Correlates of concurrent sexual partnering among heterosexually active homeless men

Background: Homeless men are at increased risk for HIV. Concurrent sexual partnering accelerates the risk of HIV transmission, but concurrency has received little attention in this population. This cross-sectional study investigates individual and social correlates of concurrent sexual partnering among heterosexually active homeless men.

Methods: We interviewed a representative probability sample of 305 homeless, heterosexually active men from 13 meal programs in Los Angeles. Study eligibility included having had sex with a woman in the past six months. We used logistic regression analysis to examine individual-level and social network-level correlates of concurrent sexual partnering (i.e. having two or more partners within the past 3 weeks) during a past 6 month period.

Results: 34% of men had had concurrent sexual partnerships in the past 6 months. Men who engaged in binge drinking, hard drug use, and who had symptoms of PTSD and depression had greater odds of concurrency. Men who reported that their sex partners used alcohol and drugs, and men who perceived that the members of their social network engaged in a variety of sexual risk behaviors, also had greater odds of engaging in concurrent sexual partnering.

Conclusions: Characteristics of the individual and his social environment may be risk factors for concurrency among heterosexually active homeless men. Attention to concurrency should be accompanied by attention to mental health and substance use among the men and their partners and to the social environments in which the men live. Multi-faceted interventions are needed to reduce HIV risk among homeless men.