Financial Hardship, Condomless Anal Intercourse and HIV Risk Among Men Who Have Sex with Men

Duncan, Dustin T.; Park, Sang Hyoung; Schneider, John A.; Goedel, William C.; Elbel, Brian; Morganstein, Jace G.; Ransome, Yusuf; Mayer, Kenneth H.

doi:10.1007/s10461-017-1930-3

Cited by 17 publications

(14 citation statements)

References 33 publications

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“…Financial hardship among MSM is shown to be associated with a higher likelihood of participating in sexual risky situations (eg, alcohol or drug use before or during sex), condomless anal intercourse, transactional sex and drug use. [28][29][30] These findings confirm that among MSM, a subgroup can be identified that is vulnerable for acquiring HIV or other STIs. We recommend HIV and STI prevention organisations to provide guidance on how to reduce the risk for HIV infections and STIs when engaging in sexual practices such as group sex, chemsex or sex work.…”

Section: Discussionsupporting

confidence: 68%

Reduced sexual contacts with non-steady partners and less PrEP use among MSM in Belgium during the first weeks of the COVID-19 lockdown: results of an online survey

et al. 2020

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ObjectivesTo examine changes in the occurrence of physical sex with non-steady partners among men who have sex with men (MSM) in Belgium during the first weeks of the COVID-19 lockdown and associations with sociodemographic factors, sexual practices, drug, alcohol and pre-exposure prophylaxis (PrEP) use. A secondary objective was to explore changes in PrEP use and the need for PrEP follow-up.MethodsA cross-sectional online survey. The questionnaire was available in Dutch, French and English, between April 10 and 27 (2020), and disseminated via sexual health and lesbian, gay, bisexual, trans, queer or intersex organisations throughout Belgium. Eligibility criteria included being 18 years or older, not being exclusively heterosexual and living or being born in Belgium.ResultsThe sample included 694 MSM. Physical sex with non-steady partners decreased from 59.1% to 8.9% during the first weeks of the lockdown. Those who had sex with non-steady partners were significantly more likely to be HIV positive, to use PrEP or to have engaged in sexual practices such as group sex, chemsex and sex work before the lockdown, compared with their counterparts. Among those who used PrEP before the lockdown, 47.0% stopped using PrEP, 19.7% used event-driven PrEP and 33.3% used daily PrEP during the lockdown. Almost two-thirds of PrEP users had a PrEP care appointment in the weeks before the lockdown and a minority received follow-up elsewhere or online. Some PrEP users had concerns regarding their follow-up.ConclusionsMSM in our survey substantially reduced sexual contact with non-steady partners during the first weeks of the COVID-19 lockdown, suggesting that the risk for HIV and STI transmission in this period was low. We recommend ensuring access to sexual health services, such as HIV testing and follow-up for PrEP for the small group having multiple sex partners and engaging in sexual practices such as chemsex, or group sex, even in times of a pandemic threat.

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Section: Discussionsupporting

confidence: 68%

Reduced sexual contacts with non-steady partners and less PrEP use among MSM in Belgium during the first weeks of the COVID-19 lockdown: results of an online survey

et al. 2020

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“…In addition, young MSM were more likely to have sexual risk behaviors and have lower utilization of mental health care, which may further aggravate their psychological problem [46]. Personal income is also associated with depression, which might be partially explained by the financial hardship, discrimination and social stress related to poverty [47]. Mental health interventions and services therefore should be prioritized for younger and poorer MSM, who might be more vulnerable and lack of resources to cope with mental distress.…”

Section: Discussionmentioning

confidence: 99%

The mediating role of self-stigma and self-efficacy between intimate partner violence (IPV) victimization and depression among men who have sex with men in China

Peng

She

et al. 2020

BMC Public Health

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Background: Previous studies have shown that intimate partner violence (IPV) is prevalent in men who have sex with men (MSM). Mental health problems among MSM with IPV victimization have become a growing concern. The present study examined homosexual self-stigma and self-efficacy as potential mediators of the association between IPV victimization and depression. Methods: We recruited 578 MSM from 15 cities across China. Participants completed sociodemographic measures, the IPV-GBM (IPV among gay and bisexual men) scale, the Self-Stigma Scale-Short Form (SSS-S), the General Self-Efficacy (GSE) Scale and the Center for Epidemiologic Studies Depression 10 (CES-D-10). We calculated biascorrected 95% confidence interval (CI) for total, direct and indirect effects using bootstrapping to conduct mediation analyses. Results: Findings showed that the prevalence of IPV victimization and depression were 32.7% (189/578) and 36.0% (208/578), respectively. Result from mediation analysis using structural equation modeling indicated that the association between level of IPV victimization and depression among MSM was fully mediated by higher homosexual self-stigma and lower self-efficacy. Homosexual self-stigma had a direct effect and an indirect effect via self-efficacy on depression. Conclusion: The results provided evidence that integrated interventions that reduce self-stigma and foster selfefficacy could be promising approaches to decrease depression among MSM with IPV victimization.

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“…However, another study showed that in one personal resource construct, education did not have an impact on information or behavioral skills [23]. Low-income individuals may be more likely to encounter stressors and/or limit their access to resources to buffer against these stressors [51]. Individuals with socioeconomic disadvantages utilize their limited cognitive coping resources in dealing with these excess stressors, especially lack of social support, leading to engagement in condomless sexual behaviors [31].…”

Section: Discussionmentioning

confidence: 99%

Predictors of condom use behavior among men who have sex with men in China using a modified information-motivation-behavioral skills (IMB) model

Jiang

Chen

et al. 2019

BMC Public Health

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Background Men who have sex with men (MSM) are at high risk for human immunodeficiency virus (HIV) infection in China. Correct and consistent condom use is one of the most effective strategies for preventing the spread of HIV. This study developed a modified Information-Motivation-Behavioral Skills (IMB) model to predict condom use behavior among Chinese MSM. Methods A cross-sectional study was conducted to collect data using self-administered electronic questionnaire. Participants were recruited from HIV Voluntary Counseling and Testing clinics in six district Centers for Disease Control and Prevention in Guangzhou and two community-based HIV service centers (Lingnan Partners and Zhitong Charity) from May to September 2017. Structural equation modeling was performed to develop the modified IMB model with extended multilevel factors. Results Among the 976 MSM included, 52.05% had engaged in anal intercourse with a condom every time. The final modified IMB model fitted the data more ideally than the conventional model. The final modified IMB model revealed that behavioral skills positively contributed directly to condom use ( β = 0.385, p < 0.001) and partially mediated the associations between information ( β = 0.106, p = 0.005) and motivation ( β = 0.390, p < 0.001) and condom use. Regarding the extended multilevel factors, education, income, receiving HIV prevention services, sexual partner seeking behavior, depression, intimate partner violence, and child sexual abuse had indirect impacts on condom use that were mediated by information, motivation, and/or behavioral skills ( p < 0.05). All paths from the latent variable to the corresponding observed variables were statistically significant ( p < 0.001). Conclusion The modified IMB model with extended multilevel factors could serve as a theoretical framework for behavioral interventions for condom use among Chinese MSM. Further prospective studies are needed to examine the predictive power of the modified IMB model. Electronic supplementary material The online version of this article (10.1186/s12889-019-6593-8) contains supplementary material, which is available to authorized users.

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Financial Hardship, Condomless Anal Intercourse and HIV Risk Among Men Who Have Sex with Men

Cited by 17 publications

References 33 publications

Reduced sexual contacts with non-steady partners and less PrEP use among MSM in Belgium during the first weeks of the COVID-19 lockdown: results of an online survey

Reduced sexual contacts with non-steady partners and less PrEP use among MSM in Belgium during the first weeks of the COVID-19 lockdown: results of an online survey

The mediating role of self-stigma and self-efficacy between intimate partner violence (IPV) victimization and depression among men who have sex with men in China

Predictors of condom use behavior among men who have sex with men in China using a modified information-motivation-behavioral skills (IMB) model

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