Drug Use, Sexual Risk, and Syndemic Production Among Men Who Have Sex With Men Who Engage in Group Sexual Encounters

Background Although many within-subjects comparisons conducted on samples of men who have sex with men have sought to understand the association between specific situational characteristics (e.g. drug use or location of sex) and sexual risk behaviour, none have considered the ‘clustering’ of patterns of situational characteristics. An initial typology of sexual encounters is derived and the relationship of this typology to condomless anal intercourse (CAI) and pleasure is tested. Methods: Data from a longitudinal survey of men who have sex with men living in England were used. Multilevel latent class analyses were estimated to determine an optimal class solution on the situational characteristics, and then pseudo-imputation was used to estimate the association between class and both CAI and pleasure. Results: A three-class solution fit the data best, with a scaled relative entropy of 92.4%. Classes were characterised as featuring: regular steady partners in private locations with low drug use (class 1), casual partners with increased probability of sex occurring in a sex-on-premises venue (class 2), and high levels of polydrug use together with increased probability of casual partners (class 3). Encounters were different both in pairwise comparisons and overall on probability of CAI. They were different overall but not necessarily pairwise on pleasure. Conclusions: These initial findings demonstrate the possibility of understanding sexual encounters in terms of the contexts, or classes, within which they occur. This may have implications for tailoring HIV prevention to specific encounter types. Future research should seek to extend encounter-level typologies to specific drug use variables.

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Intersectional analysis of life stress, incarceration and sexual health risk practices among cisgender Black gay, bisexual and other men who have sex with men in the Deep South of the US: the MARI Study

Sexual Health ◽

10.1071/sh19062 ◽

2020 ◽

Vol 17 (1) ◽

pp. 38

Author(s):

Dustin T. Duncan ◽

Denton Callander ◽

Lisa Bowleg ◽

Su Hyun Park ◽

Lauren Brinkley-Rubinstein ◽

...

Keyword(s):

Drug Use ◽

Sexual Health ◽

Health Risk ◽

Sexual Risk ◽

Life Stress ◽

Black Msm ◽

Deep South ◽

Risk Practices ◽

Sex With Men ◽

Group Sex

Objectives The purpose of the present study was to examine associations between life stress and incarceration history in relation to sexual health risk practices among a sample of cisgender Black gay, bisexual and other men who have sex with men (MSM) in the Deep South. Methods: Using data from a sample of 355 cisgender Black MSM in Mississippi and Georgia, multivariable logistic regression analyses were conducted to examine associations between life stress and sexual risk practices. In addition, we assessed whether stress may interact with experiences of incarceration to influence sexual health risk practices. Results: After controlling for sociodemographic characteristics, stress was associated with some sexual risk practices (e.g. alcohol and drug use during sex and group sex). Further, when an interaction with incarceration was assessed, among participants who had been incarcerated, high compared with low levels of stress were associated with alcohol use during sex (adjusted odds ratio (aOR) 4.59, 95% confidence interval (CI) 2.11–9.99, P < 0.001), drug use during sex (aOR 3.92, 95% CI 1.79–8.60, P < 0.001), condomless sex with casual partners (aOR 2.83, 95% CI 1.31–6.12, P < 0.001), having six or more casual partners (aOR 2.77, 95% CI 1.09–7.06, P = 0.02) and participating in group sex (aOR 5.67, 95% CI 2.07–15.51, P < 0.001). Stress and incarceration produced a dose–response effect for each association; similar associations with stress were not observed among men who had not been incarcerated. Conclusions: Among people with experiences of incarceration, there are several possible ways our findings could be applied practically, including through safer sex and stress management interventions designed specifically for Black MSM following their release.

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Sexual Risk Behavior and Drug Use in Two Chicago Samples of Men Who Have Sex with Men: 1997 vs. 2002

Journal of Urban Health ◽

10.1007/s11524-009-9432-x ◽

2010 ◽

Vol 87 (3) ◽

pp. 452-466 ◽

Cited By ~ 16

Author(s):

Michael Fendrich ◽

Mary Ellen Mackesy-Amiti ◽

Timothy P. Johnson ◽

Lance M. Pollack

Keyword(s):

Drug Use ◽

Risk Behavior ◽

Sexual Risk ◽

Sexual Risk Behavior ◽

Sex With Men

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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

BMC Infectious Diseases ◽

10.1186/s12879-019-4456-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 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.

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