Jorge Fontdevila

HIV risks of men in methadone maintenance treatment programs who abuse their intimate partners: a forgotten issue.

Accumulating findings suggest a relationship between partner violence and HIV risk among women, however, this issue has yet to be adequately researched among men. This study examines the relationship between perpetrating intimate partner violence and HIV risk behavior among a sample of men in methadone maintenance treatment programs (MMTPs). Data were collected on 273 sexually active men, who were recruited from four inner-city MMTP clinics. More than a third of the sample reported perpetrating intimate physical abuse and 15% reported severe physical abuse in the past 12 months. Results from multiple logistic regression analyses indicate that after adjusting for demographic, poverty, and drug-use factors, men who abused an intimate partner were almost 4 times more likely to have more than one intimate partner, almost 3 times more likely to have unprotected anal sex, and 2.6 times more likely to have sex with a drug-injecting sexual partner than their counterparts. This study showed that men who perpetrated partner violence were at higher risk for HIV transmission. HIV prevention interventions need to consider the complex relationship between partner violence and HIV risk.

Deconstructing the relationship between intimate partner violence and sexual HIV risk among drug-involved men and their female partners.

This study, based on data from a random sample of 322 men on methadone, examines whether traditional male gender role beliefs, male substance use, and couple drug-involvement lead to male psychological dominance, which in turn leads to perpetration of intimate partner violence (IPV) and sexual HIV risk behavior. Structural equation modelingindicated that male psychological dominance is directly associated with perpetrating both physical IPV and sexual HIV risk; however, physical IPV did not lead to sexual HIV risk as predicted originally. Stronger endorsement of traditional male gender role beliefs was associated with male psychological dominance. Couple drug-involvement was also directly associated with male psychological dominance as well as sexual HIV risk. Male substance use led to couple drug-involvement, but not to physical or sexual HIV risk as hypothesized. Study findings highlight the significance of couple drug-involvement and male psychological dominance as pathways leading to physical IPV and sexual HIV risk behavior. Implications for HIV prevention efforts targeting drug-involved men and their sexual partners are discussed.

Perpetration of Intimate Partner Violence Among Men in Methadone Treatment Programs in New York City

This study examined the prevalence of perpetration of intimate partner violence among 356 men recruited from methadone maintenance treatment programs. We used logistic regression with covariance adjustment to examine the associations between intimate partner violence and illicit drug use by the participants, their female partners, or both. We found a high prevalence of intimate partner violence among the men in our sample. Significant associations between intimate partner violence and illicit drug use varied by types of drugs and whether the female partner or both partners were using drugs.

Border crossings and shifting sexualities among Mexican gay immigrant men: Beyond monolithic conceptions

This article describes patterns of interpretation and practice of same-sex desires pre- and post-migration among self-identified gay and bisexual Mexican immigrant men to the USA. Drawing on in-depth interviews with 80 such men, we argue that, contrary to stereotypes, their pre-migration interpretations and practices are considerably diverse and not solely informed by highly gendered understandings and styles of sexual interaction between men. After migration, some shift their interpretations and practices considerably, while others retain those that informed their sexualities pre-migration, either adapting them to their new sexual contexts or resisting any changes. These findings, which reveal the complexity and diversity of sexual interpretations among immigrant gay and bisexual men, pose a challenge to proposed systems of classifying same-sex desires as well as to conventional understandings of the impact of international migration on gay sexuality.

Rethinking Sexual Initiation: Pathways to Identity Formation Among Gay and Bisexual Mexican Male Youth

The topic of same-sex sexual initiation has generally remained understudied in the literature on sexual identity formation among sexual minority youth. This article analyzes the narratives of same-sex sexual initiation provided by 76 gay and bisexual Mexican immigrant men who participated in interviews for the Trayectos Study, an ethnographic study of sexuality and HIV risk. These participants were raised in a variety of locations throughout Mexico, where they also realized their same-sex attraction and initiated their sexual lives with men. We argue that Mexican male same-sex sexuality is characterized by three distinct patterns of sexual initiation—one heavily-based on gender roles, one based on homosociality, and one based on object choice—which inform the men’s interpretations regarding sexual roles, partner preferences, and sexual behaviors. We analyzed the social factors and forms of cultural/sexual socialization that lead sexual minority youth specifically to each of these three patterns of sexual initiation. Our findings confirm the importance of studying same-sex sexual initiation as a topic in its own right, particularly as a tool to gain a greater understanding of the diversity of same-sex sexual experiences and sexual identities within and among ethnic/cultural groups.

Predictors of Sharing Drugs Among Injection Drug Users in the South Bronx: Implications for HIV Transmission

Abstract HIV may be transmitted in the process of sharing injected drugs, even if all participants have their own syringes. In an effort to gain understanding of the extent and predictors of drug sharing, data were obtained via personal interviews with 1,024 injection drug users from four neighborhoods in the South Bronx. The relationship between drug-sharing and demographic, sexual, and drug-related variables was first examined in a bivariate analysis, and then via multiple logistic regression. Individuals who split drugs were more likely to be female, have had sex with a casual partner, exchanged sex for drugs or other needs, recently smoked crack cocaine, and shared needles. They were less likely to live or inject at their own home or have used a new needle the last time they injected. In a final logistic model, correlates of drug sharing included trading sex, injecting outside ones home, and using borrowed, rented or shared needles. Despite the lack of significance for gender in the final logistic model, females were at high risk of drug sharing because they constituted the great majority of those who exchanged sex. Continuing research is needed to understand how drug-sharing contributes to the spread of HIV and other infections, as are studies of approaches to reducing drug sharing. Prevention strategists and outreach organizations should be aware of the HIV risks inherent in the widespread practice of drug sharing.

HIV risk reduction among injection drug users: explaining the lack of anticipated outcomes in a community-level controlled comparison study

Abstract A quasi-experimental evaluation design was employed in order to determine whether community outreach efforts would result in reductions in drug- and sexual-related HIV risk behavior among injection drug users, and to gain insight into the potential effect of enhanced outreach on increased client participation in drug abuse treatment and STD/HIV services. Interviews were conducted with 1943 randomly selected drug users in two control neighborhoods and two experimental neighborhoods in the South Bronx. The sample was largely indigent males in their mid 30s, most with less than a high school education, of Hispanic or African American background. Data were gathered before and after enhanced outreach was instituted in the two experimental communities. Needle sharing decreased and bleach cleaning increased in both pairs of neighborhoods; however, sharing of cookers, cotton, and rinse water increased. Unprotected vaginal and anal sex decreased over time, but no between-condition differences in reductions in drug- or sex-related risk behaviors were found. Over time, an increasing proportion of drug users in both study conditions reported having attended substance abuse treatment, but longitudinal outcomes did not favor the enhanced outreach neighborhoods with respect to exposure to outreach messages or acceptance of referrals to chemical dependency treatment or STD/HIV services. In sum, HIV risks declined over time in both conditions, but there were no apparent differences in behavior change or treatment/services entry between the control and enhanced outreach neighborhoods. The study underscores the difficulty of interpreting cross-community comparisons of intervention outcomes in an environment of changing risks and neighborhood dynamics.

Relational Power from Switching across Netdoms through Reflexive and Indexical Language

We argue from a relational perspective that the reflexive and indexical dimensions of language are critical to understand “relations” formation in contemporary life. These dimensions are fundamental in the production of meaning ambiguity characteristic of social relations in highly differentiated and post-industrial orders. Moreover, as we show below, we also argue that language’s reflexive and indexical dimensions—far from producing consensual achievements—are unequally deployed and circulate unevenly among networks of relations, leading to various types of control and power mechanisms.

Switchings Among Netdoms: The Relational Sociology of Harrison C. White

Harrison C. White is a founding force behind the relational turn of American sociology and one of the most influential scholars in organizational, economic, and mathematical sociology. White builds a monumental theoretical model to answer the question of how social formations emerge. The model begins analytically with identities triggered by stochastic process at any scale—from individuals to empires. Once decoupled from their environments, identities seek footings vis-a-vis other identities in control efforts to reduce uncertainty and self-organize in disciplined molecules to accomplish vital tasks and secure perduration. Signaling and comparability among identities are key. Specialization ensues. Increased complexity triggers further control efforts and so identities polymerize ever more intricate social networks and phenomenological domains—netdoms—that merge in types of ties delivering stories and temporalities. Identities switch across these netdoms, seeking footing and changing contexts that spark new meanings. The entire process is scale-free and recursive. White recognizes that formal network analysis does not capture these switching contexts. So, to theorize social emergence and the production of phenomenological contexts—cast in framing stories and linguistic registers—White turns to language pragmatics and adopts Peirce’s semiotic model of indexical and reflexive language as the most rigorous approach to understand context and meaning production in social life. His goal is to incorporate social spread and scope into discourse and reflexive language.