title: Racial Differences in Partnership Attributes, Typologies, and Risk Behaviors Among Men Who Have Sex With Men in Atlanta, Georgia.
abstract: The role of main partnerships in shaping HIV transmission dynamics among men who have sex with men (MSM) has gained recognition in recent studies, but there is little evidence that existing definitions of partnership type are accurate or have consistent meaning for all men. Using data collected from 2011 to 2013 on 693 partnerships described by 193 Black and White MSM in Atlanta, GA, partnership attributes and risk behaviors were examined and compared by race, stratified in two ways: (1) by commonly used definitions of partnerships as "main" or "casual" and (2) by a new data-driven partnership typology identified through latent class analysis (LCA). Racial differences were analyzed using chi-square, Fisher's exact, and Wilcoxon-Mann-Whitney tests. Black participants were less likely to report condomless anal sex (CAS) within partnerships they labeled as main, yet they were also less likely to describe these partnerships as "primary" on a parallel question. In contrast, within strata defined by the LCA-derived typology, most partnership attributes were comparable and the likelihood of CAS was equivalent by race. These findings suggest that classification of partnerships as main or casual does not accurately capture the partnership patterns of MSM, resulting in differential misclassification by race. Future studies and interventions should refine and utilize more evidence-based typologies.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. dpwhite@uw.edu.|Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, 98195, USA. dpwhite@uw.edu.
authors.forename: Darcy
authors.identifier: http://orcid.org/0000-0003-0058-8513
authors.initials: D
authors.lastname: White
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Jeremy A
authors.initials: JA
authors.lastname: Grey
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.|Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Pamina M
authors.initials: PM
authors.lastname: Gorbach
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Rothenberg
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Sullivan
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Eli S
authors.initials: ES
authors.lastname: Rosenberg
mesh_terms: D000328:Adult; D005845:Georgia / Q000453:epidemiology; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012309:Risk-Taking; D012747:Sexual Partners; D047568:Unsafe Sex
keywords: HIV; Men who have sex with men (MSM); Partner type; Race; Sexual risk