Self-Reported Combination HIV Prevention Strategies Enacted by a Prospective Cohort of Midlife and Older Men Who Have Sex with Men in the United States: A Latent Class Analysis

Steven Meanley; James E. Egan; Deanna Ware; Mark Brennan-Ing; Sabina A. Haberlen; Roger Detels; Frank Palella; Mackey R. Friedman; Michael W. Plankey

doi:10.1089/apc.2022.0167

Self-Reported Combination HIV Prevention Strategies Enacted by a Prospective Cohort of Midlife and Older Men Who Have Sex with Men in the United States: A Latent Class Analysis

Steven Meanley^*, James E. Egan, Deanna Ware, Mark Brennan-Ing, Sabina A. Haberlen, Roger Detels, Frank Palella, Mackey R. Friedman, Michael W. Plankey

^*Corresponding author for this work

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Review article › peer-review

2 Scopus citations

Abstract

Insights into combination HIV prevention (CHP) strategies to reduce HIV incidence among midlife and older adult men who have sex with men (MSM) are limited. The current study is a secondary data analysis evaluating CHP in a sample of sexually active midlife and older adult MSM (N = 566) from the Multicenter AIDS Cohort Study Healthy Aging Substudy. Stratified by HIV serostatus, we used latent class analyses to identify CHP classes based on self-reported sociobehavioral and biobehavioral prevention strategies that participants and their male partners used in the prior 6 months. We identified three CHP classes among men living without HIV (MLWOH), including the following: high CHP overall (43.0%), high anal sex abstention (15.0%), and low prevention overall (42.0%). Among men living with HIV (MLWH), we identified four CHP classes, including the following: high CHP overall (20.9%), high CHP/low condom use (27.1%), high condom reliance (22.3%), and low prevention overall (29.7%). There were small differences by sociodemographic characteristics and sexual behavior practices between the classes; however, poppers use was often linked to being in high CHP groups. Our findings support that CHP is not one-size-fits-all for midlife and older adult MSM. There remains a need to scale up clinical providers' sexual health communication practices to assist midlife and older MSM incorporate prevention strategies, particularly biobehavioral prevention strategies that align with their patients' lived experiences.

Original language	English (US)
Pages (from-to)	462-473
Number of pages	12
Journal	AIDS patient care and STDs
Volume	36
Issue number	12
DOIs	https://doi.org/10.1089/apc.2022.0167
State	Published - Dec 2022

Funding

Data in this article were collected by the MACS Healthy Aging team (Co-PIs: Friedman and Plankey; 5R01MD010680- 05), a subset of the MACS/WIHS Combined Cohort Study (MWCCS). The opinions, arguments, and conclusions from our study represent those endorsed by the authors and do not necessarily reflect those of the MACS or the National Institutes of Health (NIH). MWCCS (PIs): Data Analysis and Coordination Center (Gypsyamber D'Souza, Stephen Gange, and Elizabeth Golub), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245; Chicago-Northwestern CRS (Steven Wolinsky), U01-HL146240; Los Angeles CRS (Roger Detels), U01- HL146333; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146205; Pittsburgh CRS ( Jeremy Martinson and Charles Rinaldo), U01-HL146208. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional cofunding from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), the National Human Genome Research Institute (NHGRI), the National Institute on Aging (NIA), the National Institute of Dental & Craniofacial Research (NIDCR), the National Institute of Allergy And Infectious Diseases (NIAID), the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA), the National Institute of Nursing Research (NINR), the National Cancer Institute (NCI), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and Other Communication Disorders (NIDCD), and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional cofunding from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), the National Human Genome Research Institute (NHGRI), the National Institute on Aging (NIA), the National Institute of Dental & Craniofacial Research (NIDCR), the National Institute of Allergy And Infectious Diseases (NIAID), the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA), the National Institute of Nursing Research (NINR), the National Cancer Institute (NCI), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and Other Communication Disorders (NIDCD), and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Keywords

HIV
aging
pre-exposure prophylaxis
sexual health

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1089/apc.2022.0167

Cite this

Meanley, S., Egan, J. E., Ware, D., Brennan-Ing, M., Haberlen, S. A., Detels, R., Palella, F., Friedman, M. R., & Plankey, M. W. (2022). Self-Reported Combination HIV Prevention Strategies Enacted by a Prospective Cohort of Midlife and Older Men Who Have Sex with Men in the United States: A Latent Class Analysis. AIDS patient care and STDs, 36(12), 462-473. https://doi.org/10.1089/apc.2022.0167

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title = "Self-Reported Combination HIV Prevention Strategies Enacted by a Prospective Cohort of Midlife and Older Men Who Have Sex with Men in the United States: A Latent Class Analysis",

abstract = "Insights into combination HIV prevention (CHP) strategies to reduce HIV incidence among midlife and older adult men who have sex with men (MSM) are limited. The current study is a secondary data analysis evaluating CHP in a sample of sexually active midlife and older adult MSM (N = 566) from the Multicenter AIDS Cohort Study Healthy Aging Substudy. Stratified by HIV serostatus, we used latent class analyses to identify CHP classes based on self-reported sociobehavioral and biobehavioral prevention strategies that participants and their male partners used in the prior 6 months. We identified three CHP classes among men living without HIV (MLWOH), including the following: high CHP overall (43.0%), high anal sex abstention (15.0%), and low prevention overall (42.0%). Among men living with HIV (MLWH), we identified four CHP classes, including the following: high CHP overall (20.9%), high CHP/low condom use (27.1%), high condom reliance (22.3%), and low prevention overall (29.7%). There were small differences by sociodemographic characteristics and sexual behavior practices between the classes; however, poppers use was often linked to being in high CHP groups. Our findings support that CHP is not one-size-fits-all for midlife and older adult MSM. There remains a need to scale up clinical providers' sexual health communication practices to assist midlife and older MSM incorporate prevention strategies, particularly biobehavioral prevention strategies that align with their patients' lived experiences.",

keywords = "HIV, aging, pre-exposure prophylaxis, sexual health",

author = "Steven Meanley and Egan, {James E.} and Deanna Ware and Mark Brennan-Ing and Haberlen, {Sabina A.} and Roger Detels and Frank Palella and Friedman, {Mackey R.} and Plankey, {Michael W.}",

note = "Publisher Copyright: Copyright {\textcopyright} 2022, Mary Ann Liebert, Inc.",

year = "2022",

month = dec,

doi = "10.1089/apc.2022.0167",

language = "English (US)",

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Meanley, S, Egan, JE, Ware, D, Brennan-Ing, M, Haberlen, SA, Detels, R, Palella, F, Friedman, MR & Plankey, MW 2022, 'Self-Reported Combination HIV Prevention Strategies Enacted by a Prospective Cohort of Midlife and Older Men Who Have Sex with Men in the United States: A Latent Class Analysis', AIDS patient care and STDs, vol. 36, no. 12, pp. 462-473. https://doi.org/10.1089/apc.2022.0167

Self-Reported Combination HIV Prevention Strategies Enacted by a Prospective Cohort of Midlife and Older Men Who Have Sex with Men in the United States: A Latent Class Analysis. / Meanley, Steven; Egan, James E.; Ware, Deanna et al.
In: AIDS patient care and STDs, Vol. 36, No. 12, 12.2022, p. 462-473.

Research output: Contribution to journal › Review article › peer-review

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T1 - Self-Reported Combination HIV Prevention Strategies Enacted by a Prospective Cohort of Midlife and Older Men Who Have Sex with Men in the United States

T2 - A Latent Class Analysis

AU - Meanley, Steven

AU - Egan, James E.

AU - Ware, Deanna

AU - Brennan-Ing, Mark

AU - Haberlen, Sabina A.

AU - Detels, Roger

AU - Palella, Frank

AU - Friedman, Mackey R.

AU - Plankey, Michael W.

PY - 2022/12

Y1 - 2022/12

N2 - Insights into combination HIV prevention (CHP) strategies to reduce HIV incidence among midlife and older adult men who have sex with men (MSM) are limited. The current study is a secondary data analysis evaluating CHP in a sample of sexually active midlife and older adult MSM (N = 566) from the Multicenter AIDS Cohort Study Healthy Aging Substudy. Stratified by HIV serostatus, we used latent class analyses to identify CHP classes based on self-reported sociobehavioral and biobehavioral prevention strategies that participants and their male partners used in the prior 6 months. We identified three CHP classes among men living without HIV (MLWOH), including the following: high CHP overall (43.0%), high anal sex abstention (15.0%), and low prevention overall (42.0%). Among men living with HIV (MLWH), we identified four CHP classes, including the following: high CHP overall (20.9%), high CHP/low condom use (27.1%), high condom reliance (22.3%), and low prevention overall (29.7%). There were small differences by sociodemographic characteristics and sexual behavior practices between the classes; however, poppers use was often linked to being in high CHP groups. Our findings support that CHP is not one-size-fits-all for midlife and older adult MSM. There remains a need to scale up clinical providers' sexual health communication practices to assist midlife and older MSM incorporate prevention strategies, particularly biobehavioral prevention strategies that align with their patients' lived experiences.

AB - Insights into combination HIV prevention (CHP) strategies to reduce HIV incidence among midlife and older adult men who have sex with men (MSM) are limited. The current study is a secondary data analysis evaluating CHP in a sample of sexually active midlife and older adult MSM (N = 566) from the Multicenter AIDS Cohort Study Healthy Aging Substudy. Stratified by HIV serostatus, we used latent class analyses to identify CHP classes based on self-reported sociobehavioral and biobehavioral prevention strategies that participants and their male partners used in the prior 6 months. We identified three CHP classes among men living without HIV (MLWOH), including the following: high CHP overall (43.0%), high anal sex abstention (15.0%), and low prevention overall (42.0%). Among men living with HIV (MLWH), we identified four CHP classes, including the following: high CHP overall (20.9%), high CHP/low condom use (27.1%), high condom reliance (22.3%), and low prevention overall (29.7%). There were small differences by sociodemographic characteristics and sexual behavior practices between the classes; however, poppers use was often linked to being in high CHP groups. Our findings support that CHP is not one-size-fits-all for midlife and older adult MSM. There remains a need to scale up clinical providers' sexual health communication practices to assist midlife and older MSM incorporate prevention strategies, particularly biobehavioral prevention strategies that align with their patients' lived experiences.

KW - HIV

KW - aging

KW - pre-exposure prophylaxis

KW - sexual health

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AN - SCOPUS:85143917090

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Self-Reported Combination HIV Prevention Strategies Enacted by a Prospective Cohort of Midlife and Older Men Who Have Sex with Men in the United States: A Latent Class Analysis

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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