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Contextual Correlates of Per Partner Unprotected Anal Intercourse Rates Among MSM in Soweto, South Africa

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Abstract

Men who have sex with men (MSM) throughout the world are at high-risk of HIV acquisition and transmission. Although individual behavior remains a central feature of HIV prevention efforts in sub-Saharan Africa and beyond, contextual factors likely influence behavioral risk. We identify contextual factors at the individual, dyadic (within the partnership), and extra-dyadic (relationships external to the focal dyad) levels that are associated with increased rates of unprotected anal intercourse with a given male partner among MSM in Soweto, South Africa. Drawing on data from The Soweto Men’s Study, multilevel models were applied to 758 partnerships nested within 377 MSM respondents. Independent of overall sexual engagement, dyadic (e.g. description of partner as ‘regular’), psychosocial (e.g. experiences of homonegativity), and sociocultural (e.g. income) contextual factors were significant predictors of differential 6-month rates of UAI with a given partner. By contrast, sexual partnerships outside of the focal sexual pair were not significantly related to UAI rates within the focal pair. Our findings support the need for continuing to understand and intervene on partner-level, psychosocial, and sociocultural dimensions of sexual behavior and sexual risk among MSM in Soweto.

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Acknowledgments

The Soweto Men’s Study was funded by a grant to Dr. Lane from the National Institute of Mental Health, 5K01MH074369, and by a grant to the UCSF AIDS Research Institute from the the Hurlbut-Johnson Fund of the Peninsula Community Foundation (USA). HIV testing and treatment for participants in the Soweto Men’s Study was supported by the Perinatal HIV Research Unit in Johannesburg, South Africa, with funds from the President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID). The authors’ would like to thank the reviewers of this article for their insightful and useful feedback.

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Authors and Affiliations

  1. Vaccine and Infectious Diseases, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., E2-112, Seattle, WA, 98109-1024, USA

    Michael P. Arnold

  2. Anova Health Institute, Johannesburg, South Africa

    Helen Struthers & James McIntyre

  3. School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa

    James McIntyre

  4. Center for AIDS Prevention Studies, University of California, San Francisco, USA

    Tim Lane

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  1. Michael P. Arnold
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  2. Helen Struthers
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  3. James McIntyre
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  4. Tim Lane
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Correspondence to Michael P. Arnold.

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Arnold, M.P., Struthers, H., McIntyre, J. et al. Contextual Correlates of Per Partner Unprotected Anal Intercourse Rates Among MSM in Soweto, South Africa. AIDS Behav 17 (Suppl 1), 4–11 (2013). https://doi.org/10.1007/s10461-012-0324-9

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  • DOI: https://doi.org/10.1007/s10461-012-0324-9

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