AIDS and Behavior

, Volume 21, Issue 12, pp 3478–3485 | Cite as

Financial Hardship, Condomless Anal Intercourse and HIV Risk Among Men Who Have Sex with Men

  • Dustin T. Duncan
  • Su Hyun Park
  • John A. Schneider
  • Yazan A. Al-Ajlouni
  • William C. Goedel
  • Brian Elbel
  • Jace G. Morganstein
  • Yusuf Ransome
  • Kenneth H. Mayer
Original Paper


The objective of this study was to examine the association between financial hardship, condomless anal intercourse and HIV risk among a sample of men who have sex with men (MSM). Users of a popular geosocial networking application in Paris were shown an advertisement with text encouraging them to complete a anonymous web-based survey (n = 580). In adjusted multivariate models, high financial hardship (compared to low financial hardship) was associated with engagement in condomless anal intercourse (aRR 1.28; 95% CI 1.08–1.52), engagement in condomless receptive anal intercourse (aRR 1.34; 95% CI 1.07–1.67), engagement in condomless insertive anal intercourse (aRR 1.30; 95% CI 1.01–1.67), engagement in transactional sex (aRR 2.36; 95% CI 1.47–3.79) and infection with non-HIV STIs (aRR 1.50; 95% CI 1.07–2.10). This study suggests that interventions to reduce financial hardships (e.g., income-based strategies to ensure meeting of basic necessities) could decrease sexual risk behaviors in MSM.


Social epidemiology Financial hardship Condomless anal intercourse Sexually transmitted infections Sexual health Gay men’s health Men who have sex with men (MSM) Health disparities Paris France 



Dr. Dustin Duncan was supported by grants from the National Institutes of Health and the Center for Disease Control and Prevention, including R01MH112406, U01PS005122, R21MH110190, and R03DA039748. This work was supported by Dr. Dustin Duncan’s New York University School of Medicine Start-Up Research Fund. We thank the translators and participants of this study who contributed to the project. We thank Noah Kreski for assisting in the development, translation and management of the survey used in the current study. In addition, we thank H. Rhodes Hambrick for conducting some background research used in this study.

Compliance with Ethical Standards

Conflicts of interest

Authors Dustin T. Duncan, Su Hyun Park, John A. Schneider, Yazan A. Al-Ajlouni, William C. Goedel, Brian Elbel, Jace G. Morganstein, Yusuf Ransome, and Kenneth H. Mayer declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of our institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in this study.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Dustin T. Duncan
    • 1
    • 8
  • Su Hyun Park
    • 1
  • John A. Schneider
    • 2
    • 3
  • Yazan A. Al-Ajlouni
    • 1
  • William C. Goedel
    • 1
  • Brian Elbel
    • 1
    • 4
  • Jace G. Morganstein
    • 1
  • Yusuf Ransome
    • 5
  • Kenneth H. Mayer
    • 6
    • 7
  1. 1.Department of Population HealthNew York University School of MedicineNew YorkUSA
  2. 2.Department of MedicineUniversity of Chicago School of MedicineChicagoUSA
  3. 3.Department of Public Health SciencesUniversity of Chicago School of MedicineChicagoUSA
  4. 4.New York University Wagner School of Public ServiceNew YorkUSA
  5. 5.Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonUSA
  6. 6.Fenway Health, The Fenway InstituteBostonUSA
  7. 7.Department of Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA
  8. 8.Spatial Epidemiology Lab, Department of Population HealthNew York University School of MedicineNew YorkUSA

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