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.
KeywordsHIV Sexual behavior Gay men Diagnosis Cohort study
- 3.Kendall P. HIV, stigma and society: tackling a complex epidemic and renewing HIV prevention for gay and bisexual men in British Columbia. Victoria: Ministry of Health; 2014.Google Scholar
- 16.Steward WT, Remien RH, Higgins JA, Dubrow R, Pinkerton SD, Sikkema KJ, et al. Behavior change following diagnosis with acute/early HIV infection-a move to serosorting with other HIV-infected individuals. The NIMH Multisite Acute HIV Infection Study: III. AIDS Behav. 2009;13(6):1054–60.CrossRefPubMedPubMedCentralGoogle Scholar
- 19.WHO. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. Geneva: World Health Organization; 2016.Google Scholar
- 21.Gilbert M, Cook D, Steinberg M, Kwag M, Robert W, Doupe G, et al. Targeting screening and social marketing to increase detection of acute HIV infection in MSM in Vancouver, British Columbia. AIDS. 2013;27.Google Scholar
- 26.SPSS Inc. SPSS for Windows, Version 14.0. Chicago: SPSS Inc.; 2005.Google Scholar
- 27.R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2014. https://www.R-project.org/.