Community Sample Of Gay Men Research Articles

HIV Prevalence and Undiagnosed Infection among a Community Sample of Gay and Bisexual Men in Scotland, 2005–2011: Implications for HIV Testing Policy and Prevention

ObjectiveTo examine HIV prevalence, HIV testing behaviour, undiagnosed infection and risk factors for HIV positivity among a community sample of gay men in Scotland.MethodsCross-sectional survey of gay and bisexual men attending commercial gay venues in Glasgow and Edinburgh, Scotland with voluntary anonymous HIV testing of oral fluid samples in 2011. A response rate of 65.2% was achieved (1515 participants).ResultsHIV prevalence (4.8%, 95% confidence interval, CI 3.8% to 6.2%) remained stable compared to previous survey years (2005 and 2008) and the proportion of undiagnosed infection among HIV-positive men (25.4%) remained similar to that recorded in 2008. Half of the participants who provided an oral fluid sample stated that they had had an HIV test in the previous 12 months; this proportion is significantly higher when compared to previous study years (50.7% versus 33.8% in 2005, p<0.001). Older age (>25 years) was associated with HIV positivity (1.8% in those <25 versus 6.4% in older ages group) as was a sexually transmitted infection (STI) diagnosis within the previous 12 months (adjusted odds ratio 2.13, 95% CI 1.09–4.14). There was no significant association between age and having an STI or age and any of the sexual behaviours recorded.ConclusionHIV transmission continues to occur among gay and bisexual men in Scotland. Despite evidence of recent testing within the previous six months, suggesting a willingness to test, the current opt-out policy may have reached its limit with regards to maximising HIV test uptake. Novel strategies are required to improve regular testing opportunities and more frequent testing as there are implications for the use of other biomedical HIV interventions.

Mental health literacy and the experience of depression in a community sample of gay men

BackgroundGay men are at higher risk of suffering from a variety of psychiatric disorders, yet the mental health literacy of this population has remained largely unknown. MethodsIn 2007 and 2011, surveys were conducted among gay men in Geneva, Switzerland, recruited by probability-based time-space sampling. Based on a case vignette of a man with major depression, respondents were asked a series of questions about labelling, perceived risk, and help-seeking beliefs. Men meeting caseness for major depression were asked open questions about perceived causes and additional help-seeking/self-help. ResultsAmong the 762 respondents, 14.7% met diagnostic criteria for major depression (MDD) in the past 12 months. The vignette was labelled depression by 44.1% of the entire sample, and 61.9% of the men with MDD. Discrimination (33.2%), acceptance or rejection by others (21.4%), and loneliness (24.9%) were the most common reasons given for greater susceptibility among gay men, yet men with MDD reported problems with love/relationship (32.5%) and work (28.9%) as the most common perceived causes of recent depression, and problems with love/relationship (21.9%), accepting one's homosexuality (21.1%), and family (20.2%) at initial outset. The highest proportions of gay men rated non-medical options such as a close friend (91.6%), relaxation exercises or meditation (84.4%), and physical activity (83.5%) as being helpful for the depression vignette. LimitationsNo probes used for open questions, and findings generalizable only to gay men in the sampling scheme. ConclusionsThere are many commonalities in labelling, perceived causes, and help-seeking with general populations, but also numerous specificities in mental health literacy and experience among gay men.

Actual and undiagnosed HIV prevalence in a community sample of men who have sex with men in Auckland, New Zealand

BackgroundThe prevalence of HIV infection and how this varies between subgroups is a fundamental indicator of epidemic control. While there has been a rise in the number of HIV diagnoses among men who have sex with men (MSM) in New Zealand over the last decade, the actual prevalence of HIV and the proportion undiagnosed is not known. We measured these outcomes in a community sample of MSM in Auckland, New Zealand.MethodsThe study was embedded in an established behavioural surveillance programme. MSM attending a gay community fair day, gay bars and sex-on-site venues during 1 week in February 2011 who agreed to complete a questionnaire were invited to provide an anonymous oral fluid specimen for analysis of HIV antibodies. From the 1304 eligible respondents (acceptance rate 48.5%), 1049 provided a matched specimen (provision rate 80.4%).ResultsHIV prevalence was 6.5% (95% CI: 5.1-8.1). After adjusting for age, ethnicity and recruitment site, HIV positivity was significantly elevated among respondents who were aged 30-44 or 45 and over, were resident outside New Zealand, had 6-20 or more than 20 recent sexual partners, had engaged in unprotected anal intercourse with a casual partner, had had sex with a man met online, or had injected drugs in the 6 months prior to survey. One fifth (20.9%) of HIV infected men were undiagnosed; 1.3% of the total sample. Although HIV prevalence did not differ by ethnicity, HIV infected non-European respondents were more likely to be undiagnosed. Most of the small number of undiagnosed respondents had tested for HIV previously, and the majority believed themselves to be either "definitely" or "probably" uninfected. There was evidence of continuing risk practices among some of those with known HIV infection.ConclusionsThis is the first estimate of actual and undiagnosed HIV infection among a community sample of gay men in New Zealand. While relatively low compared to other countries with mature epidemics, HIV prevalence was elevated in subgroups of MSM based on behaviour, and diagnosis rates varied by ethnicity. Prevention should focus on raising condom use and earlier diagnosis among those most at risk, and encouraging safe behaviour after diagnosis.

High Rates of Undiagnosed HIV Infections in a Community Sample of Gay Men in Melbourne, Australia

Undiagnosed HIV infections contribute disproportionately to the HIV epidemic. We recruited 639 gay men attending social venues, who completed a cross-sectional survey with oral fluid collection for HIV testing in 2008. We calculated HIV and undiagnosed HIV prevalence and used χ(2) tests and logistic regression to examine associations between participant characteristics and HIV status. Among 639 men, 61 (9.5%, 95% confidence interval: 7.4% to 12.1%) tested HIV positive, of which 19 (31.1%, 95%confidence interval: 19.9% to 44.3%) were classified as undiagnosed HIV positive. Almost a third of HIV-positive men were unaware of their HIV status, and of these men, a large proportion engaged in high-risk behaviors.

Sexual Identity Development and Self-Esteem as Predictors of Body Image in a Racially Diverse Sample of Gay Men

The current study examined the relationship between sexual identity development and body image, as well as the potential mediating effect of self-esteem, in a community sample of gay men. A diverse group of participants (N = 172), recruited through listservs and flyers, completed an online survey. Regression analyses were conducted to assess the relationships between identity development and self-esteem, identity development and body image, self-esteem and body image, and the mediating role of self-esteem. As predicted, significant relationships were identified between each pair of variables, and self-esteem was found to be a mediator when the sample was considered as a whole. When participants of color were compared to those who were White, however, between-group differences emerged; identity stage did not predict self-esteem or body image for participants of color, nor did the mediated relationship exist. Self-esteem did predict body image in both groups. The sociocultural context of these findings is considered.

HIV Prevalence and Undiagnosed Infection Among a Community Sample of Gay Men in Scotland

To examine HIV prevalence among men in gay bars in Glasgow and Edinburgh, Scotland. Self-complete questionnaires and Orasure oral fluid collection kits (OraSure Technologies, Inc., Bethlehem, PA), to collect samples to be tested anonymously for HIV antibodies, were distributed. A total of 1744 men completed questionnaires (66.1% response rate), and 1350 provided samples (51.6% response rate). HIV prevalence was 4.4% (95% confidence interval: 3.5% to 5.7%). Positivity was associated with older age (mean of 36 years for positive men vs. 32 years for negative men), having 10 or more anal intercourse (AI) partners (12.8% positive vs. 3.4% of men with <10 AI partners, P < 0.05), and self-reported sexually transmitted infections (STIs) in the previous year (12.3% positive vs. 3.5% of men without STIs in the previous year; P < 0.05). Of the HIV-positive men, 41.7% were undiagnosed. More than half had had a negative HIV test result and perceived themselves to be HIV-negative. Men who had not used a genitourinary medicine clinic or had an STI in the previous year were more likely to be undiagnosed (65.0% and 52.5%, respectively). This is the first study to assess HIV prevalence among a community sample of gay men in Scotland. There is an urgent need for HIV prevention efforts to address the high level of undiagnosed infection and incorrect assumptions of status.

High prevalence of mental disorders and comorbidity in the Geneva Gay Men’s Health Study

Several large surveys have suggested high prevalence of psychiatric disorders among gay men and other men who have sex with men. In 2002, a comprehensive health survey was conducted among 571 gay men in Geneva, Switzerland, using probability-based time-space sampling. The Composite International Diagnostic Interview Short-Form (CIDI-SF) was used to assess 12-month prevalence of major depression, specific phobia, social phobia, alcohol dependence, and drug dependence. Nearly half (43.7%, 95% CI=39.0-48.4) of the sample fulfilled the criteria for at least one of the five DSM-IV disorders: 19.2% had major depression, 21.9% had specific and/or social phobia, and 16.7% had an alcohol and/or drug dependence disorder in the past 12 months. Over one quarter of the cases were comorbid with another kind of disorder, and 35.7% of cases consulted a health care professional in the past 12 months for mental health. Like cases, screen-positives for mood and/or anxiety disorders (24.7%) also reported significantly greater disability and lower quality of life. Nearly two-thirds of this community sample of gay men was affected by psychiatric morbidity with new evidence for comorbidity, subthreshold disorders, and low levels of awareness of psychiatric disorders and their treatment. This population needs to be a priority in psychiatric epidemiology and mental public health.

Health status, behavior, and care utilization in the Geneva Gay Men's Health Survey

Background. Recent reviews and studies suggest distinctive health needs among gay men. Methods. Swiss residents in the Geneva Gay Men's Health Survey (GGMHS, n = 477) were matched with controls from the Swiss Health Survey (SHS, n = 477) along sex, age, nationality, and region of residence and compared along standard indicators of health status, health behaviors, and health care utilization. Both health surveys were conducted in 2002 using probability sampling—i.e., time-space sampling (GGMHS) and household probability telephone sampling (SHS). Results. Although gay men were significantly less likely to be overweight (adjusted odds ratio (AOR) = 0.54), they reported significantly more and severe physical symptoms (AOR ranged from 1.72 to 9.21), short-term disability (AOR = 2.56), risk factors for chronic disease—i.e., high cholesterol, high blood pressure, high glucose, and smoking (AOR ranged from 1.67 to 3.89), and greater health services utilization (AOR ranged from 1.62 to 4.28), even after adjustment for differences in socio-demographic characteristics and health behaviors. Conclusions. Evidence of greater morbidity among a community sample of gay men along standard health indicators underlines the relevance of sexual orientation as a socio-demographic indicator in public health in general and in the health inequalities discourse in particular.

Integration of one's religion and homosexuality: a weapon against internalized homophobia?

Internalized homophobia as a psychological phenomenon has attracted little systematic research despite its destructive impact on the mental health of the gay community. This study looks at the relationship between internalized homophobia and the process of integrating one's religious faith and homosexuality by comparing levels of internalized homophobia among male participants of Dignity, an organization of Catholic gay men and lesbians, with a community sample of gay men with Catholic backgrounds. While many gay men believe they must abandon their religious faith (nearly 50% of this community sample no longer endorse a "formal religion") in order to accept their sexuality, Dignity members are actively integrating their religion and homosexuality--a process which we hypothesized would result in the Dignity participants being less homophobic than the community sample. While results showed no significant differences between the groups with regard to level of internalized homophobia, there are suggestions that involvement in Dignity does foster positive attitudes towards one's homosexuality by helping to overcome a delay in the development of a gay orientation. We also examined how other variables such as HIV status, psychological distress, conservative versus liberal ideology, and integration into the gay community would be associated with internalized homophobia.

Developing a Community Sample of Gay Men for an Epidemiologic Study of AIDS

Developing a Community Sample of Gay Men for an Epidemiologic Study of AIDS