AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #15 - Rates of condom- and non-condom-based anal intercourse practices among homosexually active men in Australia: deliberate HIV risk reduction?
Authors: Presenting Author: Dr Limin Mao - The University of New South Wales
Additional Authors: Prof. Susan Kippax, Dr. Martin Holt, Prof. Garrett Prestage, Dr. Iryna Zablotska, Prof. John De Wit,
Aim: More than two decades into the HIV epidemic and with the advancement of HIV treatments, condom- and non-condom-based anal intercourse among gay men in resource-rich countries need to be re-assessed.
Method / Issue: Rates of men engaging in a range of anal intercourse were estimated from the ongoing cross-sectional Gay Community Periodic Surveys (GCPS) in eight metropolitan locations in Australia from 2007 to 2009. Further comparisons were made between HIV-negative men, HIV-positive men with an undetectable viral load, and HIV-positive men with a detectable viral load.
Results / Comments: Condoms play a key role in gay men’s practice of anal intercourse: 33.8% of the HIV-negative men, 25.5% of HIV-positive men with an undetectable viral load and 22.5% of HIV-positive men with a detectable viral load reported 100% condom use with all male partners in the six month prior to survey. Among HIV-negative men, the second largest group were men who had unprotected anal intercourse (UAI) only in the context of HIV-negative seroconcordant regular relationships. Among HIV-positive men, the second largest group after 100% condom users were men who had UAI in casual encounters preceded by HIV status disclosure to some casual partners.
Discussion: Most gay men who engaged in UAI did so consistently in specific situations, suggesting that such practices are deliberately adopted as a form of HIV risk reduction. While it is important that HIV behavioural prevention continues to reinforce condoms, it needs to address the challenges from the substantial uptake of non-condom based risk reduction strategies.
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