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Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia.
BMJ Open. 2020 11 24; 10(11):e037608.BO

Abstract

OBJECTIVES

In the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals. Men who have sex with both men and women (MSMW) have characteristics that may differ from both men who have sex with men only (MSMO) and heterosexual men. We aimed to compare the sexual practices and the trends in HIV/STI positivity between MSMO and MSMW.

DESIGN

Repeated cross-sectional study.

SETTING

A sexual health centre in Melbourne, Australia.

PARTICIPANTS

MSM aged 18 years and above who attended the Melbourne Sexual Health Centre for the first time between 2011 and 2018. This includes 12 795 MSMO and 1979 MSMW.

PRIMARY OUTCOME MEASURES

Demographic characterics, sexual practices and HIV/STI positivity.

RESULTS

Compared with MSMW, MSMO were more likely to practice anal sex and to have condomless receptive anal sex with casual male partners, and less likely to have a current regular relationship. Over the 8-year period, there was an increase in condomless receptive anal sex with casual male partners for both groups (MSMO: from 46.2% to 63.3%, ptrend <0.001; MSMW: from 41.3% to 57.9%, ptrend=0.011). Syphilis positivity increased in MSMO (from 5.5% to 7.9%, ptrend=0.012) and MSMW (from 0.9% to 6.4%, ptrend=0.004) and HIV remained stable. Gonorrhoea increased among MSMO from 2011 to 2014 (from 6.7% to 9.6%, ptrend=0.002), and remained stable from 2015 to 2018. MSMO had higher odds of testing positive for gonorrhoea (adjusted OR (aOR) 1.36, 95% CI 1.13 to 1.64), chlamydia (aOR 1.39, 95% CI 1.16 to 1.67), syphilis (aOR 1.74, 95% CI 1.37 to 2.22) and HIV (aOR 4.60, 95% CI 2.43 to 8.70) than MSMW.

CONCLUSIONS

MSMW have overall lower condomless sex and lower HIV/STI positivity. In the last years, changes in sexual practices in MSM have affected both MSMW and MSMO leading to an increased STI risk.

Authors+Show Affiliations

Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia eric.chow@monash.edu mmartin@hku.hk. Preventive Medicine and Public Health Training Unit, Parc de Salut Mar - Pompeu Fabra University - Agència de Salut Pública de Barcelona (PSMar-UPF-ASPB), Barcelona, Spain.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Central Clinical School, Monash University, Melbourne, Victoria, Australia.Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Central Clinical School, Monash University, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Central Clinical School, Monash University, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Central Clinical School, Monash University, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia eric.chow@monash.edu mmartin@hku.hk. Central Clinical School, Monash University, Melbourne, Victoria, Australia. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33234617

Citation

Martín-Sánchez, Mario, et al. "Trends and Differences in Sexual Practices and Sexually Transmitted Infections in Men Who Have Sex With Men Only (MSMO) and Men Who Have Sex With Men and Women (MSMW): a Repeated Cross-sectional Study in Melbourne, Australia." BMJ Open, vol. 10, no. 11, 2020, pp. e037608.
Martín-Sánchez M, Case R, Fairley C, et al. Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia. BMJ Open. 2020;10(11):e037608.
Martín-Sánchez, M., Case, R., Fairley, C., Hocking, J. S., Bradshaw, C., Ong, J., Chen, M. Y., & Chow, E. P. F. (2020). Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia. BMJ Open, 10(11), e037608. https://doi.org/10.1136/bmjopen-2020-037608
Martín-Sánchez M, et al. Trends and Differences in Sexual Practices and Sexually Transmitted Infections in Men Who Have Sex With Men Only (MSMO) and Men Who Have Sex With Men and Women (MSMW): a Repeated Cross-sectional Study in Melbourne, Australia. BMJ Open. 2020 11 24;10(11):e037608. PubMed PMID: 33234617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia. AU - Martín-Sánchez,Mario, AU - Case,Richard, AU - Fairley,Christopher, AU - Hocking,Jane S, AU - Bradshaw,Catriona, AU - Ong,Jason, AU - Chen,Marcus Y, AU - Chow,Eric P F, Y1 - 2020/11/24/ PY - 2020/11/25/entrez PY - 2020/11/26/pubmed PY - 2021/4/20/medline KW - HIV & AIDS KW - epidemiology KW - public health KW - sexual medicine SP - e037608 EP - e037608 JF - BMJ open JO - BMJ Open VL - 10 IS - 11 N2 - OBJECTIVES: In the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals. Men who have sex with both men and women (MSMW) have characteristics that may differ from both men who have sex with men only (MSMO) and heterosexual men. We aimed to compare the sexual practices and the trends in HIV/STI positivity between MSMO and MSMW. DESIGN: Repeated cross-sectional study. SETTING: A sexual health centre in Melbourne, Australia. PARTICIPANTS: MSM aged 18 years and above who attended the Melbourne Sexual Health Centre for the first time between 2011 and 2018. This includes 12 795 MSMO and 1979 MSMW. PRIMARY OUTCOME MEASURES: Demographic characterics, sexual practices and HIV/STI positivity. RESULTS: Compared with MSMW, MSMO were more likely to practice anal sex and to have condomless receptive anal sex with casual male partners, and less likely to have a current regular relationship. Over the 8-year period, there was an increase in condomless receptive anal sex with casual male partners for both groups (MSMO: from 46.2% to 63.3%, ptrend <0.001; MSMW: from 41.3% to 57.9%, ptrend=0.011). Syphilis positivity increased in MSMO (from 5.5% to 7.9%, ptrend=0.012) and MSMW (from 0.9% to 6.4%, ptrend=0.004) and HIV remained stable. Gonorrhoea increased among MSMO from 2011 to 2014 (from 6.7% to 9.6%, ptrend=0.002), and remained stable from 2015 to 2018. MSMO had higher odds of testing positive for gonorrhoea (adjusted OR (aOR) 1.36, 95% CI 1.13 to 1.64), chlamydia (aOR 1.39, 95% CI 1.16 to 1.67), syphilis (aOR 1.74, 95% CI 1.37 to 2.22) and HIV (aOR 4.60, 95% CI 2.43 to 8.70) than MSMW. CONCLUSIONS: MSMW have overall lower condomless sex and lower HIV/STI positivity. In the last years, changes in sexual practices in MSM have affected both MSMW and MSMO leading to an increased STI risk. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/33234617/Trends_and_differences_in_sexual_practices_and_sexually_transmitted_infections_in_men_who_have_sex_with_men_only__MSMO__and_men_who_have_sex_with_men_and_women__MSMW_:_a_repeated_cross_sectional_study_in_Melbourne_Australia_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&amp;pmid=33234617 DB - PRIME DP - Unbound Medicine ER -