Saliva Use as a Lubricant for Anal Sex Is a Risk Factor for Rectal Gonorrhoea among Men Who Have Sex with Men, A New Public Health Message

BACKGROUND:

Apart from penile-anal intercourse, other anal sexual practices (rimming, fingering and saliva use as a lubricant for anal sex) are common among men who have sex with men (MSM). The aim of this study is to evaluate whether these anal sexual practices are risk factors for rectal gonorrhoea in MSM.

METHOD:

A cross-sectional survey was conducted among MSM attending Melbourne Sexual Health Centre between 31 July 2014 and 30 June 2015. Rectal gonorrhoea cases were identified by culture.

RESULTS:

Among 1312 MSM, 4.3% (n=56) had rectal gonorrhoea. Other anal sexual practices were common among MSM: receptive rimming (70.5%), receptive fingering or penis dipping (84.3%) and using partner's saliva as a lubricant for anal sex (68.5%). Saliva as a lubricant was significantly associated with rectal gonorrhoea after adjusting for potential confounding factors. Receptive rimming and fingering or penis dipping were not statistically associated with rectal gonorrhoea. The crude population-attributable fraction of rectal gonorrhoea associated with use of partner's saliva as a lubricant for anal sex was 48.9% (7.9% to 71.7%).

CONCLUSIONS:

Saliva use as a lubricant for anal sex is a common sexual practice in MSM, and it may play an important role in gonorrhoea transmission. Almost half of rectal gonorrhoea cases may be eliminated if MSM stopped using partner's saliva for anal sex.

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By:  Chow EP1, Cornelisse VJ1, Read TR1, Lee D2, Walker S1, Hocking JS3, Chen MY1, Bradshaw CS1, Fairley CK1.

• 1Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia Faculty of Medicine, Central Clinical School, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
• 2Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
• 3Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

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Lubricant Use & Condom Use During Anal Sex in Men Who Have Sex with Men in Tanzania

The lack of data on condom and lubricant use among African men who have sex with men hinders prevention efforts. We describe use, knowledge, and access to lubricants in Dar es Salaam and Tanga, Tanzania. Data were collected in 2012 and 2013 from a cross-sectional survey of 200 men who have sex with men in Dar es Salaam and 100 men who have sex with men in Tanga, Tanzania. 

The most common reason for not using condoms was dislike of condoms. Two-thirds of the men reported always using a lubricant for anal sex. Fewer men who have sex with both men and women know about lubricants, more gay men look for, have difficulty finding, and find lubricants to be expensive; and men who have sex with men use lubricants to facilitate penetration. Men who have sex with both men and women commonly receive their lubricants from their sexual partner, while gay men got them from friends and pharmacies. HIV-negative men who have sex with men used lubricants to facilitate penetration and reduce pain. HIV-positive men who have sex with men are likely to get their lubricants from pharmacies or friends. Men who have sex with men and women use Vaseline® significantly more than gay men as a lubricant. 

Results suggest that HIV prevention knowledge among gay men is greater; HIV prevention efforts should emphasise carrying water-based lubricant among men who have sex with men and women. Consequently, there is an opportunity to co-market condoms and water-based lubricants.

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By: Romijnders KA1, Nyoni JE2, Ross MW3, McCurdy SA4, Mbwambo J5, Kok G6, Crutzen R7.

• 1Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands k.romijnders@student.maastrichtuniversity.nl.
• 2Department of Sociology and Anthropology, University of Dar es Salaam, United Republic of Tanzania.
• 3Program in Human Sexuality, Department of Family Medicine, University of Minnesota, MN USA.
• 4Division of Health Promotion and Behavioral Sciences, School of Public Health, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, USA.
• 5Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, United Republic of Tanzania.
• 6School of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
• 7CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands.  

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Individual-Level, Partnership-Level, and Sexual Event-Level Predictors of Condom Use During Receptive Anal Intercourse among HIV-Negative Men Who Have Sex with Men in Los Angeles

We examined individual-level, partnership-level, and sexual event-level factors associated with condom use during receptive anal intercourse (RAI) among 163 low-income, racially/ethnically diverse, HIV-negative men who have sex with men (MSM) in Los Angeles (2007-2010). 

At baseline, 3-month, and 12-month visits, computer-assisted self-interviews collected information on ≤3 recent male partners and the last sexual event with those partners. Factors associated with condom use during RAI at the last sexual event were identified using logistic generalized linear mixed models. 

Condom use during RAI was negatively associated with reporting ≥ high school education and methamphetamine use, specifically during RAI events with non-main partners and those that included lubricant use. 

Condom use during RAI varies according to individual-level, partnership-level, and sexual event-level factors that should be considered in the development of risk reduction strategies for this population.

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By: Pines HA1, Gorbach PM2, Weiss RE3, Reback CJ4,5, Landovitz RJ6, Mutchler MG7,8, Mitsuyasu RT6.

• 1Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Dr., MC 0507, La Jolla, CA, 92093-0507, USA. hpines@ucsd.edu.
• 2Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
• 3Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
• 4Friends Research Institute, Inc., Los Angeles, CA, USA.
• 5Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
• 6Center for Clinical AIDS Research & Education, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
• 7AIDS Project Los Angeles, Los Angeles, CA, USA.
• 8Department of Sociology, California State University, Dominguez Hills, Carson, CA, USA.  

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Lubricant Use among Men Who Have Sex with Men Reporting Anal Intercourse in Bangkok, Thailand: Impact of HIV Status & Implications for Prevention

This analysis measures prevalence and correlates of consistent lubricant use among a cohort of Thai men who have sex with men (MSM). Lubricant use was queried at the 12 month follow-up visit. Consistent lubricant use was evaluated with logistic regression. 

Consistent lubricant use was reported by 77.0% of men and associated with consistent condom use with casual partners, while binge drinking, payment for sex, and inconsistent condom use with casual, and steady partners, were negatively associated. Though consistent lubricant use is common among this Thai MSM cohort, further promotion is needed with MSM engaging in risky sexual practices.

Via:  http://ht.ly/RXs6G

By: Thienkrua W1, Todd CS, Chaikummao S, Sukwicha W, Yafant S, Tippanont N, Varangrat A, Khlaimanee P, Sirivongrangson P, Holtz TH.

• 1a HIV/STD Research Program, Thailand Ministry of Public Health , U.S. Centers for Disease Control and Prevention Collaboration , Nonthaburi , Thailand.