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Previous research has highlighted both psychological and structural risk factors as correlates of condomless anal sex, a key pathway to HIV acquisition in men who have sex with men (MSM). Fewer studies have focused on positive psychobehavioral factors, which may be associated with more consistent condom use. This study hypothesized that positive psychobehavioral factors would be associated with more frequent condom use over and above psychological and structural risk factors. MSM with histories of childhood sexual abuse in Boston, MA and Miami, FL (N = 108) completed cross-sectional assessments of psychosocial, structural, and positive psychobehavioral factors. These factors were entered simultaneously in a linear regression model to examine their association with frequency of condomless sex. More recent seroadaptive behavior (B = 0.323, 95% CI = 0.055-0.590, p = .019) and receipt of government benefits to supplement income (B = 0.892, 95% CI = 0.171-1.612, p = .016) were independently associated with higher frequency of condomless sex over and above all other psychosocial, structural, and positive psychobehavioral factors. R.sup.2 for the final model was 0.270. Ancillary analyses including participants taking and adherent to biomedical HIV prevention suggested an association between higher distress tolerance and lower frequency of condomless sex. Positive psychobehavioral factors may potentially lower risk for HIV in high-risk MSM; however, left unaddressed, structural disadvantage is a potent influence which may limit potential benefits., Author(s): Calvin Fitch [sup.1] [sup.2] [sup.3] , Caleigh Shepard [sup.2] , Jacklyn Foley [sup.1] [sup.3] , Gail Ironson [sup.4] , Steven Safren [sup.4] , Adam Carrico [sup.5] , Allan Rodriguez [...]

Men who have sex with men and identify as persons of color (MSM of color) are significantly impacted by HIV in the United States. The COVID-19 pandemic may have disproportionately exacerbated HIV-related disparities among MSM of color by affecting sexual networking behaviors and disrupting access to sexual health care. The current study explored the impact of COVID-19 on sexual networking and HIV/sexually transmitted infection (STI) prevention behaviors among MSM of color in Boston, MA. Eighteen semi-structured interviews were conducted via the 2020–2021 Boston sample of the National HIV Behavioral Surveillance (NHBS) project. Eligible participants were at least 18 years old, identified as a man or non-binary person assigned male at birth and as a person of color, and endorsed ever having sex with men. Interviews were coded using inductive and deductive approaches, and themes were extracted using thematic analysis. When participants were asked about the impact of COVID-19 on sexual networking and HIV/STI prevention, the following themes emerged: (1) differing interpretations of COVID-19 public health guidance, (2) behavior change to meet social and sexual needs, (3) limited or changed access to HIV/STI prevention services; and (4) avoidance of healthcare appointments. Overall, the pandemic affected sexual networking and HIV/STI prevention behaviors among MSM of color. Though changes in sexual networking varied, most participants decreased in-person networking, increased dating app use, and prioritized longer-term relationships. Despite loosening of restrictions, these impacts may persist and should inform the adaptation of sexual networking guidance and interventions to mitigate HIV-related disparities in communities of color. [ABSTRACT FROM AUTHOR]

Mental health symptoms may compromise health-related quality of life (HRQOL), including among men who have sex with men (MSM) living with HIV, who experience high rates of trauma and other stressors. This study sought to examine the relative contributions of post-traumatic stress disorder (PTSD) symptoms, depression symptoms, and biological indices of HIV disease status on HRQOL in this population. Participants were 79 MSM with HIV (49% White; 35% Black; 8% Hispanic/Latinx) with trauma histories (52% met current PTSD diagnostic criteria). HRQOL outcomes were general perceptions of health (0–100 visual analog scale) and functional disability (WHODAS 2.0). Dominance analysis was applied to examine the relative share of variance in these outcomes accounted for by PTSD symptom severity, depression symptom severity, viral suppression status, and CD4 count. Depression symptom severity accounted for 70% and 92% of variance in perceived health, respectively, across models (p's < 0.05). Both PTSD symptom severity (45%) and depression symptom severity (43%) scores also accounted for significant variance in functional disability (p's < 0.05). Medical indices of HIV disease progression did not explain significant variance in HRQOL in any model. A trauma-informed approach may aid clinicians in interpreting reports of health and physical functioning in MSM with HIV. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) who have intersecting stigmatized identities or characteristics are differentially at risk for acquiring HIV. However, the relationships between specific identities, discrimination and stigma, and HIV risk behaviors require investigation to develop more effective interventions. Data from Boston's 2014 National HIV Behavioral Surveillance MSM cycle were used to assess associations between socio-demographics, structural factors, substance use, discrimination, HIV-stigma, and condomless anal sex. Of the total sample (n = 382), 17.6% reported verbal abuse, 8.3% work-place discrimination, 2.6% health discrimination, and 3.8% physical assault. HIV-stigma beliefs differed by race, sexual-orientation, and income. Those with histories of drug treatment were 9.47 (OR 95%CI: 2.09, 42.79) and 8.29 (OR 95%CI: 2.27, 30.21) times more likely to report health discrimination and physical assault, respectively. Healthcare discrimination and physical assault moderated relationships between substance use and number of condomless anal sex partners such that those who experienced discrimination and substance use reported more partners. Even in Massachusetts, MSM with identities or characteristics marginalized in society disproportionately experienced discrimination and stigma and healthcare discrimination or physical assault were associated with increased sexual risk behavior among MSM who use substances. Decreasing HIV transmission requires reducing discrimination and stigma among those most vulnerable, particularly those using substances. [ABSTRACT FROM AUTHOR]