Sexual Debut and HIV-Related Sexual Risk-Taking by Birth Cohort Among Men Who Have Sex with Men in the United States

Nelson, Kimberly M.; Gamarel, Kristi E.; Pantalone, David W.; Carey, Michael P.; Simoni, Jane M.

doi:10.1007/s10461-016-1330-0

Cited by 49 publications

(47 citation statements)

References 42 publications

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“…Regardless of sex of first partner, we also found that earlier age of sexual debut was associated with an increased likelihood of having more frequent condomless sex, having more lifetime sexual partners and being infected with HIV or syphilis. Our observation of the associations between earlier age of sexual debut and later risky sexual behaviors are consistent with other studies among both MSM and general populations [19, 21, 27, 28]. …”

Section: Discussionsupporting

confidence: 92%

“…Partner characteristics and age at sexual debut may influence future mental/sexual health and set risky behavior patterns [20]. Studies show that MSM who have sexual debut at a younger age are more likely to sell sex for money/drugs, have more sexual partners, practice condomless sex and encounter psychological/emotional problems [19, 21]. Another study also shows that MSM who have their first sex with an older partner may be at elevated risk of HIV and STIs [22].…”

Section: Introductionmentioning

confidence: 99%

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Subsequent Sexual Risks Among Men Who Have Sex with Men May Differ by Sex of First Partner and Age at Sexual Debut: A Cross-Sectional Study in Beijing, China

et al. 2017

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Sexual debut experience may influence HIV/sexual risks among men who have sex with men (MSM). We assessed associations between age of sexual debut and sex of debut partner with recent (past-3-month) sexual/HIV/syphilis risks among 3588 community-based Chinese MSM. Sexual debut with women was associated with more recent (condomless) insertive anal sex with men, more recent (condomless) vaginal sex, and more lifetime female partners. Sexual debut with men was associated with more recent (condomless) receptive anal sex with men and more lifetime male partners. All associations were strongest among those having first sex ≤18 years in both groups. Earlier sexual debut was associated with higher HIV/syphilis risk; HIV risk was higher with first sex with a man, but syphilis was higher with first sex with a woman. Earlier age of sexual debut is associated with greater HIV/syphilis and sexual risks, but MSM risk differs with first sex with women versus men.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Subsequent Sexual Risks Among Men Who Have Sex with Men May Differ by Sex of First Partner and Age at Sexual Debut: A Cross-Sectional Study in Beijing, China

et al. 2017

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“…However, having sexual debut at less than 17 years and a low knowledge score in HIV transmission were positively associated with the incongruence of dfperceived and actual risk. Previous Thai study found that earlier sexual debut was associated with prevalent HIV infection , which could be a result of limited knowledge about HIV transmission, leading to engaging in condomless sex . Despite our findings, it is crucial to tailor educational materials to TGW preferences; they are more likely to allow fellow TGW peers who they can identify with to educate them .…”

Section: Discussionsupporting

confidence: 79%

Discordance between self‐perceived and actual risk of HIV infection among men who have sex with men and transgender women in Thailand: a cross‐sectional assessment

et al. 2019

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Introduction Low uptake of HIV testing and services, including pre‐exposure prophylaxis (PrEP), in Thai men who have sex with men (MSM) and transgender women (TGW) may be due to the inaccuracy in self‐risk assessment. This study investigated the discordance between self‐perceived HIV risk and actual risk. Methods Data were obtained between May 2015 and October 2016 from MSM and TGW enrolled in key population‐led Test and Treat study in six community health centres in Thailand. Eligible participants were at least 18 years old, Thai national, had sex with men, had unprotected sex with a man in the past six months or had at least three male sex partners in the past six months, and were not known to be HIV positive. Baseline demographic behavioural characteristics questionnaires, including self‐perceived HIV risk, were self‐administered. Participants received HIV/STI (syphilis/gonorrhoea/chlamydia) testing at baseline. Participants who self‐perceived to have low risk, but engaged in HIV‐susceptible practices were categorized as having risk discordance (RD). Regression was conducted to assess factors associated with RD among MSM and TGW separately. Results Of the 882 MSM and 406 TGW participants who perceived themselves as having low HIV risk, over 80% reported at least one of the following: tested HIV positive, engaged in condomless sex, tested positive for a sexually transmitted infection sexually transmitted infection (STI; or used amphetamine‐type stimulants. Logistic regression found that living with a male partner (p = 0.005), having never tested for HIV (p = 0.045), and living in Bangkok (p = 0.01) and Chiang Mai (p < 0.001) were associated with increased risk discordance among MSM. Living with a male partner (p = 0.002), being less than 17 years old at sexual debut (p = 0.001), and having a low knowledge score about HIV transmission (p < 0.001) were associated with increased risk discordance among TGW. However, for TGW, being a sex worker decreased the chance of risk discordance (p = 0.034). Conclusions Future HIV prevention messages need to fill in the gap between self‐perceived risk and actual risk in order to help HIV‐vulnerable populations understand their risk better and proactively seek HIV prevention services.

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“…Independent, binary outcome measures of condomless sexual acts limit the understanding of sexual risk taking among this group of men; utilizing a method that captures a profile of sexual positioning practices provides more insight into nuanced patterns of sexual risk. Sexual positioning practices and HIV/STI risk for BMSMW result from a complex relationship between individual and partner age and HIV status, partner type, and partner gender (Dangerfield II et al, 2016; Hampton et al, 2012; Hubach et al, 2013; Lauby et al, 2008; Mansergh & Marks, 1998; Nelson, Gamarel, Pantalone, Carey, & Simoni, 2016; Osmond, Pollack, Paul, & Catania, 2007; Scott et al, 2014). LCA is one way to explore the conditional probabilities of behaviors within profiles of sexual “risk” and to consider the complex relationship factors that influence condomless sexual acts.…”

Section: Introductionmentioning

confidence: 99%

Latent Classes of Sexual Risk Among Black Men Who Have Sex with Men and Women

et al. 2018

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Black men who have sex with men and women (BMSMW) are at high risk for HIV and other sexually transmitted infections (STIs). Despite knowing that HIV/STI risk varies by sexual positioning practices, limited data have characterized the risk profiles of BMSMW. This study utilized latent class analysis (LCA) to explore BMSMW’s sexual risk profiles regarding condomless sexual positioning practices. Participants were BMSMW who participated in intervention studies in Los Angeles, Chicago, and Philadelphia. LCA was used to characterize sexual risk profiles. Age, study location, HIV status, social support, and internalized homophobia were used as covariates in a multinomial regression model predicting the likelihood of latent class membership. Among the 546 participants, three latent classes of risk were identified: Seropositive Serosorters, Seronegative/unknown Serosorters, and Main Partners Only. All groups had the greatest probabilities of condomless sex with main partners. Seropositive Serosorters had the highest probabilities of condomless sex with HIV-positive partners. Seronegative/unknown Serosorters had highest probabilities of condomless sex with HIV-negative or unknown status partners. HIV-positive BMSMW had 87% lower odds of being classified as Seronegative/unknown Serosorters than Seropositive Serosorters than HIV-negative/unknown status BMSMW (AOR=0.13, 95% CI=0.06, 0.28). HIV-positive BMSMW had 71% lower odds of being classified as Main Partners only than Seropositive Serosorters than HIV-negative/unknown status BMSMW (AOR=0.29, 95% CI=0.16, 0.51). Findings highlight opportunities for clinicians to promote condom use and risk reduction among BMSMW with differing sexual risk profiles. Increased understanding of sexual positioning practices among BMSMW might help address HIV/STIs among this group.

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Sexual Debut and HIV-Related Sexual Risk-Taking by Birth Cohort Among Men Who Have Sex with Men in the United States

Cited by 49 publications

References 42 publications

Subsequent Sexual Risks Among Men Who Have Sex with Men May Differ by Sex of First Partner and Age at Sexual Debut: A Cross-Sectional Study in Beijing, China

Subsequent Sexual Risks Among Men Who Have Sex with Men May Differ by Sex of First Partner and Age at Sexual Debut: A Cross-Sectional Study in Beijing, China

Discordance between self‐perceived and actual risk of HIV infection among men who have sex with men and transgender women in Thailand: a cross‐sectional assessment

Latent Classes of Sexual Risk Among Black Men Who Have Sex with Men and Women

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