Abstract
We explored the effect of older partner's age and age difference between partners on condomless sex among men who have sex with men (MSM). We analyzed dyads (n=1720) from participants (n=969) in the Sexual Acquisition Transmission of HIV Cooperative Agreement Program. We used modified Poisson regression to model the probability of a sexual encounter's being condomless as a function of older partner's age and age difference between partners adjusting for HIV status, substance use, race/ethnicity, and partner type. We found an interaction between older partner's age and age difference (p<0.05). Condomless sex decreased with increasing age of the older partner when the age difference was 5-9years (p=0.004) or ≥10years (p=0.04), but not when <5years. Condomless sex was less likely among older MSM when there was ≥5years age difference between partners than <5years difference. Both age and age discordance affect the likelihood of a sexual encounter between MSM being condomless.
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