Amsterdam 2015
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| Abstract #2129 - Boystown - MSM I | ||||
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Session: 15.4: Boystown - MSM I (Symposium) on Wednesday @ 14.30-16.00 in C104 Chaired by Udi Davidovich, Kenneth Mayer Authors: Presenting Author: Dr. Jeffrey Kelly - Medical College of Wisconsin, United States |
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| Additional Authors: | ||||
| Aim: In the United States, African American MSM bear disproportionate burden of HIV disease and—in contrast to stable or declining incidence in other population segments—continue to contract HIV infection at very high rates. Prior research comparing racial minority and nonminority MSM has shown few behavioral characteristics that might account for this disparity. However, less research has compared Black MSM who are at very high risk with racial minority men who are very safe in their sexual behavior, and few studies have examined the simultaneous influence of a broad range of factors potentially related to the risk or safety of sexual practices among Black MSM. This study sought to identify influences most strongly related to sexual risk behavior in a large multi-city sample of African American MSM. | ||||
| Method / Issue: This study used social network recruitment to enroll a community cohort of 445 racial minority MSM in three US cities: Milwaukee, Cleveland, and Miami. “Seeds” identified in a variety of community venues were enrolled and then invited the participation of their MSM friends. The friends, in turn, invited their own friends, a process that continued outward for three “rings” from each seed. Participants completed an A-CASI interview that included: (1) a detailed partner-by-partner assessment of sexual practices over the past 3 months, including partner type and serostatus concordance (2) measures of demographic characteristics (3) substance abuse (4) AIDS risk-specific scales measuring risk reduction knowledge, attitudes, norms, and intentions and (5) scales measuring broad contextual domains (internalized homonegativity, religiosity, self-ascribed masculinity, resilience, and gay community acculturation). Multiple regression analyses were used to identify independent predictors of whether MSM were high in risk (UAI with someone other than a seroconcordant main partner in the past 3 months) and—if so—their number of UAI acts. | ||||
| Results / Comments: Over one-third of MSM reported UAI outside of a main concordant partnership in the past 3 months. This was significantly associated with higher alcohol and marijuana use, high gay community acculturation, and weak risk reduction intentions. How often high-risk men engaged in UAI was associated with having unstable housing, illicit drug use, income < $10,000, longer time since last HIV test, and negative condom use attitudes and perceived norms. | ||||
| Discussion: Sexual safety among Black MSM was associated with lower substance use, lower indicators of socioeconomic status, and more positive views about condom use. These factors identify areas for intervention development. Attention in the field now focuses on treatment-as-prevention as a primary strategy. However, until ART treatment uptake, PrEP access, and treatment adherence challenges are solved, risk behavior reduction also remains important for populations such as African American MSM and behavioral prevention efforts remain needed. | ||||
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