Cognitive and Behavioral Resilience Among Young Gay and Bisexual Men Living with HIV

Abstract

Purpose: HIV/AIDS disproportionately affects young gay, bisexual, and other men who have sex with men (Y-GBMSM). Resilience remains understudied among Y-GBMSM living with HIV, but represents a potentially important framework for improving HIV-related outcomes in this population. We sought to explore cognitive and behavioral dimensions of resilience and their correlates among Y-GBMSM to gain insights to inform future interventions. Methods: Our study sample consisted of 200 Y-GBMSM living with HIV enrolled in a multisite study of the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). Participants completed a one-time, self-administered structured questionnaire, including validated scales capturing a range of cognitive, behavioral, demographic, and psychosocial data. Utilizing these data, we examined cognitive and behavioral dimensions of resilience and their potential psychosocial correlates using linear regression modeling.Results: Multiple regression analyses demonstrated that education, stigma, social support, ethnic identity, internalized homonegativity, and behavioral resilience were statistically significant predictors of cognitive resilience (P < 0.001, R 2 = 0.678). Social support satisfaction and cognitive resilience were significant predictors of behavioral resilience (P < 0.001, R 2 = 0.141). Conclusions: Our findings point to potential strategies for incorporating resilience-promoting features into future interventions to support Y-GBMSM living with HIV. Specifically, strengths-based interventions in this population should seek to enhance social support, promote positive identity development, and encourage education. Future research can also seek to utilize and refine our measures of resilience among youth.

Resilience, condom use self-efficacy, internalized homophobia, and condomless anal sex among black men who have sex with men, New York City

“…Among our sample of BMSM in NYC, who had median resilience scores of 75 out of 100, resilience was not associated with condomless anal sex. This was unexpected given the known benefits that resilience has for sexual health behaviors among MSM, including BMSM [10, 11]. Though we also examined internalized homophobia and condom-use self-efficacy as parallel psychosocial factors, adding other variables and a larger sample size may be warranted in future studies to further examine this question.…”

“…Resilience is the ability to recover quickly from stressful life situations; it is associated with psychological well-being and can potentially reduce HIV risk behaviors by buffering the effects of stigma and social stressors that contribute to condomless anal sex among MSM [7–9]. Data from mostly young black, Hispanic/Latino, and Native American MSM suggest that social supports, including family and house-ball communities (informal community networks of lesbian, gay, bisexual, transgender, and queer people), serve as sources of resilience [10–11]. A study with older, HIV-infected MSM showed that resilience was positively associated with improved health-related quality of life in later years [12].…”

“Stay strong! keep ya head up! move on! it gets better!!!!”: resilience processes in the healthMpowerment online intervention of young black gay, bisexual and other men who have sex with men

“…Yet, a risk or deficits-based approach to addressing the HIV epidemic focuses on what is lacking and carries the hazard of reinforcing negative stereotypes and mis-perceptions that fuel further stigma ( Herrick et al, 2013 ; Rowan et al, 2014 ). In contrast, a strengths-based approach builds on young Black GBMSM’s existing individual and community-level strengths (regardless of HIV status), recognizing the remarkable ways in which they are facing and overcoming significant barriers to both HIV prevention and care ( Aiyer, Zimmerman, Morrel-Samuels, & Reischl, 2015 ; DiFulvio, 2011 ; Herrick, Stall, Goldhammer, Egan, & Mayer, 2014 ; Hussen et al, 2017 ; Matthews et al, 2016 ). Specifically, resilience is a process through which individuals counter adversity ( Masten, Best, & Garmezy, 1990 ) and reduce or avoid negative outcomes ( Harper, Bruce, Hosek, Fernandez, & Rood, 2014 ; Luthar, Cicchetti, & Becker, 2000 ).…”

Brothers Building Brothers by Breaking Barriers: development of a resilience-building social capital intervention for young black gay and bisexual men living with HIV

“…According to Fergus and Zimmerman, resilience is comprised of both assets (referring to internally held factors such as self-efficacy or coping skills) and resources (factors external to the individual, such as parental support or community-based organizations) that enable an individual to withstand or overcome challenges in their lives (Fergus & Zimmerman, 2005). Despite multiple, intersecting societal disadvantages, YB-GBMSM living with HIV have been observed to display both assets (e.g., strong ethnic and/or gay identity beliefs) and resources (e.g., enlisting social support, peer mentorship), and to translate these resilience factors into HIV care engagement behaviors (Harper, Bruce, Hosek, Fernandez, & Rood, 2014;Hussen et al, 2015;Hussen et al, 2017).…”