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.     

Perceptions of Physical Sexual Health Among Young Men Who Have Sex with Men with a Previous History of Childhood Sexual Abuse

Childhood sexual abuse (CSA) has been reported to be disproportionately higher among young men who have sex with men (YMSM) than among heterosexual men. Most research and public health programs among YMSM CSA survivors have been mainly infectious disease-based, and research on the physical sexual health among this group is limited. This study sought to further understand components of physical sexual health among YMSM with CSA histories. Sixteen participants were recruited, and through a phenomenological approach, semi-structured interviews were conducted. Four themes were found, participants (1) reported a one-dimensional definition of sexual health; (2) had limitations in health insurance hindering preventative care; (3) described reoccurring anal pain during sexual intercourse; and (4) conveyed a positive perception of sexual satisfaction. These findings indicate a need for healthcare providers, health educators, and researchers to increase awareness about the comprehensive needs of YMSM with CSA histories.     

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.     

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.     

The Relationship Between Online Sexual Compulsivity,Dissociation, and Past Child Abuse Among Men Who Have Sex with Men

The objective of this study was to measure the relationships between online sexual compulsivity, three dimensions of dissociation (absorption, depersonalization, and amnesia), and past child abuse among men who have sex with men (MSM). A total of 517 MSM, recruited from Internet chat rooms, completed the survey. Results indicated that past child abuse was significantly related to dissociation but not online sexual compulsivity. It was also found that the amount of time MSM spent online in a one-week period, in general and specifically engaged in sexual activity, was significantly related to online sexual compulsivity and three dimensions of dissociation. Online sexual compulsivity was a significant predictor of absorption, depersonalization, and amnesia. Implications for clinicians and future research are presented.     

Providing HIV Education and Outreach via Internet Chat Rooms to Men who Have Sex with Men

Abstract

This article describes a pilot project that provided Internet-based outreach and HIV educational information to Men Who Have Sex with Men (MSM). The project provided services via chat rooms designated for MSM who meet there anonymously for sexual encounters. Services were designed to support behavior changes as well as serving a gateway function for additional services at the host agency. The experiences of the project suggest that the target population may engage in high-risk sexual activity more than what was initially assumed; and that Internet outreach provides a relevant means of conducting outreach to this group.     

The Healthy Young Men's Study: Sampling Methods to Recruit a Random Cohort of Young Men Who Have Sex With Men

Recruiting a scientifically sound cohort of young men who have sex with men (YMSM) is an enduring research challenge. The few cohort studies that have been conducted to date on YMSM have relied on nonprobability sampling methods to construct their cohorts. While these studies have provided valuable information about HIV risk behaviors among YMSM, their generalizability to broader YMSM populations is limited. In this article, the authors describe a venue-based sampling methodology used to recruit a large and diverse cohort of YMSM from public venues in Los Angeles County, California. Venue-based sampling is a multistage probability sampling design that uses standard outreach techniques and standard survey methods to systematically enumerate, sample, and survey hard-to-reach populations. The study design allowed the authors to estimate individual, familial, and interpersonal psychosocial factors associated with HIV risk and health-seeking behaviors for a cohort of YMSM with known properties. Study participants completed an extensive baseline survey and over a 2-year period completed four follow-up surveys at 6-month intervals. The baseline survey was administered in both English and Spanish.     

A Novel,Self-guided,Home-Based Intervention to Improve Condom Use Among Young Men Who Have Sex With Men

Abstract

Objective: This pilot study tested the efficacy of a brief, novel, theory-driven, self-guided, home-based intervention designed to promote condom use among young men who have sex with men (YMSM). Participants: Thirty YMSM were recruited from a large public US midwestern university during spring of 2012. Methods: The intervention was tested using a repeated measures design with the primary follow-up assessment occurring 6 weeks after enrollment. Results: Forty-five percent of men reported a reduced frequency of unprotected insertive penile–anal intercourse in the past 30 days compared with baseline (p = .01). Consistency of condom use improved (p = .013), as did motivation to use condoms correctly, condom use self-efficacy, and condom attitudes. All participants indicated that they were glad they participated, would recommend the program, and that overall, they had liked the program. Conclusions: This pilot study supports an expanded trial of this intervention with MSM at high-risk of acquiring human immunodeficiency virus/sexually transmitted infections (HIV/STIs).     

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.     

Sexual Problems and Distress among Men and Women with Same-Sex and Opposite-Sex Sexual Partners: An Analysis of a Nationally Representative Sample of Adults in Great Britain

Abstract

Objective: This study aimed to examine differences in reporting sexual problems and distress among men and women with same-sex and opposite-sex sexual partners.

Methods: Multinomial regression was undertaken on risk of reporting sexual problems and/or distress using data from the third National Survey of Sexual Attitudes and Lifestyles.

Results: Differences were detected between men of different sexual behavior groups when considering the problems “lack of enjoyment in sex,” “felt anxious during sex,” “felt no excitement or arousal during sex,” “lack of interest in sex,” “did not reach/took a long time to reach climax,” and “getting or keeping an erection.” Fewer differences were detected among women.

Conclusions: Women reporting same sex sexual partners, and to a greater extent men reporting same sex sexual partners , have different sexual health needs and report sexual health problems and distress to a different extent than is the case for individuals who only have opposite-sex sexual partners     

Predictors of Sexual Behavior Among Early and Middle Adolescents Affected by Maternal HIV

ABSTRACT. We describe the extent to which men who have sex with men and women (MSMW) tell their female sex partners that they have male sex partners and the association between disclosure of male partners and condom use with female partners. Data were from U.S. Internet-using MSMW recruited from a social networking Web site. Of 666 MSMW, 70% told their last female partner that they had male sex partners. MSMW who disclosed having male sex partners were equally likely to have used a condom during their last vaginal intercourse with a female partner (42%) as were men who did not disclose (47%). Because disclosure was not associated with condom use and condom use was low, it is important to continue efforts to promote consistent condom use, especially among females, regardless of the reported sexual orientation of their partners.     

The Social Environmental Elements of Resilience Among Vulnerable African American/Black Men Who Have Sex With Men

Resilience theory has been suggested as a strong framework for research on HIV prevention among men who have sex with men (MSM). Among this population, literature indicates that African American/Black MSM are particularly vulnerable to health and social disparities associated with HIV transmission risk. Conceptualizing resilience as a part of one’s social environment, this qualitative study investigates the specific elements of resilience, and the associated contexts and relationships, among a sample of 21 substance-using African American/Black MSM. Data indicate that (1) elements contributing to resilience are multiple and co-occurring, including inner strengths, social relationships, diversity of experience, religion/spirituality, altruism, and creativity; (2) as an element of resilience, social support was experienced differently among men who did and did not have supportive relationships with other gay and bisexual men, which has implications for social service provision and intervention approaches; and (3) diversity of experiences and relationships is an important influencing factor on expressions of resilience. Social services or interventions that facilitate the development of these elements of resilience will likely be especially beneficial for vulnerable African American/Black MSM.     

Rates of Asymptomatic Nonurethral Gonorrhea and Chlamydia in a Population of University Men Who Have Sex With Men

ABSTRACT

Objective: To evaluate a text message (SMS) program as a booster to an in-person alcohol intervention with mandated college students. Participants: Undergraduates (N = 224; 46% female) who violated an on-campus alcohol policy over a 2-semester period in 2014. Methods: The SMS program sent drinking-related queries each Thursday and Sunday and provided tailored feedback for 6 weeks. Response rates to SMS drinking-related queries and the associations between weekend drinking plans, drinking-limit goal commitment, and alcohol consumption were examined. Gender differences were explored. Results: Ninety percent of SMS queries were completed. Weekend binge drinking decreased over 6 weeks, and drinking-limit goal commitment was associated with less alcohol consumption. Compared with women, men had greater reductions in alcohol consumption when they committed to a drinking-limit goal. Conclusions: Preliminary evidence suggests that an SMS program could be useful as a booster for helping mandated students reduce weekend binge drinking.     

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.     

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.     

Social,Relational and Network Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut,Lebanon

Objectives: We examined the social, relational and network determinants of condom use and HIV testing among men who have sex with men (MSM) in Beirut. Methods: Two-hundred thirteen men were recruited via respondent driven sampling and administered a survey. Results: Sixty-four percent reported unprotected anal intercourse (UAI), including 23% who had UAI with unknown HIV status partners (UAIU); 62% of participants had tested for HIV. In multivariate analysis, being in a relationship was associated with UAI and HIV testing; lower condom self-efficacy was associated with UAIU and HIV testing; gay discrimination was associated with UAIU; MSM disclosure was associated with UAI, UAIU and HIV testing; and network centralization was associated with HIV testing. Conclusions: Multi-level social factors influence sexual health in MSM.     

Sexual Relationships,Behaviors, and Experiences Among Bisexual Men in Mumbai,India

ABSTRACT

Objectives: This exploratory study attempted to assess a range of sexual behaviors, relationships, and related factors among a sample of bisexual men in Mumbai, India. Methods: Data collection occurred in two separate phases. First, focus group discussions were facilitated with local community members in order to finalize an interviewer-administered questionnaire. Afterward, structured interviews were conducted with a sample of 50 bisexual men using this questionnaire. Results: Participants reported a wide range of sexual behaviors and relationships with male and female partners. Conclusions: Findings have implications for future research and practice focusing on bisexual men in India,as well as their partners of all genders.     

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.     

Gay Men's Perspectives on HIV Prevention and Treatment in Berlin,Germany: Lessons for Policy and Prevention

Qualitative data from interviews with gay men in Berlin, Germany were used to identify challenges facing HIV prevention and treatment as well as opportunities to improve them. In 2015, 20 self-identified gay men in Berlin—who had all received HIV prevention services and/or treatment (broadly defined)—participated in 1-on-1 qualitative interviews (30–75 min long). Ages ranged from 24 to 54, 35% self-identified as HIV-positive, and the remainder as HIV-negative. With regard to challenges to HIV prevention, participants highlighted (a) an already high HIV burden among gay men in Berlin and thus a need for doing prevention with positives (test-and-treat, and treatment as prevention); (b) the lack of a universal free condom distribution program; and (c) relaxed attitudes around the seriousness of HIV as a result of HIV treatment optimism. Participants highlighted that although condoms are an effective HIV prevention strategy (and thus certainly an area for focus), HIV prevention campaigns would benefit from updates with regard to embracing a diverse range of biological and behavioral prevention strategies, as well as expanded methods for making access to postexposure prophylaxis and free rapid HIV-antibody testing. This study informs HIV prevention approaches in Berlin, Germany as well as other urban centers where MSM are disproportionally affected by the HIV epidemic.     

Shattering the Myth of Invulnerability: Exploring the Prevention Needs of Sexual Minority Women Living with HIV/AIDS

Developing effective safer-sex programs for women living with HIV/AIDS (WLH/A) is a national HIV prevention priority. Existing programs focus predominantly on heterosexual women's experiences and ignore the needs of sexual minority women (SMW). Thus, we conducted semi-structured interviews with 16 sexual minority WLH/A to better understand their sexual risk behaviors and corresponding HIV prevention needs. Most of the interviewees were African American (75%) and poor (75%). We used strategies of Grounded Theory to code the interviews for key themes, which included the following: differences between relationships, risk, and protective behaviors in male and female relationships; links between substance abuse and unsafe sex; need for safer-sex or prevention programs to address SMW-specific skills and topics; and the importance of addressing women's resiliency and the social context of women's risk in prevention programs. Conclusions include concrete suggestions to make safer-sex programs more responsive to the needs of SMW.