Increases in Unprotected Anal Intercourse with Serodiscordant Casual Partners Among HIV-Negative Gay Men in Sydney

Zablotska, Iryna; Crawford, June; Imrie, John; Prestage, Garrett; Jin, Fengyi; Grulich, Andrew E.; Kippax, Susan

doi:10.1007/s10461-008-9506-x

Cited by 27 publications

(21 citation statements)

References 10 publications

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“…Quanto à autopercepção de risco, poucos estudos com homens usuários da internet exploraram este fator em suas análises 5,18,24,30 , o mais comum é associar esta percepção ao uso de drogas e outros fatores intermediários que podem influenciar no envolvimento em práticas de risco para a infecção por HIV. Mas destacamos que neste trabalho a autopercepção aparece como um fator importante na presença dos demais fatores estudados, mas chama atenção o fato de a percepção alta e média do risco elevar as chances (OR=2,7) de envolvimento na prá-tica do sexo anal desprotegido.…”

Section: Discussionunclassified

“…Na literatura internacional, estudos que coletaram dados na internet e em locais de sociabilidade gay também encontraram associações similares 1,2,5,7,[17][18][19][20][21][22][23][24][25][26]29,30 . Alguns desses estudos compararam grupos de HSH soropositivo e negativo para HIV, analisando o sexo anal insertivo sem o uso do preservativo e sexo com parceiro sorodiscordante, e nestes estudos, o grupo que recruta parceiros sexuais na internet apresentou maior risco de envolvimento em práticas sexuais desprotegidas [5][6][7]23,26 .…”

Section: Discussionunclassified

“…Alguns desses estudos compararam grupos de HSH soropositivo e negativo para HIV, analisando o sexo anal insertivo sem o uso do preservativo e sexo com parceiro sorodiscordante, e nestes estudos, o grupo que recruta parceiros sexuais na internet apresentou maior risco de envolvimento em práticas sexuais desprotegidas [5][6][7]23,26 . Frequentar locais específicos de sociabilidade gay, como saunas, banheiros públi-cos e cinemas pornôs, com o objetivo de encontrar parceiros sexuais e a associação com a prática do sexo anal sem proteção é demonstrada em estudos internacionais que recrutaram HSH na internet 2,3,7,[17][18][19][20]27 ou em outros locais da "cena" gay 2,27 . Porém, na nossa análise multivariada, esse fator não atingiu níveis de significância estatística.…”

Section: Discussionunclassified

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Inquérito sociocomportamental sobre as práticas sexuais desprotegidas entre homens que fazem sexo com homens usuários da Internet

Brignol

Dourado

2011

Rev. bras. epidemiol.

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ResumoIntrodução: O sexo anal sem o uso do preservativo masculino é um importante fator de risco para a infecção por HIV e outras doenças sexualmente transmissíveis. Objetivo: Investigar fatores individuais e sociais que se relacionam ao sexo anal desprotegido entre homens que se autodeclararam HIV negativos e que fizeram sexo anal com parceiros HIV positivos ou de sorologia desconhecida. Metodologia: Este estudo é parte de um inquérito sociocomportamental entre homens que fazem sexo com homens (HSH), a coleta de dados foi on-line no site do projeto Convida. A amostra deste estudo foi de 487 HSH. A análise descritiva precedeu a análise bivariada com o uso do teste χ 2 . Para a modelagem utilizou-se a regressão logística. Resultados: Praticaram sexo anal desprotegido com parceiro HIV positivo ou de sorologia desconhecida no último ano 30,8% dos participantes, sendo a maioria de classes sociais mais elevadas, brancos e solteiros. Os fatores que se associaram à prática do sexo anal sem proteção foram: ter mais de três parceiros no último ano (OR=1,7; IC95% 1,1-2,7), autopercepção de alto ou médio risco para adquirir HIV/Aids (OR=2,7; IC95% 1,5-3,6) e gostar de sexo oral passivo (OR=0,3; IC95% 0,2-0,8). Conclusão: O sexo anal desprotegido é uma prática frequente entre os HSH entrevistados. A frequência a banheiros públi-cos deve ser explorada enquanto fator de risco para o envolvimento no sexo anal sem proteção. Outros estudos on-line são necessários e importantes para o entendimento dessas relações e do envolvimento em prá-ticas sexuais arriscadas para infecção por HIV entre HSH. Palavras AbstractIntroduction: Unprotected anal sex (insertive or receptive) is an important risk factor for HIV infection and other STDs. Objetive: The objective was to investigate individual and social factors associated with unprotected anal sex among Men Who have Sex with Men (MSM) that declared being HIV negative and engaged in anal sex with an HIV positive partner or of ignored serology. Methods: This study is part of a survey among MSM and among Internet users, with data collected from an on line questionnaire in project site. The internet sample for this study was 487 MSM. Descriptive and stratified analyses were carried out and χ 2 test was used. Logistic regression was used for modeling the data. Results: Among the participants 30.8% referred unprotected anal sex in the previous 12 months with an HIV positive partner or partner with unknown serology. Most of them belonged to higher social classes, were white and single. Factors associated with unprotected anal sex were: number of partners (more than 3) in the previous 12 months (OR=1.7; 95% CI 1.1-2.7), high or medium perception of risk to HIV/Aids (OR=2.7; 95% CI 1.5-3.6) and enjoy passive oral sex (OR=0.3; 95% CI 0.2-0.8). Conclusion: Unprotected anal sex was a frequent practice among MSM in this survey. The frequency to public bathrooms should be further explored as a risk factor for unprotected anal sex. It is important to further explore these findings in order to understan...

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Section: Discussionunclassified

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Inquérito sociocomportamental sobre as práticas sexuais desprotegidas entre homens que fazem sexo com homens usuários da Internet

Brignol

Dourado

2011

Rev. bras. epidemiol.

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“…[8][9][10] Negotiated safety agreements have been described among men who have sex with men (MSM) as strategies for selectively practicing condomless anal intercourse (CAI) while maintaining sexual pleasure and intimacy within relationships. [11][12][13][14][15][16][17] While intended to reduce HIV risk, such strategies may fail in practice due to factors such as inaccurate assessment of individual and partner serostatus, infrequent testing, failure to maintain the agreement, and lack of protection against STIs. [18][19][20][21] Shortcomings in assessing partner HIV risk have also been reported among heterosexuals.…”

Section: Introductionmentioning

confidence: 99%

Relationship Dynamics and Sexual Risk Reduction Strategies Among Heterosexual Young Adults: A Qualitative Study of Sexually Transmitted Infection Clinic Attendees at an Urban Chicago Health Center

Hotton¹,

French

Hosek

et al. 2015

AIDS Patient Care and STDs

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Few studies have examined risk-reduction alternatives to consistent condom use for HIV prevention among heterosexual young adults. We used qualitative methodology to explore risk reduction strategies and contextual factors influencing attempts to reduce risk in an urban, high morbidity sexually transmitted infection (STI) clinic. Focus groups were conducted October-December 2014 with heterosexually identified men (n = 13) and women (n = 20) aged 18-29 seeking STI screening at an urban clinic. Groups were audio recorded, transcribed verbatim, and analyzed for thematic content using Atlas.ti software. Quantitative information included sociodemographics, HIV/STI testing history, and 6-month sexual behaviors. Among 33 predominantly AfricanAmerican participants with a median age of 22, risk-reduction strategies included monogamy agreements, selective condom use with casual and high-risk partners, and frequent HIV/STI testing, though testing was commonly used as a post-hoc reassurance after risk exposure. Many men and women used implicit risk assessment strategies due to mistrust or difficulty communicating. Concurrency was common but rarely discussed within partnerships. Despite attempts to reduce risk, monogamy agreements were often poorly adhered to and not openly discussed. Alcohol and substance use frequently interfered with safer sexual decisions. Participants were aware of HIV/STI risk and commonly practiced risk-reduction strategies, but acknowledged faulty assumptions and poor adherence. This work provides insights into risk-reduction approaches that are already used and may be strengthened as part of effective HIV/STI prevention interventions.

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“…That some gay men may already be using viral load as one possible factor in negotiating condom use and that there have also been recent increases in sexual risk behaviour (Zablotska et al , 2009, suggests that any changes in recommendations about risk-minimisation need to be wellfounded. Apart from the evidence of a capacity for HIV transmission in the context of viral suppression, a riskminimisation strategy that incorporates undetectable viral load needs to account for the differing perspectives of HIV-positive and HIV-negative individuals.…”

Section: Introductionmentioning

confidence: 99%

Use of Viral Load to Negotiate Condom Use Among Gay Men in Sydney, Australia

et al. 2009

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Using two cohort studies (Health in men-HIM and positive health-PH) and repeated large cross-sectional surveys (Gay Community Periodic Survey-GCPS) of gay men in Sydney, Australia, we examined the association between viral load and unprotected anal intercourse (UAI) between HIV sero-discordant regular partners. Between 2001 and 2007, we conducted 243 interviews with 102 HIV-negative gay men in HIM and 148 interviews with 99 HIV-positive gay men in PH who were in regular relationships with HIV sero-discordant partners. During the same time period, 437 HIV positive men with HIV sero-discordant regular partners completed questionnaires for the GCPS. All completed interviews or questionnaires during that time period were used for these analyses. Amongst the HIV-negative respondents, sero-discordant UAI was more likely to be reported when the men believed their HIV-positive regular partner had an undetectable rather than a detectable viral load (P = 0.002). Amongst the HIV-positive respondents, sero-discordant UAI was as likely to be reported when they themselves reported having an undetectable or a detectable viral load. Use of viral load in negotiating condom use between sero-discordant gay couples may be understood very differently by the HIV-negative and HIV-positive men within those partnerships.

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Increases in Unprotected Anal Intercourse with Serodiscordant Casual Partners Among HIV-Negative Gay Men in Sydney

Cited by 27 publications

References 10 publications

Inquérito sociocomportamental sobre as práticas sexuais desprotegidas entre homens que fazem sexo com homens usuários da Internet

Inquérito sociocomportamental sobre as práticas sexuais desprotegidas entre homens que fazem sexo com homens usuários da Internet

Relationship Dynamics and Sexual Risk Reduction Strategies Among Heterosexual Young Adults: A Qualitative Study of Sexually Transmitted Infection Clinic Attendees at an Urban Chicago Health Center

Use of Viral Load to Negotiate Condom Use Among Gay Men in Sydney, Australia

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