Syndemic conditions and HIV transmission risk behavior among HIV-negative gay and bisexual men in a U.S. national sample.

Background Regular sexual partnerships among gay and bisexual men (GBM) who practice condomless anal intercourse (CLAI) have not been well characterised in terms of partnership type, HIV seroconcordance and risk of HIV transmission. Primarily sexual regular partnerships, although commonly reported by gay men, have largely been ignored in research and HIV prevention. Among regular partners reporting CLAI with each other, we determined factors differentiating romantic or committed relationships from partnerships organised primarily around sex (‘fuckbuddies’) and estimated the proportion of CLAI presenting risk for HIV transmission. Methods: An online, cross-sectional survey of Australian GBM was conducted. Univariate and multivariate generalised estimating equations were used to determine statistical associations. Results: Men reported on 2250 regular sexual partnerships. Over half the partnerships were romantic or committed relationships. Over half the partnerships were HIV-negative seroconcordant (54.9%), 3.1% were HIV-positive seroconcordant, 5.2% were serodiscordant and 36.8% were of unknown seroconcordance. Potential risks presented by CLAI were sometimes mitigated by protective factors, such as having a clear spoken agreement about sex with outside partners, having fewer outside partners, openly discussing HIV risk and having an agreement to reduce risk from outside partners. These protective factors were more often found in romantic or committed relationships than among primarily sexual partnerships, and were less often found in partnerships of unknown seroconcordance. Conclusion: CLAI is more common among regular sexual partnerships considered to be of a romantic, committed nature. However, factors associated with such romantic or committed partnerships can also protect against HIV transmission risk. Unknown seroconcordance, particularly lack of communication about HIV status among primarily sexual partnerships, is a key risk factor that needs to be addressed by HIV education.

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Pilot Randomized Trial of an Expressive Writing Intervention to Reduce Sexual HIV-Transmission Risk and Substance Use Among Emerging Adult Gay and Bisexual Men

AIDS and Behavior ◽

10.1007/s10461-021-03413-7 ◽

2021 ◽

Author(s):

Brooke E. Wells ◽

Steven Samrock ◽

Mark Pawson ◽

Tyrel J. Starks

Keyword(s):

Expressive Writing ◽

Hiv Transmission ◽

Emerging Adult ◽

Gay And Bisexual Men ◽

Transmission Risk ◽

Writing Intervention ◽

Bisexual Men ◽

Expressive Writing Intervention ◽

And Bisexual ◽

Hiv Transmission Risk

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1281. Awareness of U=U Among Gay and Bisexual Men Who Have Sex with Men

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1144 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S461-S461

Author(s):

Meredith E Clement ◽

Rick Zimmerman ◽

Josh Grimm ◽

Joseph Schwartz

Keyword(s):

Hiv Transmission ◽

Gay And Bisexual Men ◽

Bisexual Men ◽

Hiv Status ◽

Anal Sex ◽

And Bisexual ◽

Sex With Men ◽

Living With Hiv ◽

Hiv Negative ◽

Strong Agreement

Abstract Background The “Undetectable = Untransmittable” (“U=U”) campaign is gaining traction, but prior studies from 2012–2017 have shown that the proportion of gay and bisexual men who have sex with men (GBMSM) who are aware of or have perceived accuracy of U=U is low. We report findings from a survey administered to GBMSM in 2018 to understand whether the landscape is changing with respect to U=U message dissemination. Methods GBMSM were recruited on gay dating apps to complete a 96 question survey. Survey data were collected in April-August of 2018. Collected data elements included demographic information, HIV status, ART and PrEP use, and beliefs and opinions regarding HIV transmission. Results 969 GBMSM completed the survey; of whom, 678 had analyzable data (241 had never had anal sex with a man and 54 were missing ≥1 of the variables used in the analysis). Average age was 43 years, 65% were white, 15% black, 15% white, and 15% were HIV-infected (of whom 92% were on anti-retrovirals). Of the 85% who were HIV-uninfected, 39% were on PrEP. In response to the statement that a person with an undetectable viral load cannot transmit HIV to an HIV-uninfected person, 24% strongly agreed. Among HIV-negative GBMSM, 33% of those on PrEP agreed and 12% of those not on PrEP agreed. Among those living with HIV, 42% agreed. A multivariable logistic regression was run to explain correlates of strong agreement with U=U, using the following variables: age, education, being Black, being Hispanic, relationship status, number of lifetime male sexual partners, condom use with most recent anal sex, HIV status, PrEP use, and attitudes about living with HIV. Variables associated with strong agreement with U=U were living with HIV (AOR = 1.63, P < 0.001), taking PrEP (AOR = 2.85, P < 0.001), most recent encounter’s condom use (AOR = 2.22, P = 0.003), and having positive attitudes about living with HIV (AOR= 1.93, P < 0.001). Table 1 shows percentages for each of these variables (bivariate relationships) strongly agreeing with U=U. Conclusion Now that U=U has been scientifically proven, the challenge is public awareness. U=U awareness seems to be improving among GBMSM, with HIV-negative GBMSM making the greatest strides. Education around U=U and PrEP efficacy may help reduce guilt around HIV transmission and alleviate HIV stigma. Disclosures All authors: No reported disclosures.

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