Correlates of Condomless Anal Intercourse (CAI) with a Partner of Unknown HIV Status Among the 2019 American Men’s Internet Survey (AMIS) Participants Público

Abstract

Introduction: HIV continues to be a significant issue in both public and LGBTQ+ health, especially among gay, bisexual, and other men who have sex with men (MSM) in the United States. Condom use during sex is an important mechanism of HIV prevention among MSM as condomless anal intercourse (CAI) is a main pathway to HIV transmission. A second significant prevention mechanism is disclosure of HIV statuses between partners. This study aims to determine which correlates are associated with and more common among those with the outcome of interest, CAI with a partner of unknown (versus known) HIV status in the past 12 months, among MSM in the US.

 

Methods: Data from the 2019 American Men’s Internet Survey (AMIS) were used for this study. AMIS is a large cross-sectional online HIV behavioral survey of MSM in the US and has been IRB-approved at Emory University. Bivariate unadjusted log binomial regression models were used to obtain unadjusted prevalence ratios (PR). Multivariate adjusted log binomial regression models were used to obtain adjusted prevalence ratios (aPR). SAS statistical software was used to perform both the bivariate and multivariate analyses.

 

Results: Statistically significant increased likelihoods of CAI with a partner of unknown HIV status in the past 12 months were found with the following correlates: being in the lowest income level, identifying as Black non-Hispanic, identifying as Hispanic, identifying as other multiple, or unknown race/ethnicity, living with HIV, PrEP use, experiencing depressive symptoms, heavy alcohol use, various substance use, having more than 0 or 1 male anal sex partners, and worrying about a partner’s HIV status.

 

Discussion: This study identified numerous important factors that may play a role in engaging in CAI with a partner of unknown HIV status among MSM in the US. The findings of this study can be used to inform and shape future research investigating the correlates and relationships associated with CAI with a partner of unknown HIV status among MSM partners. Additionally, these findings can be used to elucidate factors that could inform prevention and educational strategies and identify target populations for prevention and educational programming.

Table of Contents

Introduction ………………………………………………………………… 1

Methods …………………………………………………..…………….…… 3

Results ………………………………………….……………………….…… 6

Discussion …………………………………………………………...……… 10

Tables …………………………………………………………………...…… 18

References ……………………...…………………………………………… 25

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Palavra-chave	Condomless Anal Intercourse CAI MSM HIV AMIS
Committee Chair / Thesis Advisor	Guest, Jodie L., Emory University

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