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Piersiala K, Krajewski J, Dadej D, Loroch A, Czerniak W, Rozpłochowski B, Kierepa A, Mozer-Lisewska I. Correlates of inconsistent condom use and drug use among men having sex with men in Poland: a cross-sectional study. Int J STD AIDS 2021; 31:894-902. [PMID: 32702284 PMCID: PMC7750669 DOI: 10.1177/0956462420929136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The number of new human immunodeficiency virus (HIV) diagnoses is rising in many
parts of Europe. We sought to evaluate the rising prevalence of new HIV
diagnoses in Poland, where the majority of newly-diagnosed HIV cases are men
having sex with men (MSM). This study aims to measure the prevalence of condom
use and drug use and to identify risk factors for contracting sexually
transmitted infections (STIs) among MSM in Poland by distributing an anonymous
online survey aimed toward MSM. Among the 1438 participants who completed valid
surveys, those with low education level and greater than 100 prior sexual
partners showed the highest odds for inconsistent condom use (adjusted odds
ratio [aOR] 3.027, 2.044, respectively). Participants who identified themselves
as heterosexuals, with multiple sexual partners and living in big cities showed
the highest odds for drug use (aOR 4.869, 3.305, 1.720, respectively). This
study identifies groups at the highest risk of HIV/STIs and provides valuable
information for public health experts to develop targeted STI prevention
campaigns.
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Affiliation(s)
- Krzysztof Piersiala
- Student Research Group at the Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland.,Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Joanna Krajewski
- Student Research Group at the Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Daniela Dadej
- Student Research Group at the Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Anna Loroch
- Student Research Group at the Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Witold Czerniak
- Student Research Group at the Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Błażej Rozpłochowski
- Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Agata Kierepa
- Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Iwona Mozer-Lisewska
- Department of Infectious Diseases, Hepatology and Acquired Immunodeficiencies, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
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2
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Singleton AL, Marshall BD, Zang X, Nunn AS, Goedel WC. Added Benefits of Pre-Exposure Prophylaxis Use on HIV Incidence with Minimal Changes in Efficiency in the Context of High Treatment Engagement Among Men Who Have Sex with Men. AIDS Patient Care STDS 2020; 34:506-515. [PMID: 33216618 DOI: 10.1089/apc.2020.0151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Although there is ongoing debate over the need for substantial increases in pre-exposure prophylaxis (PrEP) use when antiretroviral treatment confers the dual benefits of reducing HIV-related morbidity and mortality and the risk of HIV transmission, no studies to date have quantified the potential added benefits of PrEP use and changes in its efficiency in the context of high treatment engagement across multiple US subpopulations. We used a previously published agent-based model to simulate HIV transmission in a dynamic network of Black/African American and White men who have sex with men (MSM) in Atlanta, Georgia (2015-2024) to understand how reductions in HIV incidence attributable to varying levels of PrEP use change when United Nations Joint Programme on HIV/AIDS (UNAIDS) "90-90-90" goals for HIV treatment are achieved and maintained. Even at achievement of "90-90-90" goals, 75% PrEP coverage further reduced incidence by 67.9% and 74.2% to 1.53 [simulation interval (SI): 1.39-1.70] and 0.355 (SI: 0.316-0.391) per 100 person-years for Black/African American and White MSM, respectively, compared with the same scenario with no PrEP use. Increasing PrEP coverage from 15% to 75% under "90-90-90" goals only increased the number of person-years of PrEP use per infection averted by 8.1% and 10.5% to 26.7 (SI: 25.6-28.0) and 73.3 (SI: 70.6-75.7) among Black/African American MSM and White MSM, respectively. Even with high treatment engagement, substantial expansion of PrEP use contributes to meaningful decreases in HIV incidence among MSM with minimal changes in efficiency.
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Affiliation(s)
- Alyson L. Singleton
- Department of Biostatistics, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Brandon D.L. Marshall
- Department of Epidemiology, and School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Xiao Zang
- Department of Epidemiology, and School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Amy S. Nunn
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - William C. Goedel
- Department of Epidemiology, and School of Public Health, Brown University, Providence, Rhode Island, USA
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3
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Reynolds GL, Fisher DG, Erlyana E, Otterloo LV. Rectal douching in a community sample of men and women. Int J STD AIDS 2020; 31:1082-1092. [PMID: 32914687 DOI: 10.1177/0956462419837483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rectal douching (RD) may be a vector for sexually transmitted infection (STI) acquisition. The aim of this study was to describe the relationship between RD, and the prevalence of various STIs and sexual behaviors in a sample of women and men in Long Beach, California. Five hundred and forty-seven men (mean age 42.8 years) and 530 women (mean age 37 years) recruited from a community-based setting between April 2010 and August 2014 completed the Risk Behavior Assessment and a questionnaire eliciting information on use of lubricants and enemas for vaginal intercourse (VI) and anal intercourse (AI). Participants were screened for high-risk behaviors for human immunodeficiency virus infection including injection drug use. Bivariate analyses were conducted separately for women and men. Based on the empirical results, separate logistic regression models for women and men were constructed. Sensitivity analysis was conducted to assess model fit for reduced samples of only those men and women who reported AI. For men, RD was associated with a lower odds of being hepatitis C antibody positive, greater odds of being positive for hepatitis B virus surface antigen, syphilis, and using lubricants for receptive anal intercourse (RAI). RD in women was associated with higher odds of a positive test for syphilis, ever vaginally douching for VI, and using lubricants for RAI. Men and women who practice RD report positive syphilis test results and use of lubricants for RAI. RD should not be perceived as preventing STIs.
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Affiliation(s)
- Grace L Reynolds
- Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA.,Center for Behavioral Research and Services, Psychology Department, California State University, Long Beach, CA, USA
| | - Dennis G Fisher
- Center for Behavioral Research and Services, Psychology Department, California State University, Long Beach, CA, USA.,Center for Behavioral Research and Services, Department of Health Care Administration, California State University, Long Beach, CA, USA
| | - Erlyana Erlyana
- Department of Health Care Administration, Center for Behavioral Research and Services, California State University, Long Beach, CA, USA.,Center for Behavioral Research and Services, Psychology Department, California State University, Long Beach, CA, USA
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4
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Wray TB, Monti PM. Characteristics of Sex Events, Partners, and Motivations and Their Associations with HIV-Risk Behavior in a Daily Diary Study of High-Risk Men Who Have Sex with Men (MSM). AIDS Behav 2020; 24:1851-1864. [PMID: 31832855 PMCID: PMC7228849 DOI: 10.1007/s10461-019-02760-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the United States, men who have sex with men (MSM) continue to be at high-risk for HIV and other STIs, and condoms represent the most popular, affordable, and accessible method of prevention. Although a vast body of research has explored various factors associated with condom use in MSM, fewer studies have explored situation-level characteristics that affect their decisions about sex partners and condom use. Daily diary studies are well-suited to help improve our understanding of these event-level factors in detail, including the sex events themselves, partner characteristics, and motivations. As part of a larger study using ecological momentary assessment methods, high-risk MSM completed daily diary surveys about their sexual behavior on their smartphones each day for 30 days. This study explored detailed descriptive characteristics of sex events, partner characteristics, and motivations for sex and condom use, and examined whether specific aspects of these characteristics were associated with having condomless anal sex (CAS) with high-risk partners. High-risk CAS was common among MSM, with the majority of participants having met their partners online and many reporting sex the same day they met. Results showed that the odds of CAS were not higher with partners met online versus those met in other ways, but MSM were more likely to have asked online partners about their HIV status and testing history before sex. The odds of engaging in high-risk CAS was higher when MSM reported intimacy or self-assurance motives. Not having condoms readily available was a CAS motivation reported more commonly when MSM had sex with high-risk partners. Findings suggest that interventions should incorporate strategies that help MSM be safer specifically when meeting partners online and when having sex for intimacy or re-assurance. Interventions that remind MSM to carry condoms at opportune moments may also help reduce some HIV risk.
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Affiliation(s)
- Tyler B Wray
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, Providence, RI, 02906, USA.
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912, USA.
| | - Peter M Monti
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, Providence, RI, 02906, USA
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5
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HIV Prevention Method Preferences Within Sexual Partnerships Reported by HIV-Negative MSM and TW in Tijuana, Mexico. AIDS Behav 2020; 24:839-846. [PMID: 30945030 DOI: 10.1007/s10461-019-02492-x] [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: 10/27/2022]
Abstract
To assess the potential for decreased condom use as pre-exposure prophylaxis (PrEP) is scaled-up in Latin America, we examined HIV prevention method preferences (neither PrEP nor condoms, condoms only, PrEP only, or PrEP with condoms) within 1302 sexual partnerships reported by 397 HIV-negative men who have sex with men (MSM) and transgender women (TW) in Tijuana, Mexico. Using PrEP with condoms (56%) was preferred to using condoms only (24%), using PrEP only (17%), and using neither PrEP nor condoms (3%). Compared to using condoms only, using PrEP only was preferred within primary (adjusted odds ratio [AOR] = 4.13, 95% confidence interval [CI] 1.92, 8.90) and condomless sex practicing (AOR = 6.97, 95% CI 3.92, 12.40) partnerships, suggesting PrEP use may not displace condom use among MSM and TW in Tijuana and other similar settings.
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6
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Chan PA, Goedel WC, Nunn AS, Sowemimo-Coker G, Galárraga O, Prosperi M, Patel R, Mena L, Montgomery MC, Marshall BD. Potential Impact of Interventions to Enhance Retention in Care During Real-World HIV Pre-Exposure Prophylaxis Implementation. AIDS Patient Care STDS 2019; 33:434-439. [PMID: 31584857 DOI: 10.1089/apc.2019.0064] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Pre-exposure prophylaxis (PrEP) has the potential to significantly reduce HIV incidence among men who have sex with men (MSM) in the United States. However, the extent to which suboptimal PrEP adherence and retention in care may limit successful implementation is unknown. An agent-based model was used to represent the entire population of MSM in Rhode Island from 2013 to 2017. The impact of potential interventions to improve PrEP adherence and retention in care on HIV transmission was evaluated. Demographics, behaviors, and PrEP adherence and retention in care rates were based on local clinical data. We assumed that 20% of HIV-negative MSM had ever taken PrEP. The primary outcome was HIV incidence over the 5-year period. The model included 23,815 MSM with an estimated 4.1% HIV prevalence based on local surveillance data. An estimated 173.1 new infections occurred over 5 years [95% simulation interval (SI): 171.5-174.7], including 29.1 new infections among individuals who had ever initiated PrEP (95% SI: 28.6-29.7). Interventions that improved retention in PrEP care by an odds of 5.0 compared with the base case maximized reductions in HIV incidence among MSM who had ever initiated PrEP by 37.5%. Interventions focusing on improving PrEP adherence had little to no effect on HIV incidence, regardless of intervention efficacy. Retention in care is a critical component of the PrEP care continuum. Interventions that improve retention in PrEP care may lead to greater reductions in population-level HIV incidence compared with interventions focused exclusively on adherence.
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Affiliation(s)
- Philip A. Chan
- Department of Medicine, Brown University, Providence, Rhode Island
- Department of Behavioral and Social Sciences, Policy and Practice, Brown University, Providence, Rhode Island
| | - William C. Goedel
- Department of Epidemiology, and Policy and Practice, Brown University, Providence, Rhode Island
| | - Amy S. Nunn
- Department of Behavioral and Social Sciences, Policy and Practice, Brown University, Providence, Rhode Island
| | | | - Omar Galárraga
- Department of Health Services, Policy and Practice, Brown University, Providence, Rhode Island
| | - Mattia Prosperi
- Department of Epidemiology, University of Florida, Gainesville, Florida
| | - Rupa Patel
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - Leandro Mena
- Department of Population Health Science, University of Mississippi, Jackson, Mississippi
| | | | - Brandon D.L. Marshall
- Department of Epidemiology, and Policy and Practice, Brown University, Providence, Rhode Island
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Swann G, Newcomb ME, Crosby S, Mroczek DK, Mustanski B. Historical and Developmental Changes in Condom Use Among Young Men Who Have Sex with Men Using a Multiple-Cohort, Accelerated Longitudinal Design. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1099-1110. [PMID: 30888554 PMCID: PMC6532987 DOI: 10.1007/s10508-019-1407-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/04/2019] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
Young men who have sex with men (YMSM) have the highest HIV incidence in the U.S. The last 5 years has seen emergence of new methods for HIV prevention and societal shifts in gay rights. It is important to understand if there have been generational shifts in condom use during the developmental transition from adolescents to young adulthood. To disentangle history from development, we require a multiple-cohort, longitudinal design-a methodology never before applied to study YMSM. We followed three cohorts of YMSM recruited in 2007, 2010, and 2015 (N = 1141) from the ages of 17-26 years and modeled their longitudinal change over time in counts of anal sex acts and the ratio of condomless anal sex (CAS) acts to anal sex acts using latent curve growth modeling. We found that there was no significant developmental change in raw counts of anal sex acts, but there was a significant decline in the ratio of anal sex acts that were condomless. We also found significantly different patterns for ratio of CAS acts for the 2015 cohort. The 2015 cohort reported a significantly lower ratio of CAS acts at age 17, but significantly higher growth in ratio of CAS acts over development. The present study suggests that YMSM recruited in 2015 have very different trajectories of CAS compared to previous cohorts, including lower risk in late adolescence, but with the potential for higher risk after the transition into adulthood.
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Affiliation(s)
- Gregory Swann
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
| | - Shariell Crosby
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
- Department of Psychology, Northwestern University Weinberg College of Arts & Sciences, Evanston, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA.
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8
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Goedel WC, King MR, Lurie MN, Nunn AS, Chan PA, Marshall BD. Effect of Racial Inequities in Pre-exposure Prophylaxis Use on Racial Disparities in HIV Incidence Among Men Who Have Sex With Men: A Modeling Study. J Acquir Immune Defic Syndr 2018; 79:323-329. [PMID: 30044303 PMCID: PMC6342014 DOI: 10.1097/qai.0000000000001817] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Pre-exposure prophylaxis (PrEP) uptake has been slow among African American men who have sex with men (AAMSM) in the United States. We used an agent-based model (ABM) to simulate race-specific PrEP coverage to estimate their impact on racial disparities in HIV incidence among MSM in Atlanta, GA. METHODS An ABM was constructed to simulate HIV transmission in a dynamic network of 10,000 MSM over 10 years, beginning in 2015. We modeled a base scenario with estimated PrEP coverage of 2.5% among AAMSM and 5.0% among white MSM (WMSM). We then compared HIV incidence over 10 years and calculated a disparity ratio of AAMSM to WMSM incidence rates across varying PrEP scale-up scenarios, with equal and unequal coverage among AAMSM and WMSM. RESULTS Assuming current coverage remains constant, the model predicts HIV incidence rates of 2.95 and 1.76 per 100 person-years among AAMSM and WMSM, respectively, with a disparity ratio of 1.68. If PrEP coverage was to increase 6-fold without addressing inequities in PrEP uptake, the model predicts incidences of 2.65 and 1.34, corresponding to a mean decrease of 10.4% and 24.0% in HIV incidence, respectively. This stronger benefit for WMSM increased the disparity ratio to 1.98. Equal PrEP coverage among AAMSM and WMSM resulted in lower incidence rates overall with lower disparity ratios. CONCLUSIONS Lower uptake among AAMSM relative to WMSM may limit the population-level impact of PrEP use among AAMSM, which may ultimately culminate in wider racial disparities in HIV incidence among MSM.
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Affiliation(s)
- William C. Goedel
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
| | - Maximilian R.F. King
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
| | - Mark N. Lurie
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
| | - Amy S. Nunn
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
| | - Philip A. Chan
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI
- Division of Infectious Diseases, The Miriam Hospital, Providence, RI
| | - Brandon D.L. Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
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9
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Dubov A, Galbo P, Altice FL, Fraenkel L. Stigma and Shame Experiences by MSM Who Take PrEP for HIV Prevention: A Qualitative Study. Am J Mens Health 2018; 12:1843-1854. [PMID: 30160195 PMCID: PMC6199453 DOI: 10.1177/1557988318797437] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Pre-exposure prophylaxis (PrEP) uptake has been extremely low among key groups. PrEP-related stigma and shaming are potential barriers to uptake and retention in PrEP programs. There is a lack of literature describing PrEP stigma. In order to fill this gap, we recruited online 43 HIV-negative Men who have Sex with Men (MSM) who use PrEP. Semistructured interviews were conducted to explore their perceptions and experience of stigma related to PrEP use. Data were analyzed using Strauss and Corbin's grounded theory and constant comparison techniques to enhance understanding of the lived experiences of MSM who use PrEP. The participants experienced PrEP stigma as rejection by potential/actual partners, stereotypes of promiscuity or chemsex, and labeling of both the user and the medication. They connected PrEP stigma with HIV stigma, generational differences, moralization of condom use, and inability to embrace one's own sexuality. These findings point to a need to develop tailored interventions to address PrEP-related stigma and shaming for individuals, health-care professionals, and the MSM community-at-large.
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Affiliation(s)
- Alex Dubov
- 1 Assistant Professor, Loma Linda University School of Public Health, Sanitarium Dr. Loma Linda, CA, USA
| | - Phillip Galbo
- 2 Department of Neuro-Oncology, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, USA
| | - Frederick L Altice
- 3 Professor of Medicine and Public Health, Director of Clinical and Community Research, Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA
| | - Liana Fraenkel
- 4 Professor of Medicine, Yale University School of Medicine, Section of Rheumatology, New Haven, CT, USA
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10
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Gantenberg JR, King M, Montgomery MC, Galárraga O, Prosperi M, Chan PA, Marshall BDL. Improving the impact of HIV pre-exposure prophylaxis implementation in small urban centers among men who have sex with men: An agent-based modelling study. PLoS One 2018; 13:e0199915. [PMID: 29985949 PMCID: PMC6037355 DOI: 10.1371/journal.pone.0199915] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 06/15/2018] [Indexed: 11/28/2022] Open
Abstract
Objectives Identifying prescribing strategies that improve the efficiency of PrEP should increase its impact at the population level. This study identifies PrEP allocation criteria that most effectively reduce 10-year HIV incidence by 25%, in accordance with the US National HIV/AIDS Strategy’s goal for the proportionate reduction in new diagnoses. Methods We used a discrete-time stochastic agent-based model to simulate several PrEP engagement strategies. The model represented MSM aged 15–74 in Rhode Island and was calibrated to statewide prevalence from 2009–2014. We simulated HIV transmission in the absence of PrEP and compared the following PrEP engagement scenarios: 1) allocation to the current patient population; 2) random allocation; 3) allocation to MSM with greater than 5 sexual partners in one year; 4) allocation to MSM with greater than 10 sexual partners in one year. For each scenario and coverage level we estimated the number and proportion of infections averted and the person-years on PrEP per averted infection. Results In 2014, HIV prevalence before PrEP implementation was between 4% and 5%. In the No PrEP scenario 826 new infections (95% simulation limits [SL]: 711, 955) occurred over 10 years, with an incidence rate of 3.51 per 1000 person-years (95% SL: 3.00, 4.08). Prevalence rose to 7.4% (95% SL: 6.7, 8.1). None of the PrEP scenarios reduced new HIV infections by 25% while covering less than 15% of the HIV-uninfected population. At 15% coverage, allocating PrEP to the current patient population, MSM with greater than 5 sexual partners in a year, and MSM with greater than 10 partners reduced new infections by at least 25%, requiring 161 (95% SL: 115, 289), 150 (95% SL: 107, 252), and 128 (95% SL: 100, 184) person-years on PrEP per averted infection, respectively. Conclusions Engaging MSM with high numbers of sexual partners would improve the population-level impact and efficiency of PrEP in settings where PrEP coverage remains low. However, the sustained population-level PrEP coverage needed to reduce new infections by 25% is substantially higher than current levels of PrEP uptake.
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Affiliation(s)
- Jason R. Gantenberg
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
| | - Maximilian King
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
| | | | - Omar Galárraga
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, United States of America
| | - Mattia Prosperi
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Philip A. Chan
- Department of Medicine, Brown University, Providence, RI, United States of America
| | - Brandon D. L. Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
- * E-mail:
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11
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Jeffries WL, Greene KM, Paz-Bailey G, McCree DH, Scales L, Dunville R, Whitmore S. Determinants of HIV Incidence Disparities Among Young and Older Men Who Have Sex with Men in the United States. AIDS Behav 2018; 22:2199-2213. [PMID: 29633094 DOI: 10.1007/s10461-018-2088-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This study sought to determine why young men who have sex with men (MSM) have higher HIV incidence rates than older MSM in the United States. We developed hypotheses that may explain this disparity. Data came from peer-reviewed studies published during 1996-2016. We compared young and older MSM with respect to behavioral, clinical, psychosocial, and structural factors that promote HIV vulnerability. Compared with older MSM, young MSM were more likely to have HIV-discordant condomless receptive intercourse. Young MSM also were more likely to have "any" sexually transmitted infection and gonorrhea. Among HIV-positive MSM, young MSM were less likely to be virally suppressed, use antiretroviral therapy, and be aware of their infection. Moreover, young MSM were more likely than older MSM to experience depression, polysubstance use, low income, decreased health care access, and early ages of sexual expression. These factors likely converge to exacerbate age-associated HIV incidence disparities among MSM.
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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, 1600 Clifton Road NE, Atlanta, GA, 30329, USA.
- Centers for Disease Control and Prevention, 1600 Clifton Road, MS E40, Atlanta, GA, 30333, USA.
| | - Kevin M Greene
- Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Gabriela Paz-Bailey
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Donna Hubbard McCree
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Lamont Scales
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Richard Dunville
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
| | - Suzanne Whitmore
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, 30329, USA
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Marshall BDL, Goedel WC, King MRF, Singleton A, Durham DP, Chan PA, Townsend JP, Galvani AP. Potential effectiveness of long-acting injectable pre-exposure prophylaxis for HIV prevention in men who have sex with men: a modelling study. Lancet HIV 2018; 5:e498-e505. [PMID: 29908917 DOI: 10.1016/s2352-3018(18)30097-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 04/11/2018] [Accepted: 05/02/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral pre-exposure prophylaxis (PrEP) prevents HIV infection in men who have sex with men (MSM); however, adherence is an ongoing concern. Long-acting injectable PrEP is being tested in phase 3 trials and could address challenges associated with adherence. We examined the potential effectiveness of long-acting injectable PrEP compared with oral PrEP in MSM. METHODS We used an agent-based model to simulate HIV transmission in a dynamic network of 11 245 MSM in Atlanta, GA, USA. We used raw data from studies in macaque models and pharmacokinetic data from safety trials to estimate the time-varying efficacy of long-acting injectable PrEP. The effect of long-acting injectable PrEP on the cumulative number of new HIV infections over 10 years (2015-24) was compared with no PrEP and daily oral PrEP across a range of coverage levels. Sensitivity analyses were done with varying maximum efficacy and drug half-life values. FINDINGS In the absence of PrEP, the model predicted 2374 new HIV infections (95% simulation interval [SI] 2345-2412) between 2015 and 2024. The cumulative number of new HIV infections was reduced in all scenarios in which MSM received long-acting injectable PrEP compared with oral PrEP. At a coverage level of 35%, compared with no PrEP, long-acting injectable PrEP led to a 44% reduction in new HIV infections (1044 new infections averted [95% SI 1018-1077]) versus 33% (792 infections averted [763-821]) for oral PrEP. The relative benefit of long-acting injectable PrEP was sensitive to the assumed efficacy of injections received every 8 weeks, discontinuation rates, and terminal drug half-life. INTERPRETATION Long-acting injectable PrEP has the potential to produce larger reductions in HIV transmission in MSM than oral PrEP. However, the real-world, population-level impact of this approach will depend on uptake of this prevention method and its effectiveness, as well as retention of patients in clinical care. FUNDING National Institute on Drug Abuse and National Institute of Mental Health.
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Affiliation(s)
- Brandon D L Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
| | - William C Goedel
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Maximilian R F King
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Alyson Singleton
- Department of Applied Mathematics, Brown University, Providence, RI, USA
| | - David P Durham
- Center for Infectious Disease Modeling and Analysis, School of Public Health, Yale University, New Haven, CT, USA
| | - Philip A Chan
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Jeffrey P Townsend
- Department of Biostatistics, School of Public Health, Yale University, New Haven, CT, USA; Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA; Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, School of Public Health, Yale University, New Haven, CT, USA; Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA; Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
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Sucharitakul K, Boily MC, Dimitrov D, Mitchell KM. Influence of model assumptions about HIV disease progression after initiating or stopping treatment on estimates of infections and deaths averted by scaling up antiretroviral therapy. PLoS One 2018; 13:e0194220. [PMID: 29554136 PMCID: PMC5858778 DOI: 10.1371/journal.pone.0194220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 02/27/2018] [Indexed: 01/17/2023] Open
Abstract
Background Many mathematical models have investigated the population-level impact of expanding antiretroviral therapy (ART), using different assumptions about HIV disease progression on ART and among ART dropouts. We evaluated the influence of these assumptions on model projections of the number of infections and deaths prevented by expanded ART. Methods A new dynamic model of HIV transmission among men who have sex with men (MSM) was developed, which incorporated each of four alternative assumptions about disease progression used in previous models: (A) ART slows disease progression; (B) ART halts disease progression; (C) ART reverses disease progression by increasing CD4 count; (D) ART reverses disease progression, but disease progresses rapidly once treatment is stopped. The model was independently calibrated to HIV prevalence and ART coverage data from the United States under each progression assumption in turn. New HIV infections and HIV-related deaths averted over 10 years were compared for fixed ART coverage increases. Results Little absolute difference (<7 percentage points (pp)) in HIV infections averted over 10 years was seen between progression assumptions for the same increases in ART coverage (varied between 33% and 90%) if ART dropouts reinitiated ART at the same rate as ART-naïve MSM. Larger differences in the predicted fraction of HIV-related deaths averted were observed (up to 15pp). However, if ART dropouts could only reinitiate ART at CD4<200 cells/μl, assumption C predicted substantially larger fractions of HIV infections and deaths averted than other assumptions (up to 20pp and 37pp larger, respectively). Conclusion Different disease progression assumptions on and post-ART interruption did not affect the fraction of HIV infections averted with expanded ART, unless ART dropouts only re-initiated ART at low CD4 counts. Different disease progression assumptions had a larger influence on the fraction of HIV-related deaths averted with expanded ART.
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Affiliation(s)
- Kanes Sucharitakul
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Marie-Claude Boily
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Dobromir Dimitrov
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, United States of America
| | - Kate M. Mitchell
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- * E-mail:
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Franks J, Mannheimer SB, Hirsch‐Moverman Y, Hayes‐Larson E, Colson PW, Ortega H, El‐Sadr WM. Multiple strategies to identify HIV-positive black men who have sex with men and transgender women in New York City: a cross-sectional analysis of recruitment results. J Int AIDS Soc 2018; 21:e25091. [PMID: 29537178 PMCID: PMC5850046 DOI: 10.1002/jia2.25091] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 02/09/2018] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Black men who have sex with men and transgender women are at high risk for HIV infection, but are more likely to be unaware of their infection or not in care for diagnosed HIV compared to other races. Respondent driven sampling has been advanced as a method to reach stigmatized and hidden populations for HIV testing. We compared strategies to recruit black, substance-using men who have sex with men and transgender women to identify newly diagnosed HIV infection, or those previously diagnosed but not in care. METHODS The STAR (Seek, Test, and Retain) study (ClinicalTrials.gov NCT01790360) used several recruitment strategies to identify black, substance-using men who have sex with men and transgender women with undiagnosed HIV infection or with previously diagnosed HIV infection but who were not in HIV care. Respondent-driven sampling, community-based recruitment and online advertising were used to recruit participants. Incentivized peer referral was integrated into all recruitment strategies. Participants completed interviewer-administered questionnaires and HIV testing. Demographic and HIV risk-related characteristics and recruitment strategy were summarized and stratified by HIV status. Associations were tested using Pearson's chi-squared, Fisher's exact, and Wilcoxon rank sum tests. Factors associated with HIV-positive diagnosis at p < 0.1 were included in a multivariable logistic regression model. RESULTS From July 2012 through October 2015, the study enrolled 1929 participants; 96.3% men who have sex with men and 3.7% transgender women. Behavioural risk factors included recent condomless anal sex (55.6%) and recent substance use during sex (73.1%). HIV prevalence was 8.7%. In multivariable analysis, significant associations with HIV infection included being transgender; non-Hispanic black; gay/homosexual orientation; not homeless; and less likely to have insufficient income for necessities. Among recruitment strategies, respondent driven sampling was least effective in identifying HIV-positive participants. CONCLUSIONS Integrating multiple recruitment strategies yielded a large sample of black men who have sex with men and transgender women at substantial risk for HIV. Respondent-driven sampling was less effective than other strategies at identifying men who have sex with men and transgender women with HIV.
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Affiliation(s)
- Julie Franks
- Harlem Prevention CenterICAP at Columbia UniversityNew YorkNYUSA
| | - Sharon B Mannheimer
- Harlem Prevention CenterICAP at Columbia UniversityNew YorkNYUSA
- Harlem Hospital CenterNew YorkNYUSA
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNYUSA
| | - Yael Hirsch‐Moverman
- Harlem Prevention CenterICAP at Columbia UniversityNew YorkNYUSA
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNYUSA
| | - Eleanor Hayes‐Larson
- Harlem Prevention CenterICAP at Columbia UniversityNew YorkNYUSA
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNYUSA
| | - Paul W Colson
- Harlem Prevention CenterICAP at Columbia UniversityNew YorkNYUSA
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNYUSA
| | - Hugo Ortega
- Harlem Prevention CenterICAP at Columbia UniversityNew YorkNYUSA
| | - Wafaa M El‐Sadr
- Harlem Prevention CenterICAP at Columbia UniversityNew YorkNYUSA
- Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkNYUSA
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15
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Menacho L, Garcia PJ, Blas MM, Díaz G, Zunt JR. What Men Who Have Sex With Men in Peru Want in Internet-Based Sexual Health Information. JOURNAL OF HOMOSEXUALITY 2017; 65:934-946. [PMID: 28820663 PMCID: PMC6205510 DOI: 10.1080/00918369.2017.1364939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We aimed to gather information among gay men regarding their preferences for online sexual health information; 1,160 Peruvian MSM, 18 years or older, completed an online survey hosted on www.tunexo.org . The mean age was 26.8 years. Around 90% had post-high school education. The self-reported HIV prevalence was 12.3%. The acceptability of sexual health content was greater in the most highly educated group. The highest rated topics and services of interest were those related to improving sexual and mental health. The least educated group was significantly more interested in "getting prevention messages on mobiles" compared to men with the highest level of education (71% vs. 52%; p < 0.001). Men's sexual health was of more interest to the 30-39-year-old group compared to the 18-24-year-old one (97% vs. 87%; p = 0.005). Future Web-based interventions related to sexual health among targeted groups of MSM in Peru can be tailored to meet their preferences.
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Affiliation(s)
- Luis Menacho
- Epidemiology, HIV and STD Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Patricia J. Garcia
- Epidemiology, HIV and STD Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Magaly M. Blas
- Epidemiology, HIV and STD Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Giovani Díaz
- Faculty of Health Sciences, Universidad Católica Sedes Sapientiae, Lima, Peru
| | - Joseph R. Zunt
- Department of Epidemiology, School of Public Health, and Department of Neurology, Global Health and Medicine, University of Washington, Seattle, Washington, USA
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Frye V, Nandi V, Egan JE, Cerda M, Rundle A, Quinn JW, Sheehan D, Ompad DC, Van Tieu H, Greene E, Koblin B. Associations Among Neighborhood Characteristics and Sexual Risk Behavior Among Black and White MSM Living in a Major Urban Area. AIDS Behav 2017; 21:870-890. [PMID: 27817101 DOI: 10.1007/s10461-016-1596-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Identifying neighborhood characteristics associated with sexual HIV risk behavior among gay, bisexual and other men who have sex with men (MSM) living in urban areas may inform the development of policies and programs to reduce risk and subsequently HIV prevalence in urban areas. New York City M2M was a cross-sectional study designed to identify neighborhood-level characteristics associated with sexual risk behaviors among MSM living in New York City. This paper presents results of an analysis of neighborhood-level indicators of three distinct social theories of influence of the neighborhood environment on human behavior: physical disorder, social disorganization and social norms theories. Using multilevel modeling on a sample of 766 MSM stratified by race/ethnicity, we found little support for the role of social disorganization on the sexual risk behavior of MSM, whereas different indicators of physical disorder exerted negative effects across race groups. Our results suggest that the beneficial effects of housing stock maintenance and general neighborhood physical orderliness and cleanliness may have positive effects beyond those traditionally studied for African American MSM and that the field needs novel theorizing regarding whether and how neighborhood or virtual community-level factors relate to sexual behavior among MSM.
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Affiliation(s)
- Victoria Frye
- Department of Community Health and Social Medicine, School of Medicine, City University of New York, 160 Convent Avenue, 404A Harris Hall, New York, NY, 10031, USA.
- Laboratory of Social and Behavioral Sciences, New York Blood Center, New York, NY, USA.
| | - Vijay Nandi
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
| | - James E Egan
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Magdalena Cerda
- Department of Emergency Medicine, School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, USA
| | - James W Quinn
- Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, USA
| | - Daniel Sheehan
- Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, USA
| | - Danielle C Ompad
- New York University College of Global Public Health, New York University, New York, NY, USA
- Center for Drug Use and HIV Research, New York University Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Hong Van Tieu
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Emily Greene
- Laboratory of Social and Behavioral Sciences, New York Blood Center, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, USA
| | - Beryl Koblin
- Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA
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Andrew BJ, Mullan BA, de Wit JBF, Monds LA, Todd J, Kothe EJ. Does the Theory of Planned Behaviour Explain Condom Use Behaviour Among Men Who have Sex with Men? A Meta-analytic Review of the Literature. AIDS Behav 2016; 20:2834-2844. [PMID: 26860535 DOI: 10.1007/s10461-016-1314-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this meta-analysis was to explore whether the constructs in the theory of planned behaviour (TPB; i.e., attitude, subjective norm, perceived behavioural control, intention) explain condom use behaviour among men who have sex with men (MSM). Electronic databases were searched for studies that measured TPB variables and MSM condom use. Correlations were meta-analysed using a random effects model and path analyses. Moderation analyses were conducted for the time frame of the behavioural measure used (retrospective versus prospective). Attitude, subjective norm and perceived behavioural control accounted for 24.0 % of the variance in condom use intention and were all significant correlates. Intention and PBC accounted for 12.4 % of the variance in condom use behaviour. However, after taking intention into account, PBC was no longer significantly associated with condom use. The strength of construct relationships did not differ between retrospective and prospective behavioural assessments. The medium to large effect sizes of the relationships between the constructs in the TPB, which are consistent with previous meta-analyses with different behaviours or target groups, suggest that the TPB is also a useful model for explaining condom use behaviour among MSM. However, the research in this area is rather small, and greater clarity over moderating factors can only be achieved when the literature expands.
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Affiliation(s)
| | - Barbara A Mullan
- School of Psychology, University of Sydney, Sydney, Australia.
- School of Psychology and Speech Pathology, Curtin University, GPO BOX U1987, Perth, WA, 6845, Australia.
| | - John B F de Wit
- Centre for Social Research in Health, UNSW, Sydney, Australia
| | - Lauren A Monds
- School of Psychology, University of Sydney, Sydney, Australia
| | - Jemma Todd
- School of Psychology, University of Sydney, Sydney, Australia
| | - Emily J Kothe
- School of Psychology, Deakin University, Geelong, Australia
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18
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Individual-Level, Partnership-Level, and Sexual Event-Level Predictors of Condom Use During Receptive Anal Intercourse Among HIV-Negative Men Who Have Sex with Men in Los Angeles. AIDS Behav 2016; 20:1315-26. [PMID: 26471884 DOI: 10.1007/s10461-015-1218-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We examined individual-level, partnership-level, and sexual event-level factors associated with condom use during receptive anal intercourse (RAI) among 163 low-income, racially/ethnically diverse, HIV-negative men who have sex with men (MSM) in Los Angeles (2007-2010). At baseline, 3-month, and 12-month visits, computer-assisted self-interviews collected information on ≤3 recent male partners and the last sexual event with those partners. Factors associated with condom use during RAI at the last sexual event were identified using logistic generalized linear mixed models. Condom use during RAI was negatively associated with reporting ≥ high school education (adjusted odds ratio [AOR] = 0.32, 95 % confidence interval [CI] 0.11-0.96) and methamphetamine use, specifically during RAI events with non-main partners (AOR = 0.20, 95 % CI 0.07-0.53) and those that included lubricant use (AOR = 0.20, 95 % CI 0.08-0.53). Condom use during RAI varies according to individual-level, partnership-level, and sexual event-level factors that should be considered in the development of risk reduction strategies for this population.
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Grov C, Rodríguez-Díaz CE, Jovet-Toledo GG. Male Escorts' and Male Clients' Sexual Behavior During Their Last Commercial Sexual Encounter: Comparing and Contrasting Findings from Two Online Studies. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:965-73. [PMID: 25953422 DOI: 10.1007/s10508-015-0531-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 03/09/2015] [Accepted: 03/13/2015] [Indexed: 05/10/2023]
Abstract
Much of what is known about commercial sexual encounters between men is based on data gathered from escorts. With few exceptions, studies have not compared male clients' reports of behavior during commercial sexual encounters with male escorts'. The present study draws from two datasets, a 2012 survey of clients (n = 495) and a 2013 survey of escorts (n = 387)--both used virtually identical measures of sexual behavior during the most recent commercial sexual encounter. For clients and escorts, the majority eschewed having sex without a condom, and kissing and oral sex were among the most common behaviors reported. Using logistic regression, both samples were compared across 15 sexual behaviors, finding significant differences in six--the escort sample had greater odds of reporting their last commercial sexual encounter involved watching the client masturbate, viewing porn, role play (dad/son, dominant/submissive), and having prior sexual experience with their commercial partner. The escort sample had lower odds of reporting that the client watched the escort masturbate, and being told partner's HIV status. In multivariable modeling, both samples did not significantly differ in reports of condomless anal sex. Male-male commercial sexual encounters appear to be involved in a wide range of sexual behaviors, many of which convey low-to-no risk of HIV transmission.
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Affiliation(s)
- Christian Grov
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York (CUNY), 2900 Bedford Avenue, Brooklyn, NY, 11210, USA.
- Doctoral Program in Public Health, The Graduate Center of CUNY, New York, USA.
- Center for HIV/AIDS Educational Studies and Training (CHEST), New York, USA.
| | - Carlos E Rodríguez-Díaz
- Department of Social Sciences, School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
- Center for Sexual Health Promotion and Health Equity, School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - Gerardo G Jovet-Toledo
- Center for Sexual Health Promotion and Health Equity, School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
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Phillips G, Birkett M, Kuhns L, Hatchel T, Garofalo R, Mustanski B. Neighborhood-level associations with HIV infection among young men who have sex with men in Chicago. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1773-1786. [PMID: 26168977 PMCID: PMC4561028 DOI: 10.1007/s10508-014-0459-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 11/30/2014] [Accepted: 12/02/2014] [Indexed: 06/01/2023]
Abstract
The rising incidence of HIV infection among young men who have sex with men (YMSM) is a substantial public health concern. Traditional research on HIV among YMSM has focused largely on individual-level predictors and infrequently accounts for contextual or neighborhood-level factors such as ethnic composition and socioeconomic status. This study used neighborhood-level data from the US Census and other public sources, and individual-level data from a longitudinal cohort of YMSM in Chicago (Crew 450). Of the original 450 YMSM in the cohort, 376 reported living in Chicago (83.6 %) and were included in the analytic sample. A clustering approach was used to group the 77 community areas together by common characteristics, resulting in the identification of 11 distinct clusters. An unconditional model of individual HIV status indicated a significant amount of variance existed between neighborhood clusters (χ (2) = 21.66; p = 0.006). When individual-level variables were added to the model, only having an HIV-positive sex partner (OR = 6.41; CI 2.40, 17.1) and engaging in exchange sex in the past 6 months (OR = 3.25; 95 % CI 1.33, 7.93) were significant predictors of HIV status. Clusters with higher Walk Scores were less likely to contain HIV-positive individuals (OR = 0.94; 95 % CI 0.90, 0.98). Conversely, clusters with a larger proportion of vacant buildings were more likely to contain HIV-positive individuals (OR = 1.19; 95 % CI 1.07, 1.33). Future research among YMSM needs to investigate the mechanisms by which neighborhood of residence might influence engagement in risk behaviors or acquisition of HIV.
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Affiliation(s)
- Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, 60611, IL, USA,
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Rendina HJ. When parsimony is not enough: considering dual processes and dual levels of influence in sexual decision making. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1937-47. [PMID: 26168978 PMCID: PMC4560994 DOI: 10.1007/s10508-015-0569-2] [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: 07/14/2014] [Revised: 04/23/2015] [Accepted: 05/18/2015] [Indexed: 05/28/2023]
Abstract
The literature on sexual decision making that has been used to understand behaviors relevant to HIV and STI risk has relied primarily on cognitive antecedents of behavior. In contrast, several prominent models of decision making outside of the sexual behavior literature rely on dual process models, in which both affective and cognitive processing are considered as important precursors to behavior. Moreover, much of the literature on sexual behavior utilizes individual-level traits and characteristics to predict aggregated sexual behavior, despite decision making itself being a situational or event-level process. This article proposes a framework for understanding sexual decision making as the result of dual processes (affective and cognitive) operating at dual level of influence (individual and situational). Finally, this article ends with a discussion of the conceptual and methodological benefits and challenges to its use and future directions for research.
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Affiliation(s)
- H Jonathon Rendina
- The Center for HIV Educational Studies & Training (CHEST), Hunter College, CUNY, 142 W. 36th Street, 9th Floor, New York, NY, 10018, USA,
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Lachowsky NJ, Saxton PJW, Hughes AJ, Dickson NP, Summerlee AJS, Milhausen RR, Dewey CE. Younger Gay and Bisexual Men's Condom Use With Main Regular Sexual Partner in New Zealand. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:257-74. [PMID: 26010316 DOI: 10.1521/aeap.2015.27.3.257] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Main partners are a common source of new HIV infections among men who have sex with men (MSM). National behavioral surveillance data (2006-2011) for younger MSM (YMSM, aged 16-29) in New Zealand were analyzed to investigate condom use during anal intercourse with a regular partner (boyfriend/fuckbuddy) by sexual position (insertive/receptive). Backward-stepwise multivariate multinomial logistic regression was used to identify demographic, relational, behavioral, and cognitive factors associated with condom use frequency (high, medium, low). Most YMSM who reported a current regular partner (n=1,221) classified them as a boyfriend (59.5%) versus fuckbuddy (40.5%), though condom use was higher with the latter partner type. Condom use or nonuse was habitual across partners, although insertive sexual position was positively associated with condom use. YMSM who believed condoms reduce sensitivity reported lower condom use. Condoms remain the leading HIV/STI prevention tool for YMSM; efforts to improve condom use must consider sexual position and relationship factors.
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Sanchez TH, Sineath RC, Kahle EM, Tregear SJ, Sullivan PS. The Annual American Men's Internet Survey of Behaviors of Men Who Have Sex With Men in the United States: Protocol and Key Indicators Report 2013. JMIR Public Health Surveill 2015; 1:e3. [PMID: 27227126 PMCID: PMC4869242 DOI: 10.2196/publichealth.4314] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/17/2015] [Accepted: 03/17/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) are disproportionately affected by human immunodeficiency virus (HIV) and there is evidence that this population is participating in increasingly risky sexual behavior. These changes are occurring in the context of new modes of online social interaction-many MSM now report first meeting their sex partners on the Internet. Better monitoring of key behavioral indicators among MSM requires the use of surveillance strategies that capitalize on these new modes of interaction. Therefore, we developed an annual cross-sectional behavioral survey of MSM in the United States, the American Men's Internet Survey (AMIS). OBJECTIVE The purpose of this paper was to provide a description of AMIS methods. In addition we report on the first cycle of data collection (December 2013 through May 2014; AMIS-2013) on the same key indicators used for national HIV behavioral surveillance. METHODS AMIS-2013 recruited MSM from a variety of websites using banner advertisements or email blasts. Adult men currently residing in the United States were eligible to participate if they had ever had sex with a man. We examined demographic and recruitment characteristics using multivariable regression modeling (P<.05) stratified by the participants' self-reported HIV status. RESULTS In the AMIS-2013 round, 79,635 persons landed on the study page and 14,899 were eligible, resulting in 10,377 completed surveys from MSM representing every US state. Participants were mainly white, 40 years or older, living in the US South, living in urban areas, and recruited from a general social networking website. Self-reported HIV prevalence was 10.73% (n=1113). Compared to HIV-negative/unknown status participants, HIV-positive participants were more likely to have had anal sex without a condom with any male partner in the past 12 months (72.24% versus 61.24%, respectively; P<.001) and more likely to have had anal sex without a condom with their last male sex partner who was discordant/unknown HIV status (42.95% versus 13.62%, respectively; P<.001). Illicit substance use in the past 12 months was more likely to be reported by HIV-positive participants than HIV-negative/unknown status participants (39.17% versus 26.85%, respectively; P<.001). The vast majority of HIV-negative/unknown status participants (84.05%) had been previously HIV tested, but less than half (44.20%) had been tested in the past 12 months. Participants 18-24 years of age were more likely than those 40 years or older to have had anal sex without a condom with a discordant/unknown HIV status partner, were more likely to report substance use, and were less likely to have been HIV tested. Compared to general social networking, those from a geospatial social networking website were more likely to have reported all risk behaviors but were more likely to have been HIV tested. CONCLUSIONS The first round of AMIS generated useful behavioral measures from more than 10,000 MSM Internet users. Preliminary findings identified some subgroups of MSM Internet users that are at potentially higher risk of HIV acquisition/transmission. AMIS will provide an ongoing data source for examining trends in sexual risk behavior of MSM. This will help to plan and monitor the impact of programs to improve this population's health.
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Shiu C, Chen Y, Tseng P, Chung A, Wu M, Hsu S, Ko N. Curvilinear Relationship Between Depression and Unprotected Sexual Behaviors among Men Who Have Sex with Men. J Sex Med 2014; 11:2466-73. [DOI: 10.1111/jsm.12638] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jones RK, Lindberg LD, Higgins JA. Pull and pray or extra protection? Contraceptive strategies involving withdrawal among US adult women. Contraception 2014; 90:416-21. [PMID: 24909635 DOI: 10.1016/j.contraception.2014.04.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/22/2014] [Accepted: 04/29/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Research assessing contraceptive use often focuses on the most effective method used and suggests that very few women rely on withdrawal. We adopted a new measurement strategy in an attempt to measure contraceptive practices and withdrawal in particular. STUDY DESIGN We collected data from a national sample of 4634 US women aged 18-39; the survey was administered online in November and December 2012. We obtained information about recent use of hormonal methods and coital methods using two separate items, and we placed withdrawal first on the list of coital methods. The analysis examines several measures of withdrawal use in the last 30 days: most effective method used, any use, use with other methods and withdrawal "method mix." RESULTS Among women at risk of unintended pregnancy, 13% reported that withdrawal was the most effective method used in the last 30 days, but 33% had used withdrawal at least once. Most women who used withdrawal had also used a hormonal or long-acting method (13% of the sample) or condoms (11%) in the last 30 days, and a minority reported using only withdrawal (12%). Younger women, women in dating relationships and women strongly motivated to avoid pregnancy had some of the highest levels of "dual" use of withdrawal with condoms or highly effective methods. CONCLUSION Many women and couples in our sample used withdrawal in combination, or rotation, with condoms and highly effective methods. Findings suggest that some people who use withdrawal may be more versus less vigilant about pregnancy prevention. IMPLICATIONS Health care providers who discuss contraception should include withdrawal in these conversations. A substantial minority of individuals has used it recently, and many appear to be using it as a backup or secondary method. If dual use were more widespread, it could help reduce the incidence of unintended pregnancy.
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Affiliation(s)
- Rachel K Jones
- Guttmacher Institute, 125 Maiden Lane, New York, NY 10038.
| | | | - Jenny A Higgins
- Department of Gender and Women's Studies, University of Wisconsin, Madison
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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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Prevalence and correlates of sexual partner concurrency among Australian gay men aged 18-39 years. AIDS Behav 2014; 18:801-9. [PMID: 24057932 DOI: 10.1007/s10461-013-0613-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Mathematical models predict higher rates of HIV and sexually transmitted infections (STIs) in populations with higher rates of concurrent sexual partnerships. Although gay men and other men who have sex with men (MSM) have disproportionately high rates of HIV/STIs, little is known about the prevalence and correlates of sexual concurrency in these populations. This paper reports findings from a national community-based survey of 1,034 Australian gay-identified men aged 18-39 years, who gave detailed information about their sexual partners over the past 12 months. In all, 237 (23 %) reported two or more concurrent sexual partners. For their most recent period of concurrency, 44 % reported three or more partners and 66 % reported unprotected sex with one or more of their partners. A multivariate logistic regression found sexual concurrency was significantly more likely among men on higher incomes (P = 0.02), who first had anal sex at a relatively young age (P = 0.03), and who reported a large number of partners in the past 12 months (P < 0.001). Age, education, HIV status, and other sociodemographic and sexual behavior variables were not significant correlates. However, men who reported sexual concurrency were significantly more likely to have been diagnosed with an STI in the past 12 months (P = 0.04). Findings from this study suggest sexual concurrency is common among younger Australian gay men. With many of these men not always using condoms, health agencies should consider the potential impact of concurrency on HIV/STI epidemics among gay men and other MSM.
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Rosenberger JG, Schick V, Schnarrs P, Novak DS, Reece M. Sexual behaviors, sexual health practices, and community engagement among gay and bisexually identified men living in rural areas of the United States. JOURNAL OF HOMOSEXUALITY 2014; 61:1192-1207. [PMID: 24344718 DOI: 10.1080/00918369.2014.872525] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Limited research has focused on the sexual behaviors of men who have sex with men (MSM) from rural communities. We examined the sexual and health-related behaviors of MSM living in rural areas of the United States in order to understand the sexual health repertoire of this population. A total of 5,357 participants living in rural settings were recruited online and completed an anonymous Internet-based survey that assessed sexual behaviors, condom use, and men's engagement with various community activities and events. These data provide a greater understanding of sexual health profiles that exist among rural MSM and will help inform the design of effective programs for men in these often underserved communities.
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Affiliation(s)
- Joshua G Rosenberger
- a Department of Global and Community Health , George Mason University , Fairfax , Virginia , USA
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Grov C, Breslow AS, Newcomb ME, Rosenberger JG, Bauermeister JA. Gay and bisexual men's use of the Internet: research from the 1990s through 2013. JOURNAL OF SEX RESEARCH 2014; 51:390-409. [PMID: 24754360 PMCID: PMC4154140 DOI: 10.1080/00224499.2013.871626] [Citation(s) in RCA: 208] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We document the historical and cultural shifts in how gay and bisexual men have used the Internet for sexuality between the 1990s and 2013-including shifting technology as well as research methods to study gay and bisexual men online. Gay and bisexual men have rapidly taken to using the Internet for sexual purposes: for health information seeking, finding sex partners, dating, cybersex, and pornography. Men have adapted to the ever-evolving technological advances that have been made in connecting users to the Internet-from logging on via dial-up modem on a desktop computer to geo-social-sexual networking via handheld devices. In kind, researchers have adapted to the Internet to study gay and bisexual men. Studies have carefully considered the ethics, feasibility, and acceptability of using the Internet to conduct research and interventions. Much of this work has been grounded in models of disease prevention, largely as a result of the ongoing HIV/AIDS epidemic. The need to reduce HIV in this population has been a driving force to develop innovative research and Internet-based intervention methodologies. The Internet, and specifically mobile technology, is an environment gay and bisexual men are using for sexual purposes. These innovative technologies represent powerful resources for researchers to study and provide outreach.
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Affiliation(s)
- Christian Grov
- Brooklyn College and the Graduate Center of CUNY, New York, NY. USA
- The Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY. USA
| | - Aaron S. Breslow
- The Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY. USA
| | - Michael E. Newcomb
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Joshua G. Rosenberger
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | - Jose A Bauermeister
- The Center for Sexuality & Health Disparities, University of Michigan, Ann Arbor, MI, USA
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de Visser RO, Badcock PB, Rissel C, Richters J, Smith AMA, Grulich AE, Simpson JM. Safer sex and condom use: findings from the Second Australian Study of Health and Relationships. Sex Health 2014; 11:495-504. [DOI: 10.1071/sh14102] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 08/23/2014] [Indexed: 11/23/2022]
Abstract
Background It is important to have current and reliable estimates of the frequency and correlates of condom use among Australian adults. Methods: A representative sample of 20 094 men and women aged 16–69 years, from all states and territories, completed computer-assisted telephone interviews. The overall participation rate among eligible people was 66.2%. Results: Although most respondents had used a condom at some time in their lives, fewer than half of those who were sexually active in the year before being interviewed had used a condom in that year. Condom use in the last year was associated with youth, speaking a language other than English at home, bisexual identity, greater education, residence in major cities, lower income and having multiple sexual partners in the last year. One-quarter of respondents used a condom the last time they had vaginal intercourse and one-sixth of these were put on after genital contact. Condom use during most recent vaginal sex was associated with youth, lower income, having sex with a non-regular partner and not using another form of contraception. Condom use appears to have increased between 2001–02 and 2012–13. Conclusion: Consistent with other research, this study showed that condom use was strongly associated with partner type and use of other contraception. There may be a need to highlight among people with multiple sexual partners the fact that non-barrier methods of contraception do not offer protection against sexually transmissible infections. The finding that many condoms were applied after genital contact suggests a need to promote both use and correct use of condoms.
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Grov C, Rendina HJ, Breslow AS, Ventuneac A, Adelson S, Parsons JT. Characteristics of men who have sex with men (MSM) who attend sex parties: results from a national online sample in the USA. Sex Transm Infect 2013; 90:26-32. [PMID: 24052337 DOI: 10.1136/sextrans-2013-051094] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To compare three groups of men who have sex with men (MSM)-men who had attended a sex party in the past year (45.2%); men who had been to a sex party more than a year ago (23.3%); and men who had never been to one (31.5%)-on socio-demographic and behavioural characteristics. METHOD In spring 2012, 2063 sexually active MSM in the USA were recruited using banner advertising on a sexual networking website to complete an online survey about their sexual behaviour and attendance at sex parties. RESULTS A significantly higher proportion of past year attendees were HIV-positive (28.1%), single (31.7%), demonstrated sexual compulsivity symptomology (39.2%), recently used drugs (67.8%), averaged the greatest number of recent male partners (Mdn=15, <90 days), and had greater instances of recent unprotected anal intercourse (UAI) with male partners (median=3, <90 days). Adjusting for covariates, those having been to a sex party in the last year were significantly more likely than others to report UAI. Free lubricant (93.4%) and condoms (81.0%) were the most desirable services/products men wanted at sex parties. More than half of men having been to a sex party expressed interest in free rapid HIV testing at sex parties (52.8%); however, few considered it acceptable to see 'medical providers' (11.7%) and 'peer outreach workers' (9.5%) at sex parties. CONCLUSIONS MSM who have attended a sex party in the last year are appropriate candidates for targeted HIV and sexually transmitted infection (STI) prevention. Collaborating with event promoters presents valuable opportunities to provide condoms, lubricant and HIV/STI testing.
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Affiliation(s)
- Christian Grov
- Department of Health and Nutrition Sciences, Brooklyn College, City University of New York, , New York, New York, USA
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Higgins JA, Fennell JL. Providing for women's pleasure in the next generation of condoms. J Sex Med 2013; 10:3151-3. [PMID: 23981853 DOI: 10.1111/jsm.12299] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Maatouk I, Moutran R. Perianal streptococcal dermatitis due to Streptococcus dysgalactiae ssp. Equisimilis in a man who has sex with men. J Sex Med 2013; 10:2351-2. [PMID: 23845120 DOI: 10.1111/jsm.12243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Ismaël Maatouk
- Hôtel-Dieu de France hospital, Faculty of medicine, Saint-Joseph University, Dermatology Department, Beirut, Lebanon
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Grov C, Rendina HJ, Ventuneac A, Parsons JT. HIV risk in group sexual encounters: an event-level analysis from a national online survey of MSM in the U.S. J Sex Med 2013; 10:2285-94. [PMID: 23809410 DOI: 10.1111/jsm.12227] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Researchers have investigated group sexual encounters (GSEs) as potential sources for HIV/STI transmission among men who have sex with men (MSM); however, much of this work has focused on organized sex parties. AIM To compare behavioral and social characteristics of groups of men who engaged in three types of GSEs: threesomes, spontaneous group sex, and organized sex parties. METHODS In 2012, 1,815 U.S.-based MSM completed an online survey. MAIN OUTCOME MEASURE We compared men based on their most recent type of GSE: threesome (68.2%), spontaneous group sex (19.7%), or organized sex party (12.1%). RESULTS Using multinomial logistic regression, with type of GSE as the dependent variable, MSM who were HIV-positive, used stimulants (cocaine, methamphetamine, crack), consumed five or more alcoholic drinks, and reported receptive unprotected anal intercourse (UAI) during the most recent GSE had significantly higher odds of having had spontaneous group sex as compared to a threesome. MSM who were HIV-positive, not in a relationship, and did not report receptive UAI during the most recent GSE had significantly higher odds of having attended an organized sex party as compared to a threesome. MSM who were in a relationship, had consumed five or more alcoholic drinks, had used stimulants, and reported receptive UAI during the most recent GSE had significantly higher odds of having had spontaneous group sex as compared to an organized sex party. Compared to others, those having engaged in a GSE were more likely to report recent UAI (65% vs. 45%). CONCLUSIONS Men having engaged in a GSE were at greater risk for behaviors that transmit HIV and STIs. Unique social and behavioral characteristics inherent to threesomes, spontaneous group sex, and sex parties highlight the need to identify prevention strategies to help those who participate in GSEs reduce their risk for HIV and STI transmission.
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Affiliation(s)
- Christian Grov
- Department of Health and Nutrition Sciences, Brooklyn College, City University of New York, New York, NY, USA; Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA; CUNY School of Public Health, The Graduate Center of CUNY, New York, NY, USA
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Newcomb ME, Mustanski B. Racial differences in same-race partnering and the effects of sexual partnership characteristics on HIV Risk in MSM: a prospective sexual diary study. J Acquir Immune Defic Syndr 2013; 62:329-33. [PMID: 23187943 PMCID: PMC3640752 DOI: 10.1097/qai.0b013e31827e5f8c] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Men who have sex with men (MSM) account for more than half of new HIV infections each year, and young black MSM experience the highest incidence rates. Black MSM have not been found to engage in more HIV risk behaviors, and it has been proposed that sexual network factors (racially homophilous networks) and partnership characteristics (influence of older partners and familiarity with partners) may help account for this disparity. METHODS One hundred forty-three ethnically diverse MSM were enrolled in an online prospective diary study of sexual behavior. Participants completed weekly diaries of sexual encounters and associated situational factors for 12 weeks. All analyses were conducted with Hierarchical Linear Modeling software. RESULTS Black MSM reported significantly less unprotected sex than other groups and were the most racially homophilous group in terms of sexual partnerships. Having older sexual partners and familiarity with partners were both associated with increased odds of sexual risk in black MSM only. A 3-way interaction between participant age, participant race, and sexual partner age revealed a strong association between having older partners and odds of sexual risk for young black MSM, and a strong association between having younger partners and sexual risk for older non-black MSM. CONCLUSIONS Findings expand upon previous theory and cross-sectional research. Results indicate that some of the driving forces behind the disproportionate HIV incidence in black MSM may be the greater likelihood of racially homophilous sexual networks combined with the stronger influence of sexual partner age and familiarity with partners on condom use.
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Affiliation(s)
- Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.
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Grov C, Agyemang L, Ventuneac A, Breslow AS. Navigating condom use and HIV status disclosure with partners met online: a qualitative pilot study with gay and bisexual men from Craigslist.org. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2013; 25:72-85. [PMID: 23387953 PMCID: PMC3666352 DOI: 10.1521/aeap.2013.25.1.72] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We conducted face-to-face semi-structured interviews with 50 men recruited from the New York City men-seeking-men section of Craigslist.org. Participants discussed their favorite venues for meeting sex partners (n = 28 said the Internet), and we focused on these men's responses to probes regarding decisions around condom use and HIV status disclosure with online partners. A majority indicated they set a priori rules for themselves to always use condoms, and they cited the Internet as their favorite venue in part because it helped them sort for like-minded partners. Participants indicated that having in-person conversations around condom use and HIV was often difficult, and that the Internet was a convenient medium to facilitate the process. Notable differences were observed in how HIV-positive and HIV-negative men navigated serostatus disclosure-HIV-negative men were less subtle in starting the conversation. Finally, participants described a common narrative around distrust with online partners, which is one reason why they consistently use condoms. These data suggest that features which allow men to easily indicate, and filter for, condom use preferences should be built into (or maintained on) profile-based sexual networking sites and sexual bulletin board sites.
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Affiliation(s)
- Christian Grov
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York (CUNY), Brooklyn, NY 11210, USA.
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Calabrese SK, Rosenberger JG, Schick VR, Novak DS, Reece M. An event-level comparison of risk-related sexual practices between black and other-race men who have sex with men: condoms, semen, lubricant, and rectal douching. AIDS Patient Care STDS 2013; 27:77-84. [PMID: 23373663 DOI: 10.1089/apc.2012.0355] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Black men who have sex with men (MSM) living in the U.S. are disproportionately affected by HIV/AIDS. An online survey of sexual behavior was completed by Black, White, Hispanic/Latino, Asian/Pacific Islander, and other-race MSM (n=11,766) ages 18-87 years. Complete condom use, semen exposure, pre-coital rectal douching (enema use), and lubricant use at last male-partnered sexual event were compared by race, controlling for relevant sociodemographic variables and stratifying by sexual position (receptive, insertive, or both). Across sexual positions, 55-62% of Black MSM reported condom use, 5-8% reported semen exposure, 18-53% reported douching, and 33-43% reported lubricant use. Reported behavioral profiles were not significantly different from other races, except that Black MSM reported greater condom use than White MSM in the insertive position. Although findings argue against disproportionate rates of risk behavior accounting for racial disparities in HIV prevalence, they nonetheless highlight a need for continued behavioral intervention.
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Affiliation(s)
- Sarah K. Calabrese
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut
| | - Joshua G. Rosenberger
- Department of Global and Community Health, George Mason University, Fairfax, Virginia
| | - Vanessa R. Schick
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
| | - David S. Novak
- OLB Research Institute, Online Buddies, Inc., Cambridge, Massachusetts
| | - Michael Reece
- Center for Sexual Health Promotion, Indiana University, Bloomington, Indiana
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Hald GM, Smolenski D, Rosser BRS. Perceived effects of sexually explicit media among men who have sex with men and psychometric properties of the pornography consumption effects scale (PCES). J Sex Med 2012; 10:757-67. [PMID: 23110358 DOI: 10.1111/j.1743-6109.2012.02988.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Researchers have proposed that consumption of Sexually Explicit Media (SEM) may not only adversely influence sexual attitudes and behaviors of Men Who Have Sex with Men (MSM) but (also) play a positive role in the development and sexual education of MSM, be a major source of sexual information for MSM, and provide validation, understanding, and confirmation of MSM's sexual orientation. However, such claims are in urgent need of empirical validation as is the development of psychometrically sound and easily implemented instruments able to reliably assist such validations. AIMS To investigate how MSM who consume SEM self-perceive the impact of SEM on their sexually-transmitted-infections-related sexual risk behaviors (i.e., anal intercourse), sexual knowledge, enjoyment of sex, interest in sex, attitudes toward sex, and understanding of their sexual orientation. Further, to provide a thorough psychometric validation of a reduced and reworked version of the Pornography Consumption Effects Scale (PCES). Main Outcome Measure. A revised version of the PCES by Hald and Malamuth. METHODS Online cross-sectional survey study of 1,333 US adult Men Who Have Sex with Men. RESULTS This study found that 97% of MSM reported positive effects of SEM consumption on their sexual knowledge, enjoyment of and interest in sex, attitudes toward sex, and understanding of their sexual orientation. Only 3% reported any negative effects of their SEM consumption. SEM consumption was found to significantly increase consumers' interest in having protected anal intercourse while not significantly influencing their interests in having unprotected anal intercourse. The revised version of the PCES showed excellent psychometric performance. CONCLUSION The study found that MSM generally report positive effects of their consumption of sexually explicit materials in areas related to their sexual knowledge, attitudes, behaviors, and orientation. This finding could have important implications for the sexual health and well-being of MSM by suggesting that SEM-based education and intervention might hold considerable overall health potential for MSM.
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Affiliation(s)
- Gert Martin Hald
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark.
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Calabrese SK, Reisen CA, Zea MC, Poppen PJ, Bianchi FT. The pleasure principle: the effect of perceived pleasure loss associated with condoms on unprotected anal intercourse among immigrant Latino men who have sex with men. AIDS Patient Care STDS 2012; 26:430-5. [PMID: 22663165 DOI: 10.1089/apc.2011.0428] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Sexual pleasure has been identified as an important consideration in decision-making surrounding condom use. We examined the impact of perceived pleasure loss associated with condom use on recent history of insertive and receptive unprotected anal intercourse (UAI) among Latino men who have sex with men (MSM) living in the United States. A total of 482 Dominican, Colombian, and Brazilian immigrant MSM were surveyed regarding sexual attitudes and practices via computer-assisted self-interviewing technology with audio enhancement (ACASI). Participants rated the pleasure they derived from protected and unprotected anal intercourse in each position (insertive and receptive) and also reported their HIV status, relationship status, and recent sexual history. Men who had engaged in both positions, with and without condoms (n=268), perceived a greater pleasure loss associated with condoms during anal intercourse in the insertive versus receptive position. Logistic regression analyses controlling for HIV status, relationship status, and age revealed that men who perceived greater pleasure loss from condoms were more likely to have engaged in UAI over the past 3 months (n[insertive]=297; n[receptive]=284). Findings indicate that the pleasure loss associated with condoms may be a key deterrent for their use in either sex position among Latino MSM. Therefore, pleasure needs to be prioritized in the development of condoms and other sexual safety measures as well as in the promotion of their use.
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Affiliation(s)
| | - Carol A. Reisen
- The George Washington University, Washington, District of Columbia
| | | | - Paul J. Poppen
- The George Washington University, Washington, District of Columbia
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Rosenberger JG, Reece M, Schick V, Herbenick D, Novak DS, Van Der Pol B, Fortenberry JD. Sexual Behaviors and Situational Characteristics of Most Recent Male‐Partnered Sexual Event among Gay and Bisexually Identified Men in the United States. J Sex Med 2011; 8:3040-50. [DOI: 10.1111/j.1743-6109.2011.02438.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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