Frequent condom use with casual partners varies by sexual position among younger gay and bisexual men in New Zealand: national behavioural surveillance 2006–2011

Sexual Health ◽  
2016 ◽  
Vol 13 (1) ◽  
pp. 81 ◽  
Author(s):  
Nathan J. Lachowsky ◽  
Peter J. W. Saxton ◽  
Anthony J. Hughes ◽  
Nigel P. Dickson ◽  
Robin R. Milhausen ◽  
...  
Keyword(s):  
New Zealand ◽  
Condom Use ◽  
Anal Intercourse ◽  
Multivariable Logistic Regression Analysis ◽  
Receptive Anal Intercourse ◽  
Bisexual Men ◽  
Regular Partner ◽  
Sexual Position ◽  
Behavioural Surveillance ◽  
And Bisexual

Background Condom promotion remains a cornerstone of HIV/STI control, but must be informed by evidence of uptake and address disparities in use. This study sought to determine the prevalence of, and demographic, behavioural and relational factors associated with, condom use during insertive and receptive anal intercourse with casual partners among younger gay, bisexual and other men who have sex with men (YMSM) in New Zealand. Methods: The 2006–2011 national HIV behavioural surveillance data for YMSM aged 16–29 years was pooled. Separately for each sexual position, frequent (always/almost always) versus infrequent condom use was regressed onto explanatory variables using manual backward stepwise multivariable logistic regression analysis. Results: Three-quarters of YMSM reported frequent condom use during insertive (76.0%) and receptive (73.8%) anal intercourse. YMSM who were exclusively insertive were more likely to report frequent condom use than versatile YMSM. Factors positively associated with frequent condom use, irrespective of sexual position were: in-person versus web-based recruitment, testing HIV negative versus never testing or testing HIV positive, having no recent sex with women, reporting two to five versus one male sexual partner in the past 6 months, reporting no current regular partner, but if in a regular relationship, reporting a boyfriend-type versus fuckbuddy-type partner, and frequent versus infrequent regular partner condom use. Pacific ethnicity and less formal education were negatively associated with frequent condom use only during receptive anal intercourse. Conclusions: The findings from this study demonstrate that condom norms can be actively established and maintained among YMSM. Condom promotion efforts must increase YMSM’s capacity, agency and skills to negotiate condom use, especially for the receptive partner.

scholarly journals Adapting behavioural surveillance to antiretroviral-based HIV prevention: reviewing and anticipating trends in the Australian Gay Community Periodic Surveys

Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 72 ◽  
Author(s):  
Martin Holt ◽  
Toby Lea ◽  
Limin Mao ◽  
Iryna Zablotska ◽  
Evelyn Lee ◽  
...  
Keyword(s):  
Condom Use ◽  
Hiv Testing ◽  
Antiretroviral Drugs ◽  
Hiv Treatment ◽  
Treatment As Prevention ◽  
Bisexual Men ◽  
Condomless Sex ◽  
Gay Community ◽  
Behavioural Surveillance ◽  
And Bisexual

Background In Australia, the preventative use of antiretroviral drugs [pre-exposure prophylaxis (PrEP) and treatment as prevention] is being embraced to protect individuals at high risk of HIV and reduce onward transmission. Methods: The adaptation of a behavioural surveillance system, the Gay Community Periodic Surveys, was reviewed to monitor the uptake and effect of new prevention strategies in Australia’s primary HIV-affected population (gay and bisexual men, GBM). The national trends in key indicators during 2000–15 were reviewed and a new measure to take account of antiretroviral-based prevention was developed. Results: Between 2000 and 2015, there were significant increases (P < 0.001) in annual HIV testing (56.1–64.8%), condomless sex with casual partners (26.8—38.8%) and the proportion of HIV-positive men on HIV treatment (72.5–88.4%) and with an undetectable viral load (73.7–94.7%). The proportion of casual partners who were HIV negative, not on PrEP and who engaged in receptive condomless sex also increased between 2000 and 2015 from 12.8 to 19.3%. Two scenarios anticipating the effect of PrEP highlighted the need to target GBM who engage in receptive condomless sex while also sustaining condom use at a population level. Conclusions: Behavioural surveillance can be successfully adapted to follow the effect of antiretroviral-based prevention. It is anticipated that HIV testing and HIV treatment will continue to increase among Australian GBM, but to prevent new infections, intervention in the growing proportion of GBM who have condomless sex with casual partners is needed. For PrEP to have its desired effect, condom use needs to be sustained.

Baseline characteristics of gay and bisexual men in a HIV pre-exposure prophylaxis demonstration project with equity quotas in Auckland, New Zealand

Sexual Health ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 47 ◽  
Author(s):  
Peter J. W. Saxton ◽  
Sunita Azariah ◽  
Richard A. Franklin ◽  
Rose F. Forster ◽  
Suzanne F. Werder ◽  
...  
Keyword(s):  
New Zealand ◽  
Risk Behaviour ◽  
Gay And Bisexual Men ◽  
Demonstration Project ◽  
Receptive Anal Intercourse ◽  
Sexual Risk Behaviour ◽  
Bisexual Men ◽  
Baseline Characteristics ◽  
And Bisexual ◽  
Exposure Prophylaxis

Background In New Zealand, pre-exposure prophylaxis (PrEP) should target gay and bisexual men (GBM), and equity is an important principle. Baseline characteristics of GBM offered PrEP in a demonstration project with an enrolment quota of 50% non-Europeans are described. Methods: An open-label, single-arm treatment evaluation study design (‘NZPrEP’) was used. The settings were four publicly funded sexual health clinics in Auckland in 2017. The study population was 150 GBM recruited from clinics, community sources and social media. Participants self-completed an online questionnaire about PrEP awareness, attitudes and sexual risk behaviour in the last 3 months. Baseline characteristics are described and examined to determine whether these were associated with PrEP initiation status (self-referral vs doctor/nurse recommendation). Results: In total, 150 GBM of whom half (52%) were non-European, including 21.3% Maori, 19.3% Asian and 8.7% Pacific, were enrolled into the study. Two-thirds (65.3%) self-referred for PrEP and one-third (34.7%) were recommended PrEP by the doctor/nurse. Participants reported a high number of male condomless receptive anal intercourse partners (MenAICLR) (median 3, range 0–50), with 10% reporting 10 or more MenAICLR and 45.3% reporting group sex. In the previous year, 65.3% had a sexually transmissible infection (STI); 18% had rectal chlamydia or gonorrhoea at enrolment. Almost half (47.7%) had recently used drugs with sex, including 8.1% who used methamphetamine. Participants recommended PrEP had lower education, lived less centrally and had a higher STI prevalence than PrEP self-referrers, but their risk behaviour was similar. Conclusions: Early PrEP adopters in New Zealand have high HIV risk. Demonstration projects should consider equity mechanisms so that minorities can participate meaningfully.

scholarly journals Correlates of Unprotected Receptive Anal Intercourse Among Gay and Bisexual Men: Kampala, Uganda

2009 ◽  
Vol 13 (4) ◽  
pp. 677-681 ◽  
Author(s):  
H. Fisher Raymond ◽  
Phoebe Kajubi ◽  
Moses R. Kamya ◽  
George W. Rutherford ◽  
Jeffrey S. Mandel ◽  
...  
Keyword(s):  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Receptive Anal Intercourse ◽  
Bisexual Men ◽  
Unprotected Receptive Anal Intercourse ◽  
And Bisexual

Proctitis in gay and bisexual men. Are microscopy and proctoscopy worthwhile?

2020 ◽  
Vol 96 (7) ◽  
pp. 475-477
Author(s):  
Gwamaka Eliudi Mwasakifwa ◽  
Colleen Nugent ◽  
Rick Varma
Keyword(s):  
Health Centre ◽  
Positive Likelihood Ratio ◽  
Mycoplasma Genitalium ◽  
Gay And Bisexual Men ◽  
Anal Intercourse ◽  
Nucleic Acid Amplification ◽  
Receptive Anal Intercourse ◽  
Polymorphonuclear Cells ◽  
Bisexual Men ◽  
And Bisexual

ObjectivesWe explored the association between nucleic acid amplification testing (NAAT) and rectal microscopy/proctoscopy findings and correlates of rectal STIs among 150 gay and bisexual men (GBM) diagnosed with proctitis at the Sydney Sexual Health Centre from March 2016 to October 2017.MethodsFrom case files, we analysed risk behaviours, microscopy, proctoscopy and NAAT results for rectal STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, herpes simplex virus type 1/2, lymphogranuloma venereum and syphilis). χ2 test assessed the association between microscopy/proctoscopy findings and NAAT results. Linear regression assessed the association between NAAT positivity and correlates of rectal STIs.ResultsThe mean age was 32.5 (9.8) years, 43% (65/150) were taking pre-exposure prophylaxis, 17% (26/150) were HIV positive and 24% (36/147) had multiple rectal STIs.Among GBM with documented proctoscopy findings (n=113), 58% (65/113) had discharge, 36% (41/113) had anorectal erythema and 25% (28/113) had bleeding. A quarter of GBM (28/113) had negative proctoscopy findings.Discharge found on proctoscopy (p=0.001), positive HIV status (p=0.030) and time since last receptive anal intercourse (p=0.028) were independently associated with NAAT positivity for any rectal STI. Discharge had a positive likelihood ratio of 1.6 (95% CI 1.0 to 2.4).Among those with documented microscopy findings (n=69), 59% (41/69) and 41% (28/69) were NAAT positive and negative, respectively. Among NAAT-positive GBM, 27 (66%) had polymorphonuclear cells (PMNs) (mean number of PMNs, 10 (SD 9) cells per oil immersion field), 1 (2%) had Gram-negative intracellular diplococci and 11 (27%) had negative findings. There was no significant association between microscopy findings and NAAT results (p=0.651) or the number of rectal STI (p=0.279).ConclusionMicroscopy does not reliably provide information necessary to tailor the management of GBM diagnosed with proctitis. Discharge found during proctoscopy may identify GBM with rectal STI. Services should consider recommendations to perform these investigations.

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