Psychosocial Correlates of Unprotected Sex Without Disclosure of HIV-Positivity among African-American,Latino, and White Men Who Have Sex with Men and Women

African-American, Latino, and White men who have sex with men and women (MSMW) may be a bridge of HIV transmission from men to women. Very little research has directly compared culturally specific correlates of the likelihood of unprotected sex among MSMW. The present study examined psychosocial correlates of unprotected sex without disclosure of HIV status with male and female partners among 50 African American, 50 Latino, and 50 White HIV-positive MSMW recruited from AIDS service organizations in Los Angeles County. Multivariate logistic regressions were conducted to examine relationships of race/ethnicity and psychosocial variables (e.g., condom attitudes, self-efficacy for HIV disclosure, sexual identification) to unprotected sex without disclosure of HIV status, for male and female partners separately. For female partners, different effects emerged by race/ethnicity. Among African-Americans, less exclusively homosexual identification and low self-efficacy for disclosure of HIV status to female partners were associated with unprotected sex without disclosure; among Latinos, less exclusively homosexual identification and negative attitudes about condoms were significant. Participants who were more exclusively homosexually identified, who held less positive condom attitudes, and who had low self-efficacy for disclosure to female partners were more likely to have unprotected sex without disclosure of HIV status to male partners. Culturally tailored community-level interventions may help to raise awareness about HIV and bisexuality, and decrease HIV and sexual orientation stigma, thereby increasing African-American and Latino MSMW's comfort in communicating with their female partners about sexuality, HIV and condoms. Addressing norms for condom use and disclosure between male partners is recommended, especially for homosexually identified MSMW.     

Masculine Gender Roles Associated with Increased Sexual Risk and Intimate Partner Violence Perpetration among Young Adult Men

This study sought to assess the association between traditional masculine gender role ideologies and sexual risk and intimate partner violence (IPV) perpetration behaviors in young men's heterosexual relationships. Sexually active men age 18–35 years attending an urban community health center in Boston were invited to join a study on men's sexual risk; participants (N=307) completed a brief self-administered survey on sexual risk (unprotected sex, forced unprotected sex, multiple sex partners) and IPV perpetration (physical, sexual and injury from/need for medical services due to IPV) behaviors, as well as demographics. Current analyses included men reporting sex with a main female partner in the past 3 months (n=283). Logistic regression analyses adjusted for demographics were used to assess significant associations between male gender role ideologies and the sexual risk and IPV perpetration behaviors. Participants were predominantly Hispanic (74.9%) and Black (21.9%); 55.5% were not born in the continental U.S.; 65% had been in the relationship for more than 1 year. Men reporting more traditional ideologies were significantly more likely to report unprotected vaginal sex in the past 3 months (OR_adj = 2.3, 95% CI = 1.2–4.6) and IPV perpetration in the past year (OR_adj = 2.1, 95% CI = 1.2–3.6). Findings indicate that masculine gender role ideologies are linked with young men's unprotected vaginal sex and IPV perpetration in relationships, suggesting that such ideologies may be a useful point of sexual risk reduction and IPV prevention intervention with this population.Santana and Raj are with the Department of Social and Behavioral Sciences, Boston University School of Public Health, Boston, MA, USA; Decker and Silverman are with the Department of Society, Human Development and Health and Division of Public Health Practice, Harvard University School of Public Health, Boston, MA, USA; La Marche is with the Martha Eliot Health Center, Boston, MA, USA.     

History of Arrest and Associated Factors among Men Who Have Sex with Men

Incarceration has been proposed to be a driving factor in the disproportionate impact of HIV in African-American communities. However, few data have been reported on disparities in criminal justice involvement by race among men who have sex with men (MSM). To describe history of arrest and associated factors among, we used data from CDC’s National HIV Behavioral Surveillance system. Respondents were recruited by time–space sampling in venues frequented by MSM in 15 US cities from 2003 to 2005. Data on recent arrest (in the 12 months before the interview), risk behaviors, and demographic information were collected by face-to-face interview for MSM who did not report being HIV-positive. Six hundred seventy-nine (6.8%) of 10,030 respondents reported recent arrest. Compared with white MSM, black MSM were more likely to report recent arrest history (odds ratio (OR), 1.6; 95% confidence interval (CI), 1.3–2.1). Men who were less gay-identified (bisexual [OR, 1.5; 95% CI, 1.1–1.9] or heterosexual [OR, 2.0; 95% CI, 1.2–3.5]) were more likely to report recent arrest than homosexually identified men. In addition, men who reported arrest history were more likely to have used non-injection (OR, 3.0; 95% CI, 2.4–3.6) and injection (OR, 4.7; 95%, 3.3–6.7) drugs, exchanged sex (OR, 2.7; 95% CI, 2.1–3.4), and had a female partner (OR, 1.5; 95% CI, 1.2–2.0) in the 12 months before interview. Recent arrest was associated with insertive unprotected anal intercourse in the 12 months before interview (OR, 1.4; 95% CI, 1.2–1.7). Racial differences in arrest seen in the general US population are also present among MSM, and history of arrest was associated with high-risk sex. Future research and interventions should focus on clarifying the relationship between criminal justice involvement and sexual risk among MSM, particularly black MSM.     

Perceived Neighborhood Safety Is Associated with Poor Sleep Health among Gay,Bisexual, and Other Men Who Have Sex with Men in Paris,France

Recent studies have examined sleep health among men who have sex with men (MSM), but no studies have examined associations of neighborhood characteristics and sleep health among this population. The purpose of this study was to examine associations between perceived neighborhood safety and sleep health among a sample of MSM in Paris, France. We placed broadcast advertisements on a popular smartphone application for MSM in October 2016 to recruit users in the Paris (France) metropolitan area (n = 580). Users were directed to complete a web-based survey, including previously used items measuring perceptions of neighborhood safety, validated measures of sleep health, and socio-demographics. Modified Poisson models were used to estimate risk ratios (RRs) and 95% confidence intervals (CI) for the associations between perceived neighborhood safety and the following outcomes: (1) poor sleep quality, (2) short sleep duration, and (3) self-reported sleep problems. Poor sleep health was common in our sample; e.g., 30.1% reported poor sleep quality and 44.7% reported problems falling asleep. In multivariate regression models, perceived neighborhood safety was associated with poor sleep quality, short sleep duration, and having sleep problems. For example, reporting living in a neighborhood perceived as unsafe during the daytime (vs. safe) was associated with poor sleep quality (aRR, 1.60; 95% CI, 1.01, 2.52), short sleep duration (aRR, 1.92; 95% CI, 1.26, 2.94), problems falling asleep (aRR, 1.57; 95% CI, 1.17, 2.11), and problems staying awake in the daytime (aRR, 2.16; 95% CI, 1.05, 4.43). Interventions to increase neighborhood safety may improve sleep health among MSM.     

某区男男性行为人群性伴网络特征与高危行为分析

[目的]了解男男性行为（MSM）人群性伴网络特征及该人群中高危性行为的发生情况,探讨性病（STDs）、人类免疫缺陷病毒（HIV）在该人群中传播及向普通人群传播的模式,为开展性病、艾滋病预防控制提供依据。[方法]通过艾滋病自愿咨询检测门诊、同性恋人群活动场所、同性恋QQ群内动员、＂滚雪球＂等途径寻找MSM人群,招募151人,采用面对面匿名问卷调查方式收集信息。[结果]151名被调查者中最近6个月有30人（19.9%）与异性发生过性行为,高危性行为的发生率为53.3%;与同性性活动情况,其中91人（60.3%）有同性固定性伴,76人（50.3%）与非固定同性性伴的人发生过多次男男性行为（简称有多次男性伴）,77人（51.0%）发生过偶遇性行为（简称有偶遇男性伴）,10人（6.6%）从事商业性行为。而在与固定性伴、多次男性伴、偶遇男性伴、商业性行为中高危性行为的发生率依次是69.2%、57.9%、50.6%、70.0%。与固定男性伴高危性行为的发生率高于与偶遇男性伴高危性行为的发生率（P=0.014）。最近6个月有2种及以上性伴类型占58.9%。30名已感染HIV者中有多次男性伴及偶遇男性伴类型的比例分别为53.3%和63.3%;有过多次男性伴、偶遇男性伴性行为者中发生高危性行为的比例分别为50.0%和63.2%。感染HIV者与固定男性伴发生高危性行为的率低于未感染HIV者（P=0.029）。[结论]MSM人群性伴网络复杂多样,高危性行为发生率高。不仅使HIV在该人群中容易传播,且该人群已成为向普通人群传播HIV的＂桥梁＂人群。     

Racial/Ethnic Differences in the Association between Arrest and Unprotected Anal Sex among Young Men Who Have Sex with Men: The P18 Cohort Study

This analysis aimed to determine whether the relationship between a history of arrest and unprotected anal sex (UAS) is the same for Black/Latino gay, bisexual, and other young men who have sex with men (YMSM) as compared to White/Asian/Pacific Islander (API) YMSM in New York City (NYC). Baseline audio-computer-assisted self-interview (ACASI) and interviewer-administered survey data from a sample of 576 YMSM aged 18–19 years old who self-reported being HIV-negative were analyzed. Data included history of arrest and incarceration as well as UAS in the past 30 days. Race/ethnicity was an effect modifier of the association between arrest and UAS among YMSM: White/API YMSM with a lifetime arrest history were more than three times as likely to report UAS, and Black/Latino YMSM with a lifetime history of arrest were approximately 70 % less likely to report UAS as compared with White/API YMSM with no reported arrest history. Race/ethnicity may modify the relationship between arrest and sexual risk behavior because the etiology of arrest differs by race, as partially evidenced by racial/ethnic disparities in police stop, arrest, and incarceration rates in NYC. Arrest could not only be an indicator of risky behavior for White/API YMSM but also an indicator of discrimination for Black/Latino YMSM. Further research is needed to assess whether the differential associations observed here vis-à-vis race/ethnicity are robust across different populations and different health outcomes.     

HIV Prevalence and Demographic Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut,Lebanon

The limited epidemiological data in Lebanon suggest that HIV incident cases are predominantly among men who have sex with men (MSM). We assessed the prevalence of HIV and demographic correlates of condom use and HIV testing among MSM in Beirut. Respondent-driven sampling was used to recruit 213 participants for completion of a behavioral survey and an optional free rapid HIV test. Multivariate regression analysis was used to examine demographic correlates of unprotected anal sex and any history of HIV testing. Nearly half (47 %) were under age 25 years and 67 % self-identified as gay. Nearly two-thirds (64 %) reported any unprotected anal intercourse (UAI) with men in the prior 3 months, including 23 % who had unprotected anal intercourse with men whose HIV status was positive or unknown (UAIPU) to the participant. Three men (1.5 % of 198 participants tested) were HIV-positive; 62 % had any history of HIV testing prior to the study and testing was less common among those engaging in UAIPU compared to others (33 % vs. 71 %). In regression analysis, men in a relationship had higher odds of having UAI but lower odds of UAIPU and any university education was associated with having UAI; those with any prior history of HIV testing were more likely to be in a relationship and have any university education. HIV prevention efforts for MSM need to account for the influence of relationship dynamics and promotion of testing needs to target high-risk MSM.     

Factors affecting awareness of emergency contraception among college students in Kathmandu, Nepal

Background  

In Nepal, Emergency Contraception (EC) could play a critical role in reducing unintended pregnancies, but very few people aware about it. This paper aims to investigate the level of awareness and factors influencing awareness of EC among college students.     

Economic,Legal, and Social Hardships Associated with HIV Risk among Black Men who have Sex with Men in Six US Cities

We assessed whether economic, legal, and social hardships were associated with human immunodeficiency virus (HIV) risk among a sample of Black men who have sex with men (MSM) and whether associations were moderated by city of residence. The study analyzed baseline and follow-up data from HIV Prevention Trials Network 061 (N = 1553). Binary logistic regression assessed associations between hardships and HIV risk indicators. Multivariate regressions were used to test if city of residence had a moderating effect for hardships and HIV risks. Adjusted analyses showed that Black MSM with recent job loss were more likely to engage in condomless insertive anal intercourse (adjusted odds ratios (AOR) = 1.37, 95 % CI 1.01–1.87) and that those with recent financial crisis were more likely to have had two or more male sexual partners in the past 6 months (AOR = 1.65; 95 % CI 1.18–2.29). Black MSM with recent convictions were more likely to have a sexually transmitted infection at 6 months (AOR = 3.97; 95 % CI 1.58–9.94), while those who were unstably housed were more likely to have a sexually transmitted infection at 12 months (AOR = 1.71; 95 %CI 1.02 = 2.86). There were no city of residence and hardship interaction effects on HIV risks. Hardships are important factors that influence HIV risk for Black MSM. Integrating strategies that address structural factors that influence HIV risk may enhance HIV prevention interventions implementation efforts.     

Entertainment-Education in the Context of Humor: Effects on Safer Sex Intentions and Risk Perceptions

Past research has examined the effects of entertainment narratives on story-related behaviors, but most has focused primarily on dramatic genres rather than comedy. The present study examines how the presence or absence of pregnancy-related humor influences viewers' counterarguing, perceived severity, and intentions to engage in unprotected sexual behavior. Results were consistent with expectations in that related humor reduced counterarguing while also trivializing the severity of the consequences of sexual behavior. When the pregnancy storyline was presented in its original humorous context, viewers reported greater intentions to engage in unprotected sex than when pregnancy was presented in a more serious tone. Model testing clarified this finding by revealing the underlying mechanisms. Practical and theoretical implications are discussed.     

Increased Dietary Inflammatory Index (DII) Is Associated With Increased Risk of Prostate Cancer in Jamaican Men

Prostate cancer is the most common nonskin malignancy, and it accounts for the most cancer deaths among Jamaican males. Diet has been implicated in the etiology of prostate cancer, including through its effects on inflammation. We examined the association between a newly developed dietary inflammatory index (DII) and prostate cancer in a case-control study of 40–80 yr old Jamaican males. A total of 229 incident cases and 250 controls attended the same urology out-patient clinics at 2 major hospitals and private practitioners in the Kingston, Jamaica metropolitan area between March 2005 and July 2007. The DII was computed based on dietary intake assessed using a previously validated food frequency questionnaire (FFQ) that was expanded to assess diet and cancer in this Jamaican population. Multivariable logistic regression was used to estimate odds ratios, with DII as continuous and expressed as quartiles. Logistic regression analysis adjusted for age, total energy intake, education, body mass index, smoking status, physical activity, and family history of prostate cancer. Men in the highest quartile of the DII were at higher risk of prostate cancer [odds ratio (OR) = 2.39; 95% confidence interval (CI) = 1.14–5.04; P_trend = 0.08] compared to men in the lowest DII quartile. These data suggest a proinflammatory diet, as indicated by increasing DII score, may be a risk factor for prostate cancer in Jamaican men.     

Increase in Sexually Transmitted Infections among Men Who Have Sex with Men,England, 2014

Surveillance data from sexual health clinics indicate recent increases in sexually transmitted infections, particularly among men who have sex with men. The largest annual increase in syphilis diagnoses in a decade was reported in 2014. Less condom use may be the primary reason for these increases.     

Congruence of Home,Social and Sex Neighborhoods among Men Who Have Sex with Men,NYCM2M Study

Substantial literature demonstrates the influence of the neighborhood environment on health behaviors and outcomes. But limited research examines on how gay and bisexual men experience and exist in various geographic and virtual spaces and how this relates to their sexual behavior. New York City Men 2 Men (NYCM2M) was a cross-sectional study designed to identify neighborhood-level characteristics within the urban environment that influence sexual risk behaviors, substance use, and depression among men who have sex with men (MSM) living in NYC. The sample was recruited using a modified venue-based time-space sampling methodology and through select websites and mobile applications. Whether key neighborhoods of human activity, where a participant resided (termed home), socialized (termed social), or had sex most often (termed sex), were the same or different was evaluated. “Congruence” (or the sameness) of home, social, and most often sex neighborhood was reported by 17 % of men, while 30 % reported that none of their neighborhoods were the same. The largest group of men (39 %) reported that their home and sex neighborhoods were the same but their social neighborhood was different while 10 % reported that their home neighborhood was different than their social and sex neighborhood; 5 % men reported same home and social neighborhoods with a different sex neighborhood. Complete neighborhood incongruence was highest among men who were Black and/or Latino, had lower education and personal income levels, and had greater financial insecurity. In adjusted analysis, serodiscordant condomless anal intercourse and condomless anal intercourse with partners from the Internet or mobile applications were significantly associated with having the same social and sex (but not home) neighborhoods. Understanding the complexity of how different spaces and places relate to the health and sexual behavior of MSM is essential for focusing interventions to best reach various populations of interest.     

Rapid Increase in Lymphogranuloma Venereum among HIV-Negative Men Who Have Sex with Men,England, 2019

Incidence of lymphogranuloma venereum increased in England during 2018–2019, after a period of decline. Our retrospective analysis of national surveillance data identified a rapid increase in diagnoses among HIV-negative men who have sex with men. These findings indicate a need for sustained surveillance and targeted public health action.     

Intimacy, Monogamy, and Condom Problems Drive Unprotected Sex Among Young Men in Serious Relationships with Other Men: A Mixed Methods Dyadic Study

This mixed methods study aimed to examine partner and relationship characteristics associated with HIV risk among young men who have sex with men (YMSM). A sub-sample of YMSM (18–25 years) who were involved in serious relationships with other men were recruited from two on-going longitudinal studies, Project Q2 and Crew450 (N = 20 couples). The mean age of the dyadic sample was 22.5 years (SD = 5.33, range 18–46 years) and participants were racially and ethnically diverse, with the largest percentage of the sample identifying as African American (47.5 %), followed by Hispanic (20 %). Participants completed individual self-report measures using computer-assisted self-interview technology and engaged in couples-based interviews. Mixed methods analyses indicated three global reasons for unprotected sex among YMSM in serious relationships: (1) the desire to achieve emotional intimacy; (2) the perception of being in a monogamous relationship; and (3) the difficulties associated with accessing and/or using condoms. Couples’ decision-making processes, including decisions made “in the heat of the moment,” have implications for HIV prevention interventions.     

Mutual HIV Disclosure among HIV-Negative Men Who have Sex with Men in Beijing, China, 2010

HIV is rising rapidly among Chinese men who have sex with men (MSM). Discussion of HIV status between sexual partners is potentially a key prevention behavior. It is unclear if HIV-negative Chinese MSM talk about HIV and disclose their HIV status with sexual partners. Understanding the correlates of disclosure among this population could provide insight into developing disclosure-based interventions. We conducted a respondent driven sampling based study of 500 MSM in Beijing. A total of 332 men had a previous HIV-negative test result and thus considered themselves to be HIV-negative and were included in our analysis of disclosure. Equal numbers of these men reported talking about HIV and disclosing their HIV status to at least one sexual partner. MSM who disclosed were more likely to be living with a main partner. No other demographic characteristics were associated with disclosure in bivariate analysis. We also used data on up to three sexual partners per participant to examine disclosure on the partnership level. Main partnerships, meeting partners at bars/clubs, sometimes using alcohol before sex in a partnership, and usually having sex at home compared to other venues were associated with disclosure. Using generalized estimating equation analysis to characterize individuals from their partnership data, we found only having at least one main partnership and knowing people who were infected with HIV to be associated with a participant being a discloser. Interventions that wish to harness discussion of HIV and HIV status among Chinese MSM will need to focus on moving these discussions towards having them with casual partners.     

福建省某市男男性接触人群相关血清学监测及分析

[目的]对福建省某市男男性接触者(MSM)进行相关血清学监测,了解该人群中艾滋病病毒(HIV)和梅毒等性传播疾病(STDs)的感染状况,为制定干预措施提供依据。[方法]采用方便抽样法对MSM人群进行匿名问卷调查,并抽取静脉血进行HIV抗体、梅毒抗体、乙肝病毒HBsAg及丙肝病毒抗HCV-IgG的检测。[结果]共采血检测MSM159例,结果梅毒抗体TRUST阳性率为12.6%(20/159),TPPA阳性率为25.8%(41/159);HIV抗体阳性率为1.9%(3/159),其中1例同时检出梅毒和HIV抗体阳性,HIV和梅毒累积感染率为27.0%;HBsAg阳性率为12.6%(20/159);未检出抗HCV-IgG。年龄大于25岁是HIV和梅毒累积感染的危险因素。[结论]HIV/STDs在MSM人群中存在局部流行的可能性,应及时采取干预措施,控制其流行及向一般人群的传播。