Background To determine factors associated with age-disparate sexual partners among Vancouver gay, bisexual and other men who have sex with men (GBM).
Methods Sexually active GBM aged ≥16 years were recruited from February 2012 to February 2014. Participants self-completed a questionnaire on demographics, attitudes and sexual behaviour and substance use at last sexual event with five most recent partners. Two generalised linear mixed models identified factors associated with: (1) ‘same-age’ (referent), ‘younger’ or ‘much-younger’ and (2) ‘same-age’ (referent), ‘older’ or ‘much-older’ partners. Statistical interactions between age and HIV status were tested.
Results Participants (n=719) were predominantly gay (85.1%), White (75.0%), HIV-negative/unknown status (72.9%) with median age of 33 years (Q1,Q3: 26,47). A minority of sexual events were reported with much-older/much-younger partners (13.7%). In the multivariable models, GBM reporting older partners were more likely to be Asian or Latino, have greater Escape Motivation scores, report their partner used erectile dysfunction drugs (EDDs) and have received something for sex; compared with condom-protected insertive anal sex, participants with older partners were more likely to report condomless insertive anal sex with a serodiscordant or unknown status partner or no insertive anal sex. GBM reporting older partners were less likely to be bisexual-identified, have given something for sex and report event-level alcohol and EDD use. GBM reporting younger partners were more likely to have annual incomes >$30 000 and have met their partner online. As per significant statistical interactions, age-disparate relations were more common for younger HIV-positive and older HIV-negative GBM.
Conclusions Differences among age-disparate partners highlight important targets for health promotion and future research.
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Handling editor Jackie A Cassell
Contributors RSH and DMM are co-principal investigators for this study and take responsibility for the integrity and accuracy of the data and have the final decision in the submission of the manuscript. EAR is a co-investigator for this study and developed the event-level questionnaire matrix. KC, NJL and RSH conceptualised the idea for the analysis, PS prepared the data set and ZC ran the analysis. KC and NJL interpreted the results from the analysis and wrote the initial draft with contributions from all authors.
Funding National Institute on Drug Abuse (1R01DA031055-01A1); Canadian Institutes for Health Research (107544, 143342).
Competing interests None declared.
Ethics approval This study protocol was approved by Research Ethics Boards of Simon Fraser University (2011s0691), University of British Columbia/Providence Health (H11-00691) and the University of Victoria (11-459).
Provenance and peer review Not commissioned; externally peer reviewed.
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