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Abstract
Objectives The objectives are to analyse social determinants of sexual health behaviour (condom use and HIV testing) among young, internet-active, cis men who have sex with men (MSM) in a high-income country. The aspects of sexual health behaviour analysed here are condomless anal intercourse with one or more new or casual partner(s), condomless anal intercourse during the most recent sex with a man and HIV testing.
Methods A randomised sample of men active on Sweden’s main online community for Lesbian, Gay, Bisexual and Trans people responded to an online survey (response rate 19%). A subsample of young people, aged 15–29, was analysed (effective sample 597–669) using multivariable logistic regression with respect to factors associated with condomless anal intercourse with one or more new or casual partner(s), condomless anal intercourse at most recent sex and not having had a test for HIV.
Results Low education, being single and living in a metropolitan area were found to be independently associated with condomless anal intercourse with new or casual partner(s). Sex with a steady partner was associated with condomless anal intercourse during the most recent sex. Knowledge of where to get tested, high education, being born outside Sweden and condomless anal intercourse with new or casual sex partner(s) were independently associated with having been tested for HIV.
Conclusions The factors associated with sexual health behaviour among young MSM are complex, and preventive messages need to be tailored accordingly.
- adolescent
- condoms
- gay men
- HIV testing
- public health
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Footnotes
Handling editor Stefan Baral
Contributors KJ conceived the article, did analyses and drafted the manuscript. KIP participated in data collection and formulation of research question, and critically reviewed the manuscript. CD participated in formulation of research question, and critically reviewed the manuscript. ZEK conceived the article, did analyses and participated in drafting the manuscript. All authors read and approved the final manuscript.
Funding The study was funded by the Public Health Agency of Sweden (grant number 05434/2014), and the data collection was performed by the Public Health Agency in collaboration with Karolinska Institutet and Qruiser QX.
Competing interests The MSM survey was designed and conducted by the Public Health Agency of Sweden, while the analyses and writing of this substudy were done at Umeå University, funded by the Public Health Agency. The funding agency had insight into but no decision over the choice of research question, the analyses, the writing or decision of where to submit. KJ also has ongoing consultancies with the Public Health Agency of Sweden on sexual health issues, unrelated to this study, but her work on this study was done through employment at Umeå University, funded by the Public Health Agency. KIP and CD have employments at the Public Health Agency of Sweden, but participated in this study as part of their affiliations with Karolinska Institutet. Since the Public Health Agency has no vested interest in biasing the results or the research questions in any direction, the close connection with the funding agency should not constitute a problematic conflict of interest. ZEK has nothing to disclose.
Ethics approval Regional Ethics Review Board in Stockholm (Dnr 2013/3:3).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The data from the MSM suvey 2013 are under the responsibility of the Public Health Agency of Sweden.