Suchergebnisse

AbstractIn a sample of men who have sex with men (MSM) (N = 3436) in Spain who bear intrinsic HIV risk, we investigated how internalised homonegativity (IH) is associated with the number of non-steady male partners with condomless intercourse (as a proxy of sexual risk behaviour). Using structural equation modelling (SEM), we examined the relationship between IH and sexual risk behaviour, and mediating effects of HIV/PrEP knowledge and substance use during sex on this relationship. We found no direct association between IH and sexual risk behaviour, nor did IH influence substance use during sex. In line with our hypothesis, association between IH and sexual risk behaviour was significant when mediated by HIV/PrEP knowledge. We found that as IH increased, sexual risk behaviour decreased, because higher IH was associated with lower HIV/PrEP knowledge while higher HIV/PrEP knowledge was associated with increased non-condom use with non-steady partners. Substance use during sex was significantly associated with sexual risk behaviour. Our results emphasize the continuing importance of prevention strategies focused on behavioural changes and community level interventions, especially targeting substance use.

IntroductionPeople living with HIV (PLHIV) on antiretroviral therapy (ART), with sustained undetectable viral load (sUVL) and no history of sexually transmitted infections for at least six months, are considered to have a low risk of HIV transmission (LRT). We aimed to characterize, in a representative sample of French PLHIV, the sexual behaviour of LRT PLHIV compared with non‐LRT PLHIV.MethodsThe cross‐sectional ANRS‐VESPA2 survey was conducted on adult PLHIV attending French hospitals in 2011. The LRT PLHIV group included participants with sUVL and no sexually transmitted infection for at least 12 months. Socio‐behavioural and medical data were collected. Chi‐square tests helped compare sexual risk indicators between LRT and non‐LRT PLHIV. The survey's retrospective nature allowed us to perform complementary category‐based analyses of LRT PLHIV according to whether they had sUVL for at least 18, 24 or 36 months in three socio‐epidemiological groups: men who have sex with men (MSM), other men and women.ResultsAnalysis included 2638 PLHIV diagnosed >12 months with available viral load data. The proportion of LRT PLHIV varied from 58% (≥12 months sUVL) to 38% (≥36 months sUVL). Irrespective of sUVL duration, we found the following: 1) LRT men (MSM and other men) were more likely to report having no sexual partner than their non‐LRT counterparts. Among men having sexual partners in the previous 12 months, no significant difference was seen between LRT and non‐LRT men in the number of sexual partners. LRT women were less likely to report having more than one sexual partner than non‐LRT women; 2) LRT MSM were more likely to report being in sexually inactive couples than their non‐LRT counterparts; 3) among sexually active participants, no difference was observed between LRT and non‐LRT PLHIV concerning condom use with their serodiscordant steady partner or with their most recent casual sexual partners.ConclusionsLRT PLHIV with sUVL ≥12 months did not report more sexual risk behaviours than their non‐LRT counterparts. Because the same result was obtained for those having a sUVL ≥36 months, the hypothesis of increased sexual risk behaviour over time in PLHIV meeting non‐transmission biomedical criteria is not supported.