Article Text

Download PDFPDF
Older partner selection, sexual risk behaviour and unrecognised HIV infection among black and Latino men who have sex with men
  1. Heather A Joseph1,
  2. Gary Marks1,
  3. Lisa Belcher1,
  4. Gregorio A Millett1,
  5. Ann Stueve2,
  6. Trista A Bingham3,
  7. Jennifer Lauby4
  1. 1Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  2. 2Education Development Center, New York, New York, USA
  3. 3Los Angeles County Department of Public Health, HIV Epidemiology Program, Los Angeles, California, USA
  4. 4Public Health Management Corporation, Philadelphia, Pennsylvania, USA
  1. Correspondence to Heather A Joseph, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-37, Atlanta, GA 30333, USA; hjoseph1{at}


Objectives The authors examine whether young black and Latino men who have sex with men (MSM) who have older sex partners are more likely than those who do not have older sex partners to have unrecognised HIV infection. The authors examine whether the association stems from (1) increased sexual risk behaviour with male partners of any age, (2) heightened risk of being exposed to HIV infection by older partners or (3) a combination of these two factors.

Methods The analytical sample consisted of 723 black and Latino MSM, aged 18–35 years, who were HIV negative or of unknown serostatus at study entry. Participants completed a self-administered questionnaire and were tested for HIV infection. Men who reported having a male sex partner who was at least 4 years older than themselves were compared with those who did not. Outcomes included unprotected receptive anal intercourse (URAI) with male partners of any age (past 3 months) and having unrecognised HIV infection.

Results Men with older partners reported a higher prevalence of URAI (AOR=1.50, 95% CI 1.02 to 2.21). A second model found that men with older partners had increased odds of having unrecognised HIV infection (AOR=2.51, 95% CI 1.18 to 5.34) after controlling for the number of URAI partners of any age, which remained an independent predictor.

Conclusions Young black and Latino MSM who had older male sex partners were at increased risk of having unrecognised HIV infection. This heightened risk was associated with sexual risk behaviour with partners of any age as well as possible increased exposure to HIV infection from older partners.

  • Behavioural science
  • men
  • epidemiology (general)
  • sexual networks

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Disclaimer: The findings and conclusions of this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • Funding This study was funded through a cooperative agreement from the US Centers for Disease Control and Prevention.

  • Competing interests None.

  • Ethics approval The protocol was approved by the Institutional Review Boards at the US Centers for Disease Control and Prevention (protocol #4417) and at each study site.

  • Provenance and peer review Not commissioned; externally peer reviewed.