1
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Silva JDRPD, Knauth DR, Leal AF, Magno L, Dourado I, Veras MADSM, Kerr LRS. [Factors associated with inconsistent condom use among men who have sex with men in Brazil and their commercial sexual partners]. CAD SAUDE PUBLICA 2023; 38:e00099822. [PMID: 36921187 DOI: 10.1590/0102-311xpt099822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 10/20/2022] [Indexed: 01/31/2023] Open
Abstract
We aimed to analyze the factors associated with inconsistent condom use among men who have sex with men (MSM) and their commercial sexual partners in Brazil. This is a cross-sectional study with adult MSM who were recruited via respondent-driven sampling (RDS) in 12 Brazilian capitals in 2016. MSM answered a sociobehavioral questionnaire which included questions on their sexual behavior. The inconsistent use of condoms with their clientele was measured via insertive and receptive anal sex in the six months prior to our research and in their last sexual intercourse. The association between independent variables and the inconsistent use of condoms was measured via a Poisson regression model with robust variance and estimation of adjusted prevalence ratios (aPR). Data from 461 MSM were analyzed. We found a 26% prevalence of inconsistent condom use with their clientele (95%CI: 19.0-34.3, n = 123). Belonging to the lowest economic classes (D/E), having medium or low knowledge about HIV, having practiced insertive and receptive anal sex, and having never tested for HIV throughout their lives were associated with inconsistent use of condoms with their clientele. The variables associated with inconsistent use indicated that commercial sex is practiced in a context of greater vulnerability to HIV infection, referring to the need for biomedical and behavioral interventions which focus on access to and use of prevention strategies together with public policies to reduce socioeconomic inequalities among MSM who practice commercial sexual.
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Affiliation(s)
| | - Daniela Riva Knauth
- Instituto de Filosofia e Ciências Humanas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Andréa Fachel Leal
- Instituto de Filosofia e Ciências Humanas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Laio Magno
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Brasil
| | - Ines Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
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2
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Kolstee J, MacGibbon J, Prestage G, Clackett S, Paynter H, Bavinton BR, Broady TR, Ellard J, Murphy DA, de Wit J, Power C, Holt M. Changing Attitudes Towards Condoms Among Australian Gay and Bisexual Men in the PrEP Era: An Analysis of Repeated National Online Surveys 2011-2019. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:453-466. [PMID: 36454135 DOI: 10.1521/aeap.2022.34.6.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Condoms have been the primary form of HIV prevention for gay and bisexual men (GBM) for most of the HIV epidemic. The introduction of biomedical HIV prevention may have changed attitudes towards condoms. Data from repeated national online surveys of GBM in Australia were used to examine how attitudes towards condoms and confidence discussing condoms with partners changed in the period 2011-2019. The proportion of all participants who reported a positive experience in using condoms remained low and unchanged (9.6% in 2011 to 6.0% in 2019). Confidence in discussing condoms with partners decreased over time (from 72.2% in 2011 to 56.6% in 2019). Confidence in discussing condoms was associated with concern about sexually transmitted infections, and more consistent condom use. Sustaining confidence in using condoms may be more challenging as biomedical prevention methods become more commonly used.
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Affiliation(s)
| | - James MacGibbon
- Centre for Social Research in Health, UNSW Sydney, Australia
| | | | | | - Heath Paynter
- Australian Federation of AIDS Organisations, Sydney, Australia
| | | | | | - Jeanne Ellard
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | | | - John de Wit
- Kirby Institute, UNSW Sydney, Australia
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | | | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Australia
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3
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Hong C, Feinstein BA, Holloway IW, Yu F, Huang W, Sullivan PS, Siegler AJ, Mi G. Differences in Sexual Behaviors, HIV Testing, and Willingness to Use PrEP between Gay and Bisexual Men Who Have Sex with Men in China. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:424-431. [PMID: 38596280 PMCID: PMC10903611 DOI: 10.1080/19317611.2022.2053922] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/08/2022] [Accepted: 03/10/2022] [Indexed: 04/11/2024]
Abstract
Objectives: Accumulating evidence suggests that there may be differences in sexual behaviors, condom use, and HIV prevention service utilization (e.g., HIV testing, PrEP use) between gay and bisexual men, but this remains under-explored, especially among gay and bisexual men in China. Methods: We surveyed 4,142 gay and bisexual men on a geosocial networking app in China. Results: In adjusted model, bisexual men were less likely to have received HIV testing in their lifetime (AOR = .62, 95% CI [.53, .72]) or to have received a recent HIV test (AOR = .78, 95% CI [.68, .90]). Conversely, among those who reported having had anal sex in the past six months, bisexual men were more likely to report consistent condom use than gay men (OR = 1.38, 95% CI [1.17, 1.62]). Compared with gay men, bisexual men were significantly less likely to be aware of PrEP (AOR = .62, 95% CI [.52, .74]) and significantly less willing to use PrEP (AOR = .58, 95% CI [.46, .73]). Conclusions: Tailored HIV prevention interventions are needed to address bisexual men's needs in the context of the unique sociocultural influences on sexual behavior in China.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA
| | - Brian A. Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Ian W. Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA
| | - Fei Yu
- Danlan Beijing Media Limited, Beijing, China
| | - Wenting Huang
- Department of Epidemiology, Emory University, Atlanta, GA, USA
| | | | | | - Guodong Mi
- Danlan Beijing Media Limited, Beijing, China
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4
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Starks TJ, I Lovejoy T, Sauermilch D, Robles G, Stratton MJ, Cain D, Naar S, Ewing SWF. Developmental Barriers to Couples' HIV Testing and Counseling Among Adolescent Sexual Minority Males: A Dyadic Socio-ecological Perspective. AIDS Behav 2021; 25:787-797. [PMID: 32944842 DOI: 10.1007/s10461-020-03044-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 11/26/2022]
Abstract
Couples HIV Testing and Counseling (CHTC) is now a standard of care for partnered sexual minority men. While adolescent sexual minority men (ASMM; ages 15-19) face disproportionate HIV risk, the emergent nature of relationships and communication skills may present challenges to accessing and engaging in CHTC. This study utilized qualitative data from 28 ASMM recruited in 4 urban centers in the USA during the formative stage of Adolescent Trials Network study ATN-156. Participants were cis-male, HIV-negative, and in a relationship with a similarly-aged cis-male partner. Thematic analysis indicated low and high levels of commitment were barriers to CHTC. Concerns about caregiver attitudes towards HIV testing were salient. Adolescents' perception of structural barriers highlighted reliance on caregiver resources, which limited access to sexual health services. Prevention programming must address structural barriers to access encountered by adolescents. ASMM in relationships may benefit from programming that includes options for individual and dyadic participation.
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Affiliation(s)
- Tyrel J Starks
- Hunter College of the City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA.
- Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York, New York, NY, USA.
| | - Travis I Lovejoy
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | | | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Mark J Stratton
- Hunter College of the City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Demetria Cain
- Hunter College of the City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Sylvie Naar
- Florida State University, Tallahassee, FL, USA
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5
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Starks TJ, Dellucci1 TV, Lovejoy T, Robles G, Jemenez R, Cain D, Naar S, Feldstein Ewing SW. Adolescent Sexual Minority Males, Relationship Functioning, and Condomless Sex. J Adolesc Health 2021; 68:419-421. [PMID: 32646828 PMCID: PMC9639032 DOI: 10.1016/j.jadohealth.2020.05.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 03/27/2020] [Accepted: 05/27/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Adolescent sexual minority males (SMMs) are at a high risk of contracting HIV through condomless sex. Many develop serious partnerships, and sex with main partners accounts for many new infections. Previous research with adolescent SMMs largely focused on relationship seriousness and found a positive association with sexual HIV risk. This study tested associations between three relationship functioning indicators and condomless sex. METHODS Adolescent SMMs aged 15-19 years (n = 85) completed a brief online survey. Respondents rated commitment, seriousness, and satisfaction on 7-point Likert-type scales. RESULTS Among adolescent SMMs who had sex in their lifetime, those who were more satisfied in their relationship were less likely to have condomless in the past 90 days (odds ratio = .56, p = .04). CONCLUSIONS Results support examining multiple domains of relationship functioning in this age group to identify relationship mechanisms that may serve as the target of HIV risk-reduction interventions among adolescent SMMs initiating relationships.
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Affiliation(s)
- Tyrel J. Starks
- Hunter College of the City University of New York, New York, NY United States,Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York, New York, NY United States
| | - Trey V. Dellucci1
- Hunter College of the City University of New York, New York, NY United States,Health Psychology and Clinical Science Doctoral Program, Graduate Center of the City University of New York, New York, NY United States
| | - Travis Lovejoy
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, Oregon, United States
| | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, United States
| | - Ruben Jemenez
- Hunter College of the City University of New York, New York, NY United States
| | - Demetria Cain
- Hunter College of the City University of New York, New York, NY United States
| | - Sylvie Naar
- Florida State University, Tallahassee, FL, United States
| | - Sarah W. Feldstein Ewing
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, Oregon, United States
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6
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Li DH, Newcomb M, Macapagal K, Remble T, Mustanski B. Condom-Associated Erectile Function, But Not Other Domains of Sexual Functioning, Predicts Condomless Insertive Anal Sex Among Young Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:161-174. [PMID: 31980999 PMCID: PMC7018619 DOI: 10.1007/s10508-020-01642-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/10/2020] [Accepted: 01/11/2020] [Indexed: 05/09/2023]
Abstract
Condoms effectively prevent against HIV, especially when used in conjunction with biomedical strategies such as PrEP and viral suppression. However, consistent use of condoms in the real world has been a continual health promotion challenge, even among populations at highest risk, such as young men who have sex with men (YMSM). Inconsistent condom use may be related to poor sexual functioning, but limited research exists. The analytic sample comprised 688 racially diverse YMSM aged 16-29 (M = 22.9 years) living in Chicago, IL (19.2% living with HIV). Using multivariable logistic regression, we examined longitudinal associations between condom-associated sexual functioning (erectile function, orgasm satisfaction, global satisfaction, and anal discomfort) and condomless insertive anal sex (CIAS) and condomless receptive anal sex (CRAS) 6 months later. CIAS at Time 2 was associated with condom-associated erectile function at the bivariate and multivariable levels, even after controlling for CIAS at Time 1 (p < .05). Condom-associated erectile function, orgasm satisfaction, and global satisfaction predicted Time 2 CRAS in bivariate models, but none remained significant in the multivariable models. Age, having had a serious partner in the past 6 months, and HIV/PrEP status at Time 2 were significant predictors of CIAS/CRAS in some but not all models. Future interventions to improve consistent condom use should specifically highlight information and skills on how to use condoms within real-world contexts rather than from a clinical perspective. Our results also support the importance of biomedical strategies for those who have continued problems with sexual functioning when using condoms.
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Affiliation(s)
- Dennis H Li
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA.
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Michael Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Thomas Remble
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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7
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Bavinton BR, Grulich AE, Duncan D, Zablotska IB, Prestage GP. How partnership type and HIV seroconcordance affect HIV transmission risk in regular sexual partnerships: a cross-sectional survey of Australian gay and bisexual men. Sex Health 2019. [PMID: 28637581 DOI: 10.1071/sh16198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Regular sexual partnerships among gay and bisexual men (GBM) who practice condomless anal intercourse (CLAI) have not been well characterised in terms of partnership type, HIV seroconcordance and risk of HIV transmission. Primarily sexual regular partnerships, although commonly reported by gay men, have largely been ignored in research and HIV prevention. Among regular partners reporting CLAI with each other, we determined factors differentiating romantic or committed relationships from partnerships organised primarily around sex ('fuckbuddies') and estimated the proportion of CLAI presenting risk for HIV transmission. METHODS An online, cross-sectional survey of Australian GBM was conducted. Univariate and multivariate generalised estimating equations were used to determine statistical associations. RESULTS Men reported on 2250 regular sexual partnerships. Over half the partnerships were romantic or committed relationships. Over half the partnerships were HIV-negative seroconcordant (54.9%), 3.1% were HIV-positive seroconcordant, 5.2% were serodiscordant and 36.8% were of unknown seroconcordance. Potential risks presented by CLAI were sometimes mitigated by protective factors, such as having a clear spoken agreement about sex with outside partners, having fewer outside partners, openly discussing HIV risk and having an agreement to reduce risk from outside partners. These protective factors were more often found in romantic or committed relationships than among primarily sexual partnerships, and were less often found in partnerships of unknown seroconcordance. CONCLUSION CLAI is more common among regular sexual partnerships considered to be of a romantic, committed nature. However, factors associated with such romantic or committed partnerships can also protect against HIV transmission risk. Unknown seroconcordance, particularly lack of communication about HIV status among primarily sexual partnerships, is a key risk factor that needs to be addressed by HIV education.
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Affiliation(s)
| | | | - Duane Duncan
- University of New England, Armidale, NSW 2351, Australia
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8
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Feinstein BA, Moran KO, Newcomb ME, Mustanski B. Differences in HIV Risk Behaviors Between Self-Identified Gay and Bisexual Young Men Who are HIV-Negative. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:261-275. [PMID: 29508171 PMCID: PMC6123308 DOI: 10.1007/s10508-018-1148-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 11/22/2017] [Accepted: 01/06/2018] [Indexed: 05/18/2023]
Abstract
Young men who have sex with men (MSM) are disproportionately affected by HIV, but it remains unclear whether there are differences in HIV risk behaviors between self-identified gay and bisexual young men. To address this, the current study examined differences in condomless sex and substance use before sex with male partners between self-identified gay and bisexual young men who are HIV-negative. Additionally, we examined differences in HIV risk behaviors with male versus female partners among the bisexual men. We used four waves of data spanning 24 months from a cohort of young MSM ages 16-29. At each wave, participants reported on up to four partners, allowing us to examine within-person associations. Compared to gay men, bisexual men reported more insertive condomless anal sex (CAS) with casual partners, they were more likely to report marijuana use before sex, and they were less likely to report lifetime HIV testing and PrEP use. Alcohol and marijuana use before sex were associated with CAS for both gay and bisexual men, but the association between marijuana use and insertive CAS was stronger for bisexual men. Bisexual men reported more condomless sex with female partners compared to male partners, but this was not significant after accounting for alcohol and marijuana use. Bisexual men were more likely to report alcohol and marijuana use with female partners compared to male partners, but both alcohol and marijuana use were associated with condomless sex regardless of partner gender. Findings support the need for tailored HIV prevention for self-identified bisexual men to address their lack of preventive behaviors, their increased engagement in certain risk behaviors with male partners, and their engagement in risk behaviors with female partners.
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Affiliation(s)
- Brian A Feinstein
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., Suite 1400, Chicago, IL, 60611, USA.
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.
| | - Kevin O Moran
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
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9
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Shaver J, Freeland R, Goldenberg T, Stephenson R. Gay and Bisexual Men's Perceptions of HIV Risk in Various Relationships. Am J Mens Health 2018; 12:655-665. [PMID: 29355071 PMCID: PMC6131437 DOI: 10.1177/1557988317745759] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/25/2017] [Accepted: 11/02/2017] [Indexed: 11/24/2022] Open
Abstract
Men who have sex with men (MSM) bear a disproportionate burden of HIV incidence in the United States. Previous study of sexual decision-making and HIV risk among MSM has not accounted for relationship dynamics. Further research must examine this connection between relationship dynamics and sexual decision-making, especially regarding condomless anal intercourse. This study analyzes data gathered from gay and bisexual men regarding their sexual partners and sexual decision-making over a 10-week period through personal relationship diaries (PRDs) and a follow-up in-depth interview (IDI). Through coding and extraction of relationship dynamics, key patterns of participants' sexual decision-making processes were examined based on relationship type, which was categorized by commitment, formality, and sexual agreement. Participants' sexual relationships can be divided into five categories: (a) Uncommitted, one time, (b) Uncommitted, ongoing, (c) Transitioning or unknown commitment, (d) Committed, nonmonogamous, and (e) Committed, monogamous. These five categories correspond to patterns in sexual decision making and consequent sexual risk-taking behaviors. Each of these influence HIV risk within male-male sexual encounters in a particular manner, and understanding these is important for appropriately tailored HIV prevention interventions for MSM. Recommendations are included for interventions seeking to address HIV risk across a wide variety of MSM sexual relationships.
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Affiliation(s)
- John Shaver
- Center for Sexuality and Health
Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Ryan Freeland
- Center for Sexuality and Health
Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Tamar Goldenberg
- Center for Sexuality and Health
Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
- Health Behavior and Health Education,
University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rob Stephenson
- Center for Sexuality and Health
Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
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10
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He J, Xu HF, Cheng WB, Zhang SJ, Gu J, Hao YT, Hao C. Intimate relationship characteristics as determinants of HIV risk among men who have sex with regular male sex partners: a cross-sectional study in Guangzhou, China. BMC Infect Dis 2018; 18:150. [PMID: 29606100 PMCID: PMC5879993 DOI: 10.1186/s12879-018-3044-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 03/12/2018] [Indexed: 11/10/2022] Open
Abstract
Background China faces a serious HIV epidemic among men who have sex with men (MSM), and a large proportion of new infections are attributed to their regular male sex partners (RP). The objective of this study was to investigate the association between intimate relationship characteristics and HIV-related behaviors among MSM with RP in Guangzhou, China. Methods A convenience-sampling method was used in data collection. A total of 608 MSM were screened, of whom 406 HIV negative MSM with at least one RP in the past six months were used for data analysis. Three-step logistic regressions were used to analyze the data. Results The prevalence of unprotected anal intercourse (UAI) with regular male sex partners, non-regular male sex partners, and concurrent UAI in the past six months was 53.9%, 23.6%, 20.7%, respectively. Variables associated with UAI with regular male sex partners included expectations for this relationship (adjusted odds ratio in multiple forward stepwise logistic regression, ORm = 1.66) and open communication about the sexual relationship (ORm = 1.79), while expectations for the relationship (ORm = 0.46 to 0.54) and conflicts of interest (ORm = 5.46 to 5.97) were associated with concurrent UAI and UAI with non-regular male sex partners. Conclusion Intimate relationship characteristics were related to HIV-related risk behaviors. Future HIV prevention interventions should take MSM couples into consideration, include a focus on the quality of their intimate relationships, and encourage open communication about their sexual relationships. Electronic supplementary material The online version of this article (10.1186/s12879-018-3044-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Juan He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Hui-Fang Xu
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, 510440, People's Republic of China
| | - Wei-Bin Cheng
- Department of HIV/AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, 510440, People's Republic of China
| | - Sheng-Jie Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China.,Current address: Medical Research & Biometrics Center, National Center for Cardiovascular Disease, Chinese Academy of Medical Science & Peking Union Medical College, A105, Xishan Institute of Fuwai Hospital, Fengcunxili, Mentougou Dist, Beijing, 102300, China
| | - Jing Gu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China.,Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Yuan-Tao Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China.,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China.,Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Chun Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China. .,Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China. .,Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, People's Republic of China.
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11
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Card KG, Lachowsky NJ, Cui Z, Carter A, Armstrong H, Shurgold S, Moore D, Hogg RS, Roth EA. A Latent Class Analysis of Seroadaptation Among Gay and Bisexual Men. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:95-106. [PMID: 27987086 PMCID: PMC5474217 DOI: 10.1007/s10508-016-0879-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/16/2016] [Accepted: 10/08/2016] [Indexed: 05/30/2023]
Abstract
Initial research into seroadaptive strategies suggests that, individually, they are potentially effective behavioral methods to reduce risk of HIV transmission. Combining strategies, therefore, has the potential to increase risk reduction. The aim of this study was to determine how gay and bisexual men (GBM) combine strategies. To this end, a total of 774 sexually active GBM, aged ≥16 years, in Metro Vancouver, Canada, were recruited. Grouped by self-reported HIV status, latent class analysis of self-reported condom use, strategic positioning, anal sex avoidance, serosorting, viral-load sorting, and withdrawal were conducted. Multinomial logistical regression identified explanatory variables of class membership (i.e., sensation seeking, treatment optimism, sexual altruism, relationship status, number of partners, anal sex preference). Four latent classes were identified: Condom Users, Multiple Prevention Users, Viral-Load Sorters, and Serosorters. The majority of HIV-negative/unknown men (72 %) and a large proportion of HIV-positive men (42 %) belonged to the Condom Users class. Class membership was associated with age, relationship status, treatment optimism, sexual altruism, sensation seeking, number of recent male anal sex partners, and recent condomless anal sex with a serodiscordant or unknown-status partner. Understanding these distinct patterns allows for tailored interventions addressing GBM's sexual health needs.
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Affiliation(s)
- Kiffer G Card
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada.
- Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada.
| | - Nathan J Lachowsky
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Zishan Cui
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
| | - Allison Carter
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
- Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada
| | - Heather Armstrong
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
| | - Susan Shurgold
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
| | - David Moore
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Robert S Hogg
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, Canada
- Faculty of Health Science, Simon Fraser University, Vancouver, BC, Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria, Victoria, BC, Canada
- Centre for Addiction Research of British Columbia, University of Victoria, Victoria, BC, Canada
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Cornelisse VJ, Fairley CK, Phillips T, Walker S, Chow EP. Fuckbuddy partnerships among men who have sex with men - a marker of sexually transmitted infection risk. Int J STD AIDS 2017; 29:44-50. [PMID: 28683600 DOI: 10.1177/0956462417717647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
'Fuckbuddies' are a type of regular sexual partner with whom men have ongoing sexual contact, generally in the absence of romantic attachment. We surveyed 989 men who have sex with men (MSM) at the Melbourne Sexual Health Centre, Australia, with the aim of determining the frequency of 'fuckbuddy' partnerships among sexual health clinic attendees and assessing their sexual risk. The majority (60%) of 1139 regular partnerships were described as 'fuckbuddies'. Most MSM (63%) with a 'fuckbuddy' had multiple 'fuckbuddies'. MSM with 'fuckbuddies' were more likely to also have casual sexual partners (odds ratio [OR] 5.7; 95% confidence interval 3.6-8.9) and had more casual sexual partners (median of 4 versus 1, p < 0.001) and more rectal chlamydia (12.4% versus 5.7%; adjusted OR 2.3; p < 0.05) than MSM without 'fuckbuddies', and this risk persisted after adjusting for total numbers of sexual partners. Our findings suggest that patients with 'fuckbuddies' are at particular risk of sexually transmitted infections. We argue that clinicians should specifically ask about 'fuckbuddy' partnerships as part of their risk assessment during patient interviews, as these patients may benefit from HIV prevention strategies such as pre-exposure prophylaxis (PrEP).
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Affiliation(s)
- Vincent J Cornelisse
- 1 198098 Melbourne Sexual Health Centre , Alfred Health, Melbourne, Australia.,2 Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, 22457 Monash University , Melbourne, Australia
| | - Christopher K Fairley
- 1 198098 Melbourne Sexual Health Centre , Alfred Health, Melbourne, Australia.,2 Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, 22457 Monash University , Melbourne, Australia
| | - Tiffany Phillips
- 1 198098 Melbourne Sexual Health Centre , Alfred Health, Melbourne, Australia
| | - Sandra Walker
- 1 198098 Melbourne Sexual Health Centre , Alfred Health, Melbourne, Australia.,2 Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, 22457 Monash University , Melbourne, Australia
| | - Eric Pf Chow
- 1 198098 Melbourne Sexual Health Centre , Alfred Health, Melbourne, Australia.,2 Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, 22457 Monash University , Melbourne, Australia
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