A comparison of HIV risk practices among unprotected sex-seeking older and younger men who have sex with other men

Abstract

Purpose: In recent years, much attention has been devoted to understanding the HIV risk behaviors of younger men who have sex with men (MSM). Recent data suggest that HIV is becoming an increasing problem for older adults, but little attention has been devoted to understanding their HIV risk behaviors or the factors that underlie their risk taking. This study provides a comparison of these issues among younger and older MSM. Methods: The data come from a subset of younger (ages 18–39, n = 113) and older (ages 50+, n = 109) men participating in a national study of 332 men who use the Internet to find other men for unprotected sex. Men were sampled randomly from 16 websites. Data were collected via telephone interviews conducted in 2008 and 2009. Results: Younger and older men reported comparable involvement in HIV risk, including involvement in unprotected sex, proportion of sex acts involving internal ejaculation, number of times having anonymous sex, and number of times having multiple-partner sex. Generally speaking, the factors underlying the risk practices of younger and older men were quite different (e.g. self-esteem and condom use self-efficacy for younger men, versus HIV serostatus and depression for older men). Conclusions: Older MSM using the Internet to find partners for unprotected sex engage in high rates of behaviors that place them at risk for contracting or transmitting HIV. They were just as likely as their younger counterparts to practice these behaviors. The factors “fueling” involvement in risk generally differ for older and younger men, thereby warranting the development of age-specific HIV interventions that can take into account the unique life circumstances and needs of older MSM.

Keywords::

• Older men
• older MSM
• HIV risk
• Internet

Acknowledgments

The author wishes to acknowledge, with gratitude, the contributions made by Thomas P. Lambing to this study’s data collection and data entry/cleaning efforts. The author also thanks David Tilley for providing comments on an earlier draft of this work.

Declaration of Interest: This research (officially entitled Drug Use and HIV Risk Practices Sought by Men Who Have Sex with Other Men, and Who Use Internet Websites to Identify Potential Sexual Partners) was supported by a grant (5R24DA019805) from the National Institute on Drug Abuse.

Notes

¹The questionnaire included scales used and validated by other researchers to measure such phenomena as self-esteem [25], depression [26], attitudes toward condom use [27], condom use self-efficacy [28], childhood maltreatment experiences [29], knowledge about HIV [30], locus of control regarding HIV safety [31], partner communication skills [32], current life satisfaction [33], optimism about the future [34], impulsivity [35], extent of “outness” as a gay or bisexual man [36], and perceptions of being stigmatized as a result of one’s sexual orientation [37]. Lifetime and recent substance use information was collected using a format very similar to that employed by the Risk Behavior Assessment [38]. Additional information about these scales and their psychometric properties in the present study may be obtained by contacting the author.