The Effect of Partner Characteristics on HIV Infection Among African American Men Who Have Sex With Men in the Young Men's Survey, Los Angeles, 1999–2000

Abstract

Previous studies have documented disparities in HIV prevalence by race among men who have sex with men (MSM), even after adjusting for traditional risk factors. In this analysis of data collected for the 1999-2000 Los Angeles Young Men's Survey, a cross-sectional venue-based survey of MSM aged 23-29, we investigated whether information on male sex-partner characteristics accounts for some of the racial/ethnic differences in HIV prevalence. In this sample of survey participants, we observed that African American MSM reported similar or lower levels of HIV risk behaviors compared with White MSM but much higher HIV prevalence (26% vs. 7.4%, respectively). In an unadjusted logistic regression model, African American participants had 4.4 times higher odds of HIV infection compared with White participants. In a multiple logistic regression model adjusting for participant behaviors, we observed elevation of the relative odds of HIV infection for African Americans compared with Whites (odds ratio [OR] = 6.9, 95% confidence limits [CL] = 2.5, 19). In a fully adjusted model, controlling for the effects of having older partners and more African American partners, we observed a 20% reduction in the relative odds of HIV for African American participants compared with White participants (OR = 5.5, 95% CL = 1.8, 17). Our findings suggest that differences in male partner types, namely older and African American partners, may account for some of the observed racial disparity in HIV infection, especially for African American MSM compared with White MSM in Los Angeles.

Sexual Mixing Patterns and Partner Characteristics of Black MSM in Massachusetts at Increased Risk for HIV Infection and Transmission

“…13 Moreover, for Black MSM compared to White MSM, sexual partner choices (i.e., older age and having Black sexual partners) were better predictors of the higher rates of HIV seroprevalence in the sample than individual behavioral histories (i.e., HIV risk behavior). 13 Similarly, Berry and colleagues, in an analysis of data from the 2004 National HIV Behavioral Surveillance Survey in San Francisco, confirmed a significant tendency among Black MSM to have more partners of the same race. 24 Accordingly, a combination of intraracial and intergenerational sexual mixing may explain the disproportionate rates of HIV and STDs among Black MSM.…”

“…Possible explanations for racial disparities in HIV and STD incidence have included socioeconomic position and cultural factors, structural barriers in accessing health care, and differences in sexual behavior. [7][8][9][10][11] Although studies have consistently found higher HIV prevalence among Black MSM relative to MSM of other races/ethnicities, comparable or lower rates of sexual risk behavior (i.e., unprotected anal sex [UAS]) have been observed among Black MSM compared to White and/or Latino MSM, 10,[12][13][14][15] suggesting that behavioral risk factors for HIV infection alone do not sufficiently explain elevated rates of HIV among Black MSM. 12 One potential explanation for higher HIV infection rates-that the sexual networks of Black MSM place them at greater risk for HIV and STDs than the sexual networks of other MSM-has not yet been sufficiently investigated.…”

“…20,21 Studies have more recently begun to underscore the importance of focusing on and understanding racial dynamics in sexual networks. 13,[22][23][24] For example, Laumann and Youm demonstrated that the incidence and prevalence of HIV and STDs remained higher within Black populations because Black men and women were more likely than White and Latino men and women to have sex exclusively with partners of the same race who were more likely to be HIV-and/or STD-infected. 22 In more recent research focused on MSM, Bingham and colleagues found that racial differences in male partner types partially accounted for elevated rates of HIV infection by examining the role of partner characteristics among 400 MSM ages 23 to 29 in the Los Angeles Young Men's Survey.…”

“…22 In more recent research focused on MSM, Bingham and colleagues found that racial differences in male partner types partially accounted for elevated rates of HIV infection by examining the role of partner characteristics among 400 MSM ages 23 to 29 in the Los Angeles Young Men's Survey. 13 Approximately 27% of Black MSM reported having a Black male sex partner in the past 12 months compared to 12% of Hispanic/Latinos and 3% of Whites. 13 Moreover, for Black MSM compared to White MSM, sexual partner choices (i.e., older age and having Black sexual partners) were better predictors of the higher rates of HIV seroprevalence in the sample than individual behavioral histories (i.e., HIV risk behavior).…”

“…13 Approximately 27% of Black MSM reported having a Black male sex partner in the past 12 months compared to 12% of Hispanic/Latinos and 3% of Whites. 13 Moreover, for Black MSM compared to White MSM, sexual partner choices (i.e., older age and having Black sexual partners) were better predictors of the higher rates of HIV seroprevalence in the sample than individual behavioral histories (i.e., HIV risk behavior). 13 Similarly, Berry and colleagues, in an analysis of data from the 2004 National HIV Behavioral Surveillance Survey in San Francisco, confirmed a significant tendency among Black MSM to have more partners of the same race.…”