title: 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.
abstract: 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.
authors: Unité de recherche en santé des populations, Centre hospitalier affilié universitaire de Québec, Québec, Canada.
authors: Elaine
authors: E
authors: Lavoie
authors: Michel
authors: M
authors: Alary
authors: Robert S
authors: RS
authors: Remis
authors: Joanne
authors: J
authors: Otis
authors: Jean
authors: J
authors: Vincelette
authors: Bruno
authors: B
authors: Turmel
authors: René
authors: R
authors: Lavoie
authors: Benoît R
authors: BR
authors: Masse
authors: Roger
authors: R
authors: Le Clerc
mesh_terms: 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