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  1. Impact of perceived HIV stigma within men who have sex with men community on mental health of seropositive MSM.

    PubMed

    Chong, Eddie S K; Mak, Winnie W S; Tam, Terence C Y; Zhu, Chen; Chung, Rita W Y

    2017-01-01

    Emerging evidence has suggested that seropositive men who have sex with men (MSM) do not only face biased treatment from the general public but also from members of the MSM community. We conceptualized such biases perpetuated within the MSM community as human immunodeficiency virus (HIV) in-group stigma. This study examined the pathways by which perceived HIV in-group stigma impacted the mental health of seropositive MSM in Hong Kong. Internalized HIV stigma, serostatus disclosure concerns, and negative reactions towards HIV stigma were hypothesized as intermediate factors. Based on 100 Chinese seropositive MSM who were on antiretroviral therapy, results of a path analysis partially supported our hypotheses. Only negative reactions towards HIV stigma within the MSM community was a significant intermediate factor. The findings highlight the importance of understanding seropositive MSM's different reactions to HIV stigma perpetuated within the MSM community. On top of stigma reduction research, further research may explore ways that help seropositive MSM cope with HIV in-group stigma and foster resilience.

  2. Syphilis and MSM (Men Who Have Sex with Men)

    MedlinePlus

    ... Transmitted Diseases (STDs) Syphilis & MSM (Men Who Have Sex With Men) - CDC Fact Sheet Language: English (US) ... among gay, bisexual, and other men who have sex with men (MSM). MSM Fact Sheet | View Images ...

  3. Preferences for HIV pre-exposure prophylaxis (PrEP) information among men-who-have-sex-with-men (MSM) at community outreach settings

    PubMed Central

    Merchant, Roland C.; Corner, David; Garza, Eduardo; Guan, Wentao; Mayer, Kenneth H.; Brown, Larry; Chan, Philip A

    2016-01-01

    Community outreach efforts to increase HIV pre-exposure prophylaxis (PrEP) utilization by at risk men-who-have-sex-with-men (MSM) first need to elucidate preferences for learning about PrEP and linking to PrEP resources. In this pilot study, we observed that among MSM recruited through community outreach, HIV sexual risk-taking was significant, yet self-perceived PrEP knowledge was low and interest in learning more about PrEP was moderate. Most preferred learning about PrEP and being provided local PrEP clinic information through electronic media. However, receipt of PrEP information alone did not appear to motivate these men into presenting to a local clinic for PrEP evaluation. PMID:27076865

  4. HIV community viral load and factors associated with elevated viremia among a community-based sample of men who have sex with men (MSM) in Vancouver, Canada

    PubMed Central

    Moore, David M.; Cui, Zishan; Lachowsky, Nathan; Raymond, Henry F.; Roth, Eric; Rich, Ashleigh; Sereda, Paul; Howard, Terry; McFarland, Willi; Lal, Allan; Montaner, Julio; Corneil, Trevor; Hogg, Robert S.

    2016-01-01

    Background We developed estimates of community viral load (VL) and risk factors for unsuppressed VL from a cross-sectional study of men who have sex with men (MSM) in Vancouver, Canada. Methods MSM were recruited from February 25, 2012 – February 28, 2014 using Respondent-Driven Sampling (RDS). Participants completed a computer assisted self-interview questionnaire and a nurse-administered point-of-care HIV test. For HIV positive participants, we conducted VL and CD4 cell counts. We used RDS-weighted analysis to obtain population estimates of key variables and multivariable logistic regression to examine factors associated with having a VL ≥200 copies/mL among HIV-positive participants. Results We recruited 719 participants, of whom 119 (16.6%) were seeds. Our estimate of the population HIV prevalence was 23.4% (95% CI 15.8 – 31.0%) after RDS-adjustments. We estimated that 18.6% (95% confidence interval [CI] 8.8 – 30.4%) of HIV-positive MSM in Vancouver had a VL ≥200 copies/mL. Having an unsuppressed VL was associated with non-Caucasian ethnicity (adjusted odds ratio [AOR]= 4.34; 95% CI 1.67 – 11.1); an annual income of <$15,000 CAD (AOR=6.43; 95%CI 2.08–19.9); using GHB in the previous six months (AOR=4.85; 95%CI 1.79–13.2); unprotected anal intercourse with a known HIV negative or unknown serostatus partner (AOR=3.13; 95%CI 1.10–8.90); and disclosing one’s HIV serostatus ≥50% of the time (AOR=7.04; 95%CI 1.01–49.1). Conclusion Despite a high prevalence of HIV, we estimated that a small proportion of HIV positive MSM have undiagnosed HIV and unsuppressed VL. Our results highlight the importance of continued work to address health inequities using a social determinants of health framework. PMID:26825177

  5. Correlates of group sex among a community-based sample of men who have sex with men (MSM) in Washington, DC.

    PubMed

    Phillips, Gregory; Magnus, Manya; Kuo, Irene; Rawls, Anthony; Peterson, James; West-Ojo, Tiffany; Jia, Yujiang; Opoku, Jenevieve; Greenberg, Alan E

    2014-08-01

    Participation of MSM in group sex events (GSEs) is an understudied phenomenon. Studies on GSEs identified significant proportions of MSM engaging in unprotected anal intercourse (UAI). We sought to identify the prevalence of group sex participation among MSM in Washington, DC and to characterize these experiences. Data were collected for NHBS-MSM-3 in 2011. More than one-quarter of MSM (27.2 %) reported engaging in group sex in the prior year, with one-third reporting no condom use with their sex partners (33.0 %). In multivariable logistic regression, men who participated in a GSE in the prior year were significantly younger, more likely to be white, and to have used crystal meth, poppers, and downers in the past year. The high prevalence of UAI during GSEs, especially in view of the fact that HIV-positive MSM were significantly less likely to report condom use, offers an opportunity to develop risk reduction interventions specific to GSE attendees.

  6. Prevalence of HIV, STIs, and Risk Behaviors in a Cross-Sectional Community- and Clinic-Based Sample of Men Who Have Sex with Men (MSM) in Lima, Peru

    PubMed Central

    Perez-Brumer, Amaya G.; Konda, Kelika A.; Salvatierra, H. Javier; Segura, Eddy R.; Hall, Eric R.; Montano, Silvia M.; Coates, Thomas J.; Klausner, Jeff D.; Caceres, Carlos F.; Clark, Jesse L.

    2013-01-01

    Background Further research is necessary to understand the factors contributing to the high prevalence of HIV/STIs among men who have sex with men (MSM) in Peru. We compared HIV/STI prevalence and risk factors between two non-probability samples of MSM, one passively enrolled from an STI clinic and the other actively enrolled from community venues surrounding the clinic in Lima, Peru. Methods A total of 560 self-identified MSM were enrolled between May-December, 2007. 438 subjects enrolled from a municipal STI clinic and 122 subjects enrolled during community outreach visits. All participants underwent screening for HIV, syphilis, HSV-2, gonorrhoea, and chlamydia and completed a survey assessing their history of HIV/STIs, prior HIV testing, and sexual behavior. Results HIV prevalence was significantly higher among MSM enrolled from the clinic, with previously undiagnosed HIV identified in 9.1% compared with 2.6% of community participants. 15.4 % of all MSM screened were infected with ≥1 curable STI, 7.4% with early syphilis (RPR≥1∶16) and 5.5% with urethral gonorrhoea and/or chlamydia. No significant differences between populations were reported in prevalence of STIs, number of male sex partners, history of unprotected anal intercourse, or alcohol and/or drug use prior to sex. Exchange of sex for money or goods was reported by 33.5% of MSM enrolled from the clinic and 21.2% of MSM from the community (p = 0.01). Conclusions Our data demonstrate that the prevalence of HIV and STIs, including syphilis, gonorrhoea, and chlamydia are extremely high among MSM enrolled from both clinic and community venues in urban Peru. New strategies are needed to address differences in HIV/STI epidemiology between clinic- and community-enrolled samples of MSM. PMID:23634201

  7. Access to HIV Services at Non-Governmental and Community-Based Organizations among Men Who Have Sex with Men (MSM) in Cameroon: An Integrated Biological and Behavioral Surveillance Analysis

    PubMed Central

    Holland, Claire E.; Papworth, Erin; Billong, Serge C.; Kassegne, Sethson; Petitbon, Fanny; Mondoleba, Valentin; Moukam, Laure Vartan; Macauley, Isaac; Eyene Ntsama, Simon Pierre; Yomb, Yves Roger; Eloundou, Jules; Mananga, Franz; Tamoufe, Ubald; Baral, Stefan D.

    2015-01-01

    Background Men who have sex with men (MSM) are more likely to be living with HIV than other adult men in low- and middle-income countries. MSM experience barriers to accessing HIV services including a lack of available specialized care, and community-level stigma and discrimination. This study aims to examine the uptake of HIV services at non-governmental and community-based organizations (NGOs/CBOs) to identify ways to improve coverage of HIV prevention and treatment among MSM. Methods An Integrated Biological and Behavioral Surveillance (IBBS) survey was conducted in Yaoundé and Douala, Cameroon in 2011 using the respondent driven sampling (RDS) method to recruit and interview 239 MSM in Yaoundé and 272 MSM in Douala. Results MSM in Yaoundé were statistically significantly more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they had any STI symptoms (aOR 2.17 CI 1.02-4.59. p=0.04), or if they had a larger MSM social network (aOR 1.02 CI 1.01-1.04. p<0.01). MSM in Douala were more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they were living with HIV (aOR 3.60 CI 1.35-9.60. p=0.01), or if they reported higher numbers of male sexual partners (aOR 1.17 CI 1.00-1.36. p=0.046). Compared to men in Douala, MSM in Yaoundé were significantly less likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months (aOR 0.22 CI 0 .14-0.34. p=<0.01). Conclusions With appropriate funding and resources, community-based organizations that provide care specifically for MSM can improve access to HIV prevention, treatment, and care services. Additionally, using social networks to reach MSM can connect greater numbers of the population to effective HIV interventions, which will improve health outcomes and decrease onward transmission of HIV. PMID:25906046

  8. Amphetamine-type stimulant use among men who have sex with men (MSM) in Vietnam: Results from a socio-ecological, community-based study.

    PubMed

    Vu, Nga Thi Thu; Holt, Martin; Phan, Huong Thi Thu; Le, Huong Thi; La, Lan Thi; Tran, Gioi Minh; Doan, Tung Thanh; Nguyen, Trang Nhu Nguyen; de Wit, John

    2016-01-01

    Amphetamine-type-stimulants (ATS) use is associated with HIV-related sexual risk behaviours and is an emergent problem among men who have sex with men (MSM) in Vietnam. The purpose of this study is to describe ATS use patterns and understand the correlates of recent methamphetamine use from a socio-ecological perspective. From September through December, 2014, 622 MSM were recruited in Hanoi and Ho Chi Minh City, Vietnam. We collected information on demographic characteristics, HIV testing behaviours, use of ATS and other recreational drugs (ever and recently), sexual sensation seeking, depressive mood, experienced and internalized stigma related to homosexuality, social involvement with other MSM, and perceptions of ATS use in MSM networks. We performed descriptive statistics to describe ATS use patterns and multivariate logistic regression to establish independent correlates of recent methamphetamine use. Nearly one-third (30.4%) had ever used ATS, including 23.6% who had used methamphetamine, 4.3% who had used amphetamine ('speed') and 20.9% who had used ecstasy. 20.1% and 11.9% had ever used methamphetamine and ecstasy, respectively, during sex. Eighteen percent of methamphetamine users were classified as engaged in high-risk use. Recent methamphetamine use (in the last 3 months) was associated with participants perceiving more methamphetamine use in their MSM network, recent sex work, and higher sexual sensation seeking scores. ATS use is relatively prevalent among MSM sampled in Vietnam's main cities. Interventions to address methamphetamine are warranted for MSM in Vietnam. Methamphetamine treatments are needed for high-risk users. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. ‘The Devil has entered you’: A qualitative study of Men Who Have Sex With Men (MSM) and the stigma and discrimination they experience from healthcare professionals and the general community in Bosnia and Herzegovina

    PubMed Central

    Stojisavljevic, Stela; Djikanovic, Bosiljka; Matejic, Bojana

    2017-01-01

    Men who have sex with men (MSM) are often exposed to unequal treatment in societies worldwide as well as to various forms of stigma and discrimination in healthcare services. Bosnia and Herzegovina (B&H) is a postconflict developing country located in Southeast Europe and the Western Balkans, where little is known about the experiences of MSM regarding their communities and interactions with healthcare services. The aim of this study was to explore the types of experiences MSM face and to assess the level of stigma and discrimination they are exposed to in this setting. We conducted twelve in-depth face-to-face interviews with MSM who were 16 to 45 years old and residing in B&H. The main findings indicated that they all experienced various levels of stigma, discrimination, prejudice and inequities in treatment and attitudes from different segments of society, including the health care sector, that prevented them from fully developing their human and health potential. Additionally, these experiences were adversely related to opportunities to receive good quality health care services due to the insufficiently educated and old-fashioned health professionals who sometimes believed in black magic practices. The findings present numerous opportunities for educational trainings and structural reform to create a society that provides and guarantees equal opportunities for all. PMID:28591214

  10. Toward a Better Understanding of Non-Addicted, Methamphetamine-Using, Men who Have Sex with Men (MSM) in Atlanta.

    PubMed

    Dew, Brian J

    2010-05-14

    Methamphetamine use has increasingly become linked with sexual risk behaviors among men have sex with men (MSM). Yet, the majority of research has been done with methamphetamine dependent MSM or with samples in which addiction to the substance was not evaluated. Furthermore, research with methamphetamine-using MSM in the Southern U.S. is lacking. In this study, focus groups and in-depth interviews were conducted in order to understand the motives, context, and other facilitators and barriers of methamphetamine use among non-addicted MSM residing in Atlanta. Participants included 30 non-addicted, methamphetamine-using MSM and 16 local mental and public health officials. Findings from the first of this two-phase formative research project will result in the initial development of a community-tested, culturally-specific social marketing campaign and an individual-based intervention based in HIV-testing facilities.

  11. Community-based prevention leads to an increase in condom use and a reduction in sexually transmitted infections (STIs) among men who have sex with men (MSM) and female sex workers (FSW): the Frontiers Prevention Project (FPP) evaluation results.

    PubMed

    Gutierrez, Juan-Pablo; McPherson, Sam; Fakoya, Ade; Matheou, Alexander; Bertozzi, Stefano M

    2010-08-18

    India has an estimated 2.0 million to 3.1 million people living with HIV; it has the highest number of HIV-positive people in Asia and ranks third in the world. The Frontiers Prevention Project (FPP) was implemented in 2002 to conduct targeted prevention intervention geared towards female sex workers (FSW) and men who have sex with men (MSM) in the state of Andhra Pradesh (AP). This paper reports the overall changes in behaviour and STI outcomes between 2003/4 and 2007 and also describes the changes attributed to the FPP. The evaluation used two cross-sectional surveys among MSM and FSW at 24 sites in AP. Surveys were implemented using a similar methodology. Univariate analyses were conducted by comparing means: baseline vs. four-year follow-up and FPP vs. non-FPP. For both MSM and FSW, random and fixed-effects logit regression models at the site level were estimated for condom use with last partner, syphilis sero-positivity and HSV 2 sero-positivity. In addition, for FSW we estimated models for condom use with regular partner, and for MSM we estimated models for condom use with last female partner. Among MSM, fixed-effects analysis revealed that FPP was positively correlated with the probability of condom use with last female sexual partner and negatively correlated with the individual probability of sero-positivity to syphilis and HSV 2. Among FSW, the FPP intervention was significantly correlated with increased condom use with regular partners and with lower probability of STI sero-positivity. Important changes in behaviours related to an increase in prevention activities translated to reductions in STI sero-prevalence in AP, India. In contrast with non-FPP sites, the FPP sites experienced an intense community approach as part of the FPP intervention, and the general increase in condom use and its effect on STI sero-prevalence reflected the efficacy of these intense prevention activities focused on key populations in AP.

  12. Community-based prevention leads to an increase in condom use and a reduction in sexually transmitted infections (STIs) among men who have sex with men (MSM) and female sex workers (FSW): the Frontiers Prevention Project (FPP) evaluation results

    PubMed Central

    2010-01-01

    Background India has an estimated 2.0 million to 3.1 million people living with HIV; it has the highest number of HIV-positive people in Asia and ranks third in the world. The Frontiers Prevention Project (FPP) was implemented in 2002 to conduct targeted prevention intervention geared towards female sex workers (FSW) and men who have sex with men (MSM) in the state of Andhra Pradesh (AP). This paper reports the overall changes in behaviour and STI outcomes between 2003/4 and 2007 and also describes the changes attributed to the FPP. Methods The evaluation used two cross-sectional surveys among MSM and FSW at 24 sites in AP. Surveys were implemented using a similar methodology. Univariate analyses were conducted by comparing means: baseline vs. four-year follow-up and FPP vs. non-FPP. For both MSM and FSW, random and fixed-effects logit regression models at the site level were estimated for condom use with last partner, syphilis sero-positivity and HSV 2 sero-positivity. In addition, for FSW we estimated models for condom use with regular partner, and for MSM we estimated models for condom use with last female partner. Results Among MSM, fixed-effects analysis revealed that FPP was positively correlated with the probability of condom use with last female sexual partner and negatively correlated with the individual probability of sero-positivity to syphilis and HSV 2. Among FSW, the FPP intervention was significantly correlated with increased condom use with regular partners and with lower probability of STI sero-positivity. Discussion Important changes in behaviours related to an increase in prevention activities translated to reductions in STI sero-prevalence in AP, India. In contrast with non-FPP sites, the FPP sites experienced an intense community approach as part of the FPP intervention, and the general increase in condom use and its effect on STI sero-prevalence reflected the efficacy of these intense prevention activities focused on key populations in AP

  13. A description of common mental disorders in men who have sex with men (MSM) referred for assessment and intervention at an MSM clinic in Cape Town, South Africa.

    PubMed

    Stoloff, Kevin; Joska, John A; Feast, Dorothy; De Swardt, Glenn; Hugo, Johan; Struthers, Helen; McIntyre, James; Rebe, Kevin

    2013-05-01

    Men who have sex with men (MSM) have a higher prevalence of common mental disorders (CMD), as compared with heterosexual men. HIV infection is independently associated with higher rates of CMD. Given this context, and the high background community prevalence of HIV in South Africa, MSM are at even greater risk of developing CMD. The aim of this research was to investigate neuropsychiatric symptoms and disorders in MSM who were referred for assessment and management of mental health problems, in an MSM Clinic in urban Cape Town, South Africa. Twenty-five men were screened using the MINI, AUDIT, DUDIT, and IPDE Screener. Depression, suicidality, as well as alcohol and drug use disorders were highly prevalent in this group (44, 56, 48, and 56 % respectively). The personality disorder screening was suggestive of a high prevalence of personality disorders. The high prevalence of neuropsychiatric disorders in this sample supports the idea that integrated mental health services are needed to address the complex needs of this population. Adequate input into the mental health needs of this population could reduce the potential for HIV acquisition and transmission, improve adherence to treatment and care, and ensure the provision a comprehensive health service for MSM.

  14. Validity of the CAGE questionnaire for men who have sex with men (MSM) in China

    PubMed Central

    Chen, Yen-Tyng; Ibragimov, Umedjon; Nehl, Eric J.; Zheng, Tony; He, Na; Wong, Frank Y.

    2016-01-01

    Background Detection of heavy drinking among men who have sex with men (MSM) is crucial for both intervention and treatment. The CAGE questionnaire is a popular screening instrument for alcohol use problems. However, the validity of CAGE for Chinese MSM is unknown. Method Data were from three waves of cross-sectional assessments among general MSM (n=523) and men who sell sex to other men (“money boys” or MBs, n=486) in Shanghai, China. Specifically, participants were recruited using respondent-driven, community popular opinion leader, and venue-based sampling methods. The validity of the CAGE was examined for different cutoff scores and individual CAGE items using self-reported heavy drinking (≥14 drinks in the past week) as a criterion. Results In the full sample, 75 (7.4%) of participants were classified as heavy drinkers. 32 (6.1%) of general MSM and 43 (8.9%) of MBs were heavy drinkers. The area under curve statistics for overall sample was 0.7 (95% CI: 0.36–0.77). Overall, the sensitivities (ranging from 18.7 to 66.7%), specificities (ranging from 67.5 to 95.8%), and positive predictive values (ranging from 14.1 to 26.4%) for different cutoff scores were inadequate using past week heavy drinking as the criterion. The ability of CAGE to discriminate heavy drinkers from non-heavy drinkers was limited. Conclusions Our findings showed the inadequate validity of CAGE as a screening instrument for current heavy drinking in Chinese MSM. Further research using a combination of validity criteria is needed to determine the applicability of CAGE for this population. PMID:26850511

  15. HIV Knowledge and Beliefs among men who have sex with men (MSM) in Buenos Aires, Argentina

    PubMed Central

    Pando, MA; Balan, I; Marone, R; Dolezal, C; Barreda, V; Carballo Dieguez, A; Avila, MM

    2013-01-01

    Five hundred men who have sex with men (MSM), recruited through Respondent Driven Sampling in Buenos Aires, Argentina, were interviewed in order to assess knowledge and beliefs about HIV infection. The mean proportion of HIV correct knowledge answers was 62%; however participants whose sexual partners in the prior year included women (MSM&W) had lower frequencies of correct answers than participants with no women partners. Men with previous HIV testing experience and those who were HIV positive had higher HIV knowledge. In relation to HIV beliefs, less than half of participants responded correctly to each of the scenarios presented. Accurate answers for all items were more likely among those who only have sex with men. Men have basic HIV knowledge but also many misconceptions about transmission and prevention. Furthermore, MSM&W have less information than those who are exclusively MSM, probably related to the fact that information campaigns specifically targeted gay identified men. PMID:23297085

  16. HIV Testing among Men Who Have Sex with Men (MSM): Systematic Review of Qualitative Evidence

    ERIC Educational Resources Information Center

    Lorenc, Theo; Marrero-Guillamon, Isaac; Llewellyn, Alexis; Aggleton, Peter; Cooper, Chris; Lehmann, Angela; Lindsay, Catriona

    2011-01-01

    We conducted a systematic review of qualitative evidence relating to the views and attitudes of men who have sex with men (MSM) concerning testing for HIV. Studies conducted in high-income countries (Organisation for Economic Co-operation and Development members) since 1996 were included. Seventeen studies were identified, most of gay or bisexual…

  17. Reevaluating Canada's policy for blood donations from men who have sex with men (MSM).

    PubMed

    Jubran, Bellal; Billick, Maxime; Devlin, Gabriel; Cygler, Jeremy; Lebouché, Bertrand

    2016-12-01

    During the HIV/AIDS epidemic of the 1980s, most of the developed world instituted a permanent ban on blood donations from men who have sex with men (MSM). In recent years, public health agencies across Europe and North America are reconsidering and rescinding these restrictions. We examine the Canadian climate, where MSM may donate blood only after a 5-year deferral period. We review circumstances of the initial ban on MSM blood donations and recent social, legal, and economic changes that have encouraged Canadian public health officials to consider policy reform. We also review international evidence about the impact of reforming MSM blood donations. Given improvements in HIV screening technology, results from mathematical modeling studies, and empirical data from Italy, the UK, and Australia, we conclude that changing Canada's MSM blood donation policy from a 5- to a 1-year deferral would not increase the number of transfusion-transmitted HIV infections. We provide empirical support to the recently elected Liberal Canadian government's political promise to decrease restrictions on MSM blood donations.

  18. Reevaluating Canada's policy for blood donations from men who have sex with men (MSM).

    PubMed

    Jubran, Bellal; Billick, Maxime; Devlin, Gabriel; Cygler, Jeremy; Lebouché, Bertrand

    2016-08-17

    During the HIV/AIDS epidemic of the 1980s, most of the developed world instituted a permanent ban on blood donations from men who have sex with men (MSM). In recent years, public health agencies across Europe and North America are reconsidering and rescinding these restrictions. We examine the Canadian climate, where MSM may donate blood only after a 5-year deferral period. We review circumstances of the initial ban on MSM blood donations and recent social, legal, and economic changes that have encouraged Canadian public health officials to consider policy reform. We also review international evidence about the impact of reforming MSM blood donations. Given improvements in HIV screening technology, results from mathematical modeling studies, and empirical data from Italy, the UK, and Australia, we conclude that changing Canada's MSM blood donation policy from a 5- to a 1-year deferral would not increase the number of transfusion-transmitted HIV infections. We provide empirical support to the recently elected Liberal Canadian government's political promise to decrease restrictions on MSM blood donations.

  19. A CBPR Partnership Increases HIV Testing among Men Who Have Sex with Men (MSM): Outcome Findings from a Pilot Test of the "CyBER/Testing" Internet Intervention

    ERIC Educational Resources Information Center

    Rhodes, Scott D.; Vissman, Aaron T.; Stowers, Jason; Miller, Cindy; McCoy, Thomas P.; Hergenrather, Kenneth C.; Wilkin, Aimee M.; Reece, Michael; Bachmann, Laura H.; Ore, Addison; Ross, Michael W.; Hendrix, Ellen; Eng, Eugenia

    2011-01-01

    The Internet has emerged as an important tool for the delivery of health promotion and disease prevention interventions. Our community-based participatory research (CBPR) partnership developed and piloted "CyBER/testing", a culturally congruent intervention designed to promote HIV testing among men who have sex with men (MSM) within existing…

  20. Engagement of Gay Men and Other Men Who Have Sex with Men (MSM) in the Response to HIV: A Critical Step in Achieving an AIDS-Free Generation.

    PubMed

    Stahlman, Shauna; Beyrer, Chris; Sullivan, Patrick S; Mayer, Kenneth H; Baral, Stefan D

    2016-12-01

    Men who have sex with men (MSM) continue to be at elevated risk for HIV acquisition and transmission secondary to biological and behavioral characteristics, social and sexual network characteristics, community environmental factors, and structural factors. HIV incidence rates remain high among MSM in both low- and high-income settings, and in both concentrated and more generalized HIV epidemic settings. While data quality tends to be poorer, the best estimates collectively suggest that MSM have up to 20 times the odds of living with HIV as compared to other reproductive aged adults across low- and middle-income countries. Recent prevention strategies to lower biological HIV transmission and acquisition risks, including the early use of antiretrovirals to decrease infectiousness for those living with HIV, and pre-exposure prophylaxis for those at significant risk of HIV acquisition, have demonstrated the potential to change the trajectory of the HIV epidemics among MSM. However, the coverage and effectiveness of these approaches is limited by structural factors including the punitive legal frameworks and institutional discrimination that contribute to limited uptake, challenges to adherence, and suboptimal health-seeking behaviors among MSM. More intensive efforts will be required to reach MSM who do not currently have access to relevant and effective prevention and treatment services or elect not to access these services given enacted and/or perceived stigma. Respect for human rights, including efforts to aggressively confront and combat the forms of stigma that are preventing us from achieving an AIDS-Free generation, are needed for all people including gay men and other MSM.

  1. Friends, sisters, and wives: Social support and social risks in peer relationships among men who have sex with men (MSM) in India

    PubMed Central

    Tomori, Cecilia; Srikrishnan, Aylur K.; Ridgeway, Kathleen; Solomon, Sunil S.; Mehta, Shruti H.; Solomon, Suniti; Celentano, David D.

    2016-01-01

    Globally men who have sex with men (MSM) are at high risk for HIV. Many HIV-prevention efforts rely on community outreach and mobilization to engage MSM. This study examines peer relationships and their potential role in HIV-prevention through 31 focus group discussions (FGDs) and 121 in-depth interviews (IDIs) with 363 MSM across 15 sites in India. Results indicate that MSM receive social support in friendships, sex-worker collaborations, constructed kin relationships, and romantic partnerships. Access to these relationships, however, is uneven across MSM, and can carry risks of disclosure of same-sex behavior and exclusion based on HIV-positive status. Positive peer relationships can serve as the basis of community empowerment, education and couple-based interventions for MSM, and peer counselors can also provide a buffer against the social risks of peer relationships and facilitate linkage to care and continued engagement in treatment. These insights can improve HIV-interventions for MSM in India and elsewhere. PMID:27459166

  2. “Boys Must be Men, and Men Must Have Sex with Women”: A Qualitative CBPR Study to Explore Sexual Risk among African American, Latino, and White Gay Men and MSM

    PubMed Central

    Rhodes, Scott D.; Hergenrather, Kenneth C.; Vissman, Aaron T.; Stowers, Jason; Davis, A. Bernard; Hannah, Anthony; Alonzo, Jorge; Marsiglia, Flavio F.

    2012-01-01

    Men who have sex with men (MSM) continue to be disproportionately impacted by HIV and sexually transmitted diseases (STD). This study was designed to explore sexual risk among MSM using community-based participatory research (CBPR). An academic-community partnership conducted nine focus groups with 88 MSM. Participants self-identified as African American/Black (n=28), Hispanic/Latino (n=33), white (n=21), and bi-racial/ethnic (n=6). Mean age was 27 (range 18–60) years. Grounded theory was used. Twelve themes related to HIV risk emerged, including low HIV and STD knowledge particularly among Latino MSM and MSM who use the Internet for sexual networking; stereotyping of African American MSM as sexually “dominant” and Latino MSM as less likely to be HIV infected; and the eroticization of “barebacking.” Twelve intervention approaches also were identified, including developing culturally congruent programming using community-identified assets; harnessing social media used by informal networks of MSM; and promoting protection within the context of intimate relationships. A community forum was held to develop recommendations and move these themes to action. PMID:20413391

  3. HIV Testing Preferences Among MSM Members of an LGBT Community Organization in Los Angeles.

    PubMed

    Medline, Alexandra; Daniels, Joseph; Marlin, Robert; Young, Sean; Wilson, Greg; Huang, Emily; Klausner, Jeffrey D

    Lack of regular HIV testing puts African American, Asian, and Latino men who have sex with men (MSM) at high risk for HIV infection. Rapid self-testing may be an effective option for these men. We explored acceptability, preferences, and usability of HIV self-test kits with MSM of color using semi-structured focus groups to discuss HIV testing history, reasons for testing, and self-testing preferences. Participants (n = 21) lived in Los Angeles, identified as MSM of color, and were 18-35 years of age. Discussions were audio-recorded, transcribed, and analyzed using grounded theory. Participants expressed needs for (a) accessibility, (b) privacy, (c) local support, and (d) access to testing professionals. Self-testing for HIV infection may be an effective method for high-risk MSM. Effective self-testing programs need to consider accessibility, confidentiality, and support to increase routine testing. Community-based organizations have an opportunity to increase HIV testing for MSM of color. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  4. The cost-effectiveness in the use of HIV counselling and testing-mobile outreaches in reaching men who have sex with men (MSM) in northern Nigeria

    PubMed Central

    Ifekandu, Chiedu; Suleiman, Aliyu; Aniekwe, Ogechukwu

    2014-01-01

    Introduction Men who have sex with men (MSM) are at increased risk of HIV and other STI infections in Nigeria. This is because MSM are afraid to seek medical help because the healthcare workers in various facilities are afraid of the consequences if they provide services for MSM citing the law as a reason not to intervene. MSM in northern states of Nigeria are facing double-jeopardy because the few international partners working in MSM in Nigeria are pulling out of these volatile areas because of the fear of attacks by the Boko Haram and the Nigerian law enforcement agencies. Objectives The intervention was conducted to promote affordable and sustainable HIV care and treatment for MSM in Nigeria. Methods This intervention was conducted in the Boko Haram ravaged cities of Kano and Maiduguri (North-East Nigeria). Twenty MSM-key influencers from the two cities were identified and trained on HIV counselling and testing, caregivers, case managers and on initiation process for ARV treatment for new HIV+MSM as well as ethical considerations. Results The mean age of the key influencers was 24 years +/−SD. Each of the trained 20 key influencers reached 20 MSM-peer with condom promotion, HCT, referral to identified MSM-community health centers and follow-up/caregiving within the space of one month. The project was able to reach 400 MSM in the two cities. 89% of the peers consented to HCT. HIV prevalence among the participants was at 18%. The project recorded ARV-successful referral to healthcare facilities for the respondents that tested positive. The key influencers have been following up for ARV-adherence. Conclusions Use of community members should be promoted for sustainability and ownership. It also helps in eradicating socio-cultural barrier to HIV intervention for MSM. Moreover, this proves to be one of the safest and affordable methods of reaching MSM in Nigeria in this ugly time of legalization of homophobia in the country's constitution. PMID:25394114

  5. HIV-testing behavior among young migrant men who have sex with men (MSM) in Beijing, China.

    PubMed

    Song, Yan; Li, Xiaoming; Zhang, Liying; Fang, Xiaoyi; Lin, Xiuyun; Liu, Yinjie; Stanton, Bonita

    2011-02-01

    Previous studies suggested a rapid increase of HIV prevalence among men who have sex with men (MSM) in China in recent years, from 0.4% in 2004 to 5.8% in 2006. However, some MSM had never been tested for HIV. In order to expand the accessibility to HIV testing, understanding HIV-testing behavior and barriers among MSM is important. Using data collected from 307 young migrant MSM (aged 18-29 years) in 2009 in Beijing, we aimed to identify psychological and structural barriers to HIV testing. MSM were recruited through peer outreach, informal social networks, Internet outreach, and venue-based outreach. Participants completed a confidential self-administered questionnaire. Results show that about 72% of MSM ever had an HIV test. Logistic regression analysis indicated that the HIV-testing behavior was associated with sexual risk behaviors (e.g., multiple sexual partners and inconsistent condom use for anal sex) and history of sexually transmitted diseases. Eighty four MSM (28%) who never had an HIV test reported that the psychological barriers mainly were perceived low risk of HIV infection and fears of being stigmatized. The structural barriers reported inconvenience of doing test and lack of confidentiality. Future HIV prevention programs should be strengthened among MSM to increase their awareness of HIV risk. Efforts are needed to increase access to quality and confidential HIV testing among MSM and reduce stigma against MSM.

  6. "But the moment they find out that you are MSM…": a qualitative investigation of HIV prevention experiences among men who have sex with men (MSM) in Ghana's health care system.

    PubMed

    Kushwaha, Sameer; Lalani, Yasmin; Maina, Geoffrey; Ogunbajo, Adedotun; Wilton, Leo; Agyarko-Poku, Thomas; Adu-Sarkodie, Yaw; Boakye, Francis; Zhang, Nanhua; Nelson, LaRon E

    2017-10-03

    The prevalence of HIV in Ghana is 1.3%, compared to 17% among men who have sex with men (MSM). There is limited empirical data on the current health care climate and its impact on HIV prevention services for Ghanaian MSM. The purposes of this study were to investigate (1) MSM's experiences using HIV prevention resources, (2) what factors, including health care climate factors, influenced MSM's use of prevention resources and (3) MSM self-identified strategies for improving HIV/sexually transmitted infection (STI) prevention among MSM in Ghanaian communities. We conducted 22 focus groups (n = 137) with peer social networks of MSM drawn from three geographic communities in Ghana (Accra, Kumasi, Manya Krobo). The data were examined using qualitative content analysis. Interviews with individual health care providers were also conducted to supplement the analysis of focus group findings to provide more nuanced illuminations of the experiences reported by MSM. There were four major findings related to MSM experiences using HIV prevention resources: (1) condom quality is low, condom access is poor, and condom use is disruptive, (2) inaccurate information undermines HIV testing (3), stigma undermines HIV testing, and (4) positive attitudes towards HIV prevention exist among MSM. The main healthcare climate factors that affected prevention were that MSM were not free to be themselves, MSM were not understood by healthcare providers, and that MSM did not feel that healthcare providers cared about them. To improve HIV prevention MSM suggested increased education tailored to MSM should be provided to enable self-advocacy and that education and awareness are needed to protect human rights of MSM in Ghana. MSM in Ghana are exposed to negative health care climates. Health care spaces that are unsupportive of MSM's autonomy undermine the uptake of prevention measures such as condoms, HIV testing, and accurate sexual health education. These findings contribute to knowledge to

  7. Risk Factors Associated With HIV Among Men Who Have Sex With Men (MSM) in Ecuador.

    PubMed

    Hernandez, Isabel; Reina-Ortiz, Miguel; Johnson, Ayesha; Rosas, Carlos; Sharma, Vinita; Teran, Santiago; Naik, Eknath; Salihu, Hamisu M; Teran, Enrique; Izurieta, Ricardo

    2016-05-08

    The Joint United Nations Program on HIV/AIDS estimates that between 0.3% and 0.7% of adults aged 15 to 49 years were living with HIV in Ecuador in 2013. However, very little is known about the HIV prevalence rate among men who have sex with men (MSM) in that country. A cross-sectional survey was conducted to investigate the knowledge, attitudes, and practices regarding HIV/AIDS as well as to estimate the prevalence of HIV among MSM in one of the cities with high HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 307 adult MSM. An HIV prevalence of 10% was observed. Knowledge about HIV was high; 91% of participants could identify how HIV is transmitted. Although consistent condom use for anal sex was relatively high (89%) among participants who reported having pay-for-service clients, only 64% reported using a condom during oral sex with a client. Participants who had multiple male sexual partners (i.e., their stable male partners plus other partner[s]) had 3.7 times higher odds of testing positive for HIV compared with those who did not. They also had reduced odds of condom use. Participants who were forced to have anal receptive sex had 3 times higher odds of testing positive for HIV. Despite the finding that participants exhibited high knowledge about HIV/AIDS, a high prevalence rate of HIV was observed, which warrants targeted behavioral interventions. These data are consistent with MSM being one of the highest at-risk population groups for HIV in this region of Ecuador.

  8. HIV testing and self-reported HIV status in South African MSM: Results from a community-based survey

    PubMed Central

    Sandfort, Theo G. M.; Nel, Juan; Rich, Eileen; Reddy, Vasu; Yi, Huso

    2009-01-01

    Objective To investigate the characteristics of South African men who have sex with men (MSM) who (1) have been tested for HIV and (2) are HIV-positive. Methods Data were collected among 1045 MSM in community surveys using questionnaires which were administered either face-to-face, mail, or on the internet. The mean age of the men was 29.9 years. The racial distribution was as follows: 35.3% black, 17.0% coloured, 5.3% Indian, and 41.1% white. Results The proportion of MSM that were HIV-tested was 69.7%; having been tested was independently associated with being older, being more open about one's homosexuality, and being homosexually instead of bisexually attracted; black MSM, students, and MSM living in KwaZulu-Natal were less likely to have been tested. Of the 728 MSM who had ever been tested, 14.1% (n=103) reported to be HIV-positive (9.9% of the total sample). Being HIV-positive is independently associated with two factors: men who were positive were more likely to have a lower level of education and to know other persons who were living with HIV/AIDS; race was not independently associated with HIV status among those who had been tested. Conclusions The likelihood of having been tested for HIV seems to decrease with increasing social vulnerability. Racially, the distribution of HIV among MSM seems to differ from that of the general South African population, suggesting that while intertwined with the heterosexual epidemic, there is also an epidemic among South African MSM with specific dynamics. These findings suggest that in-depth research is urgently needed to address the lack of understanding of HIV testing practices and HIV prevalence in South African MSM. PMID:19028940

  9. A shared regulatory perspective on deferral from blood donation of men who have sex with men (MSM).

    PubMed

    Epstein, J; Ganz, P R; Seitz, R; Jutzi, M; Schaerer, C; Michaud, G; Agbanyo, F; Smith, G; Prosser, I; Heiden, M; Saint-Marie, I; Oualikene-Gonin, W; Hamaguchi, I; Yasuda, N

    2014-11-01

    National Regulatory Authorities (NRAs) establish deferral criteria for donors with risk factors for transfusion transmissible infections (TTI). In most jurisdictions, epidemiological data show that men who have sex with men (MSM) have a significantly higher rate of TTI than the general population. Nevertheless, changes from an indefinite donor deferral for MSM have been considered in many countries in response to concerns over a perceived discrimination and questioning of the scientific need. Changes to MSM donor deferral criteria should be based on sound scientific evidence. Safety of transfusion recipients should be the first priority, and stakeholder input should be sought.

  10. The Relationship of Religiosity, Spirituality, Substance Abuse, and Depression Among Black Men Who Have Sex with Men (MSM).

    PubMed

    Watkins, Tommie L; Simpson, Cathy; Cofield, Stacey S; Davies, Susan; Kohler, Connie; Usdan, Stuart

    2016-02-01

    HIV infection rates continue to disproportionately affect Black men who have sex with men (Black MSM) compared to other groups. Research has shown that higher rates of substance use and higher levels of depression are positively correlated with higher sexual risk behavior, and little research has examined relationships between high levels of religiosity and spirituality prevalent in Black culture and issues of substance use and depression among Black MSM. This study did just that and found a relationship between religiosity, spirituality, and risk behavior. These relationships suggest that future HIV prevention models might incorporate religiosity and spirituality to increase the efficacy of risk reduction interventions for Black MSM.

  11. Use of geosocial networking (GSN) mobile phone applications to find men for sex by men who have sex with men (MSM) in Washington, DC.

    PubMed

    Phillips, Gregory; Magnus, Manya; Kuo, Irene; Rawls, Anthony; Peterson, James; Jia, Yujiang; Opoku, Jenevieve; Greenberg, Alan E

    2014-09-01

    Current advances have added geosocial networking (GSN) mobile phone applications as an option for men who have sex with men (MSM) to meet other men. This is the first study to assess GSN application use and sex-seeking behaviors of MSM recruited using venue-based sampling. Among the 379 MSM in this study, 63.6 % reported using GSN applications to find men in the past year. Nearly one-quarter of MSM had sex with a man met using a GSN application in the prior year; these men were more likely to be under 35 years old and have had sex with a man met on the Internet; they were also less likely to be HIV-positive and have <5 male sex partners in the last year. GSN applications are a viable option for use in sampling and delivering interventions to young MSM who are often missed through other methods.

  12. Psychosocial and Behavioral Characteristics of High-Risk Men Who Have Sex with Men (MSM) of Unknown HIV Positive Serostatus in Bangkok, Thailand.

    PubMed

    Sapsirisavat, Vorapot; Phanuphak, Nittaya; Keadpudsa, Siriwan; Egan, James E; Pussadee, Kanitta; Klaytong, Preeyarach; Reuel Friedman, M; van Griensven, Frits; Stall, Ron

    2016-12-01

    HIV prevalence remains high in men who have sex with men (MSM) in Bangkok. Even though resources for HIV testing and treatment are available for all, a large proportion of MSM still do not get HIV tested. We studied high risk MSM who are unaware of their HIV status to help maximize effectiveness of our resources. Convenience sampling was conducted among MSM who came for HIV testing at the Thai Red Cross Anonymous Clinic and two popular drop-in centers in Bangkok. Inclusion criteria were MSM aged >18 years, have not been tested positive for HIV, who reported ≥1 of the following in the previous 6 months: condomless sex with a male, being a sex worker, or having a sexual transmitted infection diagnosis. Audio-Computer-Assisted Self-Interview was used to assess psychosocial profile, sexual risks, and HIV testing patterns prior to being informed of their HIV positive status. Among 499 high-risk MSM enrolled, the median age was 24.8 years and 112 (22 %) tested HIV-positive. Among the HIV-positive participants, 92 % self-identified as gay (versus bisexual), 39 % attained a bachelors degree or higher, 65 % had monthly income 10,000-29,999 baht ($280-830 USD), 10 % had vaginal or anal sex with a woman in the past 12 months, 39 % had condomless receptive sex with men and 21 % went to Lat Phrao to find a sexual partner. Compared to HIV negative MSM, HIV-positive MSM had less HIV testing: 31 % had ever been tested for HIV, 12 % had been tested in the past 6 months; but were more likely to guess correctly their positive status (31 %). Regarding psychosocial variables among HIV-positive MSM, 7 % had regular methamphetamine use in the past 3 months, 10 % had >2 sources of discrimination, and 8 % had >2 sources of discrimination due to being MSM. In multivariable model, age<30 year old, self-identified as gay, had monthly income <50,000 baht ($1400 USD), had anal sex with men in past 12 months, had >2 sources of discrimination because of being MSM, did not

  13. Experiences of HIV postexposure prophylaxis (PEP) among highly exposed men who have sex with men (MSM).

    PubMed

    Palich, Romain; Martin-Blondel, Guillaume; Cuzin, Lise; Le Talec, Jean-Yves; Boyer, Pierre; Massip, Patrice; Delobel, Pierre

    2017-07-24

    HIV postexposure prophylaxis (PEP) is indicated after sexual exposure with high risk of transmission. Men who have sex with men (MSM) are the main target of PEP. The aim of our study was to investigate the experience and shortcomings of PEP among people with a high risk of HIV exposure. Subjects with ongoing follow-up for HIV infection and PEP history were selected for the qualitative study. Semistructured interviews were conducted at the patients' homes. They were audio-recorded, transcribed and deidentified before data analysis, double coding and thematic analysis with an inductive approach. Twenty-three patients were eligible for the qualitative study. Thirteen interviews were carried out. All patients were 20-60-year-old MSM. The median time between PEP and HIV diagnosis was 3.3 years (interquartile range (IQR)25-75=0.9-4.9). Many participants reported negative PEP experiences: awkward access to the PEP clinic, uneasiness and shame in the hospital setting, unpleasant interaction and moral disapprobation from the medical staff, treatment intolerance and prevention messages that were 'inconsistent with real life' CONCLUSION: Our data highlight PEP management failures among its target population that may have compromised any subsequent attempts to seek out PEP. Practitioners should be more aware of MSM sexual contexts and practices. PEP consultations should provide the opportunity to discuss prevention strategies with highly exposed HIV-negative subjects, which may include pre-exposure prophylaxis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. What Drives the US and Peruvian HIV Epidemics in Men Who Have Sex with Men (MSM)?

    PubMed Central

    Goodreau, Steven M.; Carnegie, Nicole B.; Vittinghoff, Eric; Lama, Javier R.; Sanchez, Jorge; Grinsztejn, Beatriz; Koblin, Beryl A.; Mayer, Kenneth H.; Buchbinder, Susan P.

    2012-01-01

    In this work, we estimate the proportions of transmissions occurring in main vs. casual partnerships, and by the sexual role, infection stage, and testing and treatment history of the infected partner, for men who have sex with men (MSM) in the US and Peru. We use dynamic, stochastic models based in exponential random graph models (ERGMs), obtaining inputs from multiple large-scale MSM surveys. Parallel main partnership and casual sexual networks are simulated. Each man is characterized by age, race, circumcision status, sexual role behavior, and propensity for unprotected anal intercourse (UAI); his history is modeled from entry into the adult population, with potential transitions including HIV infection, detection, treatment, AIDS diagnosis, and death. We implemented two model variants differing in assumptions about acute infectiousness, and assessed sensitivity to other key inputs. Our two models suggested that only 4–5% (Model 1) or 22–29% (Model 2) of HIV transmission results from contacts with acute-stage partners; the plurality (80–81% and 49%, respectively) stem from chronic-stage partners and the remainder (14–16% and 27–35%, respectively) from AIDS-stage partners. Similar proportions of infections stem from partners whose infection is undiagnosed (24–31%), diagnosed but untreated (36–46%), and currently being treated (30–36%). Roughly one-third of infections (32–39%) occur within main partnerships. Results by country were qualitatively similar, despite key behavioral differences; one exception was that transmission from the receptive to insertive partner appears more important in Peru (34%) than the US (21%). The broad balance in transmission contexts suggests that education about risk, careful assessment, pre-exposure prophylaxis, more frequent testing, earlier treatment, and risk-reduction, disclosure, and adherence counseling may all contribute substantially to reducing the HIV incidence among MSM in the US and Peru. PMID:23209768

  15. Informal confidential voting interviewing in a sexual risk assessment of men who have sex with men (MSM) and transgenders (hijra) in Bangalore, India.

    PubMed

    Phillips, Anna Elizabeth; Molitor, John; Boily, Marie Claude; Lowndes, Catherine M; Gurav, Kaveri; Blanchard, James; Alary, Michel

    2013-05-01

    The accuracy of self-reporting sensitive sexual risk behaviours is highly susceptible to misreporting. Informal confidential voting interviews (ICVIs) may minimise social desirability bias by increasing the privacy of the interview setting. The objective was to investigate determinants of risky behaviour among men who have sex with men (MSM) and 'hijra' (transgenders) reported through two interviewing tools: ICVIs and face-to-face interviews (FTFIs). Cluster random sampling was used to recruit MSM in 85 cruising sites in Bangalore, including eight hammams (bath houses) and 77 public locations where MSM and hijra cruise for sex. Individuals were randomly allocated to one of the data collection methods(5:2 FTFI : ICVI). Data were analysed using standard regression and a profile regression approach that associates clusters of behaviours with our outcome (FTFI vs ICVI). A total of 372 MSM and hijra were interviewed for the FTFIs and 153 respondents completed ICVIs. Participants were more likely to report injecting drug use (4% vs 1%; p=0.008) and paying to have sex with a female sex worker (FSW) in the last year (28% vs 8%; p=0.001) in the ICVIs. There were no differences to questions on sociodemographics, sexual debut with another male, non-condom use (12% vs 14%), ever selling sex to men (58% vs 56%), current female partner (26% vs 20%) and non-condom use with a main female partner (17% vs 19%). The significant differences between interview modes for certain outcomes, such as intravenous drug use and sex with a FSW, demonstrate how certain behaviour is stigmatised among the MSM community. Nevertheless, the lack of effect of the interviewing tool in other outcomes may indicate either less reporting bias in reporting this behaviour or environmental factors such as the interviewers not adequately screening themselves from the respondent or a potential disadvantage of using other MSM as interviewers.

  16. Risk Factors for Acute and Early HIV Infection Among Men Who Have Sex With Men (MSM) in San Diego, 2008 to 2014: A Cohort Study.

    PubMed

    Hoenigl, Martin; Green, Nella; Mehta, Sanjay R; Little, Susan J

    2015-07-01

    The objectives of this study were to identify risk factors associated with acute and early HIV infection (AEH) among men who have sex with men (MSM) undergoing community HIV testing and to compare demographics in those diagnosed with AEH with those diagnosed at chronic stage of HIV infection.In this retrospective cohort study, we analyzed risk factors associated with AEH among 8925 unique MSM (including 200 with AEH [2.2%] and 219 [2.5%] with newly diagnosed chronic HIV infection) undergoing community-based, confidential AEH screening in San Diego, California.The combination of condomless receptive anal intercourse (CRAI) plus ≥5 male partners, CRAI with an HIV-positive male, CRAI with a person who injects drugs, and prior syphilis diagnosis were significant predictors of AEH in the multivariable Cox regression model. Individuals reporting ≥1 of these 4 risk factors had a hazard ratio of 4.6 for AEH. MSM diagnosed with AEH differed in race (P = 0.005; more reported white race [P = 0.001], less black race [P = 0.030], trend toward less Native American race [P = 0.061]), when compared to those diagnosed with chronic HIV infection, while there was no difference observed regarding age.We established a multivariate model for the predicting risk of AEH infection in a cohort of MSM undergoing community HIV screening, which could be potentially used to discern those in need of further HIV nucleic acid amplification testing for community screening programs that do not test routinely for AEH. In addition, we found that race differed between those diagnosed with AEH and those diagnosed at chronic stage of HIV infection underlining the need for interventions that reduce stigma and promote the uptake of HIV testing for black MSM.

  17. Validation of the ‘Drinking Expectancy Questionnaire for Men Who Have Sex with Men’ (DEQ-MSM) in Peru

    PubMed Central

    Vagenas, Panagiotis; Wickersham, Jeffrey A.; Calabrese, Sarah K.; Lama, Javier R.; Benites, Carlos M.; Pun, Monica; Sanchez, Jorge; Altice, Frederick L.

    2016-01-01

    Introduction and Aims Alcohol use disorders are highly prevalent among men who have sex with men (MSM) in Peru where the HIV epidemic is concentrated 100-fold greater among MSM, than in the general population. Drinking expectancies have been associated with the intent to drink and engage in high-risk behaviors. Assessing them in this population may uncover attractive intervention targets that in turn can be used to reduce problematic drinking and risky sexual behaviors. The drinking expectancy questionnaire for MSM (DEQ-MSM) was developed to accurately measure drinking expectancies, specifically among MSM. This study aimed to validate this instrument for the first time in Spanish, in South America and among MSM in Peru. Design and Methods To validate the DEQ-MSM among Spanish-speaking MSM in Peru, we used exploratory and confirmatory factor analysis in a sample of 5,148 MSM, including 700 transgender women (TGW). Results Exploratory factor analysis showed a 2-factor structure to the Spanish version of the DEQ-MSM (DEQ-MSM-S), which was similar for MSM and TGW. The reliability of the translated DEQ-MSM was excellent (α=0.91). Discussion and Conclusions The DEQ-MSM-S was shown to be highly reliable in a large population of Peruvian MSM and TGW. This short instrument can be effectively integrated into research or clinical practice, in order to identify alcohol-consuming, high-risk MSM, who can then be directed for further screening and/or intervention. Future research should aim to associate the Spanish version of the DEQ-MSM with risky sexual behaviors among this population, in order to identify potential intervention targets. PMID:26120824

  18. Emergence in Japan of an HIV-1 Variant Associated with Transmission among Men Who Have Sex with Men (MSM) in China: First Indication of the International Dissemination of the Chinese MSM Lineage

    PubMed Central

    Kondo, Makiko; Lemey, Philippe; Sano, Takako; Itoda, Ichiro; Yoshimura, Yukihiro; Sagara, Hiroko; Tachikawa, Natsuo; Yamanaka, Ko; Iwamuro, Shinya; Matano, Tetsuro; Imai, Mitsunobu; Kato, Shingo

    2013-01-01

    A survey of HIV-1 strains circulating in the Tokyo-Kanagawa metropolitan area of Japan during 2004 to 2011 (n = 477) identified six Japanese males (patients 1 to 6), who harbored viruses with genome segments derived from a distinct CRF01_AE variant uniquely found among men who have sex with men (MSM) in China (designated CN.MSM.01-1). These six HIV infections were diagnosed in 2010 and 2011 among MSM (3 of 75) and men with unknown risk factors (3 of 63) and differed from the vast majority of HIV infections among MSM in Japan, which are overwhelmingly characterized by subtype B (239 of 246 [97.2%]). Approximately one-third (91 of 239 [38.1%]) of subtype B strains from MSM in Japan belong to a large monophyletic cluster (designated JP.MSM.B-1). In addition, we identified a smaller subtype B cluster (n = 8) (designated JP.MSM.B-2) that also contains strains from two Chinese MSM living in Japan. Interestingly, patients 5 and 6 were found to be coinfected with CRF01_AE (CN.MSM.01-1) and subtype B (JP.MSM.B-2 or JP.MSM.B-1) variants that are unique to the HIV-1 epidemics among MSM in China and Japan, respectively. Our study demonstrates for the first time the effect of the expanding HIV epidemic among MSM in China on transmission in neighboring countries and shows the ongoing mixing of CRF01_AE and subtype B lineages unique to HIV-1 that cocirculate in MSM populations in East Asia. This finding highlights the importance of strengthening epidemiological surveillance in the region and the need for effective measures to limit transmission among MSM in East Asia. PMID:23365432

  19. Increased HIV disclosure three months after an online video intervention for men who have sex with men (MSM).

    PubMed

    Chiasson, Mary Ann; Shaw, Francine Shuchat; Humberstone, Mike; Hirshfield, Sabina; Hartel, Diana

    2009-09-01

    A behavioral intervention for men who have sex with men (MSM) was created for online delivery. The nine-minute video drama "The Morning After" (www.hivbigdeal.org) was designed to promote critical thinking about HIV risk. MSM were recruited for the evaluation through banner ads on a subscription-based gay sexual meeting web site. Participants viewed the intervention online and completed online behavioral questionnaires at enrollment and three month follow-up. Each participant served as his own control. No participant incentives were provided. Follow-up was completed by 522 (54%) of 971 eligible men. Men completing follow-up were similar to those who did not by age and prevalence of unprotected anal intercourse (UAI) but reported more lifetime sex partners. They also differed somewhat by race, education, and HIV testing. In the three months after the intervention, men were significantly more likely to disclose HIV status to partners (odds ratio [OR] = 3.37, p<0.001) and less likely to report a casual partner or UAI in their most recent sexual encounter than at baseline. Of 120 men HIV tested during follow-up, 17 (14%) reported being HIV seropositive. These findings show that MSM at high risk for HIV will participate in a brief online video intervention designed to engage critical thinking and that significant, self-reported increases in HIV disclosure and decreases in risk behavior occurred three months after MSM viewed the video.

  20. HPV vaccine acceptability in HIV-infected and HIV negative men who have sex with men (MSM) in Ireland.

    PubMed

    Sadlier, C; Lynam, A; O'Dea, S; Delamere, S; Quinlan, M; Clarke, S; Sheils, O; Bergin, C

    2016-06-02

    Background Men who have sex with men (MSM), particularly HIV-infected MSM are disproportionately affected by HPV infection and associated disease. The HPV vaccine has potential to greatly reduce the burden of HPV-associated disease including anal cancer in MSM. The efficacy of the HPV vaccine is dependent on high levels of vaccine uptake. The aim of this study was to examine HPV vaccine acceptability and factors influencing vaccine acceptability in MSM in Ireland. Methods A self-administered survey was distributed to HIV-infected and HIV negative MSM examining HPV vaccine acceptability and factors associated with vaccine acceptability. Logistic regression was used to identify key variables and predictors of HPV vaccine acceptability. Results 302 MSM participated in the study. Acceptability of HPV vaccine was 31% (unconditional), 51% (conditional on stated efficacy and a cost of €300), 65% (conditional on stated efficacy and a cost of €100) and 78% (conditional on stated efficacy and no cost). Cost was negatively associated with HPV vaccine acceptability (p<0.01) while knowledge of HPV vaccine efficacy was significantly associated with vaccine acceptability, even in the context of associated cost (p<0.01). Conclusions Acceptability of HPV vaccine in MSM in Ireland is high based on no cost vaccine and on stated vaccine efficacy (78%). Cost is negatively associated with vaccine acceptability. Understanding levels of knowledge of HPV infection, HPV associated disease and attitudes toward HPV vaccination are important as they will contribute to HPV vaccine acceptability among MSM and will help guide effective preventive programs.

  1. Risk Factors for HIV and Unprotected Anal Intercourse among Men Who Have Sex with Men (MSM) in Almaty, Kazakhstan

    PubMed Central

    Berry, Mark; Wirtz, Andrea L.; Janayeva, Assel; Ragoza, Valentina; Terlikbayeva, Assel; Amirov, Bauyrzhan; Baral, Stefan; Beyrer, Chris

    2012-01-01

    Introduction Men who have sex with men (MSM) are at high risk for HIV infection. MSM in Central Asia, however, are not adequately studied to assess their risk of HIV transmission. Methods: This study used respondent driven sampling methods to recruit 400 MSM in Almaty, the largest city in Kazakhstan, into a cross-sectional study. Participation involved a one-time interviewer-administered questionnaire and rapid HIV screening test. Prevalence data were adjusted for respondent network size and recruitment patterns. Multivariate logistic regression was used to investigate the association between HIV and selected risk factors, and unprotected anal intercourse (UAI) and selected risk factors. Results After respondent driven sampling (RDS) weighted analysis, 20.2% of MSM were HIV-positive, and 69.0% had unprotected sex with at least one male partner in the last 12 months. Regression analysis showed that HIV infection was associated with unprotected receptive anal sex (AOR: 2.00; 95% CI: 1.04–3.84). Having unprotected anal intercourse with male partners, a measure of HIV risk behaviors, was associated with being single (AOR: 0.38; 95% CI: 0.23–0.64); very difficult access to lubricants (AOR: 11.08; 95% CI: 4.93–24.91); STI symptoms (AOR: 3.45; 95% CI: 1.42–8.40); transactional sex (AOR: 3.21; 95% CI: 1.66–6.22); and non-injection drug use (AOR: 3.10; 95% CI: 1.51–6.36). Conclusions This study found a high HIV prevalence among MSM in Almaty, and a population of MSM engaging in multiple high-risk behavior in Almaty. Greater access to HIV education and prevention interventions is needed to limit the HIV epidemic among MSM in Almaty. PMID:22937013

  2. "Hard to crack": experiences of community integration among first- and second-generation Asian MSM in Canada.

    PubMed

    Nakamura, Nadine; Chan, Elic; Fischer, Benedikt

    2013-07-01

    Asians are the largest racial minority in Canada making up 11% of the population and represented over 60% of new immigrants between 2001 and 2006. We examined the experiences of community integration for first-generation (n = 27) and second-generation (n = 22) Asian Canadian men who have sex with men (MSM) in their ethnic and gay communities. Through focus group interviews, we explored their level of connectedness and the level of discrimination they experienced in the two communities. Findings indicate that Asian MSM in general perceived their ethnic community as homophobic, stemming from a combination of seeing sex as taboo, stereotypes about being gay, and the affiliation with religion. Although the literature indicates that immigrants rely on the support of their ethnic communities, our finding suggest that this is not the case for Asian immigrant MSM, who in our sample reported feeling less connected compared to their second-generation counterparts. For the gay community, our sample reported mixed experiences as some regarded it as welcoming, whereas others described it as racist. However, these experiences did not differ by generational status. Many were aware of explicit messages stating "No Asians" in dating contexts, while at the same time being aware that some older White men were interested in dating Asians exclusively. Barriers to integration in both communities may contribute to feelings of isolation. Theoretical implications are discussed.

  3. Problem drinking is associated with increased prevalence of sexual risk behaviors among men who have sex with men (MSM) in Lima, Peru

    PubMed Central

    Deiss, Robert G.; Clark, Jesse L.; Konda, Kelika A.; Leon, Segundo R.; Klausner, Jeffrey D.; Caceres, Carlos F.; Coates, Thomas J.

    2014-01-01

    Background Alcohol use is an important but understudied HIV risk factor among men who have sex with men (MSM), particularly in Latin America. We studied the relationship between problem drinking and sexual risk among MSM in Lima, Peru. Methods We recruited 718 participants from 24 neighborhoods for a study on sexually transmitted infections and community-building among MSM. Multivariate analysis was used to identify factors independently associated with problem drinking, which was defined via the CAGE Questionnaire. Results Of 718 participants, 58% met criteria for problem drinking. In univariate analysis, problem drinkers were significantly more likely to report failing to always use condoms, use alcohol or drugs prior to their most recent sexual encounter, report a history of sexual coercion and to engage in transactional sex. Problem drinkers also reported significantly higher numbers of recent and lifetime sexual partners. In multivariate analysis, factors independently associated with problem drinking included a history of sexual coercion [OR 1.8 95%, CI 1.2–2.6], having consumed alcohol prior to the most recent sexual encounter [OR 2.1 95%, CI 1.5–2.9], receiving compensation for sex in the last six months [OR 1.6, 95% CI 1.1–2.2] or having reported a prior HIV+ test [OR 0.5, 95% CI 0.2–0.9]. Discussion We found a high prevalence of problem drinking among MSM in Lima, Peru, which was associated with increased sexual risk in our study. Of note, individuals who were already HIV-infected were less likely to be problem drinkers. Further studies and targeted interventions to reduce problem drinking among MSM are warranted. PMID:23434130

  4. Demographic and Behavioral Determinants of Self-Reported History of Sexually-Transmitted Diseases (STDs) among Young Migrant Men Who Have Sex with Men (MSM) in Beijing, China

    ERIC Educational Resources Information Center

    Song, Yan; Li, Xiaoming; Zhang, Liying; Liu, Yingjie; Jiang, Shulin; Stanton, Bonita

    2012-01-01

    Background: Sexually-transmitted disease (STD) is a facilitating cofactor that contributes to human immunodeficiency virus (HIV) transmission. Previous studies indicated a high prevalence of STDs among men who have sex with men (MSM) in China. To date, limited data are available for correlates of STD infection among young migrant MSM in China. The…

  5. Demographic and Behavioral Determinants of Self-Reported History of Sexually-Transmitted Diseases (STDs) among Young Migrant Men Who Have Sex with Men (MSM) in Beijing, China

    ERIC Educational Resources Information Center

    Song, Yan; Li, Xiaoming; Zhang, Liying; Liu, Yingjie; Jiang, Shulin; Stanton, Bonita

    2012-01-01

    Background: Sexually-transmitted disease (STD) is a facilitating cofactor that contributes to human immunodeficiency virus (HIV) transmission. Previous studies indicated a high prevalence of STDs among men who have sex with men (MSM) in China. To date, limited data are available for correlates of STD infection among young migrant MSM in China. The…

  6. Prevalence of HIV testing and associated factors among young men who have sex with men (MSM) in Bangkok, Thailand.

    PubMed

    Vutthikraivit, Possawat; Lertnimitr, Buncha; Chalardsakul, Piyawat; Imjaijitt, Worarachanee; Piyaraj, Phunlerd

    2014-02-01

    Without the safety and effective vaccine for HIV the HIVvoluntary counseling testing (VCT) has been documented as a central component ofcomprehensive HIV prevention strategies targeting individual risk reduction by modified high risk behaviors. However, the coverage of HIV testing among men who have sex with men (MSM) is suboptimal. Moreove, the information regarding to factors associated with HIV testing among young Thai MSM are limited and not well understood. This study aimed to evaluate the prevalence and factors associated with HIV testing among young MSM in Bangkok, Thailand. A cross-sectional study was conducted in Bangkok. Descriptive statistics were presented with crude- and adjusted-odds ratios with 95% confidence interval and the logistic regression models were used to identify factors associated with prior HIV testing. Fifty-six participants were enrolled into study and 51.8% of men previously had an HIV test. After adjusting for potential confounders, logistic regression revealed that older age was positively associated with HIV testing (AOR = 14.4, 95% CI 1.88-111.22) while perceived at low riskfor HIV infection was inversely association with HIV testing (AOR = 0.1, 95% CI 0.02-0.94). Young MSM in Thailand are at risk for HIV infection and uptake of HIV testing is suboptimal. Understanding the motivators and barriers to HIV testing are essential to planning and improving the effective HIVprevention interventions-relevance to HIV-serostatus.

  7. Barriers to HIV Testing Among Young Men Who Have Sex With Men (MSM): Experiences from Clark County, Nevada.

    PubMed

    Pharr, Jennifer R; Lough, Nancy L; Ezeanolue, Echezona E

    2015-11-03

    Clark County, Nevada had a 52% increase in newly diagnosed HIV infections in young people age 13-24 with 83% of the new diagnoses in this age group being men who have sex with men (MSM). HIV testing and counseling is critical for HIV prevention, care and treatment, yet young people are the least likely to seek HIV testing. The purpose of this study was to identify barriers and facilitators to HIV testing experienced by young MSM in Clark County, Nevada. We conducted a qualitative focus group discussion to identify barriers and facilitators to HIV testing among eleven young MSM in March, 2015. The primary barrier to HIV testing identified by the group was a lack of awareness or knowledge about testing for HIV. Other barriers within the person included: fear of results, fear of rejection, and fear of disclosure. Barriers identified within the environment included: access issues, stigma, and unfriendly test environments for young people. In addition to increasing awareness, intervention to increase HIV testing among MSM young people should incorporate access to testing in environments where the adolescents are comfortable and which reduces stigma. HIV testing sites should be convenient, accessible and young person/gay friendly.

  8. Barriers to HIV Testing Among Young Men Who Have Sex With Men (MSM): Experiences from Clark County, Nevada

    PubMed Central

    Pharr, Jennifer R.; Lough, Nancy L.; Ezeanolue, Echezona E.

    2016-01-01

    Clark County, Nevada had a 52% increase in newly diagnosed HIV infections in young people age 13-24 with 83% of the new diagnoses in this age group being men who have sex with men (MSM). HIV testing and counseling is critical for HIV prevention, care and treatment, yet young people are the least likely to seek HIV testing. The purpose of this study was to identify barriers and facilitators to HIV testing experienced by young MSM in Clark County, Nevada. We conducted a qualitative focus group discussion to identify barriers and facilitators to HIV testing among eleven young MSM in March, 2015. The primary barrier to HIV testing identified by the group was a lack of awareness or knowledge about testing for HIV. Other barriers within the person included: fear of results, fear of rejection, and fear of disclosure. Barriers identified within the environment included: access issues, stigma, and unfriendly test environments for young people. In addition to increasing awareness, intervention to increase HIV testing among MSM young people should incorporate access to testing in environments where the adolescents are comfortable and which reduces stigma. HIV testing sites should be convenient, accessible and young person/gay friendly. PMID:26925893

  9. Engagement in group sex among geosocial networking (GSN) mobile application-using men who have sex with men (MSM)

    PubMed Central

    Phillips, Gregory; Grov, Christian; Mustanski, Brian

    2015-01-01

    Background Men who have sex with men (MSM) remain the group most affected by the HIV epidemic in the United States. At least one-quarter of MSM report engagement in group sex events (GSEs), which can pose a risk for HIV transmission and acquisition. In this study, we sought to identify event-level correlates of sexual and drug use behaviors at GSEs to better inform prevention activities. Methods For this study, we recruited participants via banner and pop-up advertisements placed on a geosocial networking mobile phone application for MSM to meet. Results Of the 1,997 individuals who completed the study screener, 36.0% reported participating in at least one GSE in the prior year. In multivariable logistic regression, attendance at a GSE in the past year was significantly associated with older age, full/part time employment, and being HIV-positive. Of the men who attended a GSE, more than half reported condomless anal sex (CAS) with at least one of their partners (insertive: 57.7%; receptive: 56.3%). MSM who indicated drug use had significantly higher odds of having insertive CAS (odds ratio (OR) = 2.45; 95% confidence interval (CI): 1.37, 4.39) and receptive CAS (OR = 3.60; 95% CI: 1.96, 6.63) at their last GSE. Conclusions The high prevalence of HIV-positive MSM engaging in group sex, coupled with their greater odds of CAS, poses a significant risk for HIV/STI transmission within the group sex setting. More research is needed to determine patterns of condom use at these events, and whether seroadaptive behaviors are driving CAS. PMID:26255156

  10. The relationship between online social networking and sexual risk behaviors among men who have sex with men (MSM).

    PubMed

    Young, Sean D; Szekeres, Greg; Coates, Thomas

    2013-01-01

    Online social networking usage is growing rapidly, especially among at-risk populations, such as men who have sex with men (MSM). However, little research has studied the relationship between online social networking usage and sexual risk behaviors among at-risk populations. One hundred and eighteen Facebook-registered MSM (60.1% Latino, 28% African American; 11.9% other) were recruited from online (social networking websites and banner advertisements) and offline (local clinics, restaurants and organizations) venues frequented by minority MSM. Inclusion criteria required participants to be men who were 18 years of age or older, had had sex with a man in the past 12 months, were living in Los Angeles, and had a Facebook account. Participants completed an online survey on their social media usage and sexual risk behaviors. Results from a multivariable regression suggest that number of sexual partners met from online social networking technologies is associated with increased: 1) likelihood of having exchanged sex for food, drugs, or a place to stay within the past 3 months; 2) number of new partners within the past 3 months; 3) number of male sex partners within the past 3 months; and 4) frequency of engaging in oral sex within the past 3 months, controlling for age, race, education, and total number of sexual partners. Understanding the relationship between social media sex-seeking and sexual risk behaviors among at-risk populations will help inform population-focused HIV prevention and treatment interventions.

  11. Antiretroviral Therapy and Reasons for Not Taking It among Men Having Sex with Men (MSM)—Results from the European MSM Internet Survey (EMIS)

    PubMed Central

    Marcus, Ulrich; Hickson, Ford; Weatherburn, Peter; Furegato, Martina; Breveglieri, Michele; Berg, Rigmor C.; Schmidt, Axel J.

    2015-01-01

    Background The preventive effects of antiretroviral treatment (ART) on onward transmission of HIV are a major reason for broadening eligibility for ART. In the WHO European Region, surveillance reveals substantial differences in access to ART across regions and sub-populations. We analysed self-reported data on ART and reasons for not taking ART from EMIS, a large Pan-European Internet survey among men-who-have-sex-with-men (MSM). Methods Respondents from 38 European countries reported their last HIV test result and, if diagnosed with HIV, their treatment status, and reasons for not taking or having stopped ART from a 7 item multiple choice list and/ or answered an open-ended question to give other reasons. Responses were classified as fear of consequences, perceived lack of need, and ART inaccessibility based on factor analysis. Associations between not taking ART because of fear of consequences, and demographic, behavioural and contextual indicators were identified in a multivariable regression model. Results 13,353 (7.7%) of 174,209 respondents had been diagnosed with HIV. Among them 3,391 (25.4%) had never received ART, and 278 (2.1%) had stopped taking ART. Perceived lack of need was by far the most common reason for not taking or stopping ART (mentioned by 3259 (88.8%) respondents), followed by fear of consequences (428 (11.7%)), and ART inaccessibility (86 (2.3%)). For all reasons, an East-West gradient could be seen, with larger proportions of men living in Central and Eastern Europe reporting reasons other than medical advice for not taking ART. A minority of men were reluctant to start ART independent of medical advice and this was associated with experiences of discrimination in health care systems. Conclusions ART is widely available for MSM diagnosed with HIV across Europe. Not being on treatment is predominantly due to treatment not being recommended by their physician and/or not perceived to be needed by the respondent. PMID:25793882

  12. Sexual risk taking in relation to sexual identification, age, and education in a diverse sample of African American men who have sex with men (MSM) in New York City.

    PubMed

    Hampton, Melvin C; Halkitis, Perry N; Storholm, Erik D; Kupprat, Sandra A; Siconolfi, Daniel E; Jones, Donovan; Steen, Jeff T; Gillen, Sara; McCree, Donna Hubbard

    2013-03-01

    HIV disproportionately affects African American men who have sex with men (MSM) in the United States. To inform this epidemiological pattern, we examined cross-sectional sexual behavior data in 509 African American MSM. Bivariate logistic regression analyses were conducted to examine the extent to which age, education,and sexual identity explain the likelihood of engaging in sex with a partner of a specific gender and the likelihood of engaging in unprotected sexual behaviors based on partner gender. Across all partner gender types,unprotected sexual behaviors were more likely to be reported by men with lower education. Younger, non-gay identified men were more likely to engage in unprotected sexual behaviors with transgender partners, while older, non-gay identified men were more likely to engage in unprotected sexual behaviors with women. African American MSM do not represent a monolithic group in their sexual behaviors, highlighting the need to target HIV prevention efforts to different subsets of African American MSM communities as appropriate.

  13. Sex partner meeting places over time among newly HIV diagnosed men who have sex with men (MSM) in Baltimore, Maryland

    PubMed Central

    Jennings, Jacky M.; Reilly, Meredith L.; Perin, Jamie; Schumacher, Christina; Sharma, Megha; Safi, Amelia Greiner; Fields, Errol L.; Muvva, Ravikiran; Nganga-Good, Carolyn; Chaulk, Patrick

    2015-01-01

    Background Sex partner meeting places may be important locales to access men who have sex with men (MSM) and implement targeted human immunodeficiency virus (HIV) control strategies. These locales may change over time, but temporal evaluations have not been performed. Methods The objectives of this study were to describe the frequency of report of MSM sex partner meeting places over time, and to compare frequently reported meeting places in the past five years and past year among newly HIV diagnosed MSM in Baltimore City, Maryland. Public health HIV surveillance data including partner services information was obtained for this study from the Baltimore City Health Department from May 2009 to June 2014. Results 869 sex partner meeting places were reported, including 306 unique places. Bars/clubs (31%) and internet-based sites (38%) were the most frequently reported meeting place types. Over the five year period, the percentage of bars/clubs decreased over time and the percentage of internet-based sites increased over time. Among bars/clubs, 4/5 of those most frequently reported in the past five years were also most frequently reported in the most recent year. Among internet-based sites, 3/5 of those most frequently reported in the past five years were also in the top five most frequently reported in the past year. Conclusion This study provides a richer understanding of sex partner meeting places reported by MSM over time and information to health departments on types of places to access a population at high risk for HIV transmission. PMID:26372926

  14. Hepatitis A outbreak among men who have sex with men (MSM) predominantly linked with the EuroPride, the Netherlands, July 2016 to February 2017

    PubMed Central

    Freidl, Gudrun S; Sonder, Gerard JB; Bovée, Lian PMJ; Friesema, Ingrid HM; van Rijckevorsel, Gini GC; Ruijs, Wilhelmina LM; van Schie, Frank; Siedenburg, Evelien C; Yang, Jyh-Yuan; Vennema, Harry

    2017-01-01

    Between July 2016 and February 2017, 48 male cases of hepatitis A were notified in the Netherlands. Of these, 17 identified as men who have sex with men (MSM). Ten of the 13 cases for whom sequencing information was available, were infected with a strain linked with the EuroPride that took place in Amsterdam in 2016. This strain is identical to a strain that has been causing a large outbreak among MSM in Taiwan. PMID:28251892

  15. Hepatitis A outbreak among men who have sex with men (MSM) predominantly linked with the EuroPride, the Netherlands, July 2016 to February 2017.

    PubMed

    Freidl, Gudrun S; Sonder, Gerard Jb; Bovée, Lian Pmj; Friesema, Ingrid Hm; van Rijckevorsel, Gini Gc; Ruijs, Wilhelmina Lm; van Schie, Frank; Siedenburg, Evelien C; Yang, Jyh-Yuan; Vennema, Harry

    2017-02-23

    Between July 2016 and February 2017, 48 male cases of hepatitis A were notified in the Netherlands. Of these, 17 identified as men who have sex with men (MSM). Ten of the 13 cases for whom sequencing information was available, were infected with a strain linked with the EuroPride that took place in Amsterdam in 2016. This strain is identical to a strain that has been causing a large outbreak among MSM in Taiwan.

  16. Beyond 'MSM': Sexual Desire Among Bisexually-Active Latino Men in New York City.

    PubMed

    Muñoz-Laboy, Miguel A

    2004-02-01

    Latino male bisexuality has been studied for the most part with a focus on men who have sex with men (MSM) and with little attention to sexual desire. The goal of this article is to present a comprehensive understanding of how sexual desire is organized, enacted through sexual activity, and interpreted in the sexual lives of bisexually-active Latino men. To achieve this aim, an analysis was made of 18 sexual histories of bisexually active Latino men who participated in a two-year ethnographic study. Four configurations of sexual desire were constructed to reflect what was found in this population of bisexually-active Latino men: (a) lifetime homoerotic desire and casual sex with women; (b) lifetime heteroerotic desire, but commercial sex with men; (c) lifetime heteroerotic/transgender desire; (d) lifetime sexual desire for women and men. These configurations are explored in detail in this article. The analysis presented here is intended to offer insights into the overall study of Latino male bisexuality and into the foundations for the design of HIV and STI prevention programs directed toward bisexually-active Latino men and their partners.

  17. Willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study

    PubMed Central

    Bourne, Adam; Cassolato, Matteo; Thuan Wei, Clayton Koh; Wang, Bangyuan; Pang, Joselyn; Lim, Sin How; Azwa, Iskandar; Yee, Ilias; Mburu, Gitau

    2017-01-01

    Abstract Background: Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers to access or uptake. Methods: As part of a larger mixed-methods study exploring acceptability and willingness to use PrEP among MSM in Malaysia, 19 men took part in audio-recorded focus group discussions hosted by a community-based HIV organization and facilitated by a trained researcher. Discussions focussed on awareness and potential information management, general perceptions of PrEP and potential motivations or barriers to the use of PrEP, including those at the personal, social, health system or structural level. Data were transcribed verbatim and underwent a detailed thematic analysis. Results: Rather than perceiving PrEP as a replacement for condoms in terms of having safer sex, many participants viewed it as an additional layer protection, serving as a crucial barrier to infection on occasions where condom use was intended, but did not occur. It was also perceived as more valuable to “at-risk” men, such as those in HIV sero-discordant relationships or those with a higher number of sexual partners. Elements of discussion tended to suggest that some men taking PrEP may be subject to stigma from others, on the assumption they may be promiscuous or engage in high-risk sexual behaviours. Conclusions: This qualitative study indicates that, broadly speaking, PrEP may be acceptable to MSM in Malaysia. However, in order for its potential to be realized, and uptake achieved, educative interventions are required to inform the target population as to the efficacy and potential

  18. Willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study.

    PubMed

    Bourne, Adam; Cassolato, Matteo; Thuan Wei, Clayton Koh; Wang, Bangyuan; Pang, Joselyn; Lim, Sin How; Azwa, Iskandar; Yee, Ilias; Mburu, Gitau

    2017-08-02

    Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers to access or uptake. As part of a larger mixed-methods study exploring acceptability and willingness to use PrEP among MSM in Malaysia, 19 men took part in audio-recorded focus group discussions hosted by a community-based HIV organization and facilitated by a trained researcher. Discussions focussed on awareness and potential information management, general perceptions of PrEP and potential motivations or barriers to the use of PrEP, including those at the personal, social, health system or structural level. Data were transcribed verbatim and underwent a detailed thematic analysis. Rather than perceiving PrEP as a replacement for condoms in terms of having safer sex, many participants viewed it as an additional layer protection, serving as a crucial barrier to infection on occasions where condom use was intended, but did not occur. It was also perceived as more valuable to "at-risk" men, such as those in HIV sero-discordant relationships or those with a higher number of sexual partners. Elements of discussion tended to suggest that some men taking PrEP may be subject to stigma from others, on the assumption they may be promiscuous or engage in high-risk sexual behaviours. This qualitative study indicates that, broadly speaking, PrEP may be acceptable to MSM in Malaysia. However, in order for its potential to be realized, and uptake achieved, educative interventions are required to inform the target population as to the efficacy and potential, positive impact of PrEP. Given concerns for how those

  19. Syphilis and HIV/Syphilis Co-infection Among Men Who Have Sex With Men (MSM) in Ecuador.

    PubMed

    Hernandez, Isabel; Johnson, Ayesha; Reina-Ortiz, Miguel; Rosas, Carlos; Sharma, Vinita; Teran, Santiago; Naik, Eknath; Salihu, Hamisu M; Teran, Enrique; Izurieta, Ricardo

    2016-12-05

    There is a reemergence of syphilis in the Latin American and Caribbean region. There is also very little information about HIV/Syphilis co-infection and its determinants. The aim of this study is to investigate knowledge, attitudes, and practices regarding sexually transmitted infections (STIs), in particular syphilis infection and HIV/Syphilis co-infection, as well as to estimate the prevalence of syphilis among men who have sex with men (MSM) in a city with one of the highest HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 291 adult MSM. Questions included knowledge about STIs and their sexual practices. Blood samples were taken from participants to estimate the prevalence of syphilis and HIV/syphilis co-infection. In this population, the prevalence of HIV/syphilis co-infection was 4.8%, while the prevalence of syphilis as mono-infection was 6.5%. Participants who had syphilis mono-infection and HIV/syphilis co-infection were older. Men who had multiple partners and those who were forced to have sex had increased odds of syphilis and HIV/syphilis co-infection. A high prevalence of syphilis and self-reported STI was observed, which warrants targeted behavioral interventions. Co-infections are a cause for concern when treating a secondary infection in a person who is immunocompromised. These data suggest that specific knowledge, attitudes, and behaviors among MSM are associated with increased odds of STIs (including HIV/syphilis co-infections) in this region of Ecuador.

  20. A CBPR Partnership Increases HIV Testing among men who have sex with men (MSM): Outcome Findings from a Pilot Test of the CyBER/testing Internet Intervention

    PubMed Central

    Rhodes, Scott D.; Vissman, Aaron T.; Stowers, Jason; Miller, Cindy; McCoy, Thomas P.; Hergenrather, Kenneth C.; Wilkin, Aimee M.; Reece, Michael; Bachmann, Laura H.; Ore, Addison; Ross, Michael W.; Hendrix, Ellen; Eng, Eugenia

    2012-01-01

    The Internet has emerged as an important tool for the delivery of health promotion and disease prevention interventions. Our community-based participatory research (CBPR) partnership developed and piloted CyBER/testing, a culturally congruent intervention designed to promote HIV testing among men who have sex with men (MSM) within existing Internet chat rooms. Using a quasi-experimental, single-group study design, cross-sectional data were collected from chat room participants, known as “chatters,” at pretest (n=346) and post-test (n=315). Extant profile data also were collected to describe the demographics of the online population. The intervention significantly increased self-reported HIV testing among chatters overall, increasing rates from 44.5% at pretest to nearly 60% at post-test (p<.001). Furthermore, chatters who reported having both male and female sexual partners had nearly 6 times the odds of reporting HIV testing at post-test. Findings suggest that chat room-based HIV testing intervention may increase testing among MSM who may be difficult to reach in traditional physical spaces. PMID:21393625

  1. Pleasure, affection, and love among Black men who have sex with men (MSM) versus MSM of other races: countering dehumanizing stereotypes via cross-race comparisons of reported sexual experience at last sexual event.

    PubMed

    Calabrese, Sarah K; Rosenberger, Joshua G; Schick, Vanessa R; Novak, David S

    2015-10-01

    Black men have historically been stereotyped as hedonistic, aggressive, and animalistic in their sexual interactions. This study sought to describe pleasure, affection, and love experienced by Black men who have sex with men (MSM) during their last male-partnered sexual event and to examine differences relative to White, Latino, and Asian MSM. A total of 21,696 (793 Black, 18,905 White, 1,451 Latino, and 547 Asian) U.S. men ages 18-87 (M Age = 39) were recruited from social/sexual networking sites targeting MSM in 2010-2011. Participants reported multiple dimensions of sexual experience (pleasure, affection, and love) occurring at their last male-partnered sexual event, partner relationship, and sociodemographic characteristics. Across relationship categories, a sizeable percentage of Black MSM reported pleasure (72-87  % orgasmed, 57-82 % experienced high subjective pleasure) and affection (70-91 % kissed, 47-90 % cuddled). Love was primarily reported for events involving main partners (felt love for partner: 96 %; felt loved by partner: 97 %; verbalized love to partner: 89 %). Latent class analysis with MSM of all races, adjusting for partner relationship and sociodemographic characteristics, revealed three distinct profiles of sexual experience: affection and love (Class 1); affection in the absence of love (Class 2); and neither affection nor love (Class 3). Pleasure was probable across profiles. Some racial differences in profile probability were present, but no overall pattern emerged. Contrary to Black male stereotypes, Black MSM commonly reported pleasure, affection, and love at their last male-partnered sexual event and did not show a meaningful pattern of difference from other-race MSM in their likelihood of experiencing all three.

  2. Pleasure, Affection, and Love Among Black Men Who Have Sex with Men (MSM) versus MSM of Other Races: Countering Dehumanizing Stereotypes via Cross-Race Comparisons of Reported Sexual Experience at Last Sexual Event

    PubMed Central

    Rosenberger, Joshua G.; Schick, Vanessa R.; Novak, David S.

    2015-01-01

    Black men have historically been stereotyped as hedonistic, aggressive, and animalistic in their sexual interactions. This study sought to describe pleasure, affection, and love experienced by Black men who have sex with men (MSM) during their last male-partnered sexual event and to examine differences relative to White, Latino, and Asian MSM. A total of 21,696 (793 Black, 18,905 White, 1,451 Latino, and 547 Asian) U. S. men ages 18–87 (MAge = 39) were recruited from social/sexual networking sites targeting MSM in 2010–2011. Participants reported multiple dimensions of sexual experience (pleasure, affection, and love) occurring at their last male-partnered sexual event, partner relationship, and sociodemographic characteristics. Across relationship categories, a sizeable percentage of Black MSM reported pleasure (72–87 % orgasmed, 57–82 % experienced high subjective pleasure) and affection (70–91 % kissed, 47–90 % cuddled). Love was primarily reported for events involving main partners (felt love for partner: 96 %; felt loved by partner: 97 %; verbalized love to partner: 89 %). Latent class analysis with MSM of all races, adjusting for partner relationship and sociodemographic characteristics, revealed three distinct profiles of sexual experience: affection and love (Class 1); affection in the absence of love (Class 2); and neither affection nor love (Class 3). Pleasure was probable across profiles. Some racial differences in profile probability were present, but no overall pattern emerged. Contrary to Black male stereotypes, Black MSM commonly reported pleasure, affection, and love at their last male-partnered sexual event and did not show a meaningful pattern of difference from other-race MSM in their likelihood of experiencing all three. PMID:25604209

  3. Novel approaches to HIV prevention and sexual health promotion among Guatemalan gay and bisexual men, MSM, and transgender persons.

    PubMed

    Rhodes, Scott D; Alonzo, Jorge; Mann, Lilli; Downs, Mario; Simán, Florence M; Andrade, Mario; Martinez, Omar; Abraham, Claire; Villatoro, Guillermo R; Bachmann, Laura H

    2014-08-01

    The burden of HIV is disproportionate for Guatemalan sexual minorities (e.g., gay and bisexual men, men who have sex with men [MSM], and transgender persons). Our bi-national partnership used authentic approaches to community-based participatory research (CBPR) to identify characteristics of potentially successful programs to prevent HIV and promote sexual health among Guatemalan sexual minorities. Our partnership conducted Spanish-language focus groups with 87 participants who self-identified as male (n=64) or transgender (n=23) and individual in-depth interviews with ten formal and informal gay community leaders. Using constant comparison, an approach to grounded theory, we identified 20 characteristics of potentially successful programs to reduce HIV risk, including providing guidance on accessing limited resources; offering supportive dialogue around issues of masculinity, socio-cultural expectations, love, and intimacy; using Mayan values and images; harnessing technology; increasing leadership and advocacy skills; and mobilizing social networks. More research is clearly needed, but participants reported needing and wanting programming and had innovative ideas to prevent HIV exposure and transmission.

  4. Conducting HIV Interventions for Asian Pacific Islander Men Who Have Sex with Men: Challenges and Compromises in Community Collaborative Research

    ERIC Educational Resources Information Center

    Operario, Don; Nemoto, Tooru; Ng, Terence; Syed, Javid; Mazarei, Mazdak

    2005-01-01

    This article describes the process of implementing a community collaborative HIV prevention intervention research project targeting Asian and Pacific Islander (API) men who have sex with men (MSM). This article traces the genesis of the project--which linked university researchers with an API-focused community based organization--starting from its…

  5. Conducting HIV Interventions for Asian Pacific Islander Men Who Have Sex with Men: Challenges and Compromises in Community Collaborative Research

    ERIC Educational Resources Information Center

    Operario, Don; Nemoto, Tooru; Ng, Terence; Syed, Javid; Mazarei, Mazdak

    2005-01-01

    This article describes the process of implementing a community collaborative HIV prevention intervention research project targeting Asian and Pacific Islander (API) men who have sex with men (MSM). This article traces the genesis of the project--which linked university researchers with an API-focused community based organization--starting from its…

  6. HIV testing history and preferences for future tests among gay men, bisexual men and other MSM in England: results from a cross-sectional study

    PubMed Central

    Witzel, T Charles; Melendez-Torres, G J; Hickson, Ford; Weatherburn, Peter

    2016-01-01

    Objectives The British HIV Association's (BHIVA) testing guidelines recommend men who have sex with men (MSM) test annually or more frequently if ongoing risk is present. We identify which groups of MSM in England are less likely to have tested for HIV and their preferences for future tests by testing model, in order to inform health promotion programmes. Methods Data come from the Gay Men's Sex Survey 2014, a cross-sectional survey of MSM, aged 16 years or older and living in the UK. Only men who did not have diagnosed HIV and were living in England were included in this analysis. We used logistic regression models to understand how social determinants of health were associated with not testing for HIV in the past 12 months, and never having tested. We then cross-tabulated preferred testing location by demographic characteristics. Results Younger men, older men and men who were not gay identified were least likely to have tested for HIV. Higher educational attainment, migrancy, Black ethnicity and being at higher of risk were associated with greater levels of HIV testing. Men who were less likely to have tested for HIV preferred a wider range of options for future HIV testing. Conclusions If the BHIVA's HIV testing policy of 2008 was used to guide testing priorities among MSM focus would be on increasing the rate of annual testing among MSM at less risk of HIV (ie, younger men, older men and non-gay identified MSM). Instead the promotion of more frequent testing among the groups most at risk of infection should be prioritised in order to reduce the time between infection and diagnosis. PMID:27630068

  7. Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 - linked to other German cities and European countries.

    PubMed

    Werber, Dirk; Michaelis, Kai; Hausner, Marius; Sissolak, Dagmar; Wenzel, Jürgen; Bitzegeio, Julia; Belting, Anne; Sagebiel, Daniel; Faber, Mirko

    2017-02-02

    Since 14 November 2016, 38 cases of hepatitis A have been notified in Berlin; of these, 37 were male and 30 reported to have sex with men (MSM). Median age of MSM cases is 31 years (range: 24-52 years). Phylogenetic analysis revealed three distinct sequences, linking cases in Berlin to those in other German cities and to clusters recognised in other European countries in 2016. This article is copyright of The Authors, 2017.

  8. Ongoing outbreaks of hepatitis A among men who have sex with men (MSM), Berlin, November 2016 to January 2017 – linked to other German cities and European countries

    PubMed Central

    Werber, Dirk; Michaelis, Kai; Hausner, Marius; Sissolak, Dagmar; Wenzel, Jürgen; Bitzegeio, Julia; Belting, Anne; Sagebiel, Daniel; Faber, Mirko

    2017-01-01

    Since 14 November 2016, 38 cases of hepatitis A have been notified in Berlin; of these, 37 were male and 30 reported to have sex with men (MSM). Median age of MSM cases is 31 years (range: 24–52 years). Phylogenetic analysis revealed three distinct sequences, linking cases in Berlin to those in other German cities and to clusters recognised in other European countries in 2016. PMID:28183391

  9. Community-Based HIV-1 Early Diagnosis and Risk Behavior Analysis of Men Having Sex with Men in Hong Kong.

    PubMed

    Liang, Jianguo; Liu, Li; Cheung, Mandy; Lee, Man-Po; Wang, Haibo; Li, Chun-Ho; Chan, Chun-Chung; Nishiura, Kenji; Tang, Xian; Tan, Zhiwu; Peng, Jie; Cheung, Ka-Wai; Yam, Wing-Cheong; Chen, Zhiwei

    2015-01-01

    The increasing prevalence of HIV-1 among men having sex with men (MSM) calls for an investigation of HIV-1 prevalence and incidence in MSM by early diagnosis to assist with early preventive interventions in Hong Kong. The participants were recruited randomly from MSM communities within a one-year period. Rapid HIV Test (RHT) and real-time dried blood spot (DBS)-based quantitative polymerase chain reaction (DBS-qPCR) were used for the early diagnosis of 474 participants. Risk behavior analysis was performed by studying information obtained from the participants during the study period. The HIV-1 prevalence and incident rates in the studied MSM population were 4.01% (19/474) and 1.47% (7/474), respectively. Three infected participants were found at the acute phase of infection by DBS-qPCR. Only 46.4% (220/474) MSM were using condoms regularly for anal sex. HIV infection significantly correlated with unprotected receptive anal sex and syphilis infection. An increased number of infections was found among foreign MSM in Hong Kong. This study is the first to use DBS-qPCR to identify acutely infected individuals in a community setting and to provide both the prevalence and incident rates of HIV-1 infection among MSM in Hong Kong. The risk analysis provided evidence that behavior intervention strengthening is necessary to fight against the increasing HIV-1 epidemic among MSM in Hong Kong and surrounding regions in Asia.

  10. Community-Based HIV-1 Early Diagnosis and Risk Behavior Analysis of Men Having Sex with Men in Hong Kong

    PubMed Central

    Cheung, Mandy; Lee, Man-Po; Wang, Haibo; Li, Chun-ho; Chan, Chun-Chung; Nishiura, Kenji; Tang, Xian; Tan, Zhiwu; Peng, Jie; Cheung, Ka-Wai; Yam, Wing-Cheong; Chen, Zhiwei

    2015-01-01

    The increasing prevalence of HIV-1 among men having sex with men (MSM) calls for an investigation of HIV-1 prevalence and incidence in MSM by early diagnosis to assist with early preventive interventions in Hong Kong. The participants were recruited randomly from MSM communities within a one-year period. Rapid HIV Test (RHT) and real-time dried blood spot (DBS)-based quantitative polymerase chain reaction (DBS-qPCR) were used for the early diagnosis of 474 participants. Risk behavior analysis was performed by studying information obtained from the participants during the study period. The HIV-1 prevalence and incident rates in the studied MSM population were 4.01% (19/474) and 1.47% (7/474), respectively. Three infected participants were found at the acute phase of infection by DBS-qPCR. Only 46.4% (220/474) MSM were using condoms regularly for anal sex. HIV infection significantly correlated with unprotected receptive anal sex and syphilis infection. An increased number of infections was found among foreign MSM in Hong Kong. This study is the first to use DBS-qPCR to identify acutely infected individuals in a community setting and to provide both the prevalence and incident rates of HIV-1 infection among MSM in Hong Kong. The risk analysis provided evidence that behavior intervention strengthening is necessary to fight against the increasing HIV-1 epidemic among MSM in Hong Kong and surrounding regions in Asia. PMID:25915755

  11. A systematic community-based participatory approach to refining an evidence-based community-level intervention: the HOLA intervention for Latino men who have sex with men.

    PubMed

    Rhodes, Scott D; Daniel, Jason; Alonzo, Jorge; Duck, Stacy; García, Manuel; Downs, Mario; Hergenrather, Kenneth C; Alegría-Ortega, José; Miller, Cindy; Boeving Allen, Alex; Gilbert, Paul A; Marsiglia, Flavio F

    2013-07-01

    Our community-based participatory research partnership engaged in a multistep process to refine a culturally congruent intervention that builds on existing community strengths to promote sexual health among immigrant Latino men who have sex with men (MSM). The steps were the following: (1) increase Latino MSM participation in the existing partnership, (2) establish an Intervention Team, (3) review the existing sexual health literature, (4) explore needs and priorities of Latino MSM, (5) narrow priorities based on what is important and changeable, (6) blend health behavior theory with Latino MSM's lived experiences, (7) design an intervention conceptual model, (8) develop training modules and (9) resource materials, and (10) pretest and (11) revise the intervention. The developed intervention contains four modules to train Latino MSM to serve as lay health advisors known as Navegantes. These modules synthesize locally collected data with other local and national data; blend health behavior theory, the lived experiences, and cultural values of immigrant Latino MSM; and harness the informal social support Latino MSM provide one another. This community-level intervention is designed to meet the expressed sexual health priorities of Latino MSM. It frames disease prevention within sexual health promotion.

  12. Use of Respondent Driven Sampling (RDS) Generates a Very Diverse Sample of Men Who Have Sex with Men (MSM) in Buenos Aires, Argentina

    PubMed Central

    Carballo-Diéguez, Alex; Balan, Ivan; Marone, Rubén; Pando, María A.; Dolezal, Curtis; Barreda, Victoria; Leu, Cheng-Shiun; Ávila, María Mercedes

    2011-01-01

    Background Prior research focusing on men who have sex with men (MSM) conducted in Buenos Aires, Argentina, used convenience samples that included mainly gay identified men. To increase MSM sample representativeness, we used Respondent Driven Sampling (RDS) for the first time in Argentina. Using RDS, under certain specified conditions, the observed estimates for the percentage of the population with a specific trait are asymptotically unbiased. We describe, the diversity of the recruited sample, from the point of view of sexual orientation, and contrast the different subgroups in terms of their HIV sexual risk behavior. Methodology 500 MSM were recruited using RDS. Behavioral data were collected through face-to-face interviews and Web-based CASI. Conclusion In contrast with prior studies, RDS generated a very diverse sample of MSM from a sexual identity perspective. Only 24.5% of participants identified as gay; 36.2% identified as bisexual, 21.9% as heterosexual, and 17.4% were grouped as “other.” Gay and non-gay identified MSM differed significantly in their sexual behavior, the former having higher numbers of partners, more frequent sexual contacts and less frequency of condom use. One third of the men (gay, 3%; bisexual, 34%, heterosexual, 51%; other, 49%) reported having had sex with men, women and transvestites in the two months prior to the interview. This population requires further study and, potentially, HIV prevention strategies tailored to such diversity of partnerships. Our results highlight the potential effectiveness of using RDS to reach non-gay identified MSM. They also present lessons learned in the implementation of RDS to recruit MSM concerning both the importance and limitations of formative work, the need to tailor incentives to circumstances of the less affluent potential participants, the need to prevent masking, and the challenge of assessing network size. PMID:22102896

  13. Use of respondent driven sampling (RDS) generates a very diverse sample of men who have sex with men (MSM) in Buenos Aires, Argentina.

    PubMed

    Carballo-Diéguez, Alex; Balan, Ivan; Marone, Rubén; Pando, María A; Dolezal, Curtis; Barreda, Victoria; Leu, Cheng-Shiun; Avila, María Mercedes

    2011-01-01

    Prior research focusing on men who have sex with men (MSM) conducted in Buenos Aires, Argentina, used convenience samples that included mainly gay identified men. To increase MSM sample representativeness, we used Respondent Driven Sampling (RDS) for the first time in Argentina. Using RDS, under certain specified conditions, the observed estimates for the percentage of the population with a specific trait are asymptotically unbiased. We describe, the diversity of the recruited sample, from the point of view of sexual orientation, and contrast the different subgroups in terms of their HIV sexual risk behavior. 500 MSM were recruited using RDS. Behavioral data were collected through face-to-face interviews and Web-based CASI. In contrast with prior studies, RDS generated a very diverse sample of MSM from a sexual identity perspective. Only 24.5% of participants identified as gay; 36.2% identified as bisexual, 21.9% as heterosexual, and 17.4% were grouped as "other." Gay and non-gay identified MSM differed significantly in their sexual behavior, the former having higher numbers of partners, more frequent sexual contacts and less frequency of condom use. One third of the men (gay, 3%; bisexual, 34%, heterosexual, 51%; other, 49%) reported having had sex with men, women and transvestites in the two months prior to the interview. This population requires further study and, potentially, HIV prevention strategies tailored to such diversity of partnerships. Our results highlight the potential effectiveness of using RDS to reach non-gay identified MSM. They also present lessons learned in the implementation of RDS to recruit MSM concerning both the importance and limitations of formative work, the need to tailor incentives to circumstances of the less affluent potential participants, the need to prevent masking, and the challenge of assessing network size.

  14. The Relationship Between HIV Risk, High-Risk Behavior, Religiosity, and Spirituality Among Black Men Who Have Sex with Men (MSM): An Exploratory Study.

    PubMed

    Watkins, Tommie L; Simpson, Cathy; Cofield, Stacey S; Davies, Susan; Kohler, Connie; Usdan, Stuart

    2016-04-01

    Blacks in the USA, including black men who have sex with men (MSM), tend to have stronger religious and spiritual affiliations compared with other racial/ethnic populations. HIV and STD incidence rates continue to rise among Black MSM. Using data from the CDC Brothers y Hermanos (ByHS) project, this study examined correlations between high-risk behavior, e.g., substance use and high-risk sexual behavior (e.g., condom use history, unprotected sexual intercourse, HIV infection status, and STD infection status) religiosity, spirituality, age, among Black MSM (N = 1141). This exploratory study examined whether religiosity and spirituality were associated with high-risk behavior and high-risk sexual behavior among Black MSM. Religiosity and spirituality indices were compiled from the ByHS data. The religiosity index was significantly associated with HIV infection and use of cocaine, crack, and poppers as well as marginally associated with ecstasy use. Spirituality was significantly associated with HIV infection status, STD infection status, alcohol use, and crack use. Given these relationships, current and future HIV prevention models targeting Black MSM should consider the potential importance of the roles of religiosity and spirituality in the lives of Black MSM to increase the efficacy of risk reduction interventions.

  15. “Facing Our Fears”: Using facilitated film viewings to engage communities in HIV research involving MSM in Kenya

    PubMed Central

    Kombo, Bernadette; Sariola, Salla; Gichuru, Evanson; Molyneux, Sassy; Sanders, Eduard J.; van der Elst, Elise

    2017-01-01

    Abstract Kenya is a generally homophobic country where homosexuality is criminalised and people who engage in same sex sexuality face stigma and discrimination. In 2013, we developed a 16 min documentary entitled “Facing Our Fears” that aimed at sharing information on how and why men who have sex with men (MSM) are involved in on-going KEMRI HIV prevention research, and associated community engagement. To consider the film’s usefulness as a communication tool, and its perceived security risks in case the film was publicly released, we conducted nine facilitated viewings with 122 individuals representing seven different stakeholder groups. The documentary was seen as a strong visual communication tool with potential to reduce stigma related to homosexuality, and facilitated film viewings were identified as platforms with potential to support open dialogue about HIV research involving MSM. Despite the potential, there were concerns over possible risks to LGBT communities and those working with them following public release. We opted—giving emphasis to the “do no harm” principle—to use the film only in facilitated settings where audience knowledge and attitudes can be carefully considered and discussed. The results highlight the importance of carefully assessing the range of possible impacts when using visuals in community engagement. PMID:28670602

  16. Is HIV/AIDS Stigma Dividing the Gay Community? Perceptions of HIV-Positive Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Courtenay-Quirk, Cari; Wolitski, Richard J.; Parsons, Jeffrey T.; Gomez, Cynthia A.

    2006-01-01

    Stigma surrounding HIV/AIDS has existed since the beginning of the epidemic, but little is known about HIV/AIDS stigma within the gay community and how it affects men who have sex with men (MSM) living with HIV. A better understanding of the effects of stigma on this population is needed to reduce it and its harmful effects. Our study used…

  17. Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS).

    PubMed

    Schmidt, Axel J; Bourne, Adam; Weatherburn, Peter; Reid, David; Marcus, Ulrich; Hickson, Ford

    2016-12-01

    Anecdotal evidence suggests that men who have sex with men (MSM) are increasingly combining sex and illicit drugs (an activity referred to as 'chemsex'), in particular GHB/GBL, ketamine, crystal meth, or mephedrone (here called 4-chems). Use of such drugs has been associated with mental health and sexual health harms. We aim to compare patterns of illicit drug use among MSM in 44 European urban centres. In 2010, EMIS recruited 174,209 men from 38 countries to an anonymous online questionnaire in 25 languages. As harm reduction services for drugs and sex are organised at a local level, we chose to compare cities rather than countries. We defined 44 cities based on region/postal code and settlement size. For multivariable regression analyses, three comparison groups of MSM not living in these cities were applied: MSM living in Germany, the UK, and elsewhere in Europe. Data from 55,446 MSM living in 44 urban centres were included. Use of 4-chems (past 4 weeks) was highest in Brighton (16.3%), Manchester (15.5%), London (13.2%), Amsterdam (11.2%), Barcelona (7.9%), Zurich (7.0%) and Berlin (5.3%). It was lowest in Sofia (0.4%). The rank order was largely consistent when controlling for age, HIV diagnosis, and number of sexual partners. City of residence was the strongest demographic predictor of chemsex-drug use. Use of drugs associated with chemsex among MSM varies substantially across European cities. As city is the strongest predictor of chemsex-drug use, effective harm reduction programmes must include structural as well as individual interventions. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Evolutionary history of HIV-1 subtype B and CRF01_AE transmission clusters among men who have sex with men (MSM) in Kuala Lumpur, Malaysia.

    PubMed

    Ng, Kim Tien; Ong, Lai Yee; Lim, Sin How; Takebe, Yutaka; Kamarulzaman, Adeeba; Tee, Kok Keng

    2013-01-01

    HIV-1 epidemics among men who have sex with men (MSM) continue to expand in developed and developing countries. Although HIV infection in MSM is amongst the highest of the key affected populations in many countries in Southeast Asia, comprehensive molecular epidemiological study of HIV-1 among MSM remains inadequate in the region including in Malaysia. Here, we reported the phylodynamic profiles of HIV-1 genotypes circulating among MSM population in Kuala Lumpur, Malaysia. A total of n = 459 newly-diagnosed treatment-naïve consenting subjects were recruited between March 2006 and August 2012, of whom 87 (18.9%) were self-reported MSM. Transmitted drug resistance mutations were absent in these isolates. Cumulatively, phylogenetic reconstructions of the pro-rt gene (HXB2∶2253-3275) showed that HIV-1 subtype B and CRF01_AE were predominant and contributed to approximately 80% of the total HIV-1 infection among MSM. In addition to numerous unique transmission lineages within these genotypes, twelve monophyletic transmission clusters of different sizes (2-7 MSM sequences, supported by posterior probability value of 1) were identified in Malaysia. Bayesian coalescent analysis estimated that the divergence times for these clusters were mainly dated between 1995 and 2005 with four major transmission clusters radiating at least 12 years ago suggesting that active spread of multiple sub-epidemic clusters occurred during this period. The changes in effective population size of subtype B showed an exponential growth within 5 years between 1988 and 1993, while CRF01_AE lineage exhibited similar expansion between 1993 and 2003. Our study provides the first insight of the phylodynamic profile of HIV-1 subtype B and CRF01_AE circulating among MSM population in Kuala Lumpur, Malaysia, unravelling the importance of understanding transmission behaviours as well as evolutionary history of HIV-1 in assessing the risk of outbreak or epidemic expansion.

  19. Evolutionary History of HIV-1 Subtype B and CRF01_AE Transmission Clusters among Men Who Have Sex with Men (MSM) in Kuala Lumpur, Malaysia

    PubMed Central

    Ng, Kim Tien; Ong, Lai Yee; Lim, Sin How; Takebe, Yutaka; Kamarulzaman, Adeeba; Tee, Kok Keng

    2013-01-01

    HIV-1 epidemics among men who have sex with men (MSM) continue to expand in developed and developing countries. Although HIV infection in MSM is amongst the highest of the key affected populations in many countries in Southeast Asia, comprehensive molecular epidemiological study of HIV-1 among MSM remains inadequate in the region including in Malaysia. Here, we reported the phylodynamic profiles of HIV-1 genotypes circulating among MSM population in Kuala Lumpur, Malaysia. A total of n = 459 newly-diagnosed treatment-naïve consenting subjects were recruited between March 2006 and August 2012, of whom 87 (18.9%) were self-reported MSM. Transmitted drug resistance mutations were absent in these isolates. Cumulatively, phylogenetic reconstructions of the pro-rt gene (HXB2∶2253–3275) showed that HIV-1 subtype B and CRF01_AE were predominant and contributed to approximately 80% of the total HIV-1 infection among MSM. In addition to numerous unique transmission lineages within these genotypes, twelve monophyletic transmission clusters of different sizes (2–7 MSM sequences, supported by posterior probability value of 1) were identified in Malaysia. Bayesian coalescent analysis estimated that the divergence times for these clusters were mainly dated between 1995 and 2005 with four major transmission clusters radiating at least 12 years ago suggesting that active spread of multiple sub-epidemic clusters occurred during this period. The changes in effective population size of subtype B showed an exponential growth within 5 years between 1988 and 1993, while CRF01_AE lineage exhibited similar expansion between 1993 and 2003. Our study provides the first insight of the phylodynamic profile of HIV-1 subtype B and CRF01_AE circulating among MSM population in Kuala Lumpur, Malaysia, unravelling the importance of understanding transmission behaviours as well as evolutionary history of HIV-1 in assessing the risk of outbreak or epidemic expansion. PMID:23840653

  20. Differences Between Men Who Have Sex with Men (MSM) with Low CD4 Cell Counts at Their First HIV Test and MSM with Higher CD4 Counts in Bangkok, Thailand.

    PubMed

    Sapsirisavat, Vorapot; Phanuphak, Nittaya; Sophonphan, Jiratchaya; Egan, James E; Langevattana, Kamonthip; Avihingsanon, Anchalee; Friedman, M Reuel; Stall, Ron

    2016-12-01

    Although HIV prevalence remains high among Bangkok's MSM early HIV testing as an entry point to ART has not been successfully implemented among in this population. Men who present late for initial HIV testing are a particular concern in the context of the Bangkok HIV epidemic, in that if long-term positives have had condomless sex during the time that they remained untreated they are likely to have been efficient transmitters of infection, to say nothing of the implications for their own health. A sequential sample of MSM who tested HIV positive, and CD4 counts, was taken at the Thai Red Cross Anonymous Clinic and two drop-in centers in Bangkok. Inclusion criteria were MSM aged >18 years, having not tested HIV positive earlier, who reported ≥1 of the following in the previous 6 months: condomless sex with a male, being a sex worker, or having a sexual transmitted infection (STI) diagnosis. Analysis was conducted by distinguishing between three groups of CD4 counts: <200, 200-500, >500 cells/μ to identify the social and behavioral characteristics of the men who presented late for HIV testing. Median CD4 was 325 cells/μ(n = 95). MSM with initial CD4< 200 cells/μ were significantly more likely to report problematic alcohol use. They were also more likely to report receptive anal sex and more likely to be engaged in sex work. MSM with CD4< 200 cells/μ were less likely to report recent HIV testing. Main barriers to HIV testing included being afraid of finding out that they were HIV positive and concerns about efficacy and side effects of HIV treatment. HIV stigma and concerns about treatment are still widespread and are potential barriers to HIV care among MSM in Bangkok. These barriers may work to keep men from finding out their positive HIV status in a timely manner. Thai MSM need to be made aware of the current availability of friendly HIV testing and ART services, and public health programs need to work to change their perceptions regarding ART

  1. Social geographies of African American men who have sex with men (MSM): a qualitative exploration of the social, spatial and temporal context of HIV risk in Baltimore, Maryland.

    PubMed

    Tobin, K E; Cutchin, M; Latkin, C A; Takahashi, L M

    2013-07-01

    This qualitative study utilized a time-geography framework to explore the daily routines and daily paths of African American men who have sex with men (AA MSM) and how these shape HIV risk. Twenty AA MSM aged 18 years and older completed an in-depth interview. Findings revealed (1) paths and routines were differentiated by indicators of socio-economic status, namely employment and addiction, and (2) risk was situated within social and spatial processes that included dimensions of MSM disclosure and substance use. This study highlights the critical need for future research and interventions that incorporate the social and spatial dimensions of behavior to advance our ability to explain racial disparities in HIV and develop effective public health responses.

  2. A commentary on the role of sexually explicit media (SEM) in the transmission and prevention of HIV among men who have sex with men (MSM).

    PubMed

    Rosser, B R Simon; Grey, Jeremy A; Wilkerson, J Michael; Iantaffi, Alex; Brady, Sonya S; Smolenski, Derek J; Horvath, Keith J

    2012-08-01

    Although research has been conducted over the last half century to test the hypothesis that pornography, or sexually explicit media (SEM), influences behavior, information regarding usage and its effect on men who have sex with men (MSM) is limited. It is important for researchers studying online risk factors for HIV to consider the relationship between SEM consumption and risky sexual behavior, particularly given the exponential increase in SEM exposure as a result of the near-compulsory use of the Internet. In this commentary, we review findings regarding this relationship from studies of international and heterosexual populations. We then suggest future directions for research regarding MSM in the United States and practical applications of such research if the results from other populations extend to them. Research suggests there might be ways to use SEM to create innovative approaches to online HIV prevention, particularly among such at-risk populations as youth and MSM of lower socio-economic statuses.

  3. From personal survival to public health: community leadership by men who have sex with men in the response to HIV

    PubMed Central

    Trapence, Gift; Collins, Chris; Avrett, Sam; Carr, Robert; Sanchez, Hugo; Ayala, George; Diouf, Daouda; Beyrer, Chris; Baral, Stefan D

    2013-01-01

    Community leadership and participation by gay men and men who have sex with men (MSM) have been central to the response to HIV since the beginning of the epidemic. Through a wide array of actions, engagement of MSM has been important in the protection of communities. The connection between personal and community health as drivers of health advocacy continue to be a powerful element. The passion and urgency brought by MSM communities have led to the targeting and expansion of HIV and AIDS research and programming, and have improved the synergy of health and human rights, sustainability, accountability, and health outcomes for all people affected by HIV. MSM are, however, frequently excluded from the evidence-based services that they helped to develop, despite them generally being the most effective actors in challenging environments. Without MSM community involvement, government-run health programmes might have little chance of effectively reaching communities or scaling up interventions to lessen, and ultimately end, the HIV pandemic. PMID:22819662

  4. From personal survival to public health: community leadership by men who have sex with men in the response to HIV.

    PubMed

    Trapence, Gift; Collins, Chris; Avrett, Sam; Carr, Robert; Sanchez, Hugo; Ayala, George; Diouf, Daouda; Beyrer, Chris; Baral, Stefan D

    2012-07-28

    Community leadership and participation by gay men and men who have sex with men (MSM) have been central to the response to HIV since the beginning of the epidemic. Through a wide array of actions, engagement of MSM has been important in the protection of communities. The connection between personal and community health as drivers of health advocacy continue to be a powerful element. The passion and urgency brought by MSM communities have led to the targeting and expansion of HIV and AIDS research and programming, and have improved the synergy of health and human rights, sustainability, accountability, and health outcomes for all people affected by HIV. MSM are, however, frequently excluded from the evidence-based services that they helped to develop, despite them generally being the most effective actors in challenging environments. Without MSM community involvement, government-run health programmes might have little chance of effectively reaching communities or scaling up interventions to lessen, and ultimately end, the HIV pandemic. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. A systematic community-based participatory approach to refining an evidence-based community-level intervention: The HOLA intervention for Latino men who have sex with men

    PubMed Central

    Rhodes, Scott D.; Daniel, Jason; Alonzo, Jorge; Duck, Stacy; Garcia, Manuel; Downs, Mario; Hergenrather, Kenneth C.; Alegria-Ortega, Jose; Miller, AAS, Cindy; Boeving Allen, Alex; Gilbert, Paul A.; Marsiglia, Flavio F.

    2014-01-01

    Our community-based participatory research (CBPR) partnership engaged in a multi-step process to refine a culturally congruent intervention that builds on existing community strengths to promote sexual health among immigrant Latino men who have sex with men (MSM). The steps were: (1) increase Latino MSM participation in the existing partnership; (2) establish an Intervention Team; (3) review the existing sexual health literature; (4) explore needs and priorities of Latino MSM; (5) narrow priorities based on what is important and changeable; (6) blend health behavior theory with Latino MSM’s lived experiences; (7) design an intervention conceptual model; (8) develop training modules and (9) resource materials; and (10) pretest and (11) revise the intervention. The developed intervention contains four modules to train Latino MSM to serve as lay health advisors (LHAs) known as “Navegantes”. These modules synthesize locally collected data with other local and national data; blend health behavior theory, the lived experiences, and cultural values of immigrant Latino MSM; and harness the informal social support Latino MSM provide one another. This community-level intervention is designed to meet the expressed sexual health priorities of Latino MSM. It frames disease prevention within sexual health promotion. PMID:23075504

  6. HIV Infection Rates and Risk Behavior among Young Men undergoing community-based Testing in San Diego.

    PubMed

    Hoenigl, Martin; Chaillon, Antoine; Morris, Sheldon R; Little, Susan J

    2016-05-16

    Approximately 80% of new HIV infections in the United States occur in men. Four out of five men diagnosed with HIV infection are men who have sex with men (MSM), with an increasing proportion of young MSM (i.e. ≤24 years of age). We performed a retrospective analysis 11,873 cisgender men participating in a community based HIV screening program in San Diego between 2008 and 2014 to characterize the HIV prevalence and sexual risk behaviors among young men. In young heterosexual men HIV prevalence was lower compared to heterosexual men between 25 and 49 years of age (0.3% vs. 1.4%, p = 0.043). Among young MSM, HIV prevalence was 5.5%, per test positivity rate 3.6%, and HIV incidence 3.4 per 100 person years (95% CI 2.2-5.4). Per test positivity rate (p = 0.008) and incidence (p < 0.001) were significantly higher among young MSM than among MSM above 24-years of age. Young MSM diagnosed with HIV infection reported significantly more serodiscordant condomless anal intercourse, bacterial sexually transmitted infections, and higher rates of methamphetamine and gamma hydroxybutyrate use when compared to young MSM who tested negative. In conclusion, young MSM are particularly vulnerable to HIV infection and may represent ideal candidates for targeted prevention interventions that increase testing uptake and/or decrease the risk of acquiring HIV infection.

  7. HIV Prevalence Trends, Risky Behaviours, and Governmental and Community Responses to the Epidemic among Men Who Have Sex with Men in China

    PubMed Central

    Chow, Eric P. F.; Lau, Joseph T. F.; Zhang, Xiaohu; Wang, Yanjie

    2014-01-01

    Purpose of Review. Numerous studies reported the rapid spread of HIV/AIDS epidemic among men who have sex with men (MSM) in China. This paper aims to investigate the overall epidemic trend and associated high-risk behaviours among Chinese MSM and to explore the governmental and community responses to the epidemic. Recent Findings. HIV prevalence among Chinese MSM increased rapidly in all Chinese regions in the past decade and disproportionally affected the Southwest China. In addition to the high-risk homosexual behaviours, overlapping bisexual, commercial, and drug use behaviours are commonly observed among Chinese MSM. The Chinese government has significantly expanded the surveillance efforts among MSM over the past decade. Community responses against HIV have been substantially strengthened with the support of international aid. However, lack of enabling legal and financial environment undermines the role of community-based organisations (CBOs) in HIV surveillance and prevention. Conclusion. HIV continues to spread rapidly among MSM in China. The hidden nature of MSM and the overlapping homosexual, bisexual, and commercial behaviours remain a challenge for HIV prevention among MSM. Strong collaboration between the government and CBOs and innovative intervention approaches are essential for effective HIV surveillance and prevention among MSM in China. PMID:24822214

  8. HIV Status Disclosure Among Infected Men Who Have Sex With Men (MSM) in Buenos Aires, Argentina

    PubMed Central

    Carballo-Diéguez, Alex; Balán, Iván C.; Dolezal, Curtis; Ibitoye, Mobolaji; Pando, María A.; Marone, Rubén; Barreda, Victoria; Ávila, María Mercedes

    2013-01-01

    Five hundred men who have sex with men were recruited in Buenos Aires using respondent driven sampling. Of them, 46 respondents (24 of them not gay identified) who were HIV infected were asked questions on serodisclosure. The sample was characterized by indicators of low socioeconomic status. Most of the respondents reported being in good to excellent health despite 42% of them having been diagnosed with AIDS. Only 10% of respondents had not disclosed their serostatus to at least one person. Coworkers and lovers or main sexual partners were those most likely to know the respondents' serostatus. Reactions to disclosure were for the most part supportive. Those who had not disclosed anticipated less favorable reactions than those who had disclosed. No significant differences were observed between gay and non-gay identified respondents. The progressive social environment of Argentina that includes federal laws recognizing gay marriage may contribute to create a climate favorable for serostatus disclosure. PMID:24245593

  9. Community engagement in sexual health and uptake of HIV testing and syphilis testing among MSM in China: a cross-sectional online survey

    PubMed Central

    Zhang, Tiange P.; Liu, Chuncheng; Han, Larry; Tang, Weiming; Mao, Jessica; Wong, Terrence; Zhang, Ye; Tang, Songyuan; Yang, Bin; Wei, Chongyi; Tucker, Joseph D.

    2017-01-01

    Abstract Introduction: HIV and syphilis testing rates remain low among men who have sex with men (MSM) in low- and middle-income countries (LMICs). Community engagement has been increasingly used to promote HIV testing among key populations in high-income countries, often in settings with stronger civil society. This study aimed to assess socio-demographic, behavioural, and community engagement factors associated with HIV and syphilis testing among MSM in China. Methods: MSM ≥16 years old who had condomless sex in the past three months were recruited nationwide to complete a cross-sectional online survey in November 2015. Data were collected on socio-demographics, sexual behaviours, HIV testing, syphilis testing, and community engagement in sexual health. We defined community engagement in sexual health using six items assessing awareness and advocacy of sexual health programmes. The underlying factor structure of a 6-item community engagement scale was determined through exploratory factor analysis. Univariate and multivariable logistic regressions identified correlates of HIV and syphilis testing. Results: 1189 MSM were recruited. 54% (647/1189) of men had ever tested for HIV and 30% (354/1189) had ever tested for syphilis. Factor analysis suggested three levels of community engagement (minimal, moderate, and substantial) and this model explained 79.5% of observed variance. A quarter (26%, 312/1189) reported none to minimal engagement, over one half (54%, 644/1189) reported moderate engagement, and a fifth (20%, 233/1189) reported substantial engagement. Multivariable logistic regression showed that MSM with greater community engagement in sexual health were more likely to have ever tested for HIV (substantial vs. no engagement: aOR 7.91, 95% CI 4.98–12.57) and for syphilis (substantial vs. no engagement: aOR 5.35, 95% CI 3.16–9.04). Conclusions: HIV and syphilis testing are suboptimal among MSM in China. Community engagement may be useful for promoting

  10. Community engagement in sexual health and uptake of HIV testing and syphilis testing among MSM in China: a cross-sectional online survey.

    PubMed

    2017-02-06

    HIV and syphilis testing rates remain low among men who have sex with men (MSM) in low- and middle-income countries (LMICs). Community engagement has been increasingly used to promote HIV testing among key populations in high-income countries, often in settings with stronger civil society. This study aimed to assess socio-demographic, behavioural, and community engagement factors associated with HIV and syphilis testing among MSM in China. MSM ≥16 years old who had condomless sex in the past three months were recruited nationwide to complete a cross-sectional online survey in November 2015. Data were collected on socio-demographics, sexual behaviours, HIV testing, syphilis testing, and community engagement in sexual health. We defined community engagement in sexual health using six items assessing awareness and advocacy of sexual health programmes. The underlying factor structure of a 6-item community engagement scale was determined through exploratory factor analysis. Univariate and multivariable logistic regressions identified correlates of HIV and syphilis testing. 1189 MSM were recruited. 54% (647/1189) of men had ever tested for HIV and 30% (354/1189) had ever tested for syphilis. Factor analysis suggested three levels of community engagement (minimal, moderate, and substantial) and this model explained 79.5% of observed variance. A quarter (26%, 312/1189) reported none to minimal engagement, over one half (54%, 644/1189) reported moderate engagement, and a fifth (20%, 233/1189) reported substantial engagement. Multivariable logistic regression showed that MSM with greater community engagement in sexual health were more likely to have ever tested for HIV (substantial vs. no engagement: aOR 7.91, 95% CI 4.98-12.57) and for syphilis (substantial vs. no engagement: aOR 5.35, 95% CI 3.16-9.04). HIV and syphilis testing are suboptimal among MSM in China. Community engagement may be useful for promoting testing in China and should be considered in intervention

  11. Genetic diversity and transmission networks of HIV-1 strains among men having sex with men (MSM) in Lomé, Togo.

    PubMed

    Konou, Abla A; Vidal, Nicole; Salou, Mounerou; Anato, Simplice; Singo-Tokofaï, Assetina; Ekouevi, Didier K; Pitché, Palokinam; Prince-David, Mireille; Delaporte, Eric; Peeters, Martine; Dagnra, Anoumou Y

    2016-12-01

    Understanding the HIV epidemic in key populations is important. Today only scarce information is available on HIV-1 strains that circulate in men having sex with men (MSM) in sub-Saharan Africa. Here, we studied for the first time the genetic diversity of HIV-1 strains circulating in the MSM population in Lomé, the capital city from Togo. The overall subtype/CRF distribution in pol (protease and/or partial reverse transcriptase (RT)) among the 79 HIV-1 strains from MSM was as follows: CRF02_AG (72%, n=57), subtype G (2.5%, n=2), sub-subtype A3 (1.3%, n=1), and unique recombinant forms (URF) (24%, n=19). Among the 19 URFs four different mosaic structures were observed, annotated as URF1 to URF4. Fifteen sequences (URF1) had the same mosaic structure in pol (G/CRF02_AG) and could represent a new circulating recombinant form (CRF). Phylogenetic analysis of the RT sequences showed that there were several introductions of CRF02_AG strains in the MSM population, however half of the CRF02_AG and all URF1 strains formed a separate, well-supported cluster suggesting one major introduction of CRF02_AG in the MSM population followed by efficient transmission and emergence of a possible new CRF. At least 40% of the strains fell into recent transmission chains involving two to seven MSM. Comparison with >950 HIV-1 sequences from previous studies in Togo showed intermixing of the HIV-1 epidemics between MSM and the general population. Moreover, an HIV-1 strain from a recently HIV-1 infected male patient from Germany, fell within a cluster of HIV-1 strains from MSM from Togo, illustrating recent exchange between MSM from Africa and people from other geographic regions. With growing evidence of the importance of MSM in the dynamic of the HIV epidemic in Africa there is an urgent need for appropriate interventions to limit HIV transmission in this population group. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Racial differences in the accuracy of perceived partner HIV status among men who have sex with men (MSM) in Atlanta, Georgia.

    PubMed

    Grey, Jeremy A; Rothenberg, Richard; Sullivan, Patrick S; Rosenberg, Eli S

    2015-01-01

    We compared perceptions of partner HIV status to HIV test results in a cross-sectional study of sexual networks of men who have sex with men (MSM) in Atlanta. We then examined differences between black and white MSM in the predictive value of perceived partner status. We recruited men ("seeds") using time-space venue sampling. These seeds then referred up to three partners, who could also refer partners. All participants reported sexual behavior and HIV status for recent partners and received HIV tests. For partners who enrolled, we compared laboratory diagnoses to their partner's perception of their status. Black MSM who perceived themselves to be HIV negative were more likely than perceived-negative white MSM to have a positive partner among those they perceived to be HIV negative or whose status was unknown to them (OR=6.6). Furthermore, although frequency of unprotected anal intercourse (UAI) was similar by race, black men were more likely to have had UAI with an unknown-positive partner (OR=9.3). © The Author(s) 2014.

  13. Modeling the impact of post-diagnosis behavior change on HIV prevalence in Southern California men who have sex with men (MSM).

    PubMed

    Khanna, Aditya S; Goodreau, Steven M; Gorbach, Pamina M; Daar, Eric; Little, Susan J

    2014-08-01

    Our objective here is to demonstrate the population-level effects of individual-level post-diagnosis behavior change (PDBC) in Southern Californian men who have sex with men (MSM), recently diagnosed with HIV. While PDBC has been empirically documented, the population-level effects of such behavior change are largely unknown. To examine these effects, we develop network models derived from the exponential random graph model family. We parameterize our models using behavioral data from the Southern California Acute Infection and Early Disease Research Program, and biological data from a number of published sources. Our models incorporate vital demographic processes, biology, treatment and behavior. We find that without PDBC, HIV prevalence among MSM would be significantly higher at any reasonable frequency of testing. We also demonstrate that higher levels of HIV risk behavior among HIV-positive men relative to HIV-negative men observed in some cross-sectional studies are consistent with individual-level PDBC.

  14. Willingness of US Men Who Have Sex with Men (MSM) to Participate in Couples HIV Voluntary Counseling and Testing (CVCT)

    PubMed Central

    Wagenaar, Bradley H.; Christiansen-Lindquist, Lauren; Khosropour, Christine; Salazar, Laura F.; Benbow, Nanette; Prachand, Nik; Sineath, R. Craig; Stephenson, Rob; Sullivan, Patrick S.

    2012-01-01

    Background We evaluated willingness to participate in CVCT and associated factors among MSM in the United States. Methods 5,980 MSM in the US, recruited through MySpace.com, completed an online survey March-April, 2009. A multivariable logistic regression model was built using being “willing” or “unwilling” to participate in CVCT in the next 12 months as the outcome. Results Overall, 81.5% of respondents expressed willingness to participate in CVCT in the next year. Factors positively associated with willingness were: being of non-Hispanic Black (adjusted odds ratio [aOR]: 1.5, 95% confidence interval [CI]: 1.2–1.8), Hispanic (aOR: 1.3, CI: 1.1–1.6), or other (aOR: 1.4, CI: 1.1–1.8) race/ethnicity compared to non-Hispanic White; being aged 18–24 (aOR: 2.5, CI: 1.7–3.8), 25–29 (aOR: 2.3, CI: 1.5–3.6), 30–34 (aOR: 1.9, CI: 1.2–3.1), and 35–45 (aOR: 2.3, CI: 1.4–3.7) years, all compared to those over 45 years of age; and having had a main male sex partner in the last 12 months (aOR: 1.9, CI: 1.6–2.2). Factors negatively associated with willingness were: not knowing most recent male sex partner’s HIV status (aOR: 0.81, CI: 0.69–0.95) compared to knowing that the partner was HIV-negative; having had 4–7 (aOR: 0.75, CI: 0.61–0.92) or >7 male sex partners in the last 12 months (aOR: 0.62, CI: 0.50–0.78) compared to 1 partner; and never testing for HIV (aOR: 0.38, CI: 0.31–0.46), having been tested over 12 months ago (aOR: 0.63, CI: 0.50–0.79), or not knowing when last HIV tested (aOR: 0.67, CI: 0.51–0.89), all compared to having tested 0–6 months previously. Conclusions Young MSM, men of color, and those with main sex partners expressed a high level of willingness to participate in couples HIV counseling and testing with a male partner in the next year. Given this willingness, it is likely feasible to scale up and evaluate CVCT interventions for US MSM. PMID:22905191

  15. Examining Levels of Risk Behaviors among Black Men Who Have Sex with Men (MSM) and the Association with HIV Acquisition

    PubMed Central

    Irvin, Risha; Vallabhaneni, Snigdha; Scott, Hyman; Williams, John K.; Wilton, Leo; Li, Xin; Buchbinder, Susan

    2015-01-01

    Seroadaptation is defined as the practice of modifying sexual behavior based on one’s own HIV serostatus, the perceived HIV serostatus of sexual partners, and differences in risk of HIV transmission by sexual acts. Because this definition implies intent, we use the term “seroprotection” to describe HIV negative participants reporting condomless anal sex (CAS) either exclusively with seronegative partners, or only as the insertive partner with HIV positive or unknown serostatus partners. Little is known about seroprotection in Black men who have sex with men (MSM). We evaluated the independent association of seroprotection and HIV acquisition among the 1144 HIV-negative Black MSM enrolled in HPTN 061 using Cox models; we stratified by city of enrollment, and controlled for number of partners, age, and drug use. Behaviors reported at 0, 6, and 12 months were assigned to three mutually exclusive categories: (1) No CAS; (2) Seroprotection; and (3) CAS without seroprotection. In 2,861 six-month intervals; 28 HIV seroconversions occurred. No CAS was reported at 33.3% of visits, seroprotection at 46.6% of visits, and CAS without seroprotection at 20.1% of visits. The seroconversion rate per 100 person-years for no CAS was 0.98 (95% CI: 0.27, 2.51), compared with 2.39 (95% CI: 1.03, 4.71) and 13.33 (95% CI: 7.62, 21.66) for seroprotection and CAS without seroprotection, respectively. Compared to CAS without seroprotection, intervals without CAS were associated with an 87% reduction (aHR: 0.13, 95% CI: 0.03–0.46) in HIV acquisition and intervals with seroprotection with a 78% reduction (aHR: 0.22, 95% CI: 0.09–0.57). No CAS is the safest behavior to prevent HIV acquisition. Seroprotective behaviors significantly reduced risk, but HIV incidence was still >2/100 person-years, suggesting that additional strategies, such as pre-exposure prophylaxis, are warranted for this population. PMID:25688980

  16. Experiences of Antihomosexual Attitudes and Young Black Men Who Have Sex with Men in the South: A Need for Community-Based Interventions

    PubMed Central

    Ricks, JaNelle M.; McGladrey, Margaret; Crosby, Richard A.; Mena, Leandro A.; Ottmar, Jessica M.

    2016-01-01

    Abstract Purpose: In 2012, Jackson, Mississippi, had the third highest incidence rate of human immunodeficiency virus (HIV) among young Black men who have sex with men (MSM). The goal of this qualitative study (the initial phase of an HIV prevention clinical trial) was to explore how cultural norms regarding antihomosexual attitudes interfere with the safe sex practices and relationship norms of young Black MSM in Mississippi. Methods: Nine focus groups (N = 54) were conducted with young Black MSM aged 18–29. Participants were recruited through medical providers at local sexually transmitted infection clinics and through community organizers at local LGBT outreach programs. The data were analyzed through the use of grounded theory, multiple coders for consistency and intercoder reliability, and a qualitative data analysis software. Results: Three major themes were identified during the analysis: (1) resiliency and condom use, (2) inconsistent condom use among closeted young Black MSM, and (3) intimate partner violence (IPV) among closeted young Black MSM. Black MSM in Mississippi continue to be highly stigmatized within their social networks (i.e., families, sexual partners, and community). Conclusions: The findings suggest that cultural and community norms regarding antihomosexual attitudes may be a barrier to the practices of safe sex and a contributing factor to IPV among young Black MSM. There is a need for tailored interventions that address these cultural norms and establish social and community support for young Black MSM in Mississippi. PMID:26886074

  17. Results of a pilot study to reduce methamphetamine use and sexual risk behaviors among methamphetamine-using men who have sex with men (MSM) not currently in treatment.

    PubMed

    Zule, William A; Poulton, Winona E; Coomes, Curtis M; Mansergh, Gordon; Charania, Mahnaz; Wechsberg, Wendee M; Jones, Hendree E

    2012-01-01

    Methamphetamine use, which has been linked to unprotected anal intercourse and incident HIV infection, is an important contributor to HIV transmission among men who have sex with men (MSM). The purpose of this study was to develop and pilot test a single-session motivational interviewing (MI) intervention for reducing HIV risk among an out-of-treatment sample of MSM who use methamphetamine. MSM who use methamphetamine (n = 39) were recruited in 2008 and 2009 in North Carolina. They completed baseline data collection and a single-session MI intervention. Eighty percent completed a follow-up interview two months after enrollment. Men reported reductions in methamphetamine use during the previous 60 days from an average of 9.4 days at baseline to 3.3 days at follow-up (p < 0.05) and unprotected anal intercourse from an average of 4.8 sex partners during the previous 60 days at baseline to 2.9 at follow-up (p < 0.05). Self-reported unprotected anal intercourse at last sex with a nonprimary partner decreased significantly (from 81% at baseline to 25% at follow-up; p = 0.001). These results suggest that a single-session MI intervention may be useful for reducing methamphetamine use and sexual risk among MSM who use methamphetamine, especially in settings where multisession interventions are not feasible.

  18. Structural and environmental factors are associated with internalised homonegativity in men who have sex with men: findings from the European MSM Internet Survey (EMIS) in 38 countries.

    PubMed

    Berg, Rigmor C; Ross, Michael W; Weatherburn, Peter; Schmidt, Axel J

    2013-02-01

    Internalised homonegativity refers to a gay person's negative feelings about homosexuality and is believed to stem from negative societal stereotypes and attitudes towards homosexuality. Surprisingly, little research has centred on this link. In this research, we aimed to examine the associations between internalised homonegativity and structural forces, cultural influence, and access to sexual health promotion measures among a sample of 144,177 men who have sex with men (MSM) in 38 European countries. Participants were recruited as part of the European MSM Internet Survey (EMIS) during 2010. It was a self-completion, multilingual Internet-based survey for men living in Europe who have sex with men and/or feel attracted to men. Assumed causal relations were tested through multiple regression models. Variables at the structure of rule-systems (macro-level) that were significantly and negatively associated with internalised homonegativity were the presence of laws recognising same-sex relationships and same-sex adoption. In the meso-level model, greater proportions of the population expressing that they would not like to have homosexuals as neighbours predicted higher internalised homonegativity. In the last model, five variables were significantly and negatively associated with internalised homonegativity: being exposed to HIV/STI information for MSM, access to HIV testing, access to STI testing, access to condoms, and experience of gay-related hostility. In turn, men who had tested for HIV in the past year evidenced lower internalised homonegativity. This is the largest and certainly most geographically diverse study to date to examine structural and environmental predictors of internalised homonegativity among MSM. Our results show that one insidious consequence of society's stigma towards homosexuals is the internalisation of that stigma by gay and bisexual men themselves, thus, drawing attention to the importance of promoting social equity for self

  19. Latent class analysis of substance use among men who have sex with men in Malaysia: Findings from the Asian Internet MSM Sex Survey.

    PubMed

    Lim, Sin How; Cheung, Doug H; Guadamuz, Thomas E; Wei, Chongyi; Koe, Stuart; Altice, Frederick L

    2015-06-01

    High prevalence of substance use among men who have sex with men (MSM) may drive the HIV epidemic in Malaysia but patterns of substance use among Malaysian MSM have not been examined. Our study investigated specific Malaysian MSM risk groups to determine the association between their substance use and sexual risk behaviors. Data from Malaysian respondents (n=1235) in a large, multinational online survey of Asian MSM in 2010 were used to identify latent classes of substance use. Subsequent covariates were included in a joint model to predict class membership. The 3-class model was identified as the best fitting model, which included: (1) 'negligible substance use' for those reporting none or using any substance sparingly; (2) 'soft substance use' for those using poppers, ecstasy and drinking before sex; and (3) 'amphetamine-type stimulant (ATS) use' for those using stimulants (methamphetamine, ecstasy), erectile dysfunction drugs and recreational drug use before sex. Men in the 'ATS use' category were significantly less likely to not know their HIV status (AOR: 0.30, 95%CI: 0.14,0.66), more likely to have had more than 6 male sex partners (AOR: 4.83, 95% CI: 1.92-12.2), to have group sex (AOR:4.07, 95% CI: 2.31-7.15), to report inconsistent condom use (AOR:2.01, 95% CI: 1.12-3.60), to be HIV-infected (AOR:3.92, 95% CI: 1.63-8.42) and to have had any sexually transmitted infections (AOR:3.92, 95% CI:1.70, 9.08), compared to men in the 'negligible substance use' category. Our study identified subgroups of Malaysian MSM with distinct substance use patterns and HIV-related risk profiles, which provides implication for targeting HIV prevention in this subpopulation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India.

    PubMed

    Tomori, Cecilia; McFall, Allison M; Srikrishnan, Aylur K; Mehta, Shruti H; Nimmagadda, Nymisha; Anand, Santhanam; Vasudevan, Canjeevaram K; Solomon, Suniti; Solomon, Sunil S; Celentano, David D

    2016-08-12

    Childhood sexual abuse (CSA) is a significant global public health problem, which is associated with negative psychosocial outcomes and high-risk sexual behaviors in adults. Men who have sex with men (MSM) often report higher prevalence of CSA history than the general population, and CSA may play a key role in MSM's greater vulnerability to HIV. This study examined the prevalence of CSA history and its impact on the number of recent HIV-related risk behaviors (unprotected anal intercourse, high number of male and female sexual partners, alcohol use, drug use, and sex work in prior 6 months) and lifetime risk behaviors and experiences (high number of lifetime male and female sexual partners, early sexual debut, injection drug use, sex work, and intimate partner violence) among 11,788 adult MSM recruited via respondent driven sampling across 12 sites in India, with additional insights from thematic analysis of qualitative research with 363 MSM from 15 sites. Nearly a quarter (22.4 %) of participants experienced CSA, with substantially higher prevalence of CSA in the South and among kothis (feminine sexual identity). Qualitative findings revealed that older, trusted men may target young and, especially, gender nonconforming boys, and perpetrators' social position facilitates nondisclosure. CSA may also initiate further same-sex encounters, including sex work. In multivariable analysis, MSM who experienced CSA had 21 % higher rate of recent (adjusted rate ratio [aRR = 1.21], 95 % confidence interval [CI]: 1.14-1.28), and 2.0 times higher lifetime (aRR = 2.04, 95 % CI: 1.75-2.38) HIV-related behaviors/experiences compared with those who did not. This large, mixed-methods study found high overall prevalence of CSA among MSM (22.4 %), with substantially higher prevalence among MSM residing in the South and among more feminine sexual identities. Qualitative findings highlighted boys' vulnerabilities to CSA, especially gender nonconformity, and CSA's role in

  1. The Role of Discrimination in Alcohol-related Problems in Samples of Heavy Drinking HIV-Negative and Positive Men who have Sex with Men (MSM)

    PubMed Central

    Wray, Tyler B.; Pantalone, David W.; Kahler, Christopher W.; Monti, Peter M.; Mayer, Kenneth H.

    2016-01-01

    Background Heavy drinking is a major public health concern among men who have sex with men (MSM), as it is in many other populations. However, the consequences of heavy drinking among MSM may be particularly severe, especially for sexual risk behavior, due to the relatively high prevalence of HIV. Minority stress models suggest that, among members of marginalized groups, discrimination may be associated with heavier alcohol use as these individuals increasingly drink to cope with such experiences. Past studies have provided some support for this association. However, they have not explored the role other drinking motives play, how these relationships might differ across MSM who are HIV-positive versus HIV-negative, or how this relationship extends to alcohol-related problems. Methods In this study, we used path modeling to explore associations between perceived discrimination experiences, drinking motives, alcohol use, and alcohol-related problems in samples of heavy drinking MSM with and without HIV. Results In both HIV-negative and positive MSM, perceived discrimination was significantly positively associated with alcohol problems. Drinking to cope appears to play an important role in this relationship in both samples. Reporting more discrimination experiences was associated with drinking more frequently for sexual reasons among both groups. While the total effect of drinking to facilitate sex was positively associated with alcohol-related problems, sex motives did not mediate associations between discrimination and either drinking outcome. Conclusion These results suggest that interventions addressing discrimination and specific drinking motivations may be useful in helping reduce alcohol use of heavy drinking MSM. PMID:27481457

  2. Role flexing: how community, religion, and family shape the experiences of young black men who have sex with men.

    PubMed

    Balaji, Alexandra B; Oster, Alexandra M; Viall, Abigail H; Heffelfinger, James D; Mena, Leandro A; Toledo, Carlos A

    2012-12-01

    While the disproportionate impact of HIV on young black men who have sex with men (MSM) is well documented, the reasons for this disparity remain less clear. Through in-depth interviews, we explored the role of familial, religious, and community influence on the experiences of young black MSM and identified strategies that these young men use to negotiate and manage their sexual minority status. Between February and April 2008, 16 interviews were conducted among HIV-infected and HIV-uninfected young (19- to 24-year-old) black MSM in the Jackson, Mississippi, area. Results suggest that overall, homosexuality remains highly stigmatized by the men's families, religious community, and the African American community. To manage this stigma, many of the participants engaged in a process of "role flexing," in which individuals modified their behavior in order to adapt to a particular situation. The data also provided evidence of internalized homophobia among a number of the participants. The impact of stigma on risk behavior should be more fully explored, and future intervention efforts need to explicitly address and challenge stigma, both among young men themselves and the communities in which they reside. Attention should also be paid to the role masculinity may play as a driver of the HIV epidemic among young black MSM and how this knowledge can be used to inform prevention efforts.

  3. The Effect of Commuting Patterns on HIV Care Attendance Among Men Who Have Sex With Men (MSM) in Atlanta, Georgia.

    PubMed

    Dasgupta, Sharoda; Kramer, Michael R; Rosenberg, Eli S; Sanchez, Travis H; Reed, Landon; Sullivan, Patrick S

    2015-01-01

    Travel-related barriers to human immunodeficiency virus (HIV) care, such as commute time and mode of transportation, have been reported in the United States. The objective of the study was to investigate the association between public transportation use and HIV care attendance among a convenience sample of Atlanta-based, HIV-positive men who have sex with men (MSM), evaluate differences across regions of residence, and estimate the relationship between travel distance and time by mode of transportation taken to attend appointments. We used Poisson regression to estimate the association between use of public transportation to attend HIV-related medical visits and frequency of care attendance over the previous 12 months. The relationship between travel distance and commute time was estimated using linear regression. Kriging was used to interpolate commute time to visually examine geographic differences in commuting patterns in relation to access to public transportation and population-based estimates of household vehicle ownership. Using public transportation was associated with lower rates of HIV care attendance compared to using private transportation, but only in south Atlanta (south: aRR: 0.75, 95% CI 0.56, 1.0, north: aRR: 0.90, 95% CI 0.71, 1.1). Participants living in south Atlanta were more likely to have longer commute times associated with attending HIV visits, have greater access to public transportation, and may live in areas with low vehicle ownership. A majority of attended HIV providers were located in north and central Atlanta, despite there being participants living all across the city. Estimated commute times per mile traveled were three times as high among public transit users compared to private transportation users. Improving local public transit and implementing use of mobile clinics could help address travel-related barriers to HIV care.

  4. Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM).

    PubMed

    Cioe, Patricia A; Gamarel, Kristi E; Pantalone, David W; Monti, Peter M; Mayer, Kenneth H; Kahler, Christopher W

    2016-07-20

    Cigarette smoking and heavy alcohol use is prevalent among HIV-infected men who sex with men (MSM) and have been linked to imperfect antiretroviral therapy (ART) adherence. Our study examined the correlates of smoking and whether smoking was independently associated with imperfect adherence in heavy-drinking HIV-infected MSM. Of the 185 participants, approximately half (n = 91, 49.2 %) reported having smoked cigarettes in the past 30 days. Current smokers were more likely to have reported imperfect adherence compared to non-smokers (37.4.2 vs. 22.3 %, p < 0.05). In multivariable regression analyses, only lower education was significantly associated with imperfect adherence. This study demonstrated that the greatest risk factor for smoking and imperfect ART adherence was low socioeconomic status, in which MSM of color were over-represented. As the first study to examine smoking and ART adherence in this population, our study has the potential to inform the clinical care provided to heavy-drinking MSM.

  5. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships

    PubMed Central

    Gamarel, Kristi E.; Golub, Sarit A.

    2014-01-01

    Background In the United States, men who have sex with men (MSM) in primary partnerships are at elevated risk for human immunodeficiency virus (HIV) infection. Pre-exposure prophylaxis (PrEP), a new biomedical prevention strategy, has potential to reduce HIV transmission. This study examined predictors of PrEP adoption intentions among HIV-negative MSM in primary partnerships. Methods The sample included HIV-negative MSM (n = 164) who participated in an ongoing cross-sectional study with an in-person interview examining PrEP adoption intentions. Results Higher HIV risk perception, intimacy motivations for condomless sex, recent condomless anal sex with outside partners, education, and age were each independently associated with PrEP adoption intentions. In a multivariate model, only age, education, and intimacy motivations for condomless sex were significantly associated with PrEP adoption intentions. Conclusions Intimacy motivations may play a central role in PrEP adoption for MSM couples. Incorporating relationship dynamics into biomedical strategies is a promising avenue for research and intervention. PMID:25124457

  6. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships.

    PubMed

    Gamarel, Kristi E; Golub, Sarit A

    2015-04-01

    In the USA, men who have sex with men (MSM) in primary partnerships are at elevated risk for human immunodeficiency virus (HIV) infection. Pre-exposure prophylaxis (PrEP), a new biomedical prevention strategy, has potential to reduce HIV transmission. This study examined predictors of PrEP adoption intentions among HIV-negative MSM in primary partnerships. The sample included HIV-negative MSM (n = 164) who participated in an ongoing cross-sectional study with an in-person interview examining PrEP adoption intentions. Higher HIV risk perception, intimacy motivations for condomless sex, recent condomless anal sex with outside partners, education, and age were each independently associated with PrEP adoption intentions. In a multivariate model, only age, education, and intimacy motivations for condomless sex were significantly associated with PrEP adoption intentions. Intimacy motivations may play a central role in PrEP adoption for MSM couples. Incorporating relationship dynamics into biomedical strategies is a promising avenue for research and intervention.

  7. Barriers to Access and Adoption of Pre-Exposure Prophylaxis for the Prevention of HIV Among Men Who Have Sex With Men (MSM) in a Relatively Rural State.

    PubMed

    Hubach, Randolph D; Currin, Joseph M; Sanders, Carissa A; Durham, André R; Kavanaugh, Katherine E; Wheeler, Denna L; Croff, Julie M

    2017-08-01

    Biomedical intervention approaches, including antiretroviral pre-exposure prophylaxis (PrEP), have been demonstrated to reduce HIV incidence among several at-risk populations and to be cost effective. However, there is limited understanding of PrEP access and uptake among men who have sex with men (MSM) residing in relatively rural states. Twenty semistructured interviews were conducted (August-November 2016) to assess opinions of and perceived barriers to accessing and adopting PrEP among MSM residing in Oklahoma. Participants perceived substantial barriers to accessing PrEP including a stigmatizing environment and less access to quality, LGBT-sensitive medical care. Overall, geographic isolation limits access to health providers and resources that support sexual health for Oklahoma MSM. Addressing stigma situated across ecological levels in an effort to increase adoption of PrEP by MSM residing in rural states remains necessary. Without this, social determinants may continue to negatively influence PrEP adoption and sexual health outcomes.

  8. Prevalence of anal high-risk human papillomavirus infections among HIV-positive and HIV-negative men who have sex with men (MSM) in Nigeria

    PubMed Central

    Nowak, Rebecca G.; Gravitt, Patti E.; He, Xin; Ketende, Sosthenes; Anom, Wuese; Omuh, Helen; Blattner, William A.; Charurat, Manhattan E.

    2016-01-01

    Background Prevalence estimates of anal high-risk human papillomavirus (HR-HPV) are needed in sub-Saharan Africa where HIV is endemic. This study evaluated anal HR-HPV in Nigeria among HIV-positive and HIV-negative men who have sex with men (MSM) for future immunization recommendations. Methods We conducted a cross-sectional study to compare the prevalence of anal HR-HPV infections between 64 HIV-negative and 90 HIV-positive MSM. Multivariate Poisson regression analyses were used to examine demographic and behavioral risk factors associated with any HR-HPV infections. Results The median age of the 154 participants was 25 years (interquartile range [IQR]: 22-28, range: 16-38) and the median age at initiation of anal sex with another man was 16 years (IQR: 13-18, range: 7-29). The prevalence of anal HR-HPV was higher among HIV-positive than HIV-negative MSM (91.1% vs. 40.6%, p<0.001). In the multivariate analysis, HIV infection (adjusted prevalence ratio [aPR]: 2.02, 95% CI: 1.49-2.72), ten years or more since anal sexual debut (aPR: 1.26, 95% CI: 1.07-1.49), and concurrent relationships with men (aPR: 1.32, 95% CI: 1.04-1.67) were associated with increased anal HR-HPV prevalence. Conclusions Anal HR-HPV infection is high for young Nigerian MSM and rates are amplified in those co-infected with HIV. Providing universal coverage as well as catchup immunization for young MSM may be an effective anal cancer prevention strategy in Nigeria. PMID:26967301

  9. [The survival and development conditions of community-based organizations for HIV/AIDS prevention and control among men who have sex with men in three Chinese cities].

    PubMed

    Fu, Xiaojing; Shan, Duo; Qi, Jinlei; Ouyang, Lin; Wang, Hui; Fu, Jie; Sun, Jiangping

    2015-06-01

    To investigate the survival and development conditions of community-based organizations (CBOs) for HIV/AIDS prevention and control among men who have sex with men (MSM) in Chinese cities including Shanghai, Hangzhou, Chongqing. This study employed both qualitative (focus groups) and quantitative (questionnaire survey) methods to obtain information from 15 MSM CBOs in three Chinese cities. The mean work time of the 15 CBOs for HIV/AIDS prevention and control among MSM was 6.7 years (2.1-11.3 years), and the majority of their funds was from international cooperation projects (80 447 000 RMB, 73.0%) from 2006 to 2013. The survival cost of MSM CBOs apart from expenditure of activities was 2 240-435 360 RMB per year. As it was shown in the graph, the survival and development of MSM CBOs was closely related to the development of international cooperation projects. There was a few small size MSM CBOs taking part in the prevention and control of HIV/AIDS and their work content was limited before 2006. From 2006 to 2008, some international cooperation projects were launched in China, such as the China Global Fund AIDS project and the China-Gates Foundation HIV Prevention Cooperation program. As a result, the number of MSM CBOs was increased sharply, and both the scale and 2012, the performance of these programs further promote the establishment of new MSM CBOs and the development of all MSM CBOs with regard to the work places, full-time staffs, work contents, work patterns and the specific targeted population. After 2012, most international cooperation programs were completed and the local department of disease prevention and control continued to cooperate with MSM CBOs. However, the degree of support funds from the local department was different among different regions. Where the funds were below the half of program funds, the development of MSM CBOs ceased and work slowed down. Besides, there were still some constraints for the survival and development of MSM CBOs, such

  10. Role Flexing: How Community, Religion, and Family Shape the Experiences of Young Black Men Who Have Sex with Men

    PubMed Central

    Balaji, Alexandra B.; Oster, Alexandra M.; Viall, Abigail H.; Heffelfinger, James D.; Mena, Leandro A.; Toledo, Carlos A.

    2016-01-01

    While the disproportionate impact of HIV on young black men who have sex with men (MSM) is well documented, the reasons for this disparity remain less clear. Through in-depth interviews, we explored the role of familial, religious, and community influence on the experiences of young black MSM and identified strategies that these young men use to negotiate and manage their sexual minority status. Between February and April 2008, 16 interviews were conducted among HIV-infected and HIV-uninfected young (19- to 24-year-old) black MSM in the Jackson, Mississippi, area. Results suggest that overall, homosexuality remains highly stigmatized by the men’s families, religious community, and the African American community. To manage this stigma, many of the participants engaged in a process of “role flexing,” in which individuals modified their behavior in order to adapt to a particular situation. The data also provided evidence of internalized homophobia among a number of the participants. The impact of stigma on risk behavior should be more fully explored, and future intervention efforts need to explicitly address and challenge stigma, both among young men themselves and the communities in which they reside. Attention should also be paid to the role masculinity may play as a driver of the HIV epidemic among young black MSM and how this knowledge can be used to inform prevention efforts. PMID:23134543

  11. Trends in Sexual Behavior Among Men Who have Sex with Men (MSM) in High-Income Countries, 1990-2013: A Systematic Review.

    PubMed

    Hess, Kristen L; Crepaz, Nicole; Rose, Charles; Purcell, David; Paz-Bailey, Gabriela

    2017-05-29

    HIV diagnoses among men who have sex with men (MSM) have been increasing in several high-income countries. A better understanding of the sexual behavior trends among MSM can be useful for informing HIV prevention. We conducted a systematic review of studies that examined behavioral trends (1990-2013) in any condomless anal sex, condomless anal sex with an HIV-discordant partner, and number of partners. Studies included come from the United States, Europe, and Australia. We found increasing trends in condomless anal sex and condomless anal sex with an HIV-discordant partner, and a decreasing trend in number of partners. The increase in condomless anal sex may help to explain the increase in HIV infections. More explanatory research is needed to provide insight into factors that contribute to these behavior trends. Continuous monitoring of HIV, risk behaviors, and use of prevention and treatment is needed to evaluate prevention efforts and monitor HIV transmission risk.

  12. HIV among Black men who have sex with men (MSM) in the United States: a review of the literature.

    PubMed

    Maulsby, Cathy; Millett, Greg; Lindsey, Kali; Kelley, Robin; Johnson, Kim; Montoya, Daniel; Holtgrave, David

    2014-01-01

    In 2006, Millett published a seminal literature review that examined 12 hypotheses to explain the high rates of HIV among black MSM. This paper augments Millett's article by reviewing the recent literature on behavioral, biomedical, structural, social contextual, psychosocial, and social network factors that affect HIV rates among black MSM. We searched three databases: PubMed, Scopus, and Google Scholar. First we searched all articles that included black or African American and MSM and HIV. We then searched the following terms for each area: behavioral (drug use during sex, crack cocaine use, and serosorting); biomedical (circumcision, STDs, and STIs); structural (access to care, HIV care, ART, HAART, patient-provider communication, HIV quality of care); social contextual (stigma, discrimination, internalized homophobia, internalized heterosexism, medical mistrust, social isolation, and incarceration); psychosocial (peer support and mental health); and social network (sexual mixing, partner characteristics, and social networks) factors. We identified 39 articles to include in this review. We found inconclusive evidence that incarceration, stigma, discrimination, social isolation, mental health disparities, or social networks explain the elevated rates of HIV among black MSM. We found evidence that the differences in rates of HIV between black and white MSM may be explained by differences in STIs, undiagnosed seropositivity, access to care and treatment services, and use of HAART. There is an overwhelming need for HIV testing, linkage to care, retention in care, and adherence programs for black MSM.

  13. Is the HIV Epidemic Stable among MSM in Mexico? HIV Prevalence and Risk Behavior Results from a Nationally Representative Survey among Men Who Have Sex with Men

    PubMed Central

    Bautista-Arredondo, Sergio; Colchero, M. Arantxa; Romero, Martín; Conde-Glez, Carlos J.; Sosa-Rubí, Sandra G.

    2013-01-01

    Background Recent evidence points to the apparent increase of HIV prevalence among men who have sex with men (MSM) in different settings with concentrated epidemics, including the Latin American region. In 2011, Mexico implemented an ambitious HIV prevention program in all major cities, funded by the Global Fund to Fight Aids, Tuberculosis and Malaria. The program was intended to strengthen the prevention response for the most at risk populations: MSM and injecting drug users. This paper presents the HIV prevalence results of a nationally representative baseline survey in 24 Mexican cities throughout the 5 regions in the country and reports the socio-demographic and sexual risk behaviors that predict the probability of infection. Methods The survey was implemented in two phases. We first identified and characterized places where MSM gather in each city and then conducted in a second phase, a seroprevalence survey that included rapid HIV testing and a self-administered questionnaire. The prevalence of HIV was estimated by adjusting for positive predicted value. We applied a probit model to estimate the probability of having a positive result from the HIV test as a function of socio-demographic characteristics and self-reported sexual risk behaviors. Results We found an overall HIV prevalence among MSM gathering in meeting points of 16.9% [95% CI: 15.6–18.3], significantly higher than previously reported estimates. Our regression results suggest that the risk of infection increases with age, with the number of sexual partners, and among those who play a receptive sexual role, and the risk decreases with higher education. Discussion Our findings suggest a higher HIV prevalence among MSM than previously acknowledged and that a significant regional variability exist throughout the country. These two findings combined, signal an important dynamic in the epidemic that should be better understood and promptly addressed with strong prevention efforts targeted at key

  14. Community engagement among men who have sex with men living with HIV/AIDS in Taiwan.

    PubMed

    Chuang, Deng-Min; Lacombe-Duncan, Ashley

    2016-01-01

    Community engagement was developed as a global principle in the provision of HIV/AIDS services, yet evidence-based research of implementation of the principle is lacking in Taiwan. This short report aims to understand factors associated with engagement in two types of activities with varying levels of visibility: HIV-related community events and HIV-related community action, in Taiwanese men who have sex with men (MSM) living with HIV. A cross-sectional survey was distributed to a purposive sample of participants recruited from AIDS service organizations (ASOs). Among participants (n = 178), 63.6% were involved in HIV-related community events, while less than half (47.7%) were involved in HIV-related community action. In multivariable analysis, age, involvement in ASOs, and AIDS knowledge were positively associated with engagement in community events, and living in the north of Taiwan, years of infection, and self-stigma were negatively associated with this type of engagement. Few factors, with the exception of involvement in ASOs, were positively associated with engagement in HIV-related community action. To this end, ASOs appear to play a strong role in improving and organizing both types of community engagement in Taiwan. Future studies should evaluate tailored programs delivered through ASOs for strengthening community connectedness among younger, stigmatized, and longer diagnosed MSM living with HIV.

  15. Ongoing hepatitis A among men who have sex with men (MSM) linked to outbreaks in Europe in Tel Aviv area, Israel, December 2016 - June 2017.

    PubMed

    Gozlan, Yael; Bar-Or, Itay; Rakovsky, Aviya; Savion, Michal; Amitai, Ziva; Sheffer, Rivka; Ceder, Noa; Anis, Emilia; Grotto, Itamar; Mendelson, Ella; Mor, Orna

    2017-07-20

    Between December 2016 and June 2017, 19 Hepatitis A virus (HAV)-positive cases, 17 of which were among men who have sex with men (MSM) were identified in the Tel Aviv area. Seven of the 15 sewage samples collected between January and June 2017 were also HAV-positive. All sequences clustered with two of the three strains identified in the current European HAV outbreak. We demonstrate that despite an efficient vaccination programme, HAV can still be transmitted to an unvaccinated high-risk population. This article is copyright of The Authors, 2017.

  16. Factors Associated with Low Levels of HIV Testing among Men Who Have Sex with Men (MSM) in Brazil

    PubMed Central

    Brito, Ana Maria; Kendall, Carl; Kerr, Ligia; Mota, Rosa Maria Salani; Guimarães, Mark Drew Crosland; Dourado, Inês; Pinho, Adriana A.; Benzaken, Adele Schwartz; Brignol, Sandra; Reingold, Arthur L.

    2015-01-01

    The aim of this study was to assess risk factors associated with low levels of HIV testing among MSM recruited through respondent driven sampling (RDS) in Brazil. Of 3,617 participants, 48.4% had never tested previously for HIV. A logistic model indicated that younger age, lower socioeconomic class, education, poor HIV/AIDS knowledge, no history of cruising, and having been tested during the study were characteristics independently associated with low levels of previous HIV testing. The HIV testing rate among MSM in Brazil is still low in spite of the availability of a large number services providing universal and free access to HIV/AIDS diagnosis and treatment. To respond to low utilization, the authors propose a higher priority for testing for key populations such as MSM, expanded education, expanding testing sites and a welcoming and nonjudgmental environment in health services. PMID:26098559

  17. Testing Comprehensive Models of Disclosure of Sexual Orientation in HIV-Positive Latino Men Who Have Sex with Men (MSM)

    PubMed Central

    Lechuga, Julia; Zea, María Cecilia

    2012-01-01

    Individuals who disclose their sexual orientation are more likely to also disclose their HIV status. Disclosure of HIV-serostatus is associated with better health outcomes. The goal of this study was to build and test comprehensive models of sexual orientation that included 8 theory-informed predictors of disclosure to mothers, fathers, and closest friends in a sample of HIV-positive Latino gay and bisexual men. US acculturation, gender non-conformity to hegemonic masculinity in self-presentation, comfort with sexual orientation, gay community involvement, satisfaction with social support, sexual orientation and gender of the closest friend emerged as significant predictors of disclosure of sexual orientation. PMID:22690708

  18. Testing comprehensive models of disclosure of sexual orientation in HIV-positive Latino men who have sex with men (MSM).

    PubMed

    García, Luis I; Lechuga, Julia; Zea, María Cecilia

    2012-01-01

    Individuals who disclose their sexual orientation are more likely to also disclose their HIV status. Disclosure of HIV-serostatus is associated with better health outcomes. The goal of this study was to build and test comprehensive models of sexual orientation that included eight theory-informed predictors of disclosure to mothers, fathers, and closest friends in a sample of HIV-positive Latino gay and bisexual men. US acculturation, gender nonconformity to hegemonic masculinity in self-presentation, comfort with sexual orientation, gay community involvement, satisfaction with social support, sexual orientation and gender of the closest friend emerged as significant predictors of disclosure of sexual orientation.

  19. HIV testing, gay community involvement and internet use: social and behavioural correlates of HIV testing among Australian men who have sex with men.

    PubMed

    Holt, M; Rawstorne, P; Wilkinson, J; Worth, H; Bittman, M; Kippax, S

    2012-01-01

    A significant minority of Australian men who have sex with men (MSM) have never been tested for HIV and many men do not test as often as recommended. Using data from 1770 HIV-negative and untested MSM collected in a national, online survey, we compared men who had never tested for HIV with those who had tested over 12 months ago and men who had tested over 12 months ago with those that had tested in the past year. Two multivariate logistic regression models were constructed. Compared with men tested over 12 months ago, untested men were younger, less educated, less likely to have unprotected anal intercourse with a regular male partner, less likely to have sought advice from a doctor, nurse or community organisation, more likely to expect HIV-negative disclosure, had fewer gay friends and spent more time using social networking websites. Compared with men who had tested over 12 months ago, men who had tested within the last year were younger, more likely to expect HIV-negative disclosure and disclose to casual partners, more likely to have sought advice from a doctor or nurse, had attended gay pools, gyms or beaches and had more gay friends and more male sex partners. Our findings suggest that the Internet and sex education in schools are important ways to promote HIV testing to untested MSM. Testing reinforcement messages delivered through gay community outreach and primary care will reach previously tested MSM.

  20. Community associated methicillin resistant Staphylococcus aureus among New York City men who have sex with men: qualitative research findings and implications for public health practice.

    PubMed

    Galindo, Gabriel R; Casey, Amber J; Yeung, Alice; Weiss, Don; Marx, Melissa A

    2012-04-01

    Academic literature has recorded increased microbial resistance in the United States and recent news media has adversely portrayed men who have sex with men (MSM) at increased risk for community associated methicillin resistant Staphylococcus aureus (CA-MRSA) transmission. CA-MRSA is a specific type of bacteria resistant to certain antibiotics, which limits treatment options for those needing clinical care. Infection can manifest as painful abscesses and can cause severe illness. With increased CA-MRSA infections overall, and attention given to MSM populations regarding CA-MRSA, as well as the fact that limited data on sociocultural factors that may facilitate transmission, we undertook a qualitative study to explore contextual influences that may fuel infection among MSM in New York City so that public health professionals can better recognize, and respond appropriately to, potential future outbreaks. In-depth interviews were used to qualitatively investigate perceptions and beliefs regarding transmission, as well as community understandings of treatment options. Participants included thirteen MSM who reported a previous CA-MRSA infection and nine community practitioners. A thematic content analysis of these interviews was conducted and data suggests that behaviors and exposures associated with transmission of CA-MRSA are common in certain MSM networks. Specifically, sociocultural influences and methamphetamine use activities were found to contribute to CA-MRSA transmission. We underscore the role of public health and health services practitioners in providing appropriate CA-MRSA awareness and education to MSM populations.

  1. Evaluation of the CDC proposed laboratory HIV testing algorithm among men who have sex with men (MSM) from five US metropolitan statistical areas using specimens collected in 2011.

    PubMed

    Masciotra, Silvina; Smith, Amanda J; Youngpairoj, Ae S; Sprinkle, Patrick; Miles, Isa; Sionean, Catlainn; Paz-Bailey, Gabriela; Johnson, Jeffrey A; Owen, S Michele

    2013-12-01

    Until recently most testing algorithms in the United States (US) utilized Western blot (WB) as the supplemental test. CDC has proposed an algorithm for HIV diagnosis which includes an initial screen with a Combo Antigen/Antibody 4th generation-immunoassay (IA), followed by an HIV-1/2 discriminatory IA of initially reactive-IA specimens. Discordant results in the proposed algorithm are resolved by nucleic acid-amplification testing (NAAT). Evaluate the results obtained with the CDC proposed laboratory-based algorithm using specimens from men who have sex with men (MSM) obtained in five metropolitan statistical areas (MSAs). Specimens from 992 MSM from five MSAs participating in the CDC's National HIV Behavioral Surveillance System in 2011 were tested at local facilities and CDC. The five MSAs utilized algorithms of various screening assays and specimen types, and WB as the supplemental test. At the CDC, serum/plasma specimens were screened with 4th generation-IA and the Multispot HIV-1/HIV-2 discriminatory assay was used as the supplemental test. NAAT was used to resolve discordant results and to further identify acute HIV infections from all screened-non-reactive missed by the proposed algorithm. Performance of the proposed algorithm was compared to site-specific WB-based algorithms. The proposed algorithm detected 254 infections. The WB-based algorithms detected 19 fewer infections; 4 by oral fluid (OF) rapid testing and 15 by WB supplemental testing (12 OF and 3 blood). One acute infection was identified by NAAT from all screened-non-reactive specimens. The proposed algorithm identified more infections than the WB-based algorithms in a high-risk MSM population. OF testing was associated with most of the discordant results between algorithms. HIV testing with the proposed algorithm can increase diagnosis of infected individuals, including early infections. Published by Elsevier B.V.

  2. A study of perceived racial discrimination in Black men who have sex with men (MSM) and its association with healthcare utilization and HIV testing.

    PubMed

    Irvin, R; Wilton, L; Scott, H; Beauchamp, G; Wang, L; Betancourt, J; Lubensky, M; Wallace, J; Buchbinder, S

    2014-07-01

    In HPTN 061, a study of Black men who have sex with men (MSM), we evaluated the association of healthcare-specific racial discrimination with healthcare utilization and HIV testing among 1167 HIV-negative participants. Median age was 38 years, 41 % were uninsured, and 38 % had an annual household income <$10,000. Overall, 19 % reported healthcare-specific racial discrimination directed toward family, friend, or self; 61 % saw a healthcare provider in the previous 6 months and 81 % HIV tested within the past year. Healthcare-specific racial discrimination was positively associated with seeing a provider [adjusted odds ratio (AOR) = 1.4 (1.0, 2.0)] and HIV testing [AOR = 1.6 (1.1, 2.4)] suggesting that barriers other than racial discrimination may be driving health disparities related to access to medical care and HIV testing among Black MSM. These results contrast with previous studies, possibly due to measurement or cohort differences, strategies to overcome discrimination, or because of greater exposure to healthcare.

  3. Public Health Responses to the HIV Epidemic Among Black Men Who Have Sex With Men: A Qualitative Study of US Health Departments and Communities

    PubMed Central

    Moore, Terrance E.

    2009-01-01

    In the United States, Black men who have sex with men (MSM) are disproportionately affected by HIV/AIDS. Thus, there is a need to understand the challenges facing health departments and community-based organizations responding to the HIV epidemic among this population. We interviewed 71 AIDS program directors, health department staff, and leaders of community-based organizations in 9 states and the District of Columbia. Participants identified psychosocial factors, a lack of capacity-building efforts, and stigma as barriers to HIV prevention responses targeting Black MSM. Participants identified culturally competent staff and culturally sensitive interventions as facilitating prevention responses. To ensure that HIV/AIDS interventions targeting Black MSM are effective, it is imperative to solicit the perceptions of frontline workers in health departments and community-based organizations. PMID:19372516

  4. Sex and condom use in a large jail unit for men who have sex with men (MSM) and male-to-female transgenders.

    PubMed

    Harawa, Nina T; Sweat, Jeffery; George, Sheba; Sylla, Mary

    2010-08-01

    Few data are available on factors contributing to sexual activity and condom use in custody settings, particularly among self-identified sexual minority prisoners. To address this gap, we undertook a study of sexual behavior and condom use of 101 randomly-selected men who have sex with men (MSM) and male-to-female transgender inmates in a segregated Los Angeles jail unit that has weekly condom access. Most survey participants (53%) reported anal sex during custody. Although 65% of these reported using condoms, 75% also reported having sex without condoms. Qualitative interviews (n=17) indicate a wide range of reasons for participating in protected and unprotected sex during custody, the use of cues within the custody environment to assess potential partners' HIV status, and support for increased condom availability. Findings also indicate that high-risk sex occurs frequently in this unit and that condom distribution likely prevents a substantial amount of related HIV/STD risk.

  5. Outcomes of a community-based HIV-prevention pilot programme for township men who have sex with men in Cape Town, South Africa

    PubMed Central

    Batist, Elizabeth; Brown, Benjamin; Scheibe, Andrew; Baral, Stefan D; Bekker, Linda-Gail

    2013-01-01

    Introduction Men who have sex with men (MSM) in Cape Town's townships remain in need of targeted HIV-prevention services. In 2012, a pilot community-based HIV-prevention programme was implemented that aimed to reach MSM in five Cape Town townships, disseminate HIV-prevention information and supplies, and promote the use of condoms and HIV services. Methods Convenience sampling was used to recruit self-identified MSM who were 18 years old or older in five Cape Town townships. The six-month pilot programme trained five community leaders who, along with staff, provided HIV-prevention information and supplies to MSM through small-group meetings, community-based social activities and inter-community events. After the completion of the pilot programme, in-depth interviews and focus group discussions (FGDs) were conducted with a subset of conveniently sampled participants and with each of the community leaders. Qualitative data were then analyzed thematically. Results Overall, 98 mostly gay-identified black MSM consented to participate, 57 community-based activities were facilitated and 9 inter-community events were conducted. Following their enrolment, 60% (59/98) of participants attended at least one pilot activity. Of those participants, 47% (28/59) attended at least half of the scheduled activities. A total of 36 participants took part in FGDs, and five in-depth interviews were completed with community leaders. Participants reported gaining access to MSM-specific HIV-prevention information, condoms and water-based lubricant through the small-group meetings. Some participants described how their feelings of loneliness, social isolation, self-esteem and self-efficacy were improved after taking part. Conclusions The social activities and group meetings were viable strategies for disseminating HIV-prevention information, condoms and water-based lubricant to MSM in this setting. Many MSM were also able to receive social support, reduce social isolation and improve their

  6. Profiles of men-who-have-sex-with-men seeking anonymous voluntary HIV counseling and testing at a community-based centre in Malaysia.

    PubMed

    Koh, K C; Kamarulzaman, A

    2011-12-01

    Community-based HIV voluntary counseling and testing (VCT) services is an effective alternative for mapping the local demographics of at-risk populations for HIV as well as provide an acceptable and reliable means of early detection of HIV. We describe the profiles of men-who-have-sex-with-men (MSM) who sought VCT services in a community based centre in Kuala Lumpur.

  7. HIV risk perception and testing behaviours among men having sex with men (MSM) reporting potential transmission risks in the previous 12 months from a large online sample of MSM living in Germany.

    PubMed

    Marcus, Ulrich; Gassowski, Martyna; Drewes, Jochen

    2016-10-22

    HIV testing and serostatus awareness are essential to implement biomedical strategies (treatment as prevention; oral chemoprophylaxis), and for effective serostatus-based behaviours (HIV serosorting; strategic positioning). The analysis focuses on the associations between reported sexual risks, the perceived risk for HIV infection, and HIV testing behaviour in order to identify the most relevant barriers for HIV test uptake among MSM living in Germany. MSM were recruited to a nationwide anonymous online-survey in 2013 on MSM social networking/dating sites. Questions covered testing behaviours, reasons for testing decisions, and HIV risk perception (5-point scale). Additional questions addressed arguments in favour of home/ home collection testing (HT). Using descriptive statistics and logistic regression we compared men reporting recent HIV testing (RT; previous 12 month) with men never tested (NT) in a subsample not previously diagnosed with HIV and reporting ≥2 episodes of condomless anal intercourse (CLAI) with a non-steady partner of unknown HIV serostatus in the previous 12 months. The subsample consisted of 775 RT (13 % of RT) and 396 NT (7 % of NT). The number of CLAI episodes in the last 12 months with non-steady partners of unknown HIV status did not differ significantly between the groups, but RT reported significantly higher numbers of partners (>5 AI partners: 65 vs. 44 %). While perceived risks regarding last AI were comparable between the groups, 49vs. 30 % NT were <30 years, lived more often in towns/villages <100,000 residents (60 vs. 39 %), were less out-particularly towards care providers-about being attracted to men (aOR 10.1; 6.9-14.8), more often identified as bisexual (aOR 3.5; 2.5-4.8), and reported lower testing intentions (aOR 0.08; 0.06-0.11). Perceived risks (67 %) and routine testing (49 %) were the most common testing reasons for RT, while the strong belief not to be infected (59 %) and various worries (41 %) and fears of

  8. Enhancement of a locally developed HIV prevention intervention for Hispanic/Latino MSM: A partnership of community-based organizations, a university, and the Centers for Disease Control and Prevention

    PubMed Central

    Rhodes, Scott D.; Alonzo, Jorge; Mann, Lilli; Freeman, Arin; Sun, Christina J.; Garcia, Manuel; Painter, Thomas M.

    2015-01-01

    Hispanic/Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs); however, no efficacious behavioral interventions are currently available for use with this vulnerable population. We describe the development and enhancement of HOLA en Grupos, a community-based behavioral HIV/STD prevention intervention for Spanish-speaking Hispanic/Latino MSM that is currently being implemented and evaluated. Our enhancement process included incorporating local data on risks and context; identifying community priorities; defining intervention core elements and key characteristics; developing a logic model; developing an intervention logo; enhancing intervention activities and materials; scripting intervention delivery; expanding the comparison intervention; and establishing a materials review committee. If efficacious, HOLA en Grupos will be the first behavioral intervention to be identified for potential use with Hispanic/Latino MSM, thereby contributing to the body of evidence-based resources that may be used for preventing HIV/STD infection among these MSM and their sex partners. PMID:26241382

  9. Enhancement of a Locally Developed HIV Prevention Intervention for Hispanic/Latino MSM: A Partnership of Community-Based Organizations, a University, and the Centers for Disease Control and Prevention.

    PubMed

    Rhodes, Scott D; Alonzo, Jorge; Mann, Lilli; Freeman, Arin; Sun, Christina J; Garcia, Manuel; Painter, Thomas M

    2015-08-01

    Hispanic/Latino men who have sex with men (MSM) in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs); however, no efficacious behavioral HIV/STD prevention interventions are currently available for use with this vulnerable population. We describe the enhancement of HOLA en Grupos, a community-based behavioral HIV/STD prevention intervention for Spanish-speaking Hispanic/Latino MSM that is currently being implemented and evaluated in North Carolina with support from the Centers of Disease Control and Prevention (CDC). Our intervention enhancement process included incorporating local data on risks and context; identifying community needs and priorities; defining intervention core elements and key characteristics; developing a logic model; developing an intervention logo; enhancing intervention activities and materials; scripting intervention delivery; expanding the comparison intervention; and establishing a materials review committee. If the CDC-sponsored evaluation determines that HOLA en Grupos is efficacious, it will be the first such behavioral HIV/STD prevention intervention to be identified for potential use with Hispanic/Latino MSM, thereby contributing to the body of evidence-based resources that may be used for preventing HIV/STD infection among these MSM and their sex partners.

  10. Hepatitis B vaccination uptake and correlates of serologic response among HIV-infected and uninfected men who have sex with men (MSM) in Bangkok, Thailand.

    PubMed

    Chonwattana, Wannee; Raengsakulrach, Boonyos; Holtz, Timothy H; Wasinrapee, Punneeporn; Tongtoyai, Jaray; Chaikummao, Supaporn; Pattanasin, Sarika; McNicholl, Janet M; van Griensven, Frits; Curlin, Marcel E

    2016-04-12

    Vaccination against hepatitis B virus (HBV) is recommended for all HBV-susceptible men who have sex with men (MSM). There is limited information on correlates of immunity to HBV vaccination in this group. We present serologic response rates to hepatitis B vaccine and identify factors associated with impaired response among HIV-uninfected and HIV-infected Thai MSM. HBV-susceptible volunteers were offered hepatitis B vaccination at months zero, one, and six. We measured baseline (pre-vaccination) total serum IgG and IgG subclasses (all participants), baseline CD4 count, and plasma HIV-1 viral load (PVL) (HIV+ participants). HBV serologies were retested at 12 months. Serologic responses were compared between all groups in men receiving three vaccine doses. 511/651 HIV-negative and 64/84 HIV-positive participants completed the three-dose series. Response rates in HIV-uninfected and -infected participants were 90.1% vs. 50.0% (p<0.0001). Median pre-vaccination IgG was higher among non-responders than responders overall (1238.9.0 vs. 1057.0mg/dL, p=0.003) and among HIV-infected participants (1534.0 vs. 1244.5mg/dL, p=0.005), but not significantly among HIV-uninfected participants (1105.5 vs. 1054.3mg/dL, p=0.96). Pre-vaccination IgG1 and IgG3 levels were higher among HIV-positive than HIV-negative participants (median 866.0 vs. 520.3, and 105.8 vs. 83.1mg/dL, respectively, p<0.0001). Among HIV-infected participants, median CD4 count in non-responders was 378 cells/μL vs. 431 cells/μL in responders (p=0.20). Median PVL in non-responders was 64,800 copies/mL vs. 15500 copies/mL in responders (p=0.04). Participants with pre-vaccination plasma IgG >1550 mg/dL and PVL >10,000 copies/mL were almost always non-responsive (p<0.01). HIV infection was associated with poor vaccine responses. High plasma viral load, elevated pre-vaccination total serum IgG and elevated pre-vaccination IgG1 are associated with poorer response to vaccination among HIV-infected MSM. In this group

  11. Transactional Sex: Supply and Demand Among European Men Who have Sex with Men (MSM) in the Context of Local Laws

    PubMed Central

    Berg, Rigmor C.; Schmidt, Axel J.; Weatherburn, Peter; The EMIS Network

    2015-01-01

    ABSTRACT Objectives: Transactional sex (TS) is generally defined as the trading of sex for material goods. Cast within the broader context of prostitution laws, we examined variations in the sociodemographic profile of men who have sex with men engaging in TS by payment direction (buying/selling). Methods: The data were collected as part of the 38-country European Men who have sex with men Internet Survey project, conducted in 2010. Results: About 12% of respondents reported engaging in TS in the past year. TS was associated with laws, age, education, employment, and residence. Conclusions: The striking sociodemographic differences in TS by payment direction suggest a power differential and a leading role of socioeconomic factors in TS. PMID:26430474

  12. Outbreak of hepatitis A associated with men who have sex with men (MSM), England, July 2016 to January 2017.

    PubMed

    Beebeejaun, Kazim; Degala, Srilaxmi; Balogun, Koye; Simms, Ian; Woodhall, Sarah Charlotte; Heinsbroek, Ellen; Crook, Paul David; Kar-Purkayastha, Ishani; Treacy, Juli; Wedgwood, Kate; Jordan, Kate; Mandal, Sema; Ngui, Siew Lin; Edelstein, Michael

    2017-02-02

    Between July 2016 and January 2017, 37 confirmed cases of hepatitis A with two unique IA genotype strains primarily among men who have sex with men, were reported across eight areas in England and Northern Ireland. Epidemiological and laboratory investigations indicate that these strains may have been imported several times from Spain, with secondary sexual transmission in the United Kingdom. Local and national public health services are collaborating to control this ongoing outbreak.

  13. Sexual health of ethnic minority MSM in Britain (MESH project): design and methods.

    PubMed

    Elford, Jonathan; McKeown, Eamonn; Doerner, Rita; Nelson, Simon; Low, Nicola; Anderson, Jane

    2010-07-14

    Men who have sex with men (MSM) remain the group most at risk of acquiring HIV infection in Britain. HIV prevalence appears to vary widely between MSM from different ethnic minority groups in this country for reasons that are not fully understood. The aim of the MESH project was to examine in detail the sexual health of ethnic minority MSM living in Britain. The main objectives of the MESH project were to explore among ethnic minority MSM living in Britain: (i) sexual risk behaviour and HIV prevalence; (ii) their experience of stigma and discrimination; (iii) disclosure of sexuality; (iv) use of, and satisfaction with sexual health services; (v) the extent to which sexual health services (for treatment and prevention) are aware of the needs of ethnic minority MSM.The research was conducted between 2006 and 2008 in four national samples: (i) ethnic minority MSM living in Britain; (ii) a comparison group of white British MSM living in Britain; (iii) NHS sexual health clinic staff in 15 British towns and cities with significant ethnic minority communities and; (iv) sexual health promotion/HIV prevention service providers. We also recruited men from two "key migrant" groups living in Britain: MSM born in Central or Eastern Europe and MSM born in Central or South America.Internet-based quantitative and qualitative research methods were used. Ethnic minority MSM were recruited through advertisements on websites, in community venues, via informal networks and in sexual health clinics. White and "key migrant" MSM were recruited mostly through Gaydar, one of the most popular dating sites used by gay men in Britain. MSM who agreed to take part completed a questionnaire online. Ethnic minority MSM who completed the online questionnaire were asked if they would be willing to take part in an online qualitative interview using email.Service providers were identified through the British Association of Sexual Health and HIV (BASHH) and the Terrence Higgins Trust (THT) CHAPS

  14. Spontaneous viral clearance of hepatitis C virus (HCV) infection among people who inject drugs (PWID) and HIV-positive men who have sex with men (HIV+ MSM): a systematic review and meta-analysis.

    PubMed

    Smith, Daniel J; Jordan, Ashly E; Frank, Mayu; Hagan, Holly

    2016-09-05

    Hepatitis C virus (HCV) infection causes significant morbidity and mortality among people who inject drugs (PWID) and HIV+ men who have sex with men (MSM). Characterizing spontaneous viral clearance of HCV infection among PWID and HIV+ MSM is important for assessing the burden of disease and treatment strategies in these populations. Electronic and other searches of medical literature were conducted. Reports were eligible if they presented original data from upper-middle- and high-income countries on laboratory-confirmed HCV infection and spontaneous viral clearance among PWID or HIV+ MSM. Pooled estimates of spontaneous viral clearance were generated using fixed-effect and random-effects models. Meta-regression examined potential predictors related to individual characteristics and research methodology. The meta-analysis estimated that spontaneous viral clearance occurs in 24.4 % of PWID and 15.4 % of HIV+ MSM. In univariate meta-regression among PWID, male sex and age were significantly associated with spontaneous viral clearance, and in multivariate analysis, male sex and HIV positivity were predictors of spontaneous viral clearance; among HIV+ MSM no variables were found to affect spontaneous viral clearance. The variability in estimates of spontaneous viral clearance between HIV+ MSM and PWID suggests the impact of HIV co-infection and HCV re-infection. Due to limited data on additional factors that may affect the natural history of HCV, more research is needed to further understand spontaneous viral clearance in these risk groups. The protocols for the PWID and HIV+ MSM research were registered with PROSPERO (CRD42014008805; CRD42013006462).

  15. Amphetamine-Type-Stimulants (ATS) Use and Homosexuality-Related Enacted Stigma Are Associated With Depression Among Men Who Have Sex With Men (MSM) in Two Major Cities in Vietnam in 2014.

    PubMed

    Vu, Nga Thi Thu; Holt, Martin; Phan, Huong Thi Thu; La, Lan Thi; Tran, Gioi Minh; Doan, Tung Thanh; Nguyen, Trang Nguyen Nhu; de Wit, John

    2017-09-19

    Men who have sex with men (MSM) are disproportionately affected by mental health concerns, including depression. Amphetamine-type-stimulants (ATS) use and homosexuality-related stigma and discrimination have been found associated with depression among MSM. To assess the prevalence of depression and its associations with ATS use and homosexuality-related stigma and discrimination among MSM in Vietnam. 622 MSM were conveniently recruited in Hanoi and Ho Chi Minh city, Vietnam, from September to December 2014. We collected information on demographic characteristics, ATS, alcohol and other drug use, sexual behaviors, homosexuality-related and discrimination stigma, and sexual sensation-seeking. Depression and suicidal thoughts were assessed by the Patient Health Questionnaire (PHQ-9). We assessed associations of depression with ATS use and homosexuality-related stigma and discrimination using logistic regression. Of 622 sampled MSM, 11.3% were classified as having major depression, 9.8% reported any suicidal thoughts in the last two weeks, 30.4% ever had used any ATS, 88.8% ever ad drank alcohol and 21.5% had ever used any other drugs. In multivariate analysis, depression was significantly associated with ATS use (Adjusted Odds Ratio [AOR: 2.20; (95% Confidence Interval (CI): 1.32-3.67], younger age of sexual debut with another man (AOR: 0.09; 95% CI: 0.02-0.50), and greater enacted homosexuality-related stigma (AOR: 1.97; 95% CI: 1.19-3.26). We found a moderate prevalence of depression among sampled MSM, which was associated with ATS use and enacted homosexuality-related stigma. We recommend integrating assessment and interventions regarding depression and methamphetamine use into gay-friendly, culturally adapted holistic HIV prevention for MSM in Vietnam.

  16. Challenges of respondent driven sampling to assess sexual behaviour and estimate the prevalence of human immunodeficiency virus (HIV) and syphilis in men who have sex with men (MSM) in Singapore.

    PubMed

    Chua, Arlene C; Chen, Mark Ic; Cavailler, Philippe; Jiang, Lili; Abdullah, Mohammed Ridzwan; Ng, Oon Tek; Chio, Martin; Koe, Stuart; Tay, Joanne; Wong, Mee Lian; Chan, Roy

    2013-07-01

    There is a lack of representative samples to provide reliable and accurate seroprevalence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) as well as behavioural information among men who have sex with men (MSM) in Singapore. We used respondent driven sampling (RDS) to recruit MSM. Participants completed a survey used by Asian Internet MSM Sex Survey (AIMSS) and were tested for HIV and syphilis. We compared the characteristics of the RDS participants with STI diagnosis against those who did not have any STI diagnosis in the past 6 months. We compared RDS participants with AIMSS participants. Of 72 MSM recruited, 1 was positive for HIV (1.3%) and 4 (5.5%) tested positive for syphilis. Median age was 30 years and majority was Chinese (69.4%). RDS participants who had any STI diagnosis reported to have more use of recreational drugs (P = 0.006), and lower condom use (P = 0.054). Comparing RDS participants (n = 72) with the AIMSS participants (n = 2075), RDS respondents had ≥1 male partner in the past 6 months (P = 0.003), more casual sex partners (P = 0.012) and more STI symptoms (P = 0.019). There was no difference in terms of HIV testing and recreational drug use. The HIV and syphilis seroprevalence rates from our study are similar to previous reports conducted in high-risk MSM. In contrast to other settings, RDS did not work well among MSM in Singapore. The public health implications of our study highlight the challenges in obtaining data for HIV surveillance in assessing prevalence and risk behaviours among MSM.

  17. The Importance of Risk Perception: Predictors of PrEP Acceptance Among Thai MSM and TG Women at a Community-Based Health Service.

    PubMed

    Plotzker, Rosalyn; Seekaew, Pich; Jantarapakde, Jureeporn; Pengnonyang, Supabhorn; Trachunthong, Deondara; Lingjongrat, Danai; Janyam, Surang; Nakpor, Thitiyanun; Charoenying, Sutinee; Mills, Stephen; Vannakit, Ravipa; Cassell, Michael; Phanuphak, Praphan; Lertpiriyasuwat, Cheewanan; Phanuphak, Nittaya

    2017-09-07

    HIV prevalence among Thai men who have sex with men (MSM) and transgender women (TG) are 9.15% and 11.8% respectively, compared to 1.1% in the general population. To better understand early adopters of Pre-Exposure Prophylaxis (PrEP) in Thailand, we analyzed bio-behavioral and socio-demographic characteristics of PrEP-eligible MSM and TG. Four Thai urban community clinics between October 2015 and February 2016 METHODS:: Socio-demographics, HIV risk characteristics, and PrEP knowledge and attitudes, were analyzed in association with PrEP initiation among eligible Thai MSM and TG. Adjusted analysis explored factors associated with PrEP acceptance. We then analyzed HIV risk perception, which was strongly associated with PrEP initiation. Of 297 participants, 55% accepted PrEP (48% of MSM, 54% of TG). Perceived HIV risk levels were associated with PrEP acceptance (OR 4.3; 95%CI:1.5-12.2. OR 6.3; 95%CI:2.1-19.0. OR 14.7; 95%CI:3.9-55.1; for minimal, moderate, and high perceived risks, respectively). HIV risk perception was associated with prior HIV testing (OR 2.2; 95%CI:1.4-3.5); inconsistent condom use (OR:1.8; 95%CI:1.1-2.9); amphetamine use in the past 6 months (OR:3.1; 95%CI:1.1-8.6); and uncertainty in STI history (OR:2.3; 95%CI:1.4-3.7). Approximately half of those who reported either inconsistent condom use (46%), multiple partners (50%), group sex (48%), or had baseline bacterial STI (48%) perceived themselves as having no or mild HIV risk. HIV risk perception plays an important role in PrEP acceptance. Perception does not consistently reflect actual risk. It is therefor critical to assess a client's risk perception, and provide education about HIV risk factors that will improve the accuracy of perceived HIV risk.

  18. Biomarker-Based HIV Incidence in a Community Sample of Men Who Have Sex with Men in Paris, France

    PubMed Central

    Le Vu, Stéphane; Velter, Annie; Meyer, Laurence; Peytavin, Gilles; Guinard, Jérôme; Pillonel, Josiane; Barin, Francis; Semaille, Caroline

    2012-01-01

    Background Population-based estimates of HIV incidence in France have revealed that men who have sex with men (MSM) are the most affected population and contribute to nearly half of new infections each year. We sought to estimate HIV incidence among sexually active MSM in Paris gay community social venues. Methodology/ Principal Findings A cross-sectional survey was conducted in 2009 in a sample of commercial venues such as bars, saunas and backrooms. We collected a behavioural questionnaire and blood sample. Specimens were tested for HIV infection and positive specimens then tested for recent infection by the enzyme immunoassay for recent HIV-1 infection (EIA-RI). We assessed the presence of antiretroviral therapy among infected individuals to rule out treated patients in the algorithm that determined recent infection. Biomarker-based cross-sectional incidence estimates were calculated. We enrolled 886 MSM participants among which 157 (18%) tested HIV positive. In positive individuals who knew they were infected, 75% of EIA-RI positive results were due to ART. Of 157 HIV positive specimens, 15 were deemed to be recently infected. The overall HIV incidence was estimated at 3.8% person-years(py) [95%CI: 1.5–6.2]. Although differences were not significant, incidence was estimated to be 3.5% py [0.1–6.1] in men having had a negative HIV test in previous year and 4.8% py [0.1–10.6] in men having had their last HIV test more than one year before the survey, or never tested. Incidence was estimated at 4.1% py [0–8.3] in men under 35 years and 2.5% py [0–5.4] in older men. Conclusions/ Significance This is the first community-based survey to estimate HIV incidence among MSM in France. It includes ART detection and reveals a high level of HIV transmission in sexually active individuals, despite a high uptake of HIV testing. These data call for effective prevention programs targeting MSM engaged in high-risk behaviours. PMID:22768150

  19. Sexual behaviors, sexual health practices, and community engagement among gay and bisexually identified men living in rural areas of the United States.

    PubMed

    Rosenberger, Joshua G; Schick, Vanessa; Schnarrs, Phillip; Novak, David S; Reece, Michael

    2014-01-01

    Limited research has focused on the sexual behaviors of men who have sex with men (MSM) from rural communities. We examined the sexual and health-related behaviors of MSM living in rural areas of the United States in order to understand the sexual health repertoire of this population. A total of 5,357 participants living in rural settings were recruited online and completed an anonymous Internet-based survey that assessed sexual behaviors, condom use, and men's engagement with various community activities and events. These data provide a greater understanding of sexual health profiles that exist among rural MSM and will help inform the design of effective programs for men in these often underserved communities.

  20. Associations of current marital status and living arrangements with HIV and syphilis risk: findings from a community-based sample of men who have sex with men in China.

    PubMed

    Liu, Yu; Li, Dongliang; Vermund, Sten H; Zhang, Chen; Ruan, Yuhua; Yin, Lu; Liu, Hongjie; Amico, K Rivet; Shao, Yiming; Qian, Han-Zhu

    2016-11-01

    Chinese men who have sex with men (MSM) are disproportionally affected by HIV and sexually transmitted infections (STIs), but little is known about the role of current marital status and living arrangements in shaping their HIV/syphilis risk. A cross-sectional study was conducted among MSM in Beijing, China to assess their sociodemographic/behavioral characteristics between married and single MSM, and test the hypothesis that currently married MSM have a lower odds of being HIV- and/or syphilis-infected. Participants were recruited via short message services, peer referral, internet, and community outreach. Data collection was based on a questionnaire survey and self-report. Infection status was lab-confirmed. Multivariable logistic regression modeling was used to assess the association of marital status and living arrangement with HIV/syphilis risk. Of the 3588 MSM, infection prevalence was high (HIV = 12.7%; syphilis = 7.5%). Compared to single MSM living with their boyfriends or male sex partners, single/alone MSM and married MSM living with wives were less likely to practice condomless insertive (CIAI) or receptive (CRAI) anal intercourse with men; while married MSM living with boyfriends or male sex partner were more likely to practice CIAI and CRAI, and married MSM were more likely to practice condomless vaginal sex. Compared to men living with boyfriends/sexual partners, significantly reduced odds of being HIV-positive were seen among married MSM who were living alone (aOR: 0.52; 95%CI: 0.28, 0.94) or living with their wives (aOR: 0.53; 95%CI: 0.31, 0.89). Similarly, single MSM living alone (aOR: 0.67; 95%CI: 0.48, 0.95) and married MSM living with their wives were comparatively less likely to be syphilis-infected (aOR: 0.43; 95%CI: 0.23, 0.79). Future efforts should consider characteristics of marital status and living arrangements for designing subgroup-specific risk reduction strategies among Chinese MSM.

  1. Correlates of Seroadaptation Strategies Among Black Men Who have Sex with Men (MSM) in 4 US Cities

    PubMed Central

    Koblin, Beryl; Nandi, Vijay; Xu, Guozhen; Latkin, Carl; Seal, David; Flores, Stephen A.; Spikes, Pilgrim

    2015-01-01

    We assessed associations of demographic, psychosocial, and substance use factors with seroadaptation strategies among 835 BMSM in four US cities. Seroadaptation strategies were practiced by 59.8 % of men, with 10.5 % practicing 100 % condom use, 26.5 % serosorting, 7.2 % condom serosorting, and 15.6 % seropositioning. In multivariable analyses, compared to men who used no seroadaptation strategies, serosorters were older, were less likely to be HIV infected, had fewer male sex partners, and had higher levels of social support and sexual self-efficacy. Condom serosorters had less psychological distress, were more likely to use methamphetamine, and had higher levels of sexual self-efficacy. Seropositioners were older, were less likely to be HIV infected, to have a main partner, and report alcohol/drug use with sex, while having higher levels of sexual self-efficacy. Seroadaptation practices among BMSM need to be considered to address perceived safer sex strategies and strengthen access to a broader reach of culturally-relevant prevention efforts. PMID:26363789

  2. HIV Prevention Messages Targeting Young Latino Immigrant MSM

    PubMed Central

    Solorio, Rosa; Forehand, Mark; Aguirre, Joel

    2014-01-01

    Young Latino immigrant men who have sex with men (MSM) are at risk for HIV and for delayed diagnosis. A need exists to raise awareness about HIV prevention in this population, including the benefits of timely HIV testing. This project was developed through collaboration between University of WA researchers and Entre Hermanos, a community-based organization serving Latinos. Building from a community-based participatory research approach, the researchers developed a campaign that was executed by Activate Brands, based in Denver, Colorado. The authors (a) describe the development of HIV prevention messages through the integration of previously collected formative data; (b) describe the process of translating these messages into PSAs, including the application of a marketing strategy; (c) describe testing the PSAs within the Latino MSM community; and (c) determine a set of important factors to consider when developing HIV prevention messages for young Latino MSM who do not identify as gay. PMID:24864201

  3. HIV Prevention Messages Targeting Young Latino Immigrant MSM.

    PubMed

    Solorio, Rosa; Norton-Shelpuk, Pamela; Forehand, Mark; Martinez, Marcos; Aguirre, Joel

    2014-01-01

    Young Latino immigrant men who have sex with men (MSM) are at risk for HIV and for delayed diagnosis. A need exists to raise awareness about HIV prevention in this population, including the benefits of timely HIV testing. This project was developed through collaboration between University of WA researchers and Entre Hermanos, a community-based organization serving Latinos. Building from a community-based participatory research approach, the researchers developed a campaign that was executed by Activate Brands, based in Denver, Colorado. The authors (a) describe the development of HIV prevention messages through the integration of previously collected formative data; (b) describe the process of translating these messages into PSAs, including the application of a marketing strategy; (c) describe testing the PSAs within the Latino MSM community; and (c) determine a set of important factors to consider when developing HIV prevention messages for young Latino MSM who do not identify as gay.

  4. Correlates of sexual risk for HIV among US-born and foreign-born Latino men who have sex with men (MSM): an analysis from the Brothers y Hermanos study.

    PubMed

    Mizuno, Yuko; Borkowf, Craig B; Ayala, George; Carballo-Diéguez, Alex; Millett, Gregorio A

    2015-02-01

    Little research has been conducted to examine whether correlates of sexual risk vary by nativity among Latino men who have sex with men (MSM). We used cross sectional data collected from 870 Latino MSM recruited with respondent-driven sampling techniques. For each sub-sample (US-born and foreign-born), we assessed the association between each of the potential correlates (substance use, acculturation, social support, and social discrimination) and sexual risk behavior. Illicit drug use was associated with increased odds of sexual risk behavior in both US-born (OR = 2.17, 95% CI 1.17-4.03) and foreign-born (OR = 1.86, 1.14-3.05) subgroups. Multivariate correlates specific to foreign-born men included binge drinking (OR = 1.91, 1.17-3.14), 15 years or longer spent in the US (OR = 1.79, 1.06-3.03) and exposure to social discrimination (OR = 2.02, 1.03-3.99). Given the diversity of Latino MSM, information from research that identifies both common and different HIV risk factors across subgroups of Latino MSM may help better tailor HIV prevention programs.

  5. Correlates of sexual risk for HIV among U.S.-born and Foreign-born Latino Men who have Sex with Men (MSM): An Analysis from the Brothers y Hermanos study

    PubMed Central

    Mizuno, Yuko; Borkowf, Craig B.; Ayala, George; Carballo-Diéguez, Alex; Millett, Gregorio A.

    2015-01-01

    Little research has been conducted to examine whether correlates of sexual risk vary by nativity among Latino men who have sex with men (MSM). We used cross sectional data collected from 870 Latino MSM recruited with respondent-driven sampling techniques. For each sub-sample (US-born and foreign-born), we assessed the association between each of the potential correlates (substance use, acculturation, social support, and social discrimination) and sexual risk behavior. Illicit drug use was associated with increased odds of sexual risk behavior in both US-born (OR=2.17, 95% CI: 1.17–4.03) and foreign-born (OR=1.86, 1.14–3.05) subgroups. Multivariate correlates specific to foreign-born men included binge drinking (OR=1.91, 1.17–3.14), 15 years or longer spent in the US (OR=1.79, 1.06–3.03) and exposure to social discrimination (OR=2.02, 1.03–3.99). Given the diversity of Latino MSM, information from research that identifies both common and different HIV risk factors across subgroups of Latino MSM may help better tailor HIV prevention programs. PMID:23949695

  6. Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up?

    PubMed

    Lallemand, Anne; Bremer, Viviane; Jansen, Klaus; Nielsen, Stine; Münstermann, Dieter; Lucht, Andreas; Tiemann, Carsten

    2016-10-26

    Patients asking for a free anonymous HIV test may have contracted other sexually transmitted infections (STIs) such as Chlamydia trachomatis, yet Chlamydia prevalence in that population is unknown. This study aimed to assess the prevalence and factors associated with Chlamydia infection in patients seeking HIV testing at local public health authorities (LPHA) in order to evaluate whether Chlamydia testing should be routinely offered to them. We conducted a cross-sectional study among patients (≥18 years) attending 18 LPHA in North Rhine-Westphalia from November 2012 to September 2013. LPHA collected information on participants' socio-demographic characteristics, sexual and HIV testing behaviours, previous STI history and clinical symptoms. Self-collected vaginal swabs and urine (men) were analysed by Transcription-Mediated Amplification. We assessed overall and age-stratified Chlamydia prevalence and 95 % confidence intervals (95 % CI). Using univariate and multivariable binomial regression, we estimated adjusted prevalence ratios (aPR) to identify factors associated with Chlamydia infection. The study population comprised 1144 (40.5 %) women, 1134 (40.1 %) heterosexual men and 549 (19.4 %) men who have sex with men (MSM); median age was 30 years. Chlamydia prevalence was 5.3 % (95 % CI: 4.1-6.8 %) among women, 3.2 % (95 % CI: 2.2-4.4) in heterosexual men and 3.5 % (95 % CI: 2.1-5.4) in MSM. Prevalence was highest among 18-24 year-old women (9 %; 95 % CI: 5.8-13) and heterosexual men (5.7 %; 95 % CI: 3.0-9.8 %), respectively. Among MSM, the prevalence was highest among 30-39 year-olds (4.4 %; 95 % CI: 1.9-8.5 %). Among those who tested positive, 76.7 % of women, 75.0 % of heterosexual men and 84.2 % of MSM were asymptomatic. Among women, factors associated with Chlamydia infection were young age (18-24 years versus ≥ 40 years, aPR: 3.0, 95 % CI: 1.2-7.8), having had more than 2 partners over the past 6 months (ref.: one partner, aPR: 2

  7. Partner notification in cooperation with community-based organizations among HIV-positive men who have sex with men in two Chinese cities

    PubMed Central

    Fu, Xiaojing; Qi, Jinlei; Hu, Yifei; Pan, Xiaohong; Li, Youfang; Liu, Hui; Wu, Di; Yin, Wenyuan; Zhao, Yuan; Shan, Duo; Zhang, Nanci Nanyi; Zhang, Dapeng

    2016-01-01

    The epidemic of HIV/AIDS among Chinese men who have sex with men (MSM) is rapidly escalating. We implemented partner notification among HIV-infected MSM, cooperating with MSM-serving community-based organizations (CBOs) in two Chinese cities from June 2014 to May 2015. CBOs participated in identifying new HIV-positive MSM utilizing rapid HIV tests and partner notification among index cases. 253 index cases were recruited and 275 sexual partners were notified and tested with 10.5% screened positive. Compared with previously identified index cases, the proportion of contactable sexual partners of newly identified index cases was higher, but the testing rate was lower (p < 0.001). Overall, 83.7% of sexual partners were casual with a contactable rate of 24.9% and a HIV testing rate of 71.1%. Having no contact information for sexual partners and fear of disclosure of HIV status are the main reasons for declining partner notification. It is feasible and effective to perform partner notification in cooperation with CBOs serving Chinese MSM. PMID:27140946

  8. Estimating the Population Sizes of Men Who Have Sex With Men in US States and Counties Using Data From the American Community Survey.

    PubMed

    Grey, Jeremy A; Bernstein, Kyle T; Sullivan, Patrick S; Purcell, David W; Chesson, Harrell W; Gift, Thomas L; Rosenberg, Eli S

    2016-01-01

    In the United States, male-to-male sexual transmission accounts for the greatest number of new human immunodeficiency virus (HIV) diagnoses and a substantial number of sexually transmitted infections (STI) annually. However, the prevalence and annual incidence of HIV and other STIs among men who have sex with men (MSM) cannot be estimated in local contexts because demographic data on sexual behavior, particularly same-sex behavior, are not routinely collected by large-scale surveys that allow analysis at state, county, or finer levels, such as the US decennial census or the American Community Survey (ACS). Therefore, techniques for indirectly estimating population sizes of MSM are necessary to supply denominators for rates at various geographic levels. Our objectives were to indirectly estimate MSM population sizes at the county level to incorporate recent data estimates and to aggregate county-level estimates to states and core-based statistical areas (CBSAs). We used data from the ACS to calculate a weight for each county in the United States based on its relative proportion of households that were headed by a male who lived with a male partner, compared with the overall proportion among counties at the same level of urbanicity (ie, large central metropolitan county, large fringe metropolitan county, medium/small metropolitan county, or nonmetropolitan county). We then used this weight to adjust the urbanicity-stratified percentage of adult men who had sex with a man in the past year, according to estimates derived from the National Health and Nutrition Examination Survey (NHANES), for each county. We multiplied the weighted percentages by the number of adult men in each county to estimate its number of MSM, summing county-level estimates to create state- and CBSA-level estimates. Finally, we scaled our estimated MSM population sizes to a meta-analytic estimate of the percentage of US MSM in the past 5 years (3.9%). We found that the percentage of MSM among adult

  9. Estimating the Population Sizes of Men Who Have Sex With Men in US States and Counties Using Data From the American Community Survey

    PubMed Central

    Bernstein, Kyle T; Sullivan, Patrick S; Purcell, David W; Chesson, Harrell W; Gift, Thomas L; Rosenberg, Eli S

    2016-01-01

    Background In the United States, male-to-male sexual transmission accounts for the greatest number of new human immunodeficiency virus (HIV) diagnoses and a substantial number of sexually transmitted infections (STI) annually. However, the prevalence and annual incidence of HIV and other STIs among men who have sex with men (MSM) cannot be estimated in local contexts because demographic data on sexual behavior, particularly same-sex behavior, are not routinely collected by large-scale surveys that allow analysis at state, county, or finer levels, such as the US decennial census or the American Community Survey (ACS). Therefore, techniques for indirectly estimating population sizes of MSM are necessary to supply denominators for rates at various geographic levels. Objective Our objectives were to indirectly estimate MSM population sizes at the county level to incorporate recent data estimates and to aggregate county-level estimates to states and core-based statistical areas (CBSAs). Methods We used data from the ACS to calculate a weight for each county in the United States based on its relative proportion of households that were headed by a male who lived with a male partner, compared with the overall proportion among counties at the same level of urbanicity (ie, large central metropolitan county, large fringe metropolitan county, medium/small metropolitan county, or nonmetropolitan county). We then used this weight to adjust the urbanicity-stratified percentage of adult men who had sex with a man in the past year, according to estimates derived from the National Health and Nutrition Examination Survey (NHANES), for each county. We multiplied the weighted percentages by the number of adult men in each county to estimate its number of MSM, summing county-level estimates to create state- and CBSA-level estimates. Finally, we scaled our estimated MSM population sizes to a meta-analytic estimate of the percentage of US MSM in the past 5 years (3.9%). Results We found

  10. HIV risk and prevention among men who have sex with men (MSM) in peri-urban townships in Cape Town, South Africa.

    PubMed

    Jobson, Geoffrey; de Swardt, Glenn; Rebe, Kevin; Struthers, Helen; McIntyre, James

    2013-05-01

    Current guidelines on HIV prevention for MSM emphasise the need for 'combination prevention' based on context-specific understandings of HIV risk. MSM in South Africa are a population with a high risk of HIV infection, however there is little research available on the drivers of this risk. In the context of a focus on combination prevention, this paper argues that effective HIV prevention for MSM in South Africa requires an understanding of the factors at multiple 'distances' from individuals that contribute to HIV risk. Based on qualitative research with MSM in Cape Town, South Africa, we situate HIV risk using a socio-ecological framework and identify factors at distal, proximal, and personal, levels that contribute to MSM's high risk of HIV infection. By understanding the interactions and linkages between risk environments and the risk situations in which HIV is transmitted, HIV prevention programmes will be more effectively able to address the multiple drivers of HIV risk in this population.

  11. The dynamics of the HIV epidemic among men who have sex with men (MSM) from 2005 to 2012 in Shenzhen, China

    PubMed Central

    Zhao, Jin; Chen, Lin; Chaillon, Antoine; Zheng, Chenli; Cai, Wende; Yang, Zhengrong; Li, Guilian; Gan, Yongxia; Wang, Xiaohui; Hu, Yihong; Zhong, Ping; Zhang, Chiyu; Smith, Davey M.

    2016-01-01

    HIV-1 epidemics among MSM are a major public health concern in China, especially in large cities. This study sought to better understand the dynamics of HIV molecular epidemiology among MSM in Shenzhen, a rapidly developing city with over 13.8 million people. HIV-1 pol sequences were obtained from 996 (53.5%) of 1862 HIV-infected MSM and 403(9.0%) of 4498 heterosexuals and injection drug users in Shenzhen, China from 2005-2012. Eight HIV-1 subtypes and some inter-subtype recombinants were identified among sampled MSM with CRF07_BC (39.1%) and CRF01_AE (35.1%) being the most predominant. From 2006 to 2012, the prevalence of CRF07_BC and CRF55_01B rapidly increased, while the prevalence of subtypes B and CRF01_AE gradually decreased. The genetic distances within CRF07_BC and CRF55_01B groups were significantly lower than within CRF01_AE and B groups. The vast majority (90.3%) of HIV-1 infected MSM in Shenzhen were migrants who came from 31 of the 34 provinces of China, and these migrants had significantly different HIV-1 subtype distributions from the local MSM. This study highlighted the importance of CRF07_BC and migrants in the changing HIV epidemic among MSM in China, and provides a molecular epidemiology framework for understanding how HIV-1 epidemics can change in large cities with diverse risk groups. PMID:27352965

  12. Expanding Access to Non-Medicalized Community-Based Rapid Testing to Men Who Have Sex with Men: An Urgent HIV Prevention Intervention (The ANRS-DRAG Study)

    PubMed Central

    Lorente, Nicolas; Preau, Marie; Vernay-Vaisse, Chantal; Mora, Marion; Blanche, Jerome; Otis, Joanne; Passeron, Alain; Le Gall, Jean-Marie; Dhotte, Philippe; Carrieri, Maria Patrizia; Suzan-Monti, Marie; Spire, Bruno

    2013-01-01

    Background Little is known about the public health benefits of community-based, non-medicalized rapid HIV testing offers (CBOffer) specifically targeting men who have sex with men (MSM), compared with the standard medicalized HIV testing offer (SMOffer) in France. This study aimed to verify whether such a CBOffer, implemented in voluntary counselling and testing centres, could improve access to less recently HIV-tested MSM who present a risk behaviour profile similar to or higher than MSM tested with the SMOffer. Method This multisite study enrolled MSM attending voluntary counselling and testing centres’ during opening hours in the SMOffer. CBOffer enrolees voluntarily came to the centres outside of opening hours, following a communication campaign in gay venues. A self-administered questionnaire was used to investigate HIV testing history and sexual behaviours including inconsistent condom use and risk reduction behaviours (in particular, a score of “intentional avoidance” for various at-risk situations was calculated). A mixed logistic regression identified factors associated with access to the CBOffer. Results Among the 330 participants, 64% attended the CBOffer. Percentages of inconsistent condom use in both offers were similar (51% CBOffer, 50% SMOffer). In multivariate analyses, those attending the CBOffer had only one or no test in the previous two years, had a lower intentional avoidance score, and met more casual partners in saunas and backrooms than SMOffer enrolees. Conclusion This specific rapid CBOffer attracted MSM less recently HIV-tested, who presented similar inconsistent condom use rates to SMOffer enrolees but who exposed themselves more to HIV-associated risks. Increasing entry points for HIV testing using community and non-medicalized tests is a priority to reach MSM who are still excluded. PMID:23613817

  13. Men's Alcohol Expectancies at Selected Community Colleges

    ERIC Educational Resources Information Center

    Derby, Dustin C.

    2011-01-01

    Men's alcohol expectancies are an important cognitive-behavioral component of their consumption; yet, sparse research details such behaviors for men in two-year colleges. Selected for inclusion with the current study were 563 men from seven Illinois community colleges. Logistic regression analysis indicated four significant, positive relationships…

  14. Men's Alcohol Expectancies at Selected Community Colleges

    ERIC Educational Resources Information Center

    Derby, Dustin C.

    2011-01-01

    Men's alcohol expectancies are an important cognitive-behavioral component of their consumption; yet, sparse research details such behaviors for men in two-year colleges. Selected for inclusion with the current study were 563 men from seven Illinois community colleges. Logistic regression analysis indicated four significant, positive relationships…

  15. Diverse Rates of Depression Among Men Who Have Sex with Men (MSM) Across India: Insights from a Multi-site Mixed Method Study

    PubMed Central

    McFall, Allison M.; Srikrishnan, Aylur K.; Mehta, Shruti H.; Solomon, Sunil S.; Anand, Santhanam; Vasudevan, Canjeevaram K.; Solomon, Suniti; Celentano, David D.

    2015-01-01

    Poor psychosocial health contributes to HIV risk behavior and reduced engagement in treatment and care. This study investigates depression and its correlates among 11,992 MSM recruited via respondent driven sampling in 12 cities across India using the Patient Health Questionnaire-9 and supplemented by analysis of qualitative research from 15 sites with 363 MSM. Overall prevalence of depression was 11 %, with substantial variation across sites and subgroups of MSM, and high prevalence of suicidal thoughts among depressed MSM. In multivariable analyses identification as a kothi (feminine sexual identity) [adjusted odds ratio (aOR) = 1.91], disclosure of being MSM to non-family (aOR = 1.7) and family (aOR = 2.4), disclosure of HIV-status (aOR = 5.6), and substance use were associated with significantly higher odds of depression. Qualitative results emphasized dire social consequences of disclosing MSM- and HIV- status, especially to family, including suicidality. Combination prevention interventions should include mental health services that address disclosure, suicidality, and substance use. PMID:26386592

  16. Phylodynamic profile of HIV-1 subtype B, CRF01_AE and the recently emerging CRF51_01B among men who have sex with men (MSM) in Singapore.

    PubMed

    Ng, Kim Tien; Ng, Kah Ying; Khong, Wei Xin; Chew, Kuan Kiat; Singh, Palvinder Kaur; Yap, Joe Kwan; Tan, Mei Ting; Leo, Yee Sin; Laeyendecker, Oliver; Quinn, Thomas C; Kamarulzaman, Adeeba; Tee, Kok Keng; Ng, Oon Tek

    2013-01-01

    HIV-1 subtype B and CRF01_AE are the predominant infecting subtypes among men who have sex with men (MSM) in Singapore. The genetic history, population dynamics and pattern of transmission networks of these genotypes remain largely unknown. We delineated the phylodynamic profiles of HIV-1 subtype B, CRF01_AE and the recently characterized CRF51_01B strains circulating among the MSM population in Singapore. A total of 105 (49.5%) newly-diagnosed treatment-naïve MSM were recruited between February 2008 and August 2009. Phylogenetic reconstructions of the protease gene (HXB2: 2239 - 2629), gp120 (HXB2: 6942 - 7577) and gp41 (HXB2: 7803 - 8276) of the env gene uncovered five monophyletic transmission networks (two each within subtype B and CRF01_AE and one within CRF51_01B lineages) of different sizes (involving 3 - 23 MSM subjects, supported by posterior probability measure of 1.0). Bayesian coalescent analysis estimated that the emergence and dissemination of multiple sub-epidemic networks occurred between 1995 and 2005, driven largely by subtype B and later followed by CRF01_AE. Exponential increase in effective population size for both subtype B and CRF01_AE occurred between 2002 to 2007 and 2005 to 2007, respectively. Genealogical estimates suggested that the novel CRF51_01B lineages were probably generated through series of recombination events involving CRF01_AE and multiple subtype B ancestors. Our study provides the first insight on the phylodynamic profiles of HIV-1 subtype B, CRF01_AE and CRF51_01B viral strains circulating among MSM in Singapore.

  17. The Development and Feasibility of a Brief Risk Reduction Intervention for Newly HIV-Diagnosed Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Sikkema, Kathleen J.; Hansen, Nathan B.; Kochman, Arlene; Santos, Jonathan; Watt, Melissa H.; Wilson, Patrick A.; DeLorenzo, Allyson; Laudato, Jay; Mayer, Gal

    2011-01-01

    Men who have sex with men (MSM) represent more than half of all new HIV infections in the United States. Utilizing a collaborative, community-based approach, a brief risk reduction intervention was developed and pilot tested among newly HIV-diagnosed MSM receiving HIV care in a primary care setting. Sixty-five men, within 3 months of diagnosis,…

  18. The Development and Feasibility of a Brief Risk Reduction Intervention for Newly HIV-Diagnosed Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Sikkema, Kathleen J.; Hansen, Nathan B.; Kochman, Arlene; Santos, Jonathan; Watt, Melissa H.; Wilson, Patrick A.; DeLorenzo, Allyson; Laudato, Jay; Mayer, Gal

    2011-01-01

    Men who have sex with men (MSM) represent more than half of all new HIV infections in the United States. Utilizing a collaborative, community-based approach, a brief risk reduction intervention was developed and pilot tested among newly HIV-diagnosed MSM receiving HIV care in a primary care setting. Sixty-five men, within 3 months of diagnosis,…

  19. Explaining the appeal for immigrant men who have sex with men of a community-based rapid HIV-testing site in Montreal (Actuel sur Rue).

    PubMed

    Lessard, David; Lebouché, Bertrand; Engler, Kim; Thomas, Réjean; Machouf, Nimâ

    2015-01-01

    Immigrant men who have sex with men (MSM) are vulnerable to HIV. In the last decade, several rapid HIV-testing facilities targeting MSM have been established around the world and seem popular among immigrants. This study analyzes factors contributing to immigrant MSM's use of Actuel sur Rue (AsR), a community-based rapid HIV-testing site in Montreal's gay village, where 31% of clients are immigrants. From October 2013 to January 2014, AsR staff compiled a list of new clients born outside of Canada. With their consent, 40 immigrant MSM were reached among these new clients for a 15-minute phone survey entailing open-ended and multiple-choice questions. The survey sought immigrant MSM's reasons for visiting AsR; satisfaction with service and staff; and open comments. An inductive thematic analysis was conducted with the qualitative data, and descriptive statistics were produced with the quantitative data. The qualitative findings indicate that the main reasons for seeking an HIV test were a recent risk, routine testing, or being in a new relationship. Clients chose AsR mainly because it is easily accessible, service is fast or they heard about it from a friend. The quantitative findings indicate that rates of satisfaction were high (over 90% were satisfied about all aspects except for openings hours) and more than 80% felt comfortable while receiving services at AsR. Nevertheless, this study's findings have implications for improving services. They stress the importance of offering rapid yet comprehensive service and of taking into account immigrant MSM's concerns for confidentiality.

  20. Transactional Sex and the HIV Epidemic Among Men Who have Sex with Men (MSM): Results From a Systematic Review and Meta-analysis.

    PubMed

    Oldenburg, Catherine E; Perez-Brumer, Amaya G; Reisner, Sari L; Mimiaga, Matthew J

    2015-12-01

    Engagement in transactional sex has been hypothesized to increase risk of HIV among MSM, however conflicting evidence exists. We conducted a systematic review and meta-analysis comparing HIV prevalence among MSM who engaged in transactional sex to those who did not (33 studies in 17 countries; n = 78,112 MSM). Overall, transactional sex was associated with a significant elevation in HIV prevalence (OR 1.34, 95 % CI 1.11-1.62). Latin America (OR 2.28, 95 % CI 1.87-2.78) and Sub-Saharan Africa (OR 1.72, 95 % CI 1.02-2.91) were the only regions where this elevation was noted. Further research is needed to understand factors associated with sex work and subsequent HIV risk in Latin America and Sub-Saharan Africa.

  1. Transactional sex and the HIV epidemic among men who have sex with men (MSM): Results from a systematic review and meta-analysis

    PubMed Central

    Oldenburg, Catherine E.; Perez-Brumer, Amaya G.; Reisner, Sari L.; Mimiaga, Matthew J.

    2015-01-01

    Engagement in transactional sex has been hypothesized to increase risk of HIV among MSM, however conflicting evidence exists. We conducted a systematic review and meta-analysis comparing HIV prevalence among MSM who engaged in transactional sex to those who did not (33 studies in 17 countries; n=78,112 MSM). Overall, transactional sex was associated with a significant elevation in HIV prevalence (OR=1.34, 95%CI=1.11-1.62). Latin America (OR=2.28, 95%CI=1.87-2.78) and Sub-Saharan Africa (OR=1.72, 95%CI=1.02-2.91) were the only regions where this elevation was noted. Further research is needed to understand factors associated with sex work and subsequent HIV risk in Latin America and Sub-Saharan Africa. PMID:25652233

  2. Community-based HIV prevention interventions that combat anti-gay stigma for men who have sex with men and for transgender women.

    PubMed

    Cahill, Sean; Valadéz, Robert; Ibarrola, Sabina

    2013-01-01

    Men who have sex with men (MSM) have been disproportionately affected by HIV since the onset of the epidemic. Public health discourse about prevention has traditionally focused on individual risk behavior and less on the socio-structural factors that place MSM at increased risk of infection. Anti-gay bias and stigma are key structural drivers of HIV and must therefore be treated as a public health threat. Community-based prevention intervention programs that affirm the healthy formation of gay and transgender identities are strongly needed. Gay affirming school-based interventions and resiliency-focused social marketing campaigns have shown positive impact on health outcomes and should be implemented on a broader scale to challenge anti-gay stigma.

  3. Community-Based Outbreak of Neisseria meningitidis Serogroup C Infection in Men who Have Sex with Men, New York City, New York, USA, 2010−2013

    PubMed Central

    Weiss, Don; Ridpath, Alison; Zucker, Jane R.; Geevarughese, Anita; Rakeman, Jennifer; Varma, Jay K.

    2015-01-01

    In September 2012, the New York City Department of Health and Mental Hygiene identified an outbreak of Neisseria meningitidis serogroup C invasive meningococcal disease among men who have sex with men (MSM). Twenty-two case-patients and 7 deaths were identified during August 2010−February 2013. During this period, 7 cases in non-MSM were diagnosed. The slow-moving outbreak was linked to the use of websites and mobile phone applications that connect men with male sexual partners, which complicated the epidemiologic investigation and prevention efforts. We describe the outbreak and steps taken to interrupt transmission, including an innovative and wide-ranging outreach campaign that involved direct, internet-based, and media-based communications; free vaccination events; and engagement of community and government partners. We conclude by discussing the challenges of managing an outbreak affecting a discrete community of MSM and the benefits of using social networking technology to reach this at-risk population. PMID:26197087

  4. Differences in substance use and sexual partnering between men who have sex with men, men who have sex with men and women and transgender women.

    PubMed

    Bowers, Jane Rohde; Branson, Catherine M; Fletcher, Jesse; Reback, Cathy J

    2011-06-01

    Men who have sex with men (MSM), men who have sex with men and women (MSM/W) and transgender women (TGW) remain the populations most severely and disproportionately impacted upon by HIV in Los Angeles County. Baseline data from community-based HIV-prevention programmes serving these populations were analysed to explore differences in demographic characteristics, substance use and sexual partnering between the three groups. Despite high HIV prevalence overall (MSM 34.7% versus MSM/W 16.1% versus TGW 21.9%, p < .001), there were striking differences in risk behaviours. Higher rates of homelessness were reported by MSM/W compared to MSM and TGW. Lower rates of education and less substance use were reported by TGW (62.2%), compared to MSM (79.7%) and MSM/W (92.6%). A much higher number of male sexual exchange partners were reported by TGW (MSM 1.04 [SD = 4.8] versus MSM/W 1.54 [SD = 10.3] versus TGW 12.37 [SD = 23.9], p < .001). Findings support the need for HIV-prevention interventions that specifically address the unique risk patterns among each population in order to curb HIV acquisition and transmission.

  5. The syndemic of AIDS and STDS among MSM

    PubMed Central

    O'Leary, Dale

    2014-01-01

    The spread of HIV and other STDs among men who have sex with men (MSM) has been labeled a syndemic because in this population a number of different and interrelated health problems have come together and interact with one another. The various elements of the syndemic have an additive effect, each one intensifying the others. These factors include the number of infectious diseases endemic in this population, the high rate of substance abuse problems and psychological disorders, and the significant percentage of MSM who have experienced childhood sexual abuse and other adverse events. While MSM are disproportionately affected by HIV, syphilis, and other STDs, health activists from the gay community have systematically resisted the application of the full range of public health strategies traditionally used to prevent their spread. In the more than three decades since the beginning of the HIV/AIDS epidemic, there have been substantial advances in testing and treatment, yet the infection rate among MSM, and particularly young MSM, remains high, even as it has been dropping among other risk groups. This paper deals with the history of the syndemic, the failure of various risk reduction strategies, and treatment as prevention. PMID:24899736

  6. Men Who Have Sex with Men and Human Immunodeficiency Virus/Sexually Transmitted Disease Control in China

    PubMed Central

    LIU, HUI; YANG, HONGMEI; LI, XIAOMING; WANG, NING; LIU, HONGJIE; WANG, BO; ZHANG, LAN; WANG, QIANQIU; STANTON, BONITA

    2006-01-01

    Objectives: To address the role of men who have sex with men (MSM) in the human immunodeficiency virus (HIV)/sexually transmitted disease (STD) epidemic in China. Goal: To explore the prevalence of risky sexual behaviors and the existing prevention efforts among men who have sex with men (MSM) in China. Study Design: Review of behavioral and STD/HIV prevention studies addressing MSM in China. Results: Sexual risk behaviors including unprotected group sex, anal sex, casual sex, and commercial sex were prevalent among Chinese MSM. Many Chinese MSM also engaged in unprotected sex with both men and women. Most MSM either did not perceive that they were at risk of HIV/AIDS or underestimated their risk of infection. Surveillance and intervention research among these men are still in the preliminary stages. Conclusions: Chinese MSM are at risk for HIV/STD infection and potential transmission of HIV to the general population. In addition to sexual risk reduction among MSM, reduction of homosexualityrelated stigma should be part of effective intervention efforts. Volunteers from the MSM community and health care workers in primary health care system may serve as valuable resources for HIV/STD prevention and control among MSM. PMID:16354560

  7. Using Ecological Momentary Assessment (EMA) to Study Sex Events Among Very High-Risk Men Who Have Sex with Men (MSM).

    PubMed

    Wray, Tyler B; Kahler, Christopher W; Monti, Peter M

    2016-10-01

    MSM continue to represent the largest share of new HIV infections in the United States each year due to high infectivity associated with unprotected anal sex. Ecological momentary assessment (EMA) has the potential to provide a unique view of how high-risk sexual events occur in the real world and can impart detailed information about aspects of decision-making, antecedents, and consequences that accompany these events. EMA may also produce more accurate data on sexual behavior by assessing it soon after its occurrence. We conducted a study involving 12 high-risk MSM to explore the acceptability and feasibility of a 30 day, intensive EMA procedure. Results suggest this intensive assessment strategy was both acceptable and feasible to participants. All participants provided response rates to various assessments that approached or were in excess of their targets: 81.0 % of experience sampling assessments and 93.1 % of daily diary assessments were completed. However, comparing EMA reports with a Timeline Followback (TLFB) of the same 30 day period suggested that participants reported fewer sexual risk events on the TLFB compared to EMA, and reported a number of discrepancies about specific behaviors and partner characteristics across the two methods. Overall, results support the acceptability, feasibility, and utility of using EMA to understand sexual risk events among high-risk MSM. Findings also suggest that EMA and other intensive longitudinal assessment approaches could yield more accurate data about sex events.

  8. HIV serostatus disclosure is not associated with safer sexual behavior among HIV-positive men who have sex with men (MSM) and their partners at risk for infection in Bangkok, Thailand.

    PubMed

    Edwards-Jackson, Nneka; Phanuphak, Nittaya; Van Tieu, Hong; Chomchey, Nitiya; Teeratakulpisarn, Nipat; Sathienthammawit, Wassana; Pakam, Charnwit; Pharachetsakul, Nutthasun; Sobieszczyk, Magdalena E; Phanuphak, Praphan; Ananworanich, Jintanat

    2012-12-23

    The relationship between HIV serostatus disclosure and sexual risk behavior is inconsistent across studies. As men who have sex with men (MSM) are emerging as the key affected population in Bangkok, Thailand with reported HIV prevalence of 30%, we assessed whether HIV disclosure is associated with protected sex in this population. A risk behavior questionnaire was administered using Audio Computer-Assisted Self-Interviewing (ACASI) to determine whether HIV serostatus disclosure was associated with protected sex in 200 HIV-positive MSM in Bangkok. HIV serostatus disclosure to the most recent sexual partner prior to or at the time of the sexual encounter was assessed. Protected sex was defined as insertive or receptive anal intercourse with a condom at the most recent sexual encounter. The mean age was 30.2 years, CD4 was 353 cells/mm3, and one-third was on antiretroviral therapy. At the most recent sexual encounter, HIV serostatus disclosure rate was low (26%); 60.5% of subjects had not discussed their serostatus at all, while 5.5% had not revealed their true serostatus. Seventeen percent reported unprotected anal intercourse and about half had sex with their primary partners. The serostatus of the most recent sexual partner was HIV-positive in 19.2%, HIV-negative in 26.4%, and unknown in 54.4% of subjects. There was no association between disclosure and protected sex, with 41 of 48 (85.4%) disclosers and 104 of 126 (82.5%) of non-disclosers reported protected sex (p = .65). Subjects with HIV-positive partners were less likely to report protected sex overall (20 of 33, 60.6%) compared to those with HIV negative (82 of 96, 85.4%) or unknown (41 of 45, 91.1%) partners (p = .001). Age (27-32 years vs. ≤26 years, p = .008), primary partner status (p < .001), and HIV-positive serostatus of sexual partner (p < .001) were significantly associated with disclosure in the multivariate analyses. Rates of HIV disclosure to sexual partners by HIV-positive MSM

  9. HIV serostatus disclosure is not associated with safer sexual behavior among HIV-positive men who have sex with men (MSM) and their partners at risk for infection in Bangkok, Thailand

    PubMed Central

    2012-01-01

    Background The relationship between HIV serostatus disclosure and sexual risk behavior is inconsistent across studies. As men who have sex with men (MSM) are emerging as the key affected population in Bangkok, Thailand with reported HIV prevalence of 30%, we assessed whether HIV disclosure is associated with protected sex in this population. Methods A risk behavior questionnaire was administered using Audio Computer-Assisted Self-Interviewing (ACASI) to determine whether HIV serostatus disclosure was associated with protected sex in 200 HIV-positive MSM in Bangkok. HIV serostatus disclosure to the most recent sexual partner prior to or at the time of the sexual encounter was assessed. Protected sex was defined as insertive or receptive anal intercourse with a condom at the most recent sexual encounter. Results The mean age was 30.2 years, CD4 was 353 cells/mm3, and one-third was on antiretroviral therapy. At the most recent sexual encounter, HIV serostatus disclosure rate was low (26%); 60.5% of subjects had not discussed their serostatus at all, while 5.5% had not revealed their true serostatus. Seventeen percent reported unprotected anal intercourse and about half had sex with their primary partners. The serostatus of the most recent sexual partner was HIV-positive in 19.2%, HIV-negative in 26.4%, and unknown in 54.4% of subjects. There was no association between disclosure and protected sex, with 41 of 48 (85.4%) disclosers and 104 of 126 (82.5%) of non-disclosers reported protected sex (p = .65). Subjects with HIV-positive partners were less likely to report protected sex overall (20 of 33, 60.6%) compared to those with HIV negative (82 of 96, 85.4%) or unknown (41 of 45, 91.1%) partners (p = .001). Age (27-32 years vs. ≤26 years, p = .008), primary partner status (p < .001), and HIV-positive serostatus of sexual partner (p < .001) were significantly associated with disclosure in the multivariate analyses. Conclusion Rates of HIV disclosure to

  10. Running Backwards: Consequences of Current HIV Incidence Rates for the Next Generation of Black MSM in the United States

    PubMed Central

    Matthews, Derrick D.; Herrick, A. L.; Coulter, Robert W. S.; Friedman, M. Reuel; Mills, Thomas C.; Eaton, Lisa A.; Wilson, Patrick A.; Stall, Ron D.

    2015-01-01

    Black men who have sex with men (MSM) in the United States are disproportionately impacted by HIV. To better understand this public health problem, we reviewed the literature to calculate an estimate of HIV incidence among Black MSM. We used this rate to model HIV prevalence over time within a simulated cohort, which we subsequently compared to prevalence from community-based samples. We searched all databases accessible through PubMed, and Conference on Retroviruses and Opportunistic Infections abstracts for HIV incidence estimates among Black MSM. Summary HIV incidence rates and 95 % confidence intervals (CIs) were calculated using random effects models. Using the average incidence rate, we modeled HIV prevalence within a simulated cohort of Black MSM (who were all HIV-negative at the start) from ages 18 through 40. Based on five incidence rates totaling 2898 Black MSM, the weighted mean incidence was 4.16 % per year (95 % CI 2.76–5.56). Using this annual incidence rate, our model predicted that 39.94 % of Black MSM within the simulated cohort would be HIV-positive by age 30, and 60.73 % by 40. Projections were similar to HIV prevalence found in community-based samples of Black MSM. High HIV prevalence will persist across the life-course among Black MSM, unless effective prevention and treatment efforts are increased to substantially reduce HIV transmission among this underserved and marginalized population. PMID:26267251

  11. HIV Among MSM and Heterosexual Women in the United States: An Ecologic Analysis.

    PubMed

    Raymond, H Fisher; Al-Tayyib, Alia; Neaigus, Alan; Reilly, Kathleen H; Braunstein, Sarah; Brady, Kathleen A; Sey, Ekow; Risser, Jan; Padget, Paige; Lalota, Marlene; Schacht, John-Mark; Forrest, David W; Macomber, Katie; Griffin, Vivian; Higgins, Emily; Robinson, William T; Zarwell, Meagan C; Opoku, Jenevieve; Magnus, Manya; Kuo, Irene; Burt, Richard; Thiede, Hanne; Glick, Sara; Flynn, Colin; German, Danielle

    2017-07-01

    Phylogenetic studies show links between heterosexual women and men who have sex with men (MSM) that are more numerous than from heterosexual men to women suggesting that HIV infections among heterosexual women may stem from MSM. Poor communities have been associated with high rates of HIV among heterosexual women. Our analysis investigates potential transmission of HIV between MSM and female heterosexuals. National HIV Behavioral Surveillance data describe transmission risk behaviors of MSM, and HIV case reporting data describe the percentages of cases that are attributed to transmission risk categories. We examined correlations between the percentages of men who were MSM who also have sex with women and female heterosexual cases. We also examined census data to characterize each city in terms of poverty level and race/ethnicity makeup. There was a high correlation (0.93) between the percentage of reported living HIV cases attributed to male heterosexual contact and female heterosexual contact and a moderate nonsignificant correlation (0.49) between the percentage of MSM who were men who have sex with men and women (MSMW) in National HIV Behavioral Surveillance and the percentage of reported cases that were attributed to female heterosexual contact suggesting some potential overlap. Cities with high levels of poverty and African American/Black residents had higher levels of MSMW and higher levels of heterosexual female cases. Addressing HIV in cities with high levels of MSMW may have the dual effect of improving the health of MSM populations that have a high burden of HIV and to improve the health of their larger communities.

  12. HIV Self-Testing among Men Who Have Sex with Men (MSM) in the UK: A Qualitative Study of Barriers and Facilitators, Intervention Preferences and Perceived Impacts

    PubMed Central

    Witzel, T. Charles; Rodger, Alison J.; Burns, Fiona M.; Rhodes, Tim; Weatherburn, Peter

    2016-01-01

    Introduction Innovative strategies, such as HIV self-testing (HIVST), could increase HIV testing rates and diagnosis. Evidence to inform the design of an HIVST intervention in the UK is scarce with very little European data on this topic. This study aims to understand values and preferences for HIVST interventions targeting MSM in the UK. We explore the acceptability of HIVST among MSM in the context of known barriers and facilitators to testing for HIV; assess preferences for, and the concerns about, HIVST. Methods Six focus group discussions (FGD) were conducted with 47 MSM in London, Manchester and Plymouth. HIVST as a concept was discussed and participants were asked to construct their ideal HIVST intervention. OraQuickTM and BioSureTM kits were then demonstrated and participants commented on procedure, design and instructions. FGDs were recorded and transcribed verbatim, then analysed thematically. Results Convenience and confidentiality of HIVST was seen to facilitate testing. Issues with domestic privacy problematised confidentiality. HIVST kits and instructions were thought to be unnecessarily complicated, and did not cater to the required range of abilities. The window period was the most important element of an HIVST, with strong preference for 4th generation testing. Kits which used a blood sample were more popular than those using saliva due to higher perceived accuracy although phobia of needles and/or blood meant some would only access HIVST if a saliva sample option was available. A range of access options was important to maintain convenience and privacy. HIVST kits were assumed to increase frequency of testing, with concerns related to the dislocation of HIVST from sexual health care pathways and services. Discussion Utility of HIVST arises from relatively high levels of confidentiality and convenience. Until 4th generation assays are available HIVST will be seen as supplementary in a UK context. PMID:27611777

  13. Trends in late HIV diagnosis among men who have sex with men in Jiangsu province, China: Results from four consecutive community-based surveys, 2011-2014

    PubMed Central

    Hu, Haiyang; Yan, Hongjing; Liu, Xiaoyan; Xu, Xiaoqin; Xu, Jinshui; Qiu, Tao; Shi, Ling-en; Fu, Gengfeng; Huan, Xiping; McFarland, Willi; Wei, Chongyi

    2017-01-01

    Objectives To examine trends in HIV testing, late HIV diagnosis and associated factors among men who have sex with men (MSM) in Jiangsu province, China. Methods Four consecutive community-based cross-sectional surveys were conducted among MSM from 2011 to 2014 in eight cities in the province. Participants were recruited from MSM venues and via the internet. HIV bio-behavioral surveys were conducted to collect demographic and behavioral data and measure HIV infection. HIV-infected participants with CD4 counts less than 350 cells/uL were defined as having a late HIV diagnosis. Chi-square trend tests were used to compare temporal changes over the years and multivariable logistic regression analyses were used to identify factors associated with late diagnosis. Results A total of 2,441, 2,677, 2,591 and 2,610 participants were enrolled in 2011, 2012, 2013 and 2014, respectively. Testing for HIV in the last 12 months decreased over the time period, from 59.9% to 52.5% (p<0.001). Late HIV diagnosis remained high and steady, ranging from 33.3% to 44.2% over the years with no significant change over time (p = 0.418). MSM who were older than 24 years (aOR = 1.748, p = 0.020 for 25–39 years old; aOR = 3.148, p<0.001 for 40 years old or older), were recruited via internet (aOR = 1.596, p = 0.024), and did not have an HIV test in the past 12 months (aOR = 3.385, p<0.001) were more likely to be late diagnosed. Conclusions Our study showed a plateau in HIV testing among MSM in China, in parallel to high levels of late diagnosis. Emerging and innovative strategies such as HIV self-testing and reaching more MSM by internet, both highly acceptable to MSM in China, may reduce late diagnosis. PMID:28278195

  14. Building a Mobile HIV Prevention App for Men Who Have Sex With Men: An Iterative and Community-Driven Process.

    PubMed

    Goldenberg, Tamar; McDougal, Sarah J; Sullivan, Patrick S; Stekler, Joanne D; Stephenson, Rob

    2015-01-01

    Gay, bisexual, and other men who have sex with men (MSM) account for a disproportionate burden of new HIV infections in the United States. Mobile technology presents an opportunity for innovative interventions for HIV prevention. Some HIV prevention apps currently exist; however, it is challenging to encourage users to download these apps and use them regularly. An iterative research process that centers on the community's needs and preferences may increase the uptake, adherence, and ultimate effectiveness of mobile apps for HIV prevention. The aim of this paper is to provide a case study to illustrate how an iterative community approach to a mobile HIV prevention app can lead to changes in app content to appropriately address the needs and the desires of the target community. In this three-phase study, we conducted focus group discussions (FGDs) with MSM and HIV testing counselors in Atlanta, Seattle, and US rural regions to learn preferences for building a mobile HIV prevention app. We used data from these groups to build a beta version of the app and theater tested it in additional FGDs. A thematic data analysis examined how this approach addressed preferences and concerns expressed by the participants. There was an increased willingness to use the app during theater testing than during the first phase of FGDs. Many concerns that were identified in phase one (eg, disagreements about reminders for HIV testing, concerns about app privacy) were considered in building the beta version. Participants perceived these features as strengths during theater testing. However, some disagreements were still present, especially regarding the tone and language of the app. These findings highlight the benefits of using an interactive and community-driven process to collect data on app preferences when building a mobile HIV prevention app. Through this process, we learned how to be inclusive of the larger MSM population without marginalizing some app users. Though some issues in

  15. HIV Prevention for Black Men Who Have Sex With Men in the United States

    PubMed Central

    Jones, Kenneth T.

    2009-01-01

    The HIV/AIDS epidemic has exacted a devastating toll upon Black men who have sex with men (MSM) in the United States, and there is a tremendous need to escalate HIV-prevention efforts for this population. The social context in which Black MSM experience the impact of racism and heterosexism strongly affects their risk for HIV infection; thus, HIV-prevention research focused on Black MSM should focus on contextual and structural factors. There is a pronounced lack of community-level HIV-intervention research for Black MSM, but effective preliminary strategies involve adapting existing effective models and tailoring them to the needs of Black MSM. Future research should develop new, innovative approaches, especially structural interventions, that are specifically targeted toward HIV prevention among Black MSM. PMID:19372510

  16. Characteristics of Latino MSM who have sex in public settings.

    PubMed

    Reisen, Carol A; Zea, Maria C; Bianchi, Fernanda T; Poppen, Paul J

    2011-04-01

    Many men who have sex with men (MSM) have sexual encounters in public places, and some data suggest that this behavior is more common among Latino than non-Hispanic white MSM in the USA. In a sample of 482 Latino MSM born in Brazil, Colombia, and the Dominican Republic, and living in the New York City metropolitan area, we examined how demographic and psychosocial characteristics are related to having sex in public venues. Logistic regression was performed with the dichotomous outcome of sex in a public place in the previous six months. Demographic variables included education, HIV-positive serostatus, unknown HIV serostatus, and years in the USA; psychosocial variables included self-efficacy for safer sex, depression, and gay community involvement. Results indicated that those individuals with unknown serostatus were more likely than those with HIV-negative serostatus to have had sex in a public setting, as were men with lower self-efficacy for safer sex. These findings suggest that the partner pool may pose some risk to men who have sex in public sex venues, and therefore, low-risk sexual practices and condom use should be promoted in such settings. Contrary to expectations, higher education was related to sex in public settings, but neither depression nor more recent immigration was. Greater involvement in the gay community was also associated with having sex in public places, which may reflect the larger social function served by gay venues such as bathhouses and bars.

  17. High HIV prevalence and the internet as a source of HIV-related service information at a community-based organization in Peru: a cross-sectional study of men who have sex with men.

    PubMed

    Passaro, R Colby; Haley, Connie A; Sanchez, Hugo; Vermund, Sten H; Kipp, Aaron M

    2016-08-24

    The HIV prevalence among men who have sex with men (MSM) in Peru (12.4 %) is 30 times higher than in the general adult population (0.4 %). It is critical for community-based organizations to understand how to provide HIV services to MSM while maximizing limited resources. This study describes the HIV prevalence and risk profiles of MSM seeking HIV services at a community-based organization in Lima, Peru. It then compares HIV prevalence between those who found out about the HIV services through different sources. A cross-sectional study of MSM seeking HIV services at Epicentro Salud in Lima, Peru for the first time between April 2012 and October 2013. We compared HIV prevalence among MSM who found out about Epicentro via online sources of information (N = 419), those using in-person sources (friends, partners) (N = 907), and sex workers (N = 140) using multivariable logistic regression models. HIV prevalence was 18.3 % overall: 23.2 % among MSM using online sources, 19.3 % among sex workers, and 15.9 % among MSM using in-person sources. However, when compared to the in-person group, sexual risk behaviors were not statistically higher among MSM using online sources. For the sex worker group, some behaviors were more common, while others were less. After adjusting for confounders, the odds of having HIV was higher for the online group (Odds Ratio = 1.61; 95 % Confidence Interval: 1.19-2.18), but not for the sex worker group (OR = 1.12; 95 % CI: 0.68-1.86), compared to the in-person group. Internet-based promotion appears to successfully reach MSM at high risk of HIV in Peru. Outreach via this medium can facilitate HIV diagnosis, which is the critical first step in getting infected individuals into HIV care. For community-based organizations working in resource-limited settings, this may be an effective strategy for engaging a subset of high-risk persons in HIV care.

  18. Building a Mobile HIV Prevention App for Men Who Have Sex With Men: An Iterative and Community-Driven Process

    PubMed Central

    McDougal, Sarah J; Sullivan, Patrick S; Stekler, Joanne D; Stephenson, Rob

    2015-01-01

    Background Gay, bisexual, and other men who have sex with men (MSM) account for a disproportionate burden of new HIV infections in the United States. Mobile technology presents an opportunity for innovative interventions for HIV prevention. Some HIV prevention apps currently exist; however, it is challenging to encourage users to download these apps and use them regularly. An iterative research process that centers on the community’s needs and preferences may increase the uptake, adherence, and ultimate effectiveness of mobile apps for HIV prevention. Objective The aim of this paper is to provide a case study to illustrate how an iterative community approach to a mobile HIV prevention app can lead to changes in app content to appropriately address the needs and the desires of the target community. Methods In this three-phase study, we conducted focus group discussions (FGDs) with MSM and HIV testing counselors in Atlanta, Seattle, and US rural regions to learn preferences for building a mobile HIV prevention app. We used data from these groups to build a beta version of the app and theater tested it in additional FGDs. A thematic data analysis examined how this approach addressed preferences and concerns expressed by the participants. Results There was an increased willingness to use the app during theater testing than during the first phase of FGDs. Many concerns that were identified in phase one (eg, disagreements about reminders for HIV testing, concerns about app privacy) were considered in building the beta version. Participants perceived these features as strengths during theater testing. However, some disagreements were still present, especially regarding the tone and language of the app. Conclusions These findings highlight the benefits of using an interactive and community-driven process to collect data on app preferences when building a mobile HIV prevention app. Through this process, we learned how to be inclusive of the larger MSM population without

  19. Cruising in cyber space: comparing Internet chat room versus community venues for recruiting Hispanic men who have sex with men to participate in prevention studies.

    PubMed

    Fernández, M Isabel; Warren, Jacob C; Varga, Leah M; Prado, Guillermo; Hernandez, Nilda; Bowen, G Stephen

    2007-01-01

    Difficulties with recruitment of hidden populations, such as Hispanic men who have sex with men (MSM), have hampered HIV prevention research, leading researchers to explore alternative recruitment modalities such as the Internet. In this paper, we compare the efficiency and cost of recruiting HMSM from Internet chat rooms versus community venues and examine the differences between participants recruited from each type of venue. Internet recruitment was more efficient and somewhat less costly than community recruitment. Although the two groups were comparable in most demographic factors and HIV risk behaviors, Internet recruits were more likely to be bisexual, more likely to be HIV seropositive, had a higher level of education, and reported higher levels of psychological distress and lower levels of gay community attachment. Implications of our findings for using Internet chatrooms as recruitment venues are discussed.

  20. Health-related characteristics of men who have sex with men: a comparison of those living in "gay ghettos" with those living elsewhere.

    PubMed Central

    Mills, T C; Stall, R; Pollack, L; Paul, J P; Binson, D; Canchola, J; Catania, J A

    2001-01-01

    OBJECTIVES: This study investigated the limitations of probability samples of men who have sex with men (MSM), limited to single cities and to the areas of highest concentrations of MSM ("gay ghettos"). METHODS: A probability sample of 2881 MSM in 4 American cities completed interviews by telephone. RESULTS: MSM who resided in ghettos differed from other MSM, although in different ways in each city. Non-ghetto-dwelling MSM were less involved in the gay and lesbian community. They were also less likely to have only male sexual partners, to identify as gay, and to have been tested for HIV. CONCLUSIONS: These differences between MSM who live in gay ghettos and those who live elsewhere have clear implications for HIV prevention efforts and health care planning. PMID:11392945

  1. Reduced Sexual Risk Behaviors Among Young Men of Color Who Have Sex with Men: Findings from the Community-Based Organization Behavioral Outcomes of Many Men, Many Voices (CBOP-3MV) Project.

    PubMed

    Stein, Renee; Shapatava, Ekaterine; Williams, Weston; Griffin, Tanesha; Bell, Kelly; Lyons, Bridget; Uhl, Gary

    2015-11-01

    In 2006, the Centers for Disease Control and Prevention (CDC) funded community-based organizations (CBOs) to deliver Many Men, Many Voices (3MV) to young men of color who have sex with men. Although 3MV, a group-level behavioral intervention designed to reduce human immunodeficiency virus (HIV) risk behaviors of black men who have sex with men (MSM), has shown effectiveness when delivered in a controlled research environment, there is limited evidence that the intervention is associated with similar outcomes in "real world" settings. For the current project, CDC funded three CBOs to conduct outcome monitoring of the 3MV intervention to determine if young MSM of color report changes in HIV risk behaviors postintervention. Using a repeated measures design, risk behaviors were collected at baseline and again at 3 and 6 months postintervention. Changes in risk behaviors were assessed using generalized estimating equations. Participants (n = 337) reported decreases in sexual risk behaviors at both follow-up time points, such as sex without a condom, sex without a condom and multiple partners, and sex without a condom with serodiscordant or status unknown partners. Results suggest that 3MV may be an effective tool for reducing HIV risk behaviors in this critical target population.

  2. Who is omitted from repeated offline HIV behavioural surveillance among MSM? Implications for interpreting trends.

    PubMed

    Saxton, Peter; Dickson, Nigel; Hughes, Anthony

    2013-11-01

    Repeated behavioural surveillance should sample all epidemiologically relevant subgroups to provide a complete picture of trends in HIV risk behaviours. Web-based recruitment has been mooted but little empirical data exist on country experiences. We describe who is omitted from three rounds of a conventional offline-only surveillance programme among men who have sex with men (MSM) 2006-2011, but recruited subsequently on Internet dating sites, and the implications of this for understanding trends. The latter were younger, less gay identified and less gay community attached. Importantly, they reported different partnering patterns, lower condom use with casual and fuckbuddy-type male partners, and lower rates of HIV testing, compared to MSM routinely captured in offline surveillance. The replacement of offline socio-sexual activity by the Internet among many MSM means that current venue-based surveillance systems may underestimate risk behaviours, overlook trends among unsampled online MSM, and misinterpret trends observed in sampled MSM due to "sample drift" of most-at-risk MSM.

  3. Marketing the HIV Test to MSM: Ethnic Differences in Preferred Venues and Sources

    PubMed Central

    Lechuga, Julia; Owczarzak, Jill T.; Petroll, Andrew E.

    2014-01-01

    Lack of awareness of HIV status is associated with an increased likelihood of HIV transmission. We surveyed 633 men who have sex with men (MSM) from diverse ethnic groups recruited from a variety of community venues in a U.S. Midwestern city with rising HIV infection rates. Our first aim was to describe patterns of sexual risk, annual HIV testing frequency, and venues where information about HIV and HIV testing could be disseminated to inner-city MSM. Our second aim was to identify preferred sources to receive information about HIV testing and determine whether these preferences differed by ethnic background. Results indicated that despite similar proportions of high–sexual risk behaviors, compared with African American and Latino MSM, smaller proportions of non-Hispanic White MSM had received an HIV test in the last 12 months. Despite ethnic differences in health care access, a physician's office was the most common HIV testing site. Overall, a majority conveyed a preference to see advertisements in mainstream media outlets. However, when preferences were stratified by ethnicity, African American MSM were the least likely to prefer receiving information from mainstream media and conveyed a stronger preference to receive information from authority figures than non-Hispanic White and Hispanic MSM. PMID:23091299

  4. Partnering Patterns and Sexual Behavior Among Korean Men Who Have Sex With Men

    PubMed Central

    Jung, Minsoo

    2016-01-01

    This qualitative study investigates the different methods for selecting sex partners by Korean homosexuals considering factors related to homosexual identity and sexual behavior. We take the approach of the grounded theory to examine the issue of sexual partnering of men who have sex with men (MSM). In-depth interviews of urban MSM and bisexual men were conducted. The snowball sampled through a MSM portal web site. Three key informants from the several areas were collected through a MSM portal website, and then, participants were gradually recruited with the snowball samplings in South Korea, 2011 (n=32). The results of coding the interviews based on the grounded theory approach identified three types of partnering: 1) MSM who do not prefer anal intercourse, but pursue safe sex in long-term relationships with fixed partners; 2) those who have fixed partners and perform anal sex, a category into which both MSM and bisexuals fall; and 3) those engaged in anal sex, but enjoy a concurrent sexual relationship without having fixed partners, which was common among bisexuals. The findings from this study elucidate several MSM and bisexual partnering types practice safe sex. This diversity in MSM partnering may increase the vulnerability of some MSM to HIV infection as safe-sex practices remain a matter of individual choice. Changes in Korean societal policies are necessary to enhance capacity building and encourage the practice of safe sex at the community level. PMID:27347275

  5. Partnering Patterns and Sexual Behavior Among Korean Men Who Have Sex With Men.

    PubMed

    Jung, Minsoo

    2016-01-01

    This qualitative study investigates the different methods for selecting sex partners by Korean homosexuals considering factors related to homosexual identity and sexual behavior. We take the approach of the grounded theory to examine the issue of sexual partnering of men who have sex with men (MSM). In-depth interviews of urban MSM and bisexual men were conducted. The snowball sampled through a MSM portal web site. Three key informants from the several areas were collected through a MSM portal website, and then, participants were gradually recruited with the snowball samplings in South Korea, 2011 (n=32). The results of coding the interviews based on the grounded theory approach identified three types of partnering: 1) MSM who do not prefer anal intercourse, but pursue safe sex in long-term relationships with fixed partners; 2) those who have fixed partners and perform anal sex, a category into which both MSM and bisexuals fall; and 3) those engaged in anal sex, but enjoy a concurrent sexual relationship without having fixed partners, which was common among bisexuals. The findings from this study elucidate several MSM and bisexual partnering types practice safe sex. This diversity in MSM partnering may increase the vulnerability of some MSM to HIV infection as safe-sex practices remain a matter of individual choice. Changes in Korean societal policies are necessary to enhance capacity building and encourage the practice of safe sex at the community level.

  6. Community member perspectives from transgender women and men who have sex with men on pre-exposure prophylaxis as an HIV prevention strategy: implications for implementation.

    PubMed

    Galindo, Gabriel R; Walker, Ja'Nina J; Hazelton, Patrick; Lane, Tim; Steward, Wayne T; Morin, Stephen F; Arnold, Emily A

    2012-11-26

    An international randomized clinical trial (RCT) on pre-exposure prophylaxis (PrEP) as an human immunodeficiency virus (HIV)-prevention intervention found that taken on a daily basis, PrEP was safe and effective among men who have sex with men (MSM) and male-to-female transgender women. Within the context of the HIV epidemic in the United States (US), MSM and transgender women are the most appropriate groups to target for PrEP implementation at the population level; however, their perspectives on evidenced-based biomedical research and the results of this large trial remain virtually unknown. In this study, we examined the acceptability of individual daily use of PrEP and assessed potential barriers to community uptake. We conducted semi-structured interviews with an ethnoracially diverse sample of thirty HIV-negative and unknown status MSM (n = 24) and transgender women (n = 6) in three California metropolitan areas. Given the burden of disease among ethnoracial minorities in the US, we purposefully oversampled for these groups. Thematic coding and analysis of data was conducted utilizing an approach rooted in grounded theory. While participants expressed general interest in PrEP availability, results demonstrate: a lack of community awareness and confusion about PrEP; reservations about PrEP utilization, even when informed of efficacious RCT results; and concerns regarding equity and the manner in which a PrEP intervention could be packaged and marketed in their communities. In order to effectively reduce HIV health disparities at the population level, PrEP implementation must take into account the uptake concerns of those groups who would actually access and use this biomedical intervention as a prevention strategy. Recommendations addressing these concerns are provided.

  7. Community member perspectives from transgender women and men who have sex with men on pre-exposure prophylaxis as an HIV prevention strategy: implications for implementation

    PubMed Central

    2012-01-01

    Background An international randomized clinical trial (RCT) on pre-exposure prophylaxis (PrEP) as an human immunodeficiency virus (HIV)-prevention intervention found that taken on a daily basis, PrEP was safe and effective among men who have sex with men (MSM) and male-to-female transgender women. Within the context of the HIV epidemic in the United States (US), MSM and transgender women are the most appropriate groups to target for PrEP implementation at the population level; however, their perspectives on evidenced-based biomedical research and the results of this large trial remain virtually unknown. In this study, we examined the acceptability of individual daily use of PrEP and assessed potential barriers to community uptake. Methods We conducted semi-structured interviews with an ethnoracially diverse sample of thirty HIV-negative and unknown status MSM (n = 24) and transgender women (n = 6) in three California metropolitan areas. Given the burden of disease among ethnoracial minorities in the US, we purposefully oversampled for these groups. Thematic coding and analysis of data was conducted utilizing an approach rooted in grounded theory. Results While participants expressed general interest in PrEP availability, results demonstrate: a lack of community awareness and confusion about PrEP; reservations about PrEP utilization, even when informed of efficacious RCT results; and concerns regarding equity and the manner in which a PrEP intervention could be packaged and marketed in their communities. Conclusions In order to effectively reduce HIV health disparities at the population level, PrEP implementation must take into account the uptake concerns of those groups who would actually access and use this biomedical intervention as a prevention strategy. Recommendations addressing these concerns are provided. PMID:23181780

  8. Sexual mixing patterns among social networks of HIV-positive and HIV-negative Beijing men who have sex with men: a multilevel comparison using roundtable network mapping.

    PubMed

    Ruan, Yuhua; Pan, Stephen W; Chamot, Eric; Qian, Han-Zhu; Li, Dongliang; Li, Qing-Chun; Liang, Hong-Yuan; Spittal, Patricia; Shao, Yiming; Kristensen, Sibylle

    2011-08-01

    Men who have sex with men (MSM) are of immediate concern in China's HIV epidemic. In 2008, approximately 2.5-6.5% of China's eight million MSM were HIV positive, while MSM represented 11% of all new HIV cases. Two factors that will in-part determine HIV-transmission dynamics among MSM, are sexual mixing patterns and the social networks which shape them. Sexual mixing patterns and social networks of Chinese MSM, however, remain poorly understood with little refined data available. One reason is that stigma discourages disclosure of names and identifiers to researchers. Using an alternative network-mapping approach, matched case-control design, and snowball sampling, this pilot study sought to compare characteristics of social networks of HIV-positive and HIV-negative Beijing MSM at the individual, dyad, and network levels. First, HIV-negative MSM controls were matched to HIV-positive MSM cases based on age, education, residency, and ethnicity. Then, each case or control and their MSM social network convened at a specific time and location with study investigators. Venues included health clinics, karaoke clubs, brothels, and community centers. Then, using arbitrarily assigned numbers in lieu of actual names, all participants simultaneously completed self-administered surveys regarding their sexual relationships with other participants of the same social network. These new findings indicate that cross-generational sex (anal or oral sex between men with ≥10 years age difference) was more prevalent among social networks of HIV-positive MSM, and was due to older age structure of the social network, rather than behavioral differences in sex-partner selection. Members of social networks of HIV-positive MSM were also less likely to have ever disclosed their MSM identity to non-MSM. Future studies should partner with MSM advocacy groups to explore behavioral and structural interventions as possible means of reducing the cross-generational sex and sexual identity

  9. HIV/STIs risks between migrant MSM and local MSM: a cross-sectional comparison study in China

    PubMed Central

    Li, Pengsheng

    2016-01-01

    Background. Internal migration plays a significant role in China’s HIV epidemic. However, few studies have directly compared migrant men who have sex with men (MSM) with local MSM with regard to HIV/sexually transmitted infections (STIs) risks. Methods. We conducted a study in Guangzhou, China, with the aim of understanding the differences in HIV/STIs risks between migrant MSM and local MSM. A cross-sectional study was conducted among 273 migrant MSM and 249 local MSM in Guangzhou, China. Their behavioral and serologic data on HIV/syphilis were collected and compared between the two groups. A multivariate logistic regression was used to estimate the associations between HIV/STIs risks and migratory status. Results. Migrant MSM, compared to local MSM, have higher odds of reporting unprotected anal intercourse (UAI) (OR = 1.4; 95% CI [0.9–2.0]) and having multiple homosexual partners (OR = 1.2; 95% CI [0.8–1.8]). A lower rate of condom use at homosexual debut was reported in migrant MSM than in local MSM (OR = 0.7; 95% CI [0.5–0.9]). Migrant MSM have less odds of reporting HIV/STIs testing in the previous 6 months relative to local MSM (OR = 0.5; 95% CI [0.4–0.8]). In addition, migrant MSM demonstrated a lower level of HIV knowledge than local MSM (OR = 0.4; 95% CI [0.2–0.8]). Conclusion. Migrant MSM are more likely to engage in sexual risk behaviors, report a lower level of HIV knowledge and have less access to HIV/STIs testing. Further comprehensive interventions targeting migrant MSM are urged. PMID:27478695

  10. Adolescent experiences of discrimination, harassment, connectedness to community and comfort with sexual orientation reported by adult men who have sex with men as a predictor of adult HIV status.

    PubMed

    Raymond, H Fisher; Chen, Yea-Hung; Stall, Ron D; McFarland, Willi

    2011-04-01

    Using data from a probability based sample of adult men who have sex with men (MSM) we examined the association of negative life factors during adolescence and adult HIV status. 521 MSM reported on experiences of connectedness to community, comfort with sexuality, harassment and discrimination due to their sexual orientation at ages 12-18 years. HIV status was determined by serological testing. Overall, men reported moderate levels of being harassed, being discriminated against and high levels of feeling disconnected from gay communities while reporting high levels of being uncomfortable with their sexuality at those ages. However, in analyses of scores on these factors, higher experiences of harassment, higher levels of discrimination and more discomfort with sexuality at these ages are associated with HIV-negative status as adults. This study suggests that the relationship between negative adolescent experiences among MSM and adult HIV infection may not be straightforward, but may also dependent upon aspects of the intensity of the negative experiences, the relationship of the victim and the perpertrator(s), the sexual identity of the victim at the time and/or the number of these experiences or the length of time over which they occurred. Studies investigating specific multiple stressors in adolescent gay development and their effect on adult health outcomes are needed.

  11. Racial/ethnic disparities in delayed HIV diagnosis among men who have sex with men, Florida, 2000-2014.

    PubMed

    Sheehan, Diana M; Trepka, Mary Jo; Fennie, Kristopher P; Prado, Guillermo; Ibanez, Gladys; Maddox, Lorene M

    2017-03-01

    Only about 85% of men who have sex with men (MSM) with human immunodeficiency virus (HIV) have been tested for and diagnosed with HIV. Racial/ethnic disparities in HIV risk and HIV care outcomes exist within MSM. We examined racial/ethnic disparities in delayed HIV diagnosis among MSM. Males aged ≥13 reported to the Florida Enhanced HIV/AIDS Reporting System 2000-2014 with a reported HIV transmission mode of MSM were analyzed. We defined delayed HIV diagnosis as an AIDS diagnosis within three months of the HIV diagnosis. Multilevel logistic regressions were used to estimate adjusted odds ratios (aOR). Of 39,301 MSM, 27% were diagnosed late. After controlling for individual factors, neighborhood socioeconomic status, and rural-urban residence, non-Latino Black MSM had higher odds of delayed diagnosis compared with non-Latino White MSM (aOR 1.15, 95% confidence interval [CI] 1.08-1.23). Foreign birth compared with US birth was a risk factor for Black MSM (aOR 1.27, 95% CI 1.12-1.44), but a protective factor for White MSM (aOR 0.77, 95% CI 0.68-0.87). Rural residence was a risk for Black MSM (aOR 1.79, 95% CI 1.36-2.35) and Latino MSM (aOR 1.87, 95% CI 1.24-2.84), but not for White MSM (aOR 1.26, 95% CI 0.99-1.60). HIV testing barriers particularly affect non-Latino Black MSM. Social and/or structural barriers to testing in rural communities may be significantly contributing to delayed HIV diagnosis among minority MSM.

  12. Depression and Oral FTC/TDF Pre-exposure Prophylaxis (PrEP) Among Men and Transgender Women Who Have Sex With Men (MSM/TGW).

    PubMed

    Defechereux, Patricia A; Mehrotra, Megha; Liu, Albert Y; McMahan, Vanessa M; Glidden, David V; Mayer, Kenneth H; Vargas, Lorena; Amico, K Rivet; Chodacki, Piotr; Fernandez, Telmo; Avelino-Silva, Vivian I; Burns, David; Grant, Robert M

    2016-07-01

    We conducted a longitudinal and cross-sectional analysis of depressive symptomology in iPrEx, a randomized, placebo-controlled trial of daily, oral FTC/TDF HIV pre-exposure prophylaxis (PrEP) in men and transgender women who have sex with men. Depression-related adverse events (AEs) were the most frequently reported severe or life-threatening AEs and were not associated with being randomized to the FTC/TDF arm (152 vs. 144 respectively OR 0.66 95 % CI 0.35-1.25). Center for Epidemiologic Studies Depression scale (CES-D) and a four questions suicidal ideation scale scores did not differ by arm. Participants reporting forced sex at anal sexual debut had higher CES-D scores (coeff: 3.23; 95 % CI 1.24-5.23) and were more likely to have suicidal ideation (OR 2.2; 95 % CI 1.09-4.26). CES-D scores were higher among people reporting non-condom receptive anal intercourse (ncRAI) (OR 1.46; 95 % CI 1.09-1.94). We recommend continuing PrEP during periods of depression in conjunction with provision of mental health services.

  13. Associations between partner-venue specific personal responsibility beliefs and transmission risk behavior by HIV-positive men who have sex with men (MSM).

    PubMed

    O'Leary, Ann; Horvath, Keith J; Simon Rosser, B R

    2013-06-01

    Personal responsibility beliefs of HIV-positive individuals to protect sex partners are an important determinant of engagement in transmission risk behavior. However, the degree to which such beliefs vary across different partners is unknown. HIV-positive men who have sex with men (n = 248) completing an online survey rated their personal responsibility beliefs for partners met in up to four different ways: (a) in a bar; (b) through the internet; (c) in a public sex environment (PSE); or (d) through friends or family. For those reporting two or more partner-meeting venues in the prior 3 months (n = 98), about a third reported variation in responsibility ratings. Means among the venues were compared in pairwise fashion, with the strongest beliefs accruing to partners met through friends or family and the least with partners met in PSEs. These results provide further evidence that identifying ways to increase personal responsibility beliefs is an important goal, as well as is the application of Bandura's theory of moral agency to HIV transmission risk behavior.

  14. An updated protocol to detect invalid entries in an online survey of men who have sex with men (MSM): how do valid and invalid submissions compare?

    PubMed

    Grey, Jeremy A; Konstan, Joseph; Iantaffi, Alex; Wilkerson, J Michael; Galos, Dylan; Rosser, B R Simon

    2015-10-01

    Researchers use protocols to screen for suspicious survey submissions in online studies. We evaluated how well a de-duplication and cross-validation process detected invalid entries. Data were from the Sexually Explicit Media Study, an Internet-based HIV prevention survey of men who have sex with men. Using our protocol, 146 (11.6 %) of 1254 entries were identified as invalid. Most indicated changes to the screening questionnaire to gain entry (n = 109, 74.7 %), matched other submissions' payment profiles (n = 56, 41.8 %), or featured an IP address that was recorded previously (n = 43, 29.5 %). We found few demographic or behavioral differences between valid and invalid samples, however. Invalid submissions had lower odds of reporting HIV testing in the past year (OR 0.63), and higher odds of requesting no payment compared to check payments (OR 2.75). Thus, rates of HIV testing would have been underestimated if invalid submissions had not been removed, and payment may not be the only incentive for invalid participation.

  15. Associations between partner-venue specific personal responsibility beliefs and transmission risk behavior by HIV-positive men who have sex with men (MSM)

    PubMed Central

    O’Leary, Ann; Horvath, Keith J.; Simon Rosser, B. R.

    2013-01-01

    Personal responsibility beliefs of HIV-positive individuals to protect sex partners are an important determinant of engagement in transmission risk behavior. However, the degree to which such beliefs vary across different partners is unknown. HIV-positive men who have sex with men in the United States (N = 248) completing an online survey rated their personal responsibility beliefs for partners met in up to four different ways: a) in a bar; b) through the internet; c) in a public sex environment (PSE); or d) through friends or family. About a third of respondents reported variation in responsibility ratings. For those reporting two or more partner-meeting venues in the prior three months (n = 98), means among the venues were compared in pairwise fashion, with the strongest beliefs accruing to partners met through friends or family and the least with partners met in PSEs. These results provide further evidence that identifying ways to increase personal responsibility beliefs is an important goal, as well as is the application of Bandura’s theory of moral agency to HIV transmission risk behavior. PMID:22983535

  16. Correlates of internalized homonegativity among black men who have sex with men

    PubMed Central

    Quinn, Katherine; Dickson-Gomez, Julia; DiFranceisco, Wayne; Kelly, Jeffrey A.; Lawrence, Janet S.; Amirkhanian, Yuri A.; Broaddus, Michelle

    2015-01-01

    Black men who have sex with men (MSM) carry a disproportionate burden of HIV in the United States. Such disparities cannot be attributed to individual behavioral risk factors alone, prompting the exploration of social and contextual factors experienced by minority MSM. Societal homonegativity and the internalization of those attitudes by Black MSM may play an important role in understanding racial and ethnic disparities in HIV incidence and prevalence. This study explores the correlates of internalized homonegativity in a large multi-site sample of Black MSM. Findings reveal a number of significant contextual and psychosocial factors related to internalized homonegativity including religiosity, resilience, and gay community acculturation, which have important implications for HIV risk, HIV testing, and social and psychological wellbeing for Black MSM. PMID:26010313

  17. Sex hustling, injection drug use, and non-gay identification by men who have sex with men. Associations with high-risk sexual behaviors and condom use.

    PubMed

    Rietmeijer, C A; Wolitski, R J; Fishbein, M; Corby, N H; Cohn, D L

    1998-08-01

    With HIV incidence rates as high as 0.7-2.4% per year, men who have sex with men (MSM) accounted for half of all AIDS cases and 43% of non-AIDS HIV cases among men reported to the US Centers for Disease Control and Prevention in 1996. Subgroups of MSM who are at particular risk of HIV infection, such as MSM who inject drugs, MSM who have sex in exchange for money or drugs (hustlers), and non-gay-identified MSM, may be less likely to be reached by HIV/AIDS prevention messages targeted at the broader MSM community. Sex behavior-related data were collected from 1290 MSM recruited in Denver and Long Beach from gay bars and bath houses, adult video arcades, and outdoor cruising areas between September 1993 and June 1994. The 531 MSM sampled in Denver and 759 in Long Beach reported having had sex with a man during the preceding year. 417 (32%) were non-gay-identified, 86 (7%) had injected drugs in the past 6 months, and 117 (9%) had exchanged sex for drugs or money. 10% of non-gay-identified men identified themselves as being straight. Of drug-injecting MSM and hustlers, 19% and 13%, respectively, were straight-identified. Detailed information on HIV testing and serostatus, number of partners, and sex practices, including condom use, was available for the 482 men who had reported anal or oral sex with a man or who had injected drugs in the past 30 days. 55% of drug-injecting MSM reported sex hustling and 40% of hustlers reported IV drug use. Hustling was associated with a higher number of sex partners, more frequent anal sex with men and women, and less frequent condom use during anal sex with occasional male partners. Hustlers and drug-injecting MSM used condoms less consistently during vaginal intercourse with female partners than did other MSM.

  18. Gay community involvement: its interrelationships and associations with Internet use and HIV risk behaviors in Swedish men who have sex with men.

    PubMed

    Ross, Michael W; Tikkanen, Ronny; Berg, Rigmor C

    2014-01-01

    We measured aspects of "community involvement" chosen for men who have sex with men (MSM) in Sweden (gay places, media accessed, Internet, gay festivals, and social engagement, measured as proportion of gay friends) in two Swedish Internet-based samples from 2006 (n = 3,202) and 2008 (n = 4,715). Data showed low to moderate reliability with a moderate (0.57) alpha coefficient. While there is moderate internal consistency, as might be anticipated from measures of actual community involvement, they can be treated as scales. The Internet scale indicated the lowest reliability, perhaps due to respondents having Internet sites of primary choice, rather than a high level of usage across several sites. A hypothesized lack of correlation between traditional domains of the gay community and the Internet did not appear: correlations between the Internet measure and the other measures were positive and significant, but among the lowest correlations obtained between the community measures, ranging from 0.06 to 0.24. Those who use the Internet extensively are less likely to be involved in other aspects of the community. Sexual risk was associated with high social engagement at sexual meeting sites and with Internet use. Gay community involvement, including the Internet community, may be complex and associated with both increase in HIV sexual risk behaviors (by measuring use of sexual risk sites) and preventive measures (HIV testing).

  19. Economic evaluation of HIV testing for men who have sex with men in community-based organizations - results from six European cities.

    PubMed

    Perelman, Julian; Rosado, Ricardo; Amri, Omar; Morel, Stéphane; Rojas Castro, Daniela; Chanos, Sophocles; Cigan, Bojan; Lobnik, Miha; Fuertes, Ricardo; Pichon, François; Kaye, Per Slaaen; Agustí, Cristina; Fernàndez-López, Laura; Lorente, Nicolas; Casabona, Jordi

    2017-08-01

    The non-decreasing incidence of HIV among men who have sex with men (MSM) has motivated the emergence of Community Based Voluntary Counselling and Testing (CBVCT) services specifically addressed to MSM. The CBVCT services are characterized by facilitated access and linkage to care, a staff largely constituted by voluntary peers, and private not-for-profit structures outside the formal health system institutions. Encouraging results have been measured about their effectiveness, but these favourable results may have been obtained at high costs, questioning the opportunity to expand the experience. We performed an economic evaluation of HIV testing for MSM at CBVCT services, and compared them across six European cities. We collected retrospective data for six CBVCT services from six cities (Copenhagen, Paris, Lyon, Athens, Lisbon, and Ljubljana), for the year 2014, on the number of HIV tests and HIV reactive tests, and on all expenditures to perform the testing activities. The total costs of CBVCTs varied from 54,390€ per year (Ljubljana) to 245,803€ per year (Athens). The cost per HIV test varied from to 41€ (Athens) to 113€ (Ljubljana). The cost per HIV reactive test varied from 1966€ (Athens) to 9065€ (Ljubljana). Our results show that the benefits of CBVCT services are obtained at an acceptable cost, in comparison with the literature (values, mostly from the USA, range from 1600$ to 16,985$ per HIV reactive test in clinical and non-clinical settings). This result was transversal to several European cities, highlighting that there is a common CBVCT model, the cost of which is comparable regardless of the epidemiological context and prices. The CBVCT services represent an effective and "worth it" experience, to be continued and expanded in future public health strategies towards HIV.

  20. Associated factors of self-reported psychopathology and health related quality of life among men who have sex with men (MSM) with HIV/AIDS in Dalian, China: a pilot study.

    PubMed

    Hidru, Tesfaldet Habtemariam; Wang, Feng; Lolokote, Sainyugu; Jia, Yong; Chen, Min; Tong, Wei; Li, Xiao-Feng

    2016-12-01

    Despite the availability of Anti-Retroviral Therapy (ART), the health-related quality of life (HRQoL) among HIV-positive men who have sex with men (HIVMSM) in China remains poor. This study aimed to explore the relationship between self-reported psychopathology and HRQoL among HIVMSM in Dalian, China. A cross-sectional study was conducted in 112 HIVMSM. Symptom check list 90 (SCL 90): a measure of psychopathology and World Health Organization quality of life in HIV infection (WHOQOL-HIV-Bref): a measure of HRQoL were used. Correlation and multiple regression analysis were employed to explore the association between self-reported psychopathology and HRQoL in HIVMSM. Out of the total 112 HIVMSM cases, 9 (8 %) cases were homosexuals and 103 (92 %) ones were bisexuals. The participants who had low family income (P = 0.001), perceived discrimination (P = 0.001) and lack of regular attendance in medical follow-ups (P = 0.014) reported poorer HRQoL than their counterparts. Somatization, obsession, depression, phobia and overall SCL 90 scores in self-reported psycholpathology had a negative impact on the domains of HRQoL among HIVMSM. Total quality of life was predicted by family income, perceived discrimination, and medical follow-up attendance. Self-reported psychopathology was negatively correlated with HRQoL in HIVMSM. The Strategies that target MSM focusing on linking and engaging HIV-positive patients in medical care is the key step to improve their HRQoL. More emphasis is needed on the newly diagnosed HIVMSM in Dalian in order to develop a more targeted intervention to prevent perceived discrimination and lack of proper medical follow-up services. The trial registration number does not require for this manuscript. The study is cross-sectional design that do not involve intervention at all, it is not a clinical trial.

  1. Associations Among Neighborhood Characteristics and Sexual Risk Behavior Among Black and White MSM Living in a Major Urban Area.

    PubMed

    Frye, Victoria; Nandi, Vijay; Egan, James E; Cerda, Magdalena; Rundle, Andrew; Quinn, James W; Sheehan, Daniel; Ompad, Danielle C; Van Tieu, Hong; Greene, Emily; Koblin, Beryl

    2017-03-01

    Identifying neighborhood characteristics associated with sexual HIV risk behavior among gay, bisexual and other men who have sex with men (MSM) living in urban areas may inform the development of policies and programs to reduce risk and subsequently HIV prevalence in urban areas. New York City M2M was a cross-sectional study designed to identify neighborhood-level characteristics associated with sexual risk behaviors among MSM living in New York City. This paper presents results of an analysis of neighborhood-level indicators of three distinct social theories of influence of the neighborhood environment on human behavior: physical disorder, social disorganization and social norms theories. Using multilevel modeling on a sample of 766 MSM stratified by race/ethnicity, we found little support for the role of social disorganization on the sexual risk behavior of MSM, whereas different indicators of physical disorder exerted negative effects across race groups. Our results suggest that the beneficial effects of housing stock maintenance and general neighborhood physical orderliness and cleanliness may have positive effects beyond those traditionally studied for African American MSM and that the field needs novel theorizing regarding whether and how neighborhood or virtual community-level factors relate to sexual behavior among MSM.

  2. Partner Preference Among Men Who Have Sex with Men: Potential Contribution to Spread of HIV Within Minority Populations

    PubMed Central

    Birkett, Michelle; Hammond, Sydney; Mustanski, Brian

    2016-01-01

    Abstract Purpose: Human immunodeficiency virus (HIV) disproportionately affects men who have sex with men (MSM) in the United States. Most prior research into drivers of HIV transmission has focused on individual characteristics rather than on dyadic-level behaviors such as sex partner selection. This article explores racial/ethnic preferences in sex and relationship partner selection among MSM to further contextualize the spread of HIV within minority groups. Methods: Participants were recruited through a mobile application (app) for men to meet other men in 2015 and completed an online survey on behaviors related to HIV risk. All analyses on the sample of 530 MSM were conducted in 2015. Results: There was significant homophily in partner selection within racial/ethnic minorities, but not for white MSM. In general, mobile app-using MSM reported a general preference for white and Hispanic men and a dispreference for black and Asian men, both for sex and relationship partners. Conclusion: Racial/ethnic preferences were found to drive intentions to form partnerships within this sample. Combined with the stigma many of these racial/ethnic minorities may also feel from homophobic attitudes within their own racial/ethnic communities, these MSM may be at particular risk for social isolation. These partner preferences likely affect the structure of the sexual networks of MSM and may contribute to increased clustering within high HIV incident sexual networks. PMID:26907954

  3. Developing a Text Messaging Risk Reduction Intervention for Methamphetamine-Using MSM: Research Note.

    PubMed

    Reback, Cathy J; Ling, Deborah; Shoptaw, Steven; Rohde, Jane

    2010-05-14

    Men who have sex with men (MSM) who use methamphetamine experience high risks for HIV infection due to sexual transmission behaviors often engaged in when under the influence of methamphetamine. Methamphetamine-using MSM use various forms of information technology (IT) communication such as instant messaging, social networking sites, and websites to facilitate a sexual and/or drug "hook up." Given the acceptability of IT communication in their daily lives, an IT intervention represents an appropriate strategy to reach and intervene with out-of-treatment, methamphetamine-using MSM. The aim of this study was to conduct formative work to develop a text messaging intervention to reduce methamphetamine use and high-risk sexual behaviors among out-of-treatment MSM, which involved conducting focus groups, community partners' meetings, and a pre-test intervention. These activities culminated in the development of a two-week, text-messaging intervention that delivered real-time electronic correspondence based on the behavioral change theories of Social Support Theory, Health Belief Model, and Social Cognitive Theory. The focus groups, community meetings, and pre-test were used to identify the IT communication device, the text messages that best support risk reduction and healthier behavioral choices, and logo, flyer and website development. The input and feedback from the target population and community partners were critical to the successful development of a culturally appropriate intervention. The knowledge gleaned from the formative work of this study will be vitally helpful in designing future IT studies.

  4. A community-engaged randomized controlled trial of an integrative intervention with HIV-positive, methamphetamine-using men who have sex with men.

    PubMed

    Carrico, Adam W; Jain, Jennifer; Discepola, Michael V; Olem, David; Andrews, Rick; Woods, William J; Neilands, Torsten B; Shoptaw, Steven; Gómez, Walter; Dilworth, Samantha E; Moskowitz, Judith T

    2016-07-30

    Contingency management (CM) is an evidence-based intervention providing tangible rewards as positive reinforcement for abstinence from stimulants such as methamphetamine. Integrative approaches targeting affect regulation could boost the effectiveness of CM in community-based settings and optimize HIV/AIDS prevention efforts. This randomized controlled trial with HIV-positive, methamphetamine-using men who have sex with men (MSM) is examining the efficacy of a 5-session, individually delivered positive affect regulation intervention - Affect Regulation Treatment to Enhance Methamphetamine Intervention Success (ARTEMIS). ARTEMIS is designed to sensitize individuals to non-drug-related sources of reward as well as assist with managing depression and other symptoms of stimulant withdrawal during CM. HIV-positive, methamphetamine-using MSM who are enrolled in a community-based, 12-week CM program are randomized to receive ARTEMIS or an attention-matched control condition. Follow-up assessments are conducted at 3, 6, 12, and 15 months after enrollment in CM. Four peripheral venous blood samples are collected over the 15-month follow-up with specimen banking for planned biomarker sub-studies. The primary outcome is mean HIV viral load. Secondary outcomes include: sustained HIV viral suppression, T-helper cell count, psychological adjustment, stimulant use, and potentially amplified transmission risk behavior. Implementation of this randomized controlled trial highlights the importance of delineating boundaries between research activities and community-based service provision. It also provides insights into best practices for integrating the distinct agendas of academic and community partners in clinical research. This trial is currently enrolling and data collection is anticipated to be completed in September of 2018. This trial was registered on clinicaltrials.gov ( NCT01926184 ) on August 16, 2013.

  5. Community and Individual Factors Associated with Cigarette Smoking among Young Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Holloway, Ian W.; Traube, Dorian E.; Rice, Eric; Schrager, Sheree M.; Palinkas, Lawrence A.; Richardson, Jean; Kipke, Michele D.

    2012-01-01

    Young men who have sex with men (YMSM) have higher rates of cigarette smoking than their heterosexual counterparts, yet few studies have examined factors associated with cigarette smoking among YMSM. The present study sought to understand how different types of gay community connection (i.e., gay community identification and involvement, gay bar…

  6. Community and Individual Factors Associated with Cigarette Smoking among Young Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Holloway, Ian W.; Traube, Dorian E.; Rice, Eric; Schrager, Sheree M.; Palinkas, Lawrence A.; Richardson, Jean; Kipke, Michele D.

    2012-01-01

    Young men who have sex with men (YMSM) have higher rates of cigarette smoking than their heterosexual counterparts, yet few studies have examined factors associated with cigarette smoking among YMSM. The present study sought to understand how different types of gay community connection (i.e., gay community identification and involvement, gay bar…

  7. Young, Online and in the Dark: Scaling Up HIV Testing among MSM in ASEAN

    PubMed Central

    Guadamuz, Thomas E.; Cheung, Doug H.; Wei, Chongyi; Koe, Stuart; Lim, Sin How

    2015-01-01

    Background Poor HIV testing uptake by MSM may be attributable to unique challenges that are localized in Southeast Asia. Objective To characterize MSM who never tested for HIV, to identify correlates of never testing, and to elucidate the perceived barriers to HIV testing. Methods The present study used data from the Asian Internet MSM Sex Survey (AIMSS) and restricted the analysis to 4,310 MSM from the ten member countries of the Association of South East Asian Nations (ASEAN). Results Among MSM participants from ASEAN in our sample, 1290 (29.9%) reported having never been tested for HIV, 471 (10.9%) tested for HIV more than 2 years ago, and 2186 (50.7%) reported their last test date was between 6 months and two years ago, with only 363 (8.4%) of these men having been tested in the past 6 months. In multivariable logistic regression, younger MSM (age 15–22 years old [AOR: 4.60, 95% CI: 3.04–6.96]), MSM with lower education (secondary school or lower [AOR: 1.37, 95% CI: 1.03–1.83]), MSM who identify as bisexual or heterosexual (compared to gay-identified) (AOR: 1.94, 95% CI: 1.60–2.35), and MSM who had never used a condom with male partners (AOR: 1.61, 95% CI: 1.32–1.97) had higher odds of never been HIV tested. Main reason for not being tested was a low risk perception of HIV exposure (n = 390, 30.2%). Conclusion Current HIV prevention response must not leave MSM “in the dark,” but instead meet them where they are by utilizing the Internet creatively through social media and smart phones. As ASEAN Economic Community (AEC) is quickly becoming a reality, so must there be an equally fast and united response to slowing down the HIV epidemics among MSM in ASEAN. PMID:25973907

  8. Sexual identity stigma and social support among men who have sex with men in Lesotho: a qualitative analysis.

    PubMed

    Stahlman, Shauna; Bechtold, Kali; Sweitzer, Stephanie; Mothopeng, Tampose; Taruberekera, Noah; Nkonyana, John; Baral, Stefan

    2015-11-01

    Men who have sex with men (MSM) face sexual identity stigma in many settings, which can increase risk for HIV by limiting access to care. This paper examines the roles of social support, sexual identity stigma, and sexual identity disclosure among MSM in Lesotho, a lower-middle income country within South Africa. Qualitative data were collected from 23 in-depth interview and six focus group participants and content analysis was performed to extract themes. Four primary themes emerged: 1) Verbal abuse from the broader community is a major challenge faced by MSM in Lesotho, 2) participants who were open about their sexual identity experienced greater stigma but were more self-sufficient and had higher self-confidence, 3) relationships between MSM tend to be conducted in secrecy, which can be associated with unhealthy relationships between male couples and higher risk sexual practices, and 4) MSM community organisations provide significant social and emotional support. Friends and family members from outside the MSM community also offer social support, but this support cannot be utilised by MSM until the risk of disclosing their sexual identity is reduced. Greater acceptance of same-sex practices would likely result in more open, healthy relationships and greater access to social support for MSM. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Substance use and experienced stigmatization among ethnic minority men who have sex with men in the United States.

    PubMed

    Paul, Jay P; Boylan, Ross; Gregorich, Steve; Ayala, George; Choi, Kyung-Hee

    2014-01-01

    Research has documented deleterious effects of racism among ethnic minorities and of homophobia among men who have sex with men (MSM). Less is known about the impact of multiple forms of stigmatization on ethnic minority MSM. This study examined substance use by African American, Asian/Pacific Islander and Latino MSM, and the associations of experienced racism and homophobia from various sources with polydrug use and stimulant drug use. Experienced racism within the general community was associated with higher levels of use; other forms of discrimination were either not associated with polydrug or stimulant use or had more complex relationships with use. Implications for further research and interventions are discussed.

  10. The Relationship Between Online Social Network Use, Sexual Risk Behaviors, and HIV Sero-Status Among a Sample of Predominately African American and Latino Men Who have Sex with Men (MSM) Social Media Users.

    PubMed

    Chiu, ChingChe J; Young, Sean D

    2015-06-01

    Social networking technologies have emerged as potential platforms to reach HIV(+) MSM in HIV interventions. This study sought to compare use of online social networking sites (SNSs) and sexual risk behaviors between HIV(+) and HIV(-) individuals among a sample of predominately African American and Latino SNS-using MSM. A total of 112 MSM Facebook users were recruited online and offline and completed an online survey. We performed regression models to assess the association between HIV status, SNS use, and sexual risk behaviors. After adjusting for age, race, and employment status, being HIV positive was significantly associated with a greater number of sexual partners (ARR = 2.84, p = 0.0017) and lower comfort levels of discussing HIV/STI status on SNSs (AOR: 0.23, p = 0.011). Findings suggest that HIV status is associated with sexual risk behaviors and SNS use among SNS-using MSM. We discuss the implications for online HIV prevention.

  11. Bridging the Divide: HIV Prevention Research and Black Men Who Have Sex With Men

    PubMed Central

    Chandler, Christian; Powell, Borris; Humes, Damon; Wakefield, Steven; Kripke, Katharine; Eckstein, Daniel

    2014-01-01

    Objectives. We obtained contextual information regarding documented barriers to HIV clinical trial participation among Black men who have sex with men (MSM), and explored current preventive HIV clinical trial attitudes, beliefs, and perceptions among Black MSM leaders in the United States. Methods. We conducted 2 focus groups with Black MSM leaders attending an annual African American MSM Leadership Conference on HIV/AIDS. Focus group questions explored biomedical research perceptions and attitudes, barriers to participation in biomedical prevention research, and steps that need to be taken to address these barriers. A feedback and member checking (participants presented with final themes to provide feedback and guidance) session was also held at the 2012 conference. Results. Three distinct themes emerged regarding Black MSM engagement and participation in HIV vaccine research: (1) community-based organizations as true partners, (2) investment in the Black gay community, and (3) true efforts to inform and educate the community. Conclusions. A key focus for improving efforts to engage the Black MSM community in preventive HIV clinical trials is building and maintaining equitable and reciprocal partnerships among research institutions, Black-led AIDS service organizations and community-based organizations, and community members. PMID:24524520

  12. High prevalence of HIV, chlamydia and gonorrhoea among men who have sex with men and transgender women attending trusted community centres in Abuja and Lagos, Nigeria.

    PubMed

    Keshinro, Babajide; Crowell, Trevor A; Nowak, Rebecca G; Adebajo, Sylvia; Peel, Sheila; Gaydos, Charlotte A; Rodriguez-Hart, Cristina; Baral, Stefan D; Walsh, Melissa J; Njoku, Ogbonnaya S; Odeyemi, Sunday; Ngo-Ndomb, Teclaire; Blattner, William A; Robb, Merlin L; Charurat, Manhattan E; Ake, Julie

    2016-01-01

    Sexually transmitted infection (STI) and HIV prevalence have been reported to be higher amongst men who have sex with men (MSM) in Nigeria than in the general population. The objective of this study was to characterize the prevalence of HIV, chlamydia and gonorrhoea in this population using laboratory-based universal testing. TRUST/RV368 represents a cohort of MSM and transgender women (TGW) recruited at trusted community centres in Abuja and Lagos, Nigeria, using respondent-driven sampling (RDS). Participants undergo a structured comprehensive assessment of HIV-related risks and screening for anorectal and urogenital Chlamydia trachomatis and Neisseria gonorrhoeae, and HIV. Crude and RDS-weighted prevalence estimates with 95% confidence intervals (CIs) were calculated. Log-binomial regression was used to explore factors associated with prevalent HIV infection and STIs. From March 2013 to January 2016, 862 MSM and TGW (316 in Lagos and 546 in Abuja) underwent screening for HIV, chlamydia and gonorrhoea at study enrolment. Participants' median age was 24 years [interquartile range (IQR) 21-27]. One-third (34.2%) were identified as gay/homosexual and 65.2% as bisexual. The overall prevalence of HIV was 54.9%. After adjusting for the RDS recruitment method, HIV prevalence in Abuja was 43.5% (95% CI 37.3-49.6%) and in Lagos was 65.6% (95% CI 54.7-76.5%). The RDS-weighted prevalence of chlamydia was 17.0% (95% CI 11.8-22.3%) in Abuja and 18.3% (95% CI 11.1-25.4%) in Lagos. Chlamydia infection was detected only at the anorectal site in 70.2% of cases. The RDS-weighted prevalence of gonorrhoea was 19.1% (95% CI 14.6-23.5%) in Abuja and 25.8% (95% CI 17.1-34.6%) in Lagos. Overall, 84.2% of gonorrhoea cases presented with anorectal infection only. Over 95% of STI cases were asymptomatic. In a multivariable model, increased risk for chlamydia/gonorrhoea was associated with younger age, gay/homosexual sexual orientation and higher number of partners for receptive anal sex

  13. High prevalence of HIV, chlamydia and gonorrhoea among men who have sex with men and transgender women attending trusted community centres in Abuja and Lagos, Nigeria

    PubMed Central

    Keshinro, Babajide; Crowell, Trevor A; Nowak, Rebecca G; Adebajo, Sylvia; Peel, Sheila; Gaydos, Charlotte A; Rodriguez-Hart, Cristina; Baral, Stefan D; Walsh, Melissa J; Njoku, Ogbonnaya S; Odeyemi, Sunday; Ngo-Ndomb, Teclaire; Blattner, William A; Robb, Merlin L; Charurat, Manhattan E; Ake, Julie

    2016-01-01

    Introduction Sexually transmitted infection (STI) and HIV prevalence have been reported to be higher amongst men who have sex with men (MSM) in Nigeria than in the general population. The objective of this study was to characterize the prevalence of HIV, chlamydia and gonorrhoea in this population using laboratory-based universal testing. Methods TRUST/RV368 represents a cohort of MSM and transgender women (TGW) recruited at trusted community centres in Abuja and Lagos, Nigeria, using respondent-driven sampling (RDS). Participants undergo a structured comprehensive assessment of HIV-related risks and screening for anorectal and urogenital Chlamydia trachomatis and Neisseria gonorrhoeae, and HIV. Crude and RDS-weighted prevalence estimates with 95% confidence intervals (CIs) were calculated. Log-binomial regression was used to explore factors associated with prevalent HIV infection and STIs. Results From March 2013 to January 2016, 862 MSM and TGW (316 in Lagos and 546 in Abuja) underwent screening for HIV, chlamydia and gonorrhoea at study enrolment. Participants’ median age was 24 years [interquartile range (IQR) 21–27]. One-third (34.2%) were identified as gay/homosexual and 65.2% as bisexual. The overall prevalence of HIV was 54.9%. After adjusting for the RDS recruitment method, HIV prevalence in Abuja was 43.5% (95% CI 37.3–49.6%) and in Lagos was 65.6% (95% CI 54.7–76.5%). The RDS-weighted prevalence of chlamydia was 17.0% (95% CI 11.8–22.3%) in Abuja and 18.3% (95% CI 11.1–25.4%) in Lagos. Chlamydia infection was detected only at the anorectal site in 70.2% of cases. The RDS-weighted prevalence of gonorrhoea was 19.1% (95% CI 14.6–23.5%) in Abuja and 25.8% (95% CI 17.1–34.6%) in Lagos. Overall, 84.2% of gonorrhoea cases presented with anorectal infection only. Over 95% of STI cases were asymptomatic. In a multivariable model, increased risk for chlamydia/gonorrhoea was associated with younger age, gay/homosexual sexual orientation and higher

  14. Intimate partner, familial and community violence among men who have sex with men in Namibia

    PubMed Central

    Stephenson, Rob; Hast, Marisa; Finneran, Catherine; Sineath, Craig R.

    2015-01-01

    Men who have sex with men in sub-Saharan Africa are known to experience high levels of violence, yet little research has focused on their perceptions of intimate partner violence (IPV). This study examines the perceived typologies and sources of multiple forms of violence, including IPV, family/community violence and discrimination from healthcare workers, among men who have sex with men in Namibia. Focus-group discussions and in-depth interviews were conducted with a 52 men residing in five cities across Namibia. Results indicate that violence, in varying forms, is commonplace in the lives of men who have sex with men in this community, and may be associated with HIV testing patterns. PMID:24735113

  15. Intimate partner, familial and community violence among men who have sex with men in Namibia.

    PubMed

    Stephenson, Rob; Hast, Marisa; Finneran, Catherine; Sineath, Craig R

    2014-01-01

    Men who have sex with men in sub-Saharan Africa are known to experience high levels of violence, yet little research has focused on their perceptions of intimate partner violence (IPV). This study examines the perceived typologies and sources of multiple forms of violence, including IPV, family/community violence and discrimination from healthcare workers, among men who have sex with men in Namibia. Focus-group discussions and in-depth interviews were conducted with a 52 men residing in five cities across Namibia. Results indicate that violence, in varying forms, is commonplace in the lives of men who have sex with men in this community, and may be associated with HIV testing patterns.

  16. Space: The New Frontier in HIV Prevention for Young Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Easton, Delia; Iverson, Ellen; Cribbin, Melissa; Wilson, Erin; Weiss, George

    2007-01-01

    Young men who have sex with men (MSM) in urban areas of the United States continue to be vulnerable to HIV infection. Qualitative data collected with participants in a community level HIV intervention in West Hollywood and Orange County, California, suggest that space--both actual physical space and the concept of having space--should be an…

  17. Perceptions of HPV and attitudes towards HPV vaccination amongst men who have sex with men: A qualitative analysis.

    PubMed

    Nadarzynski, Tom; Smith, Helen; Richardson, Daniel; Pollard, Alex; Llewellyn, Carrie

    2017-05-01

    Men who have sex with men (MSM) are at risk of genital warts and anal cancer due to human papillomavirus (HPV) infection. This study explores MSMs' perceptions of HPV and HPV vaccination prior to the introduction of this programme. Focus groups and one-to-one interviews with self-identified MSM were conducted between November 2014 and March 2015 in Brighton, UK. Participants were recruited from community-based lesbian-gay-bisexual-transgender (LGBT) venues and organizations. Discussions were recorded, transcribed verbatim, and analysed using framework analysis. Thirty-three men took part (median age 25 years, IQR: 21-27), most of whom (n = 25) did not know about HPV, anal cancer (31), or HPV vaccination (26). While genital warts and anal cancer were perceived as severe, men did not perceive themselves at risk of HPV. All MSM would accept the HPV vaccine if offered by a health care professional. The challenges of accessing sexual health services or openly discussing same-sex experiences with health care professionals were perceived as barriers to accessing HPV vaccination. Two participants were concerned that selective HPV vaccination could increase stigma and prejudice against MSM, comparable to the AIDS epidemic. Ten MSM were unsure about the effectiveness of HPV vaccination for sexually active men and were in favour of vaccinating all adolescent boys at school. Most MSM have poor knowledge about HPV and associated anal cancer. Despite the lack of concern about HPV, most MSM expressed willingness to receive HPV vaccination. There is a need for health education about the risks of HPV and HPV-related diseases so that MSM can appraise the benefits of being vaccinated. Concerns about HPV vaccine effectiveness in sexually active men and possible stigmatization need to be addressed to optimize HPV vaccine acceptability. Statement of contribution What is already known on this subject? Men who have sex with men (MSM) have poor knowledge about HPV and HPV

  18. Homophobia is associated with sexual behavior that increases risk of acquiring and transmitting HIV infection among black men who have sex with men.

    PubMed

    Jeffries, William L; Marks, Gary; Lauby, Jennifer; Murrill, Christopher S; Millett, Gregorio A

    2013-05-01

    We investigated whether the experience of homophobic events increases the odds of engaging in unprotected anal intercourse (UAI) among black men who have sex with men (MSM) and whether social integration level buffered the association. Participants (N = 1,154) reported homophobic events experienced in the past 12 months. Social integration measures included social support, closeness with family members and friends, attachment to the black gay community, openness about sexuality within religious communities, and MSM social network size. Logistic regression analyses indicated that experiencing homophobia was associated with (1) UAI among men not previously diagnosed with HIV and (2) sexual HIV transmission risk behavior among men who knew they were HIV-infected. None of the social integration measures buffered these associations. Homophobia may promote acquisition and transmission of HIV infection among black MSM. Interventions are needed to reduce homophobia experienced by black MSM.

  19. The increased effectiveness of HIV preventive intervention among men who have sex with men and of follow-up care for people living with HIV after 'task-shifting' to community-based organizations: a 'cash on service delivery' model in China.

    PubMed

    Yan, Hongjing; Zhang, Min; Zhao, Jinkou; Huan, Xiping; Ding, Jianping; Wu, Susu; Wang, Chenchen; Xu, Yuanyuan; Liu, Li; Xu, Fei; Yang, Haitao

    2014-01-01

    A large number of men who have sex with men (MSM) and people living with HIV/AIDS (PLHA) are underserved despite increased service availability from government facilities while many community based organizations (CBOs) are not involved. We aimed to assess the feasibility and effectiveness of the task shifting from government facilities to CBOs in China. HIV preventive intervention for MSM and follow-up care for PLHA were shifted from government facilities to CBOs. Based on 'cash on service delivery' model, 10 USD per MSM tested for HIV with results notified, 82 USD per newly HIV cases diagnosed, and 50 USD per PLHA received a defined package of follow-up care services, were paid to the CBOs. Cash payments were made biannually based on the verified results in the national web-based HIV/AIDS information system. After task shifting, CBOs gradually assumed preventive intervention for MSM and follow-up care for PLHA from 2008 to 2012. HIV testing coverage among MSM increased from 4.1% in 2008 to 22.7% in 2012. The baseline median CD4 counts of newly diagnosed HIV positive MSM increased from 309 to 397 cells/µL. HIV tests among MSM by CBOs accounted for less than 1% of the total HIV tests in Nanjing but the share of HIV cases detected by CBOs was 12.4% in 2008 and 43.6% in 2012. Unit cost per HIV case detected by CBOs was 47 times lower than that by government facilities. The coverage of CD4 tests and antiretroviral therapy increased from 71.1% and 78.6% in 2008 to 86.0% and 90.1% in 2012, respectively. It is feasible to shift essential HIV services from government facilities to CBOs, and to verify independently service results to adopt 'cash on service delivery' model. Services provided by CBOs are cost-effective, as compared with that by government facilities.

  20. High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in anal and pharyngeal sites among a community-based sample of men who have sex with men and transgender women in Lima, Peru

    PubMed Central

    Leon, Segundo R; Segura, Eddy R; Konda, Kelika A; Flores, Juan A; Silva-Santisteban, Alfonso; Galea, Jerome T; Coates, Thomas J; Klausner, Jeffrey D; Caceres, Carlos F

    2016-01-01

    Objectives This study aimed to characterise the epidemiology of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. Setting Cross-sectional study in Lima, Peru. Participants We recruited a group of 510 MSM and 208 TW for a subsequent community-based randomised controlled trial. The presence of CT and NG were evaluated using Aptima Combo2 in pharyngeal and anal swabs. We also explored correlates of these infections. Primary and secondary outcome measures: Study end points included overall prevalence of C. trachomatis and N. gonorrhoeae in anal and pharyngeal sites. Results Overall prevalence of CT was 19% (95% CI 16.1% to 22.1%) and 4.8% (95% CI 3.3% to 6.6%) in anal and pharyngeal sites, respectively, while prevalence of NG was 9.6% (95% CI 7.5% to 12.0%) and 6.5% (95% CI 4.8% to 8.5%) in anal and pharyngeal sites, respectively. Conclusions The prevalence of each infection declined significantly among participants older than 34 years (p<0.05). Efforts towards prevention and treatment of extraurogenital chlamydial and gonococcal infections in high-risk populations like MSM and TW in Lima, Peru, are warranted. Trial registration number NCT00670163; Results. PMID:26739719

  1. High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in anal and pharyngeal sites among a community-based sample of men who have sex with men and transgender women in Lima, Peru.

    PubMed

    Leon, Segundo R; Segura, Eddy R; Konda, Kelika A; Flores, Juan A; Silva-Santisteban, Alfonso; Galea, Jerome T; Coates, Thomas J; Klausner, Jeffrey D; Caceres, Carlos F

    2016-01-06

    This study aimed to characterise the epidemiology of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. Cross-sectional study in Lima, Peru. We recruited a group of 510 MSM and 208 TW for a subsequent community-based randomised controlled trial. The presence of CT and NG were evaluated using Aptima Combo2 in pharyngeal and anal swabs. We also explored correlates of these infections. Study end points included overall prevalence of C. trachomatis and N. gonorrhoeae in anal and pharyngeal sites. Overall prevalence of CT was 19% (95% CI 16.1% to 22.1%) and 4.8% (95% CI 3.3% to 6.6%) in anal and pharyngeal sites, respectively, while prevalence of NG was 9.6% (95% CI 7.5% to 12.0%) and 6.5% (95% CI 4.8% to 8.5%) in anal and pharyngeal sites, respectively. The prevalence of each infection declined significantly among participants older than 34 years (p<0.05). Efforts towards prevention and treatment of extraurogenital chlamydial and gonococcal infections in high-risk populations like MSM and TW in Lima, Peru, are warranted. NCT00670163; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. weCare: A social media-based intervention designed to increase HIV care linkage, retention, and health outcomes for racially and ethnically diverse young MSM

    PubMed Central

    Tanner, Amanda E.; Mann, Lilli; Song, Eunyoung; Alonzo, Jorge; Schafer, Katherine; Arellano, Elías; Garcia, Jesus M.; Rhodes, Scott D.

    2016-01-01

    Estimates suggest that only about 30% of all individuals living with HIV in the US have achieved viral suppression. Men who have sex with men (MSM), particularly racial/ethnic minority young MSM, are at increased risk for HIV infection and may have even lower viral suppression rates. HIV testing rates among MSM are low, and when tested, racial/ethnic minority young MSM have disproportionately lower rates of retention in care and viral suppression compared to other subgroups. This paper describes the design and development of weCare, our social media-based intervention to improve care linkage and retention and health outcomes among racially and ethnically diverse MSM, ages 13–34, living with HIV that will be implemented and evaluated beginning in late 2016. The intervention harnesses established social media that MSM between these ages commonly use, including Facebook, text messaging, and established GPS-based mobile applications (“apps”). We are using community-based participatory research (CBPR) to enhance the quality and validity of weCare, equitably involving community members, organization representatives, healthcare providers, clinic staff, and academic researchers. PMID:27244190

  3. weCARE: A Social Media-Based Intervention Designed to Increase HIV Care Linkage, Retention, and Health Outcomes for Racially and Ethnically Diverse Young MSM.

    PubMed

    Tanner, Amanda E; Mann, Lilli; Song, Eunyoung; Alonzo, Jorge; Schafer, Katherine; Arellano, Elías; Garcia, Jesus M; Rhodes, Scott D

    2016-06-01

    Estimates suggest that only about 30% of all individuals living with HIV in the U.S. have achieved viral suppression. Men who have sex with men (MSM), particularly racial/ethnic minority young MSM, are at increased risk for HIV infection and may have even lower viral suppression rates. HIV testing rates among MSM are low, and when tested, racial/ethnic minority young MSM have disproportionately lower rates of retention in care and viral suppression compared to other subgroups. This article describes the design and development of weCare, our social media-based intervention to improve care linkage and retention and health outcomes among racially and ethnically diverse MSM, ages 13-34, living with HIV that will be implemented and evaluated beginning in late 2016. The intervention harnesses established social media that MSM between these ages commonly use, including Facebook, text messaging, and established GPS-based mobile applications (apps). We are using community-based participatory research (CBPR) to enhance the quality and validity of weCare, equitably involving community members, organization representatives, healthcare providers, clinic staff, and academic researchers.

  4. HIV-infected men who have sex with men, before and after release from jail: the impact of age and race, results from a multi-site study.

    PubMed

    Vagenas, Panagiotis; Zelenev, Alexei; Altice, Frederick L; Di Paola, Angela; Jordan, Alison O; Teixeira, Paul A; Frew, Paula M; Spaulding, Anne C; Springer, Sandra A

    2016-01-01

    The US HIV/AIDS epidemic is concentrated among men who have sex with men (MSM). Black men are disproportionately affected by incarceration and Black MSM experience higher infection rates and worse HIV-related health outcomes compared to non-Black MSM. We compared HIV treatment outcomes for Black MSM to other HIV-infected men from one of the largest cohorts of HIV-infected jail detainees (N = 1270) transitioning to the community. Of the 574 HIV-infected men released, 113 (19.7%) self-identified as being MSM. Compared to other male subgroups, young Black MSM (<30 years old, N = 18) were significantly less likely: (1) before incarceration, to have insurance, access to an HIV healthcare provider, and use cocaine; (2) during incarceration, to receive a disease management intervention; and (3) in the 6 months post-release, to link to HIV care. Interventions that effectively link and retain young HIV-infected Black MSM in care in communities before incarceration and post-release from jail are urgently needed.

  5. Feasibility of incorporating self-collected rectal swabs into a community venue-based survey to measure the prevalence of HPV infection in men who have sex with men.

    PubMed

    Gilbert, Mark; Kwag, Michael; Mei, Wendy; Rank, Claudia; Kropp, Rhonda; Severini, Alberto; van Niekerk, Dirk; Zhou, Chen; Press, Natasha; Ogilvie, Gina; Wong, Tom

    2011-10-01

    Inclusion of self-collected rectal swabs (SCRS) into existing community venue-based HIV surveillance systems for men who have sex with men (MSM) may provide a feasible method for monitoring human papillomavirus (HPV) vaccine-related outcomes in this population. We measured the prevalence of HPV and anal dysplasia through incorporating SCRS into ManCount, the Vancouver site of the M-Track HIV surveillance system. Participating MSM were provided with a self-collection kit for collection on-site or at a follow-up venue. Swabs were subject to polymerase chain reaction amplification for HPV detection, and cytology slides were reviewed for anal dysplasia. Factors associated with participation were identified through multivariate logistic regression. Of 766 men completing ManCount, 268 (35%) agreed to participate, self-collecting 252 specimens (247 on-site). Of 239 complete specimens, 33.5% did not have detectable β-globin; in the remainder (159 specimens) the prevalence of HPV infection was 62.3% (23.3% HPV type 16 or 18; 38.4% HPV type 6, 11, 16, or 18). In the 62.3% (149) of specimens adequate for cytology, the prevalence of anal dysplasia was 42.3% (HSIL 11.4%, LSIL 18.8%, ASC-US 6.7%, ASC-H 5.4%). Participation was associated with venue type, availability of on-site collection, and other characteristics. SCRS can be feasibly integrated within existing community venue-based HIV surveillance systems for MSM, and may be a suitable method for monitoring the impact of HPV vaccination in this population. However, participation may be influenced by venue type and availability of on-site collection, and adequacy of SCRS specimens may be lower in community venues as compared with clinical settings.

  6. Demographic and behavioral correlates of HIV risk among men and transgender women recruited from gay entertainment venues and community-based organizations in Thailand: implications for HIV prevention.

    PubMed

    Newman, Peter A; Lee, Sung-Jae; Roungprakhon, Surachet; Tepjan, Suchon

    2012-10-01

    High HIV prevalence among men who have sex with men (MSM) and transgender women in Thailand suggest a vital need for targeted interventions. We conducted a cross-sectional survey to examine and compare sexual risk behaviors, and demographic and behavioral correlates of risk, among MSM and transgender women recruited from gay entertainment venue staff and community-based organization (CBO) participants. We used venue-based sampling across nine sites in Bangkok and Chiang Mai. Among 260 participants (57.3% gay-identified, 26.9% heterosexual/bisexual-identified, 15.8% transgender; mean age = 26.7 years), nearly one-fifth (18.5%) reported unprotected anal sex (UAS), half (50.4%) sex in exchange for money, and one-fifth (20.0%) STI diagnosis (past year). Nearly one-fourth (23.1%) reported oral erectile dysfunction medication use and nearly one-fifth (19.2%) illicit drug use (past 3 months). Overall, 43.1% indicated that healthcare providers exhibited hostility towards them. Gay entertainment venue staff were significantly more likely to self-identify as heterosexual/bisexual (versus gay or transgender female), and to have less than high school degree education, higher monthly income, to have engaged in sex in exchange for money, sex with women and unprotected vaginal sex, but were significantly less likely to have engaged in UAS than CBO participants. Targeted interventions for younger MSM and transgender women, for non gay-identified men, and strategies to address structural determinants of risk, including low education and discrimination from healthcare providers, may support HIV prevention among MSM and transgender women, and serve broader national HIV prevention efforts in Thailand.

  7. Men who have sex with men in India: a systematic review of the literature.

    PubMed

    Setia, Maninder Singh; Brassard, Paul; Jerajani, Hemangi R; Bharat, Shalini; Gogate, Alka; Kumta, Sameer; Row-Kavi, Ashok; Anand, Vivek; Boivin, Jean-François

    2008-01-01

    This study systematically reviews the existing literature on sexually transmitted infections (STIs) including human immunodeficiency virus (HIV) infection in the men who have sex with men (MSM) in India. After a comprehensive literature search of Medline (1950-June 2008), Embase (1980-June 2008), and the Cochrane Library (1950-June 2008), 12 published studies met the inclusion criteria. The link between sexual identity and sexual behavior is a complex phenomenon strongly embedded in a very specific context in India. MSM in India are an important risk group for acquiring STIs/HIV and effective culturally sensitive prevention programs should be designed for them. The combined estimate of HIV prevalence in the MSM population in India calculated from 5 included studies was 16.5% (95% confidence intervals: 11% to 22%). The review also identifies the lacunae in existing literature and provides future directions for research in the MSM community in India.

  8. Hepatitis C virus infection and its relationship to certain sexual practices in men-who-have-sex-with-men in Spain: results from the European MSM internet survey (EMIS).

    PubMed

    Fernández-Dávila, Percy; Folch, Cinta; Ferrer, Laia; Soriano, Raúl; Diez, Mercedes; Casabona, Jordi

    2015-05-01

    To compare sexual practices and risk behaviours between MSM who were first diagnosed with hepatitis C (HCV) in the previous 12 months and those who were never diagnosed; and, to identify factors associated with a diagnosis of HCV. The European-MSM-Internet-Survey (EMIS) was implemented for 3 months during 2010, mainly on websites for MSM. Data on socio-demographic characteristics, sexual behaviour, drug use, STI history, and other sexual health variables were collected. The Chi-square test and logistic regression analysis were used to analyse the data. Data from 13,111 respondents were analysed. The proportion of MSM who had ever been diagnosed with HCV infection was 1.9% (n=250), and of those currently infected with the virus was 0.6% (n=78). The percentage of those first diagnosed in the last 12 months was 0.4% (n=46), of whom 70% were HIV-negative and 22% had HIV coinfection. Having a first diagnosis of HCV in the last 12 months was more common among HIV-positive than among HIV-negative MSM (0.9% vs 0.4%) and among MSM born abroad than among Spanish-born (0.7% vs 0.3%). MSM diagnosed with HCV in the last 12 months were more likely to have had: more than 10 sexual partners, sex abroad, receptive anal intercourse, insertive/receptive fisting, and unprotected anal intercourse with non-steady partners of unknown or discordant HIV-status. Likewise, they reported more frequent visits to sex-focused venues, higher drug use, as well as a higher proportion of STI diagnosis. In the multivariate model, visiting a public sex-focused venue, practicing receptive fisting, using erection enhancing medication and having a diagnosis of syphilis were independently associated with a first diagnosis of HCV in the last 12 months. HCV infection does not seem to be restricted to HIV-infected MSM. Certain sexual behaviour (fisting, visiting sex-focused venues), drug use, and ulcerative STI seem to be associated with a diagnosis of HCV. Copyright © 2014 Elsevier España, S.L.U. y

  9. HIV testing as prevention among MSM in China: the business of scaling-up.

    PubMed

    Fan, Elsa L

    2014-01-01

    In this paper, I examine the emergence of goumai fuwu, or contracting with social organisations to provide social services, in the HIV/AIDS sector in China. In particular, I interrogate the outsourcing of HIV testing to community-based organisations (CBOs) serving men who have sex with men (MSM) as a means of scaling-up testing in this population, and how the commodification of testing enables new forms of surveillance and citizenship to emerge. In turn, I tie the scaling-up of testing and its commodification to the sustainability of CBOs as they struggle to survive. In recent years, the HIV/AIDS response in China has shifted to expanding testing among MSM in order to reduce new infections. This response has been catalysed by the transition to sexual contact as the primary transmission route for HIV and the rising rates of infection among MSM, leading government institutions and international donors to mobilise CBOs to expand testing. These efforts to scale-up are as much about testing as they are about making visible this hidden population. CBOs, in facilitating testing, come to rely on outsourcing as a long-term funding base and in doing so, unintentionally extend the reach of the state into the everyday lives of MSM.

  10. HIV risk and prevention among men who have sex with men in rural South Africa.

    PubMed

    Maleke, Kabelo; Makhakhe, Nosipho; Peters, Remco Ph; Jobson, Geoffrey; De Swardt, Glenn; Daniels, Joseph; Lane, Timothy; McIntyre, James A; Imrie, John; Struthers, Helen

    2017-03-01

    Rural South African men who have sex with men (MSM) are likely to be underserved in terms of access to relevant healthcare and HIV prevention services. While research in urban and peri-urban MSM populations has identified a range of factors affecting HIV risk in South African MSM, very little research is available that examines HIV risk and prevention in rural MSM populations. This exploratory study begins to address this lack by assessing perceptions of HIV risk among MSM in rural Limpopo province. Using thematic analysis of interview and discussion data, two overarching global themes that encapsulated participants' understandings of HIV risk and the HIV risk environment in their communities were developed. In the first theme, "community experience and the rural social environment", factors affecting HIV risk within the broad risk environment were discussed. These included perceptions of traditional value systems and communities as homophobic; jealousy and competition between MSM; and the role of social media as a means of meeting other MSM. The second global theme, "HIV/AIDS knowledge, risk and experience", focused on factors more immediately affecting HIV transmission risk. These included: high levels of knowledge of heterosexual HIV risk, but limited knowledge of MSM-specific risk; inconsistent condom and lubricant use; difficulties in negotiating condom and lubricant use due to uneven power dynamics in relationships; competition for sexual partners; multiple concurrent sexual partnerships; and transactional sex. These exploratory results suggest that rural South African MSM, like their urban and peri-urban counterparts, are at high risk of contracting HIV, and that there is a need for more in-depth research into the interactions between the rural context and the specific HIV risk knowledge and behaviours that affect HIV risk in this population.

  11. HIV vulnerabilities and coercive sex at same-sex sexual debut among men who have sex with men in Beijing, China.

    PubMed

    Pan, Stephen W; Ruan, Yuhua; Spittal, Patricia M; Pearce, Margo E; Qian, Han-Zhu; Li, Dongliang; Zhang, Zheng; Shao, Yiming

    2014-01-01

    Few studies have examined coercive sex and HIV vulnerabilities among men who have sex with men (MSM) in China. The present study seeks to compare individual characteristics between MSM who did and did not experience coercive sex at their MSM sexual debut and to identify HIV risk factors correlated with coercive sex at MSM sexual debut. In 2007, we recruited 167 MSM in Beijing, China by peer-referred social network sampling. Each participant then completed self-administered questionnaires regarding their sexual experiences and practices. Results show that 14% of participants reported coercive sex at MSM sexual debut, of whom 48% reported recent unprotected anal intercourse (UAI). Coercive sex at MSM sexual debut was significantly associated with UAI [adjusted odds ratio (AOR): 5.38, 95% confidence interval: 1.95-14.87] and lifetime number of male sex partners (AOR: 7.25, 95% CI: 2.39-22.01). Coercive sex is harming MSM in China and should be immediately addressed by researchers, public health officials, and MSM community stakeholders.

  12. An Exploratory Assessment of the Validity of the Community College Survey of Men (CCSM): Implications for Serving Veteran Men

    ERIC Educational Resources Information Center

    De La Garza, Thomas; Wood, J. Luke; Harris, Frank, III

    2015-01-01

    The Community College Survey of Men (CCSM) assesses predictors of student success for historically underrepresented and underserved men in community colleges. The instrument is designed to inform programming and service-delivery for male students (Wood & Harris, 2013). While the instrument was designed for community college men in general,…

  13. An Exploratory Assessment of the Validity of the Community College Survey of Men (CCSM): Implications for Serving Veteran Men

    ERIC Educational Resources Information Center

    De La Garza, Thomas; Wood, J. Luke; Harris, Frank, III

    2015-01-01

    The Community College Survey of Men (CCSM) assesses predictors of student success for historically underrepresented and underserved men in community colleges. The instrument is designed to inform programming and service-delivery for male students (Wood & Harris, 2013). While the instrument was designed for community college men in general,…

  14. Incorporating Couples-Based Approaches into HIV Prevention for Gay and Bisexual Men: Opportunities and Challenges

    PubMed Central

    Mizuno, Yuko; Smith, Dawn K.; Grabbe, Kristina; Courtenay-Quirk, Cari; Tomlinson, Hank; Mermin, Jonathan

    2016-01-01

    Thirty years after the beginning of the HIV epidemic, gay, bisexual, and other men who have sex with men (collectively called MSM) bear a disproportionate burden of HIV in the United States and continue to acquire a distressingly high number and proportion of new infections. Historically, HIV prevention for MSM has been focused on individual-level behavior change, rarely intervening with MSM as part of a couple. Yet, an estimated 33–67% of HIV infections among MSM are acquired from primary sexual partners, suggesting that work with MSM as couples could be an important contributor to prevention. Given the emergence of high impact combination HIV prevention, it is timely to consider how work with the broad variety of male couples can improve both personal and community health. Couples HIV testing and counseling for MSM is an important advance for identifying men who are unaware that they are HIV-positive, identifying HIV-discordant couples, and supporting men who want to learn their HIV status with their partner. Once men know their HIV status, new advances in biomedical prevention, which can dramatically reduce risk of HIV transmission or acquisition, allow men to make prevention decisions that can protect themselves and their partners. This paper highlights the present-day challenges and benefits of using a couples-based approach with MSM in the era of combination prevention to increase knowledge of HIV status, increase identification of HIV discordant couples to improve targeting prevention services, and support mutual disclosure of HIV status. PMID:24233328

  15. Incorporating couples-based approaches into HIV prevention for gay and bisexual men: opportunities and challenges.

    PubMed

    Purcell, David W; Mizuno, Yoko; Smith, Dawn K; Grabbe, Kristina; Courtenay-Quick, Cari; Tomlinson, Hank; Mermin, Jonathan

    2014-01-01

    Thirty years after the beginning of the HIV epidemic, gay, bisexual, and other men who have sex with men (collectively called MSM) bear a disproportionate burden of HIV in the United States and continue to acquire a distressingly high number and proportion of new infections. Historically, HIV prevention for MSM has been focused on individual-level behavior change, rarely intervening with MSM as part of a couple. Yet, an estimated 33–67% of HIV infections among MSM are acquired from primary sexual partners, suggesting that work with MSM as couples could be an important contributor to prevention. Given the emergence of high impact combination HIV prevention, it is timely to consider how work with the broad variety of male couples can improve both personal and community health. Couples HIV testing and counseling for MSM is an important advance for identifying men who are unaware that they are HIV-positive, identifying HIV-discordant couples, and supporting men who want to learn their HIV status with their partner. Once men know their HIV status, new advances in biomedical prevention, which can dramatically reduce risk of HIV transmission or acquisition, allow men to make prevention decisions that can protect themselves and their partners. This paper highlights the present-day challenges and benefits of using a couples-based approach with MSM in the era of combination prevention to increase knowledge of HIV status, increase identification of HIV discordant couples to improve targeting prevention services,and support mutual disclosure of HIV status.

  16. Real Talk: Developing a Computer-Delivered Sexual Health Program for Black Men Who Have Sex With Men.

    PubMed

    Klein, Charles; Lomonaco, Carmela

    2016-12-01

    HIV disproportionately affects Black men who have sex with men (MSM), yet there are few evidence-based programs that respond to the diverse realities of Black MSM communities. This article examines the development of Real Talk, a new harm reduction-based, sexual health intervention for Black MSM. We first analyze the key themes from our formative research: (1) stigma, discrimination, and intersectionalities in the lives of Black MSM, (2) the importance of safe spaces and community provided by health promotion programs, and (3) moving beyond condoms in sexual health messaging. We then describe our agile design product development process and present an overview of the intervention's components and how they respond to the issues identified in the formative research. In conclusion, we discuss dissemination opportunities and challenges in an age of decreased prevention funding, pre-exposure prophylaxis (PrEP), and the increased use of e-health promotion modalities.

  17. Estimating populations of men who have sex with men in the southern United States.

    PubMed

    Lieb, Spencer; Thompson, Daniel R; Misra, Shyam; Gates, Gary J; Duffus, Wayne A; Fallon, Stephen J; Liberti, Thomas M; Foust, Evelyn M; Malow, Robert M

    2009-11-01

    Population estimates of men who have sex with men (MSM) by state and race/ethnicity are lacking, hampering effective HIV epidemic monitoring and targeting of outreach and prevention efforts. We created three models to estimate the proportion and number of adult males who are MSM in 17 southern states. Model A used state-specific census data stratified by rural/suburban/urban area and national estimates of the percentage MSM in corresponding areas. Model B used a national estimate of the percentage MSM and state-specific household census data. Model C partitioned the statewide estimates by race/ethnicity. Statewide Models A and B estimates of the percentages MSM were strongly correlated (r = 0.74; r-squared = 0.55; p < 0.001) and had similar means (5.82% and 5.88%, respectively) and medians (5.5% and 5.2%, respectively). The estimated percentage MSM in the South was 6.0% (range 3.6-13.2%; median, 5.4%). The combined estimated number of MSM was 2.4 million, including 1,656,500 (69%) whites, 339,400 (14%) blacks, 368,800 (15%) Hispanics, 34,600 (1.4%) Asian/Pacific Islanders, 7,700 (0.3%) American Indians/Alaska Natives, and 11,000 (0.5%) others. The estimates showed considerable variability in state-specific racial/ethnic percentages MSM. MSM population estimates enable better assessment of community vulnerability, HIV/AIDS surveillance, and allocation of resources. Data availability and computational ease of our models suggest other states could similarly estimate their MSM populations.

  18. Men's health and communities of practice in Australia.

    PubMed

    Henwood, Maree; Shaw, Amie; Cavanagh, Jillian; Bartram, Timothy; Marjoribanks, Timothy; Kendrick, Madeleine

    2017-04-10

    Purpose The purpose of this paper is to examine the social opportunities for Aboriginal and Torres Strait Islander men created through Men's Groups/Sheds across urban, regional and remote areas of Australia. Men's Sheds are a safe space, resembling a work-shop setting or backyard shed, where men are encouraged to socialise and participate in health promotion, informal learning and engage in meaningful tasks both individually and at the community level. Design/methodology/approach Explore five case study sites through Wenger's (1998) active communities of practice (CoP). Qualitative methods are presented and analysed; methods comprise semi-structured interviews and yarning circles (focus groups). Five Indigenous leaders/coordinators participated in semi-structured interviews, as well as five yarning circles with a total of 61 Indigenous men. Findings In a societal context in which Indigenous men in Australia experience a number of social and health issues, impeding their quality of life and future opportunities, the central finding of the paper is that the effective development of social relations and socially designed programs through Men's Groups, operating as CoP, may contribute to overcoming many social and health well-being concerns. Originality/value Contributions will provide a better understanding of how Indigenous men are engaging with Men's Sheds, and through those interactions, are learning new skills and contributing to social change.

  19. “If You Tell People That You Had Sex with a Fellow Man, It Is Hard to Be Helped and Treated”: Barriers and Opportunities for Increasing Access to HIV Services among Men Who Have Sex with Men in Uganda

    PubMed Central

    Wanyenze, Rhoda K.; Musinguzi, Geofrey; Matovu, Joseph K. B.; Kiguli, Juliet; Nuwaha, Fred; Mujisha, Geoffrey; Musinguzi, Joshua; Arinaitwe, Jim; Wagner, Glenn J.

    2016-01-01

    Background Despite the high HIV prevalence among men who have sex with men (MSM) in sub-Saharan Africa, little is known about their access to HIV services. This study assessed barriers and opportunities for expanding access to HIV services among MSM in Uganda. Methods In October-December 2013, a cross-sectional qualitative study was conducted in 12 districts of Uganda. Semi-structured in-depth interviews were conducted with 85 self-identified MSM by snowball sampling and 61 key informants including HIV service providers and policy makers. Data were analysed using manifest content analysis and Atlas.ti software. Results Three quarters of the MSM (n = 62, 72.9%) were not comfortable disclosing their sexual orientation to providers and 69 (81.1%) felt providers did not respect MSM. Half (n = 44, 51.8%) experienced difficulties in accessing health services. Nine major barriers to access were identified, including: (i) unwelcoming provider behaviours; (ii) limited provider skills and knowledge; (iii) negative community perceptions towards MSM; (iv) fear of being exposed as MSM; (v) limited access to MSM-specific services; (vi) high mobility of MSM, (vii) lack of guidelines on MSM health services; viii) a harsh legal environment; and ix) HIV related stigma. Two-thirds (n = 56, 66%) participated in MSM social networks and 86% of these (48) received support from the networks to overcome barriers to accessing services. Conclusions Negative perceptions among providers and the community present barriers to service access among MSM. Guidelines, provider skills building and use of social networks for mobilization and service delivery could expand access to HIV services among MSM in Uganda. PMID:26808653

  20. "If You Tell People That You Had Sex with a Fellow Man, It Is Hard to Be Helped and Treated": Barriers and Opportunities for Increasing Access to HIV Services among Men Who Have Sex with Men in Uganda.

    PubMed

    Wanyenze, Rhoda K; Musinguzi, Geofrey; Matovu, Joseph K B; Kiguli, Juliet; Nuwaha, Fred; Mujisha, Geoffrey; Musinguzi, Joshua; Arinaitwe, Jim; Wagner, Glenn J

    2016-01-01

    Despite the high HIV prevalence among men who have sex with men (MSM) in sub-Saharan Africa, little is known about their access to HIV services. This study assessed barriers and opportunities for expanding access to HIV services among MSM in Uganda. In October-December 2013, a cross-sectional qualitative study was conducted in 12 districts of Uganda. Semi-structured in-depth interviews were conducted with 85 self-identified MSM by snowball sampling and 61 key informants including HIV service providers and policy makers. Data were analysed using manifest content analysis and Atlas.ti software. Three quarters of the MSM (n = 62, 72.9%) were not comfortable disclosing their sexual orientation to providers and 69 (81.1%) felt providers did not respect MSM. Half (n = 44, 51.8%) experienced difficulties in accessing health services. Nine major barriers to access were identified, including: (i) unwelcoming provider behaviours; (ii) limited provider skills and knowledge; (iii) negative community perceptions towards MSM; (iv) fear of being exposed as MSM; (v) limited access to MSM-specific services; (vi) high mobility of MSM, (vii) lack of guidelines on MSM health services; viii) a harsh legal environment; and ix) HIV related stigma. Two-thirds (n = 56, 66%) participated in MSM social networks and 86% of these (48) received support from the networks to overcome barriers to accessing services. Negative perceptions among providers and the community present barriers to service access among MSM. Guidelines, provider skills building and use of social networks for mobilization and service delivery could expand access to HIV services among MSM in Uganda.

  1. Community Context and Men's Control-Seeking in Intimate Relationships.

    PubMed

    Whitaker, M Pippin

    2015-01-01

    This study explores social-ecological influences on men's control-seeking in intimate relationships with women. Desire for control is central to the battered women's movement and is incorporated into intimate partner violence (IPV) prevention work. Recent IPV scholarship re-focuses on control, but the role of community contexts is underdeveloped. Community contexts have been associated with men's risk for IPV and evidence supports that social ecology facilitates IPV against women. Given the importance of the social ecology to control in IPV, this study examines community contexts that influence men's control-seeking of women partners. The sample comprised 2,342 in-state, male undergraduate students who completed a cross-sectional survey at a public university. Hypotheses were tested using hierarchical linear modeling. Results support a connection between county contexts and men's control-seeking toward women partners. Implications for IPV research and practice are discussed.

  2. A Census Tract–Level Examination of Social Determinants of Health among Black/African American Men with Diagnosed HIV Infection, 2005–2009—17 US Areas

    PubMed Central

    Gant, Zanetta; Gant, Larry; Song, Ruiguang; Willis, Leigh; Johnson, Anna Satcher

    2014-01-01

    Background HIV disproportionately affects black men in the United States: most diagnoses are for black gay, bisexual, and other men who have sex with men (collectively referred to as MSM). A better understanding of the social conditions in which black men live and work may better explain why HIV incidence and diagnosis rates are higher than expected in this population. Methods Using data from the National HIV Surveillance System and the US Census Bureau's American Community Survey, we examined the relationships of HIV diagnosis rates and 5 census tract–level social determinants of health variables for 21,948 black MSM and non-MSM aged ≥15 years residing in 17 areas in the United States. We examined federal poverty status, marital status, education level, employment status, and vacancy status and computed rate ratios (RRs) and prevalence odds ratios (PORs), using logistic regression with zero-inflated negative binomial modeling. Results Among black MSM, HIV diagnosis rates decreased as poverty increased (RR: 0.54). At the time of HIV diagnosis, black MSM were less likely than black non-MSM to live in census tracts with a higher proportion below the poverty level (POR: 0.81) and with a higher proportion of vacant houses (POR: 0.86). In comparison, housing vacancy was positively associated with HIV diagnosis rates among black non-MSM (RR: 1.65). HIV diagnosis rates were higher for black MSM (RR: 2.75) and non-MSM (RR: 4.90) whose educational level was low. Rates were significantly lower for black MSM (RR: 0.06) and non-MSM (RR: 0.26) as the proportion unemployed and the proportion married increased. Conclusions This exploratory study found differences in the patterns of HIV diagnosis rates for black MSM and non-MSM and provides insight into the transmission of HIV infection in areas that reflect substantial disadvantage in education, housing, employment, and income. PMID:25268831

  3. The global response to HIV in men who have sex with men.

    PubMed

    Beyrer, Chris; Baral, Stefan D; Collins, Chris; Richardson, Eugene T; Sullivan, Patrick S; Sanchez, Jorge; Trapence, Gift; Katabira, Elly; Kazatchkine, Michel; Ryan, Owen; Wirtz, Andrea L; Mayer, Kenneth H

    2016-07-09

    Gay, bisexual, and other men who have sex with men (MSM) continue to have disproportionately high burdens of HIV infection in countries of low, middle, and high income in 2016. 4 years after publication of a Lancet Series on MSM and HIV, progress on reducing HIV incidence, expanding sustained access to treatment, and realising human rights gains for MSM remains markedly uneven and fraught with challenges. Incidence densities in MSM are unacceptably high in countries as diverse as China, Kenya, Thailand, the UK, and the USA, with substantial disparities observed in specific communities of MSM including young and minority populations. Although some settings have achieved sufficient coverage of treatment, pre-exposure prophylaxis (PrEP), and human rights protections for sexual and gender minorities to change the trajectory of the HIV epidemic in MSM, these are exceptions. The roll-out of PrEP has been notably slow and coverage nowhere near what will be required for full use of this new preventive approach. Despite progress on issues such as marriage equality and decriminalisation of same-sex behaviour in some countries, there has been a marked increase in anti-gay legislation in many countries, including Nigeria, Russia, and The Gambia. The global epidemic of HIV in MSM is ongoing, and global efforts to address it remain insufficient. This must change if we are ever to truly achieve an AIDS-free generation.

  4. Gym exercising patterns, lifestyle and high-risk sexual behaviour in men who have sex with men and in heterosexual men.

    PubMed

    Mor, Z; Parfionov, K; Davidovitch, N; Grotto, I

    2014-11-24

    Lifestyle may be associated with risk behaviours. This study compares gym exercise and sexual risk behaviour between men who have sex with men (MSM) and heterosexual men. The research was based on the assumption that men who become muscular and physically attractive increase their number of sex partners and consequently their risk of HIV or other sexually transmitted infections (STIs). Five gyms in central Tel Aviv, Israel. In 2012, a sample of 182 (48%) MSM and 197 (52%) heterosexual men who train in gyms completed anonymous questionnaires regarding their training, health and sexual behaviours. Participants in this cross-sectional study who exercised more than the median number of anaerobic training hours were defined as performing intensive anaerobic training (IAT), and those who had performed more than one act of unprotected anal/vaginal intercourse in the preceding 6 months with a partner whose HIV status was unknown were defined as high risk. MSM showed a stronger desire to become muscular than heterosexual men, were more likely to perform IAT, and used protein powders or anabolic steroids. They reported that improving their body shape and increasing their self-confidence were their main reasons for training, whereas heterosexual men indicated weight loss and health improvement as the main reasons for training. MSM engaged in riskier sexual behaviour than heterosexual men. Of all the high-risk men, 61.9% (N=70) performed IAT, while 38.1% (N=43) performed moderate anaerobic training (p<0.01). The association between IAT and sexual risk was stronger in MSM than in heterosexual men (p<0.01 vs p=0.05, respectively). The interaction between MSM and IAT in high-risk participants was multiplicative. MSM practised more IAT than heterosexual men, and their interaction between IAT and sexual risk was multiplicative. The MSM community could benefit from a holistic approach to sexual health and its association with body image and IAT. The gym MSM culture demonstrates how

  5. Gym exercising patterns, lifestyle and high-risk sexual behaviour in men who have sex with men and in heterosexual men

    PubMed Central

    Mor, Z; Parfionov, K; Davidovitch, N; Grotto, I

    2014-01-01

    Objective Lifestyle may be associated with risk behaviours. This study compares gym exercise and sexual risk behaviour between men who have sex with men (MSM) and heterosexual men. The research was based on the assumption that men who become muscular and physically attractive increase their number of sex partners and consequently their risk of HIV or other sexually transmitted infections (STIs). Setting Five gyms in central Tel Aviv, Israel. Participants In 2012, a sample of 182 (48%) MSM and 197 (52%) heterosexual men who train in gyms completed anonymous questionnaires regarding their training, health and sexual behaviours. Outcomes Participants in this cross-sectional study who exercised more than the median number of anaerobic training hours were defined as performing intensive anaerobic training (IAT), and those who had performed more than one act of unprotected anal/vaginal intercourse in the preceding 6 months with a partner whose HIV status was unknown were defined as high risk. Results MSM showed a stronger desire to become muscular than heterosexual men, were more likely to perform IAT, and used protein powders or anabolic steroids. They reported that improving their body shape and increasing their self-confidence were their main reasons for training, whereas heterosexual men indicated weight loss and health improvement as the main reasons for training. MSM engaged in riskier sexual behaviour than heterosexual men. Of all the high-risk men, 61.9% (N=70) performed IAT, while 38.1% (N=43) performed moderate anaerobic training (p<0.01). The association between IAT and sexual risk was stronger in MSM than in heterosexual men (p<0.01 vs p=0.05, respectively). The interaction between MSM and IAT in high-risk participants was multiplicative. Conclusions MSM practised more IAT than heterosexual men, and their interaction between IAT and sexual risk was multiplicative. The MSM community could benefit from a holistic approach to sexual health and its association

  6. Influence of stigma and homophobia on mental health and on the uptake of HIV/sexually transmissible infection services for Cameroonian men who have sex with men.

    PubMed

    Cange, Charles W; LeBreton, Matthew; Billong, Serge; Saylors, Karen; Tamoufe, Ubald; Papworth, Erin; Yomb, Yves; Baral, Stefan

    2015-08-01

    Background Men who have sex with men (MSM) in Cameroon consistently face significant stigma and discrimination. The urban HIV prevalence in MSM is estimated at 35%. This study investigates the effect of stigma, discrimination and alienation on Cameroonian MSM's engagement of the HIV treatment cascade. Qualitative interviews were semi-structured using a guide. Participants in Douala, Ngaoundere, Bamenda, Bertoua and Yaoundé were asked to describe the MSM social and structural context, MSM knowledge of existing HIV-related services in public and MSM-focussed non-governmental organisation (NGO) clinics. Using a codebook, coded text was extracted from 40 transcripts with Microsoft Word Macros. These texts were analysed for recurring themes that were developed into results. There were three main themes that emerged. First, among those MSM participants seeking HIV services, many commonly reported experiences of discrimination and physical violence outside the healthcare setting. Second, a few respondents used services provided by the Ministry of Health and local NGOs. However, most participants observed limited clinical and cultural competency of public clinic staff. Third, MSM declared that lack of social support and healthcare access caused them much stress. Several individuals recounted their alienation greatly discouraged them from seeking HIV prevention, treatment and care services. Community-level and public healthcare-related stigma impacts the mental wellbeing of Cameroonian MSM. Alienation among MSM also represents a common obstacle to the uptake of MSM-oriented HIV/AIDS services. Improving provider cultural and clinical competency among Cameroonian health care workers combined with a broader stigma-reduction intervention for Cameroonian healthcare may increase the uptake of HIV prevention, treatment and care among MSM.

  7. Secrecy and risk among MSM in Tbilisi, Georgia

    PubMed Central

    Costenbader, Elizabeth C.; Otiashvili, David; Meyer, William; Zule, William A.; Orr, Alex; Kirtadze, Irma

    2010-01-01

    There is concern that the tremendous economic, social, and political upheavals that the Republic of Georgia has undergone in the years since the fall of the Soviet Union may have created an environment fertile for HIV transmission. Notably absent from official statistics and HIV-related research in Georgia is discussion of men who have sex with men (MSM) and, therefore, little is known about the MSM population or its potential to acquire or transmit HIV. Data were collected from 30 MSM recruited through a testing and counseling center in Tbilisi, the capital of Georgia. Two focus groups with six men each and 18 individual in-depth interviews were conducted between October 2006 and February 2007. The study participants described a Georgian culture that is largely intolerant of sexual contact between men. In describing the various forms of discrimination and violence that they would face should their sexual identities be discovered, the MSM in this sample described a variety of behaviors that they and other Georgian MSM undertake to conceal their sexual behavior. Many of these could put these men and their partners at risk for HIV. Although official HIV rates in Georgia are still low, results from this qualitative study indicate that efforts to educate and to provide unobtrusive and anonymous testing and counseling services to MSM may be critical to the deterrence of an HIV epidemic in the Republic of Georgia. PMID:19444667

  8. Focusing "down low": bisexual black men, HIV risk and heterosexual transmission.

    PubMed Central

    Millett, Gregorio; Malebranche, David; Mason, Byron; Spikes, Pilgrim

    2005-01-01

    INTRODUCTION: Black men who have sex with men (MSM) and women but who do not identify as gay or disclose their bisexual activities to main female partners, also known as men "on the down-low," have been cited as the main reason for the increase in HIV infections in black women. METHODS: Three online databases (PsychInfo, MEDLINE and AIDSLINE) were searched for scientific articles related to men on the down-low. A total of 24 articles and two conference abstracts were selected for review. RESULTS: Data from existing studies of MSM reveal low agreement between professed sexual identity and corresponding sexual behavior among black and other MSM; show that black MSM are more likely than MSM of other racial or ethnic groups to be bisexually active or identified; and, compared with white MSM, are less likely to disclose their bisexual or homosexual activities to others. However, black MSM who do not disclose their homosexual or bisexual activities engage in a lower prevalence of HIV risks than black MSM who do disclose; and black men who are currently bisexually active account for a very small proportion of the overall population of black men (2%). CONCLUSION: The high prevalence of HIV in the black community and the greater likelihood of bisexuality among black men place heterosexual black women at risk for HIV infection. However, the contribution of high-risk heterosexual black men to the rising HIV caseload among black women has been largely ignored. Future research must evaluate the relative contributions of bisexual men and exclusively heterosexual black men to HIV cases among black women. PMID:16080458

  9. Assessing Appearance-Related Disturbances in HIV-Infected Men Who have Sex with Men (MSM): Psychometrics of the Body Change and Distress Questionnaire—Short Form (ABCD-SF)

    PubMed Central

    Wilson, Johannes M.; Baker, Joshua S.; Mayer, Kenneth H.; Safren, Steven A.

    2013-01-01

    Appearance-related disturbances are common among HIV-infected MSM; however, to date, there have been limited options in the valid assessment of this construct. The aim of the current study was to assess the structural, internal, and convergent validity of the assessment of body change distress questionnaire (ABCD) and its short version. Exploratory and confirmatory factor analyses indicated that both versions fit the data well. Four sub-factors were revealed measuring the following body disturbance constructs: (1) negative affect about appearance, (2) HIV health-related outcomes and stigma, (3) eating and exercise confusion, and (4) ART non-adherence. The subfactors and total scores revealed bivariate associations with salient health outcomes, including depressive symptoms, HIV sexual transmission risk behaviors, and ART non-adherence. The ABCD and its short form, offer valid means to assess varied aspects of body image disturbance among HIV-infected MSM, and require modest participant burden. PMID:24057934

  10. COBA-Cohort: a prospective cohort of HIV-negative men who have sex with men, attending community-based HIV testing services in five European countries (a study protocol)

    PubMed Central

    Fernàndez-López, Laura; Fuertes, Ricardo; Rojas Castro, Daniela; Pichon, François; Cigan, Bojan; Chanos, Sophocles; Meireles, Paula; Morel, Stéphane; Slaaen Kaye, Per; Agustí, Cristina; Klavs, Irena; Casabona, Jordi

    2016-01-01

    Introduction Community-based voluntary counselling and testing (CBVCT) services for men who have sex with men (MSM) can reach those most-at-risk and provide an environment for gay men that is likely to be non-stigmatising. Longitudinal data on the behaviour of HIV-negative MSM are scarce in Europe. The aim of this protocol, developed during the Euro HIV Early Diagnosis And Treatment (EDAT) project, is to implement a multicentre community-based cohort of HIV-negative MSM attending 15 CBVCT services in 5 European countries. Research objectives (1) To describe the patterns of CBVCT use, (2) to estimate HIV incidence, and to identify determinants of (3) HIV seroconversion and (4) HIV and/or sexually transmitted infection (STI) test-seeking behaviour. Methods and analysis All MSM aged 18 years or over and who had a negative HIV test result are invited to participate in the COmmunity-BAsed Cohort (COBA-Cohort). Study enrolment started in February 2015, and is due to continue for at least 12 months at each study site. Follow-up frequency depends on the testing recommendations in each country (at least 1 test per year). Sociodemographic data are collected at baseline; baseline and follow-up questionnaires both gather data on attitudes and perceptions, discrimination, HIV/STI testing history, sexual behaviour, condom use, and pre- and post-exposure prophylaxis. Descriptive, exploratory and multivariate analyses will be performed to address the main research objectives of this study, using appropriate statistical tests and models. These analyses will be performed on the whole cohort data and stratified by study site or country. Ethics and dissemination The study was approved by the Public Health authorities of each country where the study is being implemented. Findings from the COBA-Cohort study will be summarised in a report to the European Commission, and in leaflets to be distributed to study participants. Articles and conference abstracts will be submitted to peer

  11. The Lisbon Cohort of men who have sex with men

    PubMed Central

    Meireles, Paula; Lucas, Raquel; Martins, Ana; Carvalho, Ana Cláudia; Fuertes, Ricardo; Brito, João; Campos, Maria José; Mendão, Luís; Barros, Henrique

    2015-01-01

    Purpose Newly diagnosed HIV infections among men who have sex with men (MSM) are rising in many European countries. Surveillance tools must be tailored to the current state of the epidemic, and include decentralised prospective monitoring of HIV incidence and behavioural changes in key populations. In this scenario, an open prospective cohort study was assembled—The Lisbon Cohort of MSM—aiming to dynamically monitor the frequency of disease and its predictors. Participants The Lisbon Cohort of MSM is an ongoing observational prospective study conducted at a community-based voluntary HIV counselling and testing centre in Lisbon, Portugal (CheckpointLX). Men testing negative for HIV, aged 18 or over and reporting having had sex with men are invited to follow-up visits every 6 months. At each evaluation, a face-to-face interview using a structured questionnaire is conducted, and HIV and syphilis rapid tests are performed by trained peer counsellors. From April 2011 to February 2014, 3106 MSM were eligible to the cohort of whom 923 (29.7%) did not participate. The remaining 2183 (70.3%) MSM were enrolled and 804 had at least one follow-up evaluation, for a total of 893 person-years of observation. Future plans The study findings will be disseminated in peer-reviewed journals and presented at national and international conferences. The follow-up of this cohort of HIV-negative MSM will be a valuable tool for monitoring HIV incidence in a setting where limited prospective information existed. Moreover, it will allow for a deeper analytical approach to the study of population time trends and individual changes in risk factors that currently shape the HIV epidemic among MSM. PMID:25967995

  12. HIV and syphilis testing preferences among men who have sex with men in South China: a qualitative analysis to inform sexual health services.

    PubMed

    Bien, Cedric H; Muessig, Kathryn E; Lee, Ramon; Lo, Elaine J; Yang, Li Gang; Yang, Bin; Peeling, Rosanna W; Tucker, Joseph D

    2015-01-01

    Health services for men who have sex with men (MSM) are inadequate in many areas around the world. HIV and syphilis test uptake remain suboptimal among MSM in China and many other regions. To inform the development of more comprehensive sexually transmitted disease (STD) testing programs among MSM, we collected descriptive data on MSM testing practices and preferences. MSM in two large urban Chinese cities were recruited through community-based organizations and clinics to participate in semi-structured interviews. We purposively sampled MSM across a range of sociodemographic characteristics and testing history, and assessed preferences for HIV and syphilis testing in the context of facilitators and barriers to testing and previous testing experiences. Each interview transcript was coded and thematically analyzed using Atlas.ti 7.0. 35 MSM were interviewed. Confidentiality and privacy were the most important factors influencing participants' decisions about whether and where to get tested. Men preferred rapid testing (results available within 30 minutes) compared to conventional tests where results take several hours or days to return. Participants described concerns about quality and accuracy of rapid tests offered in non-clinical settings such as community-based organizations. Men preferred testing service providers who were MSM-friendly, non-discriminatory, and medically trained. Preferred service center environments included: convenient but discrete location, MSM-friendly atmosphere, and clean/standard medical facilities. Our data highlight the need for HIV/syphilis testing services that are confidential and inclusive of MSM. Rapid testing in decentralized (i.e. peripheral health facilities and community-level, non-clinical venues) settings provides an opportunity to reach individuals who have not been tested before, but must be accompanied by quality assurance systems and technical competence. Implementation research could further evaluate HIV/syphilis testing

  13. Evolution of the syphilis epidemic among men who have sex with men

    PubMed Central

    Solomon, Marc M.; Mayer, Kenneth H.

    2014-01-01

    Syphilis has existed for millenni, but its epidemiology was only recently linked to men who have sex with men (MSM) after the introduction of penicillin in the 1940s; the syphilis epidemic became concentrated within the MSM community in subsequent decades. The HIV/AIDS epidemic in the 1980s led to a surge of new syphilis cases and revealed the potentiation between HIV and syphilis, as evidenced by a shift in the natural history of neurosyphilis. In response, MSM revolutionised their sexual behaviour by implementing community-driven seroadaptive strategies to stem HIV transmission. The Centers for Disease Control in the US called for the elimination of syphilis in the late 1990s since the rates had fallen sharply but this effort was overtaken by a resurgence of global outbreaks among MSM in the 2000s, many of which were linked to methamphetamine use and sexual networking websites. Syphilis remains highly prevalent today, especially among MSM and individuals infected with HIV, and it continues to present a significant public health conundrum. Innovative syphilis prevention strategies are warranted. MSM engaging in high-risk behaviour such as condomless anal receptive intercourse, sex with multiple partners or recreational drug use should be routinely screened for syphilis infection; they should also be counselled about the limits of seroadaptive behaviours and HIV pre-exposure prophylaxis as they relate to syphilis transmission. PMID:25514173

  14. Elevated HIV Prevalence Despite Lower Rates of Sexual Risk Behaviors Among Black Men in the District of Columbia Who Have Sex with Men

    PubMed Central

    Kuo, Irene; Phillips, Gregory; Shelley, Katharine; Rawls, Anthony; Montanez, Luz; Peterson, James; West-Ojo, Tiffany; Hader, Shannon; Greenberg, Alan E.

    2010-01-01

    Abstract The District of Columbia (DC) has among the highest HIV/AIDS rates in the United States, with 3.2% of the population and 7.1% of black men living with HIV/AIDS. The purpose of this study was to examine HIV risk behaviors in a community-based sample of men who have sex with men (MSM) in DC. Data were from the National HIV Behavioral Surveillance system. MSM who were 18 years were recruited via venue-based sampling between July 2008 and December 2008. Behavioral surveys and rapid oral HIV screening with OraQuick ADVANCE ½ (OraSure Technologies, Inc., Bethlehem, PA) with Western blot confirmation on positives were collected. Factors associated with HIV positivity and unprotected anal intercourse were identified. Of 500 MSM, 35.6% were black. Of all men, 14.1% were confirmed HIV positive; 41.8% of these were newly identified HIV positive. Black men (26.0%) were more likely to be HIV positive than white (7.9%) or Latino/Asian/other (6.5%) men (p < 0.001). Black men had fewer male sex partners than non-black, fewer had ever engaged in intentional unprotected anal sex, and more used condoms at last anal sex. Black men were less likely to have health insurance, have been tested for HIV, and disclose MSM status to health care providers. Despite significantly higher HIV/AIDS rates, black MSM in DC reported fewer sexual risks than non-black. These findings suggest that among black MSM, the primary risk of HIV infection results from nontraditional sexual risk factors, and may include barriers to disclosing MSM status and HIV testing. There remains a critical need for more information regarding reasons for elevated HIV among black MSM in order to inform prevention programming. PMID:20863246

  15. Acceptability of Sexually Explicit Images in HIV Prevention Messages Targeting Men Who Have Sex With Men.

    PubMed

    Iantaffi, Alex; Wilkerson, J Michael; Grey, Jeremy A; Rosser, B R Simon

    2015-01-01

    Sexually explicit media (SEM) have been used in HIV-prevention advertisements to engage men who have sex with men (MSM) and to communicate content. These advertisements exist within larger discourses, including a dominant heteronormative culture and a growing homonormative culture. Cognizant of these hegemonic cultures, this analysis examined the acceptable level of sexual explicitness in prevention advertisements. Seventy-nine MSM participated in 13 online focus groups, which were part of a larger study of SEM. Three macro themes-audience, location, and community representation-emerged from the analysis, as did the influence of homonormativity on the acceptability of SEM in HIV-prevention messages.

  16. Acceptability of Sexually Explicit Images in HIV Prevention Messages Targeting Men Who Have Sex with Men

    PubMed Central

    Iantaffi, Alex; Wilkerson, J. Michael; Grey, Jeremy A.; Rosser, B. R. Simon

    2014-01-01

    Sexually explicit media (SEM) have been used in HIV-prevention advertisements to engage men who have sex with men (MSM), and to communicate content. These advertisements exist within larger discourses, including a dominant heternormative culture, and a growing homonormative culture. Cognizant of these hegemonic cultures, this analysis examined the acceptable level of sexual explicitness in prevention advertisements. 79 MSM participated in 13 online focus groups, which were part of a larger study of SEM. Three macro-themes—audience, location and community representation—emerged from the analysis, as did the influence of homonormativity on the acceptability of SEM in HIV-prevention messages. PMID:26075485

  17. Community collectivization and its association with consistent condom use and STI treatment-seeking behaviors among female sex workers and high-risk men who have sex with men/transgenders in Andhra Pradesh, India

    PubMed Central

    Saggurti, Niranjan; Mishra, Ram Manohar; Proddutoor, Laxminarayana; Tucker, Saroj; Kovvali, Dolly; Parimi, Prabhakar; Wheeler, Tisha

    2013-01-01

    We examine community collectivization among female sex workers (FSWs) and high-risk men who have sex with men and transgenders (HR-MSM) following several years of HIV prevention programming with these populations, and its association with selected outcome indicators measuring individual behaviors (condom use with different partners and sexually transmitted infection [STI] treatment-seeking from government health facilities). Data for this study were collected from a large-scale cross-sectional survey conducted in 2010–2011 among FSWs (sample size: 3557) and HR-MSM (sample size: 2399) in Andhra Pradesh, India. We measured collectivization among FSWs in terms of three binary (low, high) indices of collective efficacy, collective agency, and collective action. Collectivization among HR-MSM was measured by participation in a public event (no, yes), and a binary (low, high) index of collective efficacy. Adjusted odds ratios (adjusted OR) and their 95% confidence intervals (CI) were computed to assess the relationships between collectivization and outcome indicators directly and through mediation of variables such as self-efficacy for condom use and utilization of government health facilities. Results show that among FSWs, high levels of collective efficacy (adjusted OR: 1.3, 95% CI: 1.1–1.7) and collective action (adjusted OR:1.3, 95% CI: 1.1–1.8) were associated with consistent condom use (CCU) with regular clients. Among HR-MSM, participation in a public event (adjusted OR: 2.7, 95% CI: 2.0–3.6) and collective efficacy (adjusted OR: 1.9, 95% CI: 1.5–2.3) were correlated with condom use with paying partners. The association between collectivization and outcome indicators continued to be significant in most cases even after adjusting for the potential mediators. Indicators of collectivization exhibited significant positive association with self-efficacy for condom use and service utilization from government health facilities among both FSWs and HR-MSM. The

  18. Experiences of Black MSM at an HBCU Regarding Stigma and HIV Risk Behavior

    ERIC Educational Resources Information Center

    Jeter, Natasha Harden

    2016-01-01

    Black men who have sex with men (MSM) on Historically Black College/University (HBCU) campuses face a unique set of challenges. In addition to being disproportionately affected by HIV, Black MSM are impacted by risk behavior, stigma, and environmental policies and practices that adversely influence their experiences. The purpose of this study was…

  19. Experiences of Black MSM at an HBCU Regarding Stigma and HIV Risk Behavior

    ERIC Educational Resources Information Center

    Jeter, Natasha Harden

    2016-01-01

    Black men who have sex with men (MSM) on Historically Black College/University (HBCU) campuses face a unique set of challenges. In addition to being disproportionately affected by HIV, Black MSM are impacted by risk behavior, stigma, and environmental policies and practices that adversely influence their experiences. The purpose of this study was…

  20. Human Rights Violations among Men Who Have Sex with Men in Southern Africa: Comparisons between Legal Contexts.

    PubMed

    Zahn, Ryan; Grosso, Ashley; Scheibe, Andrew; Bekker, Linda-Gail; Ketende, Sosthenes; Dausab, Friedel; Iipinge, Scholastica; Beyrer, Chris; Trapance, Gift; Baral, Stefan

    2016-01-01

    In 1994, South Africa approved a constitution providing freedom from discrimination based on sexual orientation. Other Southern African countries, including Botswana, Malawi, and Namibia, criminalize same-sex behavior. Men who have sex with men (MSM) have been shown to experience high levels of stigma and discrimination, increasing their vulnerability to negative health and other outcomes. This paper examines the relationship between criminalization of same-sex behavior and experiences of human rights abuses by MSM. It compares the extent to which MSM in peri-urban Cape Town experience human rights abuses with that of MSM in Gaborone, Botswana; Blantyre and Lilongwe, Malawi; and Windhoek, Namibia. In 2008, 737 MSM participated in a cross-sectional study using a structured survey collecting data regarding demographics, human rights, HIV status, and risk behavior. Participants accrued in each site were compared using bivariate and multivariate logistic regression. Encouragingly, the results indicate MSM in Cape Town were more likely to disclose their sexual orientation to family or healthcare workers and less likely to be blackmailed or feel afraid in their communities than MSM in Botswana, Malawi, or Namibia. However, South African MSM were not statistically significantly less likely experience a human rights abuse than their peers in cities in other study countries, showing that while legal protections may reduce experiences of certain abuses, legislative changes alone are insufficient for protecting MSM. A comprehensive approach with interventions at multiple levels in multiple sectors is needed to create the legal and social change necessary to address attitudes, discrimination, and violence affecting MSM.

  1. Human Rights Violations among Men Who Have Sex with Men in Southern Africa: Comparisons between Legal Contexts

    PubMed Central

    Zahn, Ryan; Grosso, Ashley; Scheibe, Andrew; Bekker, Linda-Gail; Ketende, Sosthenes; Dausab, Friedel; Iipinge, Scholastica; Beyrer, Chris; Trapance, Gift; Baral, Stefan

    2016-01-01

    In 1994, South Africa approved a constitution providing freedom from discrimination based on sexual orientation. Other Southern African countries, including Botswana, Malawi, and Namibia, criminalize same-sex behavior. Men who have sex with men (MSM) have been shown to experience high levels of stigma and discrimination, increasing their vulnerability to negative health and other outcomes. This paper examines the relationship between criminalization of same-sex behavior and experiences of human rights abuses by MSM. It compares the extent to which MSM in peri-urban Cape Town experience human rights abuses with that of MSM in Gaborone, Botswana; Blantyre and Lilongwe, Malawi; and Windhoek, Namibia. In 2008, 737 MSM participated in a cross-sectional study using a structured survey collecting data regarding demographics, human rights, HIV status, and risk behavior. Participants accrued in each site were compared using bivariate and multivariate logistic regression. Encouragingly, the results indicate MSM in Cape Town were more likely to disclose their sexual orientation to family or healthcare workers and less likely to be blackmailed or feel afraid in their communities than MSM in Botswana, Malawi, or Namibia. However, South African MSM were not statistically significantly less likely experience a human rights abuse than their peers in cities in other study countries, showing that while legal protections may reduce experiences of certain abuses, legislative changes alone are insufficient for protecting MSM. A comprehensive approach with interventions at multiple levels in multiple sectors is needed to create the legal and social change necessary to address attitudes, discrimination, and violence affecting MSM. PMID:26764467

  2. The impact of childhood gender expression on childhood sexual abuse and psychopathology among young men who have sex with men

    PubMed Central

    Hidalgo, Marco A.; Kuhns, Lisa M.; Kwon, Soyang; Mustanski, Brian; Garofalo, Robert

    2015-01-01

    Young men who have sex with men (MSM) are a risk group highly vulnerable to HIV infection and psychiatric symptoms are direct predictors of sexual risk behavior in MSM. Childhood sexual abuse (CSA) is associated with psychiatric symptomology in adolescence, and MSM are disproportionately impacted by CSA compared to heterosexuals. Some evidence suggests that childhood gender nonconformity, a natural variation of human gender expression, is more common in MSM than heterosexual males and places MSM at greater risk for CSA. This study examined whether or not childhood gender expression moderated the association between incidents of unwanted, early sexual experiences occurring before age 13 (ESE) and current psychiatric symptomology in a community-based sample of 449 young MSM aged 16–20. Analyses revealed significant bivariate associations between ESE and psychological symptoms, and significant multivariable associations between ESE, gender nonconformity and psychiatric outcomes. Young MSM with childhood gender nonconformity may be disproportionately victimized by CSA thereby increasing their likelihood of developing psychiatric symptoms in adolescence. Early intervention addressing these factors may help reduce lifetime negative sequelae. PMID:26002599

  3. The impact of childhood gender expression on childhood sexual abuse and psychopathology among young men who have sex with men.

    PubMed

    Hidalgo, Marco A; Kuhns, Lisa M; Kwon, Soyang; Mustanski, Brian; Garofalo, Robert

    2015-08-01

    Young men who have sex with men (MSM) are a risk group highly vulnerable to HIV infection and psychiatric symptoms are direct predictors of sexual risk behavior in MSM. Childhood sexual abuse (CSA) is associated with psychiatric symptomology in adolescence, and MSM are disproportionately impacted by CSA compared to heterosexuals. Some evidence suggests that childhood gender nonconformity, a natural variation of human gender expression, is more common in MSM than heterosexual males and places MSM at greater risk for CSA. This study examined whether or not childhood gender expression moderated the association between incidents of unwanted, early sexual experiences occurring before age 13 (ESE) and current psychiatric symptomology in a community-based sample of 449 young MSM aged 16-20. Analyses revealed significant bivariate associations between ESE and psychological symptoms, and significant multivariable associations between ESE, gender nonconformity and psychiatric outcomes. Young MSM with childhood gender nonconformity may be disproportionately victimized by CSA thereby increasing their likelihood of developing psychiatric symptoms in adolescence. Early intervention addressing these factors may help reduce lifetime negative sequelae. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Sex with older partners is associated with primary HIV infection among men who have sex with men in North Carolina.

    PubMed

    Hurt, Christopher B; Matthews, Derrick D; Calabria, Molly S; Green, Kelly A; Adimora, Adaora A; Golin, Carol E; Hightow-Weidman, Lisa B

    2010-06-01

    Studies from the 1990s suggested sex with older partners was associated with HIV infection. We evaluated the hypothesized association between primary HIV infection (PHI) and having older sexual partners among men who have sex with men (MSM). MSM with PHI and HIV-uninfected MSM completed audio computer-assisted self-interviews exploring behaviors involving their 3 most recent sexual partners before enrollment (if uninfected) or diagnosis (if PHI). Of 74 men reporting any lifetime sex with men, 20 had PHI (27%). Demographics (including age) were similar between groups; 39% were non-white and 74% identified as gay. The mean age of sex partners differed significantly: men with PHI had partners on average 6 years older than themselves, whereas uninfected men's partners were 4 months their junior (P < 0.001). After adjusting for race, sex while intoxicated, and having a serodiscordant/serostatus unknown partner, a participant had twice the odds of PHI if his sex partner was 5 years his senior (odds ratio 2.0, 95% confidence interval: 1.2 to 3.3). Among a sample of young MSM, the odds of HIV infection increased significantly as the age of sexual partners increased. These findings can inform behavioral interventions in communities of at-risk MSM and secondary prevention efforts among those already living with HIV.

  5. High prevalence and incidence of high-grade anal intraepithelial neoplasia among young Thai men who have sex with men with and without HIV

    PubMed Central

    Phanuphak, Nittaya; Teeratakulpisarn, Nipat; Triratanachat, Surang; Keelawat, Somboon; Pankam, Tippawan; Kerr, Stephen J.; Deesua, Amornrat; Tantbirojn, Patou; Numto, Saranya; Phanuphak, Praphan; Palefsky, Joel M.; Ananworanich, Jintanat

    2013-01-01

    Background Men who have sex with men (MSM) are at elevated risk of having anal cancer. However, the prevalence and incidence among MSM of high-grade anal intraepithelial neoplasia (HGAIN), the putative precursor of anal cancer, is understudied, particularly in Asians. Methods A total of 123 HIV-positive and 123 HIV-negative MSM were enrolled at the Thai Red Cross AIDS Research Centre in Bangkok, Thailand, and followed for 12 months. Anal sample collection for human papillomavirus (HPV) genotyping and high-resolution anoscopy (HRA) with biopsies were performed at every visit. Results Mean age at enrollment was 28.9 years. HIV-positive MSM were more commonly infected with high-risk HPV types in the anus than HIV-negative MSM (57.5% vs. 36.6%, p=0.001). The prevalence of HGAIN was 18.9% in HIV-positive and 11.4% in HIV-negative MSM (p=0.1). The incidence of HGAIN at 12 months was 29% in HIV-positive and 8% in HIV-negative MSM (p=0.001). The hazard ratios for incident HGAIN in multivariate models were 5.16 (95% CI 1.89–14.08, p<0.001) in MSM with persistent HPV 16 and/or 18 infection and 2.62 (95% CI 1.04–6.61, p=0.042) in HIV-positive MSM. Conclusions Approximately one-third of HIV-positive MSM developed incident HGAIN within 12 months. Given the relative increased prevalence of HIV among MSM worldwide, local HGAIN data are needed to guide practitioners, policy makers, and communities in planning for strategies to screen for and treat HGAIN in this population. PMID:23807271

  6. Sexual Orientation, Gender Identity and Perceived Source of Infection Among Men Who Have Sex with Men (MSM) and Transgender Women (TW) Recently Diagnosed with HIV and/or STI in Lima, Peru.

    PubMed

    Blair, Cheríe S; Segura, Eddy R; Perez-Brumer, Amaya G; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

    2016-10-01

    Risk perception and health behaviors result from individual-level factors influenced by specific partnership contexts. We explored individual- and partner-level factors associated with partner-specific perceptions of HIV/STI risk among 372 HIV/STI-positive MSM and transgender women (TW) in Lima, Peru. Generalized estimating equations explored participants' perception of their three most recent partner(s) as a likely source of their HIV/STI diagnosis. Homosexual/gay (PR = 2.07; 95 % CI 1.19-3.61) or transgender (PR = 2.84; 95 % CI 1.48-5.44) partners were more likely to be considered a source of infection than heterosexual partners. Compared to heterosexual respondents, gay and TW respondents were less likely to associate their partner with HIV/STI infection, suggesting a cultural link between gay or TW identity and perceived HIV/STI risk. Our findings demonstrate a need for health promotion messages tailored to high-risk MSM partnerships addressing how perceived HIV/STI risk aligns or conflicts with actual transmission risks in sexual partnerships and networks.

  7. Sexual Orientation, Gender Identity and Perceived Source of Infection among Men Who Have Sex with Men (MSM) and Transgender Women (TW) Recently Diagnosed with HIV and/or STI in Lima, Peru

    PubMed Central

    Blair, Cheríe S; Segura, Eddy R; Perez-Brumer, Amaya G; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

    2016-01-01

    Risk perception and health behaviors result from individual-level factors influenced by specific partnership contexts. We explored individual- and partner-level factors associated with partner-specific perceptions of HIV/STI risk among 372 HIV/STI-positive MSM and transgender women (TW) in Lima, Peru. Generalized estimating equations (GEE) explored participants’ perception of their three most recent partner(s) as a likely source of their HIV/STI diagnosis. Homosexual/gay (PR = 2.07; 95% CI 1.19-3.61) or transgender (PR = 2.84; 95% CI 1.48-5.44) partners were more likely to be considered a source of infection than heterosexual partners. Compared to heterosexual respondents, gay and TW respondents were less likely to associate their partner with HIV/STI infection, suggesting a cultural link between gay or TW identity and perceived HIV/STI risk. Our findings demonstrate a need for health promotion messages tailored to high-risk MSM partnerships addressing how perceived HIV/STI risk aligns or conflicts with actual transmission risks in sexual partnerships and networks. PMID:26767533

  8. Sexual and geographic organisation of men who have sex with men in a large East African city: opportunities for outreach

    PubMed Central

    Ross, Michael W; Nyoni, Joyce; Bowen, Anne M; Williams, Mark L; Kashiha, John J

    2012-01-01

    Objectives To describe geographical and dispersion patterns of men who have sex with men (MSM)-related venues in a large East African city and their associations with times, participants and venue type. Methods Mapping of MSM sites in Dar es Salaam was carried out by community research workers who catalogued, observed and reported data on venue sites, formality, times of operation, type of participant, police or vigilante activity, length of operation and the degree to which it is known both in and outside the MSM and gay communities. Results There is a large and widely disseminated MSM/gay satellite cultures of at least 98 sites, which has some formal sites, but is largely informal and operates within mixed entertainment environments and at particular times (including some weekend-only locales) across the city. There is a mix of places for sexual contact, largely social venues and sex on location sites. Cruising appears to be limited to open spaces and parks, with no vehicular component and almost no internet component. They are widely disseminated across all suburbs and there is no central location for MSM activities. MSM sex workers (SWs) operate at a third of these sites. Conclusions There is a large number of ‘local’ MSM contact, social and sex sites and any work with MSM will have to include these less-formal and less-known sites. The widely disseminated nature of the MSM sites, however, also suggests that sexual networks may not be closely linked between sites. The climate of stigma, abuse and potential violence appear to be limiting the development of more formal sites. This pattern is probably typical of other large urban areas in East Africa and perhaps across sub-Saharan Africa (SSA). PMID:23180391

  9. HIV epidemiology and responses among men who have sex with men and transgender individuals in China: a scoping review.

    PubMed

    Tang, Songyuan; Tang, Weiming; Meyers, Kathrine; Chan, Polin; Chen, Zhongdan; Tucker, Joseph D

    2016-10-20

    Despite global efforts to control HIV among key populations, new infections among men who have sex with men (MSM) and transgender (TG) individuals are still increasing. The increasing HIV epidemic among MSM/TG in China indicates that more effective services are urgently needed. However, policymakers and program managers must have a clear understanding of MSM/TG sexual health in China to improve service delivery. To meet this need, we undertook a scoping review to summarize HIV epidemiology and responses among MSM and TG individuals in China. We searched MEDLINE, EMBASE and the Cochrane Library for recent studies on MSM/TG HIV epidemiology and responses. We also included supplemental articles, grey literature, government reports, policy documents, and best practice guidelines. Overall, HIV prevalence among Chinese MSM was approximately 8 % in 2015 with a higher prevalence observed in Southwest China. TG are not captured in national HIV, STD, or other sexual health surveillance systems. There is limited data sharing between the public health authorities and community-based organizations (CBOs). Like other low and middle income countries, China is challenged by low rates of HIV testing, linkage, and retention. Several pilot interventions have been shown to be effective to increase HIV testing among MSM and TG individuals, but have not been widely scaled up. Data from two randomized controlled trials suggests that crowdsourcing contests can increase HIV testing, creating demand for services while engaging communities. Improving HIV surveillance and expanding HIV interventions for Chinese MSM and TG individuals are essential. Further implementation research is needed to ensure high-quality HIV services for MSM and TG individuals in China.

  10. Suicidal ideation among MSM in three West African countries: Associations with stigma and social capital.

    PubMed

    Stahlman, Shauna; Grosso, Ashley; Ketende, Sosthenes; Pitche, Vincent; Kouanda, Seni; Ceesay, Nuha; Ouedraogo, Henri G; Ky-Zerbo, Odette; Lougue, Marcel; Diouf, Daouda; Anato, Simplice; Tchalla, Jules; Baral, Stefan

    2016-09-01

    Suicidal ideation is understudied among men who have sex with men (MSM) across Sub-Saharan Africa. This study aimed to explore social capital and sexual behavior stigma associated with suicidal ideation among MSM in the West African nations of The Gambia, Burkina Faso and Togo. Participants were recruited using respondent-driven sampling and snowball sampling across multiple cities (n = 1555) from July 2011 to August 2013. During a single study visit, participants completed a survey. Logistic regression models were used to assess bivariate and multivariable associations with suicidal ideation. The prevalence of lifetime suicidal ideation was 13% overall and ranged 6%-17% across study sites. After adjusting for potential confounders, MSM who reported stigma as a result of having sex with men were more likely to report suicidal ideation. Physical and sexual violence was strongly associated with suicidal ideation, including being physically harmed (adjusted odds ratio (aOR) = 2.94, 95% confidence interval (CI) = 1.91, 4.52), tortured (aOR = 3.86, 95% CI = 2.17, 6.86) and raped (aOR = 3.07, 95% CI = 2.05, 4.60). In contrast, increasing social participation with the broader community was associated with decreased report of suicidal ideation (aOR = 0.91, 95% CI = 0.85, 0.99). Sexual behavior stigma should be addressed to improve mental health among MSM in Western Sub-Saharan Africa. © The Author(s) 2016.

  11. Effects of a social network HIV/STD prevention intervention for MSM in Russia and Hungary: a randomized controlled trial.

    PubMed

    Amirkhanian, Yuri A; Kelly, Jeffrey A; Takacs, Judit; McAuliffe, Timothy L; Kuznetsova, Anna V; Toth, Tamas P; Mocsonaki, Laszlo; DiFranceisco, Wayne J; Meylakhs, Anastasia

    2015-03-13

    To test a novel social network HIV risk-reduction intervention for MSM in Russia and Hungary, where same-sex behavior is stigmatized and men may best be reached through their social network connections. A two-arm trial with 18 sociocentric networks of MSM randomized to the social network intervention or standard HIV/STD testing/counseling. St. Petersburg, Russia and Budapest, Hungary. Eighteen 'seeds' from community venues invited the participation of their MSM friends who, in turn, invited their own MSM friends into the study, a process that continued outward until eighteen three-ring sociocentric networks (mean size = 35 members, n = 626) were recruited. Empirically identified network leaders were trained and guided to convey HIV prevention advice to other network members. Changes in sexual behavior from baseline to 3-month and 12-month follow-up, with composite HIV/STD incidence, measured at 12 months to corroborate behavior changes. There were significant reductions between baseline, first follow-up, and second follow-up in the intervention versus comparison arm for proportion of men engaging in any unprotected anal intercourse (UAI) (P = 0.04); UAI with a nonmain partner (P = 0.04); and UAI with multiple partners (P = 0.002). The mean percentage of unprotected anal intercourse acts significantly declined (P = 0.001), as well as the mean number of UAI acts among men who initially had multiple partners (P = 0.05). Biological HIV/STD incidence was 15% in comparison condition networks and 9% in intervention condition networks. Even where same-sex behavior is stigmatized, it is possible to reach MSM and deliver HIV prevention through their social networks.

  12. ENSURING IT WORKS: A COMMUNITY-BASED APPROACH TO HIV PREVENTION INTERVENTION DEVELOPMENT FOR MEN WHO HAVE SEX WITH MEN IN CHENNAI, INDIA

    PubMed Central

    Thomas, Beena; Mimiaga, Matthew J.; Mayer, Kenneth H.; Closson, Elizabeth F.; Johnson, Carey V.; Menon, Sunil; Mani, Jamuna; Vijaylakshmi, R.; Dilip, Meenalochini; Betancourt, Theresa; Safren, Steven A.

    2013-01-01

    Men who have sex with men (MSM) in India have an HIV seroprevalence 22 times greater than the country’s general population and face unique challenges that may hinder the effectiveness of current HIV prevention efforts. To obtain an understanding of the logistical and sociocultural barriers MSM experience while accessing HIV prevention services, focus groups and key informant interviews were conducted with 55 MSM in Chennai, India. Qualitative data were analyzed using descriptive qualitative content analysis. Sixty-five percent of participants identified as kothi (receptive partners), 9% as panthi (insertive partners), 22% as double decker (receptive and insertive), and 4% did not disclose. Themes included: (a) fatigue with current HIV risk reduction messages; (b) increased need for non-judgmental and confidential services; and (c) inclusion of content that acknowledges individual and structural-level determinants of risk such as low self-esteem, depression, and social discrimination. MSM interventions may benefit from approaches that address multilevel psychosocial factors, including skills building and strategies to foster self-acceptance and increased social support. PMID:23206199

  13. Evaluation of gonorrhea test of cure at 1 week in a Los Angeles community-based clinic serving men who have sex with men.

    PubMed

    Beymer, Matthew R; Llata, Eloisa; Stirland, Ali M; Weinstock, Hillard S; Wigen, Christine L; Guerry, Sarah L; Mejia, Everardo; Bolan, Robert K

    2014-10-01

    Because of the decreasing susceptibility of Neisseria gonorrhoeae to cephalosporin therapy, the Centers for Disease Control and Prevention recommends test of cure (TOC) 1 week after gonorrhea (GC) treatment if therapies other than ceftriaxone are used. In addition, the Centers for Disease Control and Prevention asks clinicians, particularly those caring for men who have sex with men (MSM) on the west coast, to consider retesting all MSM at 1 week. However, it is unclear if this is acceptable to providers and patients or if nucleic acid amplification tests (NAATs) are useful for TOC at 7 days. Between January and July 2012, MSM with GC were advised to return 1 week after treatment for TOC using NAAT. A multivariate logistic regression model was used to determine demographic and behavioral differences between MSM who returned for follow-up and MSM who did not. Of 737 men with GC, 194 (26.3%) returned between 3 and 21 days of treatment. Individuals who returned were more likely to have no GC history (P = 0.0001) and to report no initial symptoms (P = 0.02) when compared with individuals who did not return for TOC. Of those who returned, 0% of urethral samples, 7.4% of rectal samples, and 5.3% of pharyngeal samples were NAAT positive at TOC. Although TOC may be an important strategy in reducing complications and the spread of GC, low return rates may make implementation challenging. If implemented, extra efforts should be considered to enhance return rates among individuals with a history of GC. If TOCs are recommended at 1 week and NAATs are used, the interpretation of positive results, particularly those from extragenital sites, may be difficult.

  14. Community involvement among behaviourally bisexual men in the Midwestern USA: experiences and perceptions across communities.

    PubMed

    Dodge, Brian; Schnarrs, Phillip W; Reece, Michael; Goncalves, Gabriel; Martinez, Omar; Nix, Ryan; Malebranche, David; Van Der Pol, Barbara; Murray, Maresa; Fortenberry, J Dennis

    2012-10-01

    Limited research exists regarding community involvement and social support among behaviourally bisexual men. Previous studies suggest that bisexual men experience high levels of social stigma in both heterosexual and homosexual community settings. Research focusing on social support has demonstrated that individuals with limited access to similar individuals experience greater risk for negative health outcomes. Using a community-based research design, participants were recruited using multiple methods. Researchers conducted in-depth, semi-structured interviews with 75 men who reported having engaged in bisexual behaviour within the past six months. Interviews elucidated the experiences of behaviourally bisexual men in heterosexual and homosexual settings, as well as their perceptions of the existence of a bisexual community or bisexual spaces. All participants perceived a lack of a visible bisexual community and expressed difficulty with being comfortable, or a feeling of belonging, within a variety of heterosexual and homosexual community spaces. Findings suggest the need for interventions focused on community building among, as well as creating spaces specifically designed for, bisexual men in order to increase perceived social support and decrease isolation and possible negative health outcomes.

  15. Community Involvement among Behaviourally Bisexual Men in the Midwestern USA: Experiences and Perceptions across Communities

    PubMed Central

    Dodge, Brian; Schnarrs, Phillip W.; Reece, Michael; Goncalves, Gabriel; Martinez, Omar; Nix, Ryan; Malebranche, David; Van Der Pol, Barbara; Murray, Maresa; Fortenberry, J. Dennis

    2012-01-01

    Limited research exists regarding community involvement and social support among behaviourally bisexual men. Previous studies suggest that bisexual men experience high levels of social stigma in both heterosexual and homosexual community settings. Research focusing on social support has demonstrated that individuals with limited access to similar individuals experience greater risk for negative health outcomes. Using a community-based research design, participants were recruited using multiple methods in Indianapolis, Indiana, USA. Researchers conducted in-depth, semi-structured interviews with 75 men who reported having engaged in bisexual behaviour within the past six months. Interviews elucidated the experiences of behaviourally bisexual men in heterosexual and homosexual settings, as well as their perceptions of the existence of a bisexual community or bisexual spaces. All participants perceived a lack of a visible bisexual community and expressed difficulty with being comfortable, or feeling belonging, within a variety of heterosexual and homosexual community spaces. Findings suggest the need for interventions focused on community building among, as well as creating spaces specifically designed for, bisexual men in order to increase perceived social support and decrease isolation and possible negative health outcomes. PMID:22978551

  16. Sex with Older Partners Is Associated with Primary HIV Infection among Men Who Have Sex with Men in North Carolina

    PubMed Central

    Hurt, Christopher B.; Matthews, Derrick D.; Calabria, Molly S.; Green, Kelly A.; Adimora, Adaora A.; Golin, Carol E.; Hightow-Weidman, Lisa B.

    2010-01-01

    Background Studies from the 1990s suggested sex with older partners was associated with HIV infection. We evaluated the hypothesized association between primary HIV infection (PHI) and having older sexual partners among men who have sex with men (MSM). Methods MSM with PHI and HIV-uninfected MSM completed audio computer-assisted self-interviews exploring behaviors involving their three most recent sexual partners prior to enrollment (if uninfected) or diagnosis (if PHI). Results Of 74 men reporting any lifetime sex with men, 20 had PHI (27%). Demographics (including age) were similar between groups; 39% were non-white and 74% identified as gay. The mean age of sex partners differed significantly: men with PHI had partners on average 6 years older than themselves, while uninfected men’s partners were 4 months their junior (P<0.001). After adjusting for race, sex while intoxicated, and having a serodiscordant/serostatus unknown partner, a participant had twice the odds of PHI if his sex partner was 5 years his senior (OR 2.0, 95% CI, 1.2, 3.3). Conclusions Among a sample of young MSM, the odds of HIV infection increased significantly as the age of sexual partners increased. These findings can inform behavioral interventions in communities of at-risk MSM as well as secondary prevention efforts among those already living with HIV. PMID:20057320

  17. “You’re an Open Target to Be Abused”: A Qualitative Study of Stigma and HIV Self-Disclosure Among Black Men Who Have Sex With Men

    PubMed Central

    Voisin, Dexter R.

    2013-01-01

    The HIV/AIDS epidemic is a health crisis among Black men who have sex with men (MSM). HIV-related stigma presents a primary barrier to sexual communication and effective HIV prevention. Using in-depth, qualitative interviews conducted with 20 HIV-positive Black MSM between 2007 and 2008 in Chicago, Illinois, we explored the themes related to HIV-related stigma and the underlying messages HIV-positive Black MSM receive regarding their status. Stigmatizing messages stem from family, churches, and the gay community and from negative, internalized, beliefs HIV-positive Black MSM held about infected individuals before their own infection. HIV stigma influences sexual silence around HIV disclosure, especially to sexual partners. PMID:24134345

  18. Reconciling Epidemiology and Social Justice in the Public Health Discourse Around the Sexual Networks of Black Men Who Have Sex With Men.

    PubMed

    Matthews, Derrick D; Smith, Justin C; Brown, Andre L; Malebranche, David J

    2016-05-01

    Several studies have implicated the sexual networks of Black men who have sex with men (MSM) as facilitating disproportionally high rates of new HIV infections within this community. Although structural disparities place these networks at heightened risk for infection, HIV prevention science continues to describe networks as the cause for HIV disparities, rather than an effect of structures that pattern infection. We explore the historical relationship between public health and Black MSM, arguing that the current articulation of Black MSM networks is too often incomplete and counterproductive. Public health can offer a counternarrative that reconciles epidemiology with the social justice that informs our discipline, and that is required for an effective response to the epidemic among Black MSM.

  19. Using Social Media to Increase HIV Testing Among Gay and Bisexual Men, Other Men Who Have Sex With Men, and Transgender Persons: Outcomes From a Randomized Community Trial

    PubMed Central

    Rhodes, Scott D.; McCoy, Thomas P.; Tanner, Amanda E.; Stowers, Jason; Bachmann, Laura H.; Nguyen, Annie L.; Ross, Michael W.

    2016-01-01

    We tested an intervention designed to increase human immunodeficiency virus (HIV) testing among men who have sex with men and transgender persons within existing and commonly used social media. At follow-up, intervention communities had significantly higher past 12-month HIV testing than the comparison communities. Findings suggest that promoting HIV testing via social media can increase testing. PMID:26980878

  20. The Increased Effectiveness of HIV Preventive Intervention among Men Who Have Sex with Men and of Follow-Up Care for People Living with HIV after ‘Task-Shifting’ to Community-Based Organizations: A ‘Cash on Service Delivery’ Model in China

    PubMed Central

    Yan, Hongjing; Zhang, Min; Zhao, Jinkou; Huan, Xiping; Ding, Jianping; Wu, Susu; Wang, Chenchen; Xu, Yuanyuan; Liu, Li; Xu, Fei; Yang, Haitao

    2014-01-01

    Background A large number of men who have sex with men (MSM) and people living with HIV/AIDS (PLHA) are underserved despite increased service availability from government facilities while many community based organizations (CBOs) are not involved. We aimed to assess the feasibility and effectiveness of the task shifting from government facilities to CBOs in China. Methods HIV preventive intervention for MSM and follow-up care for PLHA were shifted from government facilities to CBOs. Based on ‘cash on service delivery’ model, 10 USD per MSM tested for HIV with results notified, 82 USD per newly HIV cases diagnosed, and 50 USD per PLHA received a defined package of follow-up care services, were paid to the CBOs. Cash payments were made biannually based on the verified results in the national web-based HIV/AIDS information system. Findings After task shifting, CBOs gradually assumed preventive intervention for MSM and follow-up care for PLHA from 2008 to 2012. HIV testing coverage among MSM increased from 4.1% in 2008 to 22.7% in 2012. The baseline median CD4 counts of newly diagnosed HIV positive MSM increased from 309 to 397 cells/µL. HIV tests among MSM by CBOs accounted for less than 1% of the total HIV tests in Nanjing but the share of HIV cases detected by CBOs was 12.4% in 2008 and 43.6% in 2012. Unit cost per HIV case detected by CBOs was 47 times lower than that by government facilities. The coverage of CD4 tests and antiretroviral therapy increased from 71.1% and 78.6% in 2008 to 86.0% and 90.1% in 2012, respectively. Conclusion It is feasible to shift essential HIV services from government facilities to CBOs, and to verify independently service results to adopt ‘cash on service delivery’ model. Services provided by CBOs are cost-effective, as compared with that by government facilities. PMID:25050797

  1. Client and provider perspectives on new HIV prevention tools for MSM in the Americas.

    PubMed

    Lippman, Sheri A; Koester, Kimberly A; Amico, K Rivet; Lama, Javier R; Martinez Fernandes, Nilo; Gonzales, Pedro; Grinsztejn, Beatriz; Liu, Al; Buchbinder, Susan; Koblin, Beryl A

    2015-01-01

    Men who have sex with men (MSM) in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP) and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers' opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM.

  2. Client and Provider Perspectives on New HIV Prevention Tools for MSM in the Americas

    PubMed Central

    Lippman, Sheri A.; Koester, Kimberly A.; Amico, K. Rivet; Lama, Javier R.; Martinez Fernandes, Nilo; Gonzales, Pedro; Grinsztejn, Beatriz; Liu, Al; Buchbinder, Susan; Koblin, Beryl A.

    2015-01-01

    Men who have sex with men (MSM) in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP) and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers’ opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM. PMID:25826246

  3. Willingness to Take, Use of, and Indications for Pre-exposure Prophylaxis Among Men Who Have Sex With Men-20 US Cities, 2014.

    PubMed

    Hoots, Brooke E; Finlayson, Teresa; Nerlander, Lina; Paz-Bailey, Gabriela

    2016-09-01

    Pre-exposure prophylaxis (PrEP) is an effective prevention tool for people at substantial risk of acquiring human immunodeficiency virus (HIV). To monitor the current state of PrEP use among men who have sex with men (MSM), we report on willingness to use PrEP and PrEP utilization. To assess whether the MSM subpopulations at highest risk for infection have indications for PrEP according to the 2014 clinical guidelines, we estimated indications for PrEP for MSM by demographics. We analyzed data from the 2014 cycle of the National HIV Behavioral Surveillance (NHBS) system among MSM who tested HIV negative in NHBS and were currently sexually active. Adjusted prevalence ratios and 95% confidence intervals were estimated from log-linked Poisson regression with generalized estimating equations to explore differences in willingness to take PrEP, PrEP use, and indications for PrEP. Whereas over half of MSM said they were willing to take PrEP, only about 4% reported using PrEP. There was no difference in willingness to take PrEP between black and white MSM. PrEP use was higher among white compared with black MSM and among those with greater education and income levels. Young, black MSM were less likely to have indications for PrEP compared with young MSM of other races/ethnicities. Young, black MSM, despite being at high risk of HIV acquisition, may not have indications for PrEP under the current guidelines. Clinicians may need to consider other factors besides risk behaviors such as HIV incidence and prevalence in subgroups of their communities when considering prescribing PrEP. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  4. Comparing three cohorts of MSM sampled via sex parties, bars/clubs, and Craigslist.org: implications for researchers and providers.

    PubMed

    Grov, Christian; Rendina, H Jonathon; Parsons, Jeffrey T

    2014-08-01

    With limited exceptions, few studies have systematically reported on psychosocial and demographic characteristic differences in samples of men who have sex with men (MSM) based on where they were recruited. This study compared three sexually active cohorts of MSM recruited via Craigslist.org (recruited via modified time-space sampling), gay bars and clubs (recruited via time-space sampling), and private sex parties (identified via passive recruitment and listserves), finding mixed results with regard to differences in demographic characteristics, STI history, and psychosocial measures. Men recruited from sex parties were significantly older, reported more symptoms of sexual compulsivity, more likely to be HIV-positive, more likely to report a history of STIs, and more likely to self-identify as a barebacker, than men recruited from the other two venues. In contrast, men from Craigslist.org reported the lowest levels of attachment to the gay and bisexual community and were the least likely to self-identify as gay. Men from bars and clubs were significantly younger, and were more likely to report use of hallucinogens and crack or cocaine. Our findings highlight that the venues in which MSM are recruited have meaningful consequences in terms of the types of individuals who are reached.

  5. Comparing three cohorts of MSM sampled via sex parties, bars/clubs, and Craigslist.org: Implications for researchers and providers

    PubMed Central

    Grov, Christian; Rendina, H. Jonathon; Parsons, Jeffrey T.

    2014-01-01

    With limited exceptions, few studies have systematically reported on psychosocial and demographic characteristic differences in samples of men who have sex with men (MSM) based on where they were recruited. This study compared three sexually active cohorts of MSM recruited via Craigslist.org (recruited via modified time-space sampling), gay bars and clubs (recruited via time-space sampling), and private sex parties (identified via passive recruitment and listserves), finding mixed results with regard to differences in demographic characteristics, STI history, and psychosocial measures. Men recruited from sex parties were significantly older, reported more symptoms of sexual compulsivity, more likely to be HIV-positive, more likely to report a history of STIs, and more likely to self-identify as a barebacker, than men recruited from the other two venues. In contrast, men from Craigslist.org reported the lowest levels of attachment to the gay and bisexual community and were the least likely to self-identify as gay. Men from bars and clubs were significantly younger, and were more likely to report use of hallucinogens and crack or cocaine. Our findings highlight that the venues in which MSM are recruited have meaningful consequences in terms of the “types” of individuals who are reached. PMID:25068182

  6. Childhood sexual abuse and HIV-related risks among men who have sex with men in Washington, DC.

    PubMed

    Phillips, Gregory; Magnus, Manya; Kuo, Irene; Rawls, Anthony; Peterson, James; Montanez, Luz; West-Ojo, Tiffany; Jia, Yujiang; Opoku, Jenevieve; Greenberg, Alan E

    2014-05-01

    Childhood sexual abuse (CSA) has been reported to be disproportionately higher among men who have sex with men (MSM) than among heterosexual men; it has also been found to be significantly positively associated with HIV status and HIV risk factors, including unprotected anal intercourse. The purpose of this study was to assess the correlates of CSA in a sample of community-recruited MSM, investigate race as a potential effect modifier, and describe the independent association between CSA and HIV infection in Washington, DC. A total of 500 MSM were recruited by venue-based sampling in 2008 as part of the National HIV Behavioral Surveillance. More than one-half of MSM identified as White, while one-third identified as Black. CSA was reported by 17.5 % of the 451 MSM, with the first instance of abuse occurring at a median age of 8.3 (interquartile range = 5.0, 11.0). In multivariable analysis, HIV-positive men were significantly more likely to report a history of CSA compared to HIV-negative men after adjusting for intimate partner violence in the last 12 months, having been arrested in the last 12 months, and depressive symptoms. HIV-positive MSM had more than four times the odds of reporting CSA after controlling for other correlates (aOR = 4.19; 95 % CI 2.26, 7.75). Despite hypothesizing that race modified the effect of CSA on HIV infection we found this was not the case in this sample. More research is needed to investigate the potential pathway between a history of CSA and HIV infection, and how this contributes to driving the HIV epidemic among MSM in Washington, DC.

  7. What's in a label?: Multiple meanings of ‘MSM’ among same-gender-loving Black men in Mississippi

    PubMed Central

    Truong, Nhan; Perez-Brumer, Amaya; Burton, Melissa; Gipson, June; Hickson, DeMarc

    2016-01-01

    Men who have sex with men (MSM) and other same-gender-loving men continue to be disproportionately affected by HIV and AIDS, particularly among the Black population. Innovative strategies are needed to support the health of this community; however, public health efforts primarily approach MSM as a monolithic population erasing the diverse identities, practices, and sexualities within and beyond this category. To better understand diversity within MSM in a geographic region with the largest proportion of Black Americans in the U.S. and among the most heavily affected by the epidemic, the Deep South, we conducted four focus groups (n=29) with Black men who reported having sex with other men residing in Jackson, Mississippi. Results suggest multiple overlapping usages of MSM as identity and behavior, reflecting internalization of behavioral categories and co-creation of identities unique to the Black community. These narratives contribute to the literature by documenting the evolving understandings of the category ‘MSM’ among Black men to reflect intersections between race, socioeconomic status, sexual behavior, sexuality, subjectivities, and social context. Findings suggest the current monolithic approach to treating MSM may limit public health efforts in developing effective HIV prevention and promotion programs targeting same-gender-loving Black men in the Deep South. PMID:26950431

  8. Motivators of HIV Risk-Taking Behavior of Young Gay Latino Men.

    PubMed

    Meyer, Mark A; Dimmitt Champion, Jane

    2008-08-01

    Latinos have been disproportionately affected by HIV, placing young Latino men who have sex with men (MSM) at increased risk within this ethnic community. The study explored the lived experience of growing up as a young Latino MSM and motivators to HIV risk behaviors. Five young Latino MSM ages 18 to 25 years were enrolled in a qualitative, phenomenological study using semistructured interviews followed by a HIV risk-taking behavior survey. A relationship was identified between patterns of belonging and self-acceptance of sexual orientation and motivators of HIV sexual risk-taking behavior. La familia, machismo, hiding, and guilt were themes related to belonging and self-acceptance. The need to belong and be accepted by the family and self-acceptance of sexual orientation are related to the HIV sexual risk-taking behavior of young Latino MSM. J Am Psychiatr Nurses Assoc, 2008; 14(4), 310-316. DOI: 10.1177/1078390308321926.

  9. Validity of Self-Reported Substance Use In MSM

    PubMed Central

    Fendrich, Michael; Mackesy-Amiti, Mary Ellen; Johnson, Timothy P.

    2008-01-01

    Purpose To understand the validity of self-reported recent drug use in men who have sex with men (MSM). Methods We obtained a probability sample of Chicago men who have sex with men(MSM; n=216) and administered urine and saliva drug testing following a self-administered interview. Analyses examined participation in drug testing, the agreement between self-reported past month drug use and drug test results, correlates of underreporting, and the relative utility of drug testing vs. self-reports in identifying recent marijuana and cocaine use. For marijuana and cocaine, findings were compared with those obtained from a general population sample of men (n=241). Results Over three quarters of the participants in both samples provided at least one specimen for drug testing. Self reports in both samples showed a high degree of correspondence with drug tests for marijuana, but not for cocaine. Sensitivity for cocaine use reporting was 60% for the MSM sample and 40% for the general population males. Conditional kappa and sensitivity statistics for marijuana, cocaine, MDMA and methamphetamine suggested that self reports among MSMare provided with a high degree of validity. Underreporting was a correlate of social class (education, income and employment) in the general population, but not in the MSM sample. The utility of drug testing was dependent on social class in the general population sample. Conclusions Drug testing is feasible in epidemiological surveys of drug use. Self reports among MSM are at least as valid as those provided by a general population sample of males. In some instances (e. g. , cocaine use), they may actually be of higher quality. Although the findings support the merit of epidemiological studies of MSM drug use that have relied completely on self-report, drug tests may be useful for clarifying club drug ingestion patterns. PMID:18693041

  10. HIV testing and sexual risks among migrant men who have sex with men: findings from a large cross-sectional study in Beijing, China.

    PubMed

    Liu, Yu; Vermund, Sten H; Ruan, Yuhua; Liu, Hongjie; Zhang, Chen; Yin, Lu; Shao, Yiming; Qian, Han-Zhu

    2017-09-25

    Despite the exacerbating HIV transmission among migrant men who have sex with men (MSM) in China, few epidemiological studies explore their HIV testing/risk profiles. We sought to explore sociodemographic/behavioral correlates of HIV/syphilis and HIV testing among migrant MSM. A study was conducted among 3,588 HIV-uninfected MSM. Participants were recruited via short message services, peer referral, web-advertisement and community outreach. HIV/syphilis infections were lab-confirmed. Migrant MSM were more likely to be HIV-infected compared to local MSM. Among 2,699 migrant MSM, HIV testing was associated with older age, living longer in Beijing, having ≥10 lifetime male sexual partners (LMSPs), having insertive anal sex; while being unemployed/retired and having condomless receptive anal sex (CRAS) were associated with a lower odds of HIV testing. Being married, living longer in Beijing, ever testing for HIV and having sex with women were associated with lower HIV odds; while being unemployed/retired, having higher HIV perception, having ≥ 10 LMSPs and having CRAS were associated a higher HIV odds. Increased likelihood of syphilis was associated with older age, being employed, higher HIV perception, having ≥10 LMSPs and having CRAS. Our study provides implications for targeted interventions to tackle HIV/STI risks and improve HIV testing among migrant Chinese MSM.

  11. Trends in Serosorting and the Association With HIV/STI Risk Over Time Among Men Who Have Sex With Men

    PubMed Central

    Dombrowski, Julia C.; Swanson, Fred; Kerani, Roxanne P.; Katz, David A.; Barbee, Lindley A.; Hughes, James P.; Manhart, Lisa E.; Golden, Matthew R.

    2016-01-01

    Background: Serosorting among men who have sex with men (MSM) is common, but recent data to describe trends in serosorting are limited. How serosorting affects population-level trends in HIV and other sexually transmitted infection (STI) risk is largely unknown. Methods: We collected data as part of routine care from MSM attending a sexually transmitted disease clinic (2002–2013) and a community-based HIV/sexually transmitted disease testing center (2004–2013) in Seattle, WA. MSM were asked about condom use with HIV-positive, HIV-negative, and unknown-status partners in the prior 12 months. We classified behaviors into 4 mutually exclusive categories: no anal intercourse (AI); consistent condom use (always used condoms for AI); serosorting [condom-less anal intercourse (CAI) only with HIV-concordant partners]; and nonconcordant CAI (CAI with HIV-discordant/unknown-status partners; NCCAI). Results: Behavioral data were complete for 49,912 clinic visits. Serosorting increased significantly among both HIV-positive and HIV-negative men over the study period. This increase in serosorting was concurrent with a decrease in NCCAI among HIV-negative MSM, but a decrease in consistent condom use among HIV-positive MSM. Adjusting for time since last negative HIV test, the risk of testing HIV positive during the study period decreased among MSM who reported NCCAI (7.1%–2.8%; P= 0.02), serosorting (2.4%–1.3%; P = 0.17), and no CAI (1.5%–0.7%; P = 0.01). Serosorting was associated with a 47% lower risk of testing HIV positive compared with NCCAI (adjusted prevalence ratio = 0.53; 95% confidence interval: 0.45 to 0.62). Conclusions: Between 2002 and 2013, serosorting increased and NCCAI decreased among Seattle MSM. These changes paralleled a decline in HIV test positivity among MSM. PMID:26885806

  12. MALE HOMOSEXUAL IDENTITIES, RELATIONSHIPS, AND PRACTICES AMONG YOUNG MEN WHO HAVE SEX WITH MEN IN VIETNAM: IMPLICATIONS FOR HIV PREVENTION

    PubMed Central

    Ngo, Duc Anh; Ross, Michael W.; Phan, Ha; Ratliff, Eric A.; Trinh, Thang; Sherburne, Lisa

    2010-01-01

    Rapid socioeconomic transformation in Vietnam in last 15 years has been followed by more liberation of sexual expression and representation of sexual identity among young people. There has been an increase in the visibility of homosexual men in major cities of Vietnam who were largely an unknown population until the emergence of the HIV epidemic. Men who have sex with men (MSM) are now considered as one of the target groups in many HIV prevention programs. This qualitative study examines local identities, relationships, and sexual practices among young MSM aged 15–24 in the cities of Hanoi and Ho Chi Minh City. Our analyses were based on 26 in-depth interviews and 10 focus group discussions with young MSM recruited through public place intercepts and cruising areas. Data document the linguistic classification, sexual relationships and behaviors, identity and process of homosexual identification, and the potential linkage between sexual identity and sexual behaviors of MSM in Vietnam. Data also highlight the stages of homosexual community development in urban Vietnam and important differences between Vietnam and the West in the representation of homosexual identity, relationships, and practices. In light of the findings, we suggest that the continuing development and elaboration of a homosexual community in Hanoi and Ho Chi Minh City offers significant opportunities for targeted HIV/AIDS prevention activities in the Vietnamese MSM population. PMID:19519239

  13. HIV and syphilis infection among men who have sex with men--Bangkok, Thailand, 2005-2011.

    PubMed

    2013-06-28

    Although efforts to control the heterosexual human immunodeficiency virus (HIV) epidemic in Thailand had shown success by the late 1990s, HIV continued to spread in other risk groups, including men who have sex with men (MSM). In 2003, the Thailand Ministry of Public Health-U.S. CDC Collaboration (TUC) started surveillance among MSM in Bangkok, finding an HIV prevalence of 17.3%. By 2005, HIV prevalence in this group had risen to 28.3% and has since stabilized at around 30%. To obtain additional information about HIV and sexually transmitted infection (STI) prevalence and incidence in a clinic-based population of MSM, TUC, in collaboration with the Thai Red Cross AIDS Research Center, analyzed data collected at the Silom Community Clinic (SCC), an HIV and STI testing center targeting MSM. This report describes trends in HIV and syphilis prevalence and incidence seen among SCC MSM clients during 2005-2011. At first clinic visit, the prevalence of HIV infection among 4,762 clients was 28.3% and of syphilis (all stages) was 9.8%. Among those returning for HIV or syphilis testing before the end of 2011, the incidence of HIV infection was 6.3 per 100 person-years (PY) and 3.6 per 100 PY for syphilis. These results show ongoing epidemics of HIV and syphilis infection in MSM in Bangkok, underscoring the urgent need for preventive interventions to reduce the spread of HIV and STI in this population.

  14. Structural violence against Kothi-identified men who have sex with men in Chennai, India: a qualitative investigation.

    PubMed

    Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; McLuckie, Alan; Melwin, Fredrick

    2007-08-01

    This qualitative investigation explored the experiences and contexts of stigma and discrimination among HIV-positive and high-risk kothi-identified men who have sex with men (MSM) in Chennai, India, and ramifications for HIV prevention. MSM were recruited through community agencies (n = 10) and public sex environments (n = 8), along with three key informants. In-depth, semistructured interviews were conducted, audiotaped, and transcribed. Narrative thematic analysis and a constant comparative method were used to identify themes. Findings revealed multiple intersecting social and institutional contexts and experiences of stigmatization, discrimination, and violence across police, community, family, and health care systems, as well as illuminating consequences for MSM. Multisystemic structural violence places kothis at extreme vulnerability for HIV infection and AIDS. Public mass media antidiscrimination campaigns, education and training of health care providers and police, funding of indigenous MSM community organizations, and decriminalization of consensual sex between same-sex adults may help to combat stigma, discrimination, and violence against MSM, which is fundamental to effective HIV prevention.

  15. Gay identity-related factors and sexual risk among men who have sex with men in San Francisco.

    PubMed

    Flores, Stephen A; Mansergh, Gordon; Marks, Gary; Guzman, Robert; Colfax, Grant

    2009-04-01

    This study explored the relationship between gay identity-related factors (gay community involvement, gay bar attendance, gay identity importance, and self-homophobia) and unprotected anal sex (UA) in the past 3 months among men who have sex with men (MSM) of three different race/ethnicity groups. Four hundred eighty-three MSM (mean age 34) were recruited in the San Francisco Bay Area (33% African American, 34% Latino and 33% White). Compared with White MSM, African American and Latino MSM were less likely to identify as gay, and to attend gay bars/clubs, and more likely to report self-homophobia. Just over one third of the sample reported UA (did not vary by race). Gay community involvement was associated with receptive UA with all partners (adjusted odds ratio [AOR = 1.30, 95% Confidence Interval (CI) = 1.06-1.60). Gay bar attendance was associated with insertive UA with all partners (AOR = 1.20, 95% CI = 1.01-1.43) and with HIV-discordant partners (AOR = 1.35, 95% CI = 1.08-1.69). Implications for prevention include addressing community norms and encouraging alternatives to bars as settings in which to meet and socialize with other MSM.

  16. Knowledge, Attitudes and Beliefs regarding Post Exposure Prophylaxis among South African Men who have Sex with Men.

    PubMed

    Hugo, J M; Stall, R D; Rebe, K; Egan, J E; Jobson, G; De Swardt, G; Struthers, H; McIntyre, J A

    2016-12-01

    The Soweto Men's Study (2008), demonstrated an overall HIV prevalence rate of 13.2 %, with 10.1 % among straight-identified Men-who-have-sex-with-men (MSM), 6.4 % among bisexual-identified MSM and 33.9 % among gay-identified MSM. Behavioral interventions are imperative, but insufficient to prevent new HIV infections. Biomedical prevention of HIV offers a variety of combination prevention tools, including Post-exposure prophylaxis (PEP). PEP studies amongst MSM have been conducted in Amsterdam, Brazil and San Francisco, but never before in Africa. A cross-sectional, Internet-based survey was initiated to measure knowledge, attitudes and beliefs regarding PEP among South African MSM. Recruitment commenced in June 2014 and ran until October 2015. Participants were recruited through banner advertisements on Facebook.com and mambaonline.com, advertisements in the local gay media and at Health4Men (H4M) MSM-targeted clinics. Outreach workers distributed flyers advertising the study in their local communities. The survey was also made available on a computer at the H4M clinics in Cape Town and Johannesburg to reach MSM who may not have Internet access. A total of 408 men completed the survey. The majority of these men were under the age of 40, identified as gay/homosexual and were employed; 51 % (208/408) self-identified as black or of mixed race. In multivariate analysis participants who identified as gay had greater odds of having previously heard of PEP (AOR 1.91, 95 % CI 1.04, 3.51; p = 0.036), as did those who reported their HIV status as positive (AOR 2.59, 95 % CI 1.47, 4.45; p = 0.001). Participants with medical insurance had greater odds of having used PEP previously (AOR 2.67, 95 % CI 1.11, 6.43; p = 0.029). Bivariate analysis showed that condomless sex in the past 6 months was not significantly associated with PEP knowledge (p = 0.75) or uptake (p = 0.56) of PEP. Our findings suggest a lack of PEP knowledge and uptake among non-gay identified

  17. HIV and Men Who Have Sex with Men: Where Is the Canadian Epidemic Headed?

    ERIC Educational Resources Information Center

    Siushansian, Jennifer A.; Nguyen, Mai; Archibald, Chris P.

    2000-01-01

    Canada's recent increase in HIV infections among men who have sex with men (MSM) is substantiated by data on ongoing sexual risk behavior and increases in sexually transmitted diseases among MSM. This situation is discussed in the international context, noting an upswing in HIV-associated risk behaviors among MSM worldwide and possible…

  18. Predictors of HIV testing among men who have sex with men: a focus on men living outside major urban centres in Canada.

    PubMed

    Holtzman, Susan; Landis, Lisa; Walsh, Zachary; Puterman, Eli; Roberts, Daryle; Saya-Moore, Kevin

    2016-01-01

    Men who have sex with men (MSM) represent almost half of new HIV infections in Canada each year. However, the vast majority of research on HIV testing among MSM has been conducted in major urban centres. The present study addressed this gap by investigating HIV testing behaviour and predictors of HIV testing among MSM living outside major urban centres, in the Interior of British Columbia. An anonymous online survey of 153 MSM assessed HIV testing behaviour and psychosocial factors that may impact HIV testing (internalized homophobia, disclosure to healthcare providers (HCPs) of same sex attraction, and gay community involvement). Almost one-quarter (24%) had never been tested and over one-third (35%) had not disclosed same sex attraction to HCPs. Internalized homophobia was associated with a lower likelihood of HIV testing, and this relationship was partially explained by the fact that those high in internalized homophobia were less likely to disclose same sex attraction to their HCPs. Neither formal nor informal involvement in the gay community was related to HIV testing, and both types of involvement were relatively low in our sample. Further research is needed to better understand the distinctive health issues facing MSM living outside major urban centres.

  19. A call to action for comprehensive HIV services for men who have sex with men

    PubMed Central

    Beyrer, Chris; Sullivan, Patrick S.; Sanchez, Jorge; Dowdy, David; Altman, Dennis; Trapence, Gift; Collins, Chris; Katabira, Elly; Kazatchkine, Michel; Sidibe, Michel; Mayer, Kenneth H.

    2013-01-01

    Where surveillance has been done, it has shown that men (MSM) who have sex with men bear a disproportionate burden of HIV. Yet they continue to be excluded, sometimes systematically, from HIV services because of stigma, discrimination, and criminalisation. This situation must change if global control of the HIV epidemic is to be achieved. On both public health and human rights grounds, expansion of HIV prevention, treatment, and care to MSM is an urgent imperative. Effective combination prevention and treatment approaches are feasible, and culturally competent care can be developed, even in rights-challenged environments. Condom and lubricant access for MSM globally is highly cost effective. Antiretroviral-based prevention, and antiretroviral access for MSM globally, would also be cost effective, but would probably require substantial reductions in drug costs in high-income countries to be feasible. To address HIV in MSM will take continued research, political will, structural reform, community engagement, and strategic planning and programming, but it can and must be done. PMID:22819663

  20. Comprehensive clinical care for men who have sex with men: an integrated approach.

    PubMed

    Mayer, Kenneth H; Bekker, Linda-Gail; Stall, Ron; Grulich, Andrew E; Colfax, Grant; Lama, Javier R

    2012-07-28

    Men who have sex with men (MSM) have unique health-care needs, not only because of biological factors such as an increased susceptibility to infection with HIV and sexually transmitted infections associated with their sexual behaviour, but also because of internalisation of societal stigma related to homosexuality and gender non-conformity, resulting in depression, anxiety, substance use, and other adverse outcomes. Successful responses to the global HIV/AIDS epidemic will require the development of culturally sensitive clinical care programmes for MSM that address these health disparities and root causes of maladaptive behaviour (eg, societal homophobia). Health-care providers need to become familiar with local outreach agencies, hotlines, and media that can connect MSM with positive role models and social opportunities. Research is needed to understand how many MSM lead resilient and productive lives in the face of discrimination to develop assets-based interventions that build on community support. Optimum clinical care for sexual and gender minorities is a fundamental human right. MSM deserve to be treated with respect, and health-care providers need to interact with them in ways that promote disclosure of actionable health information.

  1. Prevalence Estimates of Health Risk Behaviors of Immigrant Latino Men Who Have Sex With Men

    PubMed Central

    Rhodes, Scott D.; McCoy, Thomas P.; Hergenrather, Kenneth C.; Vissman, Aaron T.; Wolfson, Mark; Alonzo, Jorge; Bloom, Fred R.; Alegría-Ortega, Jose; Eng, Eugenia

    2011-01-01

    Purpose Little is known about the health status of rural immigrant Latino men who have sex with men (MSM). These MSM comprise a subpopulation that tends to remain “hidden” from both researchers and practitioners. This study was designed to estimate the prevalence of tobacco, alcohol, and drug use, and sexual risk behaviors of Latino MSM living in rural North Carolina. Methods A community-based participatory research (CBPR) partnership used respondent-driven sampling (RDS) to identify, recruit, and enroll Latino MSM to participate in an interviewer-administered behavioral assessment. RDS weighted prevalence of risk behaviors was estimated using the RDS Analysis Tool. Data collection occurred in 2008. Results A total of 190 Latino MSM was reached; the average age was 25.5 years old and nearly 80% reported being from Mexico. Prevalence estimates of smoking everyday and past 30-day heavy episodic drinking were 6.5% and 35.0%, respectively. Prevalence estimates of past 12-month marijuana and cocaine use were 56.0% and 27.1%, respectively. Past 3-month prevalence estimates of sex with at least one woman, multiple male partners, and inconsistent condom use were 21.2%, 88.9%, and 54.1%, respectively. Conclusions Respondents had low rates of tobacco use and club drug use, and high rates of sexual risk behaviors. Although this study represents an initial step in documenting the health risk behaviors of immigrant Latino MSM who are part of a new trend in Latino immigration to the southeastern US, a need exists for further research, including longitudinal studies to understand the trajectory of risk behavior among immigrant Latino MSM. PMID:22236317

  2. Prevalence estimates of health risk behaviors of immigrant latino men who have sex with men.

    PubMed

    Rhodes, Scott D; McCoy, Thomas P; Hergenrather, Kenneth C; Vissman, Aaron T; Wolfson, Mark; Alonzo, Jorge; Bloom, Fred R; Alegría-Ortega, Jose; Eng, Eugenia

    2012-01-01

    Little is known about the health status of rural immigrant Latino men who have sex with men (MSM). These MSM comprise a subpopulation that tends to remain "hidden" from both researchers and practitioners. This study was designed to estimate the prevalence of tobacco, alcohol, and drug use, and sexual risk behaviors of Latino MSM living in rural North Carolina. A community-based participatory research (CBPR) partnership used respondent-driven sampling (RDS) to identify, recruit, and enroll Latino MSM to participate in an interviewer-administered behavioral assessment. RDS-weighted prevalence of risk behaviors was estimated using the RDS Analysis Tool. Data collection occurred in 2008. A total of 190 Latino MSM was reached; the average age was 25.5 years and nearly 80% reported being from Mexico. Prevalence estimates of smoking everyday and past 30-day heavy episodic drinking were 6.5% and 35.0%, respectively. Prevalence estimates of past 12-month marijuana and cocaine use were 56.0% and 27.1%, respectively. Past 3-month prevalence estimates of sex with at least one woman, multiple male partners, and inconsistent condom use were 21.2%, 88.9%, and 54.1%, respectively. Respondents had low rates of tobacco use and club drug use, and high rates of sexual risk behaviors. Although this study represents an initial step in documenting the health risk behaviors of immigrant Latino MSM who are part of a new trend in Latino immigration to the southeastern United States, a need exists for further research, including longitudinal studies to understand the trajectory of risk behavior among immigrant Latino MSM. © 2011 National Rural Health Association.

  3. Feasibility of a combination HIV prevention program for men who have sex with men in Blantyre, Malawi

    PubMed Central

    Wirtz, AL; Trapence, G; Jumbe, V; Umar, E; Ketende, S; Kamba, D; Berry, M; Strömdahl, SK; Beyrer, C; Muula, AS; Baral, S

    2016-01-01

    Introduction The use of combination HIV prevention interventions (CHPI) now represent the standard of care to minimize HIV acquisition risks among men who have sex with men (MSM). There has been limited evaluation of these approaches in generalized HIV epidemics and/or where MSM are stigmatized. A peer-based CHPI program to target individual, social, and structural risks for HIV was developed for MSM in Blantyre, Malawi. Methods To test the feasibility of CHPI, adult MSM were followed prospectively from January 2012-May 2013. Participants (N=103) completed sociobehavioral surveys and HIV testing at each of three follow-up study visits. Results Approximately 90% of participants attended each study visit and 93.2% (n=96) completed the final visit. Participants met with peer-educators a median of 3 times (range: 1-10) in follow-up visits 2 and 3. Condom use at last sex improved from baseline through follow-up visit 3 with main (Baseline:62.5%, Follow-up 3:77.0%, p=0.02) and casual male partners (Baseline:70.7%, Follow-up 3:86.3%, p=0.01). Disclosure of sexual behaviors/orientation to family increased from 25% in follow-up 1 to 55% in follow-up 3 (p<0.01). Discussion Participants maintained a high level of retention in the study highlighting the feasibility of leveraging community based organizations to recruit and retain MSM in HIV prevention and treatment interventions in stigmatizing settings. Group-level changes in sexual behavior and disclosure in safe settings for MSM were noted. CHPI may represent a useful model to providing access to other HIV prevention for MSM and aiding retention in care and treatment services for MSM living with HIV in challenging environments. PMID:26010028

  4. Recruitment-adjusted estimates of HIV prevalence and risk among men who have sex with men: effects of weighting venue-based sampling data.

    PubMed

    Jenness, Samuel M; Neaigus, Alan; Murrill, Christopher S; Gelpi-Acosta, Camila; Wendel, Travis; Hagan, Holly

    2011-01-01

    We investigated the impact of recruitment bias within the venue-based sampling (VBS) method, which is widely used to estimate disease prevalence and risk factors among groups, such as men who have sex with men (MSM), that congregate at social venues. In a 2008 VBS study of 479 MSM in New York City, we calculated venue-specific approach rates (MSM approached/MSM counted) and response rates (MSM interviewed/MSM approached), and then compared crude estimates of HIV risk factors and seroprevalence with estimates weighted to address the lower selection probabilities of MSM who attend social venues infrequently or were recruited at high-volume venues. Our approach rates were lowest at dance clubs, gay pride events, and public sex strolls, where venue volumes were highest; response rates ranged from 39% at gay pride events to 95% at community-based organizations. Sixty-seven percent of respondents attended MSM-oriented social venues at least weekly, and 21% attended such events once a month or less often in the past year. In estimates adjusted for these variations, the prevalence of several past-year risk factors (e.g., unprotected anal intercourse with casual/exchange partners, ≥5 total partners, group sex encounters, at least weekly binge drinking, and hard-drug use) was significantly lower compared with crude estimates. Adjusted HIV prevalence was lower than unadjusted prevalence (15% vs. 18%), but not significantly. Not adjusting VBS data for recruitment biases could overestimate HIV risk and prevalence when the selection probability is greater for higher-risk MSM. While further examination of recruitment-adjustment methods for VBS data is needed, presentation of both unadjusted and adjusted estimates is currently indicated.

  5. Recruitment-Adjusted Estimates of HIV Prevalence and Risk Among Men Who Have Sex with Men: Effects of Weighting Venue-Based Sampling Data

    PubMed Central

    Jenness, Samuel M.; Neaigus, Alan; Murrill, Christopher S.; Gelpi-Acosta, Camila; Wendel, Travis; Hagan, Holly

    2011-01-01

    Objectives We investigated the impact of recruitment bias within the venue-based sampling (VBS) method, which is widely used to estimate disease prevalence and risk factors among groups, such as men who have sex with men (MSM), that congregate at social venues. Methods In a 2008 VBS study of 479 MSM in New York City, we calculated venue-specific approach rates (MSM approached/MSM counted) and response rates (MSM interviewed/MSM approached), and then compared crude estimates of HIV risk factors and seroprevalence with estimates weighted to address the lower selection probabilities of MSM who attend social venues infrequently or were recruited at high-volume venues. Results Our approach rates were lowest at dance clubs, gay pride events, and public sex strolls, where venue volumes were highest; response rates ranged from 39% at gay pride events to 95% at community-based organizations. Sixty-seven percent of respondents attended MSM-oriented social venues at least weekly, and 21% attended such events once a month or less often in the past year. In estimates adjusted for these variations, the prevalence of several past-year risk factors (e.g., unprotected anal intercourse with casual/exchange partners, ≥5 total partners, group sex encounters, at least weekly binge drinking, and hard-drug use) was significantly lower compared with crude estimates. Adjusted HIV prevalence was lower than unadjusted prevalence (15% vs. 18%), but not significantly. Conclusions Not adjusting VBS data for recruitment biases could overestimate HIV risk and prevalence when the selection probability is greater for higher-risk MSM. While further examination of recruitment-adjustment methods for VBS data is needed, presentation of both unadjusted and adjusted estimates is currently indicated. PMID:21886323

  6. Arrest History among Men and Sexual Orientation

    ERIC Educational Resources Information Center

    Fisher, Dennis G.; Milroy, Michael E.; Reynolds, Grace L.; Klahn, Jennifer A.; Wood, Michele M.

    2004-01-01

    This study explored associations between ever having been arrested and other variables among 490 male drug users. Participants were classified into three groups based on recent sexual history: men who had not had sex (NOSEX), men who had had sex with women (HETERO), and men who had had sex with men (MSM). We found that MSM who had been arrested…

  7. Arrest History among Men and Sexual Orientation

    ERIC Educational Resources Information Center

    Fisher, Dennis G.; Milroy, Michael E.; Reynolds, Grace L.; Klahn, Jennifer A.; Wood, Michele M.

    2004-01-01

    This study explored associations between ever having been arrested and other variables among 490 male drug users. Participants were classified into three groups based on recent sexual history: men who had not had sex (NOSEX), men who had had sex with women (HETERO), and men who had had sex with men (MSM). We found that MSM who had been arrested…

  8. Community environments shaping transactional sex among sexually active men in Malawi, Nigeria, and Tanzania.

    PubMed

    Stephenson, Rob; Winter, Amy; Elfstrom, Miriam

    2013-01-01

    Transactional sex, or the exchange of sex for material goods or money, is a risky sexual behavior that has been linked to HIV/AIDS and gender-based violence. Throughout sub-Saharan Africa, transactional sex remains a common practice, putting men and women at risk of HIV. However, little is known of how community environments shape men's participation in risky transactional sex. This analysis examines community-level influences on participation in risky transactional sex among sexually active men in three African countries (Malawi, Tanzania, and Nigeria). The analysis uses Demographic and Health Survey (DHS) data to examine the association between men's report of risky transactional sex and community characteristics including economic, gender norms, HIV behavior and knowledge, and demographic factors. The results show that men residing in communities with more female education and later age of first birth are less likely to report risky transactional sex, while men who live in communities where men report higher number of sexual partners are more likely to report risky transactional sex. While programmatic interventions should continue to improve women's status individually and relative to men, such efforts should be extended to recognize that many community and cultural influences also affect men's sexual behavior. Programs that understand, discuss, and challenge community factors that influence men's sexual behavior may be able to provide a more effective intervention resulting in opportunities for communities to initiate behavioral change.

  9. Risk and protective factors related to HIV-risk behavior: a comparison between HIV-positive and HIV-negative young men who have sex with men.

    PubMed

    Forney, Jason C; Miller, Robin L

    2012-01-01

    The objective of this study was to assess and compare the prevalence of high-risk sexual behaviors among young HIV-negative (n=8064) and HIV-positive (n=171) men who have sex with men (MSM) on predictors of unprotected anal intercourse (UAI). Using venue-based time-space sampling, 8235 MSM aged 15-25 were anonymously surveyed as a part of the Community Intervention Trial for Youth (CITY). The Project was conducted in 13 communities across the USA from 1999 to 2002. Forty percent of HIV-positive men and 34% of HIV-negative men reported that they had UAI in the previous 3 months. HIV-positive MSM were more likely than their uninfected peers to have traded sex within the previous year, to have had sex while high during their last sexual encounter, and to have UAI with a greater number of partners. Multivariate analyses indicated that for HIV-negative men, positive peer norms regarding safer sex and being Black or Latino predicted avoidance of UAI. Among HIV-positive men, having social support for safer sex and positive peer norms predicted avoidance of UAI. Young HIV-positive MSM are a relevant subgroup for prevention because they constitute a significant source from which future infections could be generated.

  10. MSM law in francophone Africa and the fight against AIDS: the hypocrisy of certain countries.

    PubMed

    Legrand, Alain; Yomb, Yves; Bourrelly, Michel; Lorente, Nicolas; NKom, Alice

    2010-06-01

    In addition to being the targets of frequent discrimination and violence,African men who have sex with men (MSM) are being hit hard by the HIV/AIDS epidemic. Although there is still insufficient research regarding the methods of HIV transmission in sub-Saharan Africa, several studies show that the prevalence of HIV infection among MSM is more than ten times higher than among the general population.

  11. Perspectives on Sexual Identity Formation, Identity Practices, and Identity Transitions Among Men Who Have Sex With Men in India.

    PubMed

    Tomori, Cecilia; Srikrishnan, Aylur K; Ridgeway, Kathleen; Solomon, Sunil S; Mehta, Shruti H; Solomon, Suniti; Celentano, David D

    2016-07-08

    Men who have sex with men (MSM) remain at high risk for HIV infection. Culturally specific sexual identities, encompassing sexual roles, behavior, and appearance, may shape MSM's experiences of stigmatization and discrimination, and affect their vulnerability to HIV. This multi-site qualitative study (n = 363) encompassing 31 focus group discussions (FGDs) and 121 in-depth interviews (IDIs) across 15 sites in India investigated sexual identity formation, identity practices, and transitions and their implications for HIV prevention. IDIs and FGDs were transcribed, translated, and underwent thematic analysis. Our findings document heterogeneous sexual identity formation, with MSM who have more gender nonconforming behaviors or appearance reporting greater family- and community-level disapproval, harassment, violence, and exclusion. Concealing feminine aspects of sexual identities was important in daily life, especially for married MSM. Some participants negotiated their identity practices in accordance with socioeconomic and cultural pressures, including taking on identity characteristics to suit consumer demand in sex work and on extended periods of joining communities of hijras (sometimes called TG or transgender women). Participants also reported that some MSM transition toward more feminine and hijra or transgender women identities, motivated by intersecting desires for feminine gender expression and by social exclusion and economic marginalization. Future studies should collect information on gender nonconformity stigma, and any changes in sexual identity practices or plans for transitions to other identities over time, in relation to HIV risk behaviors and outcomes.

  12. Facilitators and Barriers to HIV Status Disclosure Among HIV-positive MSM Age 50 and Older

    PubMed Central

    Halkitis, Perry N; Kingdon, Molly J.; Barton, Staci; Eddy, Jessica

    2016-01-01

    Objective Most HIV-positive men who have sex with men (MSM) ages 50 and older feel a responsibility to protect their sex partners from HIV transmission risk. For some, this is enacted through HIV disclosure, for others, this is realized through reduced risk behaviors. Methods To examine this, we analyzed interviews of 23 HIV-positive MSM ages 50 and older. Results We identified several contextual, relational, and psychosocial factors that served as either barriers or facilitators to HIV disclosure. Conclusions Our findings suggest HIV status disclosure is multifaceted and continues to impact sexual communication in the lives of MSM as they enter middle age. PMID:28496563

  13. HIV Risk and Perceptions of Masculinity among Young Black MSM

    PubMed Central

    Fields, Errol L.; Bogart, Laura M.; Smith, Katherine C.; Malebranche, David J.; Ellen, Jonathan; Schuster, Mark A.

    2011-01-01

    Purpose Young Black men who have sex with men (MSM) have among the highest rates of HIV infection in the US. Although reported rates of unprotected anal intercourse are similar to MSM of other racial/ethnic backgrounds, young Black MSM (YBMSM) aged 15–22 are 5 times more likely than comparably aged white MSM to be HIV-infected. We explored contextual social-environmental factors that may influence how YBMSM assess risk, choose partners, and make decisions about condom use. Methods We analyzed semi-structured interviews with 35 YBMSM (18–24) in New York City, upstate NY, and Atlanta. We used structured analytic coding based on a theoretical scheme that emerged from the data. Results Perception of masculinity was the primary contextual factor influencing partner selection, risk assessment, and condom decision-making. Four primary themes emerged: 1) greater preference for partners perceived as masculine; 2) discomfort with allowing men perceived as feminine to be the insertive partner in anal intercourse; 3) a power dynamic such that partners perceived as more masculine made condom-use decisions within the dyad; and 4) use of potential partners’ perceived masculinity to assess HIV risk. Conclusions Perceived masculinity may play a significant role in HIV risk for YBMSM and may be an important concept to consider in prevention strategies directed towards this population. PMID:22325136

  14. The burden of HIV experience and care among MSM having an HIV-positive seroconcordant steady partner: a possible research hypothesis. Results from the French VESPA ANRS EN-12 study.

    PubMed

    Suzan-Monti, Marie; Préau, Marie; Blanche, Jérôme; Cabut, Sandrine; Carrieri, Patrizia M; Lert, France; Obadia, Yolande; Spire, Bruno

    2011-08-01

    Prevention fatigue, relapse into unsafe sex practices and sexual behaviour changes have been reported in the community of men who have sex with men (MSM) since the introduction of highly active antiretroviral therapy. Engaging in a relationship with a seroconcordant partner is perceived by some HIV-positive MSM as an alternative prevention strategy to consistent condom use. This study addresses whether underlying clinical factors exist characterising HIV-positive MSM in seroconcordant stable partnerships, enrolled in the French national cross-sectional survey VESPA ANRS EN-12. The study group comprised 322 HIV-positive MSM in stable relationships for more than 12 months, with a serodiscordant (n = 251) or seroconcordant (n = 71) steady partner. Clinical and psychosocial factors were analysed for HIV-positive MSM with a seroconcordant steady partner. Multiple adjustment by logistic regression showed that individuals with a seroconcordant steady partner were more likely to have a history of an AIDS-defining event (OR 95% CI 2.0 (1.1 to 3.7), p = 0.02) or be diagnosed as HIV positive before 1990 (OR 95% CI 2.2 (1.3 to 3.9), p = 0.004). Conversely, HIV-positive MSM experiencing virological success (ie, high treatment adherence and an undetectable viral load) were more likely to have a serodiscordant steady partner (OR 95% CI 0.5 (0.3 to 0.9), p = 0.02). Longitudinal studies are required to understand to what extent HIV history might influence partnership choices among HIV-positive MSM. Positive prevention programmes and reinforcement of treatment adherence strategies are needed for this population and their steady sexual partners.

  15. Men with disabilities - A cross sectional survey of health promotion, social inclusion and participation at community Men's Sheds.

    PubMed

    Wilson, Nathan J; Cordier, Reinie; Parsons, Richard; Vaz, Sharmila; Buchanan, Angus

    2016-01-01

    The intersections between chronicity, disability and social inequality are well understood. Novel ways to counter the social determinants of health and disability are needed. Men's Sheds are a community space where men can participate in a range of shared activities and potentially experience a health and social benefits. This cross-sectional survey was conducted to inform future research by determining who attended Men's Sheds and the range of health, social, community, and educational activities undertaken there. This paper explores the membership of people with disabilities (PWD) at Men's Sheds and the factors that predict their membership. An online survey link was sent to all known Men's Sheds internationally in 2012. Data were analyzed using descriptive and inferential (univariate and multivariate) statistics. 32.2% of international sheds and 29% of Australian sheds specifically targeted the inclusion of PWD. 80% of these sheds have significantly more members with disabilities than sheds who do no target PWD. Factors associated with greater membership of PWD included the provision of transport, social outings and promoting occupational skills. PWD are being encouraged to join and are joining Men's Sheds. This is significant as the value of participation and inclusion toward better health and wellbeing is well known. Men's Sheds offer a community space where the social determinants of chronicity and disability can potentially be countered. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Sexual Stigma, Psychological Well-Being and Social Engagement among Men Who Have Sex with Men in Beirut, Lebanon

    PubMed Central

    Wagner, Glenn J.; Aunon, Frances M.; Kaplan, Rachel L.; Karam, Rita; Khouri, Danielle; Tohme, Johnny; Mokhbat, Jacques

    2013-01-01

    This qualitative study sought to explore the sexual identity development of men who have sex with men (MSM) in Beirut, the stigma experienced by these men, and how their psychological well-being and social engagement are shaped by how they cope with this stigma. Semi-structured interviews were conducted with 31 MSM, and content analysis was used to identify emergent themes. While many men reported feeling very comfortable with their sexual orientation and had disclosed their sexual orientation to family, most men struggled at least somewhat with their sexuality, often because of perceived stigma from others and internal religious conflict about the immorality of homosexuality. Most participants described experiencing verbal harassment or ridicule, or being treated as different or lesser than in social relationships with friends or family. Mechanisms for coping with stigma included social avoidance (trying to pass as heterosexual; limiting interaction with MSM to the internet) or withdrawal from relationships in an attempt to limit exposure to stigma. Our findings suggest that effective coping with both internal and external sexual stigma is central to the psychological well-being and social engagement of MSM in Beirut, much like what has been found in Western gay communities. PMID:23730919

  17. Imagined comrades and imaginary protections: identity, community and sexual risk among men who have sex with men in China.

    PubMed

    Jones, Rodney H

    2007-01-01

    This paper describes the recent development of identity and community among gay men in China. It focuses both on the ways emerging forms of gay identity relate to larger ideological and discursive shifts within society, and on the ways these new forms of identity and community affect situated social interaction among gay men themselves. In particular, it addresses the question of how these emerging forms of gay identity and gay community affect the ways gay men in China understand the threat of HIV and make concrete decisions about sexual risk and safety. Among the chief tactics used by gay men in China to forge identity and community involves appropriating and adapting elements from dominant discourses of the Party-State and the mass media. This strategy has opened up spaces within which gay men can claim "cultural citizenship" in a society in which they have been heretofore marginalized. At the same time, this strategy also implicated in the formation of attitudes and social practices that potentially increase the vunerability of Chinese gay men to HIV infection.

  18. Sexually Explicit Online Media, Body Satisfaction, and Partner Expectations Among Men who have Sex with Men: a Qualitative Study

    PubMed Central

    Nelson, Kimberly; Simoni, Jane

    2016-01-01

    Limited research has investigated the perceived influence of sexually explicit online media (SEOM) on body satisfaction and partner expectations of men who have sex with men (MSM). Semi-structured qualitative interviews were conducted with 16 MSM, covering the perceived influence of MSM-specific SEOM. All nine men who broached the topics of body satisfaction and partner expectations reported that MSM-specific SEOM set unreasonably high physical appearance expectations for themselves and/or their potential partners. Although MSM-specific SEOM might be negatively affecting body satisfaction and partner expectations among MSM, its ubiquity may make it a useful tool to support body positivity. PMID:28979572

  19. Predictors of condom use among peer social networks of men who have sex with men in Ghana, West Africa.

    PubMed

    Nelson, LaRon E; Wilton, Leo; Agyarko-Poku, Thomas; Zhang, Nanhua; Zou, Yuanshu; Aluoch, Marilyn; Apea, Vanessa; Hanson, Samuel Owiredu; Adu-Sarkodie, Yaw

    2015-01-01

    Ghanaian men who have sex with men (MSM) have high rates of HIV infection. A first step in designing culturally relevant prevention interventions for MSM in Ghana is to understand the influence that peer social networks have on their attitudes and behaviors. We aimed to examine whether, in a sample of Ghanaian MSM, mean scores on psychosocial variables theorized to influence HIV/STI risk differed between peer social networks and to examine whether these variables were associated with condom use. We conducted a formative, cross-sectional survey with 22 peer social networks of MSM (n = 137) in Ghana. We assessed basic psychological-needs satisfaction, HIV/STI knowledge, sense of community, HIV and gender non-conformity stigmas, gender equitable norms, sexual behavior and condom use. Data were analyzed using analysis of variance, generalized estimating equations, and Wilcoxon two sample tests. All models were adjusted for age and income, ethnicity, education, housing and community of residence. Mean scores for all psychosocial variables differed significantly by social network. Men who reported experiencing more autonomy support by their healthcare providers had higher odds of condom use for anal (AOR = 3.29, p<0.01), oral (AOR = 5.06, p<0.01) and vaginal (AOR = 1.8, p<0.05) sex. Those with a stronger sense of community also had higher odds of condom use for anal sex (AOR = 1.26, p<0.001). Compared to networks with low prevalence of consistent condom users, networks with higher prevalence of consistent condom users had higher STD and HIV knowledge, had norms that were more supportive of gender equity, and experienced more autonomy support in their healthcare encounters. Healthcare providers and peer social networks can have an important influence on safer-sex behaviors in Ghanaian MSM. More research with Ghanaian MSM is needed that considers knowledge, attitudes, and norms of their social networks in the development and implementation of culturally relevant HIV

  20. Changes in Community Mobility in Older Men and Women. A 13-Year Prospective Study

    PubMed Central

    Fristedt, Sofi; Dahl, Anna K.; Wretstrand, Anders; Björklund, Anita; Falkmer, Torbjörn

    2014-01-01

    Community mobility, defined as “moving [ones] self in the community and using public or private transportation”, has a unique ability to promote older peoples’ wellbeing by enabling independence and access to activity arenas for interaction with others. Early predictors of decreased community mobility among older men and women are useful in developing health promoting strategies. However, long-term prediction is rare, especially when it comes to including both public and private transportation. The present study describes factors associated with community mobility and decreased community mobility over time among older men and women. In total, 119 men and 147 women responded to a questionnaire in 1994 and 2007. Respondents were between 82 and 96 years old at follow-up. After 13 years, 40% of men and 43% of women had decreased community mobility, but 47% of men and 45% of women still experienced some independent community mobility. Cross-sectional independent community mobility among men was associated with higher ratings of subjective health, reporting no depression and more involvement in sport activities. Among women, cross-sectional independent community mobility was associated with better subjective health and doing more instrumental activities of daily living outside the home. Lower subjective health predicted decreased community mobility for both men and women, whereas self-reported health conditions did not. Consequently, general policies and individual interventions aiming to improve community mobility should consider older persons’ subjective health. PMID:24516565

  1. Sex networking of young men who have sex with men in densely connected saunas in Hong Kong.

    PubMed

    Poon, Chin Man; Lee, Shui Shan

    2013-12-01

    Some men who have sex with men (MSM) meet and have sex with male partners at gay saunas, the connections between which are little explored for designing HIV prevention measures. This study aims to describe the network configuration of gay saunas and explore its relationship with risk behavior of MSM in the respective sauna communities, in the city of Hong Kong. Using venue-based sampling, 205 MSM were recruited in 8 saunas in July 2011 for a cross-sectional anonymous questionnaire survey. A network of saunas was constructed based on the proportion of clients shared between them. Core saunas with higher intensity of linkages were delineated from core-periphery analysis. Men who have sex with men in core saunas were compared with those in peripheral ones in terms of their demographics and risk behavioral profiles. Eight core saunas were differentiated from a highly connected sauna network, consisting of 13 saunas with a diameter of 2. Men who have sex with men visiting core saunas were more likely to be younger and users of the Internet for sex networking (odds ratio, 5.43; 95% confidence interval, 1.84-16.01). On average, they visited 1.7 saunas and had 2.6 sauna partners over a 1-month period, which were both significantly higher than those for MSM in peripheral saunas. However, there was no association between having unprotected anal sex and visiting core saunas. Sauna affiliation patterns were age dependent and geographically related. Saunas were not homogeneously connected with each other. Prioritization may be considered so that public health interventions can be targeted at saunas in denser networks. An assortative mixing in age among MSM in sauna community informs planning for client-specific venue-based prevention programs.

  2. Partner Selection among Latino Immigrant Men Who Have Sex with Men

    PubMed Central

    Shedlin, Michele G.; Brooks, Kelly D.; Penha, Marcelo Montes; Reisen, Carol A.; Zea, Maria Cecilia; Poppen, Paul J.

    2010-01-01

    This qualitative study explored partner selection in a sample of immigrant Latino men who have sex with men (MSM). In-depth interviews were conducted with men living in the greater New York metropolitan area who had been born in Brazil (n = 10), Colombia (n = 14), or the Dominican Republic (n = 9). One focus group was conducted with MSM from each of the three countries (9 Brazilian, 11 Colombian, and 5 Dominican participants). A grounded theory approach revealed three main themes relating to partner selection. The first concerned stereotypes of how Latino and Anglo-American men tend to behave in their sexual encounters and relationships. The participants perceived Latinos to be more affectionate and passionate, whereas they saw Anglo-American men as more independent and practical. These cultural discrepancies sometimes resulted in a preference for Latino partners. A second theme concerned stereotypes of the national groups, including expectations that Brazilians would be sexy and sensual and that Dominicans would have large penises. As found in other research on MSM of color, ethnic and national stereotypes were associated with experiences of sexual objectification. The third theme addressed the importance of masculine characteristics in sexual attraction and partner selection. Negative feelings towards effeminate men who did not conform to normative male physical or behavioral presentation reflect a stigma found inside and outside of the gay community. These findings suggest that gender and ethnic stereotypes play an important role in shaping partner choice and have implications for sexual risk and relationship formation. PMID:19688592

  3. Sex in public and private settings among Latino MSM

    PubMed Central

    Reisen, Carol A; Iracheta, Miguel A.; Zea, Maria Cecilia; Bianchi, Fernanda T.; Poppen, Paul J.

    2009-01-01

    Latino men who have sex with men (MSM) constitute a group at high risk for HIV. Recent approaches to understanding sexual risk have emphasized the role that contextual factors can play in shaping behavior. This study examined sexual behavior of Latino MSM in private and public settings. First, a within-person comparison of behaviors performed in sexual encounters that occurred in public and private settings was conducted. Unprotected anal intercourse and other sexual behaviors involving anal stimulation were more common in private settings; group sex was more likely in public settings. Second, a between-person analysis compared sexual behaviors of MSM who went to three different types of public sex settings during the previous six months. The types were: 1) commercial sex venues (CSVs), which were defined as businesses with the function of providing a space where MSM can go to have sexual encounters, such as gay bathhouses; 2) commercial sex environments (CSEs), which were defined as businesses with another apparent function, but in which MSM sometimes have sexual encounters, such as gay bars or pornographic movie houses; and 3) public sex environments (PSEs), which were defined as free public areas where MSM can go to find partners for anonymous sex, such as parks or public restrooms. Results indicated that anal sexual behavior was most likely to occur in CSVs and least likely in PSEs, but the probability of unprotected anal intercourse was not found to differ among the three types of settings. Behavioral differences were discussed in terms of structural conditions related to privacy and safety, and psychological factors related to intimacy. PMID:20461575

  4. High levels of adherence to a rectal microbicide gel and to oral Pre-Exposure Prophylaxis (PrEP) achieved in MTN-017 among men who have sex with men (MSM) and transgender women

    PubMed Central

    Carballo-Diéguez, Alex; Marzinke, Mark A.; Hendrix, Craig W.; Piper, Jeanna M.; Richardson, Barbra A.; Grossman, Cynthia; Johnson, Sherri; Gomez, Kailazarid; Horn, Stephanie; Kunjara Na Ayudhya, Ratiya Pamela; Patterson, Karen; Jacobson, Cindy; Bekker, Linda-Gail; Chariyalertsak, Suwat; Chitwarakorn, Anupong; Gonzales, Pedro; Holtz, Timothy H.; Liu, Albert; Mayer, Kenneth H.; Zorrilla, Carmen; Lama, Javier; McGowan, Ian; Cranston, Ross D.

    2017-01-01

    Trials to assess microbicide safety require strict adherence to prescribed regimens. If adherence is suboptimal, safety cannot be adequately assessed. MTN-017 was a phase 2, randomized sequence, open-label, expanded safety and acceptability crossover study comparing 1) daily oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF), 2) daily use of reduced-glycerin 1% tenofovir (RG-TFV) gel applied rectally, and 3) RG-TFV gel applied before and after receptive anal intercourse (RAI)—if participants had no RAI in a week, they were asked to use two doses of gel within 24 hours. Product use was assessed by mixed methods including unused product return count, text messaging reports, and qualitative plasma TFV pharmacokinetic (PK) results. Convergence interviews engaged participants in determining the most accurate number of doses used based on product count and text messaging reports. Client-centered adherence counseling was also used. Participants (N = 187) were men who have sex with men and transgender women enrolled in the United States (42%), Thailand (29%), Peru (19%) and South Africa (10%). Mean age was 31.4 years (range 18–64 years). Based on convergence interviews, over an 8-week period, 94% of participants had ≥80% adherence to daily tablet, 41% having perfect adherence; 83% had ≥80% adherence to daily gel, 29% having perfect adherence; and 93% had ≥80% adherence to twice-weekly use during the RAI-associated gel regimen, 75% having perfect adherence and 77% having ≥80% adherence to gel use before and after RAI. Only 4.4% of all daily product PK results were undetectable and unexpected (TFV concentrations <0.31 ng/mL) given self-reported product use near sampling date. The mixed methods adherence measurement indicated high adherence to product use in all three regimens. Adherence to RAI-associated rectal gel use was as high as adherence to daily oral PrEP. A rectal microbicide gel, if efficacious, could be an alternative for individuals

  5. High levels of adherence to a rectal microbicide gel and to oral Pre-Exposure Prophylaxis (PrEP) achieved in MTN-017 among men who have sex with men (MSM) and transgender women.

    PubMed

    Carballo-Diéguez, Alex; Balán, Ivan C; Brown, William; Giguere, Rebecca; Dolezal, Curtis; Leu, Cheng-Shiun; Marzinke, Mark A; Hendrix, Craig W; Piper, Jeanna M; Richardson, Barbra A; Grossman, Cynthia; Johnson, Sherri; Gomez, Kailazarid; Horn, Stephanie; Kunjara Na Ayudhya, Ratiya Pamela; Patterson, Karen; Jacobson, Cindy; Bekker, Linda-Gail; Chariyalertsak, Suwat; Chitwarakorn, Anupong; Gonzales, Pedro; Holtz, Timothy H; Liu, Albert; Mayer, Kenneth H; Zorrilla, Carmen; Lama, Javier; McGowan, Ian; Cranston, Ross D

    2017-01-01

    Trials to assess microbicide safety require strict adherence to prescribed regimens. If adherence is suboptimal, safety cannot be adequately assessed. MTN-017 was a phase 2, randomized sequence, open-label, expanded safety and acceptability crossover study comparing 1) daily oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF), 2) daily use of reduced-glycerin 1% tenofovir (RG-TFV) gel applied rectally, and 3) RG-TFV gel applied before and after receptive anal intercourse (RAI)-if participants had no RAI in a week, they were asked to use two doses of gel within 24 hours. Product use was assessed by mixed methods including unused product return count, text messaging reports, and qualitative plasma TFV pharmacokinetic (PK) results. Convergence interviews engaged participants in determining the most accurate number of doses used based on product count and text messaging reports. Client-centered adherence counseling was also used. Participants (N = 187) were men who have sex with men and transgender women enrolled in the United States (42%), Thailand (29%), Peru (19%) and South Africa (10%). Mean age was 31.4 years (range 18-64 years). Based on convergence interviews, over an 8-week period, 94% of participants had ≥80% adherence to daily tablet, 41% having perfect adherence; 83% had ≥80% adherence to daily gel, 29% having perfect adherence; and 93% had ≥80% adherence to twice-weekly use during the RAI-associated gel regimen, 75% having perfect adherence and 77% having ≥80% adherence to gel use before and after RAI. Only 4.4% of all daily product PK results were undetectable and unexpected (TFV concentrations <0.31 ng/mL) given self-reported product use near sampling date. The mixed methods adherence measurement indicated high adherence to product use in all three regimens. Adherence to RAI-associated rectal gel use was as high as adherence to daily oral PrEP. A rectal microbicide gel, if efficacious, could be an alternative for individuals uninterested in

  6. Men Who Have Sex With Men in Kisumu, Kenya: Comfort in Accessing Health Services and Willingness to Participate in HIV Prevention Studies

    PubMed Central

    OKALL, DANCUN O.; ONDENGE, KEN; NYAMBURA, MONICAH; OTIENO, FREDRICK O.; HARDNETT, FELICIA; TURNER, KYLE; MILLS, LISA A.; MASINYA, KENNEDY; CHEN, ROBERT T.; GUST, DEBORAH A.

    2016-01-01

    Men who have sex with men (MSM) are a crucial and marginalized at risk population for HIV in Africa but are poorly studied. Like other areas of Africa, homosexuality is illegal in Kenya. We assessed MSM comfort in accessing health services and willingness to participate in HIV prevention research in Kisumu, Kenya—an area of high HIV prevalence. We conducted a two-phase formative study with individual interviews (n = 15) and a structured survey (n = 51). Peer contact or snowball method (n = 43, 84.3%) was the primary recruitment strategy used to locate MSM. Exact logistic regression models were used for survey data analysis. Over 60% (32/51) of survey participants were not very comfortable seeking health services from a public hospital. Almost all MSM (49/51; 96.1%) reported willingness to be contacted to participate in future HIV research studies. Efforts to provide facilities that offer safe and confidential health services and health education for MSM is required. Continued community engagement with the MSM population in Kenya is needed to guide best practices for involving them in HIV prevention research. PMID:25089554

  7. Location-based HIV behavioural surveillance among MSM in Auckland, New Zealand 2002-2011: condom use stable and more HIV testing.

    PubMed

    Saxton, Peter J W; Dickson, Nigel P; Hughes, Anthony J

    2014-03-01

    Over the last decade, annual HIV diagnoses among men who have sex with men (MSM) in New Zealand increased, then stabilised in 2006 and have not increased further. The aim was to examine trends in behaviours in order to better understand this pattern and inform community-based prevention. From 2002 to 2011, we conducted five repeat cross-sectional behavioural surveillance surveys among MSM at community locations in Auckland (fair day, gay bars, sex-on-site venues; n=6091). Participation was anonymous and self-completed. Recruitment methods were consistent at each round. Overall, the samples became more ethnically diverse and less gay community attached over time. Condom use during anal intercourse was stable across three partnering contexts (casual, current regular fuckbuddy, current regular boyfriend), with a drop among casual contacts in 2011 only. In the 6 months prior to surveys, there was a gradual decline over time in the proportion reporting >20 male partners, an increase in acquiring partners from the internet and increases in engagement in anal intercourse in some partnering contexts. HIV testing in the 12 months prior to surveys rose from 35.1% in 2002 to 50.4% in 2011, mostly from 2008. This first indepth examination of trends in HIV-related behaviours among five consecutive large and diverse samples of MSM in New Zealand does not suggest condom use is declining. However, subtle changes in sexual networks and partnering may be altering the epidemic determinants in this population and increasing exposure.

  8. Assessing the Role of Masculinity in the Transmission of HIV: A Systematic Review to Inform HIV Risk Reduction Counseling Interventions for MSM

    PubMed Central

    Zeglin, Robert J.

    2017-01-01

    HIV affects over 1.2 million people in the United States; a substantial number are men who have sex with men (MSM). Despite an abundance of literature evaluating numerous social/structural and individual risk factors associated with HIV for this population, relatively little is known regarding the individual-level role of masculinity in community-level HIV transmission risk. To address this gap, the current analysis systematically reviewed the masculinity and HIV literature for MSM. The findings of 31 sources were included. Seven themes were identified: 1) Number of partners, 2) Attitudes toward condoms, 3) Drug use, 4) Sexual positioning, 5) Condom decision-making, 6) Attitudes toward testing, and 7) Treatment compliance. These factors, representing the enactment of masculine norms, potentiate the spread of HIV. The current article aligns these factors into a Masculinity Model of Community HIV Transmission. Opportunities for counseling interventions include identifying how masculinity informs a client’s cognitions, emotions, and behaviors as well as adapting gender transformative interventions to help create new conceptualizations of masculinity for MSM clients. This approach could reduce community-level HIV incidence. PMID:25917411

  9. Ethical issues in a study of bipolar disorder and HIV risk among African-American men who have sex with men: case study in the ethics of mental health research.

    PubMed

    Loue, Sana

    2012-03-01

    African-American men who have sex with men (MSM) are at increased risk of HIV infection, as are individuals with severe mental illness. This study was conducted at the behest of members of the African-American MSM community in Cleveland, Ohio, to assess the co-occurrence of HIV risk and bipolar disorder among African-American MSM. A sample of 125 participants was recruited via flyers and word of mouth at venues used by members of this community. Individuals were assessed for HIV risk and severe mental illness. Various ethical issues were presented, including participant capacity and voluntariness and the risk-benefit ratio. Divergent perspectives of the local institutional review board and the community advisory group with respect to the risks and benefits of participation required reconciliation before the study could proceed. Solutions for the resolution of such conflicts are discussed.

  10. Intragroup Stigma Among Men Who Have Sex with Men: Data Extraction from Craigslist Ads in 11 Cities in the United States

    PubMed Central

    Vansia, Dhrutika; Stephenson, Rob

    2016-01-01

    Background Gay, bisexual, and other men who have sex with men (MSM) regularly experience homophobic discrimination and stigma. While previous research has examined homophobic and HIV-related intergroup stigma originating from non-MSM directed at MSM, less is known about intragroup stigma originating from within MSM communities. While some research has examined intragroup stigma, this research has focused mostly on HIV-related stigma. Intragroup stigma may have a unique influence on sexual risk-taking behaviors as it occurs between sexual partners. Online sexual networking venues provide a unique opportunity to examine this type of stigma. Objective The purpose of this study is to examine the presence and patterns of various types of intragroup stigma represented in Men Seeking Men Craigslist sex ads. Methods Data were collected from ads on Craigslist sites from 11 of the 12 US metropolitan statistical areas with the highest HIV/AIDS prevalence. Two categories of data were collected: self-reported characteristics of the authors and reported biases in the ads. Chi-square tests were used to examine patterns of biases across cities and author characteristics. Results Biases were rarely reported in the ads. The most commonly reported biases were against men who were not “disease and drug free (DDF),” representing stigma against men living with HIV or a sexually transmitted infection. Patterns in bias reporting occurred across cities and author characteristics. There were no variations based on race, but ageism (mostly against older men) varied based on the ad author’s age and self-reported DDF status; bias against feminine gender expression varied based on self-reported sexual orientation; bias against “fat” men varied by self-reported DDF status; bias against “ugly” men varied by a self-report of being good-looking; and bias against people who do not have a DDF status varied based on self-reported HIV status and self-reported DDF status. Conclusions

  11. Intragroup Stigma Among Men Who Have Sex with Men: Data Extraction from Craigslist Ads in 11 Cities in the United States.

    PubMed

    Goldenberg, Tamar; Vansia, Dhrutika; Stephenson, Rob

    2016-01-01

    Gay, bisexual, and other men who have sex with men (MSM) regularly experience homophobic discrimination and stigma. While previous research has examined homophobic and HIV-related intergroup stigma originating from non-MSM directed at MSM, less is known about intragroup stigma originating from within MSM communities. While some research has examined intragroup stigma, this research has focused mostly on HIV-related stigma. Intragroup stigma may have a unique influence on sexual risk-taking behaviors as it occurs between sexual partners. Online sexual networking venues provide a unique opportunity to examine this type of stigma. The purpose of this study is to examine the presence and patterns of various types of intragroup stigma represented in Men Seeking Men Craigslist sex ads. Data were collected from ads on Craigslist sites from 11 of the 12 US metropolitan statistical areas with the highest HIV/AIDS prevalence. Two categories of data were collected: self-reported characteristics of the authors and reported biases in the ads. Chi-square tests were used to examine patterns of biases across cities and author characteristics. Biases were rarely reported in the ads. The most commonly reported biases were against men who were not "disease and drug free (DDF)," representing stigma against men living with HIV or a sexually transmitted infection. Patterns in bias reporting occurred across cities and author characteristics. There were no variations based on race, but ageism (mostly against older men) varied based on the ad author's age and self-reported DDF status; bias against feminine gender expression varied based on self-reported sexual orientation; bias against "fat" men varied by self-reported DDF status; bias against "ugly" men varied by a self-report of being good-looking; and bias against people who do not have a DDF status varied based on self-reported HIV status and self-reported DDF status. Despite an overall low reporting of biases in ads, these findings

  12. Correlates of Sexual HIV Risk Among African American Men Who Have Sex With Men

    PubMed Central

    St Lawrence, Janet S.; Tarima, Sergey S.; DiFranceisco, Wayne J.; Amirkhanian, Yuri A.

    2016-01-01

    Objectives. We examined correlates of condomless anal intercourse with nonmain sexual partners among African American men who have sex with men (MSM). Methods. We recruited social networks composed of 445 Black MSM from 2012 to 2014 in Milwaukee, Wisconsin; Cleveland, Ohio; and Miami Beach, Florida. Participants reported past-3-month sexual behavior, substance use, and background, psychosocial, and HIV-related characteristics. Results. Condomless anal intercourse outside main concordant partnerships, reported by 34.4% of MSM, was less likely in the case of no alcohol and marijuana use in the past 30 days, and higher risk-reduction behavioral intentions. High frequency of condomless anal intercourse acts with nonmain partners was associated with high gay community participation, weak risk-reduction intentions, safer sex not being perceived as a peer norm, low condom-use self-efficacy, and longer time since most recent HIV testing. Conclusions. Condomless anal intercourse with nonmain partners among Black MSM was primarily associated with gay community participation, alcohol and marijuana use, and risk-reduction behavioral intentions. PMID:26562130

  13. Engaging men as promotores de salud: perceptions of community health workers among Latino men in North Carolina.

    PubMed

    Villa-Torres, Laura; Fleming, Paul J; Barrington, Clare

    2015-02-01

    The promotor de salud, or community health worker (CHW) role, is highly feminized and little is known about how men view their participation in CHW programs. We conducted in-depth interviews with Latino men in North Carolina to explore this gap. We used systematic coding and display procedures informed by Grounded Theory to analyze the data. Men described their communities as lacking cohesion, making integration of Latino immigrants difficult. Most did not consider themselves leaders or feel they had leaders in their communities. Their perceptions of the feminized CHW role as well as the volunteer or low-paid nature of CHW work conflicted with men's provider role. They also did not think they could perform the CHW role because they lacked education, skills, and broad networks. Efforts to increase male participation in CHW programs in new Latino immigrant destinations will need to understand and address these gender and migration-related dynamics in order to engage both women and men in improving the health of their communities.

  14. Willingness of community-recruited men who have sex with men in Washington, DC to use long-acting injectable HIV pre-exposure prophylaxis

    PubMed Central

    Patrick, Rudy; Gamble, Jonjelyn; Rawls, Anthony; Opoku, Jenevieve; Magnus, Manya; Kharfen, Michael; Greenberg, Alan E.; Kuo, Irene

    2017-01-01

    Objectives Clinical trials are currently investigating the safety and efficacy of long-acting injectable (LAI) agents as HIV pre-exposure prophylaxis (PrEP). Using National HIV Behavioral Surveillance data, we assessed the self-reported willingness of men who have sex with men (MSM) to use LAI PrEP and their preference for LAI versus daily oral PrEP. Methods In 2014, venue-based sampling was used to recruit MSM aged ≥18 years in Washington, DC. Participants completed an interviewer-administered survey followed by voluntary HIV testing. This analysis included MSM who self-reported negative/unknown HIV status at study entry. Correlates of being “very likely” to use LAI PrEP and preferring it to daily oral PrEP were identified using multivariable logistic regression. Results Of 314 participants who self-reported negative/unknown HIV status, 50% were <30 years old, 41% were non-Hispanic Black, 37% were non-Hispanic White, and 14% were Hispanic. If LAI PrEP were offered for free or covered by health insurance, 62% were very likely, 25% were somewhat likely, and 12% were unlikely to use it. Regarding preferred PrEP modality, 67% chose LAI PrEP, 24% chose oral PrEP, and 9% chose neither. Correlates of being very likely versus somewhat likely/unlikely to use LAI PrEP included age <30 years (aOR 1.64; 95% CI 1.00–2.68), reporting ≥6 (vs. 1) sex partners in the last year (aOR 2.60; 95% CI 1.22–5.53), previous oral PrEP use (aOR 3.67; 95% CI 1.20–11.24), and being newly identified as HIV-infected during study testing (aOR 4.83; 95% CI 1.03–22.67). Black (vs. White) men (aOR 0.48; 95% CI 0.24–0.96) and men with an income of <$20,000 (vs. ≥$75,000; aOR 0.37; 95% CI 0.15–0.93) were less likely to prefer LAI to oral PrEP. Conclusions If LAI PrEP were found to be efficacious, its addition to the HIV prevention toolkit could facilitate more complete PrEP coverage among MSM at risk for HIV. PMID:28827821

  15. Willingness of community-recruited men who have sex with men in Washington, DC to use long-acting injectable HIV pre-exposure prophylaxis.

    PubMed

    Levy, Matthew E; Patrick, Rudy; Gamble, Jonjelyn; Rawls, Anthony; Opoku, Jenevieve; Magnus, Manya; Kharfen, Michael; Greenberg, Alan E; Kuo, Irene

    2017-01-01

    Clinical trials are currently investigating the safety and efficacy of long-acting injectable (LAI) agents as HIV pre-exposure prophylaxis (PrEP). Using National HIV Behavioral Surveillance data, we assessed the self-reported willingness of men who have sex with men (MSM) to use LAI PrEP and their preference for LAI versus daily oral PrEP. In 2014, venue-based sampling was used to recruit MSM aged ≥18 years in Washington, DC. Participants completed an interviewer-administered survey followed by voluntary HIV testing. This analysis included MSM who self-reported negative/unknown HIV status at study entry. Correlates of being "very likely" to use LAI PrEP and preferring it to daily oral PrEP were identified using multivariable logistic regression. Of 314 participants who self-reported negative/unknown HIV status, 50% were <30 years old, 41% were non-Hispanic Black, 37% were non-Hispanic White, and 14% were Hispanic. If LAI PrEP were offered for free or covered by health insurance, 62% were very likely, 25% were somewhat likely, and 12% were unlikely to use it. Regarding preferred PrEP modality, 67% chose LAI PrEP, 24% chose oral PrEP, and 9% chose neither. Correlates of being very likely versus somewhat likely/unlikely to use LAI PrEP included age <30 years (aOR 1.64; 95% CI 1.00-2.68), reporting ≥6 (vs. 1) sex partners in the last year (aOR 2.60; 95% CI 1.22-5.53), previous oral PrEP use (aOR 3.67; 95% CI 1.20-11.24), and being newly identified as HIV-infected during study testing (aOR 4.83; 95% CI 1.03-22.67). Black (vs. White) men (aOR 0.48; 95% CI 0.24-0.96) and men with an income of <$20,000 (vs. ≥$75,000; aOR 0.37; 95% CI 0.15-0.93) were less likely to prefer LAI to oral PrEP. If LAI PrEP were found to be efficacious, its addition to the HIV prevention toolkit could facilitate more complete PrEP coverage among MSM at risk for HIV.

  16. Crowdsourcing to promote HIV testing among MSM in China: study protocol for a stepped wedge randomized controlled trial.

    PubMed

    Tucker, Joseph D

    2017-10-02

    HIV testing for marginalized populations is critical to controlling the HIV epidemic. However, the HIV testing rate among men who have sex with men (MSM) in China remains low. Crowdsourcing, the process of shifting individual tasks to a group, has been increasingly adopted in public health programs and may be a useful tool for spurring innovation in HIV testing campaigns. We designed a multi-site study to develop a crowdsourced HIV test promotion campaign and evaluate its effectiveness against conventional campaigns among MSM in China. This study will use an adaptation of the stepped wedge, randomized controlled trial design. A total of eight major metropolitan cities in China will be randomized to sequentially initiate interventions at 3-month intervals. The intervention uses crowdsourcing at multiple steps to sustain crowd contribution. Approximately 1280 MSM, who are 16 years of age or over, live in the intervention city, have not been tested for HIV in the past 3 months, and are not living with HIV, will be recruited. Recruitment will take place through banner advertisements on a large gay dating app along with other social media platforms. Participants will complete one follow-up survey every 3 months for 12 months to evaluate their HIV testing uptake in the past 3 months and secondary outcomes including syphilis testing, sex without condoms, community engagement, testing stigma, and other related outcomes. MSM HIV testing rates remain poor in China. Innovative methods to promote HIV testing are urgently needed. With a large-scale, stepped wedge, randomized controlled trial our study can improve understanding of crowdsourcing's long-term effectiveness in public health campaigns, expand HIV testing coverage among a key population, and inform intervention design in related public health fields. ClinicalTrials.gov, NCT02796963 . Registered on 23 May 2016.

  17. Favorable Socioeconomic Status and Recreational Polydrug Use Are Linked With Sexual Hepatitis C Virus Transmission Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men

    PubMed Central

    Chen, Yun-Chi; Wiberg, Kjell J.; Hsieh, Yu-Hsiang; Bansal, Arun; Bolzan, Philipe; Guy, Janelle A.; Maina, Erastus N.; Cox, Andrea L.; Thio, Chloe L.

    2016-01-01

    Background. Sexual transmission of hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) is an emerging issue. Studies addressing the temporal trends and risk factors associated with incident HCV in HIV-infected MSM in the community-based primary care settings in the United States are scarce. Methods. Using a retrospective cohort study design, HCV incidence, defined as HCV antibody seroconversion, was determined in 1147 HIV-infected men receiving care at Chase Brexton Health Care clinics in Baltimore, Maryland between 2004 and 2014. Multivariate regression analyses were used to identify factors associated with incident HCV. Results. There were 42 incident HCV infections during 5242 person-years (PY) of follow up (incidence rate [IR], 8.01/1000 PY). Thirty-seven (88%) of the incident infections were in MSM, of whom 31 (84%) reported no injection-drug use (IDU). The annual IRs for MSM were 13.1–15.8/1000 PY between 2004 and 2007, decreased to 2.7–6.2/1000 PY between 2008 and 2011, and increased to 10.4/1000 PY and 13.3/1000 PY in 2013 and 2014, respectively. Injection-drug use was strongly associated with incident HCV among all MSM (IR ratio [IRR], 14.15; P = .003); however, among MSM without IDU, entering care between 2010 and 2013 (IRR, 3.32; P = .01), being employed (IRR, 3.14; P = .03), and having a history of ulcerative sexually transmitted infections (IRR, 3.70; P = .009) or of polydrug use (IRR, 5.54; P = .01) independently predicted incident HCV. Conclusions. In this cohort of HIV-infected men, a re-emerging HCV epidemic was observed from 2011 to 2014 among MSM. In addition to IDU, high-risk sexual behaviors, favorable socioeconomic status, and polydrug use fueled this increase in HCV infections. PMID:27703998

  18. Do men who have sex with men use serosorting with casual partners in France? Results of a nationwide survey (ANRS-EN17-Presse Gay 2004).

    PubMed

    Velter, A; Bouyssou-Michel, A; Arnaud, A; Semaille, C

    2009-11-26

    We examined whether men who have sex with men (MSM) in France have adopted serosorting with their casual partners, serosorting being one strategy to reduce the risk of HIV transmission. We expected to see the same predictors of this practice with casual partners in France as in other similar MSM communities (HIV-seropositive, Internet dating). Data from a cross-sectional survey was used, based on a self-administered questionnaire conducted among readers of the gay press and users of gay websites in 2004. The study population consisted of MSM who reported their HIV status, as well as the practice of unprotected anal intercourse (UAI) with a casual partner at least once during the previous 12 months. Among 881 respondents included in the analysis, 195 (22%) had practiced serosorting: 14% among HIV-seropositive men and 26% among HIV-seronegative men. Serosorting was independently associated with the use of cruising venues (AOR 0.28, p=0.001) and Internet dating (AOR 2.16, p=0.051) among HIV-seropositive men, whereas it was independently associated with the use of cruising venues (AOR 0.59, p=0.013) and the fact of having less partners (AOR 1.50, p=0.046) among HIV-seronegative men. Serosorting requires an up-to-date knowledge of HIV serostatus for MSM and their UAI casual partners, and does not prevent from acquiring other sexually transmitted infections. Prevention campaigns are needed to underline the risks associated with serosorting.

  19. Community-based harm reduction substance abuse treatment with methamphetamine-using men who have sex with men.

    PubMed

    Carrico, Adam W; Flentje, Annesa; Gruber, Valerie A; Woods, William J; Discepola, Michael V; Dilworth, Samantha E; Neilands, Torsten B; Jain, Jennifer; Siever, Michael D

    2014-06-01

    Harm reduction approaches endeavor to assist individuals with avoiding the most detrimental consequences of risk taking behaviors, but limited research has documented the outcomes of harm reduction substance abuse treatment. In total, 211 methamphetamine-using men who have sex with men (MSM) enrolled in two outcome studies of substance abuse treatment programs that were implementing an evidence-based, cognitive-behavioral intervention (i.e., the Matrix Model) from a harm reduction perspective. Study 1 (N = 123) examined changes in self-reported substance use, Addiction Severity Index (ASI) composite scores, and HIV care indicators over a 12-month follow-up. Study 2 (N = 88) assessed changes in substance use, sexual risk taking, and HIV care indicators over a 6-month follow-up. Participants in study 1 reported reductions in cocaine/crack use as well as decreases in the ASI drug and employment composite scores. Among HIV-positive participants in study 1 (n = 75), 47 % initiated or consistently utilized anti-retroviral therapy and this was paralleled by significant increases in self-reported undetectable HIV viral load. Study 2 participants reported reductions in methamphetamine use, erectile dysfunction medication use in combination with other substances, and sexual risk-taking behavior while using methamphetamine. Participants in both studies reported concurrent increases in marijuana use. Taken together, these studies are among the first to observe that clients may reduce stimulant use and concomitant sexual risk-taking behavior during harm reduction substance abuse treatment. Randomized controlled trials are needed to examine the differential effectiveness of harm reduction and abstinence-based approaches to substance abuse treatment.

  20. Ties that bind: community attachment and the experience of discrimination among Black men who have sex with men

    PubMed Central

    Van Sluytman, Laurens; Spikes, Pilgrim; Nandi, Vijay; Van Tieu, Hong; Frye, Victoria; Patterson, Jocelyn; Koblin, Beryl

    2015-01-01

    In the USA, the impact of psychological distress may be greater for Black men who have sex with men given that they may experience both racial discrimination in society at large and discrimination due to sexual orientation within Black communities. Attachments to community members may play a role in addressing psychological distress for members of this vulnerable population. This analysis is based on 312 Black men who have sex with men recruited for a behavioural intervention trial in New York City. Analyses were conducted using bivariate and multivariable logistic regression to examine the relationship of discrimination and community attachment to psychological distress. Most participants (63%) reported exposure to both discrimination due to race and sexual orientation. However, a majority of participants (89%) also reported racial and/or sexual orientation community attachment. Psychological distress was significant and negatively associated with older age (40 years and above), being a high school graduate and having racial and/or sexual orientation community attachments. Psychological distress was significantly and positively associated with being HIV-positive and experiencing both racial and sexual orientation discrimination. Similar results were found in the multivariable model. Susceptibility to disparate psychological distress outcomes must be understood in relation to social membership, including its particular norms, structures and ecological milieu. PMID:25647586

  1. Ties that bind: community attachment and the experience of discrimination among Black men who have sex with men.

    PubMed

    Van Sluytman, Laurens; Spikes, Pilgrim; Nandi, Vijay; Van Tieu, Hong; Frye, Victoria; Patterson, Jocelyn; Koblin, Beryl

    2015-01-01

    In the USA, the impact of psychological distress may be greater for Black men who have sex with men given that they may experience both racial discrimination in society at large and discrimination due to sexual orientation within Black communities. Attachments to community members may play a role in addressing psychological distress for members of this vulnerable population. This analysis is based on 312 Black men who have sex with men recruited for a behavioural intervention trial in New York City. Analyses were conducted using bivariate and multivariable logistic regression to examine the relationship of discrimination and community attachment to psychological distress. Most participants (63%) reported exposure to both discrimination due to race and sexual orientation. However, a majority of participants (89%) also reported racial and/or sexual orientation community attachment. Psychological distress was significant and negatively associated with older age (40 years and above), being a high school graduate and having racial and/or sexual orientation community attachments. Psychological distress was significantly and positively associated with being HIV-positive and experiencing both racial and sexual orientation discrimination. Similar results were found in the multivariable model. Susceptibility to disparate psychological distress outcomes must be understood in relation to social membership, including its particular norms, structures and ecological milieu.

  2. Hepatitis vaccination of men who have sex with men at gay pride events.

    PubMed

    Storholm, Erik David; Fisher, Dennis G; Reynolds, Grace L; Napper, Lucy E; Morrisse, Timothy A; Kochems, Lee M

    2010-06-01

    Prevention researchers have advocated primary prevention such as vaccination in alternative venues. However, there have been major questions about both the attendance of, and the ability to, vaccinate high-risk individuals in such settings. The current study seeks to assess the feasibility of vaccinating high-risk men who have sex with men (MSM) at Gay Pride events. The research questions are: Do gay men who are sampled at Gay Pride events engage in more or less risky behavior than gay men sampled at other venues? Do the gay men who receive hepatitis vaccinations at Gay Pride engage in more or less risky behavior than gay men at Gay Pride who do not receive hepatitis vaccination? Of the 3689 MSM that completed the Field Risk Assessment (FRA), 1095/3689 = 29.68% were recruited at either the 2006 or 2007 Long Beach, California Gay Pride events. The remaining, 2594/3689 = 70.32% were recruited at Long Beach gay bars, gay community organizations and institutions, and through street recruitment in various gay enclaves in the Long Beach area. Logistic regression analysis yielded eight factors that were associated with non-attendance of Gay Pride: Age, had sex while high in the last 12 months, had unprotected anal intercourse (UAI) in the last 12 months, had sex for drugs/money in the last 12 months, been diagnosed with a sexually transmitted infection (STI) in the last 12 months, used nitrites (poppers) in the last 12 months, and used methamphetamine in the last 12 months. Identifying as White, Asian, or African American compared to Hispanic was also associated with non-attendance. Bivariate analysis indicated that, of the MSM sampled at Gay Pride, 280/1095 = 25.57% received a hepatitis vaccination there. The MSM sampled at Gay Pride who reported engaging in UAI or having used any stimulant (cocaine, crack-cocaine, or methamphetamine) in the last 12 months were more likely to receive hepatitis vaccination on-site. The results provide evidence for the viability of

  3. Impact of Highly Active Antiretroviral Treatment on HIV Seroincidence Among Men Who Have Sex With Men: San Francisco

    PubMed Central

    Katz, Mitchell H.; Schwarcz, Sandra K.; Kellogg, Timothy A.; Klausner, Jeffrey D.; Dilley, James W.; Gibson, Steven; McFarland, William

    2002-01-01

    Objectives. This study assessed the countervailing effects on HIV incidence of highly active antiretroviral treatment (HAART) among San Francisco men who have sex with men (MSM). Methods. Behavioral risk was determined on the basis of responses to cross-sectional community interviews. HIV incidence was assessed through application of an enzyme-linked immunoassay testing strategy. Results. Use of HAART among MSM living with AIDS increased from 4% in 1995 to 54% in 1999. The percentage of MSM who reported both unprotected anal intercourse and multiple sexual partners increased from 24% in 1994 to 45% in 1999. The annual HIV incidence rate increased from 2.1% in 1996 to 4.2% in 1999 among MSM who sought anonymous HIV testing, and the rate was high (5.3%) but stable in a blinded survey of MSM seeking sexually transmitted disease services. Conclusions. Any decrease in per contact risk of HIV transmission due to HAART use appears to have been counterbalanced or overwhelmed by increases in the number of unsafe sexual episodes. (Am J Public Health. 2002;92:388–394) PMID:11867317

  4. Stigma and self-esteem across societies: avoiding blanket psychological responses to gay men experiencing homophobia

    PubMed Central

    Zervoulis, Karyofyllis; Lyons, Evanthia; Dinos, Sokratis

    2015-01-01

    Aims and method The relationship between homophobia (varying from actual and perceived to internalised) and measures of well-being is well documented. A study in Athens, Greece and London, UK attempted to examine this relationship in two cities with potentially different levels of homophobia. One-hundred and eighty-eight men who have sex with men (MSM) living in London and 173 MSM living in Athens completed a survey investigating their views on their sexuality, perceptions of local homophobia and their identity evaluation in terms of global self-esteem. Results The results confirmed a negative association between homophobia and self-esteem within each city sample. However, Athens MSM, despite perceiving significantly higher levels of local homophobia than London MSM, did not differ on most indicators of internalised homophobia and scored higher on global self-esteem than London MSM. The city context had a significant impact on the relationship. Clinical implications The findings are discussed in relation to the implications they pose for mental health professionals dealing with MSM from communities experiencing variable societal stigmatisation and its effect on a positive sense of self. PMID:26755948

  5. Stigma and self-esteem across societies: avoiding blanket psychological responses to gay men experiencing homophobia.

    PubMed

    Zervoulis, Karyofyllis; Lyons, Evanthia; Dinos, Sokratis

    2015-08-01

    Aims and method The relationship between homophobia (varying from actual and perceived to internalised) and measures of well-being is well documented. A study in Athens, Greece and London, UK attempted to examine this relationship in two cities with potentially different levels of homophobia. One-hundred and eighty-eight men who have sex with men (MSM) living in London and 173 MSM living in Athens completed a survey investigating their views on their sexuality, perceptions of local homophobia and their identity evaluation in terms of global self-esteem. Results The results confirmed a negative association between homophobia and self-esteem within each city sample. However, Athens MSM, despite perceiving significantly higher levels of local homophobia than London MSM, did not differ on most indicators of internalised homophobia and scored higher on global self-esteem than London MSM. The city context had a significant impact on the relationship. Clinical implications The findings are discussed in relation to the implications they pose for mental health professionals dealing with MSM from communities experiencing variable societal stigmatisation and its effect on a positive sense of self.

  6. Preferences for a Mobile HIV Prevention App for Men Who Have Sex With Men.

    PubMed

    Goldenberg, Tamar; McDougal, Sarah J; Sullivan, Patrick S; Stekler, Joanne D; Stephenson, Rob

    2014-10-29

    use a mobile HIV prevention app. Finally, men described the potential impact that a mobile HIV prevention app could have, identifying individual, interpersonal, and community-based benefits. In summary, participants described a comprehensive app that should incorporate innovative ideas to educate and engage men so that they would be motivated to use the app. In order for an app to be useful, it needs to feel safe and trustworthy, which is essential when considering the app's language and privacy. Participants provided a range of preferences for using an HIV prevention app, including what they felt MSM need with regards to HIV prevention and what they want in order to engage with an app. Making an HIV prevention app enjoyable and usable for MSM is a difficult challenge. However, the usability of the app is vital because no matter how great the intervention, if MSM do not use the app, then it will not be useful.

  7. Using Social Media to Increase HIV Testing Among Gay and Bisexual Men, Other Men Who Have Sex With Men, and Transgender Persons: Outcomes From a Randomized Community Trial.

    PubMed

    Rhodes, Scott D; McCoy, Thomas P; Tanner, Amanda E; Stowers, Jason; Bachmann, Laura H; Nguyen, Annie L; Ross, Michael W

    2016-06-01

    We tested an intervention designed to increase human immunodeficiency virus (HIV) testing among men who have sex with men and transgender persons within existing and commonly used social media. At follow-up, intervention communities had significantly higher past 12-month HIV testing than the comparison communities. Findings suggest that promoting HIV testing via social media can increase testing. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  8. Ethnic and gay community attachments and sexual risk behaviors among urban Latino young men who have sex with men.

    PubMed

    O'Donnell, Lydia; Agronick, Gail; San Doval, Alexi; Duran, Richard; Myint-U, Athi; Stueve, Ann

    2002-12-01

    Culturally relevant prevention programs are required to reduce HIV risk exposure of Latino young men who have sex with men (YMSM). As part of Hermanos Jóvenes, 465 Latino YMSM were surveyed at community venues of New York City outside the gay-identified area of lower Manhattan. We examined factors that influence ethnic and gay community attachments; the association between community attachments and social support in sexual matters; and the relationship between levels of attachment, social support in sexual matters, and sexual risk behaviors. Sixty-eight percent felt closely connected to their ethnic community; about 34% were highly attached to both neighborhood and New York City gay communities. Greater social support in sexual matters was associated with ethnic and gay community attachments. Latino YMSM connected to their ethnic community were about 40% less likely to report recent unprotected anal intercourse (UAI) with a male partner, and 60% less likely to have engaged in UAI during the last sexual contact with a nonmain male partner. Gay community attachment was not significantly related to risk behaviors. Findings point to the importance of ethnic ties and involving ethnic community organizations in HIV prevention efforts.

  9. Evidence-Based HIV/STD Prevention Intervention for Black Men Who Have Sex with Men

    PubMed Central

    Herbst, Jeffrey H.; Painter, Thomas M.; Tomlinson, Hank L.; Alvarez, Maria E.

    2015-01-01

    Summary This report summarizes published findings of a community-based organization in New York City that evaluated and demonstrated the efficacy of the Many Men, Many Voices (3MV) human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention intervention in reducing sexual risk behaviors and increasing protective behaviors among black men who have sex with men (MSM). The intervention addressed social determinants of health (e.g., stigma, discrimination, and homophobia) that can influence the health and well-being of black MSM at high risk for HIV infection. This report also highlights efforts by CDC to disseminate this evidence-based behavioral intervention throughout the United States. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion to provide an example of a program that might be effective for reducing HlV infection- and STD-related disparities in the United States. 3MV uses small group education and interaction to increase knowledge and change attitudes and behaviors related to HIV/STD risk among black MSM. Since its dissemination by CDC in 2004, 3MV has been used in many settings, including health department- and community-based organization programs. The 3MV intervention is an important component of a comprehensive HIV and STD prevention portfolio for at-risk black MSM. As CDC continues to support HIV prevention programming consistent with the National HIV/AIDS Strategy and its high-impact HIV prevention approach, 3MV will remain an important tool for addressing the needs of black MSM at high risk for HIV infection and other STDs. PMID:24743663

  10. Sampling gay men: Random Digit Dialing versus sources in the Gay Community.

    PubMed

    Meyer, I H; Colten, M E

    1999-01-01

    To assess the feasibility of obtaining a probability sample of gay/bisexual men using Random Digit Dialing (RDD), assess its validity, and describe differences between such a sample and a sample recruited from sources in the gay community. Two samples, one of men participating in an event at the Gay Community Center (N = 26) and one of randomly selected men (N = 52), were recruited by telephone in targeted New York City neighborhoods. A five-minute questionnaire for identifying gay/bisexual men was administered. Respondents who identified themselves as gay/bisexual were also asked about their gay identity and level of affiliation with the gay community. The screen questionnaire had excellent sensitivity (.96) in identifying gay/bisexual men. RDD sampling identified a high percent of gay/bisexual-identified men (29%). Gay/bisexual men identified through the RDD technique were qualitatively different from gay/bisexual men contacted through the gay community: they were less affiliated with the gay community, had higher levels of internalized homophobia, and differed in the attitudes they endorsed. To reduce bias imported by sampling highly affiliated respondents, RDD sampling techniques should, and can, be used in studies of gay/bisexual men.

  11. Optimizing Partner Notification Programs for Men Who Have Sex with Men: Factorial Survey Results from South China

    PubMed Central

    Tucker, Joseph D.; Chakraborty, Hrishikesh; Cohen, Myron S.; Chen, Xiang-Sheng

    2016-01-01

    Background Syphilis is prevalent among men who have sex with men (MSM) in China. Syphilis partner notification (PN) programs targeting MSM has been considered as one of effective strategies to prevention and control of the infection in the population. We examined willingness and preferences for PN among MSM to measure feasibility and optimize uptake. Methods Participation in a syphilis PN program was measured using a factorial survey from both the perspective of the index patient and the partner. Respondents were recruited from April-July 2011 using convenience sampling at two sites—a MSM sexually transmitted disease (STD) clinic and a MSM community based organization (CBO). Respondents first evaluated three factorial survey vignettes to measure probability of participation and then an anonymous sociodemographic questionnaire. A two-level mixed linear model was fitted for the factorial survey analysis. Results In 372 respondents with mean age (± SD) 28.5 (± 6.0) years, most were single (82.0%) and closeted gays (66.7%). The Internet was the most frequent place to search for sex. Few (31.2%) had legal names for casual partners, but most had instant messenger (86.5%) and mobile phone numbers (77.7%). The mean probability of participation in a syphilis PN program was 64.5% (± 32.4%) for index patients and 63.7% (± 32.6%) for partners. Referral of the partner to a private clinic or MSM CBO for follow-up decreased participation compared to the local Center for Disease Control and Prevention (CDC) or public STD clinic. Conclusions Enhanced PN services may be feasible among MSM in South China. Internet and mobile phone PN may contact partners untraceable by traditional PN. Referral of partners to the local CDC or public STD clinic may maximize PN participation. PMID:27462724

  12. Rapid assessment of drug-related HIV risk among men who have sex with men in three South African cities.

    PubMed

    Parry, Charles; Petersen, Petal; Dewing, Sarah; Carney, Tara; Needle, Richard; Kroeger, Karen; Treger, Latasha

    2008-05-01

    The current assessment was undertaken to examine the link between drug use and sexual risk behavior among men who have sex with men (MSM) in locations known to have high prevalence rates of drug use and sexual risk behavior in Cape Town, Durban and Pretoria, South Africa. Street intercepts and purposive snowball sampling were used to recruit drug-using MSM. A rapid assessment was undertaken which included observation, mapping, key informant interviews and focus group interviews with MSM. Drug using key informants were tested for HIV. The use of drugs like crack cocaine, cannabis and methamphetamine to specifically facilitate sexual encounters was evident. Drugs led to inconsistent condom use and other high-risk sexual activities despite HIV risk knowledge being high. Many injecting drug-using MSM shared needles and reused equipment. Among MSM who agreed to HIV testing, one-third tested positive. Views about drug and HIV treatment and preventive services and their efficacy were mixed. Various barriers to accessing services were highlighted including homosexual stigmatization and availability of drugs in treatment facilities. Recommendations include addressing the gap between HIV-risk knowledge and practice, extending VCT services for MSM, increasing the visibility of drug abuse services within communities, addressing concerns about drug availability in treatment centers as well as reintegration issues and the need for after-care services, reducing stigmatization in drug and HIV services for MSM and finally, strengthening the link between drug treatment services and HIV prevention by integrating HIV/drug-related risks into HIV prevention efforts and HIV risks into drug use prevention efforts.

  13. Validation of the 'drinking expectancy questionnaire for men who have sex with men' in Peru.

    PubMed

    Vagenas, Panagiotis; Wickersham, Jeffrey A; Calabrese, Sarah K; Lama, Javier R; Benites, Carlos M; Pun, Monica; Sanchez, Jorge; Altice, Frederick L

    2015-06-29

    Alcohol use disorders are highly prevalent among men who have sex with men (MSM) in Peru, where the HIV epidemic is concentrated 100-fold greater among MSM than in the general population. Drinking expectancies have been associated with the intent to drink and engage in high-risk behaviours. Assessing them in this population may uncover attractive intervention targets that in turn can be used to reduce problematic drinking and risky sexual behaviours. The drinking expectancy questionnaire for MSM (DEQ-MSM) was developed to accurately measure drinking expectancies, specifically among MSM. This study aimed to validate this instrument for the first time in Spanish, in South America and among MSM in Peru. To validate the DEQ-MSM among Spanish-speaking MSM in Peru, we used exploratory and confirmatory factor analysis in a sample of 5148 MSM, including 700 transgender women (TGW). Exploratory factor analysis showed a two-factor structure to the Spanish version of the DEQ-MSM (DEQ-MSM-S), which was similar for MSM and TGW. The reliability of the translated DEQ-MSM was excellent (α = 0.91). The DEQ-MSM-S was shown to be highly reliable in a large population of Peruvian MSM and TGW. This short instrument can be effectively integrated into research or clinical practice, in order to identify alcohol-consuming, high-risk MSM, who can then be directed for further screening and/or intervention. Future research should aim to associate the Spanish version of the DEQ-MSM with risky sexual behaviours among this population, in order to identify potential intervention targets. [Vagenas P, Wickersham JA, Calabrese SK, Lama JR, Benites CM, Pun M, Sanchez J, Altice FL. Validation of the 'drinking expectancy questionnaire for men who have sex with men' in Peru. Drug Alcohol Rev 2015]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  14. HIV Risk Perception, Sexual Behavior, and HIV Prevalence among Men-Who-Have-Sex-with-Men at a Community-Based Voluntary Counseling and Testing Center in Kuala Lumpur, Malaysia

    PubMed Central

    2014-01-01

    We describe the HIV risk perception, sexual behavior, and HIV prevalence among 423 men-who-have-sex-with-men (MSM) clients who received voluntary counseling and testing (VCT) services at a community-based center in Kuala Lumpur, Malaysia. The mean age was 29 years old. One hundred one (23.9%) clients rated themselves as low risk, 118 (27.9%) as medium risk, 36 (8.5%) as high risk, and 168 (39.7%) were unsure of their risk. Twenty-four (9.4%) clients tested HIV positive (4 (4%) low risk, 9 (7.6%) medium risk, 11 (30.6%) high risk, and 13 (7.7%) unsure risk). We found a positive correlation between risk perception and HIV infection in this study. Clients with high HIV risk perception have 17x the odds of testing HIV positive compared to low risk clients. High HIV risk perception was significantly associated with multiple sex partners, multiple types of sex partners, alcohol use before intercourse, unprotected sex beyond 6 months, and inconsistent condom use during anal sex compared to low risk clients. There were no statistically significant differences between medium risk and unsure risk clients compared to low risk clients. Strategies should be targeted towards change in sexual practices among those who are perceived to be at high risk. PMID:25053941

  15. Post-exposure prophylaxis use and recurrent exposure to HIV among men who have sex with men who use crystal methamphetamine

    PubMed Central

    Oldenburg, Catherine E.; Jain, Sachin; Mayer, Kenneth H.; Mimiaga, Matthew J.

    2014-01-01

    Background Men who have sex with men (MSM) who use crystal methamphetamine (CM) are at increased risk for HIV infection. Post-exposure prophylaxis (PEP) is a useful HIV prevention strategy if individuals are able to identify high-risk exposures and seek timely care, however to date there has been limited data on the use of PEP by CM users. Methods A retrospective cohort study of all PEP prescriptions (N=1,130 prescriptions among 788 MSM) at Fenway Community Health in Boston, MA was undertaken. Multivariable models were used to assess the association between CM use during exposure (7.4% used CM during exposure) and chronically (7.4% of MSM were chronic CM users) and individual-level and event-level outcomes among MSM who used PEP at least once. Results Compared to those who had not used CM, MSM PEP users who used CM more frequently returned for repeat PEP (aOR 5.13, 95%CI 2.82 to 9.34) and were significantly more likely to seroconvert over the follow-up period (aHR 3.61, 95%CI 1.51 to 8.60). MSM who used CM had increased odds of unprotected anal intercourse as the source of exposure (aOR 2.12, 95%CI 1.16 to 3.87) and knowing that their partner was HIV infected (aOR 2.27, 95%CI 1.42 to 3.64). Conclusions While MSM who use CM may have challenges accessing ART in general, these data highlight the fact that those who were able to access PEP subsequently remained at increased risk of HIV seroconversion Counseling and/or substance use interventions during the PEP course should be considered for CM-using MSM. PMID:25482500

  16. Post-exposure prophylaxis use and recurrent exposure to HIV among men who have sex with men who use crystal methamphetamine.

    PubMed

    Oldenburg, Catherine E; Jain, Sachin; Mayer, Kenneth H; Mimiaga, Matthew J

    2015-01-01

    Men who have sex with men (MSM) who use crystal methamphetamine (CM) are at increased risk for HIV infection. Post-exposure prophylaxis (PEP) is a useful HIV prevention strategy if individuals are able to identify high-risk exposures and seek timely care, however to date there has been limited data on the use of PEP by CM users. Retrospective cohort study of all PEP prescriptions (N=1130 prescriptions among 788 MSM) at Fenway Community Health in Boston, MA was undertaken. Multivariable models were used to assess the association between CM use during exposure (7.4% used CM during exposure) and chronically (7.4% of MSM were chronic CM users) and individual-level and event-level outcomes among MSM who used PEP at least once. Compared to those who had not used CM, MSM PEP users who used CM more frequently returned for repeat PEP (aOR 5.13, 95% CI 2.82 to 9.34) and were significantly more likely to seroconvert over the follow-up period (aHR 3.61, 95% CI 1.51 to 8.60). MSM who used CM had increased odds of unprotected anal intercourse as the source of exposure (aOR 2.12, 95% CI 1.16 to 3.87) and knowing that their partner was HIV infected (aOR 2.27, 95% CI 1.42 to 3.64). While MSM who use CM may have challenges accessing ART in general, these data highlight the fact that those who were able to access PEP subsequently remained at increased risk of HIV seroconversion. Counseling and/or substance use interventions during the PEP course should be considered for CM-using MSM. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Condom use and HIV testing among men who have sex with men in Jordan

    PubMed Central

    Alkaiyat, Abdulsalam; Schaetti, Christian; Liswi, Mohammad; Weiss, Mitchell G

    2014-01-01

    Introduction To identify sociocultural determinants of self-reported condom use and HIV testing and examine variables related to accessibility, motivation and obstacles among men who have sex with men (MSM) in Jordan. Design Cross-sectional study among MSM who were identified through services of a local non-governmental organization (NGO). Methods Respondents were studied with a semi-structured interview based on the Explanatory Model Interview Catalogue (EMIC) framework. The vignette-based EMIC interview considered locally relevant HIV/AIDS-related knowledge, risk perception and perceived causes, as well as awareness of services and sources of support. Results Of the 97 respondents, 27% reported that they used a condom at last intercourse; 38% had been tested at least once for HIV. Positive determinants of condom use were higher education level, acknowledging MSM as a high-risk group, seeking advice from a medical doctor and the perceived causes “sex with prostitutes” and “sex with animals.” Awareness of available treatment was a positive determinant of HIV testing. Blood transfusion as a perceived cause and asking advice from friends were negative determinants. Conclusions Jordanian MSM seem to be aware of the risk of HIV infection and effective prevention methods, and they are willing to be tested for HIV. Our findings addressed the importance of the sexual meaning of HIV/AIDS on the control of HIV/AIDS among MSM. More effective engagement of NGOs and MSM in the prevention and control of HIV/AIDS is needed, enlisting the support of medical doctors and community health workers. Peer education should be strategically strengthened. Political commitment is needed to mitigate social stigma. PMID:24695243

  18. Engaging Men as Promotores de Salud: Perceptions of Community Health Workers among Latino Men in North Carolina*

    PubMed Central

    Villa-Torres, Laura; Fleming, Paul; Barrington, Clare

    2016-01-01

    The promotor de salud, or community health worker (CHW) role, is highly feminized and little is known about how men view their participation in CHW programs. We conducted in-depth interviews with Latino men in North Carolina to explore this gap. We used systematic coding and display procedures informed by Grounded Theory to analyze the data. Men described their communities as lacking cohesion, making integration of Latino immigrants difficult. Most did not consider themselves leaders or feel they had leaders in their communities. Their perceptions of the feminized CHW role as well as the volunteer or low-paid nature of CHW work conflicted with men’s provider role. They also did not think they could perform the CHW role because they lacked education, skills, and broad networks. Efforts to increase male participation in CHW programs in new Latino immigrant destinations will need to understand and address these gender and migration-related dynamics in order to engage both women and men in improving the health of their communities. PMID:24989349

  19. Willingness to Participate in HIV Vaccine Trials among Men Who Have Sex with Men in Chennai and Mumbai, India: A Social Ecological Approach

    PubMed Central

    Chakrapani, Venkatesan; Newman, Peter A.; Singhal, Neeti; Jerajani, Jhalak; Shunmugam, Murali

    2012-01-01

    Background Recruitment of low- and middle-income country volunteers from most-at-risk populations in HIV vaccine trials is essential to vaccine development. In India, men who have sex with men (MSM) are at disproportionately high risk for HIV infection and an important population for trial recruitment. Investigations of willingness to participate (WTP) in HIV vaccine trials have focused predominantly on individual-level determinants. We explored multi-level factors associated with WTP among MSM in India. Methods We conducted 12 focus groups (n = 68) with low socioeconomic MSM in Chennai and Mumbai, and 14 key informant interviews with MSM community leaders and service providers. Focus groups/interviews were recorded, transcribed and translated into English. Two bilingual investigators conducted thematic analysis using line-by-line coding and a constant comparative method, with member-checking by community representatives. Results Factors associated with WTP were evidenced across the social ecology of MSM–social-structural: poverty, HIV-, sexual- and gender non-conformity stigma, institutionalized discrimination and government sponsorship of trials; community-level: endorsement by MSM community leaders and organizations, and fear of within-group discrimination; interpersonal: anticipated family discord, partner rejection, having financially-dependent family members and disclosure of same-sex sexuality; and individual-level: HIV vaccine trial knowledge and misconceptions, safety concerns, altruism and preventive misconception. Conclusion Pervasive familial, community and social-structural factors characteristic of the Indian sociocultural context may complicate individual-focused approaches to WTP and thereby constrain the effectiveness of interventions to support recruitment and retention in HIV vaccine trials. Interventions to reduce stigma and discrimination against MSM and people living with HIV, capacity-building of MSM community organizations and

  20. [Analysis of quality of life and its influencing factors among MSM].

    PubMed

    Chen, Jiangpeng; Wang, Hong; Liao, Zijun; Han, Mingming; Liu, Liang; Xiong, Weixiang

    2014-01-01

    To investigate the quality of life ( QOL) and its influencing factors among men who have sex with men ( MSM) in Chongqing city. Snowball sampling and internet investigation techniques were applied to recruit MSM and 803 MSM in Chongqing were collected. The WHOQOL-BREF and SSRS questionnaire were used among MSM. Scores of the physiological domain, psychological domain, social relation domain, environmental domain and total score of QOL were (14. 03 +/- 2. 14) (13.38 +/- 2.44), (13.45 +/- 2.88), (12.52 +/- 2.48) and (13.29 +/- 2.05), respectively. Except for the environmental domain, scores of other domains of MSM were lower than that of common residents. The factors of social support and the domains of the quality of life were positive correlation. The multivariate analysis indicated that the main factors involved in influenced the QOL of the MSM were monthly income and scores of total social support. Frequency of condom, objective support, presence of regular homo-sex partners, the number of friends in gay circles, presence of regular sexual partner, the situation of only child,utilization of support, profession, knowing the VCT or not,native place had impacts on a few domains of the QOL. According to different demographic characteristics, and combining HIV health education and psychological intervention is helpful to improve the quality of life among MSM.

  1. HIV testing among MSM in Bogotá, Colombia: The role of structural and individual characteristics

    PubMed Central

    Reisen, Carol A.; Zea, Maria Cecilia; Bianchi, Fernanda T.; Poppen, Paul J.; del Río González, Ana Maria; Romero, Rodrigo A. Aguayo; Pérez, Carolin

    2014-01-01

    This study used mixed methods to examine characteristics related to HIV testing among men who have sex with men (MSM) in Bogotá, Colombia. A sample of 890 MSM responded to a computerized quantitative survey. Follow-up qualitative data included 20 in-depth interviews with MSM and 12 key informant interviews. Hierarchical logistic set regression indicated that sequential sets of variables reflecting demographic characteristics, insurance coverage, risk appraisal, and social context each added to the explanation of HIV testing. Follow-up logistic regression showed that individuals who were older, had higher income, paid for their own insurance, had had a sexually transmitted infection, knew more people living with HIV, and had greater social support were more likely to have been tested for HIV at least once. Qualitative findings provided details of personal and structural barriers to testing, as well as interrelationships among these factors. Recommendations to increase HIV testing among Colombian MSM are offered. PMID:25068180

  2. Depression and Social Stigma Among MSM in Lesotho: Implications for HIV and Sexually Transmitted Infection Prevention.

    PubMed

    Stahlman, Shauna; Grosso, Ashley; Ketende, Sosthenes; Sweitzer, Stephanie; Mothopeng, Tampose; Taruberekera, Noah; Nkonyana, John; Baral, Stefan

    2015-08-01

    Social stigma is common among men who have sex with men (MSM) across Sub-Saharan Africa, and may influence risks for HIV and sexually transmitted infections (STIs) via its association with depression. We conducted a cross-sectional study of 530 MSM in Lesotho accrued via respondent-driven sampling. Using generalized structural equation models we examined associations between stigma, social capital, and depression with condom use and testing positive for HIV/STIs. Depression was positively associated with social stigma experienced or perceived as a result of being MSM. In contrast, increasing levels of social cohesion were negatively associated with depression. Social stigma was associated with testing positive for HIV; however, this association did not appear to be mediated by depression or condom use. These data suggest a need for integrated HIV and mental health care that addresses stigma and discrimination and facilitates positive social support for MSM.

  3. [Review on the association between social culture and HIV prevalence among MSM in China].

    PubMed

    He, Huijing; Lyu, Fan

    2015-11-01

    Social culture have significant influence on HIV transmission. Men who have sex with men (MSM), have their own sub-culture, by which made them very different with other population in social norm, behavior mode, as well as some HIV related behavior and the disease transmission risk. Up to date, study focused on the association between social culture and HIV transmission among MSM was limited, thus we reviewed relevant studies in the view of social culture and sub-culture of MSM, analyzed how social culture could potentially influence HIV transmission, and how sub-culture could affect MSM's friend-making, HIV risk behaviors in three aspects including social identity, social norm and social development. Furthermore, we provided some recommendations and suggestions on the future work.

  4. Depression and Social Stigma among MSM in Lesotho: Implications for HIV and Sexually Transmitted Infection Prevention

    PubMed Central

    Stahlman, Shauna; Grosso, Ashley; Ketende, Sosthenes; Sweitzer, Stephanie; Mothopeng, Tampose; Taruberekera, Noah; Nkonyana, John; Baral, Stefan

    2016-01-01

    Social stigma is common among men who have sex with men (MSM) across Sub-Saharan Africa, and may influence risks for HIV and sexually transmitted infections (STIs) via its association with depression. We conducted a cross-sectional study of 530 MSM in Lesotho accrued via respondent-driven sampling. Using generalized structural equation models we examined associations between stigma, social capital, and depression with condom use and testing positive for HIV/STIs. Depression was positively associated with social stigma experienced or perceived as a result of being MSM. In contrast, increasing levels of social cohesion were negatively associated with depression. Social stigma was associated with testing positive for HIV; however, this association did not appear to be mediated by depression or condom use. These data suggest a need for integrated HIV and mental health care that addresses stigma and discrimination and facilitates positive social support for MSM. PMID:25969182

  5. The men's health forum: an initiative to address health disparities in the community.

    PubMed

    Grant, Cathy G; Davis, Jenna L; Rivers, Brian M; Rivera-Colón, Venessa; Ramos, Roberto; Antolino, Prado; Harris, Erika; Green, B Lee

    2012-08-01

    Racial/ethnic, socioeconomic, and gender disparities in health and access to and use of health care services currently exist. Health professionals are continually striving to reduce and eliminate health disparities within their own community. One such effort in the area of Tampa Bay, Florida was the creation of the African American Men's Health Forum, currently referred to as the Men's Health Forum. The African American Men's Health Forum was the result of the community's desire to reduce the gap in health outcomes for African American men. Later, it was recognized that the gap in health outcomes impacts other communities; therefore, it was broadened to include all men considered medically underserved (those who are uninsured, underinsured, or without a regular health care provider). The Men's Health Forum empowers men with the resources, knowledge, and information to effectively manage their health by providing health education and screenings to the community. This article provides an explanation of the key components that have contributed to the success of the Men's Health Forum, including challenges and lessons learned. It is intended that this information be replicated in other communities in an effort to eliminate health disparities.

  6. The Association of HIV Stigma and HIV/STD Knowledge With Sexual Risk Behaviors Among Adolescent and Adult Men Who Have Sex With Men in Ghana, West Africa.

    PubMed

    Nelson, LaRon E; Wilton, Leo; Agyarko-Poku, Thomas; Zhang, Nanhua; Aluoch, Marilyn; Thach, Chia T; Owiredu Hanson, Samuel; Adu-Sarkodie, Yaw

    2015-06-01

    Ghanaian men who have sex with men (MSM) have a high HIV seroprevalence, but despite a critical need to address this public health concern, research evidence has been extremely limited on influences on sexual risk behavior among MSM in Ghana. To investigate associations between HIV/STD knowledge, HIV stigma, and sexual behaviors in a sample of MSM in Ghana, we conducted a secondary data analysis of cross-sectional survey data from a non-probability sample of Ghanaian MSM (N = 137). Nearly all the men (93%) had more than one current sex partner (M = 5.11, SD = 7.4). Of those reported partners, the average number of current female sexual partners was 1.1 (SD = 2.6). Overall, knowledge levels about HIV and STDs were low, and HIV stigma was high. There was no age-related difference in HIV stigma. Younger MSM (≤25 years) used condoms less often for anal and vaginal sex than did those over 25. Relative frequency of condom use for oral sex was lower in younger men who had higher STD knowledge and also was lower in older men who reported high HIV stigma. Knowledge and stigma were not associated with condom use for anal or vaginal sex in either age group. These descriptive data highlight the need for the development of intervention programs that address HIV/STD prevention knowledge gaps and reduce HIV stigma in Ghanaian communities. Intervention research in Ghana should address age-group-specific HIV prevention needs of MSM youth.

  7. Prevalence, correlates and trends in seroadaptive behaviours among men who have sex with men from serial cross-sectional surveillance in San Francisco, 2004-2011.

    PubMed

    Snowden, Jonathan M; Wei, Chongyi; McFarland, Willi; Raymond, H Fisher

    2014-09-01

    We sought to assess the prevalence and correlates of seroadaptive behaviours (i.e., sexual history incorporating some unprotected anal intercourse (UAI)) and conventional risk reduction behaviours (i.e., consistent condom use or no anal intercourse) among men who have sex with men (MSM) in San Francisco in 2011. We compared the prevalence of seroadaptive behaviours between serial cross-sectional surveys from 2004, 2008 and 2011. We analysed data from the 2011 wave of the National HIV Behavioral Surveillance system in San Francisco. We categorised men's self-reported sexual behaviour history in the past 6 months into a schema of seroadaptive behaviours and conventional risk reduction behaviours. We compared the prevalence of behaviour categories by self-reported HIV serostatus, HIV testing history, awareness of pre-exposure HIV prophylaxis (PrEP) and diagnosis of a sexually transmitted infection (STI). Seroadaptive behaviours remained common in San Francisco MSM, with a 2011 prevalence of 46.6%, up from 35.9% in 2004. Consistent condom use or no anal intercourse was more common than seroadaptive behaviours in HIV-negative MSM, men who had not heard of PrEP and men without an STI diagnosis. Seroadaptive behaviours increased from 2004 to 2011. HIV seroadaptive behaviours remain common in San Francisco MSM, have increased in the last decade and are practiced differently by MSM with different sexual health knowledge and outcomes. Public health researchers and officials should continue to document the prevalence, intentionality, efficacy and safety of seroadaptive behaviours among diverse communities of MSM. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Bisexual behavior and infection with HIV and syphilis among men who have sex with men along the east coast of China.

    PubMed

    Liao, Meizhen; Kang, Dianming; Jiang, Baofa; Tao, Xiaorun; Qian, Yueshen; Wang, Tongzhan; Bi, Zhenqiang; Xiao, Yan; Li, Chunmei; Wu, Pingsheng; Vermund, Sten H; Jia, Yujiang

    2011-11-01

    This study examined the correlates of bisexual behavior and infection with HIV/syphilis among men who have sex with men only (MSM-only) and those who have sex with both men and women (MSMW) in Shandong, China. Cross-sectional surveys probed sociodemographic information, sexual and drug use behaviors, knowledge, and use of prevention services; blood samples were tested for HIV/syphilis status. Of 2996 participants, 39.5% acknowledged being MSMW; 60.5% being MSM-only; 2.5% were HIV-infected with similar rates for MSMW (2.5%) and MSM-only (2.6%); 5.5% syphilis-infected with comparable rates for MSMW (5.6%) and MSM-only (5.5%). In multivariable models, MSMW were more likely than MSM-only to be older, local residents, recruited from outdoor cruising area, drug users, and less likely to have used a condom during last anal sex with a male partner. HIV-infected MSMW were more likely to have syphilis and other sexually transmitted diseases (STDs) and less likely to have received peer education. HIV-infected MSM-only were more likely to be older, nonlocal residents, and have syphilis and other STDs. MSMW with syphilis were more likely to be recruited from Jinan, Qingdao, and Zibo (versus Yantai), infected with HIV, and less likely to have received lubricant promotion. MSM-only with syphilis were more likely to be recruited from Jinan and Qingdao (versus Yantai), drug users, infected with HIV, and have had sex with male partners in the past 6 months. High prevalence of bisexual behavior and HIV/other STDs with common unprotected sex and multiple sexual partners among Shandong's gay community revealed in this study highlighted the importance of bisexuals as a potential epidemiologic bridge. Further research is needed to investigate the impact of bisexual behaviors on population transmission.

  9. Syphilis and MSM (Men Who Have Sex with Men)

    MedlinePlus

    ... be spread through contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils. ... to each other about their HIV status and history of other STDs so that preventive action can ...

  10. Experiences of discrimination and their impact on the mental health among African American, Asian and Pacific Islander, and Latino men who have sex with men.

    PubMed

    Choi, Kyung-Hee; Paul, Jay; Ayala, George; Boylan, Ross; Gregorich, Steven E

    2013-05-01

    We examined the associations between specific types and sources of discrimination and mental health outcomes among US racial/ethnic minority men who have sex with men (MSM) and how these associations varied by race/ethnicity. A chain-referral sample of 403 African American, 393 Asian and Pacific Islander (API), and 400 Latino MSM recruited in Los Angeles County, California completed a standardized questionnaire. Data were obtained from the Ethnic Minority Men's Health Study from May 2008 to October 2009. Past-year experiences of racism within the general community and perceived homophobia among heterosexual friends were positively associated with depression and anxiety. Past-year homophobia experienced within the general community was also positively associated with anxiety. These statistically significant associations did not vary across racial/ethnic groups. The positive association of perceived racism within the gay community with anxiety differed by race/ethnicity, and was statistically significant only for APIs. Perceived homophobia within the family was not associated with either depression or anxiety. Higher levels of experiences of discrimination were associated with psychological distress among MSM of color. However, specific types and sources of discrimination were differentially linked to negative mental health outcomes among African American, API, and Latino MSM.

  11. Accessing HIV Testing and Treatment among Men Who Have Sex with Men in China: A Qualitative Study

    PubMed Central

    Wei, Chongyi; Yan, Hongjing; Yang, Chuankun; Raymond, H. Fisher; Li, Jianjun; Yang, Haitao; Zhao, Jinkou; Huan, Xiping; Stall, Ron

    2013-01-01

    Barriers to HIV testing and HIV care and treatment pose significant challenges to HIV prevention among men who have sex with men (MSM) in China. We carried out a qualitative study to identify barriers and facilitators to HIV testing and treatment among Chinese MSM. In 2012, 7 focus group discussions were conducted with 49 MSM participants in Nanjing, China. Purposive sampling was used to recruit a diverse group of MSM participants. Semi-structured interviews were conducted to collect FG data. Major barriers to testing included gay- and HIV-related stigma and discrimination, relationship type and partner characteristics, low perception of risk or threat, HIV is incurable or equals death, concerns of confidentiality, unaware that testing is offered for free, and name-based testing. Key facilitators of testing included engaging in high-risk sex, sense of responsibility for partner, collectivism, testing as a part of standard/routine medical care, MSM-friendly medical personnel, increased acceptance of gay/bisexual men by the general public, legal recognition and protection of homosexuals, and home self-testing. Barriers to treatment included negative coping, non-disclosure to families, misconceptions of domestically produced antiretroviral drugs and the benefits of treatment, and costs associated with long-term treatment. Facilitators of treatment included sense of hopefulness that a cure would be found, the cultural value of longevity, peer social support and professional psychological counseling, affordable and specialized treatment and care, and reduced HIV-related stigma and discrimination. Finally, for both testing and treatment, more educational and promotional activities within MSM communities and among the general public are needed. PMID:23909807

  12. Accessing HIV testing and treatment among men who have sex with men in China: a qualitative study.

    PubMed

    Wei, Chongyi; Yan, Hongjing; Yang, Chuankun; Raymond, H Fisher; Li, Jianjun; Yang, Haitao; Zhao, Jinkou; Huan, Xiping; Stall, Ron

    2014-01-01

    Barriers to HIV testing and HIV care and treatment pose significant challenges to HIV prevention among men who have sex with men (MSM) in China. We carried out a qualitative study to identify barriers and facilitators to HIV testing and treatment among Chinese MSM. In 2012, seven focus group (FG) discussions were conducted with 49 MSM participants in Nanjing, China. Purposive sampling was used to recruit a diverse group of MSM participants. Semi-structured interviews were conducted to collect FG data. Major barriers to testing included gay- and HIV-related stigma and discrimination, relationship type and partner characteristics, low perception of risk or threat, HIV is incurable or equals death, concerns of confidentiality, unaware that testing is offered for free, and name-based testing. Key facilitators of testing included engaging in high-risk sex, sense of responsibility for partner, collectivism, testing as a part of standard/routine medical care, MSM-friendly medical personnel, increased acceptance of gay/bisexual men by the general public, legal recognition and protection of homosexuals, and home self-testing. Barriers to treatment included negative coping, nondisclosure to families, misconceptions of domestically produced antiretroviral drugs (ARVs) and the benefits of treatment, and costs associated with long-term treatment. Facilitators of treatment included sense of hopefulness that a cure would be found, the cultural value of longevity, peer social support and professional psychological counseling, affordable and specialized treatment and care, and reduced HIV-related stigma and discrimination. Finally, for both testing and treatment, more educational and promotional activities within MSM communities and among the general public are needed.

  13. Sexual risk and HIV prevention behaviours among African-American and Latino MSM social networking users.

    PubMed

    Young, Sean D; Szekeres, Greg; Coates, Thomas

    2013-08-01

    This study explores the feasibility of recruiting minority men who have sex with men Facebook users for human immunodeficiency virus (HIV) prevention studies and notes demographic and sexual risk behaviours. Facebook-registered men who have sex with men (MSM; N = 118) were recruited using online and offline methods. Participants validated Facebook-user status through using a Facebook Connect (computer science) application. Participants were primarily Latino (60.2%) and African-American (28.0%), with 33.1% using social media to find sex partners. Black MSM social networking users reported engaging in a lower frequency (coefficient = -0.48, p < 0.05) of unprotected receptive anal intercourse compared to Latino MSM. Results suggest that minority social media users can be recruited for HIV studies and that sexual risk behavioural differences exist among minority social networking users. Findings highlight the importance of incorporating technologies into population-focused HIV interventions.

  14. MSM and drug use: A latent class analysis of drug use and related sexual risk behaviors.

    PubMed

    McCarty-Caplan, David; Jantz, Ian; Swartz, James

    2014-07-01

    This study examined patterns of drug use among gay men and other men who have sex with men (MSM) to identify sub-categories of men whose drug use and sexual behavior place them at especially high risk for HIV. A latent class analysis of a sample of MSM yielded a four-class model with two distinct high drug use sub-groups: one whose drug use concentrated on "sex-drugs" (SDU); and a distinct polydrug use class that showed higher probabilities of using all other drugs assessed. Comparative follow-up analyses indicated the SDU group was also more likely to engage in particular potentially high-risk sexual behaviors, be older, and to be HIV positive. Implications of distinguishing between patterns of drug use for HIV-risk prevention efforts with MSM are discussed.

  15. Anthropological Assessment for Culturally Appropriate Interventions Targeting Men Who Have Sex With Men

    PubMed Central

    Silenzio, Vincent M. B.

    2003-01-01

    Although social and cultural factors play a fundamental role in the health of sexual minority populations and the development of culturally appropriate interventions, public health activities and research have sometimes lacked appropriate sophistication or attention to issues of cultural competency. In areas such as HIV prevention for men who have sex with men (MSM), biomedical interpretations of same-sex phenomena should be applied with caution. Communities and societies may broadly understand same-sex desire, attraction, behavior, and identity through age-structured/initiatory, gender-defined, profession/social role–defined, or egalitarian/gay frameworks. When more detailed, locally specific information is required, such as for youth, ethnic minorities, or urban versus rural populations, the approach to rapid anthropological assessment presented can provide nuanced insights for effective health programs targeting MSM. PMID:12773342

  16. Aspects of the Student Engagement of African American Men in Community College

    ERIC Educational Resources Information Center

    Romney, Paulette B.

    2012-01-01

    High attrition rates of African American college students' is a continuing concern of higher education administrators. This is particularly true of African American men attending community college. African American men consistently experience low levels of scholastic achievement as a result of entering college underprepared, with academic deficits…

  17. Aspects of the Student Engagement of African American Men in Community College

    ERIC Educational Resources Information Center

    Romney, Paulette B.

    2012-01-01

    High attrition rates of African American college students' is a continuing concern of higher education administrators. This is particularly true of African American men attending community college. African American men consistently experience low levels of scholastic achievement as a result of entering college underprepared, with academic deficits…

  18. Behavioural, not biological, factors drive the HCV epidemic among HIV-positive MSM: HCV and HIV modelling analysis including HCV treatment-as-prevention impact.

    PubMed

    MacGregor, Louis; Martin, Natasha K; Mukandavire, Christinah; Hickson, Ford; Weatherburn, Peter; Hickman, Matthew; Vickerman, Peter

    2017-06-12

    Uncertainty surrounds why hepatitis C virus (HCV) is concentrated among HIV-positive men who have sex with men (MSM). We used mathematical modelling to explore reasons for these infection patterns, and implications for HCV treatment-as-prevention. Using a joint MSM HIV/HCV transmission model parameterized with UK behavioural data, we considered how biological (heightened HCV infectivity and reduced spontaneous clearance among HIV-positive MSM) and/or behavioural factors (preferential sexual mixing by HIV status and risk heterogeneity) could concentrate HCV infection in HIV-positive MSM as commonly observed (5-20 times the HCV prevalence in HIV-negative MSM; defined as the HCV ratio). We explored how HCV treatment-as-prevention impact varies under differing HCV ratios. Biological factors produced low HCV ratios (< 3), not explaining the skewed epidemic. However, combining preferential mixing by HIV status with sexual risk behaviour heterogeneity produced high HCV ratios (> 10) that were highly sensitive to both factors. Irrespective of the HCV ratio or behavioural/biological factors, HCV treatment of HIV-diagnosed MSM markedly reduced the HCV prevalence among HIV-positive MSM, but less impact was achieved among all MSM for lower HCV ratios. Sexual behaviour patterns likely drive observed HCV infection patterns among HIV-positive MSM. Changes in these patterns could disseminate HCV amongst HIV-negative MSM, limiting the impact of targeting HCV treatment to HIV-diagnosed MSM.

  19. An HIV Intervention Tailored for Black Young Men Who Have Sex with Men in the House Ball Community

    PubMed Central

    Hosek, Sybil G.; Lemos, Diana; Hotton, Anna L.; Fernandez, M. Isabel; Telander, Kyle; Bell, Margo; Footer, Dana

    2014-01-01

    Black young men who have sex with men (BYMSM) are the group most disproportionately impacted by HIV in the United States and most in need of efficacious interventions to address community-level factors that increase their vulnerability to HIV. The House Ball Community (HBC) is a distinct social network within the larger BYMSM community that may be particularly vulnerable to social norms and stigma around HIV. This study tailored an evidence-based, community-level popular opinion leader (OL) intervention for use within the HBC. The intervention, called POSSE, was then piloted to evaluate feasibility, acceptability and preliminary efficacy. Recruiting opinion leaders from the community and training them to deliver risk reduction messages was found to be feasible and highly acceptable. Community-level surveys (n=406) were completed over 5 waves of data collection. Overall exposure to the intervention increased across waves. Statistically significant (p < .05) declines were observed for multiple sexual partners, condomless anal intercourse with any male partners and with male partners of unknown HIV status. HIV stigma declined as well, but the trend was not statistically significant. PMID:25300319

  20. Developing a Conceptual Framework of Seroadaptive Behaviors in HIV-Diagnosed Men Who Have Sex With Men

    PubMed Central

    Rönn, Minttu; White, Peter J.; Hughes, Gwenda; Ward, Helen

    2014-01-01

    Background. Seroadaptive behaviors are strategies employed by men who have sex with men (MSM) to reduce the transmission risk for human immunodeficiency virus (HIV). It has been suggested that they contribute to the increasing diagnoses of sexually transmitted infections in HIV-diagnosed MSM. To understand the context in which the reemerging sexually transmitted infections appear, we developed a social epidemiological model incorporating the multiple factors influencing seroadaptive behaviors. Methods. A literature review of seroadaptive behaviors in HIV-diagnosed MSM was conducted. The literature was synthesized using a social epidemiological perspective. Results. Seroadaptive behaviors are adopted by MSM in high-income countries and are a way for HIV-diagnosed men to manage and enjoy their sexual lives. Influences are apparent at structural, community, interpersonal, and intrapersonal levels. There is little evidence of whether and when the behavior forms part of a premeditated strategy; it seems dependent on the social context and on time since HIV diagnosis. Social rules of HIV disclosure and perception of risk depend on the setting where partners are encountered. Conclusions. Seroadaptive behaviors are strongly context dependent and can reduce or increase transmission risk for different infectious diseases. Further data collection and mathematical modeling can help us explore the specific conditions in more detail. PMID:25381379

  1. Self-Reported Sexual Assault in Convicted Sex Offenders and Community Men

    PubMed Central

    Widman, Laura; Olson, Michael A.; Bolen, Rebecca M.

    2013-01-01

    Although self-reported sexual assault perpetrated by men against women has been well documented among college men, less is known about self-reported perpetration among convicted sex offenders and community men. This study provides unique descriptive and comparative information on sexual assaults in these understudied populations. Participants were 40 convicted sex offenders and 49 demographically-comparable community men who completed the Sexual Experiences Survey (SES; Abbey, Parkhill, & Koss, 2005; Koss, Gidycz, & Wisniewski, 1987) and other surveys to capture the promiscous sex and hostile masculinity pathways posited by the confluence model (Malamuth, 2003). We found notably few differences between sex offenders and community men in the rate and severity of sexual assault perpetration and the tactics used to obtain unwanted sexual contact. Specifically, 68% of sex offenders and 59% of community men acknowledged they had perpetrated sexual assault. Both groups used guilt and anger as the most frequent tactics to obtain unwanted sexual activity from their female victims. Consistent with the confluence model, an impersonal orientation towards sexual relationships was associated with sexual assault for both sex offenders and community men. Future directions for research on sexual assault perpetration and violence prevention efforts are discussed in light of these findings. PMID:23262829

  2. Self-reported sexual assault in convicted sex offenders and community men.

    PubMed

    Widman, Laura; Olson, Michael A; Bolen, Rebecca M

    2013-05-01

    Although self-reported sexual assault perpetrated by men against women has been well documented among college men, less is known about self-reported perpetration among convicted sex offenders and community men. This study provides unique descriptive and comparative information on sexual assaults in these understudied populations. Participants were 40 convicted sex offenders and 49 demographically comparable community men who completed the Sexual Experiences Survey (SES; Abbey, Parkhill, & Koss, 2005; Koss, Gidycz, & Wisniewski, 1987) and other surveys to capture the promiscuous sex and hostile masculinity pathways posited by the confluence model (Malamuth, 2003). We found notably few differences between sex offenders and community men in the rate and severity of sexual assault perpetration and the tactics used to obtain unwanted sexual contact. Specifically, 68% of sex offenders and 59% of community men acknowledged they had perpetrated sexual assault. Both groups used guilt and anger as the most frequent tactics to obtain unwanted sexual activity from their female victims. Consistent with the confluence model, an impersonal orientation toward sexual relationships was associated with sexual assault for both sex offenders and community men. Future directions for research on sexual assault perpetration and violence prevention efforts are discussed in light of these findings.

  3. A Syndemic including Cigarette Smoking and Sexual Risk Behaviors among a Sample of MSM in Shanghai, China

    PubMed Central

    Yu, F; Nehl, EJ; Zheng, T; He, N; Berg, CJ; Lemieux, AF; Lin, L; Tran, A; Sullivan, PS; Wong, FY

    2013-01-01

    Objectives We explored possible correlates of cigarette smoking and their associations with levels of smoking among a sample of Chinese men who have sex with men (MSM). We also explored the syndemic associations of substance use and psychosocial problems on sexual risk behaviors. Methods Cross-sectional data collection from 404 MSM in Shanghai, China. Results MSM exhibit a high prevalence of smoking (66.3%). Both light and heavy smoking were associated with alcohol and drug use, depression, intimate partner violence, sexual attitudes, and gay identity (though the associations for light smokers were moderate compared to those for heavy smokers). Conclusions Our findings indicate the presence of a health syndemic among MSM, and suggest that smoking prevention and cessation and other substance abuse interventions should be integrated into efforts preventing sexual risk behaviors among MSM. PMID:23517682

  4. Community-based Men's Sheds: promoting male health, wellbeing and social inclusion in an international context.

    PubMed

    Cordier, Reinie; Wilson, Nathan J

    2014-09-01

    Males experience greater mortality and morbidity than females in most Western countries. The Australian and Irish National Male Health Policies aim to develop a framework to address this gendered health disparity. Men's Sheds have a distinct community development philosophy and are thus identified in both policies as an ideal location to address social isolation and positively impact the health and wellbeing of males who attend. The aim of this international cross-sectional survey was to gather information about Men's Sheds, the people who attend Men's Sheds, the activities at Men's Sheds, and the social and health dimensions of Men's Sheds. Results demonstrate that Men's Sheds are contributing a dual health and social role for a range of male subgroups. In particular, Men's Sheds have an outward social focus, supporting the social and mental health needs of men; health promotion and health literacy are key features of Men's Sheds. Men's Sheds have an important role to play in addressing the gendered health disparity that males face. They serve as an exemplar to health promotion professionals of a community development context where the aims of male health policy can be actualized as one part of a wider suite of global initiatives to reduce the gendered health disparity.

  5. Chlamydia trachomatis genotypes among men who have sex with men in Australia.

    PubMed

    Twin, Jimmy; Moore, Elya E; Garland, Suzanne M; Stevens, Matthew P; Fairley, Christopher K; Donovan, Basil; Rawlinson, William; Tabrizi, Sepehr N

    2011-04-01

    Chlamydia trachomatis is a common bacterial sexually transmitted infection in men who have sex with men (MSM), although little is known about its distribution in Australian MSM communities. From 2004 to 2008, 612 consecutive C. trachomatis positive anal swab and urine samples were collected for genotyping and quantification from MSM attending 2 sexual health centers (Melbourne and Sydney). The most common serovars detected were D (35.2%), G (32.7%), and J (17.7%), although these distributions changed significantly by year and city. C. trachomatis infections (2.8%) involved more than 1 serovar and only 1 lymphogranuloma venereum isolate was detected. The majority of serovar strains showed an identical omp1 genotype, with only 7.5% showing genotypic variability. Serovar G infections were not associated with overseas sexual activity; whilst individuals with serovar J were less likely to have had a prior C. trachomatis infection, and with serovar E were those who had prior C. trachomatis infection. Symptoms were present in 68% of urethral infections and 28% anal infections, and were associated with gonorrheal coinfection (13.8%), prior C. trachomatis infection (20.6%) and increasing age. A higher C. trachomatis load was identified in anal samples versus urine (1.48 × 10(4) genome copies/anal swab; 3.72 × 10(3) copies/mL urine) and no association was made to concentration including the presence of symptoms and prior C. trachomatis infection. This is the largest study of C. trachomatis serovars in MSM: it is the first to report C. trachomatis rectal loads, and provides an overview on C. trachomatis serovars and genotypic variants that circulate in Australian MSM communities.

  6. Assessing Collectivism in Latino, Asian/Pacific Islander, and African American Men Who Have Sex With Men: A Psychometric Evaluation.

    PubMed

    Sauceda, John A; Paul, Jay P; Gregorich, Steven E; Choi, Kyung-Hee

    2016-02-01

    The study of collectivism has implications for HIV prevention research, especially in studies that use a social networking or community mobilization approach. However, research on collectivism in race/ethnicity and sexual minority groups is limited. We psychometrically evaluated a brief version of the Individualism-Collectivism Interpersonal Assessment Inventory (ICIAI) in a chain-referral sample of 400 Latino, 393 Asian/Pacific Islander, and 403 African American men who have sex with men (MSM). Data were collected via a one-time survey on demographics, the ICIAI, acculturation, and ethnicity identity. We conducted a multiple groups confirmatory factor analysis to assess for measurement invariance across the three groups of MSM, as well as tested its reliability and validity. The ICIAI evidenced good psychometric properties and was invariant across all groups. We highlight implications for how this measure of collectivism can be applied toward the study of HIV prevention and in lesbian, gay, bisexual and transgender communities.

  7. An Evaluation of Mpowerment on Individual-Level HIV Risk Behavior, Testing, and Psychosocial Factors Among Young MSM of Color: The Monitoring and Evaluation of MP (MEM) Project.

    PubMed

    Shelley, Gene; Williams, Weston; Uhl, Gary; Hoyte, Tamoka; Eke, Adanze; Wright, Carolyn; Rebchook, Gregory; Pollack, Lance; Bell, Kelly; Wang, Yan; Cheng, Qi; Kegeles, Susan M

    2017-02-01

    Young men who have sex with men (MSM) of color are at increased risk for HIV infection. Mpowerment (MP) is an intervention designed to reduce risky sexual behavior and increase HIV testing among young MSM ages 18-29. From 2009 to 2012, three community-based organizations with support from the U.S. Centers for Disease Control and Prevention evaluated MP among N = 298 participants. Following a repeated measures design, data from 3- and 6-month follow-ups were compared to baseline. HIV testing and self-efficacy for safer sex increased at both follow-up time points; self-acceptance as an MSM was higher at follow-up 2. Condomless anal/vaginal sex was lower at follow-up 1 only. Frequency of exchange of safer sex messages among gay/bisexual/transgender friends was lower at follow-up 1, but similar to baseline at follow-up 2. Exposure to MP was associated with improved perceived positive social norms about safer sex and safer sex messages among gay/bisexual/transgender friends.

  8. The Process of Adaptation of a Community-Level, Evidence-Based Intervention for HIV-Positive African American Men Who Have Sex with Men in Two Cities

    ERIC Educational Resources Information Center

    Robinson, Beatrice E.; Galbraith, Jennifer S.; Lund, Sharon M.; Hamilton, Autumn R.; Shankle, Michael D.

    2012-01-01

    We describe the process of adapting a community-level, evidence-based behavioral intervention (EBI), Community PROMISE, for HIV-positive African American men who have sex with men (AAMSM). The Centers for Disease Control and Prevention (CDC) Map of the Adaptation Process (MAP) guided the adaptation process for this new target population by two…

  9. The Process of Adaptation of a Community-Level, Evidence-Based Intervention for HIV-Positive African American Men Who Have Sex with Men in Two Cities

    ERIC Educational Resources Information Center

    Robinson, Beatrice E.; Galbraith, Jennifer S.; Lund, Sharon M.; Hamilton, Autumn R.; Shankle, Michael D.

    2012-01-01

    We describe the process of adapting a community-level, evidence-based behavioral intervention (EBI), Community PROMISE, for HIV-positive African American men who have sex with men (AAMSM). The Centers for Disease Control and Prevention (CDC) Map of the Adaptation Process (MAP) guided the adaptation process for this new target population by two…

  10. HIV-related stigma within communities of gay men: a literature review.

    PubMed

    Smit, Peter J; Brady, Michael; Carter, Michael; Fernandes, Ricardo; Lamore, Lance; Meulbroek, Michael; Ohayon, Michel; Platteau, Tom; Rehberg, Peter; Rockstroh, Jürgen K; Thompson, Marc

    2012-01-01

    While stigma associated with HIV infection is well recognised, there is limited information on the impact of HIV-related stigma between men who have sex with men and within communities of gay men. The consequences of HIV-related stigma can be personal and community-wide, including impacts on mood and emotional well-being, prevention, testing behaviour, and mental and general health. This review of the literature reports a growing division between HIV-positive and HIV-negative gay men, and a fragmentation of gay communities based along lines of perceived or actual HIV status. The literature includes multiple references to HIV stigma and discrimination between gay men, men who have sex with men, and among and between many gay communities. This HIV stigma takes diverse forms and can incorporate aspects of social exclusion, ageism, discrimination based on physical appearance and health status, rejection and violence. By compiling the available information on this understudied form of HIV-related discrimination, we hope to better understand and target research and countermeasures aimed at reducing its impact at multiple levels.

  11. HIV-related stigma within communities of gay men: A literature review

    PubMed Central

    Smit, Peter J.; Brady, Michael; Carter, Michael; Fernandes, Ricardo; Lamore, Lance; Meulbroek, Michael; Ohayon, Michel; Platteau, Tom; Rehberg, Peter; Rockstroh, Jürgen K.; Thompson, Marc

    2011-01-01

    While stigma associated with HIV infection is well recognised, there is limited information on the impact of HIV-related stigma between men who have sex with men and within communities of gay men. The consequences of HIV-related stigma can be personal and community-wide, including impacts on mood and emotional well-being, prevention, testing behaviour, and mental and general health. This review of the literature reports a growing division between HIV-positive and HIV-negative gay men, and a fragmentation of gay communities based along lines of perceived or actual HIV status. The literature includes multiple references to HIV stigma and discrimination between gay men, men who have sex with men, and among and between many gay communities. This HIV stigma takes diverse forms and can incorporate aspects of social exclusion, ageism, discrimination based on physical appearance and health status, rejection and violence. By compiling the available information on this understudied form of HIV-related discrimination, we hope to better understand and target research and countermeasures aimed at reducing its impact at multiple levels. PMID:22117138

  12. "HIV Testing Is so Gay": The Role of Masculine Gender Role Conformity in HIV Testing among Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Parent, Mike C.; Torrey, Carrie; Michaels, Matthew S.

    2012-01-01

    Men who have sex with men (MSM) account for more than half of all new cases of HIV infection in the United States. Yet, many MSM are unaware of their HIV serostatus. Consistent with research indicating that gender role conformity impacts health behaviors, this study examined how masculine norms may influence HIV testing among MSM in the United…

  13. "HIV Testing Is so Gay": The Role of Masculine Gender Role Conformity in HIV Testing among Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Parent, Mike C.; Torrey, Carrie; Michaels, Matthew S.

    2012-01-01

    Men who have sex with men (MSM) account for more than half of all new cases of HIV infection in the United States. Yet, many MSM are unaware of their HIV serostatus. Consistent with research indicating that gender role conformity impacts health behaviors, this study examined how masculine norms may influence HIV testing among MSM in the United…

  14. Trends in Infectious Diseases and the Male to Female Ratio: Possible Clues to Changes in Behavior among Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Beltrami, John F.; Shouse, R. Luke; Blake, Paul A.

    2005-01-01

    Men who have sex with men (MSM) are a priority population for HIV care and prevention programs. This report describes HIV and other sexually transmitted disease (STD) trends among MSM in metropolitan Atlanta by analyzing nine databases. We describe the use of the male-to-female (M:F) ratio, a surrogate marker for MSM in databases without…

  15. Trends in Infectious Diseases and the Male to Female Ratio: Possible Clues to Changes in Behavior among Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Beltrami, John F.; Shouse, R. Luke; Blake, Paul A.

    2005-01-01

    Men who have sex with men (MSM) are a priority population for HIV care and prevention programs. This report describes HIV and other sexually transmitted disease (STD) trends among MSM in metropolitan Atlanta by analyzing nine databases. We describe the use of the male-to-female (M:F) ratio, a surrogate marker for MSM in databases without…

  16. HIV-Untested Men who have Sex with Men in South Africa: The Perception of Not Being at Risk and Fear of Being Tested

    PubMed Central

    Nel, Juan A.; Yi, Huso; Sandfort, Theo G. M.; Rich, Eileen

    2012-01-01

    A community-based needs assessment among men who have sex with men (MSM) in South Africa found that 27% (n=280/1045) of MSM had never been tested for HIV. The most frequently reported reasons for not having been tested were the perception of not being at risk (57%) and fear of being tested (52%). This article explores factors associated with these two reasons among the untested MSM. In multiple logistic regressions, the perception of not being at risk of HIV infection was negatively associated with being black, coloured or Indian, being sexually active, knowing people living with HIV, and a history of sexually transmitted infections (STIs) in the past 24 months (adj. OR = 0.24, 0.32, 0.38, and 0.22, respectively). Fear of being tested for HIV was positively associated with being black, coloured or Indian, preferred gender expression as feminine, being sexually active, a history of STIs, and experience of victimization on the basis of sexual orientation (adj. OR = 2.90, 4.07, 4.62, 5.05, and 2.34, respectively). Results suggest that HIV prevention programs directed at South African MSM will be more effective if testing and treatment of STIs are better integrated into HIV testing systems. Finally, social exclusion on the basis of race and sexual orientation ought to be addressed in order to reach hidden, at-risk, populations of MSM. PMID:23054041

  17. Emerging themes for sensitivity training modules of African healthcare workers attending to men who have sex with men: a systematic review.

    PubMed

    Dijkstra, Maartje; van der Elst, Elise M; Micheni, Murugi; Gichuru, Evanson; Musyoki, Helgar; Duby, Zoe; Lange, Joep M A; Graham, Susan M; Sanders, Eduard J

    2015-05-01

    Sensitivity training of front-line African health care workers (HCWs) attending to men who have sex with men (MSM) is actively promoted through national HIV prevention programming in Kenya. Over 970 Kenyan-based HCWs have completed an eight-modular online training free of charge (http://www.marps-africa.org) since its creation in 2011. Before updating these modules, we performed a systematic review of published literature of MSM studies conducted in sub-Saharan Africa (sSA) in the period 2011-2014, to investigate if recent studies provided: important new knowledge currently not addressed in existing online modules; contested information of existing module topics; or added depth to topics covered already. We used learning objectives of the eight existing modules to categorise data from the literature. If data could not be categorised, new modules were suggested. Our review identified 142 MSM studies with data from sSA, including 34 studies requiring module updates, one study contesting current content, and 107 studies reinforcing existing module content. ART adherence and community engagement were identified as new modules. Recent MSM studies conducted in sSA provided new knowledge, contested existing information, and identified new areas of MSM service needs currently unaddressed in the online training. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  18. Emerging themes for sensitivity training modules of African healthcare workers attending to men who have sex with men: a systematic review

    PubMed Central

    Dijkstra, Maartje; van der Elst, Elise M.; Micheni, Murugi; Gichuru, Evanson; Musyoki, Helgar; Duby, Zoe; Lange, Joep M.A.; Graham, Susan M.; Sanders, Eduard J.

    2015-01-01

    Sensitivity training of front-line African health care workers (HCWs) attending to men who have sex with men (MSM) is actively promoted through national HIV prevention programming in Kenya. Over 970 Kenyan-based HCWs have completed an eight-modular online training free of charge (http://www.marps-africa.org) since its creation in 2011. Before updating these modules, we performed a systematic review of published literature of MSM studies conducted in sub-Saharan Africa (sSA) in the period 2011–2014, to investigate if recent studies provided: important new knowledge currently not addressed in existing online modules; contested information of existing module topics; or added depth to topics covered already. We used learning objectives of the eight existing modules to categorise data from the literature. If data could not be categorised, new modules were suggested. Our review identified 142 MSM studies with data from sSA, including 34 studies requiring module updates, one study contesting current content, and 107 studies reinforcing existing module content. ART adherence and community engagement were identified as new modules. Recent MSM studies conducted in sSA provided new knowledge, contested existing information, and identified new areas of MSM service needs currently unaddressed in the online training. PMID:25596188

  19. “What Could Have Been Different”: A Qualitative Study of Syndemic Theory and HIV Prevention among Young Men Who Have Sex with Men

    PubMed Central

    Lyons, Thomas; Johnson, Amy K.; Garofalo, Robert

    2013-01-01

    Young men who have sex with men (MSM) experience multiple health disparities, including alcohol and drug use, partner violence, victimization due to sexual orientation, and HIV infection. Syndemic theorists explain the clustering of these disparities among adult MSM as a result of cultural marginalization. To date, research on a similar emerging syndemic among young MSM has been limited to quantitative studies. This study seeks to better understand these disparities, and how they may cluster together, via qualitative interviews with 21 ethnically diverse, HIV infected young MSM aged 18–24 years old. These youth report a lack of gay-specific HIV prevention education, absence of role models, and lack of productive future goal-related activities as factors related to their acquisition of HIV, and downplay substance use as a factor. Although not necessarily the components traditionally cited by syndemic theorists, these findings support the notion that multiple factors of cultural marginalization cluster together in the lives of young MSM, and underscore the importance of community-level interventions, such as sexual health education, access to mentors, and assistance with future goal setting and planning. PMID:24244112

  20. Peer social support is associated with recent HIV testing among young black men who have sex with men.

    PubMed

    Scott, Hyman M; Pollack, Lance; Rebchook, Gregory M; Huebner, David M; Peterson, John; Kegeles, Susan M

    2014-05-01

    Resiliency factors such as social support have been associated with more frequent HIV testing among MSM. We examined the association between social support and delayed HIV testing in the context of structural discrimination and individual factors among young Black MSM. We combined two independent cross-sectional samples recruited 1 year apart from a venue-based, modified time-location sampling study of young Black MSM aged 18-29 years in the US South. Our subsample (N = 813) was men who self-reported not being HIV positive and who indicated they had one or more male sex partners in the past 2 months. Using a social epidemiology framework we estimated associations of structural (racism and homophobia), social (social support from other Black MSM friends) and individual factors with delayed HIV testing (>6 months ago) using logistic regression. Bivariate analyses demonstrated that individual level variables as well as experiences of racism (OR 1.20, 95% CI 1.02-1.41) and homophobia (OR 1.49, 95 % CI 1.02-2.17) were associated with higher risk of delayed HIV testing. Receiving social support from other Black MSM friends was associated with lower risk of delayed HIV testing (OR 0.80, 95 % CI 0.67-0.95). In multivariable models, social support remained significantly associated with lower risk of delayed HIV testing after inclusion of structural and individual level variables. Social support has a positive and robust association with HIV testing among young Black MSM. Whether community building and development of resiliency factors can overcome structural, social, and individual-level barriers to HIV prevention and care for young Black MSM warrants further study.

  1. Older Single Gay Men's Body Talk: Resisting and Rigidifying the Aging Discourse in the Gay Community.

    PubMed

    Suen, Yiu Tung

    2017-01-01

    Previous research saw older gay men as subject to structural marginalization of ageism but yet possessing agency to interpret aging in diverse ways. I move beyond this duality, drawing on the theory of defensive othering to understand how older gay men live with the aging discourse in the gay community. Informed by grounded theory, I analyzed interviews with 25 self-identified single gay men aged 50 or above in England inductively. It emerged that many older gay men found it difficult to escape the discourse that marginalizes the aging body. Even when they argued they were the exception and "looked good," they were discursively producing a two-tier system: they themselves as the "good older gay men," as opposed to the other "bad older gay men," who "had given up." Such a defensive othering tactic seemingly allowed them to resist age norms from applying to them personally, but unintentionally reinforced an ageist discourse.

  2. How Participants Envision Community Music in Welsh Men's Choirs

    ERIC Educational Resources Information Center

    Rohwer, Debbie; Rohwer, Mark

    2012-01-01

    The purpose of this study was to describe choristers' perceptions of Welsh men's choir participation. Four choirs were observed in concert and rehearsal settings across Wales. Focus group interviews were conducted with between 4 and 10 members in each of the 4 choral settings for a total of 24 total interview respondents. The interviewees had a…

  3. High HIV Prevalence among MSM in Jamaica is associated with Social Vulnerability and other Sexually Transmitted Infections

    PubMed Central

    Figueroa, JP; Weir, SS; Jones-Cooper, C; Byfield, L; Hobbs, MM; McKnight, I; Cummings, S

    2013-01-01

    Background HIV prevalence among men who have sex with men (MSM) is thought to be high in Jamaica. The objective of this study was to estimate HIV prevalence and identify risk factors in order to improve prevention approaches. Methods With the help of influential MSM, an experienced research nurse approached MSM in four parishes to participate in a cross-sectional survey in 2007. MSM were interviewed and blood taken for HIV and syphilis tests, and urine taken for gonorrhoea, Chlamydia and Trichomonas testing using transcription-mediated amplification assays. A structured questionnaire was administered by the nurse. Results One third (65 of 201; 32%, 95% Confidence Interval (CI) 25.2% – 47.9%) of MSM were HIV positive. Prevalence of other sexually transmitted infections (STI) was: Chlamydia 11%, syphilis 6%, gonorrhea 3.5% and Trichomonas 0%. One third (34%) of MSM identified themselves as being homosexual, 64% as bisexual and 1.5% as heterosexual. HIV positive MSM were significantly more likely to have ever been told by a doctor that they had a STI (48% vs. 27%, OR 2.48 CI 1.21 – 5.04, p=0.01) and to be the receptive sexual partner at last sex (41% vs. 23%, OR 2.41 CI 1.21 – 4.71, p=0.008). MSM who were of low socio-economic status, ever homeless and victims of physical violence were twice as likely to be HIV positive. The majority (60%) of HIV positive MSM had not disclosed their status to their partner and over 50% were not comfortable disclosing their status to anyone. Conclusions The high HIV prevalence among MSM is an important factor driving the HIV epidemic in Jamaica. More effective ways need to be found to reduce the high prevalence of HIV among MSM including measures to reduce their social vulnerability, combat stigma and discrimination and empower them to practice safe sex. PMID:24756602

  4. Exploring Living-Learning Communities as a Venue for Men's Identity Construction

    ERIC Educational Resources Information Center

    Jessup-Anger, Jody E.; Johnson, Brianne N.; Wawrzynski, Matthew R.

    2012-01-01

    This qualitative study explored how male undergraduate students experienced living-learning community environments. Findings revealed that living-learning communities provided men a "safe haven" from rigid gender role expectations, offered a plethora of involvement opportunities, and fostered relationships with faculty and peers. The findings…

  5. Taking Charge at Any Age: Learning and Wellbeing by Older Men through Community Organisations in Australia

    ERIC Educational Resources Information Center

    Golding, Barry

    2011-01-01

    This paper examines and compares learning narratives associated with older men's participation in three community organisations in an Australian rural setting: an adult and community education provider, an emergency service organization and an aged care facility. The interview data are from a larger Australian study of learning in community…

  6. Community Involvement, Perceived Control, and Attitudes toward Aging among Lesbians and Gay Men

    ERIC Educational Resources Information Center

    Hostetler, Andrew J.

    2012-01-01

    A person-environment approach was used to explore the relationship between community involvement and attitudes toward aging among middle-age and older lesbians and gay men. Specifically, this study investigated the relationships between participation in gay community activities, perceived control, and aging-related concerns among two…

  7. Exploring Living-Learning Communities as a Venue for Men's Identity Construction

    ERIC Educational Resources Information Center

    Jessup-Anger, Jody E.; Johnson, Brianne N.; Wawrzynski, Matthew R.

    2012-01-01

    This qualitative study explored how male undergraduate students experienced living-learning community environments. Findings revealed that living-learning communities provided men a "safe haven" from rigid gender role expectations, offered a plethora of involvement opportunities, and fostered relationships with faculty and peers. The findings…

  8. Community Involvement, Perceived Control, and Attitudes toward Aging among Lesbians and Gay Men

    ERIC Educational Resources Information Center

    Hostetler, Andrew J.

    2012-01-01

    A person-environment approach was used to explore the relationship between community involvement and attitudes toward aging among middle-age and older lesbians and gay men. Specifically, this study investigated the relationships between participation in gay community activities, perceived control, and aging-related concerns among two…

  9. The green shoots of a novel training programme: progress and identified key actions to providing services to MSM at Kenyan health facilities

    PubMed Central

    van der Elst, Elise M; Kombo, Bernadette; Gichuru, Evans; Omar, Anisa; Musyoki, Helgar; Graham, Susan M; Smith, Adrian D; Sanders, Eduard J; Operario, Don

    2015-01-01

    Introduction Although men who have sex with men (MSM) in sub-Saharan Africa are at high risk for HIV acquisition, access to and quality of health and HIV services within this population are negatively affected by stigma and capacity within the health sector. A recently developed online MSM training programme (www.marps-africa.org) was shown to contribute to reductions in MSM prejudice among healthcare providers (HCPs) in coastal Kenya. In this study, we used qualitative methods to explore the provision of MSM healthcare services two years post-training in coastal Kenya. Methods From February to July 2014, we held 10 focus group discussions (FGD) with 63 participants, including HCP from 25 facilities, county AIDS coordinators and MSM from local support groups. Participants discussed availability, acceptability and accessibility of HIV healthcare for MSM. HCP also discussed changes in their health service practices after completing the training. FGD were recorded, transcribed verbatim and analyzed using Ritchie and Spencer's “framework approach” for qualitative data. Results HCPs described continued improvements in their ability to provide service in a non-stigmatizing way to MSM patients since completing the training programme and expressed comfort engaging MSM patients in care. Four additional recommendations for improving MSM healthcare services were identified: 1) expanding the reach of MSM sensitivity training across the medical education continuum; 2) establishing guidelines to manage sexually transmitted anal infections; 3) promoting legal and policy reforms to support integration of MSM-appropriate services into healthcare; and 4) including MSM information in national reporting tools for HIV services. Conclusions Positive impacts of this sensitivity and skills training programme were reflected in HCP attitudes two years post-intervention. Scaling-up of efforts will rely on continued policies to include MSM in healthcare programmes to reduce stigma in

  10. Certain attributes of the sexual ecosystem of high-risk MSM have resulted in an altered microbiome with an enhanced propensity to generate and transmit antibiotic resistance.

    PubMed

    Kenyon, C; Osbak, K

    2014-08-01

    Surveillance data from a number of countries have indicated that antibiotic resistance in Neisseriagonorrhoea is strongly associated with men who have sex with men (MSM). This manuscript advances the hypothesis that certain features of the MSM sexual ecosystem may be responsible for this association. It is argued that in comparison with heterosexuals, high-risk MSM (hrMSM) have a higher prevalence of oro-penile, oro-rectal and anal sex which facilitates an enhanced mixing of the pharyngeal, rectal and penile microbiomes. In addition, hrMSM have an increased number of sexual partners per unit time and an increased prevalence of sexual relationships overlapping in time. The increased flux of microbiomes between different body habitats between sexual partners, in combination with the increased connectivity of the sexual network, serve to create a novel high-risk MSM sexual ecosystem with important consequences for the genesis and spread of antibiotic resistance. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Exploring the perspectives of substance abusing Black men who have sex with men and women in addiction treatment programs: a need for a human sexuality educational model for addiction professionals.

    PubMed

    Washington, Thomas Alex; Brocato, Jo

    2011-09-01

    This study examined the perspectives of African American male injection drug users who have sex with both men and women (IDU-MSM/W) and who are involved in sex trade regarding the need for a human sexuality educational model (HSEM) for addiction professionals. Focus groups were conducted involving an exploratory sample (N = 105) of men who met the following parameters: aged 18 to 40 years, African American, engage in injection drug using behavior, have sex with male and female partners, and who frequent parks and other sex working areas in Baltimore City and surrounding areas. Data suggest that an HSEM may be useful for addiction professionals who work with substance abusing Black MSM/W. Moreover, the model should include opportunities for addiction professionals to (a) identify their personal biases about homosexuality in general (acknowledging personal biases so not to allow those personal biases to influence service); (b) understand the diversity within the Black MSM/W community (e.g., challenge assumptions that all Black MSM/W self-identify as gay); (c) understand how to, and the need for, assessing sexual trauma in Black MSM/W; and (d) understand the need to incorporate risk factors and safer sex practices that may be of concern to a subpopulation of Black MSM/W, such as "barebacking." These findings suggest the need for, and topics to include in, an HSEM that assists professionals with exploring their biases about sexuality and MSM/W and better prepares counselors to address HIV prevention and risky behavior using language that is appropriate for the Black IDU-MSM/W population.

  12. Alcohol use and HIV sexual risk among MSM in Chennai, India.

    PubMed

    Mimiaga, M J; Thomas, B; Mayer, K H; Reisner, S L; Menon, S; Swaminathan, S; Periyasamy, M; Johnson, C V; Safren, S A

    2011-03-01

    Men who have sex with men (MSM) in India are a core risk group for HIV. Heavy alcohol consumption is associated with increased sexual risk-taking behaviours in many cultures, in particular among MSM. However, no studies to date have explored alcohol use and HIV risk among MSM in India. MSM in Chennai, India (n = 210) completed an interviewer-administered behavioural and psychosocial assessment. Bivariate and multivariable logistic regression procedures examined behavioural and demographic associations with weekly alcohol consumption. Twenty-eight percent of the sample (n = 58) reported using alcohol at least weekly to the point of being buzzed/intoxicated, which was associated with older age, being married to a woman, being panthi (masculine appearing, predominantly insertive partners) versus kothi (feminine acting/appearing and predominantly receptive partners), weekly tobacco use, unprotected anal sex and unprotected vaginal sex in the three months prior to study enrollment (all P < 0.05). In a multivariable model, unprotected vaginal sex in the previous three months and being married to a women were unique variables associated with weekly alcohol use (all P < 0.01). Further investigation of alcohol use within the context of sexual risk taking is warranted among Indian MSM. Panthis and MSM who are married to women may be particularly likely to benefit from interventions to decrease alcohol intake and concurrent unsafe sex.

  13. Sexual Preferences and Presentation on Geosocial Networking Apps by Indian Men Who Have Sex With Men in Maharashtra

    PubMed Central

    Patankar, Pallav; Ekstrand, Maria L

    2016-01-01

    Background The affordability of smartphones and improved mobile networks globally has increased the popularity of geosocial networking (GSN) apps (eg, Grindr, Scruff, Planetromeo) as a method for men who have sex with men (MSM) to seek causal sex partners and engage with the queer community. As mobile penetration continues to grow in India, it is important to understand how self-presentation on GSN app is relevant because it offers insight into a population that has not been largely studied. There is very little information about how Indian MSM discuss their sexual preferences and condom preferences and disclose their human immunodeficiency virus (HIV) status with potential sex partners on Web-based platforms. Objective The objective of this study was to describe how self-presentation by Indian MSM on GSN apps contributes to sexual preferences, HIV or sexually transmitted infection (STI) disclosure, and if the presentation differs due to proximity to the Greater Mumbai or Thane region. Methods Between September 2013 and May 2014, participants were recruited through banner advertisements on gay websites, social media advertisements and posts, and distribution of print materials at outreach events hosted by lesbian, gay, bisexual, transgender (LGBT) and HIV service organizations in Maharashtra, India. Eligible participants self-identified as being MSM or hijra (transgender) women, living in Maharashtra, aged above 18 years, having regular Internet access, and having at least one male sex partner in the previous 90 days. Results Indian MSM living inside and outside the Greater Mumbai or Thane region reported an average of 6.7 (SD 11.8) male sex partners in the last 3 months; on average HIV status of the sex partners was disclosed to 2.9 (SD 8.9). The most commonly used websites and GSN apps by MSM living inside Greater Mumbai or Thane region were Planetromeo, Grindr, and Gaydar. Results demonstrated that MSM used smartphones to access GSN apps and stated a preference

  14. Clear Links Between Starting Methamphetamine and Increasing Sexual Risk Behavior: A Cohort Study Among Men Who Have Sex With Men.

    PubMed

    Hoenigl, Martin; Chaillon, Antoine; Moore, David J; Morris, Sheldon R; Smith, Davey M; Little, Susan J

    2016-04-15

    It remains unclear if methamphetamine is merely associated with high-risk behavior or if methamphetamine use causes high-risk behavior. Determining this would require a randomized controlled trial, which is clearly not ethical. A possible surrogate would be to investigate individuals before and after starting the use of methamphetamine. We performed a cohort study to analyze recent self-reported methamphetamine use and sexual risk behavior among 8905 men who have sex with men (MSM) receiving the "Early Test," a community-based HIV screening program in San Diego, CA, between April 2008 and July 2014 (total 17,272 testing encounters). Sexual risk behavior was evaluated using a previously published risk behavior score [San Diego Early Test (SDET) score] that predicts risk of HIV acquisition. Methamphetamine use during the last 12 months (hereafter, recent-meth) was reported by 754/8905 unique MSM (8.5%). SDET scores were significantly higher in the 754 MSM with recent-meth use compared with the 5922 MSM who reported that they have never used methamphetamine (P < 0.001). Eighty-two repeat testers initiated methamphetamine between testing encounter, with significantly higher SDET scores after starting methamphetamine [median 5 (interquartile range, 2-7) at recent-meth versus median 3 (interquartile range, 0-5) at never-meth; P < 0.001, respectively]. Given the ethical impossibility of conducting a randomized controlled trial, the results presented here provide the strongest evidence yet that initiation of methamphetamine use increases sexual risk behavior among HIV-uninfected MSM. Until more effective prevention or treatment interventions are available for methamphetamine users, HIV-uninfected MSM who use methamphetamine may represent ideal candidates for alternative effective prevention interventions (ie, preexposure prophylaxis).

  15. Sexual Behaviors Linked to Drug and Alcohol Use Among Men Who Have Sex With Men in China

    PubMed Central

    Zhang, Chen; Qian, Han-Zhu; Yin, Lu; Liu, Yu; Strauss, Shiela M.; Ruan, Yuhua; Shao, Yiming; Lu, Hongyan; Vermund, Sten H.

    2017-01-01

    Background High-risk sexual behaviors drive the HIV epidemic among men who have sex with men (MSM). Alcohol consumption and use of club drugs may increase sexual risk behaviors. We evaluated effects of drug and alcohol use on sexual behaviors with both their male and female partners as well as on HIV and syphilis infections among MSM in China. Methods As the part of a community randomized clinical trial that conducted among MSM in Beijing from 2013 to 2015, we recruited a total of 3,680 participants cross-sectionally. A self-administered questionnaire was employed to collect information regarding demographics, sexual behaviors, and a history of alcohol and drug use. Blood sample was collected for HIV and syphilis testing. Results A total of 3,588 MSM completed the survey and were included in the data analysis. The mean age was 29.9 with 97.3% of Han-ethnicity and 85.0% unmarried. The HIV and syphilis prevalence was 12.7% and 7.4%, respectively. Drug use was significantly associated with higher odds of HIV infection (aOR = 1.3, 95% Confidence Interval [CI] = 1.0,1.6), but not associated with syphilis. A higher level of alcohol consumption was similarly associated with higher odds of HIV risks with both male (e.g., condomless sex acts) and female partners (e.g., numbers of sexual partners). Conclusion The association between drug and alcohol use and high-risk behaviors is notable among MSM in China. Integrated HIV interventions that target substance use among MSM may be more effective than programs that only target HIV alone. PMID:27608264

  16. Male circumcision and risk of HIV acquisition among MSM.

    PubMed

    Sánchez, Jorge; Sal Y Rosas, Victor G; Hughes, James P; Baeten, Jared M; Fuchs, Jonathan; Buchbinder, Susan P; Koblin, Beryl A; Casapia, Martín; Ortiz, Abner; Celum, Connie

    2011-02-20

    To assess the association between male circumcision, insertive anal sex practices, and HIV acquisition in a cohort of MSM. Data were from 1824 HSV-2-seropositive, HIV-seronegative MSM, 1362 (75%) from Peru and 462 (25%) from the US, who participated in a randomized placebo-controlled trial of HSV-2 suppression for HIV prevention (HPTN 039). Circumcision status was determined by examination at enrollment. HIV testing was done every 3 months for up to 18 months. Partner-specific sexual behavior for up to the last three partners during the previous 3 months was analyzed. There was no significant association between male circumcision and HIV acquisition in univariate analysis [relative risk (RR) = 0.84, 95% confidence interval (CI) 0.50-1.42]. In a prespecified multivariate analysis that assumed a linear relationship between the proportion of insertive acts and effect of circumcision on HIV acquisition, the interaction between circumcision and proportion of insertive acts was not significant (P = 0.11). In an exploratory analysis that categorized behavior with recent partners by proportion of insertive acts (<60 or ≥60% insertive acts), circumcision was associated with a nonstatistically significant 69% reduction in the risk of HIV acquisition (RR = 0.31, 95% CI 0.06-1.51) among men who reported at least 60% of insertive acts with recent male partners. Circumcision does not have a significant protective effect against HIV acquisition among MSM from Peru and US, although there may be reduced risk for men who are primarily insertive with their male partners. This association needs to be investigated across diverse cohorts of MSM.

  17. Community Influences on Married Men's Uptake of HIV Testing in Eight African Countries

    PubMed Central

    Stephenson, Rob; Elfstrom, K. Miriam; Winter, Amy

    2014-01-01

    Despite efforts to increase HIV testing in the African region, the proportion of men who report ever having been tested for HIV remains low. Research has focused on individual level determinants of women's testing however little is known about factors associated with men's testing behavior. This analysis investigates community influences on HIV testing among men ages 15–54, using Demographic and Health Survey (DHS) data from Chad, Ghana, Malawi, Nigeria, Tanzania, Uganda, Zambia, and Zimbabwe. Multilevel models were fitted in each country for the outcome of ever receiving an HIV test. After controlling for individual and household level factors, community level factors of demographics, economics, and behavior and knowledge remain significantly associated with HIV testing among men. The results of this analysis highlight the need to recognize the impact of community influences on men's HIV test seeking behavior, and to harness these community factors in the design of programs aimed at encouraging the uptake of HIV testing among men in Africa. PMID:22677974

  18. Experiences of Discrimination and Their Impact on the Mental Health Among African American, Asian and Pacific Islander, and Latino Men Who Have Sex With Men

    PubMed Central

    Paul, Jay; Ayala, George; Boylan, Ross; Gregorich, Steven E.

    2013-01-01

    Objectives. We examined the associations between specific types and sources of discrimination and mental health outcomes among US racial/ethnic minority men who have sex with men (MSM) and how these associations varied by race/ethnicity. Methods. A chain-referral sample of 403 African American, 393 Asian and Pacific Islander (API), and 400 Latino MSM recruited in Los Angeles County, California completed a standardized questionnaire. Data were obtained from the Ethnic Minority Men’s Health Study from May 2008 to October 2009. Results. Past-year experiences of racism within the general community and perceived homophobia among heterosexual friends were positively associated with depression and anxiety. Past-year homophobia experienced within the general community was also positively associated with anxiety. These statistically significant associations did not vary across racial/ethnic groups. The positive association of perceived racism within the gay community with anxiety differed by race/ethnicity, and was statistically significant only for APIs. Perceived homophobia within the family was not associated with either depression or anxiety. Conclusions. Higher levels of experiences of discrimination were associated with psychological distress among MSM of color. However, specific types and sources of discrimination were differentially linked to negative mental health outcomes among African American, API, and Latino MSM. PMID:23488483

  19. Correlates of anal sex roles among Malay and Chinese MSM in Kuala Lumpur, Malaysia.

    PubMed

    Dangerfield, Derek T; Gravitt, Patti; Rompalo, Anne M; Tai, Raymond; Lim, Sin How

    2016-03-01

    Identifying roles for anal sex is an important issue for populations of MSM. We describe the prevalence of identifying as being 'top', 'bottom', 'versatile', or 'don't know/not applicable' among Malay and Chinese MSM in Kuala Lumpur, Malaysia, and behavioural outcomes according to these labels for sexual role identity. Data analysis was conducted on a survey administered during weekly outreach throughout Kuala Lumpur in 2012. Pearson's Chi square tests were used to compare demographic and behavioural characteristics of MSM who reported roles for anal sex. Binary logistic regression was used to explore the odds of behavioural outcomes among MSM who identified as 'bottom', 'versatile,' and 'don't know' compared to MSM who reported that 'top' was their sexual role. Labels for anal sex roles were significantly associated with condom use for last anal sex. Among MSM who used labels for anal sex roles, MSM who identified as 'bottom' had highest level of not using condoms for last anal sex (24.1%, p = .045). In binary logistic regression model, identifying as 'top' was significantly associated with reporting using a condom during last anal sex and reported consistent condom use for anal sex in the past six months (p = .039 and .017, respectively). With regard to sexual role identity, some MSM may be a part of a special subgroup of at-risk men to be targeted. Future research should evaluate the origins, meanings, and perceptions of these labels, and the developmental process of how these MSM identify with any of these categories. Research should also uncover condom use decision making with regard to these labels for sexual positioning. © The Author(s) 2016.

  20. Implementation of a Confidential Helpline for Men Having Sex With Men in India

    PubMed Central

    2015-01-01

    Background In India, men who have sex with men (MSM) often face physical violence and harassment from police and the general society. Many MSM may not openly disclose their sexual identity, especially if they are married to women and have families. Due to pervasive stigma and discrimination, human immunodeficiency virus (HIV) prevention programs are unable to reach many MSM effectively. Objective The objective of this paper was to describe the design, operations, and monitoring of the Sahaay helpline, a mHealth intervention for the MSM population of India. Methods We established the “Sahaay” mHealth intervention in 2013; a MSM-dedicated helpline whose main goal was to increase access to comprehensive, community-based HIV prevention services and improve knowledge, attitudes, and behaviors of MSM towards HIV and sexually transmitted infections (STI) in three states of India (Chhattisgarh, Delhi, and Maharashtra). The helpline provided a 24x7 confidential and easy to use interactive voice response system (IVRS) to callers. IVRS function was monitored through an online dashboard of indicators. The system also provided real-time reporting on callers and services provided. Results The helpline received more than 100,000 calls from 39,800 callers during the first nine months of operation. The helpline maintained an operational uptime of 99.81% (6450/6462 hours); and answered more than 81.33% (83,050/102,115) of all calls. More than three-fourths of the calls came between 9:00 am-12:00 pm. The most successful promotional activity was “interpersonal communication” (reported by 70.05%, 27,880/39,800, of the callers). Nearly three-fourths of the callers self-identified as MSM, including 17.05% (6786/39,800) as rural MSM and 5.03% (2001/39,800) as a married MSM. Most callers (93.10%, 37,055/39,800) requested information, while some (27.01%, 10,750/39,800) requested counseling on HIV/acquired immune deficiency syndrome (AIDS), STIs, and other health and nonhealth issues

  1. Childhood sexual abuse and depression in Latino MSM: Does resilience protect against nonadherence to ART?

    PubMed Central

    Sauceda, John A.; Wiebe, John S.; Simoni, Jane M.

    2015-01-01

    This study tested depression as a mediator between childhood sexual abuse (CSA) and adherence to antiretroviral therapy (ART), an effect moderated by resilience. One-hundred and forty-nine HIV+ Latino men who have sex with men (MSM) were recruited for this study. Using a regression-based bootstrap approach, depression mediated the relationship between CSA and ART adherence, with worse adherence for participants at lowest percentiles of the resilience index. The prevalence of CSA and depression in HIV+ MSM is high and must be addressed to better prevent disease progression, reduce transmission, especially in expanding Latino populations. PMID:25156387

  2. The ban on blood donation on men who have sex with men: time to rethink and reassess an outdated policy.

    PubMed

    Karamitros, Georgios; Kitsos, Nikolaos; Karamitrou, Ioanna

    2017-01-01

    During the 1980s the HIV/AIDS epidemic outbreak occurred. Due to the high prevalence of the disease on men who had sex with men (MSM) a lifetime ban on blood donations on men who had sex with men (MSM) was implemented. In the recent years, organizations like the European Union (EU) and the World Health Organization (WHO) have established new guidelines introducing the term of "risky sexual behavior" without any reference to the sex orientation of the potential donor, however many countries are hesitant to review the ban on men who had sex with men (MSM). Given the lack of screening methods for HIV back in the '80s the ban on men who had sex with men seemed like the only choice in order to limit the disease. However, nowadays the screening methods have advanced and the possibility of a transfusion related HIV infection is extremely low. Many countries, considering the new data available, have reformed their policies and moved from the lifetime ban to 5-year and 1-year deferrals but only a fraction of countries have adopted the guidelines for the "risky sexual behavior" assessment. The ban that forbid men who have sex with men from donating blood was implemented more than 30 years ago. During the '80s, the epidemiology was different and it seems not only hypocritical but also naïve to rely on guidelines that are far outdated and old-fashioned. The medical community has a duty to secure safe blood for every person who might need it, let us not waste safe potential donors and stigmatize them by focusing on outdated policies.