Sexual Risk Behaviors of HIV-Positive, HIV-Negative, and Serostatus-Unknown Black Men Who Have Sex with Men and Women

Research and Evaluation, Philadelphia Health Management Corp., 260 S. Broad St., 18th Floor, Philadelphia, PA 19102, USA.
Archives of Sexual Behavior (Impact Factor: 3.53). 10/2008; 37(5):708-19. DOI: 10.1007/s10508-008-9365-6
Source: PubMed


Black men who have sex with men and women (MSMW) are at high risk for HIV infection and transmission. This study compared the sexual risk behaviors of Black MSMW who self-reported being HIV-positive with those who reported being HIV-negative and those who did not know their HIV status. Respondent-driven sampling (RDS) was used to recruit 1,154 Black MSM in Philadelphia and New York who completed an audio computer-assisted self-interview (ACASI). Of these men, 212 had engaged in anal sex with male partners and vaginal or anal sex with female partners in the past 3 months. A quarter (23.6%; n = 50) of MSMW self-reported testing positive for HIV at their last test, 59.4% (n = 126) reported testing negative for HIV at their last test, and 17.0% (n = 36) reported never having an HIV test. Multivariate logistic regression analysis revealed that HIV-positive MSMW were much less likely than HIV-negative men and never-tested men to have engaged in unprotected intercourse with main male and main female partners perceived to be HIV-negative or of unknown serostatus. However, HIV-positive men were equally as likely as HIV-negative men to have unprotected intercourse with non-main male and non-main female partners perceived as HIV-negative or of unknown serostatus. Our findings indicate that some HIV-positive MSMW engage in unprotected sex that places female and male partners at risk for HIV infection. However, MSMW who have never taken an HIV test, or who have not been recently tested, may be a greater source of HIV transmission to their female and male partners.

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    • "HIV-positive GBM by looking at multiple layers of influence (individual, community, and structural). Previous research has also demonstrated that GBM who do not know their HIV status are more likely to report greater HIV risk (Lauby et al., 2008). A systematic review of qualitative evidence suggested several reasons GBM do not know their status (Lorenc et al., 2011). "
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    • "We also found HIV-positive men were more likely to report having HIV-positive main and casual partners than HIV-negative men. The use of serosorting (i.e., choosing to have sex with only HIV-infected partners) as a strategy to reduce HIV transmission has been documented in several studies (Elford, Bolding , Sherr, & Hart, 2007; Lauby et al., 2008). While HIVpositive serosorting does not present a risk of HIV transmission to uninfected persons, it does present additional risks that may not be well known within the AAMSM community. "
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