Networks of transmission: Exploring methicillin resistant Staphylococcus aureus among New York City men who have sex with men

Objectives: A 2005 a population-based study by the NYC Department of Health and Mental Hygiene showed that, among patients diagnosed by a large commercial laboratory serving private clinicians, 58 percent of the men interviewed reported having sex with a man in the previous year suggesting that men who have sex with men (MSM) in NYC are disproportionately diagnosed with methicillin resistant Staphylococcus aureus (MRSA). We undertook a qualitative study to investigate behaviors, perceptions and knowledge surrounding MRSA transmission among MSM in NYC.

Methods: Recruitment for this study incorporated a purposeful sampling approach, recruiting subjects who could speak about personal experiences with MRSA, the perception of MRSA transmission within the community, and social service resources available to MSM. In-depth interviews were conducted with thirteen MSM who previously reported a MRSA infection and with nine community practitioners who serve MSM populations. We conducted a thematic analysis of these in-depth interviews.

Results: We delineated three main themes associated with MRSA infection: a connection to “party and play” (PNP) activities, misinformation surrounding transmission, and home treatments that compromise skin integrity. The main finding notes that both participants and practitioners perceived transmission to have been driven by specific high-risk behaviors including methamphetamine use, barebacking, group sex activities, and shared use of contaminated items.

Conclusions: The data suggests that behaviors and exposures associated with transmission of MRSA are common in certain MSM social networks, in particular those who engage in PNP activities. Future intervention strategies would benefit by targeting these social networks within the MSM community.