183830 Assessing risk in men who have sex with men (MSM) based on number of sexual partners

Monday, October 27, 2008

Christopher M. Fisher, MA , Center for Sexual Health Promotion, Indiana University, Bloomington, IN
David Koceja, PhD , School of Health, Physical Education and Recreation, Indiana University, Bloomington, IN
Michael Reece, PhD, MPH , Center for Sexual Health Promotion, Indiana University, Bloomington, IN
Brian Dodge, PhD , Center for Sexual Health Promotion, Indiana University, Bloomington, IN
Sonya Satinsky , Center for Sexual Health Promotion, Indiana University, Bloomington, IN
BACKGROUND: Practitioners often associate number of sexual partners with risk of infection for STI including HIV. Little empirical evidence exists to support or refute this belief.

METHODS: Data were collected from 504 MSM in a large Midwestern US city. Variables included number of sexual partners in the past 90 days, STI status within the last 2 years, and unprotected sexual behaviors in the past 90 days as a proxy for HIV risk. Mann-Whitney tests were conducted to test for differences in number of sexual partners. Only sexually active respondents were included (n = 403; range = 1 to 20 partners).

RESULTS: Men engaging in unprotected anal sex (receptive, n = 169; insertive, n = 181) and oral sex without a condom (n = 355) were not significantly more likely to have more or less partners than those not engaging in these behaviors (p = 0.865, 0.679, & 0.125, respectively). Those who had chlamydia (n = 14), gonorrhea (n = 26), HPV/genital warts (n = 22) or syphilis (n = 7) had significantly more partners (p < 0.05).

CONCLUSIONS: The results demonstrate the complexity of assessing risk in MSM populations based on number of sexual partners. While higher HIV risk behaviors were not associated with number of partners, several clinical outcomes such as bacterial STI were related to number of partners. Future research should seek to develop a more nuanced understanding of these complexities based on number of partners as well as behavioral mechanisms.

Learning Objectives:
Differentiate between risk associated with number of partners and riskier behavior Discuss implications of using number of sexual partners for assessing risk in a clinical setting. Elaborate on the complexities of discussing sexual risk with patients/clients.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I earned an MA from San Francisco State University and am pursuing a PhD at Indiana University. I have presented at APHA in the past.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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