Determinants of HIV seroconversion among men who have sex with men living in a low HIV incidence population in the era of highly active antiretroviral therapies.
OBJECTIVE
To estimate human immunodeficiency virus (HIV) incidence and associated risk factors among men who have sex with men (MSM) participating in the Omega Cohort Study in Montreal, 1996-2003.


METHODS
Longitudinal study of 1587 MSM seronegative at baseline with > or =1 six-month follow-up visit. Multivariate Cox regression with time-dependent variables was used for data analysis.


RESULTS
HIV incidence was 0.62 per 100 person-years (95% confidence interval: 0.41-0.84). In multivariate analyses compared with subjects not reporting any anal sex with serodiscordant or casual partners, those reporting anal sex with such partners (all P values <0.05), whether consistently protected [hazard ratio (HR) = 3.4], or unprotected exclusively receptive (HR = 12.0), exclusively insertive (HR = 4.7), or both receptive and insertive (HR = 8.3), were at increased risk of seroconversion. Sexual behaviors with seroconcordant regular partners were not associated with seroconversion.


CONCLUSIONS
These results observed in a cohort of MSM with low HIV incidence provide new insights regarding the debate about harm-reduction strategies to prevent sexual HIV transmission.
Lavoie
Elaine
E
Unité de recherche en santé des populations, Centre hospitalier affilié universitaire de Québec, Québec, Canada.
Alary
Michel
M
Remis
Robert S
RS
Otis
Joanne
J
Vincelette
Jean
J
Turmel
Bruno
B
Lavoie
René
R
Masse
Benoît R
BR
Le Clerc
Roger
R
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D006679:HIV Seropositivity / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D011792:Quebec / Q000453:epidemiology; D012725:Sexual Behavior; D011795:Surveys and Questionnaires