Characteristics of Sexual Partnerships Among Men With Diagnosed HIV Who Have Sex With Men, United States and Puerto Rico-2015-2019

Overview

Journal J Acquir Immune Defic Syndr

Specialty Infectious Diseases

Date 2020 Jul 22

PMID 32692102

Citations 3

Authors

Sharoda Dasgupta

Yunfeng Tie

Heather Bradley

Linda Beer

Eli S Rosenberg

David Holtgrave

Jennifer Fagan

Shana Green

Roy L Shouse

Affiliations

Soon will be listed here.

Abstract

Background: Understanding sexual partnerships of HIV-positive persons, particularly at the dyad level, can help in quantifying HIV transmission risk. We described sexual partnerships among HIV-positive men who have sex with men (MSM), including partnerships with a high risk for sexual HIV transmission.

Setting: The Medical Monitoring Project is an annual, cross-sectional study that reports representative estimates on U.S. HIV-positive adults.

Methods: During 2015-2019, we assessed sexual behaviors by interview, and viral load results from medical records. Among sexually active HIV-positive MSM (n = 4923), we described prevalence of high-risk sex, defined as: (1) not having sustained viral suppression, and (2) having condomless sex with an HIV-negative partner not known to be taking pre-exposure prophylaxis or an HIV-unknown partner. We described sexual partnerships among HIV-positive MSM (n = 13,024 partnerships among 4923 MSM). For HIV-discordant partnerships (n = 7768), we reported the proportion involved in high-risk sex, and associations with high-risk sex using prevalence ratios with predicted marginal means, controlling for age of the HIV-positive partner (P < 0.05).

Results: More than half (66%) of sexually active HIV-positive MSM had condomless sex; 11% had high-risk sex. Blacks were more likely to have detectable viral loads, but less likely to have condomless sex, making prevalence of high-risk sex comparable between racial/ethnic groups. Dyad-level analyses among HIV-discordant partnerships indicated that prevalence of high-risk sex was higher among partnerships with HIV-positive white MSM, which was not observed using person-level data alone.

Conclusions: In the context of ending the HIV epidemic, behavioral and clinical surveillance data can help monitor HIV transmission risk and target prevention efforts to reduce transmission among populations at disproportionate risk.

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References

Millett G, Peterson J, Flores S, Hart T, Jeffries 4th W, Wilson P . Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet. 2012; 380(9839):341-8. DOI: 10.1016/S0140-6736(12)60899-X. View

Rosenberg E, Purcell D, Grey J, Hankin-Wei A, Hall E, Sullivan P . Rates of prevalent and new HIV diagnoses by race and ethnicity among men who have sex with men, U.S. states, 2013-2014. Ann Epidemiol. 2018; 28(12):865-873. DOI: 10.1016/j.annepidem.2018.04.008. View

Goodreau S, Rosenberg E, Jenness S, Luisi N, Stansfield S, Millett G . Sources of racial disparities in HIV prevalence in men who have sex with men in Atlanta, GA, USA: a modelling study. Lancet HIV. 2017; 4(7):e311-e320. PMC: 5706457. DOI: 10.1016/S2352-3018(17)30067-X. View

Hall H, Holtgrave D, Tang T, Rhodes P . HIV transmission in the United States: considerations of viral load, risk behavior, and health disparities. AIDS Behav. 2013; 17(5):1632-6. DOI: 10.1007/s10461-013-0426-z. View

Iachan R, Johnson C, Harding R, Kyle T, Saavedra P, Frazier E . Design and Weighting Methods for a Nationally Representative Sample of HIV-infected Adults Receiving Medical Care in the United States-Medical Monitoring Project. Open AIDS J. 2016; 10:164-81. PMC: 5013474. DOI: 10.2174/1874613601610010164. View

Mattson C, Freedman M, Fagan J, Frazier E, Beer L, Huang P . Sexual risk behaviour and viral suppression among HIV-infected adults receiving medical care in the United States. AIDS. 2014; 28(8):1203-11. PMC: 4004641. DOI: 10.1097/QAD.0000000000000273. View

Patel P, Borkowf C, Brooks J, Lasry A, Lansky A, Mermin J . Estimating per-act HIV transmission risk: a systematic review. AIDS. 2014; 28(10):1509-19. PMC: 6195215. DOI: 10.1097/QAD.0000000000000298. View

Rodger A, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J . Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy. JAMA. 2016; 316(2):171-81. DOI: 10.1001/jama.2016.5148. View

Kelley C, Vaughan A, Luisi N, Sanchez T, Salazar L, Frew P . The Effect of High Rates of Bacterial Sexually Transmitted Infections on HIV Incidence in a Cohort of Black and White Men Who Have Sex with Men in Atlanta, Georgia. AIDS Res Hum Retroviruses. 2015; 31(6):587-92. PMC: 4458736. DOI: 10.1089/AID.2015.0013. View

10.

Millett G, Flores S, Peterson J, Bakeman R . Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. AIDS. 2007; 21(15):2083-91. DOI: 10.1097/QAD.0b013e3282e9a64b. View

11.

Hoots B, Finlayson T, Nerlander L, Paz-Bailey G . Willingness to Take, Use of, and Indications for Pre-exposure Prophylaxis Among Men Who Have Sex With Men-20 US Cities, 2014. Clin Infect Dis. 2016; 63(5):672-7. PMC: 5009903. DOI: 10.1093/cid/ciw367. View

12.

Mustanski B, Morgan E, DAquila R, Birkett M, Janulis P, Newcomb M . Individual and Network Factors Associated With Racial Disparities in HIV Among Young Men Who Have Sex With Men: Results From the RADAR Cohort Study. J Acquir Immune Defic Syndr. 2018; 80(1):24-30. PMC: 6289601. DOI: 10.1097/QAI.0000000000001886. View

13.

Raymond H, McFarland W . Racial mixing and HIV risk among men who have sex with men. AIDS Behav. 2009; 13(4):630-7. PMC: 2841470. DOI: 10.1007/s10461-009-9574-6. View

14.

Kelley C, Rosenberg E, OHara B, Frew P, Sanchez T, Peterson J . Measuring population transmission risk for HIV: an alternative metric of exposure risk in men who have sex with men (MSM) in the US. PLoS One. 2013; 7(12):e53284. PMC: 3532405. DOI: 10.1371/journal.pone.0053284. View

15.

Grant R, Lama J, Anderson P, McMahan V, Liu A, Vargas L . Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010; 363(27):2587-99. PMC: 3079639. DOI: 10.1056/NEJMoa1011205. View

16.

Johnson L, Lewis D . The effect of genital tract infections on HIV-1 shedding in the genital tract: a systematic review and meta-analysis. Sex Transm Dis. 2008; 35(11):946-59. DOI: 10.1097/OLQ.0b013e3181812d15. View

17.

Beer L, Oster A, Mattson C, Skarbinski J . Disparities in HIV transmission risk among HIV-infected black and white men who have sex with men, United States, 2009. AIDS. 2013; 28(1):105-14. PMC: 4682567. DOI: 10.1097/QAD.0000000000000021. View

18.

Grey J, Bernstein K, Sullivan P, Kidd S, Gift T, Hall E . Rates of Primary and Secondary Syphilis Among White and Black Non-Hispanic Men Who Have Sex With Men, United States, 2014. J Acquir Immune Defic Syndr. 2017; 76(3):e65-e73. PMC: 5634915. DOI: 10.1097/QAI.0000000000001508. View

19.

Maulsby C, Millett G, Lindsey K, Kelley R, Johnson K, Montoya D . HIV among Black men who have sex with men (MSM) in the United States: a review of the literature. AIDS Behav. 2013; 18(1):10-25. DOI: 10.1007/s10461-013-0476-2. View

20.

Cohen M, Chen Y, McCauley M, Gamble T, Hosseinipour M, Kumarasamy N . Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med. 2016; 375(9):830-9. PMC: 5049503. DOI: 10.1056/NEJMoa1600693. View