1
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Traeen B, Fischer N, Grøndahl P. Norwegian Data on Prevalence, Sexual Risk Behaviors, Sexual Problems, and Sexual Satisfaction in Men Who Have Sex Exclusively with Women, Men Who Have Sex Exclusively with Men, and Men Who Have Sex with Men and Women. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:702-715. [PMID: 38596394 PMCID: PMC10903632 DOI: 10.1080/19317611.2022.2126056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 06/10/2022] [Accepted: 06/26/2022] [Indexed: 04/11/2024]
Abstract
Objective: This study investigates how men who have sex exclusively with women (MSEW) differ from men who have sex exclusively with men (MSEM), and men who have sex with men and women (MSMW) on selected variables. Methods: A probability-based web sample of 2,181 men was recruited. Results: Most MSEM considered their sexual identity as gay, and most MSMW as heterosexual. The MSEM were the most frequent condom users, while MSMW were the least frequent users and had the highest number of sexual partners. The MSEM and MSMW had a lower likelihood of premature ejaculation than MSEW. Conclusions: MSMW should be targeted in health campaigns.
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Affiliation(s)
- Bente Traeen
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Nantje Fischer
- Department of Psychology, University of Oslo, Oslo, Norway
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2
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Tomori C. Overcoming Barriers to Breastfeeding. Best Pract Res Clin Obstet Gynaecol 2022; 83:60-71. [DOI: 10.1016/j.bpobgyn.2022.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/23/2022]
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Power J, Amir S, Lea T, Brown G, Lyons A, Carman M, Rule J, Bourne A. Bisexual Men Living with HIV: Wellbeing, Connectedness and the Impact of Stigma. AIDS Behav 2021; 25:4085-4093. [PMID: 33768382 PMCID: PMC7994180 DOI: 10.1007/s10461-021-03236-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2021] [Indexed: 11/28/2022]
Abstract
Social research with people living with HIV (PLHIV) rarely distinguishes between gay men and bisexual men. However, bisexual men may have unique experiences of HIV-related stigma and distinct support needs. In this paper, findings are presented from a cross-sectional survey of Australian PLHIV, which included the Berger (HIV) stigma scale. A total of 872 PLHIV completed the survey, of which 48 (6.0%) were bisexual men. Bisexual men reported higher levels of internalised HIV-related stigma, greater negative self-image and poorer emotional wellbeing than gay men. Bisexual men also reported less social support, less connection with lesbian, gay, bisexual, transgender and queer (LGBTQ) communities, and less connection with other PLHIV. Analysis of data from an open-text question revealed feelings of social isolation and fear of rejection was associated with participant's HIV diagnosis. Study findings suggest that existing social supports for PLHIV may not adequately address the unique support needs of bisexual men.
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Affiliation(s)
- Jennifer Power
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, Melbourne, VIC, 3086, Australia.
| | - Stephanie Amir
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, Melbourne, VIC, 3086, Australia
| | - Toby Lea
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, Melbourne, VIC, 3086, Australia
- Centre for Social Research in Health, UNSW Sydney, John Goodsell Building, Sydney, NSW, Australia
| | - Graham Brown
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, Melbourne, VIC, 3086, Australia
- Centre for Social Impact, UNSW Sydney, Science Engineering Building, Sydney, NSW, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, Melbourne, VIC, 3086, Australia
| | - Marina Carman
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, Melbourne, VIC, 3086, Australia
- Rainbow Health Victoria, La Trobe University, Building NR6, Bundoora, Melbourne, Australia
| | - John Rule
- National Association of People with HIV Australia, Sydney, NSW, Australia
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, Melbourne, VIC, 3086, Australia
- Kirby Institute UNSW, UNSW, Wallace Wurth Building, Sydney, Australia
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Okoli C, Van de Velde N, Brough G, Hardy WD, Corbelli G, Allan B, Muchenje M, Castellanos E, Young B, Eremin A, Ramothwala P, de los Rios P. Differences in HIV treatment experiences, perceptions, and behaviors by gender and sexual orientation in 25 middle-income and high-income countries: Findings from the 2019 Positive Perspectives Survey. POPULATION MEDICINE 2020. [DOI: 10.18332/popmed/128600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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5
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Changes in Characteristics and Behavior Among African American Men Who Have Sex with Men and Women in the Context of Reductions in HIV Diagnoses Among Women. AIDS Behav 2020; 24:960-966. [PMID: 31073947 DOI: 10.1007/s10461-019-02528-2] [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] [Indexed: 10/26/2022]
Abstract
Men who have sex with men and women (MSMW) connect lower prevalence populations of women to higher prevalence populations of men who have sex with men only. We hypothesize that HIV testing and treatment among MSMW have increased in recent years, and this increase can help explain the declining rates of new HIV diagnoses among African American women. We analyzed data from 2008, 2011, and 2014 of the National HIV Behavioral Surveillance system. African American men who have sex with men (MSM) were surveyed from 19 United States cities using venue-based sampling and tested for HIV infection. We used generalized estimating equations, using year of survey as an independent variable, adjusting for age, to determine differences for selected outcomes regarding healthcare and risk behaviors over time. Among the 1299 African American MSMW interviewed, significant increases were observed in the percent of men who had an HIV test in the previous 12 months (2008: 54%, 2011: 69%, and 2014: 68%, p-value < 0.001). Among HIV-positive men, the percentage of men who were aware of their infection at the time of the interview increased significantly over time (26, 35, and 48%, p-value = 0.002). Among those men, the percentage who reported currently being on antiretroviral therapy also increased significantly over time (46, 69, and 72%, p-value = 0.050). The percentage of men reporting high-risk sexual risk behaviors increased or remained stable. Our findings support the hypothesis that HIV testing and treatment has increased among African American MSM from 2008 to 2014. Additional research is needed to fully explore the population-level impact it has on HIV transmission among women.
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Abdallah I, Conserve D, Burgess TL, Adegbite AH, Oraka E. Correlates of HIV-related risk behaviors among self-identified heterosexual men who have sex with men (HMSM): national survey of family growth (2002, 2006-2010, and 2011-2017). AIDS Care 2020; 32:1529-1537. [PMID: 32024380 DOI: 10.1080/09540121.2020.1724254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Self-identified heterosexual men who have sex with men (HMSM) have unique sexual behaviors that may increase their risk of HIV infection. We assessed the correlates of recent sex with other men and HIV-related risk behaviors among HMSM by sex of their sex partners. We analyzed data from the 2002 and 2006-2017 National Survey of Family Growth limited to men who self-identified as heterosexual and reported any anal/oral sex with another man (N = 787). Prevalence ratios based on logistic regression models determined the association between sociodemographic and behavior variables with reporting a same-sex partner or at least one HIV-related risk behavior with a female sex partner in the last 12 months. Approximately 17.7% and 42.5% of HMSM with recent same-sex partners reported HIV-related risk behaviors with male and female sex partners, respectively. HMSM who reported a recent same-sex partner and an HIV-related risk behavior reported more annual male (Ave = 2.6:95%CI;1.6-3.7) and female (Ave = 5.0:95%CI;3.3-6.8) sex partners than HMSM with a recent same-sex partner who did not report an HIV-related risk behavior [male (Ave = 1.7:95%CI;1.2-2.1) and female (Ave = 1.6:95%CI;1.1-2.1)]. HMSM with recent same-sex partners may engage in HIV-related risk behaviors with men and women concurrently. Further studies should assess gender-specific risk of infection.
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Gaines MT, McCree DH, Gaul Z, Henny KD, Hickson DA, Sutton MY. Comparison of Selected Sociodemographic Characteristics and Sexual Risk Behaviors of Black/African American Men Who Have Sex with Men Only and Men Who Have Sex with Men and Women, Southeastern United States, 2013-2016. J Racial Ethn Health Disparities 2019; 7:84-89. [PMID: 31502106 DOI: 10.1007/s40615-019-00636-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/08/2019] [Accepted: 08/29/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE Compare selected sociodemographic and sexual risk characteristics of black/African American (black) men who have sex with men only (MSMO) and men who have sex with men and women (MSMW) in the southeastern United States (the South). METHODS We conducted bivariate and multivariable analyses to explore the sociodemographic characteristics and sexual risk behaviors of 584 MSMW and MSMO in the South. RESULTS MSMW had lesser odds of having a college or graduate degree (aOR = 0.32; 95% CI = 0.19, 0.54) and having > 2 male oral sex partners (aOR = 0.20; 95% CI = 0.08, 0.48) compared to MSMO. MSMW had greater odds of being homeless (aOR = 3.11; 95% CI = 1.80, 5.38) and selecting "top" sexual position (aOR = 1.70; 95% CI = 1.07, 2.72) compared to MSMO. CONCLUSION MSMW in the South experience social and structural factors that may affect their risk for HIV infection. Strategies to address these factors should be considered in prevention and care efforts for this population.
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Affiliation(s)
- Malendie T Gaines
- Oak Ridge Institute for Science and Education, 100 ORAU Way, Oak Ridge, TN, 37830, USA.
| | - Donna Hubbard McCree
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30333, Georgia
| | - Zaneta Gaul
- ICF, 3 Corporate Square NE, Suite 370, Atlanta, GA, 30329, Georgia
| | - Kirk D Henny
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30333, Georgia
| | - DeMarc A Hickson
- My Brothers' Keeper, 510 George Street, Suite 100, Jackson, MS, 39202, USA.,Us Helping Us, Inc., 3636 Georgia Avenue NW, Washington, DC, 20010, USA
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, National Centers for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-45, Atlanta, GA, 30333, Georgia.,Department of Obstetrics and Gynecology, Morehouse School of Medicine, 80 Jesse Hill Jr. Drive SE, Atlanta, GA, 30303, Georgia
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Henny KD, Drumhiller K, Sutton MY, Nanín J. "My Sexuality…It Creates a Stress": HIV-Related Communication Among Bisexual Black and Latino Men, New York City. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:347-356. [PMID: 30141119 PMCID: PMC6541911 DOI: 10.1007/s10508-018-1264-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/16/2018] [Accepted: 06/21/2018] [Indexed: 06/08/2023]
Abstract
Men who have sex with men and women (including bisexual men) comprise 35% of all men who have sex with men (MSM) in the U.S. It is estimated that 121,800 men who have been bisexually active within the past year are living with HIV in the U.S. Communication about HIV may result in risk-reduction behaviors. However, little is known about the nature or context for HIV prevention communication among bisexual men, particularly for blacks and Hispanic/Latinos who are disproportionately at greater HIV risk. Therefore, we explored patterns and contexts of HIV-related communications occurring within personal social networks among bisexual black and Hispanic/Latino men. Using respondent-driven sampling methods, we conducted semi-structured interviews from 2011 to 2012 among 36 participants living in New York City. We examined interview responses from participants for main themes using computer-assisted thematic analyses. The three main themes identified were: (1) communication strategies (e.g., "You can tell a lot from how a person responds just by the tone of their voice"), (2) barriers (e.g., "My sexuality…it creates a stress"), and (3) motivations for these communications (e.g., "I know that's a(n) issue in the black community…if I could help another brother, I will do it"). Our findings can inform HIV prevention efforts such as social messaging campaigns and other risk-reduction interventions designed for bisexual men.
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Affiliation(s)
- Kirk D Henny
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-45, Atlanta, GA, 30329, USA.
| | - Kathryn Drumhiller
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-45, Atlanta, GA, 30329, USA
- Chenega Professional and Technical Services, Chesapeake, VA, USA
| | - Madeline Y Sutton
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-45, Atlanta, GA, 30329, USA
| | - José Nanín
- Community Health Program at Kingsborough Community College, City University of New York, Brooklyn, NY, USA
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Lauby J, Milnamow M, Joseph HA, Hitchcock S, Carson L, Pan Y, Mendoza M, Millett G. Evaluation of Project RISE, an HIV Prevention Intervention for Black Bisexual Men Using an Ecosystems Approach. AIDS Behav 2018; 22:164-177. [PMID: 28871506 DOI: 10.1007/s10461-017-1892-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Black men who have sex with men and women (MSMW) are among the populations at highest risk for HIV infection. We describe the evaluation of Project RISE, a six-session individual-level intervention developed for black MSMW using an ecosystems approach. A randomized controlled trial was used to test the effect of the intervention on sexual risk outcomes. Eligibility criteria included having both male and female sex partners in the past 12 months. Complete data at 5-month follow-up were collected from 86.7% of the 165 participants. In analyses controlling for HIV status, age, and baseline risk, intervention participants were found to have significantly greater reductions in number of female partners (p < 0.05) and total male and female partners (p < 0.05) at follow-up, compared to the control group. Intervention participants also were significantly more likely to report a reduction in number of sex episodes without a condom with female partners (p < 0.05) and with all partners (p < 0.02) at follow-up, compared to the control group.
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Affiliation(s)
- Jennifer Lauby
- Research & Evaluation Group, Public Health Management Corp., Philadelphia, PA, USA.
- , 84 Peregrine Dr., Voorhees, NJ, 08043, USA.
| | - Mary Milnamow
- Research & Evaluation Group, Public Health Management Corp., Philadelphia, PA, USA
| | | | - Shannon Hitchcock
- Research & Evaluation Group, Public Health Management Corp., Philadelphia, PA, USA
| | - Lee Carson
- The COLOURS Organization, Philadelphia, PA, USA
| | - Yi Pan
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maria Mendoza
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Greg Millett
- amfAR, The Foundation for AIDS Research, Washington, DC, USA
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Joseph HA, Pan Y, Mendoza M, Harawa NT, Lauby J, Hosek SG, Bluthenthal RN, Milnamow M, Fernandez MI, Jeffries WL, Belcher L, Millett GA. HIV Acquisition and Transmission Potential Among African American Men Who Have Sex with Men and Women in Three U.S. Cities. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:183-194. [PMID: 29124541 PMCID: PMC8386249 DOI: 10.1007/s10508-017-1052-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 07/14/2017] [Accepted: 07/24/2017] [Indexed: 06/02/2023]
Abstract
Black men who have sex with men and women (BMSMW) are at increased HIV risk, but few efficacious interventions meet their unique needs. Three HIV prevention interventions were evaluated with a common protocol. Baseline data were pooled to describe sexual behavior involving transmission risk with male, female, and male-to-female transgender partners and identify factors associated with transmission risk. BMSMW from Los Angeles, Philadelphia, and Chicago who reported sexual risk and bisexual behavior in the past year were recruited via modified chain referral sampling and community recruitment. Baseline assessments were conducted via audio computer-assisted interview and sexual behaviors assessed over the past 3 months. From December 2010 to November 2012, 584 BMSMW were enrolled across the three cities. More than half (55%) were recruited by other participants. Overall, the mean age was 43 years. Seventy-five percent reported an annual income <$10,000 and selling sex was prevalent (31%). Three-quarters identified as bisexual. Thirty-nine percent were HIV-positive. Among HIV-positive participants, 46% reported sex without condoms with HIV-negative or unknown male partners and 45% with HIV-negative or unknown female partners. Overall, factors associated with sex without condoms included network size, education, income, sexual orientation identification, HIV status, exchange sex, homonegativity, and social support. Findings support the need for enhanced HIV prevention efforts for this population. Future studies should examine contextual factors in addition to individual risk behaviors to inform the development and implementation of promising strategies to prevent HIV and promote the overall health and wellness of BMSMW and their sexual partners.
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Affiliation(s)
- Heather A Joseph
- Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA.
| | - Yi Pan
- Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA
| | - Maria Mendoza
- Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA
| | - Nina T Harawa
- College of Medicine, Charles Drew University, Los Angeles, CA, USA
| | - Jennifer Lauby
- Public Health Management Corporation, Philadelphia, PA, USA
| | - Sybil G Hosek
- Research Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL, USA
| | - Ricky N Bluthenthal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California , Los Angeles, CA, USA
| | - Mary Milnamow
- Public Health Management Corporation, Philadelphia, PA, USA
| | | | | | - Lisa Belcher
- Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA
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Dyer TV, Khan MR, Sandoval M, Acheampong A, Regan R, Bolyard M, Mateu-Gelabert P, Friedman SR. Drug Use and Sexual HIV Transmission Risk Among Men Who have Sex with Men and Women (MSMW), Men Who have Sex with Men only (MSMO), and Men Who have Sex with Women Only (MSWO) and the Female Partners of MSMW and MSWO: A Network Perspective. AIDS Behav 2017; 21:3590-3598. [PMID: 28229245 DOI: 10.1007/s10461-017-1736-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We described drug use, sex risk, and STI/HIV among men who have sex with men and women (MSMW) and their female partners. We used the Network, Norms and HIV/STI Risk among Youth (NNAHRAY) study to evaluate drug use, sex risk, and biologically-confirmed STI/HIV in (1) MSMW and men who had sex with men only (MSMO) versus men who had sex with women only (MSWO) and (2) female partners of MSMW versus female partners of MSWO (N = 182 men, 152 women). MSMW versus MSWO had 30 to 60% increased odds of substance use, over twice the odds of multiple partnerships, and almost five times the odds of sex trade and HIV infection. Female partners of MSMW versus female partners of MSWO had approximately twice the odds of substance use and 1.5-2 times the odds of multiple partnerships and sex trade. Interventions should address STI/HIV risk among MSMW and their female partners.
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Affiliation(s)
- Typhanye V Dyer
- Department of Epidemiology and Biostatistics, The University of Maryland, 2234FF School of Public Health, College Park, MD, 20742, USA.
| | - Maria R Khan
- Population Health, New York University School of Medicine, New York, NY, USA
| | - Milagros Sandoval
- National Development and Research Institutes Inc., New York, NY, USA
| | - Abenaa Acheampong
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Rotrease Regan
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Melissa Bolyard
- Office of Institutional Research, Planning and Effectiveness, Emory University, Atlanta, GA, USA
| | | | - Samuel R Friedman
- National Development and Research Institutes Inc., New York, NY, USA
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Characteristics and Risk Behaviors of Men Who Have Sex With Men and Women Compared With Men Who Have Sex With Men-20 US Cities, 2011 and 2014. J Acquir Immune Defic Syndr 2017; 75 Suppl 3:S281-S287. [PMID: 28604429 DOI: 10.1097/qai.0000000000001403] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) are heterogeneous with respect to sexual behavior. We examined differences in sex behaviors between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO). METHODS Data for this analysis were from MSM who participated in National HIV Behavioral Surveillance in 2011 and 2014. We used the combined years to evaluate demographic and behavioral differences between MSMW and MSMO. Using log-linked Poisson regression models, adjusted prevalence ratios (aPR) were calculated for behavioral outcomes. RESULTS Overall, 2042 (11.9%) participants were classified as MSMW. MSMW were less likely than MSMO to have condomless sex with male partners [aPR 0.77; 95% confidence interval (CI): 0.74 to 0.81] and to have been diagnosed with another sexually transmitted disease (aPR 0.83; 95% CI: 0.72 to 0.95). MSMW were more likely than MSMO to have given money or drugs for sex (aPR 2.85; 95% CI: 2.52 to 3.24) or received money or drugs for sex (aPR 2.64; 95% CI: 2.37 to 2.93) and to ever have injected drugs (aPR 2.05; 95% CI: 1.80 to 2.34). MSMW had more total sex partners (median 6, interquartile range: 4-11 vs. 3, 2-8), casual sex partners (5, 2-10 vs. 3, 1-7), and condomless sex partners (2, 1-4 vs. 1, 0-2) in the last 12 months (P < 0.01 for all comparisons). CONCLUSIONS MSMW have distinct sexual risk behaviors from MSMO and may contribute to HIV transmission among women. MSMW could benefit from tailored interventions to reduce HIV risk behaviors.
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Socio-demographic Characteristics, Sexual and Test-Seeking Behaviours Amongst Men Who have Sex with Both Men and Women: Results from a Bio-behavioural Survey in 13 European Cities. AIDS Behav 2017. [PMID: 28643241 DOI: 10.1007/s10461-017-1831-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Within the MSM population, men who have sex with both men and women (MSMW) are identified as a high-risk group both worldwide and in Europe. In a multi-centred bio-behavioural cross-sectional study, we aimed to assess the relationship(s) between socio-demographic factors, stigma, sexual behavioural patterns, test seeking behaviour and sero-status amongst MSMW. A multi-level analysis was conducted to identify factors associated with being MSMW versus Men who have Sex with Men Only (MSMO). A total of 4901 MSM were enrolled across the 13 study sites. Participants were categorised as MSMW in the 12.64% of the cases. Factors such as educational status, perceived homonegativity, testing facilities knowledge and HIV testing lifetime seem to be relevant factors when characterising the MSMW group. The results highlight the vulnerability of MSMW and the wide spectrum of risky behavioural and psycho-social patterns, particularly in terms of HIV testing, 'outness', and perceived stigma.
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McCree DH, Oster AM, Jeffries WL, Denson DJ, Lima AC, Whitman H, Ivy W, Henny KD. HIV acquisition and transmission among men who have sex with men and women: What we know and how to prevent it. Prev Med 2017; 100:132-134. [PMID: 28450120 DOI: 10.1016/j.ypmed.2017.04.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 04/13/2017] [Accepted: 04/22/2017] [Indexed: 11/27/2022]
Abstract
Men who have sex with men and women (MSMW) compose a subset of men who have sex with men (MSM) and represent an estimated 35% of MSM. Research on the HIV risk behaviors of MSMW has largely focused on their behaviors in comparison to men who have sex with men only (MSMO). Results suggest that compared to MSMO, MSMW are less likely to have ever had an HIV test, are at greater risk of being unaware of their HIV infection and are less likely to have encountered HIV prevention activities or materials. Additional research is needed to provide a more comprehensive understanding of the unique sexual behaviors and lived experience of MSMW as a group in order to better inform HIV prevention efforts. The purpose of this paper is to summarize existing data and discuss strategies to reduce HIV acquisition and transmission among MSMW.
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Affiliation(s)
- Donna Hubbard McCree
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Alexandra M Oster
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - William L Jeffries
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Damian J Denson
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Ashley C Lima
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Hilary Whitman
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Wade Ivy
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Kirk D Henny
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Baumgartner P, Peiper N. Utilizing Big Data and Twitter to Discover Emergent Online Communities of Cannabis Users. Subst Abuse 2017; 11:1178221817711425. [PMID: 28615950 PMCID: PMC5462814 DOI: 10.1177/1178221817711425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 04/06/2017] [Indexed: 01/15/2023]
Abstract
Large shifts in medical, recreational, and illicit cannabis consumption in the United States have implications for personalizing treatment and prevention programs to a wide variety of populations. As such, considerable research has investigated clinical presentations of cannabis users in clinical and population-based samples. Studies leveraging big data, social media, and social network analysis have emerged as a promising mechanism to generate timely insights that can inform treatment and prevention research. This study extends a novel method called stochastic block modeling to derive communities of cannabis consumers as part of a complex social network on Twitter. A set of examples illustrate how this method can ascertain candidate samples of medical, recreational, and illicit cannabis users. Implications for research planning, intervention design, and public health surveillance are discussed.
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Affiliation(s)
| | - Nicholas Peiper
- Behavioral Health and Criminal Justice Research Division, RTI International, Durham, NC, USA
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Bernard CL, Brandeau ML, Humphreys K, Bendavid E, Holodniy M, Weyant C, Owens DK, Goldhaber-Fiebert JD. Cost-Effectiveness of HIV Preexposure Prophylaxis for People Who Inject Drugs in the United States. Ann Intern Med 2016; 165:10-19. [PMID: 27110953 PMCID: PMC5118181 DOI: 10.7326/m15-2634] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The total population health benefits and costs of HIV preexposure prophylaxis (PrEP) for people who inject drugs (PWID) in the United States are unclear. OBJECTIVE To evaluate the cost-effectiveness and optimal delivery conditions of PrEP for PWID. DESIGN Empirically calibrated dynamic compartmental model. DATA SOURCES Published literature and expert opinion. TARGET POPULATION Adult U.S. PWID. TIME HORIZON 20 years and lifetime. INTERVENTION PrEP alone, PrEP with frequent screening (PrEP+screen), and PrEP+screen with enhanced provision of antiretroviral therapy (ART) for individuals who become infected (PrEP+screen+ART). All scenarios are considered at 25% coverage. OUTCOME MEASURES Infections averted, deaths averted, change in HIV prevalence, discounted costs (in 2015 U.S. dollars), discounted quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. RESULTS OF BASE-CASE ANALYSIS PrEP+screen+ART dominates other strategies, averting 26 700 infections and reducing HIV prevalence among PWID by 14% compared with the status quo. Achieving these benefits costs $253 000 per QALY gained. At current drug prices, total expenditures for PrEP+screen+ART could be as high as $44 billion over 20 years. RESULTS OF SENSITIVITY ANALYSIS Cost-effectiveness of the intervention is linear in the annual cost of PrEP and is dependent on PrEP drug adherence, individual transmission risks, and community HIV prevalence. LIMITATION Data on risk stratification and achievable PrEP efficacy levels for U.S. PWID are limited. CONCLUSION PrEP with frequent screening and prompt treatment for those who become infected can reduce HIV burden among PWID and provide health benefits for the entire U.S. population, but, at current drug prices, it remains an expensive intervention both in absolute terms and in cost per QALY gained. PRIMARY FUNDING SOURCE National Institute on Drug Abuse.
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Affiliation(s)
- Cora L. Bernard
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Margaret L. Brandeau
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Keith Humphreys
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Eran Bendavid
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Mark Holodniy
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Christopher Weyant
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Douglas K. Owens
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Jeremy D. Goldhaber-Fiebert
- From Stanford University, Stanford, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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Zule WA, Oramasionwu C, Evon D, Hino S, Doherty IA, Bobashev GV, Wechsberg WM. Event-level analyses of sex-risk and injection-risk behaviors among nonmedical prescription opioid users. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:689-697. [PMID: 27285847 DOI: 10.1080/00952990.2016.1174706] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Nonmedical prescription opioid use has been linked to hepatitis C virus (HCV) infection among people who inject drugs and with using high dead space syringes that retain more blood and transfer more HIV if shared. Little is known regarding its effects on sex-risk behaviors. OBJECTIVES This paper examines event-level associations between nonmedical prescription opioid use and sharing high dead space syringes (injection risk) and unprotected intercourse (sex risk) behaviors. METHODS We recruited 1,985 participants from two overlapping risk groups-drug users and men who have sex with men (MSM)-and their sex partners. Participants completed an interview that included event-level sex questions with recent sex partners and injection questions with recent injection partners. We used multivariable generalized estimating equations (GEE) to assess the associations between nonmedical prescription opioid use and unprotected intercourse during sexual encounters and sharing syringes during injection episodes, while adjusting for within-person correlations. RESULTS When both partners used nonmedical prescription opioids, its use was independently associated with unprotected intercourse in sexual encounters (OR = 2.24; 95% CI = 1.12, 4.49). The use of nonmedical prescription opioids was also associated with sharing high dead space syringes during injection episodes (OR = 6.57; 95% CI = 1.63, 26.51). CONCLUSION Nonmedical prescription opioid use is associated with an increase in the risk of unprotected sex and sharing high dead space syringes. HIV and HCV prevention interventions for nonmedical prescription opioid users should address sex-risk behaviors and encourage the use of acceptable low dead space needles and syringes.
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Affiliation(s)
- William A Zule
- a Substance Abuse Treatment Evaluations and Interventions Program, RTI International , Research Triangle Park , NC , USA
| | - Christine Oramasionwu
- b UNC Eshelman School of Pharmacy , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Donna Evon
- c Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Sayaka Hino
- c Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Irene A Doherty
- a Substance Abuse Treatment Evaluations and Interventions Program, RTI International , Research Triangle Park , NC , USA
| | - Georgiy V Bobashev
- d Center for Data Science, RTI International , Research Triangle Park , NC , USA
| | - Wendee M Wechsberg
- a Substance Abuse Treatment Evaluations and Interventions Program, RTI International , Research Triangle Park , NC , USA
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18
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Shen H, Tang S, Mahapatra T, Tucker JD, Huang S, Yang B, Zhao J, Detels R, Tang W. Condomless Vaginal Intercourse and Its Associates among Men Who Have Sex with Men in China. PLoS One 2016; 11:e0154132. [PMID: 27115604 PMCID: PMC4846008 DOI: 10.1371/journal.pone.0154132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 04/08/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND HIV prevalence has increased rapidly among men who have sex with men (MSM) in China reaching alarmingly high levels in some cities. Bisexual MSM have potential to transmit HIV and syphilis to their female partners through condomless vaginal intercourse (CVI). Thus, estimation of the burden of CVI and identification of its associates seemed necessary to control this cross-gender transmission. METHOD In a cross-sectional study, using respondent-driven-sampling and snowball sampling, 2958 MSM were recruited from seven Chinese cities, interviewed and tested for HIV and syphilis. Descriptive analysis of the socio-demographic and behaviors followed by simple and multiple logistic regressions [adjusted for income, city, race and social network size to determine adjusted odds ratio (aOR)] were performed using SAS-9.1. RESULTS Among participating MSM, 19.03% were engaged in CVI. Prevalence of HIV and syphilis among participants involved in CVI were 5.86% and 14.74% respectively. MSM who were older [aOR for aged 40-49 = 2.60 (95% CI: 1.54-4.37)], married [aOR = 6.13 (4.95-7.58)], attended primary school or below [aOR = 3.86 (2.26-6.69)], met male partners at spa/bathhouse/sauna/massage parlor [aOR = 3.52 (2.62-4.72)] and had heterosexual orientation [aOR = 13.81 (7.14-26.70)] were more likely to have CVI. Furthermore, correct knowledge regarding HIV [aOR = 0.70 (0.55, 0.88)] and exposure to HIV prevention interventions [aOR = 0.67 (0.54, 0.82)] were negatively associated with CVI. CONCLUSIONS CVI was found to be common among MSM in China. To minimize the transmission of HIV and syphilis from bisexual MSM to their relatively female partners, targeted interventions should specifically focus on bisexual MSM especially the older and married subgroups.
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Affiliation(s)
- Hongcheng Shen
- Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, China
| | - Songyuan Tang
- Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, China
- University of North Carolina, Project-China, Guangzhou, China
| | - Tanmay Mahapatra
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
| | | | - Shujie Huang
- Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, China
| | - Bin Yang
- Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, China
| | - Jinkou Zhao
- Monitoring and Evaluation Unit, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - Roger Detels
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
| | - Weiming Tang
- Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, China
- University of North Carolina, Project-China, Guangzhou, China
- * E-mail:
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Noor SW, Wilkerson JM, Schick V, Iantaffi A. Non-monosexual Partnerships: Information, Motivation and Self-Efficacy among Methamphetamine-Using Men Who Have Sex with Men Who Also Have Sex with Women or Transgender Persons. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2016; 28:205-215. [PMID: 28255423 PMCID: PMC5328189 DOI: 10.1080/19317611.2016.1168903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Sex with more than one gender is associated with higher substance use, and sexual HIV risk. METHODS We examined knowledge, motivation, and self-efficacy to engage in safer substance use and sexual behavior among methamphetamine-using U.S. men who have sex with more than one gender (N=343). RESULTS Almost half(46.2%) of the men reported having sex with a man and a woman or transgender partner in the last 30 days. Compared to monosexual MSM, non-monosexual MSM reported greater condom use self-efficacy however, they reported more sexual partners who inject drugs. CONCLUSION We observed distinct differences between men who do or do not have sex with more than one gender.
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Affiliation(s)
- Syed Wb Noor
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - J Michael Wilkerson
- The University of Texas Health Science Center at Houston (UT Health) School of Public Health, Houston, Texas, USA
| | - Vanessa Schick
- The University of Texas Health Science Center at Houston (UT Health) School of Public Health, Houston, Texas, USA
| | - Alex Iantaffi
- Program in Human Sexuality, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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20
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Crosby RA, Mena L, Geter A, Hickson D. Similarities and Differences in Sexual Risk Behaviors Between Young Black MSM Who Do and Do Not Have Sex with Females. AIDS Behav 2016; 20:717-21. [PMID: 26547716 DOI: 10.1007/s10461-015-1227-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study is to determine whether young Black MSM who also have sex with females report similar levels of sexual risk behaviors as those not having sex with females. YBMSM (N = 400) were recruited from an STI clinic, located in the Southern U.S. Men completed an audio-computer assisted self-interview and donated specimens for STI/HIV testing. Forty-three percent recently engaged in penile-vaginal sex. They were less likely to report having concurrent partners (P = .01), unprotected fellatio (P = .04), multiple partners as a bottom (P < .02), any unprotected anal sex as a bottom (P < .013), and any anal sex (P = .007). They were equally likely to report favorable attitudes toward serosorting (P = .80), multiple male partners as a top (P = .20), unprotected anal insertive sex with males (P = .15). Frequency of sex with males as a top (P = .61) or bottom (P = .61) did not differ. Compared to YBMSM not having sex with females, those having sex with females may be exercising greater caution.
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Affiliation(s)
- Richard A Crosby
- College of Public Health at the University of Kentucky, 151 Washington Ave., Lexington, KY, 40506-0003, USA.
- University of Mississippi Medical Center, Jackson, USA.
| | - Leandro Mena
- University of Mississippi Medical Center, Jackson, USA
| | - Angelica Geter
- College of Public Health at the University of Kentucky, 151 Washington Ave., Lexington, KY, 40506-0003, USA
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21
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Reilly KH, Neaigus A, Wendel T, Marshall DM, Hagan H. Bisexual Behavior Among Male Injection Drug Users in New York City. AIDS Behav 2016; 20:405-16. [PMID: 26607927 DOI: 10.1007/s10461-015-1257-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Drug using men who have sex with men and women (MSMW) may be at high risk for HIV infection and transmitting HIV to sex partners. In 2012, injection drug users (IDUs) were sampled in New York City for the National HIV Behavioral Surveillance cross-sectional study using respondent-driven sampling. Logistic regression was used to calculate crude and adjusted odds ratios (aOR) and 95 % confidence intervals (95 %CI) to determine correlates of bisexual behavior in the past 12 months. Of 333 participants, 47(14.1 %) reported MSMW. Variables independently associated (p < 0.05) with MSMW included bisexual sexual identity (vs. "straight") (adjusted odds ratio (aOR) 92.6; 95 % CI 18.9, 454.5), Bronx residence [vs. Manhattan (aOR 8.4; 95 %CI 1.6,43.7)], past 12 month behaviors of having sex with ≥3 sex partners (aOR 18.1; 95 % CI 3.3,98.4), "sold" sex (aOR 8.5; 95 % CI 2.3, 31.5), "bought" sex (aOR 0.2; 95 % CI 0.1, 0.9), and injection methamphetamine use (aOR 20.5; 95 % CI 3.0, 139.7). MSM IDUs are an important subgroup to consider for HIV interventions, as they may not be reached through HIV prevention programming aimed at MSM.
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Affiliation(s)
- Kathleen H Reilly
- HIV Epidemiology Program, New York City Department of Health and Mental Hygiene, 42-09 28th Street, CN: 22-109, Long Island City, NY, 11101, USA.
| | - Alan Neaigus
- HIV Epidemiology Program, New York City Department of Health and Mental Hygiene, 42-09 28th Street, CN: 22-109, Long Island City, NY, 11101, USA
| | | | - David M Marshall
- Center for HIV Educational Studies & Training, New York, NY, USA
| | - Holly Hagan
- College of Nursing, New York University, New York, NY, USA
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The Role of Syndemic in Explaining Health Disparities Among Bisexual Men: A Blueprint for a Theoretically Informed Perspective. SOCIAL DISPARITIES IN HEALTH AND HEALTH CARE 2016. [DOI: 10.1007/978-3-319-34004-3_4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ludlam AH, Saxton PJW, Dickson NP, Adams J. Respondent-driven sampling among gay and bisexual men: experiences from a New Zealand pilot study. BMC Res Notes 2015; 8:549. [PMID: 26453538 PMCID: PMC4600264 DOI: 10.1186/s13104-015-1449-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 09/16/2015] [Indexed: 11/27/2022] Open
Abstract
Background Respondent-driven sampling (RDS) is a method of approximating random sampling of populations that are difficult to locate and engage in research such as gay, bisexual and other men who have sex with men (GBM). However, its effectiveness among established urban gay communities in high-income countries is largely unexplored outside North America. We conducted a pilot study of RDS among urban GBM in Auckland, New Zealand to assess its local applicability for sexual health research. Findings Pre-fieldwork formative assessment explored RDS suitability among local GBM. Highly-networked initial participants (“seeds”) and subsequent participants completed a questionnaire, took a rectal swab for chlamydia and gonorrhoea testing, and were asked to recruit up to three eligible peers over the subsequent 2 weeks using study coupons. Compensation was given for participating and for each peer enrolled. Feedback on the pilot was obtained through questionnaire items, participant follow-up, and a focus group. Nine seeds commenced recruitment, directly enrolling 10 participants (Wave One), who in turn enrolled a further three (Wave Two). Two of the 22 participants (9 %) had undiagnosed rectal chlamydia. The coupon redemption rate (23 %) was lower than the expected rate (33 %) for this population. Participants were motivated by altruism above financial incentives; however, time, transport and reluctance recruiting peers were perceived as barriers to enrolment. Discussion Slow recruitment in our pilot study suggests that RDS might not be an effective or efficient method of sampling gay men in all high-income urban settings. However those who participated in the pilot were willing to provide anal swabs and information on their sexual behaviour, and also on the size of their GBM social network which is necessary to weight data in RDS. Refinements and adaptations such as reducing the transaction costs of taking part (e.g. offering online participation) could improve responses but these have their own drawbacks (higher set-up costs, difficulty collecting biological specimens).
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Affiliation(s)
- Adrian H Ludlam
- Gay Men's Sexual Health Research Group, Department of Social and Community Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. .,AIDS Epidemiology Group, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
| | - Peter J W Saxton
- Gay Men's Sexual Health Research Group, Department of Social and Community Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. .,AIDS Epidemiology Group, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
| | - Nigel P Dickson
- AIDS Epidemiology Group, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
| | - Jeffery Adams
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand.
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Allen VC, Myers HF, Ray L. The Association Between Alcohol Consumption and Condom Use: Considering Correlates of HIV Risk Among Black Men Who Have Sex with Men. AIDS Behav 2015; 19:1689-700. [PMID: 25935215 PMCID: PMC4553138 DOI: 10.1007/s10461-015-1075-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Epidemiological data indicate Black men who have sex with men (MSM) are the most at-risk group for HIV infection. However, the factors driving this disparity are not fully understood. Condom use remains a significant point of intervention in mitigating sexually transmitted infections. Alcohol consumption is highly prevalent among Black MSM, has a significant role in the culture of sex, and may significantly interfere with condom use. This review will examine the relationship between alcohol consumption and condom use among Black MSM. In this review we, (a) discuss the prevalence of alcohol use among MSM and its association with condom use; (b) consider the role of alcohol in the culture of MSM; (c) review the literature on the relationship between alcohol and condom use; and (d) discuss the role of several empirically-supported moderating variables in strengthening the relationship between alcohol use and noncondom use. This review places the finding and implications for HIV risk among Black MSM in the context of the broader literature on MSM.
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Affiliation(s)
- Vincent C Allen
- Psychology Department, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA,
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25
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Dyer TP, Regan R, Pacek LR, Acheampong A, Khan MR. Psychosocial vulnerability and HIV-related sexual risk among men who have sex with men and women in the United States. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:429-41. [PMID: 25183549 PMCID: PMC4324087 DOI: 10.1007/s10508-014-0346-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 01/31/2014] [Accepted: 01/31/2014] [Indexed: 05/12/2023]
Abstract
In the U.S., HIV is concentrated among men who have sex with men (MSM), some of whom have had female partners (MSMW). MSMW are disproportionately impacted by psychosocial vulnerabilities, like depression and substance use that increase sexually transmitted infection (STI) and HIV risk. Research on psychosocial vulnerability and HIV-related sexual risk among MSMW is warranted to reduce infection transmission among MSM and to prevent bridging to female partners. We analyzed data from Wave IV (2007-2008) of the National Longitudinal Study of Adolescent Health to assess psychosocial vulnerability and HIV risk-taking among MSMW. Using lifetime and past year sexual activity, we classified men as ever having sex with: women only (MSW), men only (MSMO) or MSMW, with further refined categorization of MSMW with male only partners in the past 12 months, only female partners in the past 12 months, and both male and female partners in the past 12 months (N = 6,945). We compared psychosocial vulnerability characteristics and HIV-related risk behaviors among the five categories of men. MSMW were more likely to report depression, suicidality, substance use, and incarceration than MSW and MSMO. Compared to MSW, MSMW with current female partners had greater odds of unprotected sex, exchange sex, and STI. MSMW with male partners in the past year had greater odds of multiple or concurrent partners in the past year. HIV risk and psychosocial vulnerability factors are elevated among MSMW, a priority population for HIV risk reduction. HIV risk reduction interventions should address this and heterogeneity of sexual partnerships among MSMW.
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Affiliation(s)
- Typhanye P Dyer
- Department of Epidemiology and Biostatistics, University of Maryland, 2234FF School of Public Health, College Park, MD, 20742, USA,
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Abstract
Worldwide, men who have sex with men (MSM) remain one of the most HIV-vulnerable community populations. A global public health priority is developing new methods of reaching MSM, understanding HIV transmission patterns, and intervening to reduce their risk. Increased attention is being given to the role that MSM networks play in HIV epidemiology. This review of MSM network research studies demonstrates that: (1) Members of the same social network often share similar norms, attitudes, and HIV risk behavior levels; (2) Network interventions are feasible and powerful for reducing unprotected sex and potentially for increasing HIV testing uptake; (3) HIV vulnerability among African American MSM increases when an individual enters a high-risk sexual network characterized by high density and racial homogeneity; and (4) Networks are primary sources of social support for MSM, particularly for those living with HIV, with greater support predicting higher care uptake and adherence.
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Jeffries WL. Beyond the bisexual bridge: sexual health among U.S. men who have sex with men and women. Am J Prev Med 2014; 47:320-9. [PMID: 24970239 DOI: 10.1016/j.amepre.2014.05.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 03/28/2014] [Accepted: 05/01/2014] [Indexed: 10/25/2022]
Abstract
CONTEXT Men who have sex with both men and women (MSMW) experience health problems in ways that distinguish them from men who only have sex with men (MSM) and men who only have sex with women (MSW). Historically, an undue focus on MSMW's potential role in transmitting HIV to women has resulted in limited understanding of these men's unique sexual health needs. This article discusses the sexual health of MSMW in the U.S. EVIDENCE ACQUISITION The author searched PubMed, Sociological Abstracts, PsycINFO, and GoogleScholar to acquire peer-reviewed studies pertaining to MSMW that were published during January 2008 and December 2013. Reference lists for these studies provided additional studies not acquired through this search. EVIDENCE SYNTHESIS MSMW are more likely than MSW to be infected with HIV. MSMW may be at increased risk for some other sexually transmitted infections (STIs) compared with both MSW and MSM. Some factors that affect their sexual health include unprotected sex, early sexual debut, forced sexual encounters, increased numbers of sexual partners, substance use, exchange sex, risk behaviors of their male and female partners, and pregnancy-related considerations. These factors uniquely shape MSMW's vulnerability to HIV/STIs and other sexual health problems. Anti-bisexual sentiment, socioeconomic marginalization, culturally specific masculine ideologies, and sexual identity can negatively influence their sexual partnerships and likelihood of disease acquisition. CONCLUSIONS Risk-reduction interventions alone are likely insufficient to improve MSMW's sexual health. Efforts should also address the social contexts affecting MSMW in order to decrease HIV/STI vulnerability and mitigate other barriers to MSMW's sexual health.
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Affiliation(s)
- William L Jeffries
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
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Friedman MR, Stall R, Silvestre AJ, Mustanski B, Shoptaw S, Surkan PJ, Rinaldo CR, Plankey MW. Stuck in the middle: longitudinal HIV-related health disparities among men who have sex with men and women. J Acquir Immune Defic Syndr 2014; 66:213-20. [PMID: 24662298 PMCID: PMC4030741 DOI: 10.1097/qai.0000000000000143] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Men who have sex with men and women (MSMW) have been shown in cross-sectional studies to suffer HIV-related health disparities above and beyond those found among men who have sex with men only (MSMO). We conducted a secondary data analysis over a 7-year time frame of participants in the Multicenter AIDS Cohort Study, a long-standing prospective cohort study, to examine whether MSMW had persistently higher rates of depression symptoms, polydrug use, and (among HIV-positive men who have sex with men) HIV viral load levels compared with MSMO. METHODS Men were behaviorally defined as bisexual if they reported sexual activity with at least 1 male and 1 female partner between study waves 38 and 50. We used generalized mixed modeling with repeated measures to test differences in CES-D score, polydrug use, and viral load between sexually active MSMO (n = 1514) and MSMW (n = 111), adjusting for age, income, race/ethnicity, and recent seroconversion. RESULTS MSMW were significantly more likely than MSMO to have higher CES-D scores, polydrug use, and viral load levels (all P < 0.01). Outcome trajectories did not differ significantly over time between these groups. Black and Hispanic HIV-positive MSMW had higher viral load levels relative to white HIV-positive MSMW (P < 0.01). DISCUSSION Compared with MSMO, MSMW in the Multicenter AIDS Cohort Study suffer from profound and persistent HIV-related health disparities across biological, behavioral, and psychosocial domains. Further qualitative and quantitative research contextualizing the pathways underlying these disparities is recommended for intervention development targeting MSMW at risk for HIV acquisition and transmission.
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Affiliation(s)
- M. Reuel Friedman
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ron Stall
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anthony J. Silvestre
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Steve Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Pamela J. Surkan
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Charles R. Rinaldo
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael W. Plankey
- Department of Medicine, Georgetown University Medical Center, Washington, D.C., USA
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Hubach RD, Dodge B, Goncalves G, Malebranche D, Reece M, Van Der Pol B, Martinez O, Schnarrs PW, Nix R, Fortenberry JD. Gender matters: condom use and nonuse among behaviorally bisexual men. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:707-17. [PMID: 23912775 PMCID: PMC3912218 DOI: 10.1007/s10508-013-0147-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 04/29/2013] [Accepted: 04/30/2013] [Indexed: 05/12/2023]
Abstract
Although frequently cited as being at high risk for HIV/STI transmission, little is known about behaviorally bisexual men's patterns and experiences of condom use and nonuse with male and female sexual partners. Using a variety of recruitment techniques informed by a Community Advisory Committee, a total of 77 behaviorally bisexual men were recruited from Indianapolis, Indiana to participate in semi-structured interviews focused on sexual health. Qualitative data were collected containing detailed information on their patterns and experiences of condom use and nonuse with both male and female partners. Participants described numerous commonly reported barriers for consistent condom use, as well as distinct bisexual-specific barriers. The majority reported consistent condom use with male and female casual partners, but many who did not use condoms described doing so in the context of ongoing relationships. In addition, participants provided reasons for condom use and nonuse that varied based on the gender of the partner and the type of relationship with the partner. Future interventions focused on increasing condom use among behaviorally bisexual men should take into account the unique complexities of gender and relationship configurations in this distinct population.
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Affiliation(s)
- Randolph D. Hubach
- Center for Sexual Health Promotion, Department of Applied Health Science, SPH 116, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405
| | - Brian Dodge
- Center for Sexual Health Promotion, Department of Applied Health Science, SPH 116, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405
| | - Gabriel Goncalves
- Center for Sexual Health Promotion, Department of Applied Health Science, SPH 116, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405
| | | | - Michael Reece
- Center for Sexual Health Promotion, Department of Applied Health Science, SPH 116, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405
| | - Barbara Van Der Pol
- Center for Sexual Health Promotion, Department of Applied Health Science, SPH 116, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405
- Department of Epidemiology & Biostatistics, Indiana University, Bloomington, IN
| | - Omar Martinez
- HIV Center for Clinical and Behavioral Studies, Columbia University/New York State Psychiatric Institute, New York, NY
| | | | | | - J. Dennis Fortenberry
- Center for Sexual Health Promotion, Department of Applied Health Science, SPH 116, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405
- Division of Adolescent Medicine, Indiana University, Indianapolis, IN
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Schrimshaw EW, Downing MJ, Cohn DJ, Siegel K. Conceptions of privacy and the non-disclosure of same-sex behaviour by behaviourally-bisexual men in heterosexual relationships. CULTURE, HEALTH & SEXUALITY 2014; 16:351-65. [PMID: 24597480 PMCID: PMC4011836 DOI: 10.1080/13691058.2014.887779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 01/22/2014] [Indexed: 05/26/2023]
Abstract
Little attention has been paid to why some behaviourally-bisexual men (i.e., men who have sex with both men and women) choose not to disclose their same-sex behaviour. Using Communication Privacy Management (CPM) theory, we report on the ways these men conceptualise their same-sex behaviour as private, and thus feel justified in not disclosing it to family, friends and female partners. In-depth interviews were conducted with an ethnically diverse sample of 203 non-disclosing behaviourally-bisexual men in New York City. The men offered a number of privacy rules to justify their non-disclosure, including: (1) their same-sex behaviours were their own business and nobody else's, (2) others had no reason to know, (3) the topic of sexual behaviour was too personal, (4) they were private people in general and (5) it was inappropriate to discuss same-sex behaviour in many contexts. Some privacy rules were used more often to justify non-disclosure to friends and family than to female partners. These findings provide insights into the reasons for non-disclosure among behaviourally-bisexual men, offer support for and extend CPM theory for the management of sexual information and offer insights into the importance of privacy for the design and delivery of health-promotion services for this population.
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Affiliation(s)
- Eric W. Schrimshaw
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | | | - Daniel J. Cohn
- Department of Public Health Sciences, University of Rochester, Rochester, New York, USA
| | - Karolynn Siegel
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA
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Downing MJ, Schrimshaw EW. Self-Presentation, Desired Partner Characteristics, and Sexual Behavior Preferences in Online Personal Advertisements of Men Seeking Non-Gay-Identified Men. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2014; 1:30-39. [PMID: 25750927 DOI: 10.1037/sgd0000022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite attention to the sexual behaviors of non-gay-identified (NGI) men who have same-sex encounters, virtually no research has focused on issues of partner desirability and selection. Limited evidence suggests that a subgroup of men who have sex with men (MSM) advertise online for sexual encounters with NGI men. Exchange theory provided a framework to investigate this seeking of NGI men, based on the content of Internet personal advertisements for same-sex encounters. Researchers analyzed 282 ads posted to an online bulletin board. Ads by men who explicitly desired encounters with NGI men were compared with those by men who did not indicate this preference in potential partners. Multivariate analyses revealed that NGI-seeking men had significantly increased odds of identifying as discreet (Adjusted odds ratio [AOR] = 2.82), seeking a discreet encounter (AOR = 4.68), seeking a masculine partner (AOR = 2.18), being willing to host (AOR = 2.77), as well as seeking oral-receptive sex (AOR = 2.69), unprotected oral sex (AOR = 6.76), and anal-receptive sex (AOR = 2.18). Further, NGI-seeking ads were more likely to not mention condom use or safer sex practices (AOR = 4.13) and were less likely to indicate a desire for oral-insertive sex (AOR = 0.34) and rimming (AOR = 0.21). Findings suggest that some men may deliberately present themselves in ways that they perceive as being attractive to NGI men, and have research implications for NGI MSM, their partners, and the risk outcomes of these online ads.
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Affiliation(s)
- Martin J Downing
- National Development and Research Institutes, Inc., 71 W. 23 St., 4 Floor, New York, NY, 10010, USA. . Ph. 212-845-4410
| | - Eric W Schrimshaw
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168 Street, New York, NY 10032, USA
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Friedman MR, Wei C, Klem ML, Silvestre AJ, Markovic N, Stall R. HIV infection and sexual risk among men who have sex with men and women (MSMW): a systematic review and meta-analysis. PLoS One 2014; 9:e87139. [PMID: 24498030 PMCID: PMC3907399 DOI: 10.1371/journal.pone.0087139] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 12/18/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To estimate the number of men who have sex with men and women who are HIV-positive in the United States, and to compare HIV prevalence rates between men who have sex with men and women, men who have sex with men only, and men who have sex with women exclusively. METHODS Following PRISMA guidelines, we conducted a systematic review and meta-analysis of reports referencing HIV prevalence and men who have sex with men and women. We searched PubMed and Ovid PsycINFO for peer-reviewed, U.S.-based articles reporting on HIV prevalence among men who have sex with men and women. We conducted event rate, effect size, moderation and sensitivity analyses. RESULTS We estimate that 1.0% of U.S. males are bisexually-behaving, and that 121,800 bisexually-behaving men are HIV-positive. Men who have sex with men and women are less than half as likely to be HIV-positive as men who have sex with men only (16.9% vs. 33.3%; OR = 0.41, 95% CI: 0.31, 0.54), but more than five times as likely to be HIV-positive as men who have sex with women exclusively (18.3% vs. 3.5%; OR = 5.71, 95% CI: 3.47, 9.39). They are less likely to engage in unprotected receptive anal intercourse than men who have sex with men only (15.9% vs. 35.0%; OR = 0.36, 95% CI: 0.28, 0.46). Men who have sex with men and women in samples with high racial/ethnic minority proportions had significantly higher HIV prevalence than their counterparts in low racial/ethnic minority samples. CONCLUSIONS This represents the first meta-analysis of HIV prevalence in the U.S. between men who have sex with men and women and men who have sex with men only. Data collection, research, and HIV prevention and care delivery specifically tailored to men who have sex with men and women are necessary to better quantify and ameliorate this population's HIV burden.
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Affiliation(s)
- M. Reuel Friedman
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Center for Lesbian, Gay, Bisexual, and Transgender Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
| | - Chongyi Wei
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Mary Lou Klem
- Center for Lesbian, Gay, Bisexual, and Transgender Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Health Sciences Library System, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Anthony J. Silvestre
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Center for Lesbian, Gay, Bisexual, and Transgender Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Nina Markovic
- Center for Lesbian, Gay, Bisexual, and Transgender Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Ron Stall
- Center for Lesbian, Gay, Bisexual, and Transgender Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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Friedman MR, Kurtz SP, Buttram ME, Wei C, Silvestre AJ, Stall R. HIV risk among substance-using men who have sex with men and women (MSMW): findings from South Florida. AIDS Behav 2014; 18:111-9. [PMID: 23653091 DOI: 10.1007/s10461-013-0495-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Compared with men who have sex with men only (MSMO), men who have sex with men and women (MSMW) consistently report higher rates of two HIV risk behaviors: transactional sex (TS) and concurrent substance use and sex (CSS). Within MSMW, little is known about how synergistic epidemics ("syndemics") affect TS and CSS. Using a sample of substance-using MSM (n = 515) in South Florida, we compared TS and CSS among MSMO and MSMW; examined whether, within MSMW (n = 86), TS and CSS predict unprotected anal intercourse with partners of serodiscordant/unknown HIV status (SU-UAI); and tested whether syndemics predict TS and CSS. MSMW reported higher rates of engaging in both TS and CSS (AOR = 1.7; 95 % CI 1.0-3.0). Within MSMW, engagement in both TS and CSS predicted SU-UAI (AOR = 3.3; 95 % CI 1.2-9.6); and syndemics predicted TS and CSS involvement (p < 0.01). Substance-using MSMW may benefit from interventions targeting TS, CSS, and background syndemics.
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Affiliation(s)
- M Reuel Friedman
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, P.O. Box 7319, Pittsburgh, PA, 15213, USA,
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Eaton LA, Pitpitan EV, Kalichman SC, Sikkema KJ, Skinner D, Watt MH, Pieterse D. Men who report recent male and female sex partners in Cape Town, South Africa: an understudied and underserved population. ARCHIVES OF SEXUAL BEHAVIOR 2013; 42:1299-308. [PMID: 23519592 PMCID: PMC3760968 DOI: 10.1007/s10508-013-0077-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 11/13/2012] [Accepted: 11/17/2012] [Indexed: 05/26/2023]
Abstract
The HIV/AIDS epidemic in South Africa has largely focused on the needs of heterosexual men and women. However, little is known about the sexual risk histories of men who have sex with both men and women (MSMW). Furthermore, we know very little about the psychosocial health needs or of the possibility of a syndemic (numerous interrelated epidemics) among MSMW. We surveyed 1,203 men attending drinking establishments in a township located in Cape Town, South Africa. We compared the behaviors and experiences of MSMW to men reporting only having sex with women (MSW). Twelve percent of the sample reported having sex with both men and women in the past 4 months. MSMW were twice as likely as MSW to report being HIV positive (10.5 vs. 4.6 %). MSW were more likely to be married than MSMW but reported similar numbers of female sex partners. MSMW were more likely to report a history of childhood sexual abuse, recent experienced and perpetrated physical and sexual partner violence, both receiving and giving sex for money, drugs, or shelter, and a recent STI. These factors were found to be interrelated among MSW but not MSMW. Although MSMW demonstrate considerable risk taking and report higher rates of HIV infection than MSW, their needs are largely unmet and underemphasized. Findings suggest the need to better understand factors contributing to sexual risk taking among MSMW. HIV prevention interventions should consider psychosocial health problems unique to MSMW residing in South African townships.
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Affiliation(s)
- Lisa A Eaton
- Center for Health, Intervention and Prevention, University of Connecticut, 2006 Hillside Road, Storrs, CT, 06269-1020, USA,
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Hess KL, Reynolds GL, Fisher DG. Heterosexual anal intercourse among men in Long Beach, California. JOURNAL OF SEX RESEARCH 2013; 51:874-881. [PMID: 24024565 PMCID: PMC3864563 DOI: 10.1080/00224499.2013.809512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Anal intercourse poses a greater risk for human immunodeficiency virus (HIV) transmission than vaginal intercourse, and in recent years there has been a growing understanding that heterosexual anal intercourse (HAI) is not uncommon. However, the majority of the anal intercourse literature has focused on men who have sex with men. The little research on HAI has mostly looked at women, with limited work among men. This analysis examined the association between HAI and high-risk behaviors (N = 1,622) and sexual sensation seeking (N = 239) in a sample of men recruited from 2001 to 2012 in Long Beach, California. Almost half of the sample was non-Hispanic Black. The median age was 42 years, 42% were homeless, and 20% reported recent HAI. Men who reported HAI were likely to be Hispanic, were likely to be homeless, had a male partner, engaged in sex exchange, and used cocaine or amphetamines during sex. Men who reported HAI scored higher on the Sexual Sensation Seeking scale. This research supports other work showing the relationship between HAI and high-risk behaviors. More important, it contributes new knowledge by demonstrating the association between HAI and sexual sensation seeking. This research highlights the importance of personality traits when trying to understand sexual behavior and when developing HIV prevention interventions.
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Affiliation(s)
- Kristen L. Hess
- Center for Behavioral Research and Services, California State University, Long Beach Long Beach, California
| | - Grace L. Reynolds
- Center for Behavioral Research and Services, California State University, Long Beach Long Beach, California
| | - Dennis G. Fisher
- Center for Behavioral Research and Services, California State University, Long Beach Long Beach, California
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Tucker JS, Wenzel SL, Golinelli D, Kennedy DP, Ewing B, Wertheimer S. Understanding heterosexual condom use among homeless men. AIDS Behav 2013; 17:1637-44. [PMID: 22392155 DOI: 10.1007/s10461-012-0165-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study uses an event-based approach to examine individual, relationship, and contextual correlates of heterosexual condom use among homeless men. Structured interviews were conducted with a predominantly African American sample of 305 men recruited from meal lines in the Skid Row area of Los Angeles. Men reported on their most recent heterosexual event involving vaginal or anal intercourse. Adjusting for demographic characteristics only, condom use was more likely when men had higher condom use self-efficacy, greater HIV knowledge, or talked to their partner about condoms prior to sex. Condom use was less likely when men held more negative attitudes towards condoms, the partner was considered to be a primary/serious partner, hard drug use preceded sex, or sex occurred in a public setting. Condom attitudes, self-efficacy, partner type, and communication were the strongest predictors of condom use in a multivariate model that included all of the above-mentioned factors. Associations of unprotected sex with hard drug use prior to sex and having sex in public settings could be accounted for by lower condom self-efficacy and/or less positive condom attitudes among men having sex under these conditions. Results suggest that it may be promising to adapt existing, evidence-based IMB interventions for delivery in non-traditional settings that are frequented by men experiencing homelessness to achieve HIV risk reduction and thus reduce a significant point of disparity for the largely African American population of homeless men.
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Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138, USA.
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Kim EJ, Creswell J, Guardado ME, Shah N, Kim AA, Nieto AI, de Maria Hernandez-Ayala F, Monterroso E, Paz-Bailey G. Correlates of bisexual behaviors among men who have sex with men in El Salvador. AIDS Behav 2013; 17:1279-87. [PMID: 22361925 DOI: 10.1007/s10461-012-0152-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Bisexual behaviors may increase transmission pathways of HIV and sexually transmitted infections (STIs) from a higher prevalence group to lower prevalence groups in El Salvador. In 2008, men who have sex with men (MSM) were recruited in San Salvador and San Miguel using respondent driven sampling. Participants were interviewed and tested for HIV and STIs. Sixteen seeds and 797 MSM participated; 34.9% in San Salvador and 58.8% in San Miguel reported bisexual behavior. Bisexual behavior was associated with drug use (adjusted odds ratio (AOR) = 2.57, 95% CI: 1.30-5.06) and insertive anal sex (AOR = 5.45, 95% CI: 3.01-9.87), and inversely associated with having a stable male partner (AOR = 0.47, 95% CI: 0.26-0.84) and disclosing MSM behavior to family (AOR = 0.41, 95% CI: 0.22-0.75). Bisexual behavior was associated with risk behaviors with male and female partners that may be associated with HIV and STI transmission. Bisexual men displayed a distinct identity calling for tailored interventions.
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Affiliation(s)
- Evelyn J Kim
- Division of Global HIV/AIDS, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-30, Atlanta, GA 30333, USA.
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Sexual Behaviors, Perception of Sexually Transmitted Infection Risk, and Practice of Safe Sex Among Southern African American Women Who Have Sex With Women. Sex Transm Dis 2013; 40:395-400. [DOI: 10.1097/olq.0b013e31828caf34] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Correlates of unprotected vaginal or anal intercourse with women among substance-using men who have sex with men. AIDS Behav 2013; 17:889-99. [PMID: 23229336 DOI: 10.1007/s10461-012-0357-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The role men who have sex with men and women (MSMW) play in heterosexual HIV transmission is not well understood. We analyzed baseline data from Project MIX, a behavioral intervention study of substance-using men who have sex with men (MSM), and identified correlates of unprotected vaginal intercourse, anal intercourse, or both with women (UVAI). Approximately 10 % (n = 194) of the men reported vaginal sex, anal sex, or both with a woman; of these substance-using MSMW, 66 % (129) reported UVAI. Among substance-using MSMW, multivariate analyses found unemployment relative to full/part-time employment (OR = 2.28; 95 % CI 1.01, 5.17), having a primary female partner relative to no primary female partner (OR = 3.44; CI 1.4, 8.46), and higher levels of treatment optimism (OR = 1.73; 95 % CI 1.18, 2.54) increased odds of UVAI. Strong feelings of connection to a same-race gay community (OR = 0.71; 95 % CI 0.56, 0.91) and Viagra use (OR = 0.31; 95 % CI 0.10, 0.95) decreased odds of UVAI. This work suggests that although the proportion of substance-using MSM who also have sex with women is low, these men engage in unprotected sex with women, particularly with primary female partners. This work highlights the need for further research with the substance using MSMW population to inform HIV prevention interventions specifically for MSMW.
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Everett BG. Sexual orientation disparities in sexually transmitted infections: examining the intersection between sexual identity and sexual behavior. ARCHIVES OF SEXUAL BEHAVIOR 2013; 42:225-36. [PMID: 22350122 PMCID: PMC3575167 DOI: 10.1007/s10508-012-9902-1] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 08/27/2011] [Accepted: 12/01/2011] [Indexed: 05/18/2023]
Abstract
The terms MSM (men who have sex with men) and WSW (women who have sex with women) have been used with increasing frequency in the public health literature to examine sexual orientation disparities in sexual health. These categories, however, do not allow researchers to examine potential differences in sexually transmitted infection (STI) risk by sexual orientation identity. Using data from the National Longitudinal Survey of Adolescent Health, this study investigated the relationship between self-reported STIs and both sexual orientation identity and sexual behaviors. Additionally, this study examined the mediating role of victimization and STI risk behaviors on the relationship between sexual orientation and self-reported STIs. STI risk was found to be elevated among heterosexual-WSW and bisexual women, whether they reported same-sex partners or not, whereas gay-identified WSW were less likely to report an STI compared to heterosexual women with opposite sex relationships only. Among males, heterosexual-identified MSM did not have a greater likelihood of reporting an STI diagnosis; rather, STI risk was concentrated among gay and bisexual identified men who reported both male and female sexual partners. STI risk behaviors mediated the STI disparities among both males and females, and victimization partially mediated STI disparities among female participants. These results suggest that relying solely on behavior-based categories, such as MSM and WSW, may mischaracterize STI disparities by sexual orientation.
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Affiliation(s)
- Bethany G Everett
- Institute of Behavioral Science, Population Program, University of Colorado, Campus Box 484, Boulder, CO, 80309-0484, USA.
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Dodge B, Schnarrs PW, Reece M, Martinez O, Goncalves G, Malebranche D, Van Der Pol B, Nix R, Fortenberry JD. Sexual behaviors and experiences among behaviorally bisexual men in the midwestern United States. ARCHIVES OF SEXUAL BEHAVIOR 2013; 42:247-56. [PMID: 22187027 PMCID: PMC3310970 DOI: 10.1007/s10508-011-9878-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 07/11/2011] [Accepted: 10/16/2011] [Indexed: 05/08/2023]
Abstract
Research examining the sexual behaviors and experiences of behaviorally bisexual men is limited. Most studies focus primarily on highlighting sexual risk behaviors among groups of "men who have sex with men (MSM)" or "gay and bisexual men," which may not be appropriate in terms of behaviorally bisexual men's sexual repertoires with both men and women. This study aimed to assess a broad range of sexual behaviors and associated experiences among bisexual men living in the midwestern United States. An interviewer-administered questionnaire containing items from the National Survey of Sexual Health and Behavior assessed lifetime and recent (i.e., past 6 months and last event) sexual behaviors and experiences with both male and female partners among a diverse sample of 75 behaviorally bisexual men. Responses were quantified and analyzed using descriptive and multivariate statistics. A wide range of sexual behaviors with partners of both genders was found. Vaginal intercourse and oral sex with both men and women were the most commonly reported behaviors. Subjective reports of pleasure, arousal, and sexual function during sexual activity were similar with both male and female sexual partners. Many participants reported using condoms during insertive sexual behaviors with male and female partners, but less during oral sex. Unprotected receptive anal sex was less commonly reported. Overall, participants reported a variety of sexual behaviors and experiences; however, unlike other populations, they shared these with partners of both genders. Results have implications for interventions targeting the sexual behaviors and associated issues among behaviorally bisexual men.
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Affiliation(s)
- Brian Dodge
- Center for Sexual Health Promotion, Indiana University, 1025 E. 7th Street, HPER 116, Bloomington, IN, 47405, USA.
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Doherty IA, Serre ML, Gesink D, Adimora AA, Muth SQ, Leone PA, Miller WC. Sexual networks, surveillance, and geographical space during syphilis outbreaks in rural North Carolina. Epidemiology 2012; 23:845-51. [PMID: 23007041 PMCID: PMC4074028 DOI: 10.1097/ede.0b013e31826c2b7e] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sexually transmitted infections (STIs) spread along sexual networks whose structural characteristics promote transmission that routine surveillance may not capture. Cases who have partners from multiple localities may operate as spatial network bridges, thereby facilitating geographical dissemination. We investigated how surveillance, sexual networks, and spatial bridges relate to each other for syphilis outbreaks in rural counties of North Carolina. METHODS We selected from the state health department's surveillance database cases diagnosed with primary, secondary, or early latent syphilis during October 1998 to December 2002 and who resided in central and southeastern North Carolina, along with their sex partners and their social contacts irrespective of infection status. We applied matching algorithms to eliminate duplicate names and create a unique roster of partnerships from which networks were compiled and graphed. Network members were differentiated by disease status and county of residence. RESULTS In the county most affected by the outbreak, densely connected networks indicative of STI outbreaks were consistent with increased incidence and a large case load. In other counties, the case loads were low with fluctuating incidence, but network structures suggested the presence of outbreaks. In a county with stable, low incidence and a high number of cases, the networks were sparse and dendritic, indicative of endemic spread. Outbreak counties exhibited densely connected networks within well-defined geographic boundaries and low connectivity between counties; spatial bridges did not seem to facilitate transmission. CONCLUSIONS Simple visualization of sexual networks can provide key information to identify communities most in need of resources for outbreak investigation and disease control.
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Affiliation(s)
- Irene A Doherty
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Lyons A, Pitts M, Grierson J, Smith A, McNally S, Couch M. Sexual behavior and HIV testing among bisexual men: a nationwide comparison of Australian bisexual-identifying and gay-identifying men. AIDS Behav 2012; 16:1934-43. [PMID: 22290610 DOI: 10.1007/s10461-012-0148-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Men who have sex with men (MSM) are typically studied as though they were a homogeneous population. This has resulted in a lack of knowledge about the sexual health and behavior of bisexual men as distinct from gay men. In this study, patterns of sexual behavior and rates of HIV testing were compared between 854 gay-identifying and 164 bisexual-identifying men who participated in an Australian nationwide online survey. Approximately half of both groups engaged in unprotected anal intercourse (UAI) at their most recent sexual encounter, but bisexual-identifying men were more likely to have had sex with a partner who was either serodiscordant or with whom their seroconcordance was unknown. Despite these patterns, only 62% of bisexual-identifying men had ever been tested for HIV compared to 84% of gay-identifying men. Multivariate logistic regression focused on rates of UAI and HIV testing among bisexual-identifying men. Patterns were similar across all age groups and educational backgrounds. However, bisexual-identifying men were less likely to engage in UAI with a casual partner and were more likely to have been tested for HIV if they had multiple partners or had disclosed their sexual orientation to their social networks. In all, these data reveal important differences between gay- and bisexual-identifying men, particularly with regard to HIV testing, and highlight a need for HIV prevention strategies to focus more strategically on finding ways of promoting safer sex and HIV testing among all MSM.
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Affiliation(s)
- Anthony Lyons
- Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia,
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Schnarrs PW, Dodge B, Reece M, Goncalves G, Martinez O, Van Der Pol B, Malebranche D, Murray M, Nix R, Fortenberry JD. Subjective Sexual Experiences of Behaviorally Bisexual Men in the Midwestern United States: Sexual Attraction, Sexual Behaviors, & Condom Use. JOURNAL OF BISEXUALITY 2012; 12:246-282. [PMID: 22745592 PMCID: PMC3382978 DOI: 10.1080/15299716.2012.674863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Studies concerning behaviorally bisexual men continue to focus on understanding sexual risk in according to a narrow range of sexual behaviors. Few studies have explored the subjective meanings and experiences related to bisexual men's sexual behaviors with both male and female partners. In-depth, semi-structured interviews were conducted with 75 men who engaged in bisexual behavior within the past six months. Participants were asked about their subjective sexual experiences with male and female partners. Findings suggest adherence to normative gender roles, with attraction to men and women conforming to these stereotypes, as well as a segregation of sexual behaviors along gendered lines. Overall, condom use was influenced by perceptions of potential negative consequences. Based on these findings, it remains critical that public health and other social and behavioral sciences continue to study bisexual men's sexual health issues as separate and distinct from their exclusively homosexual and heterosexual counterparts.
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Affiliation(s)
- Phillip W. Schnarrs
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
| | - Brian Dodge
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
| | - Michael Reece
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
| | - Gabriel Goncalves
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
| | - Omar Martinez
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
| | - Barbara Van Der Pol
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
- Indiana University, Department of Kinesiology, Bloomington, IN, USA
- Indiana University, Division of Infectious Diseases, Indianapolis, IN, USA
| | | | - Maresa Murray
- Indiana University, Department of Applied Health Science, Bloomington, IN, USA
| | - Ryan Nix
- Step Up, Inc., Indianapolis, IN, USA
| | - J. Dennis Fortenberry
- Indiana University, Center for Sexual Health Promotion, Bloomington, IN, USA
- Indiana University, Division of Adolescent Medicine, Indianapolis, IN, USA
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Tieu HV, Spikes P, Patterson J, Bonner S, Egan JE, Goodman K, Stewart K, Frye V, Xu G, Hoover DR, Koblin BA. Sociodemographic and risk behavior characteristics associated with unprotected sex with women among black men who have sex with men and women in New York City. AIDS Care 2012; 24:1111-9. [PMID: 22533637 PMCID: PMC3704079 DOI: 10.1080/09540121.2012.672723] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The objectives of this cross-sectional study were to compare sociodemographic and risk behavior characteristics between black men who have sex with both men and women (MSMW) and those who have sex with men only (MSMO) and assess factors associated with having any unprotected vaginal and/or anal intercourse (UVAI) with women in the last 3 months. Data from 326 black men who reported recent unprotected anal intercourse with a man in an HIV behavioral intervention study in New York City were analyzed. Baseline characteristics were compared between MSMW and MSMO, and factors associated with having any UVAI in the past 3 months with women among MSMW were evaluated. In total, 26.8% reported having sex with both men and women in the last 3 months. MSMW were less likely to be HIV infected, use amyl nitrates, and have unprotected receptive anal sex with most recent male partner. MSMW were more likely to be over 40 years old and use heroin. A total of 55.6% of MSMW reported having UVAI with women in the last 3 months. Compared to MSMW having only protected sex, MSMW having any UVAI with women were less likely to be HIV infected and to disclose having sex with men to female partners; they were more likely to have greater than four male sex partners in the last 3 months. In conclusion, HIV prevention interventions among black MSMW should directly address the risk of HIV transmission to both their female and male partners. Disclosure of bisexuality to female partners may be an important component of future prevention efforts.
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Affiliation(s)
- Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, USA.
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Guo Y, Li X, Song Y, Liu Y. Bisexual behavior among Chinese young migrant men who have sex with men: implications for HIV prevention and intervention. AIDS Care 2011; 24:451-8. [PMID: 22085021 DOI: 10.1080/09540121.2011.613914] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Data from 307 young migrant men who have sex with men (MSM) in Beijing were analyzed to examine bisexual behavior and the associated sociodemographic and behavioral factors among Chinese young migrant MSM. More than one-fourth (27%) of the MSM were also concurrently engaged in sexual behavior with women (MSMW). Among MSMW, 8.4% were infected with HIV, and 10.8% with Syphilis, compared to 4.9% and 23.7%, respectively, among men who have sex with men only (MSM-only). Various HIV-related risk behaviors among MSMW were similar to those of MSM-only, such as unprotected anal sex, multiple sexual partners, involvement in commercial sex, and substance use. Compared with MSM-only, MSMW were less likely to have tested for HIV, to participate in HIV prevention activities, and were less knowledgeable about condom use and HIV/AIDS. MSMW also had a higher rate of unprotected sex with female stable sexual partners than with male stable sexual partners (79.5% vs. 59.5%). Results indicated that MSMW were at a very high risk for both HIV infection and transmission. Intervention efforts are needed to target this subgroup of MSM and promote AIDS knowledge and HIV/STD testing among MSMW, and to reduce HIV transmission through MSM's bisexual behavior.
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Affiliation(s)
- Yan Guo
- Carman and Ann Adams Department of Pediatrics, Pediatric Prevention Research Center, Wayne State University School of Medicine, Detroit, MI, USA.
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Latkin C, Yang C, Tobin K, Penniman T, Patterson J, Spikes P. Differences in the social networks of African American men who have sex with men only and those who have sex with men and women. Am J Public Health 2011; 101:e18-23. [PMID: 21852650 DOI: 10.2105/ajph.2011.300281] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared social network characteristics of African American men who have sex with men only (MSMO) with social network characteristics of African American men who have sex with men and women (MSMW). METHODS Study participants were 234 African American men who have sex with men who completed a baseline social network assessment for a pilot behavioral HIV prevention intervention in Baltimore, Maryland, from 2006 through 2009. We surveyed the men to elicit the characteristics of their social networks, and we used logistic regression models to assess differences in network characteristics. RESULTS MSMO were significantly more likely than were MSMW to be HIV-positive (52% vs 31%). We found no differences between MSMO and MSMW in the size of kin networks or emotional and material support networks. MSMW had denser sexual networks, reported more concurrent and exchange partners, used condoms with more sexual partners, and reported interaction with a larger number of sexual partners at least once a week. CONCLUSIONS Although there were many similarities in the social and sexual network characteristics of MSMO and MSMW, differences did exist. HIV prevention interventions should address the unique needs of African American MSMW.
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Affiliation(s)
- Carl Latkin
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, Hampton House, 624 North Broadway, Room 737, Baltimore, MD 21205.
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Bobashev GV, Zule WA. Modeling the effect of high dead-space syringes on the human immunodeficiency virus (HIV) epidemic among injecting drug users. Addiction 2010; 105:1439-47. [PMID: 20528817 DOI: 10.1111/j.1360-0443.2010.02976.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIMS To illustrate the impact of different proportions of injecting drug users (IDUs) sharing high dead-space syringes (HDSS) or low dead-space syringes (LDSS) on the probability of human immunodeficiency virus (HIV) transmission; and thus the impact on injection-related HIV prevalence and incidence. DESIGN A stochastic mathematical model was used to evaluate the impact of HDSS use in high- and low-risk IDU populations. Model parameters were obtained from peer-reviewed publications. Analytical solutions of a simplified deterministic model were obtained to explain the effect of HDSS on HIV endemic states. FINDINGS Simulation analysis shows that the HIV epidemic could be sustained even when a small percentage of sharing (10%) involved HDSS. The effect is much stronger in high-risk compared with low-risk populations. Steady state HIV prevalence increases with the proportion of HDSS, and for high- and low-risk populations reaches around 80% and 20%, respectively. For low-risk populations, the use of LDSS could result in the virtual elimination of HIV. These results are dependent upon an evidence-supported assumption of a significant difference in HIV transmission risk associated with HDSS versus LDSS. CONCLUSIONS Our models suggest that injection-related HIV epidemics may not occur when most (e.g. 95% or more) IDUs use LDSS. While these results are based on indirect risk measures and a number of simplifying assumptions, the effect of blood retained in high dead-space syringes on HIV prevalence seems to be very strong, even using relatively conservative assumptions. The findings have potential implications for needle exchange programs and the types of syringes produced and distributed world-wide.
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Affiliation(s)
- Georgiy V Bobashev
- RTI International, Statistics and Epidemiology, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA.
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Zule WA, Coomes CM, Karg R, Harris JL, Orr A, Wechsberg WM. Using a modified intervention mapping approach to develop and refine a single-session motivational intervention for methamphetamine-using men who have sex with men. Open AIDS J 2010; 4:132-40. [PMID: 20657716 PMCID: PMC2908891 DOI: 10.2174/1874613601004030132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 11/15/2009] [Accepted: 11/25/2009] [Indexed: 11/22/2022] Open
Abstract
There is an ongoing need for the development and adaptation of behavioral interventions to address behaviors related to acquisition and transmission of infectious diseases and for preventing the onset of chronic diseases. This paper describes the application of an established systematic approach to the development of a behavioral intervention to reduce sexual risk behaviors for HIV among men who have sex with men and who use methamphetamine. The approach includes six steps: (1) a needs assessment; (2) preparing matrices of proximal program objectives; (3) selecting theory-based methods and practical strategies; (4) producing program components and materials; (5) planning for program adoption, implementation, and sustainability; and (6) planning for evaluation. The focus of this article is on the intervention development process; therefore the article does not describe steps 5 and 6. Overall the process worked well, although it had to be adapted to fit the sequence of events associated with a funded research project. This project demonstrates that systematic approaches to intervention development can be applied even in research projects where some of the steps occur during the proposal writing process rather than during the actual project. However, intervention developers must remain flexible and be prepared to adapt the process to the situation. This includes being ready to make choices regarding intervention efficacy versus feasibility and being willing to select the best intervention that is likely to be delivered with available resources rather than an ideal intervention that may not be practical.
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Affiliation(s)
- William A Zule
- Behavioral Health and Criminal Justice Research Division, RTI International, 3040 Cornwallis Rd., Research Triangle Park, NC 27709-2194, USA
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