Associations between sexual partner number and HIV risk behaviors: implications for HIV prevention efforts in a Treatment as Prevention (TasP) environment

ABSTRACT

Previous research indicates that gay and bisexual men (GBM) have significantly more sexual partners than same-aged heterosexual men and women. As a result, some HIV intervention programs have focused on partner reduction. However, new research findings question the relevance of sexual partner number as a sexual risk measure for GBM given Treatment as Prevention (TasP) programs and new seroadaptive strategies which have led to lower GBM community viral load and new HIV prevention behaviors. To assess if sexual partner number continues to remain an important measure of sexual risk for GBM living in a city that actively promotes TasP as provincial policy, we analysed cross-sectional data from 719 GBM recruited through respondent-driven sampling in Vancouver, Canada. Multivariable negative binomial regression analysis showed that partner number was significantly associated with previously identified HIV risk factors including condomless anal intercourse with serodiscordant and/or unknown serostatus partners, using sex toys, attending group sex events, receiving money for sex, and sex drug use. These results indicate that sexual partner number remains an important proximate HIV risk measure. However, more nuanced measures of HIV treatment status and greater understanding of the possible causes of increased partner number among GBM are needed.

KEYWORDS:

• Gay and bisexual men
• men who have sex with men
• sexual partners
• HIV
• sexual risk

Acknowledgements

We thank our community colleagues at the Health Initiative for Men, YouthCO HIV & HepC Society of BC, and Positive Living BC for their support. We also thank the research participants for sharing their important life history data with the Momentum Health Study.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Heather L. Armstrong http://orcid.org/0000-0002-1071-8644

Nathan J. Lachowsky http://orcid.org/0000-0002-6336-8780

Zishan Cui http://orcid.org/0000-0002-9236-3890

Kiffer G. Card http://orcid.org/0000-0001-6545-1249

Robert S. Hogg http://orcid.org/0000-0003-3463-5488

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research [MOP-107544, FDN-143342, PJT-153139] and the National Institutes of Health, National Institute on Drug Abuse [R01DA031055-01A1]. NJL was supported by a CANFAR/CTN Postdoctoral Fellowship Award. DMM and NJL are supported by Scholar Awards from the Michael Smith Foundation for Health Research (#5209, #16863). HLA is supported by a Postdoctoral Fellowship Award from the Canadian Institutes of Health Research (Grant # MFE-152443). AJR is supported by a Frederick Banting and Charles Best Doctoral Research Award from the Canadian Institutes of Health Research (#379361).