Differential patterns of risk and vulnerability suggest the need for novel prevention strategies for black bisexual men in the HPTN 061 study

Typhanye V. Dyer, Maria R. Khan, Rotrease Regan, Nina T. Harawa, Laron E. Nelson, Leo Wilton, Lei Wang, Lili Peng, San San Ou, Steve Shoptaw

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background: Black men who have sex with men (BMSM) and some who also have sex with women (BMSMW) account for over 70% of new HIV infections in the United States representing an elevated HIV risk in this group, also informing risks of HIV transmission to other BMSM and female sexual partners. Settings: We examined trajectories of self-reported substance use, HIV-related sexual risk behaviors, and psychosocial vulnerabilities among BMSMW versus BMSM over a 1-year study period. Methods: We analyzed baseline, 6-, and 12-month follow-up data from the HIV Prevention Trials Network "BROTHERS" Study (HPTN 061; n = 1126). Categorizing participants by sexual partner type across 3 time points: (1) BMSMO: Having male and no female partners across assessments and (2) BMSMW: Having sex with male and one or more female partners at least at 1 time point. Using generalized estimating equations, we estimated associations between being BMSMW (versus BMSMO) and changes in psychosocial vulnerability, substance use, and HIV-related sexual risk behaviors. Results: Generalized estimating equation models controlling for sociodemographics, time-varying effects, and intervention status showed that BMSMW versus BMSMO had 50% increased odds of crack use, 71% increased odds of alcohol use during condomless anal intercourse (CAI), 51% greater odds of using drugs at last CAI, and twice the odds of receiving goods at last CAI. Conclusions: Findings show stable and comparatively elevated illicit drugs, alcohol, and exchange sex during last CAI among BMSMW. Future intervention research should focus on ways to address changes in substance-related HIV-transmission behaviors over time in this population of men.

Original languageEnglish
Pages (from-to)491-498
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume78
Issue number5
DOIs
Publication statusPublished - 15 Aug 2018

Keywords

  • black MSM
  • black MSMW
  • cohort studies
  • HIV sexual risk
  • repeated measures
  • substance use

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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