scholarly journals Psychosocial Challenges and Protective Factors Among MSM Living with HIV: An Integrative Review of the Literature Using an Intersectional Framework

2021 ◽  
Author(s):  
Anthony Theodore Amato ◽  
Gilbert Émond
Keyword(s):  
Protective Factors ◽  
Minority Stress ◽  
Internalized Homophobia ◽  
Well Being ◽  
Integrative Review ◽  
Hiv Positive ◽  
Sexual Minority Men ◽  
Intersecting Identities ◽  
Minority Men ◽  
Sex With Men

Objective: Given the emerging data on intersecting identities involving men who have sex with men (MSM) with respect to various factors, there lies a need to include one’s human immunodeficiency virus (HIV) status in this intersection, given the experience of stigmatization and inequalities. This integrative review covers psychosocial risk and protective factors experienced by MSM of HIV-positive status, while also considering other intersecting identities (e.g., ethnicity, older age). Method: Following a standardized search inquiry, 2139 records were identified and narrowed down to 24 peer reviewed articles. Results: Psychological and social protective factors such as positive mental health outcomes; lessened or resolved internalized homophobia; social networks in younger and older MSM, with a discussion on the contextually relevant impact that religion has among Black MSM. Some risk factors such as co-occurring stigmas, psychological distress, exposure to violence, and trauma are explained.Implications: These immediate findings highlight factors that contribute to resilient pathways among ethnic minorities, and of other intersections among sexual minority men. In order to mitigate risks, developing tailoredinterventions with a focus on co-occurring and syndemic stigmas is crucial, to help ensure the psychological and social well-being of diverse HIV-positive MSM. An adapted version to the minority stress model is thus presented.

scholarly journals Venturing beyond the “Behavioural MSM”: Sex, Chems, & Satisfaction in their Syndemic Contexts

2020 ◽  
Keyword(s):  
Hiv Testing ◽  
Sexual Minority ◽  
Sexual Behaviour ◽  
Minority Stress ◽  
Online Survey ◽  
Well Being ◽  
Steady Partner ◽  
Sexual Minority Men ◽  
Sexually Transmitted ◽  
Minority Men

BACKGROUND: The health and well-being of those sexual-minority men who are often behaviourally defined as men who have sex with men (MSM) is affected by a system of interlinked factors that interact on the structural, interpersonal, and individual levels. Recently, two of the most common MSM health issues have been (a) the risks of acquiring sexually transmitted infections (STIs), mostly HIV, and (b) the sexualized use of addictive substances, known as chemsex. AIMS: On the basis of the first comprehensive Czech dataset to integrate several mutually interlinked factors on the behavioural, as well as the psychological and structural domains, we attempt to shed light on the barriers to HIV testing and adherence to safer sex practices, including the most thorough description of the chemsex phenomenon that is available. We aim to go beyond the behavioural perspective and draw links to the well-being and satisfaction of this sexual minority and their sex lives. METHODS: A series of descriptive statistical analyses was conducted on a sample of 547 respondents obtained within a self-administered online survey. RESULTS: More than half of our respondents (55%) and three-quarters (72%) of the men younger than 25 years have never been tested for HIV. One-third of the respondents considered testing services to be insufficiently friendly to gay, bisexual, or other men, and they also reported stigmatization and discrimination by healthcare workers as a problem that exists. 84% of the MSM have experience with anal sex; 43% of them always use condoms. Of all the respondents, nearly 6% have had at least one chemsex experience during their life. Only 46% of the MSM reported being satisfied with their sex lives; 52% of those who were dissatisfied attributed this to “not having a steady partner” and 49% to “not having any sex”. CONCLUSION: The sexual behaviour of MSM and their experience with HIV testing, chemsex, perceived stigma, and satisfaction with their sex lives are among the phenomena that deserve to be more regularly covered by relevant epidemiological examinations. Although our current analysis was more exploratory than in-depth, it may contribute to a better understanding of the syndemic and multifactorial conditions that influence the sexual behaviour of MSM, including the minority stress that may be rooted in deficiencies in our understanding of these populations.

scholarly journals Rationale and design of the Prevent Anal Cancer Self-Swab Study: a protocol for a randomised clinical trial of home-based self-collection of cells for anal cancer screening

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051118
Author(s):  
Alan G Nyitray ◽  
Vanessa Schick ◽  
Michael D Swartz ◽  
Anna R Giuliano ◽  
Maria E Fernandez ◽  
...  
Keyword(s):  
Anal Canal ◽  
Anal Cancer ◽  
Sexual Minority ◽  
Hiv Positive ◽  
Hpv Dna ◽  
Sexual Minority Men ◽  
Home Based ◽  
Exfoliated Cells ◽  
Transgender Persons ◽  
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.

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.

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

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.

scholarly journals Adaptation of a Group-Based HIV RISK Reduction Intervention to a Mobile App for Young Sexual Minority Men

2018 ◽  
Vol 30 (6) ◽  
pp. 449-462 ◽  
Author(s):  
Rebecca Schnall ◽  
Lisa M. Kuhns ◽  
Marco A. Hidalgo ◽  
Dakota Powell ◽  
Jennie Thai ◽  
...  
Keyword(s):  
Software Development ◽  
Expert Panel ◽  
Mobile App ◽  
Evidence Based ◽  
Sexual Minority Men ◽  
Individual Level ◽  
Intervention Content ◽  
Minority Men ◽  
Sex With Men ◽  
Panel Review

There is a dearth of evidence-based HIV prevention interventions for very young men who have sex with men (YMSM) ages 13–18 years, at high risk for HIV. We adapted the MyPEEPS intervention—an evidence-based, group-level intervention—to individual-level delivery by a mobile application. We used an expert panel review, in-depth interviews with YMSM (n = 40), and weekly meetings with the investigative team and the software development company to develop the mobile app. The expert panel recommended changes to the intervention in the following areas: (1) biomedical interventions, (2) salience of intervention content, (3) age group relevance, (4) technical components, and (5) stigma content. Interview findings reflected current areas of focus for the intervention and recommendations of the expert panel for new content. In regular meetings with the software development firm, guiding principles included development of dynamic content, while maintaining fidelity of the original curriculum and shortening intervention content for mobile delivery.

scholarly journals Minority stress, intra-minority stress and social anxiety: Examining an extended psychological mediation framework among sexual minority men

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Mahon ◽  
G Kiernan ◽  
P Gallagher
Keyword(s):  
Sexual Orientation ◽  
Social Anxiety ◽  
Sense Of Coherence ◽  
Sexual Minority ◽  
Minority Stress ◽  
Rejection Sensitivity ◽  
Sexual Minority Men ◽  
Lgbt Community ◽  
Minority Men ◽  
Everyday Discrimination

Abstract Background Compared to their heterosexual counterparts, sexual minority men (SMM) are at an increased risk of social anxiety disorder. Distal (i.e., everyday discrimination) and proximal (i.e., internalised homophobia, rejection sensitivity, concealment of sexual orientation) minority stress processes are associated with heightened social anxiety for SMM. Stressors emerging from within the sexual minority male community, termed intra-minority stress, and psychological processes that may foster resilience (i.e., a sense of coherence, connectedness to the LGBT community) are less explored in this area. This study examined potential pathways between everyday discrimination, intra-minority stress, proximal minority stressors, resilience and social anxiety. Methods Self-identified SMM (N = 255) residing in the Republic of Ireland completed an online survey containing measures of minority stress, intra-minority stress, resilience and social anxiety. Structural equation modelling was used to examine the model. Results The model yielded a good fit to the data, X2(16) = 26.61, CFI = .99, TLI = .97, RMSEA = .05, and SRMR = .03. Rejection sensitivity and a sense of coherence had a significant indirect effect in the relationships between both exogenous variables (i.e., discrimination and intra-minority stress) and social anxiety. There were no significant pathways to social anxiety involving concealment of sexual orientation, internalised homophobia or LGBT community connectedness. Conclusions For SMM, minority stress processes and intra-minority stress are important determinants of social anxiety. Our findings demonstrate that proximal minority stressors may operate differently in a social anxiety context for SMM in western European countries. A sense of coherence was an integral factor in the model and demonstrated the strongest association with social anxiety.

Sign in / Sign up

Export Citation Format

Share Document