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The UMHS and SEA surveys gathered partner-specific data only for partners in the past year. The cooperation rates were based on the proportion of eligible individuals who opted to participate and were higher for UMHS and SEA (78–97%) than the SSS (46%). This denominator was the sum of the number of interviews, refusals, and an estimate of the number of eligible individuals among those for whom eligibility could not be determined 25. Only SSS and SEA provided response rates, which were <50% and computed by dividing the number of interviews by an estimate of the number of eligible individuals from the RDD sampling frame. To increase comparability across all surveys, we restricted analyses to participants aged 18–39 years. Oral informed consent was obtained from all participants. UMHS MSM were also eligible if they self-identified as homosexual, gay, or bisexual.
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Men who reported same-sex sexual behavior since age 14 were eligible.
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For UHMS and SEA, telephone numbers were sampled from zip codes with high proportions of MSM. For this analysis, we excluded SSS participants who had never had sex or reported partnerships that were not exclusively heterosexual. The SSS and the two SEA RDDs were conducted in the mid-2000s, while the UMHS, which enrolled MSM from 4 U.S. In this paper we used population-based studies to compare the sexual behaviors of MSM and heterosexual men and women in the U.S., paying particular attention to how patterns of behavior differed across age groups. While some of these behaviors have been assessed to better understand observed racial disparities in HIV/STI rates 15– 18, much less has been done to compare the behaviors of MSM and heterosexuals 9, 19. These factors likely play important roles in the epidemiology of HIV/STI and in explaining observed disparities. Prior research has found that MSM tend to have higher numbers of sex partners than heterosexuals 9, but the dynamics of partnership formation 10, concurrency 11, and age mixing patterns 12– 14 have not been extensively characterized. However, the sexual behaviors of MSM and of male and female heterosexuals are substantially different in ways that are not explained by biology alone. These factors alone would result in significant disparities in HIV rates between MSM and heterosexuals even if both populations had similar numbers of sex partners, frequency of sex, and condom use levels 8. Furthermore, the transmission probability of HIV associated with anal sex is higher than that associated with vaginal sex 6, 7. demonstrated that an MSM population with a very high level of versatility would have a higher HIV prevalence than one with less versatility 5. In part, these differences reflect the fact that an individual MSM can engage in both insertive and receptive sexual roles (i.e., versatility), while exclusively heterosexual men and women each engage in only one of these roles. The Centers for Disease Control and Prevention (CDC) estimates that HIV and early syphilis rates among MSM are >40 times higher than those among heterosexuals 4. population 1, but accounted for 59% of new HIV infections and 62% of cases of early syphilis in 2009 2, 3. MSM comprise approximately 2% of the U.S. Sexually transmitted infections (STI) disproportionately affect men who have sex with men (MSM).