AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #153 - Barebacking among MSM recruited through a Swedish website: Associations with sexual activities during last sexual encounter
Authors: Presenting Author: Dr Rigmor Berg - The Norwegian Knowledge Centre for Health Services
Additional Authors: Dr. Ronny Tikkanen, Dr. Michael Ross,
Aim: Twenty years of research about barebacking, generally defined as intentionally engaging in unprotected anal sex with a casual male partner, has produced invaluable knowledge of factors that help explain the behavior among men who have sex with men (MSM). Few studies, however, have examined barebacking among European MSM, nor have they considered the characteristics of last sexual encounter related to bareback sex. Our objectives were to describe sexual activities associated with barebacking behavior during last sex among MSM and to evaluate the relationship of barebacking with HIV testing, having sex with women, and the use of gay cruising places and chat rooms.
Method / Issue: A socio-behavioral internet survey was carried out in 2008 among 3,634 MSM who had Swedish as their preset language in the Qruiser community. Descriptive statistics and bivariate analyses were used to evaluate sexual activities related to barebacking. In addition, for aim two, four predictor variables whose p value was <0.001 in the univariate logistic regression models were included in a multivariate logistic model and the odds ratio (OR) with their respective confidence intervals (95% CI) were calculated.
Results / Comments: The sample was predominantly gay (74%), HIV-negative (85%) and almost 96% lived in Sweden. 10% of the respondents (n=356) said they had engaged in barebacking in the past year. In terms of situations regarding last sexual encounter, barebacking was associated with (p< 0.01) finding the sexual partner through the Internet, and having sex at a cruising location, with ≥2 people, an unknown casual partner, and engaging in unprotected anal intercourse, rimming, fisting, and oral sex. Barebackers were also more likely during last sex to have talked about and know the partner's HIV-status. Results for the second aim showed that all four variables were significantly associated with barebacking in the univariate logistic regression analyses (p<0.01). In the multivariate regression analysis, the likelihood of engaging in barebacking was higher for those MSM who reported more frequent HIV testing in the past year (OR=5.16, CI=4.03-6.61), a higher number of female sex partners in the past year (OR=16.80, CI=13.09-21.56), using gay cruising places in the past year (OR=1.51, CI=1.18-1.94), and using gay chat rooms at least weekly (OR=2.11, CI=1.65-2.70).
Discussion: This sample of MSM was diverse with respect to the sexual behaviors they enacted, and barebackers were more likely than men not reporting bareback sex to engage in a variety of sexual behaviors implicated in HIV/STI transmission. However, they were also more likely both to test for HIV and communicate about HIV-status with their most recent sexual partner, suggesting barebackers may negotiate safety around unprotected sex.
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