Partner meeting place is significantly associated with gonorrhea and chlamydia in adolescents participating in a large high school sexually transmitted disease screening program.

BACKGROUND: From 2003 to 2012, the Philadelphia High School STD Screening Program screened 126,053 students, identifying 8089 Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (GC) infections. We examined sociodemographic and behavioral factors associated with CT/GC diagnoses among a sample of this high-risk population. METHODS: Standardized interviews were given to infected students receiving in-school CT/GC treatment (2009-2012) and to uninfected students calling for results (2011-2012). Sex-stratified multivariable logistic models were created to examine factors independently associated with a CT/GC diagnosis. A simple risk index was developed using variables significant on multivariable analysis. RESULTS: A total of 1489 positive and 318 negative students were interviewed. Independent factors associated with a GC/CT diagnosis among females were black race (adjusted odds ratio [AOR], 2.27; confidence interval, 1.12-4.58), history of arrest (AOR, 2.26; 1.22-4.21), higher partner number (AOR, 1.75; 1.05-2.91), meeting partners in own neighborhood (AOR, 1.92; 1.29-2.86), and meeting partners in venues other than own school, neighborhood, or through friends ("all other"; AOR, 9.44; 3.70-24.09). For males, factors included early sexual debut (AOR, 1.99; 1.21-3.26) and meeting partners at "all other" venues (AOR, 2.76; 1.2-6.4); meeting through friends was protective (AOR, 0.63; 0.41-0.96). Meeting partners at own school was protective for both sexes (males: AOR, 0.33; 0.20-0.55; females: AOR, 0.65; 0.44-0.96). CONCLUSIONS: Although factors associated with a GC/CT infection differed between males and females in our sample, partner meeting place was associated with infection for both sexes. School-based screening programs could use this information to target high-risk students for effective interventions.

Gay men who attend sex resorts: a typology associated with high-risk sexual behaviour.

Our objective was to determine a sociodemographic profile (typology) of men for whom a relatively greater number of sex partners was associated with engaging in unprotected anal sex. A cross-sectional survey of 150 men who have sex with men (MSM) attending a large sex resort was conducted. The sex resort was located in the Southeastern United States. Men from 14 states attended the resort and completed an anonymous, self-administered, questionnaire. The typology that emerged showed that the co-occurring risk behaviours (greater number of partners and having unprotected sex) were reported by older men (P = 0.002), men with incomes of at least US 50,000 dollars (P = 0.018), men growing up in rural areas (P = 0.005), men who were not knowingly HIV positive (P = 0.004), and men who had received the full series of vaccinations against hepatitis B (P = 0.029). This typology may be useful for more efficient targeting of prevention and counselling programmes designed to reduce sexually transmitted infection incidence among this high-risk (and understudied) population of MSM.

A descriptive analysis of HIV risk behavior among men having sex with men attending a large sex resort.

This study assessed the prevalence of various HIV-associated risk behaviors among men who have sex with men (MSM) attending a popular sex resort in the southern United States. One hundred fifty men completed an anonymous self-administered questionnaire (91% response rate). Men currently resided in 14 states. One sixth reported being HIV-positive. During a typical resort visit, men averaged 4 sex partners. About two thirds of the men had anal sex during a typical resort stay; of these, 21% reported never using condoms and 41% reported always using condoms. HIV risk behavior over the past few months was also assessed. Men averaged 10 sex partners. Meeting partners by means of the Internet (57%) and bathhouses--excluding sex resorts--(40%) was common. Most men (62%) reported having group sex. About one half (49%) engaged in unprotected anal sex. Significant differences in recent frequency of unprotected anal sex between HIV-positive and HIV-negative men were not found (P = 0.74). Among those using condoms, 20% reported not using condoms from start to finish of sex, 7% reported breakage, and 6% reported slippage. Twenty-three percent had anal sex without lubrication. Fisting and the use of nonprescription sildenafil citrate (Viagra) was reported by about one sixth of the men. The findings suggest that MSM attending sex resorts may experience substantial risk of HIV infection. Sex resorts may be an important venue for HIV prevention.

Correlates of recent unprotected anal sex among men having sex with men attending a large sex resort in the South.

BACKGROUND: Published studies have not investigated sexually transmitted disease-associated risk behaviors among men who have sex with men (MSM) attending U.S. sex resorts. GOAL: We conducted an exploratory study to identify demographic and behavioral correlates of recently engaging in unprotected anal sex (UAS) among MSM attending a sex resort in the southern United States. STUDY DESIGN: A cross-sectional survey of 150 men. RESULTS: In multivariate analyses, men were more likely to practice risky sex if they also recently engaged in the practices of having group sex (adjusted odds ratio [AOR], 3.0), rimming (AOR, 2.0), or if they used public restrooms to meet potential sex partners (AOR, 2.6). UAS was also more likely among men vaccinated against hepatitis B (AOR, 1.9). Men who reported having primary partners and men who reported being HIV-positive were no less likely than other men in the sample to report recent UAS. CONCLUSION: Sex resorts can be an important venue for sexually transmitted disease and HIV prevention among MSM. Tailored prevention messages could be warranted for men who report group sex, rimming, meeting partners in public restrooms, or being vaccinated against hepatitis B.