Sustained Reduction in Sexual Behavior that May Pose a Risk of HIV Transmission Following Diagnosis During Early HIV Infection Among Gay Men in Vancouver, British Columbia
Increased viral load during early HIV infection (EHI) disproportionately contributes to HIV transmission among gay men. We examined changes in sexual behavior that may pose a risk of HIV transmission (condomless anal sex (AS) with a serodiscordant or unknown status partner, CAS-SDU) in a cohort of 25 gay men newly diagnosed during EHI who provided information on 241 sexual partners at six time points following diagnosis. Twenty-two (88%) participants reported ≥1 AS partner (median time to first AS 80 days) and 12 (55%) reported ≥1 partnership involving CAS-SDU (median 116 days). In hierarchical generalized linear mixed effects models, AS was significantly less likely in all time periods following diagnosis and more likely with serodiscordant partners. The likelihood of CAS-SDU decreased three months after diagnosis and was higher in recently versus acutely infected participants. Most men in our study abstained from sex immediately after diagnosis with sustained longer-term reduction in CAS-SDU, confirming the importance of timely diagnosis during EHI.