Lancet: Young Gay Men Risk HIV Because ‘Less Developed’ Impulse Control

gay men and marriage
AP Photo/Armando Franca

The UK Lancet medical journal said homosexual men continue to be the most at-risk group for HIV-AIDS, especially younger men with a greater number of partners.

In the United States, “gay men and other men who have sex with men (MSM) were the first population associated with what came to be known as AIDS,” the Lancet notes in its most recent issue, and “male-to-male anal intercourse remains associated with the largest number of new HIV infections diagnosed annually in the USA.”

Men who have sex with men “continue to be at very high risk of HIV acquisition,” the article states. “Common features of the HIV epidemic in American MSM include role versatility and biological, individual, and social and structural factors.”

“Young MSM have additional risks for HIV because their impulse control is less developed and they are less familiar with serostatus and other risk mitigation discussions,” the article adds.

According to a 2012 study titled “A comparison of sexual behavior patterns among men who have sex with men and heterosexual men and women,” men who have sex with men have higher rates of HIV and other sexually transmitted infections (STI) than women and heterosexual men, despite higher levels of condom use.

“MSM comprise approximately 2% of the U.S. population, but accounted for 59% of new HIV infections and 62% of cases of early syphilis in 2009,” the study found, and the Centers for Disease Control and Prevention (CDC) “estimates that HIV and early syphilis rates among MSM are >40 times higher than those among heterosexuals.”

The sexual behaviors of MSM and of male and female heterosexuals “are substantially different in ways that are not explained by biology alone,” the study revealed. “Prior research has found that MSM tend to have higher numbers of sex partners than heterosexuals,” but less attention has been devoted to the dynamics of partnership formation, concurrency (overlapping partnerships), and age mixing patterns, all of which “likely play important roles in the epidemiology of HIV/STI and in explaining observed disparities.”

Regarding age at sexual debut, the study found that on average men who have sex with men had their first sexual encounter more than two years earlier than either heterosexual men or heterosexual women (15.4, 17.4, 17.8 years, respectively).

MSM also reported an average of four times as many sexual partners in the last year as heterosexuals, with far greater divergency. While heterosexual men averaged one partner in the last year with a range of between zero and 99, men who have sex with men averaged four partners in the last year with a range between zero and 500.

As regards the number of sexual partners over a lifetime, MSM reported nearly six times as many partners as heterosexual men and nearly eight times as many as heterosexual women. In the study, MSM averaged 45 partners during their lives (range: 0-9005) while heterosexual men averaged eight (range: 1-99) and heterosexual women averaged six (range: 1-99).

Men who have sex with men also reported a far greater likelihood of engaging in sexual congress with partners more than five years older or younger than them as compared with heterosexuals.

Just under 8 percent of heterosexual men and 10 percent of heterosexual women reported that their most recent sexual partner was more than five years older or younger than them, while upwards of 40 percent of men who have sex with men said their last partner was more than five years distant from them in age.


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