Journal of AIDS & Clinical Research: 5(2): 276, 2014
Purpose: Barebacking is a term that is used to refer to intentional involvement in unprotected an... more Purpose: Barebacking is a term that is used to refer to intentional involvement in unprotected anal sex. This paper examines the relationship between masculinity and self-identification as a barebacker, and how these factors related to HIV risk practices in a sample of men who have sex with other men (MSM). Method: As part of the Men4Men Study, a brief Internet-based survey was completed in 2007 with English-speaking MSM aged 18+ who were not involved in a marital/romantic relationship at the time of interview. 886 participants were recruited by placing electronic postings and banner advertisements on Weblogs, social and sexual networking sites, and listservs frequented by MSM. Results: A number of factors differentiated men who self-identified as barebackers from those who did not, and barebacking identity was linked with greater involvement in HIV risk practices. Multivariate analysis revealed that having a high level of masculinity was associated with a greater likelihood of self-identifying as a barebacker. Conclusions: HIV prevention and intervention efforts targeting MSM ought to address issues of self-identification as a barebacker as well as the extent to which men adhere to a masculine ideology.
Journal of Health Disparities Research and Practice: 7(S1): 19-36, 2014
Hispanic students are the fastest growing minority population on U.S. college campuses. The purpo... more Hispanic students are the fastest growing minority population on U.S. college campuses. The purpose of this study was to examine differences in the sexual and reproductive health behaviors and outcomes between Hispanic and non-Hispanic White college students. Analyses utilized data from 15,518 non-married undergraduates (aged 18-24 years) responding to the Fall 2009 American College Health Association-National College Health Assessment II, a national sample of U.S. college students. Binary logistic regression analyses were used to examine disparities in sexual and reproductive health behaviors and outcomes, including sexual behavior, contraceptive and condom use, HIV testing, and STD and unintended pregnancy history, between Hispanic and non-Hispanic Whites. Hispanics had greater odds of reporting a past-year STD, although rates of reported sexual risk behaviors were no higher among Hispanics compared with non-Hispanic Whites. Compared to non-Hispanic Whites, fewer Hispanics reported using birth control pills. Hispanics were 2.5 times less likely to report using any method to prevent pregnancy, which may explain why Hispanics were more likely to report emergency contraceptive use in the past 12 months and a past-year unintended pregnancy. Important sexual health disparities exist among U.S. students, which have important practical implications for college health policy, practice, and intervention. Further research is warranted to understand the ethnic differences in the use of both hormonal and emergency contraceptives, particularly among college students.
Annals of Anthropological Practice: 36(2): 232–256, 2013
Syndemic Theory posits that an understanding of the HIV/AIDS pandemic can only be gained by exami... more Syndemic Theory posits that an understanding of the HIV/AIDS pandemic can only be gained by examining the dynamic interaction of the disease with other health problems (e.g., tuberculosis, sexually transmitted infections, malnutrition, substance abuse), in the context of social and structural conditions such as poverty, unequal access to resources, violence, stigma, etc. While the theory has been extensively used to guide research, it has not been widely utilized as a training tool. This article presents a model for the use of Syndemic Theory as a framework for the training and mentorship of researchers and practitioners, particularly from underrepresented groups interested in HIV/AIDS prevention and treatment among ethnic minorities.
American Journal of Men’s Health: 6(4): 280–293., 2012
The current study examines the risk perceptions of HIV-negative men who have sex with men (MSM) w... more The current study examines the risk perceptions of HIV-negative men who have sex with men (MSM) who use the Internet to seek unprotected sex. The research questions include the following: How great do these men perceive their HIV risk to be? Are their perceptions based on HIV knowledge or related to their risk behaviors? What factors are associated with greater/lesser perceived risk? Results revealed that more than half of the men believed that they had no or only a slight chance of contracting HIV. Risk perceptions were not related to HIV knowledge or to involvement in HIV risk practices. Four factors were identified as being associated with greater perception of HIV risk: self-identity as a sexual “bottom,” having sex while high, greater use of bareback-focused websites, and younger age. Internet-using HIV-negative men who have sex with men tend to underestimate their risk for acquiring HIV, and interventions need to help them accurately assess their risk.
International Public Health Journal: 4(1): 33-42, 2012
Using a Syndemics Theory conceptual model, this study examines the relationship between childhood... more Using a Syndemics Theory conceptual model, this study examines the relationship between childhood maltreatment experiences and involvement in HIV risk taking in a sample of adult men who actively seek partners for unprotected sex via the Internet. Methods: The study was based on a national random sample of 332 men who have sex with men (MSM), who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Structural equation analysis was undertaken to examine the specific nature of the relationships involved in understanding HIV risk practices. Results: Childhood maltreatment experiences were not found to be related directly to involvement in HIV risk taking in adulthood. Childhood maltreatment, particularly in the form of emotional neglect, was found to be an important variable in the overall structural equation. Its effect on HIV risk taking was indirect, operating principally by having a negative impact upon self-esteem, which in turn had a negative effect on attitudes toward condom use, which in turn were related strongly and directly to risk taking. Conclusions: Childhood maltreatment experiences are relevant to understanding HIV risk practices among MSM in adulthood, but the relationship is not as simple as usually conceptualized. Rather, childhood maltreatment appears to impact risk taking indirectly, through its effects on mental health functioning, which in turn affects risk-related attitudes.
Journal of AIDS & Clinical Research: 5(2): 276, 2014
Purpose: Barebacking is a term that is used to refer to intentional involvement in unprotected an... more Purpose: Barebacking is a term that is used to refer to intentional involvement in unprotected anal sex. This paper examines the relationship between masculinity and self-identification as a barebacker, and how these factors related to HIV risk practices in a sample of men who have sex with other men (MSM). Method: As part of the Men4Men Study, a brief Internet-based survey was completed in 2007 with English-speaking MSM aged 18+ who were not involved in a marital/romantic relationship at the time of interview. 886 participants were recruited by placing electronic postings and banner advertisements on Weblogs, social and sexual networking sites, and listservs frequented by MSM. Results: A number of factors differentiated men who self-identified as barebackers from those who did not, and barebacking identity was linked with greater involvement in HIV risk practices. Multivariate analysis revealed that having a high level of masculinity was associated with a greater likelihood of self-identifying as a barebacker. Conclusions: HIV prevention and intervention efforts targeting MSM ought to address issues of self-identification as a barebacker as well as the extent to which men adhere to a masculine ideology.
Journal of Health Disparities Research and Practice: 7(S1): 19-36, 2014
Hispanic students are the fastest growing minority population on U.S. college campuses. The purpo... more Hispanic students are the fastest growing minority population on U.S. college campuses. The purpose of this study was to examine differences in the sexual and reproductive health behaviors and outcomes between Hispanic and non-Hispanic White college students. Analyses utilized data from 15,518 non-married undergraduates (aged 18-24 years) responding to the Fall 2009 American College Health Association-National College Health Assessment II, a national sample of U.S. college students. Binary logistic regression analyses were used to examine disparities in sexual and reproductive health behaviors and outcomes, including sexual behavior, contraceptive and condom use, HIV testing, and STD and unintended pregnancy history, between Hispanic and non-Hispanic Whites. Hispanics had greater odds of reporting a past-year STD, although rates of reported sexual risk behaviors were no higher among Hispanics compared with non-Hispanic Whites. Compared to non-Hispanic Whites, fewer Hispanics reported using birth control pills. Hispanics were 2.5 times less likely to report using any method to prevent pregnancy, which may explain why Hispanics were more likely to report emergency contraceptive use in the past 12 months and a past-year unintended pregnancy. Important sexual health disparities exist among U.S. students, which have important practical implications for college health policy, practice, and intervention. Further research is warranted to understand the ethnic differences in the use of both hormonal and emergency contraceptives, particularly among college students.
Annals of Anthropological Practice: 36(2): 232–256, 2013
Syndemic Theory posits that an understanding of the HIV/AIDS pandemic can only be gained by exami... more Syndemic Theory posits that an understanding of the HIV/AIDS pandemic can only be gained by examining the dynamic interaction of the disease with other health problems (e.g., tuberculosis, sexually transmitted infections, malnutrition, substance abuse), in the context of social and structural conditions such as poverty, unequal access to resources, violence, stigma, etc. While the theory has been extensively used to guide research, it has not been widely utilized as a training tool. This article presents a model for the use of Syndemic Theory as a framework for the training and mentorship of researchers and practitioners, particularly from underrepresented groups interested in HIV/AIDS prevention and treatment among ethnic minorities.
American Journal of Men’s Health: 6(4): 280–293., 2012
The current study examines the risk perceptions of HIV-negative men who have sex with men (MSM) w... more The current study examines the risk perceptions of HIV-negative men who have sex with men (MSM) who use the Internet to seek unprotected sex. The research questions include the following: How great do these men perceive their HIV risk to be? Are their perceptions based on HIV knowledge or related to their risk behaviors? What factors are associated with greater/lesser perceived risk? Results revealed that more than half of the men believed that they had no or only a slight chance of contracting HIV. Risk perceptions were not related to HIV knowledge or to involvement in HIV risk practices. Four factors were identified as being associated with greater perception of HIV risk: self-identity as a sexual “bottom,” having sex while high, greater use of bareback-focused websites, and younger age. Internet-using HIV-negative men who have sex with men tend to underestimate their risk for acquiring HIV, and interventions need to help them accurately assess their risk.
International Public Health Journal: 4(1): 33-42, 2012
Using a Syndemics Theory conceptual model, this study examines the relationship between childhood... more Using a Syndemics Theory conceptual model, this study examines the relationship between childhood maltreatment experiences and involvement in HIV risk taking in a sample of adult men who actively seek partners for unprotected sex via the Internet. Methods: The study was based on a national random sample of 332 men who have sex with men (MSM), who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Structural equation analysis was undertaken to examine the specific nature of the relationships involved in understanding HIV risk practices. Results: Childhood maltreatment experiences were not found to be related directly to involvement in HIV risk taking in adulthood. Childhood maltreatment, particularly in the form of emotional neglect, was found to be an important variable in the overall structural equation. Its effect on HIV risk taking was indirect, operating principally by having a negative impact upon self-esteem, which in turn had a negative effect on attitudes toward condom use, which in turn were related strongly and directly to risk taking. Conclusions: Childhood maltreatment experiences are relevant to understanding HIV risk practices among MSM in adulthood, but the relationship is not as simple as usually conceptualized. Rather, childhood maltreatment appears to impact risk taking indirectly, through its effects on mental health functioning, which in turn affects risk-related attitudes.
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