Risk of Fecal Incontinence Following Receptive Anal Intercourse: Survey of 21,762 Men Who Have Sex With Men

2021 ◽  
Author(s):  
Aurélien Garros ◽  
Michel Bourrely ◽  
Luis Sagaon-Teyssier ◽  
Abdourahmane Sow ◽  
Nathalie Lydie ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Anal Intercourse ◽  
Receptive Anal Intercourse ◽  
Sex With Men

Getting to the Bottom of It: Sexual Positioning and Stage of Syphilis at Diagnosis, and Implications for Syphilis Screening

2019 ◽  
Vol 71 (2) ◽  
pp. 318-322
Author(s):  
Vincent J Cornelisse ◽  
Eric P F Chow ◽  
Rosie L Latimer ◽  
Janet Towns ◽  
Marcus Chen ◽  
...  
Keyword(s):  
Health Centre ◽  
Anal Intercourse ◽  
Human Immunodeficiency Virus Status ◽  
Secondary Syphilis ◽  
Multivariable Logistic Regression Analysis ◽  
Computer Assisted ◽  
Receptive Anal Intercourse ◽  
Primary Stage ◽  
Primary Syphilis ◽  
Sex With Men

Abstract Background Syphilis control among men who have sex with men (MSM) would be improved if we could increase the proportion of cases who present for treatment at the primary stage rather than at a later stage, as this would reduce their duration of infectivity. We hypothesized that MSM who practiced receptive anal intercourse were more likely to present with secondary syphilis, compared to MSM who did not practice receptive anal intercourse. Methods In this retrospective analysis of MSM diagnosed with primary or secondary syphilis at Melbourne Sexual Health Centre between 2008 and 2017, we analyzed associations between the stage of syphilis (primary vs secondary) and behavioral data collected by computer-assisted self-interviews. Results There were 559 MSM diagnosed with primary (n = 338) or secondary (n = 221) syphilis. Of these, 134 (24%) men reported not practicing receptive anal sex. In multivariable logistic regression analysis, MSM were more likely to present with secondary rather than primary syphilis if they reported practicing receptive anal intercourse (adjusted odds ratio 3.90; P < .001) after adjusting for age, human immunodeficiency virus status, and condom use. MSM with primary syphilis who did not practice receptive anal intercourse almost always (92%) had their primary syphilis lesion on their penis. Conclusions The finding that MSM who practiced receptive anal intercourse more commonly presented with secondary syphilis—and hence, had undetected syphilis during the primary stage—implies that anorectal syphilis chancres are less noticeable than penile chancres. These men may need additional strategies to improve early detection of anorectal chancres, to reduce their duration of infectivity and, hence, reduce onward transmission. Men who practiced receptive anal intercourse (AI) were more likely to present with secondary syphilis, compared to men who exclusively practiced insertive AI. Hence, men who practice receptive AI may need additional strategies to detect anal chancres, to reduce transmission.

Comparing non-occupational post-exposure prophylaxis drug regimens for HIV: insights from a linked HIV surveillance system

Sexual Health ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 179 ◽  
Author(s):  
Anna B. Pierce ◽  
Carol El-Hayek ◽  
Damien McCarthy ◽  
Jude Armishaw ◽  
Kerrie Watson ◽  
...  
Keyword(s):  
Anal Intercourse ◽  
Post Exposure Prophylaxis ◽  
Receptive Anal Intercourse ◽  
Hiv Diagnosis ◽  
Hiv Surveillance ◽  
Post Exposure ◽  
Hiv Serostatus ◽  
Drug Regimens ◽  
Sex With Men ◽  
Exposure Prophylaxis

Background International non-occupational post-exposure prophylaxis (NPEP) guidelines recommend routine use of three drug NPEP regimens, despite absence of evidence for greater prevention efficacy compared with two drug regimens. This study examines the potential for excess HIV seroconversions among high-risk men who have sex with men (MSM) reporting receptive anal intercourse with a source of unknown HIV serostatus (RAIU) following a two-drug versus a three-drug NPEP regimen. Methods: Data for MSM in the Victorian NPEP service database between 10 August 2005 and 31 December 2012 were linked with all Victorian HIV notifications up to 31 December 2013. The primary outcome was NPEP failure following NPEP presentation among MSM reporting RAIU, stratified by the number of drugs prescribed. Results: Among 1482 MSM reporting 2002 episodes of RAIU and prescribed two- or three-drug NPEP, 70 seroconverted to HIV, but only 19 were considered possible NPEP failures. HIV diagnosis incidence among men reporting RAIU was 1.2/100 person years (PY) (95%CI = 1.0–1.6); 1.1/100 PY (95%CI = 0.8–1.4) among MSM prescribed two drugs and 2.2/100 PY (95%CI = 1.4–3.7) among MSM prescribed three drugs (P < 0.01). Of the 19 possible NPEP failures, 13 (0.7%) were prescribed two drugs and six (2.7%) three drugs (P < 0.001). Conclusions: This study suggests that two-drug NPEP regimens do not result in excess seroconversions compared with three-drug regimens when used following RAIU. Clinical services should carefully consider their use of three drug NPEP and whether resources might be better invested in other prevention strategies, particularly pre-exposure prophylaxis (PrEP).

scholarly journals Enhancing HIV Prevention Services: Exploring Psychosocial Associations of HIV Antibody Testing Frequency among Sexually Active Men who have Sex with Men

2021 ◽  
Vol 9 (4) ◽  
Author(s):  
Todd Sabato
Keyword(s):  
Hiv Prevention ◽  
Hiv Testing ◽  
Internalized Homophobia ◽  
Anal Intercourse ◽  
Receptive Anal Intercourse ◽  
Sexually Active ◽  
Antibody Testing ◽  
Prevention Services ◽  
Testing Frequency ◽  
Sex With Men

Despite recommendations of annual HIV testing for high-risk individuals, one-third of infected men who have sex with men (MSM) are unaware of their serostatus. In an effort to improve HIV prevention services and subsequently decrease prevalence, this study aimed to examine the HIV testing patterns and factors associated with testing frequency among MSM. Utilizing eight reliable and validated instruments and a sample of 374 sexually active MSM, this study examined a series of demographic, behavioral and psychosocial associations of antibody testing frequency, including substance use/abuse, depression levels, internalized homophobia, unprotected anal intercourse, sexual regulation and attribution, and HIV knowledge, . MSM who tested for HIV frequently were more likely to be older, have higher levels of educational attainment, and self-identify as gay. Respondents who reported never having been tested and irregularly tested had higher levels of internalized homophobia, depression, and alcohol use and abuse patterns. Respondents who had never been tested or infrequently tested engaged in lower levels of sexual risk, particularly unprotected receptive anal intercourse. Those with no or irregular histories of testing also exhibited greater external sexual loci of control, and were significantly more likely to attribute life events to external, unstable, and pessimistic causes.

Condomless Receptive Anal Intercourse is Associated with Markers of Mucosal Injury in a Cohort of Men Who Have Sex with Men

2020 ◽  
Author(s):  
Colleen F. Kelley ◽  
Ilana Pollack ◽  
Rami Yacoub ◽  
Zhengyi Zhu ◽  
Sanjeev Gumber ◽  
...  
Keyword(s):  
Mucosal Injury ◽  
Anal Intercourse ◽  
Receptive Anal Intercourse ◽  
Sex With Men

scholarly journals Individual-Level, Partnership-Level, and Sexual Event-Level Predictors of Condom Use During Receptive Anal Intercourse Among HIV-Negative Men Who Have Sex with Men in Los Angeles

2015 ◽  
Vol 20 (6) ◽  
pp. 1315-1326 ◽  
Author(s):  
Heather A. Pines ◽  
Pamina M. Gorbach ◽  
Robert E. Weiss ◽  
Cathy J. Reback ◽  
Raphael J. Landovitz ◽  
...  
Keyword(s):  
Los Angeles ◽  
Condom Use ◽  
Anal Intercourse ◽  
Receptive Anal Intercourse ◽  
Individual Level ◽  
Sex With Men ◽  
Hiv Negative

scholarly journals Factors associated with self-reported discrimination against men who have sex with men in Brazil

2017 ◽  
Vol 51 ◽  
pp. 102 ◽  
Author(s):  
Laio Magno ◽  
Inês Dourado ◽  
Luís Augusto V da Silva ◽  
Sandra Brignol ◽  
Ana Maria de Brito ◽  
...  
Keyword(s):  
Sexual Orientation ◽  
Low Income ◽  
Community Involvement ◽  
Physical Violence ◽  
Anal Intercourse ◽  
Cross Sectional Study ◽  
Receptive Anal Intercourse ◽  
Cross Sectional ◽  
Sex With Men ◽  
Years Of Schooling

OBJECTIVE: To estimate self-reported discrimination due to sexual orientation among men who have sex with men (MSM) in Brazil and to analyze associated factors. METHODS: A cross-sectional study of 3,859 MSM recruited in 2008–2009 with respondent driven sampling. Data collection conducted in health centers in 10 Brazilian cities. A face-to-face questionnaire was used and rapid HIV and syphilis tests conducted. Aggregated data were weighted and adjusted odds ratio estimated to measure the association between selected factors and self-reported discrimination due to sexual orientation. RESULTS: The sample was predominantly young, eight plus years of schooling, pardo (brown), single, low-income, and identified themselves as gay or homosexual. The prevalence of self-reported discrimination due to sexual orientation was 27.7% (95%CI 26.2–29.1). Discrimination was independently associated with: age < 30 years, more years of schooling,community involvement and support, history of sexual and physical violence, suicidal thoughts, and unprotected receptive anal intercourse. CONCLUSIONS: The prevalence of self-reported discrimination among MSM in Brazil is high. These results challenge the assumptions that MSM-specific prevention and support programs are not required or that health professionals do not need special training to address MSM needs.

Relationship power and HIV risk among young Black men who have sex with men in the Southern United States

Sexual Health ◽  
2018 ◽  
Vol 15 (4) ◽  
pp. 292
Author(s):  
JaNelle M. Ricks ◽  
Richard A. Crosby ◽  
Leandro Mena
Keyword(s):  
Black Men ◽  
Hiv Risk ◽  
Male Partner ◽  
Risk Behaviour ◽  
Anal Intercourse ◽  
Receptive Anal Intercourse ◽  
Relationship Power ◽  
Southern Us ◽  
Sex With Men ◽  
The Impact

Background The purpose of this study was to examine the impact of relationship power on HIV risk behaviour among young Black men who have sex with men (MSM) in the Southern US. Methods: Data from 425 Black/African American males aged 18–29 years who reported recent anal intercourse with a male partner were analysed. Five selected measures of relationship power were tested for correlation and association with protected receptive anal intercourse using contingency tables and logistic regression analysis. Results: Acts of 100% protected receptive anal intercourse were common (n = 277, 65.2%). Men who reported low barriers to condom negotiation were significantly more likely to report protected acts (P < 0.001). Men who reported 100% protected acts were less likely to report financial dependence on male sexual partners and serosorting behaviour (12.0% vs 20.7%, P = 0.02; 31.5% vs 49.8%, P < 0.001 respectively). Conclusion: Future efforts should further examine the role of relationship power in HIV risk among young Black MSM, including the intersection of individual, dyadic and social-structure risks.

scholarly journals Predictive factors for HIV infection among men who have sex with men and who are seeking PrEP: a secondary analysis of the PROUD trial

2019 ◽  
Vol 95 (6) ◽  
pp. 449-454 ◽  
Author(s):  
Ellen White ◽  
David T Dunn ◽  
Monica Desai ◽  
Mitzy Gafos ◽  
Peter Kirwan ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Incidence Rate ◽  
Secondary Analysis ◽  
Anal Intercourse ◽  
Receptive Anal Intercourse ◽  
Hiv Incidence ◽  
Open Label ◽  
Eligibility Criteria ◽  
Sex With Men ◽  
Hiv Acquisition

ObjectivesPre-exposure prophylaxis (PrEP) is a highly effective method of HIV prevention for men who have sex with men (MSM). However, uncertainty remains around the optimal eligibility criteria for PrEP, specifically whether there are subgroups at low risk of HIV for whom PrEP might not be warranted.MethodsPROUD was an open-label waitlist trial design that randomised MSM attending participating sexual health centres in England to receive PrEP immediately (IMM) or after a deferral period of 1 year (DEF). This analysis is based on participants who were randomised to the deferred arm, when they did not have access to PrEP. HIV incidence was compared between subgroups defined by baseline characteristics.ResultsOverall, 21 participants acquired HIV infection over 239.3 person-years (PY) follow-up, yielding an incidence rate of 8.8/100 PY (95% CI 5.4 to 13.4). Two highly significant predictors for HIV acquisition were identified. Men with a self-reported diagnosis of syphilis, rectal chlamydia (CT) or rectal gonorrhoea (GC) in the previous 12 months had an incidence of 17.2/100 PY (95% CI 9.7 to 28.5); those reporting receptive anal intercourse without a condom (ncRAI) with two or more partners in the previous 3 months had an incidence of 13.6/100 PY (95% CI 7.9 to 21.7). The incidence rate among participants lacking both of these risk factors was 1.1/100 PY (1/87.6, 95% CI 0.03 to 6.4).ConclusionsThe high HIV incidence in PROUD suggests that most participants appropriately judged their need for PrEP. Eligibility criteria for a PrEP programme can therefore be broad, as in the current guidelines. However, a recent history of syphilis or rectal CT/GC, or multiple ncRAI partners indicates a high imminent risk of HIV infection. MSM with any of these characteristics should be offered PrEP as a matter of urgency.

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