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Men & Women Both Say This Is How Long Sex Should Last - YouTubeYour account has been temporarily blocked due to the wrong signal in the attempts and will automatically unlock 30 minutes. For immediate assistance, contact the Customer Service: 800-638-3030 (United States), 301-223-2300 (international) Log inLippincott Magazine Subscribers, use your username or email along with your password to log in. Registration of a free account Registered users can save items, searches and manage email alerts. All registration fields are necessary. Side Logos Colleague's email is Invalid Your message has been sent to your colleague. Final note Procite Reference Manager Save my selection ♪ Men who have sex with men and women: a single risk group for HIV transmission on the campus of North Carolina CollegeHightow, Lisa B. MD, MPH*; Leone, Peter A. MD*†; MacDonald, Pia D. M. PhD, MPH†§; McCoy, Sandra I. MPH†; Sampson, Lynne A. MPH† E-mail: Received for publication on 9 June 2005 and accepted on 31 January 2006. Objective: To better understand the role of men who have sex with men and women (MSM/W) in the spread of HIV in young adults in North Carolina, we determine the prevalence of MSM/W among newly diagnosed HIV-infected men, we compare the social and behavioral characteristics of this group with MSM and MSW, and we examine sexual networks associated with university students infected with HIV among these groups. Methods: We review state HIV monitoring records for all new HIV diagnosis in men aged 18 to 30 who live in North Carolina between 1 January 2000 and 31 December 2004. Results: Of 1105 records available for review, 15% were MSM/W and 13% were university students. Compared to MSM, MSM/W was more likely to enrol in the university, to inform the sexual partners of the year prior to diagnosis, or to have sexual partners that were also MSM/W. Analysis of the sexual network of HIV-infected university students revealed that MSM/W was at the centre of the world. Of 20 people who described themselves as MSW or abstinent at the time of their first voluntary advisory and evidence visit, 80% reported that they were MSM or MSM/W during follow-up. Discussion: MSM/W represents a unique risk group within the MSM population that deserves additional research. The MSM/W College appears to occupy a unique and central place in the network of HIV-infected students. An investigation of young people who are newly diagnosed with HIV infection in North Carolina reveals that men who have sex with men and women are a unique risk group that occupy a central position within sex networks. DESIGNING NOVEL PUBLIC HEALTH interventions to reduce human immunodeficiency virus (HIV) transmission requires an in-depth understanding of the target population. In addition, interventions that adapt to the incorporation of cultural buildings are more likely to be effective. In addition, a precise description of the characteristics of HIV-infected persons is required to inform policymakers and public health officials because they allocate prevention resources. Available evidence suggests that the epidemiology of HIV infection in the United States has shifted over the past decade. Several serosurveys have documented an increase in the number of HIV cases among non-Hispanic/Latin Blacks. This pattern is especially pronounced in the southeast of the United States, which is experiencing a disproportionate increase in HIV infections. Seroepidemiological studies have documented a change in risk behaviors associated with new HIV infections. Although men who have sex with men (MSM) still constitute the majority of HIV infections reported, the incidence of HIV is increasing among women and men who have sex with women (MSW). From 2000 to 2003, 80 per cent of Black women acquired HIV through heterosexual contacts, while only 27 per cent of Black men acquired HIV through heterosexual contacts; most Black men (54%) claimed to be MSM as their risk of transmission. Current risk classification hierarchies in most states depend on self-reported risk behaviour at the time of HIV testing. Few studies have assessed the validity of these self-reported risk behaviors. Several researchers have raised the possibility that men who have sex with men and women (MSM/W) can serve as a "bridge" for infection among these groups. Despite these concerns, the behaviour and characteristics of the HIV-infected MSM/W have received relatively little attention. Network analysis can help explain the transmission of HIV and other sexually transmitted infections (STIs) and support the use of the network perspective in understanding HIV risk behaviors. The network structure has been found to be an important factor in the spread of infectious diseases, and there is evidence that a basic group of people is responsible for most of the maintenance and spread of sexually transmitted infections, including HIV. In addition, the analysis of sociosexual networks may have potential applications for future STI interventions targeting high-risk groups. As part of our attempts to understand the role played by MSM/W in the spread of HIV in young adults from 18 to 30 years in North Carolina, we determine the prevalence of MSM/W among newly diagnosed HIV-infected men between 1 January 2000 and 31 December 2004, we compare the social and behavioral characteristics of this group with MSM and MSW, and we examine sexual networks associated with HIV-infected university students. In addition, we compare reported risk behaviors at the initial session of voluntary counselling and HIV testing with risk behaviours reported to disease intervention specialists (DIS) during follow-up interviews of infected individuals. MethodsWe have conducted a review of North Carolina HIV/AIDS (AIDS) surveillance records for men aged 18 to 30 who were recently diagnosed with HIV infection between 1 January 2000 and 31 December 2004. All reports and interview records submitted by DIS, as well as information from the VCT site on patients diagnosed with HIV infection and patients' contacts were included in these records as reported to DIS. In North Carolina, reporting on HIV is mandatory and DIS is required to investigate and interview any positive HIV test results reported to the state or local health department by a medical provider or clinical laboratory. Using information from these records, men were classified as MSM/W, MSM or MSW. This monitoring background review was considered part of an ongoing epidemiological public health investigation sanctioned by the North Carolina Health Services Division and thus exempted from the approval of the Institutional Review Board. Cross-Sectional Study We compare the risk behavior and demographic information of newly diagnosed MSM/W with MSM, MSM/W with MSW, and MSM/W students with MSM/W students do not take it. In bivariate analysis, we calculate test statistics (t-test) and P values (2-cuts) for continuous variables and probabilities ratios (OR), 95% confidence intervals (CIs), and P values (with 2 tails) for binary variables using Epi Info 2002 (Atlanta, GA) and SAS (version 9.1.2; Cary, NC). Given the size of the small sample, exact methods were used to compare proportions. To determine the factors associated independently with MSM/W compared to MSM and MSW, respectively, we build 2 models of exploratory logistic regression. Variables that had a P-value Sexual Networks Among University StudentsPreviously we reported an increase in HIV infections in university students and noted that males from the university infected with HIV were more likely to be MSM/W. Therefore, in addition to the comparisons of risk behavior and demographic information, we also evaluate the impact of MSM/W on university sex networks of HIV. We build a network of sexual partners through the information obtained from DIS interview records of university men and their sexual contacts. We examine potential network links of sexual partners defined by student reports to DIS of sexual partners at their university of enrollment or sexual partners at other universities. This was achieved through the manual review of all DIS interview records of index patients diagnosed with HIV infection and their contacts from 1 January 2000 to 31 December 2004. DIS is intended to investigate any positive HIV test results reported to the state health department. They review medical records to obtain demographic and clinical information about the patient's reported index and try to contact the patient to perform a voluntary, confidential and detailed interview. Interviews with infected people are conducted using a case report form that includes demographic information, place of employment and/or school attendance, risk factors, sexual partners in the 12 months before diagnosis and social acquaintances of people with HIV infection. The case report form also includes an area for a narrative in which the DIS can register comments from the interview that are not captured elsewhere on the form (e.g., activities reported by interviewees and places where they socialize, collect couples and have sex). Cluster interview is applied to obtain information on the social circles of indices patients, which may include additional people exposed through unpreserved sexual networks. Comparison of reported risk behavior in university students We compare the self-denominated sexual risk behaviors given by male university patients during their initial visits to VCT sites with information on risk behaviors reported during DIS interviews. Male university case patients who reported sex with men during VCT and DIS interviews were compared to those men who had different risk behaviors recorded in both interviews. Results Between 1 January 2000 and 31 December 2004, 1292 men aged 18 to 30 were reported with newly diagnosed HIV infection in North Carolina. Of 1105 (85.5%) records available for review, 1013 records had valid information about sexual partners in the 12 months prior to diagnosis. Of these men infected with HIV, 573 (57%), 279 (27%) and 161 (16%) were classified as MSM, MSW and MSM/W respectively during their interviews with DIS. Cross-sectional study comparing MSM/W with MSM, MSM/W were more likely to be black (OR = 1.84; 95% CI = 1.21–2.79; referee = white), enrolled in the university at the time of diagnosis (OR = 2.10; 95% CI = 1.39–3.18), and report having sex partners who were also university students (OR = 2.42; 95% CI = 1.56–3,74). In multivariate analysis, the MSM/W was considerably more likely than the MSM to meet their sexual partners at university and to report 2 to 5, 6 to 10, or ±10 sexual partners in the year before diagnosis (reference = 0 to 1 sexual partners). In this analysis, we found that the effect of having MSM/W sexual partners was not the same in the college enrollment strata, and the effect of exchanging sex for drugs or money was not the same in the race categories. Among those who did not have MSM/W partners, the students were 1.86 (1.08-3.21) times more likely to be MSM/W compared to non-students. Among non-students, those who had MSM/W partners were 2,14 (1,25–3.66) times more likely to be MSM/W compared to those who did not have MSM/W partners. The odds of being MSM/W among those who exchange sex and are white are 9.93 (95% CI = 3.24–30.49) times the chances of being MSM/W among whites who do not exchange sex. The odds of being MSM/W among those who exchange sex and are black are 3.27 (95% CI = 1.39-7.67) times the odds among whites who do not exchange sex. Comparing MSM/W with MSW, MSM/W was more likely to be younger (OR = 6.07; 95% CI = 3.22–11.43 for 18–22 years, refer = age 29–30 years) and black (OR = 1.90; 95% CI = 1.21–2.99; reference = white) (). MSM/W was more likely to be coined with syphilis (OR = 3.00; 95% CI = 1.41–6.35), to be enrolled in the university at the time of diagnosis (OR = 17.10; 95% CI = 7.10–41.23), and less likely to have been imprisoned (OR = 0.45; 95% CI = 0.28–0.72). Factors that continued to be significant in multivariate analysis included university inscription, sexual partners that were also enrolled in the university, syphilis incoding and reporting from 2 to 5, 6 to 10, or sexual partners from ±10 in the year prior to diagnosis (reference = 0 to 1 sexual partners). We found significant interactions in this model with an age group and with fellow university students and incarceration and ethnicity. The odds of being MSM/W among those who have university student couples and are 18 to 22 years old are 17.61 (95% CI = 2.00–154.90) times the likelihood of being MSM/W without a university partner and age 29 to 30 years old. Of newly diagnosed HIV-infected men, 44 (27.3%) of the 161 MSM/W attended the university at the time of diagnosis (). All but 2 of the MSM/W university (95.5%) were black compared to 69.2% of the MSM/W does not catch (P = 0.02). The 44 MSM/W who attended the university were more likely to meet sexual partners at higher universities than the 117 MSM/W who were not university students (OR = 12.66; 95% CI = 3.34–48.07). However, the places to meet with sexual partners were not limited to university campuses. Only a minority of MSM/W university students (25.0%) reported meeting with sexual partners at the university. These students also reported meeting partners in bars or clubs (31.8 per cent) and/or on the Internet (27.3 per cent). Only 2 (4.5%) of MSM/W university students reported having sex with a person known for HIV/AIDS compared to 30 (25.6%) of MSM/W non-collective students (OR = 0.14; 95% CI = 0.03–0.61). Overall, the MSM/W appointed a total of 293 partners; 191 (65%) were men and 102 (35%) women. Fifty-five (34%) MSM/W were found with a total of 66 infected partners, either a positive or new diagnosis. Of these, 54 (82%) were men, 10 (15%) were women, and for 2 (3%) people, there was no gender information. In fact, 6 of the infected women were Hispanic, 3 were pregnant at the time of diagnosis, and 2 were university students. Sexual networks among university students We examine possible network links of sexual partners, defined by university males infected with HIV self-reported to DIS of sexual partners at their school of enrollment or sexual partners in other schools or with uncollected students. The network illustrated a dense interconnection pattern among university students infected with HIV with MSM/W occupying a central position within the network. When only MSM and MSW are considered, 6 discrete networks consist of 17 schools, 58 students and 5 student contacts are shown (). However, when MSM/W is included, a single network connects 26 schools, 95 students and 8 student contacts (). This network represents 67 per cent of all HIV-diagnosed students over the 5-year period. Reported risk behavior of university students As part of our attempts to characterize the report of risk behaviors, we compare the behaviors of self-reported sexual risk given by the patients of the university case during their initial visits to publicly funded TCV sites with information on risk behaviors reported during DIS visits. For 83 of the 142 students (58%), VCT data was available for review. Nearly 50% of these students had discrepant information between their VCT data and their interview with DIS. Of the 20 people who described themselves as MSW or reported that they did not have sexual risk factors at the time of their initial visit to TCV, 40% reported that they were MSM/W and 40% MSM during the follow-up visit with DIS. Compared to university patients who changed the reports of their risk behaviors (16 individuals), those MSM who reported sex with men during interviews with VCT and DIS (61 individuals) were more likely to be coined with syphilis (11.5% vs. 0%), to meet sexual partners in bars/clubs (36.1% vs. 25.0%) or on the Internet (32.8% vs. 25.0%). Debate Among the men of North Carolina from 18 to 30 years who were newly infected with HIV, MSM/W was more likely to be young, black and enrolled at the university at the time of their diagnosis of HIV. In addition, it was found that MSM/W was significantly different from MSM and MSW in terms of both demography and risk behaviors. There have been mixed reports on the role that male bisexual behaviour can play in heterosexual HIV transmission. Previous studies examining bisexual behavior have significant limitations. First, studies are largely transverse and do not examine behaviors reported over time. Second, these studies usually use a large window of time to define bisexual behavior. In addition, the previous study samples of behaviorally bisexual men have generally been composed of gay men who also have sex with women or have added MSM and MSM/W in a single group. This study is unique in measuring the self-report of sexual behavior in the 12 months before the infection, thus characterizing bisexual behavior more accurately. The finding that MSM/W was more likely than both MSM and MSW to be black agrees with other studies that found that black MSM is more likely than MSM of other races to identify as bisexual and be bisexually active. Several recent reports have focused on a group of Black youth who identify themselves as MSW but also have unrevealed sexual encounters with other men. These men called "lower" (DL) have received relatively little scientific scrutiny, but have been the subject of much recent media attention. These descriptions in the popular media describe DL men as secrets and, because they do not perceive themselves at risk of HIV infection, they do not receptive to standard HIV prevention messages. We do not know the precise prevalence of the DL phenomenon among students of the black university infected with HIV in our cohort and is not directly addressed in our studies. We found evidence of the probable transmission of HIV infection to 2 MSM/W associates at the university and 12 MSM/W male couples. This would suggest the potential for transmission of HIV by MSM/W to heterosexual women, especially in the black community; however, to date, this remains to be proved. In addition, of the 83 university patients with VCT and DIS information, 3 out of 8 (37%) white men did not report their MSM activity at the time of the test compared to 13 out of 75 (17%) black men. Despite the small size of the sample, this finding underlines the point that identifying itself as heterosexual and having sex with men is not unique to black men. Network analysis provides a unique vision of HIV transmission and sexually transmitted infections among people and communities. A network approach facilitates the identification of people in the social group of an infected individual who can benefit from diagnostic detection and selective treatment. Our data support the notion that the MSM/W of the university occupies a central position in the sexual network of students of the male university infected with HIV. The inclusion of MSM/W formed the "bridge" that united 6 discrete networks of schools and students to form a complex and large network (26 schools) of HIV-infected male students that spread across North Carolina and in surrounding states. A significant number of MSM/W students reported sex with anonymous partners (36%), thus avoiding the full definition of the network. Furthermore, because we only review the diagrams of men infected with HIV, we cannot fully comment on the impact that this network may have on the black heterosexual community. However, this network shows numerous interconnections and underlines the importance of HIV prevention interventions targeting individuals, as well as social circles linked through different places, both defined and through the Internet, where there may be a higher risk of sexual transmission. The results of this study are subject to several limitations. Because all information on new HIV infections in this research referred to new diagnoses, case reporting may be influenced by changes in the provision or absorption of HIV testing in specific populations (e.g. on campus testing sites) over time. However, during the 5 years of case data, the proportion of cases diagnosed with early HIV infection (defined as the presence of plasma-detected ribonucleic acid in the presence of a negative HIV antibodies test or a negative HIV antibody test and a subsequent positive HIV antibodies test in 6 months) has increased from 4.5 per cent in 2002 to 9.4 per cent in 2004, indicating the transmission of HIV. In addition, the retrospective nature of this study limited our ability to validate the responses of the DIS interviewed during their interviews. In addition, social and sexual networks may be incomplete and biased because men infected with HIV can be placed on networks that are different from men not infected with HIV, and contact tracking is inevitably incomplete. Data from the DIS information and the VCT site were only available for 58% of university students infected with HIV, so our findings may not be applicable to students who perform tests on non-CTV-related sites, such as medical offices where this information is not accessible. Finally, it should be noted that North Carolina is one of the 10 states in which HIV is confidential and is not offered as anonymous or confidential. Concerns about the lack of confidentiality among our participants may have led to a large number of changes in the risk factors reported. To design successful prevention messages and direct limited resources, we must recognize differences in HIV risk behaviors and transmission patterns within MSM populations. A rather hidden group of MSM/W is at high risk of HIV and poses a potential threat to the wider black community. The MSM/W College appears to occupy a unique and central place in the network of HIV-infected students. Sexual contact with men and women increases the likelihood that these university students can serve as bridge contacts, responsible for HIV transmission and other sexually transmitted infections among sexual networks; however, this research did not find evidence to support black MSM/W as the main source of HIV infection for black women. Is HIV infection in the black community the result of a highly interconnected single epidemic between MSM, MSMW and heterosexuals? Or is there essentially 2 epidemics of loose connection, one between MSM and one between heterosexuals? The answer to these questions is essential for successful prevention efforts. Support for HRSA Special Projects of National Significance IH97H03789-01-01 and UNC Chapel Hill CFAR.References Source Colleague's email is Invalid Your message has been sent to your colleague. Thank you for registering! Be sure to check your new user account in the next 24 hours", "Related Articles Colleague's email is Invalid Your message has been sent to your colleague. Final note Procite Reference Manager Save my selection Items at the level of article Related links Related videos Readers of this article Read also Never miss a numberBrowse Journal ContentFor Journal Authors Customer Service This website uses cookies. By continuing to use this website, you are consenting to the cookies used. For information about cookies and how you can disable them, visit our policy and ours.

COVID-19 is an emerging and rapidly evolving situation. Account name Save an appointment to archive E-mail citation Add to Collections Add to My Bibliography Your search saved Create a file for external dating management software Your RSS Feed Actions Share Page navigation Unsafe sex in men who have sex with men and women Membership Unsafe sex in men who have sex with men and women Authors Membership Summary Sexual behaviors of bisexually active men, defined as men who have sex with a man and a woman in 6 months earlier, were compared to men who only had sex with men. Differential sexual practices associated with the risk of HIV were evaluated between the two groups of men, as well as bisexual men with their male and female partners. Cross-sectional analyses of baseline data were carried out from a possible cohort of 508 young gays recruited into bars, university campuses and a health centre in Boston from 1993 to 1994. The confidence intervals (OR) and 95% (CI) were calculated on categorical variables, and McNemar's chi2 was used to compare the behaviors of bisexual men with their male sex partners against females. Six months before the interview, 47 (10%) men had male and female sexual partners, and 383 men only had male sexual partners during the last year or always. Fifty-eight per cent of the men in the study had a female sexual partner in their lives, and 18 per cent in the last year. Bisexual men were more likely to have drinking problems identified by the Michigan alcohol screening test (MAST; OR = 3.96, 95% CI = 1.54-10.20), and less male couples during their lifetime (medium +/- standard deviation [SD], 24+/-42; median, 7; versus median +/- SD, 69+/-516; median, 12), although this difference was not statistically. The two groups had similar levels of unprotected anal sexual intercourse (25.5% vs 29.5%); however, bisexual men were half likely to have anal sex as homosexual men (OR = .50; 95% CI = .27-0.93). Bisexual men were three times more likely to have unprotected sex with their female partner as male couple (OR = 3.0; 95% CI = 1.02-8.8). Stratified analysis revealed similar discordant behavior while sober (OR = 4.0), drinking (OR = 7.0), and while drinking with concurrent drug use (OR = 8.0). Among these cohorts of men who have sex with men (MSM), a considerable proportion also had vaginal sex with female couples in the last 6 months. Bisexually active men are more likely to have unprotected sex with their female partners compared to their male partners, which could increase the risk of HIV and other sexually transmitted diseases. Conductive interventions directed towards MSM need to address bisexual behaviors. PIP: Data were collected from 508 gay men recruited from bars, 17 university campuses in the Boston area, and a health center in Boston during 1993-94 for use in a study that compares the sexual behaviors of men who had sex with a man and a woman during the previous 6 months against men who had sex with only men. Participants in the study were between 18 and 27 years old, although 85.1 per cent were between 18 and 26 years old. 6 months before the interview, 10% of men had male and female sex partners, while 383 men only had male sex partners during the last year or never. Fifty-eight per cent of the men in the study had ever had a female sexual partner, and 18 per cent had had had had been in the last year. Bisexual men were more likely to have drinking problems identified by Michigan's alcohol screening and fewer male couples during their lifetime. 25.5% of bisexual men and 29.5% of homosexuals reported having unprotected anal sex, but bisexual men were less prone than homosexual men to have anal sex. Bisexual men were 3 times more likely to have unprotected sex with a female couple like with their male partner. The stratified analysis revealed this same discording behavior while sobering, drinking and drinking along with other drug use. Similar articles Cited by 10 articles Types of publication MeSH Terms Related information Grant support Link Out - more resources Total Text sourcesMedicalMiscellaneousNCBI Literacy resources National Library of Medicine

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