National Trends in Sexual Behavior, Substance Use and HIV Testing Among United States Men Who Have Sex With Men Recruited Online, 2017 Through 2024.

Authors

Michael Smith, Cristian Acero-Martinez, Irah L Lucas, Mariah Valentine-Graves, Stefan Baral, Sarah M Murray, Patrick S Sullivan, Travis Sanchez

Published in

Journal of the International Association of Providers of AIDS Care. Volume 25. Pages 23259582261497550. Epub Oct 16, 2026.

Abstract

BackgroundGay men and other men who have sex with men are disproportionately impacted by HIV and other sexual transmitted infections. Thus, monitoring changes to HIV-related risk and prevention behaviors are relevant to contextualizing public health programming. The American Men's Internet Survey (AMIS) is conducted annually for gay men and other men who have sex with men (MSM), aged 15 and older to describe recent trends in key behaviors relevant to HIV prevention.MethodsData from 62,125 analysis-eligible MSM participants in 7 AMIS cross-sectional cycles conducted from July 2017 through October 2024 were analyzed to identify temporal trends in the annual prevalence of sexual behaviors, substance use, and testing behaviors, stratified by participants' self-reported HIV status. Age interactions with behavior trends were also examined.ResultsMSM who reported a negative or unknown HIV status had significant increases in the prevalence of condomless anal intercourse with male partners (CAI) and use of illicit drugs other than marijuana. STI testing and diagnosis prevalence among MSM decreased in 2020 and rebounded starting in 2021. HIV testing prevalence increased among MSM HIV negative/unknown status MSM aged 15-24; MSM in other age groups experienced a reduction in HIV testing in 2020 and a rebound starting in 2021. MSM living with HIV had significant increases in the prevalence of CAI and illicit drug use, including marijuana. STI testing and diagnosis prevalence among MSM living with HIV decreased in 2020 and rebounded starting in 2021.ConclusionsConsistent increases in behaviors that may increase HIV and STI acquisition/transmission risk occurred during a time when HIV and STI testing was significantly impacted by the COVID-19 pandemic followed by a rebound. The complexity of these trends highlights a need for ongoing monitoring of prevention and care behaviors, prevention strategies targeted at reducing risky behaviors and substance use, and expanded access to HIV/STI testing, particularly during times when traditional in-person services may be curtailed.

PMID:
42885750
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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