Search

Objectives: This study explored how coping moderates the association between discrimination and health outcomes in lesbian, gay, and bisexual (LGB) and heterosexual midlife and older adults. Methods: This study analyzed longitudinal data from 163 LGB and 326 propensity-matched heterosexual midlife and older adults over approximately 20 years, using the Midlife in the United States study. Results: Discrimination was associated with slower chronic condition accumulation over time for LGB individuals. Problem-focused and avoidance coping moderated discrimination's impact on mental health in LGB participants over time, and in heterosexual participants, they moderated the association between discrimination and chronic conditions. Discussion: The results suggest a potential "steeling" effect in LGB midlife and older adults facing higher discrimination levels. Furthermore, the findings suggest that effective coping strategies for mitigating the adverse impacts of discrimination on physical and mental health may vary by sexual orientation. [ABSTRACT FROM AUTHOR]

Unhealthy alcohol use is a significant public health concern among ethnic minority immigrant gay, bisexual men, and other men who have sex with men (GBMSM) in North America. The definition of unhealthy alcohol use is any use that increases the risk of health consequences or has already led to negative health consequences. Despite its association with various health problems, this issue remains understudied in this population. Therefore, we aim to synthesize key findings to provide the prevalence of unhealthy alcohol use and related factors among this population in North America. We conducted a comprehensive literature search in multiple scientific databases to identify studies on alcohol use among ethnic minority immigrant GBMSM. Using random-effect modeling strategies, we aggregate and weigh the individual estimates, providing a pooled prevalence of unhealthy alcohol use within this population. Our review included 20 articles with 2971 participants (i.e., 53% were Latino, 45% were Asian/Pacific Islanders, and 2% were African). The meta-analysis revealed that 64% (95% CI 0.50, 0.78) of the participants reported recent alcohol use, while 44% (95% CI 0.30, 0.59) engaged in unhealthy alcohol use. Co-occurring health issues identified in the studies are other substance use (32%; 95% CI 0.21, 0.45), positive HIV status (39%; 95% CI 0.14, 0.67), and mental health issues (39%; 95% CI 0.21, 0.58). We also identified several factors associated with unhealthy alcohol use, including risky sexual behaviors, experiences of discrimination based on race and sexual orientation, and experiences of abuse. However, meta-regression results revealed no statistically significant associations between alcohol use and co-occurring health problems. This is the first study to systematically review unhealthy alcohol use among ethnic minority immigrant GBMSM. Despite the high burden of alcohol use, there is a dearth of research among Asian and African GBMSM. Our findings underscore the need for more research in these groups and provide insights to inform targeted clinical prevention and early intervention strategies to mitigate the adverse consequences of unhealthy alcohol use among ethnic minority immigrant GBMSM. [ABSTRACT FROM AUTHOR]

To end the HIV epidemic, there is need for targeted strategies to reduce HIV incidence for those most vulnerable, including an HIV vaccine. This study seeks to understand the perceptions that non-PrEP using gay and bisexual men and other men who have sex with men (GBMSM) have about a potential HIV vaccine, while contextualizing their perspectives within the context of heightened vaccine hesitancy that has emerged since the COVID-19 pandemic. Between March and May of 2022, GBMSM (N = 20) participated in in-depth interviews, which assessed their perceptions about an HIV vaccine. Interviews were analysed using a codebook approach to thematic analysis. We oversampled for those unvaccinated against COVID-19 as a proxy for vaccine hesitation. Participants expressed a range of enthusiastic support, cautious optimism and skepticism when presented with the possibility of an HIV vaccine. Factors that drove willingness to receive an HIV vaccine included community-oriented altruism, individualized risk-benefit assessment, and/or the perception that a vaccine could provide a beneficial shift in sexual experiences. Participants also expressed hesitations about receiving an HIV vaccine, including concerns about potential side-effects and efficacy, as well as mistrust in the vaccine development process. Notably, participants often evaluated the vaccine in comparison to PrEP and condoms. Participants offered specific insights into information they would like to receive about an HIV and where/how they would like to receive it. Our findings can help inform future HIV vaccine implementation efforts by offering insights into the factors that motivate and deter GBMSM to receive an HIV vaccine. [ABSTRACT FROM AUTHOR]

Latino gay men asylum seekers leave their homeland to avoid traditional male-dominated societies where they endure persistent sexual and physical violence, homonegativity, and discrimination within their communities. These men often arrive in the U.S. with mental health issues brought on by traumatic events experienced in their home countries. In the U.S. Latino gay asylum seekers experience additional stressors due to their multiple identities as an ethnic minority, a sexual minority, and an immigrant. This practice corner addresses the need to explore Latino gay men asylum seekers' pre- and post-migration experiences in the U.S. and its impact on their mental health. Culturally responsive strategies for clinicians are discussed. [ABSTRACT FROM AUTHOR]

Purpose: While associations between adverse childhood experiences (ACEs) and intimate partner violence (IPV) have been well-documented, few studies have identified relationship factors that buffer this association. Even fewer studies have examined these relationships among Latino sexual minority men (SMM). To address this gap, we tested a model in which relationship functioning moderated this association in a sample of Latino SMM couples. Methods: Data were collected from 95 couples (190 participants) using a sequential index-partner recruitment design. Actor-Partner Interdependence Models were calculated using generalized estimating equations (GEE). Results: Among men whose partners scored low on the Revised Dyadic Adjustment Scale, those who reported 1 or more ACEs reported more forms of IPV victimization. In contrast, the association between the actor effect of ACEs and IPV victimization was not significant among those whose partners scored high on the Dyadic Adjustment Scale. In a symmetrical pattern, among men who scored low on the Dyadic Adjustment Scale those whose partners reported 1 or more ACEs reported more forms of IPV victimization; however, at high levels of self-reported relationship functioning, partner reported ACEs were relatively associated with fewer reported forms of IPV victimization. Conclusions: These results are consistent with the premise that relationship functioning may serve as one source of resilience, attenuating the association between ACEs and IPV victimization among a sample of coupled Latino SMM. We interpret these findings within the larger IPV literature and provide suggestions for IPV prevention program development, with a particular emphasis on reaching Latino SMM. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a serious social and public health problem in the United States. Adverse childhood experiences (ACEs) and poor mental health are associated with IPV. Sexual minority men (SMM) experience each of these disproportionately; however, limited studies have examined the interrelationships of these variables among SMM. Cross-sectional data from the first wave (September 1, 2020–April 25, 2021) of the National Couples' Health and Time Study were used to assess the prevalence of physical, sexual, and psychological IPV victimization and perpetration and the association with ACEs and depression, anxiety, and stress among cisgender men in same-gender and different-gender relationships. Log-binomial regression was used to evaluate relationships, stratified by couples' gender identity. In a sample of 1,681 men, including 689 sexual minority men, 40.6% reported IPV victimization and 33.1% reported IPV perpetration. Stratified by couples' gender identity, victimization and perpetration were reported more frequently among men in different-gender relationships compared to men in same-gender relationships (40.7% vs. 33.9%; 33.2% vs. 30.2%). Psychological victimization and perpetration were the most commonly reported. Among men in same-gender relationships, depression symptoms had the highest association with IPV victimization (prevalence ratio [PR] = 2.14, 95% confidence interval [CI]: 1.56–2.95) and perpetration (PR = 1.72, 95% CI: 1.24–2.39). Research, clinical screenings, and other settings that focus on understanding and intervening on partner violence victimization and perpetration should intentionally consider the experiences of SMM in order to effectively promote healthy relationships and optimal mental health. [ABSTRACT FROM AUTHOR]

Friendships between heterosexual men and gay, bisexual, and other men who have sex with men (gbMSM) appear to be less common than other friendship dyads. While some heterosexual men's fear of being perceived as gay may act as a barrier in forming these friendships, research conducted within the past decade suggests that attitudes toward gbMSM are improving in Western cultures. Little is known regarding how heterosexual men react to their peers who are gbMSM after disclosing their sexual orientations to them during this cultural shift in North America. Using inclusive masculinity theory as a framework, the purpose was to examine how friendships between heterosexual men and gbMSM are impacted following their coming out experiences. Data were collected from heterosexual men and gbMSM aged 18–36 (M = 28.52) residing in the United States and Canada (N = 443) through Amazon Mechanical Turk. Heterosexual and gbMSM were asked to answer open-ended questions regarding the gbMSM's coming out experiences and describe changes in their friendships afterward. Thematic analysis guidelines were followed to analyze the responses. Results indicated three pathways for friendships: a positive coming-out experience with an improved friendship, a neutral coming-out experience with no change in the friendship, and a negative experience followed by a damaged or terminated friendship. Findings suggest that positive attitudes toward cross-orientation friendships may be more prevalent and accepted at present than historically. These findings start an important dialogue with the potential implication of further normalizing positive friendships between heterosexual men and gbMSM. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission, but uptake and adherence among young men who have sex with men (YMSM) remains suboptimal. New PrEP formulations may enhance PrEP use, but little is known about their acceptability. We enrolled 39 cis- and transgender YMSM (age 18–34) from Boston, MA; Jackson, MS; Birmingham, AL; and New Orleans, LA, who participated in video-based focus groups (n = 30) or in-depth interviews (n = 9) to examine how new PrEP products (e.g., injections, monthly pills, implants) are perceived and might be improved for YMSM. Focus groups were transcribed, coded, and analyzed using grounded theory and content analysis. Nearly half (46%) of participants were Black; 11% identified as Hispanic. Seventy-nine percent were PrEP experienced. Product preference was driven by the desire for flexible, safe, effective, and affordable PrEP options. A majority of participants preferred subcutaneous injections every 6 months or monthly pills dispersed in 3 or 4 doses. Subcutaneous injections and batched monthly pills were favored by those with demanding schedules and those who desired fewer provider visits; monthly pills were more appealing for those who feared needles. Despite broad preferences for longer-acting products for convenience, participants raised concerns regarding side effects and waning protection after missed doses. Participants felt that more education about safety and efficacy profiles of new products could influence their attitudes. These findings suggest that it is important to prioritize YMSM's dynamic lifestyles during product development, and that product safety and efficacy information should be accessible in youth-friendly language. [ABSTRACT FROM AUTHOR]

Scholars have documented harm associated with positive stereotypes about groups that experience inequality. We surveyed five samples from the United States to explore antecedents to dominant group endorsement of positive stereotypes about women, gay men, Asian Americans, Black Americans, and Native Americans. We found more liberal participants, and those with more close contact with members of these groups, were more internally motivated to respond without prejudice, which was then associated with greater endorsement of positive stereotypes about women, gay men, Black Americans, and Native Americans. In contrast, more conservative participants were more likely to believe in system legitimacy, which was then associated with greater endorsement of positive stereotypes about women and Asian Americans. We theorize that positive stereotypes are used by dominant group members in divergent ways, sometimes to legitimate inequality and other times with concern about inequality. The latter likely involves naivety regarding the harmful nature of positive stereotypes. [ABSTRACT FROM AUTHOR]

This study analyzes 351 homicides where defendants raised gay or trans panic defenses within the United States from 1970 to 2022. This work builds on prior research by focusing on gay men and trans women as distinct groups to examine the demographic and socio-economic variables of these victims and their killers. This study also explores how the offenders killed their victims, focusing on the fatal weapon, time of murder, and homicide location. Finally, this study investigates situational variables, including relationship between victim and killer, use of drugs/alcohol, offender's stated motivation for murder, and whether the offender stole the victim's property. [ABSTRACT FROM AUTHOR]

This research explored baby boomer gay men’s experiences with primary healthcare and their perspectives of future long-term care. Baby boomer gay men’s perspectives about primary healthcare remain understudied in the United States. A descriptive qualitative study was conducted with 30 baby boomer men in the Southwest USA. We used semi-structured interviews to assess participants’ initiation and maintenance of primary healthcare, disclosure of sexual orientation to providers, and perspectives about future healthcare needs, including long-term care. Data were analyzed with a latent thematic analysis. We found baby boomer gay men anticipate discrimination because of their sexual orientation whenever they establish healthcare with new providers. Participants identified circumstantial comfort in the new healthcare setting as a key motivator to disclose their sexual orientation. Thus, baby boomer gay men specifically sought gay or gay-friendly healthcare providers to ease the burden of managing disclosure and to permit free discussion of their sexual orientation and healthcare needs. Participants faced recurring anticipation of rejection and discrimination from healthcare providers, which extends to their perceptions of current healthcare encounters and future long-term care placement. Healthcare providers would benefit from understanding the practice implications of this dynamic. Future research on primary healthcare inclusivity is needed. [ABSTRACT FROM AUTHOR]

Biomedical tools for HIV prevention such as post-exposure prophylaxis (PEP) continue to be underutilized by subgroups experiencing significant HIV inequities. Specifically, factors associated with both PEP awareness and uptake both cross-sectionally and longitudinally are under-researched, despite PEP being a part of the United States' Plan for Ending the HIV Epidemic. The current study examined longitudinal predictors of PEP awareness among Latino sexual minority men (LSMM) living in South Florida. This current study (N = 290) employed hierarchal linear modeling across three timepoints (baseline, 4-months, 8-months) to assess within-person and between-person effects over time for several psychosocial and structural factors. Most participants (67.5%) reported little to no awareness of PEP at baseline with general PEP awareness growing slightly across the study (60.5% reporting little to no awareness of PEP at 8 months). Results of the final conditional model suggest significant within-person effects of PrEP knowledge (p = 0.02) and PrEP self-efficacy (p < 0.001), as well as a significant positive between-person effect of PrEP knowledge (p < 0.01) on PEP awareness. Between-person HIV knowledge was also a significant predictor in this model (p = 0.01). This longitudinal analysis of LSMM's PEP awareness indicates that more must be done to increase PEP awareness among this subgroup. Future studies should explore how to build on existing interventions focused on HIV and PrEP knowledge and PrEP self-efficacy to incorporate information about PEP to increase the reach of this effective biomedical HIV prevention tool. [ABSTRACT FROM AUTHOR]

Suboptimal adherence to oral PrEP medications, particularly among younger sexual minority men (SMM), continues to be a key barrier to achieving more substantial declines in new HIV infections. Although variety of interventions, including web and text-message-based applications, have successfully addressed PrEP adherence, very few have addressed the potential influence of alcohol. This pilot study explored whether the Game Plan for PrEP, a brief, web-based and text messaging intervention, helped promote PrEP persistence and adherence and reduced condomless sex and alcohol use. Seventy-three heavy-drinking SMM on PrEP were recruited online from states with Ending the HIV Epidemic jurisdictions and randomly assigned 1:1 to receive either the Game Plan for PrEP intervention or an attention-matched control. We collected online surveys assessing primary outcomes at one, three, and six months post-enrollment. As secondary outcomes, we also collected dried blood spot samples at baseline, three, and six months to analyze for biomarkers of PrEP and alcohol use. Our results showed that the odds of stopping PrEP or experiencing a clinically meaningful lapse in PrEP adherence (≥ 4 consecutive missed doses) were not different across the two conditions. We also did not find evidence of any differences in condomless sex or drinking outcomes across conditions, although participants in both conditions reported drinking less often over time. These findings were consistent across both self-reported outcomes and biomarkers. Overall, we did not find evidence that our brief, web and text messaging intervention encouraged more optimal PrEP coverage or moderate their alcohol use. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Recent scholarship indicates that sexual minority adults have higher caregiving rates than heterosexuals and that women are more likely to be caregivers than men. However, little research has addressed how gender and sexuality intersect in shaping caregiving status. This study uses data from the Behavioral Risk Factor Surveillance System and aggregates a probability-based sample of adults living in 36 U.S. states between 2015 and 2021. We examine who provides care among adult heterosexual, lesbian, gay, and bisexual men and women. Results reveal that women are more likely to be caregivers than men, but only among heterosexuals. We find little variation in caregiving by sexuality among women, but bisexual men are more likely than heterosexual men to be caregivers; the latter result appears to be driven by unpartnered, bisexual men. Lastly, we contextualize caregivers' experiences and reveal selected descriptive differences in patterns of care recipient--caregiver relationships across gender and sexual identity groups. Our findings advance understanding of caregiving and changing family ties in an era of population aging and increasing diversity in sexual identities. [ABSTRACT FROM AUTHOR]

Rapid point-of-care tests that diagnose gonococcal infections and identify susceptibility to antibiotics enable individualized treatment. This could improve patient outcomes and slow the emergence and spread of antibiotic resistance. However, little is known about the long-term impact of such diagnostics on the burden of gonorrhea and the effective life span of antibiotics. We used a mathematical model of gonorrhea transmission among men who have sex with men in the United States to project the annual rate of reported gonorrhea cases and the effective life span of ceftriaxone, the recommended antibiotic for first-line treatment of gonorrhea, as well as 2 previously recommended antibiotics, ciprofloxacin and tetracycline, when a rapid drug susceptibility test that estimates susceptibility to ciprofloxacin and tetracycline is available. The use of a rapid drug susceptibility test with ≥50% sensitivity and ≥95% specificity, defined in terms of correct ascertainment of drug susceptibility and nonsusceptibility status, could increase the combined effective life span of ciprofloxacin, tetracycline, and ceftriaxone by at least 2 years over 25 years of simulation. If test specificity is imperfect, however, the increase in the effective life span of antibiotics is accompanied by an increase in the rate of reported gonorrhea cases even under perfect sensitivity. [ABSTRACT FROM AUTHOR]

This article is a commentary written by an individual community member who shares their personal experience and views on HIV cure-related research. The author, a 60-year-old gay white male living in the United States with HIV for the past twenty-five years, has been involved in various aspects of clinical research and has participated in HIV-related clinical studies. The author expresses their hopes for both classical and functional cure interventions, emphasizing the importance of access, uptake, and addressing the diverse needs of people living with HIV. They also discuss their perceptions of acceptable adverse events and the need for psychosocial support in cure interventions. The author calls for the modernization of laws and the creation of platforms to highlight the experiences of HIV cure research participants. [Extracted from the article]

Little research has examined mechanisms driving cannabis use disparities among sexual minority (SM; versus heterosexual) young adults (YAs). Participants were US YA women (N  = 1345; 24.8% bisexual, 6.1% lesbian) and men (N  = 998: 8.9% bisexual, 13.8% gay). Bivariate analyses examined associations between sexual orientation (heterosexual, gay/lesbian, bisexual) and cannabis use outcomes (past 30-day [current] use, use frequency, cannabis-tobacco dual use, use intentions), perceived risks (harm, addictiveness) and social norms (social acceptability, peer use). Regressions examined sexual orientation, perceived risks and social norms as correlates of cannabis outcomes. Bisexual and lesbian (versus heterosexual) women reported lower cannabis-related perceived risks, greater social norms and higher odds of current use. Bisexual (versus heterosexual) women reported more days of use, higher odds of cannabis-tobacco dual use and greater use intentions. Gay (versus heterosexual) men reported lower perceived addictiveness, greater social norms and higher odds of current use. Lower perceived risks and greater social norms predicted greater use outcomes for women and men. Bisexual women displayed higher odds of several cannabis use outcomes, whereas lesbian women and gay men displayed higher odds of current cannabis use only. Cannabis-related perceptions and social norms may be important targets for public health messaging for SMYAs. [ABSTRACT FROM AUTHOR]

This article estimates the empirical relationship between prejudicial attitudes toward homosexuality and the wages of gay men in the United States. It combines data on prejudicial attitudes toward homosexuality from the General Social Survey with data on wages from the U.S. Decennial Censuses and American Community Surveys—both aggregated to the state level. The author finds that a one standard deviation increase in the share of individuals in a state who are prejudiced toward homosexuals is correlated with a decrease in the wages of gay men of between 2.7% and 4.0%. The results also suggest that the prejudice of managers is responsible for this correlation. The author finds that a one standard deviation increase in the share of the managers in a state who are prejudiced toward homosexuals is associated with a 1.9% decrease in the wages of gay men. The author finds no evidence that the wage penalty for gay men is correlated with the prejudice of customers or co-workers. [ABSTRACT FROM AUTHOR]

Relatively little is known about how gender and sexual orientation intersect to predict young adults' responses to unwanted romantic and sexual overtures from men and women suitors. To better understand these potential differences, and explore possible mechanisms that explain them, this pre-registered study used an online questionnaire to assess reactions to both hypothetical and recalled suitors among a sample of 855 cisgender heterosexual and gay young adults (18–35) from the United States. Results revealed that gay women and heterosexual men reported the most negative hypothetical reactions to men (versus women) suitors, while gay women, heterosexual men, and heterosexual women all recalled more negative reactions to men than women suitors. Gay men recalled relatively benign reactions to suitors of both genders. A desire to be seen as one's true orientation was a mediating factor for both gay women's and heterosexual men's negative reactions to men suitors. These findings and their potential explanations highlight the complexity of how gender and sexual orientation intersect to shape responses to romantic and sexual overtures from men and women suitors. [ABSTRACT FROM AUTHOR]

Although there is a large body of knowledge on the coming-out experience, only few studies examine the coming-out experience of Latino gay men in the United States and whether cultural norms in the Latino community influence the way fathers respond to their sons' disclosure of same-sex attraction. The author conducted a systematic review to identify studies that focused on the coming out experience of Latino gay men in the U.S. The author searched ProQuest, PsychINFO, and Social Work Abstracts, using search terms including LGBT, gay or homosexual, Latino or Hispanic, coming out or disclosure, father or parents, or family. Findings revealed that cultural norms influenced the coming out process for most Latino gay men in the studies, resulting in negative health outcomes. Limitations, as well as implications for practice and research were discussed in this article. [ABSTRACT FROM AUTHOR]

According to data analyzed from the Gallup Daily Tracking Politics and Economy survey between 2015 and 2017, nearly half (46.7%) of LGBT adults in the U.S. are religious, and just over half (53.3%) of LGBT adults are not religious. The majority who identified as religious attend Protestant churches. The Pentecostal church is a member of the Protestant Christian tradition. In a Constructivist Grounded Theory study of six U.S. gay male, Pentecostal Christians, our study excavates and chronicles their journey toward wholeness. Three major themes emerged from our study: embracing the journey, belonging to a community, and living unapologetically. From these themes, we learned that wholeness becomes possible when gay male Christians can form identities that are uniquely and holistically their own. We used these themes as a clarion call for clinicians who engage with clients encountering a conflict between their religious/spiritual tradition and their sexual orientation to actively assist their clients with reducing the dissonance they experience. [ABSTRACT FROM AUTHOR]

Background: Although the Eating Disorder Examination-Questionnaire (EDE-Q) is one of the most widely used self-report assessments of eating disorder symptoms, evidence indicates potential limitations with its original factor structure and associated psychometric properties in a variety of populations, including sexual minority populations. The aims of the current investigation were to explore several previously published EDE-Q factor structures and to examine internal consistency and measurement invariance of the best-fitting EDE-Q model in a large community sample of cisgender gay men and cisgender lesbian women. Methods: Data were drawn from 1624 adults (1060 cisgender gay men, 564 cisgender lesbian women) who participated in The PRIDE Study, a large-scale longitudinal cohort study of sexual and gender minorities from the United States. A series of confirmatory factor analyses (CFAs) were conducted to explore the fit of eight proposed EDE-Q models; internal consistency (Cronbach's alphas, Omega coefficients) and measurement invariance (multi-group CFA) were subsequently evaluated. Results: A brief seven-item, three-factor (dietary restraint, shape/weight overvaluation, body dissatisfaction) model of the EDE-Q from Grilo et al. (Obes Surg. 23:657–662, 2013), consistently evidenced the best fit across cisgender gay men and lesbian women. The internal consistencies of the three subscales were adequate in both groups, and measurement invariance across the groups was supported. Conclusions: Taken together, these findings support the use of the seven-item, three-factor version of the EDE-Q for assessing eating disorder symptomatology in cisgender gay men and lesbian women. Future studies can confirm the current findings in focused examinations of the seven-item, three-factor EDE-Q in diverse sexual minority samples across race, ethnicity, socioeconomic status, and age ranges. Plain English summary: We asked cisgender gay men and lesbian women in The PRIDE Study to fill out a widely used survey about eating disorders, the Eating Disorder Examination-Questionnaire. We found that a version of this questionnaire based on seven questions including three parts—(1) dietary restraint, (2) shape and weight overvaluation, and (3) body dissatisfaction—had the best fit. These findings can assist doctors and scientists in understanding eating disorders in cisgender gay men and lesbian women. [ABSTRACT FROM AUTHOR]

Routine screening and testing for HIV are recommended for all adolescents and adults. However, only one-third of the U.S. population has been tested for HIV. Women, sexual minorities, and people who use alcohol are more likely to be tested for HIV, but less is known about how alcohol use and sexual orientation impact the likelihood of HIV testing synergistically. Examining both alcohol use and sexual orientation is especially relevant, because sexual minorities are at increased risk for alcohol use, including heavy drinking. This study tested an alcohol x sexual orientation interaction effect on HIV testing through logistic regression modeling with a nationally representative sample. Results of the significant interaction identify demographic groups that are particularly at-risk for not being tested for HIV. These groups include lesbian women who currently use alcohol or previously used alcohol; bisexual men who have not used or previously used alcohol; and gay men who previously used alcohol. Although efforts to test all adolescents and adults are warranted, these findings highlight the importance of assessing alcohol and sexual orientation and augmenting testing efforts for highrisk groups. [ABSTRACT FROM AUTHOR]

Attitudes toward gay men and lesbians in the United States have liberalized dramatically over time yet vary substantially between states. Trends in college attainment mirror this uneven progress. This study draws on theories of the university as a cultural institution to examine the relationship between college-educated populations and attitudes toward gay men and lesbians over time and across American states. Employing 1984–2016 American National Election Studies data, this study demonstrates that larger shares of college graduates in a state are associated with more favorable attitudes on average toward gay men and lesbians, including among those who do not have a college degree. These results are robust to competing state-level religious, political, and economic explanations. Results also show that individuals in states with more college graduates are more likely to identify as LGB. This increases the likelihood of knowing someone who is LGB, which in turn leads to more accepting views. Cultural values of tolerance and acceptance espoused by university graduates may create social contexts in which sexual minorities feel safe to come out, thus increasing the visibility of sexual minority communities and enhancing favorable attitudes. [ABSTRACT FROM AUTHOR]

Undetectables Atlanta (UA), a peer support network for Black gay men living with HIV, conducted an exploratory evaluation to begin identifying outcomes of UA membership. Th is initial evaluation suggested decreased HIV stigma and increased comfort with disclosure, treatment adherence, and other areas of well-being that warrant prospective evaluation. [ABSTRACT FROM AUTHOR]

HIV remains a principal inequity for queer men across the United States. Biomedical practices all but dominate interventions, and HIV-related stress persists among queer men. Regarding HIV as discourse is not well represented in prevention and care. This study is a response, then, to this need that seeks to build an HIV-informed model of praxis, entitled HIV Stress Exchange. A Queer Discourse Study was conducted with 20 queer men across two generations, pre-AIDS and post-AIDS. The data included in-depth interviews and material resources participants brought to the conversation. In all, this data speaks to the ways in which HIV is given life in discourse and what meaning it holds in embodied lives. Resultantly, five themes materialized, inclusive of all ages and sero-statuses: HIV provided meaning as in-/validated, un-/voiced, un-/intelligible, holding intimacy/-ies, and being PrEP/-ared. Based on the findings, the conceptual model for HIV Stress Exchange is presented along with an HIV-informed model of practice. [ABSTRACT FROM AUTHOR]

Objectives. To examine the potential impact of contact tracing to identify contacts and prevent mpox transmission among gay, bisexual, and other men who have sex with men (MSM) as the outbreak expanded. Methods. We assessed contact tracing outcomes from 10 US jurisdictions before and after access to the mpox vaccine was expanded from postexposure prophylaxis for persons with known exposure to include persons at high risk for acquisition (May 17–June 30, 2022, and July 1–31, 2022, respectively). Results. Overall, 1986 mpox cases were reported in MSM from included jurisdictions (240 before expanded vaccine access; 1746 after expanded vaccine access). Most MSM with mpox were interviewed (95.0% before vaccine expansion and 97.0% after vaccine expansion); the proportion who named at least 1 contact decreased during the 2 time periods (74.6% to 38.9%). Conclusions. During the period when mpox cases among MSM increased and vaccine access expanded, contact tracing became less efficient at identifying exposed contacts. Public Health Implications. Contact tracing was more effective at identifying persons exposed to mpox in MSM sexual and social networks when case numbers were low, and it could be used to facilitate vaccine access. (Am J Public Health. 2023;113(7):815–818. https://doi.org/10.2105/AJPH.2023.307301) [ABSTRACT FROM AUTHOR]

This mixed-methods study explores dating app use within the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) community. LGBTQIA+ dating app users (N = 231) from across the U.S. were surveyed about their relationship initiation experiences. Thematic analysis was used to identify the benefits and challenges participants faced on dating apps and their motives for adopting (or avoiding) dating apps specifically for the LGBTQIA+ community (e.g., Grindr, Her, Butterfly). Participants described benefitting from dating apps, but also confronting significant challenges such as discrimination and the erasure of identity. Just over half (55.0%) of the sample reported using LGBTQIA+ dating apps, which functioned as safe spaces, reduced uncertainty about others' identities, and were better adapted to community norms. Multiple logistic regression was also used to test predictions regarding user adoption. Findings have implications for understanding how people in historically thin dating markets are using mobile technology to expand their opportunities for relationship initiation. [ABSTRACT FROM AUTHOR]

Gamma-hydroxybutyrate (GHB) was a somewhat prevalent club drug two decades ago, but research has been lacking regarding the current epidemiology of use. In this study, prevalence and correlates of past-year GHB use were estimated based on noninstitutionalized US adults participating in the 2015-2020 National Survey of Drug Use and Health (N= 241,675). An estimated 0.05% (95% CI: 0.04-0.07) of adults in the US have used GHB in the past year. Compared to those age 18-25, those age 35-49 were at increased odds for use (aOR = 2.28, 95% CI: 1.02-5.10), and compared to heterosexual men, gay men in particular were at high odds for use (aOR = 27.82, 95% CI: 11.09-69.80). Those identifying as bisexual men (aOR = 3.39, 95% CI: 1.17-9.82) and lesbian/bisexual women (aOR = 3.37, 95% CI: 1.44-7.90) were also at high odds for use. Despite all drugs examined being significant correlates of use in bivariable models (ps < .001), only past-year use of methamphetamine (aOR = 15.68, 95% CI: 7.40-33.25), ketamine (aOR = 8.52, 95% CI: 2.67-27.20), and ecstasy (aOR = 4.41, 95% CI: 1.80-10.75) was associated with increased odds of use in the multivariable model. Results suggest that GHB use is currently rare, but gay men and people who use other party drugs are at particularly high risk for use. [ABSTRACT FROM AUTHOR]

While there has been a growth in studies examining sexual violence among sexual minority men, little research attention has been paid to the experience of sexual violence among young sexual minority men (YSMM). In this article we analyze secondary data from the baseline of a pilot randomized control trial with 318 YSMM aged 15 to 24 years in the United States who were in relationships with other males to examine the associations between sexual minority-specific stigma and sociodemographic and relationship characteristics and experiences of intimate partner violence (IPV) and sexual IPV in their relationships. Approximately one-in-five participants reported experiencing any form of IPV and 6% reported sexual IPV in their current relationship. Participants who reported sexual minority-specific familial rejection (Adjusted Odds Rato (aOR) = 2.33, 95% confidence interval [CI] [1.03, 5.26], p < .05), internalized heterosexism (aOR = 3.17, 95% CI [1.45, 6.95], p < .01), and housing insecurity (aOR = 7.22, 95% CI [1.66, 31.34], p < .01) reported higher odds of sexual IPV in their relationship. Study findings point to the role of multiple sexual minority-specific forms of stigma in creating vulnerabilities for the experience of sexual IPV among YSMM, and highlight the need for continued research and interventions that address sexual minority-specific stigma and structural vulnerabilities to guide violence prevention efforts with YSMM. [ABSTRACT FROM AUTHOR]

Background: After decades of navigating HIV and other sexually transmitted infections, gay and bisexual men are responding to new and uncertain risks presented by the coronavirus (COVID-19) pandemic by adapting their sexual behavior. Methods: This paper uses data from a national sample of 728 gay and bisexual men collected from April 10 to May 10, 2020, to examine changes to sexual behavior in response to the first wave of the pandemic in the USA. We also assess whether behavior modifications are associated with exposure to statewide public health measures, including Stay-at-Home orders. Results: Sexual minority men report significant changes to their sexual behavior and partner selection during the first wave. Nine out of 10 men reported having either one sexual partner or no sexual partner in the last 30 days at the time of interview, a decrease compared to just before the pandemic for nearly half of men surveyed. Reporting no sexual partners in the last 30 days was significantly predicted by increased exposure to a Stay-at-Home order. Sexual minority men also reduced interactions with casual partners, increased no-contact sexual behaviors (e.g., masturbation and virtual sex), and engaged in new strategies to reduce their risks of infection from partners. HIV-positive men were particularly likely to adopt strategies including avoiding casual partners and avoiding public transportation to meet sexual partners. Conclusion: Sexual minority men's behavior changes during the first wave may have reduced the impact of the coronavirus pandemic on their communities. Despite substantial changes in sexual behavior for most men in our sample during the initial first wave, we identify some concerns around the sustainability of certain behavioral changes over time and nondisclosure of COVID-19 symptoms to partners. [ABSTRACT FROM AUTHOR]

People who are 50 and older constitute the majority of those living with HIV/AIDS (PLWHA) in the US. Aging PLWHA face myriad biopsychosocial health challenges related to HIV/AIDS and the aging process. Resilience may act as a buffer to the negative impact of these challenges however measuring it among PLWHA has been inconsistent, so the HIV-Related Resilience Screener (HIV-RRS) was developed. Data for the present study are drawn from 250 sociodemographically diverse HIV-positive gay men ages 50–69 in NYC. Tests of reliability and validity were conducted, and an Exploratory Factor Analysis indicated a three-factor model was the most parsimonious solution. Items were examined for their underlying relationships and labeled: adaptive coping, optimism, and effective coping. The total HIV-RRS yielded a Cronbach's α of 0.84. Convergent and face validity were established using psychosocial and physical outcomes. The HIV-RRS is a psychometrically sound instrument to assess resilience among older HIV-positive gay men. [ABSTRACT FROM AUTHOR]

The meaning and experience of masculinity differs across people and groups, and previous research has demonstrated that such differences are reflected in mental health outcomes. For gay Black men situated at the intersection of identifying as both a sexual minority and a racial minority, navigating the norms and expectations associated with masculinity often presents many challenges. This phenomenological study explored how 17 gay Black men ranging in age from 26 to 67 years, who live in a major city in the southeastern region of the United States, define, understand, and experience masculinity, as well as their perceptions about its connection to their mental health and well-being. Participant narratives reflected a strong consensus that masculinity is a social construction that is associated with a range of both limiting and liberating characteristics and experiences, and that has strong implications for mental health. Increased awareness and understanding of the relevance of a masculine identity to the mental health and well-being of gay Black men can help provide more appropriate and more compassionate mental health programs and services that are likely to promote service utilization among members of this community. [ABSTRACT FROM AUTHOR]

Few studies among gay, bisexual and other men who have sex with men (GBMSM) have examined facilitators and barriers to self-collecting specimens for extragenital STI screening, and none have evaluated attitudes towards self-collecting hair samples that can be utilized for PrEP drug level testing to assess adherence. To address this gap, we interviewed 25 sexually active GBMSM who were offered a choice to self-collect and return finger-stick blood samples (for actual HIV testing), pharyngeal swabs, rectal swabs and urine specimens (for actual gonorrhea and chlamydia testing), and hair samples (to visually determine their adequacy for PrEP drug level testing): 11 who returned all, 4 who returned some, and 10 who did not return any. Participants found self-collecting finger-stick blood samples and rectal swabs more challenging than other specimens. Frequently discussed facilitators of return included an opportunity to confirm one's HIV or STI status, limited access to a healthcare provider and a desire to advance research focusing on home-based testing. Commonly cited barriers to return included low self-efficacy pertaining to self-collection and apprehension around the possibility of delay or loss of specimens during transit. Offering additional support such as real-time video conferencing may prove helpful in future field-based research with GBMSM. [ABSTRACT FROM AUTHOR]

Background: Adolescent gay/bisexual men exhibit the highest prevalence of undiagnosed HIV infections. Ascertaining antecedents of behaviorally acquired HIV infections among adolescent gay/bisexual men can be challenging; however, these challenges can be overcome through the utilization of secondary data, such as the Youth Risk Behavior Survey. Objective: Syndemics theory suggests that HIV infections are not a singular phenomenon; instead, many infections occur at the intersection of syndemic factors, such as substance use, violence, and mental health. Our objective is to describe and synthesize research methods of secondary data analyses that examine syndemic factors in relation to HIV risk behavior outcomes among subsamples of adolescent gay/bisexual men. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo were systematically searched. Inclusion criteria were (a) peer-reviewed Youth Risk Behavior Survey secondary data analyses conducted in the United States after 1991, (b) subsamples with adolescent gay/bisexual men, (c) one or more syndemic factor(s), and (d) one or more HIV risk behavior outcome(s). We used the National Institutes of Health Quality Assessment Tools for quality appraisal. Results: Of 1,036 citations retrieved, nine studies met inclusion criteria. Results included using logistic regression analysis and data from 2015 to 2017 in six studies and underpinnings with minority stress theory in four studies. Eight studies omitted race/ethnicity in subsamples and six grouped lesbians with adolescent gay/bisexual men. Seven studies examined substance use, six examined violence, and five examined mental health. Condom use and number of partners were the most studied HIV risk behavior outcomes in four studies, whereas intercourse in the last 3 months was an outcome in only one study. Protective factors were not present. Conclusion: Limitations found the need to highlight better inclusion of race/ethnicity and sexual orientation. Adding contemporary survey items is also necessary, such as nonbinary sex and gender identity, access to HIV prevention (condoms, HIV testing, and preexposure prophylaxis), and experiences with stigma, to elucidate risk behaviors among populations disproportionately affected by HIV infections, including Blacks/African Americans and Hispanics/Latinos. [ABSTRACT FROM AUTHOR]

Black, Indigenous, and People of Color (BIPOC) racial/ethnic groups, sexual minorities (SM), and men have higher odds of smoking, less access to smoking cessation education and services, and lower smoking cessation rates than their white, heterosexual, and women counterparts. The purpose of this study is to examine the experiences of BIPOC gay men in accessing smoking cessation counseling from their healthcare providers and understand the facilitators and barriers to smoking cessation. This study analyzed data from BIPOC gay men who smoke daily via social media and organizational listservs throughout the United States and conducted semi-structured individual qualitative interviews. Two trained coders used thematic analysis to analyze the data. Findings identified three overarching themes: 1) Sources of Information, 2) Facilitators and Barriers, and 3) Areas of Improvement for Smoking Cessation Counseling. Participants reported trusting advice from community members over healthcare providers regarding smoking cessation counseling. They also felt that the smoking cessation advice received from healthcare providers was, at times, confusing and inadequate. Identity concordance between patient and healthcare provider helped participants feel seen by their provider, which motivated them to engage in smoking cessation counseling. Finally, participants suggested improvements for smoking cessation counseling for BIPOC gay men such as integrating mental health support in smoking cessation services, accountability for patients, and providing harm reduction alternatives instead of smoking cessation only. BIPOC gay men who smoke daily value the importance of receiving culturally adaptive and gender-affirming care from healthcare providers who share their identities when receiving smoking cessation and harm reduction counseling. • BIPOC gay men trusted people in their community about smoking cessation advice. • Identity concordance with their primary healthcare providers is important. • Smoking cessation should include mental health counseling. [ABSTRACT FROM AUTHOR]

Sexual stigma, mental health disorders, and socioeconomic disparities present important yet incompletely understood barriers to PrEP adoption among gay men and other men who have sex with men (MSM). This study examines how these factors interact and affect PrEP uptake, adherence, and persistence among MSM. Data from the 2018 and 2019 American Men's Internet Survey cycles, involving 6907 adult MSM eligible for PrEP, were analyzed. We assessed sexual stigma heterogeneity among this group using latent class analysis and investigated individual relationships between i) stigma class membership, ii) mental distress, and PrEP engagement (past-year use, adherence, and persistence) using Poisson regression with a robust error variance, considering potential variations based on poverty status. The combined associations of sexual stigma and mental distress with PrEP engagement was evaluated using inverse probability weighting. Four distinct sexual stigma classes were identified, each exhibiting varied associations with PrEP engagement. Associations with mental distress lost statistical significance after adjusting for confounders. However, having both mental distress and sexual stigma was associated with lower past-year PrEP use, with the strongest association observed for those with anticipated healthcare stigma class membership and mental distress (aPR 0.53 [95% CI: 0.37, 0.76]). Sexual stigma accompanied by mental distress was also associated with significantly increased poor PrEP adherence, particularly among those with family and general social stigma class membership (aPR 2.31 [95% CI: 1.08, 4.97]). Psychosocial factors exert synergistic impacts on PrEP engagement among MSM. Tailored interventions addressing these subtleties may effectively optimize PrEP uptake and improve consistency of use among MSM. • Among 6420 MSM: 29% PrEP uptake, 5% poor adherence, 58% used for >1 year. • Wealthier MSM had higher PrEP uptake (32% vs 19%) & lower nonadherence (5% vs 14%). • MSM with mainly family/social sexual stigma experiences had poorest PrEP adherence. • MSM with mainly anticipated healthcare stigma had the lowest uptake & persistence. • Sexual stigma combined with mental distress was linked to lower PrEP engagement. [ABSTRACT FROM AUTHOR]

There is a paucity of empirical literature examining the experiences of gay Latino sexual assault survivors in the United States, due in part because there is little research focused on how to effectively recruit and engage Latino sexual assault survivors as participants in the research process. While researchers have utilized various recruitment methods to engage with gay Latino men, they have not focused specifically on sexual assault survivors. To address this gap, this study examined effective strategies for recruiting and engaging with gay Latino sexual assault survivors. Various recruitment methods were used, and social media-based recruitment methods proved to be the most effective. Researchers need to develop rapport and trust during the screening interview and avoid the risk of re-traumatization. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Much of the body of literature on LGBT+ populations within the United States place urban areas and so-called gayborhoods as goals and eventualities, paralleling early US studies on immigration. Using a multistage, mixed-methods approach, consisting of secondary analysis of the Pew 2013 Study of LGBT Persons (N = 1197) and in-depth interviews (35 gay men, 2 trans-identifying individuals, 1 heterosexual woman, and 2 lesbians), we found that rural LGBT+ residents engaged in both short-term and long-term travel to mitigate feelings of being spatially segregated from the loci of gay social life—what Ghaziani (2019a) refers to as cultural archipelagos. However, rural residents also used their geographical location to resist dominant narratives about LGBT+ life. Some of our respondents felt that living in rural areas better situated them to be activists and advocates for LGBT+ rights, while others simply did not feel they could be comfortable within more urban contexts. These findings suggest that rural LGBT+ residents may have delinked their sexual selves with their cultural and political selves, thus illustrating the plurality of rural queer voices that exists. As we also argue, while residence category should be considered as influencing one's experience, care must be used to avoid overly deterministic accounts. Finally, this article extends earlier work by Brekhus (2003), Mattson (2015), and Ghaziani (2019a) by presenting the meaningfulness of travel to and from queer cultural strongholds. [ABSTRACT FROM AUTHOR]

Sexual consent research often focuses on how those who identify as heterosexual communicate consent, with limited research examining how sexual minority (SM) men communicate consent. Factors that influence how people communicate consent – such as the type of sexual behaviour being consented to and the relationship status of those engaged in sexual behaviour – is understudied among SM men. The purpose of this exploratory study was to assess how SM men communicate sexual consent and examine if these factors influence how men consent to sex. SM men (N = 234) were recruited from social media and Qualtrics' panel. Participants completed an open-ended survey assessing how consent was communicated during oral and anal sex and who their partner was during this encounter. Responses were analysed using an inductive coding approach. Six overarching consent cues emerged: Explicit Verbal, Explicit Nonverbal, No-Response, Implicit Nonverbal, Virtual Consent and Implicit Verbal. Sexual consent communication appeared to vary by sexual behaviour and relationship status. Overall, SM men and people who identify as heterosexual appear to communicate sexual consent similarly; however, some new cues emerged for SM men. Consent education initiatives should consider findings from more diverse populations when discussing sexual consent to take a more inclusive approach to sexual health education. [ABSTRACT FROM AUTHOR]

One-quarter of gay, bisexual, and other men who have sex with men (GBMSM) with diagnosed HIV are not engaged in HIV care. Between 2018 and 2019, 50 GBMSM completed qualitative interviews 3 months after receiving an HIV-positive result. Interviews explored barriers to and facilitators of engagement and retention in HIV testing and care. Thematic analysis revealed five major themes: (1) reason for HIV testing (e.g., self-testing), (2) linkage to care (e.g., appointment/logistic issues and social support as encouragement), (3) barriers to engagement in care (e.g., financial burden, competing priorities, and fear/stigma), (4) facilitators of engagement (e.g., financial assistance, patient-provider relationships, auxiliary support services, and health agency), and (5) PrEP as a missed prevention opportunity. Addressing individual-, social-, and policy-level barriers could improve GBMSM's engagement in HIV care. Further, capitalizing on GBMSM's health agency through partnerships with local agencies and fostering better patient-provider relationships could optimize HIV care continuity. [ABSTRACT FROM AUTHOR]

Purpose: Research suggests social support may protect sexual minorities from the harmful effects of victimization that undermine mental and sexual health wellness; however, this relationship has been underexplored among a diverse youth population. We examined the association between lifetime homonegative victimization, perceived stress in the last month, and resilience factors among a diverse sample of adolescent sexual minority males. Methods: Data were collected between June 2018 and April 2020 as part of the MyPEEPS Mobile study, a multi-site randomized controlled trial evaluating the effectiveness of a mobile behavioral HIV prevention intervention for adolescents living in the U.S. We analyzed baseline survey data from 542 sexual minority males, aged 13–18 years. We used bivariate analyses to examine relationships among variables and multivariable linear regression models to determine if resilience factors attenuated the association between homonegative victimization and perceived stress. Results: Perceived stress was positively associated with younger age, internalized homophobia, experiencing verbal victimization, threats of being outed, and threats of physical violence. Relying on online friends for support and having good family relations both attenuated the relationship between verbal victimization and perceived stress. However, neither of these resilience factors significantly weakened the associations between perceived stress, threats of physical violence, and being outed. Conclusion: Resilience factors, including peer and family support, may play an attenuating role in the relationship between homonegative victimization and perceived stress among adolescent sexual minority males. ClinicalTrials.gov Identifier: NCT03167606 [ABSTRACT FROM AUTHOR]

Since the 2015 U.S. Supreme Court ruling that marriages of same-sex couples are legal in all states in the union, federal surveys have adapted to the shifting legal climate and included new measures that more directly identify same-sex and different-sex cohabiting and married couples. In this research note comparing the largest and most recent federal surveys—the 2019 American Community Survey and Current Population Survey—we find consistent levels of cohabitation and marriage across surveys. While the vast majority (90%) of different-sex couples were married, we report a more even split in cohabitation and marriage among same-sex couples. Our evaluation of sociodemographic characteristics of married and cohabiting couples indicates that differences were less prominent among same-sex couples than among different-sex couples, suggesting weaker sociodemographic selection into marriage among the former. However, factors affecting same-sex and different-sex couples’ decisions to live together and marry may differ because of legal and social climates that still present unique obstacles for same-sex couples. Researchers need to acknowledge these differences in assessments of the implications of marriage for health and well-being. [ABSTRACT FROM AUTHOR]

Inequities in pre-exposure prophylaxis (PrEP) experiences will impede HIV epidemic elimination among gay and bisexual men (GBM). Ethnicity is a strong marker of inequity in the United States, but evidence from other countries is lacking. We investigated experiences on-PrEP to 12 months follow-up in a prospective cohort of 150 GBM in Auckland, New Zealand with an equity quota of 50% non-Europeans. Retention at 12 months was 85.9%, lower among Māori/Pacific (75.6%) than non-Māori/Pacific participants (90.1%). Missed pills increased over time and were higher among Māori/Pacific. PrEP breaks increased, by 12 months 35.7% of Māori/Pacific and 15.7% of non-Māori/Pacific participants had done so. Condomless receptive anal intercourse partners were stable over time. STIs were common but chlamydia declined; 12-month incidence was 8.7% for syphilis, 36.0% gonorrhoea, 46.0% chlamydia, 44.7% rectal STI, 64.0% any STI. Structural interventions and delivery innovations are needed to ensure ethnic minority GBM gain equal benefit from PrEP. Clinical trial number ACTRN12616001387415. [ABSTRACT FROM AUTHOR]

Background: HIV infections disproportionately impact Latino gay and bisexual men (GBM) in the United States. Pre-Exposure Prophylaxis (PrEP) is a proven prevention strategy that can help reduce new HIV infections in this population. Unfortunately, PrEP adoption and persistence among Latino GBM remain low. The added benefits of using PrEP experienced by Latino GBM can provide important insights to inform the development of PrEP messaging to motivate this population to explore and consider PrEP as an appropriate and acceptable HIV prevention tool. Methods: We conducted in-depth interviews with Latino GBM PrEP users to explore positive feelings and emotions, and additional benefits gained from using PrEP. Data were analyzed using thematic analysis. Results: A total of 29 Latino GBM completed the study interview. The average age of participants was 30 years, and the mean length of time using PrEP was 17.1 months. Five themes were constructed from the data representing the additional benefits gained by Latino GBM PrEP users, and included: (1) reduced fear, anxiety, and stress about HIV, HIV testing, and sex; (2) feeling empowered and in control of their HIV risk; (3) greater awareness of sexual risk behaviors and sexual health; (4) greater sexual exploration and pleasure, and comfort having condomless sex; and (5) a greater connection to community and a feeling of contributing to the elimination of HIV. Conclusions: The added benefits identified in this study represent a range of social, emotional, and psychological benefits that Latino GBM experience while using PrEP. They speak to the complementary benefits that PrEP can bring to Latino GBM who decide to use the medication, that go beyond HIV prevention. These findings can inform the development of future PrEP messaging to help improve motivation for PrEP uptake and persistent use among Latino GBM. [ABSTRACT FROM AUTHOR]

Objective: Limited research assesses how sexual orientation and gender identity and expression (SOGIE)-based discrimination affects alcohol use above and beyond non-SOGIE-related discrimination and how this may differ for sexual minority subgroups. We examined if SOGIE-related discrimination is additive in affecting alcohol use above and beyond non-SOGIE-related discrimination and examined differences in alcohol use, everyday discrimination, and the attribution of discrimination by sex and sexual identity. Methods: A national probability sample of sexual minority adults in the United States was used (N = 1311, female = 56.4%). Bivariate sexual identity and sex-based differences in drinking frequency, heavy episodic drinking (HED), everyday discrimination, and the attribution of discrimination were assessed. Sexual identity and sex-stratified logistic regression models were estimated, where everyday discrimination and the attribution of discrimination predicted drinking frequency and HED. Results: Several differences by sex assigned at birth and sexual identity in drinking frequency, HED, everyday discrimination, and the attribution of discrimination were found in bivariate analyses. In logistic regression models, experiencing SOGIE-related in addition to other types of discrimination was associated with higher odds of HED only for gay males. No other associations were found for everyday discrimination or the attribution of discrimination with drinking frequency or HED. Conclusions: Findings suggest sex and sexual identity-based differences in everyday discrimination and the attribution of discrimination. [ABSTRACT FROM AUTHOR]

Early onset of drug use could lead to long-term impairments, and research suggests that substance use and substance use disorders are more common among lesbian, gay, and bisexual (LGB) individuals. We sought to determine whether adults of different sexual identities were at differential risk for an earlier onset of drug use. We examined data from adults participating in the five waves (2015–2019) of the National Survey on Drug Use and Health, a nationally representative sample of noninstitutionalized adults in the United States. We determined whether current sexual identity was associated with retrospectively reported age of the first use of marijuana, cocaine, inhalants, ecstasy, and methamphetamine. Compared to heterosexual individuals of the same sex, gay men had a later age of onset of use of all five drugs examined (marijuana, cocaine, inhalants, ecstasy, and methamphetamine) and bisexual men had a later onset of marijuana and inhalant use. Bisexual women had earlier age of onset for marijuana, cocaine, and ecstasy use. When examining early initiation (prior to age 15), both lesbian and bisexual women had greater odds of early initiation for marijuana, cocaine, and ecstasy; bisexual men had greater odds of early initiation for cocaine. Gay men had lower odds of initiation prior to age 15 for marijuana, inhalants, and methamphetamine. Current sexual identity is a correlate of earlier onset drug use. Longitudinal research is needed to further examine such associations as sexual identity can shift over time. Results are discussed in relation to prevention efforts aiming younger LGB persons. [ABSTRACT FROM AUTHOR]

Objective: To elucidate trends of prostate-cancer (PCa) screening in gay and bisexual men and assess the association of sexual orientation with PCa screening in the United States of America.Methods: Data for men ≥40 years-old with no history of PCa were collected from the National Health Interview Survey for the years 2013, 2015, and 2018. Multivariable logistic regression models were created to determine the associations between sexual orientation and PCa screening and the discussion of advantages and disadvantages prior to PCa screening.Results: Gay men screened for prostate cancer were younger than their straight counterparts with a median age (IQR) of 58 years (52-66) vs 64 years (56-71). Gay men were more likely to have undergone a screening PSA test (OR 1.56; 95% CI 1.20-2.02) and discuss the advantages of PSA testing with the physician prior to the test (OR 1.64; 95% CI 1.22-2.21) when compared to straight men. In yearly analysis, gay men were more likely to have undergone screening in 2013 (OR 1.65, 95% CI 1.01-2.68) and 2015 (OR 1.95, 95 CI% 1.30-2.91), however, there was no difference when compared to straight men in 2018 (OR 1.32, 95% CI 0.85-2.04).Conclusion: Gay men were screened for PCa at a younger age comparted to straight men. They were also more likely to have undergone PCa cancer screening than straight men between 2013 and 2018. Further study is needed to better understand the role of sexual orientation in PCa screening and management. [ABSTRACT FROM AUTHOR]