Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
J Urban Health. 2020 Oct;97(5):668-678. doi: 10.1007/s11524-020-00458-2.
Black men who have sex with men (BMSM) bear a disproportionate burden of HIV in the USA. BMSM face stigma, discrimination and barriers to health care access, and utilization. Peers (male or female) may assist BMSM in navigating their health issues by engaging in communication to support in their health care needs. Individuals with high self-efficacy of communicating about men's health issues with peers can be trained as community popular opinion leaders (CPOLs) to change peer behaviors by promoting risk reduction communication. We examined the characteristics associated with high self-efficacy of communicating with peers about men's health issues among 256 BMSM from a behavioral HIV intervention conducted in Baltimore, Maryland. In the multivariate logistic model, gay identity (AOR: 2.10, 95% CI: 1.15,3.83), involvement in the house and ballroom community (AOR: 2.50, 95% CI: 1.14,5.49), larger number of network members who are living with HIV (AOR: 6.34, 95% CI: 1.48,27.11), and larger number of network members who would loan them money (AOR: 1.46, 95% CI: 1.05,2.03) were statistically significantly associated with high self-efficacy of communicating with peers about men's health issues. We also found that having depressive symptoms (AOR: 0.43, 95% CI: 0.24, 0.77) was negatively associated with high self-efficacy of communicating with peers about men's health issues. Findings from the current study can inform future studies to identify better CPOLs who are able to communicate effectively with peers about men's health issues for BMSM.
男男性行为者(BMSM)在美国承担着不成比例的艾滋病毒负担。BMSM 面临污名化、歧视和获得医疗保健的障碍,并且利用不足。同伴(男性或女性)可以通过沟通来帮助 BMSM 解决他们的健康问题,从而满足他们的医疗保健需求。具有与同伴就男性健康问题进行沟通的高度自我效能感的个体可以被培训为社区舆论领袖(CPOL),通过促进风险降低沟通来改变同伴的行为。我们研究了 256 名来自马里兰州巴尔的摩行为 HIV 干预研究的 BMSM 中,与与同伴就男性健康问题进行沟通的高度自我效能感相关的特征。在多变量逻辑模型中,同性恋身份(AOR:2.10,95%CI:1.15,3.83)、参与家庭和舞厅社区(AOR:2.50,95%CI:1.14,5.49)、拥有更多HIV 感染者网络成员(AOR:6.34,95%CI:1.48,27.11)和更多愿意借钱给他们的网络成员(AOR:1.46,95%CI:1.05,2.03)与与同伴就男性健康问题进行沟通的高度自我效能感呈统计学显著相关。我们还发现,抑郁症状(AOR:0.43,95%CI:0.24,0.77)与与同伴就男性健康问题进行沟通的高度自我效能感呈负相关。本研究的结果可以为未来的研究提供信息,以确定能够与 BMSM 的同伴就男性健康问题进行有效沟通的更好的 CPOL。