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A Person-Centered Approach to HIV-Related Protective and Risk Factors for Young Black Men Who Have Sex with Men: Implications for Pre-exposure Prophylaxis and HIV Treatment as Prevention

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Abstract

Although young Black men who have sex with men (YBMSM) are disproportionately affected by HIV, they may be more heterogeneous as a group than is typically appreciated. Thus, the present study used a person-centered data-analytic approach to determine profiles of HIV-related risk among YBMSM and whether these profiles could be distinguished by age, HIV status, and socioeconomic risk (i.e., socioeconomic distress). YBMSM (N = 1808) aged 18 to 29 years completed a survey of sociodemographic characteristics, HIV status, and HIV-related behavioral and attitudinal factors (i.e., safer-sex self-efficacy, negative condom attitudes, being in difficult sexual situations, being in difficult sexual relationships, HIV treatment optimism, perceived HIV stigma). Latent profile analysis was used to identify HIV risk profiles and whether age, HIV status, and socioeconomic distress were associated with these profiles. Four profiles emerged: low-, medium-, and high-risk profiles, respectively, and a mixed profile characterized by a tendency to be in difficult sexual situations and relationships while also reporting high safer-sex self-efficacy and low negative attitudes toward condom use. Difficult sexual situations emerged as the key defining indicator of whether a profile reflected higher or lower risk. Younger age, being HIV-positive, and socioeconomic distress were associated with having a higher-risk profile. Given that unique risk profiles emerged that were differentially predicted by sociodemographic characteristics and HIV status, these findings have implications for tailoring interventions to the needs of different subgroups of YBMSM. Also, disempowering or risky sexual situations and relationships among YBMSM must be addressed.

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Acknowledgements

This research was supported in part by the National Institute of Mental Health (R01 MH096690). Dr. Vincent was also supported by the National Institute of Mental Health (K23 MH111402). Dr. Storholm was supported by the National Institute of Drug Abuse (R03DA042660). The authors would like to thank Anne Freeman, Douglas Sheehan, and Stephen Brown from the University of Texas Southwestern; and Jan Risser and Paige Padgett from the University of Texas, Houston.

Funding

This study was funded by the National Institute of Mental Health (R01 MH096690).

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Authors and Affiliations

  1. University of California, UCSF Mailcode 0886, 550 16th St., 3rd Floor, San Francisco, CA, 94158, USA

    Wilson Vincent, Torsten B. Neilands, Gregory M. Rebchook, Judy Y. Tan, Lance Pollack & Susan M. Kegeles

  2. Georgia State University, Atlanta, GA, USA

    John L. Peterson

  3. RAND Corporation, Santa Monica, CA, USA

    Erik D. Storholm

  4. George Washington University, Washington, DC, USA

    David M. Huebner & Sarah K. Calabrese

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  1. Wilson Vincent
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Vincent, W., Peterson, J.L., Storholm, E.D. et al. A Person-Centered Approach to HIV-Related Protective and Risk Factors for Young Black Men Who Have Sex with Men: Implications for Pre-exposure Prophylaxis and HIV Treatment as Prevention. AIDS Behav 23, 2803–2815 (2019). https://doi.org/10.1007/s10461-019-02630-5

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