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The rate of syphilis infections among sexual minority men (SMM) has continued to increase in recent decades. As such, this analysis sought to identify demographic, biological, and behavioral factors associated with recent syphilis infection in emerging adult SMM. Data were drawn from a 3-year cohort study of emerging adult SMM (n = 665), from July 2014 to March 2019. Biannual study assessments included rapid HIV testing and behavioral surveys. At baseline, and at the 18- and 36-month time points, participants underwent chlamydia, gonorrhea, and syphilis screening. Generalized estimating equations were used to generate four models of repeated syphilis screening. In this racially/ethnically and socioeconomically diverse sample of SMM, 5.0% of participants tested positive for syphilis at baseline and 9.0% had an infection at the subsequent time points. Across all models, racial/ethnic minority SMM had higher odds of syphilis. Higher odds of syphilis infection were also significantly associated with more frequent condomless anal sex, more frequent marijuana use, HIV seropositivity, not currently using pre-exposure prophylaxis (PrEP), and not receiving syphilis testing in the previous 6 months; lower odds were associated with more frequent oral sex and more frequent alcohol use. These findings support current screening guidelines based on SMM who may be at increased risk for sexually transmitted infection (STI) acquisition, such as people living with HIV or those who engage in condomless sex. Further, our findings of reduced syphilis incidence among those who are on PrEP and engaged in regular STI testing support existing efforts to increase the availability and accessibility of preventive sexual health care for SMM. [ABSTRACT FROM AUTHOR]

The article discusses a study that describes data on human papillomavirus (HPV) among transgender young adults in New York City. Highlights include the use of the Alere Determine HIV-1/2 Ag/Ab Combo to conduct HIV testing, HPV vaccination recommended for cisgender women, and the need for further studies to better understand barriers and facilitators to vaccination among transgender women.

Young gay, bisexual, and other men who have sex with men (YMSM) under age 30 in New York City are at high risk for acquiring HIV. Using the theoretical framing of fundamental causes, this analysis examined the extent to which sociodemographic factors (race/ethnicity, perceived familial socioeconomic status [SES], U.S.-born status, and sexual orientation) explain the likelihood that HIV-negative YMSM ages 18 and 19 engage in unprotected sexual behavior, which may place them at risk for serconversion. Data were drawn from the baseline (Wave 1) assessment of a cohort study ( N=592) collected between July 2009 and May 2011. The sample consisted predominantly of racial/ethnic minority YMSM (70.8%). A high level of association was demonstrated for each of the demographic factors with unprotected sexual behaviors. Multinomial logistic regression analyses were undertaken to examine associations between demographic covariates with the likelihood of engaging in unprotected sexual behaviors with male partners (any unprotected anal intercourse, as well as unprotected receptive anal, insertive anal, and receptive oral intercourse) irrespective of partner serostatus, in the month prior to assessment. U.S-born status and perceived socioeconomic status consistently were significant in differentiating risk behaviors. Being born outside the U.S. and perceiving a lower SES was associated with greater levels of risk. These findings suggest that efforts to address the disproportionate burden of HIV disease among YMSM in the United States must not focus solely on issues of race/ethnicity, but must be tailored and targeted to low SES and foreign-born young gay and bisexual men. It is posited that these demographic factors may lead to disproportionate levels of psychosocial burdens, which engender risk. [ABSTRACT FROM AUTHOR]

Sexual pleasure has been identified as an important consideration in decision-making surrounding condom use. We examined the impact of perceived pleasure loss associated with condom use on recent history of insertive and receptive unprotected anal intercourse (UAI) among Latino men who have sex with men (MSM) living in the United States. A total of 482 Dominican, Colombian, and Brazilian immigrant MSM were surveyed regarding sexual attitudes and practices via computer-assisted self-interviewing technology with audio enhancement (ACASI). Participants rated the pleasure they derived from protected and unprotected anal intercourse in each position (insertive and receptive) and also reported their HIV status, relationship status, and recent sexual history. Men who had engaged in both positions, with and without condoms ( n=268), perceived a greater pleasure loss associated with condoms during anal intercourse in the insertive versus receptive position. Logistic regression analyses controlling for HIV status, relationship status, and age revealed that men who perceived greater pleasure loss from condoms were more likely to have engaged in UAI over the past 3 months ( n[insertive]=297; n[receptive]=284). Findings indicate that the pleasure loss associated with condoms may be a key deterrent for their use in either sex position among Latino MSM. Therefore, pleasure needs to be prioritized in the development of condoms and other sexual safety measures as well as in the promotion of their use. [ABSTRACT FROM AUTHOR]

To examine antiretroviral (ARV) drug resistance, we recruited a community sample ( n=347) of sexually active HIV-positive men who have sex with men (MSM) in New York City, each of whom completed a structured interview and donated a blood sample for HIV genotyping. Participants reported high levels of sexual activity, with 94.6% reporting at least one sexual contact in the past month, and an average of 3.13 partners during this time. Anal intercourse was common, with 70.7% reporting at least one act of insertive anal intercourse (21% of whom reported ejaculating inside their partner without a condom) and 62.1% reporting at least one act of receptive anal intercourse during this time (22.6% of whom received ejaculate without a condom). Seventeen percent reported having sex with a woman in the past year. Although 17.4% of participants reported having ever injected drugs, no association was found between injection and antiretroviral resistance. Average HIV diagnosis was 12.1 years prior to the interview, and 92.1% had taken ARV medication. Sexually transmitted infections (STIs) were widely reported, with 78% having been diagnosed with an STI since being diagnosed with HIV. A genotype was obtained for 188 (54.7%) of the samples and 44.7% revealed mutations conferring resistance to at least one ARV. Resistance to at least one ARV within a given class of medication was most common for nucleoside reverse transcriptase inhibitors (30.3%) and non-nucleoside reverse transcriptase inhibitors (27.7%) and least common for protease inhibitors (18.1%). The combination of high prevalence of antiretroviral resistance and risky sexual practices makes transmission between sex partners a likely mode of acquisition. [ABSTRACT FROM AUTHOR]

HIV prevention has become a new priority for HIV clinicians, as their patients live longer and more sexually active lives. Prevention interventions can be effective in clinical settings, but first patients must be screened and inconsistent condom use must be disclosed. Audio computer-assisted self-interviews (ACASI) are an effective way to elicit this sensitive information. We assessed condom use by ACASI among 198 English- or Spanish-speaking HIV patients at 2 community hospital-based HIV clinics in Queens and the Bronx, New York. Among 120 patients reporting sex with a regular partner in the past 4 weeks, 41 (34%) reported not using a condom every time and 22 (18%) reported never using a condom. Among 81 reporting sex with a casual partner in the past 4 weeks, 21 (26%) reported not using a condom every time and 12 (15%) reported never using a condom. Overall, 24 of 129 sexually active patients (19%) reported never using a condom. In a multivariable model controlling for age, race/ethnicity, gender, and HIV exposure category, depression symptoms (Center for Epidemiological Studies Depression Scale [CES-D] score ≥ 16; p = 0.03) and self-reported antiretroviral medication non-adherence (≤95% doses in past 3 days; p = 0.03) were significantly associated with never using a condom with a regular or casual partner. ACASI interviews may be an effective way of identifying patients in clinical settings who require prevention counseling as well as other psychosocial services. [ABSTRACT FROM AUTHOR]