Prevalence Of Unprotected Anal Intercourse Research Articles

High rates of unprotected anal intercourse with regular and casual partners and associated risk factors in a sample of ethnic Malay men who have sex with men (MSM) in Penang, Malaysia

ObjectiveTo assess the prevalence of unprotected anal intercourse (UAI) and its correlates among ethnic Malay men who have sex with men (MSM).MethodsIn 2010, a convenience sample of 350 MSM in...

Sexually Explicit Media on the Internet: A Content Analysis of Sexual Behaviors, Risk, and Media Characteristics in Gay Male Adult Videos

Recent research suggests that viewing sexually explicit media (SEM), i.e., adult videos, may influence sexual risk taking among men who have sex with men. Despite this evidence, very little is known about the content of gay male SEM on the Internet, including the prevalence of sexual risk behaviors and their relation to video- and performer-characteristics, viewing frequency, and favorability. The current study content analyzed 302 sexually explicit videos featuring male same-sex performers that were posted to five highly trafficked adult-oriented websites. Findings revealed that gay male SEM on the Internet features a variety of conventional and nonconventional sexual behaviors. There was a substantial prevalence of unprotected anal intercourse (UAI) (34 %) and was virtually the same as the prevalence of anal sex with a condom (36 %). The presence of UAI was not associated with video length, amateur production, number of video views, favorability, or website source. However, the presence of other potentially high-risk behaviors (e.g., ejaculation in the mouth, and ejaculation on/in/rubbed into the anus) was associated with longer videos, more views, and group sex videos (three or more performers). The findings of high levels of sexual risk behavior and the fact that there was virtually no difference in the prevalence of anal sex with and without a condom in gay male SEM have important implications for HIV prevention efforts, future research on the role of SEM on sexual risk taking, and public health policy.

Correlates of Group Sex Among a Community-Based Sample of Men Who Have Sex With Men (MSM) in Washington, DC

Participation of MSM in group sex events (GSEs) is an understudied phenomenon. Studies on GSEs identified significant proportions of MSM engaging in unprotected anal intercourse (UAI). We sought to identify the prevalence of group sex participation among MSM in Washington, DC and to characterize these experiences. Data were collected for NHBS-MSM-3 in 2011. More than one-quarter of MSM (27.2 %) reported engaging in group sex in the prior year, with one-third reporting no condom use with their sex partners (33.0 %). In multivariable logistic regression, men who participated in a GSE in the prior year were significantly younger, more likely to be white, and to have used crystal meth, poppers, and downers in the past year. The high prevalence of UAI during GSEs, especially in view of the fact that HIV-positive MSM were significantly less likely to report condom use, offers an opportunity to develop risk reduction interventions specific to GSE attendees.

Factors Associated with Unprotected Anal Intercourse Among Men Who Have Sex with Men: Results from a Respondent Driven Sampling Survey in Nanjing, China, 2008

Unprotected anal intercourse (UAI) is a well-documented risk factor for acquiring HIV, but not well-studied in China. We studied demographic and behavioral correlates for UAI among men who have sex with men (MSM) in a respondent-driven-sampling (RDS) survey in Nanjing, China. Four hundred and thirty MSM (including ten seeds) participated in this study, rendering an adjusted rate of UAI as 62.3 % (95 % CI 56.4-68.4 %). Adjusted HIV and syphilis prevalence rates were 6.6 % (95 % CI 3.0-10.4) and 12.6 % (95 % CI 8.1-18.3), respectively. HIV- and syphilis-positive cases were more likely to have engaged in UAI. Being unwilling to use condoms, meeting partners in non-conventional venues, having multiple male sex-partners in the past 6 months, having sex with regular and casual male partners in the past 6 months, and consumption of alcohol before sex were all positively associated with UAI. Based on the observed high prevalence of UAI among MSM in Nanjing, we can conclude that implementation of strategies to motivate MSM with high-risk behaviors to use condoms is urgently required in Nanjing.

Syphilis-related perceptions not associated with risk behaviors among men who have sex with men having regular male sex partner(s) in Nanjing, China

The prevalence of HIV among men who sex with men (MSM)has been increasing sharply in China. The prevalence of unprotected anal intercourse (UAI)among them is very high, especially when male regular sex partners are involved. Many MSM having regular sex partners are engaged in multiple sex partnerships, which often involved UAI. This study interviewed 168 MSM in Nanjing, China, having had anal intercourse with at least one male regular sex partner in the last six months. Amongst the participants, 52.4% reported having had UAI with male regular sex partners whilst 50.0% reported multiple male sex partnerships in the last six months. Multivariate analysis showed that monthly personal income higher than 2000 RMB (multivariate OR = 0.49, 95% CI: 0.26–0.96), HIV antibody testing in the last year (multivariate OR = 0.19, 95% CI: 0.06–0.60), sexual position being both insertive and receptive during anal sex with male sex partners in general (multivariate OR = 0.43, 95% CI: 0.18–0.99; reference group: with receptive position only) were associated with lower likelihoods of UAI. Syphilis-related perceptions, including knowledge, cognitions (perceived susceptibility, perceived severity, self-efficacy in avoiding syphilis infection and perceived infectivity and perceived syphilis-related norms among MSM in general)were not associated with risk behaviors (UAI and multiple male sex partnerships). Our sampled MSM are exposed to very high risk of HIV/STD transmission. We found no association between syphilis-related perceptions and the two types of risk behaviors. Future studies are warranted to understand such associations in the context of sexual intercourse with nonregular sex partners among MSM.

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.

A Randomized Controlled Trial to Evaluate the Relative Efficacy of Enhanced Versus Standard Voluntary Counseling and Testing on Promoting Condom Use among Men Who Have Sex with Men in China

The randomized controlled trial investigated the relative efficacy of an enhanced (EVCT) versus standard (SVCT) voluntary counseling and testing in reducing unprotected anal intercourse (UAI) among men who have sex with men (MSM) in China. 295 participants who recruited by respondent driven sampling methods were randomly allocated to the two arms. In addition to the SVCT, the EVCT group watched a theory-based video narrated by a HIV positive MSM, received enhanced counseling and a reminder gift. As compared to the SVCT group, the EVCT group reported lower prevalence of UAI with any male sex partners (48.4% versus 66.7%, RR = 0.7, ARR = -18.3%, p = 0.010) and with regular male sex partners (52.2% versus 68.9%, RR = 0.8, ARR = -16.7%, p = 0.043) at Month 6, whilst baseline between-group differences were statistically non-significant. Between-group differences in HIV/syphilis incidence were statistically non-significant. Translational research should be conducted to integrate non-intensive enhancements such as the EVCT into regular testing services.

HIV, Syphilis Infection, and Risky Sexual Behaviors among Male University Students Who Have Sex with Men in Beijing, China: A Cross-Sectional Study

Young male university students who have sex with men are at high risk of HIV and sexually transmitted infections (STIs). We conducted a cross-sectional survey to assess the prevalence of risky sexual behaviors, HIV, and syphilis among male university students who have sex with men in Beijing, China; and to identify risk factors for unprotected anal intercourse (UAI). Among 157 study participants, HIV and syphilis prevalence were 2.5% and 7.0%, respectively. We found a high prevalence of UAI in our study population. Multiple logistic regression analysis revealed two significant predictors of UAI: believing it is not necessary to use a condom with a regular sex partner and not feeling anxious about being gay. Not using a condom during first sexual experience with a man was a marginally significant predictor of UAI. Male university students who have sex with men are especially vulnerable to HIV and STIs. Intensified education and HIV testing programs are needed to reduce risk in this population.

Analysis on the relationship between condom social norms and unprotected anal intercourse among men who have sex with men in Beijing

To understand the prevalence of and factors associated with unprotected anal intercourse (UAI) among men who have sex with men (MSM) in Beijing. Five hundred MSM were recruited for a survey using Respondent Driven Sampling (RDS) method, from September to October in 2009. A computer-assisted, interviewer-administered questionnaire was used to gather information including demographics, sexual behaviors and condom use social norms (a scaled number). Variables were evaluated by using RDSAT and SAS software. Mean age of the participants was 30.6 years, with 96.0% of them as Han ethnicity and 68.5% having had at least high school or higher education level. 72.8% of them were unmarried, with 61.7% of them identified themselves as homosexual, 61.2% had > 1 male partners in the past six months, and the prevalence of UAI was 42.0%. Significant bivariate predictors of UAI would include condom use social norms score, role for anal sex with male sex partner, number of male sexual partners in the past 6 months and amount of alcohol consumed. In multivariable analysis, UAI was associated with a higher condom use social norms score (AOR = 1.2, 95%CI: 1.1 - 1.3), receptive anal intercourse (AOR = 2.0, 95%CI: 1.3 - 3.2) and drinking alcohol more than 3 times per month in the past 12 months (AOR = 1.6, 95%CI: 1.1 - 2.5). The prevalence of UAI was high in the MSM community in Beijing, suggesting that efforts should be targeting on how to make the condom use a social norm and being promoted.

The Emerging HIV Epidemic among Men Who have Sex with Men in Tamil Nadu, India: Geographic Diffusion and Bisexual Concurrency

In India, men who have sex with men (MSM) remain hidden because anal intercourse was criminalized and marriage socially required. We characterize HIV/STI prevalence among MSM in Tamil Nadu. Eligible participants were recruited using respondent-driven sampling in eight cities (n=721). Median age was 28, 34% were married and 40% self-identified as homosexual. Median number of male partners in the prior year was 15; 45% reported any unprotected anal intercourse (UAI). HIV, herpes simplex virus-2 (HSV-2), chronic hepatitis B virus (HBV) and syphilis prevalence were 9, 26, 2 and 8%, respectively; among married men, all were higher: 14, 32, 3 and 11% (p<0.01 for HIV and HSV-2). Less education, HSV-2, more male partners, UAI and not having a main male partner were associated with HIV prevalence. The high STI and UAI prevalence may lead to a burgeoning HIV epidemic among MSM, reinforcing the need for focused preventive measures incorporating complex circumstances.

Increased HIV disclosure three months after an online video intervention for men who have sex with men (MSM)

A behavioral intervention for men who have sex with men (MSM) was created for online delivery. The nine-minute video drama “The Morning After” (www.hivbigdeal.org) was designed to promote critical thinking about HIV risk. MSM were recruited for the evaluation through banner ads on a subscription-based gay sexual meeting web site. Participants viewed the intervention online and completed online behavioral questionnaires at enrollment and three month follow-up. Each participant served as his own control. No participant incentives were provided. Follow-up was completed by 522 (54%) of 971 eligible men. Men completing follow-up were similar to those who did not by age and prevalence of unprotected anal intercourse (UAI) but reported more lifetime sex partners. They also differed somewhat by race, education, and HIV testing. In the three months after the intervention, men were significantly more likely to disclose HIV status to partners (odds ratio [OR] = 3.37, p<0.001) and less likely to report a casual partner or UAI in their most recent sexual encounter than at baseline. Of 120 men HIV tested during follow-up, 17 (14%) reported being HIV seropositive. These findings show that MSM at high risk for HIV will participate in a brief online video intervention designed to engage critical thinking and that significant, self-reported increases in HIV disclosure and decreases in risk behavior occurred three months after MSM viewed the video.

Prevalence of unprotected anal intercourse among HIV-diagnosed MSM in the United States: a meta-analysis

To integrate the empirical findings on the prevalence of unprotected anal intercourse (UAI) among HIV-diagnosed men who have sex with men (MSM) in the United States. Comprehensively searching MEDLINE, EMBASE, PsycINFO (2000-2007), hand searching bibliographic lists, and contacting researchers. Thirty US studies (n = 18,121) met selection criteria. Analyses were conducted using random-effects models and meta-regression. The prevalence of UAI was considerably higher with HIV-seropositive partners (30%; 95% confidence interval 25-36) than with serostatus unknown (16%; 95% confidence interval 13-21) or HIV-seronegative partners (13%; 95% confidence interval 10-16). The prevalence of UAI with either a serostatus unknown or HIV-seronegative partner was 26%. The UAI prevalence did not differ by the length of the behavioral recall window but did vary by the type of anal intercourse (insertive vs. receptive). Studies with the following features had a lower UAI prevalence: recruiting participants before 2000, MSM of color being the majority of study sample, recruiting participants from medical settings, using random or systematic sampling methods, and having interviewers administer the questionnaire. Being on antiretroviral therapy, having an undetectable viral load, and reporting more than 90% medication adherence were not associated with UAI. Most HIV-diagnosed MSM protect partners during sexual activity, but a sizeable percentage continues to engage in sexual behaviors that place others at risk for HIV infection and place themselves at risk for other sexually transmitted infections. Prevention with positives programs continues to be urgently needed for MSM in the United States.

Internet y riesgo sexual en hombres que tienen sexo con hombres

Objective 1) To compare sociodemographic characteristics, Internet use to seek sexual partners, and sexual behavior in two samples of men who have sex with men: one sample that was surveyed on-line and another that was interviewed in gay venues. 2) To determine the variables associated with unprotected anal intercourse with sexual partners met on-line. Methods For 1 month, 804 men who have sex with men completed a pen-and-paper survey in gay venues and 1,240 completed a web survey in Madrid, Barcelona and Bilbao/San Sebastián (Spain). Results The sociodemographic characteristics differed in the two samples. Compared with men who have sex with men surveyed off-line, a higher proportion of those surveyed on-line used the Internet to meet sexual partners (81% vs. 65%, p<0.05), had unprotected anal intercourse with sexual partners met on-line (31% vs. 27%, p>0.05), had intentionally practised unprotected anal intercourse (81% vs. 65%, p<0.05), did not know their HIV status (35% vs. 28%, p<0.05), used drugs when they practised unprotected anal intercourse (68% vs. 55%, p<0.05) and had had a sexually transmitted infection in the previous year (24% vs. 20%, p<0.05). In the multivariate analysis, unprotected anal intercourse with sexual partners met on-line was associated with having more than 20 sexual partners (odds ratio [OR]: 1.528; 95% confidence interval [95%CI]: 1.024–2.282; p=0.038), using drugs before/during sexual relations (OR: 1.962; 95% CI: 1.478–2.604; p=0.000), having had a sexually transmitted infection in the previous year (OR: 2.042; 95% CI: 1.535–2.716; p=0.000) and being HIV-positive (OR: 2.124; 95% CI: 1.355–3.330; p=0.001), amongst other factors. Conclusions Although the prevalence of unprotected anal intercourse was similar in the two samples, certain variables could explain why the men who have sex with men surveyed on-line had a greater risk of sexually transmitted infections than those surveyed off-line.

Increases in Unprotected Anal Intercourse with Serodiscordant Casual Partners Among HIV-Negative Gay Men in Sydney

Prevalence of unprotected anal intercourse between casual male partners (UAIC) has been increasing worldwide. We explored trends in serodiscordant UAIC and the associated factors among gay men in Sydney. Proportions of HIV-positive and negative men with serodiscordant casual partners increased during 2003-2006. Prevalence of serodiscordant UAIC increased among HIV-negative men. Age, number of partners, seeking partners online, drug use and esoteric practices were associated with serodiscordant UAIC. Increases in serodiscordant UAIC may be related to growing disclosure. These findings do not indicate a core group of high-risk men. More research is needed about the context in which serodiscordant UAIC happens.

Differences between Internet and community samples of MSM: implications for behavioral surveillance among MSM in China

This study compared the difference between two samples of men who have sex with men (MSM) in Harbin, China, using cross-sectional data that were collected via the Internet and through conventional venue-based outreach. All participants in both samples lived in or nearby Harbin in northeast China. Results showed that the Internet sample was significantly younger, more educated and more likely to be students and to self-identify as homosexual than the community sample. After controlling for demographic characteristics, the community sample was more likely to have had sex with females (OR 2.01, CI 1.22–3.30, p=0.006) and to have had ≥6 male partners in the previous six months than the Internet sample (OR 4.88, CI 3.51–6.80, p<0.001). No significant difference was observed in the prevalence of unprotected anal intercourse, exchanging sex for money, exchanging money for sex or illicit drug use between the two samples. For those seeking sex both on the Internet and in traditional gay venues, participants in the community sample were nearly three times more likely to have had ≥6 male partners during the previous six months than those in the Internet sample (p=0.001). In conclusion, the online and offline samples of MSM are significantly different and carry different levels of risk for HIV transmission. Using the Internet as a data collection method may serve as an additional mechanism for the existing gay venue-based behavioral surveillance system in China.

Understanding differences in HIV sexual transmission among Latino and black men who have sex with men: The Brothers y Hermanos Study.

HIV sexual transmission risk behaviors were examined among 1,065 Latino and 1,140 black men who have sex with men (MSM). Participants completed a computer-administered questionnaire and were tested for HIV infection. Of men who reported that their last HIV test was negative or that they had never been tested or did not get the result of their last test, 17% of black and 5% of Latino MSM tested HIV-positive in our study. In both ethnic groups, the three-month prevalence of unprotected anal intercourse (UAI) with HIV-negative or unknown serostatus partners was twice as high among men unaware of their HIV infection than men who knew they were HIV seropositive at the time of enrollment. UAI exclusively with HIV-positive partners was more prevalent among HIV-positive/aware than HIV-positive/unaware men. The findings advance understanding of the high incidence of HIV infection among black MSM in the U.S.

A Comparative Analysis of Sexual Risk Characteristics of Black Men Who Have Sex with Men or with Men and Women

Many behavioral studies of Black men fail to differentiate between those who have sex exclusively with men (MSM) and those who have sex with both men and women (MSMW). Respondent-driven sampling was used to recruit a total of 1,154 Black MSM and MSMW in New York City and Philadelphia. In descriptive analyses, MSMW and MSM were compared on several demographic, health, and behavioral risk correlates using chi-square tests. Differences in prevalence of unprotected anal intercourse (UAI) between these two groups were examined in two multivariate logistic regressions. Age, country of birth, self-identified sexual orientation, experience of being forced to have sex, self-reported HIV status, exchange sex for money/food/ drug, and drug use in the past 3 months were significantly associated with either insertive or receptive UAI in the past 3 months. The strongest correlate of either insertive or receptive UAI among both groups of men was engaging in exchange sex. Differences between MSMW and MSM were found in the areas of forced sexual experiences, disclosure of same sex behavior, and history of being arrested or incarcerated. Findings from our study highlight the need for specific HIV prevention interventions targeting Black MSMW as distinguished from Black MSM.

Closing Bathhouses Unlikely to Decrease Number of Sex Acts and May Reduce Condom Use

Closing Bathhouses Unlikely to Decrease Number of Sex Acts and May Reduce Condom Use

«Fuck buddies»: a high risk behavior for contracting HIV among homo/bisexual men

OBJECTIVE Despite prevention efforts, the prevalence of unprotected anal intercourse (UAI) remains substantial among men who have sex with men (MSM). This study describes and analyzes how a group of MSM manages sexual risk with sexual partners. METHOD Qualitative study by means in-depth, semi-structured interviews with 20 MSM, aged 21 to 40 years old, who had had at least one episode of UAI within the previous 3 months. A grounded theory approach was used to understand sexual risk management with sexual partners as seen by the MSM interviewed. RESULTS Most MSM were involved in UAI when they established relationships with > as a way to balance their need for sexual expression with their need for sexual security. In these relationships, the partner's serostatus was assessed on the basis of trust and the assumption of sharing the same serologic status. CONCLUSIONS Subjective evaluations (e.g. trust, intuition) played a key role in the decision to engage in UAI with > without precise knowledge of their HIV serostatus. Future approaches need to include the role of subjectivity in making decisions related to risk management and the specific contexts (e.g. type of sexual partner) in which UAI takes place.

«Amigos con derecho a roce»: una oportunidad para contraer la infección por el virus de la inmunodeficiencia humana en hombres homo/bixesuales con prácticas sexuales de alto riesgo

Objective Despite prevention efforts, the prevalence of unprotected anal intercourse (UAI) remains substantial among men who have sex with men (MSM). This study describes and analyzes how a group of MSM manages sexual risk with sexual partners. Method Qualitative study by means in-depth, semi-structured interviews with 20 MSM, aged 21 to 40 years old, who had had at least one episode of UAI within the previous 3 months. A grounded theory approach was used to understand sexual risk management with sexual partners as seen by the MSM interviewed. Results Most MSM were involved in UAI when they established relationships with «fuck buddies» as a way to balance their need for sexual expression with their need for sexual security. In these relationships, the partner’s serostatus was assessed on the basis of trust and the assumption of sharing the same serologic status. Conclusions Subjective evaluations (e.g. trust, intuition) played a key role in the decision to engage in UAI with «fuck buddies» without precise knowledge of their HIV serostatus. Future approaches need to include the role of subjectivity in making decisions related to risk management and the specific contexts (e.g. type of sexual partner) in which UAI takes place.