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HIV-Negative Gay Men’s Perceived HIV Risk Hierarchy: Imaginary or Real?

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Abstract

HIV-related risk perceptions and risk practices among gay men have changed over time. We revisited perceived HIV risk and engagement in anal intercourse with casual partners among HIV-negative gay men who participated in one of the Sydney Gay Community Periodic Surveys (GCPS). Perceived HIV risk was assessed by a range of anal intercourse practices combined with pre-specified casual partners’ HIV status and viral load levels. Perceived HIV risk forms a potential hierarchy, broadly reflecting differences in the probability of HIV transmission through various anal intercourse practices. To a lesser extent, it also varies by casual partners’ HIV status and viral load. Men who had unprotected anal intercourse with casual partners (UAIC) perceived lower HIV risk than those who used condoms consistently in the 6 months prior to survey. Recognising the complex associations between risk perceptions and risk practices helps to better address challenges arising from the ‘Treatment as Prevention’ (TasP).

Resumen

Con el tiempo han cambiado las percepciones de riesgo y las prácticas de riesgo relacionadas con el VIH entre los hombres gays. Hemos repasado la percepción de riesgo de VIH y la participación en relaciones sexuales anales con parejas casuales entre los hombres gays VIH-negativos que participaron en una de las encuestas periódicas de la comunidad gay de Sydney (GCPS). La percepción de riesgo con relación al VIH fue evaluada por una gama de prácticas de sexo anal combinadas con el estado de VIH y niveles de carga viral de parejas casuales preespecificadas. La percepción del riesgo de VIH forma una jerarquía potencial reflejando amplias diferencias en la probabilidad de transmision de VIH a través de las diversas prácticas de relaciones sexuales anales. En menor medida, también varía según el estado de VIH y niveles de carga viral de parejas casuales. Los hombres que mantuvieron coito anal sin protección con parejas casuales (UAIC) percibieron un menor riesgo de VIH que aquellos que usaron preservativos sistemáticamente en los seis meses previos a la encuestas. Reconocer las complejas asociaciones entre las percepciones de riesgo y las prácticas de riesgo ayuda a enfrentar de una mejor manera los desafíos derivados del ‘tratamiento como prevención’ (TasP).

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References

  1. The Antiretroviral Therapy Cohort Collaboration. Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet. 2008;372(9635):293–9.

    Article  Google Scholar 

  2. Holtgrave DR, Hall HI, Prejean J. HIV transmission rates in the United States, 2006–2008. Open AIDS J. 2012;6:26–8.

    Article  PubMed  Google Scholar 

  3. Wilson DP, Jin F, Jansson J, Zablotska I, Grulich AE. Infectiousness of HIV-infected men who have sex with men in the era of highly active antiretroviral therapy. AIDS. 2010;24(15):2420–1.

    Article  PubMed  Google Scholar 

  4. Elford J. Changing patterns of sexual behaviour in the era of highly active antiretroviral therapy. Curr Opin Infect Dis. 2006;19(1):26–32.

    Article  PubMed  Google Scholar 

  5. Hart GJ, Elford J. Sexual risk behaviour of men who have sex with men: emerging patterns and new challenges. Curr Opin Infect Dis. 2010;23(1):39–44.

    Article  PubMed  Google Scholar 

  6. Kalichman SC, Eaton LA, Cain D, et al. Changes in HIV treatment beliefs and sexual risk behaviors among gay and bisexual men, 1997–2005. Health Psychol. 2007;26(5):650–6.

    Article  PubMed  Google Scholar 

  7. Van de Ven P, Rawstorne P, Nakamura T, Crawford J, Kippax S. HIV treatments optimism is associated with unprotected anal intercourse with regular and with casual partners among Australian gay and homosexually active men. Int J STD AIDS. 2002;13(3):181–3.

    Article  PubMed  Google Scholar 

  8. Vittinghoff E, Douglas J, Judson F, McKirnan D, MacQueen K, Buchbinder SP. Per-contact risk of human immunodeficiency virus transmission between male sexual partners. Am J Epidemiol. 1999;150(3):306–11.

    Article  PubMed  CAS  Google Scholar 

  9. Jin F, Jansson J, Law M, et al. Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS. 2010;24(6):907–13.

    Article  PubMed  Google Scholar 

  10. Mao L, Crawford JM, Hospers HJ, et al. “Serosorting” in casual anal sex of HIV-negative gay men is noteworthy and is increasing in Sydney, Australia. AIDS. 2006;20(8):1204–6.

    Article  PubMed  Google Scholar 

  11. Mao L, Kippax SC, Holt M, Prestage GP, Zablotska IB, de Wit JB. Rates of condom and non-condom-based anal intercourse practices among homosexually active men in Australia: deliberate HIV risk reduction? Sex Transm Infect. 2011;87(6):489–93.

    Article  PubMed  Google Scholar 

  12. Kowalewski MR, Henson KD, Longshore D. Rethinking perceived risk and health behavior: a critical review of HIV prevention research. Health Educ Behav. 1997;24(3):313–25.

    Article  PubMed  CAS  Google Scholar 

  13. Ostrow DG, Silverberg MJ, Cook RL, et al. Prospective study of attitudinal and relationship predictors of sexual risk in the multicenter AIDS cohort study. AIDS Behav. 2008;12(1):127–38.

    Article  PubMed  Google Scholar 

  14. Reisen CA, Poppen PJ. Partner-specific risk perception: a new conceptualization of perceived vulnerability to STDs. J Appl Soc Psychol. 1999;29(4):667–84.

    Article  Google Scholar 

  15. Van de Ven P, Kippax S, Crawford J, et al. In a minority of gay men, sexual risk practice indicates strategic positioning for perceived risk reduction rather than unbridled sex. AIDS Care. 2002;14(4):471–80.

    PubMed  Google Scholar 

  16. Jin F, Crawford J, Prestage GP, et al. Unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men. AIDS. 2009;23:243–52.

    Article  PubMed  Google Scholar 

  17. Kippax S, Noble J, Prestage G, et al. Sexual negotiation in the AIDS era: negotiated safety revisited. AIDS. 1997;11(2):191–7.

    Article  PubMed  CAS  Google Scholar 

  18. Snowden JM, Raymond HF, McFarland W. Seroadaptive behaviours among men who have sex with men in San Francisco: the situation in 2008. Sex Transm Infect. 2011;87(2):162–4.

    Article  PubMed  Google Scholar 

  19. Varghese B, Maher JE, Peterman TA, Branson BM, Steketee RW. Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use. Sex Transm Dis. 2002;29(1):38–43.

    Article  PubMed  Google Scholar 

  20. Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367–77.

    Article  PubMed  Google Scholar 

  21. Zablotska IB, Kippax S, Grulich A, Holt M, Prestage G. Behavioural surveillance among gay men in Australia: methods, findings and policy implications for the prevention of HIV and other sexually transmissible infections. Sex Health. 2011;8(3):272–9.

    Article  PubMed  Google Scholar 

  22. Zablotska IB, Prestage G, Grulich AE, Imrie J. Differing trends in sexual risk behaviours in three Australian states: New South Wales, Victoria and Queensland, 1998–2006. Sex Health. 2008;5(2):125–30.

    Article  PubMed  Google Scholar 

  23. Van de Ven P, Prestage G, Knox S, Kippax S. Gay men in Australia who do not have HIV test results. Int J STD AIDS. 2000;11(7):456–60.

    Article  PubMed  Google Scholar 

  24. Van de Ven P, Prestage G, Crawford J, Grulich A, Kippax S. Sexual risk behaviour increases and is associated with HIV optimism among HIV-negative and HIV-positive gay men in Sydney over the 4 year period to February 2000. AIDS. 2000;14(18):2951–3.

    Article  PubMed  Google Scholar 

  25. Van de Ven P, Rawstorne P, Crawford J, Kippax S. Increasing proportions of Australian gay and homosexually active men engage in unprotected anal intercourse with regular and with casual partners. AIDS Care. 2002;14(3):335–41.

    Article  Google Scholar 

  26. de Wit J, Holt M, Hopwood M, Treloar C. HIV/AIDS, hepatitis and sexually transmitted infections in Australia: annual report of trends in behaviour 2011. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2011.

    Google Scholar 

  27. Jin F, Prestage GP, McDonald A, et al. Trend in HIV incidence in a cohort of homosexual men in Sydney: data from the Health in Men Study. Sex Health. 2008;5(2):109–12.

    Article  PubMed  Google Scholar 

  28. Prestage G, Ferris J, Grierson J, et al. Homosexual men in Australia: population, distribution and HIV prevalence. Sex Health. 2008;5(2):97–102.

    Article  PubMed  Google Scholar 

  29. Hopwood M, Holt M, Treloar C, de Wit JE. HIV/AIDS, hepatitis and sexually transmissible infections in Australia: annual report of trends in behaviour 2010. Sydney: The University of New South Wales; 2010.

    Google Scholar 

  30. Mao L, Crawford J, Van De Ven P, et al. Differences between men who report frequent, occasional or no unprotected anal intercourse with casual partners among a cohort of HIV-seronegative gay men in Sydney, Australia. AIDS Care. 2006;18(8):942–51.

    Article  PubMed  CAS  Google Scholar 

  31. Jin F, Prestage GP, Ellard J, Kippax SC, Kaldor JM, Grulich AE. How homosexual men believe they became infected with HIV—the role of risk-reduction behaviors. J Acquir Immune Defic Syndr. 2007;46(2):245–7.

    Article  PubMed  Google Scholar 

  32. Down I, Triffitt K, Persson A, Ellard J, Brown G, Prestage G. Experiences of HIV: the seroconversion study report 2012. Sydney: The Kirby Institute, The University of New South Wales; 2012.

    Google Scholar 

  33. Becker U. Risk society: towards a new modernity. London: Sage; 1992.

    Google Scholar 

  34. Van de Ven P, Mao L, Fogarty A, et al. Undetectable viral load is associated with sexual risk taking in HIV serodiscordant gay couples in Sydney. AIDS. 2005;19(2):179–84.

    Article  PubMed  Google Scholar 

  35. Zablotska IB, Grulich AE, De Wit J, Prestage G. Casual sexual encounters among gay men: familiarity, trust and unprotected anal intercourse. AIDS Behav. 2011;15(3):607–12.

    Article  PubMed  Google Scholar 

  36. Holt M, Lee E, Prestage GP, Zablotska I, de Wit J, Mao L. The converging and diverging characteristics of HIV-positive and HIV-negative gay men in the Australian Gay Community Periodic Surveys, 2000–2009. AIDS Care. 2013;25(1):28–37.

    Article  PubMed  Google Scholar 

  37. Holtgrave DR, Maulsby C, Wehrmeyer L, Hall HI. Behavioral factors in assessing impact of HIV treatment as prevention. AIDS Behav. 2012;16(5):1085–91.

    Article  PubMed  Google Scholar 

  38. Zablotska IB, Prestage G, Holt M, et al. Australian gay men who have taken nonoccupational postexposure prophylaxis for HIV are in need of effective HIV prevention methods. J Acquir Immune Defic Syndr. 2011;58(4):424–8.

    Article  PubMed  Google Scholar 

  39. Wilson DP. HIV treatment as prevention: natural experiments highlight limits of antiretroviral treatment as HIV prevention. PLoS Med. 2012;9(7):e1001231.

    Article  PubMed  Google Scholar 

  40. Kippax S, Reis E, de Wit J. Two sides to the HIV prevention coin: efficacy and effectiveness. AIDS Educ Prev. 2011;23(5):393–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The National Centre in HIV Social Research and the Kirby Institute are supported by the Australian Government Department of Health and Ageing. The Sydney Gay Community Periodic Surveys are funded by the Department of Health in New South Wales. We thank our key community partners: the Australian Federation of AIDS Organisations, National Association of People Living with HIV/AIDS, ACON and Positive Life NSW. We value the ongoing trust, input and support from our participants.

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Authors and Affiliations

  1. National Centre in HIV Social Research, The University of New South Wales, Room 307, Level 3 John Goodsell Building, Sydney, NSW, 2052, Australia

    Limin Mao, Philippe Adam, Martin Holt & John de Wit

  2. The Social Policy Research Centre, UNSW, Sydney, NSW, Australia

    Susan Kippax

  3. The Kirby Institute, UNSW, Sydney, NSW, Australia

    Garrett Prestage & Iryna Zablotska

  4. ACON, Sydney, NSW, Australia

    Yves Calmette

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  1. Limin Mao
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  2. Philippe Adam
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  3. Susan Kippax
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  4. Martin Holt
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  7. Iryna Zablotska
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  8. John de Wit
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Correspondence to Limin Mao.

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Mao, L., Adam, P., Kippax, S. et al. HIV-Negative Gay Men’s Perceived HIV Risk Hierarchy: Imaginary or Real?. AIDS Behav 17, 1362–1369 (2013). https://doi.org/10.1007/s10461-012-0406-8

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