One of the happy consequences of HAART is that HIV-positive (HIV+) individuals now have available to them medications that allow them to reach old age. This means that we have the previously unexpected challenge of finding ways to support healthy aging in communities with high HIV prevalence rates. This challenge is likely to be particularly difficult among men who have sex with men (MSM) due to not only their very high background HIV prevalence rates but also the general dearth of proven models to promote healthy aging among older MSM. To meet this challenge, we need to develop health promotion programs that are more potent than the efficacious but time-limited effects found among HIV prevention interventions. Thus, we need to identify mechanisms to raise levels of intervention efficacy to support healthy aging beyond those that have already been tapped to support other health promotion efforts among MSM. In previous research by our group, we documented that specific resiliencies among MSM appear to have robust health-promoting properties. Resiliencies research conducted among aging MSM is an innovative agenda on several counts. The dominant approach to explaining patterns of health among MSM has been to study the effects of deficits in creating health disparities. While an emphasis on deficits is useful in explaining the life course trajectories of men who have multiple psychosocial health problems that result in poor health outcomes, this focus is less helpful in explaining the trajectories of te far larger proportion of MSM who have also experienced cultural marginalization and yet remain healthy well into later life. This application proposes the following aims to test a theory-based approach to identifying both deficits and resiliencies among aging MSM over six waves of data collection (N=1850) using an ongoing cohort study.1)To measure changes in prevalence rates of psychosocial health problems and resiliencies over time; 2)To test if changing rates of resiliencies over time are associated with changes in substance use and other psychosocial health problems and to test whether resiliencies moderate the pathway to syndemics; and 3)To test if changing rates of resiliencies over time are associated with better HIV-related outcomes and biomarkers among HIV-positive MSM and to test if resiliencies moderate the impact of syndemics on these same outcomes. By identifying the resiliencies already used by some aging MSM to stay healthy but which have yet to be incorporated in current health promotion efforts for MSM, we can progress to the testing of potentially efficacious health promotion programs to support healthy aging among MSM.
Although many older men who have sex with men (MSM) exhibit significant strengths that have helped them remain healthy well into later life, these strategies have not been well documented. In particular, the strengths, or resiliencies, of older MSM have not been carefully studied in terms of their ability to support health as men age. This study will use a theory-based approach to follow aging MSM in six waves of an ongoing cohort study to document how resiliencies moderate the effects of health risks to better explain patterns of health and illness among aging MSM.
|Eaton, Lisa A; Matthews, Derrick D; Driffin, Daniel D et al. (2017) A Multi-US City Assessment of Awareness and Uptake of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Black Men and Transgender Women Who Have Sex with Men. Prev Sci 18:505-516|