Evaluating the impact of COVID-19: A cohort comparison study of drug use and risky sexual behavior among sexual minority men in the U.S.A.

Abstract Background Increased risky sexual behaviors (RSB) in sexual minority people relative to heterosexual individuals are well documented. However, the role of trans-diagnostic factors that are not sexual orientation-specific, such as self-criticism, in predicting RSB was understudied. The present study aimed to test participants’ gender and sexual orientation as moderators between self-criticism and RSB. Methods Data were collected during 2019. The total sample included 986 sexual minority people (Nwomen = 51%) and 853 heterosexual people (Nwomen = 46%), ranging from 18 to 35 years of age. Self-criticism dimensions (self-hate, self-inadequacy, self-reassurance), types of positive affect (relaxed, safe/content, and activated affect), and RSB were assessed. Bivariate, multivariate analyses, and moderated regression analyses were conducted. Results Sexual minority participants showed higher levels of RSB, self-hate, and self-inadequacy than heterosexual people. Only in sexual minority men, RSB correlated positively with self-hate and negatively with safe/content positive affect. Moderated regressions showed that only for sexual minority participants, higher RSB were predicted by higher levels of self-hate. At the same time, this association was not significant for heterosexual people controlling the effects of age, presence of a stable relationship, other self-criticism dimensions, and activation safe/content affect scale. The two-way interaction between sexual orientation and gender was significant, showing that regardless of self-hate, the strength of the association between sexual orientation and RSB is stronger for sexual minority men than sexual minority women and heterosexual participants. Conclusions Findings highlight the distinctive role of self-hate in the occurrence of RSB in sexual minority people and support the usefulness of developing a compassion-focused intervention to target self-hate in sexual minority people.

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Refining POSSIBLE: A Multicomponent Intervention to Increase HIV Risk Perceptions and PrEP Initiation Among Black Sexual Minority Men (Preprint)

10.2196/preprints.34181 ◽

2021 ◽

Author(s):

Derek Dangerfield ◽

Janeane N. Anderson ◽

Charleen Wylie ◽

Renata Arrington-Sanders ◽

Ricky N. Bluthenthal ◽

...

Keyword(s):

Hiv Risk ◽

Sexual Behaviors ◽

Sexual Minority ◽

Risk Perceptions ◽

Future Research ◽

Self Monitoring ◽

Hiv Prevention Intervention ◽

Sexual Minority Men ◽

Minority Men ◽

The Impact

BACKGROUND Increased HIV pre-exposure prophylaxis (PrEP) initiation is urgently needed to substantially decrease the incidence among Black sexual minority men (BSMM). However, BSMM are less likely than other groups to accept a clinician’s recommendation to initiate PrEP and uptake remains suboptimal. Peers and smartphone apps are popular HIV prevention-intervention mechanisms that are typically used independently. Few studies have combined these strategies into a multi-component intervention to increase PrEP initiation for BSMM. OBJECTIVE This study refined an intervention using a smartphone app and a peer change agent (PCA) to increase HIV risk perceptions (HRP) and PrEP initiation among BSMM. METHODS Data were obtained from 12 focus groups and one in-depth interview among BSMM from Baltimore, MD, between October 2019 and May 2020 (N=39). Groups were stratified by age group: 18-24, 25-34, and 35 and older. Facilitators probed on attitudes towards the app, working with a PCA, and preferences for PCA characteristics. RESULTS Most self-identified as homosexual, gay, or same gender-loving (68%), were employed (69%), single (66%), and interested in self-monitoring sexual behaviors (68.4%). Overall, participants had low HRP and suggested that self-monitoring sexual behaviors could trigger internalized stigma. An acceptable PCA should be a “possible self” for BSMM to aspire. CONCLUSIONS Future research should explore the impact of implementing this strategy on HRP and PrEP initiation among BSMM.

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PEP as a potential antecedent to PrEP among an online sample of HIV-negative and unknown status cis- and transgender sexual minority men: A cross-sectional study (Preprint)

10.2196/preprints.31237 ◽

2021 ◽

Author(s):

Steven A. John ◽

K. Marie Sizemore ◽

Ruben H. Jimenez ◽

S. Scott Jones ◽

Andrew E. Petroll ◽

...

Keyword(s):

Drug Use ◽

Sexual Minority ◽

Multivariable Analysis ◽

Sexual Minority Men ◽

Club Drug Use ◽

Unknown Status ◽

Minority Men ◽

Exposure Prophylaxis ◽

Club Drug ◽

Hiv Negative

BACKGROUND HIV disproportionately affects sexual minority men (SMM) in the U.S. OBJECTIVE We sought to determine past HIV post-exposure prophylaxis (PEP) use and current pre-exposure prophylaxis (PrEP) use among an online sample of cisgender and transgender men who have sex with men. METHODS In 2019, HIV-negative and unknown status SMM (n=63,015) were recruited via geosocial networking apps, social media, and other online venues to participate in a brief eligibility screening survey. Individuals were asked about past PEP and current PrEP use. We examined associations of demographics, socioeconomic indicators, recent club drug use, and current PrEP use on past PEP use using fully-adjusted logistic regression. RESULTS Prior PEP use was relatively uncommon (11.3%), with 2.66 times more men reporting current PrEP use (30.1%). Most (85.9%) past PEP users were current PrEP users, representing 32.2% of all current PrEP users. In multivariable analysis, current PrEP users had 20.1 times higher odds (95%CI: 18.6-21.6) of past PEP use compared to non-PrEP users. Other factors significantly (p<0.001) associated with past PEP use but with smaller effect sizes included: older age (>24 years old) compared to younger age (AOR=1.15); bisexual identity compared to gay (AOR=0.86); Latino, Black, and other/multiracial race/ethnicity compared to white, individually (AORs=1.37-1.52); having health insurance (AOR=0.80); and recent club drug use (AOR=1.19). CONCLUSIONS Prior PEP use was relatively uncommon in our online sample of SMM, but our findings indicate PEP could potentially be a gateway to PrEP. Advertising and prescribing PEP could support efforts to increase PrEP.

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Rapid mixed-methods assessment of COVID-19 impact on Latinx sexual minority men and Latinx transgender women

PLoS ONE ◽

10.1371/journal.pone.0244421 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244421

Author(s):

Sarah MacCarthy ◽

Max Izenberg ◽

Joanna L. Barreras ◽

Ron A. Brooks ◽

Ana Gonzalez ◽

...

Keyword(s):

Mixed Methods ◽

Sexual Minority ◽

Healthcare Access ◽

Transgender Women ◽

Medical Attention ◽

Computer Assisted ◽

Hiv Knowledge ◽

Sexual Minority Men ◽

Minority Men ◽

The Impact

We conducted a rapid, mixed-methods assessment to understand how COVID-19 affected Latinx sexual minority men (LSMM) and transgender women (LTGW). Using a computer-assisted telephone interviewing software, one interviewer called 52 participants (randomly sampled from a larger HIV prevention pilot study aiming to increase HIV knowledge and testing frequency; n = 36 LSMM and n = 16 LTGW) between 04/27/20-05/18/20. We quantified core domains using the Epidemic-Pandemic Impacts Inventory scale and provided important context through open-ended qualitative questions assessing: 1) COVID-19 infection history and experiences with quarantine; 2) Health and healthcare access; 3) Employment and economic impact of COVID-19. Participants reported increases in physical conflict or verbal arguments with a partner (13.5%) or other adult(s) (19.2%) due to stressors associated with the safer-at-home order. Participants also reported increased alcohol consumption (23.1%), problems with sleep (67.3%) and mental health (78.4%). Further, disruptions in access to Pre-Exposure Prophylaxis or PrEP–a daily pill to prevent HIV–occurred (33.3% of 18 participants who reported being on PrEP). Many said they received less medical attention than usual (34.6%), and LTGW reported delays in critical gender-affirming hormones/procedures. Half of the participants lost their jobs (50.0%); many undocumented participants relayed additional financial concerns because they did not qualify for financial assistance. Though no COVID-19 infections were noted, COVID-19 dramatically impacted other aspects of health and overall wellbeing of LSMM and LTGW. Public health responses should address the stressors faced by LSMM and LTGW during the COVID-19 pandemic and the impact on wellbeing.

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Comparative impact of methamphetamine and other drug use on viral suppression among sexual minority men on antiretroviral therapy

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2021.108622 ◽

2021 ◽

Vol 221 ◽

pp. 108622

Author(s):

Jennifer A. Fulcher ◽

Marjan Javanbakht ◽

Chelsea L. Shover ◽

Amy Ragsdale ◽

Ron Brookmeyer ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Drug Use ◽

Sexual Minority ◽

Viral Suppression ◽

Sexual Minority Men ◽

Minority Men

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Sexual Identity, Sexual Behavior and Pre-exposure Prophylaxis in Black Cisgender Sexual Minority Men: The N2 Cohort Study in Chicago

AIDS and Behavior ◽

10.1007/s10461-021-03246-4 ◽

2021 ◽

Author(s):

Liadh Timmins ◽

John A. Schneider ◽

Yen-Tyng Chen ◽

William C. Goedel ◽

Russell Brewer ◽

...

Keyword(s):

Sexual Behavior ◽

Cohort Study ◽

Sexual Identity ◽

Sexual Minority ◽

Sexual Minority Men ◽

Minority Men ◽

Exposure Prophylaxis

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The impact of depression and post-traumatic stress symptoms on physical health perceptions and functional impairment among sexual minority men living with HIV with histories of trauma

AIDS Care ◽

10.1080/09540121.2021.1967852 ◽

2021 ◽

pp. 1-9

Author(s):

Matthew C. Sullivan ◽

Megan R. Wirtz ◽

Samantha M. McKetchnie ◽

Trevor A. Hart ◽

Calvin Fitch ◽

...

Keyword(s):

Sexual Minority ◽

Traumatic Stress ◽

Health Perceptions ◽

Post Traumatic Stress ◽

Sexual Minority Men ◽

Stress Symptoms ◽

Post Traumatic ◽

Minority Men ◽

Living With Hiv ◽

The Impact

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Testing the drug use and condomless anal sex link among sexual minority men: The predictive utility of marijuana and interactions with relationship status

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2020.108318 ◽

2020 ◽

Vol 216 ◽

pp. 108318

Author(s):

Tyrel J. Starks ◽

S. Scott Jones ◽

Kory Kyre ◽

Gabriel Robles ◽

Demetria Cain ◽

...

Keyword(s):

Drug Use ◽

Sexual Minority ◽

Relationship Status ◽

Anal Sex ◽

Predictive Utility ◽

Condomless Anal Sex ◽

Sexual Minority Men ◽

Minority Men

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Effects of victimization on mental health and substance use trajectories in young sexual minority men

Development and Psychopathology ◽

10.1017/s0954579418001013 ◽

2018 ◽

Vol 31 (04) ◽

pp. 1423-1437 ◽

Cited By ~ 2

Author(s):

Gregory Swann ◽

Emily Forscher ◽

Emily Bettin ◽

Michael E. Newcomb ◽

Brian Mustanski

Keyword(s):

Mental Health ◽

Substance Use ◽

Drug Use ◽

Sexual Minority ◽

Internalizing Symptoms ◽

Illicit Drug ◽

Externalizing Symptoms ◽

Sexual Minority Men ◽

Minority Men ◽

Over Time

AbstractYoung sexual minority men (YSMM) experience more victimization and are at higher risk for mental health and substance use problems compared with heterosexual youth. We attempt to understand change over time in the experience of these constructs among YSMM. Data were taken from a diverse community-based sample of YSMM (N = 450, baseline mean age 18.93) surveyed every 6 months for 2.5 years. Multilevel modeling was used to model within-person change in victimization, internalizing symptoms, externalizing symptoms, alcohol frequency, marijuana use, and illicit drug use. We tested the indirect effect of concurrent and time-lagged victimization on the association between age and mental health and substance use. Victimization, internalizing symptoms, and externalizing symptoms decreased over time. Concurrent victimization was associated with higher internalizing symptoms, externalizing symptoms, alcohol use, marijuana use, and illicit drug use. Analysis of indirect effects suggested that the association between victimization and mental health and substance use outcomes decreased as participants transitioned from adolescence into adulthood. This study found that the reduction in victimization that YSMM experience as they grow older is associated with a reduction in negative mental health and substance use outcomes. Prevention efforts to limit victimization exposure may reduce health disparities for YSMM.

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