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Sexual Debut and HIV-Related Sexual Risk-Taking by Birth Cohort Among Men Who Have Sex with Men in the United States

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Abstract

Age-discordant and earlier sexual debut are risk factors for HIV among men who have sex with men (MSM). Despite differences in the sociopolitical landscape over time, there are no studies sampling participants from the United States that have examined the role of birth cohort in relations between sexual debut characteristics and sexual risk among MSM. We assessed sexual debut patterns and associations with sexual risk-taking in 812 adult MSM stratified by ten-year birth cohorts (i.e., before 1970, 1970–1979, 1980–1989, after 1990). Sexual debut characteristics differed by birth cohort. In multivariate models controlling for birth cohort, both younger age of sexual debut and younger age of anal sex debut were associated with an increased likelihood of condomless sex. Men born in the 1990s had increased odds of engaging in sexual risk regardless of sexual debut characteristics. Sexual risk reduction interventions tailored to the unique needs of young MSM are encouraged.

Resumen

La diferencia en edad entre personas en un encuentro sexual y la edad de inicio sexual son factores de riesgo para adquirir VIH en hombres que tienen sexo con hombres (HSH). A pesar del progreso sociopolítico a través del tiempo, aun no existen estudios que examinen el efecto de haber nacido en un cohorte particular en relación a las características de inicio sexual y riesgo sexual en HSH en EU. En este estudio evaluamos patrones del inicio sexual en relación con riesgos sexuales en 812 hombres adultos que tienen sexo con hombres estratificado por cohortes de nacimiento a lo largo de diez años (e., antes de 1970, 1970–1979, 1980–1989, después de 1990). Utilizamos modelos multivariados contralando por cohorte de nacimiento para evaluar las conductas de riesgo. Los resultados demuestran que las características del inicio sexual difieren por cohorte de nacimiento. El inicio sexual entre los dos grupos de edades más jóvenes y la edad más joven de inicio de sexo anal se asociaron con una probabilidad mayor de relaciones sexuales sin condón. Los hombres nacidos en 1990s tenían mayor probabilidad de participar en sexo riesgoso aun controlando la edad de inicio sexual. Estos resultados demuestran la importancia de desarrollar intervenciones de reducción en el comportamiento de sexo riesgoso que reflejen las necesidades específicas de los hombres jóvenes que tienen sexo con hombres.

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Acknowledgments

We would like to thank our participants for sharing their experiences, our research assistant, Emily Leickly, for her many hours of work, as well as members of the Simoni Lab for their help with this project. We would additionally like to thank Dr. Oswaldo Moreno for the Spanish translation of our abstract. The work was supported in part by the National Institutes of Health (T32MH078788, F31MH088851, K24MH093243, P30AI27757). Additional support was provided by the University of Washington Department of Psychology and the American Psychological Association of Graduate Students. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other sources of support.

Funding

 The work was supported in part by the National Institutes of Health (T32MH078788, F31MH088851, K24MH093243, P30AI27757). Additional support was provided by the University of Washington Department of Psychology and the American Psychological Association of Graduate Students.

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Correspondence to Kimberly M. Nelson.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Nelson, K.M., Gamarel, K.E., Pantalone, D.W. et al. Sexual Debut and HIV-Related Sexual Risk-Taking by Birth Cohort Among Men Who Have Sex with Men in the United States. AIDS Behav 20, 2286–2295 (2016). https://doi.org/10.1007/s10461-016-1330-0

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