title: Earlier anal sexarche and co-occurring sexual risk are associated with current HIV-related risk behaviors among an online sample of men who have sex with men in Asia.
abstract: Studies of heterosexual populations across the globe and men who have sex with men (MSM) in a few developed countries showed that earlier sexual debut (sexarche) was associated with higher levels of co-occurring and subsequent HIV risk behaviors. We examined the relationships between earlier anal sexarche, unprotected earlier anal sexarche and current HIV risks among MSM from Asia. A cross-sectional online survey was conducted among MSM (N = 10,826) in Asia in 2010. Bivariate and multivariable logistic regressions were used to identify co-occurring (i.e., sexual experiences during sexarche) and current HIV-related risk factors (i.e., past 6 months) associated with earlier anal sexarche (before the age of 18) and unprotected earlier anal sexarche, respectively. Earlier anal sexarche was significantly associated with lack of condom use, being anal receptive or both receptive and insertive, and having a partner who were older during sexarche. It was also associated with current HIV-related risk behaviors including having multiple male sexual partners, having been paid for sex, and increased frequencies of recreational drug use. Unprotected earlier anal sexarche was significantly associated with inconsistent condom use in the past the 6 months. Improved and culturally sensitive sex education at schools should be included in national and regional HIV/AIDS prevention programming and policies in Asia. Such sex education programs should incorporate curriculum that address sexuality, sexual orientation, and sexual behaviors beyond those related to reproductive health.
authors.affiliation: Harvard School of Public Health, Boston, MA, USA.
authors.forename: Doug H
authors.initials: DH
authors.lastname: Cheung
authors.forename: Christian
authors.initials: C
authors.lastname: Suharlim
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Guadamuz
authors.forename: Sin How
authors.initials: SH
authors.lastname: Lim
authors.forename: Stuart
authors.initials: S
authors.lastname: Koe
authors.forename: Chongyi
authors.initials: C
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001208:Asia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000706:statistics & numerical data; D015658:HIV Infections / Q000453:epidemiology*; D006306:Health Surveys; D018451:Homosexuality, Male; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data