First Build Gay Men's Resilience. HIV Prevention Will Follow.

The Huffington Post
John-Manuel Andriote
Original Article:

A recently published study connects the dots between the disproportionate rate of mental health problems among gay and bisexual men and their equally disproportionate rate of HIV infection. It suggests that to be effective, HIV prevention efforts must first support our mental health, rather than simply try to discourage risky sexual behavior.

HIV prevention and gay men’s health experts for years have said a holistic approach is needed to address the "upstream" drivers of risk behavior — exactly the sorts of psychosocial problems the new study measured. The study, reported in the Journal of Acquired Immune Deficiency Syndromes, examined how five mental health conditions — depression, alcohol abuse, stimulant use, multi-drug abuse and exposure to childhood sexual violence — affect gay and bisexual men’s risk for HIV infection. Researchers analyzed data from 4,295 HIV-negative men who reported having sex with men within the previous year. The men completed a behavioral survey and were tested for HIV every six months for 48 months.

Of the 680 men who completed the study, those who reported the largest number of psychosocial problems were the most likely to be HIV-positive by the end of the study. Men who reported four or five psychosocial problems were about nine times more likely to have become infected. They were also more likely to have unprotected anal sex with an HIV-positive man than men without any of the problems measured.

Based on their findings the behavioral scientists concluded "the HIV prevention agenda requires a shift toward improved assessment of psychosocial comorbidities and stronger integration with mental health and substance abuse treatment services." In other words, healthy and protected sexual behavior will follow if we first focus on healing the psychological wounds gay men routinely experience in a society where we can now legally marry a same-sex partner in 36 states while in 29 states we can be fired from a job simply for being gay.

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