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Perceived HIV Status is a Key Determinant of Unprotected Anal Intercourse Within Partnerships of Men Who Have Sex With Men in Amsterdam

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Abstract

The practice of unprotected anal intercourse (UAI) involves at least two partners. We examined the associations between insertive or receptive UAI and perceived HIV seroconcordance and partnership type in self-perceived HIV-negative and self-perceived HIV-positive men who have sex with men (MSM). MSM (age ≥ 18 years) were recruited for a cross-sectional survey at the sexually transmitted infections clinic in Amsterdam, the Netherlands, in 2008–2009. Participants completed a questionnaire concerning partnerships in the preceding 6 months. Associations were quantified via multinomial logistic regression models using generalized estimating equations. The outcomes were ‘no, or safe anal intercourse’, ‘insertive UAI’, and ‘receptive UAI’. We included 5,456 partnerships from 1,890 self-perceived HIV-negative men and 1,861 partnerships from 558 self-perceived HIV-positive men. Within the partnerships, perceived HIV status of the partner was an important determinant of UAI (p < 0.001). Among HIV-negative men, perceived HIV discordance was negatively associated with receptive UAI compared with no or safe UAI (OR 0.57; 95 % CI 0.36–0.92); when the partners were more familiar with each other, the risk of receptive UAI was increased relative to no or safe anal intercourse. Among HIV-positive men, perceived HIV discordance was negatively associated with insertive UAI (OR 0.05; 95 % CI 0.03–0.08). Within partnerships, perceived HIV status of the partner was one of the strongest determinants of UAI among self-perceived HIV-negative and HIV-positive MSM, and discordant serostatus was negatively associated with UAI. The findings suggest that serosorting is one of the main strategies when engaging in UAI.

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Acknowledgments

The authors thank all study participants and members of the study team including Roel Coutinho, Reinier Bom, Raymond Heymans and Jan Prins. Also, we thank Udi Davidovich for his scientific input, Martijn van Rooijen for the datamanagement and Sally Hebeling for editing the manuscript.

Funding

This work was funded by the Netherlands Organisation for Health Research (Grant No. 125010008).

Author information

Authors and Affiliations

  1. Department of Research, Cluster of Infectious Diseases, Public Health Service of Amsterdam, Postbox 2200, 1000 CE, Amsterdam, The Netherlands

    Amy Matser, Titia Heijman, Ronald Geskus, Henry de Vries, Arjen Speksnijder, Han Fennema & Maarten Schim van der Loeff

  2. Julius Centre for Health Sciences & Primary Care, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands

    Amy Matser & Mirjam Kretzschmar

  3. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center (AMC), Amsterdam, The Netherlands

    Ronald Geskus

  4. Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands

    Henry de Vries & Maarten Schim van der Loeff

  5. Department of Dermatology, Academic Medical Center (AMC), Amsterdam, The Netherlands

    Henry de Vries

  6. National Institute of Public Health and the Environment, Centre for Infectious Disease Control (RIVM), Bilthoven, The Netherlands

    Henry de Vries, Mirjam Kretzschmar & Maria Xiridou

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  1. Amy Matser
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  2. Titia Heijman
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Correspondence to Amy Matser.

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Matser, A., Heijman, T., Geskus, R. et al. Perceived HIV Status is a Key Determinant of Unprotected Anal Intercourse Within Partnerships of Men Who Have Sex With Men in Amsterdam. AIDS Behav 18, 2442–2456 (2014). https://doi.org/10.1007/s10461-014-0819-7

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  • DOI: https://doi.org/10.1007/s10461-014-0819-7

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