Beliefs about better treatment for HIV leads gay men to engage in riskier sex

February 8, 2017, Springer

A survey spanning 19 years of participants at a gay pride event in the US notes a consistent increase in the occurrence of condomless anal sex among men, as well as a rise in how many sex partners they have. Condomless receptive anal sex among HIV uninfected men has doubled, while insertive condomless anal sex has more than tripled among HIV-positive men. The findings show that, although antiretroviral therapies (ART) have revolutionized the treatment and prevention of HIV infections, knowing that they have ART as a protective back-up against contracting or transmitting the disease makes people complacent. This complacency can lead to increased risks when it comes to sex and their health, says study leader Seth Kalichman of the University of Connecticut in an article in Springer's journal Archives of Sexual Behavior.

Trials have shown that early treatment with ART prevents HIV transmission. This shifted the focus of HIV prevention campaigns away from condom use as a form of protection toward detecting and treating those already infected. Despite these efforts there have not yet been significant reductions in new HIV infections in major cities, for instance. In addition, HIV infections remain stable or are rising among gay men in countries that have scaled-up HIV testing programs and access to ART.

Kalichman and his team analyzed surveys conducted in 1997, 2005, 2006, and 2015 at the Atlanta Gay Pride Festival. Through self-administered surveys 1,831 gay men provided anonymous information about their substance use, sexual behavior, beliefs about HIV treatment, and how they perceive sexual risks in relation to the HIV treatment status of potential .

Among uninfected men and those who did not know their HIV status, condomless anal sex increased from 43 percent in 1997 to 61 percent in 2015. The number of those having multiple sex partners also rose from9 percent in 1997 to 33 percent in 2015. This pattern is also reflected among HIV-positive men. Condomless anal sex increased from 25 percent in 1997 to 67 percent in 2015. In 1997 only 9 percent of men in this group reported having had unprotected intercourse with two or more partners in the six months before the survey. By 2015 this figure rose to 52 percent. In 1997 condoms were used about eight out of ten times (82 percent) when HIV-positive men had intercourse, but it dropped by 2015 to less than one in two (47 percent) instances. These shifts in behavior create increased risks for sexually transmitted infections, which in turn can increase risks for HIV transmission.

HIV-positive men as well as those who had not tested positive held increased beliefs reflecting public health messages that ART prevents HIV and therefore make condomless anal sex safe. Also consistent with public health messaging, they believed their risk of contracting HIV to be much lower when their partner had an undetectable blood plasma viral load.

"Treatment-related behavioral beliefs in this study paralleled a resurgence in condomless anal sex among men who have sex with men measured over nearly two decades," explains Kalichman. "The current study adds to the mounting evidence that substantial changes have occurred in community-held beliefs that condomless anal sex is safer in the era of HIV treatment as prevention."

Explore further: When pornography uses condoms, those watching have safer sex, study finds

More information: Seth C. Kalichman et al, Diminishing Perceived Threat of AIDS and Increasing Sexual Risks of HIV Among Men Who Have Sex with Men, 1997–2015, Archives of Sexual Behavior (2017). DOI: 10.1007/s10508-016-0934-9

Related Stories

When pornography uses condoms, those watching have safer sex, study finds

April 27, 2016
Men who view more sexually explicit pornography where condoms were used were less likely to have anal sex without a condom themselves. A study by Eric Schrimshaw, PhD, at Columbia University's Mailman School of Public Health, ...

Study examines risk of HIV transmission from condomless sex with virologically suppressed HIV infection

July 12, 2016
Among nearly 900 serodifferent (one partner is HIV-positive, one is HIV-negative) heterosexual and men who have sex with men couples in which the HIV-positive partner was using suppressive antiretroviral therapy and who reported ...

Risky sexual behavior by young men with HIV who have sex with men

December 7, 2015
Young men who have sex with men and have detectable levels of the human immunodeficiency virus (HIV) were more likely to report condomless anal sex, including with a partner not infected with HIV, than virologically suppressed ...

Annual survey reveals significant gains in HIV treatment over the past decade

November 15, 2016
There is compelling evidence that treatment greatly reduces HIV transmission but prevention of the disease remains complex, the latest report by UNSW's Centre for Social Research in Health shows.

High rates of recreational drug use among HIV-positive gay and bisexual men strongly linked with condomless sex

September 8, 2014
New research published in The Lancet HIV shows that polydrug use is common among HIV-positive men who have sex with men (MSM) and is strongly linked to sex without a condom (condomless sex).

Anal sex linked to increased risk of incontinence in both males, females

February 11, 2016
Engaging in the practice of anal sex may increase risks for bowel problems, including fecal incontinence and bowel leakage, according to a University of Alabama at Birmingham Department of Medicine study published in the ...

Recommended for you

HIV exports viral protein in cellular packages

February 15, 2018
HIV may be able to affect cells it can't directly infect by packaging a key protein within the host's cellular mail and sending it out into the body, according to a new study out of a University of North Carolina Lineberger ...

Can gene therapy be harnessed to fight the AIDS virus?

February 13, 2018
For more than a decade, the strongest AIDS drugs could not fully control Matt Chappell's HIV infection. Now his body controls it by itself, and researchers are trying to perfect the gene editing that made this possible.

Big data methods applied to the fitness landscape of the HIV envelope protein

February 7, 2018
Despite significant advances in medicine, there is still no effective vaccine for the human immunodeficiency virus (HIV), although recent hope has emerged through the discovery of antibodies capable of neutralizing diverse ...

Scientists report big improvements in HIV vaccine production

February 5, 2018
Research on HIV over the past decade has led to many promising ideas for vaccines to prevent infection by the AIDS virus, but very few candidate vaccines have been tested in clinical trials. One reason for this is the technical ...

Microbiome research refines HIV risk for women

January 25, 2018
Drawing from data collected for years by AIDS researchers in six African nations, scientists have pinpointed seven bacterial species whose presence in high concentrations may significantly increase the risk of HIV infection ...

Researchers find latent HIV reservoirs inherently resistant to elimination by CD8+ T-cells

January 22, 2018
The latest "kick-and-kill" research to eliminate the HIV virus uncovered a potential obstacle in finding a cure. A recent study by researchers at the George Washington University (GW) found that latent HIV reservoirs show ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.