Earlier Anal Sexarche and Co-occurring Sexual Risk are Associated with Current HIV-Related Risk Behaviors Among an Online Sample of Men Who Have Sex with Men in Asia

Abstract

Studies of heterosexual populations across the globe and men who have sex with men (MSM) in a few developed countries showed that earlier sexual debut (sexarche) was associated with higher levels of co-occurring and subsequent HIV risk behaviors. We examined the relationships between earlier anal sexarche, unprotected earlier anal sexarche and current HIV risks among MSM from Asia. A cross-sectional online survey was conducted among MSM (N = 10,826) in Asia in 2010. Bivariate and multivariable logistic regressions were used to identify co-occurring (i.e., sexual experiences during sexarche) and current HIV-related risk factors (i.e., past six months) associated with earlier anal sexarche (before the age of 18) and unprotected earlier anal sexarche, respectively. Earlier anal sexarche was significantly associated with lack of condom use, being anal receptive or both receptive and insertive, and having a partner who were older during sexarche. It was also associated with current HIV-related risk behaviors including having multiple male sexual partners, having been paid for sex, and increased frequencies of recreational drug use. Unprotected earlier anal sexarche was significantly associated with inconsistent condom use in the past the six months. Improved and culturally sensitive sex education at schools should be included in national and regional HIV/AIDS prevention programming and policies in Asia. Such sex education programs should incorporate curriculum that address sexuality, sexual orientation, and sexual behaviors beyond those related to reproductive health.

Suboptimal HIV Testing Uptake Among Men Who Engage in Commercial Sex Work with Men in Asia

“…However, these messages may not be effectively saturating communities of younger MSMSW, which may be contributing to high rates of HIV incidence across Asia in populations of very young MSM. 26 While it is encouraging to see that MSMSW in their 20s may be receiving HIV testing, perhaps as a result of exposure to MSM-focused HIV prevention and sexual health information online, 24 this study demonstrates the importance of reaching communities of young MSM, who may be involved in sex work, with salient HIV testing messages. We also found that having other STIs was associated with a higher likelihood of being tested for HIV.…”

Factors associated with disclosing men who have sex with men (MSM) sexual behaviors and HIV-positive status: A study based on a social network analysis in Nanjing, China

“…However, few studies have comparable results. Researches concerning same-sex behavior focused mainly on age and HIV risk [ 39 – 42 ], while others found that older MSM reported less MSM behaviors [ 32 , 43 ].…”

Perceptions of HIV Seriousness, Risk, and Threat Among Online Samples of HIV-Negative Men Who Have Sex With Men in Seven Countries

“…It is possible that a higher perceived seriousness of HIV actually delayed participants’ sexual debut. An earlier age of sexual debut has been associated with engaging in sexual risk behaviours and positive HIV status [ 32 , 33 ]. We have observed the inverse; perhaps a later age of sexual debut may in turn be associated with more conservative sexual behaviors or fewer sexual partners, leading to participants’ perception of a lower risk of contracting HIV.…”