Unsafe sexual behavior and correlates of risk in a probability sample of men who have sex with men in the era of highly active antiretroviral therapy.

Abstract

OBJECTIVE:

To assess the levels and correlates of potential exposure to and transmission of HIV in a contemporary, community-based probability sample of men who have sex with men (MSM).

METHODS:

In 2003, 311 sexually active MSM participated in a random-digit dial telephone survey in Seattle neighborhoods with a high prevalence of MSM. The primary outcomes were potential exposure to and transmission of HIV, defined as unprotected anal intercourse with a man of opposite or unknown HIV status in the preceding 12 months.

RESULTS:

Fourteen percent of respondents reported being HIV-positive, 77% reported being HIV-negative, and 8% had not been tested. Of 241 HIV-negative MSM, 25 (10%; 95% confidence interval [CI], 7-15%) were potentially exposed to HIV; among 45 HIV-positive MSM, 14 (31%; 95% CI, 20-46%) were potential HIV-transmitters. Among HIV-negative men, the strongest bivariate correlates of potential exposure to HIV were recent bacterial sexually transmitted disease (odds ratio [OR], 5.8), number of recent male sexual partners (OR, 1.01 per partner), recent sex at a bathhouse (OR, 9.1), and recent use of sildenafil (OR, 4.4), amyl nitrite (OR, 6.2), and methamphetamine (OR, 8.0). Among HIV-infected men, the strongest correlates of potential HIV transmission were recent use of amyl nitrite (OR, 3.1), number of recent male sex partners (OR, 1.07 per partner), and having a male spouse or domestic partner (OR, 0.3).

CONCLUSIONS:

Most MSM knew their HIV status and adopted safer sexual behaviors to reduce their risk of HIV acquisition or transmission. However, 10% of HIV-negative MSM and 31% of HIV-positive MSM recently engaged in behaviors that placed them at high risk for acquiring or transmitting HIV.

• Authors: Devon D Brewer, Matthew R Golden, H Hunter Handsfield
• Journal: Sexually transmitted diseases (Sex Transm Dis) Vol. 33 Issue 4 Pg. 250-5 (Apr 2006) ISSN: 0148-5717 [Print] United States
• PMID: 16505748 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Topics

• Adult
• Antiretroviral Therapy, Highly Active
• Disease Transmission, Infectious (prevention & control)
• HIV Infections (epidemiology, etiology, prevention & control, transmission)
• Homosexuality, Male
• Humans
• Male
• Risk Factors
• Surveys and Questionnaires
• Unsafe Sex
• Washington (epidemiology)