Sexual Partner Concurrency and Sexual Risk Among Gay, Lesbian, Bisexual and Transgender American Indian/Alaska Natives

Disproportionately high rates of HIV infection are among the "pervasive health disparities" found among American Indian and Alaska Natives, wrote the authors, who noted, "Sexual network dynamics, including concurrency and sexual mixing patterns, are key determinants of HIV disparities."

Data from the first national study of gay, lesbian, bisexual, and transgender American Indian and Alaska Natives were analyzed to study the prevalence of concurrency, sex and race of partners, and level of risk across different partnership patterns. "Egocentric network data were analyzed at the level of respondents, who were grouped according to the sex of their last three partners," the authors wrote.

In this population, the researchers noted overall high rates of HIV and concurrency. Men who had sex with men exclusively had the highest HIV prevalence (34 percent) and cumulative prevalence of concurrency (55 percent). Concurrency and HIV prevalence were lower among women who had sex with women exclusively. HIV prevalence of 15 percent was found among women who had sex with women and men. These women also had a slightly higher concurrency risk and low rates of condom use, "making them effective bridge populations," the authors wrote.

"The uniformly high rates of Native partner selection creates the potential for amplification of disease spread within this small community, while the high rates of selecting partners of other races creates the potential for bridging to other groups in the transmission network," the researchers concluded. "These findings provide some of the first insights into sexual networks and concurrency among Native gay, lesbian, bisexual, and transgender populations and suggest that both men and women deserve attention in HIV prevention efforts at individual, dyadic, and populations levels."

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