The rectal mucosa and condomless receptive anal intercourse in HIV-negative MSM: implications for HIV transmission and prevention

OBJECTIVES/SPECIFIC AIMS: In the first aim, we will evaluate the proportion of highly HIV-susceptible memory CD4+ T cells present in the rectal mucosa, based on the proliferation status and expression of the HIV susceptibility markers, CCR5 and α4β7, between HIV-negative adolescent MSM and adult MSM engaging in RAI. The second aim will assess differences between the two study groups in the ratio of Th17 cells (CD4+ IL17+) to Treg cells (CD4+ FoxP3+ CD25+) in the rectal mucosa as a determinant of mucosal inflammation. Finally, in the third aim, we will utilize ex vivo rectal biopsy explant challenge experiments to examine whether HIV target cell availability and the Th17/Treg ratio influence rectal mucosal HIV susceptibility. METHODS/STUDY POPULATION: Rectal biopsy specimens are being collected from healthy, HIV-negative men that comprise the two study groups: 40 adolescent MSM 18-21 years of age who have engaged in RAI at least once previously in their lifetime and 40 adult MSM ≥35 years of age who have engaged in RAI for the previous 5 consecutive years with a minimum of 12 episodes annually. To identify CD4+ subsets of interest for aims 1 and 2, rectal mucosal mononuclear cells are isolated and phenotyped with CD45, CD3, CD4, CD45RA, CCR7, CD69, CCR5, α4β7, Ki67, FOXP3, and CD25 antibodies. To identify the Th17 cell subtype, the cells are stimulated with PMA/Ionamycin and stained with an antibody specific to IL-17A. Using cross-sectional analyses, we will compare the frequencies of mucosal CD4+ T cells that express certain phenotypic characteristics and evaluate differences in the Th17/Treg ratio between adolescent and adult MSM. For aim 3, rectal biopsy specimens are inoculated with HIV virus and the culture supernatant is assayed for p24 concentration on days 3, 7, 10 14, and 18. Longitudinal analyses will be performed to detect differences in p24 concentration at each time point and assess associations with mucosal target cell availability and with the Th17/Treg ratio. RESULTS/ANTICIPATED RESULTS: We hypothesize that younger age will be associated with enhanced memory CD4+ T cell proliferation and increased expression of HIV susceptibility markers (CCR5 and/or α4β7). In addition, we expect that the rectal mucosa of adolescent MSM will demonstrate a higher Th17/Treg ratio as compared to adult MSM, which could facilitate HIV transmission. It is also anticipated that rectal mucosal immune phenotypes characterized by increased HIV target cell availability and high Th17/Treg ratios will be associated with enhanced mucosal HIV susceptibility in the explant challenge model. DISCUSSION/SIGNIFICANCE OF IMPACT: There is a paucity of information regarding the mechanisms of rectal HIV transmission, and no studies to date investigate the immunologic effects of aging on transmission in the rectal mucosa. The results from this study will provide important information regarding age-related differences in the immune cell composition of the rectal mucosa as a critical step in better understanding immunologic factors that influence rectal HIV transmission.

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Alcohol and Condomless Insertive Anal Intercourse Among Black/Latino Sexual-Minority Male Non-PrEP Users

Urban Social Work ◽

10.1891/usw-d-20-00001 ◽

2021 ◽

Vol 5 (1) ◽

pp. 43-59

Author(s):

Thomas Alex Washington ◽

Jo Brocato ◽

Sheldon Applewhite ◽

Yarneccia D. Dyson ◽

Angel Ramos

Keyword(s):

Los Angeles ◽

Alcohol Use ◽

Hiv Transmission ◽

Anal Intercourse ◽

Self Report ◽

Anal Sex ◽

Research Attention ◽

Insertive Anal Intercourse ◽

Condomless Anal Intercourse ◽

Hiv Negative

ObjectiveThis study examined factors associated with alcohol use and condomlessinsertive anal sex among a sample of BLMSM (N = 188), self-identified as HIV- negative, ages 18–40. The influence of alcohol use on sexual positioning during condomless anal intercourse among Black and Latino men who have sex with men (BLMSM) warrants research attention because of the pervasive misinformation regarding the risk of HIV transmission and the disproportionate impact of the HIV epidemic for this population.MethodsSelf-report survey questionnaires were administered in real time at bars/clubs; public organized events; local colleges/universities; social media advertisements; private men's groups; and organized events in Los Angeles County.ResultsLogistic regression predicted those reporting risky sex when using alcohol were seven times more likely to report condomless insertive anal sex.ConclusionClear messaging about alcohol moderation, dispelling the myths about strategic positioning, and pre-exposure prophylaxis (PrEP) use among HIV negative BLMSM could potentially reduce HIV acquisition/transmission.

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Condom Use, Disclosure, and Risk for Unprotected Sex in HIV-Negative Midlife and Older Men Who Have Sex With Men

American Journal of Men s Health ◽

10.1177/1557988312463417 ◽

2012 ◽

Vol 7 (3) ◽

pp. 186-197 ◽

Cited By ~ 13

Author(s):

Robin J. Jacobs ◽

Michael N. Kane ◽

Raymond L. Ownby

Keyword(s):

Sexual Risk ◽

Anal Intercourse ◽

Unprotected Sex ◽

Receptive Anal Intercourse ◽

Sexual Risk Taking ◽

Cross Sectional ◽

Insertive Anal Intercourse ◽

Sex With Men ◽

Older Msm ◽

Hiv Negative

Sexual risk behaviors account for most HIV infections in men who have sex with men (MSM), and the risk of exposure from each sexual encounter increases with age. The focus of this study was to investigate which behaviors in midlife and older MSM influence their sexual risk/protection. Cross-sectional data were collected from a community-based sample of 802 MSM aged 40 years and older from community venues (e.g., bars) who completed an anonymous questionnaire. Data from a subset of 420 MSM who were HIV-negative (aged 40-81 years) were used to investigate which behaviors were associated with greater risk for unprotected anal sex. Regression analyses indicated that erection difficulties (odds ratio [OR] = 4.7; 95% confidence interval [CI] = 1.8-12.2), practicing safe sex with outside partners but not with one’s primary partner (OR = 0.54; 95% CI = 0.3-0.94), and recreational drug use (OR = 2.6; 95% CI = 1.3-5.1) were associated with higher risk for unprotected receptive anal intercourse. Younger age (OR = 0.96; 95% CI = 0.9- 0.9), not telling partners about HIV status (OR = 3.2; 95% CI = 1.5-6.5), finding partners in backrooms/sex clubs (OR = 2.8; 95% CI = 1.1- 6.8), and erection difficulties (OR = 10.3; 95% CI = 2.8-37.8) were associated with higher risk for unprotected insertive anal intercourse. These data indicate there may be certain factors specific to older MSM that influence their sexual risk taking behaviors. Programs may be more effective if they are tailored for older cohorts of MSM and address interpersonal communication, erection problems, and substance use to reduce health risks and promote healthier lifestyles.

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The Classification of the Persistent Infection Risk for Human Papillomavirus among HIV-Negative Men Who Have Sex with Men: Trajectory Model Analysis

BioMed Research International ◽

10.1155/2020/8174983 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Bingxue Huang ◽

Duolao Wang ◽

Christiana Papamichael ◽

Tian Tian ◽

Xiaoqing Tuo ◽

...

Keyword(s):

Risk Factors ◽

Condom Use ◽

Anal Intercourse ◽

Infection Risk ◽

Receptive Anal Intercourse ◽

Anal Sex ◽

The Past ◽

Sex With Men ◽

Hiv Negative

Objective. To classify the infection risk of human papillomavirus (HPV) among human immunodeficiency virus- (HIV-) negative men who have sex with men (MSM) using group-based trajectory modeling (GBTM). Methods. This study collected data on demographic and sexual behavior characteristics by questionnaires at semiannual visits from March 1st, 2016 to December 31th, 2017. Researchers collected anal exfoliated cells to finish HPV testing and blood samples to finish HIV testing at baseline and follow-up visits. Accumulative infection numbers of different types of HPV as the primary outcome and the follow-up visits as the independent predicator to build a GBTM model. Results. There were 500 potentially eligible HIV-negative participants at baseline, 361 (72.2%) of whom were included in this study after screening. Three trajectory groups were identified as the best-fitted GBTM model. Trajectory 1, defined as decreased group (DG) accounted for 44.6% (161/361) of the sample, showed a declining pattern with visits. Trajectory 2, defined as flat group (FG) accounted for 49.6% (179/361) of the sample, showed a flat pattern with visits. Trajectory 3, regarded as the increased group (IG) accounted for 5.8% (21/361) of the sample, showed an uptrend. Compared to the DG, risk factors for the FG included receptive anal intercourse (AOR, 2.24; 95% CI, 1.36-3.71), occasional condom use in anal sex during the past six months (AOR, 1.90; 95% CI, 1.16-3.14), experience of transactional sex with males in the past year (AOR, 3.60; 95% CI, 1.12-11.54), and substance use (AOR, 1.81; 95% CI, 1.08-3.04). Risk factors for the IG included receptive anal intercourse (AOR, 2.81; 95% CI, 1.04-7.70), occasional condom use in anal sex during the past six months (AOR, 3.93; 95% CI, 1.40-11.01), and history of other STIs (AOR, 5.72; 95% CI, 1.40-23.46). Conclusion. The MSM data in this study showed three distinct developmental trajectories (DG, FG, and IG) of HPV infection among HIV-negative MSM, with receptive anal intercourse and occasional condom use in anal sex during the past six months being the risk factors associated with FG and IG.

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High levels of undiagnosed rectal STIs suggest that screening remains inadequate among Black gay, bisexual and other men who have sex with men

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054563 ◽

2021 ◽

pp. sextrans-2020-054563

Author(s):

Ryan J Watson ◽

Charlene Collibee ◽

Jessica L Maksut ◽

Valerie A Earnshaw ◽

Katherine Rucinski ◽

...

Keyword(s):

Hiv Transmission ◽

Anal Intercourse ◽

Sex Partners ◽

Hiv Diagnosis ◽

Key Population ◽

Condomless Anal Intercourse ◽

Rapid Tests ◽

Sex With Men ◽

Hiv Acquisition ◽

Hiv Negative

ObjectiveTo better understand rectal STI screening practices for Black gay, bisexual and other men who have sex with men (BGBMSM).FindingsAlthough 15% of BGBMSM lab tested positive for a rectal STI, the majority of these (94%) were asymptomatic. Though all participants reported their status as HIV negative/unknown, 31 of 331 (9.4%) tested positive on HIV rapid tests. Neither condomless anal intercourse nor the number of male sex partners was associated with rectal STI or HIV diagnosis, although rectal STI diagnosis was positively related to testing HIV positive.ConclusionsFindings suggest that substantial numbers of BGBMSM have asymptomatic STIs but are not tested—an outcome that is likely a strong driver of onward HIV acquisition. Therefore, we must address the asymptomatic STI epidemic among GBMSM in order to reduce HIV transmission, as well as temper STI transmission, among this key population.

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Short Communication: Anatomic Site of Sampling and the Rectal Mucosal Microbiota in HIV Negative Men Who Have Sex with Men Engaging in Condomless Receptive Anal Intercourse

AIDS Research and Human Retroviruses ◽

10.1089/aid.2017.0206 ◽

2018 ◽

Vol 34 (3) ◽

pp. 277-281 ◽

Cited By ~ 6

Author(s):

Nicole A. Pescatore ◽

Rebecca Pollak ◽

Colleen S. Kraft ◽

Jennifer G. Mulle ◽

Colleen F. Kelley

Keyword(s):

Short Communication ◽

Anal Intercourse ◽

Receptive Anal Intercourse ◽

Anatomic Site ◽

Sex With Men ◽

Hiv Negative

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Improved PrEP Awareness and Use among Trans Women in San Francisco, California

AIDS and Behavior ◽

10.1007/s10461-021-03417-3 ◽

2021 ◽

Author(s):

Erin C. Wilson ◽

Christopher J. Hernandez ◽

Susan Scheer ◽

Dillon Trujillo ◽

Sean Arayasirikul ◽

...

Keyword(s):

San Francisco ◽

Anal Intercourse ◽

Receptive Anal Intercourse ◽

The Past ◽

National Hiv Behavioral Surveillance ◽

Trans Women ◽

Gender Based ◽

Prep Awareness ◽

Almost All ◽

Exposure Prophylaxis

AbstractTransgender women face a serious risk of HIV infection. Despite this, there is limited knowledge and use of Pre-exposure prophylaxis (PrEP). We measured the continuity of prevention across services in the PrEP cascade and correlates of PrEP use among trans women in San Francisco enrolled in the 2019/20 National HIV Behavioral Surveillance Study. Knowledge and use of PrEP among trans women in San Francisco increased in recent years; almost all (94.0%) had heard about PrEP, 64.7% had discussed PrEP with a healthcare provider, and 44.8% had taken PrEP in the past 12 months. PrEP use was associated with participation in a PrEP demonstration project (aOR = 31.44, p = 0.001) and condomless receptive anal intercourse (aOR = 3.63, p = 0.024). Injection drug use was negatively associated (aOR = 0.19, p = 0.014). Efforts are needed to combat the gender-based stigma and discrimination faced by trans women, which can result in avoidance and mistrust of the medical system.

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How condom use, number of receptive anal intercourse partners and history of external genital warts predict risk for external anal warts

International Journal of STD & AIDS ◽

10.1258/0956462053420176 ◽

2005 ◽

Vol 16 (3) ◽

pp. 203-211 ◽

Cited By ~ 9

Author(s):

D J Wiley ◽

Diane M Harper ◽

David Elashoff ◽

Michael J Silverberg ◽

Christine Kaestle ◽

...

Keyword(s):

Condom Use ◽

Anal Intercourse ◽

Consistent Condom ◽

Prior History ◽

Receptive Anal Intercourse ◽

Protective Effects ◽

Lifetime Number ◽

History Of ◽

Anal Warts ◽

External Genital Warts

Few analytic opportunities have allowed us to evaluate the role that specific sexual acts and male latex condoms play in the acquisition of external anal warts (EAW) using longitudinal data. The acquisition of EAWs occurs from epithelial contact with other HPV-infected surfaces, and hence is dependent upon sexual behaviour. Our objectives were to classify the relative importance of condom use, receptive anal intercourse (RAI) and prior history of EGWs on acquisition of EAWs. The observational Multicenter AIDS Cohort Study followed 2925 men over nine semiannual study visits for behavioural and physical examinations with laboratory testing. The main outcome measure was the occurrence of examiner-diagnosed EAWs in a homosexual population. EAWs were diagnosed among 10% of men studied across 22,157 visits reviewed for this study. Men with history of EGWs were more likely than those previously unaffected to have developed EAWs (cOR = 2.4 (2.0, 2.9)), as were men who reported multiple anoreceptive intercourse partners (e.g., compared with men who reported no RAI partners, men with 1, 2–5, ≥6 RAI partners had crude risk ratios 1.0 (0.8, 1.3), 1.6 (1.2, 2.1), 3.9 (2.7, 5.8), respectively). These relations persisted after other demographic and sexual risk factors were controlled for in the analyses. Consistent condom usage showed no protective effect for EAWs in our crude or adjusted analyses. Patient education messages should be tailored to reflect our uncertainty about the protective nature of condoms for the development of anal warts, but to continue to assert the protective effects of a limited lifetime number of sexual partners and the heightened risk for wart recurrence once infected.

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HIV Risk Behavior and Beliefs of HIV-Seropositive Drug Users

Journal of Drug Issues ◽

10.1177/002204269202200403 ◽

1992 ◽

Vol 22 (4) ◽

pp. 833-847 ◽

Cited By ~ 5

Author(s):

Christina Hartgers ◽

Pieta Krijnen ◽

Johanna A.R. van den Hoek ◽

Roel A. Coutinho ◽

Joop van der Pligt

Keyword(s):

Risk Behavior ◽

Hiv Risk ◽

Drug Users ◽

Hiv Transmission ◽

Hiv Risk Behavior ◽

Unsafe Sex ◽

Response Efficacy ◽

Female Prostitute ◽

Hiv Seropositive ◽

Hiv Negative

To assess HIV risk behavior, beliefs, attitudes and intentions among HIV-seropositive drug users (DUs), we studied 122 HIV-positive DUs (including ninety-five current injectors) participating in a longitudinal HIV-study among DUs in Amsterdam. All were familiar with their serostatus. Over a period of four months, 20% of the sample put others at risk of HIV infection, mainly through unsafe sex. Forty-nine percent think they might infect someone with HIV in the future, again mainly through unsafe sex. Although the majority intends to use condoms, self-efficacy and response efficacy is low; that is, many do not think they are able to use condoms when necessary and many have limited confidence in the efficacy of condoms in preventing HIV transmission. Correlates of HIV risk behavior were non-Dutch nationality and being a female prostitute. The results suggest that, next to efforts which aim to prevent new infections among HIV-negative injectors or sexual partners of injectors, prevention efforts should focus on HIV-seropositive DUs or former DUs.

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