CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

in MSM community activities, larger networks of MSM, participation in an earlier RDS accrual wave, greater numbers of male anal sex partners, and higher levels of sexual identity stigma (Table 1). After adjusting for age, sexual orientation, education, marital status, religion, and study site, online sex-seeking was associated with testing positive for HIV at a follow-up visit (Adjusted Odds Ratio [aOR]=1.79, 95% Confidence Interval [CI]=1.17, 2.74) among those who were unaware of or not living with HIV at baseline. Online sex-seekers were marginally more likely to test positive for chlamydia/gonorrhea (aOR=1.28, 95% CI=1.00, 1.65). Among those living with HIV, online sex-seekers were not more likely to be taking antiretroviral medication (aOR=1.33, 95% CI=0.93, 1.90) or demonstrating suppressed viral load (aOR=0.74, 95% CI=0.48, 1.13). Conclusions: Online sex-seekers in Nigeria are at increased risk for HIV/STIs but are not benefiting from Internet-based risk reduction opportunities. Furthermore, MSM less engaged with the MSM or gay community are not connected to the Internet. The potential for applying Internet-based interventions for risk reduction requires further study in the African context.

925 Stigma and Openness About Sexual Identity Among MSM: A Latent Class Analysis Shauna Stahlman 1 ; Claire Holland 1 ; Sosthenes Ketende 1 ; LynnVan Lith 1 ; Duncan Kochelani 2 ; Zandile Mnisi 3 ; Bhekie Sithole 4 ; Libet Maloney 2 ; Stefan Baral 1 1 Johns Hopkins Bloomberg Sch of PH, Baltimore, MD, USA; 2 Johns Hopkins Univ Cntr for Communication Progs, Baltimore, MD, USA; 3 Swaziland Ministry of Hlth, Mbabane, Swaziland; 4 Hlth Communication Capacity Collaborative Proj, Mbabane, Swaziland Background: Men who have sex with men (MSM) in Sub-Saharan Africa are subjected to high levels of sexual identity-related stigma, which may affect mental health and sexual risk behaviors. MSM who are open about their sexual identity appear to be most affected by stigma. Characterizing the mechanism of action of stigma in potentiating HIV-risks among MSM is important to support the development of interventions. Methods: MSMwere recruited across 5 cities/towns in Swaziland through snowball sampling ending in December 2014. Participants (N=532) completed a survey that included questions about demographics, stigma, and mental and sexual health. Latent class analysis was used to identify classes based on self-reported measures of sexual identity stigma and whether the sexual identity of the participant was known to his family or healthcare workers. Logistic regression was used to identify demographic characteristics, sexual risk behaviors, and mental health characteristics (i.e., depression – PHQ9) associated with latent class membership. Results: A three-latent-class model was selected. The first class consistent of MSM who demonstrated overall low probabilities of sexual identity stigma (55%). MSM in the second class exhibited high probabilities of physical violence and fear/avoidance of healthcare, and were less likely to have their sexual identities known (10%). Members of the third class demonstrated high probabilities of verbal harassment, stigma from family and friends, and were more likely to have their sexual identities known (34%). Relative to the “low stigma” class, participants who were sampled from an urban area (Adjusted Odds Ratio [aOR]=2.78, 95% Confidence Interval [CI]=1.53, 5.07) and who engaged in condomless anal sex (aOR=1.85, 95% CI=1.17, 2.91) were more likely to belong to the “high stigma, ‘out’” class. In contrast, participants who had a concurrent partner (including female partners) were more likely to belong to the “high stigma, not ‘out’” class (aOR=2.73, 95% CI=1.05, 7.07). Depression was associated with membership in both high-stigma classes (aOR=2.42, 95% CI=1.51, 3.87 “out” and aOR=3.14, 95% CI=1.50, 6.55 not “out”). Conclusions: Community-level sexual identity stigma is associated with individual-level risk behaviors among MSM and these associations vary by level of sexual identity openness. Comprehensive HIV interventions should aim to reduce stigma and encourage community-level support.

Poster Abstracts

391

CROI 2016