In Ghana, prevalence of HIV among MSM is significantly higher than that of the general population. Substance use and transactional sex in the urban settings of Ghana have been identified as risk behaviors that exacerbate chances of transmission for this vulnerable group. This thesis draws upon the findings of two companion studies that were conducted in Kumasi, Ghana by Boston University researchers in 2012. The objectives of the studies were to gain a deeper understanding of the behaviors and attitudes regarding substance use and transactional sex among younger and older MSM in Kumasi, Ghana. In the first study 99 MSM between the ages of 15 to 29 years old participated, of whom 55 attended focus group discussions (FGDs) and 44 participated in in-depth interviews (IDIs). In the second study 44 participants aged 30 years or older participated including 20 in IDIs and 24 in FGDs. Condom use was found to be inconsistent across all ages and most commonly attributed to reduced caution while drinking alcohol. Transactional sex was high among both young and older MSM, but younger MSM were more likely to be on the ‘receiving’ end of the transaction with the older men providing money and gifts. For both groups the internet was identified as a key method to contact prospective sexual partners suggesting the need to include social media in future HIV prevention interventions.

In John 5:39-40 we see a dividing line being drawn over the proper interpretation of “the Scriptures” between the Jewish leaders of the first century and the early Christians of the Johannine community. Both parties agreed that “searching the Scriptures” was essential; however, the two groups disagreed about the nature with which one was to “search the Scriptures” and how one was to possess or lay hold of this eternal life. “The Jews” viewed eternal life as a birthright that was maintained by rigorous study of the law and strict observance of its principles. The study of the law became an end in itself. The Christians of the Johannine community, on the other hand, believed that eternal life was only granted as gift when a person comes to the one of whom the Scriptures testified, Jesus Christ. Eternal life was neither a birthright nor something that could be merited, but rather a gift given to those who truly “search the Scriptures” and truly see the one who they are written of. This disagreement between the Johannine community and the first century Jewish leadership is a reflection of the division between Jesus and the Jewish leaders during his day as well as a reflection of the division between Christians and Jews in our day. But perhaps more importantly, it is a reflection of the complacent attitude that pervades much of the church today. The words of this passage are a warning or wake-up call to us all. We must be careful not to presume that eternal life is ours because of any merit or association. We must be careful to search “the Scriptures” with our eyes wide open and without presuppositions that will hinder of from discerning its true meaning. But most importantly, we must look to the one of whom these “Scriptures” testify, Jesus Christ. If we truly want to live, as we assume all men do, then we must do what is necessary to inherit eternal life. We must heed the words of “the Scriptures” and we must heed Jesus’ words: we must come to Jesus who alone is the source of eternal life. This begins and ends with proper interpretation of the Word of God. / Dissertation (MA (New Testament Studies))--University of Pretoria, 2007. / New Testament Studies / MA / unrestricted

Background: Binge drinking (BD) is common in Peru, but may not be routinely detected by standard assessments of hazardous drinking. Objectives: We describe prevalence and risk behaviors of men who have sex with men (MSM) and transgender women (TW) in Peru who met criteria for BD as compared with those who met criteria for hazardous drinking. Methods: In a cross-sectional sample of MSM and TW from Lima (2012-2014), we calculated prevalence of BD (consuming ≥6 alcoholic drinks per occasion by AUDIT-3 criteria), conducted bivariate analyses of associations of BD with demographic and behavioral characteristics, and compared prevalence and behaviors of BD to those of hazardous drinkers (identified by AUDIT-10 criteria). Results: Of 1,520 MSM (n = 1,384) and TW (n = 137) with median age 27 years, 74.4% of MSM and 86.9% of TW met criteria for BD. Among MSM, BD was associated with a greater likelihood of using alcohol (41.6% vs. 13.8%; p <.01) or drugs (7.8% vs. 2.8%; p <.01) prior to a recent sexual contact. Among TW, BD was associated with greater frequency of alcohol use (44.9% vs. 11.1%; p <.01) or unprotected anal intercourse (58.8% vs. 33.3%; p =.04) during ≥1 of their three most recent sexual contacts. There was a higher prevalence of BD (75.5%) than hazardous drinking (53.2%) in our sample, with binge drinkers exhibiting similar sexual risk behaviors to hazardous drinkers. Conclusions: Binge drinking is common among MSM and TW in Lima, associated with risky sexual behavior, and may not be adequately captured by AUDIT-10 criteria. / Revisión por pares

To evaluate the association between general self-efficacy and depression/anxiety among newly HIV-diagnosed Chinese men who have sex with men (MSM) in Beijing, our study evaluated the baseline survey data of MSM taking part in a clinical trial among Chinese MSM in Beijing. The baseline survey of the trial was conducted between March 2013 and March 2014. General self-efficacy and depression/anxiety were measured using standard scales. Logistic regression and cumulative logistic regression were used to evaluate the associations between general self-efficacy and depression/anxiety. A total of 367 newly HIV-diagnosed Chinese MSM in Beijing were recruited. There were negative associations between general self-efficacy and depression/anxiety among the study population. As general self-efficacy increased by one unit, the odds of “likely” or “borderline” depression versus normal, or “likely” depression versus “borderline” depression or normal decreased by 12% [adjusted odds ratio (AOR): 0.88, 95% confidence interval (CI): 0.85–0.92] after adjusting for potential confounders. Similarly, general self-efficacy was negatively associated with anxiety (AOR: 0.89, 95% CI: 0.86–0.93). A higher level of general self-efficacy was associated with lower levels of depression and anxiety among newly HIV-diagnosed Chinese MSM. Interventions promoting overall health and wellness should address self-efficacy, depression and anxiety.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Pre-exposure prophylaxis (PrEP) has limited availability across Latin America, though access is increasing. We explored PrEP uptake in Mexico via an online survey completed by Spanish-speaking, Hornet geosocial networking application (GSN app) users without HIV (n = 2020). Most (81.3%) had heard of PrEP, 3.5% were current users, and 34.2% intended to take PrEP within six months. Current PrEP use was associated with PrEP eligibility (aOR 26.07 [95%CI 13.05–52.09], p < 0.001), recent STI testing (aOR 3.79 [95%CI 1.10–13.11], p = 0.035), and recent chemsex (aOR 3.02 [95%CI 1.02–8.93], p = 0.046). Recent STI testing was associated with hearing about PrEP from a doctor (aOR 3.26 [95%CI 1.98–5.36], p < 0.001), and those who lived in large cities were less likely to have learned about PrEP via Hornet (aOR 0.52 [95%CI 0.32–0.85], p = 0.009). Interventions to increase PrEP uptake in Mexico should build upon existing health networks and utilize GSN apps for PrEP information dissemination, particularly in less populated areas. / University of California / Revisión por pares

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Sexual communication with partners informs risk assessment and sexual practices. We evaluated participant, partner, and network factors associated with communication about condom use and HIV serostatus and explored their relationships with condomless anal intercourse (CAI) among 446 men who have sex with men (MSM) and 122 transgender women (TW) in Lima, Peru. Generalized estimating equations assessed contextual influences on communication and practices with recent sexual partners. More frequent HIV communication was reported by MSM who: identified as heterosexual, compared to bisexual or gay; characterized partnerships as stable, compared to casual, anonymous, or commercial; or discussed HIV/STIs with close social contacts (p < 0.05). TW in concurrent partnerships discussed condom use more frequently than those in monogamous relationships (p < 0.05). Condom use discussions and alcohol use among MSM were associated with CAI (p < 0.05). Findings highlight complexity in sexual decision-making and call for further study of conversation content and practices to inform HIV prevention messaging. / National Institutes of Health / Revisión por pares

No description available.

Men who have sex with men continue to be at highest risk of HIV infection, with Black and Latino men who have sex with men [BLMSM] disproportionately at risk. The impact of alcohol consumption on condomless anal intercourse [CAI] is compounded for BLMSM by unique risk factors like internalized homophobia and racial stigma, reinforcing barriers to treatment. The traditional formats of existing HIV interventions fail to address heightened confidentiality concerns of BLMSM and few target both CAI and alcohol use. Existing interventions may be modified with mobile health [mhealth] technologies to improve outcomes for BLMSM. The current study examined the feasibility and acceptability of a novel mhealth intervention to reduce heavy drinking episodes [HDE], reduce CAI, and increase intentions to use pre-exposure prophylaxis medication [PrEP]. METHODS: Enrollment criteria included (1) Black and/or Latino man, (2) at least one episode of CAI with another man in the past six months, (3) at least one HDE in the past month and (4) no current PrEP use. Twelve participants completed a brief videoconferencing session then four weeks of interactive mobile messages. Outcome assessment was completed 8-weeks post-baseline. To assess feasibility and acceptability (primary outcomes), message response rates, ratings of intervention satisfaction (Client Satisfaction Questionnaire-8, CSQ), and ratings from a 10-item acceptability measure were used. RESULTS: Message response rates (M= 96%, SD = 0.04, Mdn = 98%) indicated high engagement. Ratings at follow-up indicated high acceptability (item rating M = 1.77, SD = 0.73, Mdn = 1.45; scores range from 1-5, lower ratings indicate higher acceptability) and high satisfaction (CSQ M = 26.7, SD = 4.08, Mdn = 27.5; scores range from 8-32, higher scores indicate higher satisfaction). Descriptive statistics were used to characterize post-intervention outcomes. HDEs decreased by 45% from baseline while PrEP use intentions remained largely unchanged (decreased by 5%). Only three of twelve participants reported CAI at post-intervention. DISCUSSION: Results show high engagement, acceptability, and satisfaction with the mhealth modality and support the feasibility of this approach to address HDE among BLMSM. Future efficacy testing of this novel mhealth intervention via randomized controlled trial is warranted.

Sexual and gender politics inform relational expectations surrounding sexual experiences of Peruvian transgender women (TW) and men who have sex with men (MSM). We used the framework of sexual role strain, or incongruence between preferred sexual role and actual sexual practices, to explore potential conflicts between personally articulated identities and externally defined norms of gender and sexuality and its potential to increase HIV/STI risk. Cross-sectional individual- and dyad-level data from 766 TW and MSM in Lima, Peru were used to assess the partnership contexts within which insertive anal intercourse was practiced despite receptive role preference (receptive role strain), and receptive anal intercourse practiced despite insertive role preference (insertive role strain). Sexual role strain for TW was more common with non-primary partners, while for MSM it occurred more frequently in the context of a primary partnership. Receptive role strain was more prevalent for TW with unknown HIV status (reference: without HIV) or pre-sex drug use (reference: no pre-sex drug use). For homosexual MSM, receptive role strain was more prevalent during condomless anal intercourse (reference: condom-protected) and with receptive or versatile partners (reference: insertive). Among heterosexual or bisexual MSM, insertive role strain was more prevalent with insertive or versatile partners (reference: receptive), and less prevalent with casual partners (reference: primary). Our findings suggest TW and MSM experience different vulnerabilities during sexual role negotiation with different partner-types. Future studies should explore the impact of sexual role strain on condom use agency, HIV/STI risk, and discordances between public and private presentations of gender and sexual orientation. / National Institutes of Health / Revisión por pares

No description available.