Search

Black men face high rates of police violence, including direct victimization and indirect exposure to or knowledge of harmful policing. This violence can result in death and physical harm, as well as in numerous poor mental health outcomes. There has been little research examining experiences of police violence experienced by Black gay and bisexual men or the effects of police brutality on HIV continuum of care outcomes. To address this important gap, in this exploratory study, we examined the effects of police brutality on engagement in HIV care and adherence to antiretroviral medications. Cross-sectional survey data were collected from 107 Black gay and bisexual men living with HIV. The path analysis showed that men with greater exposure to police violence had increased symptoms of post-traumatic stress disorder and were more likely to have missed HIV care appointments in the past year. Additionally, there was a significant indirect effect of exposure to police violence on missed medication doses via PTSD symptoms. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The goal of this study was to examine the effects of racial discrimination, depression, and Black LGBTQ community support on HIV care outcomes among a sample of Black sexually minoritized men living with HIV. We conducted a cross-sectional survey with 107 Black sexually minoritized men living with HIV in Chicago. A path model was used to test associations between racial discrimination, Black LGBTQ community support, depressive symptoms, and missed antiretroviral medication doses and HIV care appointments. Results of the path model showed that men who had experienced more racism had more depressive symptoms and subsequently, missed more doses of HIV antiretroviral medication and had missed more HIV care appointments. Greater Black LGBTQ community support was associated with fewer missed HIV care appointments in the past year. This research shows that anti-Black racism may be a pervasive and harmful determinant of HIV inequities and a critical driver of racial disparities in ART adherence and HIV care engagement experienced by Black SMM. Black LGBTQ community support may buffer against the effects of racial discrimination on HIV care outcomes by providing safe, inclusive, supportive spaces for Black SMM. [ABSTRACT FROM AUTHOR]

Intramuscular cabotegravir for long-acting injectable HIV pre-exposure prophylaxis (i.e., LAI-PrEP) was approved by the U.S. FDA in 2021. We sought to explore LAI-PrEP decision-making among a nationwide sample of young sexual minority men (YSMM) 17–24 years old. In 2020, HIV-negative/unknown YSMM (n = 41) who met CDC criteria for PrEP were recruited online to participate in synchronous online focus groups eliciting preferences and opinions about LAI-PrEP, as well as the impact of a potential self-administered option. Data were analyzed using inductive and deductive thematic analysis with constant comparison. Preferences and decision-making about LAI-PrEP varied widely among YSMM, with participants frequently comparing LAI-PrEP to oral PrEP regimens. We identified five key themes related to LAI-PrEP decision-making including concerns about adherence to PrEP dosing and clinic appointments, awareness and knowledge of PrEP safety and efficacy data, comfort with needles, minimizing PrEP stigma, and considerations of self-administration. YSMM acknowledged more PrEP options as beneficial to supporting uptake and persistence. [ABSTRACT FROM AUTHOR]

Intersectional stigma and discrimination have increasingly been recognized as impediments to the health and well-being of young Black sexual minority men (YBSMM) and transgender women (TW). However, little research has examined the relationship between intersectional discrimination and HIV pre-exposure prophylaxis (PrEP) outcomes. This study with 283 YBSMM and TW examines the relationship between intersectional discrimination and current PrEP use and likelihood of future PrEP use. Path models were used to test associations between intersectional discrimination, resilience and social support, and PrEP use and intentions. Individuals with higher levels of anticipated discrimination were less likely to be current PrEP users (OR = 0.59, p =.013), and higher levels of daily discrimination were associated with increased likelihood of using PrEP in the future (B = 0.48 (0.16), p =.002). Greater discrimination was associated with higher levels of resilience, social support, and connection to the Black LGBTQ community. Social support mediated the effect of day-to-day discrimination on likelihood of future PrEP use. Additionally, there was a significant and negative indirect effect of PrEP social concerns on current PrEP use via Black LGBTQ community connectedness. The results of this study highlight the complexity of the relationships between discrimination, resilience, and health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: HIV and human papillomavirus (HPV) are common sexually transmitted infections among young sexual minority men (YSMM) that are prevented by pre-exposure prophylaxis (PrEP) and HPV vaccination, respectively. We sought to determine the association between a history of PrEP use and HPV vaccination uptake among YSMM. Methods: Data were collected from an online survey of YSMM (n = 287; Mage = 20.6 years; range: 17–24; 58% Black or Latinx) recruited from social media and men-for-men geosocial networking apps in 2020 and analyses were conducted using chi-squared comparisons and Poisson regression using STATA (IC) version 15.1. Results: About half (45.0%) of YSMM reported receiving at least one dose of the HPV vaccine. Controlling for other factors, YSMM who were living with HIV or had used PrEP were significantly more likely to have received at least one dose of an HPV vaccine (PR = 2.48, 95% CI = 1.52–4.07; PR = 1.70, 95% CI = 1.26–2.31, respectively). Conclusions: YSMM living with HIV or with PrEP use experience reported higher rates of HPV vaccination compared to their counterparts, potentially due to greater utilization of health care or contacts with providers attuned to their health needs. Nevertheless, HPV vaccination uptake is suboptimal given the high prevalence of high-risk HPV genotypes among YSMM. Policy Implications: Standard of care for YSMM should include revisiting HPV vaccination status and discussion of PrEP and other HIV prevention methods given suboptimal rates of HPV vaccination and PrEP uptake among this priority population for HPV, anal cancer, and HIV prevention. [ABSTRACT FROM AUTHOR]

Prior research has highlighted the impact of the COVID-19 pandemic on HIV prevention services within the U.S., but few studies have explored this impact through an exploratory, qualitative lens. In this study, we sought to highlight the voices of young sexual minority men (YSMM) 17–24 years old and explored the perceived impact of the pandemic on HIV prevention among a diverse, nationwide sample of YSMM who participated in synchronous online focus group discussions between April and September 2020. Forty-one YSMM described the negative effects of the COVID-19 pandemic on HIV testing and prevention services, including limited and disrupted access to HIV testing, HIV pre-exposure prophylaxis (PrEP), and HIV post-exposure prophylaxis. COVID-19-related challenges were compounded by ongoing, pre-COVID-19 barriers experienced by YSMM in the U.S. For instance, many YSMM relocated back home with family, causing men to avoid HIV prevention services for fear of outing themselves to relatives. YSMM also worried about placing their family at increased risk of COVID-19 by attending clinical appointments. YSMM who did seek HIV prevention services, including access to PrEP, experienced significant barriers, including limited appointment availability and services not tailored to YSMM. Further efforts are needed to support YSMM re-engaging in HIV prevention during and after the COVID-19 era. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The United States (US) is on track to achieve the 90-90-90 targets set forth by UNAIDS and the National HIV/AIDS strategy, yet significant racial disparities in HIV care outcomes remain, particularly for young Black men who have sex with men (YBMSM). Research has demonstrated that various types of violence are key aspects of syndemics that contribute to disparities in HIV risk. However, little research has looked collectively at cumulative violent experiences and how those might affect HIV treatment and care outcomes. Drawing on extant literature and theoretical underpinnings of syndemics, we provide a conceptual model that highlights how continuous traumatic violence experienced by YBMSM may affect HIV outcomes and contribute to racial disparities in HIV outcomes. The findings of this focused review suggest a need for research on how continuous exposure to various types of violence influence HIV prevention and treatment outcomes for young Black MSM. [ABSTRACT FROM AUTHOR]

As communities struggle with how to cope with the health and social consequences of coronavirus disease 2019 (COVID-19), sexual and gender minority men living with or affected by the HIV/AIDS epidemic have important insights into how to cope with uncertainty, public health protocols, and grief. We recruited sexual and gender minority men using online networking apps from April 18–24, 2020 to enroll a longitudinal cohort. We analyzed baseline qualitative data from open-ended responses using content analysis to examine how the HIV/AIDS epidemic has helped sexual minority men with the current COVID-19 pandemic. Of the 437 participants who completed the survey, 155 (35%) indicated that HIV/AIDS had helped them cope with COVID-19. Free-response data from those 135 of those participants clustered around four themes: (1) experience having lived through a pandemic, (2) experience coping with stigma, (3) familiarity with public health protocols, and (4) belief in collective action. Based on the experiences of these men, public health approaches centered on resilience and collective action could be particularly helpful in responding and coping with COVID-19—especially if the pandemic persists over longer periods of time. [ABSTRACT FROM AUTHOR]

The article focuses on the applying the popular opinion leader intervention for HIV to COVID‑19. Topics discussed include the 2019 novel coronavirus disease (COVID-19) pandemic has demanded an immediate public health response and community-wide adoption of various behavior change strategies; and public health guidelines and recommendations emerged rapidly and have been modified as the pandemic has shifted.

Non-occupational post-exposure prophylaxis (nPEP) has been clinically recommended since 2005. HIV providers and non-HIV providers (n = 480) practicing within above-average HIV prevalence ZIP codes of the 10 U.S. cities with greatest overall HIV prevalence participated in a cross-sectional survey between July 2014 and May 2015. Providers were asked about their awareness of post-exposure prophylaxis (PEP) and nPEP prescribing experience for patients with potential sexual exposures to HIV, which we coded into a PEP prescribing cascade with three categories: (1) PEP unaware, (2) PEP aware, no nPEP prescribing experience, and (3) nPEP prescribing experience. Overall, 12.5% were unaware of PEP, 43.5% were aware but hadn't prescribed nPEP, and 44.0% had prescribed nPEP for potential sexual exposures to HIV. Fewer providers practicing in the U.S. South had ever prescribed nPEP compared to providers in other regions (χ2= 39.91, p < 0.001). HIV providers, compared to non-HIV providers, were more likely to be classified in the nPEP prescription group compared to the PEP aware without nPEP prescription group (RRR = 2.96, p < 0.001). PrEP prescribers, compared to those PrEP unaware, were more likely to be classified in the nPEP prescription group compared to PEP aware without nPEP prescription group (RRR = 12.49, p < 0.001). [ABSTRACT FROM AUTHOR]

Purpose: Permanent supportive housing (PSH) is an effective intervention to improve residential stability and reduce the utilization of costlier healthcare services for the chronically homeless. However, there has been little focus on health-related quality of life (HRQL) once they enter PSH, and the potential influence of other factors including the PSH model. Study results can shed light on the HRQL of the PSH population and inform strategies to improve PSH program effectiveness in this area. Methods: In this cross-sectional study, survey methods were used to assess the HRQL of PSH residents in the Chicago metropolitan area. The survey also included questions on socio-demographics, health behaviors, housing and neighborhood characteristics, and housing satisfaction. The SF-36 was used to obtain physical (PCS) and mental component summary (MCS) scores for HRQL. Other variables were selected using the Wilson and Cleary HRQL model. Statistical analyses included summary statistics, bivariate analyses, and fully adjusted linear regression models. Results: The study sample included 855 adults currently in PSH. The sample was predominantly African American men with an average age of 53 years. Mean scores for PCS and MCS were 39.4 and 46.1, respectively, (out of 100). In adjusted analyses, older age and being on disability were associated with worse PCS. Having HIV was associated with better PCS. Being non-Hispanic Black, living in fixed-sited housing, and being in PSH for longer durations were associated with better MCS. More depressive symptoms was associated with worse PCS and MCS. Conclusion: While both aspects of the PSH model (housing configuration and service provision) were initially associated with HRQL in unadjusted analyses, housing configuration was the only PSH model variable that remained significant once accounting for other factors. Depressive symptomology and the social environment also appear to be important correlates of HRQL and are potential areas to target in PSH programs. [ABSTRACT FROM AUTHOR]

A significant proportion of new HIV infections among gay, bisexual, and other men who have sex with men (MSM) occur within primary relationships. Although PrEP use continues to increase, there is a need to better understand the factors that contribute to PrEP decision-making within primary relationships. We qualitatively examined how relationship context influences perceptions of PrEP and decisions to initiate and discontinue PrEP among young Black MSM to provide a nuanced understanding of PrEP use within relationships. Between late 2017 and mid-2018, we conducted 10 focus groups with young Black MSM (n = 80) in Milwaukee, WI, Minneapolis, MN, Kansas City, KS, and Detroit, MI. We used inductive thematic analysis to examine how young Black MSM make decisions about PrEP use within the context of primary relationships. We identified three primary themes: (1) perceptions of PrEP as an indication of distrust and infidelity, (2) perceptions of PrEP use as necessary, even in primary relationships, and (3) the influence of partners on PrEP. Our results demonstrate the considerable variation in how young Black MSM view PrEP within primary relationships and the influence of primary partners in PrEP use decisions. The dynamics between two or more individuals can shape an individual's conceptualizations of and decisions around PrEP use, and these may be key drivers of racial disparities in HIV and PrEP use. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) is a promising part of HIV prevention, yet racial disparities in PrEP uptake persist. Evidence indicates that Black gay, bisexual, and other men who have sex with men (GBM) face numerous social and structural barriers to PrEP, including stigma, medical mistrust, and exclusion from the healthcare system. However, little research has examined how social networks can influence PrEP use and help Black GBM overcome these identified barriers. To understand the influence of peers and social networks on Black GBM's perceptions of and decisions about PrEP use, we conducted in-depth interviews with 46 Black GBM in Milwaukee, WI and Cleveland, OH. Data were analyzed using multistage inductive coding and thematic content analysis, using MAXQDA software. Results indicate that participants' primary source of information on PrEP was other Black GBM in their communities. Peers and social networks served three primary functions with regard to PrEP: (1) filling informational gaps left by healthcare providers, (2) increasing trust of PrEP, and (3) reducing PrEP stigma. Participants described the "movers and shakers" in Black LGBT communities who have been influential in educating others and advocating for PrEP. Well-respected vocal advocates for PrEP have emerged in the Black LGBT community as PrEP champions who have successfully influenced young Black GBM's views on PrEP. Our results reveal the role social networks and peer groups can play in increasing PrEP use among Black GBM. Social network interventions may help overcome the stigma and mistrust that are contributing to PrEP disparities. [ABSTRACT FROM AUTHOR]

Purpose of Review: In the USA, gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. High levels of adherence to antiretroviral therapy (ART) can dramatically improve outcomes for persons living with HIV and reduce the risk of HIV transmission to others. Yet, there are numerous individual, social, and structural barriers to optimal ART adherence. Many of these factors disproportionately impact Black MSM and may contribute to their poorer rates of ART adherence. This review synthesizes the key challenges and intervention opportunities to improve ART adherence among MSM in the USA. Recent Findings: Key challenges to ART adherence include stigma, violence, depression, and substance use. Black MSM are significantly disadvantaged by several of these factors. There are several promising interventions to improve ART adherence among MSM, and there remains an opportunity to culturally tailor these to the needs of Black MSM populations to enhance adherence. Summary: Despite high rates of HIV among MSM, there continues to be a paucity of research on the various contributors to poor ART adherence among this population. Similarly, few interventions have been tested that lead to increased and sustained ART adherence among Black MSM. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) is effective at reducing new HIV infections among adherent users. However, there are potential benefits of PrEP beyond HIV prevention that remain understudied, particularly among young Black gay, bisexual, and other men who have sex with men (MSM). In 2018, we conducted six focus groups (n = 36) in four midwestern cities: Milwaukee, WI; Minneapolis, MN; Detroit, MI; and Kansas City, MO with current and former PrEP users who identified as Black MSM. The focus groups covered medical care and provider experiences, patterns of PrEP use and adherence, relationships while on PrEP, and PrEP stigma. Results revealed four unanticipated benefits of PrEP for young Black MSM: (1) improved engagement in medical care, (2) reduced sexual and HIV anxiety, (3) increased sexual comfort and freedom, and (4) positive sexual relationships with people living with HIV. Findings from this study fill a gap in our understanding of the potential benefits of PrEP beyond HIV prevention. Public health campaigns and messaging around PrEP should incorporate such benefits to reach young Black MSM who may be motivated by benefits beyond HIV prevention. [ABSTRACT FROM AUTHOR]

This study examined social and health-related correlates of AIDS conspiracy theories among 464 African American men who have sex with men (MSM). Exploratory factor analysis revealed two subscales within the AIDS conspiracy beliefs scale: medical mistrust and AIDS genocidal beliefs. Multiple regression analyses revealed medical mistrust and AIDS genocidal beliefs were both associated negative condom use attitudes and higher levels of internalized homonegativity. Medical mistrust was also associated with lower knowledge of HIV risk reduction strategies. Finally, we conducted bivariate regressions to examine the subsample of participants who reported being HIV-positive and currently taking HIV antiretroviral therapy (ART) to test associations between sexual behavior and HIV treatment and AIDS conspiracy theories. Among this subsample, medical mistrust was associated with having a detectable viral load and not disclosing HIV-status to all partners in the previous 3 months. Collectively, these findings have implications for HIV prevention and treatment for African American MSM. [ABSTRACT FROM AUTHOR]