HIV infection and risk factors related to early sexual debut in a 2016 national cross-sectional survey of American men who have sex with men Open Access
Brightwell, N. Chase (Spring 2018)
A significant portion of HIV research aims to assess HIV risk factors in men who have sex with men (MSM), yet there is a paucity of research investigating the role of sexual debut age (SDA) in determining later HIV risk within the MSM community, especially in the US. This analysis employed data from the American Men’s Internet Survey (AMIS), an annual cross-sectional representative sample of US MSM, to determine the relationship between SDA and later HIV risk, along with other potentially contributing HIV risk behaviors. The authors categorized self-reported SDA in MSM by age of oral sexual debut (OSD) with a man and age of anal sexual debut (ASD) with a man in four categories: <13, 13-14, 15-17, and 18+ years. The outcome HIV status was self-reported. After adjusting for age at time of survey, race, education level, and current household income, early age of ASD was associated with elevated HIV risk (for <13 versus 18+, adjusted odds ratio (AOR): 2.23, 95% confidence interval (CI): 1.51-2.26), as was early OSD (for OSD <13 versus 18+, OR: 2.52, 95% CI: 2.12-3.00). The AMIS sample is disproportionately older, wealthier, and more well-educated than other MSM samples, which potentially contributed bias to the study. Given the demonstrated association between SDA and HIV risk, more research is necessary to validate this relationship in more diverse populations and other contexts.
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