WEPE123 - Poster Exhibition
Event-level analysis of multipartner sexual encounters: situational characteristics and sexual outcomes reported by MSM in England
G.J. Melendez-Torres1,2, F. Hickson3, D. Reid3, P. Weatherburn3, C. Bonell2
1Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom, 2Social Science Research Unit, Institute of Education, University of London, London, United Kingdom, 3Sigma Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
Background: Digital communication and urban socio-sexuality make
multipartner sexual encounters increasingly easy to facilitate, while rising HIV
incidence and prevalence of unprotected anal intercourse (UAI) in men who have
sex with men (MSM) suggest an emerging risk milieu. Yet few event-level studies examine multipartner
encounters, and none address MSM in England or the United Kingdom generally. Moreover, event-level analyses generally do
not examine sexual outcomes beyond HIV risk.
This analysis tests whether situational characteristics predict UAI,
pleasure, and control in a sample of multipartner encounters reported by MSM in
Methods: MSM in England participated in a web-based
survey throughout 2011 and early 2012 in which they reported up to three
multipartner encounters with men.
Generalised estimating equations with exchangeable correlation matrices
and canonical link functions tested whether number of male participants, respondent
substance use, sex venue, and serodiscordance predicted UAI, self-reported
control over personal outcomes (yes/no), and pleasure (1-10, with 10 best).
Results: 321 MSM reported 438 encounters. In univariate models, any substance use
(OR=1.73, p< 0.05), number of substances used (OR=1.24, p< 0.001), erectile
dysfunction medication (OR=2.23, p< 0.05) and crystal methamphetamine
(OR=3.18, p< 0.05) use, and not knowing partners'' serostatuses (OR=0.39,
p< 0.001)?but not place of sex or number of partners?were significantly
associated with engagement in UAI.
Effects were similar in multivariate models.
In univariate models testing associations with pleasure,
number of substances used (beta=0.14, p< 0.01), number of partners
(beta=0.05, p< 0.01), outdoors location (beta=-1.02, p< 0.001), and not
knowing partners'' serostatuses (beta=-0.38, p< 0.05), but not any or specific
substance use, were statistically significant.
Except for serodiscordance, effects significant in univariate models
remained significant in multivariate models.
No situational characteristics, except crystal
methamphetamine use (OR=0.15, p< 0.001), were associated with reduced control.
Conclusions: This event-level analysis is among the first to
examine either multipartner encounters, or sexual outcomes beyond UAI. Situational characteristics?including
substance use?that predict sexual risk and pleasure do not predict control,
suggesting that in the context of multipartner encounters, control may not
mediate the relationship between substance use and sexual risk. Further research should investigate
additional situational characteristics and compare encounters within
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