Abstract
HIV disproportionately affects African American men who have sex with men (MSM) in the United States. To inform this epidemiological pattern, we examined cross-sectional sexual behavior data in 509 African American MSM. Bivariate logistic regression analyses were conducted to examine the extent to which age, education, and sexual identity explain the likelihood of engaging in sex with a partner of a specific gender and the likelihood of engaging in unprotected sexual behaviors based on partner gender. Across all partner gender types, unprotected sexual behaviors were more likely to be reported by men with lower education. Younger, non-gay identified men were more likely to engage in unprotected sexual behaviors with transgender partners, while older, non-gay identified men were more likely to engage in unprotected sexual behaviors with women. African American MSM do not represent a monolithic group in their sexual behaviors, highlighting the need to target HIV prevention efforts to different subsets of African American MSM communities as appropriate.
Resumen
En los Estados Unidos el VIH afecta desproporcionadamente a los hombres Afroamericanos que tienen sexo con otros hombres. Para explorar este patrón epidemiológico, examinamos transversalmente la conducta sexual de 509 hombres Afroamericanos que tienen sexo con otros hombres. Se realizó un análisis de regresión logística binaria para examinar en qué medida la edad, la educación, y la identidad sexual explicarían la probabilidad de tener relaciones sexuales con una pareja de un género específico y la probabilidad de tener relaciones sexuales sin protección basada en el género de la pareja. Independientemente del genero de la pareja (hombres, mujeres, y transgénero), el tener relaciones sexuales sin protección fue reportado más frecuentemente por hombres con menor educación formal. Los hombres más jóvenes y que no se identifican como gay tuvieron una mayor probabilidad de reportar relaciones sexuales sin protección con parejas transgénero. Mientras que los hombres más viejos y que no se identifican como gay tuvieron una mayor probabilidad de reportar relaciones sexuales sin protección con mujeres. Los hombres Afroamericanos que tienen sexo con otros hombres no representan un grupo monolítico en sus relaciones sexuales, destacando la necesidad de dirigir los esfuerzos de prevención del VIH en modo específico a diferentes subgrupos de estas comunidades.
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References
Centers for Disease Control and Prevention. HIV/AIDS surveillance report, vol 19. 2007. http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2007report/pdf/2007SurveillanceReport.pdf. Accessed 21 Oct 2011.
Centers for Disease Control and Prevention. Gay and Bisexual Men’s Health. 2011. http://www.cdc.gov/msmhealth/HIV.htm. Accessed 21 Oct 2011 (Updated September 27, 2011).
Centers for Disease Control and Prevention. HIV and AIDS among gay and bisexual men. 2011. http://www.cdc.gov/nchhstp/newsroom/docs/fastfacts-msm-final508comp.pdf. Accessed 21 Oct 2011.
Centers for Disease Control and Prevention. Trends in HIV/AIDS diagnoses among men who have sex with men—33 states (2001–2006). MMWR. 2008;57(25):681–686.
Hall HI, Song R, Rhodes P, et al. Estimation of HIV incidence in the United States. JAMA. 2008;300(5):520–9. doi:10.1001/jama.300.5.520.
Centers for Disease Control and Prevention. Subpopulation estimates from the HIV incidence surveillance system—United States, 2006. MMWR. 2008;57(36):985–9.
Centers for Disease Control and Prevention. HIV Surveillance Report, vol 21. 2009. http://www.cdc.gov/hiv/surveillance/resources/reports/2009report/pdf/2009SurveillanceReport.pdf. Accessed 21 Oct 2011 (Published February 2011).
Mansergh G, Marks G. Age and risk of HIV infection in men who have sex with men. AIDS. 1998;12(10):1119–28. doi:10.1097/00002030-199810000-00003.
Osmond D, Pollack L, Paul J, Catania JA. Changes in prevalence of HIV infection and sexual risk behavior in men who have sex with men in San Francisco: 1997–2002. Am J Public Health. 2007;97:1677–83. doi:10.2105/AJPH.2005.062851.
Myers H, Javanbakht J, Martinez M, Obediah S. Psychosocial predictors of risky sexual behaviors in African American men: implications for prevention. AIDS Educ Prev. 2003;15:66–79. doi:10.1521/aeap.15.1.5.66.23615.
New York City Department of Health and Mental Hygiene. New HIV diagnoses rising in New York City among men who have sex with men. New York: Department of Health; 2007.
Janssen M, De Wit J, Stroebe W, Griensven F. Educational status and risk of HIV in young gay men. J Health Psychol. 2000;5:487–99. doi:10.1177/135910530000500407.
Kalichman SC, Nachimson D, Cherry C, Williams E. AIDS treatment advances and behavioral prevention setbacks: preliminary assessment of reduced perceived threat of HIV-AIDS. Health Psychol. 1998;17:546–50. doi:10.1037/0278-6133.17.6.546.
Sanchez T, Finlayson T, Drake A, et al. Human immunodeficiency virus (HIV) risk, prevention, and testing behaviors-United States, National HIV behavioral surveillance system: men who have sex with men, November 2003–April 2005. MMWR 2006;55(SS06):1–16.
Strathdee SA, Hogg RS, Martindale SL, et al. Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;19(1):61–6. doi:10.1097/00042560-199809010-00010.
Courtenay-Quirk C, Pals SL, Colfax G, McKirnan D, Gooden L, Eroglu D. Factors associated with sexual risk behavior among persons living with HIV: gender and sexual identity group differences. AIDS Behav. 2008;12(5):685–94. doi:10.1007/s10461-007-9259-y.
Hart T, Peterson J, and Community Intervention Trail for Youth Study Team. Predictors of risky sexual behavior among young African American men who have sex with men. Am J Public Health 2004;94(7):1122–4. doi:10.2105/AJPH.94.7.1122.
Mashburn AJ, Peterson JL, Bakeman R, Miller RL, Clark LF, Community Intervention Trail for Youth Study Team. Influences on HIV testing among young African American men who have sex with men and the moderating effect of geographic setting. J Community Pscychol. 2004;32(1):45–60. doi:10.1002/jcop.10080.
Williams JK, Wyatt GE, Resell J, Peterson J, Asuan-O’Brien A. Psychosocial issues among gay- and non-gay-identifying HIV-seropositive African American and Latino MSM. Cultur Divers Ethnic Minor Psychol. 2004;10(3):268–86. doi:10.1037/1099-9809.10.3.268.
Harawa NT, Williams JK, Ramamurthi HC, Manago C, Avina S, Jones M. Sexual behavior, sexual identity, and substance abuse among low-income bisexual and non-gay-identifying African American men who have sex with men. Arch Sex Behav. 2008;37(5):748–62. doi:10.1007/s10508-008-9361-x.
Millett GA, Peterson JL, Wolitski RJ, Stall R. Greater risk for HIV infection of black men who have sex with men: a critical literature review. Am J Public Health. 2006;96(6):1007–19. doi:10.2105/AJPH.2005.066720.
Millett G, Malebranche D, Mason B, Spikes P. Focusing “down low”: bisexual black men, HIV risk and heterosexual transmission. J Natl Med Assoc. 2005;97(7 Suppl):52S–9S.
Halkitis PN, Kupprat SA, McCree DH, et al. Evaluation of the relative effectiveness of three HIV testing strategies targeting African American men who have sex with men (MSM) in New York City. Ann Behav Med. 2011;42(3):361–9. doi:10.1007/s12160-011-9299-4.
Halkitis PN. Measurement considerations in HIV behavioral research. Paper presented at: 107th Annual Convention of the American Psychological Association; Boston;1999.
McElrath K, Chitwood DD, Griffin DK, Cornerford M. The consistency of self-reported HIV behavior among injection drug users. Am J Public Health. 1994;84(12):1965–70. doi:10.2105/AJPH.84.12.1965.
Samuels JF, Vlahov D, Anthony JC, Chaisson RE. Measurement of HIV risk behaviors among intravenous drug users. Br J Addict. 1992;87(3):417–28. doi:10.1111/j.1360-0443.1992.tb01942.x.
Halkitis PN, Palamar JJ, Mukherjee PP. Poly-club-drug use among gay and bisexual men: a longitudinal analysis. Drug Alcohol Depend. 2007;89(2–3):153–60. doi:10.1016/j.drugalcdep.2006.12.028.
Mansergh G, Shouse RL, Marks G, et al. Methamphetamine and sildenafil (Viagra) use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of men who have sex with men. Sex Transm Infect. 2006;82(2):131–4. doi:10.1136/sti.2005.017129.
Deaux K. Sex and gender. Annu Rev Psychol. 1985;36:49–81. doi:10.1146/annurev.psych.36.1.49.
Frable DES. Gender, racial, ethnic, sexual, and class identities. Annu Rev Psychol. 1997;48:139–62. doi:10.1146/annurev.psych.48.1.139.
Bocour A, Renaud TC, Wong MR, Udeagu CCN, Shepard CW. Differences in risk behaviors and partnership patterns between younger and older men who have sex with men in New York City. J Acquir Immune Defic Syndr. 2011;58(4):417–23. doi:10.1097/QAI.0b013e318230e6d9.
Warren JC, Fernandez MI, Harper GW, Hidalgo MA, Jamil OB, Torres RS. Predictors of unprotected sex among young sexually active African American, Hispanic, and White MSM: the importance of ethnicity and culture. AIDS Behav. 2008;12:459–68. doi:10.1007/s10461-007-9291-y.
Halkitis PN, Brockwell S, Siconolfi DE, et al. Sexual behaviors of adolescent emerging and young adult men who have sex with men ages 13–29 in New York City. J Acquir Immune Defic Syndr. 2011;56(3):285–91. doi:10.1097/QAI.0b013e318204194c.
Halkitis PN. Reframing HIV prevention for gay men in the United States. Am Psychol. 2010;65(8):752–63. doi:10.1037/0003-066X.65.8.752.
Heckman TG, Kelly JA, Bogart LM, Kalichman SC, Rompa DJ. HIV risk differences between African American and white men who have sex with men. J Natl Med Assoc. 1999;91(2):92–100.
McKirnan DJ, Stokes JP, Doll L, Burzette RG. Bisexually active men: social characteristics and sexual behavior. J Sex Res. 1995;32(1):65–76. doi:10.1080/00224499509551775.
Miller M, Serner M, Wagner M. Sexual diversity among black men who have sex with men in an inner-city community. J Urban Health. 2005;82(1 Suppl 1):i26–34. doi:10.1093/jurban/jti021.
Montgomery JP, Mokotoff ED, Gentry AC, Blair JM. The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners. AIDS Care. 2003;15(6):829–37. doi:10.1080/09540120310001618676.
Mutchler MG, Bogart LM, Elliott MN, McKay T, Suttorp MJ, Schuster MA. Psychosocial correlates of unprotected sex without disclosure of HIV-positivity among African American, Latino, and White men who have sex with men and women. Arch Sex Behav. 2008;37(5):736–47. doi:10.1007/s10508-008-9363-8.
Meyer IH. Minority stress and mental health in gay men. J Health Soc Behav. 1995;36(1):38–56. doi:10.2307/2137286.
Acknowledgment
This study was funded by a Cooperative Agreement from the U.S. Centers for Disease Control and Prevention Contract # 1UR6 PS000369.
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Hampton, M.C., Halkitis, P.N., Storholm, E.D. et al. Sexual Risk Taking in Relation to Sexual Identification, Age, and Education in a Diverse Sample of African American Men Who Have Sex with Men (MSM) in New York City. AIDS Behav 17, 931–938 (2013). https://doi.org/10.1007/s10461-012-0139-8
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DOI: https://doi.org/10.1007/s10461-012-0139-8