Background: Recent US data on unsafe sexual behaviors among viremic HIV-infected men who have sex with men (MSM) are limited.
Method: Using data abstracted from medical records of the participants in the HIV Outpatient Study (HOPS) and a supplemental behavioral survey, we assessed the frequency of high-risk sexual practices among HIV-infected MSM in care and examined the factors associated with risky sexual practices. We also compared the frequency of unprotected anal sex (UAS) with HIV-negative or unknown serostatus partners among viremic (HIV viral load ≥400 copies per milliliter) vs virologically suppressed (HIV viral load <400 copies per milliliter) MSM.
Results: Among 902 HIV-infected MSM surveyed, 704 (78%) reported having sex in the past 6 months, of whom 54% reported UAS (37% insertive, 42% receptive) and 40% UAS with a male partner who was HIV-negative or of unknown serostatus (24% insertive, 31% receptive). In multivariable regression with an outcome of engaging in any UAS with a male partner who was HIV-negative or of unknown serostatus, MSM aged <50 years, who reported injection drug use risk, had ≥2 sex partners, and who disclosed their HIV status to some but not to all of their sex partners were more likely to report this practice. Among MSM who reported any UAS, 15% were viremic; frequency of the UAS did not differ between viremic and virologically suppressed MSM.
Conclusions: The high frequency of UAS with HIV-negative or unknown-status partners among HIV-infected MSM in care suggests the need for targeted prevention strategies for this population.
*Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention , Centers for Disease Control and Prevention, Atlanta, GA;
†Infectious Disease Insights – Population Health – Research, Cerner Corporation, Vienna, VA;
‡BrightOutcome, Buffalo Grove, IL; and
§Infectious Disease Research Institute, Tampa, FL.
Correspondence to: Marcus D. Durham, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E45, Atlanta, GA 30333 (e-mail: firstname.lastname@example.org).
The authors have no conflicts of interest to disclose.
The HOPS Investigators are given in Appendix 1.
The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Supported by the Centers for Disease Control and Prevention (contract nos. 200-2001-00133, 200-2006-18797, and 200-2011–41872).
Received October 18, 2012
Accepted February 05, 2013