Unsafe Sexual Behavior and Correlates of Risk in a Probability Sample of Men Who Have Sex With Men in the Era of Highly Active Antiretroviral Therapy

Brewer, Devon D.; Golden, Matthew R.; Handsfield, H. Hunter

doi:10.1097/01.olq.0000194595.90487.ed

Cited by 71 publications

(65 citation statements)

References 35 publications

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“…The present study replicates findings among a community-based sample of young MSM that social performance anxiety was associated with unprotected insertive anal intercourse, 10 and extends these findings by demonstrating that social performance anxiety is associated with this high-risk behavior controlling for club drug use, tobacco use, and depression, all of which have been linked to HIV risk behaviors in previous studies. 29,40 Findings also suggest that social performance anxiety may be a specific risk factor for MSM and not all HIV-positive men.…”

Section: Discussionmentioning

confidence: 80%

“…Given that depression has been found to be associated with unprotected sex among MSM, [20][21][22] and is typically correlated with social anxiety, 23,24 the associations between social performance anxiety with unprotected sex were examined controlling for depression. Other risk factors for unprotected sex, such as smoking, 25 alcohol use, [26][27][28] and use of club drugs such as ecstasy, ketamine, cocaine, GHB, and crystal methamphetamine, 26,[29][30][31][32] were also controlled for in the present study to examine if social performance anxiety would be a robust correlate of unprotected insertive and receptive anal intercourse in multivariate analyses. Given that there is a lack of data on social performance anxiety and unprotected insertive sex among men who have sex with women only (MSW), analyses were also conducted to examine if social performance anxiety is associated with unprotected insertive sex among MSM only, or also among MSW.…”

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confidence: 99%

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Social Anxiety and HIV Transmission Risk among HIV-Seropositive Male Patients

Hart

James

Purcell

et al. 2008

AIDS Patient Care and STDs

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The role of psychological factors in predicting HIV sexual transmission risk behavior is increasingly of interest in prevention research. Social anxiety, or anxiety about being evaluated in interpersonal situations, is associated with unprotected insertive anal intercourse among young men who have sex with men (MSM) and with other behavioral risk factors for unprotected intercourse, such as depression, smoking, alcohol use, and drug use. Social anxiety may be especially relevant in understanding HIV risk among HIV-seropositive men, given its stronger association with unprotected insertive than with receptive anal intercourse. In the present study, for which participants were recruited between October 2002 and May 2003, HIV-positive men attending regularly scheduled primary care medical appointments at a community HIV clinic were approached by research personnel and informed about the study topic and procedures. Ninety percent of patients approached agreed to participate, resulting in a sample of 206 patients. The sample was primarily African American, unemployed, of low educational level, and 95% of the sample had an AIDS diagnosis. The present study replicated and extended previous research from community samples by demonstrating an association between social anxiety and unprotected insertive anal intercourse with non-HIV-positive partners in a clinical sample of HIV-positive MSM and men who have sex with women (MSW). This association was maintained controlling for depression, smoking, and club drug use. Social anxiety is a relatively robust risk factor for unprotected insertive anal intercourse among MSM. Future work should examine the mechanisms by which social anxiety is associated with sexual risk among MSM. 879

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Section: Discussionmentioning

confidence: 80%

mentioning

confidence: 99%

Social Anxiety and HIV Transmission Risk among HIV-Seropositive Male Patients

Hart

James

Purcell

et al. 2008

AIDS Patient Care and STDs

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“…[13][14][15][16] Although there are no racial differences in drug use and exchange sex among MSM, 6 it is important to address these behaviors because they are associated with sexual risk behaviors in this population. [26][27][28][29][30][31] In focus group interviews conducted among NGI black MSM/MSMW, the men revealed that they use drugs, alcohol, and exchange sex as coping mechanisms to resolve conflicts between their racial and sexual identities. 32 Among the interviewed men, those in treatment for substance abuse indicated that self-acceptance of their sexuality was necessary for recovery.…”

Section: Discussionmentioning

confidence: 99%

History of Arrest and Associated Factors among Men Who Have Sex with Men

et al. 2011

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Incarceration has been proposed to be a driving factor in the disproportionate impact of HIV in African-American communities. However, few data have been reported on disparities in criminal justice involvement by race among men who have sex with men (MSM). To describe history of arrest and associated factors among, we used data from CDC's National HIV Behavioral Surveillance system. Respondents were recruited by time-space sampling in venues frequented by MSM in 15 US cities from 2003 to 2005. Data on recent arrest (in the 12 months before the interview), risk behaviors, and demographic information were collected by face-to-face interview for MSM who did not report being HIV-positive. Six hundred seventy-nine (6.8%) of 10,030 respondents reported recent arrest. Compared with white MSM, black MSM were more likely to report recent arrest history (odds ratio (OR), 1.6; 95% confidence interval (CI), 1.3-2.1). Men who were less gay-identified (bisexual [OR, 1.5; 95% CI, 1.1-1.9] or heterosexual [OR, 2.0; 95% CI, 1.2-3.5]) were more likely to report recent arrest than homosexually identified men. In addition, men who reported arrest history were more likely to have used non-injection (OR, 3.0; 95% CI, 2.4-3.6) and injection (OR, 4.7; 95%, 3.3-6.7) drugs, exchanged sex (OR, 2.7; 95% CI, 2.1-3.4), and had a female partner (OR, 1.5; 95% CI, 1.2-2.0) in the 12 months before interview. Recent arrest was associated with insertive unprotected anal intercourse in the 12 months before interview (OR, 1.4; 95% CI, 1.2-1.7). Racial differences in arrest seen in the general US population are also present among MSM, and history of arrest was associated with high-risk sex. Future research and interventions should focus on clarifying the relationship between criminal justice involvement and sexual risk among MSM, particularly black MSM.

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“…Both methamphetamine use and abuse and HIV have had a disproportionate impact on the MSM community, particularly in large urban areas with sizable gay populations, leading some researchers to label them a "dual epidemic" among gay men (Halkitis, Parsons, & Stirratt, 2001). This synergistic relationship between methamphetamine use and HIV is supported by research showing the correlation between the use of this substance, high-risk sexual behavior, and HIV transmission among MSM (Brewer, Golden, & Handsfield, 2006;Frosch, Shoptaw, Huber, Rawson, & Ling, 1996;Halkitis et al, 2001;Halkitis, Green, & Carragher, 2006;Halkitis, Shrem, & Martin, 2005;Molitor, Truax, Ruiz, & Sun, 1998;Nemoto, Operario, & Soma, 2002;Rawson, Washton, Domier, & Reiber, 2002;Semple, Patterson, & Grant, 2002).…”

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confidence: 87%