Correlates of Sexual Violence among Men Who Have Sex with Men in Tijuana, Mexico

Sexual violence among men who have sex with men (MSM) is prevalent in developing countries and is associated with increased HIV/STI risk. Despite high HIV prevalence (20 %) among MSM in Tijuana, Mexico, little attention has been paid to the occurrence of sexual violence in this high-risk group. 

The present study used a syndemic conditions framework to examine correlates of sexual violence victimization in a sample of 201 MSM surveyed in Tijuana, Mexico during 2012 and 2013. Participants were recruited through respondent-driven sampling and underwent a 2-h baseline interview and testing for HIV and syphilis. Sexual violence was defined as any incident during the past year in which the participant had been raped, sexually molested, or sexually harassed. 

The majority of participants self-identified as gay or bisexual, had never married, were employed, and had a high school education or greater. The average age was 29.7 years. Thirty-nine percent reported sexual violence in the past year. A hierarchical multiple linear regression model predicting more experiences of sexual violence was tested. In a final model, a higher number of experiences of sexual violence was associated with a history of childhood sexual abuse, more adult experiences of homophobia, more depression and hostility symptoms, and not living with a spouse or steady partner. 

The findings from this study support a model of co-occurring psychosocial factors that increase the likelihood of sexual violence experiences among MSM. Multi-level approaches to the prevention of childhood and adult experiences of sexual violence and homophobia are needed to avert the development of adverse mental and physical health outcomes associated with sexual violence victimization.

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By:  Semple SJ1, Stockman JK2, Goodman-Meza D3, Pitpitan EV2, Strathdee SA2, Chavarin CV1, Rangel G4, Torres K5, Patterson TL6.

• 1Department of Psychiatry, University of California San Diego, Mail Code 0680, 9500 Gilman Drive, La Jolla, CA, 92093-0680, USA.
• 2Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
• 3Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
• 4US-Mexico Border Health Commission, Tijuana, Mexico.
• 5Agencia Familiar Binacional, A.C., Tijuana, Mexico.
• 6Department of Psychiatry, University of California San Diego, Mail Code 0680, 9500 Gilman Drive, La Jolla, CA, 92093-0680, USA. tpatterson@ucsd.edu. 
• Arch Sex Behav. 2016 May 13. 

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The Association between AIDS-Related Stigma & Aggression Toward Gay Men & Lesbians

This study examined whether self-identified race and prior contact with a gay man or lesbian moderate the association between AIDS-related stigma and aggression toward gay men and lesbians when controlling for sexual prejudice. 

A regional, community-recruited sample of 194 heterosexual men (50% Black, 50% White) completed measures of AIDS-related stigma, sexual prejudice, and prior contact with gay men and lesbians. 

Regression analyses showed that AIDS-related stigma was positively associated with aggression toward gay men and lesbians among White men who reported no prior contact, but not among White men who endorsed prior contact and Black men regardless of prior contact. 

Findings suggest that intergroup contact may be a key component to reducing the effects of AIDS-related stigma towards stigmatized groups. Implications for aggression theory and intervention are discussed.

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By:  Vincent W1, Peterson JL2, Parrott DJ2.

• 1Center for AIDS Prevention Studies, Division of Prevention Science, School of Medicine, University of California, San Francisco, California.
• 2Department of Psychology, Georgia State University, Atlanta, Georgia. 

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Partner Preference among Men Who Have Sex with Men: Potential Contribution to Spread of HIV within Minority Populations

PURPOSE:

Human immunodeficiency virus (HIV) disproportionately affects men who have sex with men (MSM) in the United States. Most prior research into drivers of HIV transmission has focused on individual characteristics rather than on dyadic-level behaviors such as sex partner selection. This article explores racial/ethnic preferences in sex and relationship partner selection among MSM to further contextualize the spread of HIV within minority groups.

METHODS:

Participants were recruited through a mobile application (app) for men to meet other men in 2015 and completed an online survey on behaviors related to HIV risk. All analyses on the sample of 530 MSM were conducted in 2015.

RESULTS:

There was significant homophily in partner selection within racial/ethnic minorities, but not for white MSM. In general, mobile app-using MSM reported a general preference for white and Hispanic men and a dispreference for black and Asian men, both for sex and relationship partners.

CONCLUSION:

Racial/ethnic preferences were found to drive intentions to form partnerships within this sample. Combined with the stigma many of these racial/ethnic minorities may also feel from homophobic attitudes within their own racial/ethnic communities, these MSM may be at particular risk for social isolation. These partner preferences likely affect the structure of the sexual networks of MSM and may contribute to increased clustering within high HIV incident sexual networks.

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By:  Phillips G 2nd1, Birkett M1, Hammond S1, Mustanski B1.

• 1Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University , Chicago, Illinois. 

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'Struggling to be the Alpha': Sources of Tension & Intimate Partner Violence in Same-Sex Relationships Between Men

In countries such as the USA, gay and bisexual men experience high rates of intimate partner violence. However, little is known about the factors that contribute to this form of violence. 

In this study, we examine gay and bisexual men's perceptions of sources of tension in same-sex male relationships and how these may contribute to intimate partner violence. We conducted seven focus-group discussions with 64 gay and bisexual men in Atlanta, GA. Focus groups examined men's reactions to the short-form revised Conflicts Tactics Scale to determine if each item was considered to be intimate partner violence if it were to occur among gay and bisexual men. Analysts completed a thematic analysis, using elements of grounded theory. 

The sources of tension that men identified included: gender role conflict, dyadic inequalities (e.g. differences in income, age, education), differences in 'outness' about sexual identity, substance use, jealousy and external homophobic violence. 

Results suggest that intimate partner violence interventions for gay and bisexual men should address behavioural factors, while also focusing on structural interventions. Interventions that aim to reduce homophobic stigma and redefine male gender roles may help to address some of the tension that contributes to intimate partner violence in same-sex male relationships.

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By:  Goldenberg T1,2, Stephenson R1,2, Freeland R2, Finneran C3, Hadley C4.

• 1a Department of Health Behavior and Biological Sciences , School of Nursing, University of Michigan , Ann Arbor , MI , USA.
• 2b Center for Sexuality and Health Disparities , University of Michigan , Michigan , USA.
• 3c Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta , GA , USA.
• 4d Department of Anthropology , Emory College of Arts and Sciences , Atlanta , GA , USA. 
• Cult Health Sex. 2016 Mar 11:1-15.

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Reductions in Access to HIV Prevention & Care Services Are Associated with Arrest & Convictions in a Global Survey of Men Who Have Sex with Men

OBJECTIVES:

Men who have sex with men (MSM) are disproportionately impacted by HIV. Criminalisation of homosexuality may impede access to HIV services. We evaluated the effect of the enforcement of laws criminalising homosexuality on access to services.

METHODS:

Using data from a 2012 global online survey that was published in a prior paper, we conducted a secondary analysis evaluating differences in perceived accessibility to health services (ie, 'how accessible are ____' services) between MSM who responded 'yes'/'no' to: 'have you ever been arrested or convicted for being gay/MSM?'

RESULTS:

Of the 4020 participants who completed the study and were included in the analysis, 8% reported ever being arrested or convicted under laws relevant to being MSM. Arrests and convictions were most common in sub-Saharan Africa (23.6%), Eastern Europe/Central Asia (18.1%), the Caribbean (15%), Middle East/North Africa (13.2%) and Latin America (9.7%). Those arrested or convicted had significantly lower access to sexually transmitted infection treatment, condoms and medical care, compared with other MSM, while accounting for clustering by country and adjusting for age, HIV status, education and country-level income.

CONCLUSIONS:

Arrests and convictions under laws relevant to being MSM have a strong negative association with access to HIV prevention and care services. Creating an enabling legal and policy environment, and increasing efforts to mitigate anti-homosexuality stigma to ensure equitable access to HIV services are needed, along with decriminalisation of homosexuality, to effectively address the public health needs of this population.

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By:  Santos GM1, Makofane K2, Arreola S2, Do T3, Ayala G2.

• 1San Francisco Department of Public Health, Center for Public Health Research, San Francisco, California, USA Department of Community Health Systems, University of California, San Francisco, San Francisco, California, USA.
• 2The Global Forum on MSM and HIV (MSMGF), Oakland, California, USA.
• 3Department of Community Health Systems, University of California, San Francisco, San Francisco, California, USA. 

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Substance Use among Sexual Minority Collegiate Athletes: A National Study

BACKGROUND:

The empirical research examining substance use among sexual minority collegiate athletes is sparse. Problematically, this group may be at a greater risk of substance use due to their marginalized status within the context of sport.

OBJECTIVES:

We examined different types of substance use during the past 30 days, and diagnosis of substance use disorders during the past 12 months, among sexual minority collegiate athletes.

METHODS:

This study uses data from college students for the fall semester between 2008 and 2012 from the American College Health Association-National College Health Assessment.

RESULTS:

Sexual minority collegiate athletes had greater odds of past 30-day cigarette use, past 30-day alcohol use, past 30-day marijuana use, and indicating being diagnosed or treated for a substance use disorder during the past 12 months when compared to either heterosexual collegiate athletes or heterosexual nonathletes, but had similar odds on these outcomes when compared to sexual minority nonathletes. 

Sexual minority collegiate athletes also had greater odds of binge drinking during the past 2 weeks when compared to either heterosexual nonathletes or sexual minority nonathletes, but had similar odds on this outcome when compared to heterosexual collegiate athletes. Additional analyses by gender reveal that male sexual minority athletes are at the greatest risk of being diagnosed or treated for a substance use disorder.

CONCLUSIONS:

Possible explanations as to why sexual minority collegiate athletes (particularly males) may be at a greater risk of substance use disorders could include the difficulty of trying to maintain an athletic identity within a social environment that is traditionally homophobic.

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By:  Veliz P1, Epstein-Ngo Q1, Zdroik J2, Boyd CJ1,3, McCabe SE1.

• 1 Institute for Research on Women & Gender, University of Michigan , Ann Arbor , Michigan , USA.
• 2 Kinesiology Department , University of Michigan , Ann Arbor , Michigan , USA.
• 3 School of Nursing, University of Michigan , Ann Arbor , Michigan , USA. 
• Subst Use Misuse. 2016 Mar 4:1-16.

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The Most Prejudiced Places in America

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Experiences of Anti-Homosexual Attitudes and Young Black Men Who Have Sex with Men in the South

PURPOSE:

In 2012, Jackson, Mississippi, had the third highest incidence rate of human immunodeficiency virus (HIV) among young Black men who have sex with men (MSM). The goal of this qualitative study (the initial phase of an HIV prevention clinical trial) was to explore how cultural norms regarding anti-homosexual attitudes interfere with the safe sex practices and relationship norms of young Black MSM in Mississippi.

METHODS:

Nine focus groups (N = 54) were conducted with young Black MSM aged 18-29. Participants were recruited through medical providers at local sexually transmitted infection clinics and through community organizers at local LGBT outreach programs. The data were analyzed through the use of grounded theory, multiple coders for consistency and intercoder reliability, and a qualitative data analysis software.

RESULTS:

Three major themes were identified during the analysis: (1) resiliency and condom use, (2) inconsistent condom use among closeted young Black MSM, and (3) intimate partner violence (IPV) among closeted young Black MSM. Black MSM in Mississippi continue to be highly stigmatized within their social networks (i.e., families, sexual partners, and community).

CONCLUSIONS:

The findings suggest that cultural and community norms regarding anti-homosexual attitudes may be a barrier to the practices of safe sex and a contributing factor to IPV among young Black MSM. There is a need for tailored interventions that address these cultural norms and establish social and community support for young Black MSM in Mississippi.

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By:  Geter A1, Ricks JM2, McGladrey M1, Crosby RA1, Mena LA3, Ottmar JM1.

• 1 Department of Health Behavior, University of Kentucky, Lexington, Kentucky.
• 2 Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia .
• 3 Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi.
• LGBT Health. 2016 Feb 17.  

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Psychological Well-Being among Religious and Spiritual-identified Young Gay and Bisexual Men

Religiosity and spirituality are often integral facets of human development. Young gay and bisexual men (YGBM), however, may find themselves at odds when attempting to reconcile potentially conflicting identities like religion and their sexual orientation. 

We sought to explore how different components of religiosity (participation, commitment, spiritual coping) are linked to different markers of psychological well-being (life purpose, self-esteem, and internalized homophobia). 

Using data collected in Metro Detroit (N = 351 ages 18-29 years; 47 % African American, 29 % Non-Latino White, 8 % Latino, 16 % Other Race), we examined how components of religiosity/spirituality were associated with psychological well-being among religious/spiritual-identified participants. 

An overwhelming majority (79.5 %) identified as religious/spiritual, with most YGBM (91.0 %) reporting spirituality as a coping source. Over three quarters of our religious/spiritual sample (77.7 %) reported attending a religious service in the past year. Religious participation and commitment were negatively associated with psychological well-being. 

Conversely, spiritual coping was positively associated with YGBM’s psychological well-being. Programs assisting YGBM navigate multiple/conflicting identities through sexuality-affirming resources may aid improve of their psychological well-being. 

We discuss the public health potential of increasing sensitivity to the religious/spiritual needs of YGBM across social service organizations.

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By:  

Steven Meanley

, Emily S. Pingel

, José A. Bauermeister 

University of Michigan School of Public Health

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HIV Testing among Men Who Have Sex with Men in Tijuana, Mexico

OBJECTIVES:

HIV testing is critical to the delivery of comprehensive HIV prevention and care services, yet coverage of sexual minorities by HIV testing programmes remains insufficient in many low- and middle-income countries, including Mexico. The objective of this study was to identify the prevalence and correlates of HIV testing among men who have sex with men (MSM) in Tijuana, Mexico.

METHODS:

We conducted a cross-sectional study (2012-2013) among 189 MSM recruited via respondent-driven sampling (RDS). RDS-weighted logistic regression was used to identify correlates of prior HIV testing.

RESULTS:

RDS-adjusted prevalence of prior and recent (≤12 months) HIV testing was 63.5% and 36.8%, respectively. Prior HIV testing was positively associated with older age, being born in Tijuana, higher levels of education, identifying as homosexual or gay, being more 'out' about having sex with men, and a history of sexual abuse. Prior HIV testing was negatively associated with reporting more condomless anal intercourse acts (past 2 months) and greater internalised homophobia.

CONCLUSIONS:

Our findings indicate an urgent need for expanded HIV testing services for MSM in Tijuana. Innovative, non-stigmatising, confidential HIV testing interventions targeted at young, less educated, migrant and non-gay identifying MSM may facilitate HIV testing and timely linkage to HIV care and treatment within this population.

Full article at:   http://goo.gl/ga986c

By:  Pines HA1, Goodman-Meza D1, Pitpitan EV1, Torres K2, Semple SJ3, Patterson TL3.

• 1Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, California, USA.
• 2Agencia Familiar Binacional, AC, Tijuana, Mexico.
• 3Department of Psychiatry, University of California, San Diego, La Jolla, USA. 
• BMJ Open. 2016 Feb 4;6(2):e010388. doi: 10.1136/bmjopen-2015-010388.

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The Struggles of LGBT People in One of Europe's Most Homophobic Countries - Video

How Uganda's Anti-Gay Leaders Teach Intolerance to Young People - Video

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Who Intervenes Against Homophobic Behavior? Attributes that Distinguish Active Bystanders

Research on homophobic behavior has focused on students engaging in this behavior or students toward whom this behavior is directed. There has been little attention to the large segment of students who observe this behavior, including active bystanders who defend or support students when homophobic behavior occurs. 

Among 722 high school students (55% female, 87% white, 86% heterosexual), 66.8% had observed at least one instance of homophobic behavior in the past 30 days. Gender (in this case, girls more so than boys), leadership, courage, altruism, justice sensitivity, and number of LGBT friends were associated with engagement in more active bystander behavior in response to observing homophobic behavior. 

Further, gender, courage, altruism, and number of LGBT friends each made unique contributions in accounting for variability in students' defending behavior in a comprehensive regression model. 

Findings highlight qualities that interventionists should cultivate in students that could lead to more active bystander engagement against homophobic behavior.

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By:  Poteat VP1, Vecho O2.

• 1Boston College, Chestnut Hill, MA, USA. Electronic address: PoteatP@bc.edu.
• 2Université Paris Ouest-Nanterre la Défense, Nanterre, France. Electronic address: ovecho@u-paris10.fr. 
• J Sch Psychol. 2016 Feb;54:17-28. doi: 10.1016/j.jsp.2015.10.002. Epub 2015 Nov 7.

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