scholarly journals Understanding the complexities of HIV risk among sexual minority men in a global context

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Stojanovski ◽  
E J King
Keyword(s):  
Risk Factors ◽  
Complex Systems ◽  
Hiv Risk ◽  
Sexual Minority ◽  
Socioecological Model ◽  
Sexual Minority Men ◽  
Individual Level ◽  
Complex Systems Theory ◽  
Multiple Levels ◽  
Minority Men

Abstract Background Complex systems theory recognizes the intricacy of health issues and inequities, which permits the study of interrelationships across multiple levels of the socioecological model. We interrogated the research to identify upstream and downstream factors, their intersections, and recursive processes to develop a visualization of HIV risk among sexual minority men. Methods Using global HIV literature drawn from diverse disciplines and geographies, we elucidated HIV risk factors through a complex systems theory approach. We used thematic analysis to categorize HIV risk factors into different levels of the socioecological model, such as policies, community risk factors, individual behaviors, etc. We also identified the relationships between these risk factors to assess how they shaped HIV risk. The analyses were used to inform the connections between the various factors that lead to HIV risk in order to develop a visualization of the complex system, for which Stella Architecture was used. Results The thematic analysis of the literature and complex systems visualization portrays that HIV risk arises from a complex interplay of recursive and reinforcing factors ranging from policies, community factors, healthcare systems, and interpersonal relationships leading to manipulations in individual-level behaviors that put sexual minority men at risk for HIV. This visual representation indicates that HIV risk cannot simply be thought of as an individual-level factor nor simply related to sexual behaviors. Rather, HIV risk arises from upstream societal forces such as stigma, poor mental health, and health systems that relate to a multitude of downstream factors that socially pattern sexual minority men’s HIV risk. Conclusions The risk of HIV among sexual minority men stems from numerous intersecting factors across multiple levels of the socioecological model indicating the need to improve structural- and community-oriented approaches to address HIV. Key messages HIV risk arises from multiple social determinants. HIV preventions need to encompass multi-level interventions to fully address HIV risk.

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

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.

scholarly journals Risk and protective factors for the development of gambling-related harms and problems among Australian sexual minority men

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Rachel Bush ◽  
Alex M. T. Russell ◽  
Petra K. Staiger ◽  
Andrea Waling ◽  
Nicki A. Dowling
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Problem Gambling ◽  
Sexual Minority ◽  
Heterosexual Men ◽  
Moderate Risk ◽  
Sexual Minority Men ◽  
Gambling Cognitions ◽  
Gambling Severity ◽  
Minority Men

Abstract Background Sexual minority men (SMM) often experience stressful social environments dominated by stigma and discrimination. SMM are typically more likely than heterosexual men to engage in certain risky behaviours such as problem gambling. This study aimed to compare gambling behaviour among SMM and examine potential risk factors (erroneous gambling cognitions, gambling outcome expectancies, hazardous alcohol use, impulsivity, and psychological distress; as well as perceived stigma and discrimination for the SMM participants) and potential protective factors (resilience, social support, and community connectedness) for problem gambling severity and gambling-related harms among SMM living in Australia. Methods An online survey, with an over-representation of SMM participants and problem, moderate-risk, and low-risk gamblers, was completed by 101 SMM (mean age = 28.5) and 207 heterosexual men (mean age = 26.4). Results SMM were found to have significantly lower levels of problem gambling severity compared with heterosexual men, and report significantly lower gambling participation, frequencies and expenditure on any gambling activity, casino table games, horse racing/greyhound betting, sports betting, and keno. However, in the SMM group, 38.3% were classified in the problem gambling category of the Problem Gambling Severity Index and 27.6% were classified in the moderate-risk gambling category. There were no significant differences between groups in gambling-related harms. Multiple regression analyses revealed that problem gambling severity and related harms were independently predicted by higher levels of impulsivity and erroneous gambling cognitions for both groups. Conclusions Lower frequency of gambling behaviours among SMM and similar risk factors predicting problem gambling severity/harms for both groups suggests that problem gambling is not pronounced among SMM. This study adds new evidence to the gambling literature which can be used as comparative benchmarks for future research.

scholarly journals The Role of Gay-Related Stigma in HIV-Risk Behavior Among Sexual Minority Men in Europe

2018 ◽  
Vol 23 (3) ◽  
pp. 684-694 ◽  
Author(s):  
Corina Leluţiu-Weinberger ◽  
H. Jonathon Rendina ◽  
Massimo Mirandola ◽  
Lorenzo Gios ◽  
Cinta Folch ◽  
...  
Keyword(s):  
Risk Behavior ◽  
Hiv Risk ◽  
Sexual Minority ◽  
Hiv Risk Behavior ◽  
Sexual Minority Men ◽  
Related Stigma ◽  
Minority Men

scholarly journals Risk From Within: Intraminority Gay Community Stress and Sexual Risk-Taking Among Sexual Minority Men

2020 ◽  
Vol 54 (9) ◽  
pp. 703-712
Author(s):  
Charles L Burton ◽  
Kirsty A Clark ◽  
John E Pachankis
Keyword(s):  
Risk Behaviors ◽  
Hiv Risk ◽  
Sexual Minority ◽  
Risk Taking ◽  
Hiv Risk Behaviors ◽  
Sexual Minority Men ◽  
Gay Community ◽  
Minority Men ◽  
Community Stress ◽  
Online Group

Abstract Background Sexual minority men remain highly impacted by the human immunodeficiency virus (HIV) with social stress being a clear predictor of their risk for infection. The past several decades of stress research regarding sexual minority men’s HIV-risk behaviors has almost exclusively focused on the influence of stress emanating from outside the gay community (e.g., stigma-related stress, or minority stress, such as heterosexist discrimination). However, recent evidence suggests that sexual minority men also face stress from within their own communities. Purpose We sought to examine whether stress from within the gay community, or intraminority gay community stress, might influence sexual minority men’s risk behaviors, including HIV-risk behaviors, over-and-above more commonly examined stressors affecting this risk. Methods We tested whether intraminority gay community stress was associated with sexual minority men’s HIV-risk behaviors in a large national survey of sexual minority men (Study 1), and experimentally tested intraminority gay community stress’s impact on behavioral risk-taking and attitudes toward condom use (Study 2). Results Self-reported exposure to intraminority gay community stress was positively associated with HIV-risk behaviors when accounting for the effects of several commonly examined minority stressors and general life stress (Study 1). Participants who were rejected from an online group of other sexual minority men evidenced greater risk-taking in a subsequent task and reported fewer benefits of condom use than participants who were accepted by the online group, when accounting for state affect (Study 2). Conclusions Sexual minority men’s experiences of stress and rejection stemming from their own community may be an important and overlooked predictor of HIV infection and transmission.

scholarly journals Profiles of HIV Risk, Sexual Power, and Decision-Making among Sexual Minority Men of Color Who Engage in Transactional Sex: A Latent Profile Analysis

2021 ◽  
Vol 18 (9) ◽  
pp. 4961
Author(s):  
S. Raquel Ramos ◽  
David T. Lardier ◽  
Donte T. Boyd ◽  
José I. Gutierrez ◽  
Eliana Carasso ◽  
...  
Keyword(s):  
Decision Making ◽  
Hiv Risk ◽  
Sexual Minority ◽  
Profile Analysis ◽  
Sexual Relationship ◽  
Transactional Sex ◽  
Sexual Minority Men ◽  
Men Of Color ◽  
Minority Men ◽  
Sexual Power

Though the transmission of HIV is preventable, there were still 37,968 new documented cases in the United States in 2018. HIV incidence is disproportionate in sexual minority men of color. The purpose of this study was to examine sexual relationship power risk profiles to identify distinct subgroups within the profiles who carry the highest HIV risk. Latent class profile analysis was used to identify subgroups of sexual minority men of color at the highest risk for contracting HIV based on their sexual power profiles. Among 322 sexual minority men, we identified four latent profiles. Profile 1: Low transactional sex and high power (n = 133; 14.3%); Profile 2: Transactional sex, high decision-making in sexual relationships, and low control in sexual relationship (n = 99; 30.7%); Profile 3: Low transactional sex, low decision-making, and moderate control (n = 43; 13.4%); Profile 4: High transactional sex and low power (n = 47; 14.6%). LPA was useful to identify distinct subgroups based on measures of sexual risk and relationship sexual power. Findings carry significant implications for developing tailored strategies to increase HIV knowledge and related HIV prevention and risk reduction services for sexual minority men of color who engage in transactional sex.

Does Socio-structural Context Matter? A Multilevel Test of Sexual Minority Stigma and Depressive Symptoms in Four Asia-Pacific Countries

2019 ◽  
Vol 60 (4) ◽  
pp. 416-433
Author(s):  
Stephanie Spaid Miedema ◽  
Regine Haardörfer ◽  
Corey L. M. Keyes ◽  
Kathryn M. Yount
Keyword(s):  
Depressive Symptoms ◽  
Sexual Minority ◽  
Asia Pacific ◽  
Future Research ◽  
Sexual Minority Men ◽  
Individual Level ◽  
Sexual Stigma ◽  
Minority Men ◽  
Cluster Unit

In the Asia-Pacific region, individual sexual stigma contributes to elevated rates of depression among sexual minority men. Less well understood is the role of socio-structural sexual stigma despite evidence that social context influences the experience of stigma. We use data from the United Nations Multi-country Study on Men and Violence to conduct a multilevel test of associations between individual- and cluster unit–level indicators of sexual stigma and depressive symptoms among sexual minority men ( n = 562). In the full model, individual-level sexual stigma is not associated with depressive symptoms, although there is significant variation in the association between individual stigma and depressive symptoms across clusters. Contrary to expectation, at the community level, homophobic injunctive norms are negatively associated with depressive symptoms. We discuss the implications for policies, programs, and future research to improve mental health among sexual minority men in the region.

Relationship Power and Intimate Partner Violence in Sexual Minority Male Couples

2020 ◽  
pp. 088626052091627
Author(s):  
Stephen C. Bosco ◽  
Gabriel Robles ◽  
Rob Stephenson ◽  
Tyrel J. Starks
Keyword(s):  
Risk Factors ◽  
Sexual Minority ◽  
Partner Violence ◽  
Intimate Partner ◽  
Relationship Power ◽  
Same Sex ◽  
Male Couples ◽  
Sexual Minority Men ◽  
Individual Family ◽  
Minority Men

Objective: The objective of the present study was to test pathways implied by Disempowerment Theory to predict intimate partner violence (IPV) among men in a same-sex relationship. Background: Sexual minority men in relationships experience rates of IPV comparable with heterosexual women, yet most research on IPV focuses on heterosexual couples. Disempowerment Theory suggests that a range of individual, family-of-origin, and intimate relationship risk factors predict the use of violence to re-establish power in a relationship. Method: Data for the present study were gathered from an online survey completed by sexual minority men currently in a same-sex relationship ( n = 339). Analysis of data included two steps: (a) we tested the direct effect of individual, family, and relational predictors on the odds of IPV and (b) we calculated a path model that included relationship power as a link between the predictors (individual, family, and relational) and IPV. Results: In line with Disempowerment Theory, relationship power was negatively associated with IPV. Bivariate analysis indicated an association between childhood sexual abuse and IPV, but childhood sexual abuse was not predictive of IPV through relationship power. Other individual (depression) and relationship-specific (sexual communication and relationship satisfaction) risk factors were associated with IPV indirectly through relationship power. Conclusion: Disempowerment Theory may provide a useful framework for understanding the occurrence of IPV in sexual minority male couples. It may also provide a starting point for the development of multi-component interventions to reduce violence in these couples.

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