Use of Viral Load to Negotiate Condom Use Among Gay Men in Sydney, Australia
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Using two cohort studies (Health in men—HIM and positive health—PH) and repeated large cross-sectional surveys (Gay Community Periodic Survey—GCPS) of gay men in Sydney, Australia, we examined the association between viral load and unprotected anal intercourse (UAI) between HIV sero-discordant regular partners. Between 2001 and 2007, we conducted 243 interviews with 102 HIV-negative gay men in HIM and 148 interviews with 99 HIV-positive gay men in PH who were in regular relationships with HIV sero-discordant partners. During the same time period, 437 HIV positive men with HIV sero-discordant regular partners completed questionnaires for the GCPS. All completed interviews or questionnaires during that time period were used for these analyses. Amongst the HIV-negative respondents, sero-discordant UAI was more likely to be reported when the men believed their HIV-positive regular partner had an undetectable rather than a detectable viral load (P = 0.002). Amongst the HIV-positive respondents, sero-discordant UAI was as likely to be reported when they themselves reported having an undetectable or a detectable viral load. Use of viral load in negotiating condom use between sero-discordant gay couples may be understood very differently by the HIV-negative and HIV-positive men within those partnerships.
KeywordsGay men HIV Sexual behaviour Viral load Condoms
The authors thank the AIDS Council of New South Wales, Positive Life (NSW), the Australian Federation of AIDS Organisations and the National Association of People Living with HIV/AIDS for collaboration with these studies, and the men who have participated in them over the years. The National Centre in HIV Epidemiology and Clinical Research, the National Centre in HIV Social Research, and the Australian Research Centre in Sex Health and Society receive funding from the Commonwealth Department of Health and Ageing. Sponsorship: The SGCPS and PH study was supported by the New South Wales Health Department. Funding for HIM was provided by the New South Wales Health Department (Sydney), the Commonwealth Department of Health and Ageing (Canberra), the (Australian) National Health and Medical Research Council, and the US National Institutes of Health (NIH/NIAID/DAIDS: HVDDT Award N01-AI-05395). None of these funding agencies had any further role: in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.
Conflict of Interest
All authors declare that they have no conflicts of interest.
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