Trends in condom use among MSM in the United States: the role of antiretroviral therapy and seroadaptive strategies

Details

• Alternative Title:
  AIDS
• Personal Author:
  Paz-Bailey, Gabriela ; Mendoza, Maria C.B. ; Finlayson, Teresa ; Wejnert, Cyprian ; Le, Binh ; Rose, Charles ; Raymond, Henry Fisher ; Prejean, Joseph
• Corporate Authors:
  for the NHBS Study Group
• Description:
  Objective
  
  Evaluate changes in condomless anal sex at last sex among men who have sex with men (MSM) and assess if these changes are associated with the adoption of serosorting and biomedical prevention.
  
  Design
  
  The National HIV Behavioral Surveillance is a crosssectional survey done in up to 21 cities in 2005, 2008, 2011 and 2014.
  
  Methods
  
  MSM were recruited through venue-based sampling. Among men reporting at least one male partner, we evaluated changes in condomless anal sex at last sex with a partner with (1) HIV-concordant (proxy for serosorting) or (2) HIV-discordant (discordant/unknown) status. We hypothesized that if concordant condomless sex was increasing while discordant was stable/declining, the increases could be driven by more men attempting to serosort. We used generalized estimating equations assuming a Poisson distribution and robust variance estimator to explore whether temporal changes in the outcomes varied by selected characteristics. We also assessed changes in condomless anal sex by antiretroviral therapy (ART) use among HIV-positive MSM.
  
  Results
  
  Among 5371 HIV-positive MSM, there were increases in concordant (19% in 2005 to 25% in 2014, P < 0.001) and discordant condomless sex (15 to 19%, P < 0.001). The increases were not different by ART use. Among 30 547 HIV-negative MSM, concordant (21 to 27%, P < 0.001) and discordant condomless sex (8 to 13%, P < 0.001) increased.
  
  Conclusion
  
  Our data suggest that condom use decreased among MSM and that the trends are not explained by serosorting or ART. Promotion of condoms and increased access to preexposure prophylaxis are vital to ensure that the benefits of ART in reducing transmission of HIV are not undermined.
  
  
• Subjects:
  Adolescent Adult Anti-Retroviral Agents Article Condoms Disease Transmission, Infectious HIV Infections Homosexuality, Male Humans Male Middle Aged Sexual Behavior Surveys And Questionnaires Young Adult

  More +
• Source:
  AIDS. 30(12):1985-1990.
• Pubmed ID:
  27149088
• Pubmed Central ID:
  PMC5838316
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  30
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:21ff2f3e3a209a6e65616749dd9c656904fff115052e667ccf6aac454cad1536
• Download URL:
  https://stacks.cdc.gov/view/cdc/52375/cdc_52375_DS1.pdf
• File Type:
  [PDF - 103.59 KB ]