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Purpose We aimed to describe the prevalence of IPV victimization, changes of experiencing IPV victimization, and examined factors associated with more severe or frequent IPV victimization since the COVID-19 crisis among a global sample of sexual minority men (SMM). Methods Data were collected between October and November 2020 through a gay social networking (GSN) application. We used multinominal logistic regression to examine correlates of experiencing any IPV during the pandemic and experiencing more severe or frequent IPV since the pandemic began. Results Of all participants (n = 9420), IPV victimization prevalence in the past 6 months was 17.0%, 19.5% of whom reported experiencing more severe or frequent IPV and 55.7% reported experiencing IPV that stayed the same since the COVID-19 started. Experiencing more severe or frequent IPV victimization since the pandemic began was associated with having engaged in sex work, having an income reduction by more than 20% and cutting meals since the COVID-19 crisis began. Increased tobacco use and psychological distress were also associated with increased IPV victimization. Lastly, SMM who reported having met a sexual partner through GSN apps were more likely to say that their experience of IPV had been more severe or frequently. Conclusion Our results demonstrate relatively high levels of reporting IPV victimization during the COVID-19 pandemic among a global sample of SMM. The findings illustrate an increasing need for IPV resources and programs as the pandemic continues to evolve. New technologies such as GSN apps have the potential to deliver confidential and safe IPV screening, services, and resources., Author(s): Chenglin Hong [sup.1] , Rob Stephenson [sup.2] [sup.3] , Glenn-Milo Santos [sup.4] [sup.5] , Alex Garner [sup.6] , Sean Howell [sup.7] , Ian Holloway [sup.1] Author Affiliations: (1) grid.19006.3e, [...]

Purpose Intimate partner violence (IPV) in male couples is a public health concern, but the reliability of self-reported IPV data from gay, bisexual, and other men who have sex with men (GBMSM) is understudied. Research in heterosexual couples finds IPV-underreporting can be differential between victims/perpetrators and by gender; it is unknown if GBMSM-data has similar limitations. Methods This study assessed interpartner agreement (percent agreement; kappa statistics) between self- and partner-reported IPV, and compared agreement between 2 recall periods (1-year; 3-month), 3 granularities (any IPV; IPV domain; IPV behaviors), and across 3 surveys (BL; Wave 1 (W1); Wave 2 (W2)) in a sample of 404 male couples in the U.S. (2016-2017). Longitudinal dyadic concordance-trends were assessed to determine if couples had consistently reliable data over time. Results Past-year IPV-victimization prevalence was 66.41% and perpetration, 64.42%; past 3-month IPV-victimization prevalence was 47.30% (W1) and 52.57% (W2), and perpetration, 46.30% (W1) and 46.30% (W2). Interpartner agreement was consistently low across recall periods and granularities. Observed agreement was higher for those who did not report IPV, compared to those who reported experiencing IPV. At an individual-level, interpartner agreement on any given survey was not significantly predictive of subsequent data reliability. Conclusion Researchers should be cognizant of the potential for unpredictable and unreliable IPV reports from GBMSM. Further research on IPV data quality in male couples is needed., Author(s): Alison R. Walsh [sup.1] [sup.2] , Rob Stephenson [sup.1] [sup.2] Author Affiliations: (1) https://ror.org/00jmfr291, grid.214458.e, 0000 0000 8683 7370, Center for Sexuality and Health Disparities, University of Michigan, , [...]

Engagement in HIV care and a high level of antiretroviral therapy (ART) adherence for people living with HIV is crucial to treatment success and can minimize the population burden of the disease. Despite this, there is a critical gap in HIV prevention science around the development of interventions for serodiscordant male couples. This paper reports on the results of a randomized controlled trial to assess the efficacy of Stronger Together, a dyadic counseling intervention aimed at increasing engagement in and optimizing HIV care among serodiscordant male couples in Atlanta, GA, Boston, MA, and Chicago, IL. Between 2014 and 2017, 159 male serodiscordant couples (total N = 318) in Atlanta, GA, Boston, MA, and Chicago, IL were enrolled and equally randomized to either the Stronger Together intervention arm (a three-session dyadic intervention involving HIV testing and adherence counseling) or a standard of care (SOC) control arm. Couples completed individual study assessments via an audio computer assisted self-interviewing (ACASI) system at baseline, 6, 12 and 18 months. Primary outcomes included being prescribed and currently taking ART, and fewer missed doses of ART in the past 30 days; because the trial was not powered to examine viral suppression, we examined this as an exploratory outcome. Longitudinal data analysis was by an intention-to-treat approach. Participants ages ranged from 18 to 69 (mean = 35.9), and are predominantly white (77.5%), and college educated (68.4% earned a college degree or higher). Participants randomized to the Stronger Together arm had a significantly greater odds of being prescribed and currently taking ART over time than those in the SOC arm (at 12 months OR 2.75, 95%CI 1.35-4.67, p-value 0.020, and at 18 months OR 2.91, 95%CI 1.61-4.88, p-value 0.013). Similarly, those in the Stronger Together arm had a significantly lower odds of missing a dose of ART in the past 30 days over time compared to those in the SOC arm (at 12 months OR 0.28, 95%CI 0.09-0.81, p-value 0.019, and at 18 months OR 0.25, 95%CI 0.07-0.82, p-value 0.023). Among male couples in serodiscordant relationships, the Stronger Together intervention resulted in significantly improved HIV treatment outcomes at both 12 and 18 months of follow-up. This trial is the first to date to demonstrate evidence of efficacy for a dyadic counseling intervention and has the potential to fill a critical gap in secondary HIV prevention interventions for serodiscordant male couples.

BackgroundMen who have sex with men are disproportionately burdened by HIV/AIDS, and the advent of pre-exposure prophylaxis (PrEP) has provided an effective strategy to reduce the risk of HIV transmission. Research has shown that improving one partner's health-promoting behaviors increases the likelihood that their partner adopts healthier behaviors. We examined the longitudinal relationship between favorable HIV treatment outcomes with current PrEP use among HIV serodiscordant male partners.SettingData are from Project Stronger Together, a randomized controlled trial that recruited serodiscordant male couples from Atlanta, GA; Boston, MA; and Chicago, IL.MethodsSerodiscordant couples completed assessments at baseline, 6, 12, 18, and 24 months. We analyzed longitudinal data from 120 HIV serodiscordant male partners to assess the relationship between the HIV-negative partner's current PrEP use and their HIV-positive partner's current ART use, ART adherence, and viral load using generalized estimating equation models.ResultsFewer than half of the HIV-negative partners were on PrEP at baseline and nearly two-thirds of their HIV-positive partners were virally suppressed. HIV-negative male partners who had partners with an undetectable viral load had greater odds of being a current PrEP user than HIV-negative partners with partners with a detectable viral load.ConclusionOur study highlights the need to develop dyad-level interventions to improve HIV medication use/adherence by HIV serodiscordant male couples. Our findings also suggest that dyad-level interventions may be able to leverage our understanding of how partners can influence each other's health-promoting behaviors to develop programs that improve health outcomes for both partners.

BackgroundA significant proportion (20-59%) of people living with HIV in sub-Saharan Africa desire childbearing, are of reproductive age, and are in sero-different relationships (~50%). Thus it is plausible that some portion of new HIV transmissions are due to attempts to become pregnant. Safer conception (SC) methods that effectively reduce the risk of HIV transmission exist and can be made available in resource-constrained settings. Few studies in the region, and none in Botswana, have quantitatively examined the correlates of information, motivation, and behavioral skills for SC uptake.MethodsWe surveyed 356 women living with HIV from 6/2018 to 12/2018 at six public-sector health clinics in Gaborone, Botswana. Participants were 18-40 years old, not pregnant, and desired future children or were unsure about their childbearing plans. We examined correlates of SC information, motivation, and behavioral skills using nested linear regression models, adjusting for socio-demographic, interpersonal, and structural variables.ResultsKnowledge of SC methods varied widely. While some SC methods were well known (medical male circumcision by 83%, antiretroviral therapy for viral suppression by 64%), most other methods were known by less than 40% of participants. Our final models reveal that stigma as well as relationship and partner factors affect SC information, motivation, and behavioral skills. Both internalized childbearing stigma (ß=-0.50, 95%CI:-0.17, -0.02) and perceived community childbearing stigma were negatively associated with SC information (ß=-0.09, 95%CI:-0.80, -0.21). Anticipated (ß=-0.06, 95%CI:-0.12, -0.003) and internalized stigma (ß=-0.27, 95%CI:-0.44; -0.10) were associated with decreased SC motivation, while perceived community childbearing stigma was associated with increased SC motivation (ß=0.07, 95%CI:0.02, 0.11). Finally, internalized childbearing stigma was associated with decreased SC behavioral skills (ß=-0.80, 95%CI: -1.12, -0.47) while SC information (ß=0.24, 95%CI:0.12, 0.36), motivation (ß=0.36, 95%CI:0.15, 0.58), and perceived partner willingness to use SC (ß=0.47, 95%CI:0.36, 0.57) were positively associated with behavioral skills CONCLUSIONS: Low SC method-specific information levels are concerning since almost half (47%) of the study participants reported they were in sero-different relationships and desired more children. Findings highlight the importance of addressing HIV stigma and partner dynamics in interventions to improve SC information, motivation, and behavioral skills.

Despite the growing body of evidence demonstrating the high prevalence of intimate partner violence (IPV) among male couples and the unique antecedents to IPV that male couples may experience, research efforts have focused almost exclusively on North American populations. Missing from the literature is an understanding of the experience of IPV among male couples in African nations where social norms and legal restrictions around same-sex behavior may be more conservative. This paper presents data from an innovative study of male couples (Together Tomorrow) from two Southern African countries characterized by high prevalence of HIV: Namibia and South Africa. A one-time cross-sectional survey was conducted with 140 partnered MSM (70 couples) in Namibia and 300 partnered MSM (150 couples) in KZN, South Africa, for a total sample size of 440 partnered MSM (220 couples). Surveys measured the recent (12 month) experience of physical, sexual and emotional IPV and the experience of sexuality-related stressors. Reporting of IPV was relatively low: 7.3% reported being the victim of IPV from their male partner in the 12 months prior to the survey, and 10.2% reported participating in bi-directional IPV in their relationship in the previous 12 months. Men who reported different experiences of internalized homophobia and external acts of discrimination were more likely to report IPV and bi-directional IPV. The results offer several potential intervention points to disrupt pathways between stigma and IPV for partnered MSM in South Africa and Namibia, and point to the need for services for this critically overlooked population., Author(s): Rob Stephenson [sup.1] [sup.2] , Lynae A. Darbes [sup.2] [sup.3] , Tanaka Chavanduka [sup.2] , Zaynab Essack [sup.4] [sup.5] , Heidi van Rooyen [sup.4] [sup.6] Author Affiliations: (1) grid.214458.e, [...]

Stress arising from the experience of stigma and discrimination around gender identity is known to negatively influence health outcomes for transgender individuals. The Gender Minority Stress and Resilience (GMSR) scale is a validated tool for measuring experiences of minority stress and resilience among transgender individuals. This paper seeks to examine whether there are differences in how youth respond to the GMSR scale. Using data from a sample of 202 transgender and gender nonbinary youth collected online, this analysis compares responses to the GMSR scale between transgender youth with binary and nonbinary gender identities. While reports of non-affirmation were generally high (M = 15.02), and community connectedness for all participants was generally low (M = 7.5), there were no significant differences to scale responses across gender identity. Nonbinary assigned male at birth (AMAB) reported greater rates of threats of physical violence due to gender identity or expression. Nonbinary assigned female at birth (AFAB) reported greater rates of feeling unique in their gender identity or expression. This preliminary analysis suggests that the GMSR scale is a useful tool, however, further research is needed to understand stress and resilience among transgender and gender nonbinary youth and developing specific measures that capture their experience.

Purpose: Gender minority (GM) stress, resulting from distal (i.e., external) and proximal (i.e., internal) stigma-based stressors, is thought to drive mental health disparities among transgender and gender diverse (TGD) youth. We tested the gender minority stress and resilience (GMSR) model hypotheses that distal GM stress effects on mental health are partially mediated by proximal GM stress and moderated by GM-specific resilience (i.e., community connectedness, identity pride) among a U.S. national sample of TGD youth. Methods: As part of an HIV prevention study (NCT03185975), 159 TGD youth (ages 15–24) completed an online survey that included the GMSR measure, assessing distal and proximal GM stress and GM resilience, and the 18-item Brief Symptom Inventory, assessing past-7-day psychological distress. Three models linking GMSR constructs to psychological distress were tested using PROCESS v4.0: (1) simple partial mediation, (2) moderated partial mediation, and (3) serial partial mediation. Results: A direct effect of distal GM stress was observed in all models. An indirect effect through proximal GM stress alone was observed in model 1, but not models 2 or 3. In model 2, resilience did not moderate the effects of distal or proximal GM stress. In model 3, indirect effects were observed through proximal GM stress and GM resilience serially as well as GM resilience alone. Conclusion: Larger prospective studies are needed to confirm the role of GM resilience as a mediator, rather than moderator, of GM stress effects on mental health and a critical, rather than supplementary, target for mental health intervention among TGD youth. [ABSTRACT FROM AUTHOR]

Studies conducted early in the COVID-19 pandemic - before vaccines were widely available - indicated that drug use may have declined among sexual minority men (SMM). This study evaluated drug use trends in the second year of the pandemic. Cross-sectional responses from cisgender SMM living in the US and recruited online (n = 15,897) were grouped for analyses: Time 1: 3/1/2021-5/30/2021; Time 2: 6/1/2021-8/31/2021; Time 3: 9/1/2021-11/30/2021; and Time 4: 12/1 2021-2/28/2022. Results of multivariable models indicated that illicit drug use (excluding cannabis) increased at Times 2 (OR = 1.249, p <.001), 3 (OR = 1.668, p <.001), and 4 (OR = 1.674, p <.001) compared to Time 1. In contrast, cannabis use was relatively stable over time. Rates did not differ significantly among Times 1, 2, and 4. While rates of COVID-19 vaccination increased over time, illicit drug use was negatively associated with the odds of vaccination (OR = 0.361, p <.001). These findings highlight the need for ongoing attention to the risks drug use poses among SMM. Illicit drug use - a long-standing health disparity among SMM - increased significantly across the second year of the pandemic. Because they are less likely to be vaccinated, SMM who use illicit drugs may be at greater risk of COVID-19 infection or complications. [ABSTRACT FROM AUTHOR]

Background: Daily oral pre-exposure prophylaxis (PrEP) is available and recommended for men who have sex with men (MSM) at risk for HIV infection. Other HIV prevention products are being developed, including long-acting injectable (LAI) and event-based oral and topical formulations. Understanding preferences for potential products by MSM can help direct further development of prevention messaging. Methods: We present baseline data from HIV-negative participants enrolled in the US Mobile Messaging for Men (M-cubed) Study. Participants were asked their likelihood of and rank order preference for using daily oral PrEP and various potentia prevention products (one- to -three-month injections, 2-1-1 sexual event oral dosing, anal or penile gel, or anal suppository), and their sociodemographic characteristics. Bivariate and multivariable logistics regression assessed demographic associations with likelihood of use and rank order preference. Results: Overall, most MSM reported a likelihood of using LAI (74%), sexual event-based pills (67%) and penile gel (64%). Men who reported recent unprotected (condomless and PrEPless) anal sex most preferred a penile gel formulation (74%), followed closely by LAI and event-based pills (73% each). Current PrEP users (vs. non-users) had greater odds of reporting likelihood to use LAI (AOR = 3.29, 95% CI = 2.12 to 5.11), whereas men reporting recent unprotected anal sex had a greater odds of likelihood to use a penile gel (AOR = 1.79, 95% CI = 1.27 to 2.52) and an anal suppository (AOR = 1.48, 95% CI = 1.08 to 2.02). Hispanic/Latino (vs. White) MSM (AOR = 2.29, 95% CI = 1.40 to 3.73) and, marginally, Black MSM (AOR = 1.54, 95% CI = 1.00 to 2.38) had greater odds of reporting likelihood to use penile gel. Similar patterns were found for rank ordering preference of products, including condoms. Conclusions: Most MSM were interested in using various potential future HIV prevention products, especially LAI. However, two typologies of potential users emerged: men who prefer sexual event-based methods (condoms, event-based pill, sexua gels and suppositories) and men who prefer non-sexual event-based methods (daily pill, LAI). Men who reported recent unprotected anal sex preferred a penile gel product most, followed closely by sexual event-based pills and LAI. Racial/ethnic differences were noted as well. These findings on product preferences can help in formulation development and messaging. Keywords: PrEP; prophylaxis; HIV; MSM; men who have sex with men; prevention products; prevention methods, 1 | INTRODUCTION Currently available for use in the United States, daily administered PrEP in pill form is efficacious and recommended to prevent HIV infection in individuals at high risk [...]