Eric A. Fenkl

Aging Gay Men: A Review of the Literature

The population of older Americans is growing, as is the population of older Americans who identify as gay or lesbian. It has been estimated that by 2030, one in five Americans will be age 65 or older, with approximately four million of those individuals identifying themselves as gay or lesbian. Even by the most conservative estimates, this indicates that approximately 1.2 to 1.4 million of those individuals will be older gay men. Despite these significant shifts in population, reports show that a more contemporary appraisal of the needs of older gay men is warranted. Additional inquiry into the needs of older gay men was further validated in 2011 by the landmark report released by the Institute of Medicine that called attention to health disparities often encountered by lesbian, gay, bisexual, and transgender individuals. In an effort to more fully understand the state of the science related to aging among older gay men, an integrated literature review was conducted. The purpose of this article is to present this literature review of aging among gay men within an established framework that can facilitate and guide further research inquiry.

Evaluation of an HPV/Anal Cancer Screening Awareness Program for HIV-infected Men Who Have Sex With Men

Eric A. Fenkl, PhD, RN, is an assistant professor, Florida International University – Nicole Wertheim College of Nursing and Health Sciences, Miami, Florida, USA. Elie Schochet, MD, is a colorectal surgeon, private practice affiliated with Holy Cross Medical Group, Fort Lauderdale, Florida, USA. Sandra Gracia Jones, PhD, RN, FAAN, is an associate professor, Florida International University – Nicole Wertheim College of Nursing and Health Sciences, Miami, Florida, USA. Bruno R. da Costa, PhD, is an assistant professor, Florida International University – Nicole Wertheim College of Nursing and Health Sciences, Miami, Florida, USA. Human papillomavirus (HPV) is considered a risk factor for anal cancer. Men who have sex with men (MSM) have been reported to be 20 times more likely to be diagnosed with anal cancer, and HIV-infected MSM have been reported to be 40 times more likely to be diagnosed with anal cancer. Even prior to the HIV epidemic, MSM were reported to have a significantly higher incidence of anal cancer compared with the general population (Klencke & Palefsky, 2003). However, soon after the HIV epidemic began, it was further noted that rates of anal cancer for HIV-infected MSM were significantly higher than anal cancer rates for MSM without HIV infection. Anal cancer rates increased even more significantly for HIV-infected MSM following the lifeprolonging emergence of antiretroviral therapy in the mid-1990s (Klencke & Palefsky, 2003). Thus, a burgeoning new epidemic of anal cancer attributed to the lethal triad of MSM, HIV, and HPV became well recognized (Goedert et al., 1998; Palefsky, Holly, Hogeboom et al., 1998; Palefsky, Holly, Ralston, & Jay, 1998). Based on previous findings related to the cost burden ratio of noncervical HPVrelated disease (Goldie, Kuntz, Weinstein, Freedberg, & Palefsky, 2000; Hu & Goldie, 2008), it has been suggested that screening for anal cancer, similar to cervical cancer, both biologically and epidemiologically, could potentially impact the

The Perceived Effects of Condoms on Sexual Experience: A Comparison of Older Hispanic and Non-Hispanic Men.

Heterosexual transmission of HIV and other sexually transmitted diseases (STDs) is increasing in older adult populations around the world. This study compares Hispanic and non-Hispanic men ages 50 years and older currently using prescribed erectile dysfunction medications in relation to their perception of the effect of condoms on sexual experience. A sample of 86 men (40 Hispanic and 46 non-Hispanic men) ages 50-79 years completed the 10-item Effect on Sexual Experience (ESE) subscale. Although there was no difference between the 2 groups on the subscale mean score, t(84) = 1.449, p = .151, analysis of the subscale items found 1 item that was significantly different (p = .005) between the 2 groups, although this difference could have been related to different perceptions of the word disgusting. Hispanic men were also less concerned than non-Hispanic men about condom-related loss of erection. This study adds to the literature on HIV and STD prevention for older Hispanic/Latinos.

Condom Attitudes of Heterosexual Men Ages 50 and Older Using Prescribed Drugs (Viagra Cialis Levitra) to Treat Erectile Dysfunction.

The purpose of this study was to explore attitudes about condoms that may affect condom use by heterosexual men ages 50 and older who were sexually active and currently using prescribed oral phosphodiesterase type 5 inhibitor medications (Viagra®, Cialis®, or Levitra®) for treatment of erectile dysfunction. The study was part of a larger study that explored the need for safer-sex health promotion and education for these men. Fifty men completed factor subscales of the Condom Attitude Scale. Subscales were scored and analyzed. Positive factors were found with regard to the Interpersonal Impact, Inhibition, Perceived Risk, Perceived Seriousness, and Global Attitudes subscales. Factors with negative or neutral responses included the Effect on Sexual Experience, Relationship Safety, and Promiscuity subscales. Independent t tests revealed no differences between married and nonmarried men for the mean score on any of the subscales, but there was a difference on the Global Attitude Scale, with younger men having a more positive global attitude than older men. Study findings can be used in the development of health promotion educational activities on condom use as a safer-sex practice.

Panther Mpower: A Campus-Based HIV Intervention for Young Minority Men who Have Sex with Men

Summary: Miami-Dade and Broward counties remain an epicenter of the HIV/AIDS epidemic in the U.S. This report from the field describes the implementation of a SAMHSA-funded, campus-based initiative to address HIV prevention and testing for young minority men who have sex with men. Outcome criteria are clearly delineated and benchmarks for measuring outcomes are reported.

Effectiveness of Nursing Student-led HIV Prevention Education for Minority College Students: The SALSA Project

Abstract: Objectives. To evaluate the effectiveness of the Student Awareness of the Link between Substance Abuse and AIDS (SALSA) Student Peer Educators (SPEs) in increasing freshman students’ HIV knowledge/awareness, and to assess students’ perceptions of the SPEs as teachers/HIV prevention educators. Methods. Junior nursing students served as SALSA SPEs and presented an updated 50-minute sexual health class to freshman students. An investigator-developed questionnaire and program evaluation form was completed by attendees at the end of class. Results. A total of 66 classes were presented by 71 SALSA SPEs to 965 freshman students. Questionnaire results revealed that the freshman students increased their knowledge/awareness of HIV transmission/prevention, while decreasing their likelihood to engage in risky sex. Program evaluation resulted in ratings of excellent. Conclusion. The findings suggest that campus-based SPEs may be effective in educating freshman students about HIV and risky sexual behaviors.

Young Hispanic Men’s HIV and STI Knowledge, Attitudes, Beliefs, and Behaviors

Introduction: The rate for new infections of HIV and other sexually transmitted infections (STIs) has increased for Hispanic males. Method: This descriptive correlational study describes knowledge, attitudes, and beliefs of HIV and other STIs and explores the relationship between age and HIV and STI knowledge among young adult Hispanic males. A sample of 179 Hispanic men aged 18 to 64 years attending college completed the 80-item Community Health Packet, the 18-item Brief HIV Knowledge Questionnaire, and the 27-item STD Knowledge Questionnaire. Results: Almost half of the participants were involved in some form of high-risk sexual practices such as having multiple sex partners, holding apathetic views on condom use, showing low rates of HIV testing, having incorrect knowledge of STI transmission, and holding misconceptions about HIV. Findings included a moderate positive relationship between age (M = 24.05; SD = 7.08) and HIV knowledge scores (M = 13.21; SD = 4.04), r(175) = .43, p < .00, as well as a positive relationship between age (M = 24.05; SD = 7.08) and STI total scores (M = 14.47; SD = 7.20), r(173) = .31, p < .00. Conclusion: Study findings reveal the need to continue HIV and STI prevention education programs on college campuses to increase knowledge and help decrease new cases of STIs and HIV in Hispanic men.

Optimistically Engaging in the Present

This study explores the experiences of aging among gay men to further explain the phenomenon of gay male aging in contemporary terms, to put those experiences into a historically relevant context, and to expand upon previous findings on aging within the gay male population. Nineteen self-identifying gay men from a metropolitan area in South Florida were interviewed. The data collected were analyzed using grounded theory method. Findings from the study indicated that a great deal of optimism was revealed by the participants of the study in spite of their past adversarial experiences related to their sexuality and current challenges related to gay male sexuality and aging. Based on these findings, professionals working with an older population should consider the supportive environments that can most benefit this population in the community and even consider partnering with lesbian, gay, bisexual, and transgender (LGBT) oriented organizations to better serve the needs of their clients.

Nursing Schools in Partnership with CBOs for HIV Prevention: The SAMHSA MSI-CBO Initiative

Sande Gracia Jones, PhD, ARNP, ACRN, ACNS-BS, FAAN, is a Professor, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, Florida, USA. (*Correspondence to: joness@fiu.edu). Eric A. Fenkl, PhD, RN, CNE, is an Associate Professor, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, Florida, USA. Teri Aronowitz, PhD, APRN, FNP-BC, is an Associate Professor, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA.

Minority College Students' HPV Knowledge, Awareness, and Vaccination History

Sande Gracia Jones, PhD, ARNP, ACRN, ACNS-BS, FAAN, is a Professor of Nursing, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, Florida, USA. (*Correspondence to: joness@fiu.edu). Kayla Mathis-Gamble, MSN, ARNPBC, is an Assistant Professor, Nursing Department, Broward College, and a PhD student at Florida International University, Miami, Florida, USA. Eric A. Fenkl, PhD, RN, CNE, is an Assistant Professor, Nursing, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, Florida, USA.