title: Experimentals, bottoms, risk-reducers and clubbers: exploring diverse sexual practice in an Internet-active high-risk behaviour group of men who have sex with men in Sweden.
abstract: This study aimed to identify sub-groups of men who have sex with men at high risk of HIV infection. Data from the Swedish MSM2013 survey were analysed with a focus on respondents (n = 714) who reported having had unprotected anal intercourse with male casual partner(s) in the past 12 months. Weighted Latent Class Analysis with covariates and distal outcomes was conducted to identify sub-groups of men sharing the same sexual practice characteristics. Four latent classes emerged: experimentals, bottoms, risk-reducers and clubbers. Experimentals appeared to differ most from the other classes. They had extensive experience of barebacking, the use of poppers and fisting. Higher number of casual male sex partners and reporting having HIV were predictors for belonging to experimentals. No evidence for an association between self-rated HIV prevention knowledge and taking less part in risky practices was found. Hence, knowledge-intensive interventions may not be the best fit for reducing HIV transmission. This diversity of men based on similar sexual practice patterns should be taken into account when designing future HIV prevention interventions.
authors.affiliation: a Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden.|b Department of Knowledge Development, Unit for Health and Sexuality , Public Health Agency of Sweden , Solna , Sweden.
authors.forename: Kristina Ingemarsdotter
authors.initials: KI
authors.lastname: Persson
authors.affiliation: c Department of Social Work , University of Gothenburg , Göteborg , Sweden.
authors.forename: Ronny
authors.initials: R
authors.lastname: Tikkanen
authors.affiliation: d Department of Monitoring and Evaluation, Unit for Statistics and Surveillance , Public Health Agency of Sweden , Solna , Sweden.
authors.forename: Jakob
authors.initials: J
authors.lastname: Bergström
authors.affiliation: e Department of Monitoring and Evaluation, Unit for Epidemiology and Health Economics , Public Health Agency of Sweden , Solna , Sweden.
authors.forename: Torsten
authors.initials: T
authors.lastname: Berglund
authors.affiliation: a Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Thorson
authors.affiliation: a Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Birger C
authors.initials: BC
authors.lastname: Forsberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012306:Risk; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: HIV; Men who have sex with men; Sweden; sexual practices; unprotected anal intercourse