If You Are Not Counted,You Don’t Count: Estimating the Number of African-American Men Who Have Sex with Men in San Francisco Using a Novel Bayesian Approach

African-American men who have sex with men (AA MSM) have been disproportionately infected with and affected by HIV and other STIs in San Francisco and the USA. The true scope and scale of the HIV epidemic in this population has not been quantified, in part because the size of this population remains unknown. We used the successive sampling population size estimation (SS-PSE) method, a new Bayesian approach to population size estimation that incorporates network size data routinely collected in respondent-driven sampling (RDS) studies, to estimate the number of AA MSM in San Francisco. This method was applied to data from a 2009 RDS study of AA MSM. An estimate from a separate study of local AA MSM was used to model the prior distribution of the population size. Two-hundred and fifty-six AA MSM were included in the RDS survey. The estimated population size was 4917 (95 % CI 1267–28,771), using a flat prior estimated 1882 (95 % CI 919–2463) as a lower acceptable bound, and a large prior estimated 6762 (95 % CI 1994–13,863) as an acceptable upper bound. Point estimates from the SS-PSE were consistent with estimates from multiplier methods using external data. The SS-PSE method is easily integrated into RDS studies and therefore provides a simple and appealing tool to rapidly produce estimates of the size of key populations otherwise difficult to reach and enumerate.     

Evaluation of Respondent-Driven Sampling in a Study of Urban Young Men Who Have Sex with Men

Evidence suggests that respondent-driven sampling (RDS) is an efficient approach to sampling among varied populations of adult men who have sex with men (MSM) both in the USA and abroad, although no studies have yet evaluated its performance among younger MSM, a population with a steep rise in HIV infection in recent years. Young MSM (YMSM) may differ in terms of their connectedness to other YMSM (e.g., due to evolving sexual identity, internalization of sexual minority stigma, and lack of disclosure to others) and mobility (e.g., due to parental monitoring) which may inhibit the sampling process. The aims of this study were to evaluate the efficiency and effectiveness of RDS-based sampling among young urban MSM and to identify factors associated with recruitment success. We hypothesized that demographic, social, behavioral, and network factors, including racial/ethnic minority status, homelessness (i.e., as an indicator of socioeconomic marginalization), HIV-positive status, substance use problems, gay community connectedness, and network size would be positively related to recruitment productivity, while sexual minority stigmatization, environmental barriers (e.g., parental monitoring), and meeting sex partners on the internet (i.e., virtual venue) would be negatively related to recruitment productivity. Between December 2009 and February 2013, we used RDS to recruit a sample of 450 YMSM, ages 16–20. Findings suggest that the use of RDS for sampling among YMSM is challenging and may not be feasible based on the slow pace of recruitment and low recruitment productivity. A large number of seeds (38 % of the sample, n = 172) had to be added to the sample to maintain a reasonable pace of recruitment, which makes use of the sample for RDS-based population estimates questionable. In addition, the prevalence of short recruitment chains and segmentation in patterns of recruitment by race/ethnicity further hamper the network recruitment process. Thus, RDS was not particularly efficient in terms of the rate of recruitment or effective in generating a representative sample. Hypotheses regarding factors associated with recruitment success were supported for network size and internalized stigma (but not other factors), suggesting that participants with larger network sizes or high levels of internalized stigma may have more and less success recruiting others, respectively.     

2006年天津市部分40岁以下青年男男性行为者艾滋病知晓率和行为学调查分析

目的 了解天津市部分40岁以下青年男男性行为者(Young men who have sex with men,YMSM)的艾滋病知晓率及高危行为状况,为在该人群中开展有效的性病艾滋病防治提供依据.方法 在知情同意、保密的原则下,2006年对40岁以下的YMSM进行匿名问卷调查,用SPSS软件对调查结果进行统计分析.结果 121名YMSM的平均年龄为24.70岁,文化程度较高.该人群艾滋病知识总知晓率为79.75%.25.62%的人自认为同性恋倾向,23.14%为异性恋,36.36%为双性恋.最近一次和最近6个月,在肛交时坚持使用安全套的比例分别为62.81%和43.80%;最近6个月有17.36%的人向男性提供过性服务,而其中有61.9%的人同时与女性发生过性行为.结论 被调查的YMSM存在艾滋病传播危险因素,急需在该人群中开展性病艾滋病的知识宣传和高危行为干预,提高其安全性行为的意识和安全套使用率.     

Why HIV Infections Have Increased Among Men Who Have Sex with Men and What to Do About It: Findings from California Focus Groups

A resurgence of sexual risk taking, STDs, and HIV incidence has been reported among men who have sex with men (MSM) in several countries. We asked 113 MSM in 12 focus groups conducted in five California cities to identify factors leading to increased risk taking and assess prevention messages to reduce risk in this population. Participants perceived that HIV risk taking has increased because (1) HIV is not the threat it once was due to more effective therapies, (2) MSM communicate less about HIV, and social support for being safe has decreased, and (3) community norms have shifted such that unsafe sex is more acceptable. The prevention messages ranked most likely to motivate risk reduction encouraged individuals to seek social support from friends. Themes ranked least likely to succeed were those that described the negative consequences of HIV or reinforced existing safer sex messages.     

Polymorphisms of the beta2-adrenergic receptor gene (ADRB2) in relation to cardiovascular risk factors in men

OBJECTIVE: To investigate the effect of polymorphisms in codon 16 (Arg16Gly) and codon 27 (Gln27Glu) of the beta2-adrenergic receptor gene (ADRB2) on anthropometric, endocrine, metabolic and haemodynamic variables. DESIGN: A cross-sectional study. SUBJECTS: A subgroup of 284 Swedish men from a population sample of 1040 at the age of 51 years. MAIN OUTCOME MEASURES: Genotype examination of ADRB2 polymorphisms in codon 16 and codon 27 with polymerase chain reaction and restriction fragment length polymorphism. Anthropometric measurements included body mass index, waist-to-hip ratio and abdominal sagittal diameter. Endocrine measurements included blood levels of testosterone, insulin-like growth factor I, and leptin plus salivary cortisol. Overnight fasting values of serum insulin, blood glucose, triglycerides, total, low and high density lipoprotein cholesterol, as well as blood pressure and resting heart rate, were also determined. RESULTS: Polymorphisms were frequent in both codon 16 and codon 27. The Arg16Gly genotype showed significant relationships to elevated central distribution of body fat and to systolic blood pressure, whilst the Glu27Glu genotype was associated with elevated leptin and triglyceride levels but not to other measurements, including obesity variables. CONCLUSIONS: We conclude that only a few cardiovascular risk factors are associated with DNA sequence variation in the ADRB2 in Swedish men.     

Dynamics of Sexual Risk Behavior in HIV-Infected Men Who Have Sex with Men

Much is known about the factors associated with risky sexual behavior among HIV-negative men who have sex with men (MSM) and among MSM whose HIV antibody status is unknown. However, little is known about the dynamics of continuing risky behavior among HIV-positive MSM. This research employed both questionnaire and extensive individual interview techniques to assess the levels of risky behavior, as well as the factors associated with risky behavior, in a sample of 42 seropositive MSM. Findings suggest that risky behavior occurs with some frequency, and that it is occasioned by informational, motivational, and behavioral skills-relevant deficits in the population at focus. Moreover, levels of risky behavior appear to differ with seropositive and seronegative primary partners. Implications for designing interventions for seropositive MSM are discussed.     

江苏省部分城市男男性行为者HIV/STD感染情况研究

目的 了解男男性行为者（MSM）群体的艾滋病病毒/性病（HIV/STD）感染水平.方法 在MSM聚集的酒吧,在知情同意下,匿名填写问卷,自愿选择检查项目,在现场开展体检和实验室标本采集,标本按要求冷藏转送至实验室.结果 共检测了144人,平均年龄32.68岁,未婚者占59.03%,各种文化层次和职业者均有.他们中只有同性性行为者占38.64%,其他人均与异性有性行为.首次性行为的平均年龄为20.82岁.近3个月内被调查者有与异性的性行为及各种方式的性行为,且每次使用安全套者仅13.77%.其中11.11%的人报告曾被诊断有性病.现场体检发现尖锐湿疣患病率13.21%（14/106）.尿道分泌物检查淋球菌阳性率2.68%（3/112）,沙眼衣原体8.04%（9/112）,解脲脲原体25.00%（28/112）,生殖支原体4.46%（5/112）.血清学检查HIV抗体全部阴性,梅毒螺旋体明胶凝集试验（TPPA）阳性率18.75%（27/144）,快速血浆反应素试验（RPR）阳性率9.72%（14/144）,疱疹病毒抗体（HSV-2-IgG）阳性率7.78%（7/90）,乙型肝炎病毒表面抗原（HBsAg）阳性率9.68%（9/93）,丙型肝炎病毒抗体（抗-HCV）阳性率0（0/93）,戊型肝炎病毒抗体（抗-HEV）阳性率16.13%（15/93）.结论 MSM人群的性生活状态复杂并且缺乏安全性意识,成为HIV/STD传播的桥梁人群.他们中STD的感染水平较一般人群高,个别感染甚至接近性病门诊的感染水平,应该引起关注.     

Post-Circuit Blues: Motivations and Consequences of Crystal Meth Use Among Gay Men in Miami

Miami, Florida was at the vanguard of the rise of circuit parties and attendant club drug use—especially ecstasy, GHB, and ketamine—in the 1990s. Crystal methamphetamine, a drug of abuse among gay men for some years on the West coast, gradually moved east toward the end of the decade and recently became prevalent in Miami. This paper reports the results of focus group research into the motivations and consequences of crystal use among gay men in this new setting. Loneliness, fears about physical attractiveness due to aging and illness, and desires to lose sexual inhibitions were common motivations for using the drug. Continued use of crystal was often described as the cause of lost friendships, employment and long-term relationships, as well as sexual behaviors that put men at risk for HIV and other sexually transmitted infections. Implications for drug and sexual risk prevention interventions are discussed.     

Seroprevalence of Kaposi's sarcoma‐associated herpesvirus among men who have sex with men in Japan

Kaposi's sarcoma‐associated herpesvirus (KSHV), the etiologic agent of Kaposi's sarcoma, causes malignancies frequently in patients with acquired immunodeficiency syndrome. In the United States and Europe, KSHV infection is common among men who have sex with men. However, the seroprevalence of KSHV among men who have sex with men in Japan is unknown. In the present study, the seroprevalence of KSHV was investigated among 230 men who have sex with men and 400 age‐ and area of residence‐matched men (controls) using a mixed‐antigen (KSHV‐encoded K8.1, open reading frame 59, 65, and 73 proteins) enzyme‐linked immunosorbent assay and an immunofluorescence assay. Among the Japanese men who have sex with men, serological assays revealed that 27 (11.7%) were seropositive for KSHV; 20 (5%) of the men in the control group were also KSHV seropositive. The seroprevalence of KSHV among men who have sex with men was significantly higher than in the control group (odds ratio = 2.52, 95% confidence intervals = 1.38–4.62, P = 0.0019, Chi‐square test). Infection with the human immunodeficiency virus, Treponema pallidum, or hepatitis B and C virus did not correlate with KSHV infection. Furthermore, the association of KSHV seropositivity with specific sexual activities was not statistically significant. In conclusion, a higher KSHV seroprevalence was found among Japanese men who have sex with men than among the controls, suggesting that the circulation of KSHV infection is more efficient among men who have sex with men in Japan than among men who do not engage in such sexual activities. J. Med. Virol. 85: 1046–1052, 2013. © 2013 Wiley Periodicals, Inc.