Sex in the Era of COVID-19 in a U.S. National Cohort of Cisgender Men,Transgender Women,and Transgender Men Who Have Sex with Men: April–May 2020

Since the emergence of the COVID-19 pandemic, there has been an increasing body of research focused on the effects that measures like stay-at-home orders and social distancing are having on other aspects of health, including mental health and sexual health. Currently, there are limited extant data on the effects of the pandemic on sexual and gender minorities. Between April 15, 2020, and May 15, 2020, we invited participants in an ongoing U.S. national cohort study (Together 5000) to complete a cross-sectional online survey about the pandemic, and its effects on mental and sexual health and well-being (n?=?3991). Nearly all (97.7%) were living in an area where they were told they should only leave their homes for essentials. Most (70.1%) reported reducing their number of sex partners as a result of the pandemic. Among the 789 participants prescribed HIV pre-exposure prophylaxis (PrEP), 29.9% said they stopped taking their PrEP entirely, and 14.2% started selectively skipping doses. For those who had been taking PrEP, discontinuing PrEP was associated with having no new sex partners (β?=?0.90, 95% CI 0.40–1.40). Among the 152 HIV-positive participants, 30.9% said they were unable to maintain an HIV-related medical appointment because of the pandemic and 13.8% said they had been unable to retrieve HIV medications. Additionally, 35.3% of participants were experiencing moderate to severe anxiety because of the pandemic and 36.7% reported symptoms of depression. In a multivariable logistic regression, reporting a new sex partner in the prior 30 days was significantly associated with being aged 30 or older (vs. not, AOR?=?1.21), being Black (AOR?=?1.79) or Latinx (AOR?=?1.40, vs. white), and being unsure if they had been in close contact with someone diagnosed with COVID-19 (AOR?=?1.32, vs. no contact). It was unassociated with COVID-19-induced anxiety, depression, or knowing someone hospitalized with COVID-19. The pandemic has caused disruptions in sexual behavior (partner reduction) as well as difficulties navigating PrEP and HIV care continua. Findings will guide more comprehensive public health responses to optimize HIV prevention and treatment in the era of COVID-19.

     

Social–Emotional Aspects of Male Escorting: Experiences of Men Working for an Agency

Social situations and emotional correlates associated with male sex work have not been well documented. Most of the research in this area focuses on sexual activity with little mention of other aspects of the job. Yet, research with female sex workers finds significant social and emotional components to sex work. The current study focused on how male sex workers (MSWs) perceived and adapted to the social–emotional aspects of their job. As part of a larger project examining MSWs working for a single escort agency, 40 men (M age, 22.3 years, 75 % Caucasian) located in the mid-Atlantic U.S. participated in semi-structured interviews. The agency owner was also interviewed. Participants reported a range of social and emotional factors regarding sex work and employed a variety of strategies to provide good customer service and adapt to negative experiences. For most, social support was inhibited due to fear of stigmatization that might result if participants disclosed sex work to significant others outside the agency. Instead, interactions within the agency provided core work-related social support for most MSWs. Emotional and relational tasks inherent to escort work grew easier with experience and negativity about the job declined. Our data suggested that socially connected individuals seemed to be more satisfied with sex work. Social and emotional requirements represented a significant but unanticipated component of male sex work to which escorts actively adapted. Escorting may be similar to other service occupations in terms of the social–emotional situations and skills involved.     

Men Who Have Sex with Mens’ Exposure to,Use of,and Subjective Experiences with the ‘NYC Condom’

In 2007, the New York City (NYC) Department of Health introduced the ‘NYC Condom’—a Lifestyles^® condom with a ‘NYC’ logo. Few studies have evaluated attitudes toward or distribution of the ‘NYC Condom’ among men who have sex with men (MSM)—a population at increased risk for HIV/STIs. 148 MSM completed a survey about their exposure to, use of, and experiences using the ‘NYC Condom.’ The majority (93.2 %) had seen the ‘NYC Condom;’ 82.4 % of said men had used it. Among MSM who used it, 82.1 % rated it average or above. Exposure did not statistically differ by race/ethnicity, HIV status, gay or barebacker identification, or sex role. Use was neither significantly associated with demographic characteristics nor recruitment source, suggesting distributional success in reaching various sub-populations of MSM. Among those who had not used the ‘NYC Condom,’ 22.2 % reported size or quality concerns, suggesting a demand for alternative prevention campaigns.     

HIV Risk and Substance Use in Men Who Have Sex with Men Surveyed in Bathhouses,Bars/Clubs,and on Craigslist.org: Venue of Recruitment Matters

There has been little evaluation regarding whether men who have sex with men (MSM) recruited in one type of venue differ in behavioral and demographic characteristics from those recruited in others. We surveyed MSM in gay bars/clubs (n = 199), bathhouses (n = 194), and off Craigslist.org (n = 208). Men in bathhouses reported the greatest average number of partners and were less likely to disclose their HIV status. Among men reporting anal sex; those on Craigslist reported the least condom use. Finally, men surveyed in gay bars/clubs were the youngest of the three and the most likely to be single; they also reported the highest levels of attachment to the gay community and the most frequent alcohol use. Our findings demonstrate the need to tailor HIV prevention efforts to the location in which they are targeted, and for researchers to evaluate if participants differ by recruitment source.     

Stages of Change – Continuous Measure (URICA-E2): psychometrics of a Norwegian version

Title.  Stages of Change – Continuous Measure (URICA-E2): psychometrics of a Norwegian version.
Aim.  This paper is a report of research to translate the English version of the Stages of Change continuous measure questionnaire (URICA-E2) into Norwegian and to test the validity of the questionnaire and its usefulness in predicting behavioural change.
Background.  While the psychometric properties of the Stages of Change categorical measure have been tested extensively, evaluation of the psychometric properties of the continuous questionnaire has not been described elsewhere in the literature.
Method.  Cross-sectional data were collected with a convenience sample of 198 undergraduate nursing students in 2005 and 2006. The English version of URICA-E2 was translated into Norwegian according to standardized procedures.
Findings.  Principal components analysis clearly confirmed five of the dimensions of readiness to change (Precontemplation Non-Believers, Precontemplation Believers, Contemplation, Preparation and Maintenance), while the sixth dimension, Action, showed the lowest Eigenvalue (0·93). Findings from the cluster analysis indicate distinct profiles among the respondents in terms of readiness to change their exercise behaviour.
Conclusion.  The URICA-E2 was for the most part replicated from Reed's original work. The result of the cluster analysis of the items associated with the factor 'Action' suggests that these do not adequately measure the factor.