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.