Jesse Canchola

Battering Victimization Among a Probability-Based Sample of Men Who Have Sex With Men

OBJECTIVES This study measured the prevalence of battering victimization (i.e., experience of psychological/symbolic, physical, and sexual battering) among men who have sex with men (MSM) and identified characteristics of these men. METHODS A probability-based sample of 2881 MSM living in 4 cities completed telephone interviews between 1996 and 1998. RESULTS Prevalence estimates were 34% for psychological/symbolic battering, 22% for physical battering, and 5% for sexual battering. The strongest demographic correlate independently associated with all forms of battering was age 40 or younger, whereas education and HIV serostatus were associated with physical and psychological/symbolic violence. CONCLUSIONS Rates of battering victimization among urban MSM are substantially higher than among heterosexual men and possibly heterosexual women. Public health efforts directed toward addressing intimate partner battering among these men are needed.

EFFECTS OF INTERVIEWER GENDER, INTERVIEWER CHOICE, AND ITEM WORDING ON RESPONSES TO QUESTIONS CONCERNING SEXUAL BEHAVIOR

The authors examined factors influencing responses to questions on sexual behavior among adult respondents 18-49 years old (unweighted N = 2,030) obtained through a random-digit dialing survey. Based on self-disclosure and perceived control theory, they hypothesized that giving people a choice in selecting the gender of their interviewer rather than being assigned an interviewer, and using questions that are supportive of what may be perceived of as nonnormative behavior (enhanced items), would increase data quality relative to, respectively, matched-or opposite-gender interviewer conditions and standard worded items. The enhanced items facilitated responding to a number of sensitive topics. However, the effects of item wording on item response are often mediated by interviewer conditions. The choice results suggest that giving respondents greater control decreases question threat. However, the overall findings argue for matching respondents and interviewers on gender over opposite-gender interviewers or allowing respondents to select their interviewers gender. Wording and interviewer manipulations reduced the discrepancies between mens and womens self-reports of sexual behavior, but they did not eliminate them, and in some cases they had no effect. The present findings suggest that males tend to be influenced by variations in item wording, interviewer gender, and respondent control across a somewhat wider range of sexual topics. In general, the findings recommend matching respondents and interviewers on gender and the use of more supportive wording in sexual behavior questions. However, for assessment of some topics (e.g., sexual violence) in particular segments of the population (e.g., men), other procedures, such as increasing respondent control, may be a better choice. Overall, the data support the view that in terms of preferred procedures, not all sexual topics are created equal

Suicide Attempts Among Gay and Bisexual Men: Lifetime Prevalence and Antecedents

OBJECTIVES We examined lifetime prevalence of suicide attempts and psychosocial correlates in a large population-based sample of men who have sex with men (MSM). METHODS A telephone probability sample of US urban MSM (n = 2881) were interviewed between November 1996 and February 1998. RESULTS Twenty-one percent had made a suicide plan; 12% had attempted suicide (almost half of those 12% were multiple attempters). Most who attempted suicide made their first attempt before age 25. Although prevalence of parasuicide (i.e., attempted suicide) has remained constant across birth cohorts, mean age at initial attempts has declined. CONCLUSIONS MSM are at elevated risk for suicide attempts, with such risk clustered earlier in life. Some risk factors were specific to being gay or bisexual in a hostile environment.

Recalling sexual behavior: a methodological analysis of memory recall bias via interview using the diary as the gold standard

This study examined the effect of time lag on the validity of retrospective self‐reports of sexual behavior. Seventy‐five heterosexual students (44 women, 31 men) made daily recordings of sexual behavior, condom use, and alcohol or substance use for 1 month. Ability of respondents to recall sexual behavior recorded during this period was assessed at 1, 2, and 3 months after diary completion using recall interviews (25 interviewed at each interval). For vaginal intercourse, total recall error was significantly greater at 3 months than at 1 month post‐diary. For all other variables assessed, the 2‐ and 3‐month time intervals did not produce significant increases in total recall error. Higher frequency of vaginal intercourse, orgasm, and alcohol use prior to sexual activity were associated with total recall error for some but not all behaviors and outcomes. The results provide a partial validation of the diary‐interview recall model as a method for studying recall error.

Mediators of Childhood Sexual Abuse and High-Risk Sex Among Men-Who-Have-Sex-With-Men

OBJECTIVE Mediators of childhood sexual abuse (CSA) and HIV risk behavior were examined for men-who-have-sex-with-men (MSM). METHOD Data from a dual frame survey of urban MSM (N=1078) provided prevalence estimates of CSA, and a test of two latent variable models (defined by partner type) of CSA-risk behavior mediators. RESULTS A 20% prevalence of CSA was reported. For MSM in secondary sexual relationships, our modeling work identified two over-arching but inter-related pathways (e.g., both pathways include effects on interpersonal skills) linking CSA and high-risk behavior: (1) CSA-Motivation-Scripts-Skills-Risk Behavior; and (2) CSA-Motivation-Coping-Risk Appraisal-Skills-Risk Behavior. For men in primary relationships, there was one over-arching pathway including CSA-Motivation-Coping-Risk Appraisal-Risk Behavior processes. Exploratory analyses indicated that men with a history of CSA in only primary relationships versus only secondary relationships had, for example, fewer motivational problems, and better coping and interpersonal skills. CONCLUSIONS CSA contributes to the ongoing HIV epidemic among MSM by distorting or undermining critical motivational, coping, and interpersonal factors that, in turn, influence adult sexual risk behavior. Further, the type of adult relationships men engage in serve as markers for adult CSA-related problems. The findings are discussed in the context of current theory and HIV prevention strategies. PRACTICE IMPLICATIONS Direct extrapolation from our findings to practice is limited. However, there are general implications that may be drawn. First, the complex challenges faced by men with severe CSA experiences may limit the effectiveness of typical short-term HIV risk reduction programs; more intensive treatment maybe needed. Secondly, Clinical Psychologists and Psychiatrists with MSM patients with CSA histories should, if not already, routinely consider issues of sexual health; patterns and types of sexual partners may be useful markers for identifying more problematic cases. Lastly, public service messages directed at destigmatizing CSA for MSM may increase use of health and mental health services.

Mammography Rescreening Among Women of Diverse Ethnicities: Patient, Provider, and Health Care System Factors

This study identified patient, provider, and health care system factors that influenced mammography rescreening among non-insured, racial/ethnic minority women. Data were collected using a stratified-clustered random sample survey of 1,050 women of five racial/ethnic groups (Latina, Chinese, Filipina, African American, and Caucasian) and 102 primary care clinical sites. Women received screening services through two no-cost screening programs in California. Chi-square tests were used to assess bivariate associations and multiple logistic regressions were used to compute adjusted odds ratios and 95% confidence intervals. Mammography rescreening was associated with living in the United States longer; having higher education levels, better health care access, a history of breast problems, and favorable perceptions of mammography; obtaining regular Pap screening and hormone replacement therapy; having had better communication with clinicians; and attending clinics that conducted in-reach activities. This study suggests that simply removing financial barriers is not enough to improve mammography rescreening among underserved women.

Obtaining HIV test results with a home collection test kit in a community telephone sample

Objectives: To test the feasibility of obtaining HIV test results by home collection kit from a probability telephone sample of men who have sex with men (MSM). Methods: A quota sample of 615 MSM previously interviewed by the Urban Mens Health Study phone survey in Chicago, Los Angeles, New York City, and San Francisco were re‐contacted and offered an HIV test using an oral specimen (Orasure) home collection kit. Results: Eighty percent consented to be mailed a kit, and 84% returned a specimen, for a 67% participation rate. All self‐reported HIV‐positive persons tested positive (77 of 77); 4 of 266 (1.5%) with a prior negative test and 2 of 69 (2.9%) with no prior positive HIV test result. Participation was associated with self‐reported prior HIV test status—HIV‐positive (83%), HIV‐negative (68%), or no prior HIV test result (54%)—and marginally associated with New York City residence after adjustment for HIV status (odds ratio = 0.7; 95% confidence interval, 0.4‐1.1; p = .08). Conclusions: These results suggest that urban MSM identified and interviewed by telephone will participate in home collection HIV testing. This methodology could be used to produce population‐based estimates of HIV seroprevalence and seroincidence in MSM and could probably be extended to other populations and other viral infections.

RESPONSE TO “THEY SAID IT COULDN'T BE DONE THE NATIONAL HEALTH AND SOCIAL LIFE SURVEY”

We are writing in response to the article by Peter Miller in Public Opinion Quarterly (59 [1995]:404-19). As researchers involved in conducting surveys of peoples sexual behavior in relation to health issues, we read Peter Millers article with interest and found it to be insightful in terms of its review of the National Health and Social Life Survey (NHSLS). However, investigators on the National AIDS and Behavioral Survey (NABS) could not help but notice that Miller incorrectly presents a number of aspects of the NABS study. We will first address the comparison of numbers of sexual partners from the NABS data to the data from the NHSLS; second, we will comment on a number of misinterpretations of the NABS; and third, we will address what we perceive to be errors in Millers presentation of public health information on the disease AIDS.

Understanding the Demographic Characteristics of Urban Men who Have Sex with Men

Abstract We examined migration, closetedness, and family structure explanations of demographic profiles of urban men who have sex with men (MSM) using data from the Urban Mens Health Study and the Public Use Microdata Sample of the U.S. Census. The data suggested that the demographic profiles of urban MSM reflect a large in-migrating white, often young adult, population without children. Closetedness, an oft-cited bias in MSM population studies, did not significantly impact demographic patterns with minor exceptions. MSM urban subpopulations have demographics that differ substantially from the general population of the cities in which they reside.