244582 Correlates of unprotected vaginal and/or anal sex with female partners among urban, drug-using, men who have sex with men and women: Results from project MIX

Monday, October 31, 2011

Emily Greene, MPH , Urban Public Health, Hunter College, New York, NY
Victoria A. Frye, DrPH , Laboratory of Social and Behavioral SciencesProgram, New York Blood Center, New York, NY
Gordon Mansergh, PhD , Division of HIV/AIDS Prevention, CDC, Atlanta, GA
Grant Colfax, MD , AIDS Office, HIV Prevention Section, San Francisco Department of Public Health, San Francisco, CA
Sharon M. Hudson, PhD , Research and Evaluation Department, Kaiser Permanente Southern California, Pasadena, CA
David McKirnan, PhD , Department of Psychology, University of Illinois at Chicago, Chicago, IL
Donald R. Hoover , Statistics & Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ
Beryl Koblin, ScM, PhD , Laboratory of Infectious Disease Prevention, The New York Blood Center, New York, NY
Background: The role of men who have sex with men and women (MSMW) in heterosexual HIV transmission is not well understood. Methods: We analyzed baseline data from 2,013 substance-using men who have sex with men (MSM) recruited for Project MIX, a multi-site HIV prevention intervention trial, conducted between 2005 and 2006 in Chicago, Los Angeles, New York, and San Francisco. Using regression techniques, we identified correlates of unprotected vaginal and/or anal intercourse with women (UVAI) among the MSMW sample. Results: Approximately 10% (N=194) of MSM reported vaginal/anal sex with a woman in the past 3 months; of these MSMW, 66% (N=129) reported UVAI. Of these 129 MSMW who reported UVAI, 36% (47) had been HIV-positive for at least six months prior to the baseline assessment. Multivariate analyses found MSMW who were unemployed (OR=2.28; CI 1.01, 5.17), had a primary female partner (OR=3.44; CI 1.4, 8.46), higher treatment optimism (OR=1.73; CI 1.18, 2.54) had increased odds of reporting UVAI in the past three months. Strong feelings of connection to a same-race gay community (OR=0.71; CI 0.56, 0.91) and erectile-dysfunction medication use (OR=0.31; CI 0.10, 0.95) decreased odds of reporting UVAI. Participant HIV status was not statistically significantly associated with UVAI. Conclusions: In this sample of MSMW, several critical factors, including female partner status and treatment optimism, emerged as associated with UVAI with female partners. Further research, recruiting MSMW specifically, is needed to inform HIV prevention interventions for high-risk MSMW to reduce transmission risk behaviors to female partners.

Learning Areas:
Public health or related research

Learning Objectives:
1. Compare sociodemographic factors of MSM and MSMW among a sample of urban, substance-using men. 2. List five correlates of unprotected vaginal and/or anal sex with women among urban, substance-using men who have sex with men and women. 3. Identify weaknesses in recruitment mechanisms for MSMW as a sub-sample of MSM.

Keywords: Bisexual, HIV Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted this analysis and have several years of research experience both in the bench sciences and epidemiology. Further, I recently graduated with an MPH, specializing in epidemiology.
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.