Article Text

Download PDFPDF

P560 HIV preventive behaviour during last sex with a non-steady partner – self-reported data from 113,000 MSM from 66 countries
  1. Ulrich Marcus1,
  2. Susanne Schink1,
  3. Axel Schmidt2,
  4. Carlos Caceres3,
  5. Kai Jonas4,
  6. Maria Veras5,
  7. Percy Fernández-Davila6,
  8. Henrique Barros7,
  9. Peter Weatherburn2,
  10. Ford Hickson2,
  11. David Reid2,
  12. Jordi Casabona I Barbara6
  1. 1Robert Koch-Institut, Infectious Diseases Epidemiology, Berlin, Germany
  2. 2London School of Hygiene and Tropical Medicine, Sigma Research, London, UK
  3. 3Universidad Peruana Cayetano Heredia, Center for Interdisciplinary Studies in Sexuality, AIDS and Society, Lima, Peru
  4. 4Maastricht University, Department of Work and Social Psychology, Maastricht, Netherlands
  5. 5Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
  6. 6Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i SIDA de Catalunya, Research Department, Barcelona, Spain
  7. 7University of Porto, Institute of Public Health, Porto, Portugal


Background In Europe and the Americas, men-who-have-sex-with-men (MSM) are heavily affected by HIV. Having traditionally relied mainly on condoms and sero-adaptive behaviours to prevent HIV transmission, more recently biomedical prevention strategies such as pre-exposure prophylaxis (PrEP) among HIV-negative and viral suppression among HIV-diagnosed men have been adopted. We analysed the choice of HIV prevention behaviour (HIV-PB) and determinants of the lack of defined HIV-PB during sex among MSM across 66 countries.

Methods Between October 2017 and May 2018, self-reported data were collected online: EMIS-2017 in 48 European countries (including Lebanon and Israel), and LAMIS in 18 predominantly Latin American countries. Here we focus on men who reported on their last anal sex with a non-steady partner. We used a multilevel multivariate regression model (MMRM) to identify demographic and contextual factors associated with the lack of HIV-PB such as condom use, undetectable viral load, PrEP use or serostatus disclosure.

Results Our analysis included 71,123 MSM from EMIS-2017 and 41,834 MSM from LAMIS. Condom use remained the primary HIV-PB, followed by sero-adaptive behaviours. Using antiretrovirals as HIV-PB accounted for 14.9% (HIV-diagnosed men: 83.4%; other MSM: 3.1%). No HIV-PB as defined above was reported by 20.5%, ranging from 12.1 to 39.7% across countries. In the MMRM, increasing age, false assumptions about HIV recognisability, struggling financially, living in smaller settlements, having intercourse in a gay sex venue, a group-sex setting, and receiving money for sex were associated with increased odds for lack of HIV-PB. The strongest associations were observed among those who had never been tested for HIV (OR=1.86, 95%CI: 1.79–1.94) and those who had not bought or received condoms in the last 12 months (OR=2.75; 95%CI: 2.60–2.91).

Conclusion About 1-in-5 MSM did not use HIV-PB. While antiretrovirals for treatment and prophylaxis gain importance, HIV-testing and condom promotion remain essential to encourage HIV-PB.

Disclosure No significant relationships.

  • gay bisexual and other men who have sex with men

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.