Objectives Condomless anal intercourse contributes significantly to the spread of HIV among men who have sex with men (MSM). Factors related to condomless anal intercourse with known HIV-positive partners among MSM are not well understood. The authors describe factors associated with inconsistent condom use with known HIV-positive partners prior to participants’ diagnosis with HIV.
Methods New York City health department disease intervention specialists interviewed newly HIV-diagnosed MSM ages ≥13 years reporting knowingly having anal sex with HIV-positive partners between June 2013 and October 2014. Univariate and bivariate statistics were calculated, in addition to logistic regression analysis.
Results Among 95 MSM interviewed, 56% were >30 years and 74% had higher than a high school education. Respondents reported a median of 2 known HIV-positive sex partners. Drug or alcohol use during last sex with their last known HIV-positive partner was reported by 53% of participants. Sixty-five per cent of participants reported inconsistent condom use with last known HIV-positive partner. Inconsistent condom use with all HIV-positive partners was higher among individuals reporting two or more known HIV-positive partners since sexual debut than among those with one (90% vs 59%, p<0.01) and among those reporting feelings of love/emotional attachment as a reason for having sex (85% vs 63%, p=0.02). In the bivariate logistic regression models for inconsistent condom use, feelings of love or emotional attachment were the only significant predictor of inconsistent condom use (OR 3.43, 95% CI 1.23 to 9.58). After adjusting for confounding, the relationship feelings of love or emotional attachment continued to be the only significant predictor of inconsistent condom use (OR 3.69, 95% CI 1.06 to 12.82).
Conclusions Surveyed MSM engaged in high-risk behaviours, including condomless anal sex and drug or alcohol use during sex with persons known to be HIV-positive. These findings can inform interventions with MSM in serodiscordant partnerships.
- behavioural science
- sexual health
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Handling editor Stefan Baral
Contributors NTB, KM, AB and CC-U contributed to writing of the manuscript. AB, RG and CC-U were involved in the design and conduct of the survey. SS and AB were involved with data management. NTB and KM conducted the statistical analysis.
Funding This work was supported by a cooperative agreement between the New York City Department of Health and Mental Hygiene, HIV Epidemiology and Field Services Program, and the Centers for Disease Control and Prevention (PS08-80202, #U62/CCU223595).
Competing interests None declared.
Patient consent Not required.
Ethics approval This study was deemed 'Public Health Surveillance that is Non-Research' by the Institutional Review Board (IRB) at the NYC DOHMH.
Provenance and peer review Not commissioned; externally peer reviewed.