| Demographic characteristics
of HIV sexual risk by Men who use the Internet to seek Sex with
Men: Results of the Men's INTernet Sex Study-II.
Rosser, B.R.S., Oakes, J.M., Konstan, J., Remafedi, G., Zamboni,
B., and the Men's INTernet Sex II (MINTS-II) Team.
Abstract
Background: African Americans and Latino Americans
have the highest rates of HIV and AIDS in the United States (US).
As prevention efforts targeting men who use the Internet to seek
sex with men (MISM) are in their infancy, no previous studies have
compared risk by race/ethnicity in this potentially high risk group.
Methods: We conducted the first NIH-funded, Internet-based HIV
prevention study of MISM (n = 2,883) in the US beginning in fall 2005. Using
a block design based on race/ethnicity, we recruited 763 Anglo-Americans, 739
Latino-Americans, 532 Asian-Americans, 479 African-Americans, and 370 “other” Americans
from banners posted on a popular gay-themed website. Rates of unprotected anal
intercourse (UAI) with sex partners met in the past 3 months were compared across
races/ethnicities.
Results: Approximately one-third of participants reported at
least one UAI episode with a sex partner in the past 3 months. African-American
men had higher rates of UAI than Anglo-Americans men (crude IRR = 1.72, p<.01;
adjusted IRR = 1.80, p<.01), with no differences in risk observed for any
other race/ethnicity group. An examination of the risk distribution revealed
that the high risk estimate for African-American men were due to a small number
of men in the extreme upper tail of the distribution. No differences were observed
at the median, and only very small differences at the 95th percentile.
Conclusions: Consistent with prior knowledge that African Americans
are disproportionately affected by the HIV epidemic in the US, Black men in our
study had the highest rate of unsafe sex. However, this effect did not hold for
the majority of men since it was detected only at the extreme end of the distribution.
For this reason, it may be most effective and efficient for HIV prevention programs
to target all MISM rather than specific racial or ethnic groups at this time.
About
the Author
B. R. Simon Rosser, Ph.D., M.P.H., L.P., is professor and director
of the HIV/STI Intervention and Prevention Studies (HIPS) Program,
in the Division of Epidemiology and Community Health, School of
Public Health at the University of Minnesota. He has advanced degrees
in psychology,
epidemiology, and behavioral medicine, with postdoctoral training
in clinical/research sexology. Born and raised in New Zealand,
he helped found the New Zealand AIDS Foundation (1983), then completed
the first PhD in HIV prevention in the Southern Hemisphere at the
Flinders University of South Australia. Simon moved to University
of Minnesota in 1990. He is an award winning author of 5 books
and numerous scientific articles, serves as a reviewer for NIH
on the Behavioral and Social Consequences of HIV/AIDS, and is best
known for his research in the areas of HIV prevention, male homosexuality,
homophobia, sexual health, Internet sex, and structural level interventions.
Currently he is principal investigator on three NIH-funded studies
testing highly interactive Internet based interventions for Men
who use the Internet to seek Sex with Men, examining the long-term
impacts of HIV prevention interventions for persons living with
HIV, and structural level interventions to lower alcohol-related
HIV risk; a CDC-formative study designing online interventions
for persons living with HIV; and a state funded study to improve
the sexual health and reduce HIV risk behavior among MSM.
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