Behaviors of recently HIV-infected men who have sex with men in the year post-diagnosis: effects of drug use and partner types.

Published: November 26, 2010


OBJECTIVES: Assess behaviors of recently HIV-infected men who have sex with men (MSM).

METHODS: From 2002-2006 193 recently HIV-infected MSM in the Southern California Acute Infection and Early Disease Research Program were interviewed every 3 months. Changes in HIV status of partners, recent unprotected anal intercourse (UAI), drug use, use of antiretroviral therapy (ART), detectable viral load and partnership dynamics over one year were used to predict recent UAI in a random effect logistic regression.

RESULTS: Over a year significantly fewer partners in the past month were reported (mean 8.81 to 5.84; p<.0001). Percentage of recent UAI with HIV-status unknown last partners decreased from enrollment to 9 months (49% to 27%) and rebounded at 12 months to 71%. In multivariable models controlling for ART use, recent UAI was significantly associated with: baseline methamphetamine use (AOR 7.65, 95% CI 1.87, 31.30), methamphetamine use at follow-up (AOR 14.4, 95% CI 2.02, 103.0), HIV-uninfected partner at follow-up (AOR 0.14, 95% CI 0.06, 0.33) and partners with unknown HIV status at follow-up (AOR 0.33, 95% CI 0.11, 0.94). HIV viral load did not influence rate of UAI.

CONCLUSIONS: 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. 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.

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