Associations between the sexual behaviour of men who have sex with men and the structure and composition of their social networks

Objective: This exploratory study identified associations between the number of sexual partners reported by men who have sex with men (MSM) and the structure and composition of their social networks. Methods: A cross sectional survey was conducted of men recruited as key informants, through advertising and chain referral. A face to face interview was conducted with 206 MSM. The interview included information on the number of sexual partners in the previous year and sociodemographic and behavioural characteristics of the participant. Social networks were enumerated and network size and density were calculated. Ordered logistic regression was used to assess the associations between number of sexual partners and personal and network characteristics. Results: The number of anal sex partners reported was higher if the participant had injected drugs in the past year rather than never having injected ( odds ratio, 95% confidence interval: 3.23, 1.28 to 8.15), decreased with network density ( 0.014, 0.002 to 0.008) and increased if the network did not comprise only HIV negative people (1.77, 1.05 to 2.99). The number of additional oral sex partners increased with network size (1.06, 1.02 to 1.10) and decreased with increased network density (0.034, 0.006 to 0.205). In addition to similar effects of network size ( 1.05, 1.01 to 1.09) and network density ( 0.086, 0.013 to 0.563) the model for the number of additional manual sex partners also included age (1.03, 1.01 to 1.05). Conclusion: The density of the social networks of MSM appears strongly and consistently associated with patterns of sexual behaviour. This underlines the importance of using network approaches to understanding the sexual behaviour of MSM and their potential value in identifying novel strategies for intervention.