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Characteristics of Agreements to have Condomless Anal Intercourse in the Presence of an Undetectable Viral Load Among HIV Serodiscordant Male Couples in Australia, Brazil and Thailand

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Abstract

The use of undetectable viral load (VL) to negotiate condomless anal intercourse (CLAI) in HIV serodiscordant male relationships has become more common as more data regarding the effectiveness of antiretroviral treatments for the prevention of HIV transmission has been described. We examined viral load agreements (VLAs) for condomless sex in the presence of an undetectable VL in 343 HIV serodiscordant male couples in Australia, Brazil and Thailand. Factors associated with having a VLA included having agreements for the HIV-positive partner to report his VL result (p < 0.001), agreeing that VL affects agreements about sexual practice (p < 0.001), the HIV-negative partner’s perception of his partner’s undetectable VL (p < 0.001), the couple’s belief in the efficacy of undetectable VL in preventing HIV transmission (p < 0.001), and the couple engaging in CLAI with each other (p < 0.001). Over time, these agreements became more common although 49.3% of couples in the sample never had a viral load agreement. As these agreements become more common, further education is required to support male couples in using them safely.

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Acknowledgements

We thank all participants in the study, staff in the participating clinics, laboratory staff, and staff in gay and HIV community organisations for supporting this research. Opposites Attract was funded by: NHMRC, the American Foundation for AIDS Research, Gilead Sciences, and ViiV Healthcare.

Opposites Attract Study Group Andrew E. Grulich (Chief Investigator), Iryna B. Zablotska, Garrett P. Prestage, Fengyi Jin, Benjamin R. Bavinton (project leader), Beatriz Grinsztejn, Nittaya Phanuphak, David A. Cooper, Anthony Kelleher, Sean Emery, Christopher K. Fairley, David Wilson, Kersten K. Koelsch, Kathy Triffitt, Nicolas Doong, David Baker, Mark Bloch, David J. Templeton, Anna McNulty, Catherine Pell, Jennifer Hoy, Ban Kiem Tee, Richard Moore, Norm Roth, David Orth, Angie N. Pinto.

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Authors and Affiliations

  1. Kirby Institute, UNSW Sydney, Sydney, NSW, 2052, Australia

    James Gray, Garrett Prestage, Fengyi Jin, Anthony Kelleher, David Templeton, Andrew Grulich & Benjamin Bavinton

  2. Institute of HIV Research and Innovation, Bangkok, Thailand

    Nittaya Phanuphak

  3. Labratorio de Pesquisa Clinica Em DST/AIDS, Instituto Nacional de Infectologia Evandro Chagas/FIOCRUZ, Rio de Janeiro, Brazil

    Ruth K. Friedman

  4. Melbourne Sexual Health Centre, Melbourne, Australia

    Christopher K. Fairley

  5. Central Clinical School, Monash University, Melbourne, Australia

    Christopher K. Fairley

  6. Department of Sexual Health Medicine, Sydney Local Health District and Discipline of Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia

    David Templeton

  7. Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia

    Iryna Zablotska-Manos

  8. Western Sydney Sexual Health, Western Sydney Local Health District, Sydney, Australia

    Iryna Zablotska-Manos

  9. The Alfred Hospital, Melbourne, Australia

    Jennifer Hoy

  10. Monash University, Melbourne, Australia

    Jennifer Hoy

  11. Sydney Sexual Health Centre, Sydney and Sydney Eye Hospital, Sydney, Australia

    Anna McNulty

  12. School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia

    Anna McNulty

  13. Taylor Square Private Clinic, Sydney, Australia

    Catherine Pell

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  1. James Gray
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Gray, J., Prestage, G., Jin, F. et al. Characteristics of Agreements to have Condomless Anal Intercourse in the Presence of an Undetectable Viral Load Among HIV Serodiscordant Male Couples in Australia, Brazil and Thailand. AIDS Behav 25, 3944–3954 (2021). https://doi.org/10.1007/s10461-021-03324-7

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