The Influence of Substance Use, Social Sexual Environment, Psychosocial Factors, and Partner Characteristics on High-Risk Sexual Behavior Among Young Black and Latino Men Who Have Sex with Men Living with HIV: A Qualitative Study

Abstract

Understanding the sexual risk behaviors of youths living with HIV/AIDS is critical to secondary prevention of HIV. As part of a larger qualitative study of youths living with HIV, in-depth interviews were conducted with 27 African American and Latino, HIV-infected young men who have sex with men, aged 16-24 years, living in New York City. The study explored the role of substance use, the social-sexual-environmental, and psychological contexts in which sexual risk behaviors occurred. Since learning of their HIV infection, the majority of participants had reduced their risky sexual behaviors; however, a subset (26%) of participants continued to have unprotected sex, in most cases with multiple partners. Substance use, the social environmental context of the sexual encounter, the psychological impact of HIV on sexual behavior, and partner characteristics were associated with high-risk sexual behaviors in this group. Among high-risk participants, factors associated with risky sexual behaviors clustered, with 57% reporting two or more factors. More intensive interventions are needed for this subset of youths living with HIV, including assessment and treatment for substance use and mental health issues, strategies for stress reduction, and partner interventions.

Alcohol and Marijuana Use Outcomes in the Healthy Choices Motivational Interviewing Intervention for HIV-Positive Youth

“…21 Moreover, it may also have beneficial effects on other health behaviors, as substance use plays a significant role in high-risk sexual behavior. 22 However, it also appears that the benefits of MI for substance-using youth may take some time to take effect, as the significant differences between the trajectory groups became more apparent over time. Although the majority of studies of MI show that effects emerge relatively quickly, 23 the notion of a delayed effect is consistent with some previous findings.…”

Do Psychiatric Disorders Moderate the Relationship Between Psychological Distress and Sexual Risk-Taking Behaviors in Young Men Who Have Sex with Men? A Longitudinal Perspective

“…Additionally, the number of participants who met criteria for MDD and PTSD (especially the latter) was relatively small, which reduced our power to identify relationships, although several significant findings were observed. Further, given recent findings indicating the impact of drug use, particularly crystal methamphetamine, 53,54 and partner characteristics on high risk sexual behavior, it is a limitation that we did not include these variables in our models. 2 A number of possible mediators were not measured, and provide avenues for future research, such as motivation to use condoms, 55 self-efficacy, 19 and cognitive escape.…”

An Event-Level Comparison of Risk-Related Sexual Practices Between Black and Other-Race Men Who Have Sex with Men: Condoms, Semen, Lubricant, and Rectal Douching

“…Some men living with HIV report foregoing condom use when having anal intercourse (e.g., 32% at last episode among a sample of young ethnic minority MSM), 33 with several expressing the belief that the onus is on the HIVnegative partner to protect his own health; 34 thus, continued promotion of consistent and correct condom use among HIVnegative men is imperative.…”