title: Undetectable viral load and the decision to engage in unprotected anal intercourse among HIV-positive MSM.
abstract: We investigated how often HIV-positive MSM (n = 177) decide to engage in unprotected anal intercourse (UAI) because they have an undetectable viral load (UVL). We found that 20-57% of the UAI acts were related to having UVL, varying by partner type and partner HIV status. Among HIV-concordant partners, consideration of UVL before engaging in UAI was more prevalent with sex buddies (55%) than with casual partners (20%), although marginally significant (p = 0.051). Among HIV-discordant partners, no significant difference was found in the frequency of UVL considerations before engaging in UAI: 40% with sex buddies versus 57% with casual partners. Interestingly, while the decision to engage in UAI based on UVL was frequently discussed with HIV-concordant partners (>91%), it was only discussed with HIV-discordant partners in 13-25% of the UAI cases (according to partner type), suggesting that the decision was mostly unilateral.
authors.affiliation: Cluster Infectious Diseases, Department of Research, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands. wvdboom@ggd.amsterdam.nl
authors.forename: Wijnand
authors.initials: W
authors.lastname: Van Den Boom
authors.forename: Ineke G
authors.initials: IG
authors.lastname: Stolte
authors.forename: Robert
authors.initials: R
authors.lastname: Witlox
authors.forename: Theo
authors.initials: T
authors.lastname: Sandfort
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
authors.forename: Udi
authors.initials: U
authors.lastname: Davidovich
mesh_terms: D000328:Adult; D003657:Decision Making; D006679:HIV Seropositivity / Q000523:psychology* / Q000821:virology; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D012747:Sexual Partners / Q000523:psychology; D047568:Unsafe Sex / Q000523:psychology* / Q000706:statistics & numerical data; D019562:Viral Load