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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.)

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.)

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.)

There are several long-acting biomedical HIV prevention products in the development pipeline, including injections and implanted medication delivery devices (IMDDs). It is critical to understand concerns and preferences on the use of these products in populations that shoulder a disproportionate burden of the HIV epidemic, such as transgender women. This will allow researchers and public health professionals to construct interventions tailored to the needs of these women to promote optimal use of these tools. In studies of other biomedical HIV prevention products (e.g., oral PrEP) it is clear that transgender women have unique concerns related to the use of these strategies. This may have an impact on this group's uptake and sustained use of longacting HIV prevention products. This study conducted four focus groups with N = 18 transgender women in New York City to understand their concerns and preferences on long-acting PrEP injections and IMDDs. Findings showed that participants were overwhelmingly positive about long-acting HIV prevention strategies, though they had some apprehensions. Overall, participants felt that injections and IMDDs could help address adherence challenges, and that transgender-specific needs should be addressed during clinical trials. Also, there were concerns related to injection or IMDD logistics, concerns about injections' or IMDDs' presence in the body, and familiarity with these products affected participants' opinions on them. Findings from this work can be used to inform protocols, measures, materials, and adherence interventions in future initiatives for transgender women using PrEP injections or IMDDs. [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.)

This paper grows our understanding about PrEP knowledge in transgender women (TW) to improve PrEP-focused education/outreach. Research took place in New York City. We conducted four focus groups in English or Spanish (N = 18). Discussions focused on participants' perceptions and knowledge of oral PrEP. Most participants knew that PrEP is efficacious and requires consistent use. However, some participants were skeptical of medications; others acknowledged that false assumptions about PrEP exist among TW. Most TW in our focus groups were informed about PrEP through clinics or community-based organizations. Some participants felt that messages about medications were oversimplified, and wanted more information. [ABSTRACT FROM AUTHOR]

Transgender women may face a disparate risk for HIV/AIDS compared to other groups. In 2012, Truvada was approved for daily use as HIV pre-exposure prophylaxis (PrEP). However, there is a dearth of research about barriers and facilitators to PrEP in transgender women. This paper will shed light on transgender women living in New York City’s perceived and actual challenges to using PrEP and potential strategies to overcome them. After completing an initial screening process, four 90-min focus groups were completed with n = 18 transgender women. Participants were asked what they like and dislike about PrEP. Participants identified the following barriers: uncomfortable side effects, difficulty taking pills, stigma, exclusion of transgender women in advertising, and lack of research on transgender women and PrEP. Facilitators included: reducing pill size, increasing the types of available HIV prevention products, and conducting scientific studies to evaluate PrEP in transgender women. [ABSTRACT FROM AUTHOR]

Alcohol consumption is a significant public health concern among Latino men and Latina transgender women who have sex with men. However, characteristics and behaviors associated with alcohol consumption in this population, particularly in regard to the complex influence of syndemic factors, remain understudied. The purpose of this study was to examine predictors of high-risk alcohol consumption (i.e. binge or heavy drinking). Between January and March of 2014, 176 Latino men and Latina transgender women in New York City completed an interviewer-administered questionnaire. We developed a syndemics scale to reflect the total number of syndemic factors – clinically significant depression, childhood sexual abuse, intimate partner violence, and discrimination – reported by each participant. We also carried out a multinomial logistic regression model predicting binge and heavy drinking. Forty-seven percent of participants reported high-risk alcohol consumption in the past 30 days (21% binge and 26% heavy). Approximately 16% of participants reported no syndemic factors, 27% reported one factor, 39% reported two factors, and 18% reported three or four. In the multinomial logistic regression model, our syndemic factors scale was not significantly associated with binge drinking. However, participants who reported three or four factors were significantly more likely to report heavy drinking. In addition, having multiple sexual partners was associated with an increased risk of binge and heavy drinking; involvement in a same-sex relationship was associated with binge drinking. Further work is needed to develop effective prevention intervention approaches for high-risk alcohol consumption within this population. [ABSTRACT FROM PUBLISHER]

Little research has been conducted to examine whether correlates of sexual risk vary by nativity among Latino men who have sex with men (MSM). We used cross sectional data collected from 870 Latino MSM recruited with respondent-driven sampling techniques. For each sub-sample (US-born and foreign-born), we assessed the association between each of the potential correlates (substance use, acculturation, social support, and social discrimination) and sexual risk behavior. Illicit drug use was associated with increased odds of sexual risk behavior in both US-born (OR = 2.17, 95 % CI 1.17-4.03) and foreign-born (OR = 1.86, 1.14-3.05) subgroups. Multivariate correlates specific to foreign-born men included binge drinking (OR = 1.91, 1.17-3.14), 15 years or longer spent in the US (OR = 1.79, 1.06-3.03) and exposure to social discrimination (OR = 2.02, 1.03-3.99). Given the diversity of Latino MSM, information from research that identifies both common and different HIV risk factors across subgroups of Latino MSM may help better tailor HIV prevention programs. [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.)

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.)

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.)

ABSTRACT.Recent compelling evidence that HIV medication may decrease the chances of HIV transmission and acquisition bring to light once again the issue of ethical responsibilities of those infected and uninfected when engaging in sexual intercourse. Using data collected in New York City from 120 gay men who engaged in “barebacking” (operationalized as intentional unprotected anal intercourse in an HIV-risk context), we analyzed participants’ attributions of responsibility to self and/or others and how these attributions varied by HIV status. Nearly all participants concurred that ethical judgments were involved and frequently offered a two-tiered response based on the right to individual decision-making and recognition of one's responsibility not to harm others. However, respondents merged the imperative for ethical action with an implicit requirement for communication, and their descriptions of sexual negotiations suggested ambiguities and conflicting assumptions. The result was a frequent tendency to shift the ethical burden to the partner rather than oneself in the context of diminished community dialogue about HIV. New scientific knowledge about HIV transmission offers opportunities for community discussions of sexual fulfillment, rights and responsibilities. [ABSTRACT FROM AUTHOR]

Throughout the 1980's, HIV antiretroviral therapy was non-existent or insufficient, and patients admitted to hospitals were frequently terminal. In 1988 we evaluated the HIV related hospitalizations at the Lutheran Medical Center in Brooklyn, New York, and found that only 1.3 % of the patients had an advanced directive/living will. Fifty percent of the patients expired during their hospitalization. To assist health care professionals during this serious illness, medical decisions were needed from the patients and, at other times, from family members and/or significant others. Subsequently, patients were approached to discuss advance directives (AD). With the introduction of the Highly Active Antiretroviral Therapy, medical management has decreased HIV mortality. Patients may have started having different perceptions on the need for an AD. The study design was submitted to the Institutional Review Board (IRB), and the IRB granted a HIPPA waiver because this was a retrospective study which delinked the study data from any identification of the patient. The chart reviews were conducted to ascertain the existence of an AD for all patients admitted at the Lutheran Medical Center, Brooklyn, NY from 2004 to 2011. One hundred eighty-two patients were identified from their discharge codes for HIV or AIDS. The median age was 47 years (range 22-85 years). Median time since HIV diagnosis was 9.5 years (range 0-28 years). Ninety-two percent lacked an AD on admission. From the thirty patients that were older than 54 years of age, only four of them had an AD prior to admission. During hospitalization only 11 patients out of 187 enacted a new AD, which decreased the overall percentage of patients lacking an AD to 86.3 % (pre and during admission). The majority of HIV infected patients hospitalized lacked an AD. Our data did not indicate a greater predominance of ADs from a private practice or clinic setting. ADs did not increase with increasing age. Moreover, with longer years with an HIV diagnosis, the number of ADs did not increase. Our results would indicate that a different approach is necessary to adequately address ADs with this specific population, especially as their longevity increases. [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.)

Copyright of Culture, Health & Sexuality is the property of Taylor & Francis Ltd 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.)

n ethnically diverse sample of 120 mostly gay-identified men who engaged in 'bareback' intercourse was recruited via the Internet in New York City. By study design three quarters of participants were HIV-uninfected and engaged in condomless receptive anal intercourse. In the course of face-to-face in-depth interviews, participants were asked what led them to have their first bareback experience as well as to continue with the behavior. Qualitative analysis identified the pivotal role that sexual pleasure and intimacy have in this population and how drives for sexual satisfaction, adventure, intimacy, and love overpower health concerns and condom use recommendations. Men interested in bareback sex use a variety of defense mechanisms to account for, justify, and exonerate their behavior. HIV-prevention interventions have paid insufficient attention to libidinal drives, a crucial element of psychological functioning. [ABSTRACT FROM AUTHOR]

Gay men's use of the internet for social and sexual purposes is now so common that some predict an end to gay bars. In New York City, where this study took place, the use of the internet by men to meet other men seeking sex without condoms, called bareback sex, has created concerns among public health and gay community HIV/AIDS workers. This study of six popular bareback internet sites seeks to understand the nature of this new online sexual culture, initially by investigating the sites themselves through the methodology of cyber-cartography. That investigation suggested that masculinity as an analytic in gender studies might offer some value in understanding what was happening on these sites. Issues of race and ethnicity also emerged to challenge any singular notion of masculinity. This paper suggests that masculinity itself might need some recalibration, and that we may also need to rethink these sites as evolving ethical sexual cultures. [ABSTRACT FROM AUTHOR]

A systematic method was used to elicit the names of the six most popular free Internet sites used by gay men and other men who have sex with men in New York City, to meet partners for "bareback" sex. An analysis of the sites characteristics shows that men can use mainstream Internet sites, gay-specific sites, and sex-focused sites free of charge to search for bareback sex partners, selecting by location, physical attributes, sexual mode, HIV-serostatus, and other characteristics. Many individuals use these sites, producing the impression that bareback sex is not an oddity confined to just a few. The official language of the bareback sites associates bareback sex with masculinity and courage, prioritizing pleasure. Freedom, choice, and intimacy over HIV-transmission prevention. The sites facilitate sexual experimentation and the expansion of bareback networks. Although some consider bareback sex to represent a failure of HIV prevention, this study suggests that harm reduction strategies may be viable within bareback networks. [ABSTRACT FROM AUTHOR]

A community recruited sample of Latino gay and bisexual men in New York were asked to indicate their likelihood of adopting the insertive ( activo ) or receptive ( pasivo ) roles in oral and anal sex according to partners' characteristics. The results show that gender stereotypes of masculinity and femininity play an important role in the sexual behaviour of this population. Versatile individuals report higher likelihood of taking a pasivo sexual role when they perceive a sexual partner as being more masculine than themselves based on his appearing more macho, more aggressive, taller, endowed with a bigger penis, more handsome, or darker skinned. By contrast, respondents report more likelihood of taking an activo role when the partner is perceived as more effeminate, less aggressive, shorter, endowed with a smaller penis, less handsome, or of lighter skin colour. Nevertheless, the findings suggest that, although gender stereotypes play an important generic role, contextual and emotional circumstances may significantly affect sexual-role behaviour in specific cases. [ABSTRACT FROM AUTHOR]

Assesses the willingness of individuals seeking HIV testing to notify sexual partners about potential HIV exposure in New York City. Implementation of partner notification legislation; Forms of partner notification; Negative effects of partner-notification law.

In a sample of Colombian, Dominican, Mexican, and Puerto Rican men who have sex with men (MSM) (n = 307) living in New York City, we contrasted sexual behavior and a number of variables related to it. The four groups were consistently similar in terms of frequency of partnership types (men with lovers, one-night-stands, other partners), monogamy, types of sexual behaviors with men and women, number of occasions of different behaviors, condom use during sex, and history of childhood sexual abuse. The four groups also had similar scores in most of the psychosocial variables usually related to condom use. These similarities validate the clustering of these four populations under a common category (Latino or Hispanic) for reporting and prevention purposes. This does not imply, however, that small scale interventions tailored to the specific cultural nuances of different national groups may not have an added strength. In the few cases where intraethnic differences were found, Mexican MSM were more likely than men in the other groups to receive ejaculate both in the rectum and in the mouth. These differences were not accounted for by the other variables examined and requires further investigation. [ABSTRACT FROM PUBLISHER]

This study was conducted with 273 Latin American men who have sex with men living in the New York metropolitan area. The results show that 51% of the men reported having experienced domestic abuse at least once in their relationships. Up to 12% of these men had been forced to have receptive anal sex without condoms by one of their partners since 1981. Thirty-three percent of the respondents reported having experienced verbal and psychological abuse, and 35% reported physical abuse (but not sexual) perpetrated by one of their partners. Statistical analysis found strong correlation between being a victim of physical and sexual abuse, and practicing receptive anal sex without condoms. Additional tests showed strong relationships between having experienced sexual abuse during childhood, using recreational drugs, having low self-esteem and self-worth, and experiencing domestic abuse in intimate adult relationships. [ABSTRACT FROM AUTHOR]

Objectives. This paper describes the sexual risk behaviors of Puerto Rican men who have sex with men and their perceived obstacles to condom use. Methods. Interviews were conducted with 182 Puerto Rican men living in New York, NY. Results. Condoms were used inconsistently or not at all by half of the men who had anal sex with other men, by two thirds of the men who had vaginal sex, and be three fifths of those who had anal sex with women. Most of the men had unprotected oral sex and more than one sexual partner in the previous year. Three of 10 were positive for the human immunodeficiency virus (HIV). Dislike of condoms was the most frequently cited obstacle, followed by perception of low risk, trust in and emotional connection with partner, unavailability and inconvenience of condom use, lack of control and indifference. Conclusions. Barrier methods other than condoms, such as a microbicidal gel, need to be developed. [ABSTRACT FROM AUTHOR]

Objective: Syndemic theory has been proposed as a framework for understanding the role of multiple risk factors driving the HIV epidemic among sexual and gender minority individuals. As yet, the framework has been relatively absent in research on Latinos/as.Methods: We used logistic regression to assess relationships among cumulative syndemic conditions - including clinically significant depression, high-risk alcohol consumption, discrimination, and childhood sexual abuse - engagement with multiple partners and condomless anal intercourse (CAI) in a sample of 176 Latino men who have sex with men (MSM) in New York City.Results: In bivariate analyses, an increase in the number of syndemic factors experienced was associated with an increased likelihood of reporting multiple partners and CAI. In multivariable analyses, participants with 2, 3, and 4 factors were significantly more likely to report multiple partners than those with 0 (aOR=4.66, 95% CI [1.29, 16.85); aOR=7.28, 95% CI [1.94, 27.28] and aOR=8.25, 95% CI [1.74, 39.24] respectively; p<0.05. Regarding CAI, only participants with 3 and 4 factors differed from those with 0 aOR=7.35, 95% CI [1.64, 32.83] and OR=8.06, 95% CI [1.39, 46.73] respectively.Conclusions: Comprehensive approaches that address syndemic factors, and capitalize on resiliency, are needed to address the sexual health needs of Latino MSM. [ABSTRACT FROM AUTHOR]