Abstract: Early Sexual Debut and Exchange Sex Among Men Who Have Sex with Men (MSM) in Kazakhstan (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)
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614P Early Sexual Debut and Exchange Sex Among Men Who Have Sex with Men (MSM) in Kazakhstan

Schedule:
Sunday, January 15, 2023
Phoenix C, 3rd Level (Sheraton Phoenix Downtown)
* noted as presenting author
Caitlin Laughney, MSW, Graduate Research Assistant, Columbia University, New York, NY
Yong Gun Lee, MSW, Graduate Research Assistant, Columbia University School of Social Work, New York City, NY
Guakhar Mergenova, MD, Project Director, Global Health Research Center of Central Asia, Kazakhstan
Vitaliy Vinogradov, Project Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Gulnara Zhakupova, MSW, Project Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Emily Allen Paine, PhD, Postdoctoral Research Fellow, Columbia University, New York, NY
Sholpan Primbetova, MS, MPharm, Deputy Regional Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Assel Terlikbayeva, MD, Regional Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan
Nabila El Bassel, PhD, University Professor, Columbia University, New York, NY
Elwin Wu, PhD, Professor / Co-Director, Columbia University, New York, NY
Background and Purpose: Limited research has examined prevalence rates and associations related to exchange sex behaviors among gay, bisexual, and men who have sex with men (MSM) in Kazakhstan. Early sexual debut has been associated with exchange sex behaviors among MSM, but these associations have yet to be examined among MSM in Kazakhstan. The purpose of this study is to examine associations between early sexual debut and lifetime exchange sex behaviors among Kazakhstani MSM.

Methods: Using data from a NIDA-funded HIV prevention trial, we conducted a secondary analysis of self-reported data from 763 adult cisgender MSM in Kazakhstan who completed structured screening interviews. Measures used in these analyses include sociodemographic information, age of sexual debut (ages ≤ 12, 13-15, and ≥16), and reports of ever buying or selling sex in exchange for resources (i.e. money, shelter, drugs). The cut-off age for early sexual debut was 15 years old, with 16 years or older as the reference group. Logistic regression models were used to estimate associations between early sexual debut and lifetime reports of buying or selling sex for resources, with covariance adjustment for sociodemographic characteristics.

Results: Within our sample of MSM in Kazakhstan, 23% had sold sex and 26% had bought sex in their lifetime. Significant associations were observed between early sexual debut and exchange sex behaviors among MSM in Kazakhstan. Participants who reported an early sexual debut before 13 years old and between 13-15 years old had significantly higher odds of ever selling (aOR=2.97, 95%CI: 1.64-5.37; aOR=1.57, 95%CI: 1.04-2.39) or buying sex (aOR= 2.13, 95%CI: 1.17-4.10; aOR= 1.59, 95%CI: 1.06-2.38) in their lifetime. Early sexual debut before the age of 12 and between the ages of 13-15 was also associated with selling sex for resources at an earlier age (aOR= 6.81, 95%CI: 3.16-14.66; aOR= 3.39, 95%CI: 1.87-6.15).

Implications & Conclusions: Evidence suggests that early sexual debut is associated with reported behaviors of selling or buying sex in exchange for resources among MSM in Kazakhstan. Future research should examine how sexual development during childhood and adolescence relate to exchange sex behaviors and risk among MSM. Clinical interventions aimed at reducing risks related to exchange sex behaviors among MSM may benefit from sexual health history information including age and context of sexual debut.

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