Predictors of Identifying as a Barebacker among High-Risk New England HIV Seronegative Men Who Have Sex with Men |
| |
Authors: | Sari L Reisner Matthew J Mimiaga Patricia Case Carey V Johnson Steven A Safren and Kenneth H Mayer |
| |
Institution: | (1) The Fenway Institute, Fenway Community Health, Boston, MA, USA;(2) Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA;(3) School of Public Health, Boston University, Boston, MA, USA;(4) Brown Medical School/Miriam Hospital, Providence, RI, USA |
| |
Abstract: | Studies have found that between 14% and 46% of US men who have sex with men (MSM) consistently report “barebacking” behavior
(i.e., intentional unprotected anal intercourse) with other men. This is of public health significance because MSM continue to constitute more
than 50% of new HIV infections in the USA. Men who self-identify as barebackers may represent a different and unique subset
of MSM with distinct HIV prevention needs. In 2007, 227 HIV seronegative MSM recruited through modified respondent-driven
sampling completed an interviewer-administered survey which assessed barebacker identity (i.e., personally identifying with
the barebacker scene), demographics, sexual risk behaviors, psychosocial variables, and drug/alcohol use. Bivariate and multivariable
logistic regression procedures were used to examine predictors of barebacker identity in relation to HIV risk behavior. Overall,
31% of participants identified as a barebacker. In bivariate analyses, lower education (OR = 1.76; 95% CI = 0.99–3.13; p < 0.05), a current drinking problem (OR = 2.34, 95% CI = 1.29–4.23; p < 0.01), higher levels of HIV treatment optimism (OR = 1.06; 95% CI = 1.01–1.12; p < 0.05), meeting sexual partners at private sex parties (OR = 2.47; 95% CI = 1.28–4.74; p < 0.01) or at bars/cubs (OR = 1.97; 95% CI = 1.10–3.52; p < 0.05), and engaging in serodiscordant unprotected insertive anal sex (OR = 3.42; 95% CI = 1.27–9.21; p < 0.01) significantly predicted barebacker identification compared to those with no barebacker identification. In a multivariable
model, barebackers were more likely to screen in for alcohol abuse (adjusted OR = 2.16; 95% CI = 1.09–4.27; p < 0.05) and engage in serodiscordant unprotected insertive anal sex (adjusted OR = 3.17; 95% CI = 1.09–9.20; p < 0.05) compared to their non-barebacker counterparts. No significant differences were found in serodiscordant unprotected
receptive anal sex between barebackers and non-barebackers. These findings suggest that barebacker identity is related to
intentional HIV sexual risk taking and alcohol abuse. Furthermore, strategic positioning (i.e., engaging in insertive rather
than receptive sex) might be associated with barebacker identification and may indicate a harm-reduction strategy being used
among some HIV-uninfected MSM to reduce their risk of becoming infected. Additional research is warranted to understand the
social identity of barebacking among MSM in order to develop more nuanced prevention strategies. |
| |
Keywords: | HIV/AIDS STIs MSM Bareback Prevention |
本文献已被 SpringerLink 等数据库收录! |
|