The moderating role of resilience resources in the association between crime exposure and substance use among young sexual minority men.

Objectives: Substance use is prevalent among young sexual minority men and crime exposure is linked with adverse health behaviors. Guided by the protective model of resilience, we examined the impact of crime exposure and resilience resources on substance use behaviors, and whether resilience moderated associations between crime exposure and substance use behaviors. Methods: A cross-sectional sample of young sexual minority men (n = 720) ages 15-24 participated in a one-time survey conducted in seven cities across the United States. Participants' mean age was 21.2 years; 50% self-identified as Black, and 66% self-identified as gay. Participants self-reported on sociodemographic factors, crime exposure, resilience resources, and substance use behaviors. We fit generalized estimating models to examine associations between crime exposure, resilience resources, and the interaction between crime exposure and resilience resources on substance use behaviors. Results: Overall, 31% reported heavy alcohol use, 54% monthly marijuana use, 14% drug use, and 26% reported being a victim of a crime. Crime exposure was associated with an increased odds of alcohol (AOR = 1.45, 95%CI: 1.02, 2.14), marijuana (AOR = 1.41, 95%CI: 1.07, 2.04), and drug use (AOR = 1.94, 95%CI: 1.14, 2.98). Resilience resources were associated with a reduced odds of alcohol use (AOR = 0.66, 95%CI: 0.47, 0.93), marijuana use (AOR = 0.82, 95%CI: 0.60, 0.98), and drug use (AOR = 0.85, 95%CI: 0.54, 0.96). There was a significant interaction such that resilience resources reduced associations between crime exposure and alcohol and drug use. Conclusions: Findings support the protective effects of resilience resources for young sexual minority men. Results highlight the importance of ensuring the availability of community resources to meet the needs of sexual minority youth.

Examination of Behavioral, Social, and Environmental Contextual Influences on Sexually Transmitted Infections in At Risk, Urban, Adolescents, and Young Adults.

BACKGROUND: Despite the large body of extant literature on sexually transmitted infections (STIs) in adolescents and young adults (AYAs), more research on social and environmental contextual factors is needed. Also, further examination of STI indicators by gender remains a critical area of research focus. METHODS: Anonymous survey data were collected using audio computer-assisted self-interviews in community venues in urban, low-income, STI prevalent, US neighborhoods to reach AYAs, aged 12 to 24 years. Conventional descriptive statistics, bivariate analysis, and multiple logistical regression models were used to assess indicators of a self-reported lifetime prevalence of STIs. RESULTS: Participants (N = 1540) were on average 20.6 years; 57.2% were women, the majority were racial and ethnic minorities (92%), and almost half (49.2%) identified as sexual minorities. Nearly one third (32.%) had 1 or more STIs. As expected, gender differences were identified. For AYA men, being African American/Black, moving residences more than 4 times since kindergarten, and having a history of human immunodeficiency virus testing were each positively associated with STIs. Also, those who strongly disagreed that many young people in their community exchanged sex for money had a significantly lower likelihood of having an STI. For AYA women, exchanging sex for drugs or money, lacking money, which prevented activities, and using marijuana were each associated with STIs. CONCLUSIONS: This research extends our understanding of social and environmental contextual influences on AYAs' risk for STIs. It highlights differences in risk exposures that are distinctly different for AYA women and men, suggesting the need for tailored interventions to address their unique economic needs and social challenges.