Percy Fernández-Dávila

Silence and Assumptions: Narratives on the Disclosure of HIV Status to Casual Sexual Partners and Serosorting in a Group of Gay Men in Barcelona

ABSTRACT Disclosing HIV status and seeking sexual partners with the same serostatus (serosorting) are strategies used by some gay and bisexual men to have unprotected anal intercourse (UAI). This study aims to gain an understanding of the occurrence of disclosure and serosorting with casual sexual partners. A grounded approach was used to analyze 22 interviews with gay men from Barcelona. The results reveal that disclosure of serostatus or the seeking of sexual partners of the same HIV status are not behaviors in the repertoire of most HIV-negative men and were not even taken into account when they engaged in UAI with casual sexual partners. The opposite was observed in HIV-positive respondents who did consider the possibility of revealing their serostatus. Some relied on intuition or subjective elements to evaluate the HIV status of their occasional partners.

Hepatitis C virus infection and its relationship to certain sexual practices in men-who-have-sex-with-men in Spain: Results from the European MSM internet survey (EMIS)

OBJECTIVES To compare sexual practices and risk behaviours between MSM who were first diagnosed with hepatitis C (HCV) in the previous 12 months and those who were never diagnosed; and, to identify factors associated with a diagnosis of HCV. METHODS The European-MSM-Internet-Survey (EMIS) was implemented for 3 months during 2010, mainly on websites for MSM. Data on socio-demographic characteristics, sexual behaviour, drug use, STI history, and other sexual health variables were collected. The Chi-square test and logistic regression analysis were used to analyse the data. RESULTS Data from 13,111 respondents were analysed. The proportion of MSM who had ever been diagnosed with HCV infection was 1.9% (n=250), and of those currently infected with the virus was 0.6% (n=78). The percentage of those first diagnosed in the last 12 months was 0.4% (n=46), of whom 70% were HIV-negative and 22% had HIV coinfection. Having a first diagnosis of HCV in the last 12 months was more common among HIV-positive than among HIV-negative MSM (0.9% vs 0.4%) and among MSM born abroad than among Spanish-born (0.7% vs 0.3%). MSM diagnosed with HCV in the last 12 months were more likely to have had: more than 10 sexual partners, sex abroad, receptive anal intercourse, insertive/receptive fisting, and unprotected anal intercourse with non-steady partners of unknown or discordant HIV-status. Likewise, they reported more frequent visits to sex-focused venues, higher drug use, as well as a higher proportion of STI diagnosis. In the multivariate model, visiting a public sex-focused venue, practicing receptive fisting, using erection enhancing medication and having a diagnosis of syphilis were independently associated with a first diagnosis of HCV in the last 12 months. CONCLUSIONS HCV infection does not seem to be restricted to HIV-infected MSM. Certain sexual behaviour (fisting, visiting sex-focused venues), drug use, and ulcerative STI seem to be associated with a diagnosis of HCV.

Actitudes hacia los programas de prevención on-line del VIH y las ITS, y perfil de los usuarios de Internet en los hombres que tienen sexo con hombres

OBJECTIVES To describe the attitudes of men who have sex with men (MSM) toward online HIV/sexually-transmitted infection (STI) prevention programs and to identify and characterize user profiles with regard to their attitudes toward online prevention programs. METHOD A survey in gay venues or via the internet was completed by 2,044 participants from Madrid, Barcelona, Bilbao and San Sebastián (Spain). The survey explored socio-demographic variables, sexual behavior and other risk behaviors associated with HIV infection, as well as attitudes toward online prevention programs. The statistical analysis included factor analysis and non-hierarchical cluster analysis. RESULTS Most MSM had positive attitudes towards online HIV/STI prevention programs. Factor analysis revealed two factors: online prevention aimed at interaction and online prevention aimed at information. Based on these factors, three user profiles were identified: users oriented toward informative and interactive online prevention (53.5%), users oriented toward interactive online prevention (25.9%) and users were not oriented toward online prevention (20.7%). On characterizing these profiles, we observed a significant presence of men who were not interested in online prevention among those with a lower educational level, bisexual men and HIV-positive men. Conversely, those most receptive to online prevention were men self-identified as gay, those with a bachelors degree, those who had been tested for HIV and those who were HIV-negative. CONCLUSION The internet can facilitate sexual health promotion among MSM. Characterization of user profiles offers the possibility of segmenting prevention programs and of combining online and offline strategies.

Alto consumo de drogas recreativas y conductas sexuales de riesgo en hombres que tienen relaciones sexuales con hombres

BASIS AND OBJECTIVE To describe the pattern of drug use among men who have sex with men (MSM) living in Spain and its association with sexual risk practices. MATERIAL AND METHOD The European MSM Internet Survey was implemented in 2010 in 38 European countries on websites for MSM and collected data on sociodemographics, sexual behavior, and other sexual health variables. The association between unprotected anal intercourse (UAI) with casual partners and drug consumption was evaluated using multivariate logistic regression models. RESULTS Among the 13,111 participants, most consumed drugs were cannabis (30.1%), popper (28.4%) and cocaine (18.7%). The risk of UAI with casual partners was 1.5 among those who had used drugs in relation to the other participants. The proportion of MSM who had injected drugs at least once in life was 2.5%, and 1.4% in the last 12 months. The prevalence of UAI with casual partners (53.4%), human immunodeficiency virus (HIV) (23%), hepatitis C (8.2%) and sexually transmitted infections (STI) (15.8%) was higher in MSM injectors related to those who had not used injected drugs (P<.05). CONCLUSIONS The results of this study confirm a high prevalence of drug use in MSM and their relationship to sexual risk behavior. Although the use of injected drugs in MSM is a minority, this group reported a higher level of sexual risk behaviors, self-reported HIV, hepatitis C and other STI.

Young men who have sex with men: a group at high risk for HIV infection?

OBJECTIVES: To compare variables associated with the risk of HIV among men ≤ 25 years old who have sex with men (YMSM) and those >25 years old, and to determine the variables associated with unprotected anal intercourse (UAI) in YMSM with casual sexual partners. METHOD: For 1 month, 485 participants ≤ 25 years old and 1,470 aged >25 years old completed a pen-and-paper survey carried out in gay venues (GV) or via the Internet in Madrid, Barcelona, Bilbao and San Sebastian (Spain). The survey investigated sexual behaviors in the past 3 months according to whether the men met sexual partners in GV (SPGV) or on the Internet (SPI). RESULTS: No significant differences were found between YMSM and those >25 years old with respect to UAI with SPGV (23% vs. 30%, p>0.05) and SPI (29% vs. 30%, p>0.05), condom use in the last anal intercourse and having had a sexually-transmitted infection (STI) in the last year (19% vs. 23%, p>0.05). However, respondents>25 years old had a higher average number of SPGV (9.2 vs. 7, p 25 years old. However, there are some variables could contribute to vulnerability in this group.

Hombres jóvenes que tienen sexo con hombres: ¿un colectivo en alto riesgo para la infección por el VIH?

OBJECTIVES To compare variables associated with the risk of HIV among men ≤ 25 years old who have sex with men (YMSM) and those >25 years old, and to determine the variables associated with unprotected anal intercourse (UAI) in YMSM with casual sexual partners. METHOD For 1 month, 485 participants ≤ 25 years old and 1,470 aged >25 years old completed a pen-and-paper survey carried out in gay venues (GV) or via the Internet in Madrid, Barcelona, Bilbao and San Sebastián (Spain). The survey investigated sexual behaviors in the past 3 months according to whether the men met sexual partners in GV (SPGV) or on the Internet (SPI). RESULTS No significant differences were found between YMSM and those >25 years old with respect to UAI with SPGV (23% vs. 30%, p>0.05) and SPI (29% vs. 30%, p>0.05), condom use in the last anal intercourse and having had a sexually-transmitted infection (STI) in the last year (19% vs. 23%, p>0.05). However, respondents>25 years old had a higher average number of SPGV (9.2 vs. 7, p<0.05) and SPI (8.9 vs. 6.4, p<0.05), were more likely to have used drugs while having UAI (68% vs. 55%, p<0.05, with SPI, and 73% vs. 55%, p<0.05, with SPGV) and had a higher prevalence of HIV (11% vs. 4%, p<0.05). When exploring other variables, we found that YMSM more frequently had receptive UAI with SPI (73% vs. 57%, p<0.05), had less time to be in a stable relationship, and their sexual partner more frequently convinced them to have UAI (8% vs. 0%, p<0.05). In multivariate analysis, UAI in YMSM with casual sexual partners was not associated with any of the variables. CONCLUSIONS YMSM do not constitute a group at increased risk of HIV/STI infection compared with respondents >25 years old. However, there are some variables could contribute to vulnerability in this group.

OriginalHombres jóvenes que tienen sexo con hombres: ¿un colectivo en alto riesgo para la infección por el VIH?Young men who have sex with men: a group at high risk for HIV infection?

OBJECTIVES To compare variables associated with the risk of HIV among men ≤ 25 years old who have sex with men (YMSM) and those >25 years old, and to determine the variables associated with unprotected anal intercourse (UAI) in YMSM with casual sexual partners. METHOD For 1 month, 485 participants ≤ 25 years old and 1,470 aged >25 years old completed a pen-and-paper survey carried out in gay venues (GV) or via the Internet in Madrid, Barcelona, Bilbao and San Sebastián (Spain). The survey investigated sexual behaviors in the past 3 months according to whether the men met sexual partners in GV (SPGV) or on the Internet (SPI). RESULTS No significant differences were found between YMSM and those >25 years old with respect to UAI with SPGV (23% vs. 30%, p>0.05) and SPI (29% vs. 30%, p>0.05), condom use in the last anal intercourse and having had a sexually-transmitted infection (STI) in the last year (19% vs. 23%, p>0.05). However, respondents>25 years old had a higher average number of SPGV (9.2 vs. 7, p<0.05) and SPI (8.9 vs. 6.4, p<0.05), were more likely to have used drugs while having UAI (68% vs. 55%, p<0.05, with SPI, and 73% vs. 55%, p<0.05, with SPGV) and had a higher prevalence of HIV (11% vs. 4%, p<0.05). When exploring other variables, we found that YMSM more frequently had receptive UAI with SPI (73% vs. 57%, p<0.05), had less time to be in a stable relationship, and their sexual partner more frequently convinced them to have UAI (8% vs. 0%, p<0.05). In multivariate analysis, UAI in YMSM with casual sexual partners was not associated with any of the variables. CONCLUSIONS YMSM do not constitute a group at increased risk of HIV/STI infection compared with respondents >25 years old. However, there are some variables could contribute to vulnerability in this group.