Sexual behaviour patterns and STI risk: results of a cluster analysis among men who have sex with men in Portugal. Issue 1 (22nd January 2021)

• Record Type: Journal Article
• Authors: Blondeel, Karel; Dias, Sonia; Furegato, Martina; Seuc, Armando; Gama, Ana; Fuertes, Ricardo; Mendão, Luís; Temmerman, Marleen; Toskin, Igor
• Is Part Of: BMJ open. Volume 11:Issue 1(2021)
• Publication Date: 2021-01-22
• Subjects: sexual health -- STI -- HIV & AIDS -- syndemic -- MSM; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2019-033290
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: Portugal has the highest HIV incidence rate in Western Europe. The proportion assigned to sexual contact between men recently increased to more than 30% of all HIV infections. Men who have sex with men (MSM) are vulnerable to the acquisition of other sexually transmitted infections (STIs), increasing the per-contact risk of HIV infection. Building on syndemic theory, the aim of this analysis was to identify patterns of current sexual behaviour in MSM, and explore their relationship with self-reported current, past STI diagnoses and HIV positive serostatus. Design: A cross-sectional behavioural survey was conducted in Portugal among MSM, using a community-based participatory research approach. Hierarchical cluster analysis was used to identify patterns including behavioural and demographic factors. Results: The analysis resulted in six clusters. Three clusters showed higher rates of current STI diagnosis (ranging from 11.7% to 17.1%), past STI diagnosis (ranging from 25.5% to 41.5%) and HIV positive serostatus (ranging from 13.0% to 16.7%). From the three clusters scoring lower on current and past STI and HIV diagnoses, one was characterised by a high number of sexual partners (62% had more than 12 partners in the last year), a high proportion (94.6%) of frequent visits to gay venues to meet sexual partners and high alcohol use (46.1%). The other two clusters scored lower on high risk sexual behaviour. Conclusion: Factors other than sexual behaviour appear to reinforce the vulnerability to STIs and HIV of some MSM in this study, suggesting a syndemic of STIs, HIV and other adverse conditions. More research is needed to better understand the drivers of the STI/HIV epidemic in Portuguese MSM, using a concept that goes beyond risk behaviour, to develop effective combination prevention interventions.