12th Annual Conference of the British HIV Association 29 March–1 April 2006, Brighton, UK

INTENTIONAL AND UNINTENTIONAL UAI AMONG GAY MEN WHO HIV TEST IN THE UK: QUALITATIVE RESULTS FROM AN INVESTIGATION INTO RISK FACTORS FOR SEROCONVERSION AMONG GAY MEN WHO HIV TEST (INSIGHT)

HIV Med 2006; 7(Suppl. 1):7 (abstract no. O27)

Gillian Elam¹, Neil Macdonald¹, Kevin Fenton¹, Vicky Gilbart¹, Ford Hickson², John Imrie³, Christine McGarrigle¹, Robert Power³ and Barry Evans^1
1 Health Protection Agency Centre for Infections, ² Sigma Research, ³ Royal Free and University College London, London, UK

OBJECTIVES: Recently acquired HIV infections among gay men continue to be diagnosed in the UK whilst behavioural studies show increases in risk behaviour. INSIGHT combines qualitative and quantitative methods to understand risk factors for recently acquired infections in men who are tested for HIV.

METHODS: In-depth interviews exploring the context of sero-conversion were conducted among 48 respondents to the case-control survey (CCS) of men who had recently tested positive (cases) or negative (controls), having previously tested negative. Purposive selection ensured diversity in socioeconomic and behavioural characteristics. Analysis was conducted with the aid of Framework.

RESULTS: Results from the CCS show that unprotected anal intercourse (UAI) remains the predominant mode of HIV acquisition. Narratives of sexual behaviour demonstrate that among cases and controls, UAI with a partner of sero-discordant (sd) or unknown HIV status can be an intentional decision in sexual relationships or encounters, made as a result of tradeoffs between the perceived impact of HIV infection compared to the effect of not having UAI on the quality of men’s emotional and sexual life. Unintended UAI with casual partners occurred among men who identified periods of depression, anxiety and bereavement that were coterminous with sexual compulsivity, increased use of drugs and alcohol or feeling 'out of control' in sexual encounters. Unplanned sdUAI occurred among men in relationships who believed their long-term partners were HIV negative.

CONCLUSION: Consistent condom use in casual and sero-discordant sexual encounters presents a challenge for some groups of men. Interventions are required that are responsive to these men’s circumstances and wider needs.

2006-03-29
O27

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