The psychosocial effects of rape on heterosexual and homosexual men

The present study evaluated the psychosocial effects of rape on heterosexual and homosexual men. It was hypothesized that 1) non-closeted homosexual men would have less symptomology and more resilience than closeted homosexual men and heterosexual men; 2) the more protective factors a man had, the less symptomology he would display and the more likely he would exhibit posttraumatic growth; 3) there would be an interaction between sexual orientation of the perpetrator and sexual orientation of the victim on symptomology. One-way ANOVAs revealed that homosexual men and bisexual men reported significantly less PTSD symptomology than heterosexual men. Further, homosexual men endorsed more male rape myths than heterosexual men. A univariate-ANOVA revealed a significant interaction between victim orientation and perpetrator orientation on depression. Clinical implications and social issues surrounding male rape are reviewed

HIV preventive interventions, sampling methods and sexual risk behaviour among men who have sex with men

Background: Gay, bisexual and other men who have sex with men (MSM) are at high risk of HIV globally. HIV rates among MSM in Europe show increasing trends, in contrast to declining trends in the general population. During the last five years, an increase in reported HIV cases among foreign-born MSM have been observed in Sweden. Representative data about the MSM population is difficult to collect due to lack of a sampling frame. Respondent driven sampling has been developed to access hidden groups and achieve high response rates. Online sampling methods such as Web-based Respondent driven sampling and stratified sampling in a Web community are new and innovative ways of reaching MSM. Aims: To systematically gather and review evidence for HIV prevention interventions among men who have sex with men in the European Union/European Economic Area and to test and evaluate different sampling methods to study sexual risk behaviour among Men who have sex with Men. Methods: A systematic review of HIV preventive interventions among MSM applying the Highest Available Standard of Evidence grading framework was performed to inform European guidelines. Web-based respondent driven sampling was implemented to study sexual risk behaviour and Internet use among MSM. Stratified sampling in a Web community was performed to study HIV testing and prevention uptake among foreign-born MSM living in Sweden. Finally, the samples of MSM in Sweden achieved through Web-based respondent driven sampling, stratified sampling in a Web community, time location sampling and online banner survey sampling, were compared regarding sociodemographics and sexual risk behaviour for HIV. Results: In total, twenty-four interventions were reviewed and fifteen interventions were graded to be strongly, probably or possibly recommended. Condom use, peer outreach, peerled groups, and universal coverage of antiretroviral treatment were found to be strongly recommended. Web-based respondent driven sampling generated a sample of MSM whom all reported unprotected anal intercourse with at least one casual and one regular sex partner in the past twelve months. Stratified sampling in a Web community produced a sub-sample of foreign-born MSM of which 45% had tested for HIV during the past twelve months. A fifth of participants had never tested. Having talked with a prevention worker in the last year was associated with having tested for HIV in the same time frame. The four different sampling strategies used to study sexual risk behaviour among MSM in Sweden captured participant samples that differed regarding sociodemographic characteristic and reported sexual behaviour. Conclusions: Condom use, peer outreach, peer-led groups, and universal coverage of antiretroviral treatment are evidence-based corner stones of HIV preventive interventions for MSM. Web-based respondent driven sampling reached MSM engaging in sexual risk behaviour and holds promise for online interventions and referrals to prevention programmes. To achieve higher uptake of HIV testing among foreign-born MSM in Sweden outreach programmes could be scaled up and evaluated. Future studies could benefit from using different sampling methods to achieve comprehensive data and validate findings across samples of MSM

Sampling methods to reach hard populations: appraising and comparing different statistical methods with an application to an HIV prevalence study

Os dados de saúde, e especialmente os relacionados com o VIH, são menos robustos para populações de difícil acesso, também chamadas populações-chave ou populações de maior risco, do que para a população em geral e tendem a ser subestimados devido principalmente a problemas relacionados com estigma, discriminação e complexidade na amostragem dos elementos da população. O estigma e a discriminação desencorajam as populações-chave e, especialmente, os indivíduos VIH positivos a frequentar os serviços de saúde, a participarem em inquéritos e a revelarem os seus comportamentos de risco. As complexidades da amostragem ocorrem porque nos países onde essas populações são discriminadas, elas tendem a permanecer ocultas e, consequentemente, é mais difícil identificá-las e recolher informação. Ou seja, não é possível garantir amostras representativas dos elementos da população. O uso de estratégias de amostragem não probabilística tem sido o mais utilizado para rastrear as populações-chave mas os resultados obtidos correm o risco de serem enviesados, o que significa que, por exemplo, as estimativas de prevalência de VIH obtidas para essas populações podem não ser precisas. Nos últimos anos, no entanto, vários métodos não probabilísticos foram utilizados. Extensões desses métodos foram desenvolvidas para evitar que os elementos amostrados sejam escolhidos de maneira casual, o que deu origem aos métodos semi-probabilísticos. Focando num dos métodos semi-probabilísticos mais utilizados, o método de amostragem local-tempo (TLS), desenvolvemos uma abordagem para melhorar a precisão das estimativas de prevalência do VIH. O novo método, chamado CARES, que significa calibração pelos resíduos, consiste em imputar pesos aos entrevistados, considerando o percentil ao qual seus resíduos de regressão logística pertencem. Usando duas bases de dados de HSH de Portugal e Espanha, começámos por as ajustar o mais próximo possível de universos TLS e dos quais várias amostras TLS foram simuladas. Para cada amostra simulada, foi registada a prevalência do VIH, não ponderada e ponderada pelos pesos amostrais. Um modelo de regressão logística foi aplicado e os resíduos foram registados. O método CARES foi aplicado e a prevalência do VIH foi novamente calculada. A prevalência estimada de VIH obtida pelo método CARES foi comparada com as estimativas de prevalência calculadas usando apenas o método de amostragem TLS. Os resultados mostraram que o método CARES melhora as estimativas de prevalência do VIH obtidas quando o método de amostragem local-tempo é usado para recrutar os entrevistados. Este método é uma nova abordagem que visa fornecer melhores estimativas de prevalência do VIH e pode ser muito útil sempre que técnicas de amostragem mais confiáveis não possam ser aplicadas.Health data and especially HIV related data is less robust for hard-to-reach populations, also called key-populations or most-at-risk populations, than for general population and tend to be underestimated mainly due to issues related to stigma, discrimination and complexities in sampling the population elements. Stigma and discrimination discourages key-populations and specially HIV positive individuals to frequent health care facilities, take part in surveys and reveal their risk behaviours. Complexities in sampling happen because in countries where these populations are discriminated they tend to remain hidden and consequently it is more difficult to identify them and collect data. Therefore, it is not possible to assure representative samplings of the population elements. The use of non-probability sampling strategies have been the most used to screen key-populations but results obtained have the risk of being biased, this means that, for instance, HIV prevalence estimates obtained for these populations might not be accurate. In the last years however, several non-probabilistic methods have been used. Extensions of those methods have been developed in order to avoid that the sampled elements are chosen in a casual way, which gave rise to the semi-probabilistic methods. Focusing on one of the most used semi-probabilistic methods, the time-location sampling method (TLS), we developed an approach to improve accuracy of HIV prevalence estimates. The new method, called CARES, which means Calibration on Residuals, consists in imputing weights to respondents, considering the percentile to which their logistic regression residues belong. Using two MSM databases from Portugal and Spain, we began by adjusting the databases as close as possible to a TLS universe and from which several TLS samples were drawn. For each simulated sample HIV prevalence, unweighted and weighted by the sampling weights was recorded. A logistic regression model was run and residues were recorded. The CARES method was applied and HIV prevalence was again calculated. The estimated HIV prevalence obtained by CARES method was compared to HIV prevalence estimates calculated using the TLS method only. Results showed that CARES method improves HIV prevalence estimates obtained when time location sampling method is used to recruit respondents. This method is a new approach that aims to provide better HIV prevalence estimates and might be very useful whenever more reliable sampling techniques cannot be applied

Just a preference : exploring concepts of race among gay men looking for sex or dates online

For many gay, bisexual and other men who have sex with men, the Internet is a central aspect of their sexual and romantic lives. Although often trumpeted as a convenient way to meet people, online sex and dating present unique challenges for those looking to connect. Among these is how racial concepts are used to define desire or disinterest, which in Australia is a contentious issue among men who look for sex or dates online. Although recent media attention has propelled what is sometimes called online sexual racism into mainstream debates, very little is known about this concept, its potential impact or men s perceptions of it. This thesis addresses that gap by exploring concepts of race and racism on sex and dating webservices for same-sex attracted men. A mixed methods approach was adopted, which consisted of a content analysis of sex and dating profiles posted online, a national online survey of gay and bisexual men in Australia, and in-depth interviews with gay men who use sex and dating webservices. The findings across these methods suggest a diversity of attitudes exists towards race online, accompanied by individual and often situationally-dependent understandings and expressions of racism and online etiquette. The ways in which men talk about race and their online practices differ among racial groups and reflect broader Australian discourses of race. There seems to be, however, interest among some of the gay men who use these webservices to approach concepts of race (and racism) from a critical position. Nevertheless, widely differing opinions and experiences related to race remain, as does the need for further work to engage men and ask important questions about the role and impact of race among these online communities. Although many men are troubled or conflicted about ideas of race and racism as they intersect with their search for sex or romance, the overwhelming response to this as an issue was one of resignation. This thesis provides a first analysis of the complex tension between ideals of sexual liberty, the normalisation of racial prejudice, and the increasingly important online social spaces that are negotiated by gay and bisexual men