THAD0101 - Oral Abstract
Consistent and inconsistent use of HIV risk reduction strategies by Australian gay and bisexual men who report unprotected anal intercourse with casual male partners
Presented by Martin Holt (Australia).
M. Holt1, T. Lea1, L. Mao1, I. Zablotska2, G. Prestage2,3, J. De Wit1,4
1The University of New South Wales, Centre for Social Research in Health, Sydney, Australia, 2The University of New South Wales, The Kirby Institute, Sydney, Australia, 3La Trobe University, Australian Research Centre in Sex, Health and Society, Melbourne, Australia, 4Utrecht University, Social and Organizational Psychology, Utrecht, Netherlands
Background: Throughout the HIV epidemic, gay and bisexual men have generated
strategies to reduce the risk of HIV transmission during anal intercourse with
casual male partners, including condom use and non-condom-based strategies such
as serosorting, strategic positioning and withdrawal prior to ejaculation. It
is, however, far from clear how consistently these risk reduction strategies (RRS)
Methods: Using data from behavioural surveillance surveys conducted in 2011-12, we
analysed the frequency of use of RRS by Australian gay and bisexual men who
reported unprotected anal intercourse with casual partners (UAIC), stratified
by HIV status, and identified the characteristics of men who never/occasionally
versus often/always practised RRS using logistic regression.
Results: Results from 2,942 men (603 HIV-positive, 2339 HIV-negative) who
reported UAIC in the previous six months were analysed. The mean age was 37
years (SD=11.6) and 91% identified as gay. Seventy-four per cent of men
reported often/always practised at least one RRS (26% never or occasionally
practised any RRS). The most common RRS was serosorting, often/always practised
by 60% of HIV-positive men and 44% of HIV-negative men. Twenty-two per cent of
HIV-positive and 41% of HIV-negative participants reported often using condoms
for anal intercourse with casual partners. Strategic positioning was
often/always practised by 17% of HIV-positive and 24% of HIV-negative men.
Withdrawal was commonly practised by 15% of HIV-positive and 22% of HIV-negative
participants. HIV-positive men who identified as gay, more frequently engaged
in UAIC or disclosed their HIV status to casual partners were more likely to frequently
use RRS. HIV-negative men who were younger, more frequently engaged in UAIC or
disclosed their HIV status to casual partners were more likely to frequently
practise RRS. HIV-negative men with a serononconcordant (untested) regular
partner were less likely to practise RRS.
Conclusions: The majority of Australian gay and bisexual men who have UAIC frequently
practise some form of HIV risk reduction during anal intercourse. Serosorting
appears to be the most commonly practised strategy by these men, followed by
condoms. Around a quarter of men who report UAIC only occasionally practise
risk reduction during anal intercourse. These men should be priority targets
for education and prevention efforts.
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