Individual and Sexual Network Related HIV and STI Risk among Sexual Minority Men in Jackson, Mississippi

OBJECTIVE: Black MSM are most heavily impacted by HIV in Mississippi (MS), though the factors driving this epidemic in the Deep South remain poorly understood. We examined the individual and partner-level risks among sexual minority men in Jackson, MS.

METHODS: A cross-sectional study was conducted with men (n=492) receiving care at an urban STI clinic in Jackson, MS. Bivariate and GEE analyses, disaggregated by self-reported sexual orientation, identified risk factors associated with HIV infection, including substance abuse, sexual behaviors such as sex with partners at increased risk for HIV (including drug users and HIV-positive individuals), and sexual network characteristics (including age, race/ethnicity, and education) among sexual minority men (10.2%) compared to heterosexual men (89.8%).

RESULTS: The overall prevalence for chlamydia and gonorrhea were 22.5% and 6.2%, respectively, whereas self-reported past history of any STI was 26.6% for men. Compared to heterosexual men, sexual minority men were more likely to report having sex with a partner at increased risk for HIV (OR 4.13, 95%CI  2.17-7.87). Regarding partner-level risk factors, sexual minority men were more likely to have an older partner (OR 2.06, 95%CI 1.23-3.45) and report having one-time sexual encounters (OR 1.57, 95%CI 1.03-2.39) compared to heterosexual men.

CONCLUSIONS: Sexual minority men reported high levels of sex with a partner at increased risk for HIV, in addition to other sexual network related risks for HIV compared to heterosexual men. Complex individual and partner-level risks may contribute to high rates of STIs and HIV infection among sexual minority men in the South.