Behaviors of recently HIV-infected men who have sex with men in the year postdiagnosis: effects of drug use and partner types - PubMed (original) (raw)

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

Pamina M Gorbach et al. J Acquir Immune Defic Syndr. 2011.

Abstract

Objectives: Assess behavior change of recently HIV-infected men who have sex with men (MSM).

Methods: From 2002 to 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 1 year were used to predict recent UAI in a random effect logistic regression.

Results: Over a year significantly fewer partners in the past 3 months were reported (mean 8.81 to 5.84; P < 0.0001). Percentage of recent UAI with HIV-status unknown last partners decreased from enrollment to 9 months (49%-27%) and rebounded at 12 months to 71%. In multivariable models controlling for ART use, recent UAI was significantly associated with: baseline methamphetamine use [adjusted odds ratio (AOR): 7.65, 95% confidence interval (CI): 1.87 to 31.30], methamphetamine use at follow-up (AOR: 14.4, 95% CI: 2.02 to 103.0), HIV-uninfected partner at follow-up (AOR: 0.14, 95% CI: 0.06 to 0.33), and partners with unknown HIV status at follow-up (AOR: 0.33, 95% CI: 0.11 to 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 9 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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Figures

Figure 1

Figure 1

Mean numbers of partners reported in the prior three months over the year following HIV diagnosis:error bars are 95% confidence bounds on the means

Figure 2

Figure 2

Percentage of HIV positive, negative and unknown status partners of recently infected MSM with whom with they reported recent unprotected anal intercourse: across the first year following HIV diagnosis

Figure 3

Figure 3

Percentage of last partners of each partner type reported by MSM with recent HIV infection over the first year following diagnosis

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