Sexually adventurous gay men are more likely to engage in sexual risk behavior. Is this an individual characteristic or does it reflect participation in sexually adventurous networks?
Methods: CONNECT was an online survey of gay men recruited during 2010-2012 in Sydney, Melbourne and Perth. 937 men were asked questions about their own sexual identity and that of men in their personal networks. 912 men responded to these questions, including 452 who were referred into the study by another participant. L Factor analysis and logistic regression was used to calculate statistical associations.
Results: Most men were gay (78.1%) or homosexual (16.1%). Mean age was 35.6 years. 89.6% had been tested for HIV and 12.1% were HIV-positive. Most men identified at least somewhat with several sexual identities, such as: Bear/cub (25.2%); Sexpig (20.4%); Partyboy (21.7%); Leatherman (18.1%); Twink (12.3%); Alternative (25.4%). Most men also indicated that men in their personal networks identified at least partially with several of these same identities, such as: Bear/cub (28.7%); Sexpig (23.1%); Partyboy (33.9%); Leatherman (21.3%); Twink (20.5%); Alternative (26.2%).
Usually, but not always, men’s personal identities closely corresponded to those of their networks. Factor analysis identified six types of personal network: Sexually adventurous (accounting for 64.2% of men); Bears, cubs and chubbies (40.6%); Alternative / queer (47.4%); Gay scene (43.7%); Conservative (57.7%); and Asexual (9.2%). In multivariate analysis, after controlling for age and HIV status, only being engaged in sexually adventurous networks was associated with unprotected anal intercourse with casual partners (aOR=1.17; CI 1.10-1.24; p<0.001).
Conclusion: Men’s various sexual identities tend to also be reflected in the kinds of men with whom they engage. sexual risk behavior is more likely to occur within sexually adventurous networks, and to reflect their normative values. Targeted harm reduction programs need to address men through such networks, not just as individuals.
The majority of HIV diagnoses including delayed diagnoses in Australia occur among men who report homosexual contact – hereafter called gay and bisexual men (GBM). Delayed diagnosis is strongly associated with increased HIV-related mortality and morbidity. People who are unaware of their HIV-positive status may also be unwittingly transmitting HIV. We assessed trends in delayed HIV diagnoses among GBM in Australia.
HIV-associated leishmaniasis, endemic in the Mediterranean basin is a growing problem in India, Brazil and East Africa. Despite surviving for than 20 years, the clinical course of our visceral-leishmania (VL)-HIV co-infected patient illustrates several management challenges including diagnosis, speciation and drug resistance; monitoring burden of disease; access to and use of VL-treatments; end-organ toxicity and the combined immunosuppressive effects of HIV-VL.
Adherence to combination antiretroviral therapy (cART ) plays an important role on treatment outcomes. The TREAT Asia Studies to Evaluate Resistance – Monitoring Cohort Study (TASER-M) collects patients’ adherence based on a Visual Analogue Scale. The aim of this analysis was to assess the rates of, and factors associated with, suboptimal adherence in the first 24 months of initial cART in Asian patients.
REACH was a collaborative research and practice initiative to develop evidence building frameworks, capacity, tools and resources with the Victorian HIV community partnership.
HIV disease is associated with chronic inflammation and activation of the innate immune system. This state, as measured using plasma markers of inflammation, persists following suppression of HIV viremia using antiretroviral therapy, and may increase risk of non-AIDS co-morbidities. The causes of innate immune activation in the setting of virological suppression are unclear. Natural killer (NK) cells are innate immune cells that kill virus-infected and transformed cells without prior sensitization. We have shown that NK cells are activated both phenotypically (elevated expression of HLA-DR) and functionally (increased spontaneous degranulation measured by CD107a surface expression) in virologically suppressed (VS) HIV+ individuals. NK cells also lose expression of CD16, the receptor which mediates antibody-dependent cellular cytotoxicity.
Regular HIV testing is recommended in men who take sexual risks. We assessed the relationship between perceived barriers to HIV testing, and frequency of testing among men who engaged in unprotected anal intercourse with casual partners (UAIC), to inform HIV testing strategies.
Gay men remain the primary population affected by HIV in Australia. While recent attention has been focused on increasing HIV testing and the use of antiretroviral-based prevention to reduce infections, it is equally important to sustain safe sex and other risk reduction practices. Increases in unprotected anal intercourse (UAI), for example, may counteract any beneficial changes in testing and treatment.