HIV disproportionately impacts young men of color who have sex with men. Keep It Up! (KIU!) is an online intervention that addresses the needs of this population. The study objective was to examine intervention acceptability and engagement. Outcomes of interests were qualitative and quantitative acceptability and engagement measures, content ratings, and paradata. On average, participants rated content (4 out of 5 stars) and acceptability (3.5 out of 4) highly. Compared to White participants, Black participants found KIU! more useful, engaging, and acceptable; Latino participants found KIU! more engaging; and other non-White participants found KIU! more engaging and acceptable. Participants with high school or less education found KIU! more useful, engaging, acceptable, and deserving of five stars than college graduates (p values = .047, <.001, .002, .01) and graduate degree holders (p values = .04, .001, <.001, .004). KIU! is a promising prevention tool for highest risk populations.

The Bear community exists as a subculture in reaction to the larger gay community. It rejects the normative idealized male beauty revered by mainstream gay men. While qualitative data document such self-identifiers as masculine-acting gay men who weigh more and have more body hair, there has to date been no quantitative analysis of this group’s characteristics. In response, we conducted two large-scale studies of gay men identifying as Bears (n = 469) to survey their self-reported physical, behavioral, and psychological traits. Our studies indicated that Bears were more likely to be hairier, heavier, and shorter than mainstream gay men. They reported wanting partners who were hairier and heavier. They were less likely to reject sexual partners and the partners they did reject were more likely to be young or weigh too little (i.e., were not bearish). Bears were more likely than mainstream gay men to enact diverse sexual behaviors (e.g., fisting, voyeurism) and were comparatively more masculine. Bears had lower self-esteem but were no less (or more) hypermasculine than non-Bears. We concluded that Bears are intensely sexual. We speculate that Bears are viewed as less attractive than what is traditionally considered to be attractive. The partners they can attract may be limited and, in response to this limitation, they may be particularly attuned to seek out partners who will not reject them. This condition may produce the low self-esteem exhibited and may explain how the Bear culture developed to ensure that even the heaviest, hairiest, and/or shortest individual can partner. Future analyses of the community’s health are warranted.

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Students in the Community (SITC) is an interprofessional collaboration of health science students at the University of Washington. SITC runs a weekly free clinic at the Aloha Inn, a transitional housing facility for 70 homeless men and women in downtown Seattle. The focus of this clinic is on health education, chronic disease management, and re-integration of patients into the healthcare infrastructure. SITC serves as a valuable service learning opportunity for students. In addition to direct clinical services, students gain experience in planning health education strategies, community collaboration, and evaluating intervention outcomes. SITC also oversees a lecture and discussion-based elective course at the University of Washington focused on health issues of the homeless community and provides formal teaching which complements the service-learning component of the endeavor.

Factors associated with gay male couples’ concordance on aspects of sexual agreements remain understudied. The present study examined which relationship factors, self-reports of UAI, and patterns of HIV testing may be associated with men who were concordant about having a sexual agreement, the same type of sexual agreement, and adhering to their sexual agreement with their main partner. Various recruitment strategies were used to collect dyadic data from 142 gay male couples. Concordance on aspects of sexual agreements varied within the sample. Results indicated that relationship satisfaction was significantly associated with couples who were concordant about having and adhering to their sexual agreement. Predictability and faith of trusting a partner, and value in one’s sexual agreement were also positively associated with couples’ adhering to their sexual agreement. More research is needed to better understand how relationship dynamics, including sexual agreements, affect HIV risk among gay male couples in the U.S.

Use of MSM-specific apps was not uncommon among this sample of AMSM. Patterns of risk behavior and HIV testing were similar to samples of adult MSM app users. Further research should investigate AMSM's app-related sexual and HIV/sexually transmitted infection prevention decision-making to guide sexual health education efforts for AMSM.

Sociological, psychological, and public health studies document that many gay and bisexual men may self-label by their anal penetrative role (i.e., bottom or exclusively receptive; top or exclusively insertive; or versatile, both receptive and insertive during anal intercourse). Yet, what orients men to think of themselves as tops, bottoms or versatiles is poorly understood. We surveyed 429 men engaging in same-sex anal intercourse to investigate the degree to which anal penetrative self-identity was concordant with actual penetrative behavior. Additionally, the roles of masculinity and physical body traits (e.g., penis size, muscularity, height, hairiness, and weight) were tested as correlates of anal penetrative identity and identity-behavior concordance. Tops and bottoms showed a high degree of concordance between identity and enacted behavior; however, only half of versatiles reported concordant identity and behavior (i.e., wanting to be versatile and actually reporting versatile behavior). Generally, tops reported larger penises than bottoms. They also reported being comparatively more masculine than bottoms. Versatiles fell somewhat between the tops and bottoms on these traits. Of the six independent variables, penis size and masculinity were the only two factors to influence concordance or discordance between identity and penetrative behavior. Our study suggests that the correlates of gay men’s sexual self-labels may depend on objective traits in addition to the subjective pleasure associated with receptive or insertive anal intercourse.