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HIV Acquisition and Transmission Potential Among African American Men Who Have Sex with Men and Women in Three U.S. Cities

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Abstract

Black men who have sex with men and women (BMSMW) are at increased HIV risk, but few efficacious interventions meet their unique needs. Three HIV prevention interventions were evaluated with a common protocol. Baseline data were pooled to describe sexual behavior involving transmission risk with male, female, and male-to-female transgender partners and identify factors associated with transmission risk. BMSMW from Los Angeles, Philadelphia, and Chicago who reported sexual risk and bisexual behavior in the past year were recruited via modified chain referral sampling and community recruitment. Baseline assessments were conducted via audio computer-assisted interview and sexual behaviors assessed over the past 3 months. From December 2010 to November 2012, 584 BMSMW were enrolled across the three cities. More than half (55%) were recruited by other participants. Overall, the mean age was 43 years. Seventy-five percent reported an annual income <$10,000 and selling sex was prevalent (31%). Three-quarters identified as bisexual. Thirty-nine percent were HIV-positive. Among HIV-positive participants, 46% reported sex without condoms with HIV-negative or unknown male partners and 45% with HIV-negative or unknown female partners. Overall, factors associated with sex without condoms included network size, education, income, sexual orientation identification, HIV status, exchange sex, homonegativity, and social support. Findings support the need for enhanced HIV prevention efforts for this population. Future studies should examine contextual factors in addition to individual risk behaviors to inform the development and implementation of promising strategies to prevent HIV and promote the overall health and wellness of BMSMW and their sexual partners.

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Acknowledgements

This work is the result of a collaborative effort, funded by the Centers for Disease Control and Prevention Cooperative Agreement #1UR6PS0001099. The authors would like to thank the staff at each of the funded sites, as well as members of participating community advisory boards and community-based organizations. Specifically, the authors thank Lyle McCormick, Ilya Teplinskiy, Ann O’Leary, Steve Flores, and Lisa Bond. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Funding

Funding was provided by Centers for Disease Control and Prevention (US) (Grant No. RFA-PS-08-002).

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Author notes

  1. Yi Pan and Maria Mendoza have contributed equally to this work.

Authors and Affiliations

  1. Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA

    Heather A. Joseph, Yi Pan, Maria Mendoza, William L. Jeffries IV & Lisa Belcher

  2. College of Medicine, Charles Drew University, Los Angeles, CA, USA

    Nina T. Harawa

  3. Public Health Management Corporation, Philadelphia, PA, USA

    Jennifer Lauby & Mary Milnamow

  4. Research Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL, USA

    Sybil G. Hosek

  5. Department of Preventive Medicine, Keck School of Medicine, University of Southern California , Los Angeles, CA, USA

    Ricky N. Bluthenthal

  6. College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, USA

    Maria Isabel Fernandez

  7. amfAR, The Foundation for AIDS Research, Washington, DC, USA

    Gregorio A. Millett

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  1. Heather A. Joseph
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  2. Yi Pan
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Correspondence to Heather A. Joseph.

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This research was approved by the Institutional Review Boards at the Hektoen Institute, Charles Drew University, University of Southern California, and the Public Health Management Corporation.

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Joseph, H.A., Pan, Y., Mendoza, M. et al. HIV Acquisition and Transmission Potential Among African American Men Who Have Sex with Men and Women in Three U.S. Cities. Arch Sex Behav 47, 183–194 (2018). https://doi.org/10.1007/s10508-017-1052-z

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