Characteristics of Agreements to have Condomless Anal Intercourse in the Presence of an Undetectable Viral Load Among HIV Serodiscordant Male Couples in Australia, Brazil and Thailand

UNSW Sydney. Kirby Institute. Sydney, NSW, Australia.
UNSW Sydney. Kirby Institute. Sydney, NSW, Australia.
UNSW Sydney. Kirby Institute. Sydney, NSW, Australia.
Institute of HIV Research and Innovation. Bangkok, Thailand.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Melbourne Sexual Health Centre. Melbourne, Australia / Monash University. Central Clinical School. Melbourne, Australia.
UNSW Sydney. Kirby Institute. Sydney, NSW, Australia.
UNSW Sydney. Kirby Institute. Sydney, NSW, Australia / The University of Sydney. Faculty of Medicine and Health. Central Clinical School. Sydney Local Health District and Discipline of Medicine. Department of Sexual Health Medicine. Sydney, Australia.
University of Sydney. Faculty of Medicine and Health. Westmead Clinical School Sydney, Australia / Western Sydney Local Health District. Western Sydney Sexual Health. Sydney, Australia.
The Alfred Hospital. Melbourne, Australia / Monash University. Melbourne, Australia.
Sydney Eye Hospital. Sydney, Australia / Sydney Sexual Health Centre. Sydney, Australia / UNSW Sydney. School of Public Health and Community Medicine. Sydney, Australia.
Taylor Square Private Clinic. Sydney, Australia.
UNSW Sydney. Kirby Institute. Sydney, NSW, Australia.
UNSW Sydney. Kirby Institute. Sydney, NSW, Australia.

Abstract

The use of undetectable viral load (VL) to negotiate condomless anal intercourse (CLAI) in HIV serodiscordant male relationships has become more common as more data regarding the effectiveness of antiretroviral treatments for the prevention of HIV transmission has been described. We examined viral load agreements (VLAs) for condomless sex in the presence of an undetectable VL in 343 HIV serodiscordant male couples in Australia, Brazil and Thailand. Factors associated with having a VLA included having agreements for the HIV-positive partner to report his VL result (p < 0.001), agreeing that VL affects agreements about sexual practice (p < 0.001), the HIV-negative partner's perception of his partner's undetectable VL (p < 0.001), the couple's belief in the efficacy of undetectable VL in preventing HIV transmission (p < 0.001), and the couple engaging in CLAI with each other (p < 0.001). Over time, these agreements became more common although 49.3% of couples in the sample never had a viral load agreement. As these agreements become more common, further education is required to support male couples in using them safely.

Keywords

Gay men
HIV prevention
Homosexual
Men who have sex with men
Risk reduction strategies
Serodiscordant couples
Sexual behavior

Publisher

Springer

Citation

GRAY, James et al. Characteristics of Agreements to have Condomless Anal Intercourse in the Presence of an Undetectable Viral Load Among HIV Serodiscordant Male Couples in Australia, Brazil and Thailand. AIDS and Behavior, v. 25, n. 12, p. 3944-3954, 2021.

DOI

10.1007/s10461-021-03324-7

ISSN

1090-7165

Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/50483

Type

Copyright

Restricted access

Sustainable Development Goals

Collections

Share

Statistics

Metadata

Author

Affilliation