How Old Is He Really? The Association Between "Gay Age" and Sexual Behaviors Among Men Who Have Sex With Men.

Men who have sex with men (MSM) are disproportionately impacted by HIV and other sexually transmitted infections, with sexual behaviors acting as a primary predictor of disease acquisition. Predictors of engagement in specific sexual behaviors may act as key targets for preventive strategies. We hypothesized that time since first engaging in oral or anal sex with another man, or one's "gay age," is associated with sexual behavior among MSM. We examined 5280 MSM aged 18 to 40 years who were recruited from social and sexual connection Web sites. We used modified Poisson regression to examine associations between gay age and 4 sexual behaviors (enema use, group sex, receptive anal intercourse, insertive anal intercourse). We used time-varying effect models to examine how the prevalence of these behaviors varies across gay age. In total, 76% of participants reported receptive anal intercourse in the past year, and 76% reported insertive anal intercourse. Group sex and enema use in the past year were reported by 39% and 36%, respectively. Modified Poisson and time-varying effect model analyses indicated that the prevalence of enema use, group sex, and insertive anal intercourse significantly increased with increasing gay age. Gay age may serve as an important marker of engagement in sexual behaviors associated with sexually transmitted infection/HIV acquisition among MSM.

An event-level comparison of risk-related sexual practices between black and other-race men who have sex with men: condoms, semen, lubricant, and rectal douching.

Black men who have sex with men (MSM) living in the U.S. are disproportionately affected by HIV/AIDS. An online survey of sexual behavior was completed by Black, White, Hispanic/Latino, Asian/Pacific Islander, and other-race MSM (n=11,766) ages 18-87 years. Complete condom use, semen exposure, pre-coital rectal douching (enema use), and lubricant use at last male-partnered sexual event were compared by race, controlling for relevant sociodemographic variables and stratifying by sexual position (receptive, insertive, or both). Across sexual positions, 55-62% of Black MSM reported condom use, 5-8% reported semen exposure, 18-53% reported douching, and 33-43% reported lubricant use. Reported behavioral profiles were not significantly different from other races, except that Black MSM reported greater condom use than White MSM in the insertive position. Although findings argue against disproportionate rates of risk behavior accounting for racial disparities in HIV prevalence, they nonetheless highlight a need for continued behavioral intervention.