Barcelona 2013
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| Abstract #461 - Risk | ||||
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Session: 18.4: Risk (Symposium) on Monday @ 16.30-18.30 in Teatre Chaired by Susan Kiene, Olivia Castillo Authors: Presenting Author: Mrs Amelie McFadyen - Canadian Research Chair in Health Education, Canada |
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| Additional Authors: Professor Edwin Wouters , Mrs. Caroline Masquiller, | ||||
| Aim: 1) To identify patterns among SPOT participants with regards to the risk reduction strategies they adopt with potentially at-risk partners; 2) To compare participants? sociosexual profiles according to these patterns. | ||||
| Method / Issue: SPOT is an ongoing research-intervention project offering free, anonymous, rapid HIV testing for men who have sex with men (MSM) in Montreal. Cross-sectional data from 1740 MSM tested between July 2009 and January 2012 were gathered through structured interviews and self-administered questionnaires. Behavioral variables were used to create the profiles for a latent class analysis: 1) anal sex as a top 2) dipping as a top 3) anal sex as a bottom 4) dipping as a bottom. For each of these four variables, participants were classified according to how often they used the condom: ?Never use a condom?, ?Inconsistent use of a condom?; ?Always use a condom?, or ?Do not have this type of behavior?. Condom use was further classified in relation to the HIV status of sexual partners: unknown HIV status; HIV-positive status with unknown or detectable viral load; and HIV-positive with undetectable viral load. Profiles were then compared amongst each other for criterion variables. Univariate analyses, one-factor ANOVA with post-hoc, or chi squared, were performed. | ||||
| Results / Comments: Results indicate five patterns of risk reduction strategies with potentially at-risk partners. Some similarities were found amongst these profiles, but distinct strategies were clearly identifiable for each one. Profile 1 (51.6%): These men are mostly in closed sero-concordant relationships with HIV-negative partners. They generally avoid anal sex with potentially at-risk partners and therefore their main risk reduction strategy would be negotiated safety. Profile 2 (17.7%): men in this profile generally use serosorting (avoidance of HIV-positive partners) as their risk reduction strategy, but this is combined with low condom use with potentially at-risk partners. Profile 3 (17.7%): men in this profile use high condom use with potentially at-risk partners as main risk reduction strategy. This is combined with serosorting. Profile 4 (8.9%): men in this profile tend not to ask about or make assumptions about the serological status of their partners. However, they will use viral load sorting as a risk reduction strategy if they are aware of a partner?s HIV-positive status. This means that they will be more likely to use condoms with HIV-positive partners whose viral load is unknown or detectable. Profile 5 (4.1%): Men in this profile are mainly in sero-different, open relationships with HIV-positive men and use HIV testing as well as PEP as risk reduction strategies. | ||||
| Discussion: These results show that while MSM make strategic use of the condom to a certain extent, their risk reduction strategies are diversified and complex and go beyond condom use. These strategies include adjusting to partners? presumed or known serostatus and viral load; avoiding certain types of partners; keeping sex within the couple; and using after-sex strategies such as HIV testing and PEP. Further research is needed to develop indicators that capture the diversity of risk reduction strategies. Public health messages, prevention programs, and counseling must also be adjusted to account for this diversity. | ||||
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