Sexual, behavioral, and quality of life characteristics of healthy weight, overweight, and obese gay and bisexual men: Findings from a prospective cohort study

While there have been attempts to explore the association of obesity and risky sexual behaviors among gay men, findings have been conflicting. Using a prospective cohort of gay and bisexual men residing in Pittsburgh, we performed a semi-parametric, group-based analysis to identify distinct groups of trajectories in body mass index slopes over time from 1999 to 2007 and then correlated these trajectories with a number of psychosocial and behavioral factors, including sexual behaviors. We found many men were either overweight (41.2%) or obese (10.9%) in 1999 and remained stable at these levels over time, in contrast to recent increasing trends in the general population. Correlates of obesity in our study replicated findings from the general population. However, we found no significant association between obesity and sexual risk-taking behaviors, as suggested from several cross-sectional studies of gay men. While there was not a significant association between obesity and sexual risk-taking behaviors, we found high prevalence of overweight and obesity in this population. Gay and bisexual men's health researchers and practitioners need to look beyond HIV and STI prevention and also address a broader range of health concerns important to this population. © 2011 Springer Science+Business Media, LLC

Erratum to: Primary Care Validation of a Single-Question Alcohol Screening Test

BACKGROUND: Unhealthy alcohol use is prevalent but under-diagnosed in primary care settings. OBJECTIVE: To validate, in primary care, a single-item screening test for unhealthy alcohol use recommended by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). DESIGN: Cross-sectional study. PARTICIPANTS: Adult English-speaking patients recruited from primary care waiting rooms. MEASUREMENTS: Participants were asked the single screening question, “How many times in the past year have you had X or more drinks in a day?”, where X is 5 for men and 4 for women, and a response of >1 is considered positive. Unhealthy alcohol use was defined as the presence of an alcohol use disorder, as determined by a standardized diagnostic interview, or risky consumption, as determined using a validated 30-day calendar method. MAIN RESULTS: Of 394 eligible primary care patients, 286 (73%) completed the interview. The single-question screen was 81.8% sensitive (95% confidence interval (CI) 72.5% to 88.5%) and 79.3% specific (95% CI 73.1% to 84.4%) for the detection of unhealthy alcohol use. It was slightly more sensitive (87.9%, 95% CI 72.7% to 95.2%) but was less specific (66.8%, 95% CI 60.8% to 72.3%) for the detection of a current alcohol use disorder. Test characteristics were similar to that of a commonly used three-item screen, and were affected very little by subject demographic characteristics. CONCLUSIONS: The single screening question recommended by the NIAAA accurately identified unhealthy alcohol use in this sample of primary care patients. These findings support the use of this brief screen in primary care

Body Mass Index, Depression, and Condom Use Among HIV-Infected Men who have Sex with Men: A Longitudinal Moderation Analysis

Findings have been inconsistent regarding the association of obesity and sexual risk behaviors. The purpose of the current study was to assess the prospective nature of body mass index (BMI), depression, and their interaction in predicting condom use during anal intercourse among HIV-infected men who have sex with men (MSM). The sample (N = 490) was obtained from a large, HIV clinical cohort from four sites across the U.S. The following inclusion criteria were employed: identification as MSM and had completed at least one wave of patient-reported measures (e.g., depression, as measured by the PHQ-9) in the clinical cohort study. Longitudinal linear mixed-effects modeling revealed a significant BMI by depression interaction. Depressive symptoms were predictive of less frequent condom use for obese but not overweight men. Analogous results were found in regard to comparisons between normal weight and overweight men. Obesity, in the context of depression, is a risk factor for unprotected anal intercourse among HIV-infected MSM. Cognitive behavioral interventions to reduce HIV transmission risk behaviors among HIV-infected MSM should adopt an integrated perspective, combining sexual risk reduction with treatment for depression and body-related concerns

Body Dissatisfaction and Disordered Eating Among Men Who Have Sex with Men in Canada

Evidence suggests that gay, bisexual and other men who have sex with men (MSM) score higher than heterosexual-identifying men on disordered eating symptomology (DES). This exploratory study examined if the following psychosocial factors were associated with DES among a diverse sample of MSM: race, age, sexual identity, sexual risk, substance use, depression, history of childhood sexual abuse (CSA) and internalized homophobia. Using cross sectional data collected at Pride Toronto 2008 (N = 383), multivariate analysis revealed the following factors to be associated with DES: CSA, depression, being White (vs. Black or Asian), being younger, and engaging in behaviours to increase muscle mass. These results may inform the development of useful and efficacious interventions to reduce the risks associated with body dissatisfaction and DES among MSM