Predictors of Serosorting and Intention to Serosort Among Men Who Have Sex with Men, San Francisco

Chen, Yea‐Hung; Vallabhaneni, Snigdha; Raymond, H. Fisher; McFarland, Willi

doi:10.1521/aeap.2012.24.6.564

Cited by 16 publications

(22 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the case that a transwoman participant was HIV positive and reported her partner’s HIV status as negative, and vice versa for a transwoman who was HIV-negative and reported her partner as being HIV-positive, the partnership was categorized as serodiscordant. Transwomen’s partnerships with those of an unknown HIV status were also categorized as serodiscordant, consistent with prior literature [23, 24]. We calculated assortativity by race, partner status (main, casual, or commerical), HIV serostatus, and IDU between transwomen and their sexual networks using Newman’s assortativity coefficient.…”

Section: Methodsmentioning

confidence: 95%

Sexual mixing and the risk environment of sexually active transgender women: data from a respondent-driven sampling study of HIV risk among transwomen in San Francisco, 2010

2014

View full text Add to dashboard Cite

BackgroundResearch on the sexual networks of transwomen is central to explaining higher HIV risk for this population. This study examined HIV risk behaviors and sexual mixing patterns of transwomen by demographic and HIV-related risk behaviors.MethodsData were obtained from a 2010 study of HIV risk for transwomen in San Francisco. Assortativity by race, partner type, HIV serostatus, and IDU across sexual networks was calculated using Newman’s assortativity coefficient (NC). Multivariable generalized estimating equations (GEE) logistic regression models were used to evaluate associations between unprotected anal intercourse with race and HIV serostatus, partner-IDU status and relationship type discordance while adjusting for the HIV status of transwomen.ResultsThere were 235 sexually active transwomen in this study, of whom 104 (44.3%) were HIV-positive and 73 (31.1%) had a history of injection drug use. Within the 575 partnerships, African American/black and Latina transwomen were the most racially assortative (NC 0.40, 95% CI 0.34-0.45, and NC 0.43, 95% CI 0.38-0.49, respectively). In partnerships where the partner’s HIV status was known (n = 309, 53.7%), most transwomen were in sexual partnerships with people of their same known serostatus (71.8%, n = 222). In multivariable analyses, unprotected anal intercourse was significantly associated with primary partners, having a sexual partner who was an injection drug user, and sexual partner seroconcordance.ConclusionsPublic health efforts to reduce transwomen’s HIV risk would likely benefit from prioritizing prevention efforts to risk reduction within IDU-discordant and primary partnerships, determining risks attributable to sexual network characteristics, and actively addressing injection drug use among transwomen.

show abstract

Section: Methodsmentioning

confidence: 95%

Sexual mixing and the risk environment of sexually active transgender women: data from a respondent-driven sampling study of HIV risk among transwomen in San Francisco, 2010

2014

View full text Add to dashboard Cite

show abstract

“…Behavioral surveys among MSM usually estimate the association between alcohol use and risky sex without considering the effect of sensation seeking, 1 which is a potential confounder in this causal pathway. 4 Using the findings of this study, investigators can consider the confounding effect of sensation seeking and estimate the adjusted effect of alcohol use on risky sex among MSM.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Previous research showed that this risk was higher in heavy alcohol drinkers than in low-level alcohol drinkers or non-drinkers in both HIV-positive and HIV-negative MSM. 1 …”

Section: Introductionmentioning

confidence: 99%

Using expert opinion to quantify unmeasured confounding bias parameters

Navadeh

Mirzazadeh

McFarland

et al. 2016

Can J Public Health

Self Cite

View full text Add to dashboard Cite

OBJECTIVE To develop and apply a method to quantify bias parameters in the case example of the association between alcohol use and HIV-serodiscordant condomless anal sex with potential confounding by sensation seeking among men who have sex with men (MSM) using expert opinion as an external data source. METHODS Through an online survey, we sought the input of 41 epidemiologist and behavioral scientists to quantify six parameters in the population of MSM: the proportion of high sensation seeking among heavy drinking MSM, the proportion of sensation seeking among low level drinking MSM, and the risk ratio (RR) of the association between sensation seeking and condomless anal sex, for HIV-positive and HIV-negative MSM. RESULTS Eleven experts responded. For HIV-positive heavy drinkers, the proportion of high sensation seeking was 53.6% (beta distribution [α=5.50, β=4.78]), and 41.1% (beta distribution [α=3.10, β=4.46]) in HIV-negative heavy drinkers. In HIV-positive low level alcohol drinkers, high sensation seeking was 26.9% (beta distribution [α=1.81, β=4.92]), similar to high sensation seeking among HIV-negative low level alcohol drinkers (25.3%) (beta distribution [α=2.00, β=5.89]). The lnRR for the association between sensation seeking and condomless anal sex was ln(2.4) (normal distribution [μ=0.889, σ=0.438]) in HIV-positive and ln(1.5) (normal distribution [μ=0.625, σ=0.391]) in HIV-negative MSM. CONCLUSION Expert opinion can be a simple and efficient method for deriving bias parameters to quantify and adjust for hypothesized confounding. In this test case, expert opinion confirmed sensation seeking as a confounder for the effect of alcohol on condomless anal sex and provided the parameters necessary for probabilistic bias analysis.

show abstract

“…For analytical purposes, we combined into one item labeled “withdrawal” persons who used withdrawal as either insertive or receptive partner. These eight items are commonly used HIV risk reduction practices (Chen et al, 2012; Parsons et al, 2005; World Health Organization, 2012). …”

Section: Methodsmentioning

confidence: 99%

“…Substance-use strategies include not sharing drug paraphernalia, or rinsing shared syringes and rigs in a bleach–water solution (Abdala, Crowe, Tostov, & Heimer, 2004; Abdala, Gleghorn, Carney, & Heimer, 2001; Cox, Lawless, Cassin, & Geoghegan, 2000; Koester, Glanz, & Baron, 2005; Richard, Mosier, & Atkinson, 2002). Sexual strategies include considering HIV status (serosorting) when deciding whether to share drug paraphernalia or to engage in condomless anal intercourse (CAS; Chen, Vallabhaneni, Raymond, & McFarland, 2012; Eaton, Kalichman, O’Connell, & Karchner, 2009; Philip, Yu, Donnell, Vittinghoff, & Buchbinder, 2010; Yang, Tobin, & Latkin, 2011; Zablotska et al, 2009), or using sexual positioning or withdrawal during CAS (Binson, Pollack, Blair, & Woods, 2010; Dubois-Arber, Jeannin, Lociciro, & Balthasar, 2012; Marks et al, 2010; McDaid & Hart, 2012; Parsons et al, 2005; Van de Ven et al, 2002). Biomedical strategies (i.e., pre- and post-exposure prophylaxis, and undetectable viral loads) to reduce HIV risk (Campbell, Herbst, Koppenhaver, & Smith, 2013) are not yet widely used among HIV–negative MSM (Krakower et al, 2012; Mutua et al, 2012), but their acceptability is increasing (Escudero et al, 2014; Holt, 2014; Young, Li, & McDaid, 2013; Young & McDaid, 2014).…”

Section: Introductionmentioning

confidence: 99%

Substance-use and sexual harm reduction strategies of methamphetamine-using men who have sex with men and inject drugs

et al. 2015

View full text Add to dashboard Cite

Research indicates that men who have sex with men (MSM), use methamphetamine, and inject drugs are at high risk of HIV infection and they employ multiple harm reduction strategies simultaneously to reduce that risk. In this study, we identified substances most commonly injected and harm reduction strategies most often employed by methamphetamine-using MSM, used latent class analysis (LCA) to identify patterns of harm reduction strategies, and differentiated MSM within each class by individual characteristics. We analyzed data from 284 participants who completed an online cross-sectional survey. Commonly injected substances were methamphetamine (93.70%), gamma-hydroxybutyrate/gamma-butyrolactone (41.55%), flunitrazepam (40.49%), and cocaine (35.56%). The substance-use strategies most often used were avoidance of sharing needles (85.92%) and use of bleach to clean drug paraphernalia (64.08%). The sexual strategy most often used was avoidance of condomless anal intercourse (CAS) while using drugs (77.11%). Using an LCA approach, we identified three classes distinguishable by age, race/ethnicity, and outness. One class (19%) employed lay strategies to reduce harm: they avoided sharing drug preparation equipment, serosorted when sharing needles and equipment or having CAS, and practiced withdrawal when having CAS. The largest class (53%) combined sexual and substance use strategies: they avoided sharing needles, used bleach to clean needles and equipment, avoided CAS when using drugs, and used extra lubricant when having CAS. The remaining class (28%) employed only substance-use rather than sexual strategies. More MSM of color were in the substance-use class, and more young, non-Hispanic White men were in the lay class. The low utilization of sexual strategies by younger, non-Hispanic White men in the lay class is concerning as they are just as likely as older, non-Hispanic White men in the combined class to have CAS with multiple male partners. Interventionists should consider these differences when developing interventions tailored to methamphetamine-using MSM.

show abstract

Predictors of Serosorting and Intention to Serosort Among Men Who Have Sex with Men, San Francisco

Cited by 16 publications

References 20 publications

Sexual mixing and the risk environment of sexually active transgender women: data from a respondent-driven sampling study of HIV risk among transwomen in San Francisco, 2010

Sexual mixing and the risk environment of sexually active transgender women: data from a respondent-driven sampling study of HIV risk among transwomen in San Francisco, 2010

Using expert opinion to quantify unmeasured confounding bias parameters

Substance-use and sexual harm reduction strategies of methamphetamine-using men who have sex with men and inject drugs

Contact Info

Product

Resources

About