Beyond Anal Sex: Sexual Practices Associated with HIV Risk Reduction among Men Who Have Sex with Men in Boston, Massachusetts

Abstract

Men who have sex with men (MSM) continue to bear a disproportionate HIV and sexually transmitted disease (STD) burden. The current study examined the frequency and associations of sexual risk reduction behaviors among a sample of MSM in the greater Boston, Massachusetts area. One hundred eighty-nine MSM completed a one-time behavioral and psychosocial assessment between March 2006 and May 2007. Logistic regression procedures examined the association of demographic, psychosocial, and behavioral factors with risk reduction practices. Twenty percent of the sample reported rimming, mutual masturbation, digital penetration, using sex toys, or 100% condom use as a means to reduce their risk of acquiring or transmitting HIV in the prior 12 months. In bivariate analyses, risk reducers were more likely to disclose their MSM status (i.e., be ''out''; odds ratio [OR] ¼ 3.64; p < 0.05), and report oral sex with a condom in the prior 12 months (OR ¼ 4.85; p < 0.01). They were less likely to report: depression (Center for Epidemiologic Studies Depression Scale [CES-D] score 16þ; OR ¼ 0.48; p < 0.05), a history of one or more sexually transmitted diseases (STDs; OR ¼ 0.40; p < 0.05), and meeting sexual partners at public cruising areas (OR ¼ 0.32; p < 0.01). In a multivariable model, risk reducers were less likely to report: alcohol use during sex (adjusted odds ratio [AOR] ¼ 0.33; p < 0.05), depression (CESD score 16þ; AOR ¼ 0.32; p < 0.05), or meeting sexual partners at public cruising areas (AOR ¼ 0.30; p < 0.05), or via the Internet (AOR ¼ 0.12; p < 0.05) in the previous 12 months. Identifying and understanding such factors associated with risk reduction behaviors may be important to consider in designing effective prevention interventions to promote sexual health for MSM.

Risk factors for syphilis infection in men who have sex with men: results of a case–control study in Lille, France

“…Sex toys are often used by MSM during solo and partnered sexual activities to enhance the sexual experience 18. Seen as a way to reduce HIV risk acquisition by many MSM,19 sex toy use has been described in the past as a risk factor for hepatitis C,20 lymphogranuloma venereum proctitis21 and HIV22 infections. To our knowledge, this is the first study identifying use of anal sex toys as a risk factor for syphilis infection.…”

Depression and HIV Risk Taking Among Men Who Have Sex with Other Men and Who Use the Internet to Find Partners for Unprotected Sex

“…For example, in their sample of African American MSM, Mimiaga and colleagues (2010) reported that experiencing more clinically-significant symptoms of depression was associated with more stimulant use during sex. Other work published by members of that same research team showed that depression was associated with a nearly tripled risk of having unprotected anal sex with a serodiscordant partner, as well as an eight-fold increase in the likelihood of recently having had a sexually transmitted infection (Reisner et al ., 2009a). Additionally, MSM who were trying to reduce their risk for HIV by engaging in specific low-risk activities were less likely to experience depression than men who were not engaging in these specific risk-reduction practices (Reisner et al ., 2009b).…”

Factors That Influence Risky Sexual Behaviors Among Men Who Have Sex with Men in Liaoning Province, China: A Structural Equation Model

“…[4][5][6][7] Evidence from studies has shown that condom use among MSM remains at a very low level. 8 It has been broadly reported in China that most MSM had sex with casual sexual partners and never used a condom. 9,10 In many countries, MSM behaviors are highly unacceptable, and there is strong social pressure against the behavior of MSM.…”