Advertisement

 

 

Condomless sex in HIV-diagnosed men who have sex with men in the UK: prevalence, correlates, and implications for HIV transmission.

Condomless sex in HIV-diagnosed men who have sex with men in the UK: prevalence, correlates, and implications for HIV transmission.
Author Information (click to view)

Daskalopoulou M, Rodger AJ, Phillips AN, Sherr L, Elford J, McDonnell J, Edwards S, Perry N, Wilkins E, Collins S, Johnson AM, Burman WJ, Speakman A, Lampe FC, ,


Daskalopoulou M, Rodger AJ, Phillips AN, Sherr L, Elford J, McDonnell J, Edwards S, Perry N, Wilkins E, Collins S, Johnson AM, Burman WJ, Speakman A, Lampe FC, , (click to view)

Daskalopoulou M, Rodger AJ, Phillips AN, Sherr L, Elford J, McDonnell J, Edwards S, Perry N, Wilkins E, Collins S, Johnson AM, Burman WJ, Speakman A, Lampe FC, ,

Advertisement

Sexually transmitted infections 2017 07 05() pii 10.1136/sextrans-2016-053029

Abstract
OBJECTIVE
HIV transmission is ongoing among men who have sex with men (MSM) in the UK. Sex without a condom (condomless sex, CLS) is the main risk factor. We investigated the prevalence of and factors associated with types of CLS.

METHODS
Cross-sectional questionnaire study in UK HIV clinics in 2011/2012 (ASTRA). MSM diagnosed with HIV for ≥3 months reported on anal and vaginal sex, CLS with HIV-serodifferent partners (CLS-D) and CLS with HIV-seroconcordant (CLS-C) partners in the previous 3 months. Mutually exclusive sexual behaviours were as follows: (1) Higher HIV risk CLS-D (not on antiretroviral therapy (ART) or clinic-recorded viral load(VL) >50 c/mL), (2) Other CLS-D, (3) CLS-C without CLS-D, (4) Condom-protected sex only and (5) No anal or vaginal sex. Associations were examined of sociodemographic, HIV-related, lifestyle, and other sexual measures with the five categories of sexual behaviour. We examined the prevalence of higher HIV risk CLS-D incorporating (in addition to ART and VL) time on ART, ART non-adherence, and recent sexually transmitted infections (STIs).

RESULTS
Among 2189 HIV-diagnosed MSM (87% on ART), prevalence of any CLS in the past 3 months was 38.2% (95% CI 36.2% to 40.4%) and that of any CLS-D was 16.3% (14.8%-17.9%). The five-category classification was as follows: (1) Higher HIV risk CLS-D: 4.2% (3.5% to 5.2%), (2) Other CLS-D: 12.1% (10.8% to 13.5%), (3) CLS-C without CLS-D: 21.9% (20.2% to 23.7%), (4) Condom-protected sex only: 25.4% (23.6% to 27.3%) and (5) No anal or vaginal sex: 36.4% (34.3% to 38.4%). Compared with men who reported condom-protected sex only, MSM who reported any CLS in the past 3 months had higher prevalence of STIs, chemsex-associated drug use, group sex, higher partner numbers, and lifetime hepatitis C. Prevalence of higher HIV risk CLS-D ranged from 4.2% to 7.5% according to criteria included.

CONCLUSION
CLS was prevalent among HIV-diagnosed MSM, but CLS-D with higher HIV transmission risk was overall low. CLS-D is no longer the most appropriate measure of HIV transmission risk behaviour among people with diagnosed HIV; accounting for VL is important.

Submit a Comment

Your email address will not be published. Required fields are marked *

eleven − 10 =

[ HIDE/SHOW ]