title: Psychological distress, drug use, sexual risks and medication adherence among young HIV-positive Black men who have sex with men: exposure to community violence matters.
abstract: In the USA, Black males are disproportionately affected by community violence and HIV. The aim of this study was to assess whether exposures to community violence are related to psychological distress, drug use, sexual risk behaviors, and medication adherence among a sample of HIV-positive young Black men who had sex with men (YBMSM). Data are from 98 YBMSM ages 18-29 years recruited from Chicago who completed measures on demographics, exposures to community violence, psychological distress, drug use, condomless anal intercourse, and medication adherence. Rates of exposure to community violence were high and youth reported victimization and witnessing numerous types of violence in their lifetime. In adjusted logistic regression analyses, models indicate that YBMSM reporting higher levels of exposure to community violence had significantly higher rates of condomless anal intercourse in the previous 6 months (AOR: 5.33, 95%CI: 1.38-20.55). Additionally, exposure to community violence was positively associated with psychological distress, hard drug use, and use of marijuana as a sex drug. Adherence to HIV antiretroviral medication was negatively associated with community violence (AOR: 0.36, 95%CI: 0.13-0.97). Rates of exposure to community violence are especially high in urban communities. Overall findings suggest that treatment, intervention, and programmatic approaches that include initiatives to address exposure to community violence might correlate with better health-related outcomes for HIV-positive YBMSM.
authors.affiliation: a Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine , Medical College of Wisconsin , Milwaukee , WI , USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Quinn
authors.affiliation: b School of Social Service Administration , University of Chicago , Chicago , IL , USA.|c STI/HIV Intervention Network , University of Chicago , Chicago , IL , USA.
authors.forename: Dexter R
authors.initials: DR
authors.lastname: Voisin
authors.affiliation: b School of Social Service Administration , University of Chicago , Chicago , IL , USA.|c STI/HIV Intervention Network , University of Chicago , Chicago , IL , USA.
authors.forename: Alida
authors.initials: A
authors.lastname: Bouris
authors.affiliation: c STI/HIV Intervention Network , University of Chicago , Chicago , IL , USA.|d Department of Medicine , University of Chicago , Chicago , IL , USA.|e Department of Public Health Sciences , University of Chicago , Chicago , IL , USA.
authors.forename: John
authors.initials: J
authors.lastname: Schneider
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D002641:Chicago / Q000453:epidemiology; D019548:Crime Victims; D000069581:Exposure to Violence / Q000208:ethnology / Q000517:prevention & control / Q000523:psychology; D015658:HIV Infections / Q000208:ethnology / Q000523:psychology; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D020380:Needs Assessment; D012309:Risk-Taking; D013315:Stress, Psychological / Q000209:etiology / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000208:ethnology / Q000523:psychology; D047568:Unsafe Sex / Q000208:ethnology / Q000517:prevention & control / Q000523:psychology
keywords: HIV/AIDS; Young Black men who have sex with men; community violence; medication adherence; sexual risk behavior