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Explain use of YGM – to include gay, bisexual and all others identiiesPhD Candidate in EpidemiologyUniversity of Guelph in Guelph, Ontario, CanadaRotary International Ambassadorial ScholarshipAIDS Epidemiology Group, University of OtagoResearch InterestsSexual health and HIV prevention for young and ethnic minority MSM
Start with ABOUT ME
EXPLAIN USE OF YMSM as under 30
EXPLAIN HOW ONLINE-RECRUTIED is really another VENUE, not ONLINE SEXUAL ACTIVITY
Compared to OMSM, YMSM were more likely to have been recruited online, to be ethnically diverse, and to report a bisexual identity. Recent sexual health testing/treatment and STI diagnosis rates did not differ by age group, except that YMSM were less likely to have tested HIV-positive.
Generally, KNOWLEDGE HIGH among all MSM, with least knowledge about the increased risk for HIV transmission in the EARLY/ACUTE STAGEOverall, Younger MSM LESS KNOWLEDGE
MORE YMSM have NO PARTNERS, LESS YMSM have >5 PARTNERS large proportion of YMSM have 1-5 partners in half a yearLESS likely to have a casual partner, but SLIGHTLY MORE likely to have had anal sexLESS likely to have a current REG partner, and IF SO, that relationship is much more likely to be <6 MONTHS OLD ALSO MORE LIKELY TO HAVE ANAL SEX w REG PARTNERYMSM were more likely to have “receptive only” anal intercourse compared to OMSM irrespective of partner type. YMSM used condoms MORE with BOYFRIENDS, LESS with CASUAL and NO DIFF with FUCKBUDDIES
Largely, concurrent partnering did not differ by age. However, regardless of age, the majority of MSM reported complex patterns of sexual/relational partnering, with nearly a third engaging in sex with multiple regular and casual sex partners.
Nathan Lachowsky, "Comparing younger and older gay men & other MSM in New Zealand"
Nathan Lachowsky, PhD CandidateYoung Gay Men’s PanelBC Gay Men’s Health Summit4 November 2011
Include map Auckland: 1.42 million people (2010)
Background: New Zealand’s HIV Epidemic Younger Gay Men & HIV Objectives Methods: HIV sociobehavioural surveillance Results: Younger Gay Men vs Older Gay Men Conclusions Future Research & Next Steps Questions & Dialogue
Gay men continue to be Characteristics of MSM % Diagnosed with HIV in disproportionately and New Zealand, 2010 predominantly affected (n=90) by HIV in New Zealand Ethnicity 71.4% of new HIV NZ European/Pakeha 71 diagnoses in 2010 Maori 10 2010 was 2nd highest Asian 10 number of new Pacific 1 diagnoses in New Infected in New Zealand 71 Zealand’s history Late Diagnosis 48 Age 15-29 at Diagnosis 32
Unique New Zealand context and experience of younger gay men (YGM) Increased rights: Homosexual Law Reform 1986, Human Rights Acts 1993, Civil Unions 2005 Availability of effective HIV treatments: HAART 1997 Improved prognosis for HIV-positive individuals Connectedness to “gay community”: less or different? International interest in YGM New generation; “post-AIDS” era Recent increase in HIV infection rates within USA
Compare HIV-related knowledge, attitudes, and behaviours between: Younger gay men (YGM) & older gay men (OGM) ▪ YMSM: 16 – 29 years of age ▪ OMSM: 30+ years of age Focus on and strategy of primary prevention
Pooled sample of 3387 YGM and 5602 OGM from the 2006, 2008, and 2011 rounds of New Zealand’s sociobehavioural HIV surveillance Gay Auckland Periodic Sex Survey (GAPSS) and Gay men’s Online Sex Survey (GOSS) Anonymous and self-completed questionnaires Reproducible convenience sample Second-generation surveillance: “gold standard” World Health Organization recommended
Offline recruitment (1 week in February) Big Gay Out: 29.4% of pooled sample Gay bars: 4.7% of sample Sex-on-site venues : 7.7% of sample Online recruitment (2-4 weeks following) Internet dating sites: 58.2% of sample Statistical analyses controlled for survey year Mantel-Haenszel chi-square and multinomial logistic regression * = Statistically significant difference (p<0.05)
Table 1. Demographic and testing YGM OGMcomparisons (%) (%)Demographics Recruited: online 67.4 52.9 * Ethnicity: NZ European/Pakeha 68.5 80.6 * Identity: bisexual 24.0 21.5 *Testing (in previous 12 months) Tested for HIV (excluding known-positives) 39.9 39.5 Tested HIV positive (at last HIV test) 0.9 4.7 * Sexual health testing/treatment 47.0 45.4 Any STI (not including HIV) 9.0 9.0* Statistically significant difference between younger and older MSM, p<0.05
Figure 1. HIV-Related Knowledge inYounger and Older Gay Men in NewZealand, 2006, 2008, & 2011 combined 100% * 80% * *% of gay men who knew statement was fact 60% 40% * 20% Data only from Data from 2006. Data from 2006. Data from 2006. Data from 2006. 2006 && 2011 2008, 2008 2008, & 2011 2008, & 2011 2008, & 2011 0% “Anal sex without a “Oral sex is low risk” “HIV is more easily “HIV cannot pass condom is very high transmitted in early through an risk” stages” undamaged condom” Younger GM Older GM * p<0.05
Figure 2. HIV-Related Attitudes in Youngerand Older Gay Men in NewZealand, 2006, 2008, & 2011 combined 100%% of gay men who agreed 80% with the statement 60% * * 40% 20% 0% HIV is a less Condoms are I’d rather risk I don’t like A man who serious threat OK as part of HIV that use a condoms knew he has that it used to sex condom during because they HIV would tell be because of anal sex reduce me before sex new treatments sensitivity Younger GM Older GM * p<0.05
Table 2. Sexual behaviour and YGM OGMcondom use comparisons (%) (%)Sexual Behaviour ( in previous 6 months) Number of sex partners: None 9.8 6.8 * Number of sex partners: >5 29.1 39.6 * Any casual partner 71.9 75.3 * If casual partner, % having anal sex 80.7 77.4 * Current regular partner 42.7 50.4 * Length of relationship <6 months 41.2 18.7 * If regular partner, % having anal sex 89.2 82.3 * >1 regular partner and casual partner(s) 30.6 32.5Condom Use High condom use with boyfriend 37.2 31.9 * High condom use with fuckbuddy 58.9 61.3 High condom use with casual partner 73.6 77.0 *
Figure 5. Sexual/Relational Partnering in Last 6Months of Younger Gay Men in New Zealand 35% 30% % of gay men reporting 25% 20% 15% 10% * 5% * 0% No sex with a 1 regular >1 regular 1 regular >1 regular Casual sex man partner only partners, no partner and partners and only casual casual casual Sexual/Relational Partnering Combinations (<6 months) Younger GM Older GM * p<0.05
YGM and OGM similarities and differences: YGM less knowledge, fewer partners, less casual sex, more anal sex, and more condom use with boyfriends, but less with casual partners Need for strategic, targeted HIV/sexual health promotion for YGM and other YMSM Contributes to evidence-based health promotion and prevention efforts
Strengths: Novel research on YGM in New Zealand Gold standard HIV sociobehavioural surveillance Survey data collected both online and offline Large pooled sample allowing sub-analyses Limitations: Debate regarding “younger” definition/classification Impact of online venue (not online sexual activity) Univariate analyses presented, multivariate analyses can take into account other confounders
Disseminate this research on YGM Present to affected and interested groups Post findings to community: blogs, news stories Publish results: conferences and journal articles Continue with research plan Multivariate analyses on condom use and HIV testing Cross-ethnic analysis Advocacy and pressure for greater funding to continue and expand research efforts
Expanded research into other communities Different geographic areas in New Zealand Other populations at risk of HIV infection Further investigation into differences between HIV-related risks for YGM Sexual activity with partners met online vs offline Use qualitative research to help understand and explore sexual networks and concurrency Investigate resiliency and protective factors
University of Otago PJW Saxton NP Dickson New Zealand AIDS Foundation AJ Hughes University of Guelph CE Dewey AJS Summerlee