Applying resilience theory models to contextualize economic-dependent partnerships as a risk factor for HIV among young men who have sex with men

AIDS Care. 2018;30(sup4):42-50. doi: 10.1080/09540121.2018.1493185. Epub 2019 Jan 9.

Abstract

Economic-dependent partnerships (EDP) are an understudied HIV risk correlate among young men who have sex with men (YMSM) in the U.S. We explored whether YMSM's psychological resilience buffered against the effect of socioeconomic disadvantage on EDPs, after accounting for other psychosocial risks. Data come from an observational study assessing YMSM's HIV vulnerabilities. We developed indices for socioeconomic disadvantage, psychosocial profiles, and cumulative promotive factors. Multivariable logistic regressions tested the main associations of these indices on EDPs. Protective models tested whether psychosocial profiles exacerbated and cumulative promotive factors buffered the effects of socioeconomic disadvantage on EDPs. 31% and 23% of YMSM reported EDPs with main and casual partners, respectively. For both outcomes, we found support for adjusted compensatory models. Socioeconomic disadvantage was associated with increased odds of EDPs with main (AOR = 1.45, p < .001) and casual (AOR = 1.47, p < .001) partners. Psychosocial profiles were also associated with increased odds of EDPs with main (AOR = 1.53, p = .001) and casual (AOR = 1.67, p < .001) partners. Cumulative promotive factors was associated with decreased odds of EDPs with main (AOR = 0.66, p = .003) and casual (AOR = 0.72, p = .035) partners. Our findings elucidate the need for multilevel interventions that provide opportunities for socioeconomic advancement and improve psychosocial/psychological functioning for at-risk YMSM.

Keywords: HIV; LGBT health; partnerships; resilience; socioeconomic disadvantage.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Infections / psychology
  • Homosexuality, Male / psychology*
  • Humans
  • Logistic Models
  • Male
  • Models, Theoretical
  • Resilience, Psychological*
  • Risk Factors
  • Risk-Taking*
  • Sexual Behavior / psychology
  • Sexual Partners / psychology*
  • Socioeconomic Factors*
  • Unsafe Sex / psychology*
  • Unsafe Sex / statistics & numerical data
  • Young Adult