Curr HIV/AIDS Rep (2013) 10:398–407 DOI 10.1007/s11904-013-0187-3
BEHAVIORAL ASPECTS OF HIV MANAGEMENT (RJ DICLEMENTE AND JL BROWN, SECTION EDITORS)
Intergenerational Sex as a Risk Factor for HIV Among Young Men Who Have Sex with Men: A Scoping Review Aranka Anema & Brandon D. L. Marshall & Benjamin Stevenson & Jasmine Gurm & Gabriela Montaner & Will Small & Eric A. Roth & Viviane D. Lima & Julio S. G. Montaner & David Moore & Robert S. Hogg
Published online: 24 November 2013 # Springer Science+Business Media New York 2013
Abstract An emerging body of evidence suggests that intergenerational sexual partnerships may increase risk of HIV acquisition among young men who have sex with men (YMSM). However, no studies have comprehensively evaluated literature in this area. We applied a scoping review methodology to explore the relationships between age mixing, HIV risk behavior, and HIV seroconversion among YMSM. This study identified several individual, micro-, and mesosystem factors influencing HIV risk among YMSM in the
context of intergenerational relationships: childhood maltreatment, coming of age and sexual identity, and substance use (individual-level factors); family and social support, partner characteristics, intimate partner violence, connectedness to gay community (micro-system factors); and race/ethnicity, economic disparity, and use of the Internet (meso-system factors). These thematic groups can be used to frame future research on the role of age-discrepant relationships on HIV risk among YMSM, and to enhance public health HIV
A. Anema : B. Stevenson : J. Gurm : G. Montaner : W. Small : V. D. Lima : J. S. G. Montaner : D. Moore : R. S. Hogg (*) British Columbia Center for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada e-mail: [email protected]
B. D. L. Marshall Department of Epidemiology, Brown University School of Public Health, 121 South Main St, Box G-S-121-2, Providence, RI 02909, USA e-mail: [email protected]
R. Hogg e-mail: [email protected] A. Anema e-mail: [email protected]
W. Small : R. S. Hogg Faculty of Health Sciences, Simon Fraser University, 8888 University Dr, Burnaby, British Columbia V5A 1S6, Canada
J. Gurm e-mail: [email protected] G. Montaner e-mail: [email protected] W. Small e-mail: [email protected] e-mail: [email protected]
E. A. Roth Department of Anthropology, University of Victoria, PO Box 1700 STN CSC, Victoria, British Columbia V8W 2Y2, Canada e-mail: [email protected]
V. D. Lima e-mail: [email protected]
J. S. G. Montaner e-mail: [email protected] D. Moore e-mail: [email protected]
V. D. Lima : J. S. G. Montaner : D. Moore Faculty of Medicine, University of British Columbia, Experimental Medicine Program, Department of Medicine, Gordon and Leslie Diamond Health Care Center, 10th Floor, Room 10203, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada
Curr HIV/AIDS Rep (2013) 10:398–407
education and prevention strategies targeting this vulnerable population. Keywords Young men who have sex with men (YMSM) . HIV seroconversion . HIV risk . Intergenerational sex . Age mixing
Introduction HIV Among Young Men Who Have Sex with Men The number of men who have sex with men (MSM) living with HIV continues to increase around the world [1], despite advances in combination prevention strategies, including the expanding use of highly active antiretroviral therapy [2]. Recent estimates suggest that MSM account for 61 % of new HIV infections in the United States (US) [3], 45 % of new infections in Canada [4], and 43 % of HIV infections in the World Health Organization (WHO) European region [5]. Populations of young MSM (YMSM, which we define broadly as MSM between the age of 14 and 29) have particularly elevated HIV incidence in some contexts. For example, evidence from the US shows that between 2008 and 2010, the number of new HIV infections among MSM aged 13–24 years grew by 22 % compared with 12 % in the general MSM population [6]. In Germany, surveillance estimates from 2009 found the greatest proportion of new HIV infections to be among MSM
BEHAVIORAL ASPECTS OF HIV MANAGEMENT (RJ DICLEMENTE AND JL BROWN, SECTION EDITORS)
Intergenerational Sex as a Risk Factor for HIV Among Young Men Who Have Sex with Men: A Scoping Review Aranka Anema & Brandon D. L. Marshall & Benjamin Stevenson & Jasmine Gurm & Gabriela Montaner & Will Small & Eric A. Roth & Viviane D. Lima & Julio S. G. Montaner & David Moore & Robert S. Hogg
Published online: 24 November 2013 # Springer Science+Business Media New York 2013
Abstract An emerging body of evidence suggests that intergenerational sexual partnerships may increase risk of HIV acquisition among young men who have sex with men (YMSM). However, no studies have comprehensively evaluated literature in this area. We applied a scoping review methodology to explore the relationships between age mixing, HIV risk behavior, and HIV seroconversion among YMSM. This study identified several individual, micro-, and mesosystem factors influencing HIV risk among YMSM in the
context of intergenerational relationships: childhood maltreatment, coming of age and sexual identity, and substance use (individual-level factors); family and social support, partner characteristics, intimate partner violence, connectedness to gay community (micro-system factors); and race/ethnicity, economic disparity, and use of the Internet (meso-system factors). These thematic groups can be used to frame future research on the role of age-discrepant relationships on HIV risk among YMSM, and to enhance public health HIV
A. Anema : B. Stevenson : J. Gurm : G. Montaner : W. Small : V. D. Lima : J. S. G. Montaner : D. Moore : R. S. Hogg (*) British Columbia Center for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada e-mail: [email protected]
B. D. L. Marshall Department of Epidemiology, Brown University School of Public Health, 121 South Main St, Box G-S-121-2, Providence, RI 02909, USA e-mail: [email protected]
R. Hogg e-mail: [email protected] A. Anema e-mail: [email protected]
W. Small : R. S. Hogg Faculty of Health Sciences, Simon Fraser University, 8888 University Dr, Burnaby, British Columbia V5A 1S6, Canada
J. Gurm e-mail: [email protected] G. Montaner e-mail: [email protected] W. Small e-mail: [email protected] e-mail: [email protected]
E. A. Roth Department of Anthropology, University of Victoria, PO Box 1700 STN CSC, Victoria, British Columbia V8W 2Y2, Canada e-mail: [email protected]
V. D. Lima e-mail: [email protected]
J. S. G. Montaner e-mail: [email protected] D. Moore e-mail: [email protected]
V. D. Lima : J. S. G. Montaner : D. Moore Faculty of Medicine, University of British Columbia, Experimental Medicine Program, Department of Medicine, Gordon and Leslie Diamond Health Care Center, 10th Floor, Room 10203, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada
Curr HIV/AIDS Rep (2013) 10:398–407
education and prevention strategies targeting this vulnerable population. Keywords Young men who have sex with men (YMSM) . HIV seroconversion . HIV risk . Intergenerational sex . Age mixing
Introduction HIV Among Young Men Who Have Sex with Men The number of men who have sex with men (MSM) living with HIV continues to increase around the world [1], despite advances in combination prevention strategies, including the expanding use of highly active antiretroviral therapy [2]. Recent estimates suggest that MSM account for 61 % of new HIV infections in the United States (US) [3], 45 % of new infections in Canada [4], and 43 % of HIV infections in the World Health Organization (WHO) European region [5]. Populations of young MSM (YMSM, which we define broadly as MSM between the age of 14 and 29) have particularly elevated HIV incidence in some contexts. For example, evidence from the US shows that between 2008 and 2010, the number of new HIV infections among MSM aged 13–24 years grew by 22 % compared with 12 % in the general MSM population [6]. In Germany, surveillance estimates from 2009 found the greatest proportion of new HIV infections to be among MSM
