Intentional risk reduction practices of men in Switzerland who have anal intercourse with casual male partners.
OBJECTIVE
To identify prevalence of and factors associated with intentional use of HIV risk reduction practices by men who have sex with men during anal intercourse with casual partners.


METHODS
Cross-sectional survey pertaining to the Swiss HIV behavioral surveillance system, using an anonymous self-administered questionnaire in a self-selected sample of men who have sex with men (n = 2953). Multinomial regression was used to estimate factors associated with reporting either "no or inconsistent condom use" or "one or more risk reduction practices" over "consistent condom use."


RESULTS
57.2% reported anal intercourse with casual partner(s) over the last 12 months. Of these, 24.0% declared having used a risk reduction practice (73.8% of those who did not use condoms consistently). HIV-positive people were more likely to have done so. Most predictors were similarly associated to both regression categories. Four significant predictors were common to both regression categories: Internet partner seeking, age, age squared, and the interaction between HIV status positive and number of partners. The only association that differed markedly between the 2 regression categories was having a number of partners above median, significantly associated with the risk reduction category.


CONCLUSIONS
Although condom use is the most frequent protection strategy in anal intercourse with casual partners, risk reduction practices are highly prevalent. However, there are no clear differences regarding predictors between risk reduction practices and inconsistent or no condom use. This suggests that risk reduction is an opportunistic response rather than a strategy per se.
Institute of Social and Preventive Medicine, University Hospital Center and University of Lausanne, Lausanne, Switzerland.
Hugues
H
Balthasar
André
A
Jeannin
Stéphanie
S
Lociciro
Françoise
F
Dubois-Arber
D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D015658:HIV Infections / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D040242:Risk Reduction Behavior; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D013557:Switzerland