Gay Venues Research Articles

High Viral Loads Among HIV-Positive MSM Attending Gay Venues

High Viral Loads Among HIV-Positive MSM Attending Gay Venues

Sexual Dysfunction and Unprotected Anal Intercourse Among Men Who Have Sex With Men in Two Chinese Cities

This study investigated the associations between sexual dysfunction and unprotected anal intercourse among adult Chinese men who have sex with men; 519 participants who had had anal sex (past 12 months) were recruited from gay venues (Hong Kong and Shenzhen) and from the Internet (Hong Kong). Respectively, 48.9% and 59.6% (p< .05) of the Hong Kong and Shenzhen participants had had at least one type of sexual dysfunction for 3 consecutive months (past 12 months); the difference may be explained by differential income levels or other factors. After adjustment for significant background variables, three variables related to sexual dysfunction (premature ejaculation, erectile dysfunction, and experienced at least one sexual dysfunction) were significantly associated with unprotected anal intercourse in the Hong Kong (adjusted odds ratio = 1.65–2.80) and Shenzhen samples (adjusted odds ratio = 5.46–6.41). Anxiety about sex was significant only in the Shenzhen sample (adjusted odds ratio = 8.67). The associations may be results of coping toward sexual dysfunction. Sexual dysfunction is prevalent and may contribute to unprotected anal intercourse among men who have sex with men in China. Physiological damages of receptive anal sex may contribute to some types of sexual dysfunction. However, one limitation is that participants were not asked about insertion/receptive anal sex. HIV interventions targeting men who have sex with men in China need to take counseling related to sexual dysfunction into account.

Associations Between Perceived Characteristics of the Peer Social Network Involving Significant Others and Risk of HIV Transmission Among Men Who Have Sex with Men in China

The HIV epidemic among men who have sex with men (MSM) in China is severe. Peer can induce risky and preventive behaviors among MSM. We interviewed 220 MSM who had at least one significant other who was a peer MSM (SOPM). Interviews were conducted at two gay venues in Suzhou, China, which reported five HIV-related outcomes: HIV (8.2 %), syphilis (16.4 %), self-reported sexually transmitted infection symptoms (14.6 %), unprotected anal intercourse (UAI; 58.6 %) and having had taken up HIV testing (40.4 %). Adjusting for significant background variables, participants' perceived characteristics of the social network of SOPM, such as practicing risk behavior (e.g. UAI) or preventive behaviors (e.g. HIV antibody testing), or possessing HIV-related perceptions (e.g. dislike in condom use), were significantly associated with some of the five aforementioned outcomes (p < 0.05). Peer education and peer-based interventions involving significant others are hence potentially important in HIV prevention targeting MSM. Future pilot intervention studies are warranted.

The impact of migration on the sexual health, behaviours and attitudes of Central and East European gay/bisexual men in London

BackgroundBuilding on an earlier quantitative study which found that gay/bisexual men from Central and Eastern Europe were at greater risk of sexual ill health following migration to the UK, the aim of this qualitative study is to explore how the process of migration itself may have influenced the migrants' sexual behaviour and attitudes.MethodsTo address these questions, we conducted 17 in-depth interviews in London with gay/bisexual male migrants from Central and Eastern Europe, drawing on Fisher and Fisher's Information-Motivation-Behavioral Skills model as an interpretive framework.ResultsWe find that the sexual behaviours of our respondents have been significantly influenced by the process of migration itself. In particular, extricating themselves from the traditional systems of social control in their home societies and having greater access to gay venues in London resulted in their increased sexual activity, particularly in the first phase of migration. High-risk sexual behaviour was found to be a factor of sexual mixing, the use of commercial sex and perceptions of risk in the UK vis-á-vis Central and Eastern Europe, with each of these factors also influenced by the process of migration. Risk-prevention behaviour depended upon the possession of appropriate risk-prevention information, motivation to use condoms and appropriate behavioural skills, with the latter two factors in particular influenced by social mores in the home country and the UK.ConclusionsThe interviews suggested a number of migration-related factors that increased the STI and HIV risk for these migrants. A number of potentially important policy recommendations stem from our analysis.

Expanding Access to Non-Medicalized Community-Based Rapid Testing to Men Who Have Sex with Men: An Urgent HIV Prevention Intervention (The ANRS-DRAG Study)

BackgroundLittle is known about the public health benefits of community-based, non-medicalized rapid HIV testing offers (CBOffer) specifically targeting men who have sex with men (MSM), compared with the standard medicalized HIV testing offer (SMOffer) in France. This study aimed to verify whether such a CBOffer, implemented in voluntary counselling and testing centres, could improve access to less recently HIV-tested MSM who present a risk behaviour profile similar to or higher than MSM tested with the SMOffer.MethodThis multisite study enrolled MSM attending voluntary counselling and testing centres’ during opening hours in the SMOffer. CBOffer enrolees voluntarily came to the centres outside of opening hours, following a communication campaign in gay venues. A self-administered questionnaire was used to investigate HIV testing history and sexual behaviours including inconsistent condom use and risk reduction behaviours (in particular, a score of “intentional avoidance” for various at-risk situations was calculated). A mixed logistic regression identified factors associated with access to the CBOffer.ResultsAmong the 330 participants, 64% attended the CBOffer. Percentages of inconsistent condom use in both offers were similar (51% CBOffer, 50% SMOffer). In multivariate analyses, those attending the CBOffer had only one or no test in the previous two years, had a lower intentional avoidance score, and met more casual partners in saunas and backrooms than SMOffer enrolees.ConclusionThis specific rapid CBOffer attracted MSM less recently HIV-tested, who presented similar inconsistent condom use rates to SMOffer enrolees but who exposed themselves more to HIV-associated risks. Increasing entry points for HIV testing using community and non-medicalized tests is a priority to reach MSM who are still excluded.

Social and Sexual Contexts Explain Sexual Risk Taking in Young Gay, Bisexual, and Other Young Men Who Have Sex With Men, Ages 13–29 Years

This cross-sectional survey study is an analysis of the combined effects of contextual and personal factors in socialization, meeting of sexual partners, and sexual risk-taking among 529 young gay, bisexual, and other young men who have sex with men (ages 13–29 years). Results of binary logistic regression indicated that (a) the majority of the participants socialized outside of their home neighborhoods; (b) 13- to 20-year-olds utilized social circles to meet casual sex partners significantly more than 21- to 29-year-olds, who were more likely to make use of mainstream gay venues for this purpose; and (c) the participants who met sex partners at mainstream gay venues were less likely to engage in unprotected anal sex than those who partnered via the Internet.

Alcohol and Club Drug Use Among Same-Sex Attracted Young People: Associations With Frequenting the Lesbian and Gay Scene and Other Bars and Nightclubs

This study aimed to determine whether the lesbian and gay “scene” of bars and nightclubs is a more common site for club drug use than other bars and clubs. A cross-sectional, online survey was conducted with 254 same-sex attracted women and 318 men aged 18–25 in Sydney, Australia. Drug use was more likely in those who attended any venue type more frequently. Men, but not women, were more likely to report drug use in lesbian and gay venues than other venues. Club drug use may be more normalized within the lesbian and gay scene than elsewhere, particularly among young men. The study's limitations are noted.

HIV Prevalence and Sexual Risk Behaviors Associated with Awareness of HIV Status Among Men Who Have Sex with Men in Paris, France

A cross-sectional survey, using self-sampled finger-prick blood on blotting paper and anonymous behavioral self-administrated questionnaires was conducted in Paris in 2009 among MSM attending gay venues. Paired biological results and questionnaires were available for 886 participants. HIV seroprevalence was 17.7 % (95 % CI: 15.3-20.4). Four groups were identified according to their knowledge of their HIV biological status. Among the 157 found to be seropositive, 31 (19.7 %) were unaware of their status and reported high levels of sexual risk behaviors and frequent HIV testing in the previous 12 months. Among the 729 MSM diagnosed HIV-negative, 183 were no longer sure whether they were still HIV-negative, or had never been tested despite the fact that they engaged in at-risk sexual behaviors. This study provides the first estimate of HIV seroprevalence among MSM in Paris and underlines the specific need for combined prevention of HIV infection in this MSM population.

Serosorting and Strategic Positioning During Unprotected Anal Intercourse

Unprotected anal intercourse (UAI) remains the main risk factor for HIV among men who have sex with men (MSM), but risk varies by the sexual position adopted and the risk reduction strategies used. Here, we report on sexual position, and knowledge of partners' HIV status, during UAI to assess whether MSM in Scotland are using sexual risk reduction strategies. Anonymous, self-complete questionnaires and Orasure oral fluid specimens (OraSure Technologies, Inc., Bethlehem, Pennsylvania, USA) were provided by 1277 MSM in commercial gay venues in Glasgow and Edinburgh, Scotland, United Kingdom (59.7% response rate). Overall, 488 MSM (39.7%) reported any UAI in the past 12 months; 318 reported on partner HIV status and sexual position and are included in these analyses. Being equally either the insertive or receptive partner during UAI was most commonly reported; 23.1% of HIV-negative MSM reported exclusive insertive UAI, whereas no MSM with diagnosed HIV reported exclusive receptive UAI. Five diagnosed HIV-positive MSM reported always knowing their partners' HIV status and only having HIV-positive partners (50.0% of HIV-positive MSM reporting UAI; 11.9% of the diagnosed HIV-positive sample); 160 HIV-negative MSM reported having had an HIV test (and therefore being aware of their HIV-negative status), always knowing their partners' status, and only having HIV-negative partners (52.8% of HIV-negative MSM reporting UAI; 13.7% of the total HIV-negative sample). Behavior suggestive of serosorting and strategic positioning (among HIV-negative MSM) was evident in this sample, but inconsistent adoption of these and general versatility in sexual behavior suggest that they have a limited role.

Reaching and engaging non-gay identified, non-disclosing Black men who have sex with both men and women

Non-gay identified (NGI) Black men who have sex with both men and women (MSMW) and who use substances are at risk of acquiring and transmitting HIV to their partners. Homophobic community norms can discourage such men from disclosing their risk behaviour to female partners and others, including service providers. It is important to understand the dynamics of risk in this vulnerable population, but research is challenged by the men's need for secrecy. In this paper we report on successful efforts to recruit 33 non-disclosing, NGI Black MSMW for in-depth interviews concerning substance use, HIV risk and attitudes toward disclosing their risk behaviour. We employed targeted and referral sampling, with initial contacts and/or key informants drawn from several types of settings in New York City, including known gay venues, community organisations, neighbourhood networks and the Internet. Key informant gatekeepers and the ability to establish rapport proved central to success. Perceived stigma is a source of social isolation, but men are willing to discuss their risk behaviour when they trust interviewers to protect their privacy and engage with them in a non-judgemental manner. Findings imply that the most effective prevention approaches for this population may be those that target risk behaviours without focusing on disclosure of sexual identities.

Prevalence and Correlates of Unprotected Anal Intercourse Among Hong Kong Men Who Have Sex with Men Traveling to Shenzhen, China

In China, the HIV prevalence among men who have sex with men (MSM) has been increasing sharply. A total of 195 Hong Kong MSM having had sex with men in Shenzhen, a mainland China city separated from Hong Kong by a border, were recruited from some randomly selected gay venues in Shenzhen. Participants were face-to-face and anonymously interviewed. The results showed that in the last six months, respectively 62.1, 84.6, and 31.3 % of the participants from Hong Kong had had sex with commercial sex partners (CSP), non-regular partners (NRP) and regular partners (RP) in Shenzhen. The prevalence of unprotected anal intercourse (UAI) with these three types of sex partners was respectively 29.8, 27.9, and 78.7 %. Factors associated with UAI with any MSM in Shenzhen in the last six months included perceived chances of contracting HIV, perceived non-availability of condoms, giving money/gifts to Shenzhen MSM sex partners, and perception that MSM partners in Shenzhen would not always insist on condom use (multivariate OR = 2.9-13.90, p < 0.05), whilst factors of inverse associations included university education, having had sex with NRP but not with CSP and RP in Shenzhen and self-efficacy of insisting on condom use (multivariate OR = 0.04-0.22, p < 0.05). In sum, the prevalence of having multiple types of male sex partners and UAI was high. This was especially true when anal sex with RP was involved. Cross-border HIV prevention is greatly warranted. It should ensure condom availability and modify perceptions toward UAI.

VOLUNTARY OUTREACH COUNSELLING AND TESTING FOR HIV AND STI AMONG MEN WHO HAVE SEX WITH MEN IN ANTWERP

Background: High risk settings for transmission of HIV and sexually transmitted infections (STI) offer an opportunity for screening of difficult to reach risk groups.Methods: Free, anonymous counselling and testing for HIV, syphilis, Chlamydia and hepatitis B/C were offered to visitors in two selected gay venues in Antwerp, by a multidisciplinary team. Participants completed an anonymous questionnaire. The STI-test results were communicated by cell phone using standardised text messages.Results: In total, 137 MSM were tested. Facilitators of risky sexual behaviour (alcohol and drug use) were reported by 34 and 21%, respectively. Four men (3%) were newly diagnosed with HIV; 25 men (18%) had an active, transmittable STI. Infected MSM were significantly less often registered with a fixed general practitioner (GP).Conclusions: Outreach testing in gay venues is a suitable method to detect MSM at risk for HIV/STI. Although the outreach approach is very labour intensive, it shows a high yield of new STI-diagnoses that are not detected in the regular health system.

P125 The association between condom proficiency, condom problems and STI risk among Scottish MSM

BackgroundThe effectiveness of condoms in preventing sexually transmitted infections (STI) including HIV depends on consistent and correct use.AimsTo examine associations between demographics, STI risk, condom proficiency, condom problems and STI...

Online Sex-Seeking, Substance Use, and Risky Behaviors in Taiwan: Results from the 2010 Asia Internet MSM Sex Survey

We conducted an online behavioral survey to estimate the prevalence of online sex-seeking and substance use behaviors and to compare risky behaviors among men using different venues to seek sex with men. A cross-sectional online survey, the Asia Internet MSM Sex Survey, was conducted online from January 1 to February 28, 2010. Of the 1,645 participants enrolled from Taiwan, 72.4% reported the Internet as the main way of seeking sexual partners, 73.9% had had sex with partners found online, and 16% had used recreational drugs in the previous 6 months. There was no evidence to suggest that men who looked for sex through the Internet were more likely to engage in unprotected anal intercourse with their casual partners than those using other gay venues. Having had online sex partners in the previous 6 months was significantly associated with being young [adjusted odd ratio (AOR) = 0.97, 95% CI: 0.95-0.99], having had no steady partners in the previous year (AOR = 0.24, 95% CI: 0.15-0.39), having had more than five partners in the previous 6 months (AOR = 4.57, 95% CI: 2.95-7.11), having used recreational drugs in the previous 6 months (AOR = 2.24, 95% CI: 1.30-3.87), and having had an STI in the previous 6 months (AOR = 4.24, 95% CI: 1.59-11.30). In conclusion, because the Internet is a popular meeting place for MSM in Taiwan, effective and targeted prevention programs should be developed to minimize the HIV transmission risk in the Internet era.

Willingness to Participate in Future HIV Prevention Studies Among Gay and Bisexual Men in Scotland, UK: A Challenge for Intervention Trials

This article examines willingness to participate in future HIV prevention research among gay and bisexual men in Scotland, UK. Anonymous, self-complete questionnaires and Orasure™ oral fluid samples were collected in commercial gay venues. 1,320 men were eligible for inclusion. 78.2% reported willingness to participate in future HIV prevention research; 64.6% for an HIV vaccine, 57.4% for a behaviour change study, and 53.0% for a rectal microbicide. In multivariate analysis, for HIV vaccine research, greater age, minority ethnicity, and not providing an oral fluid sample were associated with lower willingness; heterosexual orientation and not providing an oral fluid sample were for microbicides; higher education and greater HIV treatment optimism were for behaviour change. STI testing remained associated with being more willing to participate in microbicide research and frequent gay scene use remained associated with being more willing to participate in behaviour change research. Having an STI in the past 12 months remained significantly associated with being willing to participate in all three study types. There were no associations between sexual risk behaviour and willingness. Although most men expressed willingness to participate in future research, recruitment of high-risk men, who have the potential to benefit most, is likely to be more challenging.

Acceptability of an “on-demand” pre-exposure HIV prophylaxis trial among men who have sex with men living in France

Although predictors of willingness to take daily, self-administered pre-exposure HIV prophylaxis (PrEP) for men who have sex with men (MSM) have been studied in the context of several PrEP trials internationally, little is known about MSM interested in participating in a trial on the use of PrEP on an “on -demand” basis, i.e., taking a first dose of combined tenofovir/emtricitabine a few hours before possible HIV sexual exposure and a second dose a few hours afterwards. A double-blind placebo randomized PrEP trial will soon begin in France to evaluate the effectiveness of PrEP in terms of reducing HIV infection rates, among MSM self-administering “on-demand” PrEP. To assess potential participants’ characteristics associated with willingness to participate in the trial and identify barriers and facilitators to implementation, MSM completed a self-administered questionnaire, distributed via gay venues and community websites. Among the 443 respondents who reported being HIV-negative, 40% reported being interested in participating. Factors independently associated with interest included: reporting lower educational level, more than 20 male sexual partners in the previous year, reporting unprotected anal sex with casual partners and preferring PrEP follow-up visits in a devoted area within a hospital. There is great interest in participating in a future “on-demand” PrEP trial among HIV-negative MSM and particularly in those at potentially high risk of HIV exposure. Providing confidentiality and tailored counseling during PrEP follow-up are important issues.

Prevalence and Related Risk Behaviors of HIV, Syphilis, and Anal HPV Infection Among Men who have Sex with Men from Beijing, China

Specific risk behaviors related to different sexually transmitted infections have not been widely evaluated among men who have sex with men in China. In the present study, a total of 302 MSM were recruited from Beijing with a prevalence of HIV, syphilis, and anal HPV infection as 9.9, 19.2 and 71.4%, respectively. Lower education level was observed to be related to higher infection rate of HIV and syphilis. "Ever found sexual partners in gay venues" was significantly associated with HIV infection as well. "Taking anilinction as regular sexual behavior" was observed to be a significant predictor for anal HPV infection.

Actitudes hacia los programas de prevención on-line del VIH y las ITS, y perfil de los usuarios de Internet en los hombres que tienen sexo con hombres

ObjectivesTo describe the attitudes of men who have sex with men (MSM) toward online HIV/sexually-transmitted infection (STI) prevention programs and to identify and characterize user profiles with regard to their attitudes toward online prevention programs. MethodA survey in gay venues or via the internet was completed by 2,044 participants from Madrid, Barcelona, Bilbao and San Sebastián (Spain). The survey explored socio-demographic variables, sexual behavior and other risk behaviors associated with HIV infection, as well as attitudes toward online prevention programs. The statistical analysis included factor analysis and non-hierarchical cluster analysis. ResultsMost MSM had positive attitudes towards online HIV/STI prevention programs. Factor analysis revealed two factors: online prevention aimed at interaction and online prevention aimed at information. Based on these factors, three user profiles were identified: users oriented toward informative and interactive online prevention (53.5%), users oriented toward interactive online prevention (25.9%) and users were not oriented toward online prevention (20.7%). On characterizing these profiles, we observed a significant presence of men who were not interested in online prevention among those with a lower educational level, bisexual men and HIV-positive men. Conversely, those most receptive to online prevention were men self-identified as gay, those with a bachelors degree, those who had been tested for HIV and those who were HIV-negative. ConclusionThe internet can facilitate sexual health promotion among MSM. Characterization of user profiles offers the possibility of segmenting prevention programs and of combining online and offline strategies.

Hombres jóvenes que tienen sexo con hombres: ¿un colectivo en alto riesgo para la infección por el VIH?

Objectives To compare variables associated with the risk of HIV among men ≤25 years old who have sex with men (YMSM) and those >25 years old, and to determine the variables associated with unprotected anal intercourse (UAI) in YMSM with casual sexual partners. Method For 1 month, 485 participants ≤25 years old and 1,470 aged >25 years old completed a pen-and-paper survey carried out in gay venues (GV) or via the Internet in Madrid, Barcelona, Bilbao and San Sebastián (Spain). The survey investigated sexual behaviors in the past 3 months according to whether the men met sexual partners in GV (SPGV) or on the Internet (SPI). Results No significant differences were found between YMSM and those >25 years old with respect to UAI with SPGV (23% vs. 30%, p > 0.05) and SPI (29% vs. 30%, p > 0.05), condom use in the last anal intercourse and having had a sexually-transmitted infection (STI) in the last year (19% vs. 23%, p > 0.05). However, respondents > 25 years old had a higher average number of SPGV (9.2 vs. 7, p < 0.05) and SPI (8.9 vs. 6.4, p < 0.05), were more likely to have used drugs while having UAI (68% vs. 55%, p < 0.05, with SPI, and 73% vs. 55%, p < 0.05, with SPGV) and had a higher prevalence of HIV (11% vs. 4%, p < 0.05). When exploring other variables, we found that YMSM more frequently had receptive UAI with SPI (73% vs. 57%, p < 0.05), had less time to be in a stable relationship, and their sexual partner more frequently convinced them to have UAI (8% vs. 0%, p < 0.05). In multivariate analysis, UAI in YMSM with casual sexual partners was not associated with any of the variables. Conclusions YMSM do not constitute a group at increased risk of HIV/STI infection compared with respondents >25 years old. However, there are some variables could contribute to vulnerability in this group.

Central and East European migrant men who have sex with men in London: a comparison of recruitment methods

BackgroundFollowing the expansion of the European Union, there has been a large influx of Central and East European (CEE) migrants to the UK. CEE men who have sex with men (MSM) represent a small minority within this population that are none-the-less important to capture in sexual health research among the CEE migrant community. This paper examines the feasibility of recruiting CEE MSM for a survey of sexual behaviour in London using respondent driven sampling (RDS), via gay websites and in GUM clinics.MethodsWe sought CEE MSM to start RDS chain referral among GUM clinic attendees, our personal contacts and at gay events and venues in central London. We recruited CEE MSM (n = 485) via two popular websites for gay men in Britain (March-May 2009) and at two central London GUM clinics (n = 51) (July 2008-March 2009).ResultsWe found seventeen men who knew other CEE MSM in London and agreed to recruit contacts into the study. These men recruited only three men into the study, none of whom recruited any further respondents, and RDS was abandoned after 7 months (July 2008-January 2009). Half of the men that we approached to participate in RDS did not know any other CEE MSM in London. Men who agreed to recruit contacts for RDS were rather more likely to have been in the UK for more than one year (94.1% vs 70.0%, p = 0.052). Men recruited through gay websites and from GUM clinics were similar.ConclusionsThe Internet was the most successful method for collecting data on sexual risk behaviour among CEE MSM in London. CEE MSM in London were not well networked. RDS may also have failed because they did not fully understand the procedure and/or the financial incentive was not sufficient motivation to take part.