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In Australia, Most HIV Infections Among Gay and Bisexual Men are Attributable to Sex with ‘New’ Partners

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Abstract

It has been estimated that the majority of global HIV infections among gay and bisexual men (GBM) can be attributed to sex within a committed relationship. In Australia, however, negotiated safety, whereby HIV-negative regular partners agree to discard condoms with each other but commit to consistent condom use with other partners, has been promoted as a key component of the HIV prevention response. We asked GBM recently diagnosed with HIV to describe their relationship to the person they believed to be the source of their infection (‘source person’). The majority (66.1%) ascribed their infection to a casual partner. A further 23.3% ascribed their infection to a non-committed and non-romantic partner (or ‘fuckbuddy’). Only 10.6% believed they had acquired their HIV from a ‘boyfriend’ in the context of a committed romantic relationship, and 51.7% of these occurred within the first 3 months following their first sexual contact. Most men (61.5%) believed they had acquired their HIV infection on the first occasion they had sex with the source person. In the Australian context, negotiated safety appears to have minimised infections between regular partners. However, many HIV infections between regular partners may not be in the context of a romantic committed relationship, and yet this distinction between types of regular partners has been all but ignored. Furthermore, in this sample, most infections occurred on the occasion of first meeting, suggesting that the most useful indicators of risk may be the characteristics, contexts, and lengths of sexual partnerships and how sex is negotiated, rather than how GBM categorize their partner. Findings suggest more new HIV infections occur in new partnerships, than in established relationships.

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References

  1. 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  PubMed Central  Google Scholar 

  2. Davidovich U, de Wit J, Albrecht N, et al. Increase in the share of steady partners as a source of HIV infection: a 17-year study of seroconversion among gay men. AIDS. 2001;15(10):1303–8.

    Article  CAS  PubMed  Google Scholar 

  3. Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62.

    Article  PubMed  Google Scholar 

  4. Xiridou M, Geskus R, De Wit J, Coutinho R, Kretzschmar M. The contribution of steady and casual partnerships to the incidence of HIV infection among homosexual men in Amsterdam. AIDS. 2003;17(7):1029–38.

    Article  PubMed  Google Scholar 

  5. Punyacharoensin N, Edmunds WJ, De Angelis D, et al. Modelling the HIV epidemic among MSM in the United Kingdom: quantifying the contributions to HIV transmission to better inform prevention initiatives. AIDS. 2015;29(3):339–49.

    PubMed  Google Scholar 

  6. Goodreau SM, Carnegie NB, Vittinghoff E, et al. What drives the US and Peruvian HIV epidemics in men who have sex with men (MSM)? PLoS One. 2012;7(11):e50522.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Kippax S, Slavin S, Ellard J, et al. Seroconversion in context. AIDS Care. 2003;15(6):839–52.

    Article  CAS  PubMed  Google Scholar 

  8. Volk JE, Prestage GP, Jin F, et al. Risk factors for HIV seroconversion in homosexual men in Australia. Sex Health. 2006;3:45–51.

    Article  PubMed  Google Scholar 

  9. Jin F, Prestage GP, Ellard J, et al. 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 

  10. Meireles P, Lucas R, Carvalho C, et al. Incident risk factors as predictors of HIV seroconversion in the Lisbon cohort of men who have sex with men: first results, 2011-2014. Euro Surveill. 2015;20(14):45–56.

    Article  Google Scholar 

  11. Zablotska I, Prestage G, Middleton M, Wilson D, Grulich A. Contemporary HIV diagnoses trends in Australia can be predicted by trends in unprotected anal intercourse among gay men. AIDS. 2010;24(12):1955–8.

    Article  PubMed  Google Scholar 

  12. Fonner V, Kennedy C, O’Reilly K, Sweat M. Systematic assessment of condom use measurement in evaluation of HIV prevention interventions: need for standardization of measures. AIDS Behav. 2014;18(12):2374–86.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Rosengard C, Adler NE, Gurvey JE, et al. Protective role of health values in adolescents’ future intentions to use condoms. J Adolesc Health. 2001;29(3):200–7.

    Article  CAS  PubMed  Google Scholar 

  14. Mor Z, Davidovich U, Bessudu-Manor N, et al. High-risk behaviour in steady and in casual relationships among men who have sex with men in Israel. Sex Transm Infect. 2011;87:532–7.

    Article  PubMed  Google Scholar 

  15. Bavinton BR, Duncan D, Grierson J, et al. The meaning of ‘regular partner’ in HIV research among gay and bisexual men: implications of an Australian cross-sectional survey. AIDS Behav. 2016;20(8):1777–84.

    Article  PubMed  Google Scholar 

  16. Prestage GP, Jin F, Grulich A, de Wit J, Zablotska I. Gay men are less likely to use condoms with casual sex partners they know ‘well’. AIDS Behav. 2012;16(3):664–8.

    Article  PubMed  Google Scholar 

  17. Rouwenhorst E, Mallitt KA, Prestage GP. Gay men’s use of condoms with casual partners depends on the extent of their prior acquaintance. AIDS Behav. 2012;16(6):1589–96.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  19. Hart GJ, Dawson J, Fitzpatrick RM, et al. Risk behaviour, anti-HIV and anti-hepatitis B core prevalence in clinic and non-clinic samples of gay men in England; 1991-1992. AIDS. 1993;7(6):863–70.

    Article  CAS  PubMed  Google Scholar 

  20. Kippax S, Crawford J, Davis M, Rodden P, Dowsett G. Sustaining safe sex: a longitudinal study of a sample of homosexual men. AIDS. 1993;7:257–63.

    Article  CAS  PubMed  Google Scholar 

  21. Misovich SJ, Fisher JD, Fisher WA. Close relationships and elevated HIV risk behavior: evidence and possible underlying psychological processes. Rev Gen Psychol. 1997;1(1):72.

    Article  Google Scholar 

  22. Mao L, Kippax SC, Holt M, et al. 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 

  23. Kippax S. A commentary on negotiated safety. Venereology. 1996;9(2):96–7.

    Google Scholar 

  24. Kippax S, Race K. Sustaining safe practice: twenty years on. Soc Sci Med. 2003;57(1):1–12.

    Article  PubMed  Google Scholar 

  25. Prestage GP, Jin F, Zablotska I, et al. Trends in agreements between regular partners among gay men in Sydney, Melbourne and Brisbane, Australia. AIDS Behav. 2008;12(3):513–20.

    Article  PubMed  Google Scholar 

  26. 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(2):243–52.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Guzman R, Colfax GN, Wheeler S, et al. Negotiated safety relationships and sexual behavior among a diverse sample of HIV-negative men who have sex with men. J Acquir Immune Defic Syndr. 2005;38(1):82–6.

    Article  PubMed  Google Scholar 

  28. Down I, Ellard J, Triffitt K, Brown G, Prestage GP. Factors associated with recent previous HIV testing among a sample of recently HIV-diagnosed gay men in Australia: a cross-sectional study. Sex Transm Infect. 2015;91(3):189–93.

    Article  PubMed  Google Scholar 

  29. Power J, Lyons A, Brown G, Dowsett GW, Lucke J. Use of antiretroviral treatment among people living with HIV in Australia between 1997 and 2012. AIDS Care. 2017;2016:1–6.

    Google Scholar 

  30. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Wilson DP, Hoare A, Regan DG, Law MG. Importance of promoting HIV testing for preventing secondary transmissions: modelling the Australian HIV epidemic among men who have sex with men. Sex Health. 2009;6(1):19–33.

    Article  PubMed  Google Scholar 

  32. Dowsett GW. Dangerous desires and post-queer HIV prevention: rethinking community, incitement and intervention. Soc Theory Health. 2009;7(3):218–40.

    Article  Google Scholar 

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Acknowledgements

The HIV Seroconversion Study was funded by the Health Departments of: New South Wales, Victoria, Queensland, Western Australia, South Australia, Tasmania, the Northern Territory and the Australian Capital Territory. No pharmaceutical grants were received in the development of these studies.

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Down, I., Ellard, J., Bavinton, B.R. et al. In Australia, Most HIV Infections Among Gay and Bisexual Men are Attributable to Sex with ‘New’ Partners. AIDS Behav 21, 2543–2550 (2017). https://doi.org/10.1007/s10461-017-1747-0

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