A Comparative Analysis of Behaviors and Sexual Affiliation Networks among Men Who Have Sex With Men in Hong Kong

Abstract

In Hong Kong, men who have sex with men (MSM) account for a significant proportion of HIV infections. While perceived as a hidden population, they constitute a distinct social network shaped by their differential use of unique channels for sex partnership. To characterize their pattern of connectivity and association with high-risk sexual behaviors, 311 MSM were recruited via saunas and the internet to participate in a questionnaire survey. Internet recruits were younger, and many (31/43) were solely reliant on the internet to seek sex partners, while visiting a similar number of venues as the sauna recruits (p = 0.98). Internet users generally had a high frequency of unprotected anal intercourse (UAI). MSM who had visited only a single venue reported more UAI with their regular partners (adjusted OR 6.86, 1.88-24.96) and sought fewer casual partners than those frequenting multiple venues (adjusted OR 0.33, 0.19-0.60). This study provides evidence for the heterogeneity of the sexual affiliation networks of MSM in Hong Kong. High HIV risk of UAI could be offset by fewer casual partners in certain venues, the implications of which would need to be explored in longitudinal studies. Methodologically, internet sampling was very efficient in identifying sex networking venues, while internet recruits gave a high retention rate for updating profiles. However, sampling at high centrality saunas did not necessarily identify the MSM-affiliating venues in the networks efficiently. The sampling strategy of MSM survey should therefore be objective-driven, which may differ for health message dissemination and social marketing, versus HIV surveillance or risk assessment.

A Latent Class Analysis of Seroadaptation Among Gay and Bisexual Men

“…We also note that both HIV-positive and HIV-negative/unknown Viral-load Sorters were also more likely to have more sexual partners. Together, these findings suggest that interpersonal dynamics (as measured by relationship status and number of partners) have significant influence on the types of risk management strategies used by individuals to protect themselves and their partners (Brady et al, 2013; Braine, van Sluytman, Acker, Friedman, & Des Jarlais, 2011; Leung, Poon, & Lee, 2014; Ryzin, Johnson, Leve, & Kim, 2010). This framework captures a growing body of literature that suggests seroadaptive practices are the result of myriad complex personal, interpersonal, and situational factors (Cassels & Katz, 2013; McFarland et al, 2012; Rönn et al, 2014).…”

Variations in Recruitment Yield and Characteristics of Participants Recruited Across Diverse Internet Platforms in an HIV Testing Study of Young Adult Men-Who-Have-Sex-With-Men (YMSM)

“…Of MSM-focused published investigations that compared participant characteristics (demographic characteristics, HIV testing history, sexual risk-taking behaviors, or other aspects) by recruitment source, several used single ( Grov, 2012 ; Grov & Crow, 2012 ; Grov, Rendina, & Parsons, 2014 ; Hernandez-Romieu et al, 2014 ; Hospers, Kok, Harterink, & de Zwart, 2005 ; Mor & Dan, 2012 ; Saxton, Dickson, & Hughes, 2013 ) instead of multiple ( Bolding, Davis, Hart, Sherr, & Elford, 2005 ; Elford, Bolding, Davis, Sherr, & Hart, 2004a , 2004b ; Fernandez-Davila, Lupianez-Villanueva, & Zaragoza Lorca, 2012 ; Fernandez-Davila & Zaragoza Lorca, 2009 ; Leung, Poon, & Lee, 2015 ; Parsons, Vial, Starks, & Golub, 2013 ; Sanchez, Sineath, Kahle, Tregear, & Sullivan, 2015 ; Sanchez, Smith, Denson, Dinenno, & Lansky, 2012 ; Tsui & Lau, 2010 ; van den Boom et al, 2015 ; Vial, Starks, & Parsons, 2014 ; Zhang, Bi, Lv, Zhang, & Hiller, 2008 ) platforms for recruitment, unlike this current investigation. These studies often compared participants recruited via the Internet to those recruited in person at MSM-associated venues (e.g., bars, bathhouses, special events) or through other “off-line” methods.…”

Changes of sexual risk behaviors and sexual connections among HIV-positive men who have sex with men along their HIV care continuum

“…In the mobile era, it is possible that this reflected the general preference shift of sex-networking channels from physical venues to virtual means, and its relationship with treatment status could just be coincidental. Nevertheless, the ever-changing sexual connections shown in this study and heterogeneity of sexual affiliation network among both HIV-positive and HIV-negative MSM shall be addressed when designing HIV prevention strategies [38–39]. Another perspective of sex-networking worth noting in our study was the relatively low level of serosorting among HIV-positive MSM (<20%) in Hong Kong, as compared with studies conducted elsewhere [17].…”

“…Contrary to the moderate changes in sexual risk behaviours, evolvement of sexual connection patterns along the HIV care continuum was more remarkable as elicited in this study. To infer the networking pattern, we had focused on the usage frequency of different venues for seeking male sex partners [25, 38–42]. Again, the major changes of the sexual connections occurred in the first year after HIV diagnosis, while a significant reduction of usage was observed in most identified types of sex-networking venues.…”