Child Sexual Abuse and Adult Mental Health,Sexual Risk Behaviors,and Drinking Patterns Among Latino Men Who Have Sex With Men

One in five Latino men who have sex with men has experienced child sexual abuse. Although concerning in itself, child sexual abuse may increase an individuals’ likelihood of depression and risk-taking in adult life, including engagement in HIV risk behaviors and alcohol and substance use. It is therefore urgent that researchers and practitioners better understand the long-term effects of child sexual abuse. We utilized logistic and linear regression to assess associations between child sexual abuse (operationalized as forced or coerced sexual activity before age 17) and depression, sexual behaviors, and drinking patterns in a sample of 176 adult Latino men who have sex with men from New York City. Over one-fifth (22%) of participants reported child sexual abuse. In multivariable models, participants with histories of child sexual abuse were significantly more likely than participants without such histories to screen for clinically significant depressive symptoms and heavy drinking and reported more anal sex acts, male sexual partners, and incidents of condomless anal intercourse in the previous three months. These findings confirm a high prevalence of child sexual abuse among Latino men who have sex with men and associations between child sexual abuse and adulthood depressive symptoms, high-risk alcohol consumption, and sexual risk behaviors. We recommend that providers who serve Latino men who have sex with men incorporate child sexual abuse screenings into mental health, HIV prevention, and substance use treatment programs, utilizing approaches that are inclusive of resilience.     

Accounting for unsafe sex: Interviews with men who have sex with men

Semi‐structured one‐on‐one interviews with 102 gay and bisexual men were conducted to examine the reasoning processes men use to exempt themselves from practicing safe sex. Qualitative analysis of the interviews revealed the following recurring themes: (a) Many men who were in couple relationships avoided condom use for reasons involving intimacy or trust, or because both partners were HIV‐negative; (b) unsafe sex sometimes occurred inadvertently or involuntarily; (c) negative moods and self‐images were associated with unsafe sex; (d) by “intuiting” that their partner was HIV‐negative, participants exempted themselves from the need for safe sex; and (e) when the boundary between safe and unsafe was unclear, participants used a combination of unofficial and official guidelines to determine what is safe.     

Sexual Desire Among an Online Sample of Men Sexually Attracted to Children

ABSTRACT

Sexual attraction to children occurs in roughly 3 to 9 percent of the population. However, most knowledge about such desires comes from forensic samples, and most studies fail to assess preferred sexual activity and sexual partner. A new multimodal assessment of sexual desire was used to investigate interest in consensual and nonconsensual sex with adults and children in an online sample of men sexually attracted to children (n = 101). Desires were compared across history of sex offending behavior and preferred gender of child victim. Men who have and have not acted on their sexual attractions to children reported similar levels of sexual desire. Men primarily attracted to girls reported greater desire for sex with adults than did men primarily attracted to boys. Results highlight the heterogeneity of men sexually attracted to children as well as possible distinctions across gender of children to whom they are primarily attracted.     

Predictors of HIV Sexual Risk Behavior Among Men Who Have Sex with Men,Men Who Have Sex with Men and Women,and Transgender Women

ABSTRACT

Men who have sex with men, men who have sex with men and women, and transgender women are at high risk for HIV infection. This study seeks to clarify which known HIV risk factors (partner type, sex location, serodiscordance, multiple sex partners, substance use during sex) contribute to engagement in high-risk (unprotected receptive anal) sex in each population. Data collected from June 2005 through June 2008 indicate all three populations display different HIV sexual risk profiles. The data suggest that HIV-prevention interventions should be individually tailored to address the specific needs of these three highly vulnerable and impacted populations.     

The Use of Internet Chat Rooms to Meet Sexual Partners: A Comparison of Non-Heterosexually Identified Men with Heterosexually Identified Men and Women

ABSTRACT. Objectives: Prior work suggests that many individuals use the Internet to meet romantic or sexual partners. Our intent was to explore perceptions and experiences with meeting people online. Methods: In 2008, the authors conducted U.S.-based online interviews with 65 predominantly White, self-identified heterosexual men and women and gay/bisexual men (Mean age = 30.8 years). Results: Reasons for meeting people online, desired partner characteristics, and the process of connecting for sex paralleled those observed in face-to-face contexts. People used Internet chat rooms to identify more partners and specific partner characteristics. “Background checks” of online partners, though often believed to be inaccurate, increased familiarity and trust leading to reduced condom use. Participants said online condom use negotiation was easier but usually occurred in face-to-face contexts. Conclusions: The fundamental processes of meeting partners online are similar in many ways to meeting partners face-to-face; however, the Internet facilitates rapid access to relatively large numbers of potential partners.     

Exploring and Adapting a Conceptual Model of Sexual Positioning Practices and Sexual Risk Among HIV-Negative Black Men Who Have Sex With Men

Estimates show a 50% lifetime human immunodeficiency virus (HIV) risk among Black men who have sex with men (BMSM) in the United States(U.S.). Studying the dynamics of sexual positioning practices among BMSM could provide insights into the disparities observed among U.S. groups of men who have sex with men (MSM). This study explored sexual positioning dynamics among HIV-negative BMSM and how they aligned with a theoretical model of sexual positioning and HIV/sexually transmitted infection (STI) risk among MSM. In-depth qualitative interviews were conducted with 29 HIV-negative BMSM between ages 25 and 35 in Los Angeles. Comments related to sexual behaviors were reviewed for relevance regarding oral or anal sexual positioning practices. Data presented represent the range of themes related to decision making regarding sexual positioning. Personal preference, partner attraction, HIV avoidance, and feeling obligated to practice partner preferences influenced sexual positioning. Drug use also affected decision making and was sometimes preferred in order to practice receptive anal intercourse. These variables build on the conceptual model of sexual positioning practices and sexual risk, and add understanding to the relationship between preferences, practices, and risk management. Future research on risk among HIV-negative BMSM should quantify the relative impact of personal preferences, partner attraction, partner type, compromise, and substance use on sexual positioning practices and risk.     

Using the Experience Sampling Method to Study Sexual Risk Behavior among Men Who Have Sex With Men (MSM)

Toward the goal of advancing understanding of rates of HIV transmission among men who have sex with men (MSM) populations, this article provides preliminary data on the use of the experience sampling method (ESM) in a sample of 165 MSM. Participants completed 6 weeks of experience sampling in two 3-week measurement bursts with a 3-week rest interval. Criterion validity of the random and retrospective daily assessments was supported by expected within-person correlations between sexual risk behavior and sexual arousal. Participants reported some sexual activity with a male partner on 18.62% of the days, condomless anal sex (CAS) on 6.52% of days, and not using condoms on 66.56% of days they had anal sex. Over half of the variability in CAS was at the within-person level, which suggests the significance of time varying contextual factors. Finally, CAS reports were relatively stable across the study, suggesting a lack of reactivity to the self-monitoring.     

Depressive Symptoms,Acute Alcohol Intoxication,and Risk Rationale Effects on Men’s Condom Use Resistance

This study examined the role of depressive symptoms, acute intoxication, and risk rationale in men’s use of condom use resistance (CUR) tactics in an experimental study. Participants included 313 heterosexual male, nonproblem drinkers, ages 21 to 30. Participants were randomized to one of four beverage conditions: no alcohol, placebo, low (.04%) alcohol dose, or high (.08%) alcohol dose. They read an eroticized scenario depicting a consensual sexual encounter with a female partner who requested a condom to prevent either pregnancy or sexually transmitted infections (STIs) (risk rationale) and then indicated their intentions to use 10 different CUR tactics. Hypotheses related to the pharmacological, dosage, and expectancy effects of alcohol were tested in a generalized linear model. In intoxicated (.04% and .08%) men who were given a pregnancy risk rationale, depressive symptoms were associated with stronger intentions to use CUR tactics than in sober (control and placebo) men. Men who received a high alcohol dose (.08%) and who were given a pregnancy risk rationale reported higher intentions to use CUR tactics than those who received a lower alcohol dose (.04%). Findings suggest that the pharmacological effects of alcohol on men’s likelihood to resist condoms vary by the saliency of the risk rationale and mood-related variables.     

The Burden of Sexual Problems: Perceived Effects on Men’s and Women’s Sexual Partners

Sexual dysfunction sometimes negatively affects the individual, his or her partner, and the relationship. We investigated the relationship between the distress experienced by men and women with orgasmic phase difficulties and the perceived distress of their partner(s). We also identified predictors of perceived partner distress, and related self and partner distress to severity of the problem and relationship quality. Data were drawn from 374 men with premature ejaculation (PE) and 377 women with anorgasmia who responded to a survey regarding their sexual functioning, including their distress about their condition and the perceived distress of their partners. Results yielded an overall distress score consisting of combined self and perceived partners distress, with women showing a higher overall score and higher perceived partner distress than men. For men, significant predictors of perceived partner distress included self-distress, relationship quality, interest in sex, and arousal difficulty; for women, only the level of self-distress significantly predicted perceived partner distress. These findings indicate the burden of experiencing sexual difficulty, identify factors related to perceived partner distress, and demonstrate differences in self versus partner distress across men and women. Overall, such findings reiterate the strong need for the inclusion of the partner in any attempted remediation of a sexual problem.     

Emotional Intimacy Power Predicts Different Sexual Experiences for Men and Women

Those who are more emotionally invested in relationships have less power than their partners. Furthermore, less powerful individuals may attempt to equalize power imbalances by offering rewards to their partner and using sex and condom use as exchange resources. Australian young adults reported their condom use and pressured sex experiences in both romantic (n = 708) and casual (n = 118) relationships. Results showed that greater power (lower relative emotional investment) predicted more condom use among those wanting to use condoms. In casual relationships, an interaction with gender showed that women in particular used condoms more when they had more power. Power also interacted with gender for pressured sex and, unexpectedly, men who had more power experienced more pressured sex. The possibility that condom use and pressured sex have different meanings for men and women is explored.     

An Episodic Analysis of Substance Use and Risky Sexual Behavior in a Racially Diverse Sample of Young Men Who Have Sex with Men

Many studies have examined the relations between drug use and sexual behaviors; however, few have utilized episodic data to examine the co-occurrence of both behaviors within the same episode. This study surveyed 403 racially and ethnically diverse gay, bisexual, and other young men who have sex with men (YMSM; ages 18–29) in New York City. Men were surveyed about their sexual behavior and concurrent use of illicit substances and alcohol during their most recent sexual encounter with their main and/or casual partner(s). Logistic regression models were built to analyze predictors of unprotected oral and anal intercourse with main and casual partners. Results suggest that use of inhalant nitrates and alcohol increased the odds of men engaging in unprotected receptive anal intercourse (URAI) and men who identified as middle or high socioeconomic status (SES) were at lower odds of engaging in URAI with their main partner. Use of other illicit substances was not associated with unprotected sexual intercourse. These findings indicate a need to further consider the role of licit substances used by YMSM as a means of further reducing the incidence of HIV infection in this population. In addition, the high rates of unprotected anal intercourse among men reporting a main partner has the potential to be a significant source of HIV risk, and should be further explored among YMSM.     

Gender,relationship stage,and sexual behavior: the importance of partner emotional investment within specific situations

This study examined the relationship of type of sexually instigating situation (partner behavior conveying emotional investment or not), relationship stage, and gender to self-reported likelihood of engaging in sexual behavior. Participants (200 female and 122 male college students) read scenarios describing partner behavior in eight hypothetical sexual situations. Five of the sexual situations were proposed to explicitly communicate a sense of emotional investment in the relationship, and three other scenarios were conceived as not explicitly conveying emotional investment. Emotional investment situations were hypothesized to influence likelihood ratings as a function of imagined relationship stage (dating or in a serious relationship), manipulated across participants. Situations not conveying investment were hypothesized to influence ratings as a function of both relationship stage and gender. In large part, hypotheses were confirmed. The few exceptions were consistent with other gender-role considerations related to trust and power.     

Gender,relationship stage,and sexual behavior: The importance of partner emotional investment within specific situations

This study examined the relationship of type of sexually instigating situation (partner behavior conveying emotional investment or not), relationship stage, and gender to self‐reported likelihood of engaging in sexual behavior. Participants (200 female and 122 male college students) read scenarios describing partner behavior in eight hypothetical sexual situations. Five of the sexual situations were proposed to explicitly communicate a sense of emotional investment in the relationship, and three other scenarios were conceived as not explicitly conveying emotional investment. Emotional investment situations were hypothesized to influence likelihood ratings as a function of imagined relationship stage (dating or in a serious relationship), manipulated across participants. Situations not conveying investment were hypothesized to influence ratings as afiinction of both relationship stage and gender. In large part, hypotheses were confirmed. The few exceptions were consistent with other gender‐role considerations related to trust and power.     

Context of First Same‐Sex Condom Use and Nonuse in Young Black Gay and Bisexual Males

Despite high human immunodeficiency virus (HIV) rates among young Black men who have sex with men (YBMSM), there are limited data about condom use during first same‐sex (FSS). This study sought to understand socio‐contextual factors of 50 YBMSM aged 15–19 years that influenced condom use during FSS. Condom use was influenced by individual, partner, and community factors. Individual factors—recent illness or sexually transmitted infections (STI)—prompted condom use, while frequent HIV testing prompted nonuse. Partner factors—proactive encouragement from partners—prompted condom use, while trust and condom discomfort prompted nonuse. Larger community factors—such as presence of females—were key for use, while limited sexual health information combined with peers who discouraged condoms prompted nonuse. A multilevel approach may be useful in developing sexual health programming for these young men.     

Women's Unprotected Sex Intentions: Roles of Sexual Victimization,Intoxication, and Partner Perception

Sexually victimized women may make sexual decisions differently than nonvictimized women. This study used an eroticized scenario and laboratory alcohol administration to investigate the roles of victimization history, intoxication, and relationship context in women's perceptions of a male partner and their subsequent intentions for unprotected sex. A community sample of 436 women completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. After random assignment to an alcohol or control condition, participants read and projected themselves into a sexual scenario that depicted the male partner as having high or low potential for a lasting relationship. Participants rated their perceptions of his intoxication, sexually transmitted infection (STI) risk level, and anticipated reactions to insistence on condom use. They then indicated their likelihood of allowing the partner to decide how far to go sexually (abdication) and of engaging in unprotected sex. Structural equation modeling (SEM) analyses revealed that intoxication predicted greater unprotected sex likelihood indirectly via abdication. CSA and ASA predicted partner perceptions, which in turn predicted unprotected sex likelihood. These findings indicate that, compared to their nonvictimized counterparts, sexually victimized women may respond differently in sexual encounters partly as a function of their perceptions of partners' STI risk and anticipated reactions to condom insistence.     

Behavioral Escape Avoidance Coping in African-American Men Who Have Sex with Men

The purpose of this exploratory study was to investigate differences between African-American men who have sex with men (MSM) who use behavioral escape avoidance coping responses and those who do not. In particular, we investigated differences in the African-American MSM in our study on psychosocial factors such as internalized homonegativity, exploration phase sexual identity, and the importance of race/ethnicity identity to self-concept; and we investigated the association of these factors on the likelihood of the use of behavioral escape avoidance coping responses. Eighty-three African-American MSM completed our online assessment tool. Chi-square tests and modified Poisson regression were used to test our hypotheses. Our results revealed significant differences in the internalized homonegativity, exploration phase sexual identity, and in the importance of race/ethnicity identity to self-concept for the men in this study who endorsed behavioral escape avoidance coping responses compared to those who did not endorse behavioral escape avoidance coping responses.     

Transactional Sex and Preferences for Pre-Exposure Prophylaxis (PrEP) Administration Modalities Among Men Who Have Sex With Men (MSM)

Pre-exposure prophylaxis (PrEP) is an important biomedical human immunodeficiency virus (HIV) prevention tool gaining more popularity among Parisian men who have sex with men (MSM) who engage in transactional sex. This study examines the knowledge of, and willingness to use, different modalities of PrEP among this subgroup. Broadcast advertisements were placed on a geosocial-networking smartphone application with a link to a Web-based survey during three 24-hour periods in October 2016. Modified Poisson regression models were used to assess the association between engagement in transactional sex and preferences for each of these PrEP modalities. A total of 444 respondents were included. About 14% reported engagement in transactional sex. In all, 90% of MSM who engaged in transactional sex were knowledgeable of daily oral PrEP, while 13.3% were knowledgeable about long-acting injectable PrEP or penile or rectal microbicides. They were more likely to be aware of long-acting injectable PrEP (aRR = 2.52, 95% CI = 1.16 to 5.47) and willing to use daily oral PrEP (aRR = 1.48; 95% CI = 1.11 to 1.98) or long-acting injectable PrEP (aRR = 1.40; 95% CI = 1.09 to 1.81) than MSM who had not engaged in transactional sex. Long-acting injectable PrEP may be an important HIV-prevention option for MSM who engage in transactional sex if this modality is proven effective.