Pre-exposure prophylaxis (PrEP) has the potential to help reduce new HIV infections among young men who have sex with men (YMSM). Using a cross-sectional survey of YMSM (N=1,507; ages 18–24; 65% White, 9% Black, 17% Latino, 9% Other race/ethnicity), we gauged YMSM’s PrEP awareness and PrEP-related beliefs regarding side effects, accessibility, and affordability. Overall, 27% of the sample had heard about PrEP; 1% reported ever using PrEP prior to sex. In a multivariate logistic regression, we found that YMSM were more likely to have heard about PrEP if they were older (OR=1.13), more educated (OR=1.19), were residentially unstable in prior 30 days (OR=1.37), had insurance (OR=1.50), or reported having at least one sexually-acquired infection (STI) in their lifetime (OR=1.79). We found no differences by race/ethnicity, history of incarceration, or recent sexual risk behavior. In multivariate linear regression models, Black (b=.57) and Latino (b=.31) YMSM were more likely than Whites to state they would not use PrEP because of side effect concerns. YMSM were more likely to agree that they would not be able to afford PrEP if they did not have insurance (b=.53) or reported a prior STI (b=.33). PrEP rollout may be hindered due to lack of awareness, as well as perceived barriers regarding its use. We propose strategies to maximize equity in PrEP awareness and access if it is to be scaled up among YMSM.

Religiosity and spirituality are often integral facets of human development. Young gay and bisexual men (YGBM), however, may find themselves at odds when attempting to reconcile potentially conflicting identities like religion and their sexual orientation. We sought to explore how different components of religiosity (participation, commitment, spiritual coping) are linked to different markers of psychological well-being (life purpose, self-esteem, and internalized homophobia). Using data collected in Metro Detroit (N = 351 ages 18–29 years; 47% African American, 29% Non-Latino White, 8% Latino, 16% Other Race), we examined how components of religiosity/spirituality were associated with psychological well-being among religious/spiritual-identified participants. An overwhelming majority (79.5%) identified as religious/spiritual, with most YGBM (91.0%) reporting spirituality as a coping source. Over three quarters of our religious/spiritual sample (77.7%) reported attending a religious service in the past year. Religious participation and commitment were negatively associated with psychological well-being. Conversely, spiritual coping was positively associated with YGBM’s psychological well-being. Programs assisting YGBM navigate multiple/conflicting identities through sexuality-affirming resources may aid improve of their psychological well-being. We discuss the public health potential of increasing sensitivity to the religious/spiritual needs of YGBM across social service organizations.

Purpose We know little about the prevalence of sexting behavior among young men who have sex with men (YMSM) or its association with their sexual behaviors. Methods To address these gaps, we used data from an online study examining the partner-seeking behaviors of single YMSM (N=1,502; ages 18–24) in the U.S. Most participants (87.5%) reported sexting, with 75.7% of the sample reporting having sent and received a sext. Results Sexting was more frequent among sexually-active YMSM, with YMSM who had sent and received a sext being more likely to report insertive anal intercourse, with and without condoms, than those who had not sexted. We found no association between sexting and receptive anal intercourse. Conclusions Our findings suggest that sexting may vary by YMSM’s sexual roles. We discuss our findings with attention to their implications for sexual health promotion.

Discrimination has been linked to negative health outcomes among minority populations. The increasing evidence regarding health disparities among sexual minorities has underscored the importance of addressing sexuality discrimination as a public health issue. We conducted a web-based survey between May and September of 2012 in order to obtain a diverse sample of young men who have sex with men (ages 18–29; N = 397; 83% gay; 49% Black, 27% White, 15% Latino) living in the Detroit Metro Area (Michigan, USA). Using multivariate regression models, we examined the association between overall health (self-rated health, days in prior month when their physical or mental health was not good, limited functionality) and experiences of sexuality-based work discrimination. Fifteen percent reported at least one experience of sexuality-based work discrimination in the prior year. Recent workplace discrimination was associated with poorer self-rated health, a greater number of days when health was not good, and more functional limitation. We discuss the importance of addressing sexuality-related discrimination as a public health problem and propose multilevel intervention strategies to address these discriminatory practices.

Testing for both HIV and STIs is an essential component of comprehensive sexual healthcare for young men who have sex with men (YMSM). Using data collected from YMSM living in the Detroit metropolitan area (N = 304, ages 18-29; 51% Black, 25% White, 14% Latino), we examined YMSM's access to a medical provider in the prior year and tested whether a provider's conversation regarding HIV/STI prevention was associated with their type of testing behavior: Non-Testers, HIV-Only Testing, and HIV and STI Testing. Over half (56.7%) reported a routine provider visit in the previous year. Visits were associated with having insurance, provider comfort, and prior HIV and/or STI testing. Among YMSM who visited a doctor, our multinomial regression exhibited that those whose provider discussed HIV/STI prevention were most likely to have tested for both HIV and STIs, as compared to the HIV Only and Never Tester categories. Patient-provider communication regarding HIV/STI prevention is critical to motivate comprehensive sexual healthcare access among YMSM. Strategies that enable providers to discuss HIV/STI prevention with YMSM in a sex-positive manner may help maximize comprehensive testing.