Sexual Identity, Race and HIV Risk and Prevention Behaviors among MSM

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DESCRIPTION (provided by applicant): Men who have sex with men (MSM) account for the majority of HIV infections among men and continue to be at increased risk for HIV. Though very little research has been done on the relationship between sexual identity and HIV risk, prior research suggests that sexual identity might play an important role in the epidemiology of HIV. This study will look at the intersection between sexual identity and race in the HIV risk behaviors of MSM and the relationship between sexual identity and prevention behaviors of MSM. In line with the high priority areas outlined by the Division of AIDS and Health and Behavior Research (DAHBR), this study has been designed to elucidate if sexual identity, a socially constructed factor, impacts the risk behaviors of MSM at an individual level and whether or not this relationship is modified by race. Using cross sectional data from the BESURE Study (The Behavioral Surveillance Research Study), the Baltimore sub-study of the CDC1 s NHBS-MSM (National HIV Behavioral Surveillance System- MSM), this study will aim to 1) examine if the relationships between sexual identity and HIV risk behavior differ by race among MSM, controlling for SES and other relevant confounders and 2) to examine the relationship between sexual identity and utilization of prevention services among MSM. Aim 1 will assess a number of HIV risk behaviors including likelihood to: a) have a casual partner, b) have unprotected sex with men c) have sex with men and women and d) have a main female partner and secondary male partner. The second aim will assess the differences by sexual identity in likelihood to: a) have an HIV test, b) know HIV test results, and c) utilize one-to-one or small group preventative services. Six hundred and forty-five MSM participated in the wave 1 of the BESURE Study. Of these men 62% are African American and 37% are non-gay identified. In the summer and fall of 2008, an additional 500 MSM will participate in wave 2 of the BESURE study. Public health relevance: This study will contribute to the field of public health by expanding our understanding of the social epidemiology of HIV. The findings of this study will help HIV prevention programs to develop programs that better meet the needs of a diverse population of MSM, including those MSM who might be hard-to-reach. Lastly, the findings of this research study may help to guide the direction of future research.