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An Event-Level Analysis of Condomless Anal Intercourse with a HIV-Discordant or HIV Status-Unknown Partner Among Black Men Who Have Sex with Men from a Multi-site Study

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Abstract

Despite the high HIV incidence and prevalence among black men who have sex with men (BMSM), little research has examined partner characteristics, partner seeking venue, sexual position, substance use, and sexual risk behavior at the sex event-level among BMSM. Using the baseline data from a multi-site study of 807 BMSM stratified by their HIV status, the goal of this study was to conduct a detailed event-level analysis of 1577 male anal sex events to assess the factors associated with condomless anal intercourse (CLAI) with a HIV-discordant or HIV status-unknown partner. We found CLAI with an HIV-discordant or unknown HIV status partner among HIV-negative BMSM was negatively associated with having sex with a main partner, and was positively associated with taking both receptive and insertive sexual positions during sex. As compared to a sex partner met at bar, night club or dance club, HIV-positive BMSM were less likely to engage in CLAI with HIV-discordant and unknown HIV status partner met at party or friend’s house or at community organizations. HIV-positive BMSM had lower odds of engaging in CLAI with HIV-discordant and unknown HIV status partner if they had insertive sexual position or both receptive and insertive sexual positions. These results underscore the importance of delineating unique sex event-level factors associated with sexual risk behavior depending on individuals’ HIV status. Our findings suggest event-level partner characteristics, sexual position, and partner seeking venues may contribute to disparities in HIV incidence.

Resumen

A pesar de la alta incidencia y prevalencia del VIH entre morenos que tienen sexo con hombres (MSH), pocas investigaciones han examinado las características de la pareja, lugar de encuentro de parejas, posición sexual, uso de sustancias, y comportamientos sexuales de riesgo al nivel de evento sexual entre MSH. Utilizando los puntos de referencia de 807 MSH estratificados por su estado del VIH de un estudio de sitios múltiples, el objetivo de este estudio fue realizar un análisis de nivel de evento detallado de 1577 eventos masculinos del sexo anal para evaluar los factores asociados con el coito anal sin condón (CASC) con una pareja que es VIH-discordante o desconocida de su estado del VIH. Entre los MSH, los que tuvieron CASC con una pareja que es VIH-discordante o desconocida de su estado del VIH, encontramos que los MSH que son VIH-negativo fueron asociados negativamente con teniendo relaciones sexuales con una pareja principal, y ellos eran asociados positivamente con tomando posiciones sexuales tanto receptivas como de inserción durante el sexo. En comparación a los que conocieron una pareja sexual en un bar, club nocturno, o discoteca, los MSH que son VIH-positivos eran menos probable a participar en el CASC con una pareja VIH-discordante y de estado desconocido del VIH que fue conocida en una fiesta, en casa de un amigo o en organizaciones comunitarias. Los MSH con VIH también tenían menos probabilidades de participar en el CASC con una pareja con VIH y VIH-discordante si hacían una posición sexual de inserción o ambas posiciones sexuales receptivas y de inserción. Estos resultados subrayan la importancia de delinear factores de nivel de eventos sexuales únicos asociados con el comportamiento sexual de riesgo según el estado de VIH de las personas. Nuestros resultados sugieren que las características de la pareja al nivel de evento, la posición sexual, y los lugares de encuentro de parejas pueden contribuir a las disparidades en la incidencia del VIH.

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Acknowledgements

This study was supported by a cooperative agreement between the Johns Hopkins Bloomberg School of Public Health and the Centers for Disease Control and Prevention (5UR6PS000437-03, 5UR6PS000434-03, 5UR6PS000355-03, 5UR6PS000429-03). This study was also funded by the National Institute of Alcohol Abuse and Alcoholism NIAAA R00AA020782 and the National Insitute of Mental Health NIMH R34MH116725.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention

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Authors and Affiliations

  1. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore, MD, 21205, USA

    Cui Yang, Carl Latkin & Karin Tobin

  2. Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

    David Seal

  3. Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA

    Beryl Koblin

  4. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Geetanjali Chander

  5. Rand Corporation, Pittsburg, PA, USA

    Daniel Siconolfi

  6. National Center for HIV/AIDS, Viral, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Stephen Flores & Pilgrim Spikes

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  1. Cui Yang
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Correspondence to Cui Yang.

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Yang, C., Latkin, C., Tobin, K. et al. An Event-Level Analysis of Condomless Anal Intercourse with a HIV-Discordant or HIV Status-Unknown Partner Among Black Men Who Have Sex with Men from a Multi-site Study. AIDS Behav 22, 2224–2234 (2018). https://doi.org/10.1007/s10461-018-2161-y

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