Sex partying among gay men in Sydney, Melbourne and Brisbane, Australia

Attitudes Toward Peer-Delivered Sexual-Health Services Among New York City Sexual and Gender Minority Individuals Who Have Sex with Men and Attend Collective Sex Venues

Collective sex venues such as sex clubs are strategic sites to promote sexual health among sexual and gender minority individuals. We present qualitative findings from a multiple-method study on the acceptability of sexual-health services at collective sex venues in New York City (NYC) among attendees who identified as men, transgender, or gender non-conforming. In a survey used for sample selection (n = 342), most respondents (82.7%) agreed that "having outreach workers at sex venues is a good thing." Interviewees (n = 30) appreciated how on-site services could promote sexual health in their community. They felt peer workers should be familiar with collective sex venues and share demographic characteristics with attendees. Some participants felt workers should keep some boundaries from attendees, while others felt they could be fully integrated in the environment, suggesting that either peer outreach or popular-opinion leader types of interventions could be feasible.

Racial Variations in Psychosocial Vulnerabilities Linked to Differential Poppers Use and Associated HIV-Related Outcomes among Young Men Who Have Sex with Men: A Study in Two U.S. Metropolitan Areas

Background: Poppers use has become increasingly prevalent and is associated with elevated HIV risk among young men who have sex with men (YMSM) in urban settings. However, knowledge regarding racial variations of poppers use and their psychosocial determinants to inform culturally-targeted interventions remain limited. Methods: We conducted a cross-sectional study among YMSM recruited from two US metropolitan areas (Nashville, TN and Buffalo, NY) to investigate the differences of socio-environmental and mental health factors associated with poppers use and important HIV-related outcomes [e.g., HIV testing, pre-exposure prophylaxis (PrEP, substance use, and risky sexual behaviors] among White and Black YMSM (i.e., YWMSM and YBMSM). Results: Among 347 YMSM aged 18-35 years, 32.3% reported poppers use. Notably, poppers-using YWMSM were more likely (p < 0.05) to report mental health burdens (e.g., depression, anxiety, loneliness), while poppers-using YBMSM were more likely (p < 0.05) to experience adverse social-environmental events (e.g., unstable housing, food insecurity, no health insurance, perceived HIV stigma, internalized homonegativity). Poppers-using YMSM showed a higher prevalence of sexual risk behaviors (e.g., event-level alcohol/drug use, condomless insertive/receptive anal sex, group sex) compared to their non-user counterparts, with YWMSM showing the highest likelihood to engage in these risk behaviors. Compared to poppers-using YBMSM, poppers-using YWMSM were associated with a higher likelihood of ever testing for HIV, ever using PrEP and willingness to use PrEP in the next 12 months. Conclusion: Given the distinctive patterns of psychosocial determinants of poppers use between YWMSM and YBMSM, culturally-tailored poppers reduction programs should be designed to tackle the associated HIV risks among YMSM with effectivenes.

Correlates of group sex participation among men who have sex with men in Chongqing, Southwestern China

BACKGROUND

Findings from specific countries indicated group sex was common among men who have sex with men (MSM), and men who reported group sex participation were at increased risk of human immunodeficiency virus (HIV)/sexually transmitted infections (STIs). The purpose of the current analysis was to describe the prevalence and correlates of group sex participation among a community-based sample of MSM in Chongqing, southwestern China.

METHODS

Convenience sampling method was used to recruit participants and data were collected through an anonymous questionnaire. Logistic regression analysis was employed to identify correlates of group sex participation.

RESULTS

Overall, 1151 eligible participants were enrolled in the study. 14.7% of MSM reported participating in group sex in their lifetime, and 5.8% reported group sex participation in the prior 6 months. Factors positively associated with group sex participation in both the prior 6 months and the lifetime included: monthly income ≥3000 Yuan (adjusted odds ratios [aOR] = 3.67, 95% confidence interval [CI] 1.25-10.75; aOR = 2.30, 95% CI 1.21-4.35), initiating anal sex before 18 years old (aOR = 1.86, 95% CI 1.03-3.34; aOR = 2.00, 95% CI 1.31-3.05), using gay apps to seek sex partners (aOR = 7.41, 95% CI 2.57-21.33; aOR = 9.75, 95% CI 4.92-19.33), recreational drug use (aOR = 10.10, 95% CI 5.52-18.49; aOR = 4.75, 95% CI 3.20-7.05) and having condomless internal ejaculation (CIE) (aOR = 3.66, 95% CI 2.01-6.68; aOR = 1.61, 95% CI 1.11-2.35). Factors only associated with group sex participation in the lifetime were older age (age between 26 and 35 years old: aOR = 2.06, 95% CI 1.30-3.26; age > 35 years old: aOR = 1.95, 95% CI 1.10-3.46) and history of STIs (aOR = 2.51, 95% CI 1.37-4.62).

CONCLUSIONS

The results of this study suggested that group sex participation was a potentially risky context for acquisition and transmission of HIV/STIs. Close attention should be given to MSM who participated in group sex, and appropriate risk reduction interventions should be developed specific to this subgroup of MSM.

Group sex events among female sex workers in Melbourne, Australia

Background Group sex is associated with increased risk of HIV and sexually transmissible infections (STIs), but there is limited data on group sex among female sex workers (FSW). Understanding current group sex practices among FSW may assist with understanding and addressing the rise in STIs observed among Australian FSW in the 2010s. The aim of this study was to examine the proportion of FSWs who had engaged in group sex.

METHODS

A cross-sectional survey was conducted among FSWs attending the Melbourne Sexual Health Centre, Australia, between March and April 2019. Females aged ≥18 years who self-reported as a sex worker were invited to participate in the survey asking whether they had had group sex in the past 3 months. Group sex was defined as sex that involved two or more sexual partners.

RESULTS

Of the 51 FSWs who completed the survey, the median age was 29 years (IQR 24-34). Almost half (49%; n = 25) reported having group sex in the past 3 months, with a median number of group sex events of two (IQR 1-4). Australian-born FSW were more likely to report group sex than overseas-born FSW (76% vs 42%; P = 0.02). Age, number of paid clients and injecting drug use were not associated with group sex.

CONCLUSION

The present study findings show that group sex is common among FSW and should be included in peer sexual health education and interventions among FSW.

HIV Prevalence and Factors Related to HIV Infection Among Transgender Women in Vietnam: A Respondent Driven Sampling Approach

Transgender women are at higher risk of HIV infection, however, there is a lack of information about HIV infection and related factors among transgender women in Vietnam. From February 2018 to June 2018, 456 transgender women were recruited in the study using Respondent-Driven Sampling technique. Participants completed the computer-based questionnaire and were tested for HIV serostatus. Multivariable logistic regression was used to identify factors related to HIV infection. The prevalence of HIV infection was 77 (16.5%), of which 19 (24.7%) were not aware of their HIV-positive status prior to the study. Factors associated with HIV infection included popper use (aOR 2.01, p = 0.044) and having regular male partner(s) (aOR 0.42, p = 0.006). More efforts are needed to reduce the high prevalence of HIV infection, such as expanding the reach of HIV screening and prevention programs to the transgender women population, particularly for substance users.

Group Sex Events Among Cisgender Men Who Have Sex With Men: Cross-Sectional and Longitudinal Survey Study to Explore Participation and Risk-Taking Behaviors

Background

Group sex events (GSEs) are common among cisgender men who have sex with men (MSM), pose a unique risk profile for HIV and sexually transmitted disease (STD) transmission, and may be on the rise, in part because of Web-based networking platforms. However, collecting data on GSEs can be challenging, and many gaps exist in our knowledge about GSE participation among MSM.

Objective

The objective of this study was to develop survey questions addressing aggregate and partner-specific group sex behaviors to measure prevalence of GSEs and associated risks in persons participating in Project Diagnostic Evaluation To Expand Critical Testing Technologies (DETECT), including MSM seeking HIV and STD testing at a public clinic in Seattle, Washington.

Methods

We developed a computer self-assisted survey that included questions about participant demographics, sexual history, and risk behaviors, including group sex, as a part of Project DETECT, a Centers for Disease Control and Prevention–funded study evaluating point-of-care HIV tests. Aggregate and partner-specific questions asked about participation in all GSEs, threesomes, and four-or-more-somes including questions about number and HIV status of sex partners and condom use during the events. To evaluate question performance, we assessed the discrepancies in reporting between the aggregate and partner-specific questions, quantified question refusal rates, and calculated the additional time required to answer the GSE questions. Information about network density (number of partnerships of overlapping duration) was estimated and compared for MSM who did and did not report GSEs.

Results

Among 841 visits by 690 MSM who were asked any group sex survey question, participation in a GSE of any type in the past 3 months was reported at 293 visits (293/841, 34.8%). We found that 9.0% (76/841) of MSM in the sample reported ≥1 four-or-more-some in the partner-specific questions but did not report in the aggregate. The proportion of refusals on any given aggregate GSE-related question ranged from 0% (0/273) to 10.6% (15/141) (median 2.6%) and partner-specific questions ranged from 0% (0/143) to 22% (5/23) (median 3.0%), with questions about four-or-more-somes having the highest proportions of refusals. Completing the aggregate group sex questions added 1 to 2 minutes and the partner-specific questions added an additional 2 to 4 minutes per partner to the total survey length. As expected, the partner-specific GSE questions documented higher density of sexual networks that was not captured by asking about total partner counts and overlap of specific partnerships.

Conclusions

We found that the Project DETECT survey was able to obtain nuanced information about GSEs. The question skip patterns and consistency checks were effective, and survey fatigue was minimal. More research is needed on GSEs, and our survey represents a promising data collection tool to help fill gaps in knowledge about the subject.

Network Evolution of a Large Online MSM Dating Community: 2005-2018

Due to multiple sexual partners and low rates of condom use, the HIV infection rate among MSM (men who have sex with men) is much higher than that of the general population. In order to analyze the characteristics of online activities of MSM, and to understand the evolution of their social networks, in this study we collect a comprehensive dataset, covering the period from January 2005 to June 2018, from the largest Chinese online community, Baidu Tieba. We build an online dating network for MSM-related individuals in the gay-bar community, and analyze the network from static and dynamic aspects. It is found that there is a strong homophily regarding the cities where users reside when developing interactions with others, and that most network measurements tend to be stable at the later stages of evolution, while the size of the largest community fluctuates. This is an indication that the network is formed of rapidly flexible interactions which changes quickly. In comparison with studies on heterosexual networks, we find that the MSM dating network shows differences in many aspects, such as the positive degree-degree correlation and high clustering coefficient, suggesting different thinking and measures should be taken in the policy making of public health management towards the MSM population.

Pleasure, risk perception and consent among group sex party attendees in a small Canadian Urban Centre

From a health perspective, group sex parties represent risk environments, as multiple sexual partners and polysubstance use associated with these parties may present risk practices for sexually transmitted infection (STI) transmission. At the same time, group sex parties exemplify sex as recreation, expressed in contemporary sociological theory as sex as leisure or play. In this paper, we report on the findings of an exploratory qualitative study conducted with group sex party attendees and hosts/organisers in a mid-sized Canadian city. Thematic analysis of semi-structured interviews with thirteen individuals identified several sexual communities based on gender composition, sexual orientation, and sexual practice, with variation among and within groups in terms of sexual consent and STI disclosure. All the interviewees discussed at length issues of harm reduction and consent, suggesting that these factors contribute to participants' group sex party experiences regardless of their sexual community. These insights highlight the potential use of group sex parties as avenues to understanding the integration of harm reduction practices with the pursuit of sexual pleasure, information applicable in the context of a wide range of sexuality education programmes.

Sex club/party attendance and STI among men who have sex with men: results from an online survey in New York City

OBJECTIVE

Prior studies have shown that men who have sex with men (MSM) who attend sex clubs or parties are at higher risk for HIV and other STIs than those who do not. We sought to provide data about MSM who attend sex clubs/parties in New York City (NYC) in the era of biomedical HIV prevention. METHODS : We conducted an online survey among MSM in NYC (n=766) in 2016-2017 and investigated differences between those who reported never attending a sex club/party (non-attendees 50.1%), those who had attended over a year ago (past attendees 18.0%) and those who attended in the prior year (recent attendees 30.1%). We also conducted multivariable analyses to explore associations with past-year STI diagnosis. RESULTS : Recent attendees were not more likely to be HIV positive than non-attendees. Among participants never diagnosed with HIV, recent attendees were more likely to use pre-exposure prophylaxis (PrEP, 32.6%) than non-attendees (14.5%) and past attendees (18.8%; p<0.001). Recent attendees reported the highest numbers of recent sex partners, including partners with whom they had condomless anal sex. Significantly more recent attendees reported an STI diagnosis in the prior year (27.9%) compared with non-attendees (14.0%) and past attendees (16.5%; p<0.001). However, 13.8% of non-attendees and 11.5% of past attendees reported having never tested for STIs, significantly more than recent attendees (6.0%, p=0.010). Multivariable analysis showed recent attendees to have 2.42 times the odds (compared with non-attendees) of reporting past-year STI diagnosis (95% CI 1.52 to 3.87, p<0.001).

CONCLUSIONS

Compared with those who had not done so, MSM who attended sex clubs/parties in NYC in the prior year were not only more likely to report past-year STI diagnoses but also more likely to report PrEP use or recent HIV/STI testing. Sexual health promotion among MSM who attend sex clubs/parties should address STI risk and prevention.

Rethinking Risk, Culture, and Intervention in Collective Sex Environments

This article provides a narrative overview of research on HIV/STI risk and collective sexual behavior based on an inclusive analysis of research on environments where people gather for sexual activity-sex clubs, swingers' clubs, bathhouses, parks, private sex parties, etc. The aim is to analyze how collective sex has been approached across disciplines to promote conversation across paradigms and suggest new lines of inquiry. Attention to context-such as the location of sex-was a necessary redress to universalizing models of sexual risk-taking behavior, leading to insights rooted in the particularities of each environment and its users. However, the identification of ever more precise risk groups or environmental idiosyncrasies eventually becomes theoretically restrictive, leading to an overestimation of the uniqueness of sexual enclaves, and of the difference between any given enclave and the broader social milieu. Using a theoretical framework of transgression to interpret the interdisciplinary literature, similarities in the spatial and social organization of collective sex environments are identified. Insights generated from this complementary perspective are then applied to understandings of collective sex: first, the example of male-female (MF) "swingers" is used to illustrate the need to establish, rather than assume, the distinctiveness of each non-normative sexual enclave, and to broaden the conceptualization of context; second, questions are raised about the practicality of interventions in collective sex environments. Finally, new lines of intellectual inquiry are suggested to shed light not just on collective sex but on sociosexual issues more generally, such as increasing protective sexual health behavior or negotiating consent in sexual encounters.

Prevalence of poppers use and its sexual risks among men who have sex with men in southwestern China: a cross-sectional study

Background

To investigate the prevalence of poppers use and its relationship with sexual risk behaviors among men who have sex with men (MSM) in southwestern China.

Methods

This cross-sectional study was conducted in three cities of southwestern China between July and September 2016. Anonymous questionnaire survey was administered to collect data on demographics, drug use, sexual behaviors, history of STIs and HIV infection. Logistic regression analysis was performed to explore factors correlated with sexual risk behaviors including group sex and unprotected anal intercourse (UAI).

Results

Of the 1122 participants included in the study, 24.1% reported a history of poppers use. 11.6% MSM reported ever engaging in group sex and 36.2% participants reported UAI with non-regular male partners in the past 12 months. Multivariate logistic analysis showed that age > 25 (OR = 2.96, 95% CI 1.87–4.68), seeking sex partners through the internet (OR = 3.16, 95% CI 1.59–6.29), preferring receptive anal intercourse (OR = 1.91, 95% CI 1.12–3.26) and ever using poppers (OR = 1.88, 95% CI 1.25–2.83) were positively associated with engaging in group sex. Lower levels of education (OR = 1.93, 95% CI 1.33–2.80) and ever using poppers (OR = 1.44, 95% CI 1.01–2.05) were significantly correlated with UAI with non-regular partners.

Conclusions

The study suggested poppers was prevalent among MSM and its use was significantly associated with sexual risk behaviors. Given high prevalence of HIV among this subpopulation, comprehensive measures are needed to decrease poppers use and its potential risk for HIV transmission in southwestern China.

Sexual Risk Behaviors and Perceptions of Men Who Go to Gay Sex Parties in New York City: Comparisons Between Three HIV Groups

Men who have sex with men (MSM) who attend group-sex events often engage in risky sexual behaviors that contribute to the high human immunodeficiency virus (HIV) incidence among this population. We conducted an online survey with 211 New York City MSM who attended sex parties in the prior year and asked them to describe their behaviors and perceptions of risk. We compared responses from HIV-positive-undetectable men (n = 36), HIV-negative men on pre-exposure prophylaxis (PrEP; n = 62), and HIV-negative men never on PrEP (n = 113). In bivariate analyses, undetectable and on-PrEP men had been to more sex parties in the prior six months, had more anal sex partners there, and had higher rates of sexually transmitted infection (STI) diagnoses than men never on PrEP. Although less than the other groups, 43% of the presumably HIV-negative men never on PrEP reported condomless anal sex at a party in the prior six months. About half of participants agreed that, at sex parties, they made assumptions about others' HIV status, that they sometimes took more risks than intended, and that the atmosphere of these events was conducive to risk taking. Most disagreed that there was discussion of HIV status at sex parties. Implications for sexual health interventions are discussed.

Nitrite Inhalant Use and HIV Infection Among Chinese Men Who Have Sex With Men in 2 Large Cities in China

OBJECTIVE

This study aims to examine the role that nitrite inhalants play in HIV infection and risky sex behaviors among Chinese men who have sex with men (MSM).

METHODS

The study consisted of a baseline and a follow-up survey conducted in Beijing and Nanning, China. The baseline study recruited participants through online advertisements and peer referral to complete a questionnaire interview, oral rapid HIV test, and blood HIV and syphilis tests. The follow-up included a questionnaire interview, and optional oral and/or blood HIV testing. Questionnaires collected information about sociodemographic and behavioral characteristics. Univariable and multivariable logistic regression analyses were performed to evaluate associations between characteristics and nitrite inhalant use.

RESULTS

One-third (29.8%) of 510 participants at baseline reported nitrite inhalant use during male-male sex in the past 6 months. Nitrite inhalant use was associated with higher odds of HIV infection (odds ratio 2.0, 95% confidence interval 1.1-3.7). Factors associated with nitrite inhalant use were as follows: never married, currently living in Beijing, not willing to test for HIV with oral self-test kit, and seeking male sex partners via the internet. In follow-up, 270 of 317 responded MSM reported having male-male sex after baseline and 17% of them used nitrite inhalants during sex.

CONCLUSIONS

MSM who use nitrite inhalants are more likely to engage in risky HIV behaviors and have higher HIV infection risk than those who do not. Identifying MSM who use nitrite inhalants for targeted HIV interventions, such as HIV testing, might make HIV-prevention efforts more efficient among this population.

Poppers use and Sexual Partner Concurrency Increase the HIV Incidence of MSM: a 24-month Prospective Cohort Survey in Shenyang, China

The use of poppers is highly prevalent in MSM, but little is known about the association between their use and HIV incidence in China. A prospective cohort study was conducted from 2011 to 2013 in MSM in Shenyang. 475(79.6%) of eligible HIV-negative MSM participated in this prospective survey and near one fourth MSM (23.4%) ever used poppers. About one-third of the participants had condomless anal intercourse, half had multiple sexual partners and 10.5% were syphilis positive. The HIV incidence densities were15.5 (95% CI:9.4-23.4)/100 PY[person-years]) and 4.6 (95% CI:2.9-7.0)/100 PY in poppers-users and non-poppers-users, respectively. Predictors of HIV seroconversion included poppers-using-behavior, having had more than two male partners, practicing group sex, unprotected anal intercourse(UAI) with male partners, and baseline syphilis positivity (all P < 0.05). In conclusion, the use of poppers, high-risk-sexual behaviors and syphilis infection significantly increase the HIV incidence among Shenyang MSM. It is essential for policy makers to add poppers to the official controlled illicit drug list to reduce HIV transmission among the MSM community. A comprehensive strategy should also be implemented to control both their high-risk-sexual behaviors and risk of syphilis infection, since these may represent novel ways to prevent new HIV infections in these MSM.

Correlates of engagement in group sex events among men who have sex with men in London who use geosocial-networking smartphone applications

Men who have sex with men (MSM) who attend group sex events (GSEs) tend to also engage in high-risk sexual behaviors and substance use that may place them at additional increased risk for becoming infected with HIV. These sorts of events may be facilitated by the use of geosocial-networking smartphone applications, where MSM may have access to a large virtual pool of potential partners. The purpose of the current study was to examine the prevalence of recent engagement in GSEs and its demographic and behavioral correlates among a sample of MSM ( n = 202). Log-binomial models were fit to assess correlates of engagement in GSEs in the preceding three months. Overall, 42.6% had engaged in a GSE in the preceding three months. In multivariable models, the use of inhalant nitrites (PR: 2.239; 95% CI: 1.119, 4.848; p = .024) and methamphetamine (PR: 7.601; 95% CI: 2.340, 24.691; p = .001) were associated with recent engagement in GSEs. Given the high prevalence of these potentially high-risk behaviors, future research should be conducted to examine the concurrent use of substance use and condom use at the GSEs to develop appropriate risk reduction interventions.

Is Group Sex a Higher-Risk Setting for HIV and Other Sexually Transmitted Infections Compared With Dyadic Sex Among Men Who Have Sex With Men?

BACKGROUND

Group sex has been suggested as a potential high-risk setting for HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM). We investigated whether group sex is associated with lower condom use during anal sex and higher proportions of STIs compared with dyadic sex among HIV-negative MSM between 2009 and 2012.

METHODS

Cross-sectional data from 7 data waves of the Amsterdam Cohort Studies were used. The sample consisted of 465 MSM who either reported both group and dyadic sex (at n = 706 visits) or dyadic sex only (at n = 1339 visits) in the preceding 6 months. Logistic regression with generalized estimating equations was used to investigate the association between sexual setting (group vs. dyadic sex), condomless anal sex, and STI.

RESULTS

Group sex was reported at 35% (706/2045) of visits. Condomless sex was more often reported during dyadic than group sex (odds ratio, 3.64 95% confidence interval, 2.57-5.16). Men who had group sex were more likely diagnosed as having gonorrhea compared with men with dyadic sex (odds ratio, 1.71; 95% confidence interval, 1.08-2.97), but this effect was not retained in the multivariate model.

CONCLUSIONS

Results demonstrate within-person differences in sexual behavior during group and dyadic sex among MSM. Men were more likely to use condoms during group sex than during dyadic sex. Thus, for some, group sex may not necessarily be risky for HIV infection compared with dyadic sex. However, group sex may be a higher-risk setting for acquiring STIs other than HIV, such as gonorrhea. Group sex encounters should be recognized as distinct sexual settings with specific risk characteristics that need to be addressed accordingly.

Will Gay Sex-Seeking Mobile Phone Applications Facilitate Group Sex? A Cross-Sectional Online Survey among Men Who Have Sex with Men in China

Introduction

China is amidst a sexual revolution, with changing sexual practices and behaviors. Sex–seeking mobile phone applications (gay apps) that allow multiple people to meet up quickly may facilitate group sex. This study was therefore undertaken to evaluate group sex among Chinese MSM and to better understand factors associated with group sex.

Methods

An online survey was conducted from September-October 2014, collecting data on socio-demographics, sexual behaviors, use of gay apps and occurrence of group sex among Chinese MSM. Univariate and multivariable logistic regressions were used to compare group sex and non-group sex participants.

Results

Of the 1,424 MSM, the majority were under 30 years old (77.5%), unmarried (83.9%), and were gay apps users (57.9%). Overall, 141 (9.9%) participants engaged in group sex in the last 12 months. Multivariate analyses showed that men living with HIV, engaged in condomless anal intercourse with men, and used gay apps were more likely to engage in group sex, with adjusted ORs of 3.74 (95% CI 1.92–7.28), 2.88 (95% CI 2.00–4.16) and 1.46 (95% CI: 1.00–2.13), respectively. Among gay app users, the likelihood of group sex increases with the number of sex partners and the number of sex acts with partners met through a gay app.

Conclusions

Chinese MSM who engage in group sex are also more likely to engage in other risky sexual behaviors, and gay app use may facilitate group sex. Further research is needed among MSM who engage in group sex in order to target interventions and surveillance.

Poppers use and risky sexual behaviors among men who have sex with men in Beijing, China

BACKGROUND

Although poppers are increasingly popular among MSM in China, little is known about the patterns of poppers use. The objectives of this study were to describe the patterns of poppers use and examine its association with sexual behaviors and HIV infection among MSM in Beijing, China.

METHODS

As part of a multi-component HIV intervention trial, 3588 MSM were surveyed between March 2013 and March 2014 in Beijing, China. Blood samples were collected and tested for HIV and syphilis. The questionnaire collected information about socio-demographic and behavioral characteristics. Univariate and multivariable logistic regression analyses were performed to evaluate the correlates of poppers use.

RESULTS

Over a quarter of men (27.5%) reported having used at least one type of drugs in the past three months. Poppers were the most popular one (26.8%). Poppers use was correlated with a higher HIV prevalence [odds ratio (OR): 1.38, 95% confidence interval (CI): 1.11-1.70]. Demographic and sexual behavioral factors associated with poppers use included: younger age [adjusted OR (AOR): 1.56, 95% CI: 1.25-1.94], higher education (AOR: 1.61, 95% CI: 1.33-1.96), alcohol use (AOR: 1.32, 95% CI: 1.10-1.60), seeking male partners mainly via the internet (AOR: 1.60, 95% CI: 1.28-2.00), multiple male sex partnership (AOR: 2.22, 95% CI: 1.90-2.60), and unprotected receptive anal intercourse (AOR: 1.52, 95% CI: 1.28-1.81).

CONCLUSIONS

In this study, poppers use was positively associated with HIV infection and unprotected anal intercourse. Intervention efforts should be devoted to promote safer sex and HIV testing and counseling among MSM who use poppers.

Amphetamine-type stimulant use among men who have sex with men (MSM) in Vietnam: Results from a socio-ecological, community-based study

INTRODUCTION

Amphetamine-type-stimulants (ATS) use is associated with HIV-related sexual risk behaviours and is an emergent problem among men who have sex with men (MSM) in Vietnam. The purpose of this study is to describe ATS use patterns and understand the correlates of recent methamphetamine use from a socio-ecological perspective.

METHODS

From September through December, 2014, 622 MSM were recruited in Hanoi and Ho Chi Minh City, Vietnam. We collected information on demographic characteristics, HIV testing behaviours, use of ATS and other recreational drugs (ever and recently), sexual sensation seeking, depressive mood, experienced and internalized stigma related to homosexuality, social involvement with other MSM, and perceptions of ATS use in MSM networks. We performed descriptive statistics to describe ATS use patterns and multivariate logistic regression to establish independent correlates of recent methamphetamine use.

RESULTS

Nearly one-third (30.4%) had ever used ATS, including 23.6% who had used methamphetamine, 4.3% who had used amphetamine ('speed') and 20.9% who had used ecstasy. 20.1% and 11.9% had ever used methamphetamine and ecstasy, respectively, during sex. Eighteen percent of methamphetamine users were classified as engaged in high-risk use. Recent methamphetamine use (in the last 3 months) was associated with participants perceiving more methamphetamine use in their MSM network, recent sex work, and higher sexual sensation seeking scores.

CONCLUSIONS

ATS use is relatively prevalent among MSM sampled in Vietnam's main cities. Interventions to address methamphetamine are warranted for MSM in Vietnam. Methamphetamine treatments are needed for high-risk users.

Correlates of group sex among a community-based sample of men who have sex with men (MSM) in Washington, DC

Participation of MSM in group sex events (GSEs) is an understudied phenomenon. Studies on GSEs identified significant proportions of MSM engaging in unprotected anal intercourse (UAI). We sought to identify the prevalence of group sex participation among MSM in Washington, DC and to characterize these experiences. Data were collected for NHBS-MSM-3 in 2011. More than one-quarter of MSM (27.2 %) reported engaging in group sex in the prior year, with one-third reporting no condom use with their sex partners (33.0 %). In multivariable logistic regression, men who participated in a GSE in the prior year were significantly younger, more likely to be white, and to have used crystal meth, poppers, and downers in the past year. The high prevalence of UAI during GSEs, especially in view of the fact that HIV-positive MSM were significantly less likely to report condom use, offers an opportunity to develop risk reduction interventions specific to GSE attendees.

Prevalence and correlates of sexual partner concurrency among Australian gay men aged 18-39 years

Mathematical models predict higher rates of HIV and sexually transmitted infections (STIs) in populations with higher rates of concurrent sexual partnerships. Although gay men and other men who have sex with men (MSM) have disproportionately high rates of HIV/STIs, little is known about the prevalence and correlates of sexual concurrency in these populations. This paper reports findings from a national community-based survey of 1,034 Australian gay-identified men aged 18-39 years, who gave detailed information about their sexual partners over the past 12 months. In all, 237 (23 %) reported two or more concurrent sexual partners. For their most recent period of concurrency, 44 % reported three or more partners and 66 % reported unprotected sex with one or more of their partners. A multivariate logistic regression found sexual concurrency was significantly more likely among men on higher incomes (P = 0.02), who first had anal sex at a relatively young age (P = 0.03), and who reported a large number of partners in the past 12 months (P < 0.001). Age, education, HIV status, and other sociodemographic and sexual behavior variables were not significant correlates. However, men who reported sexual concurrency were significantly more likely to have been diagnosed with an STI in the past 12 months (P = 0.04). Findings from this study suggest sexual concurrency is common among younger Australian gay men. With many of these men not always using condoms, health agencies should consider the potential impact of concurrency on HIV/STI epidemics among gay men and other MSM.

Injecting drug use among gay and bisexual men in Sydney: prevalence and associations with sexual risk practices and HIV and hepatitis C infection

Injecting drug use is commonly reported among gay and bisexual men in Australia. We examined the prevalence and covariates of injecting drug use among men participating in the Sydney Gay Community Periodic Survey between 2004-06 and 2011. In 2004-06, data was collected about which drugs were injected, while in 2011, data was collected about hepatitis C (HCV) and esoteric sexual practices. In 2004-06, 5.6 % of men reported injecting drugs in the previous 6 months; 3.4 % reported methamphetamine injection and 0.4 % heroin injection. In 2011, men who injected drugs were less likely to be employed full-time, and more likely to be HCV-positive, HIV-positive, to have used party drugs for sex, and to have engaged in esoteric sexual practices. The strong associations between injecting drug use, sexual risk practices and blood-borne virus infection suggests the need for combined sexual health and harm reduction services for gay and bisexual men who inject drugs.

Versatility and HIV vulnerability: patterns of insertive and receptive anal sex in a national sample of older Australian gay men

According to mathematical modeling, HIV is more likely to spread through a population of men who have sex with men when high numbers practice versatile anal sex roles, that is, engage in both insertive (IAI) and receptive anal intercourse (RAI). Yet, actual patterns of versatility remain largely unknown, particularly among older men who currently face growing rates of HIV. In this study, 1,135 Australian gay men aged 40 years and older completed a national online survey of their sexual health and behavior over the past 12 months. Of men who had anal intercourse, 62 % engaged in both IAI and RAI. Factors associated with being versatile included younger age (P = 0.01), higher income (P = 0.009), and larger numbers of sexual partners (P = 0.003). Among men with multiple sexual partners, 20 % were highly versatile, that is, reported similar numbers of IAI and RAI partners. Having HIV (P = 0.003) and living in a rural area (P = 0.04) were significantly associated with being highly versatile. These data point to high rates of versatility among older Australian gay men, with implications for mathematical predictions of change in HIV epidemics and for the design of future HIV prevention strategies.