Unprotected Anal Intercourse With Casual Male Partners in Urban Gay, Bisexual, and Other Men Who Have Sex With Men.

Objectives. We investigated trends in, and predictors of, unprotected anal intercourse (UAI) with casual male partners of gay, bisexual, and other men who have sex with men (GBMSM). Methods. We analyzed data from cross-sectional intercept surveys conducted annually (2003-2008) at 2 large lesbian, gay, and bisexual community events in New York City. Survey data covered GBMSM's highest-risk behaviors for HIV acquisition (HIV-negative or unknown status GBMSM, any UAI) and transmission (HIV-positive GBMSM, any serodiscordant unprotected UAI). Results. Across years, 32.3% to 51.5% of the HIV-negative or unknown status men endorsed any UAI, and 36.9% to 52.9% of the HIV-positive men endorsed serodiscordant UAI. We observed a few statistically significant fluctuations in engagement in high-risk behavior. However, these do not appear to constitute meaningful trends. Similarly, in some years, one or another demographic predictor of UAI was significant. Across years, however, no reliable pattern emerged. Conclusions. A significant proportion of urban GBMSM engage in high-risk sex, regardless of serostatus. No consistent demographic predictors emerged, implying a need for broad-based interventions that target all GBMSM.

The effects of age and physical health on processing speed in HIV.

The impact of age and physical health on processing speed was investigated in 42 non-demented HIV+ individuals ranging in age from 30 to 75. We used the Medical Outcomes Study-HIV Healthy Survey (MOS-HIV) to measure self-reported physical health, neuropsychological tests to measure psychomotor and cognitive processing speed (Delis-Kaplan Executive Function System Trail Making Test, Grooved Pegboard Test, letter and category fluency), and a test of the foreperiod effect to measure reaction time under increasing attentional load. Results indicated that aging and worse physical health each independently contributed to slowing on different processing speed measures, while the interaction between aging and physical health did not contribute to processing speed. These findings highlight the importance of considering physical health separately from age when measuring cognitive function in HIV+ adults.

What's sex got to do with it? The role of sexual affect in the relationship between HIV stigma and mental health.

This research attempts to understand the effect of HIV stigma on sexual affect (i.e., sexual anxiety) and the role sexual affect plays in the relationship between HIV stigma and mental health. Participants were 60 HIV-positive, sexually active adults. HIV stigma was found to have a negative effect on sexual anxiety. Further, the effect of HIV stigma on mental health was mediated by sexual anxiety. In other words, HIV stigma negatively affects individuals' anxious feelings about their sexuality, and these feelings negatively impact mental health. These findings highlight the importance of understanding psychological aspects of sexuality in the affect of HIV stigma.

Prevalence and correlates of sexual behavior and risk management among HIV-positive adults over 50.

BACKGROUND: This study examined the prevalence and correlates of sexual behavior, sexual risk, and behavioral risk reduction strategies among a diverse sample of HIV-positive adults over age 50. METHODS: Individual surveys were conducted with 914 HIV-positive adults age 50 and over (640 male, 264 female, 10 transgender) living in New York City. RESULTS: Over half the sample reported sexual activity in the past 3 months, and one-third of sexually active participants reported unprotected anal or vaginal sex in that time period. Sexually active participants were more likely to be younger and male, but did not differ on physical health status. Participants reported a range of risk-management strategies, including 100% condom use (49% of sexually active participants), serosorting (17%), and strategic positioning (4%). The prevalence of strategies differed by gender/sexual identity subgroups. In multivariate modeling, unprotected sex was significantly associated with recent substance use and loneliness. CONCLUSIONS: Older HIV-positive adults are sexually active, and engage in both high-risk and risk-management behaviors. Loneliness emerged as the dominant risk factor in this sample. Findings provide meaningful implications for HIV prevention interventions targeting this population.

Partner serostatus and disclosure stigma: implications for physical and mental health outcomes among HIV-positive adults.

This pilot project examined the interaction between partners' serostatus and HIV disclosure-stigma in determining physical and mental health. Participants were 38 sexually active HIV-positive adults. Over 47% of participants reported exclusively seroconcordant partners in the past 30 days. There were no main effects of partner serostatus or disclosure stigma on any of the outcome variables. However, disclosure stigma moderated the relationship between partner serostatus and: number of symptoms reported, pain, physical functioning, quality of life, anxiety, illness intrusiveness, and role-functioning. Future research should explore the implications of partner serostatus for the physical and mental health of HIV-positive individuals.

Behind closed doors: an exploration of kinky sexual behaviors in urban lesbian and bisexual women.

This study of 347 urban, self-identified lesbian (n = 289) and bisexual (n = 58) women examined women's engaging in 4 kinky sexual behaviors: bondage/domination, sadomasochism, photo/video exhibitionism, and asphyxiation/breath play. A cross-sectional, brief-intercept survey was administered at 2 New York City gay, lesbian, and bisexual community events. Over 40% reported engaging in at least 1 of these behaviors, and 25% reported engaging in multiple behaviors. Bisexual women were more likely to have engaged in any kinky sexual behavior and photo/video exhibitionism. White women were more likely than women of color to have engaged in bondage/domination. Compared to older women, younger women were more likely to have engaged in photo/video exhibitionism and asphyxiation/breath play. Participants who were younger when they came out to others, and younger at their same-sex sexual debut, were more likely to have engaged in any and each of the behaviors compared to women who were older at those developmental events.