A comparison of HIV risk practices among unprotected sex-seeking older and younger men who have sex with other men

Abstract

Purpose: In recent years, much attention has been devoted to understanding the HIV risk behaviors of younger men who have sex with men (MSM). Recent data suggest that HIV is becoming an increasing problem for older adults, but little attention has been devoted to understanding their HIV risk behaviors or the factors that underlie their risk taking. This study provides a comparison of these issues among younger and older MSM. Methods: The data come from a subset of younger (ages 18–39, n = 113) and older (ages 50+, n = 109) men participating in a national study of 332 men who use the Internet to find other men for unprotected sex. Men were sampled randomly from 16 websites. Data were collected via telephone interviews conducted in 2008 and 2009. Results: Younger and older men reported comparable involvement in HIV risk, including involvement in unprotected sex, proportion of sex acts involving internal ejaculation, number of times having anonymous sex, and number of times having multiple-partner sex. Generally speaking, the factors underlying the risk practices of younger and older men were quite different (e.g. self-esteem and condom use self-efficacy for younger men, versus HIV serostatus and depression for older men). Conclusions: Older MSM using the Internet to find partners for unprotected sex engage in high rates of behaviors that place them at risk for contracting or transmitting HIV. They were just as likely as their younger counterparts to practice these behaviors. The factors “fueling” involvement in risk generally differ for older and younger men, thereby warranting the development of age-specific HIV interventions that can take into account the unique life circumstances and needs of older MSM.

An evaluation of factors associated with sexual risk taking among Black men who have sex with men: a comparison of younger and older populations

“…In this way, our data is in line with previous research in this area ( e.g. , Klein, 2012) that suggests that differential rates of sexual risk taking are not responsible for increased HIV prevalence among YBMSM. However, YBMSM and OBMSM each had unique factors associated with their sexual risk taking behavior.…”

“…The results of previous studies do point to comparable rates of sexual risk taking, specifically condomless anal intercourse (CAI) among younger and older BMSM populations (Klein, 2012); however, little is known regarding whether the factors that contribute to HIV risk for the entire BMSM community accurately represent the HIV risks of younger BMSM in particular (Millett et al , 2012). …”

“…In the context of BMSM’s health, syndemics theory represents a useful framework through which the increased HIV rate among younger BMSM can potentially be explained. Specifically, understanding the unique contextual factors that may lead to greater risk for younger versus older BMSM is an important step towards the development, implementation, evaluation, and translation of well-informed HIV prevention interventions that target these populations (Klein, 2012). …”

Disclosure and Self-Efficacy Among HIV-Positive Men Who Have Sex with Men: A Comparison Between Older and Younger Adults

“…15 Age has also been shown to be associated with selfefficacy for condom use among people with substance use disorders in Taiwan, 16 among midlife and older women in San Diego, California, 10 and among MSM who seek sex partners from the internet in a national US study. 17 One study of Italian residents found that compared to adults aged 18-49, adults aged 60-75 reported lower scores on perceived behavioral control, the way in which individuals perceive their ability in condom use. 18 The association between age, and disclosure and selfefficacy may be explained by social cognitive theory.…”

Older adults and HIV prevention

“…Lower levels of education, and thus knowledge, of sexually transmitted diseases (STDs) also affect an individual's sense of control over the disease. Much like their younger counterparts, older adults with a decreased understanding of the disease report lower self-efficacy in using condoms, as well as communicating with their partners about the disease and negotiating condom use (Klein, 2012). Studies report a lack of condom usage amongst older adults engaging in sexual contact with casual, non-monogamous partners (Rosenfeld, Bartlam, & Smith, 2012;Treas & Giesen, 2000).…”