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Psychosocial Vulnerability and HIV-Related Sexual Risk Among Men who have Sex with Men and Women in the United States

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Abstract

In the U.S., HIV is concentrated among men who have sex with men (MSM), some of whom have had female partners (MSMW). MSMW are disproportionately impacted by psychosocial vulnerabilities, like depression and substance use that increase sexually transmitted infection (STI) and HIV risk. Research on psychosocial vulnerability and HIV-related sexual risk among MSMW is warranted to reduce infection transmission among MSM and to prevent bridging to female partners. We analyzed data from Wave IV (2007–2008) of the National Longitudinal Study of Adolescent Health to assess psychosocial vulnerability and HIV risk-taking among MSMW. Using lifetime and past year sexual activity, we classified men as ever having sex with: women only (MSW), men only (MSMO) or MSMW, with further refined categorization of MSMW with male only partners in the past 12 months, only female partners in the past 12 months, and both male and female partners in the past 12 months (N = 6,945). We compared psychosocial vulnerability characteristics and HIV-related risk behaviors among the five categories of men. MSMW were more likely to report depression, suicidality, substance use, and incarceration than MSW and MSMO. Compared to MSW, MSMW with current female partners had greater odds of unprotected sex, exchange sex, and STI. MSMW with male partners in the past year had greater odds of multiple or concurrent partners in the past year. HIV risk and psychosocial vulnerability factors are elevated among MSMW, a priority population for HIV risk reduction. HIV risk reduction interventions should address this and heterogeneity of sexual partnerships among MSMW.

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Acknowledgments

This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis. This study was supported by a NIDA Research Supplement to Promote Diversity in Health-related Research (R01 DA-028766) and The UCLA HIV/AIDS Translational Training Program (R25 MH-080644). We are also thankful for the anonymous reviewers and the Associate Editor for comments contributing to substantial improvements in the article.

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  1. Department of Epidemiology and Biostatistics, University of Maryland, 2234FF School of Public Health, College Park, MD, 20742, USA

    Typhanye P. Dyer

  2. Department of Family Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Rotrease Regan

  3. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA

    Lauren R. Pacek

  4. Department of Epidemiology, University of Florida, Gainesville, FL, USA

    Abenaa Acheampong & Maria R. Khan

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  1. Typhanye P. Dyer
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Correspondence to Typhanye P. Dyer.

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Dyer, T.P., Regan, R., Pacek, L.R. et al. Psychosocial Vulnerability and HIV-Related Sexual Risk Among Men who have Sex with Men and Women in the United States. Arch Sex Behav 44, 429–441 (2015). https://doi.org/10.1007/s10508-014-0346-7

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