HIV/STD Prevalence, Risk Behavior, and Substance Use Patterns and Predictors in Russian and Hungarian Sociocentric Social Networks of Men Who Have Sex With Men

Abstract

This study recruited four sociocentric networks (n = 156) of men who have sex with men in Budapest, Hungary, and St. Petersburg, Russia. The sampling approach was based on identifying an initial "seed" in the community for each network, and then recruiting three successive friendship group waves out from the seed. HIV prevalence in the networks was 9%, and the composite rate of other sexually transmitted diseases was 6%. 57% of participants reported both main and casual male partners, and two thirds reported unprotected anal intercourse in the past 3 months. Fifty-five percent of men's most recent anal intercourse acts were with nonexclusive partners, and 56% of most recent anal intercourse acts were unprotected. Sexual risk predictors were generally consistent with behavioral science theory. In addition, risk was associated with more often talking with friends about AIDS, higher ecstasy use, and less often drinking. Sociocentric social network sampling approaches are feasible and constitute a modality for reaching hidden high-risk populations inaccessible through conventional methods.Almost unknown during the socialist era, the HIV epidemic in parts of central and eastern Europe quickly accelerated beginning in the mid-1990s. Although HTV primarily first affected injection drug users (IDUs) in post-Soviet countries, transmission has shifted to a predominantly sexual pattern (UNAIDS, 2008). In spite of the rapid emergence of HIV in the region, there has been comparatively little published research on risk behavior as well as HIV/ STD prevalence in postsocialist countries. Men who have sex with men (MSM) remain among the world's most vulnerable populations, and research is needed to identify HIV risk behavior patterns and their determinants among MSM in eastern Europe. In addition, innovative NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript approaches need to be tested that can access those MSM community segments likely to be missed using conventional sampling methods.The appearance of the HIV epidemic in eastern Europe coincided with massive political, economic, and cultural transitions across the region. These included the breakup of the former Soviet Union and the appearance of new and sometimes fragile democracies in other former socialist countries. These transformations also resulted in fewer authoritarian controls, more personal freedoms including greater travel opportunities, liberalized sexual behaviors and norms, and increased drug use. In the context of these changes and given a weak public health infrastructure, intertwined HIV and sexually transmitted disease (STD) epidemics quickly emerged in many of the region's countries (Borisenko, Tichonova, & Renton, 1999), Russia and Ukraine are among the countries hardest hit by the HIV epidemic, with a more gradual rise in central Europe. UNAIDS estimates that 940,000 in Russia and 3,000 in Hungary, a much smaller country (UNAIDS, 2008).During the socialist era, homosexuality was officially proscribed, and there were few pub...

Central and East European migrant men who have sex with men: an exploration of sexual risk in the UK

“…The low prevalence of new HIV diagnoses among CEE MSM in their countries of origin4 means that assortative sexual mixing between CEE MSM is likely to be protective against STI and HIV infections. Barriers to HIV testing in CEE countries10 11 may mean that HIV is more likely to remain undiagnosed among MSM in CEE countries compared with the UK, but the high prevalence of HIV among MSM in the UK is likely to increase exposure to infection when CEE men have partnerships with men who are not from their home country. By comparison, the majority of heterosexual CEE migrants report that their most recent partner was from their home country (F.M.…”

“…Limited data from CEE countries suggest that UAI is practised among a substantial proportion of MSM11 13 14 and condom use may not alter following migration to the UK. Data are needed to explore the extent to which individuals practice UAI before and after migration.…”

HIV-related risky practices among Brazilian young men, 2007

“…The findings here among homo/bisexual young men show different risk behaviors and reinforce strategies geared towards groups presenting greater risk. Access strategies to population subgroups under higher risk through recruitment chain have been used internationally, achieving better results than with traditional approaches 15 .…”

Recruiting Substance-Using Men Who Have Sex With Men into HIV Prevention Research: Current Status and Future Directions

“…Individual IDU network members may serve multiple relationship functions (e.g., drug use partner, sex partner, social companion), whereas MSM networks may be more segregated in their function, even where substance use is common. In addition to RDS, other forms of chain-respondent sampling were reported as being common, such as simple snowball [19] or participants are asked to recruit one or two key network members, but not necessarily enable a long recruitment chain [20].…”