The authors conducted this study to assess whether young black and Latino men who have sex with men who have older sex partners are more likely than MSM who do not have older partners to have unrecognized HIV infection. The team examined whether the association is due to increased sexual risk behavior with male partners of any age, heightened risk of being exposed to HIV by older partners, or a combination of these two factors.
Included in the analytical sample were 723 black and Latino MSM ages 18-35. At study entry, all were HIV-negative or of unknown serostatus. Participants underwent HIV testing and completed a self-administered questionnaire. MSM who reported a male sex partner at least four years older were compared with those who did not. Study outcomes included unprotected receptive anal intercourse (URAI) with male partners of any age during the past three months, and having unrecognized HIV infection.
A higher prevalence of URAI was reported by men with older partners (adjusted odds ratio=1.50, 95 percent confidence interval 1.02 to 2.21.) A second model showed men with older partners had increased odds of having unrecognized HIV infection (AOR=2.51, 95 percent CI 1.18 to 5.34), after controlling for the number of URAI partners of any age, which remained an independent predictor.
"Young black and Latino MSM who had older male sex partners were at increased risk of having unrecognized HIV infection," the authors concluded. "This heightened risk was associated with sexual risk behavior with partners of any age as well as possible increased exposure to HIV infection from older partners."