Objectives Risk factors for HIV acquisition were examined in a recent cohort of men who have sex with men (MSM). Design A longitudinal analysis of 4295 HIV-negative MSM enrolled in a randomized behavioral intervention trial conducted in six US cities. Methods MSM were enrolled and assessed for HIV infection and risk behaviors semi-annually, up to 48 months. Results In multivariate analysis, men reporting four or more male sex partners, unprotected receptive anal intercourse with any HIV serostatus partners and unprotected insertive anal intercourse with HIV-positive partners were at increased risk of HIV infection, as were those reporting amphetamine or heavy alcohol use and alcohol or drug use before sex. Some depression symptoms and occurrence of gonorrhea also were independently associated with HIV infection. The attributable fractions of high number of male partners, use of alcohol or drugs before sex, and unprotected receptive anal intercourse with unknown status partners and the same with presumed negative partners accounted for 32.3, 29.0, 28.4 and 21.6% of infections, respectively. Conclusions The challenge is to develop strategies to identify men in need. Interventions are needed to help men reduce their number of sexual partners, occurrences of unprotected anal intercourse, alcohol or drug use before sex and address other mental health issues.

Risk factors for HIV infection among men who have sex with men.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(06)68383-9.pdf

Tuberculosis in sub-Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment.

Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the United States. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. The article concludes that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, the article suggests that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that g...

https://www.tandfonline.com/doi/pdf/10.1080/00224499.2011.558645

HIV in Young Men Who Have Sex with Men: A Review of Epidemiology, Risk and Protective Factors, and Interventions

Background: With increased life expectancy for HIV-infected persons, there is concern regarding comorbid depression because of its common occurrence and association with behaviors that may facilitate HIV transmission. Our objectives were to estimate the prevalence of current depression among HIV-infected persons receiving care and assess the burden of major depression, relative to that in the general population. Methods and Findings: We used data from the Medical Monitoring Project (MMP) and the Behavioral Risk Factors Surveillance System (BRFSS). The eight-item Patient Health Questionnaire was used to identify depression. To assess the burden of major depression among HIV-infected persons receiving care, we compared the prevalence of current major depression between the MMP and BRFSS populations using stratified analyses that simultaneously controlled for gender and, in turn, each of the potentially confounding demographic factors of age, race/ethnicity, education, and income. Each unadjusted comparison was summarized as a prevalence ratio (PR), and each of the adjusted comparisons was summarized as a standardized prevalence ratio (SPR). Among HIV-infected persons receiving care, the prevalence of a current episode of major depression and other depression, respectively, was 12.4% (95% CI: 11.2, 13.7) and 13.2% (95% CI: 12.0%, 14.4%). Overall, the PR comparing the prevalence of current major depression between HIV-infected persons receiving care and the general population was 3.1. When controlling for gender and each of the factors age, race/ethnicity, and education, the SPR (3.3, 3.0, and 2.9, respectively) was similar to the PR. However, when controlling for gender and annual household income, the SPR decreased to 1.5.

/pdf/excess-burden-of-depression-among-hiv-infected-persons-30x81aoqlk.pdf

Excess burden of depression among HIV-infected persons receiving medical care in the united states: data from the medical monitoring project and the behavioral risk factor surveillance system.

Factors associated with the well-being of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth were qualitatively examined to better understand how these factors are experienced from the youths' perspectives. Largely recruited from LGBTQ youth groups, 68 youth participated in focus groups (n = 63) or individual interviews (n = 5). The sample included 50% male, 47% female, and 3% transgender participants. Researchers used a consensual methods approach to identify negative and positive factors across 8 domains. Negative factors were associated with families, schools, religious institutions, and community or neighborhood; positive factors were associated with the youth's own identity development, peer networks, and involvement in the LGBTQ community. These findings suggest a pervasiveness of negative experiences in multiple contexts, and the importance of fostering a positive LGBTQ identity and supportive peer/community networks. Efforts should work towards reducing and eliminating the prejudicial sentiments often present in the institutions and situations that LGBTQ youth encounter.

/pdf/negative-and-positive-factors-associated-with-the-well-being-1dvpkqdnhs.pdf

Negative and Positive Factors Associated With the Well-Being of Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning (LGBTQ) Youth

Psychological depression has been identified as a condition that may influence HIV risk behavior among injection drug users (IDUs) and men who have sex with men (MSM). In two Seattle studies, 1,228 IDUs and 429 young MSM completed the Center for Epidemiologic Studies Depression Scale (CES-D); the relationship between depression and injection and sexual risk behavior was assessed using logistic regression analysis. Forty-seven percent of IDUs had CES-D scores > or = 23; a high score was significantly related to injection with a syringe used by another IDU (adjusted odds ratio 1.4) but not other injection risk behavior. Among MSM, CES-D scores > or = 16 were related to reporting 3 or more sex partners in the last 6 months but not to other sexual risk behavior. This analysis suggests that psychological depression may influence certain HIV risk behavior in young MSM and IDUs, and that interventions addressing depression may be indicated.

Depression and HIV risk behavior among Seattle-area injection drug users and young men who have sex with men.

Background: A prospective observational study of HIV seroincidence among high-risk injection drug users (IDU) was carried out in Guangxi, China. The primary objectives of this study were (1) to estimate HIV seroincidence, (2) to estimate participant retention rate, and (3) to evaluate changes in drug use and sexual behavior over a one year period. Methods: Five hundred HIV seronegative IDU were enrolled. HIV-1 incidence and retention rates were analyzed as a function of sociodemographic, behavioral, and recruitment variables. Changes in drug use and sexual behavior were analyzed at the baseline, 6-monfh and 12-monfh follow-up visits. Results: At 12 months of follow-up, the HIV-1 incidence rate was 3.1 per 100 person years, [95% CI: (1.6%; 5.2%)] and participant retention rate was 87%. Reported changes in high-risk behaviors over 12-monfhs included significant decreases in the frequency of heroin injection, in direct or indirect sharing of injection equipment, and in the number of sexual partners....

HIV incidence, retention, and changes of high-risk behaviors among rural injection drug users in Guangxi, China

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Depression and HIV risk behavior among Seattle-area injection drug users and young men who have sex with men.

HIV incidence, retention, and changes of high-risk behaviors among rural injection drug users in Guangxi, China