Factors related to condomless anal intercourse between men who have sex with men: results from a European bio-behavioural survey

Nigel Stuart Sherriff, Anna Marie Jones, Massimo Mirandola, Lorenzo Gios, Ulrich Marcus, Carrie D. Llewellyn, Magdalena Rosinska, Cinta Folch, Sónia Dias, Igor A. Toskin, Ivailo Alexiev, Sharon Kühlmann-Berenzon, João Mário Brás da Piedade Piedade, Sialon II Network

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BACKGROUND: Relationship status is an important factor associated with condomless anal intercourse (CAI) amongst men who have sex with men (MSM).

METHODS: A multi-centre bio-behavioural survey with MSM was conducted in 13 European cities (n = 4901) exploring factors associated with CAI via bivariate and multivariate multilevel logistic regression analyses.

RESULTS: Likelihood of CAI with casual partners was associated with being 'out' to a majority (AOR = 1.19;95% CI 1,1.42); knowing their HIV status (AOR = 1.86; 95% CI 1.25,2.76); using substances (1-2 AOR = 1.39; 95% CI 1.16,1.63, 2+ AOR = 1.81; 95% CI 1.35,2.42); being older (AOR = 0.98; 95% CI 0.97,0.99); successful sero-communication (AOR = 0.79; 95% CI 0.67,0.94); and, not having a recent HIV test (AOR = 0.78; 95% CI 0.66,0.92). CAI with steady partners was associated with successful sero-communication (AOR = 2.72; 95% CI 2.72,3.66); not having a recent HIV test (AOR = 1.26; 95% CI 1.09,1.46), and; being older (AOR = 0.99; 95% CI 0.98,0.99).

CONCLUSIONS: Understandings of partner type and/or relationship status in relation to CAI amongst MSM can potentially play an important role in the development of culturally appropriate HIV/STI prevention and risk-reduction efforts targeting at-risk MSM. Our results speak to the need to consider segmented and tailored public health and health promotion initiatives for MSM with differing CAI behaviours and relationship profiles.

Original languageEnglish
Pages (from-to)e174-e186
JournalJournal of public health (Oxford, England)
Issue number2
Early online date15 May 2019
Publication statusPublished - 2020


  • HIV
  • MSM
  • Relationships
  • Respondent-driven sampling
  • Time-location sampling


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