HIV-positive persons with lower viral loads are at reduced risk for transmitting the virus to their sex partners, recent studies indicate. As information about the association between viral load and HIV risk disseminates throughout high-risk communities, viral load discussions may be increasingly used as a risk-reduction strategy. In the current study, researchers sought to determine the frequency of viral load discussions and unprotected anal intercourse (UAI) in primary and casual sex partnerships among MSM.
In January 2011, 326 MSM (82 percent Caucasian, 62 percent college-educated, 7 percent HIV-positive, or thought they were) completed an online survey. The results showed that viral load discussions occurred in 93 percent of primary partnerships in which at least one partner was HIV-positive. UAI was reported with 46 percent of all primary partners and 25 percent of serodiscordant primary partners with whom viral load was discussed. Among casual sex partners, UAI was more common when viral load was not discussed compared to when it was (75 percent vs. 56 percent of encounters). Discussions about viral load were reported in 53 percent of the three recent sexual episodes with casual partners with whom respondents had sex -- either once or multiple times -- in the past three months.
"The finding that casual sexual episodes that did not include viral load discussions had a higher percentage of UAI than those that did include viral load discussions suggests either that men who do not discuss viral load may be higher risk-takers than men who do, or that the former are less adept at negotiating safer sex with casual sex partners than men who do discuss viral load," the researchers concluded. "More research is needed to understand the role of viral load discussions in negotiating sexual activities among MSM."
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