Trauma symptoms, sexual behaviors, and substance abuse: correlates of childhood sexual abuse and HIV risks among men who have sex with men

Childhood sexual abuse is associated with high-risk sexual behavior in men who have sex with men. This study examined psychological and behavioral correlates of HIV risk behavior associated with childhood sexual abuse in a sample of men who have sex with men. Men attending a large gay pride event (N = 647) completed anonymous surveys that assessed demographic characteristics, childhood sexual abuse history, symptoms of dissociation and trauma-related anxiety, borderline personality characteristics, substance use, and sexual risk behavior. Results indicated that men who have a history of childhood sexual abuse were more likely to: engage in high-risk sexual behavior (i.e., unprotected receptive anal intercourse), trade sex for money or drugs, report being HIV positive, and experience non-sexual relationship violence. Results of this study extend previous research to show that men who have sex with men and who have a history of child sexual abuse are more likely to be at high risk for HIV infection.     

Privacy and confidentiality considerations for collecting HIV risk network data among men who have sex with men and implications for constructing valid risk networks

Studies aiming to construct risk networks have historically collected network members' names, demographic characteristics and relational data (i.e., type, strength, duration, frequency of interaction, and HIV-related risk behaviors between the pair). Due to difficulties in constructing risk networks stemming from partner anonymity and the use of nicknames, some studies also collect network members’ screen names, phone numbers, physical attributes, and scars/tattoos to assist with entity resolution. In-depth interviews with 20 men who have sex with men and transgender women in Kentucky assessed privacy/confidentiality concerns as well as accuracy/recall issues associated with providing these details. Most preferred providing alters’ nicknames/first names only or a first name with the first letter of the last name. Many perceived screen names, phone numbers, and scars/tattoos to be too personal/identifying. Willingness to provide more detailed information varied by relationship type/strength, which could influence the validity of the resulting network.     

Assessing structural correlates to social capital in Facebook ego networks

Research in computer-mediated communication has consistently asserted that Facebook use is positively correlated with social capital. This research has drawn primarily on Williams’ (2006) bridging and bonding scales as well as behavioral attributes such as civic engagement. Yet, as social capital is inherently a structural construct, it is surprising that so little work has been done relating social capital to social structure as captured by social network site (SNS) Friendship networks. Facebook is particularly well-suited to support the examination of structure at the ego level since the networks articulated on Facebook tend to be large, dense, and indicative of many offline foci (e.g., coworkers, friends from high school). Assuming that each one of these foci only partially overlap, we initially present two hypotheses related to Facebook social networks and social capital: more foci are associated with perceptions of greater bridging social capital and more closure is associated with greater bonding social capital. Using a study of 235 employees at a Midwestern American university, we test these hypotheses alongside self-reported measures of activity on the site. Our results only partially confirm these hypotheses. In particular, using a widely used measure of closure (transitivity) we observe a strong and persistent negative relationship to bonding social capital. Although this finding is initially counter-intuitive it is easily explained by considering the topology of Facebook personal networks: networks with primarily closed triads tend to be networks with tightly bound foci (such as everyone from high school knowing each other) and few connections between foci. Networks with primarily open triads signify many crosscutting friendships across foci. Therefore, bonding social capital appears to be less tied to local clustering than to global cohesion.     

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.     

Experiencing release: sex environments and escapism for HIV-positive men who have sex with men

There are nonsexual reasons that may motivate people to seek out sexual activity with others. Some men who have sex with men may seek out sex environments to engage in sexual behavior. Among the nonsexual reasons that exist for men who have sex with men is a desire to escape from distressing thoughts and feelings. The amplified sexuality and other unique characteristics of sex environments allow men to have more intense emotional experiences around sex. Using the cognitive escape model as a theoretical foundation, this analysis focuses on the emotional vulnerability that some of the men who visit these venues may be avoiding and how their experiences at these venues might act as releasing mechanisms to alleviate dissonant thoughts and feelings. Implications for public health services and future research are discussed.     

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.     

Family capital: Examining social capital,family commitment,and acculturation among college-enrolled Mexican-American men and women in the Southwestern United States

Social capital is integral to an individual’s ability to access various resources embedded in social and familial networks that are important in academic access and future success. The types and dynamics of social relationships created by men and women are thought to generate different forms of social capital with factors such as acculturation resulting in differences in intercultural networks and potential resource access. However, the factors that contribute to the development of social capital require further investigation. The current study examines the relationship between acculturation, family role commitment, and various social network characteristics associated with social capital among Mexican-American college-enrolled men (n = 119) and women (n = 196). Several multiple regressions were conducted. Findings indicate that acculturation and family role commitment relate differently to social-capital-network characteristics among Mexican-American men and women. For women, marital commitment was consistently related to social-capital-network characteristics whereas acculturation factors seemed to be more salient among men. Overall, study variables accounted for a larger portion of the variance for social-capital-network characteristics across analyses for men than women indicating that other factors may be at play in generating social capital for women.     

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.     

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.     

A pole new world: Maneuvering masculinity and sexuality among men who pole dance

Research on cisgender men's experiences in feminized or women-dominated sports, physical activities, and leisure time has revealed strategies men use to circumvent or maneuver stigmas to minimize negative perceptions. Pole dancing is an under-researched activity uniquely positioned to understand dynamics of gender and sexuality. In this research dialogue, we present preliminary results from 13 semi-structured interviews with U.S. men who pole dance to understand how they navigate masculinity and sexuality in pole dancing. First, we find men very strategically disclose their pole dancing to others in the context of the activity's connections to women, gay men, and sex work. Second, we note how men who “pole” often rely on gender essentialist tropes that reinforce the assumption of natural, biological differences between men and women in attempt to legitimize their participation. Third, men who pole are aware of the potential “creepiness” of their presence in pole dance spaces and use this as an opportunity for reflection. Exploring how men rationalize their participation in pole dance is useful to understand the gender and sexual dynamics of men's presence in women-dominated spaces and broader contemporary masculinities.     

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.     

At the intersection of criminal justice involvement and sexual orientation: Dynamic networks and health among a population-based sample of young Black men who have sex with men

Mass incarceration of young Black men has a significant impact on their network composition and stability that, in turn, may have major implications for health and well-being. A sub-group of young Black men with criminal justice involvement (CJI) identify as gay, bisexual or are non-identified men who have sex with men (hereafter MSM). This paper focuses on the potential effects of CJI on the composition of Black MSM social and sexual networks, their stability over time, and concomitant health and social outcomes. We use data from the UConnect study, a population-based cohort of young Black MSM 16–29 years of age (n = 618) selected using respondent-driven sampling in Chicago from 2013 to 2016. Both confidant and sexual network name generators and interpreters were administered at 9-month intervals over three waves of data collection. Ego and dyadic-level data were collected on behaviors prevalent among MSM and including factors associated with network CJI, network stability, and health outcomes. Generalized Structural Equation Models (GSEM) were utilized to determine the relationship between CJI network composition, network stability and behaviors prevalent among young Black MSM and their networks. In the UConnect cohort, 46% had at least once been detained, arrested or spent time in jail or prison. In addition, 20% of participants reported incident CJI over the study period. Respondents with a history of CJI were significantly more likely to have CJI homophily in their confidant and sexual networks. Multivariate analyses demonstrate that the association between one’s history of CJI, housing instability and drug use is partially explained by one’s network CJI. In addition, a higher prevalence of network CJI is associated with increased turnover in the confidant network, and this network instability is also related to important health and social outcomes. This analysis describes the networks of criminal justice involved men among a representative sample of young Black MSM and demonstrates the relationship between CJI network homophily, network stability and their impact on several key health and social outcomes relevant to this population.     

Validation of tie corroboration and reported alter characteristics among a sample of young men who have sex with men

The differences between direct ties (i.e., ties between a respondent and their nominees) and ties between nominees (indirect) are key to understanding network structure, yet remain understudied. Within a sample of 175 young men who have sex with men, we explored the corroboration of sex and drug ties, and factors associated with corroboration. The majority of instances in which there was no corroboration for either sex or drug ties was due to one individual not appearing in another respondent’s network. When an individual did appear in another respondent’s network, direct sex and drug ties were corroborated in most cases. We also found that more indirect sex ties were corroborated than direct sex ties (95.7% vs. 88.9%), but the reverse was true for indirect versus direct drug ties (73.1% vs. 84.1%). Strength of relationship and frequency of communication were both associated with confirmed direct ties, but not with indirect ties. Based on these findings, we recommend that direct and indirect ties be treated differently in network analyses.     

Role versatility among men who have sex with men in urban Peru

Role versatility refers to the practice in which individual men who have sex with men (MSM) play both insertive and receptive sexual roles over time. Versatility has been thought to be relatively uncommon among Latin American MSM but possibly rising. Versatility has also been shown to be a potentially large population-level risk factor for HIV infection. In this study we examine the correlates of versatile behavior and identity among 2,655 MSM in six Peruvian cities. Versatile behavior with recent male partners was found in 9% of men and versatile ("moderno") identity was reported by 16%. Significant predictors included high education, white-collar occupation, sex work, and residence in Lima. Age was not significant in any analysis. Since sex work is negatively correlated with other predictors, versatile men appear to comprise two distinct sub-populations. Insertive-only men appear to play a strong role in bridging the HIV epidemic between MSM and women.     

A comparison of HIV risk practices among unprotected sex-seeking older and younger men who have sex with other men

Purpose: In recent years, much attention has been devoted to understanding the HIV risk behaviors of younger men who have sex with men (MSM). Recent data suggest that HIV is becoming an increasing problem for older adults, but little attention has been devoted to understanding their HIV risk behaviors or the factors that underlie their risk taking. This study provides a comparison of these issues among younger and older MSM. Methods: The data come from a subset of younger (ages 18–39, n?=?113) and older (ages 50+, n?=?109) men participating in a national study of 332 men who use the Internet to find other men for unprotected sex. Men were sampled randomly from 16 websites. Data were collected via telephone interviews conducted in 2008 and 2009. Results: Younger and older men reported comparable involvement in HIV risk, including involvement in unprotected sex, proportion of sex acts involving internal ejaculation, number of times having anonymous sex, and number of times having multiple-partner sex. Generally speaking, the factors underlying the risk practices of younger and older men were quite different (e.g. self-esteem and condom use self-efficacy for younger men, versus HIV serostatus and depression for older men). Conclusions: Older MSM using the Internet to find partners for unprotected sex engage in high rates of behaviors that place them at risk for contracting or transmitting HIV. They were just as likely as their younger counterparts to practice these behaviors. The factors “fueling” involvement in risk generally differ for older and younger men, thereby warranting the development of age-specific HIV interventions that can take into account the unique life circumstances and needs of older MSM.     

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.     

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.     

The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic

Sexual compulsivity, defined by sexual preoccupation and lack of sexual impulse control, is related to high-risk sexual behaviors. However, little is known about the prevalence and predictors of sexual compulsivity in people at high risk for contracting sexually transmitted infections (STIs). In the current study, patients receiving diagnostic and treatment services (85% African American) at an urban STI clinic completed measures of demographic characteristics, sexual compulsivity, substance use, and sexual behaviors. Measures were administered to 492 men and 193 women using confidential procedures and audio computer-assisted interviewing technology. Results showed that men and women receiving STI clinic services frequently endorsed multiple indicators of sexual compulsivity. In this mostly African American sample, individuals with scores above the 80th percentile on the sexual compulsivity scale (translating to over one standard deviation above the mean) had more sex partners, engaged in higher rates of sexual risk behaviors with casual or one-time sex partners, and were nearly four times as likely to have been recently diagnosed with multiple STIs than were individuals who scored below the 80th percentile. Although sexual compulsivity scores were associated with alcohol and other drug use, associations between sexual compulsivity and sexual risks were not accounted for by substance abuse. Findings suggest an urgent need for interventions to help men and women with sexual preoccupations and poor sexual impulse control to reduce their risks for sexually transmitted infections.     

Heterosexual Anal Intercourse among Men in Long Beach,California

Anal intercourse poses a greater risk for human immunodeficiency virus (HIV) transmission than vaginal intercourse, and in recent years there has been a growing understanding that heterosexual anal intercourse (HAI) is not uncommon. However, the majority of the anal intercourse literature has focused on men who have sex with men. The little research on HAI has mostly looked at women, with limited work among men. This analysis examined the association between HAI and high-risk behaviors (N = 1,622) and sexual sensation seeking (N = 239) in a sample of men recruited from 2001 to 2012 in Long Beach, California. Almost half of the sample was non-Hispanic Black. The median age was 42 years, 42% were homeless, and 20% reported recent HAI. Men who reported HAI were likely to be Hispanic, were likely to be homeless, had a male partner, engaged in sex exchange, and used cocaine or amphetamines during sex. Men who reported HAI scored higher on the Sexual Sensation Seeking scale. This research supports other work showing the relationship between HAI and high-risk behaviors. More important, it contributes new knowledge by demonstrating the association between HAI and sexual sensation seeking. This research highlights the importance of personality traits when trying to understand sexual behavior and when developing HIV prevention interventions.