Examining the Additive Effect of HIV-Related Stress and General Life Stress on Depression and Anxiety-Related Functional Impairment Among HIV-Positive Sexual Minority Men

IntroductionSquamous cell carcinoma of the anus is a common cancer among sexual minority men, especially HIV-positive sexual minority men; however, there is no evidenced-based national screening protocol for detection of anal precancers. Our objective is to determine compliance with annual anal canal self-sampling or clinician-sampling for human papillomavirus (HPV) DNA.Methods and analysisThis is a prospective, randomised, two-arm clinical study to evaluate compliance with annual home-based versus clinic-based HPV DNA screening of anal canal exfoliated cells. The setting is primary care community-based clinics. Recruitment is ongoing for 400 HIV-positive and HIV-negative sexual minority men and transgender persons, aged >25 years, English or Spanish speaking, no current use of anticoagulants other than nonsteroidal anti-inflammatory drugs and no prior diagnosis of anal cancer. Participants are randomised to either receive a swab in the mail for home-based collection of an anal canal specimen at 0 and 12 months (arm 1) or attend a clinic for clinician collection of an anal canal specimen at 0 and 12 months (arm 2). Persons will receive clinic-based Digital Anal Rectal Examinations and high-resolution anoscopy-directed biopsy to assess precancerous lesions, stratified by study arm. Anal exfoliated cells collected in the study are assessed for high-risk HPV persistence and host/viral methylation. The primary analysis will use the intention-to-treat principle to compare the proportion of those who comply with 0-month and 12-month sampling in the home-based and clinic-based arms. The a priori hypothesis is that a majority of persons will comply with annual screening with increased compliance among persons in the home-based arm versus clinic-based arm.Ethics and disseminationThe study has been approved by the Medical College of Wisconsin Human Protections Committee. Results will be disseminated to communities where recruitment occurred and through peer-reviewed literature and conferences.Trial registration numberNCT03489707.

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Evidence-Based Approaches to HIV-Positive Sexual Minority Men’s Sexual Health

Handbook of Evidence-Based Mental Health Practice with Sexual and Gender Minorities ◽

10.1093/med-psych/9780190669300.003.0015 ◽

2019 ◽

pp. 339-358

Author(s):

Audrey Harkness ◽

Steven A. Safren

Keyword(s):

Sexual Health ◽

Sexual Minority ◽

Hiv Transmission ◽

Future Research ◽

Hiv Positive ◽

Evidence Based ◽

Viral Load Suppression ◽

Sexual Minority Men ◽

Minority Men ◽

State Of Research

This chapter reviews the current state of research and theory regarding evidence-based sexual health interventions for HIV-positive sexual minority men. Among HIV-positive sexual minority men, sexual health promotion includes reducing sexual behavior that could lead to HIV transmission, increasing adherence to antiretroviral treatment (ART) medication to attain viral load suppression, and addressing psychosocial and contextual factors that impact both of these health behaviors. The chapter reviews evidence-based behavioral approaches to promote sexual minority men’s sexual health, including those focused on increasing condom use, reducing sexual risk, and improving communication about HIV status. It also discusses interventions to improve ART adherence, which promote HIV-positive sexual minority men’s personal health and serve as a secondary prevention intervention via reducing transmissibility. The chapter concludes with an illustration of an evidence-based intervention with an HIV-positive client. Overarching clinical implications and areas for future research regarding HIV-positive sexual minority men’s sexual health are also discussed.

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Correlates of perceptual and behavioral definitions of abuse in HIV-positive sexual minority men.

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/a0029094 ◽

2013 ◽

Vol 5 (5) ◽

pp. 417-425 ◽

Cited By ~ 8

Author(s):

Sarah E. Valentine ◽

David W. Pantalone

Keyword(s):

Sexual Minority ◽

Hiv Positive ◽

Sexual Minority Men ◽

Minority Men

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Pilot Randomized Controlled Trial of an Intervention to Improve Coping with Intersectional Stigma and Medication Adherence Among HIV-Positive Latinx Sexual Minority Men

AIDS and Behavior ◽

10.1007/s10461-020-03081-z ◽

2020 ◽

Author(s):

Laura M. Bogart ◽

Joanna L. Barreras ◽

Ana Gonzalez ◽

David J. Klein ◽

Terry Marsh ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Medication Adherence ◽

Sexual Minority ◽

Controlled Trial ◽

Hiv Positive ◽

Sexual Minority Men ◽

Randomized Controlled ◽

Minority Men ◽

Pilot Randomized Controlled Trial

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Factors Influencing Depression and Anxiety among Black Sexual Minority Men

Depression Research and Treatment ◽

10.1155/2011/587984 ◽

2011 ◽

Vol 2011 ◽

pp. 1-9 ◽

Cited By ~ 11

Author(s):

Louis F. Graham ◽

Robert E. Aronson ◽

Tracy Nichols ◽

Charles F. Stephens ◽

Scott D. Rhodes

Keyword(s):

Identity Development ◽

Sexual Identity ◽

Sexual Minority ◽

Stepwise Multiple Regression ◽

Internalized Homonegativity ◽

Depression And Anxiety ◽

Snowball Sampling ◽

Cross Sectional ◽

Sexual Minority Men ◽

Minority Men

The primary aim of this study was to examine the relationships between depression and anxiety, and ethnic and sexual identity development, and discrimination and harassment (DH) among Black sexual minority men. Additional aims were to determine whether an interaction effect existed between ethnic and sexual identity and whether coping skills level moderated these relationships. Using an observational cross-sectional design, 54 participants recruited through snowball sampling completed self-administered online surveys. Stepwise multiple regression analysis was used. Sixty-four percent of the variance in depression scores and 53% of the variance in anxiety scores were explained by DH and internalized homonegativity together. Thirty percent of the sample had scale scores indicating likelihood of depression and anxiety. Experience of DH and internalized homonegativity explained a large portion of the variability in depression and anxiety among Black sexual minority men. The study showed high prevalence of mental distress among this sample.

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Inter-Group and Intraminority-Group Discrimination Experiences and the Coping Responses of Latino Sexual Minority Men Living With HIV

Annals of LGBTQ Public and Population Health ◽

10.1891/lgbtq-2020-0028 ◽

2021 ◽

Vol 2 (1) ◽

pp. 1-21

Author(s):

Sarah MacCarthy ◽

Laura M. Bogart ◽

Frank H. Galvan ◽

David W. Pantalone

Keyword(s):

Coping Strategies ◽

Sexual Behaviors ◽

Sexual Minority ◽

Minority Group ◽

Hiv Positive ◽

Sexual Minority Men ◽

Coping Responses ◽

Group Experiences ◽

Group Members ◽

Minority Men

Discrimination negatively impacts the health of HIV-positive Latino sexual minority men (LSMM+). A growing literature on LSMM+ chronicles associations based on multiple devalued identities and mental health symptoms, HIV medication nonadherence, and sexual behaviors with the potential to transmit HIV. To gain additional insights on identity-based discrimination—as well as the associated coping responses—we conducted 30 qualitative interviews with LSMM+. Participants were probed regarding recent discrimination events (context, details, perpetrator, type) based on their intersecting identities (Latinx ethnicity, residency status, sexual minority orientation, HIV-positive serostatus) and their coping responses. We transcribed and translated the interviews and conducted a content analysis. Participants reported inter-group (i.e., between majority and minority group members) and intraminority-group (i.e., within minority group members) experiences as common. Participants described their intraminority-group experiences with discrimination based on being a Latinx sexual minority person in their families and home communities. Participants reported a range of coping responses to discrimination experiences. However, participants reported only functional (and no dysfunctional) coping strategies, and they endorsed using similar strategies in response to inter-group and intraminority-group discrimination. Coping strategies included strategic avoidance, social support, self-advocacy, and external attribution. Additional coping strategies (spirituality and positive reframing) emerged more strongly in response to inter-group experiences with discrimination. Our results underscore the need to address both inter-group and intraminority-group discrimination experiences. Future interventions can focus on strengthening the effective coping skills that LSMM+ currently employ as potential levers to address LSMM+ health disparities.

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