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A Syndemic Model of Exchange Sex Among HIV-Positive Men Who Have Sex With Men.
Journal Title
Archives of sexual behavior
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Publication Date
2020-01-21
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Publication Volume
49
Publication Issue
6
Publication Begin
1965
Publication End
1978
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nihms-1586388.pdf
Adobe PDF, 132.92 KB
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Abstract
Exchange sex is a behavior associated with HIV transmission risk among men who have sex with men (MSM). Few studies have examined exchange sex among HIV-positive MSM. We utilize a syndemic framework to account for co-occurring psychosocial problems that suggest the presence of intertwining epidemics (i.e., syndemics), which have not been examined within the context of exchange sex among HIV-positive MSM. In 2015, MSM were recruited via online sexual networking Web site and app advertisements for Sex Positive![+], a video-based online intervention that aimed to improve health outcomes for men living with HIV. Participants completed surveys every three months for a year. Surveys covered demographics, drug use, exchange sex, intimate partner violence (IPV), and past 2-week depressive symptoms. We conducted three logistic regression models to assess syndemic factors associated with exchange sex in the past 3 months. Of the 722 HIV-positive MSM included in the sample, 59 (8%) reported exchange sex in the past 3 months at 12-month follow-up. HIV-positive MSM who had more syndemic factors had greater odds of exchange sex. Exchange sex was associated with being African-American/Black, age 18-29 years, past and present experiences with IPV, stimulant use, polysubstance use, and depressive symptoms. Exchange sex was associated with multiple psychosocial factors, indicating exchange sex may be part of a syndemic involving substance use, depression, HIV, and IPV. Interventions should address the social and behavioral circumstances that perpetuate environments that can foster multiple negative health outcomes.
Citation
Walters SM, Braksmajer A, Coston B, Yoon I, Grov C, Downing MJ Jr, Teran R, Hirshfield S. A Syndemic Model of Exchange Sex Among HIV-Positive Men Who Have Sex With Men. Arch Sex Behav. 2020 Aug;49(6):1965-1978. doi: 10.1007/s10508-020-01628-8. Epub 2020 Jan 21. PMID: 31965453; PMCID: PMC7321855.