The Association between Social Support and Pre-Exposure Prophylaxis use among Sexual Minority Men in the United States: A Scoping Literature Review.

Sexual minority men (SMM) are disproportionately affected by HIV. Although pre-exposure prophylaxis (PrEP) is an effective way of reducing HIV incidence, PrEP use has remained relatively low. Social support may be one effective factor in increasing PrEP use among SMM, but the association between social support and PrEP use/adherence is not well understood. The objective of this paper was to summarize the current literature on the association of social support and PrEP use among SMM in the United States. A systematic search was conducted using six different databases MEDLINE / PubMed, PsycINFO, Cochrane CENTRAL, Google Scholar, Embase, and Web of Science using terms established from keywords and medical subject headings (MeSH) terms before being adapted to each database. Data were extracted for key study factors (e.g., study population, geographic location, study design) and main findings. This search produced eleven articles: ten manuscripts and one conference abstract. Of these, two were randomized control trials, two were interventions, three were qualitative, and four were cross-sectional. The studies were widespread across the country, but most were in major metropolitan areas. From the articles included in this review, findings were inconsistent in the association between social support; some studies showed null findings, others that only certain sources of social support were significant, and others that there was a significant association between social support and PrEP use. This review highlights the complexity of the relationship between social support and PrEP use among SMM, indicating the need for further research to identify specific types and sources of support that effectively enhance PrEP uptake and adherence. Targeted interventions based on these insights could significantly reduce HIV incidence in the population.

RESUMEN: Los hombres pertenecientes a minorías sexuales (HSH) se ven afectados de forma desproporcionada por el VIH. Aunque la profilaxis preexposición (PrEP) es una forma eficaz de reducir la incidencia del VIH, el uso de la PrEP se ha mantenido relativamente bajo. El apoyo social puede ser un factor eficaz para aumentar el uso de la PrEP entre los SMM, pero la asociación entre el apoyo social y el uso/adherencia a la PrEP no se conoce bien. El objetivo de este documento fue resumir la literatura actual sobre la asociación entre el apoyo social y el uso de la PrEP entre los HSH en los Estados Unidos. Se realizó una búsqueda sistemática en seis bases de datos diferentes MEDLINE / PubMed, PsycINFO, Cochrane CENTRAL, Google Scholar, Embase y Web of Science utilizando términos basados en palabras clave y términos de encabezamientos de materias médicas (MeSH) antes de adaptarlos a cada base de datos. Se extrajeron datos para los factores clave del estudio (p. ej., población del estudio, ubicación geográfica, diseño del estudio) y los hallazgos principales. Esta búsqueda produjo once artículos: diez manuscritos y un resumen de conferencia. De ellos, dos eran estudios controlados aleatorizados, dos eran intervenciones, tres eran estudios cualitativos y cuatro eran estudios transversales. Los estudios estaban repartidos por todo el país, pero la mayoría se realizaban en las principales áreas metropolitanas. De los artículos incluidos en esta revisión, los hallazgos fueron inconsistentes en la asociación entre el apoyo social; algunos estudios mostraron hallazgos nulos, otros que sólo ciertas fuentes de apoyo social eran significativas y otros que existía una asociación significativa entre el apoyo social y el uso de la PrEP. Esta revisión pone de manifiesto la complejidad de la relación entre el apoyo social y el uso de la PrEP entre los HSH, lo que indica la necesidad de realizar más investigaciones para identificar los tipos y las fuentes de apoyo específicos que mejoran de forma efectiva la aceptación y el cumplimiento de la PrEP. Las intervenciones específicas basadas en estos conocimientos podrían reducir significativamente la incidencia del VIH en la población.

How Intimate Partner Violence Is Influenced by Social Identity Among Sexual Minority Men.

Purpose: Sexual minority men (SMM) experience intimate partner violence (IPV) at disproportionately high rates. The objective of this article was to identify the experiences of SMM and health care providers on how social identity impacts IPV. Methods: SMM participants (N = 23) were recruited from online community settings and a lesbian, gay, bisexual, transgender, queer, and others (LGBTQ+) organization in Los Angeles; providers (N = 10) were recruited from LGBTQ+ organizations. Semistructured interviews were audio recorded and transcribed verbatim. An applied thematic analysis approach was implemented to create memos, inductively generate a codebook, apply codes to the transcripts, and identify key themes in data. Results: Three main themes were identified. The first theme was weaponizing social identity to control a partner, which had three subthemes: (1) immigration status, race/ethnicity, and skin color, (2) threatening to "out" the partner's sexual orientation, and (3) abusing power inequity. Men who perpetrated IPV often used minority identities or undisclosed sexuality to leverage power over their partner. The second theme was use of IPV to establish masculinity, by exerting power over the more "feminine" partner. The third theme was internalized homophobia as a root cause of IPV, which details how internalized homophobia was often expressed in violent outbursts toward partners. Conclusion: These findings highlight how IPV among SMM can be influenced by social and sexual identity. Future research must consider socially constructed power structures and the multiple identities of SMM when developing interventions to address IPV in this population.