Let's Talk About Gay Sex: Gay & Bisexual Men's Sexual Communication with Healthcare Professionals After Prostate Cancer

Although sexual changes after prostate cancer (PCa) have specific meanings and consequences for gay and bisexual (GB) men, little is known about how GB men navigate sexual well-being support. 

We surveyed 124 GB men with PCa and 21 male partners, and interviewed a sub-sample of 46 GB men and 7 male partners, to examine GB men's experiences of sexual communication with healthcare professionals (HCPs) since the onset of PCa. GB men perceived a number of deficits in HCPs communication: medical support dominated sexual and psychological support; heterosexuality of GB patients was often assumed; sexual orientation disclosure was problematic; and GB men perceived rejection or lack of interest and knowledge from a majority of HCPs with regard to gay sexuality and the impact of PCa on GB men. Facilitators of communication were acknowledgement of sexual orientation and exploration of the impact of PCa on GB men. 

In order to target improved support for GB men with PCa, it is concluded that HCPs need to address issues of hetero-centricism within PCa care by improving facilitation of sexual orientation disclosure, recognising that GB men with PCa might have specific sexual and relational needs, and increasing knowledge and comfort discussing gay sexuality and gay sexual practices.

Purchase full article at:   http://goo.gl/N5ZT38

By:  Rose D1, Ussher JM1, Perz J1.

• 1Centre for Health Research, School of Medicine, Western Sydney University, Sydney, NSW, Australia. 
• Eur J Cancer Care (Engl). 2016 Feb 26. doi: 10.1111/ecc.12469.

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Body Dissatisfaction among Sexual Minority Men: Psychological and Sexual Health Outcomes

Body dissatisfaction is common among sexual minority (i.e., gay and bisexual) men; however, few studies have investigated the relationship between body dissatisfaction and psychosexual health variables among this population. 

The data that do exist are exclusively cross-sectional, casting uncertainty regarding temporal associations. Thus, the aims of the current study were to assess the prospective relationship between body dissatisfaction and psychological and sexual health outcomes. 

Participants were 131 gay and bisexual men who completed a battery of self-report measures across two time points (baseline and 3-month follow-up), including assessment of body dissatisfaction, depressive symptoms, and sexual health variables (sexual self-efficacy and sexual anxiety). Generalized linear modeling was employed to assess the prospective relationship between body dissatisfaction and outcomes variables, accounting for non-normal distributions. Body dissatisfaction significantly predicted elevated depressive symptoms (B = .21, p = .01), lower sexual self-efficacy (B = −.22, p = .04), and elevated sexual anxiety (B = .05, p = .03). Elevated body dissatisfaction is prospectively associated with negative psychological and sexual health outcomes. 

Given the high prevalence of body image concerns in sexual minority men, depression and/or HIV/STI prevention programs may benefit from routinely assessing for body dissatisfaction among this population, and addressing those who report concerns.

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By:  Blashill AJ1,2, Tomassilli J3, Biello K4,5, O'Cleirigh C4,6,7, Safren SA8, Mayer KH4,7,9.

• 1Department of Psychology, San Diego State University, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA. aaron.blashill@sdsu.edu.
• 2SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA. aaron.blashill@sdsu.edu.
• 3California State University, Sacramento, Sacramento, CA, USA.
• 4The Fenway Institute, Boston, MA, USA.
• 5Department of Behavioral & Social Sciences, Brown University, Providence, RI, USA.
• 6Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
• 7Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
• 8Department of Psychology, University of Miami, Coral Gables, FL, USA.
• 9Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. 
• Arch Sex Behav. 2016 Feb 8.

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Low Prevalence of Hepatitis C Co-Infection in Recently HIV-Infected Minority Men Who Have Sex with Men in Los Angeles

Background

Geographic and sociodemographic characterization of hepatitis C virus (HCV) transmission amongst men who have sex with men (MSM) has been limited. Our aim was to characterize HCV prevalence, risk factors for HCV co-infection, and patterns of HIV and HCV co-transmission and transmitted drug resistance mutations (DRMs) in newly HIV-diagnosed Los Angeles MSM.

Methods

Viral RNA was extracted from stored plasma samples from a Los Angeles cohort of newly diagnosed HIV-infected MSM with well-characterized substance use and sexual behavioral characteristics via computer-assisted self-interviewing surveys. Samples were screened for HCV by qPCR. HCV E1, E2, core, NS3 protease and NS5B polymerase and HIV-1 protease and reverse transcriptase regions were amplified and sequenced. Phylogenetic analysis was used to determine relatedness of HCV and HIV-1 isolates within the cohort and viral sequences were examined for DRMs.

Results

Of 185 newly HIV-diagnosed MSM, the majority (65 %) were of minority race/ethnicity and recently infected (57.8 %), with median age of 28.3 years. A minority (6.6 %) reported injection drug use (IDU), whereas 96 (52.8 %) reported recent substance use, primarily cannabis or stimulant use. High risk sexual behaviors included 132 (74.6 %) with unprotected receptive anal intercourse, 60 (33.3 %) with group sex, and 10 (5.7 %) with fisting. Forty-five (24.3 %) had acute gonorrhea or chlamydia infection. Only 3 (1.6 %) subjects had detectable HCV RNA. Amongst these subjects, HIV and HCV isolates were unrelated by phylogenetic analysis and none possessed clinically relevant NS3 or NS5B HCV DRMs.

Conclusions

Prevalence of HCV co-infection was low and there was no evidence of HIV-HCV co-transmission in this cohort of relatively young, predominantly minority, newly HIV-diagnosed MSM, most with early HIV infection, with high rates of high risk sexual behaviors, STI, and non-IDU. The low HCV prevalence in a group with high-risk behaviors for non-IDU HCV acquisition suggests an opportune time for targeted HCV prevention measures.

Below:  a Phylogenetic analysis of Hepatitis C virus (HCV) isolates. Consensus sequences of an 857 nucleotide (nt) fragment of the HCV NS3 protease from the three HCV isolates from the cohort were aligned with the Los Alamos National Laboratory HCV Database consensus sequences for HCV genotype (gt) 1a and 3a, along with additional reference sequences from subjects living in Los Angeles, to make a neighbor-joining tree. The consensus sequences for gt 1a and 3a are labeled as “CON” with the corresponding genotype. The Los Angeles HCV sequences are labeled as “LA” with the corresponding subject number. The HCV-positive subject samples are labeled A, B, and C. The tree is rooted with the HCV genotype 1a consensus sequence and the genetic distance scale bar is located at the center of the figure. b Phylogenetic analysis of HIV-1 pol. A 1302 nt fragment of pol covering the HIV-1 protease and reverse transcriptase (HXB2 reference location nt 2254–3555) from N = 148 isolates from the cohort was aligned with the Clade B consensus and used to build a neighbor-joining tree. Each sequence is labeled with a unique subject identifier, and the HCV-positive subjects are labeled A, B, and C. The tree is rooted with the Clade B consensus sequence. The genetic distance scale bar is located at the lower left of the figure

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

By: Kara W. Chew^1*, Martha L. Blum²³, Marjan Javanbakht⁴, Laurel E. Clare², Lorelei D. Bornfleth², Robert Bolan⁵, Debika Bhattacharya² and Pamina M. Gorbach⁴⁶

¹Department of Medicine, David Geffen School of Medicine at UCLA, 11075 Santa Monica Blvd, Suite 100, Los Angeles 90025, CA, USA

²Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, 37-121 CHS, Los Angeles 90095, CA, USA

³Present Address: Community Hospital of the Monterey Peninsula, Infectious Diseases Division, 23625 Holman Highway, Monterey 93942, CA, USA

⁴Department of Epidemiology, UCLA Fielding School of Public Health, 71-235E CHS, Los Angeles 90095, CA, USA

⁵Los Angeles LGBT Center, 1625 N. Schrader Blvd, Los Angeles 90028, CA, USA

⁶Department of Medicine, David Geffen School of Medicine at UCLA, 41-295 CHS, Los Angeles 90095, CA, USA

 

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Association of Skin Cancer and Indoor Tanning in Sexual Minority Men and Women

Skin cancer, the most common cancer in the United States, is highly associated with outdoor and indoor tanning behaviors. Although indoor tanning has been suggested to be more common among sexual minority (self-reported as homosexual, gay, or bisexual) men compared with heterosexual men, whether rates of skin cancer vary by sexual orientation is unknown.

To investigate whether skin cancer prevalence and indoor tanning behaviors vary by sexual orientation in the general population.

We performed a cross-sectional study using data from the 2001, 2003, 2005, and 2009 California Health Interview Surveys (CHISs) and the 2013 National Health Interview Survey (NHIS) of population-based samples of the California and US noninstitutionalized civilian population. Participants included 192 575 men and women 18 years or older who identified as heterosexual or a sexual minority.

Self-reported lifetime history of skin cancer and 12-month history of indoor tanning.

The study included 78 487 heterosexual men, 3083 sexual minority men, 107 976 heterosexual women, and 3029 sexual minority women. Sexual minority men were more likely than heterosexual men to report having skin cancer and having tanned indoors. Sexual minority women were less likely than heterosexual women to report having had nonmelanoma skin cancer  and having tanned indoors.

Sexual minority men indoor tan more frequently and report higher rates of skin cancer than heterosexual men. Primary and secondary prevention efforts targeted at sexual minority men might reduce risk factors for, and consequences of, skin cancer.

Full article at: http://goo.gl/8QSWpS

By: Mansh M1, Katz KA2, Linos E3, Chren MM4, Arron S4.

• 1Department of Dermatology, University of California, San Francisco 2Stanford University School of Medicine, Stanford, California.
• 2Department of Dermatology, Kaiser Permanente, Pleasanton, California.
• 3Department of Dermatology, University of California, San Francisco.
• 4Department of Dermatology, University of California, San Francisco4Dermatology Service, San Francisco Veterans Affairs Medical Center, San Francisco, California.

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