title: The burden of HIV experience and care among MSM having an HIV-positive seroconcordant steady partner: a possible research hypothesis. Results from the French VESPA ANRS EN-12 study.
abstract: OBJECTIVE
  Prevention fatigue, relapse into unsafe sex practices and sexual behaviour changes have been reported in the community of men who have sex with men (MSM) since the introduction of highly active antiretroviral therapy. Engaging in a relationship with a seroconcordant partner is perceived by some HIV-positive MSM as an alternative prevention strategy to consistent condom use. This study addresses whether underlying clinical factors exist characterising HIV-positive MSM in seroconcordant stable partnerships, enrolled in the French national cross-sectional survey VESPA ANRS EN-12.
  
  
  METHODS
  The study group comprised 322 HIV-positive MSM in stable relationships for more than 12&emsp14;months, with a serodiscordant (n = 251) or seroconcordant (n = 71) steady partner. Clinical and psychosocial factors were analysed for HIV-positive MSM with a seroconcordant steady partner.
  
  
  RESULTS
  Multiple adjustment by logistic regression showed that individuals with a seroconcordant steady partner were more likely to have a history of an AIDS-defining event (OR 95% CI 2.0 (1.1 to 3.7), p = 0.02) or be diagnosed as HIV positive before 1990 (OR 95% CI 2.2 (1.3 to 3.9), p = 0.004). Conversely, HIV-positive MSM experiencing virological success (ie, high treatment adherence and an undetectable viral load) were more likely to have a serodiscordant steady partner (OR 95% CI 0.5 (0.3 to 0.9), p = 0.02).
  
  
  CONCLUSIONS
  Longitudinal studies are required to understand to what extent HIV history might influence partnership choices among HIV-positive MSM. Positive prevention programmes and reinforcement of treatment adherence strategies are needed for this population and their steady sexual partners.
authors.affiliation: INSERM, U912 (SE4S), 23 rue Stanislas Torrents, 13006 Marseille, France; marie.suzan@inserm.fr.
authors.forename: Marie
authors.initials: M
authors.lastname: Suzan-Monti
authors.forename: Marie
authors.initials: M
authors.lastname: Préau
authors.forename: Jérôme
authors.initials: J
authors.lastname: Blanche
authors.forename: Sandrine
authors.initials: S
authors.lastname: Cabut
authors.forename: Patrizia M
authors.initials: PM
authors.lastname: Carrieri
authors.forename: France
authors.initials: F
authors.lastname: Lert
authors.forename: Yolande
authors.initials: Y
authors.lastname: Obadia
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005602:France; D006679:HIV Seropositivity / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012747:Sexual Partners; D018454:Spouses