Sexual Mixing Patterns and Partner Characteristics of Black MSM in Massachusetts at Increased Risk for HIV Infection and Transmission

In the current study, the researchers note that black men who have sex with men are at increased risk of HIV infection compared with other MSM. To explore possible reasons for this, the authors investigated sexual mixing patterns, partner characteristics and risk behaviors among black MSM.

Between January and July 2008, researchers enrolled 197 black MSM through modified respondent-driven sampling, and participants completed optional HIV screening, counseling and demographic, behavioral and psychosocial surveys. Bivariate and multivariable logistic regression procedures were used to examine predictors of risky sex across partner types.

Of the MSM, 18 percent were HIV-infected; 50 percent reported unprotected intercourse with men, 30 percent with women, and 5 percent with transgender partners. All reported oral or anal sex with another man in the previous 12 months, and 53 percent self-identified as bisexual or straight.

Significant predictors of having serodiscordant unprotected anal sex (UAS) at least once with a male partner in the previous 12 months were risk of social isolation (adjusted odds ratio [AOR]=4.23; p=0.03); unstable housing (AOR=4.19; p=0.03); and use of poppers at least weekly during sex (AOR=5.90; p=0.05).

Significant predictors of UAS and/or unprotected vaginal intercourse with a female partner include unstable housing (AOR=4.85; p=0.04); cocaine use at least weekly during sex (AOR=16.78; p=0.006); HIV infection (AOR=0.07; p=0.02); and feeling social norms favor condom use (AOR=0.60; p=0.05).

Predictors of UAS with most recent non-main male sex partner include use of alcohol and drugs during last sex (AOR=4.04; p=0.01); Hispanic/Latino male partner (AOR=2.71; p=0.04); or a black male (AOR=0.50; p=0.05) compared with a white male partner; and lower educational attainment (AOR=1.31; p=0.02).

These findings "suggest that sexual risk behaviors of black MSM differ across partner type and by the characteristics of their sexual networks and that this subpopulation of MSM are at high risk for HIV acquisition and transmission," concluded the study authors. "Effective prevention strategies need to address the distinct sexual and behavioral risk patterns presented by different sexual partnerships reported by black MSM."

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