Gain important insight and a broader perspective on where, why, and how sex workers conduct their businessFor years, the focus of sex work research has been on street-based male and female sex workers and the HIV-related risks they pose to their clients. Contemporary Research on Sex Work moves beyond the basic association between sex work and unprotected sex to a fuller description of the varied facets of the industry while still pursuing a better understanding of HIV risk among those working the streets. The diverse approaches in this unique book include targeted sampling, qualitative and qua
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AbstractIntroductionRecent research has shown high efficacy of HIV treatment for reducing the risk of HIV transmission to sexual partners. As the efficacy of treatment as prevention (TasP) has proliferated, a new messaging campaign, Undetectable = Untransmittable, has been gaining popularity. The purpose of this paper was to assess factors associated with the perceived accuracy of this TasP messaging strategy among a large and diverse sample of gay, bisexual, and other men who have sex with men (GBMSM) in order to inform subsequent efforts at large‐scale and implementation of the HIV prevention message.MethodsWe conducted a nationwide survey of GBMSM in the U.S. recruited from an online social networking site and a mobile sexual networking app. We analysed data from 12,222 GBMSM separately by HIV status to examine sociodemographic and behavioural factors associated with ratings of the accuracy of the Undetectable = Untransmittable message, which included the option to indicate not understanding what "undetectable" meant.ResultsAmong HIV‐negative and unknown men, multivariable linear regression indicated that being on pre‐exposure prophylaxis (PrEP), identifying as gay or queer (versus bisexual or straight), recent serodiscordant condomless anal sex (CAS), testing every six months or more often, less concern about sexually transmitted infection (STI) infection, and lower perceived risk of HIV infection were the factors with the largest independent effect on rating the Undetectable = Untransmittable statement as more accurate. Fewer factors emerged as associated with accuracy ratings among HIV‐positive participants—reporting an undetectable viral load, a lifetime acquired immune deficiency syndrome (AIDS) diagnosis, and lower concern about STI infection were the factors most strongly associated with rating the statement as more accurate.ConclusionsThe findings of the current study highlight variability in the perceived accuracy of the Undetectable = Untransmittable message, suggesting potential subgroups who might benefit from targeted educational campaigns, perhaps broadcast utilizing sexual networking apps. Numerous factors, particularly among HIV‐negative and unknown GBMSM, were associated with rating the message as more accurate. In particular, being on PrEP and testing regularly were two of the variables most strongly associated with higher accuracy ratings among HIV‐negative GBMSM, suggesting HIV prevention services as potential points of intervention for increasing HIV knowledge and decreasing HIV stigma.
Examining the narratives of eighteen heterosexual drug-injecting men living with HIV, this study seeks to understand how HIV-positive men negotiate issues of masculinity, sexuality, and emotional intimacy. It focuses specifically on strategies HIV-positive men use to manage emotional vulnerability in sexual encounters. We identify a core theme of "splitting," in which men compartmentalize the domains of sexuality and emotional intimacy. We examine how this aspect of masculinity is at times exacerbated as a strategy to minimize emotional investment in sexual partners. By splitting the emotional and sexual domains, the men are able to perform sexually with casual sex partners while minimizing both the risk of infecting intimate partners and a fear of rejection from those they care about or desire most. However, the tensions created by splitting the emotional and sexual domains may disintegrate intimate interpersonal relationships that serve as a base of much-needed emotional support.
Time-space sampling has been used to generate representative samples of both hard-to-reach and location-based populations. Because of its emphasis on multi-tiered randomization (i.e., time, space, and individual), some have questioned the feasibility of time-space sampling as a cost-effective strategy. In an effort to better understand issues related to drug use among club-going young adults (ages 18 to 29) in the New York City nightlife scene, two variations of time-space sampling methods were utilized and compared (Version 1: randomized venue, day, and individuals within venues: Version 2: randomized venue and day). A list of nightlife venues were randomized and survey teams approached potential participants as they entered or exited venues to conduct brief anonymous surveys. Over the course of 24 months, 18,169 approaches were conducted and 10,678 consented to complete the brief questionnaire (V1 response rate = 46.0%, V2 response rate = 62.5%). Drug use was fairly common, with nearly two-thirds of the sample reporting having ever tried an illegal drug and more than half of drug users specifically tried either MDMA/ecstasy and/or cocaine. There were few differences between young adults surveyed during Version 1 and Version 2. Time-space sampling is an effective strategy to quickly detect and screen club drug users. Although caution is urged, elimination of the third tier of randomization (i.e., individual level counting) from time-space sampling may significantly improve response rates while only minimally impacting sample characteristics.
This exploratory investigation describes methamphetamine use among a convenience sample of gay and bisexual men in New York City. A total of 49 participants reported using methamphetamine, on average, 12 days over the past three months, and 63.1% of the participants reported use with the majority of their sexual encounters. Poly-substance use was high in this sample of methamphetamine users. Methamphetamine use was more frequent among those men who reported using the drug in bathhouses and bars, and frequency of use was associated with a need to escape unpleasant emotions and physical discomfort, avoid social conflict, and enjoy pleasant times with others. The data suggest a contextual understanding of methamphetamine use in New York City that is similar to that of gay communities of the western United States.
In: Child abuse & neglect: the international journal ; official journal of the International Society for the Prevention of Child Abuse and Neglect, Band 36, Heft 5, S. 413-422