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Correlates and Racial/Ethnic Differences in Bareback Sex Among Men Who Have Sex with Men with Unknown or Negative HIV Serostatus

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Abstract

Men who have sex with men (MSM), particularly racial/ethnic minority MSM, are disproportionately affected by HIV in the United States and Texas. Bareback sex or condomless anal intercourse (CAI) can be a high HIV risk behavior. Despite this, a majority of MSM continues to engage in barebacking. Research suggests racial/ethnic differences in barebacking exist; however, these conclusions remain unclear due to insufficient sample sizes to compare racial/ethnic groups. Our cross-sectional correlational design explores barebacking correlates (substance use during sex, safe sex fatigue, and optimistic HIV treatment beliefs) within and between racial/ethnic groups among 366 MSM. Regression models are significant for Latino and African-American MSM alone and for all MSM combined, though not significant for European-American and Other Race/Ethnicity MSM alone. Our findings suggest motivations and behaviors underlying barebacking among MSM vary by racial/ethnic membership with clinical implications for informing culturally sensitive HIV interventions and prevention programs for target racial/ethnic groups.

Resumen

En los Estados Unidos de América y en el estado de Texas, los hombres que tienen sexo con hombres (HSH), en especial aquellos que forman parte de minorías raciales/étnicas, son afectados desproporcionadamente por el VIH. El sexo anal “bareback” o sin condón puede ser un riesgo para contraer VIH. Aun así, una gran mayoría de los HSH continúan teniendo sexo sin condón. Previas investigaciones sugieren que existen diferencias raciales/étnicas en cuanto al sexo anal sin condón, pero las conclusiones de estos estudios no son claras debido al insuficiente tamaño de las muestras de cada grupo racial/étnico. Nuestro estudio transversal con diseño correlacional explora varios correlatos (uso de sustancias durante el sexo, fatiga de tener sexo seguro, y creencias optimistas del tratamiento para el VIH) dentro y entre grupos raciales/étnicos entre 366 HSH. Los modelos de regresión son significantivos para los HSH Latinos y Afro-Americanos y para todos los grupos de HSH combinados, pero no son significantivos para los HSH Europeo-Americanos o HSH de otros grupos raciales/étnicos. Nuestros resultados sugieren que puede haber motivos o comportamientos subyacentes por los cuales tener sexo sin condón varía dependiendo del grupo racial/étnico, lo cual tiene implicaciones clínicas para desarrollar intervenciones y programas de prevención de VIH enfocados a minorías raciales/étnicas.

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Acknowledgments

The authors thank the Texas Department of State Health Services – TB/HIV/STD Epidemiology and Surveillance Branch for providing the behavioral data and for their feedback and insights on this work and the participants of this study for sharing their experiences. We also thank Dr. Francisco Guzman and Cesar Villarreal for their assistance in translating the abstract into Spanish.

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  1. Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA

    Mark Vosvick & Sarah Fritz

  2. Department of Anthropology, University of North Texas, Denton, TX, USA

    Doug Henry

  3. Department of Information Technology & Decision Sciences, University of North Texas, Denton, TX, USA

    Victor Prybutok

  4. TB/HIV/STD Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA

    Shane Sheu & Jonathon Poe

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  1. Mark Vosvick
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Correspondence to Mark Vosvick.

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Vosvick, M., Fritz, S., Henry, D. et al. Correlates and Racial/Ethnic Differences in Bareback Sex Among Men Who Have Sex with Men with Unknown or Negative HIV Serostatus. AIDS Behav 20, 2798–2811 (2016). https://doi.org/10.1007/s10461-016-1366-1

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