections among clients on PrEP. Controlling for sociodemographic confounders, clients reporting chemsex at baseline had a 32% higher hazard of gonorrhoea/chlamydia diagnosis (adjusted HR=1.32; 95% CI: 1.10 to 1.57), equivalent to a risk increase of 8.9 percentage points (95% CI: 8.5 to 9.4) at 12 months. The effect was greater for clients who reported polysubstance use (adjusted HR=1.51; 95% CI: 1.21 to 1.89). The strength of the effect of chemsex on STI incidence varied by age, education and income. CONCLUSION Among PrEP users, chemsex at baseline was linked to increased incidence of gonorrhoea and chlamydia. This effect was stronger for people reporting multiple chemsex substances. The high STI incidence among gbMSM who report chemsex highlights the importance of PrEP for this population and the need for integrated services that address the complexities of sexualised substance use.
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Affiliation(s)
- Jorge Luis Flores Anato
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Québec, Canada
| | - Dimitra Panagiotoglou
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Québec, Canada
| | - Zoë R Greenwald
- Division of Epidemiology, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada,Epidemiology, L'Actuel Medical Clinic, Montréal, Québec, Canada
| | - Maxime Blanchette
- Unité d'enseignement et de recherche en sciences du développement humain et social, University of Québec in Abitibi Temiscamingue, Rouyn-Noranda, Québec, Canada
| | - Claire Trottier
- Epidemiology, L'Actuel Medical Clinic, Montréal, Québec, Canada
| | - Maliheh Vaziri
- Epidemiology, L'Actuel Medical Clinic, Montréal, Québec, Canada
| | - Louise Charest
- Clinical Department, L'Actuel Medical Clinic, Montréal, Québec, Canada
| | - Jason Szabo
- Clinical Department, L'Actuel Medical Clinic, Montréal, Québec, Canada
| | - Réjean Thomas
- Clinical Department, L'Actuel Medical Clinic, Montréal, Québec, Canada
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Québec, Canada
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Boyle SC, LaBrie JW. A Gamified, Social Media-Inspired, Web-Based Personalized Normative Feedback Alcohol Intervention for Lesbian, Bisexual, and Queer-Identified Women: Protocol for a Hybrid Trial. JMIR Res Protoc 2021; 10:e24647. [PMID: 33861212 PMCID: PMC8087973 DOI: 10.2196/24647] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/11/2021] [Accepted: 03/20/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Sexual minority women are more likely to drink alcohol, engage in heavy drinking, and experience alcohol-related problems than heterosexual women. However, culturally tailored interventions for this population have been slow to emerge. OBJECTIVE This type 1 effectiveness-implementation trial examines the feasibility and efficacy of a gamified, culturally tailored, personalized normative feedback (PNF) alcohol intervention for sexual minority women who psychologically identify as lesbian, bisexual, or queer (LBQ). METHODS The core components of a PNF intervention were delivered within LezParlay, a fun, social media-inspired, digital competition designed to challenge negative stereotypes about LBQ women and increase visibility. The competition was advertised on the web through social media platforms and collaboration with LBQ community organizations. After 2 rounds of play by a large cohort of LBQ women, a subsample of 500 drinkers already taking part in the competition were invited to participate in the evaluation study. Study participants were randomized to receive 1 of 3 unique sequences of PNF (ie, alcohol and stigma coping, alcohol and control, or control topics only) over 2 intervention rounds. Randomization was fully automated by the web app, and both researchers and participants were blinded. RESULTS Analyses will evaluate whether PNF on alcohol use reduces participants' drinking and negative consequences at 2 and 4 months postintervention; examine whether providing PNF on stigma-coping behaviors, in addition to alcohol use, further reduces alcohol use and consequences beyond PNF on alcohol alone; identify mediators and moderators of intervention efficacy; and examine broader LezParlay app engagement, acceptability, and perceived benefits. CONCLUSIONS This incognito intervention approach is uniquely oriented toward engaging and preventing alcohol-related risks among community populations of LBQ women who may view their heavy drinking as normative and not in need of change because of the visibility of alcohol use in sexual minority community spaces. Thus, this intervention strategy diverges from, and is intended to complement, more intensive programs being developed to meet the needs of LBQ women already motivated to reduce their consumption. TRIAL REGISTRATION ClinicalTrials.gov NCT03884478; https://clinicaltrials.gov/ct2/show/NCT03884478. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/24647.
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Affiliation(s)
- Sarah C Boyle
- HeadsUp Labs, Department of Psychology, Loyola Marymount University, Los Angeles, CA, United States
| | - Joseph W LaBrie
- HeadsUp Labs, Department of Psychology, Loyola Marymount University, Los Angeles, CA, United States
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