Introduction
Gay and bisexual men persistently suffer the highest burden of HIV/AIDS in the U.S. (CDC, 2008). Ever since the epidemic began, substance abuse has been proved to be one of the strongest predictors of sexual risk behaviors and seroconversion among this population. Latest research has centered on additional aspects of health disparities among men who have sex with men, including depression and other mental health problems, childhood sexual abuse, and adult victimization (Herek & Sims, 2008), suggesting that a syndemic of health problems have an impact on these men. This theoretical perspective has widened the extent of gay and bisexual men health research well beyond the HIV/AIDS and substance abuse fields. However, research on the involvement of gay and bisexual men with the criminal justice system is almost entirely lacking even though rates of drug abuse problems and HIV/AIDS infection are much higher among prison and jail inmates than among the general population. The involvement of gay and bisexual men in the criminal justice system deserves a stronger research focus because of the unique challenges facing such men and also because arrests are yet another marker for a host of health risks among them. This research therefore describes the nature, extent and predictors of the arrest histories of a sample of gay and bisexual substance users at very high risk for HIV infection and/or transmission.
The Research question
Is there a relationship between arrest history and health disparities/syndemic theory among Gay/ bisexual men?
The Research design
This study was conducted through the survey research design. This design was used to investigate populations by selecting samples to analyze and discover occurrences. It is concerned with providing quantitative and numeric descriptions of the sample and also to describe and explain the research analysis. This design is suitable because the research was thoroughly extensive.
Operational definition used by the researcher
Syndemic: In this study syndemic is seen as a set of mutually reinforcing epidemics.
Examples of inductive and deductive logic used in the research
Deductive logic: Health disparities among gay/bisexual men are predictors of arrest histories.
Inductive logic: Substance use which is one of the health disparities among the gay/bisexual men is a predictor of arrest history.
Is this research study quantitative or qualitative?
The research study is quantitative. Data from the interview questionnaires were analyzed using a standard statistical package. Descriptive statistics was calculated to describe the sample in terms of demographics, social stability, mental health, victimization, substance abuse and sexual risk behaviors, as well as to investigate the nature and extent of the arrest histories of the vulnerable gay men (Kurtz, 2008). Bivariate and multivariate logistic models were developed to predict both lifetime arrest and crime category by demographics and measures of health disparities suggested by the syndemic theory.
The methodology, population, sampling methods, and return rate
This study was carried out in Miami/Dade County, Florida which is an extremely diverse community, having high population of foreign-born (50.9%) residents. Hispanics (61.3%) are the largest ethnic group, with non-Hispanics Whites representing 18.3%, and Black/African Americans 20.2% of the county population. This county is a well-known migration destination for gay/bisexual men, with an estimated 76,500 gay and bisexual men in Miami alone (Kurtz, 2008).
Substance-using gay and bisexual men were recruited by trained peer field staff through targeted sampling strategies which aimed for maximum diversity across these variables. Geographical mapping such as identification of high concentrations of gay residential areas and entertainment places as well as internet sites frequented by local men for making sexual connections were used as sources for potential participants (Kurtz, 2008). Once these sources were identified potential participants were contacted through direct outreach advertisements, Flyers placed in strategic points and banner ads on sex –oriented websites. Eligibility requirements included meeting certain criteria which were designed to reach those men at highest risk for HIV infection, reinfection and/or transmission. Approximately 124 men were selected and Primary data was collected from them through an interview.
The findings of the study
Demographics, Social Stability, Mental Health and Victimization
The demographics reflected the targeted sampling strategies as the ethnic mix of South Florida’s population was fully represented in the Sample and also included significant numbers (over 37%) of HIV-positive men. Social risk indices were high across all measure with almost half (48.4) having been homeless at least once in their lifetime, (39.5%) reporting substance abuse while (65.3%) having been arrested (Kurtz, 2008). Depression, anxiety and traumatic stress levels were clinically significant for sizable proportions of respondents. Lifetime rates of emotional, physical and sexual victimization were very high with almost half reporting the first episode occurred when they were young.
Substance use and sexual risk behaviors
Participants were presently users of a wide range of substances, including: heavy episodic alcohol, marijuana, cocaine, ecstasy, non-prescribed pain killers, methamphetamine and amyl nitrite. Participants also averaged over 12 different anal sex partners and over 18 unprotected anal intercourse events with non primary partners in the past 90 days (Kurtz, 2008).
Arrest histories
The distribution of crimes was extensive across all categories, including property and violent crimes in addition to drug related violations. Of the 81 participants with arrest histories, 30.9% had been arrested only once, 20% two times and almost half (49.3%) three or more times (Kurtz, 2008).
Predictors of arrest histories
The significance level of bivariate and multivariate logistic regression models predicting arrest histories was set at p<.05.Almost all of the hypothesized mental health, social risk indices, substance abuse treatment history and lower level of education are significant in the bivariate models (Kurtz, 2008). Poverty, Lifetime homelessness were also related to participants’ criminal justice involvement as well. Prior victimization and mental health distress increased the likelihood of having been arrested. In multivariate models, substance abuse treatment, use of cocaine, high sex sensation seeking and lower education came out as strong independent predictors of prior arrest.
The author’s conclusions and recommendations
According to the researcher, arrest history was closely connected to many aspects of the syndemic theory of gay/bisexual men’s health disparities. Among the highly susceptible gay/bisexual men who participated, arrest histories were common and more diverse than anticipated (Kurtz, 2008). The recommendation made is that there should be widespread institutional efforts to collect sexual identification and behavioral data within criminal justice systems.
Personal opinion
The research could have been done differently especially when selecting participants. This is because the eligibility requirements were very strict making the results not likely to be generalized to the overall population. Since the data generated relied on self-reporting some participants may have refrained from reporting the full extent of socially undesirable behaviors.
References
- Centers for Disease Control and Prevention (CDC). (2008). HIV/AIDS and men who have sex with men (MSM).
- Herek, G.M. & Sims, C. (2008). Sexual orientation and violent victimization: Hate crimes and intimate partner violence among gay and bisexual males in the United States. In: R.Wolitski; R.Stall & R.O. Valdiserri (Eds.) Unequal Opportunity: Health Disparities Affecting Gay and Bisexual Men in the United States. New York: Oxford University Press.
- Kurtz, S.P. (2008). Arrest histories of high-risk gay and bisexual men in Miami: Unexpected additional evidence for syndemic theory. Journal of Psychoactive Drugs, 40(4), 513.