Associate Professor of Epidemiology
Dr. Farzana Kapadia is an epidemiologist interested in understanding the distribution, determinants, and consequences of HIV/AIDS across the lifespan. In adolescents and younger adults, Dr. Kapadia is interested in studying contextual factors that influence HIV/AIDS related health behaviors and outcomes. Given the increasingly chronic nature of HIV/AIDS, she also studies the impact of HIV/AIDS on the physical, mental, and behavioral health of older HIV+ adults.
Dr. Kapadia is co-Director of the Center for Health, Identity, Behavior, and Prevention Studies and is affiliated with the Institute of Human Development and Social Change and the NYU Population Center. She has taught courses in Introductory Epidemiology (graduate- and undergraduate-level), Intermediate Epidemiology, and Research Methods in Public Health, and History & Principles of Public Health.
BS, Biology and History, SUNY Binghamton, Binghamton, NYMPH, Community Public Health, New York University, New York, NYPhD, Epidemiology, Columbia University, New York, NY
Excellence in Public Health Faculty Award, New York University (2012)Steinhardt Goddard Award (2011)Community Collaborative Award, Steinhardt School of Culture, Education and Human Development (2009)Elected Member, American College of Epidemiology (2007)
Behavioral Determinants of HealthEpidemiologyHIV/AIDSReproductive HealthSocial BehaviorsSocial Determinants of HealthSubstance Abuse
Motivations for alcohol use to intoxication among young adult gay, bisexual, and other MSM in New York City: The P18 Cohort StudyRistuccia, A., LoSchiavo, C., Kapadia, F., & Halkitis, P. N.
Journal titleAddictive Behaviors
Page(s)44-50Introduction: Motivations for alcohol use to intoxication vary among young adults depending on social setting and other contextual factors. However, there is limited research exploring the role of different drinking motivations among young men who have sex with men (YMSM). Methods: Data from a racially/ethnically and socioeconomically diverse sample of YMSM (n = 426) were used to examine associations between recent (last 30 days) alcohol use to intoxication and scores on three distinct drinking motivation subscales: convivial, intimate, and negative coping drinking. Multinomial logistic regression models were constructed to examine associations between drinking motivations and days of alcohol use to intoxication, controlling for sociodemographic characteristics. Results: YMSM who scored higher on all three drinking motivation subscales were more likely to engage in recent alcohol use to intoxication compared to those who reported no alcohol use to intoxication. In multivariable models, Black and Hispanic YMSM had lower odds of intoxication compared to White YMSM, and those reporting lower perceived familial SES had lower odds compared to higher SES. In a final model including all three motivations, only convivial drinking was significantly associated with days of intoxication (1–2 days: AOR = 1.22; 3+ days: AOR = 1.45). Conclusions: This study identifies distinct associations between different motivations for drinking and alcohol use to intoxication in a sample of YMSM. These findings highlight a need to incorporate an understanding of motivations for alcohol use to intoxication into research and clinical practice with YMSM, as different reasons for drinking carry respective potential health risks.
A qualitative investigation of healthcare engagement among young adult gay men in New York City: A P18 cohort substudyGriffin, M., Krause, K. D., Kapadia, F., & Halkitis, P. N.
Journal titleLGBT health
Page(s)368-374Purpose: We used in-depth interviews with a cohort of young adult gay men (YAGM) to provide a more detailed understanding of their current healthcare engagement, including experiences with the healthcare system, provider knowledge of healthcare needs, and desired provider characteristics. Methods: Qualitative interviews were conducted with a sample of 40 YAGM in New York City. The interview guide examined healthcare engagement across key developmental stages: Childhood (birth-12), adolescence (13-18), young adulthood (19-22), and the present (23-26). All transcripts were coded using a consensual qualitative research approach to identify crosscutting topics. The interviews were conducted between September and October 2015. Results: The following topics were identified: Experiences with the healthcare system, provider knowledge of healthcare needs, and desired provider characteristics. Common barriers to healthcare access were financial concerns, lack of insurance, and dissatisfaction with the care provided. Reasons for dissatisfaction with care were based on perceptions of providers' anti-gay attitudes, judgment of same-sex sexual behavior, and lack of provider knowledge about YAGM's health needs. This often led men in this study to seek sexual healthcare from providers other than their primary care provider. When asked about desired provider characteristics, participants noted that basic demographics were of less importance than skills-based characteristics such as rapport, comfort discussing sexual health issues, and knowledge of YAGM's health. Conclusion: YAGM have unique challenges to engaging in healthcare, including provider stigma and lack of provider knowledge of YAGM's health needs, which are not faced by other young adult populations. The results from this study highlight the need for more extensive and standardized training in medical school and as part of continuing medical education for healthcare providers.
Access to and experiences with healthcare in urban-dwelling young adult lesbian women in the United StatesGriffin-Tomas, M., Jaiswal, J., Krause, K. D., Kapadia, F., & Halkitis, P. N.
Journal titleCulture, Health and Sexuality
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
Beliefs About the End of AIDS, Concerns About PrEP Functionality, and Perceptions of HIV Risk as Drivers of PrEP Use in Urban Sexual Minority Men: The P18 Cohort StudyHalkitis, P. N., Jaiswal, J., Griffin-Tomas, M., Krause, K. D., D’Avanzo, P., & Kapadia, F.
Journal titleAIDS and Behavior
Page(s)1-13Using cross-sectional data from an ongoing cohort study of young gay, bisexual, and other men who have sex with men (N = 492), we examined the extent to which cognitive factors such as beliefs about the end of AIDS, concerns about the manner in which PrEP works, and perceptions about risk of contracting HIV, are related to PrEP uptake and use. While almost all participants indicted awareness of PrEP, a mere 14% had ever used PrEP. Those with lower concerns about the side effects of PrEP and greater belief that treatment and PrEP would eliminate AIDS were also more likely to have ever used PrEP. Our findings support the ongoing challenges of PrEP uptake as means of curtailing HIV in young sexual minority men, and suggest that beyond the structural factors, consideration must be given to further educating the population as a means of adjusting potentially faulty beliefs, concerns, and perceptions which may influence PrEP utilization.
Reliability and Validity of a Material Resources Scale and Its Association With Depression Among Young Men Who Have Sex With Men: The P18 Cohort StudyOmpad, D. C., Palamar, J. J., Krause, K. D., Kapadia, F., & Halkitis, P. N.
Journal titleAmerican Journal of Men's Health
Page(s)1384-1397Socioeconomic status (SES) is a fundamental cause of ill health, but an understudied determinant of health for gay, bisexual, and other men who have sex with men (MSM). Surprisingly, few studies have examined the relations between poverty and depression among young MSM. The aims of this study were to determine the reliability and validity of an 18-item Family Resource Scale (FRS) as a measure of SES among YMSM and examine the relations between SES and depression, while taking into account factors associated with resilience or risk for poor mental health. Reliability of the SES scale was determined with Cronbach’s alpha. Validity was assessed with factor analysis and bivariable comparisons with other SES measures. Multiple logistic regression was used to determine the relations between depressive symptomology (via the Beck Depression Inventory–II), SES, and gay-related psychosocial variables. In this racially/ethnically diverse sample (mean age = 21.8 years, 37.3% Hispanic/Latino, 30.5% White, 14.9% Black, and 17.0% other race/ethnicity), 70.8% reported incomes ≤ $10,000 and the mean FRS score was 4.1 (SD = 0.9, range 0-5). The FRS demonstrated reliability (α =.91) and criterion and construct validity. The Beck Depression Inventory–II rated 17.6% with depressive symptomology. Higher FRS scores were associated with a lower odds of depression (adjusted odds ratio = 0.58; 95% confidence interval = 0.46-0.74) in logistic regression models controlling for gay community affinity and internalized homophobia. This diverse sample of YMSM in New York City reported substantial financial hardship and those who were more gay-identified had fewer material resources. Fewer material resources and internalized homophobia were both associated with higher odds of depression.
Sexualised drug use among sexual minority young adults in the United States: The P18 cohort studyRistuccia, A., LoSchiavo, C., Halkitis, P. N., & Kapadia, F.
Journal titleInternational Journal of Drug PolicyBackground: Substance use and condomless sexual behaviours are both well studied in sexual minority men, but few researchers have used event-level data collection to examine sexualised drug use in sexual and gender minority young adults. The aim of this study is to describe the co-occurrence of sex under the influence of substances and condomless sexual behaviours, using nuanced event-level data, in a racially/ethnically and socioeconomically diverse sample in New York City. Methods: Data from one wave of a cohort of sexual and gender minority young adults who were assigned male at birth (n = 500) were used to characterise co-occurrence of sex under the influence of drugs and condomless sexual behaviours (oral receptive, anal insertive, and anal receptive sex), in the last 30 days. Logistic regression models were constructed to assess associations between sex while high and condomless sexual behaviours, controlling for sociodemographic factors. Results: Preliminary analyses indicated significant associations between engaging in sex while high and condomless sexual behaviours. In unadjusted regression models, sexualised and non-sexualised drug use were both significantly associated with increased odds of condomless sexual behaviours. In adjusted models, sexualised drug use remained significantly associated with condomless anal insertive sex (AOR = 3.57) and condomless anal receptive sex (AOR = 4.98). Having multiple sexual partners was also significantly associated with greater odds of condomless sexual activity in all three adjusted models. Conclusion: Multivariable analyses indicated that engaging in sex while high on any drug was associated with increased condomless sexual behaviour, but that sexualised drug use was associated with particularly elevated condomless anal sex. These findings provide insight for understanding the co-occurrence of substance use and condomless sex, and suggest a need for HIV/STI risk reduction strategies that address the role of sexualised drug use.
Structural divers of PrEP use in urban sexual minority men: the P18 cohort studyJaiswal, J., Griffin-Tomas, M., Singer, S. N., Greene, R., Zambrano, I., Kaudeyr, S., Kapadia, F., & Halkitis, P. N.
Journal titleCurrent HIV Research
A Case of Rectal Ureaplasma Infection and Implications for Testing in Young Men Who Have Sex with Men: The P18 Cohort StudyAbbott, C. E., Greene, R. E., Kapadia, F., & Halkitis, P. N.
Journal titleLGBT Health
Page(s)161-163Ureaplasma is a significant cause of nongonococcal urethritis. This is a case of rectal Ureaplasma found on culture in a young man who has sex with men not previously reported in the literature. Nucleic acid amplification tests are now standard of care for sexually transmitted infection testing, but they do not test for Ureaplasma and, therefore, may be missing important infections. Ureaplasma could have important implications in urethritis and rectal HIV transmission among men who have sex with men engaging in condomless anal intercourse. Further study of Ureaplasma's role as a rectal pathogen may be warranted.
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.
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
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
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.
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.
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.