title: HIV prevalence and demographic determinants of unprotected anal sex and HIV testing among men who have sex with men in Beirut, Lebanon.
abstract: The limited epidemiological data in Lebanon suggest that HIV incident cases are predominantly among men who have sex with men (MSM). We assessed the prevalence of HIV and demographic correlates of condom use and HIV testing among MSM in Beirut. Respondent-driven sampling was used to recruit 213 participants for completion of a behavioral survey and an optional free rapid HIV test. Multivariate regression analysis was used to examine demographic correlates of unprotected anal sex and any history of HIV testing. Nearly half (47 %) were under age 25 years and 67 % self-identified as gay. Nearly two-thirds (64 %) reported any unprotected anal intercourse (UAI) with men in the prior 3 months, including 23 % who had unprotected anal intercourse with men whose HIV status was positive or unknown (UAIPU) to the participant. Three men (1.5 % of 198 participants tested) were HIV-positive; 62 % had any history of HIV testing prior to the study and testing was less common among those engaging in UAIPU compared to others (33 % vs. 71 %). In regression analysis, men in a relationship had higher odds of having UAI but lower odds of UAIPU and any university education was associated with having UAI; those with any prior history of HIV testing were more likely to be in a relationship and have any university education. HIV prevention efforts for MSM need to account for the influence of relationship dynamics and promotion of testing needs to target high-risk MSM.
authors.affiliation: RAND Corporation, 1776 Main St., Santa Monica, CA, 90407, USA, gwagner@rand.org.
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Wagner
authors.forename: Johnny
authors.initials: J
authors.lastname: Tohme
authors.forename: Matthew
authors.initials: M
authors.lastname: Hoover
authors.forename: Simon
authors.initials: S
authors.lastname: Frost
authors.forename: Allison
authors.initials: A
authors.lastname: Ober
authors.forename: Danielle
authors.initials: D
authors.lastname: Khouri
authors.forename: Martin
authors.initials: M
authors.lastname: Iguchi
authors.forename: Jacques
authors.initials: J
authors.lastname: Mokhbat
mesh_terms: D000293:Adolescent; D000328:Adult; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006306:Health Surveys; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D012959:Socioeconomic Factors; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult
references.citation: Arch Sex Behav. 2011 Feb;40(1):189-99
references.pmid: 19888643
references.citation: J Acquir Immune Defic Syndr. 2009 Jul 1;51 Suppl 3:S106-10
references.pmid: 19553777
references.citation: PLoS One. 2012;7(9):e45566
references.pmid: 23029103
references.citation: East Mediterr Health J. 2008 Jul-Aug;14(4):905-15
references.pmid: 19166174
references.citation: J Urban Health. 2009 Jul;86 Suppl 1:5-31
references.pmid: 19472058
references.citation: J Acquir Immune Defic Syndr. 2009 Dec;52 Suppl 2:S143-51
references.pmid: 19901627
references.citation: J Urban Health. 2006 Nov;83(6 Suppl):i60-72
references.pmid: 17066328
references.citation: Biometrics. 2017 Dec;73(4):1189-1198
references.pmid: 28257143
references.citation: PLoS One. 2013 Jun 19;8(6):e66701
references.pmid: 23840521
references.citation: AIDS. 2010 Jul;24 Suppl 2:S45-54
references.pmid: 20610948
references.citation: PLoS Med. 2010 Aug;8(8):e1000444
references.pmid: 21829329
references.citation: J Acquir Immune Defic Syndr. 2005 Aug 1;39(4):446-53
references.pmid: 16010168
references.citation: Sex Transm Dis. 2009 Dec;36(12):750-6
references.pmid: 19704394
references.citation: AIDS. 2009 Jun 1;23(9):1153-62
references.pmid: 19417579
references.citation: AIDS Behav. 2012 Aug;16(6):1584-8
references.pmid: 22020757
references.citation: AIDS. 2010 Jul;24 Suppl 2:S5-23
references.pmid: 20610949