Marseille 2007
| Abstract #52 - Protected and unprotected anal intercourse among homosexually active men in Melbourne: personal, social and contextual predictors | ||||
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Session: 26.98: Posters B (Poster) on Tuesday in Chaired by Authors: Presenting Author: Dr Jeffrey Grierson - La Trobe University, Australia |
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| Additional Authors: Prof Anthony Smith, Prof Marian Pitts, Prof Philippa Pattison , | ||||
| Aim: The factors associated with anal intercourse, particularly unprotected anal intercourse (UAI), are numerous. Often, research focuses on particular potentially explanatory factors such as whether the partner was met on the internet or whether either or both partners were under the influence of drugs or alcohol. An emerging focus of research on UAI is the sexual encounter in which the intercourse took place, which demonstrates that, at least in relation to the most recent sexual encounter, characteristics of the men are important predictors of behaviour. The aim of this paper is to increase our understanding of the complexity surrounding mens practice of both protected anal intercourse (PAI) and UAI by simultaneously considering the characteristics of the men, their social networks and a number of their sexual encounters. | ||||
| Method / Issue: Analyses are made on data from a cross-sectional survey. A total of 733 sexual encounters reported by 202 men recruited from the gay community in Melbourne, Australia. Most men were Australian born (79.21%), college or university educated (60.40%), in full-time (46.53%) employment, HIV-negative (73.27%), without a history of injecting drug use (83.17%) and identified as gay (90.59%). Their mean age was 36.9 years. Measures used include network characteristics (including gender mix, sexuality mix, egocentric network size, network density), context measures (including relationship to partner, location of sex, drug and alcohol use) and self-reported PAI and UAI. | ||||
| Results / Comments: Multilevel multinomial logistic regression was used to model the data in MLwiN. The outcome was no anal intercourse (NAI) versus PAI and NAI versus UAI. The men reported a total of 733 sexual events: most (56.3%) did not involve anal intercourse, and more involved PAI than UAI (30.6% versus 13.1%). PAI was more likely than no anal intercourse (NAI) if the participants social network was majority gay, if the partner was an occasional or casual partner or was HIV positive. PAI was less likely if sex took place at a beat but more likely if it took place at a sauna. PAI was more likely if the partner was affected by drugs or alcohol. UAI was more likely than NAI if the participant had injected drugs in the year prior to interview. It was less likely if the partner was occasional or casual or was HIV positive but more likely if the partners HIV status was unknown. UAI was much more likely than NAI if the encounter took place at a sex-on-premises-venue. | ||||
| Discussion: In this analysis it is the characteristics of the sexual encounter that are the major predictors of whether PAI or UAI take place. It is the relationship between the partners, the partners HIV status and where the sex takes place that predicts whether PAI or UAI rather than NAI takes place. We suggest a reframing from an understanding that a propensity to engage in UAI is an attribute of particular men, to a recognition that the occurrence of UAI (and PAI) is significantly shaped by characteristics and context of the specific sexual encounter. | ||||
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