Barcelona 2013
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| Abstract #250 - Theory and Overview | ||||
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Session: 14.6: Theory and Overview (Parallel) on Monday @ 14.30-16.00 in Raval Chaired by Richard Harding, Sheana Bull Authors: Presenting Author: Mrs Annie Velter - InVS, France, Metropolitan |
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| Additional Authors: | ||||
| Aim: Men who have sex with men (MSM) is the population most affected by HIV in France, representing half of the country's new infections with an incidence rate estimated at 1/100 person-years, despite wide access to HIV screening and antiretroviral therapy (ART). The need to have behavioral data for the most affected populations is crucial in terms of public health policies orientation. The objective of this study was to assess the different sexual behaviors implemented by HIV+ and non-HIV+ MSM (never tested or HIV negative) with their casual partners and to characterize the MSM for whom no preventive strategy is discernible in the current context of HIV prevention medicalization. | ||||
| Method / Issue: A cross-sectional study was conducted from May to July 2011 in France. The recruitment was organized predominantly online trough links and banners on more than 60 websites for MSM but also by gay press. A self-administrated questionnaire collected information on sociodemographic characteristics, self-reported HIV-status, sexual practices and preventive behaviour with regular or casual partners during the last 12 months, recruiting 10587 MSM living in France. A hierarchical scale of HIV risk behaviors with casual partners was constructed for HIV+ MSM and non-HIV+ MSM with exclusive categories. This scale was based on MSM's answers to behavioral questions; categories comprised abstinence, systematic condom use, risk reduction behaviors such as serosorting, seropositionning and viral sorting for HIV+ MSM (i.e. ART, undetectable viral load, and no STIs), and no discernible strategy. Factors associated with the lack of strategy were estimated. | ||||
| Results / Comments: Of all participants, 7318 MSM declared having had sexual casual partners in the last 12 months: 1367 reported being HIV+ and 5951 non-HIV+. Among the HIV+ MSM, 3% did not practice anal intercourse (AI), 18% used systematically condoms for AI, 54% practiced serosorting, seropositionning or viral sorting, and 25% did not implement a discernible strategy. Among the non-HIV+ MSM, 10% did not practice AI with their casual partners, 54% used systematically condoms, 11% practiced serosorting or seropositionning and 25% did not implement a discernible strategy. For HIV+ MSM, factors associated with no discernible strategy i.e. presenting a risk of transmission were being younger than 30, having been HIV+ diagnosed after 2000, regularly visiting sexual gay venues and dating websites, having more than 20 partners (median number) and having used psychoactive drugs in the last 12 months. For non-HIV+ MSM, factors associated with no discernible strategy i.e. presenting a risk of contamination, were being younger than 30, low education, living in a rural place, not having a regular partner, never being tested, regularly visiting sex gay venues and dating websites, having more than 7 partners (median number) and having used psychoactive drugs in the last 12 months. | ||||
| Discussion: Behaviors differed between HIV+ and non-HIV+ MSM. While risk reduction strategies were predominant among HIV+ MSM, there were more than half of non-HIV+ MSM who still systematically used condoms for AI with casual partners. The proportion of MSM with no strategy regarding HIV -thus at risk of HIV transmission or contamination - remained important for both HIV+ and non-HIV+ MSM. | ||||
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