Download Free Violence Exposure And Pathways To Hiv Risk Behaviors In Black And White Young Men Who Have Sex With Men Book in PDF and EPUB Free Download. You can read online Violence Exposure And Pathways To Hiv Risk Behaviors In Black And White Young Men Who Have Sex With Men and write the review.

HIV remains a critical public health issue facing men who have sex with men (MSM) in the United States. Young MSM (YMSM) ages 13-34 years account for the greatest number of new HIV infections in MSM, with Black YMSM bearing the highest burden of disease. Sexual risk behaviors (e.g. unprotected sex) continue to be the leading transmission mode for HIV among all YMSM and studies have indicated that these behaviors are associated with a number of psychosocial and environmental factors, including adverse childhood experiences (ACEs), exposure to violence, substance use, and mental health problems. Moreover, recent studies based on the syndemic model of HIV risk have shown that exposure to violence, substance use, mental health problems may interact to increase HIV risk in vulnerable populations, including YMSM. However, the relationships among these risk factors and their association with sexual risk behaviors in YMSM are not yet fully understood. Therefore, the purpose of this cross-sectional, quantitative study was to: 1) describe the degree to which YMSM engage in HIV risk behaviors, are exposed to ACEs and other multiple forms of violence, experience mental health problems, and use substances; 2) identify the ACEs and violence exposure, substance use, and mental health problems that significantly predict HIV risk behaviors in Black and White YMSM; and 3) test the indirect (through substance use and mental health pathways) effects of violence exposure on HIV risk behaviors. Data was collected using structured computer-assisted personal interviews from a convenience sample of 168 Black (97) and White (71) YMSM recruited at AIDS service organizations that provide HIV prevention programs and testing for YMSM in the St. Louis and Kansas City metropolitan areas. The current study contributed to knowledge regarding HIV risk behaviors and related syndemic risk factors in service-using YMSM. This study was unique in the assessment of adverse childhood experiences, multiple types of violence exposure, experiences of multiple types of mental health problems, and use of multiple substances in a service-using sample of HIV-negative Black and White YMSM, the populations at highest risk for HIV infection in the US. This study found that a substantial proportion of YMSM are exposed to multiple adverse childhood experiences, intimate partner violence, and community violence, all of which were previously unexplored or understudied in YMSM. Additionally, findings from the study identified unique significant mental health and substance use predictors of unprotected anal sex and number of male sex partners for YMSM when controlling for demographic factors. Further, although relationships between adverse childhood experiences or intimate partner violence and HIV risk behaviors were not significant in multiple regression models, this study demonstrated that adverse childhood experiences and intimate partner violence indirectly affect HIV risk behaviors through polydrug use, whereby higher rates of violence exposure lead to more polydrug use, which leads to a higher rate of multiple male sex partners. The results of this study have implications for social work practice and policy changes that lead to integration of mental health and substance use screening and referral into AIDS service organization that provide HIV prevention services. Moreover, results can be used by researchers to adapt theoretical models of HIV risk and prevention for YMSM.
In the United States, significant disparities in HIV/AIDS exist among Black men who have sex with men (MSM). For instance, in 2006, Black MSM comprised 63% of new HIV infections among Black men, and 35% of new HIV infections among all MSM (Centers for Disease Control and Prevention [CDC], 2010a). Further, Black MSM were the only risk group in the United States to experience statistically significant increases in new HIV infections between 2006 and 2009 (CDC, 2012a). To address such disparities, HIV prevention efforts that focus on reducing the stress associated with sociocultural factors, such as experiences and perceptions of racism and homophobia, have been proposed. Utilizing the minority stress model and the theory of Intersectionality as guiding theoretical frameworks, this study examined: the relationship between indicators of minority stress (events of racial/ethnic discrimination, internalized racism, and internalized homophobia) and HIV risk behavior; whether psychological distress and/or social support moderate this relationship; and whether a culturally congruent intervention was efficacious in reducing perceptions of internalized racism and internalized homophobia, and frequency of HIV risk behavior among a sample of HIV-positive non-gay identifying Black men who have sex with men and women and who have histories of childhood sexual abuse. The full sample included 117 men who were administered a baseline survey, as well as a sub-sample of 88 men who were randomized into either the Enhanced Sexual Health Intervention for Men (ES-HIM) intervention or Health Promotion control condition as part of the ES-HIM Project. The original randomized control trial took place between 2007 and 2011. Only perception of internalized racism was found to have a direct association with HIV risk behavior in this sample, though this relationship was negative meaning increased racial pride predicted more HIV risk behavior. The full model that included all indicators of minority stress, childhood sexual abuse, and social support explained HIV risk behavior better than each indicator of minority stress on its own. This supported the additive perspective of the theory of Intersectionality, but not the primary perspective of this theory. The interactionist perspective was also tested between internalized racism and internalized homophobia, but findings did not result in support for this perspective. The role of psychological distress was inconclusive. While ample evidence supported the removal of psychological distress in order to test a direct relationship between indicators of minority stress and HIV risk behavior, some support for moderation was found. Social support showed clear indication of a moderating effect between two indicators of minority stress and HIV risk behavior when controlling for other covariates. Further, the level of social support and the indicator of minority stress contributed to the overall effect of social support on HIV risk behavior. In terms of intervention effects, internalized racism did not decrease over the four time points for either the group as a whole (n=88), or by intervention condition. Internalized homophobia, however, significantly diminished over the four time points for the group as a whole, but no differences between the ES-HIM intervention and Health Promotion control condition were found. Finally, frequency of HIV risk behavior (i.e., intercourse without a condom) also decreased from baseline to post-intervention assessment for the group as a whole, but no intervention effects were found. Indicators of minority stress, namely internalized racism and internalized homophobia, appear to play an important role in the HIV risk behavior of this population. However, the relationship is nuanced among this highly marginalized sample. Finally, while the ES-HIM intervention was unsuccessful in effecting changes in internalized racism, internalized homophobia, and frequency of HIV risk behavior over time, significant reductions in internalized homophobia and HIV risk behavior for the group as a whole were achieved.
Neighborhood percentage of single-parent female-headed households and neighborhood population turnover were associated with reduced HIV risk; while neighborhood composition measures of poverty and socioeconomic status were associated with increased HIV risk. Neighborhood percentage of same-sex couples, also a measure of neighborhood gay presence, was associated both with factors that increase and factors that decrease risk for HIV transmission or acquisition. Young black men were more likely to live in neighborhoods characterized by increased risk while young white men were more likely to live in neighborhoods that were characterized by decreased risk. These findings suggest that HIV risk disparities experienced among black and white young MSM can be partially explained by the neighborhoods in which these men reside. As such, prevention efforts for MSM should focus on both individual characteristics of these men and the neighborhoods in which they reside.
HIV alters the lives of anyone that it touches, whether they are gay or straight. This book looks at all of the aspects of how HIV/AIDS has altered the lives of those it touches. . . . The titles of the 12 chapters give an excellent overview of what is covered in these extremely well-written reports. . . . This is a must-read book for everyone. It should be in all libraries, including school libraries. Young adolescents who are facing the problem of coming out would benefit from this book. --AIDS Book Review Journal Hit hard by the AIDS epidemic in the United States and in much of Europe, the gay and lesbian community has been forced to examine existing notions of what it means to belong to a community based on sexual orientation. The editors of this second volume in the annual series Psychological Perspectives on Lesbian and Gay Issues have collected a perceptive array of chapters that explore sexual behavior, personal identity, and community memberships of gay men and lesbian women. With the exception of a few, the chapters reflect study findings from AIDS-related research and include discussions of AIDS in large urban centers and in less populated settings outside of major AIDS epicenters. Focusing on underconsidered AIDS populations, the contributors explore specific topics concerning the AIDS epidemic among gay and bisexual men of color, lesbian women, and gay and lesbian youth. Accessible and sensitive, the book also examines relevant public policy, volunteerism, and long-term survival as important to AIDS awareness and education. AIDS, Identity, and Community is an appreciable resource for AIDS researchers and caregivers, mental health practitioners, social service professionals, behavioral and social science students, and any reader who seeks deeper insight into the complex and subtle areas of the lesbian and gay community in the AIDS era.
Human Rights; Risk behavior; Cost-effectiveness; Low and middle income countries; Human Immunodeficiency Virus; Epidemic; Men who have sex with men; Attributable fraction; Intervention/Prevention; Homosexuality.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.