Hightow LB, Leone PA, Macdonald PD, McCoy SI, Sampson LA, Kaplan AH. Men who have sex with men and women: a unique risk group for HIV transmission on North Carolina College campuses

Department of Medicine, University of North Carolina at Chapel Hill, USA.
Sex Transm Dis (Impact Factor: 2.84). 11/2006; 33(10):585-93. DOI: 10.1097/01.olq.0000216031.93089.68
Source: PubMed


To better understand the role that men who have sex with men and women (MSM/W) play in the spread of HIV in young adults in North Carolina, we determined the prevalence of MSM/W among newly diagnosed HIV-infected men, compared social and behavioral characteristics of this group with MSM and MSW, and examined the sexual networks associated with HIV-infected college students among these groups.
We reviewed state HIV surveillance records for all new diagnoses of HIV in males 18 to 30 years living in North Carolina between January 1, 2000, and December 31, 2004.
Of 1,105 records available for review, 15% were MSM/W and 13% were college students. Compared with MSM, MSM/W were more likely to be enrolled in college, to report >10 sex partners in the year before diagnosis, or have sex partners who were also MSM/W. Sexual network analysis of the HIV-infected college students revealed that MSM/W occupied a central position. Of 20 individuals who described themselves as either MSW or abstinent at the time of their initial voluntary counseling and testing visit, 80% reported that they were either MSM or MSM/W during follow up.
MSM/W represent a unique risk group within the population of MSM that deserve further investigation. College MSM/W appear to occupy a unique, central place in the network of HIV-infected students.

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    • "Hightow and colleagues (2006) examined state-wide surveillance records on new HIV diagnoses among young men, 18Á30 years old living in a southeast state in the USA. The study described an epidemic of HIV infection occurring in college students, primarily involving a unique risk group for HIV transmission in black college campuses among men who have sex with men and also women (Hightow et al., 2006). The HIV/AIDS epidemic has been a health crisis in the USA with African Americans. "

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    • "Previous studies suggest that men who have sex with men and women (MSMW) may play an important role in HIV transmission because of their bisexual behavior (Aral, 2000; Hightow et al., 2006; Potterat, Rothenberg, & Muth, 1999). By examining sexual network of HIVinfected male college students in North Carolina, Hightow and colleagues found that MSMW occupied ''a central position'' within the network (Hightow et al., 2006). In the study, MSM-only and heterosexual *Corresponding author. "
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    ABSTRACT: Data from 307 young migrant men who have sex with men (MSM) in Beijing were analyzed to examine bisexual behavior and the associated sociodemographic and behavioral factors among Chinese young migrant MSM. More than one-fourth (27%) of the MSM were also concurrently engaged in sexual behavior with women (MSMW). Among MSMW, 8.4% were infected with HIV, and 10.8% with Syphilis, compared to 4.9% and 23.7%, respectively, among men who have sex with men only (MSM-only). Various HIV-related risk behaviors among MSMW were similar to those of MSM-only, such as unprotected anal sex, multiple sexual partners, involvement in commercial sex, and substance use. Compared with MSM-only, MSMW were less likely to have tested for HIV, to participate in HIV prevention activities, and were less knowledgeable about condom use and HIV/AIDS. MSMW also had a higher rate of unprotected sex with female stable sexual partners than with male stable sexual partners (79.5% vs. 59.5%). Results indicated that MSMW were at a very high risk for both HIV infection and transmission. Intervention efforts are needed to target this subgroup of MSM and promote AIDS knowledge and HIV/STD testing among MSMW, and to reduce HIV transmission through MSM's bisexual behavior.
    AIDS Care 11/2011; 24(4):451-8. DOI:10.1080/09540121.2011.613914 · 1.60 Impact Factor
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    • "Several recent studies have specifically compared HIV-positive MSMW and MSM (Hightow, Leone, MacDonald, McCoy, & Sampson, 2006; Knight et al., 2007; Lauby et al., 2008; Montgomery, Mokotoff, Gentry, & Blair, 2003; Mutchler et al., 2008; O’Leary, Purcell, Remien, Fisher, & Spikes, 2007). These studies found that HIV-positive MSMW and MSM were different on some key variables, but not on others. "
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    ABSTRACT: This study examined demographic characteristics, sexual risk behaviors, sexual beliefs, and substance use patterns in HIV-positive, methamphetamine-using men who have sex with both men and women (MSMW) (n = 50) as compared to men who have sex with men only (MSM) (n = 150). Separate logistic regressions were conducted to predict group membership. In the final model, of 12 variables, eight were independently associated with group membership. Factors independently associated with MSMW were acquiring HIV through injection drug use, being an injection drug user, using hallucinogens, using crack, being less likely to have sex at a bathhouse, being less likely to be the receptive partner when high on methamphetamine, having greater intentions to use condoms for oral sex, and having more negative attitudes about HIV disclosure. These results suggest that, among HIV-positive methamphetamine users, MSMW differ significantly from MSM in terms of their HIV risk behaviors. Studies of gay men and HIV often also include bisexual men, grouping them all together as MSM, which may obscure important differences between MSMW and MSM. It is important that future studies consider MSM and MSMW separately in order to expand our knowledge about differential HIV prevention needs for both groups. This study showed that there were important differences in primary and secondary prevention needs of MSM and MSMW. These findings have implications for both primary and secondary HIV prevention among these high-risk populations.
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