Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

218 Abstracts WePeE6535-WePeE6539

XIV International AIDS Conference

WePeE6535I Men having sex with men (MSM): An iceberg
phenomenon in Mumbai
R.K. Trikmani1, A. Purohit, A. Haag3, R.M. Shah4, S.C. Shah4, V.D. Dodiya4.
'Counselor,FXB India SocietyMumbai Branch, FXB India Society 317/1 1,Nirlon
CHS, S V Road, Goregaon (W), Mumbai, 400062, India; 2 World Wide Director,
AFXB, Boston, United States; 3Medical Director, FXB US Foundation, Boston,
United States; 4 FXB India Society, Mumbai Branch, Mumba4 India
Issue: Stigmatisation, discrimination and rejection of homosexual activities are a
few of the reasons, which may explain the vulnerability of the homosexual populations to STI and HIV/AIDS in Mumbai, India.
Description: This presentation focuses on behavioural attitudes of MSM (N=72)
in Mumbai. The discussion is based on interviews and personal contacts done by
MSM them selves. The study revealed the bisexual nature of most MSM (89%).
The possibility of strained relation with spouses, stigmatisation of families and
discrimination by society were explanations given for not revealing their MSM
sexuality openly. The hidden and closed-door activities resulted in low usage of
condoms (65%), and high incidences of STI (32%) among this group. Fewer homosexuals knew their HIV status (4%), yet continued having high-risk sexual relations with partners.
Lesson Learned: MSM activities in Mumbai are an Iceberg phenomenon. The
men's human rights require immediate attention and protection. The social attitude towards MSM needs to be redefined.
Recommendation: More projects intended to decrease stigma and end discrimination toward homosexuals need to be developed in order to effectively control
the spread of HIV and AIDS in this population.
Presenting author: Rupal Trikmani, FXB India Society, 317/11,Nirlon CHS, S V
Road, Goregaon (W), Mumbai, 400062, India, Tel.: [phone], Fax: +91
022 877 31 44, E-mail: [email protected]
WePeE6536I Viagra use and sexual risk among HIV-seropositive
men who have sex with men
D.W. Purcell1, R.J. Wolitski1, C. Bailey2, C. Hoff3, J.T. Parsons4, W.J. Woods3,
P. N. Halkitis5. 1Centers for Disease Control and Prevention, 1600 Clifton Road,
MailStop E-37, Atlanta, Georgia 30333, United States; 2TRW, Atlanta, United
States; 3UCSF-CAPS, San Francisco, United States; 4Hunter College of CUNY,
New York City, United States; 5New York University New York City, United States
Background: Viagra may be used medically to treat erectile dysfunction or used
recreationally to enhance sexual performance. Little is known about predictors of
Viagra use among HIV-seropositive (HIV+) men who have sex with men (MSM),
whether it is used with contraindicated substances, and the relationship with sexual risk.
Methods: A community-based sample of 1168 HIV+ MSM (55% men of color)
from two large cities in the U.S. completed an A-CASI interview about their sexual
practices and substance use in the past 3 months. In univariate analyses, Viagra
use was associated with demographics, health status, substance use, and sexual risk. Logistic regression was conducted to predict Viagra use, with significant
univariate predictors entered.
Results: One in eight men (12%) used Viagra, and many reported using
contraindicated illicit substances (inhalants=53%) or HIV medications (indinavir=19%). In logistic regression, predictors of Viagra use were being older (OR,
1.06, 95% CI, 1.03-1.09), having education beyond high school (OR, 2.25, 95%
CI, 1.16-4.36), taking HIV medications (OR, 1.98, 95% CI, 1.05-3.72), using any
illicit substance (OR, 1.92, 95% CI, 1.16-3.18), using ketamine (OR, 2.82, 95%
CI, 1.09-7.32), engaging in unprotected oral insertive intercourse (UOI) with HIVnegative or unknown serostatus non-main partners (OR, 1.88, 95% CI, 1.15 -3.09), and engaging in unprotected anal insertive intercourse (UAI) with HIVpositive non-main partners (OR, 2.39, 95% CI, 1.33-4.31).
Conclusions: Many HIV+ MSM used Viagra, particularly substance using men.
Use of contraindicated illicit and prescribed medications was common. Viagra use
was associated with UOI (but not UAI) with non-main partners who might be at
risk of contracting HIV. With HIV+ non-main partners, Viagra users were more
likely to engage in UAI. Providers should educate HIV+ Viagra users about potential interactions with other substances and provide counseling to reduce HIV
and STD risks.
Presenting author: David Purcell, 1600 Clifton Road, MailStop E-37, Atlanta,
Georgia 30333, United States, Tel.: [phone], Fax: [phone], Email: [email protected]
WePeE6537 Travel in Asia among Asian-American men who
i I have sex with men: HI V-related risk behaviors and
prevention opportunities
S. Nguyen1, W. McFarland1, P Lee Chu1, K. Choi2, G. Secura3, S. Behel3,
D. MacKellar3, L. Valleroy3. 1San Francisco Department of Public Health, 1026

Potrero Avenue, San Francisco, CA 94110, United States; 2Center for AIDS
Prevention Studies, University of California, San Francisco, San Francisco,
United States; 3Centers for Disease Control and Prevention, Atlanta, United
States
Background: San Francisco is economically and socially connected to many
Asian countries. Sexual networks extending across the Pacific may facilitate the
transmission of new HIV strains, including those with drug resistant mutations,

as well as hepatitis A and B. We assessed the potential for HIV transmission
by examining the travel histories and sexual behaviors in a large sample of
Asian/Pacific Islander MSM (API MSM) in San Francisco.
Methods: From January 2000 to September 2001, API MSM aged 18 to 29 years
were recruited from 30 gay-identified venues in San Francisco, randomly selected
from a spatial-temporal sampling frame. Men completed a face-to-face standard
questionnaire which included travel to Asia and having sex with other men while
in Asia.
Results: We obtained an ethnically diverse sample of 503 API MSM: 30% Chinese, 29% Filipino, 17% Vietnamese, 6% Japanese, 4% Thai, and 4% Korean.
Seventy percent were born in Asia (mean 13 years in USA). Of 488 sexuallyactive API MSM, 404 (83%) reported travel to Asian countries since 1978, 112
(22%) reported having sex with men while in Asia, and 63 (13%) reported unprotected sex with men while traveling in Asia. Unprotected sex with men was most
prevalent in the Philippines (13%), Thailand (12%), Singapore (10%), China (9%),
Japan (8%), Vietnam (7%), and Hong Kong (5%). Of the 112 API MSM who had
sex with men in Asia, reported vaccination for hepatitis A (29%) and hepatitis B
(34%) were notably low.
Conclusions: Nearly one in seven San Franciscan API MSM had unprotected
sex with men in Asia. Although data on HIV infection, Tisk behavior, and the provenance of these Asian partners was lacking, findings suggest a substantial potential for HIV transmission between North American and Asian MSM. Providers of
preventive services should incorporate HIV/STD health education messages and
hepatitis A and B vaccinations for API MSM who travel to Asia.
Presenting author: Sean Nguyen, 1026 Potrero Avenue, San Francisco, CA
94110, United States, Tel.: [phone], Fax: [phone], E-mail: Sean.
[email protected]
WePeE6538 Toward understanding why younger men who
have sex with men (MSM) are at high risk for HIV
infection through examination of sexual mixing
characteristics
G. Mansergh1, G. Marks1, M. Rader1, G. ColfaX2, R. Guzman2, S. Buchbinder2
I CDC, CDC, 1600 Clifton Rd, Mailstop E-45, Atlanta, GA 30333, United States;
2San Francisco Department of Public Health, San Francisco, United States
Background: Younger MSM are at high risk for HIV infection, and characteristics
of their sexual mixing may contribute to the risk.
Methods: MSM in San Francisco (N=573) were recruited in 2001 through multiple
procedures (street outreach, agencies, bars/clubs) to achieve a diverse sample
(29% Latino, 28% black, 28% white; 38% HIV+; age 18-67). A cross-sectional
survey assessed perceived age category (20s, 30s, 40s, 50+), race/ethnicity and
HIV-status similarity of their most recent anal sex partner and risk behaviors that
occurred during their last encounter. Age similarity was defined as being in the
same age category.
Results: Of 376 men who reported having anal sex in the past 2 years, 52% had
unprotected anal (UA) sex during their most recent anal sex encounter (36% of
sample had receptive [URA]; 29% had insertive [UIA]). Only 28% of these men
were in a monogamous primary relationship at the time. 43% of the men who reported UA perceived that their partner had a different HIV status than their own or
they did not know the partner's status (HIV discordant). 51% had a partner similar
in age category (27% had younger and 22% had older partners); 52% reported
similar HIV status and 51% reported similar race/ethnicity Age-category dissimilarity (vs. similarity) was associated with a higher rate of discordant UA (54% vs.
43%, p < 0.05), stemming from a higher rate with younger vs. similar-age or older
partners (56% vs. 43%, p < 0.05). There was a higher rate of UA with HIV concordant vs. discordant partners (59% vs. 47%, p < 0.05), which held for UIA (34% vs.
23%, p < 0.05) but not for URA (p = 0.42). Race/ethnicity similarity/dissamiliarity
was not associated with UA.
Conclusions: Interventions are needed to address higher HIV-discordant sexual risk behavior found for men who have younger anal sex partners. Research is
needed to better understand sexual mixing and identify intervention opportunities.
Presenting author: Gordon Mansergh, CDC, 1600 Clifton Rd, Mailstop E-45,
Atlanta, GA 30333, United States, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
WePeE6539 Barebacking (intentional unsafe sex) among
HIV-seropositive MSM and implications for new
prevention strategies
D.S. Bimbi1, P.N. Halkitis2, J.T. Parsons3, C. Gomez4, C. Hoff4, R.J. Wolitski5,
D. Purcell5. 1Center for HI V/AIDS Educational Studies and Training/ CUNY
Graduate Center, CHEST 250 W 26th St., Suite 300, NYC, NY 10001, United
States; 2New York University, NYC, United States; 3Hunter College, NYC, United
States; 4Center for AIDS Prevention Studies, San Francisco, United States;
5Centers for Disease Control and Prevention, Atlanta, United States

Background: Men who have sex with men (MSM) who prefer unprotected sex
have begun to identify themselves as "barebackers" in recent years. The emergence of barebacking coincides with documented increases in unprotected sex
and STDs among MSM in the U.S. and elsewhere.
Methods: In New York and San Francisco interviews about sexual practices,
risk-related beliefs, and substance use were completed by 1168 HIV-seropositive
MSM (mean age = 41years, range 20-89), 55% of whom were men of color. In the