UCL logo

UCL Discovery

UCL home » Library Services » Electronic resources » UCL Discovery

Unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men.

Jin, F; Crawford, J; Prestage, GP; Zablotska, I; Imrie, J; Kippax, SC; Kaldor, JM; (2009) Unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men. AIDS , 23 (2) pp. 243-252. 10.1097/QAD.0b013e32831fb51a.

Full text not available from this repository.

Abstract

OBJECTIVE: A range of risk reduction behaviours in which homosexual men practise unprotected anal intercourse (UAI) has been described. We aimed to assess the extent of any reduction in HIV risk associated with these behaviours. DESIGN: A prospective cohort study of HIV-negative homosexual men in Sydney, Australia. METHODS: Men were followed up with 6-monthly detailed behavioural interviews and annual testing for HIV. The four risk reduction behaviours (behaviourally defined) examined were serosorting, negotiated safety, strategic positioning, and withdrawal during receptive UAI (UAI-R). RESULTS: In 88% of follow-up periods in which UAI was reported, it occurred in the context of consistent risk reduction behaviours. Compared with those who reported no UAI, the risk of HIV infection was not raised in negotiated safety [hazard ratio = 1.67, 95% confidence interval (CI) 0.59-4.76] and strategic positioning (hazard ratio = 1.54, 95% CI 0.45-5.26). Serosorting outside negotiated safety was associated with an intermediate rate of HIV infection (hazard ratio = 3.11, 95% CI 1.09-8.88). Withdrawal was associated with a higher risk than no UAI (hazard ratio = 5.00, 95% CI 1.94-12.92). Patterns of UAI differed greatly according to partner's serostatus. Men who reported serosorting were less likely to report either strategic positioning or withdrawal. CONCLUSION: Each behaviour examined was associated with an intermediate HIV incidence between the lowest and highest risk sexual behaviours. The inverse association between individual behaviours suggests that men who practise serosorting rely on this protection. The high prevalence of these behaviours demands that researchers address the contexts and risks associated with specific types of UAI.

Type: Article
Title: Unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men.
Location: England
DOI: 10.1097/QAD.0b013e32831fb51a
Keywords: Adolescent, Adult, Aged, Anal Canal, Condoms, Epidemiologic Methods, HIV Infections, HIV Seropositivity, Homosexuality, Male, Humans, Male, Middle Aged, New South Wales, Risk Reduction Behavior, Sexual Behavior, Unsafe Sex, Young Adult
UCL classification: UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care > Infection and Population Health
URI: http://discovery.ucl.ac.uk/id/eprint/1327155
Downloads since deposit
0Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item