Skip to main content

Advertisement

SpringerLink
Log in

A Serial, Cross-Sectional Comparison of Condomless Anal Sex and HIV Testing Among Young MSM in Beirut, Lebanon

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

In 2012, our research with young men who have sex with men (YMSM) in Beirut showed high rates of recent condomless anal sex and low rates of recent HIV testing. In 2017, we collected data from YMSM to assess for temporal changes and sociodemographic correlates. Propensity score weighting was used to eliminate any sociodemographic differences between the 2012 (n = 164) and 2017 (n = 226) samples of YMSM (age 18–29) recruited with long-chain peer referral sampling. Regression analysis was used to examine sociodemographic correlates of recent condomless anal sex and HIV testing using the 2017 sample, and whether these behaviors differed between the samples. Compared to the 2012 sample, the 2017 sample was about half as likely to report any condomless anal sex in the past 3 months with partners whose HIV status was positive or unknown (14% vs. 23%; OR [95%CI] 0.56 [0.32, 0.98]), and nearly 2.5 times as likely to report HIV testing in the past 6 months (48% vs. 27%; OR [95%CI] 2.44 [1.46, 4.10]). In the 2017 sample, any recent condomless anal sex with partners whose HIV status was positive or unknown was associated with employment and Christian religious affiliation. Low income was the sole correlate of having recently tested for HIV. These findings suggest a temporal trend toward increased HIV protective behaviors among YMSM in Beirut over the past 5 years. Further inroads could be secured if HIV prevention programming targeted economic influences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adam, P. C., de Wit, J. B., Toskin, I., Mathers, B. M., Nashkhoev, M., Zablotska, I., … Rugg, D. (2009). Estimating levels of HIV testing, HIV prevention coverage, HIV knowledge, and condom use among men who have sex with men (MSM) in low-income and middle-income countries. Journal of Acquired Immune Deficiency Syndromes,52, S143–S151.

    Article  Google Scholar 

  • Boushnak, L., & Boushnak, M. (2017, December 30). Coming out in Lebanon. New York Times. Retrieved February 15, 2018, from https://www.nytimes.com/2017/12/30/world/middleeast/lebanon-coming-out.html.

  • Duncan, D. T., Park, S. H., Schneider, J. A., Al-Ajlouni, Y. A., Goedel, W. C., Elbel, B., … Mayer, K. H. (2017). Financial hardship, condomless anal intercourse and HIV risk among men who have sex with men. AIDS and Behavior,21(12), 3478–3485.

    Article  Google Scholar 

  • El-Sayyed, N., Kabbash, I. A., & El-Gueniedy, M. (2008). Risk behaviours for HIV/AIDS infection among men who have sex with men in Cairo, Egypt. Eastern Mediterranean Health Journal,14(4), 905–915.

    PubMed  Google Scholar 

  • Gomez, A. M., Beougher, S. C., Chakravarty, D., Neilands, T. B., Mandic, C. G., Darbes, L. A., & Hoff, C. C. (2012). Relationship dynamics as predictors of broken agreements about outside sexual partners: implications for HIV prevention among gay couples. AIDS and Behavior,16(6), 1584–1588.

    Article  Google Scholar 

  • Grant, R. M., Lama, J. R., Anderson, P. L., McMahan, V., Liu, A. Y., Vargas, L., … Montoya-Herrera, O. (2010). Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. New England Journal of Medicine,363(27), 2587–2599.

    Article  Google Scholar 

  • Griffin, B. A., Ridgeway, G., Morral, A. R., Burgette, L. F., Martin, C., Almirall, D., … McCaffrey, D. F. (2014). Toolkit for weighting and analysis of nonequivalent groups (TWANG) website. Santa Monica, CA: RAND Corporation.

    Google Scholar 

  • Harder, V. S., Stuart, E. A., & Anthony, J. C. (2010). Propensity score techniques and the assessment of measured covariate balance to test causal associations in psychological research. Psychological Methods,15(3), 234–249.

    Article  Google Scholar 

  • Heimer, R., Barbour, R., Khouri, D., Crawford, F. W., Shebl, F., Aaraj, E., & Khoshnood, K. (2017). HIV risk, prevalence, and access to care among men who have sex with men in Lebanon. AIDS Research and Human Retroviruses,33(11), 1149–1154.

    Article  Google Scholar 

  • Joint United Nations Programme on HIV and AIDS. (2008). Epidemiological fact sheet on HIV and AIDS: Lebanon update. Geneva: Author.

    Google Scholar 

  • Joint United Nations Programme on HIV and AIDS. (2016a). 2016 Country progress report for Lebanon. Geneva: Author.

    Google Scholar 

  • Joint United Nations Programme on HIV and AIDS. (2016b). Regional report: Middle East and North Africa. Geneva: Author.

    Google Scholar 

  • Kalichman, S. C., Kalichman, M. O., Cherry, C., & Grebler, T. (2016). HIV disclosure and transmission risks to sex partners among HIV-positive men. AIDS Patient Care and STDs,30(5), 221–228.

    Article  Google Scholar 

  • Mahfoud, Z., Afifi, R., Ramia, S., El Khoury, D., Kassak, K., El Barbir, F., … DeJong, J. (2010). HIV/AIDS among female sex workers, injecting drug users and men who have sex with men in Lebanon: Results of the first biobehavioral surveys. AIDS,24, S45–S54.

    Article  Google Scholar 

  • Mumtaz, G., Hilmi, N., McFarland, W., Kaplan, R. L., Akala, F. A., Semini, I., … Abu-Raddad, L. J. (2011). Are HIV epidemics among men who have sex with men emerging in the Middle East and North Africa? A systematic review and data synthesis. PLoS Medicine,8(8), e1000444.

    Article  Google Scholar 

  • Mutchler, M. G., McDavitt, B. W., Tran, T. N., El Khoury, C., Ballan, E., Tohme, J., … Wagner, G. J. (2018). This is who we are: Building community for HIV prevention with young gay and bisexual men in Beirut, Lebanon. Cultural, Health & Sexuality, 20(6), 690–703.

    Article  Google Scholar 

  • Nakib, M. E., & Hermez, J. (2002). HIV/AIDS prevention among vulnerable groups in Beirut, Lebanon. Paper presented at the XIV International AIDS Conference, Barcelona, Spain.

  • Nasr, N., & Zeidan, T. (2015). “As long as they stay away”: Exploring Lebanese attitudes towards sexualities and gender identities. Beirut: Arab Foundation for Freedom and Equality.

    Google Scholar 

  • Newcomb, M. E., & Mustanski, B. (2011). Moderators of the relationship between internalized homophobia and risky sexual behavior in men who have sex with men: A meta-analysis. Archives of Sexual Behavior,40(1), 189–199.

    Article  Google Scholar 

  • Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika,70, 41–55.

    Article  Google Scholar 

  • SAS Institute. (2013). (Version 9.4) [Computer software]. Cary, NC: SAS Institute.

  • Sullivan, P. S., Salazar, L., Buchbinder, S., & Sanchez, T. H. (2009). Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS,23(9), 1153–1162.

    Article  Google Scholar 

  • Tohme, J., Egan, J. E., Stall, R., Wagner, G. J., & Mokhbat, J. (2016). HIV prevalence and demographic determinants of unprotected anal sex and HIV testing among male refugees who have sex with men in Beirut, Lebanon. AIDS & Behavior,20(S3), 408–416.

    Article  Google Scholar 

  • Wagner, G. J., Tohme, J., Hoover, M., Frost, S., Ober, A., Khouri, D., … Mokhbat, J. (2014). HIV prevalence and demographic determinants of unprotected anal sex and HIV testing among men who have sex with men in Beirut, Lebanon. Archives of Sexual Behavior, 43(4), 779–788.

    Article  Google Scholar 

  • Wagner, G. J., Aunon, F. M., Kaplan, R. L., Rana, Y., Khouri, D., Tohme, J., & Mokhbat, J. (2012). A qualitative exploration of sexual risk and HIV testing behaviors among men who have sex with men in Beirut, Lebanon. PloS One, 7(9), e45566.

    Article  Google Scholar 

  • Yeka, W., Maibani-Michie, G., Prybylski, D., & Colby, D. (2006). Application of respondent driven sampling to collect baseline data on FSWs and MSM for HIV risk reduction interventions in two urban centres in Papua New Guinea. Journal of Urban Health,83(1), i60–i72.

    Article  Google Scholar 

Download references

Funding

Funding for this research is from a grant from the National Institute of Mental Health (Grant No. R01 MH107272; PI: G. Wagner).

Author information

Authors and Affiliations

  1. Health Unit, RAND Corporation, 1776 Main St., Santa Monica, CA, 90407, USA

    Glenn Wagner, Bonnie Ghosh-Dastidar & Harold Green

  2. Association for Progressive Communications, Johannesburg, South Africa

    Cynthia El Khoury

  3. The Lebanese Center for Policy Studies, Beirut, Lebanon

    Carol Abi Ghanem

  4. Urban Community Research Center, California State University, Dominguez Hills, Carson, CA, USA

    Matt G. Mutchler

  5. AIDS Project Los Angeles, Los Angeles, CA, USA

    Matt G. Mutchler

  6. Arab Foundation for Freedom and Equality, Beirut, Lebanon

    Elie Balan

  7. Health Unit, Indiana University, Bloomington, IN, USA

    Harold Green

  8. Health Unit, University of California at San Francisco, San Francisco, CA, USA

    Susan Kegeles

  9. Department of Medicine, Lebanese American University School of Medicine, Beirut, Lebanon

    Jacques Mokhbat

  10. Lebanese AIDS Society, Beirut, Lebanon

    Jacques Mokhbat

Authors
  1. Glenn Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bonnie Ghosh-Dastidar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cynthia El Khoury
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carol Abi Ghanem
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matt G. Mutchler
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elie Balan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Harold Green
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Susan Kegeles
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jacques Mokhbat
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Glenn Wagner.

Ethics declarations

Conflict of interest

The authors 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 the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

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

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wagner, G., Ghosh-Dastidar, B., El Khoury, C. et al. A Serial, Cross-Sectional Comparison of Condomless Anal Sex and HIV Testing Among Young MSM in Beirut, Lebanon. Arch Sex Behav 49, 321–330 (2020). https://doi.org/10.1007/s10508-018-1359-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-018-1359-4

Keywords

Search

Navigation