title: Correlates of unprotected anal intercourse in HIV positive men attending an HIV/AIDS clinic in Sydney.
abstract: We examined the impact of cognitive and biomedical variables on unprotected anal intercourse between HIV-1 infected men and casual sexual partners in a Sydney-based cohort. Participants answered questionnaires examining insertive and receptive intercourse with and without ejaculation. They completed a modified optimism-scepticism scale, a sexual beliefs scale and a clinical/demographics questionnaire. CD4 count, blood and semen VL were assessed. 43 of 109 reported anal intercourse with HIV+ partners, 33 with HIV- partners and 38 with partners of unknown status. With HIV+ partners past sexually transmittable infections were associated with receptive intercourse without ejaculation (p = 0.03) and insertive intercourse without ejaculation (p = 0.06) while sexual beliefs were associated with insertive intercourse without ejaculation (p = 0.038), receptive intercourse with ejaculation (p = 0.016) and insertive intercourse with ejaculation (p = 0.077). Sexual beliefs were found to have some association with unprotected receptive intercourse without ejaculation with HIV- partners (p = 0.071). With unknown serostatus partners, treatment-optimism (p = 0.026) had association with insertive intercourse with ejaculation while optimism (p = 0.002), sexual beliefs (p = 0.039) and recent VL (p = 0.059) had associations with insertive intercourse without ejaculation. Current STI had association with receptive intercourse with ejaculation with unknown status partners (p = 0.014). We found between-group differences in variables associated with different types of unprotected anal intercourse that may guide the development of prevention strategies.
authors.affiliation: Albion Street Centre, Prince of Wales Hospital, Sydney, Australia. kim.begley@sesiahs.health.nsw.gov.au
authors.forename: Kim
authors.initials: K
authors.lastname: Begley
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Chan
authors.forename: Sarangapany
authors.initials: S
authors.lastname: Jeganathan
authors.forename: Marijka
authors.initials: M
authors.lastname: Batterham
authors.forename: Don E
authors.initials: DE
authors.lastname: Smith
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000523:psychology*; D000328:Adult; D001315:Australia; D001769:Blood / Q000821:virology; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012661:Semen / Q000821:virology; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D019562:Viral Load