Attitudes about combination HIV therapies: The next generation of gay men at risk

This study examined awareness of and attitudes about highly active antiret-roviral therapies (HAARTs) among adolescent and young men who have sex with men (MSM). As part of the multisite Young Men’s Survey, 813 MSM aged 15–22 years who attended public venues in two cities were questioned about HAART in 1997–1998. Overall, 45.1% had heard of HAART, 61.6% in Seattle, Washington, and 35.0% in New York City. MSM in New York City who were the youngest, men of color, men who were human immunodeficiency virus (HIV) antibody negative, and men who resided in New Jersey were significantly less likely to be aware of HAART. Attitudes about HAART were not associated with sexual risk behaviors. Prevention efforts among young MSM should focus on other determinants of risk, but also include information on the changing nature of HIV therapies. Presented in part at the 1999 National HIV Prevention Conference, Atlanta, Georgia, August 29–September 1, 1999.     

Vaccine acceptability,uptake and completion amongst men who have sex with men: A systematic review,meta-analysis and theoretical framework

BackgroundDue to an increased risk of sexually transmitted infections (STIs), gay, bisexual and other men who have sex with men (MSM) have been recommended to receive vaccinations against human papillomavirus, meningitis C and hepatitis A/B. This review aimed to compare the rates of vaccine acceptability, uptake and completion, and to identify determinants of vaccine outcomes specific to MSM to inform a theoretical framework.MethodsIn January 2020 four databases were explored to identify vaccination behaviours and associated factors among MSM. A narrative systematic review and meta-analysis were performed. Data were synthesised for theoretical modelling.ResultsSeventy-eight studies, mostly from the USA, were included. The average vaccine acceptability was 63% (median = 72%, range: 30%-97%), vaccine uptake 45% (median = 42%, range: 5%-100%) and vaccine completion 47% (median = 45%, range: 12%-89%). Six categories of factors associated with vaccination acceptability, uptake and completion were conceptualised: Individual (e.g., demographic and psychosocial); Interpersonal (e.g., peer education); Healthcare provider (e.g., vaccine recommendation); Organisational and practice setting (e.g., routine collection of patient sexual orientation information that is integrated into a clinical decision support system); Community environment (e.g., targeted health promotion campaigns); and National, state and local policy environment (e.g., public health guidelines targeting MSM).ConclusionDespite overall high levels of acceptability, uptake and completion rates were below targets predicted by cost-effectiveness modelling across all recommended vaccines. These parameters may need to be adjusted for more precise estimations of cost-effectiveness. Addressing the multiple levels of determinants, as outlined in our theoretical framework, will help guide interventions to increase vaccine completion among MSM.     

Obtaining waivers of parental consent: A strategy endorsed by gay,bisexual, and queer adolescent males for health prevention research

Background

Requiring parental consent in studies with sexual minority youth (SMY) can sometimes be problematic as participants may have yet to disclose their sexual orientation, may not feel comfortable asking parents' permission, and may promote a self-selection bias.

Gay male couples and assisted reproduction: should we assist?

Gay male couples seeking fatherhood through assisted reproduction deserve the same attention to care that other couples, lesbian and heterosexual, receive at fertility centers throughout the country.     

Uptake of Mpox vaccination among transgender people and gay,bisexual and other men who have sex with men among sexually-transmitted infection clinic clients in Vancouver,British Columbia

ObjectivesAs the primary public health strategy for controlling the 2022 Mpox outbreak, it is critical to evaluate the impact of Mpox vaccination campaigns for transgender people and gay, bisexual and other men who have sex with men (T/GBM). We measured vaccine uptake and associated factors among T/GBM clients of an urban STI clinic in British Columbia (BC).MethodsWe conducted a cross-sectional online survey between August 8–22, 2022 of clients who had attended the STI clinic, 5–7 weeks following the first-dose Mpox vaccination campaign in BC. We drew on a systematic review of factors associated with vaccine uptake to develop survey questions, and measured vaccine uptake among vaccine-eligible T/GBM.ResultsOverall, 51% of T/GBM had received the first dose of the vaccine. The sample (331 participants) was majority White and university educated, identified as a man and gay, 10% had trans experience, and 68% met eligibility criteria for vaccination. Among vaccine-eligible participants identifying as T/GBM, 66% had been vaccinated; being unvaccinated was more common among participants identifying as bisexual or heteroflexible/mostly straight, and who spent less time with other T/GBM. Eligible yet unvaccinated participants had lower perceived susceptibility, and reported fewer cues to action (e.g., fewer saw information promoting the vaccine), and increased constraints to vaccine access; vaccine barriers related to accessing clinics and privacy were common. The majority (85%) of those eligible and unvaccinated at time of survey were willing to receive the vaccine.ConclusionIn this sample of STI clinic clients, vaccine uptake among eligible T/GBM was high in the initial weeks following a Mpox vaccination campaign. However, uptake was patterned on social gradients with lower uptake among T/GBM who may be less effectively engaged by available promotion channels. We recommend early, intentional and diverse engagement of T/GBM populations in Mpox and other targeted vaccination programs.     

青年学生男男性行为者的同性性取向成因初探

目的:探究青年学生男男性行为者(men who have sex with men,MSM)的同性性取向相关因素。方法:于2015年5月至7月,以天津市各区级疾控中心和社会组织为依托,招募青年学生MSM 50人,并从高校招募异性恋学生35人,对所有对象进行一般人口学特征、性格特征、家庭环境等问卷调查。使用SPSS17.0软件进行统计分析。结果:调查对象共85人,全部为男性、未婚,平均年龄(21.18!2.01)岁。MSM组的汉族、户籍所在地为本市、在本地居住两年以上、所学专业类别为理工类等依次为94.0%、38.0%、76.0%、52.0%,普通男大学生组依次为97.1%、31.4%、42.9%、65.7%。MSM组童年时与父母亲关系融洽的比例低于普通男大学生组,差异具有统计学意义(P<0.05);MSM组与普通男大学生组相比,小时候不爱活动、小时候不喜冒险、小时候喜欢扮作女孩、小时候不喜欢刀枪等玩具、18岁之前接触过有关同性恋的书籍或电影、从有关同性恋的书籍或电影中体验到性快感的比例均偏高,差异具有统计学意义(P<0.05)。结论:童年或未成年时的成长环境与青年学生同性性取向一定程度上相关。