Session 116Poster Presentations The HIV/STD Interface Session Day and Time: Tuesday 1:30 - 3:30 pm Room: Hall B
920 Unprotected Anal Intercourse Between Steady Male Partners with Nonconcordant HIV Serostatus P. Denning*, M. Campsmith, K. Gallagher CDC, Atlanta, GA
Background: Although multiple studies have found that men who have sex with men (MSM) are more likely to engage in unprotected anal intercourse (UAI) with a steady partner rather than a casual one, very little research has been done specifically on male couples with nonconcordant HIV serostatus. Accordingly, we examined behavioral surveillance data from a multisite interview project to describe UAI among HIV-positive MSM who have a steady male partner with nonconcordant serostatus.
Methods: Between January 1995, and December 2000, we interviewed 3,939 HIV+ MSM in 12 U.S. states and selected those men who had a steady male sex partner with negative or unknown serostatus. Our outcome measure was any anal intercourse that was not protected with condoms (UAI). We examined associations with UAI using chi-square, Fisherís exact test, and multiple logistic regression.
Results: Of the 3,939 HIV-positive MSM interviewed, 970 (25%) had a steady male sex partner who was HIV- (n = 720) or of unknown serostatus (n = 250); 278 (29%) of these men reported UAI during the previous year (the look-back period). The prevalence of UAI varied greatly by the participantís knowledge of his serostatus during the look-back period. Men who were aware of their infection for less than half the look-back period were significantly more likely to have engaged in UAI (52%) than those who were aware of their infection for most (30%, p < 0.001) or all of the look-back period (21%, p < 0.001). Among the 664 men who were aware of their infection for the entire look-back period, factors found to be predictive of UAI in a multivariate model were heterosexual self-identity (adjusted odds ratio [AOR] = 8.3, 95% confidence interval [CI] = 1.5-48), crack cocaine use (AOR = 3.1; 95% CI = 1.5-6.3), no education beyond high school (AOR = 1.8; 95% CI = 1.2-2.7), and a partner with unknown serostatus (AOR = 1.8; 95% CI = 1.2-2.9); = 5 years between HIV diagnosis and interview was associated with lower levels of UAI (AOR = 0.6; 95% CI = 0.4-0.9).
Conclusions: Although our findings suggest that the HIV+ MSM in our study had reduced their sexual risk behavior after learning of their infection, many still engaged in UAI with a steady partner of nonconcordant serostatus. The high prevalence of UAI in these men underscores the need to expand HIV prevention interventions among them, especially those with associated risks, such as substance abuse and low educational levels.