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Poster Session I: Surveillance & Epidemiology - Behavior, Populations & Health Systems

(P60) FACTORS ASSOCIATED WITH THE CONCORDANCE OF SEXUAL ROLE IDENTITY AND PARTNER-SPECIFIC SEXUAL POSITIONING PRACTICES AMONG MSM IN TWO US CITIES

Tuesday, September 17, 2024

4:15 PM - 5:15 PM EST

Primary Author(s)

CC

Casey E. Copen, MPH, PhD

Centers for Disease Control and Prevention

Co-Author(s)(s)

AM

Alexandra K. Mueller, MHS

Baltimore City Health Department/Johns Hopkins University School of Medicine
AT

Abigail N. Turner, PhD

The Ohio State University
WM

William C. Miller, MD, MPH, PhD

University of North Carolina at Chapel Hill
JJ

Jacky M. Jennings, PhD, MPH (she/her/hers)

Professor
Johns Hopkins School of Medicine, United States
Emily Learner, PhD MPH (she/her/hers)

Lead, Epidemiology Research Team
Division of STD Prevention, Centers for Disease Control and Prevention, Georgia, United States
Brittany Liebhard, MPH (she/her/hers)

PhD Student
College of Public Health, The Ohio State University
Columbus, Ohio, United States
Julie Rushmore, DVM, PhD (she/her/hers)

Epidemiologist
Centers for Disease Control and Prevention
PL

Penny Loosier, MPH, PhD

Centers for Disease Control and Prevention
SW

Samantha P. Williams, PhD

Centers for Disease Control and Prevention

Background:
Among MSM, sexual role identities (SRI) (“top”, “bottom”) and sexual positioning practices (SPP) (insertive, receptive anal sex) (AI)) influence transmission risk for rectal STIs and HIV. Level of concordance between SRI/SPP may vary due to the characteristics of MSM and their sexual partners. Using data from a prospective cohort study of MSM aged ≥18, we described concordance in SRI/SPP overall and by participant and partner-level characteristics, including age, race/ethnicity, and HIV status.

Methods:
The Network Epidemiology of Syphilis Transmission study was implemented during 2018–2021 in Baltimore, MD and Columbus, Ohio. SRI was asked at baseline only and was defined as top, versatile top, versatile, versatile bottom, or bottom. SPP was defined by participants’ reports of types of AI with 3 most recent male partners. SRI/SPP concordance was measured by comparing the SRI to the mean numbers of insertive/receptive AI partners per study visit (e.g, SRI = Versatile Bottom; SPP = 3 receptive AI , 2 insertive AI partners) and then coding whether the pair was a match. We used participant/partner dyads to examine SRI/SPP concordance by age (18-24 only; had partner ≥5 years older), race/ethnicity (same/different) and HIV status (same/different). We calculated SRI/SPP concordance using kappa, proportions, and mixed logistic regression models.

Results:
Among 547 MSM and 5,551 recent sex partners, SRI/SPP congruence was low (k=0.22, 32.3%). SRI/SPP congruence was higher among non-Hispanic Black than non-Hispanic White MSM (40.3% vs. 29.7%, p<0.0001). Among participants living with HIV (PLWH), SRI/SPP congruence was higher among those with HIV+ partners than HIV- partners (k=0.26, 41.1% vs. k=0.19, 32.6%, p=.018). PLWH with HIV+ partners had 69% (95%CI: 1.09-2.64) higher odds of SRI/SPP concordance than PLWH whose partners were HIV-.

Conclusion:
Among MSM, congruence between SRI/SPP varied by participant/partner characteristics. Understanding the dynamic nature of SRI/SPP could assist clinicians in conducting culturally relevant sexual risk assessments with patients.