PT  - JOURNAL ARTICLE
AU  - Mao, Limin
AU  - Kippax, Susan C
AU  - Holt, Martin
AU  - Prestage, Garrett P
AU  - Zablotska, Iryna B
AU  - de Wit, John B F
TI  - Rates of condom and non-condom-based anal intercourse practices among homosexually active men in Australia: deliberate HIV risk reduction?
AID  - 10.1136/sextrans-2011-050041
DP  - 2011 Oct 01
TA  - Sexually Transmitted Infections
PG  - 489--493
VI  - 87
IP  - 6
4099  - http://sti.bmj.com/content/87/6/489.short
4100  - http://sti.bmj.com/content/87/6/489.full
SO  - Sex Transm Infect2011 Oct 01; 87
AB  - Objective Three decades into the HIV epidemic and with the advancement of HIV treatments, condom and non-condom-based anal intercourse among gay men in resource-rich countries needs to be re-assessed.Methods The proportions of men engaging in a range of anal intercourse practices were estimated from the ongoing cross-sectional Gay Community Periodic Surveys in six states in Australia from 2007 to 2009. Comparisons were made between HIV-negative men, HIV-positive men with an undetectable viral load and those with a detectable viral load.Results Condoms play a key role in gay men's anal intercourse practices: 33.8% of HIV-negative men, 25.1% of HIV-positive men with an undetectable viral load and 22.5% of those with a detectable viral load reported consistent condom use with all male partners in the 6 months before the survey. Among HIV-negative men, the second largest group were men who had unprotected anal intercourse (UAI) only in the context of HIV-negative seroconcordant regular relationships. Among HIV-positive men, the second largest group was men who had UAI in casual encounters preceded by HIV status disclosure to some, but not all, casual partners.Conclusions A minority, yet sizeable proportion, of men consistently engaged in a number of UAI practices in specific contexts, suggesting they have adopted deliberate HIV risk-reduction strategies. While it is important that HIV behavioural prevention continues to reinforce condom use, it needs to address both the challenges and opportunities of the substantial uptake of non-condom-based risk-reduction strategies.