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

• 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
• Journal Title: PLoS ONE
• Volume: Volume 10, Number 12
• Publisher: Public Library of Science | 2015-12-31, Pages e0146025-e0146025
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1371/journal.pone.0146025
• Subjects: Health Sciences, Health Care Management; Health Sciences, Public Health
• Keywords: Science & Technology; Multidisciplinary Sciences; Science & Technology - Other Topics; NEW-YORK-CITY; AFRICAN-AMERICAN COMMUNITIES; HIV-INFECTION; HEALTH-CARE; SAN-FRANCISCO; WHITE MEN; PERCEIVED DISCRIMINATION; PARTNER CHARACTERISTICS; RACIAL-DISCRIMINATION; SOCIAL DISCRIMINATION

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.