HIV AIDS remains a major health crisis among African American men who have sex with men (AA MSM). In a recent large-scale HIV seroprevalence survey, prevalence rates were highest among AA MSM (28%), compared to 16% among MSM of all other ethnicities. This is a health disparity that has been replicated in many different studies since the start of the AIDS epidemic. Given the scale of the HIV epidemic among AA MSM, we cannot prevent the ongoing spread of HIV in the United States until we find ways to field effective HIV prevention programs for AA MSM. Combination prevention approaches to HIV/AIDS offer considerable promise to achieve this goal by addressing some of the high risk contexts that increase transmission risk among AA MSM. However, our ability to design effective combination prevention approaches to lower HIV transmission risk among AA MSM depends on achieving a clear epidemiological understanding of both barriers and facilitators to HIV testing, receiving reactive test results for men who are HIV positive and timel access to medical care if HIV positive. Unfortunately, our ability to explain HIV testing and health care access behaviors among AA MSM is currently limited due to the difficulties of recruiting sufficiently large samples of AA MSM who are delaying access to HIV prevention and care services. These shortcomings hamper our ability to draw effective conclusions about targeted prevention efforts for AA MSM, including most fundamentally an informed evidence base upon which combination prevention strategies must be built. Syndemics theory, which examines the effects and interactions among multiple psychosocial health conditions (i.e. substance abuse, depression, violence victimization) associated with increased risks within marginalized and vulnerable populations provides an important theoretical framework to examining these behaviors, especially since it encompasses both vulnerabilities and resiliencies in high risk populations. This application proposes to address this situation by collecting data from a large scale sample of AA MSM (N=6000) to: 1. Measure the prevalence and identify syndemic associations of uptake of HIV testing among AA MSM 2. Measure the prevalence and identify syndemic associations of unknown HIV seropositivity among AA MSM 3. Measure the prevalence and identify syndemic associations of timely access to care among HIV+ AA MSM By partnering with well-established community groups to recruit large samples of vulnerable men, we will be in a position to characterize the barriers and facilitators to the essential buildig blocks of combination prevention approaches and so provide crucial information for developing effective programs to lower HIV transmission among AA MSM.

Public Health Relevance

HIV AIDS is a major health crisis among African American men who have sex with men (AA MSM). Our ability to design effective combination prevention approaches to lower HIV transmission risk among AA MSM depends on achieving a clear understanding of barriers and facilitators to HIV testing, receiving reactive test results for men who are HIV positive and timely access to medical care if HIV positive. Unfortunately, our ability to explain HIV testing and health care access behaviors among AA MSM is limited due to the difficulties of recruiting sufficiently large samples of AA MSM who are delaying access to HIV prevention and care services. This application proposes to address this situation by collecting data from a large sample of AA MSM to measure the prevalence of uptake of HIV testing, of unknown HIV seropositivity and of timely access to care among HIV infected AA MSM. This study will allow us to characterize for the first time the barriers and facilitators to HIV preventon and care services among these highly vulnerable men and so provide crucial information for developing effective programs to lower HIV transmission among AA MSM.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR013865-03
Application #
8825362
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Henry, Rebecca
Project Start
2013-06-01
Project End
2016-03-31
Budget Start
2015-04-01
Budget End
2016-03-31
Support Year
3
Fiscal Year
2015
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Public Health & Prev Medicine
Type
Graduate Schools
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Eaton, Lisa A; Matthews, Derrick D; Bukowski, Leigh A et al. (2018) Elevated HIV Prevalence and Correlates of PrEP Use Among a Community Sample of Black Men Who Have Sex With Men. J Acquir Immune Defic Syndr 79:339-346
Eaton, Lisa A; Kalichman, Seth C; Kalichman, Moira O et al. (2018) Randomised controlled trial of a sexual risk reduction intervention for STI prevention among men who have sex with men in the USA. Sex Transm Infect 94:40-45
Eaton, Lisa A; Earnshaw, Valerie A; Maksut, Jessica L et al. (2018) Experiences of stigma and health care engagement among Black MSM newly diagnosed with HIV/STI. J Behav Med 41:458-466
Friedman, M Reuel; Sang, Jordan M; Bukowski, Leigh A et al. (2018) HIV Care Continuum Disparities Among Black Bisexual Men and the Mediating Effect of Psychosocial Comorbidities. J Acquir Immune Defic Syndr 77:451-458
Chandler, Cristian J; Sang, Jordan M; Bukowski, Leigh A et al. (2018) Characterizing the HIV care continuum among a community sample of black men who have sex with men in the United States. AIDS Care :1-5
Watson, Ryan J; Allen, Aerielle; Pollitt, Amanda M et al. (2018) Risk and Protective Factors for Sexual Health Outcomes Among Black Bisexual Men in the U.S.: Internalized Heterosexism, Sexual Orientation Disclosure, and Religiosity. Arch Sex Behav :
Friedman, M Reuel; Bukowski, Leigh; Eaton, Lisa A et al. (2018) Psychosocial Health Disparities Among Black Bisexual Men in the U.S.: Effects of Sexuality Nondisclosure and Gay Community Support. Arch Sex Behav :
Nelson, Kimberly M; Eaton, Lisa A; Gamarel, Kristi E (2017) Preferences for Condomless Sex in Sexually Explicit Media Among Black/African American Men Who Have Sex with Men: Implications for HIV Prevention. Arch Sex Behav 46:977-985
Bauermeister, José A; Eaton, Lisa; Meanley, Steven et al. (2017) Transactional Sex With Regular and Casual Partners Among Young Men Who Have Sex With Men in the Detroit Metro Area. Am J Mens Health 11:498-507
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

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