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Sexual Partnership Types as Determinant of HIV Risk in South African MSM: An Event-Level Cluster Analysis

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Abstract

While individual determinants of HIV risk among MSM have been widely studied, there is limited understanding of how relational characteristics determine sexual risk. Based on data collected among 300 South African men who have sex with men (MSM) and using cluster analysis, this study developed a typology of four partnership types: the “Race–Economic Similar,” “Age–Race–Economic Discordant,” “Non-regular Neighbourhood,” and “Familiar” partnership types. Support for the meaningfulness of these types was found through associations of these partnership types with participant characteristics and characteristics of the last anal sex event. Furthermore, in a multivariate analysis, only partnership type independently predicted whether the last anal sex event was unprotected. Findings of the study illustrate the importance of taking into account the relational context in understanding unprotected sexual practices and present ways to target intervention efforts as well as identify relationship specific determinants of unprotected sex.

Resumen

Aunque los determinantes de riesgos individuales de VIH en HSH han sido ampliamente estudiados, existe un conocimiento limitado de como las características de las relaciones de parejas determinan el riesgo sexual. Basado en los datos recolectados entre 300 hombres sudafricanos que tienen sexo con hombres (HSH) y usando un análisis de agrupamiento, este estudio elaboró una tipología de cuatro tipos de relaciones: “Racial-Económica Similar,” “Edad-Racial-Económica Discordante,” “No del mismo Barrio,” y “Familiar.” Lo validez de estos tipos de relaciones fue encontrada a través de las asociaciones de estas parejas con las características de los participantes y características del último evento de sexo anal. Además, en el análisis multivariado, solamente el tipo de pareja predijo de forma independiente si el último evento de sexo anal fue sin protección. Los resultados de este estudio ilustran la importancia de tener en cuenta el contexto de la relación de pareja en la comprensión de las prácticas sexuales sin protección y presenta maneras de fijar esfuerzos de intervención así como identificar determinantes de las relaciones específicas del sexo sin protección.

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Acknowledgments

The study was supported by a grant from amfAR (106973; Principal Investigator: Theo Sandfort, Ph.D.) with additional support from a grant from the National Institute of Mental Health to the HIV Center for Clinical and Behavioral Studies (P30-MH43520; Principal Investigator: Anke E. Ehrhardt, Ph.D.). This research was further supported by a training grant from the National Institute of Mental Health (T32-MH19139, Behavioral Sciences Research in HIV Infection; Principal Investigator: Theo Sandfort, Ph.D.). We would like to thank the men who participated in the study and OUT Well-being, Pretoria, in particular Dawie Nel and Senku Maimane, for support in the implementation of the study.

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Authors and Affiliations

  1. HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA

    Theo Sandfort & Justin Knox

  2. School of Public Health and Primary, The Chinese University of Hong Kong Care, Hong Kong, China

    Huso Yi

  3. Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA

    Justin Knox

  4. Human and Social Development, Human Sciences Research Council and University of KwaZulu-Natal, Pretoria, South Africa

    Vasu Reddy

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  1. Theo Sandfort
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Correspondence to Theo Sandfort.

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Sandfort, T., Yi, H., Knox, J. et al. Sexual Partnership Types as Determinant of HIV Risk in South African MSM: An Event-Level Cluster Analysis. AIDS Behav 17 (Suppl 1), 23–32 (2013). https://doi.org/10.1007/s10461-012-0294-y

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