Drug Use and Sexual HIV Transmission Risk Among Men Who have Sex with Men and Women (MSMW), Men Who have Sex with Men only (MSMO), and Men Who have Sex with Women Only (MSWO) and the Female Partners of MSMW and MSWO: A Network Perspective

BACKGROUND Men who have sex with men (MSM) currently account for more than two-thirds of new HIV diagnoses in the United States and, among young MSM (YMSM) aged 20 to 29 years, as many as 79% to 84% of new infections occur between primary partners. Contributing to HIV risk, YMSM use drugs at comparatively high rates. To date, no interventions have been developed that specifically address the unique needs of partnered YMSM or incorporate a focus on relationship factors in addressing personal motivation for change. OBJECTIVE The study’s primary aim is to evaluate the efficacy of the PARTNER intervention and evaluate potential moderators or mediators of intervention effects. The study’s secondary aims were to gather ideographic data to inform a future effectiveness implementation study and develop a novel biomarker for pre-exposure prophylaxis (PrEP) adherence by analyzing PrEP drug levels in fingernails. METHODS PARTNER is a 4-session motivational interviewing–based intervention that integrates video-based communication training to address drug use and HIV prevention among partnered YMSM. This study utilizes a randomized controlled trial design to compare the PARTNER intervention with an attention-matched psychoeducation control arm that provides information about HIV-risk reduction, PrEP, and substance use. Participants are randomized in a 1-to-1 ratio stratified on age disparity between partners, racial composition of the couple, and relationship length. Follow-up assessments are conducted at 3-, 6-, 9-, and 12-months postbaseline. The study recruits and enrolls 240 partnered YMSM aged between 18 to 29 years at a research center in New York City. Participants will be HIV-negative and report recent (past 30-day) drug use and condomless anal sex with casual partners; a nonmonogamous primary partner (regardless of HIV status); or a serodiscordant primary partner (regardless of sexual agreement). Primary outcomes (drug use and HIV sexual transmission risk behavior) are assessed via a Timeline Follow-back interview. Biological markers of outcomes are collected for drug use (fingernail assay), sexual HIV transmission risk (rectal and urethral gonorrhea and chlamydia testing), and PrEP adherence (dried blood spots and fingernails for a novel PrEP drug level assay). RESULTS The study opened for enrollment in February 2018. Anticipated completion of enrollment is October 2021. Primary outcome analyses will begin after final follow-up completion. CONCLUSIONS Existing research on partnered YMSM within the framework of Couples Interdependence Theory (CIT) has suggested that relationship factors (eg, dyadic functioning and sexual agreements) are meaningfully related to drug use and HIV transmission risk. Results pertaining to the efficacy of the proposed intervention and the identification of putative moderators and mediators will substantially inform the tailoring of interventions for YMSM in relationships and contribute to a growing body of relationship science focused on enhancing health outcomes. CLINICALTRIAL ClinicalTrials.gov NCT03396367; https://clinicaltrials.gov/ct2/show/NCT03396367 (Archived by WebCite at http://www.webcitation.org/78ti7esTc. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13015

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Do Safer Sex Self-Efficacy, Attitudes toward Condoms, and HIV Transmission Risk Beliefs Differ among Men who Have Sex with Men, Heterosexual Men, and Women Living with HIV?

AIDS and Behavior ◽

10.1007/s10461-011-0108-7 ◽

2012 ◽

Vol 17 (5) ◽

pp. 1873-1882 ◽

Cited By ~ 16

Author(s):

Laura Widman ◽

Carol E. Golin ◽

Catherine A. Grodensky ◽

Chirayath Suchindran

Keyword(s):

Hiv Transmission ◽

Safer Sex ◽

Transmission Risk ◽

Heterosexual Men ◽

Men And Women ◽

Women Living With Hiv ◽

Risk Beliefs ◽

Sex With Men ◽

Hiv Transmission Risk ◽

Living With Hiv

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HIV Transmission Risk Behavior in a Cohort of HIV-Infected Treatment-Naïve Men and Women in the United States

AIDS and Behavior ◽

10.1007/s10461-016-1365-2 ◽

2016 ◽

Vol 20 (12) ◽

pp. 2983-2995 ◽

Cited By ~ 4

Author(s):

Raphael J. Landovitz ◽

Thuy Tien T. Tran ◽

Susan E. Cohn ◽

Ighovwhera Ofotokun ◽

Catherine Godfrey ◽

...

Keyword(s):

United States ◽

Risk Behavior ◽

Hiv Transmission ◽

The United States ◽

Transmission Risk ◽

Men And Women ◽

Treatment Naïve ◽

Hiv Transmission Risk

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Superimposing incident sexually transmitted infections on HIV phylogram to investigate possible misclassification of men who have sex with men as heterosexuals in a cohort in Antwerp, Belgium

International Journal of STD & AIDS ◽

10.1177/0956462418821752 ◽

2019 ◽

Vol 30 (5) ◽

pp. 486-495

Author(s):

Kara K Osbak ◽

Conor J Meehan ◽

Sergio G Ribas ◽

Leo Heyndrickx ◽

Kevin K Ariën ◽

...

Keyword(s):

Sexually Transmitted Infections ◽

Sexual Behaviour ◽

Hiv Transmission ◽

Phylogenetic Analyses ◽

Laboratory Data ◽

Risk Groups ◽

Transmission Risk ◽

Sexually Transmitted ◽

Sex With Men ◽

Hiv Transmission Risk

In this study, we assessed if the superimposition of incident sexually transmitted infections (STIs) on HIV phylogenetic analyses could reveal possible sexual behaviour misclassifications in our HIV-infected population. HIV-1 sequences collected between 1997 and 2014 from 1169 individuals attending a HIV clinic in Antwerp, Belgium were analysed to infer a partial HIV transmission network. Individual demographic, clinical and laboratory data collected during routine HIV follow-up were used to compare clustered and non-clustered individuals using logistic regression analyses. In total, 438 (37.5%) individuals were identified in 136 clusters, including 76 transmission pairs and 60 clusters consisting of three or more individuals. Individuals in a cluster were more likely to have a history of syphilis, Chlamydia and/or gonorrhoea (P < 0.05); however, when analyses were stratified by HIV transmission risk groups (heterosexual and men who have sex with men [MSM]), this association only remained significant for heterosexuals with syphilis (P = 0.001). Under closer scrutiny, this association was driven by six heterosexual men who were located in six almost exclusively MSM clusters. A parsimonious conclusion is that these six individuals were potentially misclassified as heterosexual. Improving the accuracy of sexual behaviour reporting could improve care.

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Potential HIV transmission risk among spouses: marriage intention and expected extramarital male-to-male sex among single men who have sex with men in Hunan, China

Sexually Transmitted Infections ◽

10.1136/sextrans-2018-053906 ◽

2019 ◽

Vol 96 (2) ◽

pp. 151-156 ◽

Cited By ~ 1

Author(s):

Weizi Wu ◽

Xiaochen Yan ◽

Xiaoxia Zhang ◽

Lloyd Goldsamt ◽

Yuanyuan Chi ◽

...

Keyword(s):

Hiv Transmission ◽

Multivariate Logistic Regression Analysis ◽

Transmission Risk ◽

Cross Sectional Survey ◽

Sexual Behaviours ◽

Route Of Transmission ◽

Related Stigma ◽

Male Sex ◽

Sex With Men ◽

Hiv Transmission Risk

ObjectiveThe HIV epidemic in China is shifting from the high-risk groups of men who have sex with men (MSM), injection drug users and sex workers to the general population, and sexual contact among spouses is assumed to be one route of transmission. Our objective was to determine the intention to marry and the expected extramarital male-to-male sex among single Chinese MSM, in order to estimate the potential HIV transmission risk among MSM living with HIV and their female spouses.MethodsWe conducted a web-based, cross-sectional survey between May 2016 and May 2017. A questionnaire covering sociodemographic characteristics, sexual behaviours, HIV-related and homosexuality-related stigma, marriage intention, and expected extramarital sexual behaviours was completed by 556 single MSM in Hunan, China. Descriptive statistics, χ2 test, two-sample t-test and multivariate logistic regression analysis were performed.ResultsCurrently 48.9% of the participants intended to marry a woman in their lifetime, and 91% of them reported that they would continue to have sex with men after getting married. Those who were living with parents (OR=2.26), self-identified as bisexual (OR=2.57), had at least one heterosexual partner in the previous 6 months (OR=0.33) and perceived a higher level of self-homosexual stigma (OR=1.78) had greater intention to marry a woman.ConclusionNearly half of Chinese MSM intend to marry women, which has significantly dropped from the estimated percentage more than 10 years ago for Chinese MSM. However, the expectation of extramarital homosexual behaviours was common in these men. Sexual and gender minority stresses especially from family members, homosexual identity assertiveness and related stigma were the main factors for marriage intention, which should be addressed in future studies and practices.

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