Increased attention has highlighted the role of age and sexual development on HIV risk among Black MSM (BMSM); limited focus has been given to the relationship of sexual positioning to HIV risk along the life course. This study examined BMSM's life course sexual positioning practices and accompanying HIV/STI risks. Twenty-six Black gay and bisexual men ages 24-61 completed life history interviews in Los Angeles, California, between September and November 2015. Thematic analysis evaluated domains including major life events, substance use, social support, and partner selection. Varying exposure to HIV treatment and prevention options and venues to meet male partners revealed generational differences in sexual risks. Childhood sexual abuse and internalized homonegativity impacted personal development, sexual positioning, and condom negotiation. BMSM also assumed sexual positioning using masculinity stereotypes and body language. Clarifying the sexual development and HIV/STI risk contexts among BMSM could better inform current treatment and prevention needs.

Online partner-seeking applications are sexual-identity affirming social spaces commonly accessed by young men who have sex with men (YMSM; ages 18 -24 years). Yet, prior studies with YMSM have observed sexual discrimination based on race/ethnicity and physical appearance to be common within these platforms. Few studies have explored the associations between online discrimination when partner-seeking and mental health. Our study's objective was to describe the prevalence of online sexual discrimination and test its associations with self-esteem and depression. We included cross-sectional data from the baseline survey of a web-based, HIV-prevention prospective randomized controlled trial for single YMSM (N ϭ 172) who reported seeking partners online. A national sample was recruited online from popular social and sexual networking sites. Using multivariable linear regressions, we tested the respective associations that race-based and appearance-based sexual discrimination had with self-esteem and depressive symptoms. We conducted stratified models by race/ethnicity (White vs. minority participants) and BMI categories (under-/normal weight vs. overweight/obese). Over 30% were exposed to race-based sexual discrimination and over 60% to appearance-based sexual discrimination. Weight-based sexual discrimination was associated with lower self-esteem. This association remained statistically significant in stratified models for racial/ethnic minority and overweight/obese participants only. Weightbased discrimination was positively associated with depressive symptoms among racial/ethnic minority YMSM. Our study highlights the potential contribution of weight-based discrimination when seeking partners online on YMSM's mental health. Coupled with community-level interventions to raise awareness about weight-related stigma, partner-seeking platforms should capitalize on opportunities for mass-media marketing strategies to promote body-type diversity and body-positive messaging. Public Significance StatementYoung men who have sex with men report race-based and weight-based sexual discrimination when seeking partners online. Despite high prevalence in our sample, race-based discrimination was not associated with mental health. Weight-based discrimination was negatively associated with selfesteem and positively associated with depression. Queer-targeted mass-media interventions that capitalize on promoting body-type diversity may be integral to shifting community norms away from rigid standards of attractiveness and ultimately having a positive impact on individual-level mental health.

Emphasis has been placed on HIV testing and health care engagement, but little is known about how testing and engagement intersect, especially for men. We used latent class analysis to explore underlying profiles of U.S. men regarding HIV testing and health care utilization using data from the 2014 National Health Interview Survey. Multinomial regression was used to predict class membership in four classes: (a) Low HIV Testing/No Health Care Utilization, (b) Some HIV Testing/Low Health Care Utilization, (c) No HIV Testing/Some Health Care Utilization, and (d) High HIV Testing/High Health Care Utilization. Most men were in the No HIV Testing/Some Health Care Utilization class (46%), with a 0% chance of ever having had an HIV test but an 89% chance of seeing a general practitioner in the previous year. Research should include qualitative measures to capture information on facilitators and barriers to HIV testing for men who see general practitioners.

With the increase in the US of the number of older adults living with HIV, more research is needed to understand the caregiving and advance care planning needs of this population. This descriptive study examined the relationship between social support and caregiving preferences and advance care planning. Older adults living with HIV were recruited from clinics in Los Angeles, CA and New Orleans, LA to complete cross-sectional surveys (n = 154). Logistic regression analyses were modeled to determine the characteristics associated with 1) preference for formal short-term term care, 2) preference for formal long-term care, 3) having at least one contact for emergency care, 4) having an advance directive or living will, and 5) having a healthcare proxy or agent. The mean age was 56.8 years. The majority of participants indicated a preference for informal support for both short-term (73.4%) and long-term care (66.2%), 13.2% had no one they could call for emergency care, 26.0% had an advance directive/living will, and 30.5% had a healthcare proxy/agent. In adjusted models, greater social support was associated with preference for informal short-term care and with having at least one emergency contact. Findings suggest that older adults living with HIV prefer informal sources of support for their caregiving needs despite having small social networks and individuals with limited social networks are particularly vulnerable due to lack of access to caregivers in sudden or unexpected health situations.

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