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Background: The North Carolina Community Research Partnership developed, implemented, and tested "weCare," a 12-month bilingual mHealth social media intervention designed to reduce missed HIV care appointments and increase viral suppression among racially/ethnically diverse gay, bisexual, and other men who have sex with men (GBMSM) and transgender women living with HIV by harnessing established social media platforms (i.e., Facebook, texting, and dating apps). Methods: We randomized 198 GBMSM and transgender women (mean age = 26) living with HIV to the "weCare" intervention (n = 100) or usual-care (n = 98) group. Inclusion criteria included being newly diagnosed or not in care. Participants completed structured assessments at baseline and 6-month postintervention follow-up (18 months after baseline data collection). HIV care appointment and viral load data were abstracted from each participant's electronic health record at baseline and follow-up. Follow-up retention was 85.5%. Results: Among participants, 94% self-identified as cisgender men, 6% as transgender, 64% as African American/Black, and 13% as Latine. Participants in both groups significantly reduced missed HIV care appointments and increased viral suppression at follow-up compared with baseline. However, there were no significant differences between weCare and usual-care participants for either outcome at follow-up. Conclusions: An intervention effect was not identified for our two primary outcomes. Several factors may have influenced the lack of significant differences between "weCare" and usual-care participants at follow-up, including intervention implementation (e.g., staffing changes and lack of fidelity to the intervention as originally designed by the partnership), data collection (e.g., data collection time points and retention strategies), and clinical (e.g., contamination) factors.

Gay, bisexual, queer, and other men who have sex with men (GBQMSM) and transgender and nonbinary persons are at elevated risk for HIV, sexually transmitted infections (STIs), and hepatitis C (HCV); in Appalachia, these communities experience more disease burden. However, little is known about the factors influencing risk. Sixteen semistructured in-depth interviews were conducted examining factors influencing prevention and care. Data were analyzed using constant comparison methodology. Fifteen themes emerged within four domains: social environment (e.g., microaggressions across gender, sexual orientation, and racial identities), substance use (e.g., high prevalence, use as coping mechanism), sexual health (e.g., misinformation and denial of risk for HIV and STIs), and access to health care (e.g., cost and transportation barriers, lack of local respectful care). Findings highlighted salient barriers and assets influencing prevention and care and suggest that multilevel interventions are needed to improve access to and use of HIV, STI, and HCV prevention and care services. [ABSTRACT FROM AUTHOR]

Latinos in the United States have been disproportionately affected by the intersecting epidemics of HIV and sexually transmitted diseases. Using a community-based participatory research approach to problem identification, the objective of this study is to explore sociocultural determinants of HIV/AIDS risk and service use among immigrant Latino men living with HIV/AIDS in North Carolina. In-depth key-informant interviews with stake-holders (n = 8) and Latino men living with HIV/AIDS (n = 10) were conducted. Major themes identified among Latino men living with HIV/AIDS are misconceptions about HIV/AIDS prevention and treatment, intracommunity discrimination against individuals living with HIV, and feared discovery of their undocumented status. Further research is needed to reduce HIV risk and improve access to medical services among Latino men living with HIV/AIDS.

This Internet-based study was designed to compare health risk behaviors of gay and non-gay university students from stratified random cross-sectional samples of undergraduate students. Mean age of the 4,i67 male participants was 20.5 ([+ or -]2. 7)years. Of these, 206 (4.9%) self-identified as gay and 3,961 (95.1%) self-identified as heterosexual. After adjusting for selected characteristics and clustering within university, gay men had higher odds of reporting: multiple sexual partners, cigarette smoking; methamphetamine use; gamma-hydroxybutyrate (GHB) use; other illicit drug use within the past 30 days and during lifetime; and intimate partner violence (IPV). Understanding the health risk behaviors of gay and heterosexual men is crucial to identifying associated factors and intervening upon them using appropriate and tailored strategies to reduce behavioral risk disparities and improve health outcomes. KEYWORDS gay men, sex, drug use, student, alcohol, intimate partner violence, methamphetamine, tobacco, condom, GHB DOI: 10.1080/00918360903275500

Health departments, community-based organizations (CBOs), and AIDS service organizations (ASOs) in the United States and abroad distribute large quantities of free condoms to sexually active individuals; however, little is known about where individuals who use condoms actually acquire them. This community-based participatory research (CBPR) study was designed to identify factors associated with the use of free condoms during most recent anal intercourse among self-identifying gay and bisexual men who reported condom use. Data were collected using targeted intercept interviewing during North Carolina Pride Festival events in Fall 2006, using the North Carolina Condom Acquisition and Preferences Assessment (NCCAPA). Of the 606 participants who completed the assessment, 285 met the inclusion criteria. Mean age of participants was 33 ([+ or -]10.8) years. The sample was predominantly white (80%), 50% reported being single or not dating anyone special, and 38% reported the use of free condoms during most recent anal intercourse. In multivariable analysis, participants who reported using free condoms during most recent anal sex were more likely to report increased age; dating someone special or being partnered; and having multiple male sexual partners in the past 3 months. These participants were less likely to report ever having had a sexually transmitted disease. Despite being in the third decade of the HIV epidemic, little is known about condom acquisition among, and condom preferences of, gay and bisexual men who use condoms. Although more research is needed, our findings illustrate the importance of free condom distribution.

Crystal methamphetamine is a highly addictive stimulant that initially gained popularity in the western region of the United States and has spread to all regions of the country. This study was designed to identify factors associated with methamphetamine use among men who have sex with men (MSM) in North Carolina. Participants were recruited in five gay bars and in five geographically defined Internet chat rooms concurrently in 2005 to complete a brief assessment of drug use and other risk behaviors. Of the 1189 MSM who completed the assessment, mean age was 29 years. Two thirds self-identified as black/African American or other minorities, and 25% as bisexual. Nearly 6% reported using methamphetamines during the past 30 days. In multivariable analysis, MSM who reported using methamphetamines were more likely to report higher education; health insurance coverage; inconsistent condom use during anal sex within the past 3 months; a history of sexually transmitted disease (STD) infection; positive HIV serostatus; and use of medications designed to treat erectile dysfunction. A lack of data exists on methamphetamine use among MSM in the southeastern United States, particularly in nonurban regions. Because the southeastern United States carries a disproportionate HIV, AIDS, and STD burden, our findings underscore the need for further research and intervention.

We explored the relationships between sociocultural and psychological constructs and adherence to antiretroviral therapy among predominantly Spanish-speaking immigrant Latinos in the southeastern United States. A cross-sectional clinic-based sample of immigrant Latino men and women participated in an interviewer-administered assessment. Self-reported prevalence of adherence was assessed along with demographic characteristics, acculturation, physician trust, social support, and theory of planned behavior (TPB) constructs: attitude, subjective norm (SN), and perceived behavioral control (PBC). A total of 66 respondents met inclusion criteria. Average age was 38 years old, 74% of respondents were male, 71% heterosexual, and 86% reported being from Mexico or Central America. Prevalence of "complete" adherence (i.e., not missing a single dose) in the past 30 days was 71%. Social support was significantly and inversely associated with adherence, PBC, and attitude. Positive correlates of adherence included attitude, PBC, and employment status. In multivariable analysis, SN and PBC were significantly associated with social support, controlling for acculturation, physician trust, and number of behavioral referents. TPB constructs have utility in explaining ART adherence among immigrant Latinos in the "Deep South." Further research is necessary to understand the complex relationships between social support, attribution processes, and ART adherence outcomes.