Sexual Behavior and Network Characteristics and Their Association with Bacterial Sexually Transmitted Infections among Black Men Who Have Sex with Men in the United States

• Type of Material: Article
• Authors: Hyman M. Scott, San Francisco Department of Public Health; Risha Irvin, Johns Hopkins University; Leo Wilton, State University of New York at Binghamton; Hong Van Tieu, New York Blood Center; Chauncey Watson, George Washington University; Manya Magnus, George Washington University; Iris Chen, John Hopkins University; Charlotte Gaydos, John Hopkins University; Sophia Hussen, Emory University; Sharon Mannheimer, Columbia University; Kenneth Mayer, Fenway Institute; Nancy A. Hessol, University of California San Francisco; Susan Buchbinder, San Francisco Department of Public Health
• Language: English
• Date: 2015-12-31
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2015 Scott et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0146025
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 10
• Issue: 12
• Start Page: e0146025
• End Page: e0146025
• Grant/Funding Information: The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.; This project received support from the Hope Clinic of the Emory Vaccine Center CRS and The Ponce de Leon Center CRS: Emory University HIV/AIDS CTU (5U01 AI069418), CFAR (P30 AI050409) and CTSA (UL1 RR025008). Finally, this paper was also supported by the San Francisco Vaccine and Prevention CRS: ARRA funding (3U01 AI069496-03S1, 3U01 AI069496-03S2) in addition to the UCLA Vine Street CRS: UCLA Department of Medicine, Division of Infectious Diseases CTU (U01 AI069424).; HPTN 061 grant support was provided by the National Institute of Allergy and Infectious Disease (NIAID), National Institute on Drug Abuse (NIDA) and National Institute of Mental Health (NIMH): Cooperative Agreements UM1 AI068619, UM1 AI068617, and UM1 AI068613.; Additional site funding was provided by the Fenway Institute CRS: Harvard University CFAR (P30 AI060354) and CTU for HIV Prevention and Microbicide Research (UM1 AI069480). Further support came from the George Washington University CRS: District of Columbia Developmental CFAR (P30 AI087714); Harlem Prevention Center CRS and NY Blood Center/Union Square CRS: Columbia University CTU (5U01 AI069466) and ARRA funding (3U01 AI069466-03S1).
• Keywords: HEALTH-CARE; SOCIAL DISCRIMINATION; RACIAL-DISCRIMINATION; WHITE MEN; PARTNER CHARACTERISTICS; HIV-INFECTION; Multidisciplinary Sciences; Science & Technology - Other Topics; PERCEIVED DISCRIMINATION; NEW-YORK-CITY; AFRICAN-AMERICAN COMMUNITIES; SAN-FRANCISCO; Science & Technology
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Public Health

Abstract

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background: Black men who have sex with men (MSM) have a high prevalence of bacterial sexually transmitted infections (STIs), and individual risk behavior does not fully explain the higher prevalence when compared with other MSM. Using the social-ecological framework, we evaluated individual, social and sexual network, and structural factors and their association with prevalent STIs among Black MSM. Methods: The HIV Prevention Trials Network 061 was a multi-site cohort study designed to determine the feasibility and acceptability of a multi-component intervention for Black MSM in six US cities. Baseline assessments included demographics, risk behavior, and social and sexual network questions collected information about the size, nature and connectedness of their sexual network. Logistic regression was used to estimate the odds of having any prevalent sexually transmitted infection (gonorrhea, chlamydia, or syphilis). Results: A total of 1,553 Black MSM were enrolled in this study. In multivariate analysis, older age (aOR = 0.57; 95% CI 0.49-0.66, p<0.001) was associated with a lower odds of having a prevalent STI. Compared with reporting one male sexual partner, having 2-3 partners (aOR = 1.74; 95% CI 1.08-2.81, p<0.024) or more than 4 partners (aOR = 2.29; 95% CI 1.43-3.66, p<0.001) was associated with prevalent STIs. Having both Black and non-Black sexual partners (aOR = 0.67; 95% CI 0.45-0.99, p = 0.042) was the only sexual network factor associated with prevalent STIs. Conclusions: Age and the number and racial composition of sexual partners were associated with prevalent STIs among Black MSM, while other sexual network factors were not. Further studies are needed to evaluate the effects of the individual, network, and structural factors on prevalent STIs among Black MSM to inform combination interventions to reduce STIs among these men.