Going Down Under: HIV Testing and Condom Use by Ethnicity in all MSM and Among Young MSM in Aotearoa New Zealand

Abstract

HIV and other sexually transmitted infections (STIs) disproportionately affect younger gay, bisexual, and other men who have sex with men (MSM) and MSM of certain ethnicities in some countries. Data from national HIV behavioural surveillance in New Zealand (2006, 2008, and 2011) were analyzed to study (1) prevalence of and factors associated with recent HIV testing (<12 months) and condom use (<6 months) during anal sex with regular and casual partners for younger men who have sex with men (YMSM, aged <30, n=3,387) and (2) sexual health and behaviour disparities among ethnic groups and temporal trends within ethnic groups across MSM of all ages who reported their ethnicity (693 Asian, 6155 European, 801 Māori, and 304 Pacific). Among YMSM, almost 40% were recently tested for HIV and ~71% reported anal intercourse: 36% of all YMSM with a regular partner (classified as “boyfriend”, 59.5%, or “fuckbuddy”, 40.5%) and 57% with a casual partner. High condom use (always or almost always) differed by partnership type: 75% with casual partners, 60% with fuckbuddies, and 35% with boyfriends. Condom use was clustered within individuals (ICC=0.865), but varied by anal modality and partner type. Factors associated with increased odds of recent HIV testing and with high condom use were in-person recruitment, insertive-only anal modality, and multiple partners. Longer regular relationships (>1 year) increased odds of recent HIV testing, but decreased odds of condom use. Among MSM of all ages, three different ethnicity classification methods were compared, which produced varying sample sizes and either revealed or masked differences in sexual health between ethnic groups. Compared with European men, Asian and Pacific men were less likely to report lifetime HIV testing; recent and lifetime HIV testing increased in all three ethnic groups from 2006-2011. Māori and Pacific men were more likely to report >20 partners, but this decreased for Māori men over time. Consistent condom use with casual partners was less likely for Māori and Pacific men compared with European men. However, Māori men were more likely to report always using a condom with their regular partner compared with European men.