Abstract
Dear editor,
It is laudable that in late 2023, Feelemyer et al. published an article in the American Journal of Men’s Health which pointed out the age differences in the associations between incarceration and subsequent substance use, sexual risk-taking, and incidence of sexually transmitted infection (STI) among Black sexual minority men (BSMM) and Black transgender women (BTW) in the HIV Prevention Trials Network 061 (Feelemyer et al., 2023). Although there are many studies in the literature about sexually transmitted diseases, HIV, drug use in BSMM/BTW individuals, and age-related comparisons of the effect of the incarceration status are very limited. A few points, which should be qualified as sources of confusion, are highlighted below:
Point 1: There is a huge numerical difference (375 vs. 794) between the two compared groups. Although the authors base this situation on studies in the literature that take 30 years as the cutoff age, there are studies in the literature which take 40 years as the cutoff age (Klein, 2012; Wheeler et al., 2008). The aim here is to divide the groups to be comparable in proximity. If the authors increase the age limit at which the groups are divided, the numbers of the groups will be closer to each other. Hence, more reliable results will be achieved.
Point 2: The people included in the study were those who had unprotected anal intercourse at least once. However, what needs to be considered here is that the risk of HIV and STI increases with the increase of number of partners and frequency of intercourse (Beyrer et al., 2012; Wade et al., 2005). As the groups were divided only by age and not into subgroups according to the number of partners and frequency of sexual intercourse, it is not clear that the results in the two groups are solely due to age.
Point 3: To express that the results are age-related, 30 years was determined as the cutoff age in the study. Substance use, sexual risk behavior, and STI were evaluated in groups below and above 30 years of age. However, the two groups were not evaluated and compared based on their living conditions and educational status. The study should therefore reflect on the living and educational backgrounds. A high rate of infection is seen in men who have sex with men (MSM) living in the urban areas just as MSM with a history of sexual abuse, mental illness, uneducated, and low income (Wolitski & Fenton, 2011).
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
