An Event-Level Analysis of the Interpersonal Factors Associated With Condomless Anal Sex Among Gay, Bisexual, and Other Men Who Have Sex With Men (MSM) With Online-Met Partners

Abstract

The interpersonal determinants of condomless anal sex (CAS) within online-initiated sexual relationships remain poorly understood. Therefore, respondent-driven sampling was used to recruit a prospective cohort of sexually active gay, bisexual, and other men who have sex with men (MSM), aged ≥ 16 years in Vancouver, Canada. Follow-up occurred every 6 months, up to seven visits; at each visit participants reported their last sexual encounter with their five most recent partners. Stratified by self-reported HIV status, individual-level, interpersonal, and situational covariates of event-level CAS with partners met online were modeled using generalized estimating equations (GEE). CAS was reported during 32.4% (n = 1,015/3,133) of HIV-negative/unknown men’s events, and 62.1% (n = 576/928) of HIV-positive men’s events. Social (i.e., collective identity, altruism, network size, social embeddedness) and situational (i.e., number of encounters, location, comparative age, seroconcordance, substance use) factors were identified as important correlates of CAS. Implications include the need for HIV prevention addressing social contexts associated with CAS.

Does HIV Pre-Exposure Prophylaxis Modify the Effect of Partnership Characteristics on Condom Use? A Cross-Sectional Study of Sexual Partnerships Among Men Who Have Sex with Men in San Francisco, California

“…Finally, a multivariable model for each relationship characteristic was constructed, which additionally adjusted for seroconcordance and partnership type, motivated by the strong associations of these partnership characteristics with condom use among MSM previously reported in the literature. 13,[15][16][17]25 Interaction terms were considered statistically significant using an alpha level of 0.05.…”

“…8,9 While the majority of research continues to focus on differences between individuals to explain sexual risk taking, 10 a growing body of research suggests that a significant proportion of the variability in condom use during anal intercourse exists within individuals across different sexual partnerships. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] Within the sexual partnerships of MSM, the strongest associations between condom use and partnership characteristics have been observed based on partnership type and agreement of serostatus between partners (seroconcordance). Mathematical models based on data from five US cities during the 2003-2005 cycle of the National HIV Behavioral Surveillance (NHBS) System suggested that 68% of HIV transmissions among MSM occurred within main partnerships, as a result of the higher number of sex acts and lower condom use during anal sex with main partners compared to casual or exchange partners (i.e., those where money and/or other gifts were exchanged for sex).…”

“…25 Seroconcordant partnerships, in which sexual partners share the same HIV status, have been similarly found to be associated with a higher likelihood of condomless anal intercourse (CAI). 13,16,17,24 Self-reported serodiscussion, or the mutual discussion of HIV status between sexual partners, has also been independently associated with greater engagement in CAI. [18][19][20] In addition, the rising popularity of geosocial networking apps has raised concerns about increased sexual risk taking among MSM who meet partners online, yet the evidence remains inconclusive as to whether online-initiated partnerships have a higher likelihood of CAI compared to offline-initiated partnerships.…”

Evaluating the impact of COVID-19: A cohort comparison study of drug use and risky sexual behavior among sexual minority men in the U.S.A.

“…A substantial body of literature illustrates a consistent link between the use of illegal drugs (e.g., cocaine, methamphetamine, ketamine, gamma hydroxybutyrate – GHB, mephedrone, or Methyl​enedioxy​methamphetamine – MDMA/ecstasy) and an increased risk of engaging in sexual HIV transmission risk ( Kurka et al, 2015 ; Petersson et al, 2016 ). Studies utilizing both aggregate and event-level data indicate that sexual minority men who use illegal drugs (excluding marijuana in most studies) are more likely to engage in CAS with casual partners ( Card et al, 2017 ; Daskalopoulou et al, 2014 ; Rendina et al, 2015 ).…”

HIV-AIDS prevention in the conception of HIV-positive young people

“…For some, prevention depends exclusively on the individual, without perceiving the context as a vulnerability factor 12 . The fact that young people, in the hour of pleasure, do not think about the consequences of unprotected sex reinforces that the question of sexual excitement cannot be underestimated when one thinks of prevention, nor other psychosocial barriers that make the use of condoms difficult, such as the consumption of alcohol and drugs 13 , 14 .…”