National Trends in Sexual Behavior, Substance Use and HIV Testing Among United States Men Who have Sex with Men Recruited Online, 2013 Through 2017
The American Men’s Internet Survey (AMIS) is conducted annually with 10,000 men age 15 + who have sex with men (MSM). Modeling was used with 39,863 AMIS surveys from 4 cycles between December 2013 to February 2017 to identify temporal trends in sexual behavior, substance use, and testing behavior (within 12 months preceding interview) stratified by participants’ self-reported HIV status. HIV-negative/unknown status MSM had significant increases in condomless anal intercourse (CAI), marijuana use, use of other illicit substances, sexually transmitted infection (STI) diagnoses, and HIV or STI testing (testing only increased among MSM age 25 +). HIV-negative/unknown status MSM had significant decrease in CAI with an HIV-positive or unknown status partner. HIV-positive MSM had significant increases in CAI, methamphetamine use, and STI diagnoses/testing. Although encouraging, the few indicators of improvement in HIV/STI sexual health practices are not consistently seen across sub-groups of MSM and may be counteracted by growing proportions of MSM engaging in CAI and acquiring STIs.
KeywordsMSM Sex Drug use HIV STI
The study was funded by a grant from the MAC AIDS Fund and by the National Institutes of Health [P30AI050409]—the Emory Center for AIDS Research.
TS, CS, ST and PS developed the research questions, designed the study and materials. TS, MZ, CS, EK and ST implemented the study data collection and contributed to dataset creation over the multiple cycles. MZ conducted the data analyses for this manuscript. TS, MZ and PS wrote the manuscript. All authors critically reviewed and edited the manuscript.
Compliance with Ethical Standards
Conflict of interest
The authors report no conflict of interest.
The study was conducted in compliance with Federal Regulations Governing Protection of Human Subjects and was reviewed and approved by Emory University’s Institutional Review Board.
Informed consent was obtained from all individual participants in the study.
- 1.Centers for Disease Control and Prevention. Diagnoses of HIV Infection in the United States and Dependent Areas. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2015-vol-27.pdf (2015). Accessed 23 Oct 2017.
- 2.Centers for Disease Control and Prevention. HIV Incidence: Estimated Annual Infections in the U.S., 2008–2014. https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/hiv-incidence-fact-sheet_508.pdf (2015). Accessed 23 Oct 2017.
- 3.Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance. https://www.cdc.gov/std/stats15/STD-Surveillance-2015-print.pdf (2015). Accessed 23 Oct 2017.
- 5.HIV testing and risk behaviors among gay. bisexual, and other men who have sex with men—United States. Morb Mortal Wkly Rep. 2013;62(47):958–62.Google Scholar
- 9.Centers for Disease Control and Prevention. HIV Infection Risk, Prevention, and Testing Behaviors among Men Who Have Sex with Men National HIV Behavioral Surveillance, 20 U.S. Cities. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-hssr-nhbs-msm-2014.pdf (2014). Accessed 23 Oct 2017.
- 10.Hickson F, Tomlin K, Hargreaves J, Bonell C, Reid D, Weatherburn P. Internet-based cohort study of HIV testing over 1 year among men who have sex with men living in England and exposed to a social marketing intervention promoting testing. Sex Transm Infect. 2014;91:24–30.CrossRefPubMedGoogle Scholar
- 11.The EMIS Network. EMIS 2010: The European Men-Who-Have-Sex-With-Men Internet Survey. Findings from 38 countries. https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/EMIS-2010-european-men-who-have-sex-with-men-survey.pdf Accessed 23 Oct 2017.
- 12.Pew Research Internet Project. Social Media Update. http://www.pewinternet.org/2016/11/11/social-media-update-2016/ (2016). Accessed 8 Aug 2017.
- 15.Centers for Disease Control and Prevention. 15% of American adults have used online dating sites or mobile dating apps. http://assets.pewresearch.org/wp-content/uploads/sites/14/2016/02/PI_2016.02.11_Online-Dating_FINAL.pdf (2016). Accessed 8 Aug 2017.
- 20.Ingram DD, Franco SJ. 2013 NCHS Urban-Rural Classification Scheme for Counties. Vital Health Stat. 2014;166:1–73.Google Scholar
- 24.Marijuana Policy Project. State Marijuana Policies. https://www.mpp.org/states/. Accessed 8 Jul 2017.
- 25.Centers for Disease Control and Prevention. Support for marijuana legalization continues to rise. http://www.pewresearch.org/fact-tank/2016/10/12/support-for-marijuana-legalization-continues-to-rise/. Accessed 8 Jul 2017.
- 26.Gallup. Support for Legal Marijuana Use Up to 60% in U.S. http://news.gallup.com/poll/196550/support-legal-marijuana.aspx (2016). Accessed 8 Jul 2017.
- 27.Gallup. In U.S., 45% Say They Have Tried Marijuana. http://www.gallup.com/poll/214250/say-tried-marijuana.aspx. Accessed 8 Jul 2017.
- 28.National Institute on Drug Abuse. Available at https://www.drugabuse.gov/national-survey-drug-use-health. . Accessed 23 Oct 2017.
- 35.Khosropour CM, Dombrowski JC, Hughes JP, Manhart LE, Simoni JM, Golden MR. Operationalizing the measurement of seroadaptive behaviors: a comparison of reported sexual behaviors and purposely-adopted behaviors among men who have sex with men (MSM) in Seattle. AIDS Behav. 2017;21:2935–44.CrossRefPubMedPubMedCentralGoogle Scholar
- 37.Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015. https://www.cdc.gov/std/tg2015/tg-2015-print.pdf (2015). Accessed 8 Oct 2017.
- 38.Singh SS, Ruiguang; Satcher-Johnson, Anna; McCray, Eugene; Hall, Irene. HIV incidence, prevalence and undiagnosed infections in men who have sex with men. Conference on Retroviruses and Opportunistic Infections. Seattle, WA (2017).Google Scholar
- 39.Centers for Disease Control and Prevention. HIV Infection Risk, Prevention, and Testing Behaviors among Men Who Have Sex with Men National HIV Behavioral Surveillance 20 U.S. Cities, 2014. 1/1/2016.Google Scholar