Accounting for HIV Health Disparities: Risk and Protective Factors Among Older Gay and Bisexual Men

Objective: This study examines whether disparities exist in poor health and depressive symptomatology among older gay/bisexual men (50+) with ( n = 371) and without ( n = 973) HIV. If so, what risk/promoting factors account for those disparities? Method: These cross-sectional analyses used 2014 data from the Aging With Pride: National Health, Aging, and Sexuality/Gender Study. Results: Those with HIV reported poorer health and more depressive symptomatology accounted for by lower income, resilience and social support, and more lifetime victimization. Poorer health among those with HIV was associated with more chronic conditions. Higher depressive symptomatology was associated with diagnosed anxiety and drug addiction. Community engagement reduced disparities in poor health and depression. Implications: Older gay/bisexual men living with HIV infection are at greater risk for physical and mental health issues. Assessments should be conducted with attention to these risk factors. Interventions for improving social support, resilience, and community engagement are warranted.

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“That’s kind of like the big struggle right now is can we get PrEP?”: Facilitators and Barriers to PrEP Uptake Among Active Duty Gay and Bisexual Men

Sexuality Research and Social Policy ◽

10.1007/s13178-021-00622-6 ◽

2021 ◽

Author(s):

Raiza M. Beltran ◽

Ashley C. Schuyler ◽

Cherie S. Blair ◽

Jeremy T. Goldbach ◽

Carl A. Castro ◽

...

Keyword(s):

Systems Approach ◽

Qualitative Interviews ◽

Gay And Bisexual Men ◽

Active Duty ◽

Policy Implications ◽

Bisexual Men ◽

Military Health ◽

Study Results ◽

Facilitators And Barriers ◽

And Bisexual

Abstract Introduction The US Military is experiencing a rise in HIV infections among gay and bisexual men (GBM) serving on active duty, yet little is known about this population’s uptake of pre-exposure prophylaxis (PrEP), an evidence-based intervention for HIV prevention. This mixed methods study examines the facilitators and barriers to PrEP access and uptake among active duty GBM. Methods Active duty GBM were recruited using respondent-driven sampling (2017 and 2018). Participants (n = 93) answered quantitative survey questions on PrEP interest and accessibility. Another set of participants (n = 10) discussed their PrEP experiences in qualitative interviews. We conducted descriptive and bivariate analyses of quantitative data, while qualitative data were analyzed using structural and descriptive coding techniques. Results Approximately 71% of active duty GBM indicated interest in accessing PrEP. A greater proportion of those who disclosed (vs. did not disclose) their sexual orientation to their military doctor discussed (p < 0.001) or accessed (p = 0.017) PrEP. The following qualitative themes emerged: (1) providers’ negative views and knowledge gaps related to PrEP; (2) lack of a systems approach to PrEP access; (3) confidentiality concerns; and (4) reliance on peer networks for PrEP guidance and support. Conclusions Study results indicate that active duty GBM are interested in and want to discuss PrEP with their military doctors, but gaps in providers’ PrEP-related knowledge and skills, as well as mistrust in the military health care system, remain. Policy Implications A system-wide approach that addresses confidentiality concerns and removes procedural barriers to PrEP access is recommended to improve PrEP uptake in this population.

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Cross-sectional study of sexual behaviour and health of gay and bisexual men in suburban Sydney, New South Wales, Australia: contrasts between sex venue and clinic attendees

Sexual Health ◽

10.1071/sh20196 ◽

2021 ◽

Author(s):

Catriona Ooi ◽

Basil Donovan ◽

David A. Lewis

Keyword(s):

Sexual Behaviour ◽

New South ◽

New South Wales ◽

Gay And Bisexual Men ◽

Cross Sectional Study ◽

Bisexual Men ◽

Sectional Study ◽

Cross Sectional ◽

South Wales ◽

And Bisexual

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Social Support and Health-Related Quality of Life Among Gay and Bisexual Men With Prostate Cancer

Oncology Nursing Forum ◽

10.1188/18.onf.439-455 ◽

2018 ◽

Vol 45 (4) ◽

pp. 439-455 ◽

Cited By ~ 5

Author(s):

Benjamin Capistrant ◽

Lindsey Lesher ◽

Nidhi Kohli ◽

Enyinnaya Merengwa ◽

Badrinath Konety ◽

...

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Social Support ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

And Bisexual

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A Qualitative Study of Intimate Partner Violence Among Young Gay and Bisexual Men

Journal of Interpersonal Violence ◽

10.1177/0886260520936365 ◽

2020 ◽

pp. 088626052093636

Author(s):

Christopher B. Stults ◽

Stephan A. Brandt ◽

Jonathan F. Hale ◽

Nicholas Rogers ◽

Anna E. Kreienberg ◽

...

Keyword(s):

Intimate Partner Violence ◽

Qualitative Study ◽

Partner Violence ◽

Mental Health Problems ◽

Gay And Bisexual Men ◽

Intimate Partner ◽

Bisexual Men ◽

Physical And Mental Health ◽

Psychosocial Conditions ◽

And Bisexual

Intimate partner violence (IPV) is prevalent among young gay and bisexual men (YGBM) and is associated with physical and mental health problems, as well as deleterious psychosocial conditions. Most previous studies of IPV among YGBM have been quantitative in nature and have not examined the numerous subtypes of IPV, the chronicity of IPV experiences, and how is IPV manifested in the context of these same-sex relationships. Thus, a qualitative approach may be useful in exploring these multidimensional and understudied experiences. The present qualitative study sought to (a) explore dimensions of IPV victimization, perpetration, and bidirectional IPV among a sample of ( n = 26) YGBM living in New York City and (b) explore the chronicity of IPV experiences among these YGBM. Participants were recruited from an ongoing cohort study of YGBM. Participants completed semistructured interviews that included questions about IPV victimization, perpetration, and bidirectional IPV. A modified version of the consensual qualitative research method was used to analyze the data. The YGBM in this study reported numerous forms of physical, psychological, sexual, and financial IPV victimization and perpetration. Bidirectional experiences of IPV were common. The various subtypes of IPV victimization and perpetration are explored in detail in this manuscript. In addition, many participants reported multiple experiences of abuse within the same relationship, and some participants experienced a pattern of abusive relationships over time. This study corroborates findings from quantitative studies, which indicate that IPV is a prevalent and significant health problem among YGBM, and one that warrants additional attention from researchers, practitioners, and policy-makers. Furthermore, this study adds rich qualitative data to the existing literature—data that can be used to help develop and refine future measures of IPV that are tailored for use with YGBM.

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Multi-Dimensional Factors Associated with Illegal Substance Use Among Gay and Bisexual Men in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16224476 ◽

2019 ◽

Vol 16 (22) ◽

pp. 4476 ◽

Cited By ~ 5

Author(s):

Dian-Jeng Li ◽

Shiou-Lan Chen ◽

Cheng-Fang Yen

Keyword(s):

Substance Use ◽

Logistic Regression ◽

Early Adulthood ◽

Gay And Bisexual Men ◽

Stepwise Logistic Regression ◽

Childhood And Adolescence ◽

Bisexual Men ◽

Cross Sectional ◽

Factors Associated ◽

And Bisexual

Illegal substance use in sexual minorities is an important health issue worldwide. The present cross-sectional study aimed to investigate the multi-dimensional factors associated with illegal substance use among gay and bisexual men in Taiwan. This questionnaire-survey study recruited 500 gay or bisexual men aged between 20 and 25 years. Their experiences of using eight kinds of illegal substances in the preceding month were collected. Their previous experiences of homophobic bullying, satisfaction with academic performance, truancy, perceived family and peer support in childhood and adolescence, and social-demographic characteristics, were also collected. Potential factors associated with illegal substance use were identified using univariate logistic regression, and further selected into a forward stepwise logistic regression model to identify the factors most significantly related to illegal substance use. A total of 22 (4.4%) participants reported illegal substance use in the preceding month, and mean age was 22.9 ± 1.6. Forward stepwise logistic regression revealed that being victims of homophobic cyberbullying in childhood and adolescence (odds ratio (OR) = 1.26; p = 0.011), disclosure of sexual orientation at junior high school (OR = 4.67; p = 0.001), and missing classes or truancy in senior high school (OR = 2.52; p = 0.041) were significantly associated with illegal substance use in early adulthood. Multi-dimensional factors in childhood and adolescence that were significantly associated with illegal substance use in early adulthood among gay and bisexual men were identified. Besides traditional bullying, the effect of cyberbullying and school performance on illegal substance use should not be ignored. This study is limited to the cross-sectional design and possible recall bias. Mental health professionals must routinely assess these significant factors to prevent and intervene in illegal substance use among gay and bisexual men.

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Caregiving and social support for gay and bisexual men with prostate cancer

Psycho-Oncology ◽

10.1002/pon.4249 ◽

2016 ◽

Vol 25 (11) ◽

pp. 1329-1336 ◽

Cited By ~ 20

Author(s):

Benjamin D. Capistrant ◽

Beatriz Torres ◽

Enyinnaya Merengwa ◽

William G. West ◽

Darryl Mitteldorf ◽

...

Keyword(s):

Prostate Cancer ◽

Social Support ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

And Bisexual

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Measuring and understanding the attitudes of Australian gay and bisexual men towards biomedical HIV prevention using cross-sectional data and factor analyses

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053375 ◽

2017 ◽

Vol 94 (4) ◽

pp. 309-314 ◽

Cited By ~ 5

Author(s):

Anna L Wilkinson ◽

Bridget L Draper ◽

Alisa E Pedrana ◽

Jason Asselin ◽

Martin Holt ◽

...

Keyword(s):

Hiv Prevention ◽

Community Support ◽

Gay And Bisexual Men ◽

Transmission Risk ◽

Treatment As Prevention ◽

Bisexual Men ◽

Cross Sectional ◽

Biomedical Hiv Prevention ◽

Biomedical Prevention ◽

And Bisexual

IntroductionContemporary responses to HIV embrace biomedical prevention, particularly treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP). However, large-scale implementation of biomedical prevention should be ideally preceded by assessments of their community acceptability. We aimed to understand contemporary attitudes of gay and bisexual men (GBM) in Australia towards biomedical-based HIV prevention and propose a framework for their measurement and ongoing monitoring.MethodsA cross-sectional, online survey of GBM ≥18 years has been conducted annually in Victoria, Australia, since 2008. In 2016, 35 attitudinal items on biomedical HIV prevention were added. Items were scored on five-point Likert scales. We used principal factor analysis to identify key constructs related to GBM’s attitudes to biomedical HIV prevention and use these to characterise levels of support for TasP and PrEP.ResultsA total of 462 HIV-negative or HIV-status-unknown men, not using PrEP, provided valid responses for all 35 attitudinal items. We extracted four distinct and interpretable factors we named: ‘Confidence in PrEP’, ‘Judicious approach to PrEP’, ‘Treatment as prevention optimism’ and ‘Support for early treatment’. High levels of agreement were seen across PrEP-related items; 77.9% of men agreed that PrEP prevented HIV acquisition and 83.6% of men agreed that users were protecting themselves. However, the agreement levels for HIV TasP items were considerably lower, with <20% of men agreeing treatment (undetectable viral load) reduced HIV transmission risk.ConclusionsBetter understanding of community attitudes is crucial for shaping policy and informing initiatives that aim to improve knowledge, acceptance and uptake of biomedical prevention. Our analyses suggest confidence in, acceptability of and community support for PrEP among GBM. However, strategies to address scepticism towards HIV treatment when used for prevention may be needed to optimise combination biomedical HIV prevention.

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