Large Number Of Sexual Partners Research Articles

Differences in the Social Networks of African American Men Who Have Sex With Men Only and Those Who Have Sex With Men and Women

We compared social network characteristics of African American men who have sex with men only (MSMO) with social network characteristics of African American men who have sex with men and women (MSMW). Study participants were 234 African American men who have sex with men who completed a baseline social network assessment for a pilot behavioral HIV prevention intervention in Baltimore, Maryland, from 2006 through 2009. We surveyed the men to elicit the characteristics of their social networks, and we used logistic regression models to assess differences in network characteristics. MSMO were significantly more likely than were MSMW to be HIV-positive (52% vs 31%). We found no differences between MSMO and MSMW in the size of kin networks or emotional and material support networks. MSMW had denser sexual networks, reported more concurrent and exchange partners, used condoms with more sexual partners, and reported interaction with a larger number of sexual partners at least once a week. Although there were many similarities in the social and sexual network characteristics of MSMO and MSMW, differences did exist. HIV prevention interventions should address the unique needs of African American MSMW.

Uso de preservativo y número de parejas sexuales en hombres que tienen sexo con hombres con sífilis

Background and objectives Recent years have seen a resurgence of syphilis in Spain due to changes in sexual behavior. Here we describe the incidence of the disease in our clinic and investigate its relationship with the sexual habits of men who have sex with men (MSM). Patients and methods A cross-sectional descriptive study of incident cases of syphilis in 2007 and 2008 was performed, followed by a case–control study of sexual behavior in the previous year to compare MSM with and without syphilis. Results We recorded 26 new cases of syphilis, 19 of which were diagnosed at early stages. Eight patients were infected with human immunodeficiency virus and 15 were classed as MSM. Sixty-five MSM without syphilis were selected as a control group. MSM with syphilis had a larger number of sexual partners: odds ratio (OR), 3.98 (95% confidence interval [CI], 0.90–17.46) for the category «2 to 5 sexual partners»; OR, 3.22 (95% CI, 0.84–12.43) for the category «more than 5 sexual partners». The inconsistent use of condoms was significantly more common among MSM with syphilis than among those without syphilis (OR, 3.96; 95% CI, 1.15–13.61; p=0.02). Conclusions Syphilis continues to be a public health problem in our setting, particularly among homosexual and bisexual men. In this study, inconsistent use of condoms and a greater number of sexual partners were risk factors for syphilis in MSM. The development of prevention programs targeting this at-risk population should be considered a priority.

Factors associated with risk for unprotected receptive and insertive anal intercourse in men aged 40 and older who have sex with men

The frequency of HIV infection is increasing in men who have sex with men (MSM) aged 40 and older yet little is known about factors that influence their risky sexual behavior, such as sexual positioning. The goal of this study was to examine multi-level factors associated with unprotected receptive anal intercourse (URAI) and unprotected insertive anal intercourse (UIAI) in MSM aged 40 and older. A community-based sample of 802 self-identified MSM aged 40–94 years was recruited through targeted outreach from community venues (e.g., bars, social events) in South Florida and completed an anonymous pen-and-paper questionnaire. Logistic regression showed that younger age (i.e., aged 40–59; odds ratio [OR]=0.6; 95% confidence interval [CI]: 0.4, 0.9), HIV-positive status (OR=2.8; 95% CI: 1.9, 4.0), drug use (OR=2.6; 95% CI: 1.7, 3.7), a larger number of male sexual partners (OR=1.7; 95% CI: 1.3, 2.3), and lower scores on internalized homonegativity (OR=0.9; 95% CI: 1.0, 1.0) were associated with higher risk for URAI. Younger age (OR=0.4; 95% CI: 0.3, 0.6), HIV-positive status (OR=1.5; 95% CI: 1.0, 2.1), drug use (OR=1.6; 95% CI: 1.1, 22.3), Viagra use (OR=1.7; 95% CI: 1.2, 2.4), larger number of sexual partners (OR=2.1; 95% CI: 1.6, 2.9), and holding views more characterized by high optimism concerning the future (OR=1.1; 95% CI: 1.0, 1.1) were associated with higher risk for UIAI. These results provide useful information that may guide the development of tailored prevention interventions to reduce the growing rates of HIV among MSM aged 40 and older.

Foreign travel associated with increased sexual risk: A cohort study

Background: An increasing number of people travel abroad for their holidays each year. New sexual relations while abroad may result in the acquisition and introduction of novel strains of sexually transmitted infections (STIs). Methods: We conducted a prospective cohort study to assess the impact of alcohol and drug use, and foreign travel on casual travel sex in students from a British university during the summer break in 2006. Results: Two thirds of students traveled abroad. They were more likely to consume alcohol (RR 1.59, 95% CI 1.17-2.16) and use drugs (RR 1.31, 95% CI 0.88-1.94), particularly Cannabis, and to have new sexual partnerships during holidays. They were also more likely to report sexual relations after holidays (RR 1.29, 95% CI 1.09-1.53). New partnerships were associated with being single, traveling abroad, drinking large amounts of alcohol, having previously had large number of sexual partners. The adjusted relative risk of developing new sexual partnerships with foreign travel was 2.70 (95% CI 1.11-6.61). Testing for a STI after the summer break was associated with both foreign travel (aRR 2.80, 95% CI 1.16-6.74) and younger age. Conclusion: People who travel abroad are more likely to engage in risk taking behavior and to develop new sexual partnerships during their holidays. They are also more sexually active on their return to the UK, increasing the chance of introducing new and resistant strains of STIs in the UK. These individuals are, however, also more likely to be tested for STIs.

Condom Use and Number of Sexual Partners among Male Syphilis Patients who Report Having Sex with Men

Background and objectives Recent years have seen a resurgence of syphilis in Spain due to changes in sexual behavior. Here we describe the incidence of the disease in our clinic and investigate its relationship with the sexual habits of men who have sex with men (MSM). Patients and methods A cross-sectional descriptive study of incident cases of syphilis in 2007 and 2008 was performed, followed by a case-control study of sexual behavior in the previous year to compare MSM with and without syphilis. Results We recorded 26 new cases of syphilis, 19 of which were diagnosed at early stages. Eight patients were infected with human immunodeficiency virus and 15 were classed as MSM. Sixty-five MSM without syphilis were selected as a control group. MSM with syphilis had a larger number of sexual partners: odds ratio (OR), 3.98 (95% confidence interval [CI], 0.90–17.46) for the category “2 to 5 sexual partners”; OR, 3.22 (95% CI, 0.84–12.43) for the category “more than 5 sexual partners”. The inconsistent use of condoms was significantly more common among MSM with syphilis than among those without syphilis (OR, 3.96; 95% CI, 1.15–13.61; P=.02). Conclusions Syphilis continues to be a public health problem in our setting, particularly among homosexual and bisexual men. In this study, inconsistent use of condoms and a greater number of sexual partners were risk factors for syphilis in MSM. The development of prevention programs targeting this at-risk population should be considered a priority.

Foreign travel associated with increased sexual risk-taking, alcohol and drug use among UK university students: a cohort study

We conducted a prospective cohort study to assess sexual behaviour of students at a British University during the summer break, to explore the role of foreign travel as a risk factor of sexually transmitted infections acquisition and to determine characteristics associated with casual sex. We found that those who travelled abroad were more likely to use alcohol (RR 1.59, 95% CI 1.17-2.16) and cannabis (RR 1.35, 95% CI 1.13-1.62) and to have casual sex during holidays. They also reported more sexual relationships after holidays (RR 1.26, 95% CI 1.09-1.53). New partnerships during holidays were associated with being single, foreign travel, drinking alcohol and having previously had large number of sexual partners. The adjusted relative risk of developing new sexual partnerships with foreign travel was 2.70 (95% CI 1.11-6.61). People who travel abroad during holidays are more likely to engage in risk taking behaviour and have casual sex. They are also more sexually active after holidays.

Human immunodeficiency virus testing uptake and risk behaviours in Spain

Background:The purpose of this study was to estimate the prevalence of human immunodeficiency (HIV) testing in the general population; to analyse factors related to voluntary testing; and to describe the...

Understanding human sexual networks: a critique of the promiscuity paradigm

Increases in sexually transmitted infection (STI) and HIV rates worldwide have prompted the dedication of research to identifying transmission co-factors, with one such co-factor being an individual's number of different sexual partners. Currently, the majority of STI/HIV transmission models are based on the assumptions that sexual networks have random distributions; whereas, in real-life, these assumptions have proven incorrect because group norms produce variations in sexual practices and differences in transmission co-factors (i.e. number, type, and timing of sexual contacts, use of protection, and genital co-infections). In fact, sexual groupings follow the distribution of the scale-free network. Because human sexual assemblages form scale-free networks, a large number of sexual partners does not necessarily mean that an individual is at risk for acquiring an STI, or conversely, that a small number of partners means that an individual is not at risk. Therefore, while an individual's number of sexual partners is important for population-based and case-management initiatives, it is impossible to determine group sexual norms, network location, and γ values at the individual level. This signifies that a reliance on individuals’ number of different sexual partners to determine their need for STI/HIV testing may be an unnecessarily invasive practice that negatively impacts on testing practices. Thus, it is important to be aware that it is not so much this number of contacts that is important, but rather what occurs during these connections at a network level, and how many concurrent connections exist across the group.

Knowledge and Use of Preexposure and Postexposure Prophylaxis Among Attendees of Minority Gay Pride Events, 2005 Through 2006

Knowledge and Use of Preexposure and Postexposure Prophylaxis Among Attendees of Minority Gay Pride Events, 2005 Through 2006

Correlates of late HIV diagnosis: implications for testing policy

To develop new strategies aimed to reduce the delay in seeking HIV diagnosis, we proposed to identify correlates of late diagnosis of HIV infection in France. Late testing was studied among the 1077 patients diagnosed from 1996 and enrolled in the ANRS-EN12-VESPA, a representative sample of the French HIV-infected population. Patients were defined as 'late testers' if they had presented either clinical AIDS events or CD4 cell count <200/mm(3) at diagnosis. In all, 33.1% were classified as late testers, among whom 42.6% had discovered their HIV infection at the time of AIDS events. This proportion increased with age and was higher for heterosexual men and migrants. Among the non-migrants heterosexual population, late diagnosis was more frequent among people in longstanding couple, with children and conversely was less likely among individuals with large number of sexual partners. Being on welfare benefit before diagnosis was associated with a lower risk of late diagnosis. Among migrants, lack of recent steady partnership was associated with an increased risk, as being diagnosed during the first year of stay in France. Our results showed low risk factors of infection were risk factors of late testing. Public communication should aim at improving the awareness of HIV risk in longstanding couples with stable employment, both among homosexual and heterosexual populations. Among migrants, HIV testing with informed consent short after entry should be improved, especially towards individuals not in couple.

KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS HIV/AIDS IN A RURAL KENYAN COMMUNITY

The aim of this research was to explore people's knowledge, attitude, behaviour and practice towards HIV/AIDS and sexual activity in rural Kenya, where HIV is widespread. The study community was located in south-eastern Kenya, 50 km north of Mombassa, and had an estimated population of 1500. Subjects aged between 16 and 49 were recruited using a stratified cluster-sampling method and they completed self-administered questionnaires. Almost all respondents knew the word 'IV' Around 50% knew of a person living with HIV. About 80% gave 'death' or 'fear' as words representing their image of AIDS. With regard to sexual activity, the distribution of answers to the question 'how many partners have you ever had in your life' was bimodal in males but had only one peak in females, indicating that some men have a large number of sexual partners in their lifetime. First sexual intercourse was at around 12-13 years for both sexes, but female teenagers were more sexually experienced than their male counterparts.

Impulsivity and methamphetamine use

The purpose of this study was to explore the relationship between methamphetamine (meth) use and impulsivity in a sample of 385 HIV-negative heterosexually identified meth users. Participants who scored highest on a self-report measure of impulsivity were compared with those who scored lower in terms of background characteristics, meth use patterns, use of alcohol and other illicit drugs, sexual risk behavior, and psychiatric health variables. Methamphetamine users in the high impulsivity group were younger, less educated, used larger quantities of meth, were more likely to be binge users, had a larger number of sexual partners, engaged in more unprotected vaginal and oral sex, and scored higher on the Beck Depression Inventory as compared with those in the low impulsivity group. In a logistic regression analysis, Beck depression was the factor that best distinguished between meth users who scored high and those who scored low on impulsivity. Neurophysiological pathways that may underlie the relationship between impulsivity and meth use are discussed.

Sexuality Before and After Male-to-Female Sex Reassignment Surgery

The sexual behaviors and attitudes of male-to-female (MtF) transsexuals have not been investigated systematically. This study presents information about sexuality before and after sex reassignment surgery (SRS), as reported by 232 MtF patients of one surgeon. Data were collected using self-administered questionnaires. The mean age of participants at time of SRS was 44 years (range, 18-70 years). Before SRS, 54% of participants had been predominantly attracted to women and 9% had been predominantly attracted to men. After SRS, these figures were 25% and 34%, respectively.Participants' median numbers of sexual partners before SRS and in the last 12 months after SRS were 6 and 1, respectively. Participants' reported number of sexual partners before SRS was similar to the number of partners reported by male participants in the National Health and Social Life Survey (NHSLS). After SRS, 32% of participants reported no sexual partners in the last 12 months, higher than reported by male or female participants in the NHSLS. Bisexual participants reported more partners before and after SRS than did other participants. 49% of participants reported hundreds of episodes or more of sexual arousal to cross-dressing or cross-gender fantasy (autogynephilia) before SRS; after SRS, only 3% so reported. More frequent autogynephilic arousal after SRS was correlated with more frequent masturbation, a larger number of sexual partners, and more frequent partnered sexual activity. 85% of participants experienced orgasm at least occasionally after SRS and 55% ejaculated with orgasm.

Negative Self-Perceptions and Sexual Risk Behavior Among Heterosexual Methamphetamine Users

This research examined the relationship between negative self-perceptions and sexual risk behavior in a sample of 156 heterosexually identified, methamphetamine users from San Diego, California. The Beck Depression Inventory and the Self Esteem Rating Scale, respectively, were used to assess depression and negative self-perceptions. Measures of sexual risk behavior and methamphetamine use were developed specifically for this research. Data were gathered in 2001–2002. Participants were primarily male (76%), Caucasian (56%), never married (51%), and unemployed (73%), with a mean age of 39.1 years. Participants with high levels of negative self-perceptions evidenced the greatest degree of sexual risk behavior, including significantly more unprotected vaginal sex and a larger number of sexual partners as compared to individuals with low levels of negative self-perceptions. In cross-sectional analyses, negative self-perceptions predicted intensity of methamphetamine use and depressive symptoms. However, neither of these variables were found to mediate the relationship between negative self-perceptions and sexual risk behavior. Findings are discussed in relation to the need for further research into the role of negative self-perceptions as a determinant of sexual risk behavior among methamphetamine users.

A Case Control Study of Adolescent Risky Sexual Behavior and Its Relationship to Personality Dimensions, Conduct Disorder, and Substance Use

In comparison to the general adolescent population, adolescents with a history of externalizing behaviors including substance use and conduct disorder are younger at first intercourse, have a larger number of sexual partners, and use condoms less often when they engage in intercourse, placing them at higher risk for sexually transmitted diseases as well as unplanned pregnancy (Morris, R. E., Baker, C. J., Valentine, M., and Pennisi, A. J. (1998). J. Adolesc. Health 23: 39–48). A primary goal of this paper was to examine linkages between Cloninger's novelty-seeking, harm avoidance, and reward dependence dimensions and risky sexual behavior among 200 boys in treatment for substance abuse and delinquency compared to 200 boys recruited from the community, and matched on age, ethnicity, and geographic location. Analyses indicated that though there were mean differences on all personality constructs examined, these differences in personality failed to account for observed differences in risky sexual behavior. The structure of problem behavior also differed in the 2 groups.

Risky business: health and safety in the sex industry over a 9 year period.

OBJECTIVES: To assess whether a previously established low sexually transmitted infection/HIV risk in prostitutes in London has been sustained, and to measure other occupational risks, including mortality. DESIGN: 9 year...

Differences in sexual risk behaviour between young men and women travelling abroad from the UK

Identification of people who most frequently engage in sexual risk behaviour while travelling abroad would be useful for the design and targeting of health education and promotion campaigns. Eligible participants were people living in the UK aged 18-34 years who had travelled abroad without a partner in the previous 2 years. Respondents were first screened for eligibility as part of representative face-to-face and telephone surveys by a market research company. Eligible individuals who agreed to take part then underwent a computer-assisted telephone interview. Reinterviewing continued until 400 eligible people had been contacted. We also interviewed a control group of 568 young people who had travelled abroad without a partner in the previous 2 years but who did not report a new sexual relationship during their travels. One in ten of the eligible participants reported sexual intercourse with a new partner. Travellers who reported a new sexual relationship abroad were also likely to report large numbers of sexual partners at home. Of the 400 people who had a new sexual partner abroad, 300 (75%) used condoms on all occasions with the new partner. Logistic regression modelling showed differences between men and women in those factors linked to the practice of unsafe or safer sex while travelling. For men, patterns of condom use abroad with casual partners (p<.0001) reflected patterns of use at home (p<0.001), whereas for women, patterns of condom use varied according to their partners' backgrounds (p<.0001). Condoms are widely used among young travellers, but patterns of use vary by sex. Campaigns about sexual health targeted at international travellers should continue, not least because young people who meet new sexual partners abroad may be a convenient proxy group for that minority of the population who report most sexual partners at home. Such campaigns should be designed differently for men and women.

Sexual behaviour patterns and other risk factors for HIV infection in rural Tanzania: a case-control study.

To examine the association between HIV infection and patterns of sexual behaviour and other risk factors in a rural Tanzanian population in a case-control study, nested within a randomized trial of improved sexually transmitted disease treatment. All HIV-positive patients from the baseline survey of the randomized trial were eligible as cases. Cases (n = 338) and controls (a random sample of one in eight HIV-negative persons; n = 1078) were interviewed about risk factors for HIV infection using a structured questionnaire. A significantly higher HIV prevalence was found among men and women not currently employed in farming [men: odds ratio (OR), 2.08; women: OR, 3.65], women who had travelled (OR, 3.27), educated women (OR, 4.51), and widowed/ divorced people compared with those currently married (men: OR, 3.10; women: OR, 3.54). Two spouse-related factors were significantly associated with HIV, even after adjustment for the sexual behaviour of the index case: HIV was more prevalent in men with younger spouses (P = 0.020 for trend) and in women married to men currently employed in manual work, office work or business (OR, 2.20). In women only, blood transfusions were associated with a higher HIV prevalence (OR, 2.40), but only a small population attributable fraction (4%). There was an increased HIV prevalence associated with increasing numbers of injections. Reported number of lifetime sexual partners was significantly associated with HIV infection (women: OR, 7.33 if > or = 10 lifetime partners compared with < or = 1; men: OR, 4.35 for > or = 50 compared with < or = 1). After adjustment for confounders, male circumcision was associated with a lower HIV prevalence (OR, 0.65; P = 0.11). In these rural communities, many HIV infections occur through sexual transmission. Some people are at high risk of HIV infection through large numbers of sex partners, whereas some are at risk through their spouse or regular partner. The role of circumcision in HIV transmission is unclear. Commercial sex seems to play a negligible role in HIV transmission in these communities. Our results confirm marked heterogeneity in HIV risk, indicating the scope for risk reduction strategies.

THE EFFECT OF A LUDUS LOVE STYLE ON SEXUAL EXPERIENCE

This study examined the effects of a game-playing love style – ludus – (Hendrick &amp; Hendrick, 1991) with sexual experience. In a sample of American college students (N=305) the study found that sexual experience was related to the ludus (game-playing) subscale. As the tendency to endorse items of the ludus scale increases, the individual reported an ever larger number of sexual partners. Neither the gender of the respondent nor the effect of being in a deepening interpersonal relationship mollifies the tendency to endorse the ludic items.

Student opinion leaders and HIV/AIDS knowledge and risk behavior.

This research applied the construct of opinion leadership to the health area of AIDS. Approximately 290 college students completed a questionnaire that identified individuals whom peers tended to use as sources of information about AIDS. The results showed that, among men, the AIDS opinion leaders tended to have a larger number of sexual partners than their nonleader counterparts and that they were no more likely to practice safer sex or be more knowledgeable about safer sex. Female AIDS opinion leaders tended to engage in less sexual activity than their nonleader counterparts, but showed a greater reluctance to communicate with men about condom use. In addition, female AIDS opinion leaders were neither more knowledgeable about safer sex nor more likely to engage in safer sex than were their nonleader counterparts.