Similarities in the Sexual Behavior and HIV Risk Factors of Colombian,Dominican, Mexican,and Puerto Rican MSM Residing in New York City

Abstract

In a sample of Colombian, Dominican, Mexican, and Puerto Rican men who have sex with men (MSM) (n = 307) living in New York City, we contrasted sexual behavior and a number of variables related to it. The four groups were consistently similar in terms of frequency of partnership types (men with lovers, one-night-stands, other partners), monogamy, types of sexual behaviors with men and women, number of occasions of different behaviors, condom use during sex, and history of childhood sexual abuse. The four groups also had similar scores in most of the psychosocial variables usually related to condom use. These similarities validate the clustering of these four populations under a common category (Latino or Hispanic) for reporting and prevention purposes. This does not imply, however, that small scale interventions tailored to the specific cultural nuances of different national groups may not have an added strength. In the few cases where intraethnic differences were found, Mexican MSM were more likely than men in the other groups to receive ejaculate both in the rectum and in the mouth. These differences were not accounted for by the other variables examined and requires further investigation.     

Sexual Risk,Behavior, and HIV Testing and Status Among Male and Transgender Women Sex Workers and Their Clients in Lima,Peru

Objectives: To determine the socio-demographics, sexual practices, and HIV prevalence of male sex workers (MSWs), transwomen sex workers (TSWs), and their male clients in Lima, Peru. Methods: Following ethnographic mapping of sex work venues, the authors revisited randomly selected venues to survey MSWs, TSWs and their clients. Results: MSWs and TSW clients are more educated than MSW clients and TSWs. Only 50% of TSW clients have received HIV testing. Self-reported HIV positivity is highest among MSW clients and TSWs. Conclusion: Notable differences exist between MSWs and TSWs and their clients that can affect the health of these groups and warrant intervention.     

Minority Stress Theory: An Examination of Factors Surrounding Sexual Risk Behavior Among Gay and Bisexual Men Who Use Club Drugs

Background: Few studies have examined the impact of minority stress theory (MST) upon sexual risk behavior among gay and bisexual men using club drugs. Similar studies have focused on ethnic minorities and women; however, gay and bisexual men demonstrate greater likelihood for risk behaviors leading to HIV/AIDS. Objective: This study examines sexual risk behavior from the perspective of minority stress theory upon substance-using gay and bisexual men and their partners. Methods: Multivariable logistic regression analysis examined minority stress associations with participant sexual risk behaviors, drug use, and partner type, controlling for demographics. Results: 396 gay and 54 bisexual respondents, ages 18–67, reported at least one-time drug use while engaging in sexual risk behavior. In the adjusted model, expectations of rejection associated with lower odds of sexual risk behavior, while older age approached significance. Conclusions: Theoretical origins for examining risk behavior among gay and bisexual men may underscore risk and protective factors, while ultimately holding implications for prevention and treatment interventions.     

HIV/AIDS Prevention: MSM Wants,Desires, and Needs

HIV prevention exhaustion has occurred among MSM, with resurgence of HIV beginning in 2000 a palpable effect. A stratified snowball sample was recruited from MSM social venues including gay bars, parks, and social service agencies in order to develop targets and strategies for future prevention efforts. Three methods of data collection were used: (a) individual interviews (n = 30), (b) focus groups (total n = 64), and (c) demographic survey (n = 94). Study results found support for several education topics, substance abuse intervention, and development of MSM interpersonal skills. The article concludes with a discussion of cultural and contextual strategies to curb rising HIV cases among MSM.     

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.     

Predictors of High-Risk Sexual Behavior Among Individuals Living with HIV Disease and AIDS

An important focus of the 1996 World Aids Conference related to the extent of unprotected sex among gay men, particularly those in their twenties. This paper will use logistic analysis to explore the extent of unsafe sexual practices among individuals living in Bexar County, Texas, who are HIV+ assymptomatic, HIV+ symptomatic, or have AIDS. Using survey research data, we assess the significance and impact of various independent factors on whether respondents reported they did or did not engage in unprotected sex. The most striking finding is that unprotected sexual activity is prevalent regardless of demographic and/or status differences among respondents. Findings reinforce the use of community planning processes, which emphasize the importance of sound behavioral and social science combined with efforts to include the affected constituency to create effective HIV prevention programs.     

Sexual Behavior,Mental Health,Substance Use,and HIV Risk Among Agency-Based Male Escorts in a Small U.S. City

Abstract

Relatively little research has examined the personal sex lives of indoor male sex workers (MSWs) or possible connections in this group between sexual behavior and factors related to HIV risk. As part of a larger project, this study collected data from 30 agency-based indoor MSWs (mean = 22.4 years) about their sexual behavior, mental health, and substance use. Few HIV risk behaviors with clients occurred. Drug use and mental health problems were relatively frequent, but not related to increased risk behavior. Instead, MSWs appeared to employ rational decision-making and harm-reduction strategies. Conceptualization of MSW sexual behavior may be required where HIV risk is not attributed to sex work per se, but to other influences such as economic and relational factors.     

Female Tourists, Casual Sex, and HIV Risk in Costa Rica

This paper describes the involvement of young female tourists who visit rural Costa Rica with gringueros (i.e., local men who actively seek relationships with foreign women), and explores the implications of these relations, which gringueros see as outlets for sexual adventure, for sexual behaviors that could contribute to the spread of HIV/AIDS. The findings highlight the need to use tourism-related locales to implement HIV/AIDS awareness strategies targeted at women tourists, gringueros, and other local youth.

The Relationship Among Population Size,Requests for Bareback Sex,and HIV Serostatus in Men Who Have Sex With Men Using the Internet to Meet Sexual Partners

Recent research has indicated the use of the Internet to meet sexual partners among men who have sex with men (MSM) is increasing. This medium also serves as a major source for social and sexual networking among MSM who live in more rural areas. In addition, data suggest the use of the Internet to initiate sexual relationships among this population may increase the risk of transmission of sexually transmitted infections, including HIV. The purpose of this study was to examine differences between self-reported HIV serostatus and requests for condomless bareback (BB) sex among a sample of Florida MSM (n = 483) using a popular Internet sexual networking site to meet sexual partners. Specifically, these variables were assessed in relation to population size among the site's seven geographic regions within the state. Findings indicated an overall statistically significant relationship among requests for BB sex and self-reported HIV serostatus. However, there was not a significant relationship among these variables and geographic region. Thus, although previous data have emphasized the importance of different HIV prevention strategies among rural versus urban MSM, there may not be major differences in HIV serostatus and requests for unsafe sexual practices among these men who use the Internet to meet sexual partners in comparison to MSM in more populated areas.     

Outcomes from a homegrown HIV prevention program for extremely high-risk,substance-using men who have sex with men with multiple health disparities

ABSTRACT

From February 2010 through December 2014, 585 substance-using men who have sex with men (MSM) were enrolled into a “homegrown” risk reduction intervention. Participants evidenced significant iterative factor reductions in the odds of substance use including alcohol (AOR = 0.79) and marijuana (AOR = 0.78; both p ≤ 0.05) and marginally significant reductions in the odds of methamphetamine use (AOR = 0.83; p ≤ 0.07). Participants also evidenced significant reductions in sexual risks including the odds of reporting drug/alcohol use before or during sex (AOR = 0.80) and of condomless anal intercourse (AOR = 0.72; all significant at p ≤ 0.05). Results demonstrate that the homegrown intervention was effective at reducing HIV risk behaviors among high-risk MSM.     

Condom Use,Condom Refusal,and Substituted Sexual Behaviors Among Youth at Higher and Lower Risk for HIV Infection

ABSTRACT

The purpose of this study was to describe sexual behaviors that youth substitute for protected intercourse when a partner refuses to use a condom or a condom is not used. Participants included: (a) 120 adolescents (mean age 17.2 years) undergoing substance abuse treatment and (b) 171 university students (mean age 21.3 years). The treatment sample reported significantly higher levels of discrete risk factors for HIV exposure. While only a small proportion of each sample experienced outright refusals by partners to use condoms, the majority of participants in each sample used condoms inconsistently with main partners. The university sample reported more substituted behaviors (lower risk and total) when partners did not want to use condoms. Yet, substantial proportions of participants in each sample engaged in unprotected intercourse. Implications for social work and health promotion efforts directed toward youth at risk for HIV/STD exposures are discussed.     

A Preliminary Study of Body Image and HIV Sexual Risk Behavior in Black Gay and Bisexual Men: Implications for HIV Prevention

Nearly three decades since the onset of the AIDS epidemic, Black gay and bisexual men (BGBM) experience increasingly disproportionate rates of HIV and AIDS in the United States. The aim of this exploratory research investigation was to examine the relationship between body image and HIV sexual risk behavior in a community-based sample of 481 BGBM in the New York metropolitan area. Multivariable analyses demonstrated that men with a negative body image were less likely to use condoms during anal intercourse with a male sexual partner as compared to those respondents with a positive body image. These findings pose considerable implications for the influence of body image on HIV sexual risk behavior in BGBM.     

Trust and Sexual Interaction: The Significance of the Internet on the Sex life and Sexual Risk Behaviors Of Gay and Bisexual Men in Spain

ABSTRACT

This study provides an understanding of the significance of the use of the Internet to find sexual partners, its impact on sexual life, and how it is linked to unprotected sex among gay and bisexual men. A grounded approach was used to analyze interviews with 31 men (aged 19 to 46 years) from Madrid, Barcelona, and Bilbao/San Sebastián, Spain. The results reveal that the Internet is impacting the form and style of life of many men, and particularly their experience of sexuality. Many men regard their sexual experiences with casual partners met through the Internet as unsatisfactory or frustrating. The men provided several reasons behind the search for sexual partners via the Internet: Some interviewees sought to channel needs other than the sexual (company, affection, stable partner). Trust and assumptions built into the virtual interaction become a key to understanding why some men have unprotected sex with partners met on the Internet.     

A Model Program for Increasing Treatment Access for African American Women Who Use Crack Cocaine and Are at Risk of Contracting HIV

ABSTRACT

In the United States, the threat of HIV/AIDS to African-American women's health has become the focus of much concern. This article describes a federally funded community-based program that provides services to African-American women at risk for HIV/AIDS in Nashville, TN. This program provides a culturally relevant set of interventions specific to crack cocaine users aimed at reducing substance use and HIV/AIDS risk behaviors. The model is important to the continued development of culturally relevant interventions that are vital to stemming the disproportionate rates of HIV/AIDS within the African-American community by ensuring treatment access to all populations.     

Project VOGUE: A Partnership for Increasing HIV Knowledge and HIV Vaccine Trial Awareness Among House Ball Leaders in Western New York

Men who have sex with men (MSM) and transgender individuals of color, the largest demographic in the House Ball Community (HBC), are amongst the group at highest risk for HIV infection in the United States. The HBC have limited access to culturally appropriate HIV education. This study aimed to develop a partnership with HBC leaders to uncover strategies for increasing HIV prevention knowledge, including participation in HIV vaccine trials. To this end a research institution-community-HBC partnership was established. In-depth qualitative and quantitative data were collected from the 14 HBC leaders in Western New York, revealing that knowledge of HIV and related vaccine trials was limited. Barriers to increasing HIV knowledge included fear of peer judgment, having inaccurate information about HIV, and lack of education. Among the HBC, community partnerships will further aid in the development of future HIV prevention programs and increase individuals’ willingness to participate in future HIV vaccine trials.     

A Qualitative Analysis of Cultural and Social Vulnerabilities to HIV Infection Among Gay,Lesbian, and Bisexual Asian Youth

Abstract

The study reported here was undertaken to investigate cultural and social barriers that may increase HIV risk among gay, lesbian, and bisexual Asian youth. Interviews and focus groups were used to collect the data because they are well suited for this type of exploratory research. A total of 15 gay, lesbian, and bisexual Asian youth (7 females and 8 males) were recruited. Most of the participants (n = 11) self-identified as lesbian or gay. The mean age was 20.7, ranging from 17 to 24. Twelve participated in one of three focus groups while the remaining three were interviewed. Categories and themes identified include: (1) the lack of sex education at home, (2) homophobia in Asian families, (3) unresponsive health and social service providers, (4) lack of social support, (5) negative stereotypes, (6) ideal standards of beauty, and (7) negative perceptions of safer sex practices among Asian lesbian and bisexual women. HIV prevention strategies are suggested based on the recommendations and needs of our participants.     

Understanding the Influence of Loneliness on HIV Risk Behavior in Young Men Who Have Sex with Men

In this study we used grounded theory methodology to understand the influence of loneliness in YMSM in terms of HIV risk behavior. Twenty-two YMSM, 18–29 years of age, of HIV-negative/unknown status were interviewed. Results indicated that loneliness is defined in two ways: emotional and social. A cyclical pattern emerged that included negative symptoms, “self-treatment” of loneliness through drug use and sex, temporary relief, remorse related to engaging in HIV risk behaviors, negative self-image, and ultimately the reemergence of initial loneliness symptoms. Results suggest that loneliness in YMSM plays a greater role in HIV-related behavior than previously understood. A preliminary explanatory model, implications, and directions for future research are discussed.     

Blending Prevention Models: An Effective Substance Use and HIV Prevention Program for Minority Youth

Illicit drug use and rates of HIV infection among youth have increased over the past decade, indicating the need effective substance use and HIV prevention programs. Particularly at risk are minority youth living in poor urban environments. This study examines effectiveness of an innovative prevention program that blends the “All Star” substance abuse prevention model with the “Popular Opinion Leader” model for HIV prevention. In general, the results indicate non-significant increases in drug and sex risk, behavior and significant positive changes and trends in related areas (i.e., changes in perception, self esteem) thought to be related to drug use and risky sexual behavior.Sally Stevens and Velia Leybas-Amedia are affiliated with the Southwest Institute for Research on Women, University of Arizona. Beth Bourdeau is affiliated with the Pima Prevention Partnership, Tucson, AZ. Lovelle McMichael and Alan Nyitray are affiliated with the Southern Arizona AIDS Foundation, Tucson, AZ. Financial assistance for this project was provided by the Substance Abuse and Mental Health Service Administration, Center for Substance Abuse Prevention Grant# SP08916. The opinions expressed herein are those of the authors and do not reflect official positions of the government. The Southern Arizona AIDS Foundation and the authors would like to acknowledge the staff at the Tucson Urban League Academy Charter School and Luz Social Services Charter School for their assistance and support of the Check Yourself Youth Team prevention project.     

Women,Economic Development,and HIV/AIDS: Transforming Systems of Care for Sustainable Change

ABSTRACT

In this concept article, the authors utilize Maslow's Hierarchy to define and discuss a proposed conceptual treatment framework that includes economic development efforts with examples of successes that have been demonstrated in the literature. The authors posit that HIV/AIDS treatment practitioners should not overlook the interconnectedness and interdependency of economic equilibrium and public health and suggest that the creation of treatment plans based on multi-dimensional interdisciplinary approaches are necessary to achieve maximum benefit for care and resource dollars.     

Frequency of Group Sex Participation and Risk for HIV/STI Among Young Adult Nightclub Scene Participants

Objectives: This study examines frequency of group sex participation and associated characteristics and behaviors among a sample of heterosexual young adult participants in Miami's nightclub scene (n = 498). Methods: Baseline survey assessments were analyzed using zero-inflated binomial regression. Results: Forty-one percent of the sample reported group sex participation history. Greater frequency of group sex is associated with buying sex, sex with an injection drug user, being high during sex, condomless vaginal sex, victimization history, and sexually transmitted infection incidence (p < .02). Conclusions: Sexually transmitted infection prevention and intervention efforts should address risks associated with group sex participation.