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Mental health, social support, and HIV-related sexual risk behaviors among HIV-negative adolescent sexual minority males: three U.S. cities, 2015

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Abstract

We examined the association between mental health issues, social support, and HIV among adolescent sexual minority males (SMM), who are disproportionally affected by HIV. National HIV Behavioral Surveillance among Young Men Who Have Sex with Men (NHBS-YMSM) data among SMM aged 13–18 years were collected in three cities (Chicago, New York City, and Philadelphia). Separate log-linked Poisson regression models were used to estimate associations between mental health issues and social support (general and family), and 3 HIV-related sexual risk behavior outcomes: past-year condomless anal intercourse (CAI) with a male partner, past-year sex with ≥ 4 partners, and first vaginal or anal sex before age 13. Of 547 adolescent SMM, 22% reported ever attempting suicide and 10% reported past-month suicidal ideation. The majority (52%) reported depression and anxiety. Thirty-nine percent reported CAI, 29% reported ≥ 4 sex partners and 22% reported first sex before age 13. Ever attempting suicide, suicidal ideation, and depression and anxiety were associated with CAI. Separately, ever attempting suicide and lack of family support were associated with  ≥ 4 sex partners. None of the mental health or support measures were associated with having sex before age 13. General social support was not associated with any sexual risk behaviors. Mental health issues are common among adolescent SMM and associated with sexual risk behaviors. Including mental health support in comprehensive HIV prevention for adolescent SMM could potentially reduce HIV risk in this population.

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References

  1. Centers for Disease Control and Prevention. HIV surveillance in adolescents and young adults. Atlanta, GA: Centers for Disease Control and Prevention; 2017.

    Google Scholar 

  2. Udry JR, Chantala K. Risk assessment of adolescents with same-sex relationships. J Adolesc Health. 2002;31:84–92.

    Article  Google Scholar 

  3. Burns MN, Ryan DT, Garofalo R, et al. Mental health disorders in young urban sexual minority men. J Adolesc Health. 2015;56:52–8.

    Article  Google Scholar 

  4. Mustanski B, Andrews R, Herrick A, et al. A syndemic of psychosocial health disparities and associations with risk for attempting suicide among young sexual minority men. Am J Public Health. 2014;104:287–94.

    Article  Google Scholar 

  5. Liu RT, Mustanski B. Suicidal ideation and self-harm in lesbian, gay, bisexual, and transgender youth. Am J Prev Med. 2012;42:221–8.

    Article  Google Scholar 

  6. Marshal MP, Dietz LJ, Friedman MS, et al. Suicidality and depression disparities between sexual minority and heterosexual youth: A meta-analytic review. J Adolesc Health. 2011;49:115–23.

    Article  Google Scholar 

  7. Rosario M, Schrimshaw EW, Hunter J. A model of sexual risk behaviors among young gay and bisexual men: Longitudinal associations of mental health, substance abuse, sexual abuse, and the coming-out process. AIDS Educ Prev. 2006;18:444–60.

    Article  Google Scholar 

  8. Mustanski B, Phillips G, Ryan DT, et al. Prospective effects of a syndemic on HIV and STI incidence and risk behaviors in a cohort of young men who have sex with men. AIDS Behav. 2017;21:845–57.

    Article  Google Scholar 

  9. Millar BM, Starks TJ, Grov C, et al. Sexual risk-taking in HIV-negative gay and bisexual men increases with depression: results from a US national study. AIDS Behav. 2016;21:1665–75.

    Article  Google Scholar 

  10. O’Cleirigh C, Newcomb ME, Mayer KH, et al. Moderate levels of depression predict sexual transmission risk in HIV-infected MSM: a longitudinal analysis of data from six sites involved in a “prevention for positives” study. AIDS Behav. 2013;17:1764–9.

    Article  Google Scholar 

  11. Shiu CS, Chen YC, Tseng PC, et al. Curvilinear relationship between depression and unprotected sexual behaviors among men who have sex with men. J Sex Med. 2014;11:2466–73.

    Article  Google Scholar 

  12. Poteat VP, Anderson CJ. Developmental changes in sexual prejudice from early to late adolescence: The effects of gender, race, and ideology on different patterns of change. Dev Psychol. 2012;48:1403–15.

    Article  Google Scholar 

  13. Bowleg L, Burkholder GJ, Massie JS, et al. Racial discrimination, social support, and sexual HIV risk among Black heterosexual men. AIDS Behav. 2013;17:407–18.

    Article  Google Scholar 

  14. Peterson JL, Coates TJ, Catania JA, et al. High-risk sexual behavior and condom use among gay and bisexual African-American men. Am J Public Health. 1992;82:1490–4.

    Article  CAS  Google Scholar 

  15. Garofalo R, Mustanski B, Donenberg G. Parents know and parents matter: Is it time to develop family-based HIV prevention programs for young men who have sex with men? J Adolesc Health. 2008;43:201–4.

    Article  Google Scholar 

  16. Donenberg GR, Paikoff R, Pequegnat W. Introduction to the special section on families, youth, and HIV: Family-based intervention studies. J Pediatr Psychol. 2006;31:869–73.

    Article  Google Scholar 

  17. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129:674.

    Article  Google Scholar 

  18. Mustanski BS, Garofalo R, Emerson EM. Mental health disorders, psychological distress, and suicidality in a diverse sample of lesbian, gay, bisexual, and transgender youths. Am J Public Health. 2010;100:2426–32.

    Article  Google Scholar 

  19. Balaji AB, An Q, Smith JC, et al. High human immunodeficiency virus incidence and prevalence and associated factors among adolescent sexual minority males—3 Cities, 2015. Clin Infect Dis. 2017;66:936–44.

    Article  Google Scholar 

  20. Löwe B, Wahl I, Rose M, et al. A 4-item measure of depression and anxiety: validation and standardization of the patient health questionnaire-4 (PHQ-4) in the general population. J Affect Disord. 2010;122:86–95.

    Article  Google Scholar 

  21. Lauby JL, Marks G, Bingham T, et al. Having supportive social relationships is associated with reduced risk of unrecognized HIV infection among black and Latino men who have sex with men. AIDS Behav. 2012;16:508–15.

    Article  Google Scholar 

  22. Zimet GD, Dahlem NW, Zimet SG, et al. The multidimensional scale of perceived social support. J Pers Assess. 1988;52:30–41.

    Article  Google Scholar 

  23. Paul JP, Catania J, Pollack L, et al. Suicide attempts among gay and bisexual men: Lifetime prevalence and antecedents. Am J Public Health. 2002;92:1338–45.

    Article  Google Scholar 

  24. Garofalo R, Wolf RC, Wissow LS, et al. Sexual orientation and risk of suicide attempts among a representative sample of youth. Arch Pediatr Adolesc Med. 1999;153:487–93.

    Article  CAS  Google Scholar 

  25. Salomon EA, Mimiaga MJ, Husnik MJ, et al. Depressive symptoms, utilization of mental health care, substance use and sexual risk among young men who have sex with men in EXPLORE: Implications for age-specific interventions. AIDS Behav. 2009;13:811–21.

    Article  Google Scholar 

  26. Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, et al. Age of sexual debut among US adolescents. Contraception. 2009;80:158–62.

    Article  Google Scholar 

  27. Alvy LM, McKirnan DJ, Mansergh G, et al. Depression is associated with sexual risk among men who have sex with men, but is mediated by cognitive escape and self-efficacy. AIDS Behav. 2011;15:1171–9.

    Article  Google Scholar 

  28. Parsons JT, Grov C, Golub SA. Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: Further evidence of a syndemic. Am J Public Health. 2012;102:156–62.

    Article  Google Scholar 

  29. Beautrais AL. Risk factors for suicide and attempted suicide among young people. Aust N Z J Psychiatr. 2000;34:420–36.

    Article  CAS  Google Scholar 

  30. Koblin BA, Husnik MJ, Colfax G, et al. Risk factors for HIV infection among men who have sex with men. AIDS. 2006;20:731–9.

    Article  Google Scholar 

  31. Seil KS, Desai MM, Smith MV. Sexual orientation, adult connectedness, substance use, and mental health outcomes among adolescents: Findings from the 2009 New York City Youth Risk Behavior Survey. Am J Public Health. 2014;104:1950–6.

    Article  Google Scholar 

  32. Mustanski B, Swann G, Newcomb ME, et al. Effects of parental monitoring and knowledge on substance use and HIV risk behaviors among young men who have sex with men: results from three studies. AIDS Behav. 2017;21:2046–58.

    Article  Google Scholar 

  33. Mustanski BS, Newcomb ME, Du Bois SN, et al. HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions. J Sex Res. 2011;48:218–53.

    Article  Google Scholar 

  34. Rhodes SD, Wong FY. HIV prevention among diverse young MSM: Research needs, priorities, and opportunities. AIDS Educ Prev. 2016;28:191–201.

    Article  Google Scholar 

  35. Ybarra ML, Prescott TL, Phillips GL, et al. Pilot RCT results of an mHealth HIV prevention program for sexual minority male adolescents. Pediatrics. 2017;140:e20162999.

    Article  Google Scholar 

  36. Pingel ES, Thomas L, Harmell C, et al. Creating comprehensive, youth centered, culturally appropriate sex education. What do young gay, bisexual, and questioning men want? Sex Res Social Policy 2013;10:293–301.

    Article  Google Scholar 

  37. Kosciw JG, Greytak EA, Giga NM, et al. The 2015 national school climate survey executive summary: the experiences of lesbian, gay, bisexual, transgender, and queer youth in our nation’s schools. New York, NY; 2016.

  38. Denny S, Lucassen MF, Stuart J, et al. The association between supportive high school environments and depressive symptoms and suicidality among sexual minority students. J Clin Child Adolesc Psychol. 2016;45:248–61.

    Article  Google Scholar 

  39. Wilson MN, Asbridge M, Langille DB. School connectedness and protection from symptoms of depression in sexual minority adolescents attending school in Atlantic Canada. J Sch Health. 2018;88:182–9.

    Article  Google Scholar 

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Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Funding

Funding was provided by Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd., Mailstop E-46, Atlanta, GA, USA

    Christine B. Agnew-Brune, Alexandra B. Balaji, Brooke E. Hoots, Gabriela Paz-Bailey & Dita Broz

  2. Department of Medical Social Science, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Brian Mustanski & Michael E. Newcomb

  3. Chicago Department of Public Health, Chicago, IL, USA

    Nik Prachand

  4. NYC Department for Public Health and Mental Hygiene, New York, NY, USA

    Sarah L. Braunstein

  5. Philadelphia Department of Health, Philadelphia, PA, USA

    Kathleen A. Brady

  6. Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA, USA

    Justin S. Smith

Authors
  1. Christine B. Agnew-Brune
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  2. Alexandra B. Balaji
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  3. Brian Mustanski
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  4. Michael E. Newcomb
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  5. Nik Prachand
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  6. Sarah L. Braunstein
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  9. Justin S. Smith
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  10. Gabriela Paz-Bailey
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  11. Dita Broz
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For The NHBS-YMSM Study Group

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Correspondence to Christine B. Agnew-Brune.

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Agnew-Brune, C., Balaji, A., Mustanski, B. et al. Mental health, social support, and HIV-related sexual risk behaviors among HIV-negative adolescent sexual minority males: three U.S. cities, 2015. AIDS Behav 23, 3419–3426 (2019). https://doi.org/10.1007/s10461-019-02525-5

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  • DOI: https://doi.org/10.1007/s10461-019-02525-5

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