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Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the U.S. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. We conclude that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, we suggest that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors.

Objective Young MSM (men who have sex with men), particularly young men of color, are experiencing the largest increase in HIV incidence of any risk group in the U.S. Epidemiological research suggests that the majority of transmissions among MSM are occurring in the context of primary partnerships, but little research has been done on the processes within these dyads that increase HIV risk behaviors. The aim of this study was to use longitudinal partnership-level data to explore the effects of partner and relationship characteristics on the frequency of unprotected sex within young MSM relationships. Methods One hundred twenty-two young MSM (age 16-20 at baseline) were assessed at three time-points six months apart, with 91% retention at the 12-month follow-up wave. Over 80% were racial/ethnic minorities. At each wave, participants reported on characteristics of the relationship and partner for up to three sexual partners. Hierarchical linear modeling was used for analyses. Results The largest effect was for considering the relationship to be serious, which was associated with nearly an eight-fold increase in the rate of unprotected sex. Other factors that increased risk behaviors included: older partners, drug use prior to sex, physical violence, forced sex, and partnership lasting more than 6 months. Partners met online were not associated with significantly more sexual risk. Conclusions These data provide insight into the relationship processes that should be addressed in prevention programs targeted at young MSM. Relationships may serve as a promising unit for HIV prevention interventions, although more formative research will be required to address potential logistical obstacles to implementing such interventions. The partner-by-partner analytic approach (i.e., evaluating situational variables associated with several partners for a given participant) holds promise for future HIV behavioral research.

In this review, we document the historical and cultural shifts in how gay and bisexual men have used the Internet for sexuality between the 1990s and 2013. Over that time, gay and bisexual men have rapidly taken to using the Internet for sexual purposes: sexual health information seeking, finding sex partners, dating, cybersex, and pornography. Gay and bisexual men have adapted to the ever-evolving technological advances that have been made in connecting users to the Internet—from logging into the World Wide Web via dial-up modem on a desktop computer to geo-social and sexual networking via a handheld device. In kind, researchers too have adapted to the Internet to study gay and bisexual men, though not at the same rapid pace at which technology (and its users) have advanced. Studies have carefully considered the ethics, feasibility, and acceptability of using the Internet to conduct research and interventions with gay and bisexual men. Much of this work has been grounded in models of disease prevention, largely as a result of the ongoing HIV/AIDS epidemic. The urgent need to reduce HIV in this population has been a driving force to develop innovative research and Internet-based intervention methodologies. Moving forward, a more holistic understanding of gay and bisexual men's sexual behavior might be warranted to address continued HIV and STI disparities. The Internet, and specifically mobile technology, is an environment gay and bisexual men are using for sexual purposes. These innovative technologies represent powerful resources for researchers to study and provide rapidly evolving outreach to gay and bisexual men.

Gender-affirming care, including hormone therapy, "top" (e.g., chest reconstruction surgery) and "bottom" (e.g., vaginoplasty, phalloplasty, metoidioplasty, etc.) surgeries, and puberty blockers, is an efficacious treatment of gender dysphoria for transgender and gender nonconforming (TGNC) individuals. However, many TGNC people encounter significant barriers in accessing gender-affirming care, which we detail via results from on online study. Participants included 256 TGNC individuals (78.9% White, ages 16-73, =28.4). Among participants, 61.3% were receiving hormone therapy, 22.7% had undergone top surgery, and 5.5% had undergone bottom surgery. Open-ended responses (=201) were thematically analyzed and common barriers included finances and insurance issues, a lack of service availability, and fears or worries. Participants reported various systemic issues and incidents of bias within medical and mental health fields, as well as a lack of medical provider awareness and education. Other themes were interpersonal barriers (e.g., fears of rejection); age and need of parental consent for minors; other medical issues; and a lack of information about how to acquire care. These findings can be utilized to educate professionals in medical and mental health fields about barriers their TGNC patients may encounter in receiving affirming care, and suggest a number of ways to improve access to these services.

Purpose The mental health and victimization of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth have garnered media attention with the “It Gets Better Project.” Despite this popular interest, there is an absence of empirical evidence evaluating a possible developmental trajectory in LGBTQ distress and the factors that might influence distress over time. Methods This study used an accelerated longitudinal design and multilevel modeling to examine a racially/ethnically diverse analytic sample of 231 LGBTQ adolescents aged 16–20 years at baseline, across six time points, and over 3.5 years. Results Results indicated that both psychological distress and victimization decreased across adolescence and into early adulthood. Furthermore, time-lagged analyses and mediation analyses suggested that distress was related to prior experiences of victimization, with greater victimization leading to greater distress. Support received from parents, peers, and significant others was negatively correlated with psychological distress in the cross-sectional model but did not reach significance in the time-lagged model. Conclusions Analyses suggest that psychological distress might “get better” when adolescents encounter less victimization and adds to a growing literature indicating that early experiences of stress impact the mental health of LGBTQ youth.

Research suggests that lesbian, gay, and bisexual (LGB) youth are at increased risk for both victimization and internalizing mental health problems, but limited research has studied their association or factors that increase resilience. The sample included 425 LGBs between the ages of 16 and 24 year. The majority had disclosed their sexual orientation to family or friends (98%) and 97% had someone in their lives who was accepting. Racial/ethnic minority and female participants in general reported lower levels of disclosure and acceptance. Most participants reported some form of sexual orientation-related victimization (94%). Victimization was associated with psychological distress, but a compensatory model indicated that in the context of this victimization both peer and family support had significant promotive effects. A test of a protective model found social support did not ameliorate negative effects of victimization. The positive effects of family support decreased with age. Peer and family support were particularly important, but they did not significantly dampen the negative effects of victimization. Our findings suggest that mental health professionals working with LGB youth should address social support and that public health approaches are needed to reduce levels of victimization.

Transgender and gender diverse (TGD) people are disproportionately impacted by various health issues and associated risk factors, but little is known about differences in these outcomes between gender identities within the TGD population. This study characterized the health of a diverse sample of TGD youth and young adults. Data were taken from the baseline visit of two longitudinal studies in the Chicago area, RADAR (N = 1,079, M age = 20.8 years) and FAB 400 (N = 488, M age = 19.57 years), which are cohorts of young sexual and gender minorities assigned male at birth (AMAB) and assigned female at birth (AFAB), respectively. There was a combined sample of 214 TGD (128 AFAB, 86 AMAB) individuals across cohorts. We examined differences between gender identities in self-reported health and related psychosocial variables, and compared TGD youth and their cisgender sexual minority peers from their cohort of origin on all variables. Among TGD youth, we found high rates of depression and suicidality (ideation, plan, attempt), violence (trauma, victimization, childhood sexual abuse), and substance use (cigarette, alcohol, illicit drug use). With the exception of depression, transgender women and non-binary AMAB youth reported worse health outcomes than transgender men and non-binary AFAB youth. Nonbinary AMAB youth reported the highest rates of certain outcomes, including traumatic Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. https://www.springer.com/aamterms-v1