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Situational, Partner, and Contextual Factors Associated with Level of Risk at Most Recent Intercourse Among Black Men Who Have Sex with Men

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Abstract

African American men who have sex with men (MSM) in the United States bear a disproportionate burden of HIV infection and disease incidence. 178 Black MSM provided detailed situational information concerning their most recent act of anal intercourse (AI) with a male partner including condom use, partner characteristics, serostatus disclosure, and substance use. Participants completed scales assessing AIDS-related as well as broader contextual domains. Most recent AI acts occurred with same-race partners outside of main relationships. Over one-third of AI acts were unprotected, and almost half of the unprotected acts were not between known HIV-concordant partners. Nearly half of men reported substance use before sex. In a multiple regression analysis, unprotected AI with a partner not known to be concordant was predicted by low risk reduction intentions and indicators of a casual relationship. The findings highlight issues and partner contexts associated with risk for contracting HIV infection among Black MSM.

Resumen

Los hombres Afro-Americanos que tienen sexo con hombres (HSH) en los EEUU son desproporcionadamente afectados por el VIH. 178 En este estudio, HSH Afroamericanos proporcionaron información detallada acerca del acto de sexo anal (SA) más reciente con una pareja masculina, incluyendo uso de condones, características de la pareja, revelación de estatus de VIH, y uso de drogas. Los participantes contestaron escalas que midieron dominios acerca del SIDA y dominios contextuales. Los actos SA más recientes ocurrieron con parejas de la misma raza que no eran pareja principal. Más de un tercio de los actos sexuales anales (SA) ocurrieron sin uso de protección, y casi la mitad de los hombres reportaron uso de drogas antes del acto sexual. Un análisis de regresión múltiple, indico que los actos de sexo anal sin protección con una pareja de estatus de VIH desconocido se relacionaron con bajas intenciones de reducción de riesgo e indicadores de parejas casuales. Los datos muestran los problemas y contextos de pareja asociados con el riesgo de contraer el VIH en HSH Afro-americanos.

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Acknowledgments

This research was supported by grant R01-MH089128 and by Center Grant P30-MH52776 from the National Institute of Mental Health. We extend appreciation to the study’s Senior Scientific Advisory Committee (John Peterson, David Malebranche, Sheldon Fields, and Robert Miller) for their consultation.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, 2071 North Summit Avenue, Milwaukee, WI, 53202, USA

    Jeffrey A. Kelly, Wayne J. DiFranceisco, Yuri A. Amirkhanian & Michelle Anderson-Lamb

  2. Mississippi State University, Meridian, MS, USA

    Janet S. St. Lawrence

Authors
  1. Jeffrey A. Kelly
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  2. Wayne J. DiFranceisco
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  3. Janet S. St. Lawrence
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  4. Yuri A. Amirkhanian
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  5. Michelle Anderson-Lamb
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Correspondence to Jeffrey A. Kelly.

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Kelly, J.A., DiFranceisco, W.J., St. Lawrence, J.S. et al. Situational, Partner, and Contextual Factors Associated with Level of Risk at Most Recent Intercourse Among Black Men Who Have Sex with Men. AIDS Behav 18, 26–35 (2014). https://doi.org/10.1007/s10461-013-0532-y

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