Behaviors of Recently HIV-Infected Men Who Have Sex With Men in the Year Post-Diagnosis: Effects of Drug Use and Partner Types

With the objective of assessing the behaviors of recently HIV-infected men who have sex with men, the study authors conducted interviews every three months with 193 recently infected MSM in the Southern California Acute Infection and Early Disease Research Program from 2002 to 2006. Changes in HIV status of partners, recent unprotected anal intercourse, drug use, antiretroviral therapy (ART) use, detectable viral load, and partnership dynamics over one year were employed to predict recent UAI in a random effect logistic regression.

Over a year, participants reported significantly fewer partners in the past month (mean 8.81 to 5.84; p<.0001). Percentage of recent UAI with last partner of unknown HIV status declined from enrollment to nine months (49 percent to 27 percent) and rebounded at 12 months to 71 percent. Multivariable models controlling for ART use showed recent UAI was significantly associated with: baseline methamphetamine use (adjusted odds ratio [AOR] 7.65, 95 percent confidence interval [CI] 1.87, 31.30), methamphetamine use at follow-up (AOR 14.4, 95 percent CI 2.02, 103.0), HIV-uninfected partner at follow-up (AOR 0.14, 95 percent CI 0.06, 0.33) and partners with unknown HIV status at follow-up (AOR 0.33, 95 percent CI 0.11, 0.94). "HIV viral load did not influence rate of UAI," the investigators reported.

"Transmission behaviors of these recently HIV-infected MSM decreased and serosorting increased after diagnosis; recent UAI with serostatus unknown or negative partners rebounded after nine months, identifying critical timepoints for interventions targeting recently HIV-infected individuals," concluded the study authors. "There was no evidence in this cohort that the viral load of these recently infected men guided their decisions about protected or unprotected anal intercourse."