Examining the role of partner status in an HIV prevention trial targeting HIV-positive gay and bisexual men: the seropositive urban men’s intervention trial (SUMIT)

Abstract

The goal of this analysis was to examine whether partner status impacted behavioral outcomes from the Seropositive Urban Men's Intervention Trial (SUMIT). We contrasted sample characteristics of HIV-positive gay and bisexual men with and without main partners and then examined differences in sexual behaviors among men participating in an enhanced HIV prevention intervention compared to those in a standard condition. Logistic regression analyses were performed to differentiate characteristics of men with and without main partners and mixed-model logistic regression analyses were performed to test for intervention effects. Men with main partners showed a greater likelihood of having unprotected anal sex with any partner, although the number of male sexual partners was higher for men without a main partner. SUMIT generally produced few differences in sexual risk behaviors and did not affect several potential mediator variables of the relationship between the intervention and sexual behaviors with main and nonmain partners.

Motivations to Test for HIV Among Partners in Concordant HIV-Negative and HIV-Discordant Gay Male Couples

“…The literature on gay couples and HIV offers compelling explanations as to why this may be the case. Nearly two decades of research has firmly established that many gay men in relationships have anal sex without condoms more often than their single counterparts (Davidovich, et al, 2001; Elford, Bolding, Maguire, & Sherr, 1999; Hays, Kegeles, & Coates, 1997; Hoff, et al, 2006; Hoff, et al, 1997; Kippax, et al, 2003; Lattimore, Thornton, Delpech, & Elford, 2010; Moreau-Gruet, Jeannin, Dubois-Arber, & Spencer, 2001; Prestage, et al, 2008; Prestage, et al, 2009; Remien, Carballo-Dieguez, & Wagner, 1995; Van der Bij, et al, 2007). This is not only the case for HIV-negative men in concordant HIV-negative relationships, for whom the risk of HIV infection initially comes from outside the relationship; HIV-negative men in HIV-discordant relationships sometimes also have anal sex without condoms (Beougher, et al, 2012; Prestage, et al, 2008), increasing the risk of HIV transmission inside the relationship (Bouhnik, et al, 2007; Crawford, et al, 2003; Denning & Campsmith, 2005; Lattimore, et al, 2010; Nieto-Andrade, 2010; Ostrow, et al, 2002; Palmer & Bor, 2001; Prestage, et al, 2008; Shernoff, 2006).…”

Risks worth taking: Safety agreements among discordant gay couples

“…Researchers there, as elsewhere, are increasingly calling for contextualization of gay men’s sexual behaviors that acknowledge situational factors to explain why some gay men knowingly expose themselves to HIV risk. One such context is relationship status (Harawa, et al, 2004; C. C. Hoff, et al, 2006; Scheer, et al, 2008).…”

“…Studies show that primary partners are a leading source of HIV infection (Davidovich, et al, 2001; Kippax, et al, 2003; Moreau-Gruet, Jeannin, Dubois-Arber, & Spencer, 2001; Sullivan, Salazar, Buchbinder, & Sanchez, 2009) and that gay men in relationships engage in high rates of unprotected anal intercourse (UAI) with their primary partners (Elford, Bolding, Maguire, & Sherr, 1999; Hays, Kegeles, & Coates, 1997; C. C. Hoff, et al, 2006; C.…”

Patterns and Correlates of Sexual Activity and Condom Use Behavior in Persons 50-Plus Years of Age Living with HIV/AIDS

“…To date, HIV risk reduction interventions for persons living with HIV/AIDS have focused almost exclusively on younger persons (e.g., Gasiorowicz et al 2005;Hoff et al 2006;Kalichman et al 1997). Given the challenging physical and mental health needs of older adults living with HIV/AIDS (e.g., lower knowledge about HIV-risk transmission behaviors, higher rates of comorbid health conditions) and because secondary risk reduction interventions developed primarily for younger persons living with HIV/AIDS may be inappropriate for HIV-infected older adults (e.g., they may not address physiologic changes experienced by aging persons, particularly women; Klein et al 2001;Orel et al 2005;Williams and Donnelly 2002), research that delineates rates and predictors of continued sexual risk behaviors in HIV-infected older adults is needed to inform the development of risk reduction interventions for this population.…”