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Changes in Developmental Contexts as Predictors of Transitions in HIV-Risk Behaviors Among Young Men Who Have Sex with Men (YMSM)

  • Published:
American Journal of Community Psychology

Abstract

Emerging adulthood is a transitional time often marked by instability in many areas of life, including residential status, work, school, and romantic relationships. The purpose of this study is to examine transitions in HIV-risk related behaviors among a cohort of ethnically-diverse young men who have sex with men (YMSM) and to reveal how changes in developmental contexts during emerging adulthood might be associated with these behavioral changes. Hidden Markov models were used to examine movement across different stages of behavioral risk-taking over time. Semi-annual surveys were administered across 2 years; analyses included those with at least three of the five waves of data. Results indicated substantial movement at the individual-level transitions. Additionally, high variability in sexual risk, alcohol misuse, and illicit drug-risk behaviors was predicted by age, ethnicity, and correlates of emerging adulthood, such as residential status, work, post-secondary school enrollment, and primary-relationship status. Findings provide evidence of great change in risky behaviors among YMSM during this pivotal time, particularly among those who actively experiment in varying levels of risk-taking. In order to prevent experimental behaviors from evolving into more serious risk, interventions must consider ways to assist YMSM to adjust to life changes brought on by emerging adulthood.

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Notes

  1. Hidden Markov modeling is also known as manifest Markov modeling (Kaplan 2008). We retain the terminology “hidden Markov model” throughout this paper to best convey the way these analyses are performed in Mplus, which specifies a Markov process “hidden” inside a latent class framework.

  2. Unlike the sex risk and alcohol use variables, for which the transition between higher groups and the lowest group was meaningful, it is not possible to become a lifetime non-user after engaging in any drug use. Therefore, the transition probabilities for the transitions between each prior or current usage group (groups 2, 3, and 4) and the lifetime non-use group (group 1) were fixed to zero between each wave.

  3. Conceptually, this was true at waves 3 and 5 as well, but the corresponding parameters were fixed at these waves due to empty cells in the contingency tables between relationship status and sexual risk. That is, there were no participants in primary-partner relationships at waves 3 and 5 who reported having no sexual partners in the past 3 months.

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Authors and Affiliations

  1. Community, Health Outcomes, and Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS#30, Los Angeles, CA, 90027, USA

    Carolyn F. Wong, George Weiss & Michele D. Kipke

  2. Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Carolyn F. Wong & Michele D. Kipke

  3. Division of Adolescent Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA

    Sheree M. Schrager

  4. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Chih-Ping Chou

Authors
  1. Carolyn F. Wong
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  2. Sheree M. Schrager
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  3. Chih-Ping Chou
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  4. George Weiss
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  5. Michele D. Kipke
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Correspondence to Carolyn F. Wong.

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Wong, C.F., Schrager, S.M., Chou, CP. et al. Changes in Developmental Contexts as Predictors of Transitions in HIV-Risk Behaviors Among Young Men Who Have Sex with Men (YMSM). Am J Community Psychol 51, 439–450 (2013). https://doi.org/10.1007/s10464-012-9562-2

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  • DOI: https://doi.org/10.1007/s10464-012-9562-2

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