Dr. Perry Halkitis has been at the forefront, fighting for the rights of those with and affected by HIV/AIDS and advocating for the health of the LGBT community at both the structural and individual level. He is a leading expert in biobehavioral, psychosocial, and public health research who focuses on issues of health, human behavior, development, and syndemics, with a specific application to the intersection and domains of HIV/AIDS, drug abuse, mental health, and biopsychosocial burdens.
A highly funded researcher and author of over 180 peer-reviewed academic manuscripts and four books, Dr. Halkitis is also often cited in the press, presents to academic and non-academic audiences, including on television and radio, and interviews, lectures, and speaks on all subjects relating to the health issues affecting gay men including HIV/AIDS, substance use, and mental health. He is Editor-in-Chief of the Behavioral Medicine Journal and serves on numerous other boards, including the Gay Men’s Health Crisis Board of Directors. He also served on Governor Cuomo’s End of AIDs Task Force and was appointed to the Centers for Disease Control and Prevention’s Advisory Panel on HIV/AIDS.
As the founder and Director of CHIBPS at Rutgers University, Dr. Halkitis conducts studies that focus on understanding the behavioral, biological, social, structural and psycho-social drivers of health problems primary in gay men, as well as other marginalized populations. The research at CHIBPS informs public health practice and policy, serves as a training ground for the next generation of scholars, and fosters community building and empowerment through the dissemination and translation of the research to community partners and the LGBT community.
BA, Biology and Psychology, Columbia University, New York, NYMS, Education/Human Development and Learning, Hunter College, New York, NYMPhil, Educational Psychology, Graduate Center, City University of New York, New York, NYPhD, Quantitative Methods in Educational and Psychological Research, Graduate Center, City University of New York, New York, NYMPH, Epidemiology, CUNY School of Public Health, New York, NY
Psychology and AIDS Leadership Award (Distinguished Leader), American Psychological Association Committee on Psychology and AIDS (2015)Lambda Literary Award nominee (Memoir), The AIDS Generation: Stories of Survival and Resilience (2014)Distinguished Book Award, Division of the Society for The Psychological Study of Lesbian, Gay, Bisexual, and Transgender Issues, The AIDS Generation: Stories of Survival and Resilience (2014)Outstanding Contributions to Health Psychology Award (Senior), American Psychological Association (2014)Commissioner’s Award, NY State Department of Health World AIDS Day (2013)
Behavioral Determinants of HealthEpidemiologyHIV/AIDSLGBTQuantitative ResearchSocial BehaviorsSocial Determinants of HealthSubstance Abuse
Determinants of Intimate Partner Violence Among Young Men Who Have Sex With Men: The P18 Cohort StudyStults, C. B., Javdani, S., Kapadia, F., & Halkitis, P. N.
Journal titleJournal of Interpersonal Violence
Page(s)886260519831374Intimate Partner Violence (IPV) is an understudied health problem among young gay, bisexual, and other non-identified young men who have sex with men (YMSM). According to cross-sectional studies, IPV is associated with psychosocial and mental health problems, such as stigma and depression, among YMSM. IPV is also associated with health-risk behaviors, such as substance use, among this population. Yet, to date, no studies have used longitudinal data to examine determinants of IPV among YMSM. This gap in the extant literature is problematic, as it limits our understanding of how to intervene to interrupt cycles of violence. The aim of the present study was to examine longitudinal determinants of IPV among a sample of (N = 526) YMSM living in the New York City area. Longitudinal analyses using Generalized Estimating Equations (GEE) were used to examine individual, relationship, mental health, psychosocial, and substance use factors in relation to IPV victimization and perpetration. Most notably, early experiences of IPV were a robust predictor of later experiences of IPV victimization and perpetration. Relationship status, depression, public gay-related stigma, and illicit substance use were associated with IPV victimization over time. Similarly, relationship status, depression, public gay-related stigma, marijuana, and other illicit substance were associated with IPV perpetration. These findings suggest that prevention programs and awareness campaigns should aim to reach YMSM before their first experiences of relationship violence, as these early experiences of violence are strongly linked to later experiences of violence. Also, IPV interventions should be tailored to the needs of YMSM and should target depressive symptoms, gay-related stigma, and substance use behaviors. Additionally, substance use interventions may be improved by addressing IPV. Finally, policymakers should support policies that improve the social climate for LGBTQ people, thereby reducing gay-related stigma, and potentially stemming violence against and among YMSM.
Assessing Gaps in the HIV Care Continuum in Young Men Who Have Sex With Men: The P18 Cohort StudyGreene, R. E., Luong, A., Barton, S. C., Kapadia, F., & Halkitis, P. N.
Journal titleJournal of the Association of Nurses in AIDS Care
Cardiovascular Disease Risk in Sexual Minority Women (18-59 Years Old): Findings from the National Health and Nutrition Examination Survey (2001-2012)Caceres, B. A., Brody, A. A., Halkitis, P. N., Dorsen, C., Yu, G., & Chyun, D. A.
Journal titleWomen's Health IssuesObjective: Sexual minority women (lesbian and bisexual) experience significant stigma, which may increase their cardiovascular disease (CVD) risk. The purpose of this study was to examine the prevalence of modifiable risk factors for CVD (including mental distress, health behaviors, blood pressure, glycosylated hemoglobin, and total cholesterol) and CVD in sexual minority women compared with their heterosexual peers. Materials and Methods: A secondary analysis of the National Health and Nutrition Examination Survey (2001-2012) was conducted. Multiple imputation with chained equations was performed. Logistic regression models adjusted for relevant covariates were run. Self-report (medical history and medication use) and biomarkers for hypertension, diabetes, and high total cholesterol were examined. Results: The final analytic sample consisted of 7,503 that included 346 sexual minority women (4.6%). Sexual minority women were more likely to be younger, single, have a lower income, and lack health insurance. After covariate adjustment, sexual minority women exhibited excess CVD risk related to higher rates of frequent mental distress (adjusted odds ratio [AOR], 2.05; 95% confidence interval [CI], 1.45–2.88), current tobacco use (AOR, 2.11; 95% CI, 1.53–2.91), and binge drinking (AOR, 1.66; 95% CI, 1.17–2.34). Sexual minority women were more likely to be obese (AOR, 1.61; 95% CI, 1.23–2.33) and have glycosylated hemoglobin consistent with prediabetes (AOR, 1.56; 95% CI, 1.04–2.34). No differences were observed for other outcomes. Conclusions: Sexual minority women demonstrated increased modifiable risk factors for CVD, but no difference in CVD diagnoses. Several emerging areas of research are highlighted, in particular, the need for CVD prevention efforts that target modifiable CVD risk in sexual minority women.
Acceptability of ecological momentary assessment among young men who have sex with menDuncan, D. T., Kapadia, F., Kirchner, T. R., Goedel, W. C., Brady, W. J., & Halkitis, P. N.
Journal titleJournal of LGBT Youth
Page(s)436-444The study evaluated the acceptability of text message– and voice-based ecological momentary assessment (EMA) methods among a sample (N = 74) of young men who have sex with men (MSM). We assessed the acceptability of text message– and voice-based EMA methods. Almost all participants (96%) reported that they would be willing to accept texts on their smartphone to answer questions about their current mood, surroundings, or feelings. A large majority (89%) also reported being willing to accept phone calls to answer these questions. This work suggests that different EMA methods are acceptable for use among young MSM.
Associations of Perceived Parental Psychopathology with Mental Health Burden and Lifetime Drug Use in Gay, Bisexual, and other YMSM: The P18 Cohort StudyHalkitis, P. N., Griffin-Tomas, M., Levy, M. D., Greene, R. E., & Kapadia, F.
Journal titleJournal of Homosexuality
Page(s)1-21Parental mental health may be a critical component in understanding the overlapping health burdens of mental health symptomatology and drug use in young men who have sex with men (YMSM), yet studies of YMSM have not fully examined these associations. To understand these relationships, data drawn from a study of gay, bisexual, and other YMSM were used to examine associations between perceived parental psychopathology and the health of YMSM. Findings suggest that YMSM reporting at least one parent with perceived depression, manic depression, schizophrenia, or antisocial behavior anytime during their childhoods were more likely to report higher levels of both depressive symptomatology and post-traumatic stress disorder (PTSD) than those reporting no perception of any of these psychopathologies in their parents. Number of different drugs used in one’s life were higher among participants who perceived at least one parent as depressed. Mediation analyses indicated that the relationship between perceived parental depression and lifetime drug use of YMSM was mediated both by YMSM depression and YMSM PTSD. These results suggest that parental psychopathology plays an important role in the health of sexual minority men, a population with elevated levels of mental health burden and drug use across the lifespan.
Latent Growth Curve Modeling of Non-Injection Drug Use and Condomless Sexual Behavior from Ages 18 to 21 in Gay, Bisexual, and Other YMSM: The P18 Cohort StudyHalkitis, P. N., Bub, K., Stults, C. B., Bates, F. C., & Kapadia, F.
Journal titleSubstance Use and Misuse
Page(s)1-13Background: HIV/AIDS continues to be a health disparity faced by sexual minority men, and is exacerbated by non-injection drug use. Objectives: We sought to delineate growth in non-injection drug use and condomless sex in a sample of racially and economically diverse of gay, bisexual, and other young men who have sex with men (YMSM) as they emerged into adulthood between the ages of 18 and 21 and who came of age in the post-HAART era. Methods: Behavioral data on drug use and condomless sex, collected via a calendar based technique over 7 waves of a cohort study of 600 YMSM, were analyzed using latent growth curve modeling to document patterns of growth in these behaviors, their associations, and the extent to which patterns and associations are moderated by race/ethnicity and socioeconomic status. Results: Significant growth was noted in the frequencies of condomless oral and anal intercourse, alcohol to intoxication, marijuana use, and inhalant nitrate use. High levels of association were noted between all behaviors across time but associations did not differ by either race/ethnicity or socioeconomic status. The link between drug use and risky sexual behavior continue to be evident in YMSM with significant increases in these behaviors demonstrated as YMSM transition between adolescence and young adulthood. Conclusions/Importance: Healthcare for a new generation of sexual minority males must address the synergy of these behaviors and also nest HIV prevention and care within a larger context of sexual minority health that acknowledges the advances made in the last three decades.
Pedagogical Scholarship in Public Health: A Call for Cultivating Learning Communities to Support Evidence-Based EducationMerzel, C., Halkitis, P., & Healton, C.
Journal titlePublic health reports (Washington, D.C. : 1974)
Page(s)679-683Public health education is experiencing record growth and transformation. The current emphasis on learning outcomes necessitates attention to creating and evaluating the best curricula and learning methods for helping public health students develop public health competencies. Schools and programs of public health would benefit from active engagement in pedagogical research and additional platforms to support dissemination and implementation of educational research findings. We reviewed current avenues for sharing public health educational research, curricula, and best teaching practices; we identified useful models from other health professions; and we offered suggestions for how the field of public health education can develop communities of learning devoted to supporting pedagogy. Our goal was to help advance an agenda of innovative evidence-based public health education, enabling schools and programs of public health to evaluate and measure success in meeting the current and future needs of the public health profession.
Perceptions of safety among LGBTQ people following the 2016 Pulse nightclub shootingStults, C. B., Kupprat, S. A., Krause, K. D., Kapadia, F., & Halkitis, P. N.
Journal titlePsychology of Sexual Orientation and Gender Diversity
Page(s)251-256The goals of this manuscript are twofold. First, we provide a brief reaction to this journal's "Special Section: Reflections on the Orlando Massacre on its First Anniversary." Second, we present findings from a study on perceptions of safety among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals following the Pulse shooting. These issues are discussed within the historical context of hate crimes experienced by the LGBTQ population (Herek), media coverage following the shooting (Hancock and Halderman), and the immediate reaction of LGBTQ graduate students to the event (Jackson). Our study sought to examine differences in perceptions of personal and peer safety by race/ethnicity, gender identity, and sexual orientation among a large, diverse sample of LGBTQ people. Findings from our study indicate that there were differences in perceptions of personal safety by gender identity, and differences in perceptions of peer safety by gender identity and sexual orientation. These findings also suggest that subgroups of the LGBTQ community with more marginalized gender and sexual identities (e.g., female, transgender, genderqueer, bisexual, queer respondents) perceived more concerns related to safety, on average, than subgroups with relatively more privilege (e.g., gay, male). Elevated safety concern may exacerbate multiple minority stress burden, a known driver of poor health outcomes among LGBTQ people. These findings are a call to action to health care providers to be well informed and trained to provide the appropriate care and counseling referrals that can address the safety-related concerns of LGBTQ individuals in the aftermath of identity-related attacks.
Personality and its Relation to Mental and Psychosocial Health in Emerging Adult Sexual Minority Men: The P18 Cohort StudyD’Avanzo, P. A., Barton, S. C., Kapadia, F., & Halkitis, P. N.
Journal titleBehavioral Medicine
Page(s)191-199Personality disorder and personality pathology encompass a dimension of psychological dysfunction known to severely impact multiple domains of functioning. However, there is a notable dearth of research regarding both the pervasiveness and correlates of personality pathology among young sexual minority males who themselves experience heightened mental health burdens. Using the self-report version of the Standardized Assessment of Personality-Abbreviated Scale we tested associations between distinct personality characteristics with sociodemographic and psychosocial factors as well as mental health states in a sample of 528 young (aged 21–25 years) sexual minority men. In multivariate analysis, personality traits varied significantly by race/ethnicity. Personality traits were also positively associated with psychosocial states, specifically, internalized anti-homosexual bias, level of connection with the gay community, and male body dissatisfaction, as well as mental health in the form of recent depressive and anxious symptomatology. These findings support the complex synergy which exists between personality characteristics, psychosocial conditions, and mental health burdens present among sexual minority men and support the need for an all-encompassing approach to both the study and care of this population that addresses the influences of both internal and external factors on well-being.
Psychometric Analysis of the Life Worries Scale for a New Generation of Sexual Minority Men: The P18 Cohort StudyHalkitis, P. N., Cook, S. H., Ristuccia, A., Despotoulis, J., Levy, M. D., Bates, F. C., & Kapadia, F.
Journal titleHealth PsychologyObjective: Sexual minority men (SMM) in the United States continue to experience adverse health problems and psychosocial burdens. However, there is limited psychometric research seeking to quantify the life worries of this population. Informed by syndemic theory, the Life Worries Scale (LWS) was developed to measure the concerns of young SMM. Method: Analyses of the scale were undertaken using baseline data (n = 665) from an ongoing cohort study of emerging adult, SMM. Results: Exploratory factor analyses (EFA) of an initial set of 24 Likert-type items, followed by confirmatory factor analysis (CFA) and an exploratory structural equation model (ESEM), indicated a structure consisting of 6 domains of worries: financial stability, social stability, self esteem, loneliness, physical appearance, and physical health. These 6 subscales were highly correlated and also demonstrated high levels of internal consistency. Differences in life worries were noted across demographic states, specifically HIV serostatus, sexual attraction, housing status, and self-rated health. High levels of association were also detected between all 6 subscales with both depression and PTSD, while significant correlations were detected between suicidality and both self esteem and loneliness related worries. Conclusions: The results of our analyses provide evidence for the strong psychometric characteristics of the LWS. This newly developed instrument should be utilized in research to examine the extent to which life worries explain health outcomes and risk behaviors in sexual minority males, and may be potentially extended for use in other populations. (PsycINFO Database Record
Substance Use and Cognitive Function as Drivers of Condomless Anal Sex among HIV-Positive Gay, Bisexual, and Other Men Who Have Sex with Men Aged 50 and Older: The Gold StudiesKupprat, S. A., Krause, K. D., Ompad, D. C., & Halkitis, P. N.
Journal titleLGBT Health
Page(s)434-441Purpose: Substance use has been linked to the sexual transmission of HIV among gay, bisexual, and other men who have sex with men (MSM) across the lifespan. Among older, HIV-positive, MSM populations, cognitive dysfunction associated with age and HIV disease progression also may play a role in sexual risk-taking. People aged 50 years and older represent a growing proportion of the overall HIV-positive population. This study aimed to explore relationships between substance use and cognitive function, and their impact on condomless anal sex (CAS) among HIV-positive gay, bisexual, and other MSM aged 50 years and older. Methods: Data from a cross-sectional study of HIV-positive MSM, aged 50 and older (N = 169) were gathered using a computer-assisted survey, researcher-administered behavioral and neurocognitive measures. Results: More than 50% of the men used substances and had one or more cognitive impairments. However, only 25% were at higher risk for dementia (i.e., two or more cognitive impairments). Multivariable modeling indicated that use of alcohol to intoxication and date of HIV diagnosis were the strongest predictors of CAS in both a model that included dementia risk and a model that included impaired executive function risk. Current illicit substance use was a significant predictor of CAS only in the model that included dementia risk. Those with better cognitive and executive function had higher odds of CAS. However, only executive function was a significant cognitive predictor of CAS. Conclusion: Further research is needed to clarify the impact of cognitive function and substance use on sexual risk behaviors as these HIV-positive men achieve normal life expectancies, while continuing to use substances and engage in CAS. Furthermore, addiction treatment remains a critical need for this group even as they transition into later adulthood.
A case of rectal Ureaplasma infection: molecular testing for STIs may be missing important infections in young men who have sex with men (YMSM): the P18 cohort studyAbbott, C., Greene, R. E., Kapadia, F., & Halkitis, P.
Journal titleLGBT Health
A longitudinal analysis of suicide ideation in emerging adult men who have sex with menSiconolfi, D. E., Latkin, C., Wilcox, H., Kapadia, F., & Halkitis, P.
Journal titleArchives of Suicide Research
Associations Between Neurocognitive Impairment and Biomarkers of Poor Physiologic Reserve in a Clinic-Based Sample of Older Adults Living with HIVYu, K. C., D’Avanzo, P. A., Nesheiwat, L., Greene, R. E., Urbina, A., Halkitis, P. N., & Kapadia, F.
Journal titleJournal of the Association of Nurses in AIDS CareData from a cross-sectional study of a clinic-based sample of older people living with HIV (PLWH; n = 100) were used to examine associations between biomarkers of physical health and neurocognitive impairment (NCI). In this sample, anemia, chronic kidney disease (CKD) stages 4-5, and hypocalcemia were associated with impairment in executive functioning or processing speed. Furthermore, participants with anemia were more likely to have CD4+ T cell counts <200 cells/mm3 (χ2  = 19.57, p < .001); hypocalcemia (χ2  = 17.55, p < .001); and CKD 4-5 (χ2  = 10.12, p = .006). Black and Hispanic participants were more likely to be anemic compared to other races and ethnicities (χ2  = 12.76, p = .005). Common medical conditions (e.g., anemia, hypocalcemia, CKD) should be investigated as potential contributors to NCI in older PLWH. Additionally, laboratory testing in racial/ethnic minority PLWH may help inform NCI screening.
Associations of parental psychopathology with mental health burden and drug use in sexual minority men: the P18 cohort studyHalkitis, P., Griffin-Tomas, M., Kapadia, F., Levy, M., & Greene, R. E.
Journal titleJournal of Homosexuality
Behavior- and Partner-Based HIV Risk Perception and Sexual Risk Behaviors in Men Who Have Sex with Men (MSM) Who Use Geosocial-Networking Smartphone Applications in New York CityGoedel, W. C., Halkitis, P. N., & Duncan, D. T.
Journal titleJournal of Urban Health
Correlates of Awareness of and Willingness to Use Pre-exposure Prophylaxis (PrEP) in Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Geosocial-Networking Smartphone Applications in New York CityGoedel, W. C., Halkitis, P. N., Greene, R. E., & Duncan, D. T.
Journal titleAIDS and Behavior
Page(s)1-8Geosocial-networking smartphone applications are commonly used by gay, bisexual, and other men who have sex with men (MSM) to meet sexual partners. The purpose of the current study was to evaluate awareness of and willingness to use pre-exposure prophylaxis (PrEP) among MSM who use geosocial-networking smartphone applications residing in New York City. Recruitment utilizing broadcast advertisements on a popular smartphone application for MSM yielded a sample of 152 HIV-uninfected MSM. Multivariable models were used to assess demographic and behavioral correlates of awareness of and willingness to use PrEP. Most participants (85.5 %) had heard about PrEP but few (9.2 %) reported current use. Unwillingness to use PrEP was associated with concerns about side effects (PR = 0.303; 95 % CI 0.130, 0.708; p = 0.006). Given that more than half (57.6 %) of participants were willing to use PrEP, future research is needed to elucidate both individual and structural barriers to PrEP use among MSM.
Demographic, Mental Health, Behavioral, and Psychosocial Factors Associated with Cigarette Smoking Status among Young Men Who Have Sex with Men: The P18 Cohort StudyD’Avanzo, P. A., Halkitis, P. N., Yu, K., & Kapadia, F.
Journal titleLGBT Health
Page(s)379-386Purpose: Young sexual minority men smoke at higher rates relative to heterosexual peers. The purpose of this study was to examine correlates of smoking in a sample of young gay, bisexual, and other men who have sex with men (MSM) who might differ from more general and age-diverse samples of sexual minority individuals and, thus, inform tailored approaches to addressing tobacco use within this population. Methods: Data on smoking status were examined in relation to demographics, mental health, substance use behavior, and psychosocial factors. Using multinomial logistic regression, factors were identified that differentiate current and former smokers from never smokers. Results: In bivariate analysis, smoking status was related to demographic, mental health, substance use, and psychosocial factors. Most significantly, smoking status was associated with school enrollment status, current alcohol and marijuana use, and symptoms of depression. Multivariate modeling revealed that, compared to being a never smoker, the odds of current or former smoking were highest among those currently using either alcohol or marijuana. The odds of both current and former smoking were also higher among those reporting greater levels of gay community affinity. Finally, the odds of being a former smoker were higher for those reporting internalized antihomosexual prejudice. Conclusion: This study identifies several factors related to smoking status in a diverse sample of young sexual minority males. These findings should encourage investigations of smoking disparities among younger MSM to look beyond common smoking risk factors in an attempt to understand etiologies that may be unique to this group. Such findings may indicate multiple points of potential intervention aimed at decreasing cigarette smoking within this vulnerable population.
Disparities within the Disparity – Determining HIV Risk Factors among Latino Gay and Bisexual Men Attending a Community-Based Clinic in Los Angeles, CaliforniaBeymer, M. R., Weiss, R. E., Halkitis, P. N., Kapadia, F., Ompad, D. C., Bourque, L., & Bolan, R. K.
Journal titleJournal of Acquired Immune Deficiency SyndromesBACKGROUND:: Latino gay, bisexual, and other men who have sex with men (MSM) in the United States have a 50% greater incidence of HIV when compared to White MSM. Previous studies have analyzed factors contributing to condomless anal intercourse (CAI) among Latino MSM, but few studies have followed cohorts of HIV-negative Latino MSM to determine circumstances for HIV infection. Informed by Syndemics Theory, we examine behavioral, biological, and contextual factors associated with HIV infection for Latino MSM. METHODS:: Risk assessment and HIV testing data were analyzed for all initially HIV-negative, Latino MSM (n = 3,111) visiting a community-based clinic in Los Angeles, California from January 2009 to June 2014. Survival analyses were used to determine characteristics of Latino MSM who became HIV-positive during the study timeframe. RESULTS:: Similar to previous studies of MSM, self-reported history of Chlamydia, Gonorrhea and/or Syphilis (aHR: 1.97; CI: 1.28-3.04), receptive CAI (aHR: 1.7; CI: 1.16-2.49), and methamphetamine use (aHR: 1.99; CI: 1.15-3.43) predicted HIV infection. In addition, originating from Central America (aHR: 2.31; CI: 1.41-3.79), Latino ethnicity of the last sex partner (aHR: 1.67; CI: 1.16-2.39), and experiencing intimate partner violence (IPV) (aHR: 1.73; CI: 1.13-2.64) were also associated with HIV infection among Latino MSM. CONCLUSIONS:: This is the first study to show independent associations between IPV and HIV infection among Latino MSM. This study shows that psychosocial conditions such as IPV fuel HIV incidence among Latino MSM, and psychosocial interventions should be considered to reduce HIV disparities among Latino MSM.
Drug use among HIV+ adults aged 50 and older: findings from the GOLD II studyOmpad, D. C., Giobazolia, T. T., Barton, S. C., Halkitis, S. N., Boone, C. A., Halkitis, P. N., Kapadia, F., & Urbina, A.
Journal titleAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Page(s)1-5Understanding the nexus of aging, HIV, and substance use is key to providing appropriate services and support for their aging, HIV seropositive patients. The proportion of PLWHA aged 50 and older is growing due to a variety of factors like decreases in mortality due to highly active retroviral therapy and non-negligible HIV incidence. We describe prevalence of alcohol, tobacco, and other drug use and participation in substance use treatment and 12-step programs among 95 HIV-positive patients aged 50 and older engaged in care. Most (73.7%) smoked cigarettes in their lifetime and 46.3% were current smokers. Most were at medium (81.1%) or high risk (13.7%) for an alcohol use disorder. With respect to illicit drug use, 48.4% had used marijuana, cocaine, crack, methamphetamines, heroin, and/or prescription opiates without a prescription in the last 12 months; 23.2% met criteria for drug dependence. Marijuana was the most commonly reported illicit drug (32.6%) followed by cocaine and crack (10.5% each), heroin and prescription opiates (7.4% each), and methamphetamines (6.3%). Among those who had not used drugs in the past 12 months, 36.7% had been in a substance use treatment program and 26.5% had participated in a 12-step program in their lifetime; 8.2% were currently in treatment and 16.3% were currently participating in a 12-step program. Among those who had used an illicit drug in the past 12 months, 37.0% had never been in treatment, 34.8% had been in treatment in their lifetime, and 28.3% were currently in treatment. With respect to 12-step programs, 27.3% of those meeting dependence criteria had never participated, 45.5% had participated in their lifetimes, and 27.3% were currently participating. Our findings suggest that older adults in HIV care settings could benefit from Screening, Brief Intervention, and Referral to Treatment interventions and/or integrated services for substance abuse and medical treatment.
Early Life Psychosocial Stressors and Housing Instability among Young Sexual Minority Men: the P18 Cohort StudyKrause, K. D., Kapadia, F., Ompad, D. C., D’Avanzo, P. A., Duncan, D. T., & Halkitis, P. N.
Journal titleJournal of Urban Health
Page(s)1-15Homelessness and housing instability is a significant public health problem among young sexual minority men. While there is a growing body of literature on correlates of homelessness among sexual minority men, there is a lack of literature parsing the different facets of housing instability. The present study examines factors associated with both living and sleeping in unstable housing among n = 600 sexual minority men (ages 18–19). Multivariate models were constructed to examine the extent to which sociodemographic, interpersonal, and behavioral factors as well as adverse childhood experiences explain housing instability. Overall, 13 % of participants reported sleeping in unstable housing and 18 % had lived in unstable housing at some point in the 6 months preceding the assessment. The odds of currently sleeping in unstable housing were greater among those who experienced more frequent lack of basic needs (food, proper hygiene, clothing) during their childhoods. More frequent experiences of childhood physical abuse and a history of arrest were associated with currently living in unstable housing. Current enrollment in school was a protective factor with both living and sleeping in unstable housing. These findings indicate that being unstably housed can be rooted in early life experiences and suggest a point of intervention that may prevent unstable housing among sexual minority men.
Facilitators and Barriers to HIV Status Disclosure Among HIV-Positive MSM Age 50 and OlderKingdon, M. J., Barton, S., Eddy, J., & Halkitis, P. N.
Journal titleJournal of Gay and Lesbian Mental Health
Page(s)41-56Most HIV-positive men who have sex with men (MSM) ages 50 and older feel a responsibility to protect their sex partners from HIV transmission risk. For some, this is enacted through HIV disclosure, while for others it is realized through reduced risk behaviors. To examine this, we analyzed interviews of 23 HIV-positive MSM ages 50 and older. We identified several contextual, relational, and psychosocial factors that served as either barriers or facilitators to HIV disclosure. Our findings suggest HIV status disclosure is multifaceted and continues to impact sexual communication in the lives of MSM as they enter middle age.
Feasibility and acceptability of global positioning system (GPS) Methods to study the spatial contexts of substance use and sexual risk behaviors among young men who have sex with men in New York City: A P18 cohort sub-studyDuncan, D. T., Kapadia, F., Regan, S. D., Goedel, W. C., Levy, M. D., Barton, S. C., Friedman, S. R., & Halkitis, P. N.
Journal titlePLoS One
Issue2Background No global positioning system (GPS) technology study has been conducted among a sample of young gay, bisexual, and other men who have sex with men (YMSM). As such, the purpose of this study was to evaluate the feasibility and acceptability of using GPS methods to understand the spatial context of substance use and sexual risk behaviors among a sample of YMSM in New York City, a high-risk population. Methods Data came from a subsample of the ongoing P18 Cohort Study (n = 75). GPS feasibility and acceptability among participants was measured with: 1) a pre-and post-survey and 2) adherence to the GPS protocol which included returning the GPS device, self-report of charging and carrying the GPS device as well as objective data analyzed from the GPS devices. Analyses of the feasibility surveys were treated as repeated measures as each participant had a pre-and post-feasibility survey. When comparing the similar GPS survey items asked at baseline and at follow-up, we present percentages and associated p-values based on chi-square statistics. Results Participants reported high ratings of pre-GPS acceptability, ease of use, and low levels of wear-related concerns in addition to few concerns related to safety, loss, or appearance, which were maintained after baseline GPS feasibility data collection. The GPS return rate was 100%. Most participants charged and carried the GPS device on most days. Of the total of 75 participants with GPS data, 75 (100%) have at least one hour of GPS data for one day and 63 (84%) had at least one hour on all 7 days. Conclusions Results from this pilot study demonstrate that utilizing GPS methods among YMSM is feasible and acceptable. GPS devices may be used in spatial epidemiology research in YMSM populations to understand place-based determinants of health such as substance use and sexual risk behaviors.
HIV Risk Behaviors, Perceptions, and Testing and Preexposure Prophylaxis (PrEP) Awareness/Use in Grindr-Using Men Who Have Sex With Men in Atlanta, GeorgiaGoedel, W. C., Halkitis, P. N., Greene, R. E., Hickson, D. A., & Duncan, D. T.
Journal titleThe Journal of the Association of Nurses in AIDS Care : JANAC
Page(s)133-142Geosocial-networking smartphone applications such as Grindr can help men who have sex with men (MSM) meet sexual partners. Given the high incidence of HIV in the Deep South, the purpose of our study was to assess HIV risk and preexposure prophylaxis (PrEP) awareness and use in a sample of HIV-uninfected, Grindr-using MSM residing in Atlanta, Georgia (n = 84). Most (n = 71; 84.6%) reported being somewhat or very concerned about becoming HIV infected. Most (n = 74; 88.1%) had been tested for HIV in their lifetimes. About three fourths (n = 65; 77.4%) were aware of PrEP, but only 11.9% currently used the medication. HIV continues to disproportionately impact MSM and represents a significant source of concern. As the number of new infections continues to rise, it is important to decrease risks associated with acquisition and transmission of HIV by increasing rates of HIV testing and the use of biobehavioral interventions such as PrEP.
Intimate Partner Violence and Sex Among Young Men Who Have Sex With MenStults, C. B., Javdani, S., Greenbaum, C. A., Kapadia, F., & Halkitis, P. N.
Journal titleJournal of Adolescent Health
Page(s)215-22PURPOSE: Among young men who have sex with men (YMSM) few studies have examined the relationship between intimate partner violence (IPV) perpetration versus victimization and sexual behaviors.METHODS: Using data from n = 528 urban YMSM, multinomial logistic regression models were built to examine the distinct relationships between any IPV, victimization, and perpetration with condomless sex in the previous 30 days, controlling for key sociodemographic characteristics.RESULTS: In this sample of YMSM, lifetime experience of any IPV was associated with increased odds of recent condomless oral (adjusted odds ratio [AOR] = 1.81, 95% confidence interval [CI] = 1.21-2.72) and anal receptive sex (AOR= 2.29, 95% CI = 1.22-4.31). IPV victimization was associated with a greater likelihood of condomless receptive anal sex (AOR= 2.12, 95% CI = 1.15-3.93) whereas IPV perpetration was associated with increased odds of condomless receptive (AOR= 2.11, 95% CI = 1.14-3.91) and insertive (AOR= 2.21, 95% CI = 1.06-4.59) anal sex.CONCLUSIONS: Among YMSM, reports of both IPV perpetration and victimization were associated with increased odds of recent condomless sex. These findings indicate that the need for IPV prevention and intervention programs for this new generation of YMSM is highly warranted.