Age of MSM Sexual Debut and Risk Factors: Results from a Multisite Study of Racial/Ethnic Minority YMSM Living with HIV

Given the increasing numbers of young gay/bisexual men (YGBM) diagnosed with HIV, it is important to understand the resilience processes enacted by this population in order to develop interventions that support their healthy development. Qualitative interviews were conducted with 54 YGBM (ages 17 to 24; 57% African American, 22% Latino) living with HIV from four geographically diverse clinics in the United States. Resilience processes clustered into four primary thematic areas: (1) engaging in health-promoting cognitive processes; (2) enacting healthy behavioral practices; (3) enlisting social support from others; and (4) empowering other young gay/bisexual men. These data suggest that YGBM living with HIV demonstrate resilience across multiple dimensions, including intrapersonal-level resilience related to individual cognitions and behaviors, as well as interpersonal-level resilience related to seeking support and providing support to others. Implications for the development of culturally-appropriate and strengths-based secondary prevention and other psychosocial interventions for YGBM living with HIV are discussed.

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confidence: 99%

Resilience Processes Demonstrated by Young Gay and Bisexual Men Living with HIV: Implications for Intervention

Harper

Bruce

Hosek

et al. 2014

“…In addition, the extent and patterns of symptoms may be different for those with behaviorally acquired HIV, as some studies have demonstrated high rates of risk behaviors, substance use, and psychological symptoms. 15,18,19,[30][31][32] It has been suggested that youth with behaviorally acquired HIV progress through stages in their acceptance and adaptation to the disease. An intense, emotional reaction is a common initial response to learning of one's infection, 33 followed by a transition to acceptance of treatment, 34 more active coping with the disease, 35 greater medical adherence, 11 and disclosure of infection to others.…”

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confidence: 99%

Psychological Symptoms Among 2032 Youth Living with HIV: A Multisite Study

Brown

Whiteley

Harper³

et al. 2015

This study determined the prevalence and patterns of psychological symptoms in adolescents and young adults living with HIV (YLWH) in medical care and relationships between psychological symptoms, route and duration of infection, and antiretroviral treatment (ART). A clinic-based sample of 2032 YLWH (mean age 20.3 years), recruited from 20 adolescent medicine HIV clinics, completed a cross-sectional survey of health behaviors and psychological symptoms using the Brief Symptom Inventory (BSI). Overall, 17.5% of youth reported psychological symptoms greater than the normative threshold on the Global Severity Index. A wide variety of symptoms were reported. The prevalence of clinical symptoms was significantly greater in youth with behaviorally acquired HIV compared to those with perinatally acquired infection (20.6% vs. 10.8%, OR = 2.06 in Multiple Logistic Regression (MLR)), and in those not taking ART that had been prescribed (29. 2% vs. 18.8%, OR = 1.68 in MLR). Knowing one's HIV status for more than one year and disclosure of HIV status were not associated with fewer symptoms. A large proportion of YLWH have psychological symptoms and the prevalence is greatest among those with behaviorally acquired infection. The high rate of psychological symptoms for youth not taking ART that is prescribed is a cause for concern. Symptoms do not appear to be a transient reaction to diagnosis of HIV.

“…Similarly, among a cohort of HIV-infected MSM, those who experienced sexual debut before age 16 demonstrated increased sexual risk behavior in subsequent years, and this effect was exacerbated if debut occurred before age 13. 26 A shifting culture around methods of meeting sex partners also presents increased risk, as MSM who utilize the Internet [27][28][29] and who attend ''group sex parties'' 30 often engage in higher risk sexual behavior and are more likely to be HIV infected. This behavior may be driven in part by sexual compulsivity, as emerging evidence suggests that sexual compulsivity is a significant predictor of risk behavior and subsequent HIV acquisition.…”

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confidence: 99%

Risk Patterns Preceding Diagnosis Among Newly HIV-Diagnosed Men Who Have Sex with Men in New York City

Drabkin

Sikkema

Wilson

et al. 2013

Men who have sex with men (MSM) are at high risk for contracting and transmitting HIV. They are increasingly encouraged to get tested, but understanding of the interplay between HIV testing and risk behavior is limited. One hundred fifty newly HIV-diagnosed (within past 3 months) MSM were recruited from a community clinic in New York City. Participants completed an interview assessing sexual behavior and substance use during the 3 months pre-diagnosis, current depressive symptoms, and prior HIV testing. HIV-related health characteristics at diagnosis were abstracted from medical records. Analyses examined factors associated with unprotected anal intercourse (UAI) in the 3 months pre-diagnosis, and with a negative HIV test in the 12 months pre-diagnosis. The sample was young (mean age = 32.5, SD = 8.8), ethnically diverse (62% racial/ethnic minority), low-income (71% £ $30,000/year), and educated (48% college/advanced degree). Most (95%) had a prior negative HIV test, 55% within the last 12 months. Significant risk behavior was reported, with 79% reporting UAI. UAI was associated with recent testing and use of substances during sexual behavior. Recent testing was associated with being employed/a student, having had UAI, and higher CD4 count. Implications for future research addressing perceived HIV risk, HIV testing utilization, and risk behavior are discussed.