Community and drug use among gay men: the role of neighborhoods and networks

Gay neighborhoods serve as vital places for gay men's socializing, yet few studies have examined their contributions to gay men's health-either directly or indirectly via residents' social networks. Drawing from theoretical perspectives on community and networks, we test hypotheses concerning whether gay neighborhoods and social network factors are associated with patterns of recent illicit drug use among a sample of 740 urban gay men from New York City. Higher odds of drug use were observed among individuals who resided in gay neighborhoods, had networks composed predominantly of other gay men, and had increased socialization with gay men. Network factors did not mediate associations between gay neighborhoods and drug use. These findings highlight the need to better contextualize the health risks faced by gay men by accounting for both neighborhood and network structures.     

The relation between cultural values and condom use among Latino gay men

ABSTRACT

Latino men who have sex with men (MSM) are the second largest group to be affected by human immunodeficiency virus (HIV). Latino cultural values may influence sexual behaviors that can result in HIV acquisition. This study explored the relations among traditional machismo, caballerismo, familismo, unprotected anal intercourse (UAI), and the appeal of sex without condoms (ASWC) among Latino gay men. Results indicated that higher levels of familial honor and traditional machismo predicted higher levels of ASWC. These findings suggest that exploration of gender roles and family are important factors to be included in HIV prevention and intervention programs.     

Examining identity development among gay men of color

Within the past few decades, there has been an explosion of articles examining “gay identity.” Yet, much of this work continues to center on the experiences of gay White men or fail to adequately examine the process of identity development, even when “identity” is central to the discussion. This review outlines 4 theoretical perspectives used to explore gay men of color and identity development. Taken together, these 4 perspectives can offer a rich opportunity to explore the ways that gay men of color come to develop an identity that simultaneously addresses their racial and sexual identities. I argue that examining identity development among gay men of color can help sociology better understand the identity process and provide new insights into examining intersectionality by demonstrating that identities are not only intersectional but also contextual.     

Community reactions to campaigns addressing crystal methamphetamine use among gay and bisexual men in New York City

Crystal methamphetamine (aka "crystal meth") use with high-risk sex has become an emerging health problem for gay and bisexual men in New York City since the late 1990s. Public health campaigns were eventually developed to encourage gay and bisexual men to avoid or reconsider using crystal meth. Reactions to three campaigns were measured with a cross-sectional survey administered in 2004. Among an ethnically-diverse sample of 971 gay and bisexual men, 61.8% reported seeing the campaigns. Those who reported ever using crystal meth, recent use, and recent use with sex were significantly more likely to have seen the campaigns. In general, white men, HIV-negative men, and men not currently using crystal meth responded more positively to the campaigns than their counterparts; yet, more men of color reported having discussions with partners and friends about their crystal use as a result of these campaigns. Implications for researchers and practitioners are discussed.     

Registered domestic partnerships among gay men and lesbians: the role of economic factors

In this paper, we predict the demand for a marriage-like status—registered domestic partnership–among same-sex couples. Domestic partnership in the state of California now comes with almost all of the rights and responsibilities of marriage that a state can provide. We use the LGBT (Lesbian, Gay, Bisexual, and Transgender) Tobacco Use Survey conducted by the California Department of Health and the Field Research Corporation in 2003. From this telephone survey, we use a probability sample of 1,002 lesbian and gay individuals in California. Using multinomial probit models of partnership status (single, not cohabiting, cohabiting, or registered), we find limited evidence of economic motivations in the choice to register. Gay men’s likelihood of registration rises with income; lesbians’ probability of registration rises with age. Couples with longer duration are more likely to register, suggesting that registration and duration are complementary signals of commitment and possibly of the need for rights and benefits of registration.

Identifications,communities and connections: intersections of ethnicity and sexuality among diasporic gay men

This paper explores sexual and ethnic-cultural identifications among first- and second-generation gay migrants in Belgium. Based on a theoretical framework highlighting the multiple, fluid and intersectional nature of identifications, 29 in-depth interviews are used to study self-identifications and connections to different communities. Drawing on a diverse sample, three clusters of participants can be distinguished: second-generation migrants, who were born in Belgium; sexual refugees, who escaped to Belgium; and voluntary migrants, who chose to move to Belgium. Ethnic-cultural and sexual identifications interact and vary between these groups of participants, but also within them as they intersect with other social positionings such as class, gender and race.     

Unwanted sexual experiences and sexual risks in gay and bisexual men: Associations among revictimization,substance use,and psychiatric symptoms

The data set of 2,182 gay/bisexual men's month‐long sexual diaries collected by the United Kingdom Socio‐sexual Investigations of Gay Men and Aids (Project SIGMA) was used to analyse the extent to which acts of anal intercourse (AI) are distributed among gay men, using the Lorenz/Gini methodology for measuring concentration. Most individuals (60%) who engage in AI do so only once or twice a month, but there is a long tail of those who do it much more. In terms of the amount of AI acts, one tenth of the individuals are performing half of the acts of AI. The Gini coefficient of concentration is high (0.55). Factors most affecting rates and concentration of risk behaviour include relationship status, HIV sero‐status and concordant/discordant partner status.     

Using action methods to counter social isolation and shame among gay men

ABSTRACT

Despite legal and cultural amelioration of homophobia, shame and internalized homophobia persist with concomitant adverse health and mental health consequences. J. L. Moreno's system of psychodrama, sociometry, and group psychotherapy offers approaches that help counter shame and internalized homophobia and increase peer support among diverse groups of gay men. Sociometric tools help create safety, establish group cohesion, build interpersonal connections, and strengthen identification and a sense of universality. The technique of doubling increases empathy. Explorations conducted during brief enactments using psychodramatic techniques heighten appreciation for diversity in the community while promoting self-acceptance and increased self-efficacy. Group sharing guidelines help strengthen mutual identification and mitigate shame and social isolation.     

Exploring racial and ethnic differences in recreational drug use among gay and bisexual men in New York city and Los Angeles

Reported rates of recreational drug use among gay and bisexual men are currently rising. Although there has been much empirical research documenting current trends in drug use among gay and bisexual men, little research has empirically contrasted differential rates across urban epicenters, while even less has addressed racial or ethnic variation (between and within cities). This knowledge is essential both for the development of effective culturally-sensitive health education prevention/services and for understanding drug use prevalence among urban epicenters. Using the men's data gathered from large-scale gay, lesbian, and bisexual (GLB) community events in New York and Los Angeles in the fall of 2003 and spring of 2004 (N = 2,335), this study explored racial and ethnic variance in the use of methamphetamine, cocaine, MDMA/ecstasy (methylenedioxy-methamphetamine), ketamine, GHB (gamma-hydroxy-butyrate), marijuana, and nitrate inhalants (poppers) among gay and bisexual men both between and within cities (NYC and LA). Levels of recent drug use were fairly consistent between New York City and Los Angeles; however there was some between and within city racial and ethnic variance. In particular, Asian/Pacific Islander men were among those least likely to report use of some drugs. Findings suggest substance use in the gay community permeates geographic boundaries in addition to some racial and ethnic boundaries such that interventions targeting drug-using gay and bisexual men should appropriately attend to racial and ethnic diversity within communities.     

Childhood sexual experiences and adult health sequelae among gay and bisexual men: defining childhood sexual abuse

Gay and bisexual men carry the burden of HIV infections in the United States and have high rates of childhood sexual abuse that predict HIV and other health outcomes. This study examined differential effects of forced, consensual, and no childhood sexual experiences (CSE) on health outcomes among a probability sample of adult men who have sex with men (MSM). The forced sex group had the highest levels of psychological distress, substance use, and HIV risk. There were no differences in rates of depression and suicidal ideation between the consensual- and no-sex groups. The consensual- and forced-sex groups had higher rates of substance use and transmission risk than the no-sex group. The forced-sex group, however, had significantly higher rates of frequent drug use and high-risk sex than the consensual group. Findings suggest that forced CSEs result in a higher-risk profile than consensual or no childhood sexual experiences, the kind of risk pattern differs between forced and consensual childhood sexual experiences, and the underlying mechanisms that maintain risk patterns may vary. It is important to clarify risk patterns and mechanisms that maintain them differentially for forced and consensual sex groups so that interventions may be tailored to the specific trajectories related to each experience.     

The relationship between Black and gay community involvement and HIV-related risk behaviors among Black men who have sex with men

Black gay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their White male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV-related risk and protective behaviors. Data were drawn from uConnect, a population-based cohort study of young Black men who have sex with men (YBMSM) on Chicago's South Side. The sample consists of 618 Black MSM ranging in age from 16 to 29. Cross-sectional measures for this study include Black and gay community closeness, drug use, sexual risk behaviors, HIV testing, and health promotion behaviors. Closeness with the gay community was associated with greater pre-exposure prophylaxis (PrEP) knowledge as well as participating in health promotion programs along with higher rates of transactional sex and having sex under the influence of substances, and increased odds of self-reported HIV seropositivity. Involvement in the Black community was associated with lower odds of reporting being HIV positive. Findings suggest that programs and initiatives are needed to help promote the positive aspects of the Black and gay communities, while minimizing the negative correlates of such involvements.     

Barriers to accessing HIV and sexual health services among gay men in Tasmania,Australia

We examined barriers to accessing HIV and sexual health services among gay and bisexual men (GBM) in Tasmania, Australia, using in-depth interviews. Most participants were satisfied with the care they had received at public sexual health services. Barriers included the limited number of services, concerns about anonymity and privacy in small communities, difficulties accessing services via a general practitioner, and perceived stigma and discrimination. Improving the accessibility and availability of HIV and sexual health services in Tasmania is crucial to promote the engagement of GBM, which could be achieved via combined efforts of government services and community organizations.     

Relationships and identity of gay men in Mexico: A qualitative approach

Relationships are a fundamental element of human and social interactions because they provide us with meanings around physical and abstract objects that allow us to make sense of our reality and identities. There is little Mexican research regarding how gay men construct a sense of identity through their social interactions. This article describes the relationships that gay men in Mexico City have within their families, with their friends, and with their partners. Fifteen in-depth interviews are analyzed through elements of Grounded Theory and Critical Discourse Analysis. Results show that family reproduced homophobia with participants that taught them that their gay identity is socially unaccepted. This is deconstructed through friendships with other gay men. Partner relationships are lived as one of the last milestones in the construction of a gay identity. Some men question hegemonic values around sexuality through polyamorous and polygamous relationships. Conclusions show the importance of these social relationships for gay men's emotional well-being, but that their relationships are often impacted by cultural and interpersonal homophobia.     

Heterosexuals' attitudes toward lesbians and gay men: Correlates and gender differences

This paper discusses the basis for differences among heterosexuals in their reactions to gay people, with special emphasis on the issue of gender differences. Three studies conducted with students at six different universities revealed a consistent tendency for heterosexual males to express more hostile attitudes than heterosexual females, especially toward gay men. The same social psychological variables appear to underlie both males’ and females’ attitudes toward both gay men and lesbians: religiosity, adherence to traditional ideologies of family and gender, perception of friends’ agreement with one's own attitudes, and past interactions with lesbians and gay men. The role of these variables in shaping attitudes is discussed and areas for future research are proposed. Construction and validation of the Attitudes Toward Lesbians and Gay Men (ATLG) scale are also described.     

HIV/AIDS and constructs of gay community: Researching educational practice within community-based health promotion for gay men

This paper reports on the methodology of a comparative study of three gay communities in Australia as they struggle with HIV/AIDS. The study focused on the pedagogy and practice of HIV/AIDS education for disease prevention and for health maintenance for people living with HIV/AIDS, through the investigation of three problematics: (1) constructs of 'community'; (2) the centrality of gay community-based health educators; and (3) the relations of gay men within and to their communities. The study was conceived of as a critical ethnography involving a three-part sample in the three sites and using three related research methods: (1) individual and group interviews; (2) textual analysis; and (3) participant observation. The theoretical bases for the study and its design lay in notions of 'performativity', community and adult education, organizational and institutional processes, and the idea of a 'post-AIDS' sociality. The methodology is explained in detail, as are various consultative processes embedded in the design to facilitate and enable a productive relationship with the communities researched.     

Getting your partner to use condoms: Interviews with men and women at risk of HIV/STDs

Data from individual semistructured interviews with 90 young heterosexual couples were analyzed to identify strategies that men and women at risk of HIV/STDs would use to influence their partners to use condoms for the purpose of disease prevention. In addition, we explored whether participants thought influencing strategies would differ for pregnancy prevention. Content analysis of the interview data indicated that participants would use the following verbal strategies: persuading/suggesting, commanding/asserting, and threatening to withhold sex. Several participants, particularly those who had recently used condoms with their partners, reported that they would also use non‐verbal strategies involving condoms themselves (e.g., putting a condom on, buying or getting condoms, or presenting a condom to their partner). Many participants believed that they would use a different strategy for pregnancy prevention because it would be easier to convince a partner to use condoms for that purpose.