New data from six U.S. sites show a dramatic shift by men acutely infected with HIV to choose to have unprotected intercourse only with other HIV-infected partners.
"While the findings showed condom use was up and the number of partners was down, the most startling effect was seen in men choosing to have unprotected intercourse almost exclusively with other HIV-infected individuals. This reflects a systematic shift by men, most of whom are gay, following HIV infection to behaviors that protect their sex partners," said lead author, Wayne Steward, PhD, MPH, assistant professor of medicine at UCSF's Center for AIDS Prevention Studies.
The findings, presented today (December 5) at the U.S. Centers for Disease Control National HIV Prevention Conference in Atlanta, were from clinics that enroll newly HIV-infected study participants in San Francisco, New York City, Los Angeles, New Haven, San Diego, and Providence. Over 90 percent of the 27 participants in this study were men who have sex with men.
The research showed that the men prior to HIV infection had unprotected intercourse acts with HIV-negative or HIV-unknown partners almost 75 percent of the time. Following diagnosis with acute HIV infection, they sharply altered their behavior to having unprotected anal or vaginal intercourse 97 percent of the time with other HIV-infected individuals.
Acute infection is the one-month period immediately following HIV infection when individuals tend to have the highest levels of HIV circulating in their blood, making them much more likely to infect a partner with HIV during unprotected intercourse.
"If all you are doing is counting condom usage, you are missing a powerful risk reduction strategy that is actually taking place. In addition, this study highlights the importance of identifying acute or recent HIV infections, so that this partner selection strategy can be implemented at the critical juncture when individuals are most infectious and when our data show they engage in behaviors reflecting strong motivation to avoid infecting someone else," said Steward.
Co-authors of the study include Steve Morin and Hong-Ha Troung, UCSF; Robert H. Remien, Jacqueline Correale, and Anke E. Ehrhardt, New York State Psychiatric Institute and Columbia University; Ronald A. Brooks, UCLA; Robert Dubrow, Yale University; Peter R. Kerndt, Los Angeles County Department of Health Services; Stephen D. Pinkerton, Medical College of Wisconsin; Kathleen J. Sikkema, Duke University; Corinna Young, UC- San Diego.
Funding from the National Institute for Mental Health supported the research.
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