Stable Sexual Risk Behavior in a Rapidly Changing Risk Environment: Findings from Population-Based Surveys of Men Who Have Sex with Men in Seattle, Washington, 2003–2006

Abstract

We assessed trends in behavioral risk for HIV infection among men who have sex with men (MSM). Seattle MSM participated in random digit dial telephone surveys in 2003 (n = 400) and 2006 (n = 400). Fourteen percent in 2003 and 9% in 2006 reported unprotected anal intercourse with a partner of different or unknown HIV status (non-concordant UAI; odds ratio [OR] = 0.7; 95% confidence interval [CI]: 0.5, 1.2). Compared to participants in 2003, participants in 2006 met a greater proportion of their anal sex partners through the Internet (OR = 2.0; 95% CI: 1.2, 3.1). Although the proportion of anal sex partnerships formed online increased between 2003 and 2006, Internet partnerships were not more risky than those initiated elsewhere. While the emergence of the Internet as a venue through which men meet partners demonstrates that sexual risk among MSM remains highly dynamic, our findings suggest that sexual risk behavior among MSM is currently stable.

Temporal Trends in Sexual Behavior Among Men Who Have Sex With Men in the United States, 2002 to 2006–2010

“…Additionally, there were no differences in reports of STD testing in the past 12 months (p=.945) or in receipt of last HIV test (p=.319). among sexually active MSM in the U.S. Our findings were generally consistent with a previous study of recent behavioral trends among MSM in Seattle, 10 and a study of MSM in Peru that found increases in HIV while condom use was increasing and STDs were decreasing. 9 Additionally, we found no evidence that increases in STD/HIV testing were related to the overall disease increases as recent testing among sexually active MSM did not differ across time.…”

“…5 Although studies have examined temporal trends in sexual behaviors among MSM pre-and post-HAART and in the late 1990s and early 2000s, [6][7][8][9] few studies have examined recent behavioral trends in MSM in the U.S. One study, a random digit dialing survey in Seattle, compared the sexual behavior of MSM from 2003 to 2006 and found a significant decrease in median number of sex partners in the past year over time and no change in unprotected anal intercourse (UAI). 10 However, given the widespread increases in HIV and P&S syphilis in the U.S., national data on temporal trends in the sexual behaviors of MSM are needed. To date, there has been a lack of data from national population-based surveys that include MSM.…”

Trends in Sexual Behavior Among Men Who have Sex with Men (MSM) in High-Income Countries, 1990–2013: A Systematic Review

“…From the 16 studies that examined condomless anal sex with a partner of unknown/discordant HIV status from 1994 to 2011 (22, 23, 25–29, 35, 37, 39, 42, 44, 51–53, 57), 25 findings were included in the analysis (Figure 4). The results of the multi-level models indicated a significant increase in the behavior over time (overall analysis without knot for the time period 1994–2011: beta = 0.03, p < 0.001; with a knot: 1994–2002, beta = 0.05, p < 0.001; 2003–2011, beta = 0.02, p < 0.001).…”

Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: a meta-analysis of observational studies

“…Eight studies intercepted participants in multiple online or offline venues, while two12 36 37 42 43 relied on one venue only and one41 did not conduct venue-based recruitment. Sexually explicit nature of recruitment venues varied within and across studies, as indicated in online supplementary appendix I.…”