Prevalence and Correlates of Sexual Violence Experienced by Young Adult Black Men Who Have Sex with Men

Archives of Sexual Behavior - Men who have sex with men (MSM) experience high prevalence of sexual violence (SV), and SV has well-documented effects on health. Research gaps are especially evident...     

Experiences of harassment, discrimination, and physical violence among young gay and bisexual men

OBJECTIVES: We examined the 6-month cumulative incidence of anti-gay harassment, discrimination, and violence among young gay/bisexual men and documented their associations with mental health. METHODS: Gay/bisexual men from 3 cities in the southwestern United States completed self-administered questionnaires. RESULTS: Thirty-seven percent of men reported experiencing anti-gay verbal harassment in the previous 6 months; 11.2% reported discrimination, and 4.8% reported physical violence. Men were more likely to report these experiences if they were younger, were more open in disclosing their sexual orientation to others, and were HIV positive. Reports of mistreatment were associated with lower self-esteem and increased suicidal ideation. CONCLUSIONS: Absent policies preventing anti-gay mistreatment, empowerment and community-building programs are needed for young gay/bisexual men to both create safe social settings and help them cope with the psychological effects of these events.     

Challenges and facilitators to building program evaluation capacity among community-based organizations.

We have been collaborating with many community-based organizations (CBOs) to increase their capacity to implement our evidence-based HIV prevention intervention. A frequent issue in these collaborations is how CBOs can evaluate their implementation of the intervention using feasible and sound methods. This study sought to provide the foundation for evaluation recommendations, tools, training, and technical assistance to help CBOs build their evaluation capacity. We conducted a qualitative study of 21 CBOs, 12 funders, and 11 technical assistance providers regarding beliefs and attitudes about evaluation, preferences and requirements for evaluation, evaluation methods that are currently being used at CBOs, and recommendations regarding feasible and effective evaluation that CBOs can use. The themes that arose in the telephone interviews are organized around three major topics: facilitators and barriers to conducting evaluation, evaluation methods that CBOs use, and how to increase CBOs' capacity to conduct evaluations.     

Evidence for the Model of Gender Affirmation: The Role of Gender Affirmation and Healthcare Empowerment in Viral Suppression Among Transgender Women of Color Living with HIV

Transgender women of color are disproportionately impacted by HIV, poor health outcomes, and transgender-related discrimination (TD). We tested the Model of Gender Affirmation (GA) to identify intervention-amenable targets to enhance viral suppression (VS) using data from 858 transgender women of color living with HIV (49% Latina, 42% Black; 36% virally suppressed) in a serial mediation model. Global fit statistics demonstrated good model fit; statistically significant (p ≤ 0.05) direct pathways were between TD and GA, GA and healthcare empowerment (HCE), and HCE and VS. Significant indirect pathways were from TD to VS via GA and HCE (p = 0.036) and GA to VS via HCE (p = 0.028). Gender affirmation and healthcare empowerment significantly and fully mediated the total effect of transgender-related discrimination on viral suppression. These data provide empirical evidence for the Model of Gender Affirmation. Interventions that boost gender affirmation and healthcare empowerment may improve viral suppression among transgender women of color living with HIV.

     

Correlates of Engagement in HIV Care Among Transgender Women of Color in the United States of America

HIV prevalence among transgender women of color (TWC) in the United States of America is high. We enrolled TWC living with HIV (N = 858) to evaluate 1nine HIV care interventions. We examined factors associated with four outcomes at enrollment: linkage to care, ever being on antiretroviral treatment, retention in care and viral suppression. The sample was 49% Hispanic/Latino, 42% Black; average age was 37 years; 77% were ever linked to care, 36% were ever on treatment, 22% were retained in care, and 36% were virally suppressed. Current hormone use was significantly associated with linkage, retention, and viral suppression (all aORs > 1.5), providing evidence for gender-affirming care as an important facilitator of engagement in HIV care. Greater health care empowerment was significantly associated with greater odds of all outcomes (aORs between 1.19 and 1.37). These findings identify potential intervention targets to improve the provision of care and treatment for TWC living with HIV.

     

‘It's my inner strength’: spirituality,religion and HIV in the lives of young African American men who have sex with men

Young black men who have sex with men account for 48% of 13–29-year-old HIV-positive men who have sex with men in the USA. It is important to develop an effective HIV prevention approach that is grounded in the context of young men's lives. Towards this goal, we conducted 31 interviews with 18–30-year-old men who have sex with men in the San Francisco-Oakland Bay Area. This paper examines the roles of religion and spirituality in men who have sex with men's lives, which is central in the lives of many African Americans. Six prominent themes emerged: (1) childhood participation in formal religious institutions, (2) the continued importance of spirituality among men who have sex with men, (3) homophobia and stigmatisation in traditional black churches, (4) tension between being a man who has sex with men and being a Christian, (5) religion and spirituality's impact on men's sense of personal empowerment and coping abilities and (6) treatment of others and building compassion. Findings suggest that integrating spiritual practice into HIV prevention may help programmes be more culturally grounded, thereby attracting more men and resonating with their experiences and values. In addition, faith-based HIV/AIDS ministries that support HIV-positive men who have sex with men may be particularly helpful. Finally, targeting pastors and other church leaders through anti-stigma curricula is crucial.     

“She is Like a Sister to Me.” Gender-Affirming Services and Relationships are Key to the Implementation of HIV Care Engagement Interventions with Transgender Women of Color

We present findings from qualitative interviews (N = 67) with 36 staff and 31 participants of nine distinct individual and/or group level interventions to engage transgender women of color (TWOC) in HIV care in the U.S. We examine the commonalities amongst the intervention services (addressing unmet basic needs, facilitating engagement in HIV care, health system navigation, improving health literacy, emotional support), and the relationships formed during implementation of the interventions (between interventionists and participants, among participants in intervention groups, between participants and peers in the community). Interventionists, often TWOC themselves, who provided these services developed caring relationships, promoted personal empowerment, and became role models for participants and the community. Intervention groups engaged participants to reinforce the importance of health and HIV care and provided mutual support. Gender affirming services and caring relationships may be two key characteristics of interventions that address individual and structural-level barriers to engage TWOC in HIV care.

     

Comparing Internet-Based and Venue-Based Methods to Sample MSM in the San Francisco Bay Area

Methods of collecting behavioral surveillance data, including Web-based methods, have recently been explored in the United States. Questions have arisen as to what extent Internet recruitment methods yield samples of MSM comparable to those obtained using venue-based recruitment methods. We compare three recruitment methods among MSM with respect to demographic and risk behaviors, one sample was obtained using time location sampling at venues in San Francisco, one using a venue based like approach on the Internet and one using direct-marketing advertisements to recruit participants. The physical venue approach was most successful in completing interviews with approached men than both Internet approaches. Respondents recruited via the three methods reported slight differences in risk behavior. Direct marketing internet recruitment can obtain large samples of MSM in a short time.