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Factors associated with sexual risk behaviors with non-steady partners and lack of recent HIV testing among German men who have sex with men in steady relationships: results from a cross-sectional internet survey.

Kramer SC, Drewes J, Kruspe M, Marcus U - BMC Public Health (2015)

Bottom Line: In multivariate analyses (n = 1304), participants were statistically more likely to belong to the outcome group if they reported UAI with their steady partner in the past year (OR = 2.21), did not know their steady partner's HIV status (OR = 1.98), or agreed that condoms were disruptive during sex (OR = 3.82 (strongly agree), OR = 2.19 (agree)).Participants in the outcome group were more likely to say they would use HIV home tests (OR = 1.58) or pre-exposure prophylaxis (OR = 2.11).In particular, we highlight the need for multifaceted interventions focusing not only on members of the at-risk community themselves, but on communities as a whole.

View Article: PubMed Central - PubMed

Affiliation: Department for Infectious Disease Epidemiology, HIV/AIDS, STI and Blood-borne Infections Unit, Robert Koch Institute, Berlin, Germany. KramerS@rki.de.

ABSTRACT

Background: Recent evidence suggests that the majority of HIV transmissions among men who have sex with men (MSM) occur between steady partners. We sought to determine factors associated with HIV transmission risks in steady partnerships.

Methods: Data is from the German cross-sectional 2013 Gay Men and AIDS survey. The study population was HIV-negative or untested men reporting a steady partnership and at least one non-steady anal sex partner in the previous year. Bivariate and multivariate logistic regression was used to determine which of several independent variables best predicted both unprotected anal intercourse (UAI) with a non-steady partner and lack of HIV testing in the past year (high-risk outcome group).

Results: The study population consisted of 1731 men. Among individuals in the outcome group (n = 271), 67% reported UAI with a non-steady partner of unknown status and 9% reported UAI with a non-steady HIV-positive partner in the past 12 months; 55% considered themselves to be at low risk for HIV acquisition. In multivariate analyses (n = 1304), participants were statistically more likely to belong to the outcome group if they reported UAI with their steady partner in the past year (OR = 2.21), did not know their steady partner's HIV status (OR = 1.98), or agreed that condoms were disruptive during sex (OR = 3.82 (strongly agree), OR = 2.19 (agree)). Participants were less likely to belong to the outcome group if they were out to their primary doctor (OR = 0.54), were well-educated about post-exposure prophylaxis (OR = 0.46), had sought information on HIV in the past year and kept condoms in an accessible place (OR = 0.20), or believed that insisting on condoms would lead partners to assume they were HIV-negative (OR = 0.20). Participants in the outcome group were more likely to say they would use HIV home tests (OR = 1.58) or pre-exposure prophylaxis (OR = 2.11).

Conclusions: Based on our results, we reflect on HIV prevention measures that should be improved in order to better target behaviors that may lead to HIV transmission between MSM in steady relationships. In particular, we highlight the need for multifaceted interventions focusing not only on members of the at-risk community themselves, but on communities as a whole.

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Related in: MedlinePlus

Reasons for never testing and not testing in past 5 years. This figure displays the reasons endorsed by 99 participants who indicated that they had never been tested for HIV, as well as those reasons selected by 53 participants who indicated that their last HIV test occurred over 5 years before beginning the survey. Participants were allowed to select multiple responses
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Fig1: Reasons for never testing and not testing in past 5 years. This figure displays the reasons endorsed by 99 participants who indicated that they had never been tested for HIV, as well as those reasons selected by 53 participants who indicated that their last HIV test occurred over 5 years before beginning the survey. Participants were allowed to select multiple responses

Mentions: Among the 271 individuals in our outcome group, 99 reported never testing and 53 reported that their last test was more than 5 years ago. Among both groups, the most frequently reported reason for never testing was not thinking one was infected, despite previous risk behavior. Another common reason reported was that participants did not believe they were at risk of contracting HIV. Many individuals also reported that they believed themselves to be HIV-negative because their steady partner was, despite having UAI with non-steady partners, or that they were afraid of testing positive. Individuals who had never tested in particular reported not wanting to discuss their sexual behaviors (Fig. 1).Fig. 1


Factors associated with sexual risk behaviors with non-steady partners and lack of recent HIV testing among German men who have sex with men in steady relationships: results from a cross-sectional internet survey.

Kramer SC, Drewes J, Kruspe M, Marcus U - BMC Public Health (2015)

Reasons for never testing and not testing in past 5 years. This figure displays the reasons endorsed by 99 participants who indicated that they had never been tested for HIV, as well as those reasons selected by 53 participants who indicated that their last HIV test occurred over 5 years before beginning the survey. Participants were allowed to select multiple responses
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4513622&req=5

Fig1: Reasons for never testing and not testing in past 5 years. This figure displays the reasons endorsed by 99 participants who indicated that they had never been tested for HIV, as well as those reasons selected by 53 participants who indicated that their last HIV test occurred over 5 years before beginning the survey. Participants were allowed to select multiple responses
Mentions: Among the 271 individuals in our outcome group, 99 reported never testing and 53 reported that their last test was more than 5 years ago. Among both groups, the most frequently reported reason for never testing was not thinking one was infected, despite previous risk behavior. Another common reason reported was that participants did not believe they were at risk of contracting HIV. Many individuals also reported that they believed themselves to be HIV-negative because their steady partner was, despite having UAI with non-steady partners, or that they were afraid of testing positive. Individuals who had never tested in particular reported not wanting to discuss their sexual behaviors (Fig. 1).Fig. 1

Bottom Line: In multivariate analyses (n = 1304), participants were statistically more likely to belong to the outcome group if they reported UAI with their steady partner in the past year (OR = 2.21), did not know their steady partner's HIV status (OR = 1.98), or agreed that condoms were disruptive during sex (OR = 3.82 (strongly agree), OR = 2.19 (agree)).Participants in the outcome group were more likely to say they would use HIV home tests (OR = 1.58) or pre-exposure prophylaxis (OR = 2.11).In particular, we highlight the need for multifaceted interventions focusing not only on members of the at-risk community themselves, but on communities as a whole.

View Article: PubMed Central - PubMed

Affiliation: Department for Infectious Disease Epidemiology, HIV/AIDS, STI and Blood-borne Infections Unit, Robert Koch Institute, Berlin, Germany. KramerS@rki.de.

ABSTRACT

Background: Recent evidence suggests that the majority of HIV transmissions among men who have sex with men (MSM) occur between steady partners. We sought to determine factors associated with HIV transmission risks in steady partnerships.

Methods: Data is from the German cross-sectional 2013 Gay Men and AIDS survey. The study population was HIV-negative or untested men reporting a steady partnership and at least one non-steady anal sex partner in the previous year. Bivariate and multivariate logistic regression was used to determine which of several independent variables best predicted both unprotected anal intercourse (UAI) with a non-steady partner and lack of HIV testing in the past year (high-risk outcome group).

Results: The study population consisted of 1731 men. Among individuals in the outcome group (n = 271), 67% reported UAI with a non-steady partner of unknown status and 9% reported UAI with a non-steady HIV-positive partner in the past 12 months; 55% considered themselves to be at low risk for HIV acquisition. In multivariate analyses (n = 1304), participants were statistically more likely to belong to the outcome group if they reported UAI with their steady partner in the past year (OR = 2.21), did not know their steady partner's HIV status (OR = 1.98), or agreed that condoms were disruptive during sex (OR = 3.82 (strongly agree), OR = 2.19 (agree)). Participants were less likely to belong to the outcome group if they were out to their primary doctor (OR = 0.54), were well-educated about post-exposure prophylaxis (OR = 0.46), had sought information on HIV in the past year and kept condoms in an accessible place (OR = 0.20), or believed that insisting on condoms would lead partners to assume they were HIV-negative (OR = 0.20). Participants in the outcome group were more likely to say they would use HIV home tests (OR = 1.58) or pre-exposure prophylaxis (OR = 2.11).

Conclusions: Based on our results, we reflect on HIV prevention measures that should be improved in order to better target behaviors that may lead to HIV transmission between MSM in steady relationships. In particular, we highlight the need for multifaceted interventions focusing not only on members of the at-risk community themselves, but on communities as a whole.

Show MeSH
Related in: MedlinePlus