Beyond Anal Sex: Sexual Practices of Men Who Have Sex with Men and Associations with HIV and Other Sexually Transmitted Infections

INTRODUCTION:

Unprotected anal intercourse is often used as a single indicator of risky behavior in men who have sex with men (MSM), yet MSM engage in a variety of behaviors that have unknown associations with sexually transmitted infection (STI) and HIV.

AIM:

To assess the prevalence of a wide range of sexual behaviors and their associations with prevalent STI and HIV.

METHODS:

We used a standardized, self-administered survey to collect behavioral data for this cross-sectional study of 235 MSM seeking care in a public clinic for sexually transmitted diseases.

MEAN OUTCOME MEASURES:

Using modified Poisson regression, we generated unadjusted and adjusted prevalence ratios (PRs) to characterize associations between recent participation in each behavior and prevalent STI and HIV.

RESULTS:

Participants' median age was 26 years. One third (35%) were positive for STI. STI prevalence was significantly associated with using sex slings, felching, group sex, fisting, anonymous sex, and sex toys. HIV prevalence was 17% and was significantly associated with fisting, felching, enemas, and group sex.

CONCLUSION:

Multiple behaviors were significantly associated with prevalent STI and HIV in adjusted analyses. To provide a more comprehensive understanding of sexual risk in MSM, prospective studies are needed to examine whether these behaviors are causally associated with HIV and STI acquisition.

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By:  Rice CE1, Maierhofer C2, Fields KS3, Ervin M3, Lanza ST4, Turner AN2.

• 1Department of Biobehavioral Health, The Methodology Center (https://methodology.psu.edu/), College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA. Electronic address: cer5374@psu.edu.
• 2Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH, USA.
• 3Sexual Health Clinic, Columbus Public Health, Columbus, OH, USA.
• 4Department of Biobehavioral Health, The Methodology Center, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA. 
• J Sex Med. 2016 Feb 4. pii: S1743-6095(16)00074-6. doi: 10.1016/j.jsxm.2016.01.001.

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