Age Is Associated With HIV Sexual Risk Behaviors Among Trans Women in Los Angeles County

2021 ◽  
Vol 33 (6) ◽  
pp. 483-494
Author(s):  
Kimberly A. Kisler ◽  
Jesse B. Fletcher ◽  
Anne E. Fehrenbacher ◽  
Cathy J. Reback
Keyword(s):  
Los Angeles ◽  
Risk Reduction ◽  
Sexual Risk ◽  
Sexual Behaviors ◽  
Linear Models ◽  
Anal Intercourse ◽  
Exchange Sex ◽  
Condomless Anal Intercourse ◽  
Trans Women ◽  
Hiv Sexual Risk Behaviors

Little is known about how HIV risk varies among trans women of different ages. From January 2010 to February 2021, 2,242 trans women were assessed via outreach encounters consisting of health education and risk reduction information, and queries of recent sexual behaviors. Generalized linear models provide adjusted rates of engagement in condomless anal intercourse (CAI), in exchange sex, and CAI with exchange partners in the past 30 days for each year from age 18 to 60. Most participants identified as Hispanic/Latina (52%) and most were HIV negative (80%). Engagement in exchange sex remained prevalent from participants’ early 20s through their mid-40s, though CAI with such partners never exceeded an average estimated prevalence of 15%. Condomless behaviors with non-exchange partners was more common, with at least 20% reporting engagement in non-exchange CAI regardless of age. The need for trans-specific sexual risk reduction interventions that take age into account is underscored.

scholarly journals Bias Adjustment Techniques Are Underutilized in HIV Sexual Risk Estimation: A Systematic Review

2018 ◽  
Vol 15 (8) ◽  
pp. 1696 ◽  
Author(s):  
Nguyen Tran ◽  
Neal Goldstein ◽  
Seth Welles
Keyword(s):  
Systematic Review ◽  
Sexual Behavior ◽  
High Risk ◽  
Hiv Infection ◽  
Sexual Risk ◽  
Risk Behaviors ◽  
Hiv Risk ◽  
Sexual Behaviors ◽  
Anal Intercourse ◽  
Condomless Anal Intercourse

Background: Valid measurement of determinants of HIV infection among men who have sex with men (MSM) is critical for intervention planning and resource allocation. However, sexual minority research concerning HIV risk often relies on proxy exposures of sexual behaviors such as sexual orientation and partner gender. Inferring high risk sexual behaviors (i.e., condomless anal intercourse) from these proxies inaccurately captures HIV risk, but few studies have attempted to correct for this bias. Methods: We performed a systematic review of methodological practices for estimating risk of HIV infection among MSM. Results: We identified 32 studies in which high risk sexual behavior was assessed: 82% (n = 26) measured and used sexual risk behaviors (e.g., condomless anal intercourse or sexual positioning) to assess risk of HIV infection; 9% (n = 3) used proxy measures; and 9% (n = 3) used both behavior and proxy variables. Various treatments of misclassification reported by investigators included the following: 82% (n = 26) discussed misclassification of sexual behavior as a potential limitation; however, among these studies, no attempts were made to correct misclassification; 12% (n = 4) did not report exposure misclassification, and 6% (n = 2) explicitly considered this information bias and conducted a Bayesian approach to correct for misclassification. Conclusions: Our systematic review indicates that a majority of studies engaging in collecting primary data have taken additional steps to acquire detailed information regarding sexual risk behaviors. However, reliance on population-based surveys may still lead to potentially biased estimates. Thus, bias analytic techniques are potential tools to control for any suspected biases.

scholarly journals Contextualizing condoms: a cross-sectional study mapping intersections of locations of sexual contact, partner type, and substance use as contexts for sexual risk behavior among MSM in Peru

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
R. Colby Passaro ◽  
Angelica Castañeda-Huaripata ◽  
Williams Gonzales-Saavedra ◽  
Susan Chavez-Gomez ◽  
Eddy R. Segura ◽  
...  
Keyword(s):  
Substance Use ◽  
Sexual Risk ◽  
Public Spaces ◽  
Anal Intercourse ◽  
Cross Sectional Study ◽  
Sexual Contact ◽  
Sectional Study ◽  
Cross Sectional ◽  
Partner Type ◽  
Condomless Anal Intercourse

Abstract Background Condomless anal intercourse (CAI) appears to be increasing among men who have sex with men (MSM) globally, and is reported to be as high as 70% in recent studies in Peru. To improve understanding of the evolving context of CAI among MSM in Peru, we studied associations between partner type, substance use, and condomless anal intercourse (CAI) in locations where MSM commonly report having sexual encounters. Methods In a 2017 cross-sectional study of rectal STI screening and HIV prevention, a convenience sample of MSM recruited from community venues in Lima completed a survey of demographic characteristics and sexual risk behavior with their three most recent partners. Generalized estimating equations estimated correlations of CAI with location of last sexual contact, participant substance use prior to sex, and negotiation of condom use before or during sex. The network data integration application, Cytoscape, mapped intersections of partner type, sexual orientation, substance use, and CAI by four types of locations where sex occurred: 1) Home, 2) Hotel, 3) Sauna or Internet Cabin, and 4) Public Spaces. Results Of 447 MSM (median age 27 years), 76.9% reported CAI with ≥1 of their last three partners. Participants reported sex with casual partners most commonly in homes (64.6%) and hotels (60.4%), and with anonymous partners most often in saunas/Internet cabins (57.5%) and public spaces (52.6%). CAI was less commonly reported in hotels (aPR, 95% CI: 0.85, 0.75–0.97) compared to homes. Participants who used marijuana before sex at home were more likely to report CAI than MSM who did not use marijuana (1.36, 1.01–1.92). Partner alcohol use before sex was associated with CAI in saunas/Internet cabins (3.17, 1.45–6.91) and public spaces (2.65, 1.41–4.98). In the sexual network maps, almost all MSM who used drugs prior to their sexual encounters used drugs with more than one of their last three partners. Conclusions CAI was common and associated with different risk factors, like partner type and substance use, based on location where sex occurred. Novel combination HIV, STI, and substance use prevention interventions must consider how the social environments of MSM influence condom use and other sexual risk behaviors. Trial registration ClinicalTrials.gov Identifier NCT03010020, January 4, 2017.

App use frequency and condomless anal intercourse among men who have sex with men in Beijing, China: a cross-sectional study

2019 ◽  
Vol 30 (12) ◽  
pp. 1146-1155 ◽  
Author(s):  
Qianqian Luo ◽  
Zunyou Wu ◽  
Zihuang Chen ◽  
Yue Ma ◽  
Guodong Mi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Sexual Behaviors ◽  
Anal Intercourse ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Condomless Anal Intercourse ◽  
Adjusted Logistic Regression ◽  
Sex With Men ◽  
Beijing China

Gay dating applications (apps) are popular among men who have sex with men (MSM) in China. This study examined the relationship between gay dating app use frequency and condomless anal intercourse (CAI) in a sample of MSM in Beijing. In October 2017, a web-based, cross-sectional survey was conducted among MSM from Beijing, China. Demographics, frequency of app use, and sexual behaviors were collected and analyzed. Multivariable logistic regression and restricted cubic splines were used to evaluate the association between app use frequency and CAI. Of the 9280 participants, the proportion of CAI within one month prior to the survey was 43.3%, and 43.7% logged onto the app ≥11 times per week. In adjusted logistic regression analysis, logging onto the app 6–10 times per week and ≥11 times per week were inversely associated with CAI (adjusted odds ratio [AOR] =0.88 [95%CI, 0.78–0.99]; AOR = 0.88 [95%CI, 0.82–0.97], respectively). Among those 40 years of age or older, logging onto the app ≥11 times per week was associated with lower rates of CAI (AOR = 0.57 [95%CI, 0.40–0.81]). Results indicate that frequent app use was associated with lower odds of CAI among MSM in Beijing, China. Innovative interventions, which take advantage of this popular media platform, should be developed as such apps have been found to reduce the odds of CAI in Beijing.

scholarly journals Screening HIV-positive men who have sex with men for hepatitis C re-infection risk: is a single question on condom-use enough? A sensitivity analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Patrizia Künzler-Heule ◽  
◽  
Sandra Engberg ◽  
Manuel Battegay ◽  
Axel J. Schmidt ◽  
...  
Keyword(s):  
At Risk ◽  
Hepatitis C ◽  
Drug Use ◽  
Sexual Risk ◽  
Anal Intercourse ◽  
The Other ◽  
Hiv Positive ◽  
Risk Behaviours ◽  
Condomless Anal Intercourse ◽  
Sex With Men

Abstract Background Hepatitis C virus (HCV) is common in men who have sex with men (MSM) with HIV. The Swiss HCVree Trial targeted a micro-elimination by using a treat and counsel strategy. Self-reported condomless anal intercourse with non-steady partners was used as the selection criterion for participation in a counselling intervention designed to prevent HCV re-infection. The purpose of this study was to assess the ability of this criterion to identify men who engaged in other sexual risk behaviours associated with HCV re-infection. Methods Men who disclosed their sexual and drug- use behaviours during the prior 6 months, at study baseline, were included in the current study. Using a descriptive comparative study design, we explored self-reported sexual and drug-use risk behaviours, compared the odds of reporting each behaviour in men who reported and denied condomless anal intercourse with non-steady partners during the prior year and calculated the sensitivity/specificity (95% CI) of the screening question in relation to the other at-risk behaviours. Results Seventy-two (61%) of the 118 men meeting eligibity criteria reported condomless anal intercourse with non-steady partners during the prior year. Many also engaged in other potential HCV transmission risk behaviours, e.g., 52 (44%) had used drugs. In participants disclosing drug use, 44 (37%) reported sexualised drug use and 17 (14%) injected drugs. Unadjusted odds ratios (95% CI) for two well-known risk behaviours were 2.02 (0.80, 5.62) for fisting and 5.66 (1.49, 37.12) for injecting drug use. The odds ratio for sexualised drug use - a potential mediator for increased sexual risk taking - was 5.90 (2.44, 16.05). Condomless anal intercourse with non-steady partners showed varying sensitivity in relation to the other risk behaviours examined (66.7–88.2%). Conclusions Although condomless anal intercourse with non-steady partners was fairly sensitive in detecting other HCV relevant risk behaviours, using it as the only screening criterion could lead to missing a proportion of HIV-positive men at risk for HCV re-infection due to other behaviours. This work also points to the importance of providing access to behavioral interventions addressing other sexual and drug use practices as part of HCV treatment. Trial registration Clinical Trial Number: NCT02785666, 30.05.2016.

Geosocial networking app use associated with sexual risk behavior, but also PrEP use, among gay, bisexual, and other men who have sex with men: Cross-sectional web-based survey (Preprint)

2021 ◽  
Author(s):  
Laurel Prescott Gibson ◽  
Emily B Kramer ◽  
Angela D. Bryan
Keyword(s):  
Alcohol Use ◽  
Sexual Risk ◽  
Anal Intercourse ◽  
The United States ◽  
Sexual Partners ◽  
Cannabis Use ◽  
Cross Sectional ◽  
Condomless Anal Intercourse ◽  
Geosocial Networking ◽  
Sex With Men

BACKGROUND In the United States, geosocial networking (GSN) applications (i.e., mobile dating apps) have become central to dating and sexual interactions in recent years. Among gay, bisexual, and other men who have sex with men (GBM), these apps play an important role in reducing barriers and facilitating partner-seeking. However, despite these benefits, there are concerns that these apps may facilitate risky sexual behavior and transmission of sexually transmitted infections (STIs) among GBM. OBJECTIVE The present study examined the association between GSN app use and sexual risk among a U.S. sample of GBM. METHODS Using a cross-sectional design, respondents (N = 223) completed an online survey assessing their use of GSN apps, sexual risk and protective behaviors, HIV serostatus, and previous STI diagnoses. RESULTS Respondents were ages 21-78 (M = 31.90, SD = 10.06), 69.5% Non-Hispanic White, and from 40 States and the District of Columbia. Nearly half (47%; n = 104) of the sample reported using GSN apps. GSN users were more likely to report past year condomless anal intercourse (p < .001), 3+ sexual partners in the previous year (p < .001), and a previous STI diagnosis (p = .001) relative to non-users, and also reported more frequent use of recreational drugs before sex (p = .001), alcohol use before sex (p < .001), and cannabis use before sex (p = .01). Interestingly, GSN users were also more likely to report having ever received an HIV test (p < .001) and using pre-exposure prophylaxis (PrEP; p = .03). Rates of HIV seropositivity did not significantly differ between GSN users and non-users (p = .53). Among the subset of GSN users, 38 participants reported using only GBM-specific GSN apps (e.g., Grindr), while 27 participants reported using only sexuality nonspecific GSN apps (e.g., Tinder). Exclusive users of sexual minority-specific apps reported more frequent recreational drug use before sex (p = .01) and were also more likely to report past year condomless anal intercourse (p < .001), 3+ sexual partners in the previous year (p = .004), a previous STI diagnosis (p = .002), and HIV testing (p = .003). Alcohol use before sex, cannabis use before sex, PrEP use, and HIV rates were similar between both groups (ps > .11). CONCLUSIONS Findings suggest that GSN apps may be a useful pathway for interventions aimed at reducing STI-risk among GBM. Future, prospective studies should examine how risk levels change after initiation of GSN app use.

Pre-Exposure Prophylaxis (PrEP) Use is Associated With Health Risk Behaviors Among Moderate- and Heavy-Drinking MSM

2019 ◽  
Vol 31 (5) ◽  
pp. 452-462
Author(s):  
Peter Luehring-Jones ◽  
Tibor P. Palfai ◽  
Kelli D. Tahaney ◽  
Stephen A. Maisto ◽  
Jeffrey Simons
Keyword(s):  
Drug Use ◽  
Health Risk ◽  
Risk Behaviors ◽  
Sexual Behaviors ◽  
Heavy Drinking ◽  
Anal Intercourse ◽  
Health Risk Behaviors ◽  
Sexual Practices ◽  
Condomless Anal Intercourse ◽  
Exposure Prophylaxis

Among men who have sex with men (MSM), acute alcohol consumption is associated with higher rates of condomless anal intercourse, which is linked with a greater likelihood of exposure to HIV and other sexually transmitted infections. While pre-exposure prophylaxis (PrEP) to prevent HIV infection has become more widespread in this population in recent years, so too have concerns that PrEP uptake may be associated with health risk behaviors. This study investigated differences in sexual behaviors and drug use habits between PrEP users and nonusers in a sample of moderate- and heavy-drinking MSM. Results indicated that PrEP use was associated with riskier sexual practices, weaker self-regulatory cognitions related to condom use, and more frequent illicit drug use. These findings suggest that moderate-and heavy-drinking MSM who use PrEP may comprise a unique risk group that could benefit from targeted counseling or other interventions to reduce their risk of negative health consequences.

scholarly journals Association of nitrite inhalants use and unprotected anal intercourse and HIV/syphilis infection among MSM in China: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yonghui Zhang ◽  
Rantong Bao ◽  
Sequoia I. Leuba ◽  
Jiaming Li ◽  
Hongyi Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Sexual Behaviors ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Anal Intercourse ◽  
Treatment As Prevention ◽  
Syphilis Infection ◽  
Condomless Anal Intercourse

Abstract Background Nitrite inhalant use is very common among men who have sex with men (MSM) in China. However, there is lack of national representative data on use among Chinese MSM, and the mechanism of how nitrite inhalant use impacts HIV infection in MSM is unclear. This meta-analysis aims to understand the characteristics of Chinese MSM nitrite inhalant users and to determine the associations between nitrite inhalant use and sexual behaviors, the prevalence of HIV, and the prevalence of syphilis. Methods We searched PubMed, Web of Science, Chinese National Knowledge Infrastructure, Chinese Wanfang Data, and VIP Chinese Journal Database for relevant literature published from January 1985 to December 2017. Results Fifteen eligible studies, with a total of 18,981 Chinese MSM participants, were included. Compared with nitrite inhalant nonusers, users were more likely to be younger, have a higher level of education, and seek sexual partners using the Internet. Nitrite inhalant users were more likely to engage in high-risk sexual behaviors, including condomless anal intercourse (odds ratio [OR] = 1.33), group sex (OR = 2.26), and commercial intercourse (OR = 1.50). Nitrite inhalants users had a higher prevalence of HIV (OR = 1.83), higher prevalence of syphilis (OR = 1.38) and had higher lifetime HIV testing rates (OR = 1.33) compared with nonusers (each p < 0.05). Conclusions Nitrite inhalant users have higher HIV and syphilis prevalence by increasing levels of high-risk sexual behaviors. China should expand HIV testing, treatment as prevention (TasP), and Pre-exposure prophylaxis (PrEP) among MSM, especially among nitrite inhalants using MSM, to reduce their risk of HIV infection and transmission.

scholarly journals Condomless Anal Intercourse by Partner Type Among Chinese Men Who Have Sex With Men in Tianjin

2018 ◽  
Vol 30 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Ning Zhou ◽  
José Bauermeister ◽  
Wei Guo ◽  
Maohe Yu ◽  
Jie Yang ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Hiv Risk ◽  
Anal Intercourse ◽  
Hiv Risk Reduction ◽  
Voluntary Counseling And Testing ◽  
Counseling And Testing ◽  
Condomless Anal Intercourse ◽  
Reduction Strategies ◽  
Sex With Men ◽  
Hiv Risk Reduction Interventions

HIV prevalence and incidence is high among men who have sex with men (MSM) in China, underscoring the need to support and optimize HIV risk reduction strategies for this population. We sought to estimate the prevalence of condomless anal sex among MSM living in Tianjin, China. We recruited 595 HIV-negative MSM living in Tianjin to participate in a HIV study between 2013 and 2014. Data were collected after a voluntary counseling and testing session through a face-to-face survey. We used multivariable logistic regressions to examine the association between sociodemographic characteristics and HIV risk correlates and MSM's likelihood of engaging in condomless anal intercourse with main and casual partners in the prior 6 months. Results are presented. HIV risk reduction efforts should be developed to be sensitive and responsive to the unique experiences of Chinese MSM. We discuss opportunities for future work, including the development HIV risk reduction interventions.

scholarly journals Estimation of Potential HIV Transmission Risk in Recent Anal Intercourse Events among Men Who Have Sex with Men and Transgender Women in Bali, Indonesia

2021 ◽  
Vol 6 (3) ◽  
pp. 139
Author(s):  
Benjamin R. Bavinton ◽  
I Gusti Agung Agus Mahendra ◽  
John Kaldor ◽  
Matthew Law ◽  
Andrew E. Grulich ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Potential Risk ◽  
Hiv Transmission ◽  
Anal Intercourse ◽  
Transgender Women ◽  
Transmission Risk ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Sex With Men ◽  
Hiv Transmission Risk

In recent years, prevalence of Human Immunodeficiency Virus (HIV) has increased substantially in Bali, Indonesia, in men who have sex with men (MSM) and transgender women, known locally as ‘waria’. There are limited behavioural data in this population. We conducted a behavioural survey of MSM/waria in Bali in March–April 2018. Respondents were primarily recruited by HIV outreach workers. Respondents reported details about anal intercourse events with their last male/waria romantic partner and/or last male/waria casual partner (respondents could report on both if relevant). Statistical significance was tested with generalised estimating equations. Among 709 participants, median age was 27 (interquartile range = 24–31), and 92.1% were male and 7.9% were waria. One-third were born in Bali. Overall, 85.9% had ever had an HIV test; 55.1% reported being HIV-negative, 15.0% HIV-positive, and 30.0% had unknown serostatus. Most (86.5%) reported sex with men, 9.5% with waria, and 20.0% with women in the previous 6 months. Respondents described 703 anal intercourse events (397/306 with romantic/casual partners, respectively; 191 reported on both). Over half (56.5%) of the events were protected by condoms and 7.3% by biomedical prevention (2.6% by PrEP in either partner, 4.7% by HIV treatments in either partner). Thus, 36.3% of events involved unprotected condomless anal intercourse (40.8%/30.4% in romantic/casual partners, respectively). In multivariate analysis, unprotected condomless anal intercourse events were associated with romantic partners (p < 0.001), being born in Bali (p = 0.002), lower education (p = 0.013), believing that withdrawal before ejaculation is effective (p < 0.001), liking to use withdrawal (p = 0.021), and not liking condoms (p < 0.001). One-quarter of events had potentially reduced HIV transmission risk through non-condom-based risk reduction strategies, while 11.1% had no potential risk reduction. Events presenting the highest potential risk of HIV transmission were more commonly reported by respondents born in Bali.

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

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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