Young gay, bisexual, and other MSM (YMSM) in the U.S. (especially YMSM of color) are at highly disproportionate risk for HIV acquisition and transmission. This study aimed to better understand how social, environmental, and individual risks—including mental health burden and substance use—interact to create unprotected sexual risk for MSM.
Project staff recruited almost 600 sexually active gay, bisexual, and other 18-19 year old MSM who lived in the New York City metro region. Description of participants:
- >70% non-White
- Represented a range of socioeconomic status (SES)
- Almost 9 in 10 born in the U.S.
- >85% enrolled in school
- >15% reported arrest history
- >80% reported exclusive or predominant homosexuality
- Averaged >4 days past month alcohol use and >4 days marijuana use
- Substance use, mental health burden, and unprotected sex are co-occurring and over-lapping, creating a “syndemic.”
- 19% reported unprotected anal intercourse (UAI) with a same-sex partner.
• When examining the effects of individual, psychosocial, and social factors on UAI, engaging in past-month UAI was:
— Almost 5 times more likely if in a current relationship with another man
— 3 times as likely if unstably housed or homeless
— 2 times more likely if there is an arrest history
— Almost 2 times more likely if residentially unstable (i.e., many moves since birth)
• In examining the relationship between sociodemographic characteristics and UAI, findings indicated that:
— US-born participants were less likely to have UAI than non-US born participants
— Participants who felt they belonged to middle- or high-SES groups were less likely to engage in UAI than those who perceived they were in a low-SES group
- For programs to be most effective, they should be holistically enacted, integrating mental health and substance use services into HIV prevention and treatment programs.
- While individual-level HIV prevention efforts remain important, structural-level interventions are needed, given the vulnerabilities these youth face in regard to such factors as homelessness and arrest history.
Halkitis PN, & Figueroa RP (2013) Sociodemographic characteristics explain differences in unprotected sexual behavior among young HIV-negative gay, bisexual, and other YMSM in New York City. AIDS Patient Care and STDs, 27, 181-190. doi: 10.1089/apc.2012.0415
Halkitis PN, Kapadia F, Siconolfi DE, Moeller RW, Figueroa RP, Barton SC, & Blachman-Forshay J (2013) Individual, psychosocial, and social correlates of unprotected anal intercourse in a new generation of young men who have sex with men in New York City. American Journal of Public Health, 103, 889-895. doi: 10.2105/AJPH.2012.300963
Halkitis PN, Moeller RW, Siconolfi DE, Storholm ED, Solomon TM, & Bub KL (2012) Measurement model exploring a syndemic in emerging adult gay and bisexual men. AIDS and Behavior, 17, 662-673. doi: 10.1007/s10461-012-0273-3
Kapadia F, Siconolfi DE, Barton S, Olivieri B, Lombardo L, & Halkitis PN (2013) Social support network characteristics and sexual risk taking among a racially/ethnically diverse sample of young, urban men who have sex with men. AIDS and Behavior, 17, 1819-1828. doi: 10.1007/s10461-013-0468-2
Siconolfi DE, Kapadia F, Halkitis PN, Moeller RW, Storholm ED, Barton SC, Solomon TM, & Jones D (2012) Sexual health screening among racially/ethnically diverse young gay, bisexual, and other men who have sex with men. Journal of Adolescent Health, 52, 620-626. doi: 10.1016/j.jadohealth.2012.10.002
Storholm ED, Siconolfi DE, Halkitis PN, Moeller RW, Eddy JA, & Bare MG (2013) Sociodemographic factors contribute to mental health disparities and access to services among young men who have sex with men in New York City. Journal of Gay & Lesbian Mental Health, 17, 294-313. doi: 10.1080/19359705.2012.763080
Or contact Perry Halkitis, PhD, MS, MPH at perry.halkitis@nyu.edu
Supported by a grant from the National Institute on Drug Abuse (R01DA025537).