Saturday, February 6, 2016

Sexual Networks and HIV Risk among Black Men Who Have Sex with Men in 6 U.S. Cities

Sexual networks may place U.S. Black men who have sex with men (MSM) at increased HIV risk.

Self-reported egocentric sexual network data from the prior six months were collected from 1,349 community-recruited Black MSM in HPTN 061, a multi-component HIV prevention intervention feasibility study. Sexual network composition, size, and density (extent to which members are having sex with one another) were compared by self-reported HIV serostatus and age of the men. GEE models assessed network and other factors associated with having a Black sex partner, having a partner with at least two age category difference (age difference between participant and partner of at least two age group categories), and having serodiscordant/serostatus unknown unprotected anal/vaginal intercourse (SDUI) in the last six months.

Over half had exclusively Black partners in the last six months, 46% had a partner of at least two age category difference, 87% had ≤5 partners. Nearly 90% had sex partners who were also part of their social networks. Among HIV-negative men, not having anonymous/exchange/ trade partners and lower density were associated with having a Black partner; larger sexual network size and having non-primary partners were associated with having a partner with at least two age category difference; and having anonymous/exchange/ trade partners was associated with SDUI. Among HIV-positive men, not having non-primary partners was associated with having a Black partner; no sexual network characteristics were associated with having a partner with at least two age category difference and SDUI.

Black MSM sexual networks were relatively small and often overlapped with the social networks. Sexual risk was associated with having non-primary partners and larger network size. Network interventions that engage the social networks of Black MSM, such as interventions utilizing peer influence, should be developed to address stable partnerships, number of partners, and serostatus disclosure.

Sex Partner Characteristics, Condom Use, and HIV Serostatus Disclosure of Community-Recruited Black MSM, Partner-Level Data (N = 4,449 Partners).
Characteristic, n (%)aTotalSelf-Reported HIV-Positive ParticipantSelf-Reported HIV-Negative ParticipantP-value
Partner Level
Gender of sex partners<0.01
Male3464 (78)308 (92)3156 (77)
Female800 (18)18 (5)782 (19)
Transgender172 (4)7 (2)165 (4)
Partner type<0.01
Primary partner707 (16)80 (24)627 (15)
Steady, non-primary partner/casual partner3003 (68)210 (63)2793 (68)
Exchange or trade partner/anonymous partner716 (16)42 (13)674 (16)
HIV serostatus of sex partners<0.01
Among all participants (N = 4446 partners):2284 (51)67 (20)2217 (54)
HIV-negative311 (7)142 (43)169 (4)
HIV-positive1841 (41)124 (37)1717 (42)
HIV serostatus of sex partners<0.01
Among participants age 18–30 years (N = 1659 partners):1023 (62)17 (23)1006 (63)
HIV-negative66 (4)22 (30)44 (3)
HIV-positive570 (34)35 (47)535 (34)
HIV serostatus of sex partners<0.01
Among participants age 31+ years (N = 2777 partners):1261 (45)50 (19)1211 (48)
HIV-negative245 (9)120 (46)125 (5)
HIV-positive1271 (46)89 (34)1182 (47)
Frequency of condom use with sex in past 6 months (N = 4361 partners)0.01
Never1899 (44)171 (52)1728 (43)
Sometimes740 (17)52 (16)688 (17)
Most of the time398 (9)18 (5)380 (9)
Always1324 (30)88 (27)1236 (31)
Disclosure of HIV status to sex partners by self-reported HIV-positive participants (N = 309 partners)---
No106 (34)
Yes191 (62)
Don’t know/refused to answer12 (4)
Numbers may not add up to column total due to missing data.
a P-value <0.05 for all variables compared by study city. Site-specific differences may be reflective of different recruitment strategies used by the study sites, rather than of overall differences between cities.

Full article at:

William M. Switzer, Editor
1Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States of America
2Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, United States of America
3Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
4Division of Infectious Diseases, Emory School of Medicine, Atlanta, GA, United States of America
5Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States of America
6Department of Human Development, State University of New York at Binghamton, Binghamton, NY, United States of America
7Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
8Department of Epidemiology, School of Public Health, Division of InfectiousDiseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America
9Fenway Community Health Center, Boston, MA, United States of America
10FHI 360, Research Triangle Park, NC, United States of America
11Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
12The George Washington University School of Public Health and Health Services, Department of Epidemiology and Biostatistics, Washington, DC, United States of America
13Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
14Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
Centers for Disease Control and Prevention, UNITED STATES
Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: HVT BAK CL. Performed the experiments: HVT TYL LW SB LW PG KM SG CK VE GP VC BAK CL. Analyzed the data: HVT TYL LW MC BAK CL. Wrote the paper: HVT SH BAK CL.

More about the poster:

No comments:

Post a Comment