Perception of Community Tolerance and Prevalence of Depression among Transgender Persons.

PURPOSE: The goal of the study was to examine the association between depression and perceived community tolerance after controlling for various demographic and personal characteristics, treatment receipt, and past experiences with abuse or discrimination. METHODS: An on-line survey assessed depressive symptoms among transgender and gender non-conforming individuals. Depression was assessed using the 7-item Beck Depression Inventory for Primary Care (BDI-PC) and the 10-item Center for Epidemiologic Studies Depression (CESD-10) scale. RESULTS: The prevalence ratios (95% confidence intervals) comparing depression in persons who did and did not perceive their area as tolerant were 0.33 (0.20-0.54) for BD-PC and 0.66 (0.49-0.89) for CESD-10. Other factors associated with depression were experience with abuse or discrimination, lower education, and unfulfilled desire to receive hormonal therapy. CONCLUSION: Depression was common in this sample of transgender and gender non-conforming individuals and was strongly and consistently associated with participants' perceptions of community tolerance, even after adjusting for possible confounding. The association between desire to receive hormonal therapy and depression is a finding that warrants further exploration. Future research should also assess depression and changes in perception of community tolerance in transgender individuals before and after initiation of gender confirmation treatment.

The Annual American Men's Internet Survey of Behaviors of Men Who have Sex with Men in the United States: 2014 Key Indicators Report.

The American Men's Internet Survey (AMIS) is an annual Web-based behavioral survey of men who have sex with men (MSM) who live in the United States. The purpose of this Rapid Surveillance Report is to report on the second cycle of data collection (November 2014 through April 2015; AMIS-2014) on the same key indicators previously reported for AMIS (December 2013 through May 2014; AMIS-2013). The AMIS survey methodology has not substantively changed since AMIS-2013. MSM were recruited from a variety of websites using banner advertisements or email blasts. Adult men currently residing in the United States were eligible to participate if they had ever had sex with a man. We examined demographic and recruitment characteristics using multivariable regression modeling (P<.05) stratified by the participants' self-reported human immunodeficiency virus (HIV) status. The AMIS-2014 round of data collection resulted in 9248 completed surveys from MSM representing every US state. Participants were mainly white, 40 years or older, living in the US South, living in urban/suburban areas, and recruited from a general social networking website. Self-reported HIV prevalence was 11.34% (1049/9248). Compared with HIV-negative/unknown status participants, HIV-positive participants were more likely to have had anal sex without a condom with any male partner in the past 12 months (76.55% vs 67.17%; P<.001) and more likely to have had anal sex without a condom with their last male sex partner who was discordant/unknown HIV status (39.66% vs 18.77%; P<.001). Marijuana and other illicit substance use in the past 12 months was more likely to be reported by HIV-positive participants than HIV-negative/unknown status participants (26.02% vs 21.27%, and 27.26% vs 17.60%, respectively; both P<.001). The vast majority (86.90%, 7127/8199) of HIV-negative/unknown status participants had been previously HIV tested, and 58.23% (4799/8199) had been tested in the past 12 months. Sexually transmitted infection (STI) testing and diagnosis was also more likely to be reported by HIV-positive participants than HIV-negative/unknown status participants (71.02% vs 37.34%, and 20.59% vs 7.54%, respectively; both P<.001). HIV-negative/unknown status participants <40 years of age were more likely than those 40 years or older to have had anal sex without a condom, were more likely to report substance use, were less likely to have been HIV tested, but were more likely to been tested for and diagnosed with an STI. Compared with those from general social networking, HIV-negative/unknown status participants from a geospatial social networking website were more likely to have reported all risk behaviors but were more likely to have been HIV tested, STI tested, and diagnosed with an STI.

Effects of messaging about multiple biomedical and behavioral HIV prevention methods on intentions to use among US MSM: results of an experimental messaging study.

Combining multiple biomedical and behavioral HIV prevention approaches is a priority for at-risk populations such as men who have sex with men (MSM), and it is essential to understand how receiving messages about multiple approaches impacts attitudes and intentions for their use. We examined whether receiving combinations of different HIV prevention messages produced differences in perceived benefits and costs of condom use, and in intentions to use condoms and biomedical prevention approaches. MSM (N = 803) were recruited online and were randomly assigned to view informational messages about one, two, or four of the following prevention options: pre-exposure prophylaxis (PrEP), non-occupational post-exposure prophylaxis (nPEP), rectal microbicides, and condoms. The number of HIV prevention messages did not produce differential attitudes and intentions regarding condoms, nor did it produce changes in attitudes towards unprotected sex. Receiving multiple messages was associated with greater intentions to use PrEP and nPEP, but not rectal microbicides.

Intimate partner, familial and community violence among men who have sex with men in Namibia.

Men who have sex with men in sub-Saharan Africa are known to experience high levels of violence, yet little research has focused on their perceptions of intimate partner violence (IPV). This study examines the perceived typologies and sources of multiple forms of violence, including IPV, family/community violence and discrimination from healthcare workers, among men who have sex with men in Namibia. Focus-group discussions and in-depth interviews were conducted with a 52 men residing in five cities across Namibia. Results indicate that violence, in varying forms, is commonplace in the lives of men who have sex with men in this community, and may be associated with HIV testing patterns.

Intimate Partner Violence and Social Pressure among Gay Men in Six Countries.

INTRODUCTION: Recent research suggests that men who have sex with men (MSM) experience intimate partner violence (IPV) at significantly higher rates than heterosexual men. Few studies, however, have investigated implications of heterosexist social pressures - namely, homophobic discrimination, internalized homophobia, and heterosexism - on risk for IPV among MSM, and no previous studies have examined cross-national variations in the relationship between IPV and social pressure. This paper examines reporting of IPV and associations with social pressure among a sample of internet-recruited MSM in the United States (U.S.), Canada, Australia, the United Kingdom, South Africa, and Brazil. METHODS: We recruited internet-using MSM from 6 countries through selective banner advertisements placed on Facebook. Eligibility criteria were men age over 18 reporting sex with a man in the past year. Of the 2,771 eligible respondents, 2,368 had complete data and were included in the analysis. Three outcomes were examined: reporting recent experience of physical violence, sexual violence, and recent perpetration of physical violence. The analysis focused on associations between reporting of IPV and experiences of homophobic discrimination, internalized homophobia, and heteronormativity. RESULTS: Reporting of experiencing physical IPV ranged from 5.75% in the U.S. to 11.75% in South Africa, while experiencing sexual violence was less commonly reported and ranged from 2.54% in Australia to 4.52% in the U.S. Perpetration of physical violence ranged from 2.47% in the U.S. to 5.76% in South Africa. Experiences of homophobic discrimination, internalized homophobia, and heteronormativity were found to increase odds of reporting IPV in all countries. CONCLUSION: There has been little data on IPV among MSM, particularly MSM living in low- and middle-income countries. Despite the lack of consensus in demographic correlates of violence reporting, heterosexist social pressures were found to significantly increase odds of reporting IPV in all countries. These findings show the universality of violence reporting among MSM across countries, and highlight the unique role of heteronormativity as a risk factor for violence reporting among MSM. The results demonstrate that using internet-based surveys to reach MSM is feasible for certain areas, although modified efforts may be required to reach diverse samples of MSM.