Sex Practices by HIV Awareness and Engagement in the Continuum of Care Among MSM

A National HIV Behavioral Surveillance Analysis in 21 U.S. Cities

Behavioral Surveillance Team, for the NHBS study group

Research output: Contribution to journalArticle

Abstract

Using National HIV Behavioral Surveillance (NHBS) cross-sectional survey and HIV testing data in 21 U.S. metropolitan areas, we identify sex practices among sexually active men who have sex with men (MSM) associated with: (1) awareness of HIV status, and (2) engagement in the HIV care continuum. Data from 2008, 2011, and 2014 were aggregated, yielding a sample of 5079 sexually active MSM living with HIV (MLWH). Participants were classified into HIV status categories: (1) unaware; (2) aware and out of care; (3) aware and in care without antiretroviral therapy (ART); and (4) aware and on ART. Analyses were conducted examining sex practices (e.g. condomless sex, discordant condomless sex, and number of sex partners) by HIV status. Approximately 30, 5, 10 and 55% of the sample was classified as unaware, aware and out of care, aware and in care without ART, and aware and on ART, respectively. Unaware MLWH were more likely to report condomless anal sex with a last male partner of discordant or unknown HIV status (25.9%) than aware MLWH (18.0%, p value OpenSPiltSPi 0.0001). Unaware MLWH were 3 times as likely to report a female sex partner in the prior 12 months as aware MLWH (17.3 and 5.6%, p-value OpenSPiltSPi 0.0001). When examining trends across the continuum of care, reports of any condomless anal sex with a male partner in the past year (ranging from 65.0 to 70.0%), condomless anal sex with a male partner of discordant or unknown HIV status (ranging from 17.7 to 21.3%), and median number of both male and female sex partners were similar. In conclusion, awareness of HIV and engagement in care was not consistently associated with protective sex practices, highlighting the need for continued prevention efforts.

Original languageEnglish (US)
Pages (from-to)840-847
Number of pages8
JournalAIDS and Behavior
Volume22
Issue number3
DOIs
StatePublished - Mar 1 2018

Fingerprint

Continuity of Patient Care
HIV
Sexual Behavior
HIV-2
Therapeutics

Keywords

  • HIV care continuum
  • Human immunodeficiency virus (HIV)
  • Men who have sex with men (MSM)
  • Men who have sex with men and women (MSMW)
  • Sex practices

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Sex Practices by HIV Awareness and Engagement in the Continuum of Care Among MSM : A National HIV Behavioral Surveillance Analysis in 21 U.S. Cities. / Behavioral Surveillance Team; for the NHBS study group.

In: AIDS and Behavior, Vol. 22, No. 3, 01.03.2018, p. 840-847.

Research output: Contribution to journalArticle

@article{18b3326e579c44afb6201a1626ddc877,
title = "Sex Practices by HIV Awareness and Engagement in the Continuum of Care Among MSM: A National HIV Behavioral Surveillance Analysis in 21 U.S. Cities",
abstract = "Using National HIV Behavioral Surveillance (NHBS) cross-sectional survey and HIV testing data in 21 U.S. metropolitan areas, we identify sex practices among sexually active men who have sex with men (MSM) associated with: (1) awareness of HIV status, and (2) engagement in the HIV care continuum. Data from 2008, 2011, and 2014 were aggregated, yielding a sample of 5079 sexually active MSM living with HIV (MLWH). Participants were classified into HIV status categories: (1) unaware; (2) aware and out of care; (3) aware and in care without antiretroviral therapy (ART); and (4) aware and on ART. Analyses were conducted examining sex practices (e.g. condomless sex, discordant condomless sex, and number of sex partners) by HIV status. Approximately 30, 5, 10 and 55{\%} of the sample was classified as unaware, aware and out of care, aware and in care without ART, and aware and on ART, respectively. Unaware MLWH were more likely to report condomless anal sex with a last male partner of discordant or unknown HIV status (25.9{\%}) than aware MLWH (18.0{\%}, p value OpenSPiltSPi 0.0001). Unaware MLWH were 3 times as likely to report a female sex partner in the prior 12 months as aware MLWH (17.3 and 5.6{\%}, p-value OpenSPiltSPi 0.0001). When examining trends across the continuum of care, reports of any condomless anal sex with a male partner in the past year (ranging from 65.0 to 70.0{\%}), condomless anal sex with a male partner of discordant or unknown HIV status (ranging from 17.7 to 21.3{\%}), and median number of both male and female sex partners were similar. In conclusion, awareness of HIV and engagement in care was not consistently associated with protective sex practices, highlighting the need for continued prevention efforts.",
keywords = "HIV care continuum, Human immunodeficiency virus (HIV), Men who have sex with men (MSM), Men who have sex with men and women (MSMW), Sex practices",
author = "{Behavioral Surveillance Team} and {for the NHBS study group} and Whitham, {Hilary K.} and Sansom, {Stephanie L.} and Cyprian Wejnert and Teresa Finlayson and Huang, {Ya lin A.} and Qian An and Gabriela Paz-Bailey and Jennifer Taussig and Robert Gern and Tamika Hoyte and Laura Salazar and Jianglan White and Jeff Todd and Greg Bautista and Colin Flynn and Frangiscos Sifakis and Danielle German and Debbie Isenberg and Maura Driscoll and Elizabeth Hurwitz and Maura Miminos and Rose Doherty and Chris Wittke and Nikhil Prachand and Nanette Benbow and Sharon Melville and Praveen Pannala and Richard Yeager and Aaron Sayegh and Jim Dyer and Shane Sheu and Alicia Novoa and Mark Thrun and Alia Al-Tayyib and Ralph Wilmoth and Emily Higgins and Vivian Griffin and Eve Mokotoff and Karen MacMaster and Marcia Wolverton and Jan Risser and Hafeez Rehman and Paige Padgett and Trista Bingham and Sey, {Ekow Kwa} and Marlene LaLota and Lisa Metsch and Forrest, {David W} and Dano Beck and Gabriel Cardenas",
year = "2018",
month = "3",
day = "1",
doi = "10.1007/s10461-017-1966-4",
language = "English (US)",
volume = "22",
pages = "840--847",
journal = "AIDS and Behavior",
issn = "1090-7165",
publisher = "Springer New York",
number = "3",

}

TY - JOUR

T1 - Sex Practices by HIV Awareness and Engagement in the Continuum of Care Among MSM

T2 - A National HIV Behavioral Surveillance Analysis in 21 U.S. Cities

AU - Behavioral Surveillance Team

AU - for the NHBS study group

AU - Whitham, Hilary K.

AU - Sansom, Stephanie L.

AU - Wejnert, Cyprian

AU - Finlayson, Teresa

AU - Huang, Ya lin A.

AU - An, Qian

AU - Paz-Bailey, Gabriela

AU - Taussig, Jennifer

AU - Gern, Robert

AU - Hoyte, Tamika

AU - Salazar, Laura

AU - White, Jianglan

AU - Todd, Jeff

AU - Bautista, Greg

AU - Flynn, Colin

AU - Sifakis, Frangiscos

AU - German, Danielle

AU - Isenberg, Debbie

AU - Driscoll, Maura

AU - Hurwitz, Elizabeth

AU - Miminos, Maura

AU - Doherty, Rose

AU - Wittke, Chris

AU - Prachand, Nikhil

AU - Benbow, Nanette

AU - Melville, Sharon

AU - Pannala, Praveen

AU - Yeager, Richard

AU - Sayegh, Aaron

AU - Dyer, Jim

AU - Sheu, Shane

AU - Novoa, Alicia

AU - Thrun, Mark

AU - Al-Tayyib, Alia

AU - Wilmoth, Ralph

AU - Higgins, Emily

AU - Griffin, Vivian

AU - Mokotoff, Eve

AU - MacMaster, Karen

AU - Wolverton, Marcia

AU - Risser, Jan

AU - Rehman, Hafeez

AU - Padgett, Paige

AU - Bingham, Trista

AU - Sey, Ekow Kwa

AU - LaLota, Marlene

AU - Metsch, Lisa

AU - Forrest, David W

AU - Beck, Dano

AU - Cardenas, Gabriel

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Using National HIV Behavioral Surveillance (NHBS) cross-sectional survey and HIV testing data in 21 U.S. metropolitan areas, we identify sex practices among sexually active men who have sex with men (MSM) associated with: (1) awareness of HIV status, and (2) engagement in the HIV care continuum. Data from 2008, 2011, and 2014 were aggregated, yielding a sample of 5079 sexually active MSM living with HIV (MLWH). Participants were classified into HIV status categories: (1) unaware; (2) aware and out of care; (3) aware and in care without antiretroviral therapy (ART); and (4) aware and on ART. Analyses were conducted examining sex practices (e.g. condomless sex, discordant condomless sex, and number of sex partners) by HIV status. Approximately 30, 5, 10 and 55% of the sample was classified as unaware, aware and out of care, aware and in care without ART, and aware and on ART, respectively. Unaware MLWH were more likely to report condomless anal sex with a last male partner of discordant or unknown HIV status (25.9%) than aware MLWH (18.0%, p value OpenSPiltSPi 0.0001). Unaware MLWH were 3 times as likely to report a female sex partner in the prior 12 months as aware MLWH (17.3 and 5.6%, p-value OpenSPiltSPi 0.0001). When examining trends across the continuum of care, reports of any condomless anal sex with a male partner in the past year (ranging from 65.0 to 70.0%), condomless anal sex with a male partner of discordant or unknown HIV status (ranging from 17.7 to 21.3%), and median number of both male and female sex partners were similar. In conclusion, awareness of HIV and engagement in care was not consistently associated with protective sex practices, highlighting the need for continued prevention efforts.

AB - Using National HIV Behavioral Surveillance (NHBS) cross-sectional survey and HIV testing data in 21 U.S. metropolitan areas, we identify sex practices among sexually active men who have sex with men (MSM) associated with: (1) awareness of HIV status, and (2) engagement in the HIV care continuum. Data from 2008, 2011, and 2014 were aggregated, yielding a sample of 5079 sexually active MSM living with HIV (MLWH). Participants were classified into HIV status categories: (1) unaware; (2) aware and out of care; (3) aware and in care without antiretroviral therapy (ART); and (4) aware and on ART. Analyses were conducted examining sex practices (e.g. condomless sex, discordant condomless sex, and number of sex partners) by HIV status. Approximately 30, 5, 10 and 55% of the sample was classified as unaware, aware and out of care, aware and in care without ART, and aware and on ART, respectively. Unaware MLWH were more likely to report condomless anal sex with a last male partner of discordant or unknown HIV status (25.9%) than aware MLWH (18.0%, p value OpenSPiltSPi 0.0001). Unaware MLWH were 3 times as likely to report a female sex partner in the prior 12 months as aware MLWH (17.3 and 5.6%, p-value OpenSPiltSPi 0.0001). When examining trends across the continuum of care, reports of any condomless anal sex with a male partner in the past year (ranging from 65.0 to 70.0%), condomless anal sex with a male partner of discordant or unknown HIV status (ranging from 17.7 to 21.3%), and median number of both male and female sex partners were similar. In conclusion, awareness of HIV and engagement in care was not consistently associated with protective sex practices, highlighting the need for continued prevention efforts.

KW - HIV care continuum

KW - Human immunodeficiency virus (HIV)

KW - Men who have sex with men (MSM)

KW - Men who have sex with men and women (MSMW)

KW - Sex practices

UR - http://www.scopus.com/inward/record.url?scp=85034786153&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85034786153&partnerID=8YFLogxK

U2 - 10.1007/s10461-017-1966-4

DO - 10.1007/s10461-017-1966-4

M3 - Article

VL - 22

SP - 840

EP - 847

JO - AIDS and Behavior

JF - AIDS and Behavior

SN - 1090-7165

IS - 3

ER -