title: Gay and bisexual men engage in fewer risky sexual behaviors while traveling internationally: a cross-sectional study in San Francisco.
abstract: BACKGROUND
  International travel poses potential challenges to HIV prevention. A number of studies have observed an association between travel and behavioural disinhibition. In the present study, we assessed differences in sexual behaviour while travelling internationally and within the USA, compared with being in the home environment.
  
  
  METHODS
  A probability-based sample of men who have sex with men (MSM) from the San Francisco Bay Area who had travelled internationally in the previous 12 months was recruited through an adapted respondent-driven sampling methodology (N=501). Participants completed interviewer-administered, computer-assisted surveys.
  
  
  RESULTS
  Detailed partner-by-partner behavioural data by destination type were collected on 2925 sexual partnerships: 1028 while travelling internationally, 665 while travelling within the USA and 1232 while staying in the San Francisco Bay Area. The proportion of partnerships during international travel that involved unprotected anal intercourse (UAI) was lower compared with during domestic travel and staying locally. International travel was associated with decreased odds of receptive UAI (AOR=0.65, p=0.02) compared with staying locally and there was a trend towards decreased odds of insertive UAI (AOR=0.70, p=0.07).
  
  
  CONCLUSIONS
  MSM engaged in proportionately fewer sexual activities which present a high HIV transmission risk when travelling internationally, namely unprotected receptive and insertive anal intercourse and particularly with HIV serodiscordant partners. The lower sexual risk-taking during international travel was robust to controlling for many factors, including self-reported HIV serostatus, age, relationship status and type of partnership. These findings suggest that when travelling internationally, MSM may experience behavioural disinhibition to a lesser extent than had been described previously.
authors.affiliation: University of California, San Francisco, California, USA Gladstone Institute of Virology and Immunology, San Francisco, California, USA.
authors.forename: Hong-Ha M
authors.initials: HM
authors.lastname: Truong
authors.affiliation: University of California, San Francisco, California, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Fatch
authors.affiliation: Department of Public Health, San Francisco, California, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Grasso
authors.affiliation: Department of Public Health, San Francisco, California, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: Robertson
authors.affiliation: Department of Public Health, San Francisco, California, USA.
authors.forename: Luke
authors.initials: L
authors.lastname: Tao
authors.affiliation: Department of Public Health, San Francisco, California, USA.
authors.forename: Yea-Hung
authors.initials: YH
authors.lastname: Chen
authors.affiliation: University of California, San Francisco, California, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Curotto
authors.affiliation: University of California, San Francisco, California, USA Department of Public Health, San Francisco, California, USA.
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
authors.affiliation: University of California, San Francisco, California, USA Gladstone Institute of Virology and Immunology, San Francisco, California, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Grant
authors.affiliation: University of California, San Francisco, California, USA.
authors.forename: Olga
authors.initials: O
authors.lastname: Reznick
authors.affiliation: Department of Public Health, San Francisco, California, USA.
authors.forename: H Fisher
authors.initials: HF
authors.lastname: Raymond
authors.affiliation: University of California, San Francisco, California, USA.
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Steward
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003625:Data Collection; D015658:HIV Infections / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012495:San Francisco; D012725:Sexual Behavior; D014195:Travel; D055815:Young Adult
keywords: EPIDEMIOLOGY (GENERAL); GAY MEN; HIV; SEXUAL BEHAVIOUR; TRAVEL