Abstract
In the United States, rates of human immunodeficiency virus (HIV) infection are highest among Black men who have sex with men (BMSM). Prior research indicates that younger BMSM in particular (i.e., BMSM 29 years of age and younger) are most at risk for HIV infection, and that HIV incidence in this subpopulation has risen in recent years. It remains unclear, however, why younger BMSM, relative to BMSM 30 years of age and older, are at increased risk for HIV infection. For the current study, we surveyed 450 BMSM located in the Atlanta, GA metropolitan and surrounding areas. We assessed BMSM’s depressive symptoms, substance use during sex, psycho-social risk factors (i.e., HIV risk perceptions, condom use self-efficacy, internalized homophobia, and perceived HIV stigmatization), and sexual risk taking (i.e., condomless anal intercourse [CAI]). We found that younger BMSM (YBMSM) and older BMSM (OBMSM) differed with respect to factors associated with CAI. In multivariable models, alcohol use before or during sex, lower educational attainment, and sexual orientation (i.e., bisexual sexual orientation) were significantly associated with increased CAI for YBMSM, while HIV risk perceptions and internalized homophobia were significantly, negatively associated with CAI among OBMSM. Rates of engaging in CAI were similar across the two age cohorts; however, factors related to CAI varied by these two groups. Findings emphasize the need to consider targeted interventions for different generational cohorts of BMSM.
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Acknowledgments
We gratefully acknowledge the time and effort of the participants who contributed to this project, as they have helped us to further our knowledge of this subject area. Further, we thank Dr. Jose Bauermeister and Dr. Miranda Lynch for providing thoughtful feedback. This project was supported by National Institute of Mental Health Grant R01MH094230 and by National Institute of Nursing Research Grant R01NR013865.
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Jessica L. Maksut, Lisa A. Eaton, Elizabeth J. Siembida, Daniel D. Driffin and Robert Baldwin declare that they have no conflict of interest.
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All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
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Maksut, J.L., Eaton, L.A., Siembida, E.J. et al. An evaluation of factors associated with sexual risk taking among Black men who have sex with men: a comparison of younger and older populations. J Behav Med 39, 665–674 (2016). https://doi.org/10.1007/s10865-016-9734-x
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DOI: https://doi.org/10.1007/s10865-016-9734-x