Gay Men Research Articles

Following western conceptions of masculinity: homohysteria and transgressive bodies in a masculine Turkish environment

ABSTRACT This article uses qualitative interview data derived from 18 Turkish gay males who exist within in a traditionally masculine space in order to examine for a social movement pattern based in relation to the Western context. In examining the entanglement of homophobia with cisgender masculine social hierarchies it suggests similarity between current Turkish culture and historical American culture: that the antecedent of homophobia facilitates an approximate social process of hierarchy-making that privileges heterosexuality and cisgender bodies while stigmatising femininity and queer bodies. Results also show limited signs of resistance, with a differing embodiment of hypertrophic bodies, and cautious optimism with aspirations of liberation through adopted western identity politics.

Sexual orientation concealment, hope, and depressive symptoms among gay and bisexual men: a moderated-moderation model

ABSTRACT The prevalence of depressive symptoms among gay and bisexual men is cause for concern. This study aimed to investigate whether hope and its two components (agency and pathways) moderated the relationship between sexual orientation concealment and depressive symptoms in gay and bisexual men and whether the moderating effects were conditional on sexual orientation. Participants were 197 gay men aged 18 to 71 years (M = 35.13 years, SD = 12.18 years) and 212 bisexual men aged 18 to 66 years (M = 29.24 years, SD = 10.46 years) who completed The Centre for Epidemiologic Studies Depression Scale, The Sexual Orientation Concealment Scale, and The Adult Hope Scale. Results did not support the moderating role of hope, agency, or pathways. The interaction between sexual orientation and pathways was significantly associated with depressive symptoms. Higher levels of pathways were associated with lower levels of depressive symptoms for both groups of men, however, the association was stronger for gay men compared with bisexual men. Higher levels of hope, agency, and pathways were associated with lower levels of depressive symptoms. Interventions aimed at increasing hope may be beneficial for reducing depressive symptoms among gay and bisexual men.

Sexual identity, poverty, and utilization of government services

Previous literature has established that lesbian, gay, and bisexual (LGB) people are at least as likely to be poor as heterosexual people, standing in contrast to myths of “gay affluence.” These findings have used datasets limited by either sample size or using partnership status to infer sexual orientation. Using U.S. data from the Household Pulse Survey, which allows us to identify large samples of individuals who self-identify as lesbian, gay, or bisexual, we find that bisexuals have lower incomes and are more likely to experience poverty, and bisexual individuals, gay men, and lesbian women are more likely to report financial hardship. Additionally, we find that LGB people utilize government assistance at higher rates than heterosexual people, even when allowing for selection into poverty status. We propose several explanations for these differentials, drawing on the program non-participation literature, and suggest that social network effects, lessened stigma, and increased reliance on public programs may explain these differences. Finally, we examine receipt of the enhanced child tax credit and find evidence that gay men and lesbian women with children were less likely to receive it than heterosexual men and women with children.

A Study on Perceptions of Undetectable = Untransmittable Among Gay Men with Human Immunodeficiency Virus in the HIV Community on Twitter in Japan: An Exploratory Qualitative Study Using a Modified Grounded Theory Approach.

This study explores the perceptions of the Undetectable = Untransmittable (U = U) campaign among gay men with HIV in Japan who are part of the HIV community on Twitter. We conducted detailed semistructured interviews with 12 participants using a modified grounded theory approach. The analysis resulted in 31 concepts, 5 subcategories, 9 categories, and 2 core categories. The relationship between categories and core categories was examined in conjunction with the transcriptions, yielding a comprehensive category map depicting the process of understanding U = U. The three main processes emerged: participants expressed "expectations for improvement," underwent stages of "understanding U = U," and encountered "dilemmas" in forming their opinions. There are two routes to "understanding U = U": Route 1 involved a frictionless understanding of U = U, and Route 2 involved difficulty in understanding the slogan. In both routes, participants experienced the dilemma of "but I still have HIV" and regarding its ease of use. These dilemmas and difficulties in understanding U = U affected their "expectations for improvement." Efforts to promote U = U in Japan must address challenges in public understanding and related dilemmas. This entails reformulating the U = U message in simpler terms, leveraging professional explanations, disseminating it to a broader audience, and incorporating ideas from individuals living with HIV to enhance the message.

Picturing the dance: intersections of gender, sexuality, and age in older women queer square dancers

A dearth of research has focused on the diverse experiences of aging sexual minority populations and, in particular, older sexual minority women. Studies that have disaggregated the population of lesbian, gay, bisexual, transgender, questioning, queer, intersex and two-spirit (LGBTQIS+) older adults reveal that due to minority stress and a lifetime of disadvantage. Lesbians experience higher rates of chronic health conditions and mental health problems (including loneliness) than heterosexual women and greater financial inequalities compared to gay men or heterosexual women. Despite this, limited inquiry has explored the everyday lives of older queer women and fewer still draws upon women’s commentary on their own lived experiences or centers older women as authoritative agents and experts on their own lives. In response to this knowledge deficit, this research traverses the aging experiences of female-identified members of a gay square dance (GSD) club in Toronto, Canada. We apply queer theory to explicate the unique ways in which a GSD club queers the aging process for 14 older women dancers. Findings of the inquiry highlight the ways in which these dancers confront and reject heteronormativity, while illuminating pathways to successful aging for older sexual diverse women. The older women dancers in this study perform gender in ways that challenged heteronormativity and gender binaries, enhanced belongingness and acceptance, embodied joy, and fostered wellness. These concepts have been identified as critical factors in successful aging and highlight what queering aging might look like for this resilient population who have overcome a lifetime of disadvantage.

Navigating patterns of oral PrEP use: A qualitative longitudinal study of gay, bisexual, and queer men's dynamic practices of pausing, on-demand, and stopping PrEP in Canada

The Canadian HIV pre-exposure prophylaxis (PrEP) guidelines recommend both daily and on-demand dosing for gay, bisexual, and queer men (GBQM), meeting additional risk criteria. However, limited research explored how GBQM implement pausing, on-demand, discontinuation, and resumption of PrEP, including the contextual factors affecting decision-making. Using a relationally situated implementation science framework, we examined how GBQM tailor PrEP use to changing social and sexual circumstances. We conducted 109 longitudinal interviews with current and former PrEP users from Ontario (n = 18) and British Columbia (n = 20), Canada, at three time points between 2020 and 2022. We identified three dynamic PrEP use trajectories: pausing, on-demand, and stopping. Pausing involved brief breaks followed by a return to daily use during heightened sexual activity. Others followed the 2-1-1 on-demand schedule, while some stopped PrEP with plans to resume if social and sexual circumstances change. During the COVID-19 pandemic, participants paused PrEP when sexual activities decreased, restarting daily use when sexual engagements resumed. Others paused due to relationship changes or sexual inactivity, resuming PrEP in anticipation of sex. On-demand PrEP was adopted to manage side effects or save costs. Some stopped PrEP for sustained periods due to monogamy, private insurance loss, side effects, or low perceived HIV risk. Participants expressed concerns regarding lack of information on these strategies, relying on online sources or peers for guidance. Most participants obtained enough PrEP knowledge to adapt use appropriately. Comprehensive education campaigns on adaptable PrEP use effectiveness and strategies to discontinue and resume PrEP for clinicians and GBQM should be implemented.

Developing an mHealth program to improve HIV care continuum outcomes among young Black gay and bisexual men

BackgroundYoung Black gay and bisexual men (YBGBM) in the United States face significant disparities in HIV care outcomes. Mobile health (mHealth) interventions have shown promise with improving outcomes for YBGBM across the HIV care continuum.MethodsWe developed an mHealth application using human-centered design (HCD) from 2019–2021 in collaboration with YBGBM living with HIV and with HIV service providers. Our HCD process began with six focus groups with 50 YBGBM and interviews with 12 providers. These insights were used to inform rapid prototyping, which involved iterative testing and refining of program features and content, with 31 YBGBM and 12 providers. We then collected user feedback via an online survey with 200 YBGBM nationwide and usability testing of a functional prototype with 21 YBGBM.ResultsFocus groups and interviews illuminated challenges faced by YBGBM living with HIV, including coping with an HIV diagnosis, stigma, need for social support, and a dearth of suitable information sources. YBGBM desired a holistic approach that could meet the needs of those newly diagnosed as well as those who have been living with HIV for many years. Program preferences included video-based content where users could learn from peers and experts, a range of topics, a community of people living with HIV, and tools to support their health and well-being. Providers expressed enthusiasm for an mHealth program to improve HIV care outcomes and help them serve clients. Rapid prototyping resulted in a list of content topics, resources, video characteristics, community features, and mHealth tools to support adherence, retention, goal setting, and laboratory results tracking, as well as tools to help organization staff to support clients. Online survey and usability testing confirmed the feasibility, acceptability, and usability of the content, tools, and features.ConclusionsThis study demonstrates the potential of a video-based mHealth program to address the unique needs of YBGBM living with HIV, offering support and comprehensive information through a user-friendly interface and videos of peers living with HIV and of experts. The HCD approach allowed for continuous improvements to the concept to maximize cultural appropriateness, utility, and potential effectiveness for both YBGBM and HIV service organizations.

An mHealth Intervention for Gay and Bisexual Men's Mental, Behavioral, and Sexual Health in a High-Stigma, Low-Resource Context (Project Comunică): Protocol for a Randomized Controlled Trial.

The World Health Organization reported that 80% of new HIV diagnoses in Europe in 2014 occurred in Central and Eastern Europe. Romania has a particularly high HIV incidence, AIDS prevalence, and number of related deaths. HIV incidence in Romania is largely attributed to sexual contact among gay and bisexual men. However, homophobic stigma in Romania serves as a risk factor for HIV infection for gay and bisexual men. The Comunică intervention aims to provide a much-needed HIV risk reduction strategy, and it entails the delivery of motivational interviewing and cognitive behavioral therapy skills across 8 live text-based counseling sessions on a mobile platform to gay and bisexual men at risk of HIV. The intervention is based on the information-motivation-behavior and minority stress models. There is preliminary evidence suggesting that Comunică holds promise for reducing gay and bisexual men's co-occurring sexual (eg, HIV transmission risk behavior), behavioral (eg, heavy alcohol use), and mental (eg, depression) health risks in Romania. This paper describes the protocol for a randomized controlled trial designed to test the efficacy of Comunică in a national trial. To test Comunică's efficacy, 305 gay and bisexual men were randomized to receive Comunică or a content-matched education attention control condition. The control condition consisted of 8 time-matched educational modules that present information regarding gay and bisexual men's identity development, information about HIV transmission and prevention, the importance of HIV and sexually transmitted infection testing and treatment, heavy alcohol use and its associations with HIV transmission risk behavior, sexual health communication, finding social support, and creating sexual health goals. Participants undergo rapid HIV and syphilis testing and 3-site chlamydia and gonorrhea testing at baseline and the 12-month follow-up. Outcomes are measured before the intervention (baseline) and at the 4-, 8-, and 12-month follow-ups. The study was funded in September 2018, and data collection began in May 2019. The last participant follow-up was in January 2024. Currently, the data analyst is cleaning data sets in preparation for data analyses, which are scheduled to begin in April 2024. Data analysis meetings are scheduled regularly to establish timelines and examine the results as analyses are gradually being conducted. Upon completion, a list of manuscripts will be reviewed and prioritized, and the team will begin preparing them for publication. This study is the first to test the efficacy of an intervention with the potential to simultaneously support the sexual, behavioral, and mental health of gay and bisexual men in Central and Eastern Europe using motivational interviewing support and sensitivity to the high-stigma context of the region. If efficacious, Comunică presents a scalable platform to provide support to gay and bisexual men living in Romania and similar high-stigma, low-resource countries. ClinicalTrials.gov NCT03912753; https://clinicaltrials.gov/study/NCT03912753. DERR1-10.2196/52853.

Factors Associated With Recent Decline in Anal Health Among Older Gay and Bisexual Men: A Cross-sectional Analysis.

We investigated factors associated with "worse than usual" anal health among gay and bisexual men aged ≥35 years recruited to a longitudinal study of anal human papillomavirus infection/lesions from September 2010 to August 2015.Among 616 participants (median age 49 years; 36% HIV-positive), 42 (6.8%) reported worse than usual anal health in the last 4 weeks. Associated factors included spending less time with gay friends (odds ratio [OR] = 2.25, 95% CI = 1.06-4.77), most time "feeling down"(OR = 9.17, 95% CI = 2.94-28.59), reduced libido (OR = 2.90, 95% CI = 1.52-5.52), current anal symptoms (OR = 6.55, 95% CI = 2.54-16.90), recent anal wart diagnosis (OR = 4.33, 95% CI = 1.98-9.49), and fear of developing anal cancer (OR = 9.34, 95% CI = 4.52-19.28).Concerns regarding anal health should be routinely discussed by clinicians, and potentially associated psychosocial, physical, and sexual issues further explored.

Homosexual identity and network overlap predictors of HIV infection among older men from rural China: a case–control study

BackgroundThe number of newly reported older (≥50 years old) people living with HIV/AIDS in China has been steadily increasing, and heterosexual transmission has been identified as the major route.MethodsIn this...

Exploring debates over “boys love” media in the Philippines: from misogynistic backlash to queer emancipation

ABSTRACT As a genre originally emerging from Japanese women’s popular culture and developing into a transnational phenomenon, debates over “Boys Love” (BL) media have increased in recent years. Within this article, we explore debates over BL through a case study of its reception in the Philippines, situating our analysis within the broader context of the Philippines’ heteropatriarchal culture. Drawing upon critical discourse analysis of traditional and new media discussions responding to the rise of BL fandom in the Philippines and qualitative interviews with 31 LGBTQ+ fans of BL, we reveal tensions between those who view BL positively and negatively. Through a feminist and reparative queer reading of our data, we contrast cisgender gay men’s dismissal of the genre as always already problematic due to its emergence from women’s culture with LGBTQ+ Philippine fans’ positioning of BL as an emancipatory media genre that combats homophobia. Ultimately, we argue that attempts by certain critics in the Philippines to downplay the queer emancipatory potentials of BL emerges from a misogynistic rejection of the contributions of women to Philippine queer culture. We conclude by calling for a more nuanced appreciation of BL’s queer interventions which recognises the genre’s deconstructive force.

Beyond barks and bodies: Pup play and body image in gay, bi, trans, and queer men through a Deleuzian lens

Body image is a complex issue that affects individuals from all genders and sexual orientations. Within the queer community pup play is a BDSM-related activity where participants take on the role of a pup/dog, complete with barking, crawling, and other canine behaviors. In this research, we explored how identifying as a pup shapes the body image of gay, bisexual, queer, and trans (GBQT) men using a Deleuzian approach. The process of cellphilming included attendance of three online workshops and the creation of a short cellphilm about their body image. Seventeen participants across five groups completed the workshops and submitted a cellphilm. Data was analyzed through discourse analysis, and while our analysis includes workshop quotes and film excerpts, the true depth of the films, capturing elements like lighting and sound, goes beyond the transcribed words. Three overarching discursive considerations are reported: (i) reinforcing body standards for GBTQ men, (ii) capacity for changing feelings about bodies, and (iii) becoming a pup. Participants suggested that although the pup community is more accepting of diverse bodies, hegemonic body standards for GBTQ men still apply. However, participants also described how identifying as a pup and connecting with others in the pup community was a way to navigate body image tensions.

Morphosyntactic stereotypes of speakers with different genders and sexual orientations: an experimental investigation

Abstract Previous research has identified differences in language use between speakers representing different genders and sexual orientations, as well as stereotypical beliefs about the existence of such differences. The present paper investigates such stereotypical beliefs among speakers of two varieties of Spanish and explores whether linguistic stereotypes of gender and sexual orientation are stronger in a society with more conservative gender roles. We conducted an experiment where 252 speakers of European and Mexican Spanish were shown pairs of texts and sentences depicting the same event but differing in the use of morphosyntactic resources, creating stereotypically “masculine” and “feminine” variants of the same text or sentence. The informants were asked which of the variants was more likely uttered by a woman (rather than a man), a lesbian woman (rather than a straight woman), or a gay man (rather than a straight man). Some of the morphosyntactic features were strongly associated with speaker gender (e.g., use of first- and second-person singular) and others with lesbian (e.g., use of impersonal structures) or gay speakers (e.g., direct reported speech). Contrary to expectations, the responses did not differ according to informants’ age, gender, or nationality. While the present study did not reveal any differences between the two societies, more cross-linguistic and cultural research is needed to elucidate the effect of society on morphosyntactic variation and stereotypes thereof.

Effectiveness of an eHealth intervention for reducing psychological distress and increasing COVID-19 knowledge and protective behaviors among racialized sexual and gender minority adults: A quasi-experimental study (#SafeHandsSafeHearts).

Sexual and gender minority and racialized populations experienced heightened vulnerability during the Covid-19 pandemic. Marginalization due to structural homophobia, transphobia and racism, and resulting adverse social determinants of health that contribute to health disparities among these populations, were exacerbated by the Covid-19 pandemic and public health measures to control it. We developed and tested a tailored online intervention (#SafeHandsSafeHearts) to support racialized lesbian, gay, bisexual, transgender, queer, and other persons outside of heteronormative and cisgender identities (LGBTQ+) in Toronto, Canada during the pandemic. We used a quasi-experimental pre-test post-test design to evaluate the effectiveness of a 3-session, peer-delivered eHealth intervention in reducing psychological distress and increasing Covid-19 knowledge and protective behaviors. Individuals ≥18-years-old, resident in Toronto, and self-identified as sexual or gender minority were recruited online. Depressive and anxiety symptoms, and Covid-19 knowledge and protective behaviors were assessed at baseline, 2-weeks postintervention, and 2-months follow-up. We used generalized estimating equations and zero-truncated Poisson models to evaluate the effectiveness of the intervention on the four primary outcomes. From March to November 2021, 202 participants (median age, 27 years [Interquartile range: 23-32]) were enrolled in #SafeHandsSafeHearts. Over half (54.5%, n = 110) identified as cisgender lesbian or bisexual women or women who have sex with women, 26.2% (n = 53) cisgender gay or bisexual men or men who have sex with men, and 19.3% (n = 39) transgender or nonbinary individuals. The majority (75.7%, n = 143) were Black and other racialized individuals. The intervention led to statistically significant reductions in the prevalence of clinically significant depressive (25.4% reduction, p < .01) and anxiety symptoms (16.6% reduction, p < .05), and increases in Covid-19 protective behaviors (4.9% increase, p < .05), from baseline to postintervention. We demonstrated the effectiveness of a brief, peer-delivered eHealth intervention for racialized LGBTQ+ communities in reducing psychological distress and increasing protective behaviors amid the Covid-19 pandemic. Implementation through community-based organizations by trained peer counselors supports feasibility, acceptability, and the importance of engaging racialized LGBTQ+ communities in pandemic response preparedness. This trial is registered with ClinicalTrials.gov, number NCT04870723.

HIV self-testing knowledge, attitudes, and practices among Asian-born gay, bisexual, and other men who have sex with men in Australia: a qualitative study

BackgroundAchieving virtual elimination of HIV transmission in Australia requires a combination of high treatment rates and high testing coverage among individuals at risk of acquiring HIV. HIV self-testing (HIVST) is an additional testing approach for key populations.ObjectiveWe aimed to examine the knowledge, attitudes, and practices of HIVST among Asian-born gay, bisexual and other men who have sex with men (GBMSM).MethodsThis qualitative study used semi-structured interviews of overseas-born GBMSM of Asian background in Australia. Participants were recruited from personal networks, social media platforms, snowballing, and the Melbourne Sexual Health Centre. Twenty-five participants were purposively sampled with a range of ages and previous levels of experience with HIVST. Interview transcripts were imported into Nvivo 12 for data management.ResultsThe age of the participants ranged from 19 to 44 years, with a median of 30 years. Most were unaware of HIVST before the interview, and only a few had ever used one. All had limited sexual health knowledge (i.e., HIV testing, PrEP) before they arrived in Australia. Upon learning about HIVST during the interview, many expressed willingness to use HIVST, but in limited circumstances, such as traveling overseas, interim testing while taking on-demand PrEP, and point-of-sex testing. Almost all were open to distributing HIVST to their casual partners or friends, especially those they knew who engaged in high-risk sexual practice (i.e., condomless anal sex) and were not engaged in sexual healthcare. About half still preferred conventional serology testing because of regular HIV testing as part of PrEP prescription and the need for testing for other sexually transmitted infections.ConclusionHIVST may be an acceptable additional testing approach for HIV testing among Asian-born GBMSM. Peer education and secondary distribution may help raise HIVST awareness and use.

Queer dancers’ experiences in the dancesport world: exclusion, invisibilisation and assimilation

PurposeThis paper intervenes in the consequences of a myth propagated in academic discourse about the dancesport world, according to which half of the men in Latin dancesport are gay. I challenge two assumptions that surround this myth: that cisgender gay men do not contribute to the reification of the heteronormative gender binary, and that the dancesport scene is inclusive of gay people. These assumptions are based on a blatant lack of understanding of the position of gay men within the dancesport world – that is, the ways in which subjects are constituted through the effects of power.Design/methodology/approachThis work is based on empirical research I conducted in the dancesport community, including ethnographic and autoethnographic fieldwork, extant documents (e.g. books, blogs, Judging Regulations) and interviews with experts and participants of the dancesport scene (2021/2022). To analyse the data, I relied on the principles of dispositive analysis, grounded theory and dance analysis.FindingsI show that gay dancers have turned to assimilation as their only available strategy. I discuss the negative consequences of assimilation as a political strategy and how it impacted queer dancers – between invisibilisation, residual shame and a failure to challenge the heteronormative gender binary. This led gay dancers to rationalise and perpetrate harm based on the systems of oppression they had internalised.Social implicationsI conclude the paper by highlighting a way beyond assimilation for queer dancers.Originality/valueThis paper addresses a critical gap in research on LGBT + inclusion in dancesport.

Discriminatory experiences among gay, bisexual, and other men who have sex with men, and transgender and non-binary individuals: a cross sectional analysis

Several systems of oppression combine in complex ways to impact the lives of minority populations. Following an intersectionality framework, we assessed the frequency and perceived reasons for discrimination among gay, bisexual, and other cisgender men who have sex with men (MSM) and transgender and non-binary individuals (TGNB), stratified by race. Online survey among MSM and TGNB ≥18 years living in Brazil, between November/2021 and January/2022. We used the 18-item Explicit Discrimination Scale to assess day-to-day experiences of differential treatment, and perceived discrimination. For each item, participants indicated their perceived reasons for differential treatment using 14 pre-defined options. Negative binomial regression models assessed if race was a significant predictor of discrimination. Subsequent models, stratified by race, examined associations of perceived reasons and number of reasons with perceived discrimination. Of 8464 MSM and TGNB, 4961 (58.6%) were White, 2173 (25.7%) Pardo (Brazil's official term for admixed populations), and 1024 (12.1%) Black. Black participants' scores for perceived discrimination (mean, standard deviation) were higher (10.2, 8.8) [Pardo (6.5, 6.8), White (5.2, 5.7)], and race was both the main reason for and the strongest predictor of perceived discrimination. The number of reasons participants used to interpret their discriminatory experiences was also a predictor of discrimination score among White, Pardo, and Black participants. LGBTQIA+phobia was highly prevalent among all participants. Additionally, our results indicated that Black MSM and TGNB participants were more frequently discriminated against than other racial groups, with racial discrimination uniquely contributing these experiences. Fundação Oswaldo Cruz, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro.

Exploring Anabolic Androgenic Steroid Use Among Cisgender Gay, Bisexual, and Queer Men.

Anabolic androgenic steroids (AAS) are disproportionately used by sexual minority men, with the physical and mental health implications of AAS use incompletely understood. To understand the reasons for use and health care needs of gay, bisexual, and queer cisgender men using AAS. This qualitative study was conducted from November 2021 to May 2023 using self-administered questionnaires and semistructured interviews that were transcribed and coded using reflexive thematic analysis. Participants were recruited through convenience and snowball sampling from lesbian, gay, bisexual, transgender, and queer clinical centers in New York, New York, as well as through online platforms. All patients self-identified as cisgender and gay, bisexual, or queer. History of nonprescribed AAS use for a minimum of 8 consecutive weeks was required. The primary outcomes were reasons for and health implications of AAS use and interactions with health care practitioners, as determined through interviews. Interview transcripts were collected and analyzed. Thematic saturation was reached after interviews with 12 male participants (mean [SD] age, 44 [11] years), with the majority of participants identifying as gay (10 participants [83%]), White non-Hispanic (9 participants [75%]), being in their 30s and 40s (9 participants [75%]), holding a bachelor's degree or higher (11 participants [92%]), and having used steroids for a mean (SD) of 7.5 (7.1) years. One participant (8%) self-identified as Black, and 2 (17%) identified as Hispanic. Seven men (58%) met the criteria for muscle dysmorphia on screening. Nine overarching themes were found, including internal and external motivators for initial use, continued use because of effectiveness or fear of losses, intensive personal research, physical and emotional harms experienced from use, using community-based harm reduction techniques, frustration with interactions with the medical community focused on AAS cessation, and concerns around the illegality of AAS. In this qualitative study, AAS use among cisgender gay, bisexual, and queer men was found to be associated with multifactorial motivators, including a likely AAS use disorder and muscle dysmorphia. Despite all participants experiencing harms from use, men seeking medical help found insufficient support with practitioners insistent on AAS cessation and, thus, developed their own harm reduction techniques. Further research is needed to assess the utility of practitioner education efforts, the safety and efficacy of community-developed harm reduction methods, and the impact of AAS decriminalization on health care outcomes for this patient population.

Mpox Diagnosis, Behavioral Risk Modification, and Vaccination Uptake among Gay, Bisexual, and Other Men Who Have Sex with Men, United Kingdom, 2022.

During the 2022 multicountry mpox outbreak, the United Kingdom identified cases beginning in May. UK cases increased in June, peaked in July, then rapidly declined after September 2022. Public health responses included community-supported messaging and targeted mpox vaccination among eligible gay, bisexual, and other men who have sex with men (GBMSM). Using data from an online survey of GBMSM during November-December 2022, we examined self-reported mpox diagnoses, behavioral risk modification, and mpox vaccination offer and uptake. Among 1,333 participants, only 35 (2.6%) ever tested mpox-positive, but 707 (53%) reported behavior modification to avoid mpox. Among vaccine-eligible GBMSM, uptake was 69% (95% CI 65%-72%; 601/875) and was 92% (95% CI 89%-94%; 601/655) among those offered vaccine. GBMSM self-identifying as bisexual, reporting lower educational qualifications, or identifying as unemployed were less likely to be vaccinated. Equitable offer and provision of mpox vaccine are needed to minimize the risk for future outbreaks and mpox-related health inequalities.

Patterns and Factors Associated With Alcohol Misuse Among Young Black Men Who Have Sex With Men in New York City.

Alcohol misuse is a significant health concern among gay, bisexual, same-gender-loving, and other men who have sex with men (MSM). Yet, little is known about the severity and predictors of alcohol misuse among self-reported young Black MSM. This study aimed to identify patterns of and factors associated with alcohol misuse in a sample of young Black MSM living in New York City. Baseline data from a randomized controlled trial aimed at improving the uptake of HIV testing among 250 MSM aged 18 to 29 were analyzed. Log-binominal regression analyses were conducted to assess the association of demographic and psychosocial factors with alcohol misuse in the past year and past 3 months among young Black MSM. Overall, 33.2% and 28.0% of young Black MSM in the study experienced alcohol misuse in the past year and past 3 months, respectively. In the adjusted model, factors positively associated with past-year alcohol misuse included marijuana use, a history of drug use, and having one-two or more than two male sex partners. Likewise, participants who used marijuana and those with one-two or more than two male partners were more likely to report past 3-month alcohol misuse. No significant association was found between positive screening for depressive symptoms, chemsex, internalized homophobia, and the likelihood of having alcohol misuse. The high prevalence of alcohol misuse underscores the importance of raising awareness of alcohol misuse and designing alcohol risk reduction programs that jointly address HIV risk among young Black MSM.