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“GET THEM WHILE THEY’RE YOUNG!”Newly-Diagnosed YMSM’s Perspective on HIV Prevention:
D. Dennis Flores, IIIEmory Healthcare
Barbara Blake and Richard Sowell
Kennesaw State University
OBJECTIVES
At the end of this section, the audience will be able to:
•Describe factors that influence the sexual behaviors of young men who have sex with men (YMSM)
▪ Discuss factors that makes HIV prevention a persistent challenge for YMSM
▪ Suggest recommendations to prevent new HIV infections among YMSM
PURPOSE
The purpose of this study was to Identify reasons why YMSM continue to be
disproportionately infected with HIV despite available prevention information.
Solicit insight from newly-diagnosed YMSM about how to re-structure prevention programs for their non-infected peers.
METHODOLOGY
Individual interviews Recruited from agencies providing services
to YMSM Informed consent and incentive
Audio recorded Recordings transcribed verbatim and
validated Data analyzed using content analysis
FINDINGS Sample – 10 participants Age – Range 18 – 24, Mean – 21 years Race/ethnicity
9 – African American 1 – Latino
Education 5 – high school graduates 1 – college degree 4 – other
HIV Diagnosis Range – 2 to 11 months prior to interview Mean - Six months at time of interview
THEMES
Personal risk Education Technology Role modeling
PERSONAL RISK Majority viewed themselves as either
unlikely or very unlikely to contract HIV in their lifetimes
Half of our participants reported experiencing coercion and sexual abuse at the time of sexual initiation
PERSONAL RISK
“I had to be around 13…He worked at my school, he was around 30, a janitor. He was always nice to me for no reason. I mean, I kind of guessed it after a while. He would talk to me. One day I just left school with him. The most we ever did was oral, we didn’t do anything else. But after that, like, he tried talking to me more about leaving school. I really didn’t like him after that.”
-Nathaniel, 18
EDUCATION
Knowledgeable about HIV transmission Discounted Irrelevant
Sex education in school Excludes gay sex
TECHNOLOGY
Internet Main source of information for questioning
youth View sexually graphic content De facto manual for learning dynamics of
gay sex
TECHNOLOGY
“…[internet] taught me how to grasp it, I would say, how to grasp homosexual sex. As far as tops and bottoms and stuff like that. It kinda, you know, gave me an idea of, like, the type of things that I liked to do when being sexual.”
- Anthony, 19“…[internet] sure has taught me a lot of tricks, things that I never thought were humanly possible. It gave me a reference, I guess it was kind of revolutionary for me ‘cause I’d never seen two men, like, actually get enjoyment out of it. So it was like getting exposed to that was, like, wow, you know…different.”
-Adrian, 24
ROLE MODELING
Nine participants reported not having identifiably-gay role models growing up Lack of social cues Lack of mentors
ROLE MODELING
“I was 17…we walked to his place. One thing I can remember is telling him, ‘Don’t nut in me.’... We didn’t have a condom and I was scared about that. I was like, alright, we can do this, but just don’t nut in me…we did it and I was like, did you? He was like, ‘nah’ and it turned out he did….the second time was the same day…I told him again, ‘don’t nut in me’ and it turns out he did it again and I was really pissed by that time and left…The next day came and I was selling newspapers and I got really sick…for a whole week I was doing nothing in bed…I was just just so sick…and my grandmother took care of me.”
- Alec, 18
CONCLUSIONS High incidence of sexual abuse handicaps
YMSM from forming healthy sexual identities Unlimited access to graphic materials online
normalizes high risk behavior Non-inclusive sex education causes
resistance to generic messages on safe sex practices
Current HIV prevention strategies target YMSM too late
IMPLICATIONS FOR REAL LIFE
So, what do newly-diagnosed YMSM recommend to keep their peers from getting infected?
Targeted and inclusive sex education at an early age (elementary or middle school)
Increase parental education related to sexual coercion and encourage supportive parent-child
relationships Peer or gay mentored interventions Sophisticated prevention strategies that incorporate
technology in developing positive approaches to sexuality
REFERENCESElia, John P. and Eliason, Mickey. 2010. Journal of LGBT youth.: Discourses of Exclusion: Sexuality Education's Silencing of Sexual Others.
Gavin, L., MacKay, A., Brown, K., Harrier, S., Ventura, S., Kann, L., Rangel, M., Berman, S., Dittus, P., Liddon, N., Markowitz, L., Sternberg, M., Weinstock, H., David-Ferdon, C.,2009. Ryan, G. Sexual and reproductive health of persons aged 10-24 years – United States, 2002-2007. Morbidity & Mortality Weekly Report; July 2009, Vol. 58 Surveillance Summaries 6.
Goodenow, Carol; Netherland, Julie; Szalacha, Laura. 2002. AIDS-Related Risk Among Adolescent Males Who Have Sex With Males, Females, or Both: Evidence from a Statewide Survey. American Journal of Public Health | -02 | 92:2 |203(8)
Lescano, Celia M.Brown, Larry K., Puster, Kristie L., Miller, Paul M. 2004. Sexual Abuse and Adolescent HIV Risk: A Group Intervention Framework. Journal of HIV/AIDS Prevention in Children & Youth;, Vol. 6 Issue 1, p43-57, 15p
Mutchler, Matt. 2000. Young Gay Men's Stories in the States: Scripts, Sex, and Safety in the Time of AIDS. Sexualities; Feb2000, Vol. 3 Issue 1, p31
UNAIDS (2008). 2008 Report on the global AIDS epidemic. http://www.unaids.org/en/KnowledgeCentre/ HIVData/GlobalReport/2008/2008_Global_report.asp.
ACKNOWLEDGMENTS
▪ Wellstar School of Nursing, Health and Human Services
at Kennesaw State University
▪ Atlanta Clinical and Translational Science Institute, at Emory University Hospital
▪ Metro Atlanta Chapter, Association of Nurses in AIDS Care
▪ Emory President’s Commission on Sexuality, Gender Diversity
and Queer Equality
▪ AID Atlanta’s Joye Bradley Clinic and Evolution Project
▪ AID Gwinnett
