%0 Journal Article %J AIDS Behav %D 2014 %T Prospective predictors of unprotected anal intercourse among HIV-seropositive men who have sex with men initiating antiretroviral therapy. %A Pantalone, David W %A Huh, David %A Nelson, Kimberly M %A Pearson, Cynthia R %A Simoni, Jane M %K Adult %K Anti-HIV Agents %K Drug Administration Schedule %K Health Knowledge, Attitudes, Practice %K HIV Infections %K HIV Seropositivity %K Homosexuality, Male %K Humans %K Interviews as Topic %K Latin America %K Logistic Models %K Longitudinal Studies %K Male %K Middle Aged %K Prospective Studies %K Sexual Behavior %K Socioeconomic Factors %K Stress, Psychological %K Substance-Related Disorders %K Surveys and Questionnaires %K Unsafe Sex %K Vulnerable Populations %K Washington %K Young Adult %X

Contemporary HIV prevention efforts are increasingly focused on those already living with HIV/AIDS (i.e., "prevention with positives"). Key to these initiatives is research identifying the most risky behavioral targets. Using a longitudinal design, we examined socio-demographic and psychosocial factors that prospectively predicted unprotected anal intercourse (UAI) in a sample of 134 HIV-seropositive men who have sex with men (MSM) initiating, changing, or re-starting an antiretroviral therapy regimen as part of a behavioral intervention study. Computer-based questionnaires were given at baseline and 6 months. In a sequential logistic regression, baseline measures of UAI (step 1), socio-demographic factors such as Latino ethnicity (step 2), and psychosocial factors such as crystal methamphetamine use, greater life stress, and lower trait anxiety (step 3) were predictors of UAI at 6 months. Problem drinking was not a significant predictor. Prevention efforts among MSM living with HIV/AIDS might focus on multiple psychosocial targets, like decreasing their crystal methamphetamine use and teaching coping skills to deal with life stress.

%B AIDS Behav %V 18 %P 78-87 %8 2014 Jan %G eng %N 1 %R 10.1007/s10461-013-0477-1 %0 Journal Article %J Arch Sex Behav %D 2014 %T Sexually explicit online media and sexual risk among men who have sex with men in the United States. %A Nelson, Kimberly M %A Simoni, Jane M %A Morrison, Diane M %A George, William H %A Leickly, Emily %A Lengua, Liliana J %A Hawes, Stephen E %K Adolescent %K Adult %K Cross-Sectional Studies %K Erotica %K HIV Infections %K Homosexuality, Male %K Humans %K Internet %K Male %K Middle Aged %K Risk-Taking %K Socioeconomic Factors %K United States %K Unsafe Sex %K Young Adult %X

This study aimed to describe sexually explicit online media (SEOM) consumption among men who have sex with men (MSM) in the United States and examine associations between exposure to unprotected anal intercourse (UAI) in SEOM and engagement in both UAI and serodiscordant UAI. MSM in the U.S. who accessed a men-seeking-men website in the past year (N = 1,170) were recruited online for a cross-sectional, Internet-based survey of sexual risk and SEOM consumption. In the 3 months prior to interview, more than half (57 %) of the men reported viewing SEOM one or more times per day and almost half (45 %) reported that at least half of the SEOM they viewed portrayed UAI. Compared to participants who reported that 0-24 % of the SEOM they viewed showed UAI, participants who reported that 25-49, 50-74, or 75-100 % of the SEOM they viewed portrayed UAI had progressively increasing odds of engaging in UAI and serodiscordant UAI in the past 3 months. As SEOM has become more ubiquitous and accessible, research should examine causal relations between SEOM consumption and sexual risk-taking among MSM as well as ways to use SEOM for HIV prevention.

%B Arch Sex Behav %V 43 %P 833-43 %8 2014 May %G eng %N 4 %R 10.1007/s10508-013-0238-2 %0 Journal Article %J AIDS Educ Prev %D 2013 %T A cautionary tale: risk reduction strategies among urban American Indian/Alaska Native men who have sex with men. %A Pearson, Cynthia R %A Walters, Karina L %A Simoni, Jane M %A Beltran, Ramona %A Nelson, Kimberly M %K Adolescent %K Adult %K Alaska %K Condoms %K Cross-Sectional Studies %K Health Knowledge, Attitudes, Practice %K HIV Infections %K HIV Seronegativity %K Homosexuality, Male %K Humans %K Indians, North American %K Male %K Middle Aged %K Risk Factors %K Risk Reduction Behavior %K Risk-Taking %K Sexual Partners %K Socioeconomic Factors %K Surveys and Questionnaires %K Truth Disclosure %K Unsafe Sex %K Urban Population %K Young Adult %X

American Indian and Alaska Native (AIAN) men who have sex with men (MSM) are considered particularly high risk for HIV transmission and acquisition. In a multi-site cross-sectional survey, 174 AIAN men reported having sex with a man in the past 12 months. We describe harm reduction strategies and sexual behavior by HIV serostatus and seroconcordant partnerships. About half (51.3%) of the respondents reported no anal sex or 100% condom use and 8% were in seroconcordant monogamous partnership. Of the 65 men who reported any sero-adaptive strategy (e.g., 100% seroconcordant partnership, strategic positioning or engaging in any strategy half or most of the time), only 35 (54.7%) disclosed their serostatus to their partners and 27 (41.5%) tested for HIV in the past 3 months. Public health messages directed towards AIAN MSM should continue to encourage risk reduction practices, including condom use and sero-adaptive behaviors. However, messages should emphasize the importance of HIV testing and HIV serostatus disclosure when relying solely on sero-adaptive practices.

%B AIDS Educ Prev %V 25 %P 25-37 %8 2013 Feb %G eng %N 1 %R 10.1521/aeap.2013.25.1.25 %0 Journal Article %J Ann Behav Med %D 2011 %T 'I've had unsafe sex so many times why bother being safe now?': the role of cognitions in sexual risk among American Indian/Alaska Native men who have sex with men. %A Nelson, Kimberly M %A Simoni, Jane M %A Pearson, Cynthia R %A Walters, Karina L %K Adult %K Alaska %K Attitude to Health %K Cognition %K Condoms %K Cross-Sectional Studies %K HIV Infections %K Homosexuality, Male %K Humans %K Indians, North American %K Male %K Middle Aged %K Multivariate Analysis %K Risk Factors %K Risk-Taking %K Sexual Partners %K Socioeconomic Factors %K Stress Disorders, Post-Traumatic %K Surveys and Questionnaires %K Unsafe Sex %K Young Adult %X

BACKGROUND: American Indian/Alaska Native (AI/AN) men who have sex with men (MSM) are at high risk of human immunodeficiency virus (HIV) acquisition and transmission.

PURPOSE: This study aimed to investigate a potential area of focus for HIV prevention interventions by assessing the impact of sexual risk cognitions on sexual risk-taking among AI/AN MSM.

METHODS: AI/AN MSM (Nā€‰=ā€‰173) from a national cross-sectional survey were analyzed.

RESULTS: Reporting more frequent sexual risk cognitions overall (high sexual risk cognitions) was associated with multiple HIV risk factors including unprotected anal intercourse and serodiscordant unprotected anal intercourse. Participants with high sexual risk cognitions had a 2.3 (95% Confidence Interval: 1.1, 4.7) times greater odds of engaging in unprotected anal intercourse regardless of childhood sexual abuse, depression, and alcohol dependence. Most individual sexual risk cognitions were associated with unprotected anal intercourse, serodiscordant unprotected anal intercourse, or both.

CONCLUSIONS: Results suggest that sexual risk cognitions may be a productive area for further work on HIV prevention among AI/AN MSM.

%B Ann Behav Med %V 42 %P 370-80 %8 2011 Dec %G eng %N 3 %R 10.1007/s12160-011-9302-0 %0 Journal Article %J Womens Health Issues %D 2011 %T Keeping our hearts from touching the ground: HIV/AIDS in American Indian and Alaska Native women. %A Walters, Karina L %A Beltran, Ramona %A Evans-Campbell, Tessa %A Simoni, Jane M %K Acquired Immunodeficiency Syndrome %K Adaptation, Psychological %K Culture %K Epidemics %K Female %K HIV Infections %K Humans %K Indians, North American %K Inuits %K Male %K Rape %K Residence Characteristics %K Spouse Abuse %K Stress, Psychological %K Substance-Related Disorders %K United States %K Women's Health %X

HIV/AIDS is a critical and growing challenge to American Indian and Alaska Native (AIAN) women's health. Conceptually guided by the Indigenist Stress-Coping Model, this paper explores the historical and contemporary factors implicated in the HIV epidemic among AIAN women and the co-occurring epidemics of sexual violence and substance abuse. The authors also outline multiple indicators of resiliency in AIAN communities and stress the need for HIV prevention interventions for AIAN women to capitalize on cultural and community strengths.

%B Womens Health Issues %V 21 %P S261-5 %8 2011 Nov %G eng %N 6 Suppl %R 10.1016/j.whi.2011.08.005