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Back in March, he came down to visit after he was MSM overall reported both higher numbers of partners and more concurrency than heterosexuals. In a descriptive study like this it is not possible to tease apart the relative impact of these two factors.
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Both likely contribute to greater transmission. But it is also possible that concurrency produces a qualitative difference in transmission dynamics even in this context — creating more robust connectivity in the network, compounded by the window of high infectivity during acute infection. This qualitative effect has been shown in two recent modeling studies of heterosexual spread of HIV in Zimbabwe 35 , 36 , and a similar modeling study would be needed here to identify the independent and joint impacts of concurrency and rapid partner acquisition.
This study had several limitations. First, we used three different surveys which limited the comparability of measures between groups. To our knowledge, however, no single survey includes large numbers of MSM and heterosexuals from rigorously sampled representative populations as well as the parameters we sought to study. The UMHS, on the other hand, was conducted in —98, which was 5—10 years earlier than the Seattle surveys. For example, although there were drastic changes in internet use between the mids and mids, the proportion of MSM who met their partners through less formal social venues in general did not change.
Although not presented here, there were very few differences in behavior patterns between the UMHS cities suggesting that sexual behavior patterns among urban MSM were relatively similar. A second limitation is that the low survey response rates may have affected the representativeness of our findings if there were differential participation rates associated with sexual behavior.
Third, the cross-sectional data in these studies were prone to potential recall bias and the confounding of cohort effects, which can affect the estimation of longitudinal patterns.
Because of this, we were unable to specifically evaluate the behaviors of persons with STI, which are clearly key with respect to transmission risk. Our finding that MSM continued to form new partnerships later into adulthood than heterosexuals, coupled with much higher levels of concurrency and age-disassortative mixing, demonstrates important ways in which the sexual behavior and sexual network patterns of MSM and heterosexuals differ. Relatively few MSM partnerships in our analysis were formed in the context of personal social networks.
Attitudes toward sexual minorities and laws affecting their relationships e. Thus, it is plausible that the long-standing cultural forces that promote relatively safe patterns of sexual behavior among heterosexuals have exerted relatively little influence on MSM. Public Health Service. The authors state no conflicts of interest.
Author Contribution: SNG conducted the analyses and wrote the first draft of the article. All authors contributed to the present study design, reviewed, and edited the article. All authors have read and approved the final version of this manuscript. List of Supplement Digital Content. Supplemental Digital Content 1. National Center for Biotechnology Information , U. J Acquir Immune Defic Syndr. Author manuscript; available in PMC May 1. Aral , PhD, 8 Lisa E. Sevgi O. Aral 8 U. Lisa E.
King K. Matthew R.
Author information Copyright and License information Disclaimer. Corresponding Author: Copyright notice. See other articles in PMC that cite the published article. Associated Data Supplementary Materials 1. Methods We compared sexual behavior patterns of MSM and male and female heterosexuals aged 18—39 using 4 population-based random digit dialing surveys. Results Sexual debut occurred earlier among MSM than heterosexuals.
Conclusions MSM have longer periods of partnership acquisition, a higher prevalence of partnership concurrency, and more age-disassortative mixing than heterosexuals. Methods Study populations, study designs, and survey instruments We used data from 4 random digit dialing RDD surveys Table 1.
Open in a separate window. Condom use Across all surveys, we assessed whether or not participants always used condoms with their most recent partner.
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Sex partner concurrency Using available partnership start and end dates month and year , we determined the proportion of respondents who reported any overlapping partnerships in the past year. Partner meeting place Using a question about how respondents met their most recent partner, we created three categories Statistical methods We compared each measure among heterosexual men and women and MSM using descriptive statistics. Results Sample characteristics The mean age of participants included in this analysis was similar across surveys, ranging from Age at sexual debut and number of partners The mean age at same-sex sexual debut was Partnership formation and the cessation of new partner recruitment Across all age groups, MSM were more likely than heterosexuals to report having a new partner in the past year Figure 1a.
Figure 1. Mixing by age To accurately capture partnerships formed at a given age, we restricted these analyses to participants reporting a new partnership in the past year.
Figure 2. Concurrency As shown in Figure 2b , the prevalence of sex partner concurrency during the year was much lower among heterosexual men and women 9.
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Meeting new partners Over three-quarters of heterosexual men Discussion We used data from several large population-based surveys to estimate the dynamics of sexual partnership formation, concurrency, and age mixing among MSM and heterosexuals.