Risk behaviours of an interrelated syphilis-infected sexual network of men who have sex with men.
OBJECTIVE
We examined the risk behaviours in an interrelated sexual network of 33 syphilis-infected men who have sex with men on the use of condoms, substances and websites to meet sexual partners. Our study used a descriptive exploratory design to investigate co-occurring high-risk behaviours in this interrelated sexual network to inform future health interventions and research directions.


BACKGROUND
Although the risk behaviours for human immunodeficiency virus transmission in men who have sex with men have been studied, few have studied the high-risk population of men who already have syphilis, and even fewer have studied the risk behaviours in sexual networks of syphilis-infected men who have sex with men who were identified using contact tracing.


METHODS
The data were collected from semi-structured, individual interviews at a not-for-profit lesbian, gay, bisexual and transgender health centre in a large city in the Midwestern USA.


RESULTS
Inconsistent condom use was substantial during both insertive (92%) and receptive (88%) anal intercourse. Most participants (97%) reported using one or more substances prior to or during anal intercourse, and Internet websites were the most common place to meet sexual partners (88%).


CONCLUSIONS
High-risk behaviours were significant within this syphilis-infected sexual network of men who have sex with men. The majority of our 33 participants were non-Hispanic Whites (n = 27, 82%), possessed a baccalaureate degree or higher (n = 23, 70%), and actively sought out unprotected anal intercourse [21 participants (64%) used BareBackRT.com, a website to seek out unprotected anal intercourse].


CONCLUSIONS
Nurses should be more informed about the risk factors of a high-risk sexual network of syphilis-infected men who have sex with men. Interrelated sexual networks have high levels of similarity among participants' high-risk behaviours; contact tracing may be used to identify individual participants for relevant risk-reduction interventions.
School of Nursing, DePaul University, Chicago, IL, USA.
Richie
R
Diesterheft
Department of Psychology, DePaul University, Chicago, IL, USA.
John P
JP
Brady
School of Nursing, DePaul University, Chicago, IL, USA.|Department of Community, Systems, and Mental Health Nursing, Rush University, DePaul University, Chicago, IL, USA.
Mona
M
Shattell
D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012309:Risk-Taking; D021841:Safe Sex; D012725:Sexual Behavior; D012747:Sexual Partners; D013587:Syphilis / Q000523:psychology*

AIDS
; 
HIV
; Internet; barebacking; men who have sex with men; risk behaviour; risk reduction; sexual behaviour; substance use; syphilis; unprotected anal intercourse; unprotected sex