Assessing the Determinants of Quality of Life and the Impact on HIV Prevention Measures among HIV-Negative and Status-Unknown Young Men Who Have Sex with Men: A Study in Two U.S. Metropolitan Areas
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Data Collection and Measures
2.3. Statistical Analyses
3. Results
3.1. QoL Scores and Domain Correlations
3.2. Sociodemographics and QoL
3.3. Behavioral Risk Factors and QoL
3.4. Psychosocial and Mental Health Determinants of QoL
3.5. Impact of QoL on HIV Prevention Measures
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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QoL Domains | Mean Scores (SD) | Median Scores (IQR) | Spearman’s Correlation Coefficients | ||||
---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | |||
1. Overall QoL and general health | 74.5 (21.9) | 75.0 (62.5–87.5) | 1 | ||||
2. Physical health | 68.5 (19.7) | 71.4 (57.1–82.1) | 0.525 *** | 1 | |||
3. Psychological health | 59.4 (19.8) | 62.5 (45.8–70.8) | 0.624 *** | 0.750 *** | 1 | ||
4. Social relationships | 58.7 (26.4) | 58.3 (41.7–75.1) | 0.549 *** | 0.667 *** | 0.775 *** | 1 | |
5. Environment | 65.0 (23.5) | 68.8 (53.1–81.3) | 0.556 *** | 0.769 *** | 0.788 *** | 0.753 *** | 1 |
Total (N = 347) | QoL Domains (Median, IQR) | |||||
---|---|---|---|---|---|---|
Sociodemographics | n (%) | Overall QoL and Health | Physical Health | Psychological Health | Social Relationships | Environment |
Age (years) | ||||||
18–24 | 147 (42.4) | 76.1(62.5–87.5) | 72.6(53.6–82.1) | 63.7 (45.8–70.8) | 58.2 (41.7–75) | 68.8 (50–81.3) |
25–35 | 200 (57.6) | 75 (62.5–100) | 71.4 (57.1–82.1) | 62.5 (50–70.8) | 59.3 (41.2–74.6) | 71.9 (56.3–78.1) |
p-value | 0.572 | 0.329 | 0.381 | 0.786 | 0.294 | |
Race/ethnicity | ||||||
Non-Hispanic white | 109 (31.4) | 75 (62.5–87.5) | 71.4 (60.7–82.1) | 62.5 (50–70.8) | 58.3 (50–75) | 71.8 (62.5–81.2) |
Non-Hispanic Black | 209 (60.2) | 73 (62.5–100) | 69.8 (50–82.1) | 62.5 (45.8–75) | 58.3 (41.7–75) | 65.6 (50–78.1) |
Other * | 29 (8.4) | 73.5 (62.5–87.5) | 71.4 (57.1–82.1) | 58.3 (41.7–66.7) | 66.7 (50–75) | 68.8 (53.1–78.2) |
p-value | 0.069 | 0.298 | 0.362 | 0.898 | 0.014 | |
Education | ||||||
High school or lower | 71 (20.4) | 70 (50–87.5) | 60.7 (46.4–82.1) | 54.1 (41.7–70.8) | 50 (41.7–75) | 59.3 (40.6–78.1) |
Some college | 138 (39.8) | 72 (62.5–100) | 64.3 (50–78.6) | 58.3 (45.8–70.8) | 62.5 (50–75) | 62.5 (50–75) |
College and above | 138 (39.8) | 75 (75–87.5) | 75 (67.8–85.7) | 66.7 (54.1–70.8) | 66.6 (33.3–83.3) | 71.8 (65.6–81.3) |
p-value | 0.011 | <0.001 | 0.004 | 0.009 | <0.001 | |
Employment | ||||||
Employed | 243 (70.1) | 75 (62.5–87.5) | 71.4 (57.1–82.1) | 62.5 (45.8–70.8) | 58.3 (41.7–75) | 68.8 (56.3–81.3) |
Unemployed | 51 (14.7) | 75 (50–100) | 78.6 (53.6–85.7) | 62.5 (45.8–83.3) | 66.7 (50–75) | 68.8 (50–84.3) |
College students | 53 (15.2) | 75 (62.5–87.5) | 64.2 (57.1–75) | 62.5 (45.8–70.8) | 58.3 (33.3–75) | 68.8 (56.3–78.1) |
p-value | 0.842 | 0.479 | 0.839 | 0.140 | 0.965 | |
Annual income | ||||||
<$20,000 | 144 (41.5) | 75 (62.5–87.5) | 67.8 (53.5–82.1) | 60.4 (45.8–70.8) | 58.3 (41.7–75) | 65.6 (46.9–78.1) |
$20,000–$40,000 | 132 (28.1) | 75 (62.5–87.5) | 71.4 (55.3–82.1) | 62.5 (50–70.8) | 58.3 (41.7–75) | 68.8 (56.3–75) |
>$40,000 | 71 (20.4) | 75 (75–100) | 71.4 (60.7–89.2) | 62.5 (54.2–75) | 66.6 (58.3–83.3) | 75 (59.4–90.6) |
p-value | 0.469 | 0.046 | 0.008 | 0.017 | <0.001 | |
Health insurance | ||||||
Uninsured | 65 (18.7) | 71 (50–87.5) | 57.1 (46.4–78.6) | 54.2 (45.8–66.7) | 50 (33.3–66.7) | 53.1 (37.5–65.6) |
Insured | 282 (81.3) | 76.5 (62.5–87.5) | 71.4 (60.7–82.1) | 62.5 (50–70.8) | 58.3 (50–75) | 71.9 (59.4–81.2) |
p-value | 0.013 | <0.001 | <0.001 | 0.003 | <0.001 | |
Sexual orientation | ||||||
Homosexual | 267 (77.0) | 75 (62.5–87.5) | 71.4 (57.1–82.1) | 62.5 (50–70.8) | 58.3 (41.7–75) | 71.9 (56.2–81.3) |
Heterosexual | 32 (9.2) | 81.3 (37.5–100) | 66.1 (46.4–78.6) | 66.7 (45.8–72.9) | 70.8 (37.5–91.6) | 75 (42.1–82.8) |
Bisexual | 48 (13.8) | 75 (62.5–87.5) | 67.8 (48.2–76.7) | 54.2 (41.7–66.7) | 58.3 (50–75) | 59.4 (50–68.7) |
p-value | 0.886 | 0.05 | 0.035 | 0.505 | 0.006 | |
Sexual orientation disclosure to healthcare professionals | ||||||
No | 82 (23.6) | 75 (62.5–87.5) | 66.1 (42.9–78.6) | 58.3 (41.6–78.3) | 58.3 (50–75) | 60.9 (40.6–78.1) |
Yes | 265 (76.4) | 75 (62.5–100) | 71.4 (57.1–82.1) | 62.5 (50–70.8) | 58.3 (25–75) | 68.8 (56.2–81.2) |
p-value | 0.213 | 0.019 | 0.011 | 0.141 | 0.016 |
Total (N = 347) | QoL Domains (Median, IQR) | |||||
---|---|---|---|---|---|---|
Behavioral Risk Factors | n (%) | Overall QoL and Health | Physical Health | Psychological Health | Social Relationships | Environment |
Current tobacco use in the past 12 months ‡ | ||||||
No | 89 (25.6) | 83.5 (62.5–87.5) | 72.6 (57.1–85.7) | 66.7 (54.1–79.2) | 66.7 (41.7–91.6) | 72.6 (59.4–84.3) |
Yes | 258 (74.4) | 75 (62.5–87.5) | 67.9 (53.6–82.1) | 62.5 (45.8–70.8) | 58.3 (41.7–75) | 68.7 (50–78.1) |
p-value | 0.101 | 0.014 | 0.005 | 0.093 | 0.056 | |
Recreational drug use in the past 12 months † | ||||||
No | 66 (19.0) | 75 (62.5–87.5) | 71.4 (57.1–82.1) | 67.5 (45.8–70.8) | 58.3 (50–75) | 71.8 (53.1–81.2) |
Yes | 281 (81.0) | 75 (62.5–87.5) | 64.3 (53.5–78.5) | 61.7 (45.8–70.8) | 58.3 (41.7–75) | 62.5 (53.2–75) |
p-value | 0.945 | 0.019 | 0.029 | 0.916 | 0.094 | |
Alcohol binge in the past 12 months ※ | ||||||
No | 100 (28.8) | 75 (62.5–93.7) | 73.2 (57.1–85.7) | 66.7 (54.1–81.3) | 66.7 (50–75) | 71.8 (59.4–76.6) |
Yes | 247 (71.2) | 75 (62.5–87.5) | 67.5 (57.1–82.1) | 62.5 (45.8–70.8) | 58.3 (41.7–75) | 68.7 (53.1–81.3) |
p-value | 0.358 | 0.008 | 0.013 | 0.069 | 0.361 | |
Alcohol/drug use before sex in the past 12 months | ||||||
No | 207 (59.6) | 75 (62.5–87.5) | 71.4 (57.1–82.1) | 62.5 (50–75) | 58.3 (41.7–75) | 71.8 (56.2–81.2) |
Yes | 140 (40.4) | 75 (62.5–87.5) | 67.8 (53.6–82.1) | 58.3 (45.8–70.8) | 58.3 (41.7–75) | 65.6 (51.6–75) |
p-value | 0.126 | 0.045 | 0.036 | 0.512 | 0.05 | |
Unprotected insertive/receptive anal sex with men in the past 12 months | ||||||
No | 137 (40.4) | 87.5 (75–100) | 73.4 (64.2–85.7) | 66.7 (33.3–70.8) | 58.3 (41.7–75) | 71.8 (56.2–81.2) |
Yes | 202 (59.6) | 75 (62.5–87.5) | 67.8 (53.6–82.1) | 62.5 (45.8–70.8) | 58.3 (41.7–75) | 68.7 (50–78.1) |
p-value | 0.009 | 0.042 | 0.032 | 0.297 | 0.232 |
Quality of Life | |||||
---|---|---|---|---|---|
Psychosocial Determinants † | Overall QoL/Health β (SE) | Physical Health β (SE) | Psychological Health β (SE) | Social Relationships β (SE) | Environment β (SE) |
Housing stability | 1.432 (0.419) ** | 2.134 (0.364) *** | 1.101 (0.379) ** | 1.093 (0.501) * | 2.654 (0.432) *** |
Food insecurity | −2.802 (0.503) *** | −2.352 (0.454) *** | −0.903 (0.471) | −1.897 (0.623) ** | −3.153 (0.535) *** |
Perceived HIV stigma | −0.397 (0.125) ** | −0.224 (0.114) * | −0.009 (0.115) | −0.459 (0.151) ** | −0.063 (0.136) |
Internalized homonegativity | −1.338 (0.267) *** | −0.871 (0.244) *** | −0.654 (0.247) ** | −1.086 (0.327) ** | −0.728 (0.293) * |
Perceived social support | 0.447 (0.051) *** | 0.498 (0.043) *** | 0.528 (0.042) *** | 0.739 (0.055) *** | 0.623 (0.050) *** |
Loneliness | −1.302 (0.221) *** | −0.509 (0.207) * | −0.065 (0.209) | −1.091 (0.273) *** | −0.187 (0.247) |
Suicidal tendency | −2.411 (0.348) *** | −1.809 (0.319) *** | −1.853 (0.327) *** | −2.267 (0.433) *** | −1.746 (0.386) *** |
Anxiety | −1.167 (0.193) *** | −0.916 (0.176) *** | −0.231 (0.182) ** | −0.747 (0.241) ** | −0.481 (0.215) * |
Depression | −1.062 (0.146) *** | −0.949 (0.132) *** | −0.437 (0.139) ** | −0.941 (0.182) *** | −0.545 (0.166) ** |
Perceived stress | −1.512 (0.188) *** | −1.668 (0.161) *** | −1.586 (0.164) *** | −2.338 (0.215) *** | −1.649 (0.201) *** |
HIV Prevention Measures | |||||
---|---|---|---|---|---|
QoL Domains | Condom Use Self-Efficacy (Continuous) β (SE) | HIV Testing Self-Efficacy β (SE) | General Resilience β (SE) | Frequency of HIV Testing during Lifetime β (SE) | PrEP Use (Ever/Current vs. Never) aOR (95% CI) |
Overall QoL/health | 0.052 (0.014) *** | 0.106 (0.026) *** | 0.192 (0.019) *** | 0.001 (0.001) | 1.01 (1.00–1.02) * |
Physical health | 0.047 (0.016) ** | 0.146 (0.029) *** | 0.246 (0.021) *** | 0.004 (0.001) ** | 1.03 (1.02–1.05) *** |
Psychological health | 0.035 (0.015) * | 0.147 (0.028) *** | 0.275 (0.019) *** | 0.005 (0.001) *** | 1.03 (1.02–1.04) *** |
Social relationships | 0.022 (0.011) | 0.093 (0.022) *** | 0.174 (0.015) *** | 0.001 (0.001) | 1.01 (1.00–1.02) |
Environment | 0.023 (0.013) | 0.101 (0.024) *** | 0.203 (0.017) *** | 0.003 (0.001) ** | 1.02 (1.01–1.04) *** |
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Liu, Y.; Russ, S.; Mitchell, J.; Przybyla, S.; Zhang, C. Assessing the Determinants of Quality of Life and the Impact on HIV Prevention Measures among HIV-Negative and Status-Unknown Young Men Who Have Sex with Men: A Study in Two U.S. Metropolitan Areas. Int. J. Environ. Res. Public Health 2022, 19, 726. https://doi.org/10.3390/ijerph19020726
Liu Y, Russ S, Mitchell J, Przybyla S, Zhang C. Assessing the Determinants of Quality of Life and the Impact on HIV Prevention Measures among HIV-Negative and Status-Unknown Young Men Who Have Sex with Men: A Study in Two U.S. Metropolitan Areas. International Journal of Environmental Research and Public Health. 2022; 19(2):726. https://doi.org/10.3390/ijerph19020726
Chicago/Turabian StyleLiu, Yu, Savanah Russ, Jason Mitchell, Sarahmona Przybyla, and Chen Zhang. 2022. "Assessing the Determinants of Quality of Life and the Impact on HIV Prevention Measures among HIV-Negative and Status-Unknown Young Men Who Have Sex with Men: A Study in Two U.S. Metropolitan Areas" International Journal of Environmental Research and Public Health 19, no. 2: 726. https://doi.org/10.3390/ijerph19020726