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High risk sexual behaviour in men who have sex with men: the development of a sexual risk behaviour screening tool
Presented by Tania Mary Gibbie, Australia.
T.M. Gibbie1, M. Hellard2, S. Ellen3, T. Read4, C. Fairley5, J. Lewis2, A. Mijch6
1The Alfred Hospital Infectious Diseases Dpt/Monash University, School of Psychology, Psychiatry and Psychological Medicine, Melbourne, Australia, 2Burnet Institute, Centre for Epidemiology and Population Health Research, Melbourne, Australia, 3The Alfred Hospital/Monash University, Consultation-Liaison Psychiatry/School of Psychiatry, Psychology and Psychological Medicine, Melbourne, Australia, 4Melbourne Sexual Health Centre, Melbourne, Australia, 5Melbourne Sexual Health Centre/Melbourne University, School of Population Health, Melbourne, Australia, 6Monash University, School of Medicine, Melbourne, Australia
Background: Research has identified variables associated with sexual risk behaviour (SRB) in men who have sex with men (MSM); including the number of sexual partners, substance use and personality variables. Currently there is no validated survey to rapidly screen MSM at increased risk of SRB in order to target them with prevention interventions.
Aims: To identify predictors of SRB in MSM; and to identify key questions for use as a screening tool to identify SRB in MSM.
Methods: 152 MSM recruited from community, sexual health and hospital practice completed a diagnostic interview and self-report questionnaires (depression, personality, sexual behaviour, substance use). Self reported sexual behaviour plus sexually transmitted infection test results (Chlamydia trachomatis, Neisseria gonorrheae) acted as behavioural/biological measures of SRB (unprotected anal intercourse with casual/serodiscordant partners).
Results: 42% of sexually active participants met the criteria for SRB. SRB was associated with substance use, number of casual partners, personal characteristics involved in negotiating safe sex, Sexual Sensation Seeking scores (SSS), meeting sexual partners at a beat and beliefs about HIV treatment. When controlling for these factors, SRB remained strongly associated with number of casual partners (OR 14, CI 4.04 - 48.44, p=0.000), negotiation ability and practice (OR 8.7, CI 3.28 - 23.11, p=0.000), SSS (OR 16.46, CI 4.32 - 62.77, p=0.000). The data was used to produce a weighted five question screening tool. A cut-off of 30/85 had the most discriminatory sensitivity and specificity, classifying 96% of cases, 22% of non-cases (56% of the sample). The area under the Receiver Operating Curve was 0.92 indicating the model had high accuracy in separating the two groups.
Conclusions: This study has identified five key questions with high accuracy in predicting MSM likely to engage in SRB, in particular number of casual partners, negotiation ability and SSS. Validation in the community is currently underway.
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