Sustained Reduction in Sexual Behavior that May Pose a Risk of HIV Transmission Following Diagnosis During Early HIV Infection Among Gay Men in Vancouver, British Columbia.
Increased viral load during early HIV infection (EHI) disproportionately contributes to HIV transmission among gay men. We examined changes in sexual behavior that may pose a risk of HIV transmission (condomless anal sex (AS) with a serodiscordant or unknown status partner, CAS-SDU) in a cohort of 25 gay men newly diagnosed during EHI who provided information on 241 sexual partners at six time points following diagnosis. Twenty-two (88%) participants reported ≥1 AS partner (median time to first AS 80 days) and 12 (55%) reported ≥1 partnership involving CAS-SDU (median 116 days). In hierarchical generalized linear mixed effects models, AS was significantly less likely in all time periods following diagnosis and more likely with serodiscordant partners. The likelihood of CAS-SDU decreased three months after diagnosis and was higher in recently versus acutely infected participants. Most men in our study abstained from sex immediately after diagnosis with sustained longer-term reduction in CAS-SDU, confirming the importance of timely diagnosis during EHI.
BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada. mark.gilbert@bccdc.ca.|School of Population and Public Health, University of British Columbia, Vancouver, Canada. mark.gilbert@bccdc.ca.
Mark
0000-0001-5978-6843
M
Gilbert
School of Nursing, University of British Columbia Okanagan, Kelowna, Canada.|Women's Health Research Institute, Vancouver, Canada.
Darlene
D
Taylor
School of Population and Public Health, University of British Columbia, Vancouver, Canada.
Warren
W
Michelow
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Daniel
D
Grace
BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada.|Department of Statistics, University of British Columbia, Vancouver, Canada.
Robert
R
Balshaw
CATIE, Toronto, Canada.
Michael
M
Kwag
Positive Living Society of British Columbia, Vancouver, Canada.
Elgin
E
Lim
Centre for Addiction and Mental Health, Toronto, Canada.
Benedikt
B
Fischer
BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, Canada.
David
D
Patrick
School of Population and Public Health, University of British Columbia, Vancouver, Canada.|Women's Health Research Institute, Vancouver, Canada.
Gina
G
Ogilvie
Department of Statistics, University of British Columbia, Vancouver, Canada.
Daniel
D
Coombs
Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.
Malcolm
M
Steinberg
School of Population and Public Health, University of British Columbia, Vancouver, Canada.
Michael
M
Rekart
D000328:Adult; D001955:British Columbia; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data; D042241:Early Diagnosis; D015658:HIV Infections / Q000635:transmission* / Q000821:virology; D018451:Homosexuality, Male; D006801:Humans; D016014:Linear Models; D008297:Male; D040242:Risk Reduction Behavior; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D000072339:Sexual and Gender Minorities / Q000706:statistics & numerical data*; D019562:Viral Load
Cohort study; Diagnosis; Gay men; HIV; Sexual behavior