Different cohorts of gay/bisexual men experience unique developmental factors given their distinct socio-historical contexts. This study examined the moderating effects of age on three psychosocial predictors of HIV risk behavior and substance use. Analyses drew on data from a study of substance using HIV-negative and unknown status gay/bisexual men (N = 302) at risk for HIV infection. Anxiety was a strong independent predictor of sexual risk and substance use, and its effects on the sex risk outcomes were moderated by age, such that older and more anxious participants had more frequent instances of sexual risk. Identification with the gay community protected against HIV risk, and its effects on sex risk outcomes were moderated by age, such that younger participants who identified with the gay community reported less sexual risk. Understanding HIV risk within socio-historical contexts is essential in tailoring prevention by taking into account recipients’ ages.

BackgroundAn international randomized clinical trial (RCT) on pre-exposure prophylaxis (PrEP) as an human immunodeficiency virus (HIV)-prevention intervention found that taken on a daily basis, PrEP was safe and effective among men who have sex with men (MSM) and male-to-female transgender women. Within the context of the HIV epidemic in the United States (US), MSM and transgender women are the most appropriate groups to target for PrEP implementation at the population level; however, their perspectives on evidenced-based biomedical research and the results of this large trial remain virtually unknown. In this study, we examined the acceptability of individual daily use of PrEP and assessed potential barriers to community uptake.MethodsWe conducted semi-structured interviews with an ethnoracially diverse sample of thirty HIV-negative and unknown status MSM (n = 24) and transgender women (n = 6) in three California metropolitan areas. Given the burden of disease among ethnoracial minorities in the US, we purposefully oversampled for these groups. Thematic coding and analysis of data was conducted utilizing an approach rooted in grounded theory.ResultsWhile participants expressed general interest in PrEP availability, results demonstrate: a lack of community awareness and confusion about PrEP; reservations about PrEP utilization, even when informed of efficacious RCT results; and concerns regarding equity and the manner in which a PrEP intervention could be packaged and marketed in their communities.ConclusionsIn order to effectively reduce HIV health disparities at the population level, PrEP implementation must take into account the uptake concerns of those groups who would actually access and use this biomedical intervention as a prevention strategy. Recommendations addressing these concerns are provided.

Religious faith has been instrumental in fostering positive mental health outcomes for historically disenfranchised populations, such as Black Americans. However, the religious institutional devaluing of same-sex behavior and identity fuels internalized homonegativity (i.e., negative thoughts regarding one's same-sex sexual behavior) for nonheterosexual congregants. This study sought to examine the relations between religious faith, internalized homonegativity, and resiliency for Black lesbian, gay, and bisexual (LGB) emerging adults. One hundred seventy-five Black LGB emerging adults, ranging in age between 18 and 25 years old, completed an online survey designed to examine multiple identities and psychological well-being. Utilizing hierarchical linear regression, we found that internalized homonegativity moderated the relationship between religious faith and resiliency. Religious faith was a significant contributor to resiliency when the participant concurrently reported high internalized homonegativity. This finding highlights the importance of understanding the complex interplay of religious faith, internalized homonegativity, and resiliency for Black LGB emerging adults.

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Transgender women completed questionnaires of religiosity, social support, stigma, stress-related growth, and sexual risk behavior. In a multivariate model, both social support and religious stressrelated growth were significant negative predictors of unprotected anal sex, but religious behaviors and beliefs emerged as a significant positive predictor. The interaction between religious behaviors and beliefs and social support was also significant, and post-hoc analyses indicated that high-risk sex was least likely among individuals with high-levels of social support but low levels of religious behaviors and beliefs. These data have important implications for understanding factors that might protect against HIV risk for transgender women. KeywordsTransgender; HIV; sexual risk; religiosity; stress-related growth Transgender women (also referred to as male-to-female or MTF transgender persons) are individuals who are born biologically male, but self-identify as female. Transgender women -especially transgender women of color -constitute a socially marginalized group with multiple stigmatized identities. Social stigma and marginalization are often associated with poor psychological adjustment and increased psychological distress, both critical predictors of high-risk behavior (Bockting, Robinson, & Rosser, 1998). Indeed, transgender women are at increased risk for HIV infection, with estimates of HIV seroprevalence in major urban centers in the United States ranging from 22% to 68 % (Garafalo, Deleon, Osmer, Doll & Harper, 2006;Elifson et al.,1993;Edwards, Fisher & Reynolds, 2007;Clements-Nolle, Marx, Guzman & Katz, 2001;Risser et al., 2005;Xavier, Bobbin, Singer & Budd, 2005). A recent metaanalysis of 29 studies estimated average seroprevalence among transgender women at 28% (Herbst, 2008), and some data suggest that transgender women may have HIV incidence rates higher than any other risk group (Kellogg, Clements-Nolle, Dilley, Katz, & McFarland, 2001). HIV seroprevalence estimates are even higher for transgender women of color; in studies Increased HIV risk among transgender women has been linked to a variety of behavioral factors, including high prevalence of sex work (Operario, Soma & Underhill, 2008;Nemoto, Operario, Keatley, Han & Soma, 2004), increased rates of unprotected anal sex (Garofalo et al., 2005;Nemoto et al., 2004), and high rates of sex under the influence of alcohol or drugs (Bockting et al., 1998; Garofalo et al., 2005). Engagement in these high-risk behaviors has been linked to the stigma experienced by transgender women (Bockting et al., 1998). Some research has specifically linked stressful life circumstances and sexual risk-taking, finding that exposure to stressful events is associated with a variety of unhealthy behaviors, including highrisk sexual behavior and substance use (Johnsen & Harlow, 1996;Lang et al., 2003;Semple et al., 2009). In past studies of transgender women, high rates of discrimination predicted unsafe sex (Bockting, et al., 2002), as did low self-esteem and hist...

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Rising HIV infection rates have been recently occurring among Black men who have sex with men (BMSM) in the United States. As a result, promoting HIV testing among members of this population is now considered a priority among local and federal health officials. A study was conducted to explore concerns about HIV testing among BMSM in New York City. In early 2006, data were gathered from focus groups with 29 BMSM. Discussions revealed factors affecting HIV testing, including stigma, sexuality, religion, race, and class, emphasizing responsibility, testing concerns, and media influences, among others. Recommendations were submitted to New York City health officials to inform HIV testing and prevention efforts.

Researchers and interventionist should consider the ways in which racial centrality may be a critical tool in our efforts to decrease the HIV epidemic among young Black gay and bisexual men in America.