Abstract
Although nuanced parameterization of sexual behavior may improve estimates from mathematical models of human immunodeficiency virus and sexually transmitted infection transmission, prospective estimates of the incidence of specific sexual behaviors among men who have sex with men (MSM) are limited. From December 2014 to July 2018, MSM with and without nongonococcal urethritis (NGU) completed weekly diaries over 3–12 weeks. Incidence rates of any sex, receptive anal sex, insertive anal sex, insertive oral sex, receptive rimming, and receptive hand–penile contact were 1.19, 0.28, 0.66, 0.90, 0.24, and 0.85 episodes per person-week, respectively, among 104 MSM with NGU at baseline, and 1.33, 0.54, 0.32, 0.95, 0.44, and 0.88 episodes per person-week, respectively, among 25 MSM without NGU at baseline. Most receptive anal sex (NGU + 83%, NGU − 86%) and insertive anal sex (NGU + 85%, NGU − 76%) episodes were condomless. MSM engaged in sex just over once per week, and condom use was infrequent. Insertive oral sex and receptive hand–penile contact were the most common behaviors.
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De-identified data can be made available upon request, in accordance with the University of Washington Human Subjects Division policies and procedures.
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We conducted statistical analyses using Stata 15 (StataCorp, College Station, Texas). Code can be made available upon request.
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Acknowledgements
The authors thank the study participants and the Public Health—Seattle and King County Sexual Health Clinic staff. They also gratefully acknowledge Sean Proll for data management, as well as Hologic, Inc. for donation of test collection kits and reagents.
Funding
This work was supported by the National Institutes of Health [grant number U19 AI113173]. LCC was supported by the National Institutes of Health [Grant Numbers TL1 TR002318 trainee support]. Study data were collected and managed using Research Electronic Data Capture (REDCap) tools hosted at the University of Washington Institute of Translational Health Sciences and supported by the National Institutes of Health [Grant Number UL1 TR002319].
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Authors contributed to the manuscript (MS) in the following manner. LCC and LEM contributed to MS concept. LCC, JLM, MSL, TSR, SSR, GLL, SNG, and LEM collected the data. LCC analyzed the data and drafted the manuscript. LCC, JLM, MSL, TSR, SSR, GLL, SNG, CMK, JPH, MRG, DNF, and LEM critically revised the manuscript.
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CMK has received donations of test kits and reagents from Hologic, Inc. MRG has conducted studies unrelated to this work supported by grants from Hologic, Inc. and GlaxoSmithKline. LEM has received research support and honoraria from Hologic, Inc. and Nabriva Therapeutics. All other authors declare that they have no conflict of interest.
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Portions of this work were presented at the 2017 Annual Meeting of the NIH-funded Sexually Transmitted Infections Cooperative Research Centers, held May 24-25, 2017, in Santa Fe, New Mexico, as well as the 2019 STI and HIV World Congress, held July 14-17, 2019, in Vancouver, Canada. This work was performed while LCC, TSR, and GLL were at the University of Washington and JLM was at the Public Health – Seattle and King County HIV/STD Program. LCC is currently at The Miriam Hospital Division of Infectious Diseases, the Brown University Departments of Medicine and Epidemiology, and the Rhode Island Department of Health in Providence, Rhode Island. TSR is currently at the US Centers for Disease Control and Prevention National Institute for Occupational Safety and Health Mining Research Division in Spokane, Washington. GLL is currently at the Urban Indian Health Institute in Seattle, Washington. JLM is currently at the Public Health – Seattle and King County Communicable Disease and Epidemiology Department in Seattle, Washington.
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Chambers, L.C., Morgan, J.L., Lowens, M.S. et al. The Incidence Rate of Sexual Behaviors Among Cisgender Men Who Have Sex with Men Attending a Sexual Health Clinic. Arch Sex Behav 52, 751–759 (2023). https://doi.org/10.1007/s10508-022-02370-z
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DOI: https://doi.org/10.1007/s10508-022-02370-z