Stigma, HIV Risk, and Access to HIV Prevention and Treatment Services Among Men Who have Sex with Men (MSM) in the United States: A Scoping Review

Despite significant progress in the fight against HIV/AIDS in the United States, HIV prevention and treatment disparities among key populations remain a national public health concern. While new HIV diagnoses are increasing among people under age 30—in particular among racial, ethnic, and sexual minority adolescents and young adults (AYA)—dominant prevention and treatment paradigms too often inadequately consider the unique HIV service needs of AYA. To address this gap, we characterize persistent and largely overlooked AYA disparities across the HIV prevention and treatment continuum, identify AYA-specific limitations in extant resources for improving HIV service delivery in the United States, and propose a novel AYA-centered differentiated care framework adapted to the unique ecological and developmental factors shaping engagement, adherence, and retention in HIV services among AYA. Shifting the paradigm for AYA to differentiated HIV care is a promising approach that warrants implementation and evaluation as part of reinforced national efforts to end the HIV epidemic in the United States by 2030.

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High levels of mild to moderate depression among men who have sex with men and transgender women in Lima, Peru: implications for integrated depression and HIV care

10.1101/2020.01.07.20016808 ◽

2020 ◽

Author(s):

Jerome T. Galea ◽

Stephanie Marhefka ◽

Segundo R. León ◽

Guitele Rahill ◽

Elena Cyrus ◽

...

Keyword(s):

Hiv Prevention ◽

Transgender Women ◽

Hiv Care ◽

Depression Care ◽

Care Services ◽

Treatment Services ◽

Moderate Depression ◽

Prevention And Treatment ◽

Patient Health ◽

Sex With Men

ABSTRACTDepression disproportionally affects people at risk of acquiring or living with HIV and is associated with worse health outcomes; however, depression care is not routinely integrated with HIV prevention and treatment services. Selection of the best depression intervention(s) for integration depends both on the prevalence and severity of depression among potential users. To inform depression care integration in a community-based setting in Lima, Peru, we retrospectively analyzed routinely collected depression screening data from men who have sex with men and transgender women seeking HIV prevention and care services (N=185). Depression was screened for using the Patient Health Questionnaire-9. Prevalence of any depression (PHQ-9 ≥5) was 42% and was significantly associated with the last sexual partner being “casual” (p=0.01). Most (81%) depressive symptoms were mild to moderate (≥5 PHQ-9 ≤14). Integrating depression care with HIV prevention and treatment services in Peru should begin by implementing interventions targeting mild to moderate depression.

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A systematic review of mHealth interventions for HIV prevention and treatment among gay, bisexual, and other men who have sex with men

Translational Behavioral Medicine ◽

10.1093/tbm/ibaa007 ◽

2020 ◽

Vol 10 (5) ◽

pp. 1211-1220

Author(s):

Kimberly M Nelson ◽

Nicholas S Perry ◽

Keith J Horvath ◽

Laramie R Smith

Keyword(s):

Systematic Review ◽

Hiv Prevention ◽

Text Messaging ◽

Controlled Trial ◽

The United States ◽

Current Evidence ◽

Future Research ◽

Targeted Prevention ◽

Prevention And Treatment ◽

Sex With Men

Abstract The use of mobile health (mHealth) technologies addressing HIV disparities among gay, bisexual, and other men who have sex with men (GBMSM) has increased. A systematic review of mHealth interventions for HIV prevention and treatment among GBMSM was conducted to summarize the current evidence and provide recommendations for future research. PRISMA guidelines were followed (PROSPERO ID: 148452). Studies identified via PubMed, PsychInfo, or Embase were included that (i) were in English, (ii) were published in a peer-reviewed journal prior to July 1, 2019, (iii) presented primary results, (iv) included only GBMSM, and (v) reported the results of an mHealth intervention (e.g., text message, phone/mobile application [app]) to improve HIV prevention or treatment outcomes. Of 1,636 identified abstracts, 16 published studies met inclusion criteria. Eleven studies were conducted in the United States. One study was a fully powered randomized controlled trial (RCT), seven were single-arm pilots with pre–post assessments, four were pilot RCTs, and four tested public health campaigns with post-assessments. Seven developed study-specific apps, five used text messaging, and four used existing social networking apps. Most (81%) targeted prevention outcomes. Nine cited a specific behavioral theory. All studies found that a mHealth approach was feasible and acceptable. All interventions provided evidence of preliminary efficacy or promising trends on primary outcomes. Although mHealth interventions for HIV prevention and treatment appear feasible and acceptable, most published studies are small pilot trials. Additional research assessing the efficacy and mechanisms of mHealth interventions is needed.

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Homophobia and Racism Experienced by Latino Men Who Have Sex with Men in the United States: Correlates of Exposure and Associations with HIV Risk Behaviors

AIDS and Behavior ◽

10.1007/s10461-011-9967-1 ◽

2011 ◽

Vol 16 (3) ◽

pp. 724-735 ◽

Cited By ~ 66

Author(s):

Yuko Mizuno ◽

Craig Borkowf ◽

Gregorio A. Millett ◽

Trista Bingham ◽

George Ayala ◽

...

Keyword(s):

United States ◽

Risk Behaviors ◽

Hiv Risk ◽

The United States ◽

Hiv Risk Behaviors ◽

Latino Men ◽

Sex With Men

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Mental health in 2020 for men who have sex with men in the United States

Sexual Health ◽

10.1071/sh16083 ◽

2017 ◽

Vol 14 (1) ◽

pp. 59 ◽

Cited By ~ 19

Author(s):

Abigail W. Batchelder ◽

Steven Safren ◽

Avery D. Mitchell ◽

Ivan Ivardic ◽

Conall O'Cleirigh

Keyword(s):

Mental Health ◽

Hiv Prevention ◽

The United States ◽

Hiv Care ◽

Hiv Care Cascade ◽

Age Related ◽

The Us ◽

Prevention And Treatment ◽

Sex With Men ◽

Hiv Aids

Despite continued advances in HIV prevention and treatment, gay and bisexual men and other men who have sex with men (MSM) remain the population most impacted by HIV/AIDS in the US and many other Western countries. Additionally, MSM are disproportionately affected by various psychological problems, including depression, distress, trauma and substance use. These challenges frequently co-occur, and are associated with higher rates of behaviours related to HIV acquisition and transmission, HIV infection, and, for those living with HIV/AIDS, lower levels of treatment engagement. Moreover, racial disparities exist among MSM in the US; for example, young African American MSM bear a disproportionate burden of the continuing HIV epidemic, likely related to disparate HIV prevalence in partner pools as well as long-standing structural inequities. In this review, the mental health challenges facing MSM primarily in the US, related to HIV and STI prevention and across the HIV care cascade, including HIV diagnosis, engagement and retention in care, and antiretroviral adherence, are illustrated. Disparities among MSM including racial and ethnic, age-related and structural barriers associated with HIV prevention and treatment, as well as current interventions, are also described. Moving forward towards 2020, resources will be needed to assess and implement scalable intervention strategies to address psychological and social barriers to HIV and STI risk reduction and treatment for MSM, with a particular focus on the most vulnerable subpopulations. As access to prevention and treatment strategies expand, and new breakthroughs continue to emerge, behavioural strategies will continue to be needed to reduce risk and increase uptake and engagement among MSM most at risk through 2020 and beyond.

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