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"Any Condomless Anal Intercourse" is No Longer an Accurate Measure of HIV Sexual risk Behavior in Gay and Other Men Who have Sex with Men.

Jin F, Prestage GP, Mao L, Poynten IM, Templeton DJ, Grulich AE, Zablotska I - Front Immunol (2015)

Bottom Line: In the present paper, we argue that summary measures such as "any CLAI" do not accurately measure HIV sexual risk behavior.Participants were more likely to engage in insertive CLAI with casual than with regular partners (66.7 vs. 55.3% of all acts of CLAI with each partner type, p < 0.001).Gay and other MSM engaging in CLAI demonstrate clear patterns of HIV risk reduction behavior.

View Article: PubMed Central - PubMed

Affiliation: The Kirby Institute, University of New South Wales , Kensington, NSW , Australia.

ABSTRACT

Background: Condomless anal intercourse (CLAI) has long been recognized as the primary mode of sexual transmission of HIV in gay and other men who have sex with men (MSM). A variety of measures of CLAI have been commonly used in behavioral surveillance for HIV risk and to forecast trends in HIV infection. However, gay and other MSM's sexual practices changed as the understanding of disease and treatment options advance. In the present paper, we argue that summary measures such as "any CLAI" do not accurately measure HIV sexual risk behavior.

Methods: Participants were 1,427 HIV-negative men from the Health in Men cohort study run from 2001 to 2007 in Sydney, Australia, with six-monthly interviews. At each interview, detailed quantitative data on the number of episodes of insertive and receptive CLAI in the last 6 months were collected, separated by partner type (regular vs. casual) and partners' HIV status (negative, positive, and HIV status unknown).

Results: A total of 228,064 episodes of CLAI were reported during the study period with a mean of 44 episodes per year per participant (median: 14). The great majority of CLAI episodes were with a regular partner (92.6%), most of them with HIV-negative regular partners (84.8%). Participants were more likely to engage in insertive CLAI with casual than with regular partners (66.7 vs. 55.3% of all acts of CLAI with each partner type, p < 0.001). Men were more likely to report CLAI in the receptive position with HIV-negative and HIV status unknown partners than with HIV-positive partners (p < 0.001 for both regular and casual partners).

Conclusion: Gay and other MSM engaging in CLAI demonstrate clear patterns of HIV risk reduction behavior. As HIV prevention enters the era of antiretroviral-based biomedical approach, using all forms of CLAI indiscriminately as a measure of HIV behavioral risk is not helpful in understanding the current drivers of HIV transmission in the community.

No MeSH data available.


Related in: MedlinePlus

Proportions of condomless anal intercourse by partners’ HIV status, partner type, and sexual positioning in the Health in Men study. CLAI, condomless anal intercourse.
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Figure 1: Proportions of condomless anal intercourse by partners’ HIV status, partner type, and sexual positioning in the Health in Men study. CLAI, condomless anal intercourse.

Mentions: The great majority of CLAI episodes (92.6%) were with a regular partner. CLAI with a HIV-negative regular partner accounted for 84.8% of the total CLAI episodes, and around 4% each were reported with HIV-positive and HIV status unknown regular partners (Figure 1). With a HIV-positive regular partner, only 25.4% of the total CLAI episodes were in the receptive position, and this was significantly lower than the proportion of receptive CLAI when the regular partner was HIV-negative (45.5%, p < 0.001) or HIV status unknown (48.7%, p < 0.001). Further, during receptive CLAI with a HIV-positive regular partner, only 25.0% of episodes involved ejaculation inside the participants’ rectum, which was also significantly lower than receptive CLAI with HIV-negative (63.3%, p < 0.001) and HIV status unknown partners (65.6%, p < 0.001).


"Any Condomless Anal Intercourse" is No Longer an Accurate Measure of HIV Sexual risk Behavior in Gay and Other Men Who have Sex with Men.

Jin F, Prestage GP, Mao L, Poynten IM, Templeton DJ, Grulich AE, Zablotska I - Front Immunol (2015)

Proportions of condomless anal intercourse by partners’ HIV status, partner type, and sexual positioning in the Health in Men study. CLAI, condomless anal intercourse.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4343002&req=5

Figure 1: Proportions of condomless anal intercourse by partners’ HIV status, partner type, and sexual positioning in the Health in Men study. CLAI, condomless anal intercourse.
Mentions: The great majority of CLAI episodes (92.6%) were with a regular partner. CLAI with a HIV-negative regular partner accounted for 84.8% of the total CLAI episodes, and around 4% each were reported with HIV-positive and HIV status unknown regular partners (Figure 1). With a HIV-positive regular partner, only 25.4% of the total CLAI episodes were in the receptive position, and this was significantly lower than the proportion of receptive CLAI when the regular partner was HIV-negative (45.5%, p < 0.001) or HIV status unknown (48.7%, p < 0.001). Further, during receptive CLAI with a HIV-positive regular partner, only 25.0% of episodes involved ejaculation inside the participants’ rectum, which was also significantly lower than receptive CLAI with HIV-negative (63.3%, p < 0.001) and HIV status unknown partners (65.6%, p < 0.001).

Bottom Line: In the present paper, we argue that summary measures such as "any CLAI" do not accurately measure HIV sexual risk behavior.Participants were more likely to engage in insertive CLAI with casual than with regular partners (66.7 vs. 55.3% of all acts of CLAI with each partner type, p < 0.001).Gay and other MSM engaging in CLAI demonstrate clear patterns of HIV risk reduction behavior.

View Article: PubMed Central - PubMed

Affiliation: The Kirby Institute, University of New South Wales , Kensington, NSW , Australia.

ABSTRACT

Background: Condomless anal intercourse (CLAI) has long been recognized as the primary mode of sexual transmission of HIV in gay and other men who have sex with men (MSM). A variety of measures of CLAI have been commonly used in behavioral surveillance for HIV risk and to forecast trends in HIV infection. However, gay and other MSM's sexual practices changed as the understanding of disease and treatment options advance. In the present paper, we argue that summary measures such as "any CLAI" do not accurately measure HIV sexual risk behavior.

Methods: Participants were 1,427 HIV-negative men from the Health in Men cohort study run from 2001 to 2007 in Sydney, Australia, with six-monthly interviews. At each interview, detailed quantitative data on the number of episodes of insertive and receptive CLAI in the last 6 months were collected, separated by partner type (regular vs. casual) and partners' HIV status (negative, positive, and HIV status unknown).

Results: A total of 228,064 episodes of CLAI were reported during the study period with a mean of 44 episodes per year per participant (median: 14). The great majority of CLAI episodes were with a regular partner (92.6%), most of them with HIV-negative regular partners (84.8%). Participants were more likely to engage in insertive CLAI with casual than with regular partners (66.7 vs. 55.3% of all acts of CLAI with each partner type, p < 0.001). Men were more likely to report CLAI in the receptive position with HIV-negative and HIV status unknown partners than with HIV-positive partners (p < 0.001 for both regular and casual partners).

Conclusion: Gay and other MSM engaging in CLAI demonstrate clear patterns of HIV risk reduction behavior. As HIV prevention enters the era of antiretroviral-based biomedical approach, using all forms of CLAI indiscriminately as a measure of HIV behavioral risk is not helpful in understanding the current drivers of HIV transmission in the community.

No MeSH data available.


Related in: MedlinePlus