Rates of condom and non-condom-based anal intercourse practices among homosexually active men in Australia: deliberate HIV risk reduction?

Mao, Limin; Kippax, Susan; Holt, Martin; Prestage, Garrett; Zablotska, Iryna; Wit, John de

doi:10.1136/sextrans-2011-050041

Cited by 54 publications

(41 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Yet few models exist that MSM couples may use to navigate the disclosure of breaks when they happen. 13,21,[30][31][32][33] In addition, Interdependence Theory posits that men prioritize the needs of their relationship over their personal health when making decisions-which could make negotiation and/or disclosure of broken agreements even more difficult. 34,35 These complexities between individual and partner-level priorities highlight the need to examine the influence of relationship dynamics on sexual risk behavior in MSM couples.…”

Section: Introductionmentioning

confidence: 99%

Relationship Characteristics Associated with Sexual Risk Behavior Among MSM in Committed Relationships

Hoff

Chakravarty

Beougher

et al. 2012

AIDS Patient Care and STDs

116

View full text Add to dashboard Cite

Understanding situations that increase HIV risk among men who have sex with men (MSM) requires consideration of the context in which risky behaviors occur. Relationships are one such context. This study examines the presence and predictors of unprotected anal intercourse (UAI) in the past 3 months among 566 MSM couples. A majority of couples allowed sex with outside partners. Overall, 65% of the sample engaged in UAI with primary partner, including nearly half of discordant couples. Positive relationship factors, such as attachment and intimacy, were associated with an increased likelihood of UAI with primary partner. Meanwhile, 22% of the sample engaged in at least one episode of UAI with an outside partner, half of whom were discordant or unknown HIV status outside partners. Higher levels of HIV-specific social support, equality, and sexual agreement investment were significantly associated with a decreased likelihood of engaging in UAI with a discordant or unknown HIV status outside partner. HIV-positive men in discordant relationships had two and one half times the odds of having UAI with a discordant or unknown HIV status outside partner as their HIVnegative partners. Many MSM in relationships, including some in serodiscordant ones, engage in UAI with primary partners. Potential explanations include relationship closeness, relationship length, and agreement type. In addition, relationship context appears to have a differential impact upon UAI with primary and outside partners, implying that prevention messages may need to be tailored for different types of couples. Prevention efforts involving MSM couples must take into account relationship characteristics as couples balance safer sex and HIV risk with intimacy and pleasure.

show abstract

Section: Introductionmentioning

confidence: 99%

Relationship Characteristics Associated with Sexual Risk Behavior Among MSM in Committed Relationships

Hoff

Chakravarty

Beougher

et al. 2012

AIDS Patient Care and STDs

116

View full text Add to dashboard Cite

show abstract

“…11,13 This is despite the increase in HIV treatment and undetectable viral load, the decline in partner numbers, the relatively high level of ongoing condom use and the increase in use of risk-reduction strategies such as serosorting during condomless anal sex. 12,23 Serosorting has become much more commonly practised by GBM in the last decade, 12,40 but it is does not protect HIVnegative men if HIV status is incorrectly assumed or a partner has undiagnosed HIV. 24,41,42 In fact, the greater reliance on serosorting may have increased the exposure of HIV-negative men to undiagnosed HIV, which may explain why other positive changes (such as the increase in HIV treatment and undetectable viral load) have had limited effect.…”

Section: Discussionmentioning

confidence: 99%

“…Up until recently, we have classified participants' responses to a set of questions about insertive and receptive anal intercourse with casual partners into three categories: no anal intercourse, consistent condom use and any CAI, sometimes distinguishing between men who reported any receptive CAI from those who only engaged in insertive CAI. 6,12,23 To take into account the protection offered by PrEP or sustaining an undetectable viral load through HIV treatment (TasP), we developed the following mutually exclusive classification:…”

Section: Methodsmentioning

confidence: 99%

Adapting behavioural surveillance to antiretroviral-based HIV prevention: reviewing and anticipating trends in the Australian Gay Community Periodic Surveys

et al. 2017

View full text Add to dashboard Cite

Abstract. Background:In Australia, the preventative use of antiretroviral drugs [pre-exposure prophylaxis (PrEP) and treatment as prevention] is being embraced to protect individuals at high risk of HIV and reduce onward transmission. Methods: The adaptation of a behavioural surveillance system, the Gay Community Periodic Surveys, was reviewed to monitor the uptake and effect of new prevention strategies in Australia's primary HIV-affected population (gay and bisexual men, GBM). The national trends in key indicators during 2000-15 were reviewed and a new measure to take account of antiretroviral-based prevention was developed. Results: Between 2000 and 2015, there were significant increases (P < 0.001) in annual HIV testing (56.1-64.8%), condomless sex with casual partners (26.8-38.8%) and the proportion of HIV-positive men on HIV treatment (72.5-88.4%) and with an undetectable viral load (73.7-94.7%). The proportion of casual partners who were HIV negative, not on PrEP and who engaged in receptive condomless sex also increased between 2000 and 2015 from 12.8 to 19.3%. Two scenarios anticipating the effect of PrEP highlighted the need to target GBM who engage in receptive condomless sex while also sustaining condom use at a population level. Conclusions: Behavioural surveillance can be successfully adapted to follow the effect of antiretroviral-based prevention. It is anticipated that HIV testing and HIV treatment will continue to increase among Australian GBM, but to prevent new infections, intervention in the growing proportion of GBM who have condomless sex with casual partners is needed. For PrEP to have its desired effect, condom use needs to be sustained.

show abstract

“…This reflects the recognition that UAI between casual partners is gradually becoming more common among Australian gay men (Holt et al, 2012;Mao et al, 2011). Researchers engaged in the social research epistemic community have therefore shifted position, recommending education on the effective use of risk reduction strategies.…”

Section: Serosortingmentioning

confidence: 99%

“…When I began writing this article I wanted to provide an overview of the distinctive contribution made by Australian researchers to understanding risk reduction practices; the practices that gay men engage in to reduce the risk of HIV transmission, particularly during unprotected sex (Mao et al, 2011). Out of necessity, I have restricted my focus to the examples of negotiated safety and serosorting.…”

Section: Introductionmentioning

confidence: 99%

Gay Men's HIV Risk Reduction Practices: The Influence of Epistemic Communities in HIV Social and Behavioral Research

Holt¹

2014

AIDS Education and Prevention

View full text Add to dashboard Cite

Rates of condom and non-condom-based anal intercourse practices among homosexually active men in Australia: deliberate HIV risk reduction?

Cited by 54 publications

References 42 publications

Relationship Characteristics Associated with Sexual Risk Behavior Among MSM in Committed Relationships

Relationship Characteristics Associated with Sexual Risk Behavior Among MSM in Committed Relationships

Adapting behavioural surveillance to antiretroviral-based HIV prevention: reviewing and anticipating trends in the Australian Gay Community Periodic Surveys

Gay Men's HIV Risk Reduction Practices: The Influence of Epistemic Communities in HIV Social and Behavioral Research

Contact Info

Product

Resources

About