AEGiS-15IAC: The perceived viral load level, and not the actual viral load, is a predictor for risky sex with steady partners among HIV-infected homosexual men.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

The perceived viral load level, and not the actual viral load, is a predictor for risky sex with steady partners among HIV-infected homosexual men.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WeOrC1334)

Stolte IG, de Wit JB, van Eeden A, Coutinho RA, Dukers NH
Municipal Health Service, Cluster of infectious diseases, HIV&STI research, Amsterdam, Netherlands

BACKGROUND: A previous study found that the HAART-related belief 'perceiving less HIV/AIDS threat since HAART' is associated with a switch to risky sex with casual partners (CP) among HIV-negative homosexual men (HM). We now prospectively studied the influence of HAART-related beliefs (HB), and the perceived viral load level (PVL) and CD4 cell count (PCD4) on risky sex (unprotected anal intercourse) among HIV-infected HM, and investigated time trends in risky sex.

METHODS: Fifty-seven HIV-infected HM (mean age 45 years), regularly visiting an HIV/AIDS treatment centre in Amsterdam, were interviewed in three subsequent data waves (2000-2003). Gathered data included socio-demographics, sexual behaviour, HB (perceiving less HIV/AIDS threat, perceiving lower risk of HIV transmission, perceiving less need for safe sex), PVL and PCD4, as well as the actual viral load level (VL) and CD4 cell count (CD4). Logistic regression, correcting for repeated measurements, was used to assess time trends in ri sky sex, and the effect of prior HB, PVL, PCD4, VL, and CD4 on risky sex. Analyses were done separately for risky sex with CP, and steady partners whose HIV-status is negative or unknown (SP).

RESULTS: Risky sex with CP increased over time (2000-2003) from 16% to 33% (p<.01), but remained stable with SP. HM who perceived their viral load level as more favourable, were more likely to engage in risky sex with SP (OR: 5.8 [95%CI:2.4-13.9]); this was independent of the actual VL and CD4, which were not associated. For risky sex with CP no significant predictors were found. Conclusion Risky sex with CP increased in this group of HIV-infected HM. The perceived viral load, but not the actual viral load, seems to be predictive for risky sex with SP. Given the rising share of SP in HIV transmission, prevention in this group remains important. Results indicate that addressing patients' viral load perceptions, when discussing the actual viral load level, might help prevent risky sex with an HIV-negative or status-unknown SP.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Viral Load, HIV Seropositivity, Homosexuality, Unsafe Sex, Antiretroviral Therapy, Highly Active, Sexual Behavior, Coitus, CD4 Lymphocyte Count, Safe Sex, Humans, Male

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