Situational predictors of sexual risk episodes among men with HIV who have sex with men

Abstract

Background Men with HIV who have sex with men (MSM) represent the largest group of people living with HIV/AIDS in the United States. It is important to understand the sexual risk-taking behaviours that may be linked to the transmission of HIV and other sexually transmitted infections in this population. Models of HIV risk that focus solely on personal factors have been demonstrated to be ineffective at explaining risk behaviour. Rather, in order to fully understand sexual risk-taking, it is important to examine the factors linked to high-risk sexual situations and not solely the factors linked to potentially high-risk people. Methods A diverse sample of 100 MSM with HIV completed a 6-week internet-based sex diary that collected detailed information on recent sexual encounters. In total, information on over 250 sexual episodes was collected and analysed. Generalised linear mixed models were used to examine situational predictors of risk episodes. Results Analyses revealed that drug use by self and sex partners (examined individually and together) were positively related to risk episodes. Likewise, having a sex partner met online and having a sexual encounter in a sex party or bathhouse setting was linked to risk episodes. Sexual episodes that involved a sex-partner who was perceived as sexually desirable and those involving communication about HIV and/or condom use with partners each were negatively related to risk. Conclusions Situational factors play an important role in explaining sexual risk-taking among MSM with HIV. Researchers should place a greater focus on drug use and characteristics of sex partners and settings in which sexual behaviours occur as situational predictors of risk in order to comprehensively understand sexual risk-taking in this population.

Nested Event-Level Case–Control Study of Drug Use and Sexual Outcomes in Multipartner Encounters Reported by Men Who Have Sex with Men

“…The findings from this study match those of analyses of dyadic encounters that found significant associations between drug use and UAI in MSM [2,3,5,26,27], and stands in contrast to those studies which have not found a significant association [6,7]. Previous studies have been mixed as to the association between location of sex and [5,7,[28][29][30].…”

“…Previous studies have been mixed as to the association between location of sex and [5,7,[28][29][30]. The nonsignificant associations between location of sex and sexual risk behaviour in this study continue the debate and extend findings to multipartner encounters specifically.…”

“…at least five drinks before sex) or crystal methamphetamine. While several event-level case-crossover studies have demonstrated statistically significant associations between specific drug use and sexual risk behaviour [2][3][4][5], others have demonstrated non-significant results [6,7]. In addition, few event-level studies have specifically examined the context of multipartner sexual encounters, i.e.…”

Sex Parties among Urban MSM: An Emerging Culture and HIV Risk Environment

“…Private sex parties may be an especially important type of GSE regarding HIV sexual risk among MSM [2,6,7,15]. Between 8 and 25% of MSM in various studies report having met recent male sex partners at private sex parties [6,16,17], and meeting sexual partners at sex parties has been associated with high-risk sexual behavior [6,7,9]. Bareback sex parties have been associated with particularly high-risk behaviors among MSM.…”

“…Environmental contexts, such as venues where men who have sex with men (MSM) meet sexual partners, may influence sexual behavior and HIV risk [1][2][3][4][5][6][7][8][9][10]. Group sex events (GSEs) have begun to receive attention as an emerging risk environment for transmission and acquisition of HIV and other sexually transmitted diseases (STDs) among MSM.…”