Amsterdam 2015
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| Abstract #2347 - Boystown - MSM I | ||||
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Session: 15.2: Boystown - MSM I (Symposium) on Wednesday @ 14.30-16.00 in C104 Chaired by Udi Davidovich, Kenneth Mayer Authors: Presenting Author: Professor Pamina M Gorbach - University of California, Los Angeles, United States |
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| Additional Authors: | ||||
| Aim: The effect of HIV diagnosis on transmission behaviors may vary between those with acute and chronic infection. We assessed how substance use and other behaviors change in a cohort of men who have sex with men (MSM) from the time of HIV testing to a year later in Los Angeles. | ||||
| Method / Issue: From 2009 - 2012 in partnership with a community-based organization The Los Angeles Gay, Lesbian, Bisexual and Transgender Center, The NIDA funded Metromates Cohort enrolled 328 men seeking testing for HIV who completed a questionnaire, tested for acute HIV, and a year of follow-up interviews. MSM were tested with a rapid EIA test and provided specimens for testing for acute and recent HIV infection. Demographic, behavioral and other data were collected via Computer-Assisted Self-Interview. Differences in demographic and risk behavior were evaluated using bivariate and multivariable analyses and were compared among those with new HIV infection, chronic HIV infection, and negative result. The association between methamphetamine use during last sex reported over the year, test result (recent, chronic, or negative) and risk behaviors including substance use was assessed via repeat measures multivariable regression. | ||||
| Results / Comments: Of 328 enrolled: 125 men were recently HIV infected, 113 had new diagnosis of chronic HIV infection, and were 90 HIV negative. The sample was mostly young (59% < 30 years of age), minority (50% Hispanic, 15% African American (AA)), and educated (80% had > high school education, 30% graduated college), and 60% were employed. Race/ethnicity was significantly associated with new diagnosis of chronic infection as 29% of AAs compared to 9% of Hispanics, and 9% of Whites tests indicated HIV positive but no recent infection. Median number of partners reported in past year ped significantly for recently infected MSM (10 to 5) and HIV negative men (5 to 3) but not for HIV chronically infected. There was no change in reports of frequency of sexual position with last partner: neither ive unprotected anal intercourse (UAI) nor receptive UAI. There were significant changes in substance use between baseline and one year: increase in methamphetamine use among newly diagnosed with chronic infection (16% to 22%) and increase in binge drinking among HIV negatives (14% to 45%). In multivariable analysis adjusting for race/ethnicity and time, the following were significantly associated with methamphetamine use at last sex: recently HIV-infected (vs. HIV-negative) [adjusted odds ratio (AOR) 3.20 95% confidence interval (CI) 1.63-6.28] and UAI (AOR=1.62 95% CI 1.08-2.68). | ||||
| Discussion: For MSM getting tested for HIV in Los Angeles, HIV acquisition remains associated with methamphetamine use and practice of high exposure behaviors (ie many partners and UAI). Fewer African American MSM were recently infected at the time of diagnosis, suggesting later detection of HIV following infection. Finally, there is little indication of behavior change following HIV diagnosis, indicating that unless there is rapid linkage to care and viral suppression significant transmissions may be ongoing during this highly infectious period. The association of methamphetamine use and UAI with HIV acquisition suggests an ongoing need for substance use interventions to reduce transmission of HIV. | ||||
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