Associations between economic dependence, sexual behaviours, and sexually transmitted infections among young, Black, gay, bisexual and other men who have sex with men living with and without HIV in Jackson, Mississippi, USA

Sexual Health ◽  
2018 ◽  
Vol 15 (5) ◽  
pp. 473 ◽  
Author(s):  
Kalysha Closson ◽  
Rachel Vickers Smith ◽  
Gbolahan Olarewaju ◽  
Richard Crosby
Keyword(s):  
Sexual Health ◽  
Relationship Power ◽  
Hiv Status ◽  
Economic Dependence ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Sexual Behaviours ◽  
Sexually Transmissible Infections ◽  
The Usa ◽  
Sex With Men

Background In the USA, young Black gay, bisexual or other men who have sex with men (YBMSM) bear the largest burden of HIV incidence. The aim of this study is to examine the independent associations between economic dependency on a sexual partner and several HIV risk behaviours and sexual health outcomes among YBMSM living in Jackson, Mississippi, USA. Methods: Baseline data from 589 YBMSM, with a median age of 22.0 years (IQR = 15–25) participating in a brief sex-positive HIV and STI prevention intervention, were used to measure the association between six sexual behaviours, sexually transmissible infections (STIs) status at baseline and economic dependence. Bivariate χ2 associations were tested and regression models adjusted for education level (≤ high school), employment and HIV-status. Results: In regressions, of the six sexual behaviours reported in the last 90 days and six STIs tested at baseline, economically dependent YBMSM were more likely to report condomless anal receptive sex (aOR = 2.19, 95%CI = 1.25–3.83), ≥3 partners as a top (aOR = 1.99, 95%CI = 1.17–340), ≥3 sex partners as a bottom (aOR = 2.07, 95%CI = 1.24–3.45), ≥3 sex acts as a bottom (aOR = 2.10, 95%CI = 1.16–3.82) and testing positive for oral gonorrhoea (aOR = 2.39, 95%CI = 1.18–4.83) after controlling for HIV status, employment and education. Conclusions: Interventions should consider how poverty, unemployment and economic dependence interact to influence relationship power imbalances, condom use and sexual positioning agency, and sexual health for key populations of MSM.

scholarly journals Sexual behaviours and sexually transmitted infection outcomes in a cohort of HIV-negative men who have sex with men attending sexual health clinics in England

2018 ◽  
Vol 29 (14) ◽  
pp. 1407-1416 ◽  
Author(s):  
S Desai ◽  
F Burns ◽  
G Schembri ◽  
D Williams ◽  
A Sullivan ◽  
...  
Keyword(s):  
High Risk ◽  
Sexual Health ◽  
Receptive Anal Intercourse ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Behaviours ◽  
Increased Risk ◽  
Sex With Men ◽  
Clinical Records ◽  
Hiv Negative

Men who have sex with men (MSM) attending sexual health (SH) clinics are at high risk for HIV acquisition and are disproportionately affected by sexually transmitted infections (STIs). We collected standardised behavioural data from MSM attending clinics to characterise sexual behaviours and identify predictors for HIV and STIs. In 2012–2013, HIV-negative MSM attending five SH clinics in England reported sexual behaviours in the previous three months via a self-administered questionnaire. Behaviours were linked to the individual’s clinical records using national surveillance. The prevalence and incidence of bacterial STIs (gonorrhoea, Chlamydia, lymphogranuloma venereum and syphilis) and incidence of HIV were calculated. Adjusted odds ratios and hazard ratios with 95% confidence interval (CI) were reported for significant predictors. Of 1278 HIV-negative MSM, 54% were of white ethnicity and UK-born and 43% were 25–34 years old. Almost all men reported at least one partner in the last three months. Half reported condomless anal sex and 36% condomless receptive anal intercourse (CRAI). Incidence of bacterial STIs was 46/100 (95%CI 39–54) person years (py) and of HIV was 3.1/100 (95%CI 1.7–5.6) py. A STI at baseline and CRAI with increasing numbers of partners were associated with both incident infections. In this cohort of MSM high-risk behaviours and STIs were prevalent. Engagement in CRAI increased the likelihood of subsequent infection, while men diagnosed with a bacterial STI were at increased risk of a future STI. Clinical and behavioural risk assessments to determine an individual’s risk of infection could allow a more nuanced prevention approach that has greater success in reducing transmission.

Sexual health advice for MSM and WSW in general practice

2019 ◽  
Vol 30 (5) ◽  
pp. 232-236
Author(s):  
Sally Kelsey
Keyword(s):  
Sexual Health ◽  
Health Needs ◽  
Sexually Transmitted ◽  
Practice Nurses ◽  
Sexual Behaviours ◽  
Increased Risk ◽  
Health Advice ◽  
Sex With Men ◽  
Asymptomatic Individuals ◽  
Specific Health

Men who have sex with men and women who have sex with women need specialised health considerations regarding their sexual health. Sally Kelsey describes what these health needs are and what practice nurses can do to ensure health inequalities are reduced People who identify as lesbian, gay or bisexual (LGB) make up a minority of the population, but carry a large burden of sexually transmitted infections (STIs). Some behaviours among men who have sex with men lead to an increased risk of some STIs and women who have sex with women have specific health needs. While specialist sexual health services are well placed to provide services for these patients, many people choose not to or are not able to access these services. Therefore, primary care has a prime opportunity to offer advice and screening for asymptomatic individuals, and to offer opportunistic advice. Health professionals should be educated in these specific health needs, develop awareness of patient risks and discuss sexual behaviours and risks in an open and non-judgmental way.

Sexual Health Communication of Black Men Who Have Sex With Men Who Met On or Offline: A Secondary Data Analysis (Preprint)

2020 ◽  
Author(s):  
Jacob D Gordon ◽  
Andre L Brown ◽  
Darren L Whitfield
Keyword(s):  
Sexual Health ◽  
Health Communication ◽  
Black Men ◽  
Sexual Partner ◽  
Secondary Data ◽  
Sexual Partners ◽  
Hiv Status ◽  
Sexual Health Communication ◽  
Sex With Men ◽  
Traditional Masculinity

BACKGROUND Black men who have sex with men (BMSM) continue to experience disproportionate rates of HIV/STI infection despite advances in effective prevention tools. Over the last decade the method of finding sexual partners has evolved, with BMSM increasingly using geospatial dating applications to find sexual partners. Sexual health communication between partners has been associated with safer sex practices by previous scholars, but it is unclear how sexual health communication of BMSM differs for sex partners found on or offline. OBJECTIVE The current study explored sexual health communication in relationship to how one found their last sexual partner and factors associated with poorer sexual health communication. METHODS This study used secondary data in the form of a self-administered national survey. BMSM were recruited online and in-person and answered questions about their sexual health behaviors regarding their last sexual partner. RESULTS In total, 403 individuals were included in the analysis. The majority of respondents 55.8% (225/403) were more likely to have found their last sexual partner through geospatial dating applications and online websites than offline venues 44.3% (178/225). There was not a significant difference in scores of sexual health communication between those who found their last sexual partner on or offline (P=.49). Additionally, sexual health communication was also not significantly associated (P = .25) based on the venue of their last sexual partner after controlling for covariates. Significant predictors of lower sexual health communication of BMSM were found: positive HIV status (P = .003), a casual partner type (P < .001), and endorsement of traditional masculinity ideologies (P = .01). CONCLUSIONS Findings from this study confirm high rates of sexual partner seeking via online venues among BMSM. The significant predictors of lower sexual health communication, endorsement of traditional masculinity ideologies and positive HIV status, suggest that stigma is a barrier to effective sexual health communication of BMSM.

scholarly journals Sexual health norms and communication patterns within the close social networks of men who have sex with men and transgender women in Lima, Peru: a 2017 cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amrita Ayer ◽  
Eddy R. Segura ◽  
Amaya Perez-Brumer ◽  
Susan Chavez-Gomez ◽  
Rosario Fernandez ◽  
...  
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Sexual Health ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sti Prevention ◽  
Sti Testing ◽  
Trans Women ◽  
Sex With Men

Abstract Background Social networks, norms, and discussions about sexual health may inform sexual practices, influencing risk of human immunodeficiency virus (HIV) or sexually transmitted infection (STI) acquisition. To better understand social networks of Peruvian men who have sex with men (MSM) and transgender women (trans women), we examined key social network members (SNMs), participant perceptions of these network members’ opinions toward sexual health behaviors, and associations between network member characteristics and condomless anal intercourse (CAI). Methods In a 2017 cross-sectional study, a convenience sample of 565 MSM and trans women with HIV-negative or unknown serostatus was asked to identify three close SNMs; describe discussions about HIV and STI prevention with each; and report perceived opinions of condom use, HIV/STI testing, and partner notification of STIs. Generalized estimating equations evaluated relationships between SNM characteristics, opinions, and discussions and participant-reported CAI. Results Among participants who identified as MSM, 42.3% of key SNMs were perceived to identify as gay. MSM “never” discussed HIV and STI prevention concerns with 42.4% of heterosexual SNMs, but discussed them “at least once weekly” with 16.9 and 16.6% of gay- and bisexual- identifying SNMs, respectively. Among participants who identified as trans women, 28.2% of key SNMs were perceived as heterosexual; 25.9%, as bisexual; 24.7%, as transgender; and 21.2%, as gay. Trans women discussed HIV/STI prevention least with cis-gender heterosexual network members (40.2% “never”) and most with transgender network members (27.1% “at least once weekly”). Participants perceived most of their close social network to be completely in favor of condom use (71.2% MSM SNMs, 61.5% trans women SNMs) and HIV/STI testing (73.1% MSM SNMs, 75.6% trans women SNMs), but described less support for partner STI notification (33.4% MSM SNMs, 37.4% trans women SNMs). Most participants reported CAI with at least one of their past three sexual partners (77.5% MSM, 62.8% trans women). SNM characteristics were not significantly associated with participant-reported frequency of CAI. Conclusions Findings compare social support, perceived social norms, and discussion patterns of Peruvian MSM and trans women, offering insight into social contexts and sexual behaviors. Trial registration The parent study from which this analysis was derived was registered at ClinicalTrials.gov (Identifier: NCT03010020) on January 4, 2017.

scholarly journals Association between intensity of STI screening and development of antimicrobial resistance in N. gonorrhoeae in 12 cities in the USA: An ecological study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1237
Author(s):  
Chris R. Kenyon
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Ecological Study ◽  
Geometric Mean ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Antimicrobial Sensitivity ◽  
The Usa ◽  
Sex With Men

In this study, we assessed if there was a city-level association between sexually transmitted infection (STI) screening intensity in men who have sex with men and antimicrobial sensitivity in Neisseria gonorrhoeae in the United States, 2007 to 2013.  We found positive associations between STI screening intensity and increases in minimum inhibitory concentrations for cefixime and azithromycin, but not ceftriaxone when using change in city geometric mean N. gonorrhoeae MIC between 2005 and 2013.

Prevalence of rectal Mycoplasma genitalium and macrolide resistance in men who have sex with men attending Sydney Sexual Health Centre

Sexual Health ◽  
2020 ◽  
Vol 17 (2) ◽  
pp. 114
Author(s):  
Isabella Bradley ◽  
Rick Varma ◽  
Vickie Knight ◽  
Dimitra Iliakis ◽  
Leon McNally ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Sexual Health ◽  
Rectal Swab ◽  
Health Centre ◽  
Mycoplasma Genitalium ◽  
Macrolide Resistance ◽  
Cross Sectional ◽  
Screening Guidelines ◽  
Sexually Transmissible Infections ◽  
Sex With Men

Background Sexually transmissible infections (STIs) have been increasing in men who have sex with men (MSM) in recent years; however, few studies have investigated the prevalence or antimicrobial resistance in rectal Mycoplasma genitalium in this group. This study aimed to determine the prevalence and predictors of rectal M. genitalium in MSM attending an urban sexual health service in Sydney, Australia, namely the Sydney Sexual Health Centre (SSHC), as well as estimate the rate of macrolide resistance. Methods: A prospective cross-sectional analysis was conducted of rectally asymptomatic MSM having a rectal swab collected as part of their routine care. Participants self-collected a rectal swab to be tested for M. genitalium and completed a 14-item questionnaire that provided information on behavioural risk factors. The prevalence of rectal M. genitalium was determined and multivariate analysis was performed to assess the associations for this infection. Positive specimens then underwent testing for macrolide-resistant mutations (MRMs) using the ResistancePlus MG assay (SpeeDx, Eveleigh, NSW, Australia). Results: In all, 742 patients were consecutively enrolled in the study. The median age was 31 years (interquartile range 27–39 years), with 43.0% born in Australia. Overall, 19.0% of men were bisexual, 22.9% were taking pre-exposure prophylaxis (PrEP) and 4.3% were HIV positive. The prevalence of rectal M. genitalium was 7.0% (95% confidence interval (CI) 5.3–9.1) overall and 11.8% in those taking PrEP. On multivariate analysis, PrEP use was significantly associated with having rectal M. genitalium (odds ratio 2.01; 95% CI 1.09–3.73; P = 0.01). MRMs were detected in 75.0% (36/48; 95% CI 60.4–86.4%) of infections. Conclusion: Rates of rectal M. genitalium infection were high among asymptomatic MSM attending SSHC and MRMs were detected in 75% of infections. PrEP use was found to be significantly associated with rectal M. genitalium infection. These data contribute to the evidence base for screening guidelines in MSM.

scholarly journals 423. Self-Reported Screening for Rectal Sexually Transmitted Infections Among Men Who Have Sex with Men

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S212-S213
Author(s):  
Timothy William. Menza ◽  
Lauren Lipira ◽  
Amisha Bhattarai ◽  
Joseph Ramirez ◽  
Roberto Orellana
Keyword(s):  
Sexually Transmitted Infections ◽  
Multivariable Analysis ◽  
Prevalence Ratio ◽  
Hiv Positive ◽  
Sexually Active ◽  
Hiv Status ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Hiv Negative ◽  
Hiv Positive Men

Abstract Background Rectal gonorrhea and Chlamydia are common and predict HIV acquisition among men who have sex with men (MSM); however, screening for rectal sexually transmitted infections (STIs) is not routine. Methods In 2017, we recruited sexually-active MSM in the Portland, Oregon metropolitan area through venue-based sampling. Our outcome of interest was self-reported rectal STI screening in the prior 12 months. Stratified by HIV status, we assessed the prevalence and demographic, healthcare, clinical, and behavioral predictors of screening. Results Of 448 participants, 168 (37.5%) reported rectal STI screening. One hundred twenty-seven (35.8%) of 355 HIV-negative men, 41 (58.6%) of 70 HIV-positive men, and none of 23 men who did not know their HIV status reported screening. Among HIV-negative men, having a healthcare provider who offered HIV testing (adjusted prevalence ratio [aPR]=2.09; 95% confidence interval [CI]: 1.43, 3.04), a syphilis diagnosis (aPR=1.32; 95% CI: 1.03, 1.69), use of pre-exposure prophylaxis (aPR=1.57; 95% CI 1.21, 2.04), and condomless anal sex with casual partners in the prior 12 months (aPR=1.74; 95% CI: 1.36, 2.22) independently predicted screening for rectal STI in multivariable analysis. HIV-positive men who reported having a provider who always or often initiates conversations about sex were significantly more likely to report screening compared with men who did not have such a provider (aPR=1.48; 95% CI: 1.06, 2.06). Conclusion Rectal STI screening is not universal in a venue-based sample of sexually-active MSM. Implementing innovative, acceptable, and accessible screening practices and improving provider comfort with talking about sex are paramount to increasing rectal STI screening. Disclosures All authors: No reported disclosures.

Acceptability of a digital patient notification and linkage-to-care tool for French PrEPers (WeFLASH©): Key stakeholders' perspectives

2019 ◽  
Vol 30 (14) ◽  
pp. 1397-1407
Author(s):  
David Lessard ◽  
Alexandre Aslan ◽  
Jérémy Zeggagh ◽  
Stéphane Morel ◽  
David Michels ◽  
...  
Keyword(s):  
Linkage To Care ◽  
Epidemiological Data ◽  
Management Decision ◽  
Time Data ◽  
Transmitted Infection ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Access To Data ◽  
Exposure Prophylaxis

The objective of this study was to describe stakeholders’ perspectives on the acceptability of WeFLASH© (AADISS, Paris, France), a digital smartphone sexually transmitted infection (STI) patient notification (PN) tool to be launched among French HIV pre-exposure prophylaxis users (PrEPers). In Paris, Lyon, and Nice, we conducted 2-hour focus group discussions with PrEPers (n = 21) and community mediators (n = 10), and one-on-one interviews with PrEP-prescribing physicians (n = 5) and HIV/STI management decision-makers (n = 4). Recordings were transcribed. The analysis focused on perceived benefits and risks. Concerning benefits, participants mentioned that WeFLASH© could provide: improved PN and STI screening, by refining the notification of anonymous partners; customized linkage-to-care, by providing users with tailored information on care; and transferable epidemiological data, by filling a need for real-time data. Participants anticipated risks for: privacy and confidentiality and suggested specific security settings to protect users’ identity; sexual behavior and suggested game-like functions to improve the integration of the tool in sexual contexts; and fairness and emphasized the importance of making WeFLASH© accessible to all men who have sex with men. WeFLASH© could facilitate PN for an increasing proportion of anonymous partners met online, and empower users, including notified partners, on questions of confidentiality and consent, access to STI prevention and screening services, and access to data.

Sexually transmissible infections and characteristics of men aged 60 years and over attending a public sexually transmitted diseases (STD) clinic in South Australia

Sexual Health ◽  
2015 ◽  
Vol 12 (5) ◽  
pp. 460
Author(s):  
Carole Khaw ◽  
Bin Li ◽  
Russell Waddell
Keyword(s):  
Retrospective Study ◽  
Sexually Transmitted Diseases ◽  
South Australia ◽  
Older Men ◽  
Sexually Transmitted ◽  
Social Burden ◽  
Sexually Transmissible Infections ◽  
Younger Men ◽  
Health Related ◽  
Sex With Men

Background With society ageing, sexually transmissible infections (STIs) in the older population are of interest from an economic, health-related and social burden perspective. Few studies on STIs in men older than 60 years of age exist. Methods: A retrospective study was performed looking at characteristics of, and STIs in, 29 106 men (of which 689 were older than 60 years of age), at first presentation, visiting the only South Australian public sexually transmitted diseases (STD) clinic over a 13-year period. Results: Older men [men who have sex with men (MSM) and men who have sex with women (MSW)] were less likely than younger men to have been tested for HIV. Conclusion: There is a need for increased HIV testing in older men.

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