HIV risk and HIV testing among men who have sex with men only and men who have sex with men and women in Baltimore, Maryland
C. Maulsby1, F. Sifakis2, D. Holtgrave1
1Johns Hopkins Bloomberg School of Public Health, Health Behavior and Society, Baltimore, United States, 2John Hopkins School of Public Health, Epidemiology, Baltimore, United States
Background: Men who have sex with men and women (MSMW) represent an understudied population that might play an important role in the epidemiology of HIV. This study addresses gaps in the current HIV literature by examining differences between MSMW and men who have sex with men only (MSMO) in a) associations with being HIV positive and b) associations with HIV testing.
Methods: Cross-sectional self-report data on HIV related behaviors were collected from a racially diverse sample of 448 MSM (men who have sex with men) in 2008 in Baltimore, Maryland. The study used venue-based time space sampling and included an optional HIV test. We used stratified multivariate Poisson regressions to assess associations.
Results: The following factors were associated with being HIV positive among MSMO: race, age, having had an STD in the last year, and health insurance. Among MSMW, having more than three male sex partners and having diverse friendship networks were marginally associated with being HIV positive. Partner characteristics such as race of partner and concurrency were not associated with HIV for either MSMO or MSMW after adjusting for confounding. Among MSMO, age and having a doctor recommend an HIV test were associated with having an HIV test in the past six months. Among MSMW, the following factors were associated with having an HIV test in the past six months: race, homelessness, a recent visit to doctor, HIV counseling that was not part of HIV testing, and race of partner.
Conclusions: MSMW and MSMO represent distinct populations. HIV prevention programs should address differences between MSMO and MSMW. HIV counseling might be a particularly important component of HIV prevention efforts for MSMW. Further implications of these results for prevention program development will be discussed.