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

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.

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NZPrEP Demonstration Project: protocol for an open-label, single-arm trial of HIV pre-exposure prophylaxis (PrEP) to determine feasibility, acceptability, adverse and behavioural effects of PrEP provision to gay and bisexual men in publicly funded sexual health clinics in Auckland, New Zealand

BMJ Open ◽

10.1136/bmjopen-2018-026363 ◽

2019 ◽

Vol 9 (6) ◽

pp. e026363 ◽

Cited By ~ 2

Author(s):

Sunita Azariah ◽

Peter Saxton ◽

Richard Franklin ◽

Rose Forster ◽

Suzanne Werder ◽

...

Keyword(s):

New Zealand ◽

Sexual Health ◽

Gay And Bisexual Men ◽

Demonstration Project ◽

Bisexual Men ◽

Publicly Funded ◽

Open Label ◽

Behavioural Effects ◽

And Bisexual ◽

Exposure Prophylaxis

IntroductionNew Zealand has experienced a rise in HIV diagnoses in recent years and new interventions are required to address this.Methods and analysisNZPrEP (A demonstration project of HIV preexposure prophylaxis in Aotearoa New Zealand) is an open-label, single-arm treatment evaluation study to investigate feasibility, retention, adherence, and clinical and behavioural outcomes of HIV pre-exposure prophylaxis (PrEP) provision to gay and bisexual men (GBM) in a publicly funded secondary sexual health service in Auckland, New Zealand. The sample size is 150 GBM. Inclusion criteria were specific behavioural risk factors indicating an increased risk of HIV infection. Exclusion criteria were hepatitis B infection, any medical contraindications to prescribing tenofovir/emtricitabine or factors limiting ability to adhere to the study protocol. Eligible participants will be screened for HIV and other sexually transmissible infections (STIs) and for any medical contraindications to PrEP, and enrolled for a maximum follow-up period of 96 weeks. They will be required to attend for 3-monthly testing for HIV and STIs and monitoring for renal and liver toxicity. Participants will also be required to complete an online behavioural survey after each study visit. The outcomes of interest are feasibility of PrEP provision in a sexual health clinic setting, PrEP acceptability, and adverse medical and behavioural effects of PrEP. The study sample is limited to 150 participants due to funding and service constraints. Statistical analysis of all primary and secondary outcomes will be performed using Stata V.14 at the University of Auckland. Results for primary and secondary endpoints will be reported after the conclusion of the study in March 2019.Ethics and disseminationThe study was approved by the Health and Disability Ethics Committee on 15 September 2016 (16/NTA/112). Key findings will be submitted to peer-reviewed journals. A summary report will be circulated to the study and community stakeholders, and to the Auckland District Health Board, Ministry of Health and Pharmac.Trial registration numberACTRN12616001387415; Pre-results.

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Attachment orientation and sexual risk behaviour among young Black gay and bisexual men

Psychology and Sexuality ◽

10.1080/19419899.2016.1168312 ◽

2016 ◽

Vol 7 (3) ◽

pp. 177-196 ◽

Cited By ~ 3

Author(s):

Stephanie H. Cook ◽

Daphne C. Watkins ◽

Benjamin J. Calebs ◽

Patrick A. Wilson

Keyword(s):

Sexual Risk ◽

Risk Behaviour ◽

Gay And Bisexual Men ◽

Sexual Risk Behaviour ◽

Bisexual Men ◽

Attachment Orientation ◽

And Bisexual

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Seeking sex online: social and sexual risk factors among adolescent and young gay and bisexual men

Sexual Health ◽

10.1071/sh14229 ◽

2015 ◽

Vol 12 (3) ◽

pp. 217 ◽

Cited By ~ 8

Author(s):

Guy Shilo ◽

Zohar Mor

Keyword(s):

Identity Formation ◽

Sexual Risk ◽

Risk Behaviour ◽

Gay And Bisexual Men ◽

Sexual Risk Behaviour ◽

Formation Processes ◽

Bisexual Men ◽

Risk Behaviours ◽

And Bisexual ◽

Sexual Risk Behaviours

Background With the increased use of the Internet to seek sex, research has documented its associated sexual risk behaviours, especially among gay and bisexual men. Only a few studies to date have been conducted among adolescent and young men, and these have focussed on behavioural components to do with seeking sex online, without considering the role of same-sex identity formation processes. The current study aimed to identify behavioural and identity formation variables associated with seeking sex online among adolescents and youth. Methods: A web sampling of young Israeli gay and bisexual men aged 12–30 years (n = 445) was used to assess their seeking sex online characteristics, mental health, sexual risk behaviours, substance use, same-sex disclosure and acceptance and coping resources. Results: Nearly half of the sample used the Internet to seek sex, which was correlated with substance use and sexual risk behaviour. Young adults seek for sex online more commonly than adolescents. Higher numbers of: sexual partners, level of outness, levels of friends support and stronger connectedness to the gay community predicted seeking sex online. Seeking sex online was found to be more of predictor for sexual risk behaviour than any other predictor. Conclusions: Seeking sex online is influenced by the gay sub-culture climate and peer group relationships, rather than by social stressor variables related to sexual orientation formation processes, or by the subject’s general mental health condition. These results underscore the possible risks pertaining to seeking sex among gay and bisexual men and the possible use for this venue to convey safe-sex messages to adolescents and young adults.

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Experiences of homonegativity and sexual risk behaviour in a sample of Latino gay and bisexual men

Culture Health & Sexuality ◽

10.1080/13691050903089961 ◽

2010 ◽

Vol 12 (1) ◽

pp. 73-85 ◽

Cited By ~ 37

Author(s):

Nadine Nakamura ◽

Maria Cecilia Zea

Keyword(s):

Sexual Risk ◽

Risk Behaviour ◽

Gay And Bisexual Men ◽

Sexual Risk Behaviour ◽

Bisexual Men ◽

And Bisexual

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The Impact of Pre-exposure Prophylaxis for Human Immunodeficiency Virus on Gonorrhea Prevalence

10.1101/19005207 ◽

2019 ◽

Author(s):

Joe Pharaon ◽

Chris T. Bauch

Keyword(s):

Risk Behaviour ◽

Sexual Risk Behaviour ◽

Bisexual Men ◽

Condom Usage ◽

Sti Testing ◽

Testing Frequency ◽

Wide Range ◽

And Bisexual ◽

Exposure Prophylaxis ◽

The Impact

AbstractPre-exposure prophylaxis (PrEP) has been shown to be highly effective in reducing the risk of HIV infection in gay and bisexual men who have sex with men (GbMSM). However, PrEP does not protect against other sexually transmitted infections (STIs). In some populations, PrEP has also led to riskier behaviour such as reduced condom usage, with the result that the prevalence of bacterial STIs like gonorrhea has increased. Here we develop a compartmental model of the transmission of HIV and gonorrhea, and the impacts of PrEP, condom usage, STI testing frequency and potential changes in sexual risk behaviour stemming from the introduction of PrEP in a population of GbMSM. We find that introducing PrEP causes an increase in gonorrhea prevalence for a wide range of parameter values, including at the current recommended frequency of STI testing once every 3 months for individuals on PrEP. Moreover, the model predicts that a higher STI testing frequency alone is not enough to prevent a rise in gonorrhea prevalence, unless the testing frequency is increased to impractical levels. However, testing every 2 months in combination with sufficiently high condom usage by individuals on PrEP would be successful in maintaining gonorrhea prevalence at pre-PrEP levels. The results emphasize that programs making PrEP more available should be accompanied by efforts to support condom usage and frequent STI testing, in order to avoid an increase in the prevalence of gonorrhea and other bacterial STIs.

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Effect of age on the association between recreational drug use and sexual risk behaviour: a cross-sectional observational analysis

Sexual Health ◽

10.1071/sh20115 ◽

2020 ◽

Vol 17 (6) ◽

pp. 538

Author(s):

Arthur Wong ◽

Garrett P. Prestage ◽

I. Mary Poynten ◽

Fengyi Jin ◽

Richard J. Hillman ◽

...

Keyword(s):

Drug Use ◽

Risk Behaviour ◽

Gay And Bisexual Men ◽

Sexual Risk Behaviour ◽

Recreational Drug ◽

Bisexual Men ◽

Cross Sectional ◽

Sexual Behaviours ◽

Recreational Drug Use ◽

And Bisexual

Recreational drug use (RDU) among gay and bisexual men (GBM) is associated with higher-risk sexual behaviours, however this has not been well defined among older GBM. We investigated the association between RDU and sexual behaviours among older GBM in Sydney, Australia. 617 GBM aged 35–79 years self-reported their RDU in the past 6 months and sexual behaviours. Age-stratified univariable associations between RDU and behaviour were examined. GBM aged 35–44 years were the most likely to report RDU, with rates decreasing with increasing age (Ptrend < 0.001). Associations between RDU and higher-risk sexual behaviours were most consistently found among GBM aged 35–54 years.

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Intensive sex partying with gamma-hydroxybutyrate: factors associated with using gamma-hydroxybutyrate for chemsex among Australian gay and bisexual men – results from the Flux Study

Sexual Health ◽

10.1071/sh17146 ◽

2018 ◽

Vol 15 (2) ◽

pp. 123 ◽

Cited By ~ 9

Author(s):

Mohamed A. Hammoud ◽

Adam Bourne ◽

Lisa Maher ◽

Fengyi Jin ◽

Bridget Haire ◽

...

Keyword(s):

Social Engagement ◽

Risk Behaviour ◽

Gay And Bisexual Men ◽

Sexual Risk Behaviour ◽

Bisexual Men ◽

Factors Associated ◽

The Past ◽

Gamma Hydroxybutyrate ◽

And Bisexual ◽

Group Sex

Background Gamma-hydroxybutyrate (GHB) use among gay and bisexual men (GBM) has increased in recent years. It is commonly cited as a sexual-enhancement drug. There is, however, little evidence for factors associated with GHB use or the consequences of its use among GBM. Aim: Factors associated with GHB use, its relationship to sexual risk behaviour, and the contexts, consequences, and motivations for its use were examined. Methods: The Following Lives Undergoing Change (Flux) Study is an online prospective observational study of Australian GBM. At baseline, a total of 3190 GBM provided details about their use of GHB. Data on frequency, methods, pleasures and consequences of their drug use, alongside key demographic variables were collected. Results: Mean age was 35.0 years. One in five men (19.5%) had a history of GHB use and 5.4% reported use within the past 6 months, with 2.7% having used it monthly or more frequently. Overdose had been experienced by 14.7%, this was more common among men who used GHB at least monthly. Being HIV-positive, having more gay friends, greater social engagement with gay men who use drugs, a greater number of sexual partners, group sex, and condomless anal intercourse with casual partners were independently associated with GHB use in the past 6 months. Greater social engagement with gay men who use drugs and group sex were independently associated with at least monthly use. More frequent GHB use was independently associated with experiencing overdose among GHB users. Conclusion: Most men used GHB infrequently and it was often used explicitly to enhance sexual experiences, often in the context of intensive sex partying. Men who used GHB frequently, were at greater risk of overdose and other negative health outcomes. GHB use should be considered alongside other drugs that have been implicated in sexual risk behaviour and HIV transmission. Harm-reduction interventions need to consider the particular impact of frequent GHB use.

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