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Young men who have sex with men (YMSM) have the highest HIV incidence in the U.S. The last 5 years has seen emergence of new methods for HIV prevention and societal shifts in gay rights. It is important to understand if there have been generational shifts in condom use during the developmental transition from adolescents to young adulthood. To disentangle history from development, we require a multiple-cohort, longitudinal design-a methodology never before applied to study YMSM. We followed three cohorts of YMSM recruited in 2007, 2010, and 2015 (N = 1141) from the ages of 17-26 years and modeled their longitudinal change over time in counts of anal sex acts and the ratio of condomless anal sex (CAS) acts to anal sex acts using latent curve growth modeling. We found that there was no significant developmental change in raw counts of anal sex acts, but there was a significant decline in the ratio of anal sex acts that were condomless. We also found significantly different patterns for ratio of CAS acts for the 2015 cohort. The 2015 cohort reported a significantly lower ratio of CAS acts at age 17, but significantly higher growth in ratio of CAS acts over development. The present study suggests that YMSM recruited in 2015 have very different trajectories of CAS compared to previous cohorts, including lower risk in late adolescence, but with the potential for higher risk after the transition into adulthood. [ABSTRACT FROM AUTHOR]

Across HIV prevention studies, as many as 25% of men who have sex with men (MSM) report meeting male partners at private sex events and attendance is associated with increased number of sexual partners, condomless anal sex (CAS), and HIV infection. Despite the need for effective HIV prevention interventions, no risk reduction interventions have been tested to reduce HIV sexual risk of MSM that regularly engage in sexual risk at private sex events. This randomized pilot study assessed the feasibility and acceptability of an HIV risk reduction intervention to reduce CAS among urban MSM (N = 14) reporting risk at a private sex event in the prior 12 months. The intervention arm received four group sessions (2 h/session) focusing on HIV risk reduction education and skills building. Both the intervention (n = 8) and control (n = 6) conditions received HIV testing and pre- and posttest risk reduction counseling and completed a sexual risk and psychosocial assessment visit at baseline and 3 months post-intervention. In addition, intervention participants completed a brief exit interview post-intervention. Mean age was 37 years, and 57% were racial/ethnic minorities. At follow-up, the intervention group reported greater reductions in sexual risk behavior in the past 3 months including number of CAS episodes, number of partners at private sex events, and CAS episodes at private sex events. The intervention group also reported reduced sexual compulsivity, increases in HIV disclosure, and reduced drug use at private sex events over study follow-up. Exit interviews revealed that participants found the intervention to be highly acceptable. Findings demonstrate feasibility of procedures, participant acceptability, and initial promise of a group-delivered HIV risk reduction intervention for MSM who attend and engage in CAS at private sex events. Further testing of this intervention in a larger pilot randomized controlled trial is warranted. [ABSTRACT FROM AUTHOR]

In recent years, men who have sex with men (MSM) have accounted for over 80% of all new HIV cases in Taiwan. More than 70% of new cases have occurred in those aged 15-34 years. Condomless anal intercourse (CAI) has been identified as the main route of HIV transmission among MSM. To systematically examine CAI intention and associated factors among young MSM in Taiwan, an anonymous online survey based on the Theory of Planned Behavior (TPB) was conducted. Data from 694 MSM aged 15-39 years were included in the analysis. This study found that, overall, all five TPB factors (i.e., attitudes toward positive and negative outcomes regarding CAI, perceived support for CAI from important others, and perceived behavioral control of CAI under facilitating and constraining conditions) were significantly associated with CAI intention. When data were stratified by sexual role (i.e., receptive, versatile, and insertive), the associations between TPB factors and CAI intention varied. Of the five TPB factors, positive attitudes toward positive outcomes regarding CAI were most strongly associated with high CAI intention (AOR 5.68 for all young MSM; AOR 3.80-15.93, depending on sexual role). Findings from this study could inform the development of theory-driven HIV prevention programs as well as future research and practice. These results also highlight the importance of tailoring HIV prevention initiatives for young MSM of different sexual roles to optimize the program effectiveness. [ABSTRACT FROM AUTHOR]

An exigent need exists for HIV prevention intervention research targeting young men who have sex with men (MSM)-a group of young adults that, despite composing the highest and most racially disproportionate rates of HIV incidence, have been least often the focus of behavioral intervention research. This pilot study tested a group-based HIV primary prevention intervention for young MSM to evaluate its initial efficacy, feasibility, and acceptability. Participants were randomized ( N = 101; aged 16-20 years) to one of two group-level, HIV and STI education programs: controls participated in a non-interactive, lecture-based program, while intervention participants took part in a highly interactive program tailored to young MSM aged 16-20. Sexual risk and social cognitive outcomes were assessed at baseline, 6-, and 12-weeks post-intervention. Over the entire follow-up period, intervention participants were less likely than controls to engage in any sexual behavior while under the influence of substances ( p < .05), and a decreasing trend in unprotected anal sex while under the influence of substances was also observed in this group ( p = .08). Follow-up differences between groups on social cognitive outcomes favored the intervention group, though these differences were non-significant. Acceptability ratings were modest. A 6-session behavioral intervention tailored to young MSM, aged 16-20, is feasible, acceptable, and demonstrates evidence of preliminary efficacy in reducing sexual risk, specifically sexual risk while under the influence of substances. [ABSTRACT FROM AUTHOR]