January 23, 2012
"Three 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 needs to be re-assessed," the authors wrote to introduce the current study.
The team used data from the ongoing cross-sectional Gay Community Periodic Surveys, in six Australian states from 2007 to 2009, to estimate the proportions of men engaging in a range of anal intercourse practices. Comparisons were made between men who were HIV-negative, HIV-positive men with an undetectable viral load, and those with a detectable viral load.
"Condoms play a key role in gay men's anal intercourse practices," the authors found. Consistent condom use with all male partners in the six months prior to the survey was reported by 33.8 percent of HIV-negative men, 25.1 percent of HIV-positive men with an undetectable viral load, and 22.5 percent of those with a detectable viral load.
Among HIV-negative men, the second-largest group comprised men who had unprotected anal intercourse (UAI) only within the context of HIV-negative seroconcordant regular relationships. Among the HIV-positive men, the second-largest group comprised those who had UAI in casual encounters preceded by HIV status disclosure to some, but not to all, casual partners.
"A minority, yet sizable proportion, of men consistently engaged in a number of UAI practices in specific contexts, suggesting they have adopted deliberate risk-reduction strategies," the researchers concluded. "While it is important that HIV behavioral prevention continues to reinforce condom use, it needs to address both the challenges and opportunities of the substantial uptake of non-condom-based risk-reduction strategies."