Life Chaos and Perceived Social Support Among Methamphetamine-Using Men Who Have Sex With Men Engaging in Transactional Sexual Encounters

Abstract

Objective Social support and life chaos have been inversely associated with increased risk of HIV infection. The purpose of this study was to explore among a sample of HIV-negative methamphetamine-using men who have sex with men (MSM) the association between engaging in transactional sex, life chaos, and low social support. Methods HIV-negative methamphetamine-using MSM completed an online questionnaire between July and October 2012 about recent substance use and sexual behavior. Bivariate and multivariate tests were used to obtain statistically significant associations between demographic characteristics, engaging in transactional sex, life chaos, and the participants’ perception of their social support. Results Of the 325 participants, 23.7% reported engaging in transactional sex, 45.2% reported high life chaos, and 53.5% reported low perceived social support. Participants who engaged in transactional sex were more likely to have high life chaos than participants who did not (aOR = 1.70, 95% CI = [1.01, 2.84]); transactional sex was not associated with social support. Participants with high life chaos were more out about their sexual orientation (aOR = 2.29, 95% CI = [1.18, 4.42]) and more likely to perceive they had low social support (aOR = 3.78, 95% CI = [2.31, 6.22]) than participants with low life chaos. Non-Latinos perceived they had less social support than Latinos (aOR = 0.48, 95% CI = [0.25, 0.92]). Conclusions Methamphetamine-using MSM engaging in transactional sex experience more life chaos than those who do not engage in transactional sex. Outness, perceived social support, and ethnicity are associated with life chaos.

Factors Associated with Perceived Life Chaos among Post-Myocardial Infarction Survivors in a Malaysian Cardiac Care Facility

“…The relatively limited literature that has explored life chaos in adults has mainly focused on western communities. To date, three studies have determined life chaos among adults living with HIV [ 3 , 28 , 29 ], two studies have explored life chaos in American MI cohorts [ 4 , 10 ], one study has utilized qualitative approach to understand the process of “living in chaos and striving for control” among attention deficit hyperactivity disorder (ADHD) adults [ 30 ], and another investigation has studied life chaos among methamphetamine-using men who have sex with men (MSM) and engage in transactional sex [ 31 ]. All these studies showed high levels of chaotic lifestyles, which is consistent with the findings of the current study.…”

“…The bulk of the literature have highlighted the importance of social support in post-MI survivors; having fragmented or fragile social support networks inhibits fundamental coping mechanisms to overcome unexpected psychosocial repercussions like chronic stress, fast-paced life, having too much responsibilities, accumulation of unpredicted life events, depression, anxiety, social isolation, and withdrawal and life chaos [ 13 , 31 , 34 ]. In this study, multivariate analysis showed that the association between concerns shown by others (emotional social support) and life chaos could not be considered as an independent association; therefore, adding an interaction without a main effect could not be considered.…”

Life Chaos is Associated with Reduced HIV Testing, Engagement in Care, and ART Adherence Among Cisgender Men and Transgender Women upon Entry into Jail

“…While life chaos remains an underexplored concept in the health literature, a few previous studies have demonstrated that it predicts important health outcomes. Life chaos predicted missed appointments and poor medication adherence among PLH [12,13], and patients with chronic illness, [14,15] as well as risky sexual behavior among men who have sex with men (MSM) [16]. In addition, life chaos was associated with structural barriers to HIV care -poverty, homelessness, and having unmet needs for financial, employment, and food support servicessupporting its validity [12,13].…”

“…The literature on criminal justice-involved people living with HIV describes high levels of chaos in their lives. They frequently experience poverty, comorbid substance use disorder [17,18] housing instability [19], and social isolation from HIV stigma, all of which may lead to life chaos [13,16,20]. Many come from communities where households and relationships are disrupted from high rates of incarceration [21].…”

“…Supportive social relationships have been shown to be positively associated with protective HIV-related behaviors, fewer HIV infections, and better HIV care continuum outcomes in general [25][26][27][28][29], including for incarcerated PLH [18,30,31]. Social support provides material resources or emotional support to buffer the effects of stressors [32,33], and can potentially counter the effects of life chaos [16]. On the other hand, social relationships are a source of HIV-related stigma, the devaluation and discrimination of PLH, which can be a potent barrier to continuum of care outcomes.…”