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There is currently a lack of measures testing intraminority stress within gay men. Therefore, the current study sought to develop and psychometrically test the Gay-Specific Intraminority Stigma Inventory (G-SISI). Based on a content review of the literature and a panel of experts, a pool of items assessing gay men’s perceived exposure to a range of discriminatory attitudes from other gay men was generated. Utilizing a randomly split sample of 1723 gay men between the ages of 19 and 79 years, an exploratory factor analysis was first performed (n = 861). The remaining unexamined data were then used to conduct a confirmatory factor analysis (n = 862). The results support a six-factor model: (1) Age Stigma, (2) Socioeconomic Stigma, (3) Gay Non-Conformity Stigma, (4) Racial Stigma, (5) Gender Expression Stigma, and (6) Body Stigma. Cronbach’s alpha for the total scale was 0.90 and for the subscales ranged from 0.60 to 0.85. Sociodemographic factors and measures of community involvement were differentially associated with the G-SISI subscales, providing evidence of construct validity. The findings demonstrate initial support for the dimensionality and validity of the G-SISI, which targets modifiable factors (e.g., identity-based stigma) that may increase stress and reduce community coping resources among gay men with diverse identities.

Older gay men commonly conceal their sexual identity in healthcare settings due to past experiences and expectations of encountering stigma and discrimination in these contexts. Although insights on how older gay men construct their sexual identity in healthcare may help contextualize this phenomenon, this question remains under-explored. Accordingly, we present the findings of a secondary grounded theory analysis of individual interview data, which we originally collected to examine the healthcare experiences of 27 gay men ages 50 and over, to explore constructions of sexual identity among the group. Our findings broadly reveal that older gay men’s varying exposure to intersecting systems of oppression, together with their perceptions of different healthcare settings, may be critical in shaping their constructions of sexual identity in these contexts. Our research supports the need for healthcare policies and practices that address stigma and discrimination as salient barriers to sexual identity disclosure among older gay men.

Introduction Gay men form and maintain romantic relationships in the face of stigma and discrimination, negatively impacting their well-being. Early experiences with caregivers likely influence well-being and may later impact the satisfaction felt in the romantic relationships of gay men. Method Following the 2017 legalization of same-sex marriage in Australia, 198 self-identified gay men were surveyed between June and July2019, to examine the role of well-being in the association between attachment style and relationship satisfaction. Results Results revealed securely attached men demonstrated higher levels of well-being and relationship satisfaction. Men with higher levels of anxiety and avoidant attachment had lower well-being and relationship satisfaction. Well-being partially mediated the relationship between attachment style and relationship satisfaction. Conclusions Results highlight the significant contributing role of well-being among gay men in the association between attachment processes and the satisfaction felt in their romantic relationships. Our findings suggest that insecure attachment styles are associated with reduced well-being and may place gay men at risk for poorer relationship outcomes. Policy Implications Our findings support the idea for researchers and clinicians to be mindful of the influence of attachment processes on well-being when working with gay male couples. Ongoing practitioner training should include a focus on these predictors of relationship quality for gay men. As social and public policy continues to move forward, it will be important to monitor how marriage equality evolves and the impact it continues to have on same-sex relationship outcomes.

IntroductionLike heterosexual ones, homosexual partners strive to fulfil their needs for belonging and love. They also build their relationships in countries where less favourable public opinion exists towards same-sex relationships, due in part to the lack of equivalent legislation between heterosexual and non-heterosexual persons and couples. As opponents of such relationships claim them to be less stable and of lower quality, the current study examines whether the sexual orientation of partners may determine the quality of their relationship and their commitment to it.Material and methodsThe study was conducted in a group of 530 cohabiting persons, aged 18-44 (230 persons with a homosexual orientation and 300 heterosexual) living in Poland. The participants were tested with three tools: a sociodemographic survey, the Polish version of the Partner Relations Questionnaire by Halhweg, adapted by Janicka, and the Interpersonal Commitment Inventory (KZI) by Janicka and Szymczak: the Polish adaptation of the Commitment Inventory by Stanley and Markman.ResultsThe findings indicate that sexual orientation of women and men may influence their tendencies to change partners and their interpersonal commitment, interpreted as their dedication and obligation to stay in the relationship.ConclusionsSome detailed analyses suggest that cohabitations between gay women portend better than those of gay men.

Current analyses of Asian cosmetic surgery and other beautification practices assess their use for economic gain (e.g., increasing chances of gaining employment when photos are required with applic...

This project seeks to extend the literature on the effectiveness of out-group and in-group messages on Christians’ attitudes towards members of the LGBT community and measure for differences in attitudes towards LGBT individuals and the covariates associated with those attitudes . This study will achieve the two aims outlined below: 1. Differences in Christians attitudes will be measured when primed with either an ingroup Jesus Golden Rule or an outgroup Buddha Golden Rule. We will test the polarizing effect of ingroup, and outgroup messages as identified by Vilaythong T. et al (2010). We predict that the outgroup messaging condition will increase prejudice towards LGBT persons especially when the participation lives in a majority Christian area. Identified moderating effects of attitudes towards LGBT like religiosity and political orientation will be controlled. 2. Differences in attitudes towards LGBT persons will be compared using scales that control for gender and sexual orientation. Therefore, differences in attitudes towards all the following will be measured: Lesbian women and Gay Men, Bisexual Women and Bisexual Men, and Transgender Women and Transgender Men. We hypothesize three major trends (1) differences will be found in both the attitudes towards the different genders within each of the three groups (i.e., Homosexual, Bisexual, and Transgender) as well as the covariates associated with those attitudes; (2) Christian men and Christian women will have both different attitudes about LGBT individuals and differences in the covariates associated with those attitudes; (3) negative attitudes towards LGBT will be related to the individual and multiplicative effects of the measured covariates: political beliefs, religiosity, attitudes towards science across both ingroup and outgroup samples. Scales being used to measure attitudes towards LGBT: 1. Attitudes Toward Lesbian and Gay Men Scales – Short Version (ATLG: Herek, 1994) 2. Abridged Bisexualities: Indiana Attitudes Scale (BIAS: Dodge et al., 2016) 3. Attitudes Towards Transgender Men and Women (ATTMW: Billard, 2018) Covariates expected to be dichotomously related to attitudes: 1. Political Orientation 2. Religiosity (Church Attendance and Biblical Literalism) 3. Attitudes towards Science 4. Belief about the Etiology of Homosexuality

How do the sexual scripts of men who have sex with men (MSM) become maladaptive?

This is a qualitative systematic review and thematic and narrative syntheses of qualitative studies exploring the experiences of gay men and other men who have sex with men who engage in sexualised drug use ('chemsex'). In doing so, the review will also explore how different theoretical frameworks have conceptualised these experiences and chemsex more generally.

NMSU collaborative effort to analyze the Colors of Pride dataset, a project led by Dr. Amy Stone.

This study sought to improving intimacy behaviors in self-identified gay-men by implementing Functional Analytic Psychotherapy

The purpose of this project is to understand how men select other men for chatting, trading pictures, dating, relationships, friends with benefits, and/or casual sex on dating applications using photos. How do masculinity, ethnicity, and social identity influence partner selection? Are there correlations between self-presentation and in-group prototypes?

The studies focused on analysing attitudes toward homosexuality show that the manifestation of homonegativity has evolved into more modern forms. We therefore propose using instruments that capture subtle aspects in discrimination against gay and lesbian people. The objective of this study is twofold. First, we aim to adapt and validate the Portuguese version of the Modern Homonegativity Scale. Second, we set out to analyse the modern homonegativity shown by Portuguese university students. The scale includes two parallel subscales (MHS-Gay Men and MHS-LesbianWomen), each with 12 items. Six hundred and forty-one Portuguese college students between 18 and 27 years of age participated in the study (Mage = 21.23; SD = 1.88). The results demonstrate the unidimensionality of the scale and a high degree of internal consistency, along with satisfactory fit indices. Those people who identified as male and heterosexual showed greater modern homonegativity. We conclude that the Portuguese version of the MHS is valid and reliable for evaluating modern homonegativity in Portugal., Programa Operativo FEDER, Junta de Andalucia B-SEJ-294-UGR18

What forms of intracommunity stigma do young sexual minority men narrate as they participate in communities through mobile apps? In a content analysis of 32 interviews with a racially diverse sample of young sexual minority men (ages 19–25; 84.4% non-White) from four regions of the USA, a majority of men (62.5%) spontaneously discussed mobile apps (e.g., Grindr, Scruff) when asked about their experience of community more broadly. Men’s narratives revealed engagement with intracommunity stigma related to body size, race/ethnicity, gender expression, and sexual position (e.g., bottom). Stigma related to HIV status, substance use, and social class were not spontaneously narrated in response to questions about men’s experience in communities. Expressions of stigma were frequently experienced intersectionally, particularly regarding racialized stereotype expectations (e.g., “Asian men are twinks, effeminate”). We discuss the ways in which sexual minority men reproduce dominant ideologies related to racism, misogyny, and masculine body ideals as they engage with one another on mobile apps. To the extent that many young men rely on mobile apps for community connection, their experiences of community might serve to exacerbate, rather than ameliorate, the deleterious impact of stigma.

ObjectiveThe aim of this report is to investigate the nature of the relationship between depression and condomless sex (CLS) among gay, bisexual and other men who have sex with men (GBMSM).MethodsData are from the Antiretrovirals, Sexual Transmission Risk and Attitude (ASTRA) study of people living with HIV and attending one of eight HIV outpatient clinics in England (2011–2012) and the Attitudes to and Understanding of Risk of Acquisition of HIV (AURAH) study of HIV-negative/unknown status individuals attending one of 20 genitourinary medicine clinics in England (2013–2014). This analysis included GBMSM only. For each study, the prevalence of depressive symptoms (Patient Health Questionnaire-9 score ≥10) was presented according to three categories of sex in the past 3 months (considering anal/vaginal sex with men/women and anal sex with men in separate definitions): (1) no sex, (2) condom-protected sex only and (3) CLS. Multinomial logistic regression with ‘condom-protected sex only’ as the reference group was used to adjust for age and (for ASTRA participants) time since HIV diagnosis.ResultsThere were opposing associations of depression with recent sexual behaviour: the prevalence of depression was higher among those who reported no sex and those who reported CLS, compared with those who reported condom-protected sex only. Among the 2170 HIV-positive GBMSM in ASTRA, considering anal/vaginal sex with men/women, the prevalence of depressive symptoms was 32%, 20% and 28%, respectively, among men reporting no sex (n=783), condom-protected sex only (n=551) and CLS (n=836) (global pConclusionsDepression may be linked both to lack of sexual activity and to sexual risk taking. When investigating associations between depression and CLS, it is important to separate out individuals reporting condom-protected sex only from those reporting no sex.

This exploratory study was conducted to inquire into the experiences of gay santeros – those who take care of religious statues or imahes that are used for Catholic religious activities. The study looked into the entry of the santeros to the practice of pagsasanto, their access to the imahe, their reasons for entering and maintaining the practice, and the benefits that they perceive to derive from it. Through conducting interviews with openly-gay santeros, it was found that early exposure to their religious family, school, and local community influenced them into entering the practice of pagsasanto. On access to the imahe, the participants were either owners of the imahe through purchase, donation or inheritance, or caretakers of the imahe through entrustment by their religious networks. On reasons for entering and maintaining the practice, it was found that such was conducted and maintained for egoistic reasons, self-expression, legacy, or spirituality. Lastly, it was found that advantages on health and subsistence, personal development, and social rewards were the perceived derived benefits from the practice of pagsasanto. These findings suggest implications pertaining to the dynamics of religiosity and non-normative gender identity in the Philippines where the Church finds willing caretakers among gay Catholics while gays find an avenue for the expression of gender identity and creativity in the task given to them.

ObjectivesPrevious studies have demonstrated that rectal douching (RD) is associated with HIV acquisition among men who have sex with men (MSM). However, the precise mechanism underlying the association between RD and HIV remains unclear.MethodsWe recruited participants over WeChat from October 2017 to October 2018. Respondents received mailed HIV self-testing kits, uploaded images of HIV self-test results and completed an online electronic questionnaire simultaneously. The questionnaire assessed sociodemographic characteristics, RD practices and sexual risk behaviours. HIV status was measured as the result of the HIV self-testing. The Baron and Kenny statistical method was used to assess the association between RD and HIV, controlling for condomless anal intercourse (CAI) and rectal bleeding.ResultsOf 1365 participants, 39.93% (545/1365) reported RD in the past 6 months, 60.07% had multiple male sexual partners and 43.08% had CAI in the past 6 months. The prevalence of HIV, based on self-testing, was 3.37% (46/1365). Multivariable logistic analysis showed RD was significantly associated with bottom sexual role (adjusted OR (aOR) 14.0; 95% CI 9.8 to 20.2), having multiple male sexual partners (aOR 1.8; 95% CI 1.4 to 2.2), CAI (aOR 1.3; 95% CI 1.0 to 1.6), rectal bleeding (aOR 2.0; 95% CI 1.6 to 2.6) and HIV infection (aOR 1.9; 95% CI 1.0 to 3.4). Baron and Kenny analysis found both CAI (aOR 2.2; 95% CI 1.2 to 4.1) and rectal bleeding (aOR 1.9; 95% CI 1.0 to 3.4) play a mediating role in the association between RD and HIV.ConclusionsOur study results confirmed the relationship between RD and HIV, and found CAI and rectal bleeding mediated HIV infection in Chinese MSM who douched. Strategies should be encouraged to strengthen health education and reduce high-risk sexual behaviour in order to reduce the risk of HIV in MSM who use enemas. Rectal microbicides may represent an efficient means of providing HIV prophylaxis among MSM.

The mediating effect of perceived social support on the influence of insecure attachment orientations on internalized homophobia was assessed in a group of 70 Italian gay men (mean age = 28.8, SD = 6.2, range: 19-46 years). Participants completed self-report measures of adult attachment (Experiences in Close Relationships-Revised), perceived social support (Multidimensional Scale of Perceived Social Support), and internalized homophobia (Measure of Internalized Sexual Stigma for Lesbians and Gay). Higher levels of attachment anxiety and avoidance, and perceptions of lower social support were correlated with higher levels of internalized homophobia. The mediation analyses showed that only attachment anxiety, but not avoidance, may have a direct link with internalized homophobia, while both anxiety and avoidance may have an indirect influence on internalized homophobia mediated by perceived social support. Improving social support can reduce the negative effects of homophobia on gay men, thus mitigating the detrimental fallout of any insecure attachment orientations.

This mixed‐methods article focuses on childlessness and barriers to parenthood among non‐heterosexual men in Czechia. On the quantitative sample of 419 men (165 gays, 125 bisexuals, and 129 heterosexuals with same‐sex romantic/sexual attraction), recruited on a representative online panel, we map the parenting desires, intentions, and perceived barriers to parenthood. Our analysis identifies a substantial group of gay men without parenting desires and intentions compared to heterosexuals and bisexuals, and the lack of legal recognition of same‐sex families as a crucial barrier to gay parenthood. The qualitative enquiry, based on semi‐structured interviews with 23 self‐identified gay men aged 25 to 47 years, explores how they reflect on (not) becoming parents and contextualises those reflections. The deployed concept of “parental consciousness” captures the variety of considered pathways to gay parenthood and proves itself useful in understanding the low parenting desires and a generational shift among Czech gay men. We argue that men able to come out in their early adulthood in the post‐socialist context tend to have more diversified perspectives on possible pathways to parenthood. Among gaymen without children, we identified three distinct perceptions of the state: given childlessness, chosen childfree life, and a life stage/indecision. The informants pursuing parenthood have seen identity‐specific barriers to parenthood as crucial, which is discussed in the context of state selective regulations of the relational lives of persons with non‐normative identities. Although Czech gay men’s parental consciousness has increased, legal conditions remain crucial for increasing their real‐life options.

BACKGROUND: Research on HIV and reproduction has focused largely on women and heterosexual men. This article examines whether it is relevant to address parenthood in HIV care with gay men and what ways of doing so are most appropriate. METHODS: Qualitative interviews were conducted at four London clinics with 25 men living with HIV, aged 20-45, who did not have children, and 16 HIV clinicians. A thematic analysis identified potential reasons why parenthood was rarely discussed with gay men in HIV care. RESULTS: Two sets of ideas contributed to a lack of conversations about parenthood: clinicians' ideas about what matters to gay men and men's ideas about what it means to be HIV-positive. Both sets of ideas largely excluded having children, with patients and practitioners similarly unlikely to raise the topic of parenthood in the clinic. Contrary to what clinician commonly assumed, many men expressed interest in receiving more information, highlighting the importance of reassuring people upon diagnosis that it is possible to become parents while living with HIV. CONCLUSIONS: Parenting desires and intentions were rarely discussed with men in HIV care. Our findings illuminate the potentially beneficial effects of emphasising that having children is a possibility at diagnosis, regardless of patients' gender or sexuality. Conveying this information seems meaningful, not only to men who want to become parents in the future but also to others, as it appears to alleviate fears about mortality and ill health., British HIV Association Isaac Newton Trust Leverhulme Trust (ECF-2018-146) Wellcome Trust (100606/Z/12/Z)

This research has been funded by the Ministerio de Universidades (Espana) through the Bursary [FPU19/00369] for University Professor Training as part of the first author's thesis (Psychological Doctoral Programme [B13 56 1; RD 99/2011])., Currently, no validated instrument exists for assessing the subjective experience of orgasm in the gay population. The Orgasm Rating Scale (ORS), previously validated in the heterosexual population, comprises four dimensions: Affective, Sensory, Intimacy, and Rewards. This study validated it for sexual relationships in the gay population by obtaining its factorial invariance by sexual orientation and sex, its internal consistency reliability, and evidence of validity in its relationship with other variables. We assessed 1600 cisgender Spanish adults–heterosexuals, gays, and lesbians–divided into 4, sex-based groups of 400 each, according to the Kinsey scale scores. Participants reported recent experiences of orgasm in the context of sexual relationships and responded to the ORS and other scales assessing attitude toward sexual fantasies and sexual functioning. The ORS structure showed a strict multigroup-level invariance by sexual orientation and sex, confirming its four-dimensional structure. The subjective orgasm intensity was associated with a positive attitude toward sexual fantasies and sexual functioning. Scores obtained on the Affective, Intimacy, and Rewards dimensions confirmed the ability to discriminate between gay people with and without orgasmic difficulties. The ORS’s Spanish version presents good psychometric properties as a validated scale to evaluate the subjective experience of orgasm in the gay population., Ministerio de Universidades (Espana) FPU19/00369 B13 56 1 99/2011

Background Oral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) has been found to reduce viral acquisition among HIV-negative MSM. This cross-sectional study was conducted before pre-exposure prophylaxis (PrEP) licensure in Israel, and aimed to compare men who have sex with men (MSM) who had heard of PrEP with those who had not, as well as MSM willing to take PrEP with those who were hesitant or not willing to take PrEP. Methods HIV-negative MSM responded anonymously to questionnaires in 2017 regarding their knowledge of and willingness to take PrEP, prior use of PrEP and post-exposure prophylaxis (PEP), and their sexual behaviors. Results Among 1705 participants, 1431 (83.9%) had heard about PrEP. They were older and more often reported being Jewish, having an academic degree, self-identifying as gay/bisexual, being tested for HIV in the last year, participating in group sex, using alcohol or drugs before or during sex, and having prior use of PrEP/PEP compared with MSM who had not heard about PrEP. A total of 760 (44.8%) participants indicated that they would consider taking PrEP, 567 (33.5%) maybe would consider taking PrEP, and 367 (21.7%) would not take PrEP. Those who were willing to take PrEP had a lower level of education, were involved in high-risk sexual behaviors, used alcohol or drugs before or during sex, and had previously used PrEP/PEP compared with participants who maybe would consider taking or would not take PrEP. When participants were asked to indicate if they were willing to take PrEP at different potential efficacies and costs, the willingness to using PrEP increased with the potential efficacy of the drug and adversely related to its cost. Conclusions PrEP awareness was high, and 44.8% indicated willingness to take PrEP, especially those who reported high-risk sexual behaviors. This supports the current policy in Israel to allow PrEP to MSM who are at high-risk. In order to maintain a high level of PrEP-adherence, physicians should consider structural barriers, such as negative stigma of being promiscuous, lack of perceived HIV-risk, difficulties in accessing clinics or paying for PrEP, inability to follow-up or low tolerability of the medication.

Previous studies have shown that lesbian and gay (LG) individuals, in comparison to their heterosexual counterparts, tend to report lower levels of parenthood desire. While numerous variables have been suggested to explain this gap in parenthood aspirations, no study has investigated the mediating role of avoidant attachment in the association between sexual orientation and parenthood desire. For that purpose, a sample of 790 cisgender Israelis aged 18–49 years (M = 28.27, SD = 4.76) was recruited using convenience sampling. Among the participants, 345 self-reported as predominantly or exclusively lesbian or gay and 445 self-reported as exclusively heterosexual. Participants completed online questionnaires assessing their sociodemographic characteristics, parenthood desire, and avoidant and anxious attachment styles. Mediation analyses were performed using the PROCESS macro, and the results revealed that LG individuals reported lower parenthood desire, higher avoidant attachment, and higher anxious attachment compared to heterosexual individuals. Moreover, avoidant attachment had a significant mediation effect in the association between sexual orientation and parenthood desire. The findings suggest that LG individuals are more likely to report higher avoidant attachment due to possible rejection and discrimination from family members and peers, and this may be associated with lower parenthood desire. The results contribute to the growing body of research on family formation and parenthood aspirations among LG individuals, and specifically studies aimed at delineating the factors that contribute to the gap in parenthood aspirations between sexual minority individuals and their heterosexual counterparts.

Cisgender men partnered with transgender women are an understudied and hard to engage population in HIV prevention efforts. Relationship stigma-the anticipation of negative treatment based on having a relationship with a member of a stigmatized group-has been linked to adverse health behaviors, but it remains unclear whether different sources of relationship stigma (i.e., family, friends, and the general public) are associated with HIV risk behaviors and whether these associations may vary by men's sexual identities (e.g., gay, bisexual, and heterosexual). The current study examined associations between relationship stigma and HIV risk behaviors and whether these associations were moderated by sexual identity. We recruited a convenience sample of 185 cisgender men in primary partnerships with transgender women to participate in a one-time survey. Gay identified men reported greater levels of relationship stigma from the general public compared with heterosexually identified men. In multivariable models, higher levels of relationship stigma from the public were associated with increased odds of engaging in drug use prior to having condomless sex and receiving an STI diagnosis in the last 30days. There were significant interaction effects such that higher levels of relationship stigma from the public were associated with both indicators of HIV risk for gay identified men but not for heterosexually identified men. Findings support the importance of HIV prevention approaches accounting for relationship stigma from the general public and the diverse sexual identities of men partnered with transgender women when seeking to increase linkage to and engagement in HIV prevention services, including biomedical prevention strategies.

A recently growing literature explored the effect of mindfulness on the reduction of stereotypes and prejudice. However, studies exploring the relationship between dispositional mindfulness and prejudice are very limited and contradictory. The current work focused on the associations of dispositional mindfulness with internalized sexual stigma and sexual prejudice in gay/bisexual men and heterosexual men, respectively. Participants were 180 Italian men, both heterosexual (N = 91, 50.6%) and gay/bisexual (N = 89, 49.4%), ranging between 18 and 40 years old (M = 28.23, SD = 5.59) that completed a questionnaire which contained demographic information and measures of mindfulness, need for cognitive closure, and adherence to traditional and stereotypical gender roles. In order to test the predictive power of mindfulness’ dimensions on internalized sexual stigma and on sexual prejudice over and above the other predictors, we used dominance analysis. Analyses revealed that only the FFMQ-Nonjudging of inner experience explained a proportion of variance of internalized sexual stigma significantly larger than zero, whereas the variance of the score on the sexual prejudice was mostly accounted for by right-wing political orientation and FFMQ-Observing. Having a mindful nonjudging attitude toward one’s inner experience would associate to less internalized sexual stigma in gay and bisexual men, whereas having a mindful observing disposition would help heterosexual men to have less sexual prejudice against gay men. Limitations and future directions are discussed.

This study aims to explore attitudes towards age-discrepant relationships and examine the influence of variables such as gender, generation and culture on such attitudes. The sample was made up of 1,510 participants divided into three age groups (18-29, 60-69 and 70 years and over) from eight Latin American countries. Participants' answers to two incomplete sentences regarding age-discrepant couples were content analyzed and a series of binary logistic regressions were run to test the association of the resulting categories with the independent variables included in the study. Results showed that attitudes towards age-discrepant relationships were fairly evenly split between acceptance (44.8%) and rejection (41.3%). Participants' attitudes were significantly associated with gender, generation and culture. Findings from this study suggest that negative attitudes towards age-discrepant couples are pervasive, accounting for almost 50% of responses. A broader, more inclusive view of relationships between generations should be promoted, particularly among younger generations. info:eu-repo/semantics/publishedVersion

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. PrEP is a novel, clinically effective biomedical HIV prevention tool but it has not met with widespread public acceptance. In this article, the results of a study designed to develop a scale for measuring attitudes toward PrEP is presented. The psychometric properties of the scale are described for use in both the general population and in patient samples. 222 university students completed the Attitudes toward PrEP Scale (APS) and additional measures of attitudes toward gay men, Black Africans and condom use. The APS comprised 3 factors (Attitudes toward the Science of PrEP, Perception of Sexual Health Risks of PrEP, and Perception of Dangerous Effects of PrEP) which explained 49.31% of the variance. The 14-item APS had a good internal consistency, α=.72, and satisfactory concurrent validity with measures of condom use, and attitudes toward social groups associated with PrEP. Additional studies in other non-student samples are required to assess the external validity of the scale.

Several studies have highlighted the relationship between internalized sexual stigma (ISS) and dissociation. The aim of the present study was to empirically investigate this relationship through a quantitative study. The Measure of Internalized Sexual Stigma for Lesbians and Gay Men (MISS-LG) and the Dissociation Scale (DIS) of the Trauma Symptom Inventory (TSI) were administered to 120 Caucasian participants who self-identified as gay men. Findings suggested that dissociative symptomatology, as measured by DIS-an estimation of the use of dissociation as a defense mechanism-was positively associated with MISS general index and all dimensions of MISS, especially the sexuality dimension (ISS-S). Moreover, the effect of the ISS-S on DIS was amplified in Catholic participants, suggesting a moderating role of religiosity. Implications for future research and clinical practice are discussed.

Purpose: No prior study has been published on suicide-related behaviors among gay, bisexual, transgender, and queer (GBTQ) men in Singapore, where sexual relations between men are criminalized. This study explores the association and mediational pathways between experienced homophobia and suicidal ideation or suicide attempts among young GBTQ men in Singapore. Methods: Results of this study were derived from baseline data of the Pink Carpet Y Cohort Study, Singapore's first prospective cohort study among young GBTQ men. The sample comprised 570 young GBTQ men 18 to 25 years of age who were HIV negative or unsure of their HIV status. Statistical analyses were conducted through descriptive statistics, multivariable logistic regression, and structural equation modeling techniques. Results: Of 570 participants, 58.9% (n = 308) reported ever contemplating suicide, whereas 14.2% (n = 76) had ever attempted suicide. Controlling for key demographic variables, multivariable logistic regression revealed that experienced homophobia and depression severity were positively associated with a history of suicidal ideation, whereas depression severity and outness were positively associated with a history of suicide attempts. Mediation analyses revealed that depression severity and self-esteem partially accounted for the relationship between experienced homophobia and suicidal ideation, whereas depression severity and outness partially accounted for the relationship with suicide attempts. Conclusions: The prevalence of suicidal ideation and past suicide attempts was found to be high in a sample of young GBTQ men in Singapore. Interventions to address experienced homophobia and discrimination among young GBTQ men are needed urgently in Singapore.

We investigated whether HIV stigma in the Netherlands has changed in recent years. We compared data on stigma settings and manifestations from 2007 (n = 667) and, specifically for the health care sector, 2009 (n = 262), to data acquired in 2019 and 2020 (n = 258). Results showed reductions in stigma from friends, family, acquaintances, at work, in the financial services sector, and in media. However, stigmatizing messages in media remained highly prevalent. Stigma in the LGBTQI+ community, with sexual partners, and while partying remained prevalent and, disconcertingly, relatively unchanged. Stigma in health care increased for a number of stigma manifestations, including physical distance, excessive preventive measures, awkward social interactions, avoidance, and unnecessary referrals. As expected, HIV stigma was positively related to psychological distress, and negatively related to social support and medication adherence. Further, most participants were familiar with U=U and PrEP, but 13.3% questioned the accuracy of U=U. Overall, the findings suggest that stigma reduction efforts should focus on reducing stigma in media, in the LGBTQI+ community and while dating, and in health care. In all of these contexts, a key message is U=U.

This study aimed to explore the psychological welfare, as indicated by postnatal depressive symptomatology, life satisfaction, and posttraumatic growth (growth after contending with stressful birth events), of Israeli gay fathers through surrogacy in comparison to heterosexual fathers. For that purpose, a sample of 167 Israeli fathers (M = 35.6, SD = 4.4) was recruited (68 identified as gay fathers through surrogacy and 99 as heterosexual fathers). Participants completed questionnaires assessing their postnatal depressive symptomatology, life satisfaction, and sense of posttraumatic growth after becoming fathers. Results indicated that gay fathers through surrogacy reported higher levels of life satisfaction and posttraumatic growth than heterosexual fathers. Yet, gay fathers also reported higher levels of postnatal depressive symptomatology than heterosexual fathers when life satisfaction or posttraumatic growth values were low or medium. The findings were interpreted in light of the hardships associated with cross-border surrogacy and the psychological outcomes associated with succeeding to become fathers after contending with them. The study contributes to the limited literature on postnatal depressive symptomatology and posttraumatic growth among gay fathers through surrogacy and provides clinicians and policymakers with relevant information on the psychological strengths and potential difficulties associated with cross-border surrogacy among gay fathers.

India has one of the largest numbers of men who have sex with men (MSM) globally; however, geographic data on sexually transmitted infection (STI) prevalence and associations with sexual behavior are limited. Six-hundred and eight MSM in Chennai and Mumbai underwent screening for a behavioral trial and were assessed for bacterial STIs (syphilis, chlamydia, gonorrhea), HIV, and past-month self-reported condomless anal sex (CAS). Mumbai (37.8%) had a greater prevalence of any STI than Chennai (27.6%) (prevalence ratio [PR] = 1.37, 95% CI: 1.09, 1.73). This pattern also emerged for gonorrhea and chlamydia separately but not syphilis. Conversely, Mumbai MSM reported lower rates of CAS (mean = 2.2) compared to Chennai MSM (mean = 14.0) (mean difference = -11.8, 95% CI: -14.6, -9.1). The interaction of city by CAS on any STI prevalence (PR = 2.09, 95% CI: 1.45, 3.01, p

Gay men have been severely affected by the AIDS crisis, and gay subjectivity, sexual ethics, and politics continue to be deeply influenced by HIV to this day. PrEP (Pre-Exposure Prophylaxis) is a new, drug-based HIV prevention technique, that allows disentangling gay sex from its widespread, 40 yearlong association with illness and death. This article explores PrEP’s fundamental impact on gay subjectivity, sexual ethics, and politics. It traces the genealogy of gay politics regarding homophobia and HIV stigma, suggesting a new biopolitical and body political framework that accounts for the agency of activists as well as pharma power, and proposing that PrEP is an example of democratic biopolitics. Highlighting the entanglement of medical technology, sexual ethics, and politics, the article shows how conservative and homonormative gay politics developed as a reaction to HIV stigma and how, by overcoming this stigma, PrEP enables a new era of intersectional queer politics and solidarities. It thereby develops a Foucauldian account of sexual liberation beyond the repression hypothesis that accounts for the ambivalence of sexual subjectification and the political potential of sexuality., Body Politics: Zeitschrift für Körpergeschichte, vol. 8(2020), no. 12, p. 214

Aquest estudi examina l’autopresentació dels homes gais xinesos sobre l’aplicació de cites Blued mitjançant un enfocament de mètodes mixtos. Es van realitzar dos estudis. En l’estudi 1, es van recopilar i analitzar 930 perfils per obtenir una comprensió quantitativa sobre com els homes gais xinesos utilitzen elements fotogràfics i textuals per presentar-se a Blued. Per investigar encara més com i per què els homes gais xinesos es presenten visualment i textualment de determinades maneres, 30 usuaris de Blued van ser entrevistats a l’estudi 2. Segons les conclusions de l’estudi 1, només aproximadament un terç dels perfils d’homes gais xinesos contenien, com a mínim, una foto de la cara que es pogués reconèixer als seus perfils de color blau. Es van provar les correlacions entre dades demogràfiques i divulgació facial. Els homes gais més grans tenen menys probabilitats de divulgar una foto de la cara a Blued que els gais més joves. Es van comptar les freqüències i el percentatge de masculinitat, el llenguatge corporal i esportiu i es van provar les correlacions entre la demografia i els diferents tipus d’ús del llenguatge. El percentatge de masculinitat, llenguatge corporal i esportiu utilitzat en perfils de Blued és del 37,6%, 20,9% i 6,2% respectivament. Es va trobar que l’edat, l’alçada i el pes estaven correlacionats amb diferents tipus d’ús del llenguatge. Les persones que els agrada utilitzar el llenguatge masculí són més propenses a utilitzar el llenguatge corporal i esportiu. Els resultats de l’Estudi 2 mostren que els homes gais xinesos tenen cinc motius principals per construir un perfil Blued: buscar relacions sexuals casuals, buscar relacions romàntiques / a llarg termini, buscar amics, entreteniment i buscar comoditat fisològica. Els homes gais xinesos utilitzen una sèrie d’estratègies per construir els seus perfils: prestar atenció a les petites indicacions, equilibrar l’autenticitat i l’engany, establir la credibilitat i evitar les limitacions tecnològiques. Els homosexuals xinesos tenen diferents motius per no revelar una foto de la cara als seus perfils de Blued. La preocupació per exposar la identitat gai és el motiu més freqüentment informat. Altres motius inclouen: la característica de disseny de la plataforma, la ubicació de l’usuari, els objectius relacionals, la manca de confiança en l’aspecte personal i les preocupacions pel mal ús de les fotos. L’avaluació de la impressió dels perfils d’altres també ha impactat en la construcció del perfil Blued dels homes gais xinesos. A l’hora d’avaluar els perfils construïts per altres homes gais, els homes gais xinesos utilitzen tres estratègies: prestar atenció a les petites indicacions, filtrar i creure en un engany desenfrenat. Aquest estudi omple el buit de la investigació sobre l’autopresentació dels homes gais xinesos en aplicacions de cites per a mòbils i indica que l’autopresentació és sensible als factors culturals i institucionals. Este estudio examina la autopresentación de los hombres homosexuales chinos en la aplicación de citas Blued utilizando un enfoque de métodos mixtos. Se realizaron dos estudios. En el estudio 1, se recopilaron y analizaron 930 perfiles para obtener una comprensión cuantitativa de cómo los hombres homosexuales chinos utilizan elementos tanto fotográficos como textuales para presentarse en Blued. Para investigar más a fondo cómo y por qué los hombres homosexuales chinos se presentan visual y textualmente de ciertas maneras, se entrevistó a 30 usuarios de Blued en el estudio 2. Según los hallazgos del estudio 1, solo alrededor de un tercio de los perfiles de hombres homosexuales chinos contenían al menos una foto de rostro reconocible en sus perfiles de Blued. Se probaron las correlaciones entre la demografía y la revelación facial. Los hombres homosexuales mayores son menos propensos a revelar una foto de la cara en Blued que los homosexuales más jóvenes. Se contaron las frecuencias y el porcentaje de masculinidad, el lenguaje corporal y deportivo, y se probaron las correlaciones entre la demografía y los diferentes tipos de uso del lenguaje. El porcentaje de masculinidad, lenguaje corporal y deportivo utilizado en los perfiles Blued es del 37,6%, 20,9% y 6,2% respectivamente. Se encontró que la edad, la altura y el peso estaban correlacionados con diferentes tipos de uso del lenguaje. Las personas a las que les gusta usar el lenguaje de masculinidad son más propensas a usar el lenguaje corporal y deportivo. Los resultados del Estudio 2 muestran que los hombres homosexuales chinos tienen cinco motivos principales para construir un perfil Blued: buscar sexo casual, buscar relaciones románticas / a largo plazo, buscar amigos, entretenimiento y buscar comodidad psicológica. Los hombres gay chinos utilizan una serie de estrategias para construir sus perfiles: prestar atención a las pequeñas señales, equilibrar la autenticidad y el engaño, establecer credibilidad y eludir las limitaciones tecnológicas. Los hombres homosexuales chinos tienen diferentes razones para no revelar una foto de la cara en sus perfiles de Blued. Preocuparse por exponer la identidad gay es la razón más frecuentemente denunciada. Otras razones incluyen: la característica de diseño de la plataforma, la ubicación del usuario, los objetivos relacionales, la falta de confianza en la apariencia personal y la preocupación por el mal uso de las fotos. La evaluación de la impresión de los perfiles de otros también ha afectado la construcción del perfil Blued de los hombres homosexuales chinos. Al evaluar los perfiles construidos por otros hombres homosexuales, los hombres homosexuales chinos utilizan tres estrategias: prestar atención a las pequeñas señales, filtrar y creer en el engaño desenfrenado. Este estudio llena el vacío en la investigación sobre la autopresentación de los hombres homosexuales chinos en aplicaciones de citas móviles e indica que la autopresentación es sensible a factores culturales e institucionales. This study examines Chinese gay men’s self-presentation on dating app Blued by utilizing a mixed-methods approach. Two studies were conducted. In study 1, 930 profiles were collected and analyzed to gain a quantitative understanding about how Chinese gay men utilize both photographic and textual elements to present themselves on Blued. To further investigate how and why Chinese gay men present themselves visually and textually in certain ways, 30 Blued users were interviewed in study 2. According to the findings of study 1, only about a third of Chinese gay men’s profiles contained at least a recognizable face photo in their Blued profiles. Correlations between demographics and face disclosure were test. Older gay men are less likely to disclose a face photo on Blued than younger gay men. Frequencies and percentage of masculinity, body and sport language were counted, and correlations between demographics and different types of language use were test. The percentage of masculinity, body and sport language used in Blued profiles are 37.6%, 20.9% and 6.2% respectively. Age, height and weight was found to be correlated with different types of language use. People who like using masculinity language are more likely to use body and sport language. The results of Study 2 shows that Chinese gay men have five major motives of constructing a Blued profile: looking for casual sex, looking for romantic/long term relationships, looking for friends, entertainment and seeking phycological comfort. Chinese gay men use a series of strategies to construct their profiles: paying attention to small cues, balancing authenticity and deception, establishing credibility, and bypassing technological constraints. Chinese gay men have different reasons for not disclosing a face photo in their Blued profiles. Worrying about exposing gay identity is the most frequently reported reason. Other reasons include: the design feature of the platform, location of the user, relational goals, lack of confidence in personal appearance, and concerns of photos being misused. Impression evaluation of other’s profiles have also impacted Chinese gay men’s Blued profile construction. When evaluating the profiles constructed by other gay men, Chinese gay men use three strategies: paying attention to small cues, filtering, and believing in rampant deception. This study fills the gap in the research regarding Chinese gay men’s self-presentation on mobile dating apps and indicates that self-presentation is sensitive to cultural and institutional factors. Universitat Autònoma de Barcelona. Programa de Doctorat en Comunicació i Periodisme

The purpose of the present study was to elucidate the complexity of modern-day hiring discrimination against gay men. This is the first study known to the author that experimentally manipulated gender presentation (feminine or masculine), sexual orientation (gay or heterosexual), and job type (gay- and female-typed or heterosexual- and male-typed) to examine their collective effect on hiring recommendation. Furthermore, much remains to be understood about how descriptive and prescriptive stereotypes operate to explain hiring discrimination against gay men. Drawing on implicit inversion theory, social cognitive career theory, and the lack of fit model, a descriptive stereotype model was proposed to investigate the influence of descriptive stereotypes (perceptions of communality and agency) about male subtypes (gender presentation-sexual orientation combinations), in conjunction with occupational stereotypes about the extent to which different male subtypes are believed to occupy specific job types, on perceptions of job fit and hiring recommendation. Drawing on expectancy violation theory, a prescriptive stereotype model was also proposed to explore the influence of stereotypical expectations about male subtypes, and male subtype-job type combinations, on consequences of prescriptive stereotype violation (perceptions of respect) and hiring recommendation. Sexual orientation did not have an effect in the descriptive or prescriptive stereotype models. However, results of the descriptive stereotype model revealed that perceptions of job fit decreased when gender presentation misaligned with job type (feminine-presenting men who applied to the heterosexual- and male-typed job and masculine-presenting men who applied to the gay- and female-typed job). Evidence of moderated mediation indicated that when applying to the heterosexual- and male-typed job, feminine-presenting men were seen as less agentic, and thus received lower ratings for hiring recommendation, than masculine-presenting men. In contrast, when applying to the gay- and female-typed job, masculine-presenting men were seen as less communal, and thus received lower ratings for hiring recommendation, than feminine-presenting men. These findings suggest that perceptions of agency and communality, and job fit, were serial mediators that positively correlated with hiring recommendation. Evidence of moderated mediation for the prescriptive stereotype model occurred only for the gay- and female-typed job, revealing that masculine-presenting men were less respected, and thus received lower ratings for hiring recommendation, than feminine-presenting men. Follow-up research to develop and refine the proposed descriptive and prescriptive stereotype models is crucial to furthering our understanding of hiring discrimination against gay men in today’s organizations.

In recent years, the ‘end of AIDS’ has been at the top of the international scientific and political agenda. At the same time, attention to the dark years of the epidemic is increasing, revealing a form of nostalgia for a time of collective mobilization. But what is to be said of the current state of the disease, between the nostalgia for a tragic past and the hope of a world without AIDS? This think piece was prompted by the increasing erasure of contemporary experiences of the sickness. At a time when we have the means to render HIV biologically undetectable, I propose to explore another of the virus’s materialities: its social and historic inscription in urban settings, in particularly in Montreal’s gay neighbourhood.

Background Literature in the West suggested that bisexual men have a higher smoking rate compared to gay men. Data on patterns of smoking among gay and bisexual men are limited in Eastern Asian countries like China. This study examined the cigarette smoking prevalence for gay versus bisexual men in China and their unique minority stress - smoking pathways. Methods Between September 2017 and November 2018, we surveyed a convenience sample of 538 gay men and 138 bisexual men recruited from local sexual minority organizations in four metropolitan cities in China (i.e., Beijing, Wuhan, Nanchang, and Changsha). Measures included sexual orientation, sociodemographics, theory-based minority stressors, depressive symptoms, and past 30-day cigarette smoking. Two-group (gay men vs. bisexual men) structural equation modeling (SEM) was used to test possible distinct mechanisms between theory-based stressors, depressive symptoms, and cigarette smoking among gay men and bisexual men, respectively. Results The mean age of participants was 26.51 (SD = 8.41) years old and 76.3% of them had at least a college degree. Bisexual men reported a higher rate of cigarette smoking compared to gay men (39.9% vs. 27.3%). Two-group SEM indicated that the pathways for cigarette smoking were not different between gay and bisexual men. Higher rejection anticipation was associated with greater depressive symptoms (standardized β = 0.32, p Conclusions Minority stress, specifically rejection anticipation, may be critical considerations in addressing depressive symptoms, but not smoking, among both gay and bisexual men in China.

Funder: Isaac Newton Trust, Funder: British HIV Association, It is now established that people living with HIV who have an undetectable viral load and adhere to antiretroviral treatment cannot transmit HIV to their sexual partners. Previous research has shown that ‘being undetectable’ changes how HIV‐positive gay men experience their sex lives. But how does it affect gay men’s reproductive behaviours? And what influence does it have on views about parenthood at a time when gay fatherhood has become more socially accepted and publicly visible? Drawing on qualitative interviews with patients and clinicians at four HIV clinics in London, we identify differences in how interviewees talked about the possibility of having children for HIV‐positive men. Both groups, unprompted, frequently referred to sperm washing as a method enabling safe conception. However, whereas clinicians talked about sperm washing as an historical technique, which is no longer necessary, patients spoke of it as a current tool. The men rarely mentioned being undetectable as relevant to parenthood and, when prompted, some said that they did not fully understand the mechanics of HIV transmission. Our findings offer new insights into how biomedical knowledge is incorporated into people’s understandings of living with HIV, raising important questions about how the meanings of being undetectable are communicated.

Stereotypes typically have negative impacts on stigmatized minority groups, especially when endorsed by members of that group. This paper examines the prevalence and consequences of stereotype endorsement on well-being within the gay community. Specifically, we explored how gay men’s self-stereotype (i.e., personal beliefs about the stereotypes pertaining to one’s in-group) and meta-stereotype (i.e., believing that out-group members endorse stereotypes pertaining to one’s in-group) endorsement would be related to mental and cognitive well-being. The sample of 253 gay male participants (aged 18–78 years; M = 38.25, SD = 13.51) completed an online questionnaire assessing demographics, self- and meta-stereotype endorsement, mental well-being (depression, anxiety, stress), and cognitive well-being (life satisfaction, self-worth) measures. We found evidence that our sample endorsed both self- and meta-stereotypes, with meta-stereotypes being endorsed more strongly than self-stereotypes. Regression analyses revealed a unique pattern of findings about the consequences of endorsing stereotypes: increases in self-stereotyping predicted decreases in mental well-being, whereas increases in meta-stereotyping predicted decreases in cognitive well-being. Limitations and future directions are discussed.

ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing.MethodsWe conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis.ResultsFor HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and external motivators, respectively. Availability of bundle tests, starting a new relationship and instances of mandatory testing motivated both simultaneous HIV and other STI testing. The fear of a positive diagnosis and lack of confidentiality were cited as internal and external barriers to HIV testing, respectively, while low perceived severity of other STI and the cost of STI tests were cited as internal and external barriers to other STI testing, respectively. We identified pathways to HIV and other STI testing and discussed how the introduction of HIVST may reduce opportunities for other STI testing.ConclusionsThe findings of this study suggest that introducing HIVST might weaken linkages to other STI testing if alternative strategies of promoting other STI testing are not simultaneously implemented. We recommend that future interventions address both the risks of HIV and other STI simultaneously, and that structural interventions promoting HIV and other STI preventions be balanced accordingly.

The use of HIV Treatment as Prevention (TasP) has radically changed our understandings of HIV risk and revolutionised global HIV prevention policy to focus on the use of pharmaceuticals. Yet, there has been little engagement with the very people expected to comply with a daily pharmaceutical regime. We employ the concept of HIV citizenship to explore responses by people living with HIV in the UK to TasP. We consider how a treatment-based public health strategy has the potential to reshape identities, self-governance and forms of citizenship, domains which play a critical role not only in compliance with new TasP policies, but in how HIV prevention, sero-discordant relationships and (sexual) health are negotiated and enacted. Our findings disrupt the biomedical narrative which claims an end to HIV through scaling up access to treatment. Responses to TasP were framed through shifting negotiations of identity, linked to biomarkers, cure and managing treatment. Toxicity of drugs – and bodies – were seen as something to manage and linked to the shifting possibilities in sero-discordant environments. Finally, a sense of being healthy and responsible, including appropriate use of resources, meant conflicting relationships with if and when to start treatment. Our research highlights how HIV citizenship in the TasP era is negotiated and influenced by intersectional experiences of community, health systems, illness and treatment. Our findings show that the complexities of HIV citizenship and ongoing inequalities, and their biopolitical implications, will intimately shape the implementation and sustainability of TasP.

Bear subculture exists within a larger gay community, which has been recognized by public health experts as disproportionately burdened with stigma and related health adversities. Bears are distinguished by a particular body look&mdash, body hirsuteness and heavy-set physique. Previous research documented the various health risks, and the exposure to both sexual minority and weight stigma, of this population. In this study we focused on the determinants of self-esteem in Bears. We explored the significance of such predictors as: perceived sexual minority and weight stigma, age, resilience, and physique as reflected by the BMI. Our sample consisted of 60 men from the Polish Bear community (i.e., Bears, Cubs, Otters, Wolves). Linear regression models were performed for the entire sample (N = 60) and for Bear-identified men (N = 31). Perceived sexual minority stigma negatively, and resilience positively, predicted self-esteem. In the case of Bear-identified men, age, perceived exposure to weight discrimination, and BMI were also significant predictors of self-esteem. Higher BMI in the case of Bear-identified men predicted higher self-esteem. Our results suggest that although Bear-identified men are characterized by their similarities to other gay men, subcultural identities create unique social contexts that are important for health and health interventions in this population.

BackgroundPre-exposure prophylaxis (PrEP) is an effective method for reducing HIV incidence among at-risk populations. However, concerns exist over the potential for an increase in STIs following PrEP initiation. The objective of this study is to compare the STI incidence before and after PrEP initiation within subjects among a cohort of men who have sex with men in Los Angeles, California.MethodsThe present study used data from patients who initiated PrEP services at the Los Angeles LGBT Center between October 2015 and October 2016 (n=275). A generalised linear mixed model was used with a case-crossover design to determine if there was a significant difference in STIs within subjects 365 days before (before-PrEP period) and 365 days after PrEP initiation (after-PrEP period).ResultsIn a generalised linear mixed model, there were no significant differences in urethral gonorrhoea (P=0.95), rectal gonorrhoea (P=0.33), pharyngeal gonorrhoea (P=0.65) or urethral chlamydia (P=0.71) between periods. There were modest increases in rectal chlamydia (rate ratio (RR) 1.83; 95% CI 1.13 to 2.98; P=0.01) and syphilis diagnoses (RR 2.97; 95% CI 1.23 to 7.18; P=0.02).ConclusionsThere were significant increases in rectal chlamydia and syphilis diagnoses when comparing the periods directly before and after PrEP initiation. However, only 28% of individuals had an increase in STIs between periods. Although risk compensation appears to be present for a segment of PrEP users, the majority of individuals either maintain or decrease their sexual risk following PrEP initiation.

ObjectivesInternet-based STI testing programmes may overcome barriers posed by in-clinic testing, though uptake could reflect social gradients. The role these services play in comparison to clinical testing services is unknown. We compared experiences of testing barriers between STI clinic clients to clients of GetCheckedOnline.com (GCO; where clients take a printed lab form to a lab).MethodsOur 10-month cross-sectional study was conducted after GCO was promoted to STI clinic clients and men who have sex with men (MSM). Clinic and GCO clients completed an online survey assessing testing barriers and facilitators; responses were compared using bivariate analysis (level of significance PResultsCompared with 321 clinic clients, the 73 GCO clients were more likely to be older (median 35 vs 30 years), MSM (45% vs 16%), be testing routinely (67% vs 39%), have delayed testing for any reason (76% vs 54%) and due to clinic distance (28% vs 9%), report delays due to wait times (50% vs 17%), embarrassment with testing (16% vs 6%), discomfort discussing sexual health where they usually go for testing (39% vs 22%), as well as discomfort discussing sexual history with (19% vs 5%) and fearing judgement from (30% vs 15%) any healthcare provider. GCO clients were less likely to have found clinic hours convenient (59% vs 77%) and clinic appointments easy to make (49% vs 66%), and more likely to report long wait times (50% vs 17%). We found no differences in technology skills/use.ConclusionsIn this urban setting, an internet-based testing service effectively engaged individuals experiencing testing barriers, with few social gradients in uptake. While some testing barriers could be addressed through increasing access to clinical services, others require social and structural changes, highlighting the importance of internet-based STI testing services to increasing test uptake.

With the emergence of daily oral tenofovir disoproxil fumarate and emtricitabine-based pre-exposure prophylaxis (PrEP) use in Canada, questions have emerged concerning the impacts of this HIV prevention tool on gay men's social and sexual lives. We conducted small focus groups and individual qualitative interviews with 16 gay men in Toronto who were part of the ‘first wave’ of Canadian PrEP users. Participants were on PrEP for at least one year as part of a demonstration project (November 2014–June 2016). These participants accessed PrEP before regulatory approval by Health Canada in February 2016. The mean age of participants was 37.6 years (SD 11.02); 94% completed secondary education, and 69% were white. Sex-stigma emerged as a complex theme in men's accounts of PrEP use across three overlapping domains: (1) PrEP-related stigma, including discussions of concealment and stigma from friends, family, and sexual partners, (2) PrEP as a perceived tool for combating HIV-related stigma, where some men said that they no longer discussed HIV status with sexual partners, and (3) PrEP as illuminating structural stigma, where it was attributed to unmasking stigma related to sex and sexuality. For some participants, PrEP has allowed for liberating sex and a self-described return to normalcy—normal, exciting, pleasurable sex that was no longer reliant on condom use. Paradoxically, some men said that PrEP use both led them to experience stigmatizing reactions within their social and sexual networks, while also helping to remove stigma, shame, and fear related to HIV, sexuality, and sex with gay men living with HIV.

This study examined the differences between gay men and lesbian women in their negative attitudes towards gay men and lesbians who either confirm or disconfirm stereotypical gender roles. One hundred thirty-eight gay and lesbian participants read four gender-typed scenarios: in two, a gay student and a lesbian student were portrayed as more stereotypically masculine, and in the other two, two gay and lesbian students were described as more stereotypically feminine. Participants rated the targets on a scale assessing negative emotions. The results showed that the feminine gay male target provoked more negative emotions than the other three targets, among both gay and lesbian participants. Moreover, gay and lesbian participants felt more negative emotions towards the masculine lesbian target than the feminine lesbian one. In the end, while the feminine gay man target elicited more negative emotions than the feminine lesbian target, the masculine gay man target did not elicit more negative emotions than the masculine lesbian one. Implications of the results are discussed.

OBJECTIVE: HIV transmission is ongoing among men who have sex with men (MSM) in the UK. Sex without a condom (condomless sex, CLS) is the main risk factor. We investigated the prevalence of and factors associated with types of CLS. METHODS: Cross-sectional questionnaire study in UK HIV clinics in 2011/2012 (ASTRA). MSM diagnosed with HIV for ≥3 months reported on anal and vaginal sex, CLS with HIV-serodifferent partners (CLS-D) and CLS with HIV-seroconcordant (CLS-C) partners in the previous 3 months. Mutually exclusive sexual behaviours were as follows: (1) Higher HIV risk CLS-D (not on antiretroviral therapy (ART) or clinic-recorded viral load(VL) >50 c/mL), (2) Other CLS-D, (3) CLS-C without CLS-D, (4) Condom-protected sex only and (5) No anal or vaginal sex. Associations were examined of sociodemographic, HIV-related, lifestyle, and other sexual measures with the five categories of sexual behaviour. We examined the prevalence of higher HIV risk CLS-D incorporating (in addition to ART and VL) time on ART, ART non-adherence, and recent sexually transmitted infections (STIs). RESULTS: Among 2189 HIV-diagnosed MSM (87% on ART), prevalence of any CLS in the past 3 months was 38.2% (95% CI 36.2% to 40.4%) and that of any CLS-D was 16.3% (14.8%–17.9%). The five-category classification was as follows: (1) Higher HIV risk CLS-D: 4.2% (3.5% to 5.2%), (2) Other CLS-D: 12.1% (10.8% to 13.5%), (3) CLS-C without CLS-D: 21.9% (20.2% to 23.7%), (4) Condom-protected sex only: 25.4% (23.6% to 27.3%) and (5) No anal or vaginal sex: 36.4% (34.3% to 38.4%). Compared with men who reported condom-protected sex only, MSM who reported any CLS in the past 3 months had higher prevalence of STIs, chemsex-associated drug use, group sex, higher partner numbers, and lifetime hepatitis C. Prevalence of higher HIV risk CLS-D ranged from 4.2% to 7.5% according to criteria included. CONCLUSION: CLS was prevalent among HIV-diagnosed MSM, but CLS-D with higher HIV transmission risk was overall low. CLS-D is no longer the most appropriate measure of HIV transmission risk behaviour among people with diagnosed HIV; accounting for VL is important.

This article aims to contribute to the ongoing scholarly debate about the implications of andropause in the Gender Studies literature by decentring and complicating it further using the case of Turkish gay men. Aging gay men in Turkey struggle to remain young, healthy and cool' as they use their wittiness and emotional maturity towards younger men. All of these happen at the intersection of masculinity politics and homophobia within Turkish society and the profound ageism within the global gay culture. Our questions are shaped around andropause and its absence as gay men reject and disidentify with it: Is andropause a heteronormative concept? Through the active rejection of the external outcomes of aging and andropause, mid-life Turkish gay men present an idiosyncratic vantage point to explicate the relatively understudied intersection of masculinity, homosexuality and aging in the non-western contexts. Through interviews we contend that, unlike their heterosexual equivalents, mid-life gay men do not accept andropause, but instead they develop tactics to consolidate their socially capable, self-assured and well-integrated subjectivity within the fringes of the global gay culture. Looking closer at aging gay men and their multifactorial strategies provides us the chance to grasp the ubiquitous heteronormativity inscribed in the narratives of andropause. Publisher's Version

Purpose The purpose of this paper is to examine patterns of drug use among a cohort of drug treatment-seeking drug-using gay men and other men who have sex with men (MSM), and whether these activities differ between, or predict, HIV status. Design/methodology/approach Cross-sectional study was conducted in a specialist club drug clinic in London covering 407 consecutive attendees who identified as MSM. Substance use, including injecting drug use (IDU), associated sexual activity and self-reported HIV status were measured by clinical interview and National Drug Treatment Monitoring System data tool. Findings Over a 45-month period, 407 MSM attended the clinic. In total, 62.1 per cent were HIV positive, 48.9 per cent had injected drugs, 14.9 per cent reported needle sharing and 73.3 per cent used drugs to facilitate sex. The most commonly reported problem drugs were GHB/GBL (54.3 per cent) methamphetamine (47.7 per cent) and mephedrone (37.8 per cent). HIV status was associated with methamphetamine, mephedrone, IDU, sharing equipment, using drugs to facilitate sex, older age and older age of drug initiation, as well as Hepatitis C virology (HCV) status. Use of methamphetamine, HCV infection, older age and IDU predicted HIV positive status in a logistic regression model. Practical implications The findings describe a constellation of risk factors including high levels of IDU, sharing of equipment and high-risk sexual activity in a population with high rates of HIV positive serology. They also provide further evidence for a link between HIV infection and use of methamphetamine. Social implications The authors suggest a need for greater awareness of HIV-related risk activities and promotion of HIV prevention strategies for MSM by both sexual health and drug treatment services. Originality/value This paper is amongst the very first studies of its nature.