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Sustained Reduction in Sexual Behavior that May Pose a Risk of HIV Transmission Following Diagnosis During Early HIV Infection Among Gay Men in Vancouver, British Columbia

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Abstract

Increased viral load during early HIV infection (EHI) disproportionately contributes to HIV transmission among gay men. We examined changes in sexual behavior that may pose a risk of HIV transmission (condomless anal sex (AS) with a serodiscordant or unknown status partner, CAS-SDU) in a cohort of 25 gay men newly diagnosed during EHI who provided information on 241 sexual partners at six time points following diagnosis. Twenty-two (88%) participants reported ≥1 AS partner (median time to first AS 80 days) and 12 (55%) reported ≥1 partnership involving CAS-SDU (median 116 days). In hierarchical generalized linear mixed effects models, AS was significantly less likely in all time periods following diagnosis and more likely with serodiscordant partners. The likelihood of CAS-SDU decreased three months after diagnosis and was higher in recently versus acutely infected participants. Most men in our study abstained from sex immediately after diagnosis with sustained longer-term reduction in CAS-SDU, confirming the importance of timely diagnosis during EHI.

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Acknowledgements

The authors would like to acknowledge the contributions of Dr. Richard Rothenberg for informing the design of the study and interpretation of study findings, and to Guillaume Colley, BC Centre for Excellence in HIV/AIDS and Theodora Consolacion, BC Centre for Disease Control for their assistance in accessing provincial data sources.

Funding

This study was supported by the Canadian Institutes of Health Research (CIHR), FRN: HET-85520.

Author information

Authors and Affiliations

  1. BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada

    Mark Gilbert, Robert Balshaw & David Patrick

  2. School of Population and Public Health, University of British Columbia, Vancouver, Canada

    Mark Gilbert, Warren Michelow, David Patrick, Gina Ogilvie & Michael Rekart

  3. School of Nursing, University of British Columbia Okanagan, Kelowna, Canada

    Darlene Taylor

  4. Women’s Health Research Institute, Vancouver, Canada

    Darlene Taylor & Gina Ogilvie

  5. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

    Daniel Grace

  6. Department of Statistics, University of British Columbia, Vancouver, Canada

    Robert Balshaw & Daniel Coombs

  7. CATIE, Toronto, Canada

    Michael Kwag

  8. Positive Living Society of British Columbia, Vancouver, Canada

    Elgin Lim

  9. Centre for Addiction and Mental Health, Toronto, Canada

    Benedikt Fischer

  10. Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada

    Malcolm Steinberg

Authors
  1. Mark Gilbert
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  2. Darlene Taylor
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  3. Warren Michelow
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  4. Daniel Grace
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  5. Robert Balshaw
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  6. Michael Kwag
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  7. Elgin Lim
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  8. Benedikt Fischer
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  9. David Patrick
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  10. Gina Ogilvie
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  11. Daniel Coombs
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  12. Malcolm Steinberg
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  13. Michael Rekart
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Corresponding author

Correspondence to Mark Gilbert.

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Conflict of interest

The authors declare they have no conflict of interest.

Ethical Approval

All procedures performed involving human participants were in accordance with the ethical standards of the University of British Columbia research ethics board which approved this study, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Gilbert, M., Taylor, D., Michelow, W. et al. Sustained Reduction in Sexual Behavior that May Pose a Risk of HIV Transmission Following Diagnosis During Early HIV Infection Among Gay Men in Vancouver, British Columbia. AIDS Behav 22, 2068–2078 (2018). https://doi.org/10.1007/s10461-017-1702-0

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  • DOI: https://doi.org/10.1007/s10461-017-1702-0

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