Browsing by Subject "MSM"

The HIV epidemic in the United States continues to be a significant public health problem, with approximately 50,000 new infections occurring each year. National public health priorities have shifted in recent years towards targeted HIV prevention efforts among people living with HIV/AIDS (PLWHA) that include: increasing engagement in and retention in care, improving HIV treatment adherence, and increasing screening for and treatment of substance use and psychological difficulties. This study evaluated the efficacy of Positive Choices (PC), a brief, care-based, theory-driven, 3-session counseling intervention for newly HIV-diagnosed men who have sex with men (MSM), in the context of current national HIV prevention priorities. The study involved secondary analysis of data from a preliminary efficacy trial of the PC intervention (n=102). Descriptive statistics examined baseline substance use, psychological characteristics and strategies, and care engagement and HIV-related biological outcomes. Generalized Estimating Equations (GEE) examined longitudinal changes in these variables by study condition. Results indicated that PC improved adherence to HIV treatment, but increased use of illicit drugs, specifically amyl nitrates and other stimulant drugs; additionally, moderation analyses indicated differences in patterns of change over time in viral load by baseline depression status. Implications of the findings and suggestions for future research are discussed.

Background: Young black men who have sex with men (YBMSM) are a particularly vulnerable group for HIV infection. HIV-positive YBMSM often suffer from mental health challenges as a result of discrimination based on their HIV status, race, and sexual preferences. Potential associations among HIV self-disclosure, social support, and mental health have been reported in several studies. The aim of this study is to explore the associations among self-disclosure, social support and mental health, including depression and anxiety. Methods: Cross-sectional secondary data, with a sample size of 199 HIV-positive YBMSM, was retrieved from the baseline data of an on-going study. Qualitative interviews were conducted at three sites in North Carolina. Linear regression and content analysis were used in the quantitative and qualitative analysis respectively to explore the associations among self-disclosure, social support, and mental health. Results: In linear regression models for depression and anxiety, social support was significantly associated with depression (p<0.01) and anxiety (p<0.05). Self-disclosure was not significantly associated with depression or anxiety in regression analyses. Qualitative analysis showed connections between social support and mental health as well as self-disclosure and mental health. Conclusions: Both self-disclosure and social support could affect mental health in YBMSM. Further research is needed to better understand the mechanisms linking self-disclosure, social support, and mental health to develop effective and tailored mental health interventions for this marginalized population.

Since 2005, China Global Fund AIDS programs have considered men who have sex with men (MSM) an "at-risk population" with priority and significance to receiving HIV testing. Community-based organizations (CBOs) have been involved in implementing the intervention programs, including free HIV testing, to MSM. This thesis explores the consequences of HIV testing as an intervention on local MSM's perceptions and relationships. Participant observation, in-depth interview and textual analysis were conducted during fieldwork research at a local CBO. It is argued that the complexities of everyday practices of public health programs at the community-level need to be emphasized in supervision. The success of China's HIV/AIDS intervention strategies is at stake: free HIV testing needs to be implemented as a benefit to testing receivers' health instead of as an obligation or commodity. In everyday practice, HIV testing is full of complexities and via HIV testing, interrelations among CDC system, local CBOs, and local MSM are reproduced and images and perceptions of free HIV testing are reconstructed. Moreover, receiving HIV testing was integrated into a new moral discourse of how to be a "good" MSM. It is recommended for local CBOs to cultivate their professionalization, and be aware of new stigmatization produced by free HIV testing. Meanwhile, a transition of local governmentality and supervision technologies is needed.