Assessing the Determinants of Quality of Life and the Impact on HIV Prevention Measures among HIV-Negative and Status-Unknown Young Men Who Have Sex with Men: A Study in Two U.S. Metropolitan Areas.

Yu Liu,Chen Zhang,Savanah Russ,Sarahmona Przybyla,Jason Mitchell

doi:10.3390/ijerph19020726

Abstract

Young men who have sex with men (YMSM) in the United States (U.S.) are disproportionally burdened by HIV and experience adverse social determinants of health. Minimal research has examined quality of life (QoL) and psychosocial/behavioral determinants among HIV-negative or status-unknown YMSM. We conducted a study with YMSM from two U.S. cities to assess their QoL scores, and whether specific QoL domains (e.g., physical, psychological, social, and environment) were associated with their demographics, psychosocial determinants, behavioral risk factors, and HIV prevention measures. Black YMSM, YMSM of low socioeconomic status (below high school education, income < $20,000, and lack of health insurance), and YMSM who did not disclose their sexual orientation had the lowest QoL scores across all domains. Substance use and unprotected anal intercourse were negatively associated with men’s physical/psychosocial health. Housing/food instability and perceived stress were among the strongest predictors of lower QoL in all domains. Higher physical/psychological and environment QoL scores were associated with a higher likelihood of HIV testing and PrEP use. The identification of YMSM within these demographic, behavioral, and psychosocial sub-groups is important for targeted intervention to enhance their well-being and engagement with HIV prevention.

Highlights

Within the United States, 36,801 individuals were newly diagnosed with HIV in 2019, and over 1.1 million individuals are currently living with HIV [1]
The present analysis extends the literature on Quality of life (QoL) among Young men who have sex with men (YMSM) in the U.S by providing a snapshot about YMSM’s QoL and how the QoL domains were associated with a variety of modifiable psychosocial determinants of health
Our study identified the relationship between QoL domains and the impact they have on YMSM’s engagement in substance use, sexual risk behaviors, and HIV prevention

Summary

Introduction

Within the United States, 36,801 individuals were newly diagnosed with HIV in 2019, and over 1.1 million individuals are currently living with HIV [1]. The majority of HIV cases in the U.S are among those who (1) are living in the south; (2) self-identify as Black/African. American or Hispanic/Latinx; and (3) engage in male-to-male sexual contact [1]. Among men who have sex with men (MSM) who were newly diagnosed with HIV, young MSM (YMSM; ages 13 to 34) accounted for over 50% of all new diagnoses of HIV in 2019 [1]. Beyond the study of sexual risk behaviors associated with HIV acquisition and transmission (e.g., engagement in unprotected anal sex, intravenous drug use) is the need.

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