Condom Use during Most Recent Anal Intercourse Event among a US Sample of Men Who Have Sex with Men

Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA.
Journal of Sexual Medicine (Impact Factor: 3.15). 02/2012; 9(4):1037-47. DOI: 10.1111/j.1743-6109.2012.02650.x
Source: PubMed

ABSTRACT Recent nationally representative data documenting event-level condom use have included samples that are predominantly heterosexual, resulting in limited information on rates of condom use for penile-anal intercourse (PAI) among men who have sex with men (MSM).
This study sought to document the demographic and event-specific situational factors associated with condom use during most recent PAI among MSM.
Data were collected via an Internet survey from 14,750 MSM (ages 18-87 years) from 50 U.S. states and the District of Columbia.
Measures included items related to sociodemographics, recent sexual behavior history, event characteristics, condom use, and items associated with ejaculation during the event.
Participants' median age was 39.0 years; race/ethnicities included white (83.2%), Latino (7.2%), and African American (3.9%), and most men (85.3%) identified as homosexual. Age (P ≤ 0.001), race/ethnicity (P ≤ 0.001), partner status (P ≤ 0.001), and location of sexual event (P ≤ 0.001) were all significantly related to the likelihood of condom use during men's most recent PAI with another man. In total, only 2.5% of the entire sample reported that ejaculation occurred in their own or their sexual partner's anus without a condom during most recent PAI.
This study provides a large-scale assessment of condom use during the most recent PAI among MSM in the United States. Findings from this study highlight diversity in condom use behaviors and demonstrate varying degrees of potential risk for human immunodeficiency virus and other sexually transmitted infections. Future prevention efforts should consider contextual components of condom use, including partner type, location of the sexual event, and semen exposure, to more accurately develop individualized risk reduction strategies.

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    • "However, these individual-level correlates are not universal predictors across all YMSM. Although Black YMSM have the highest incidence of HIV infection, they are more likely to use condoms, have fewer sex partners, and use drugs and alcohollessfrequentlythanotherracial/ethnicYMSM(Clerkin,Newcomb , & Mustanski, 2011; Millett, Flores, Peterson, & Bakeman, 2007; Mustanski & Newcomb, 2013; Newcomb, Ryan, Greene, Garofalo, & Mustanski, 2014b; Rosenberger et al., 2012). Thus, individual-level factors cannot be the only predictors of HIV acquisition, and we must therefore investigate other explanations , including the roles that dyadic interactions, network characteristics , and neighborhood-level factors play. "
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    ABSTRACT: The rising incidence of HIV infection among young men who have sex with men (YMSM) is a substantial public health concern. Traditional research on HIV among YMSM has focused largely on individual-level predictors and infrequently accounts for contextual or neighborhood-level factors such as ethnic composition and socioeconomic status. This study used neighborhood-level data from the US Census and other public sources, and individual-level data from a longitudinal cohort of YMSM in Chicago (Crew 450). Of the original 450 YMSM in the cohort, 376 reported living in Chicago (83.6 %) and were included in the analytic sample. A clustering approach was used to group the 77 community areas together by common characteristics, resulting in the identification of 11 distinct clusters. An unconditional model of individual HIV status indicated a significant amount of variance existed between neighborhood clusters (χ (2) = 21.66; p = 0.006). When individual-level variables were added to the model, only having an HIV-positive sex partner (OR = 6.41; CI 2.40, 17.1) and engaging in exchange sex in the past 6 months (OR = 3.25; 95 % CI 1.33, 7.93) were significant predictors of HIV status. Clusters with higher Walk Scores were less likely to contain HIV-positive individuals (OR = 0.94; 95 % CI 0.90, 0.98). Conversely, clusters with a larger proportion of vacant buildings were more likely to contain HIV-positive individuals (OR = 1.19; 95 % CI 1.07, 1.33). Future research among YMSM needs to investigate the mechanisms by which neighborhood of residence might influence engagement in risk behaviors or acquisition of HIV.
    Archives of Sexual Behavior 07/2015; 44(7). DOI:10.1007/s10508-014-0459-z · 3.53 Impact Factor
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    • "The type of sexual relationship, established or casual, has been found to influence condom use and nonuse with many individuals highlighting theneed to preventpregnancy,to preventdisease , or to prevent both (Hensel, Stupiansky, Herbenick, Dodge, & Reece, 2012). Relationship type has been found to impact condom use or nonuse in a wide range of samples, including probability (Bauman, Karasz, & Hamilton, 2007; Corbett, Dickson-Gómez , Hilario, & Weeks, 2009; Noar et al., 2012; Rosenberger et al., 2012; Sanders et al., 2010). Reasons for condom nonuse in numerous forms of relationships have been found to include perceived monogamy, perceived minimal threat for HIV/STI, or the current utilization of other forms of birth control (Civic, 2000; Reece et al., 2010; Seal & Palmer-Seal, 1996). "
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    ABSTRACT: Although frequently cited as being at high risk for HIV/STI transmission, little is known about behaviorally bisexual men's patterns and experiences of condom use and nonuse with male and female sexual partners. Using a variety of recruitment techniques informed by a Community Advisory Committee, a total of 77 behaviorally bisexual men were recruited from Indianapolis, Indiana to participate in semi-structured interviews focused on sexual health. Qualitative data were collected containing detailed information on their patterns and experiences of condom use and nonuse with both male and female partners. Participants described numerous commonly reported barriers for consistent condom use, as well as distinct bisexual-specific barriers. The majority reported consistent condom use with male and female casual partners, but many who did not use condoms described doing so in the context of ongoing relationships. In addition, participants provided reasons for condom use and nonuse that varied based on the gender of the partner and the type of relationship with the partner. Future interventions focused on increasing condom use among behaviorally bisexual men should take into account the unique complexities of gender and relationship configurations in this distinct population.
    Archives of Sexual Behavior 08/2013; 43(4). DOI:10.1007/s10508-013-0147-4 · 3.53 Impact Factor
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