Insights into sexual partners and partnerships among gay, bisexual and other men who have sex with men in the United Kingdom: results from the Reducing Inequalities in Sexual Health (RiiSH) behavioural survey

ObjectivesSexual decision-making and STI prevention are influenced not only by individuals characteristics, but also those of their partners and their relationship with each other. To inform tailored STI prevention and better understand STI transmission dynamics, this study aimed to understand the characteristics of sexual partners and partnerships among UK GBMSM, for whom there has been limited information beyond partner numbers. MethodsWorking with community-based organisations, we co-designed a sexual partnerships module for the UKs annual online cross-sectional community-based RiiSH GBMSM survey, undertaken November-December 2023. We collected data about [≤]3 most recent male sex partners since August 2023 and analysed variations in relative demographic characteristics (age, ethnicity), sexual behaviours (sexual practices, condom use, HIV-PrEP use) and communication (talking about sexual health, sharing HIV status) by partner type. ResultsAltogether 1106 participants described 2342 partners: 12%, 20%, 11% and 57% reporting 0, 1, 2 and 3 partners, respectively, of varying combinations. Casual partner types were most commonly reported (43%) vs. one-time (36%), established (14%) and uncertain relationships defined (7%). Concurrency was common with the mean number of ongoing partnerships >1 (1.23, 95%CI:1.17-1.30). Age-mixing varied by partner type, from median 2 (established partners) to 10 (one-time partners) years difference. Sexual health communication differed by partner type. While highest among established partners, it was twice as common to be unaware of one-time partners HIV status and not to have discussed sexual health (both 68%) vs. among casual partners (30% and 28%, respectively). Condom use was low across all partnership types, though HIV-PrEP was used in 49% of one-time partnerships involving condomless anal intercourse. DiscussionGBMSM in the UK have diverse types of male sexual partners and partnerships, which vary in their demographic mixing, sexual behaviour and sexual health communication. STI prevention and sexual wellbeing programmes targeting GBMSM should consider partnership and partner type. Key messagesO_ST_ABSWhat is already knownC_ST_ABSSexual behaviours vary across individuals and also partnership types. Understanding the timing, behaviours and characteristics of partnerships, and therefore the sexual contact network, may inform STI prevention efforts. What this study addsThis study of GBMSM from a large, UK-wide community sample show their sexual partnerships are diverse in their behaviour, characteristics and communication, varying both between and within individuals. What are the implicationsFurther research and practice should consider partnership type when designing and delivering STI prevention interventions to maximise their effectiveness among GBMSM and potentially more broadly.