Getting the terminology right in sexual health research: the importance of accurately classifying fuck buddies among men who have sex with men

2017 ◽  
Vol 94 (7) ◽  
pp. 487-489 ◽  
Author(s):  
Clare Bellhouse ◽  
Sandra Walker ◽  
Christopher K Fairley ◽  
Eric PF Chow ◽  
Jade E Bilardi
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Target Population ◽  
Sexual Relationships ◽  
Sexual Practices ◽  
Emotional Attachment ◽  
Sex With Men ◽  
Partner Types ◽  
Public Health Strategies

ObjectiveThe aim of this report was to raise the issue of the definition and classification of partner terminology in men who have sex with men (MSM) research, particularly in regards to ‘fuck buddies’. If definitions in research differ from general consensus in the MSM population, it is possible that public health strategies will be ineffective as the target population may be inaccurate.MethodsThirty semistructured interviews with MSM attending the Melbourne Sexual Health Centre were conducted, focusing on the willingness to change sexual practices to reduce the risk of pharyngeal gonorrhoea. As part of these interviews, men were also asked their views on the terminology they used to describe their relationships and sexual partners.ResultsThe degree of emotional attachment often defined the type or classification of relationships. There was a consensus among men that partners they engaged with for ‘sex only’ were classified as casual partners and partners with whom there was an emotional attachment or formalisation of the relationship were classified as ‘regular partners’. However, the classification of ‘fuck buddy’ as a regular or casual partner was less clear.ConclusionsFurther research is needed to ascertain the ways in which men conceptualise sexual relationships and define or classify partner types, particularly ‘fuck buddy’ relationships. A third category for sexual relationships should be considered to encapsulate fuck buddy relationships.

scholarly journals Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037608
Author(s):  
Mario Martín-Sánchez ◽  
Richard Case ◽  
Christopher Fairley ◽  
Jane S Hocking ◽  
Catriona Bradshaw ◽  
...  
Keyword(s):  
Health Centre ◽  
Cross Sectional Study ◽  
Sexual Practices ◽  
Sectional Study ◽  
Anal Sex ◽  
Cross Sectional ◽  
Men And Women ◽  
Sexually Transmitted ◽  
Receptive Anal Sex ◽  
Sex With Men

ObjectivesIn the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals. Men who have sex with both men and women (MSMW) have characteristics that may differ from both men who have sex with men only (MSMO) and heterosexual men. We aimed to compare the sexual practices and the trends in HIV/STI positivity between MSMO and MSMW.DesignRepeated cross-sectional study.SettingA sexual health centre in Melbourne, Australia.ParticipantsMSM aged 18 years and above who attended the Melbourne Sexual Health Centre for the first time between 2011 and 2018. This includes 12 795 MSMO and 1979 MSMW.Primary outcome measuresDemographic characterics, sexual practices and HIV/STI positivity.ResultsCompared with MSMW, MSMO were more likely to practice anal sex and to have condomless receptive anal sex with casual male partners, and less likely to have a current regular relationship. Over the 8-year period, there was an increase in condomless receptive anal sex with casual male partners for both groups (MSMO: from 46.2% to 63.3%, ptrend <0.001; MSMW: from 41.3% to 57.9%, ptrend=0.011). Syphilis positivity increased in MSMO (from 5.5% to 7.9%, ptrend=0.012) and MSMW (from 0.9% to 6.4%, ptrend=0.004) and HIV remained stable. Gonorrhoea increased among MSMO from 2011 to 2014 (from 6.7% to 9.6%, ptrend=0.002), and remained stable from 2015 to 2018. MSMO had higher odds of testing positive for gonorrhoea (adjusted OR (aOR) 1.36, 95% CI 1.13 to 1.64), chlamydia (aOR 1.39, 95% CI 1.16 to 1.67), syphilis (aOR 1.74, 95% CI 1.37 to 2.22) and HIV (aOR 4.60, 95% CI 2.43 to 8.70) than MSMW.ConclusionsMSMW have overall lower condomless sex and lower HIV/STI positivity. In the last years, changes in sexual practices in MSM have affected both MSMW and MSMO leading to an increased STI risk.

Prevalence of rectal Mycoplasma genitalium and macrolide resistance in men who have sex with men attending Sydney Sexual Health Centre

Sexual Health ◽  
2020 ◽  
Vol 17 (2) ◽  
pp. 114
Author(s):  
Isabella Bradley ◽  
Rick Varma ◽  
Vickie Knight ◽  
Dimitra Iliakis ◽  
Leon McNally ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Sexual Health ◽  
Rectal Swab ◽  
Health Centre ◽  
Mycoplasma Genitalium ◽  
Macrolide Resistance ◽  
Cross Sectional ◽  
Screening Guidelines ◽  
Sexually Transmissible Infections ◽  
Sex With Men

Background Sexually transmissible infections (STIs) have been increasing in men who have sex with men (MSM) in recent years; however, few studies have investigated the prevalence or antimicrobial resistance in rectal Mycoplasma genitalium in this group. This study aimed to determine the prevalence and predictors of rectal M. genitalium in MSM attending an urban sexual health service in Sydney, Australia, namely the Sydney Sexual Health Centre (SSHC), as well as estimate the rate of macrolide resistance. Methods: A prospective cross-sectional analysis was conducted of rectally asymptomatic MSM having a rectal swab collected as part of their routine care. Participants self-collected a rectal swab to be tested for M. genitalium and completed a 14-item questionnaire that provided information on behavioural risk factors. The prevalence of rectal M. genitalium was determined and multivariate analysis was performed to assess the associations for this infection. Positive specimens then underwent testing for macrolide-resistant mutations (MRMs) using the ResistancePlus MG assay (SpeeDx, Eveleigh, NSW, Australia). Results: In all, 742 patients were consecutively enrolled in the study. The median age was 31 years (interquartile range 27–39 years), with 43.0% born in Australia. Overall, 19.0% of men were bisexual, 22.9% were taking pre-exposure prophylaxis (PrEP) and 4.3% were HIV positive. The prevalence of rectal M. genitalium was 7.0% (95% confidence interval (CI) 5.3–9.1) overall and 11.8% in those taking PrEP. On multivariate analysis, PrEP use was significantly associated with having rectal M. genitalium (odds ratio 2.01; 95% CI 1.09–3.73; P = 0.01). MRMs were detected in 75.0% (36/48; 95% CI 60.4–86.4%) of infections. Conclusion: Rates of rectal M. genitalium infection were high among asymptomatic MSM attending SSHC and MRMs were detected in 75% of infections. PrEP use was found to be significantly associated with rectal M. genitalium infection. These data contribute to the evidence base for screening guidelines in MSM.

Introduction of screening guidelines for men who have sex with men at an STD clinic, the Melbourne Sexual Health Centre, Australia

Sexual Health ◽  
2005 ◽  
Vol 2 (4) ◽  
pp. 241 ◽  
Author(s):  
Nichole A. Lister ◽  
Anthony Smith ◽  
Christopher K. Fairley
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Health Clinic ◽  
Chlamydia Screening ◽  
Screening Guidelines ◽  
Computer Reminder ◽  
Sex With Men ◽  
New Guidelines ◽  
One Year ◽  
The Impact

Background: A recent audit indicated that a substantial proportion of men who have sex with men (MSM) were not screened for rectal gonorrhoea and chlamydia at the Melbourne Sexual Health Clinic, Melbourne, Australia. In response, screening guidelines for MSM were introduced at the clinic using a computer reminder. The aim of this study was to evaluate the impact of the guidelines and alert on screening MSM for gonorrhoea and chlamydia. Methods: The medical records of MSM were reviewed for gonorrhoea and chlamydia screening by site (pharyngeal, urethral and rectal), four months before the implementation of the guidelines and alert (July to October 2002), and one year thereafter (beginning November 2002). Results: After the introduction of the guidelines there was a significant increase in rectal chlamydia testing (55% to 67%, P < 0.001), and significant reduction in pharyngeal chlamydia and gonorrhoea testing (65% to 28%, P < 0.001, and 83% to 76%, P = 0.015 respectively). The proportion of tests that were positive by any site did not change (7% to 7%). Conclusions: The introduction of a computer reminder for new guidelines was temporally associated with screening that conformed more closely to clinical guidelines.

Fuckbuddy partnerships among men who have sex with men – a marker of sexually transmitted infection risk

2017 ◽  
Vol 29 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Vincent J Cornelisse ◽  
Christopher K Fairley ◽  
Tiffany Phillips ◽  
Sandra Walker ◽  
Eric PF Chow
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Romantic Attachment ◽  
Sexual Partners ◽  
Health Clinic ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hiv Prevention Strategies ◽  
Sex With Men ◽  
Exposure Prophylaxis

‘Fuckbuddies’ are a type of regular sexual partner with whom men have ongoing sexual contact, generally in the absence of romantic attachment. We surveyed 989 men who have sex with men (MSM) at the Melbourne Sexual Health Centre, Australia, with the aim of determining the frequency of ‘fuckbuddy’ partnerships among sexual health clinic attendees and assessing their sexual risk. The majority (60%) of 1139 regular partnerships were described as ‘fuckbuddies’. Most MSM (63%) with a ‘fuckbuddy’ had multiple ‘fuckbuddies’. MSM with ‘fuckbuddies’ were more likely to also have casual sexual partners (odds ratio [OR] 5.7; 95% confidence interval 3.6–8.9) and had more casual sexual partners (median of 4 versus 1, p < 0.001) and more rectal chlamydia (12.4% versus 5.7%; adjusted OR 2.3; p < 0.05) than MSM without ‘fuckbuddies’, and this risk persisted after adjusting for total numbers of sexual partners. Our findings suggest that patients with ‘fuckbuddies’ are at particular risk of sexually transmitted infections. We argue that clinicians should specifically ask about ‘fuckbuddy’ partnerships as part of their risk assessment during patient interviews, as these patients may benefit from HIV prevention strategies such as pre-exposure prophylaxis (PrEP).

Is rectal gonorrhoea a lead indicator of HIV transmission among men who have sex with men in Victoria, Australia?

Sexual Health ◽  
2013 ◽  
Vol 10 (2) ◽  
pp. 188
Author(s):  
Anna L. Wilkinson ◽  
Megan S. C. Lim ◽  
Mark Stoové ◽  
Christopher K. Fairley ◽  
Marcus Chen ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Sexual Health ◽  
Hiv Transmission ◽  
Health Centre ◽  
P Value ◽  
Hiv Diagnosis ◽  
Sex With Men ◽  
Hiv Negative

Objectives To examine whether rectal gonorrhoea (RG; Neisseria gonorrhoeae) can be used as a lead indicator of trends in HIV diagnosis in men who have sex with men (MSM). Methods: Data from a metropolitan sexual health centre in Victoria, Australia, on RG and HIV tests in HIV-negative MSM from January 2006 to December 2011 were examined. Results: Allowing RG a 12-month lead over HIV showed no concordance in proportion positive (r = 0.27; P-value = 0.28). Conclusions: The data do not support use of RG trends as a lead indicator of trends in HIV among MSM.

Characteristics, sexual practices and sexually transmissible infections diagnoses of men who have sex with men and use non-occupational HIV post-exposure prophylaxis in Victoria, Australia

Sexual Health ◽  
2016 ◽  
Vol 13 (6) ◽  
pp. 555 ◽  
Author(s):  
Jason J. Ong ◽  
Andre Landika ◽  
Christopher K. Fairley ◽  
Catriona Bradshaw ◽  
Marcus Chen ◽  
...  
Keyword(s):  
Health Centre ◽  
Risk Profile ◽  
Sexual Practices ◽  
Post Exposure Prophylaxis ◽  
Inconsistent Condom ◽  
Post Exposure ◽  
The Past ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
Exposure Prophylaxis

Background Non-occupational post-exposure prophylaxis (NPEP) is available to people with a potential risk for HIV exposure within the preceding 72 h. We sought to determine if men who have sex with men (MSM) and receive NPEP had a significantly different risk profile (before the preceding 72 h) from MSM not receiving NPEP. If this is the case, NPEP consultations may act as a cue for also discussing pre-exposure prophylaxis. Methods: We conducted a retrospective analysis to compare the demographic characteristics, sexual practices and clinical diagnoses of MSM who were NPEP users and those who were non-NPEP users attending Melbourne Sexual Health Centre from January 2008 to December 2014. Univariate and multivariate logistic regression models were used to examine the association between NPEP use and risk practices. Generalised estimating equations were used to adjust for within-individual correlations related to multiple visits of the same individual. Results: Of the 40 395 MSM consultations included in the study, 1776 consultations (4%) were related to NPEP prescription. NPEP prescribing was associated with ever having injected drugs (adjusted odds ratio (AOR) 1.8, 95% confidence interval (CI): 1.4–2.3), sex with males only (AOR 1.9, 95% CI: 1.6–2.3), more than three male partners in the past 3 months (AOR 1.5, 95% CI: 1.4–1.7) and inconsistent condom use with these partners within the past 3 months (AOR 2.1, 95% CI: 1.9–2.4). Sex workers (AOR 0.6, 95% CI: 0.3–0.9), and men reporting sex overseas within the past 12 months (AOR 0.7, 95% CI: 0.6–0.8) were less likely to receive NPEP. MSM who used NPEP were more likely to test positive for any sexually transmissible infection (AOR 1.2, 95% CI: 1.0–1.4). Conclusions: MSM receiving NPEP generally had a higher risk profile than MSM not requesting NPEP, indicating that NPEP was used by MSM at higher risk for HIV. Therefore, consultations for NPEP may be an opportune time for also discussing pre-exposure prophylaxis for HIV.

Testing for HIV among men who have sex with men needs a paradigm shift in Australia, given the minimal increase between 2003 and 2013 in Melbourne, Australia

Sexual Health ◽  
2015 ◽  
Vol 12 (5) ◽  
pp. 373 ◽  
Author(s):  
An-Chieh Lin ◽  
Christopher K. Fairley ◽  
Krishneel Dutt ◽  
Karen M. Klassen ◽  
Marcus Y. Chen ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Paradigm Shift ◽  
Point Of Care ◽  
Health Centre ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Sexual Practices ◽  
Hiv Test ◽  
Sex With Men ◽  
First Time

Background Increasing the frequency of HIV testing in men who have sex with men (MSM) will reduce the incidence of HIV. Trends in HIV testing among MSM in Melbourne, Australia over the last 11 years have been investigated. Methods: A retrospective study was conducted using electronic medical records of the first presentation of MSM who attended the Melbourne Sexual Health Centre between 2003 and 2013. Factors associated with HIV testing (year, demographic characteristics and sexual practices) were examined in multivariable logistic regression analyses. Jonckheere–Terpstra tests were used to examine the significance of trends in the mean time since the last HIV test. Results: Of 17 578 MSM seen; 13 489 attended for the first time during the study period. The proportion of first attendances who had previously tested and reported a HIV test in the last 12 months increased from 43.6% in 2003 to 56.9% in 2013 (adjusted ptrend = 0.030), with a corresponding decrease in median time since the last HIV test from 19 months [interquartile range (IQR) 6–42] in 2003 to 10 months (IQR4–24) in 2013 (ptrend <0.001). The proportion of high-risk MSM (who reported unprotected anal intercourse and/or >20 partners in 12 months) who reported an HIV test in the last 12 months was unchanged (ptrend = 0.242). Conclusions: Despite HIV testing becoming more frequent, the magnitude of change over the last decade is insufficient to substantially reduce HIV incidence. A paradigm shift is required to remove barriers to testing through strategies such as point-of-care rapid testing or access to testing without seeing a clinician.

Human papillomavirus vaccination and sexual practices among men who have sex with men in Melbourne, Australia: a cross-sectional study

2020 ◽  
Vol 31 (4) ◽  
pp. 312-317
Author(s):  
Eric PF Chow ◽  
Ei T Aung ◽  
Marcus Y Chen ◽  
Catriona S Bradshaw ◽  
Christopher K Fairley
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Health Centre ◽  
Cross Sectional Study ◽  
Sexual Practices ◽  
Human Papillomavirus Vaccination ◽  
Cross Sectional ◽  
Sex With Men ◽  
Hiv Negative

The aim of this study was to explore the factors associated with self-reported receipt of human papillomavirus (HPV) vaccine among men who have sex with men (MSM). MSM aged 16–40 years attending the Melbourne Sexual Health Centre, Australia, for their first visit in 2016 were included in the analysis. Multivariable logistic regression analyses were performed to examine the association between self-reported HPV vaccination and sexual practices: one examining the sexual practices. A total of 1332 MSM with a mean age of 27.6 (standard error [SE] = 0.1) were included in the analysis. The mean number of reported male partners in the last 3 and 12 months was 4.0 (SE = 0.1) and 8.9 (SE = 0.4), respectively. Six percent ( n =  81) of MSM reported receiving the HPV vaccine. There was no significant association between sexual practices (the number of partners or condomless anal sex) and self-reported HPV vaccine receipt after adjusting for confounding factors such as human immunodeficiency virus (HIV) status and pre-exposure prophylaxis (PrEP). HIV-negative MSM taking PrEP were three times more likely to be vaccinated against HPV compared with HIV-negative MSM not taking PrEP in both multivariable analyses. Our findings suggest that there is no association between HPV vaccination and sexual risk practices in MSM.

Hepatitis A vaccine uptake among men who have sex with men from a time-limited vaccination programme in Melbourne in 2018

2019 ◽  
Vol 96 (2) ◽  
pp. 110-114 ◽  
Author(s):  
Sam Burrell ◽  
Lenka A Vodstrcil ◽  
Christopher K Fairley ◽  
Alex Kilner ◽  
Catriona S Bradshaw ◽  
...  
Keyword(s):  
Sexual Health ◽  
Vaccination Programme ◽  
Hepatitis A ◽  
Health Centre ◽  
Vaccine Uptake ◽  
Health Clinic ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Living With Hiv ◽  
To Receive

ObjectivesIn 2017, an outbreak of hepatitis A among gay, bisexual and other men who have sex with men (MSM) was reported in Victoria, Australia. In 2018, the Victorian government implemented a free hepatitis A vaccination programme targeting all Victorian MSM. This study aimed to determine hepatitis A vaccine uptake among MSM in a sexual health clinic in Melbourne.MethodsAll MSM attending the Melbourne Sexual Health Centre (MSHC) in 2018 were included. Chart review was performed to determine the proportion of men vaccinated for at least one dose of hepatitis A and to examine why men did not receive the vaccine. Multivariable logistic regression was performed to examine the factors associated with vaccine uptake. Vaccine uptake was defined as receipt of at least one dose of hepatitis A vaccine.ResultsOf the 9582 MSM who attended MSHC in 2018, 61.3% (95% CI 60.3% to 62.2%) self-reported already being immune to hepatitis A. Of the 3713 remaining eligible men, 62.7% (95% CI 61.1% to 64.2%) received at least one dose of the hepatitis A vaccine on the day of attendance. Compared with MSM not living with HIV and not taking pre-exposure prophylaxis (PrEP), MSM taking PrEP (adjusted OR 1.28; 95% CI 1.01 to 1.62) were more likely to receive the vaccine. 1386 men (37.3%) did not receive the vaccine and 55.4% were not offered the vaccine by their treating clinician. 300 men (21.6%) were identified as non-immune after serological testing but did not return for vaccination. By the end of 2018, 85.5% of MSHC attendees (8196/9582) were immune to hepatitis A.ConclusionThe critical vaccination threshold for hepatitis A has been estimated at >70%. Continuation of the targeted hepatitis A vaccination programme will improve immunity among the MSM population to prevent ongoing transmission and the likelihood of future outbreaks.

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