13th International AIDS Conference Durban, South Africa - July 9-July 14, 2000

Int Conf AIDS 2000 Jul 9-14; 13:62 (abstract no.. LBPeD7111)

Hassad R;;; UCLA, Family Studies Unit, New York Office, NY 10038. Fax: +1 212-233-4690, E-mail: rhassad@ucla.edu.

INTRODUCTION: Early in the HIV epidemic, receptive anogenital sex was explored and conclusively documented as an independent risk factor for HIV infection. This emphasis on receptive anal sex triggered a shift in sexual practices to primarily orogenital. The objective of this analysis was to explore the role of genital ulcers and number of sex partners in HIV transmission among gay men who reported insertive orogenital sex in the past year.

METHODS: Data were obtained from a cross-sectional study of 107 gay men from Jamaica. In addition to self-reported sexual behavior, a blood sample was taken and tested for HIV antibodies. To obtain a more stable profile of sexual behavior within specific time frames, self-report of previous HIV testing was assessed as a possible confounder, as current and recent behaviors could have resulted from knowledge of HIV status.

RESULTS: The HIV sero-prevalence was 31%. Subjects with a history of insertive anogenital, and orogenital sex were more likely to report twice the number of male sex partners than those with no such history (p<.5). Among subjects who reported insertive orogenital sex in the past year (n=77), logistic regression analysis identified "report of genital ulcer in the past year" (OR =10.4, 95%Cl = 2.8 - 39.6) as the sole independent predictor of HIV seropositivity. Atiogenital and receptive oral sex variables were included in the model. Discussion: These findings strongly suggest a biological interaction between insertive orogenital sex and genital ulcer, that carries a high risk of HIV infection. In addition there is evidence of a sociological interaction between insertive sex and higher number of male sex partners, with an increased likelihood of HIV infection. These should be further explored with a larger sample. Psychosocial research is needed to better understand insertive sex behavior, and facilitate the development of targeted cognitive behavioral risk reduction interventions.

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