A Stress Process Model of Depression and Sexual Risk Among HIV Seropositive Men Who Have Sex with Men

Florom-Smith, Aubrey L.

Saturday, 29 October 2011

Aubrey L. Florom-Smith, BSN, RN
School of Nursing and Health Studies, University of Miami, Coral Gables, FL

Learning Objective 1: The learner will be able to describe stressors and chronic strains that potentially influence the health of HIV seropositive men who have sex with men.

Learning Objective 2: The learner will be able to describe the importance of the potential connections between stressors, chronic strains, and the health outcomes of interest.

Men who have sex with men (MSM) continue to be at increased risk for HIV infection. Because most prevention interventions have focused on seronegative MSM, HIV seropositive MSM are an important target for HIV prevention interventions. The purpose of the proposed cross-sectional study is to examine alternative stress process models predicting depression and sexual risk behavior among HIV seropositive MSM. The stress process model is useful for understanding the influence of multiple confluent stressors, chronic strains, and personal resources on health outcomes. As little quantitative research has applied the stress process model to HIV prevention in HIV seropositive MSM, investigation of the relationships between these potentially influential factors may lead to novel points of entry for new and more effective HIV interventions with this population.

The specific aim of the proposed study is to test two stress process models. Both models hypothesize that the stressors, gay and HIV-related discrimination, predict depression and high risk sexual behavior among HIV seropositive MSM. The models differ in that internalized homophobia and internalized HIV-related stigma, conceptualized as chronic strains or intervening variables between the stressors and the outcomes, will be examined as either statistical mediators or moderators. The role of contextual variables, negative life events and social support, will also be examined in order to place the influence of gay and HIV-related stigma in context.

Structural equation modeling will be used to analyze the data. A sample of 200 HIV seropositive MSM, aged 18-39, and reflective of the ethnic makeup of South Florida, will be recruited via MSM oriented media and at MSM oriented venues. Survey administration will be conducted in a private office, and information regarding safer sex practices and connection to services will be provided.

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