O18.4 Uncovering Risky Networks: Risk Behaviors, Sexual Partnerships, and Provider Discussions Among Men Who Have Sex with Men and Women (MSMW)
Year: 2021
Type: conference-abstract
Abstract: Background Differences in sexual networks and risk behaviors between MSM and MSMW have important implications for HIV/STI transmission networks and bridging to other populations. As most HIV/STI programming is directed toward MSM, understanding risk behaviors, healthcare provider discussions, and network factors differentially experienced by MSMW are critical toward developing targeted, efficacious HIV/STI prevention paradigms. Methods This is an analysis of a longitudinal cohort of predominantly Black/Latinx MSM in Los Angeles, California, half with substance use and half with HIV. Every 6 months from 8/2014–1/2019, respondents completed surveys evaluating the following: discussion of sexual orientation/behavior with healthcare provider in last 6 months, transactional sex, and last partnership characteristics (type, gender of partner’s sexual partners, HIV serostatus). MSMW was defined as self-reported sexual intercourse with a woman during last 6 months on two separate visits. Generalized estimating equations evaluated differences between MSM and MSMW associated with healthcare provider discussions, transactional sex, and last partnership characteristics, controlling for HIV and demographics. Results Among 431 participants across 1,258 visits, 9.3% (40/431) of participants were MSMW and 90.7% MSM. 30% of MSMW were living with HIV (12/40) compared to 52.4% (205/391) of MSM (p=0.007). In adjusted analysis, MSMW had higher odds of: not discussing sexual orientation/behavior with healthcare providers (AOR 2.19; 95% CI 1.10–4.35), unknown last partner HIV serostatus (2.19; 1.23–3.89), transactional sex (4.35; 2.27–8.36) and last partner also being MSMW (2.10; 1.10–4.02), compared to MSM. Conclusion Despite riskier behaviors for HIV/STI transmission, MSMW had lower odds of discussing these behaviors with their healthcare providers, representing potentially missed opportunities for HIV/STI screening and prevention. Additionally, MSMW had higher odds of having MSMW sexual partners, suggestive of high-risk MSMW sexual networks that may not be uncovered in routine patient-provider discussions and should be prioritized in HIV/STI interventions designed to reduce barriers and facilitate linkages to care.
Authors: C Blair, M Javanbakht, S Shoptaw, P Gorbach
Institution: University of California, Los Angeles
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W3182215994