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PLoS One. 2015 Dec 31;10(12):e0146025. doi: 10.1371/journal.pone.0146025. eCollection 2015.

Sexual Behavior and Network Characteristics and Their Association with Bacterial Sexually Transmitted Infections among Black Men Who Have Sex with Men in the United States.

Author information

Bridge HIV, San Francisco Department of Public Health, San Francisco, California, United States of America.
Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.
Department of Human Development, State University of New York at Binghamton, Binghamton, New York, United States of America.
Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa.
Laboratory of Infectious Disease Prevention, New York Blood Center, New York, New York, United States of America.
Division of Infectious Diseases, Columbia University Medical Center, New York, New York, United States of America.
Department of Epidemiology and Biostatistics, George Washington University, Washington, DC, United States of America.
Department of Pathology, John Hopkins University, Baltimore, Maryland, United States of America.
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.
Department of Medicine, Harlem Hospital, Columbia University, New York, New York, United States of America.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America.
Fenway Institute, Boston, Massachusetts, United States of America.
Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, United States of America.



Black men who have sex with men (MSM) have a high prevalence of bacterial sexually transmitted infections (STIs), and individual risk behavior does not fully explain the higher prevalence when compared with other MSM. Using the social-ecological framework, we evaluated individual, social and sexual network, and structural factors and their association with prevalent STIs among Black MSM.


The HIV Prevention Trials Network 061 was a multi-site cohort study designed to determine the feasibility and acceptability of a multi-component intervention for Black MSM in six US cities. Baseline assessments included demographics, risk behavior, and social and sexual network questions collected information about the size, nature and connectedness of their sexual network. Logistic regression was used to estimate the odds of having any prevalent sexually transmitted infection (gonorrhea, chlamydia, or syphilis).


A total of 1,553 Black MSM were enrolled in this study. In multivariate analysis, older age (aOR = 0.57; 95% CI 0.49-0.66, p<0.001) was associated with a lower odds of having a prevalent STI. Compared with reporting one male sexual partner, having 2-3 partners (aOR = 1.74; 95% CI 1.08-2.81, p<0.024) or more than 4 partners (aOR = 2.29; 95% CI 1.43-3.66, p<0.001) was associated with prevalent STIs. Having both Black and non-Black sexual partners (aOR = 0.67; 95% CI 0.45-0.99, p = 0.042) was the only sexual network factor associated with prevalent STIs.


Age and the number and racial composition of sexual partners were associated with prevalent STIs among Black MSM, while other sexual network factors were not. Further studies are needed to evaluate the effects of the individual, network, and structural factors on prevalent STIs among Black MSM to inform combination interventions to reduce STIs among these men.

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