The Implications of Respondent Concurrency on Sex Partner Risk in a National, Web-Based Study of Men Who Have Sex With Men in the United States

• Type of Material: Article
• Authors: Eli S Rosenberg, Emory University; Richard B. Rothenberg, Georgia State University; David Kleinbaum, Emory University; Robert Stephenson, Emory University; Patrick S Sullivan, Emory University
• Language: English
• Date: 2013-08-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 by Lippincott Williams & Wilkins
• Final Published Version (URL): http://journals.lww.com/jaids/pages/articleviewer.aspx?year=2013&issue=08010&article=00016&type=abstract
• Title of Journal or Parent Work: Journal of Acquired Immune Deficiency Syndromes
• ISSN: 1525-4135
• Volume: 63
• Issue: 4
• Start Page: 514
• End Page: 521
• Grant/Funding Information: Supported by National Institute on Minority Health and Health Disparities (RC1MD004370), National Institute of Mental Health (R01MH085600), Eunice Kennedy Shriver National Institute for Child Health and Human Development (R01HD067111), and NIH P30AI050409—the Emory Center for AIDS Research.
• Keywords: HIV; concurrency methods; concurrency; MSM; sexual risk
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology; Health Sciences, Immunology

Abstract

Background Men who have sex with men (MSM) represent the largest HIV risk-group in the United States. Sexual concurrency catalyzes HIV transmission in populations by increasing the indirect exposure of one’s sex partners to one another. Methods are lacking for understanding the exposure implications for partners (dyads) reported in individual-level (egocentric) designs studies. Methods We developed a technique for measuring the indirect exposure of respondents’ partners to other partners. Two partner-level outcomes were constructed: any concurrent or serially monogamous exposure (‘any exposure’), and any concurrent exposure, irrespective of serial monogamy (‘any concurrent exposure’). Reported unprotected anal intercourse (UAI) was incorporated to calculate outcomes of ‘any UAI exposure’ and ‘any concurrent UAI exposure’. This method was applied to an online study of MSM aged ≥ 18 years, with comparisons made by partner race-ethnicity, age, type, and meeting location. Results Among 4,060 repeat partners of 2,449 MSM, 73% had any exposure in the previous 6 months; 58% had any concurrent exposure. Among UAI partners, 37% had concurrent UAI exposure. Black UAI partners were more likely than white ones to have any concurrent UAI exposure (unadj. OR [95% CI] = 1.34 [1.05, 1.70]), as were casual UAI partners relative to main partners (4.37 [3.58, 5.35]). In adjusted models, black UAI partners were more likely to have any UAI exposure, but not concurrent UAI exposure. Casual UAI partners remained more exposed by both outcomes. Conclusions Sex partners of MSM, particularly casual and black non-Hispanic partners, face a high degree of exposure to other partners.