Factors Tied to Anal Sex and HIV Testing in Just-Diagnosed MSM: NYC

Recent HIV testing and substance use during sex were associated with unprotected (condom-free) anal intercourse in a study of 150 young men who have sex with men (MSM) recently diagnosed with HIV infection in New York City. Employed men and those who had unprotected anal sex were more likely to get tested for HIV. In the United States and many other countries with similar HIV epidemics, MSM account for the highest proportion of new HIV infections. Although health authorities encourage sexually active MSM to get tested for HIV yearly or more often, the interplay between testing, risk behavior, and substance use remains poorly understood in this high-risk group.

The study involved 150 MSM diagnosed with HIV within the past 3 months at a community clinic in New York City. Researchers interviewed the men about sexual behavior and substance use in the 3 months before their diagnosis. Relevant clinical characteristics were extracted from medical records. Statistical analyses probed for factors associated with (1) unprotected anal sex in the 3 months before HIV diagnosis and (2) a negative HIV test in the 12 months before diagnosis.

The men averaged 32.5 years in age (standard deviation 8.8), and 62% belonged to a racial or ethnic minority. Almost all men, 95%, had a prior negative HIV test, and 55% had a negative test within the last 12 months. Although almost half of the men (48%) had at least a college education, 71% of these men earned only $30,000 a year or less, low by New York City standards.

Statistical analysis linked unprotected anal sex to recent HIV testing and substance use during sex. Recent testing was associated with being employed or a student, having unprotected anal sex, and a higher CD4 count.

Source: Anya S. Drabkin, Kathleen J. Sikkema, Patrick A. Wilson, Christina S. Meade, Nathan B. Hansen, Allyson DeLorenzo, Arlene Kochman, Jessica C. MacFarlane, Melissa H. Watt, Frances M. Aunon, Krista W. Ranby, Gal Mayer. Risk patterns preceding diagnosis among newly HIV-diagnosed men who have sex with men in New York City. AIDS Patient Care and STDs. 2013; 27: 333-341.

Written by Mark Mascolini on behalf of the International AIDS Society