BACKGROUND: Men who have sex with men (MSM) are greatly impacted by HIV/AIDS in the United States. Early initiation of sexual behaviors have been viewed as potential health risks among youth because early initiators spend more years at risk for HIV and other sexually transmitted diseases than those who are not sexually active until a later age. The objective of this study was to determine the associations between the age at first sexual encounter and the HIV serostatus of MSM in Houston, Texas.
METHODS: The study population comprised of 1,622 participants obtained from the National HIV Behavioral Surveillance System (NHBS) three MSM cycles (MSM2 (n=523), MSM3 (n=543) and MSM4 (n=556)) in Houston, Texas. MSM were recruited using venue-based sampling, and those who consented were required to complete a standardized anonymous questionnaire that collected bio-behavioral information, including HIV test results. The age of first sexual encounter were classified as ≤17 years and >17 years using median age. Descriptive and inferential data analyses were conducted using SAS version 9.4 (SAS Institute Inc., Cary, NC).
RESULTS: Of the total sample of 1622, 25% (MSM2), 18% (MSM3) and 26% (MSM4) had positive HIV test results. The prevalence of HIV when comparing participants’ age at sexual debut (≤17 years vs >17 years) were 29% vs 20% (p=0.045); 22% vs 13% (p=0.012) and 33% vs 18% (p<0.001), respectively. A bivariate analysis indicated that for all three cycles those who were ≤17 years at the age of their first MSM sexual encounter were significantly (p<0.05) more likely than those who were older to have a positive HIV test result: MSM2 prevalence ratio (PR)=1.56 (95%CI 1.02-2.38); MSM3 PR=1.82 (95%CI 1.15-2.88) and MSM4 PR=2.30 (95%CI 1.54-3.43).
CONCLUSIONS: Our finding indicates that age at first MSM sexual encounter is significantly associated with HIV infection in Houston’s MSM population. Although more researches are needed in this area, the finding suggests that targeted HIV prevention interventions in young adolescents may be effective in preventing HIV infection and transmission among the MSM population.