1
|
Freese J, Segura ER, Gutierrez J, Lake JE, Cabello R, Clark JL, Blair C. Sexual network characteristics and partnership types among men who have sex with men diagnosed with syphilis, gonorrhoea and/or chlamydia in Lima, Peru. Sex Transm Infect 2024; 100:84-90. [PMID: 38124224 PMCID: PMC10922481 DOI: 10.1136/sextrans-2023-055910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES Sexual networks are known to structure sexually transmitted infection (STI) transmission among men who have sex with men (MSM). We sought to estimate the risks of STI diagnosis for various partnership types within these networks. METHODS Our cross-sectional survey analysed data from 1376 MSM screened for a partner management intervention in Lima, Peru. Participants were tested for HIV, syphilis, gonorrhoea (NG) and chlamydia (CT) and completed surveys on their demographics, sexual identity/role, HIV status, partnership types and sexual network from the prior 90 days. χ2 and Wilcoxon rank-sum tests compared participants without an STI to those diagnosed with (1) syphilis, (2) NG and/or CT (NG/CT) and (3) syphilis and NG/CT coinfection (coinfection). RESULTS 40.8% (n=561/1376) of participants were diagnosed with an STI (syphilis: 14.9%, NG/CT: 16.4%, coinfection: 9.5%). 47.9% of all participants were living with HIV and 8.9% were newly diagnosed. A greater proportion of participants with syphilis and coinfection were living with HIV (73.5%, p<0.001; 71.0%, p<0.001) compared with those with NG/CT (47.8%) or no STI (37.8%). Participants with syphilis more often reported sex-on-premises venues (SOPVs) as the location of their last sexual encounter (51.7%, p=0.038) while those with NG/CT tended to meet their last sexual partner online (72.8%, p=0.031). Respondents with coinfection were the only STI group more likely to report transactional sex than participants without an STI (31.3%, p=0.039). CONCLUSIONS Sexual networks and partnership types of Peruvian MSM are associated with differential risks for STIs. Participants diagnosed with syphilis tended to meet single-encounter casual partners at SOPV, while MSM with NG/CT were younger and often contacted casual partners online. Coinfection had higher frequency of transactional sex. These findings suggest the potential importance of public health interventions through combined syphilis/HIV screening at SOPV, syphilis screening at routine clinic appointments for MSM living with HIV and directed advertisements and/or access to NG/CT testing through online platforms.
Collapse
Affiliation(s)
- Jonathan Freese
- University of Nebraska Medical Center, Omaha, Nebraska, USA
- Department of Medicine, Division of Infectious Diseases, South American Program in HIV Prevention Research, Los Angeles, California, USA
| | - Eddy R Segura
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | | | | | - Jesse L Clark
- Department of Medicine, Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, Los Angeles, California, USA
| | - Cherie Blair
- Department of Medicine, Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, Los Angeles, California, USA
| |
Collapse
|
2
|
HIV Testing Patterns Among Recently Self-Tested Russian Men Who Have Sex With Men: A Qualitative Study. J Assoc Nurses AIDS Care 2022; 33:550-558. [DOI: 10.1097/jnc.0000000000000344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
3
|
Martins ADA, Queiroz AAFLN, Frota OP, Araújo TMED, Mendes IAC, Fronteira I, Sousa ÁFLD. Consumption of sexually explicit media and unprotected anal sex in men who have sex with men. CIENCIA & SAUDE COLETIVA 2021; 26:5841-5849. [PMID: 34852113 DOI: 10.1590/1413-812320212611.30532020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/04/2020] [Indexed: 11/21/2022] Open
Abstract
This study aimed to evaluate the influence of bareback sexually explicit media (SEM) consumption on anal sex without a condom by men who have sex with men (MSM). To this end, a page was created on the Facebook® social network with a link that directed interested parties to a questionnaire. Cisgender men, aged 18 years and over, who had sex with other men in the last 12 months, were included. Data were collected in 2017 and analyzed using univariate and bivariate inferential statistics and multivariate logistic regression. A total of 2,248 MSM participated in the research, with a mean age of 24.4 years and a mean number of 3.9 partners in the last 30 days. Having multiple sexual partners (ORa: 9.4; 95% CI 3.9-22.4), preferring movies with bareback scenes (ORa: 2.6; 95% CI 1.5-4.6), considering this practice a fetish and realizing it (ORa: 3.52; 95% CI 2.3-5.4), having casual partnerships (ORa: 1.8; 95% CI 1.5-1.9) and being aware of the partner's negative serological status for HIV (ORa: 1.4; 95% CI 1.1-2.3) were factors that increased the likelihood of engaging in anal sex without a condom. Thus, we found an association between the consumption of bareback SEM and sex without a condom among MSM.
Collapse
Affiliation(s)
- Anderson de Araújo Martins
- Instituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul. Cidade Universitária, s/n Universitário -900. 79070-900 Campo Grande MS Brasil.
| | | | - Oleci Pereira Frota
- Instituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul. Cidade Universitária, s/n Universitário -900. 79070-900 Campo Grande MS Brasil.
| | | | | | - Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa. Lisboa Portugal
| | | |
Collapse
|
4
|
Let's Talk About Sex: The Impact of Partnership Contexts on Communication About HIV Serostatus and Condom Use Among Men Who Have Sex with Men (MSM) and Transgender Women (TW) in Lima, Peru. AIDS Behav 2021; 25:2139-2153. [PMID: 33411208 DOI: 10.1007/s10461-020-03144-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 01/17/2023]
Abstract
Sexual communication with partners informs risk assessment and sexual practices. We evaluated participant, partner, and network factors associated with communication about condom use and HIV serostatus and explored their relationships with condomless anal intercourse (CAI) among 446 men who have sex with men (MSM) and 122 transgender women (TW) in Lima, Peru. Generalized estimating equations assessed contextual influences on communication and practices with recent sexual partners. More frequent HIV communication was reported by MSM who: identified as heterosexual, compared to bisexual or gay; characterized partnerships as stable, compared to casual, anonymous, or commercial; or discussed HIV/STIs with close social contacts (p < 0.05). TW in concurrent partnerships discussed condom use more frequently than those in monogamous relationships (p < 0.05). Condom use discussions and alcohol use among MSM were associated with CAI (p < 0.05). Findings highlight complexity in sexual decision-making and call for further study of conversation content and practices to inform HIV prevention messaging.
Collapse
|
5
|
Villa-Rueda AA, Onofre-Rodríguez DJ, Churchill S, Ramírez-Barajas F, Benavides-Torres RA. Multilevel elements associated with HIV serosorting for sexual encounters: a scoping literature review. CIENCIA & SAUDE COLETIVA 2019; 26:2183-2194. [PMID: 34231730 DOI: 10.1590/1413-81232021266.13142019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 08/05/2019] [Indexed: 11/22/2022] Open
Abstract
A scoping literature review to identify the multilevel HIV serosorting related elements was developed. Articles from EBSCO, PubMed, PsyNET and Science Direct with serosort* or serosorting at the tittle or abstract, written in English or Spanish were included. No restriction in type of population or design were applied. 239 records were retrieved after duplicates removed, but 181 references were extracted for full-text review. Individual level: HIV knowledge, serostatus, risk perceptions, abilities to disclose and for condom use negotiation, motivations, use of drugs, stigma, attitudes toward condom use, and perceptions/beliefs about the HIV and related treatments, HIV infection rates/testing and behavioral factors. Interpersonal level: social networks, abilities (sexual behavior negotiation, and communication). Community level: stigma, social norms, access to HIV related services. Structural level: political context, HIV related funding and public policies. HIV Serosorting is not solely an interpersonal behavior it involves multilevel elements that must be acknowledged by professionals and stakeholders.
Collapse
Affiliation(s)
- Alma Angélica Villa-Rueda
- School of Nursing, Universidad Autónoma de Baja California. Calle G S/N Z.C. 21100. Mexicali Baja California México
| | - Dora Julia Onofre-Rodríguez
- School of Nursing, Universidad Autónoma de Nuevo León. Dr. José Eleuterio González #1500, Mitras Centro, Z.C. 64460 Monterrey Nuevo León México
| | - Siobhan Churchill
- Department of Epidemiology and Biostatistics, University of Western Ontario. London ON Canada
| | - Fernanda Ramírez-Barajas
- School of Nursing, Universidad Autónoma de Nuevo León. Dr. José Eleuterio González #1500, Mitras Centro, Z.C. 64460 Monterrey Nuevo León México
| | - Raquel Alicia Benavides-Torres
- School of Nursing, Universidad Autónoma de Nuevo León. Dr. José Eleuterio González #1500, Mitras Centro, Z.C. 64460 Monterrey Nuevo León México
| |
Collapse
|
6
|
Bom RJM, van der Linden K, Matser A, Poulin N, Schim van der Loeff MF, Bakker BHW, van Boven TF. The effects of free condom distribution on HIV and other sexually transmitted infections in men who have sex with men. BMC Infect Dis 2019; 19:222. [PMID: 30832608 PMCID: PMC6399837 DOI: 10.1186/s12879-019-3839-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV and other sexually transmitted infections remain a burden on men who have sex with men in the era of effective combination antiretroviral therapy. New prevention efforts are therefore needed. One of these approaches is the current country-wide free condom distribution at gay bars with darkrooms and gay saunas in the Netherlands. This study assessed the effects of free condom distribution on incidence and burden of disease of HIV and other sexually transmitted infections. METHODS A static model was constructed to calculate the impact of free condom distribution on HIV, hepatitis C, chlamydia, gonorrhoea, and syphilis among men who have sex with men visiting these venues. Outcomes included new infections averted and disability-adjusted life years averted. Scenario studies were performed to predict the effects of a further increase of condom use, condom effectiveness and coverage. Lastly, cost-effectiveness and sensitivity analyses were performed. RESULTS Our model showed that condom use at public sex venues increased after the intervention. Annual incidence risk decreased, ranging from 5.73% for gonorrhoea to 7.62% for HIV. The annual number of new infections averted was largest for chlamydia and gonorrhoea (261 and 394 infections, respectively), but 42 new HIV infections were averted as well. In scenarios where condom use and condom effectiveness were further increased, the number of infections reduced more extensively. Over 99% of the decrease in burden of disease was due to HIV. The intervention was cost-effective and cost-saving (for every €1 spent on condom distribution, €5.51 was saved) and remained this in all sensitivity analyses. CONCLUSIONS Free condoms at public sex venues could reduce the transmission of HIV and other sexually transmitted infections. Condom distribution is an affordable and easily implemented intervention that could reduce the burden of disease in men who have sex with men substantially.
Collapse
Affiliation(s)
| | | | - Amy Matser
- Department of Research, Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands.,Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht (UMCU), Utrecht University (UU), Utrecht, the Netherlands
| | - Nicolas Poulin
- Centre de Statistique de Strasbourg (CeStatS), Institut de Recherche Mathématique Avancée (IRMA, UMR 7501), Université de Strasbourg & Centre National de la Recherche Scientifique (CNRS), Strasbourg, France
| | - Maarten F Schim van der Loeff
- Department of Research, Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands.,Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), University of Amsterdam (UvA), Amsterdam, the Netherlands
| | | | | |
Collapse
|
7
|
Determining the Most Likely Source of Infection: An Application to Neisseria Gonorrhoeae Among Men Who Have Sex with Men. Epidemiology 2019; 29:421-430. [PMID: 29406492 DOI: 10.1097/ede.0000000000000816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The source of an infection is often unknown. To inform directed prevention measures, it is useful to know the location and partner type with the highest transmission risk. We developed a method to estimate infection risk of Neisseria gonorrhoeae per meeting location among men who have sex with men (MSM). METHODS In 2008-2009, we collected information from 2,438 MSM attending the sexually transmitted infections clinic of Amsterdam. For up to four partners per participant (8,028 in total), we asked for details on meeting location, partner, and partnership characteristics. We used logistic regression to relate these to the participant's infection risk, accounting for unobserved transmission information in the likelihood. Based on the model estimates, we predicted the probability of a partner having N. gonorrhoeae. The probability that a partner was the source was proportional to his predicted infection risk. Each source was linked to the meeting location. We used a Bayesian method. RESULTS Rectal N. gonorrhoeae was diagnosed in 157 MSM who reported data on 422 possible source partners, urethral N. gonorrhoeae in 126 reporting 285 possible sources, and pharyngeal N. gonorrhoeae in 162 reporting 451 possible sources. We estimated that most infections were acquired from long-lasting steady partners (21%; 95% CI = 17, 24). Partners met in an Amsterdam street with gay venues posed the highest transmission risk (13%; 95% CI = 7.9, 18). CONCLUSIONS The presented method estimates the source of infection when there are multiple possible sources and enables the summation over various kinds of epidemiologic characteristics (here, meeting locations) that are relevant for prevention.
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Kampman CJG, Heijne JCM, Kistemaker-Koedijk PHM, Koedijk FDH, Visser M, Hautvast JLA. Determinants of frequent and infrequent STI testing and STI diagnosis related to test frequency among men who have sex with men in the eastern part of the Netherlands: a 6-year retrospective study. BMJ Open 2018; 8:e020495. [PMID: 29858416 PMCID: PMC5988078 DOI: 10.1136/bmjopen-2017-020495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Men who have sex with men (MSM) remain vulnerable to sexually transmitted infections (STIs) and are advised to be tested at least twice a year. The aim of this study was to assess the determinants of test frequency and their associations with an STI diagnosis. DESIGN A 6-year retrospective study. SETTING 5 STI clinics in the eastern part of the Netherlands. PARTICIPANTS MSM whose mean test interval was 6 months or more were grouped as 'infrequently tested' (n=953), and those with a mean test interval less than 6 months were grouped as 'frequently tested' (n=658). PRIMARY AND SECONDARY OUTCOME MEASURES Test frequency and STI diagnosis and determinants. RESULTS MSM who were ever diagnosed with an STI (OR=1.4, 95% CI 1.1 to 1.7), MSM who had never had STI symptoms (OR=0.8, 95% CI 0.6 to 1.0), and MSM who had ever had sex with both men and women (OR=0.6, 95% CI 0.5 to 0.8) were more often frequently tested. Moreover, in both groups, MSM who had ever been notified by a partner (OR=2.2, 95% CI 1.7 to 2.9 infrequently tested; OR=2.0, 95% CI 1.4 to 2.9 frequently tested), MSM who had ever had STI symptoms (OR=1.6, 95% CI 1.2 to 2.1 infrequently tested; OR=1.8, 95% CI 1.3 to 2.6 frequently tested) and MSM who were ever diagnosed with HIV (OR=2.7, 95% CI 1.5 to 4.6 infrequently tested; OR=6.8, 95% CI 2.6 to 17.5 frequently tested) were more likely to be diagnosed with an STI. CONCLUSIONS Among MSM visiting STI clinics, those who were ever diagnosed with HIV were more often diagnosed with an STI, but did not visit STI clinics more frequently than HIV-negative MSM. This highlights the necessity of encouraging MSM who are diagnosed with HIV to have STI tests more frequently.
Collapse
Affiliation(s)
| | - Janneke C M Heijne
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | | | - Maartje Visser
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Jeannine L A Hautvast
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
10
|
Janulis P, Feinstein BA, Phillips G, Newcomb ME, Birkett M, Mustanski B. Sexual Partner Typologies and the Association Between Drug Use and Sexual Risk Behavior Among Young Men Who Have Sex With Men. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:259-271. [PMID: 28194606 PMCID: PMC5554732 DOI: 10.1007/s10508-016-0909-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 11/14/2016] [Accepted: 11/21/2016] [Indexed: 05/12/2023]
Abstract
Numerous partner and relationship characteristics are associated with sexual risk behavior among young men who have sex with men (YMSM), including being in a serious relationship and having older partners. However, most research in this area is limited by its reliance on variable-centered approaches. Using multilevel latent class analysis, this study identified subgroups of sexual partner types with a particular emphasis on examining whether partner type moderated the association between drug use and condomless anal sex (CAS). Data were utilized from an ongoing cohort study of YMSM (ages 16-29) recruited from previous studies as well as peers and serious partners of existing cohort members. A total of 469 participants reported on 1596 sexual partners in the past 6 months. We identified four distinct sexual partner typologies, which we refer to as: casual, older-online, much older, and serious. Results indicated that rates of CAS were highest for older-online and serious partners. Additionally, there was a positive association between drug use and CAS among a predominantly marijuana using sample, but only for serious partners. While previous research has found that CAS is highest in serious relationships, findings suggest that there may be another type of partnership in which CAS is likely to occur (older partners met online). If confirmed, these results suggest interventions focused on the intersection of marijuana use and CAS may be particularly important among YMSM with serious partners.
Collapse
Affiliation(s)
- Patrick Janulis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
| | - Brian A Feinstein
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Michelle Birkett
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| |
Collapse
|
11
|
Sexual Orientation, Gender Identity and Perceived Source of Infection Among Men Who Have Sex with Men (MSM) and Transgender Women (TW) Recently Diagnosed with HIV and/or STI in Lima, Peru. AIDS Behav 2016; 20:2178-2185. [PMID: 26767533 DOI: 10.1007/s10461-015-1276-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Risk perception and health behaviors result from individual-level factors influenced by specific partnership contexts. We explored individual- and partner-level factors associated with partner-specific perceptions of HIV/STI risk among 372 HIV/STI-positive MSM and transgender women (TW) in Lima, Peru. Generalized estimating equations explored participants' perception of their three most recent partner(s) as a likely source of their HIV/STI diagnosis. Homosexual/gay (PR = 2.07; 95 % CI 1.19-3.61) or transgender (PR = 2.84; 95 % CI 1.48-5.44) partners were more likely to be considered a source of infection than heterosexual partners. Compared to heterosexual respondents, gay and TW respondents were less likely to associate their partner with HIV/STI infection, suggesting a cultural link between gay or TW identity and perceived HIV/STI risk. Our findings demonstrate a need for health promotion messages tailored to high-risk MSM partnerships addressing how perceived HIV/STI risk aligns or conflicts with actual transmission risks in sexual partnerships and networks.
Collapse
|
12
|
|
13
|
Heijman T, Stolte I, Geskus R, Matser A, Davidovich U, Xiridou M, Schim van der Loeff M. Does online dating lead to higher sexual risk behaviour? A cross-sectional study among MSM in Amsterdam, the Netherlands. BMC Infect Dis 2016; 16:288. [PMID: 27295949 PMCID: PMC4907249 DOI: 10.1186/s12879-016-1637-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/07/2016] [Indexed: 11/29/2022] Open
Abstract
Background Men having sex with men (MSM) frequently use the Internet to find sex partners. We examined the association between unprotected anal intercourse (UAI) with partners dated online and with partners dated offline (met elsewhere), and examined whether differences can be explained by self-perceived HIV status of the index and knowledge of partnership characteristics. Methods MSM were recruited at the Sexually Transmitted Infections Clinic in Amsterdam, in 2008–2009. Participants completed a questionnaire concerning sexual behaviour. Only men reporting both online and offline casual sex partners were included. We assessed the association between online/offline partner dating and UAI, using random-effects logistic regression analysis. Results Five hundred seventy-seven men (351 HIV-negative, 153 HIV-positive, and 73 HIV-unaware) reported UAI in 26 % of 878 online, and 23 % of 903 offline casual partnerships. The crude OR of online dating for UAI was 1.36 (95 % CI 1.03–1.81). HIV-positive men were more likely to report UAI than HIV-negative men (49 % vs. 28 % of partnerships). Adjusted for demographic characteristics, online dating had no significant effect on UAI among HIV-negative and HIV status-unaware men, but HIV-positive men were more likely to have UAI with online partners (aOR = 1.65 [95 % CI 1.05–2.57]). After correction for partner and partnership characteristics the effect of online/offline dating on UAI among HIV-positive MSM was reduced and no longer significant. Conclusions Online dating was not significantly associated with UAI among HIV-negative MSM. HIV-positive MSM were more likely to practise UAI with partners dated online; however, after correction for partner and partnership characteristics, online partnership acquisition was not associated with a significantly increased risk of UAI. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1637-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Titia Heijman
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.
| | - Ineke Stolte
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.,Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Ronald Geskus
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Amy Matser
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.,Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Udi Davidovich
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.,Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Maria Xiridou
- National Institute of Public Health and the Environment, Centre for Infectious Disease Control (RIVM), Bilthoven, The Netherlands
| | - Maarten Schim van der Loeff
- Department of Infectious Diseases, Public Health Service of Amsterdam, PO box 2200, 1000 CE, Amsterdam, The Netherlands.,Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
| |
Collapse
|
14
|
Wilton L, Koblin B, Nandi V, Xu G, Latkin C, Seal D, Flores SA, Spikes P. Correlates of Seroadaptation Strategies Among Black Men Who have Sex with Men (MSM) in 4 US Cities. AIDS Behav 2015; 19:2333-46. [PMID: 26363789 DOI: 10.1007/s10461-015-1190-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We assessed associations of demographic, psychosocial, and substance use factors with seroadaptation strategies among 835 BMSM in four US cities. Seroadaptation strategies were practiced by 59.8 % of men, with 10.5 % practicing 100 % condom use, 26.5 % serosorting, 7.2 % condom serosorting, and 15.6 % seropositioning. In multivariable analyses, compared to men who used no seroadaptation strategies, serosorters were older, were less likely to be HIV infected, had fewer male sex partners, and had higher levels of social support and sexual self-efficacy. Condom serosorters had less psychological distress, were more likely to use methamphetamine, and had higher levels of sexual self-efficacy. Seropositioners were older, were less likely to be HIV infected, to have a main partner, and report alcohol/drug use with sex, while having higher levels of sexual self-efficacy. Seroadaptation practices among BMSM need to be considered to address perceived safer sex strategies and strengthen access to a broader reach of culturally-relevant prevention efforts.
Collapse
|
15
|
Jacques Aviñó C, García de Olalla P, Díez E, Martín S, Caylà JA. [Explanation of risky sexual behaviors in men who have sex with men]. GACETA SANITARIA 2015; 29:252-7. [PMID: 25869152 DOI: 10.1016/j.gaceta.2015.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/04/2015] [Accepted: 03/10/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore views about risky sexual behaviors and perceptions of HIV, and to propose interventions for preventing HIV infections in a group of men who have sex with men. METHODS We performed a qualitative study in a sample of 13 men who have sex with men, who were participating in an HIV-seronegative cohort, and who we contacted via saunas for the gay community in Barcelona (Spain). We performed in-depth semi-structured interviews, followed by content analysis. RESULTS Risky sexual behaviors were associated with masculinity related to strong sexual needs, certain sexual exchange venues (such as saunas, private parties and clubs), drug use, and a desire to experiment with risk and one's own sexuality. HIV infection was perceived as a normalized disease, although becoming infected was still associated with shame and guilt. Proposed interventions included raising awareness of what it is like to live with HIV, generating greater social alarm, incorporating new technologies in prevention, and intensifying activity at gay venues. CONCLUSIONS The concept of masculinity plays a fundamental role in sexual practices among men who have sex with men. We suggest renewed innovation in preventive programs and incorporating the perception of risk and HIV infection from a gender perspective.
Collapse
Affiliation(s)
- Constanza Jacques Aviñó
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
| | - Patricia García de Olalla
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Elia Díez
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Servei de Programes i Intervencions Preventives, Agència de Salut Pública de Barcelona, Barcelona, España
| | - Silvia Martín
- Servei de Programes i Intervencions Preventives, Agència de Salut Pública de Barcelona, Barcelona, España
| | - Joan A Caylà
- Servei d'Epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| |
Collapse
|