The limited epidemiological data in Lebanon suggest that HIV incident cases are predominantly among men who have sex with men (MSM). We assessed the prevalence of HIV and demographic correlates of condom use and HIV testing among MSM in Beirut. Respondent-driven sampling was used to recruit 213 participants for completion of a behavioral survey and an optional free rapid HIV test. Multivariate regression analysis was used to examine demographic correlates of unprotected anal sex and any history of HIV testing. Nearly half (47%) were under age 25 years and 67% self-identified as gay. Nearly two-thirds (64%) reported any unprotected anal intercourse (UAI) with men in the prior 3 months, including 23% who had unprotected anal intercourse with men whose HIV status was positive or unknown (UAIPU) to the participant. Three men (1.5% of 198 participants tested) were HIV-positive; 62% had any history of HIV testing prior to the study and testing was less common among those engaging in UAIPU compared to others (33% vs. 71%). In regression analysis, men in a relationship had higher odds of having UAI but lower odds of UAIPU and any university education was associated with having UAI; those with any prior history of HIV testing were more likely to be in a relationship and have any university education. HIV prevention efforts for MSM need to account for the influence of relationship dynamics and promotion of testing needs to target high-risk MSM.
Social, relational and network determinants of condom use and HIV testing were examined among 213 men who have sex with men (MSM) in Beirut. 64% reported unprotected anal intercourse (UAI), including 23% who had UAI with unknown HIV status partners (UAIU); 62% had HIV-tested. In multivariate analysis, being in a relationship was associated with UAI and HIV testing; lower condom self-efficacy was associated with UAIU and HIV testing; gay discrimination was associated with UAIU; MSM disclosure was associated with UAI, UAIU and HIV testing; and network centralization was associated with HIV testing. Multi-level social factors influence sexual health in MSM.
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In personal network studies, respondents (egos) are asked to report information about members of their personal network (alters); egos respond based on their perceptions. Previous studies of informant accuracy present a varied picture: Some find egos' reporting on their relationships with alters to be accurate; others do not. In our study of people living with HIV/AIDS in Uganda, egos were asked to invite up to four alters named during their interview to answer questions about their relationship with ego. Using Gower's general coefficient of similarity, we calculated a measure of accuracy both by variable and by alter. Our analysis by variable tends to confirm informant accuracy research,
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