High rates of unprotected sex and serosorting among men who have sex with men: A national online study in Norway

Abstract

Unprotected sexual contact between men remains the predominant means of HIV transmission in men. Aim: To ascertain predictors of unprotected anal intercourse between non-primary partners among a sample of 2096 men who have sex with men in Norway and to characterise the sociosexual profile of men who have sex with men who engage in this behaviour. Methods: A cross-sectional survey, using an anonymous self-administered questionnaire, was conducted in 2010. Results: Multivariate logistic regression showed that the likelihood of engaging in unprotected anal intercourse with non-primary partners was lower for men over 30 years (OR = 0.60), those with higher education (OR = 0.58), and higher HIV-related knowledge (OR = 0.98). The likelihood of engaging in unprotected anal intercourse with non-primary partners was higher among men who have sex with men reporting that condoms had not been available (OR = 1.58), who had a higher number of non-primary anal intercourse partners (OR = 1.20), and who reported use of party drugs (OR = 2.34). These men were not more likely to test for HIV/sexually transmitted infections, but they were more likely to have been diagnosed with sexually transmitted infections, engage in serosorting, and various other sexual behaviours. Conclusions: As we enter the fourth decade of the HIV epidemic, the results for Norwegian men who have sex with men underscore the need for a scaling-up of prevention campaigns, highlighting messages and behavioural strategies that encourage safer sex strategies.