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  • Title: Beyond Anal Sex: Sexual Practices of Men Who have Sex with Men and Associations with HIV and Other Sexually Transmitted Infections.
    Author: Rice CE, Maierhofer C, Fields KS, Ervin M, Lanza ST, Turner AN.
    Journal: J Sex Med; 2016 Mar; 13(3):374-82. PubMed ID: 26853044.
    Abstract:
    INTRODUCTION: Unprotected anal intercourse is often used as a single indicator of risky behavior in men who have sex with men (MSM), yet MSM engage in a variety of behaviors that have unknown associations with sexually transmitted infection (STI) and HIV. AIM: To assess the prevalence of a wide range of sexual behaviors and their associations with prevalent STI and HIV. METHODS: We used a standardized, self-administered survey to collect behavioral data for this cross-sectional study of 235 MSM seeking care in a public clinic for sexually transmitted diseases. MEAN OUTCOME MEASURES: Using modified Poisson regression, we generated unadjusted and adjusted prevalence ratios (PRs) to characterize associations between recent participation in each behavior and prevalent STI and HIV. RESULTS: Participants' median age was 26 years. One third (35%) were positive for STI. STI prevalence was significantly associated with using sex slings (adjusted PR [aPR] = 2.35), felching (aPR = 2.22), group sex (aPR = 1.86), fisting (aPR = 1.78), anonymous sex (aPR = 1.51), and sex toys (aPR = 1.46). HIV prevalence was 17% and was significantly associated with fisting (aPR = 4.75), felching (aPR = 4.22), enemas (aPR = 3.65), and group sex (aPR = 1.92). CONCLUSION: Multiple behaviors were significantly associated with prevalent STI and HIV in adjusted analyses. To provide a more comprehensive understanding of sexual risk in MSM, prospective studies are needed to examine whether these behaviors are causally associated with HIV and STI acquisition.
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