title: Use of viral load to negotiate condom use among gay men in Sydney, Australia.
abstract: Using two cohort studies (Health in men-HIM and positive health-PH) and repeated large cross-sectional surveys (Gay Community Periodic Survey-GCPS) of gay men in Sydney, Australia, we examined the association between viral load and unprotected anal intercourse (UAI) between HIV sero-discordant regular partners. Between 2001 and 2007, we conducted 243 interviews with 102 HIV-negative gay men in HIM and 148 interviews with 99 HIV-positive gay men in PH who were in regular relationships with HIV sero-discordant partners. During the same time period, 437 HIV positive men with HIV sero-discordant regular partners completed questionnaires for the GCPS. All completed interviews or questionnaires during that time period were used for these analyses. Amongst the HIV-negative respondents, sero-discordant UAI was more likely to be reported when the men believed their HIV-positive regular partner had an undetectable rather than a detectable viral load (P = 0.002). Amongst the HIV-positive respondents, sero-discordant UAI was as likely to be reported when they themselves reported having an undetectable or a detectable viral load. Use of viral load in negotiating condom use between sero-discordant gay couples may be understood very differently by the HIV-negative and HIV-positive men within those partnerships.
authors.affiliation: National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, 376 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia. gprestage@nchecr.unsw.edu.au
authors.forename: Garrett
authors.initials: G
authors.lastname: Prestage
authors.forename: Limin
authors.initials: L
authors.lastname: Mao
authors.forename: Susan
authors.initials: S
authors.lastname: Kippax
authors.forename: Fengyi
authors.initials: F
authors.lastname: Jin
authors.forename: Michael
authors.initials: M
authors.lastname: Hurley
authors.forename: Andrew
authors.initials: A
authors.lastname: Grulich
authors.forename: John
authors.initials: J
authors.lastname: Imrie
authors.forename: John
authors.initials: J
authors.lastname: Kaldor
authors.forename: Iryna
authors.initials: I
authors.lastname: Zablotska
mesh_terms: D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data*; D006679:HIV Seropositivity / Q000453:epidemiology / Q000523:psychology / Q000821:virology*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017008:Negotiating / Q000379:methods*; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D047568:Unsafe Sex; D019562:Viral Load