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The risk for transmitting HIV from an infected partner to an uninfected partner through unprotected insertive anal intercourse UIAI is greater than riskj risk for transmission through receptive anal intercourse or oral sex 2. Differences in sexual risk behavior might be associated with the perceived HIV serostatus of the partner i. This report describes insertive anal intercourse practices reported by these MSM; findings indicated that a large percentage of HIV-positive MSM were sexually abstinent, practiced safer sexual behavior by having protected insertive anal intercourse, or had UIAI with an HIV-positive partner.
Questionnaire modules included questions on demographics, drug use, sexual behavior, HIV testing and medical therapy, and use of health and social services. For sexually active MSM, insertive anal intercourse and condom use at last sexual encounter were compared by serostatus of the partner. Questions on sexual behavior were specific to the last sexual encounter with the most recent partner.
The median of male sex partners during this period was two range: one to sex partners. riskg
Data on sexual risk behavior were available for 1, MSM, who were categorized into two mutually exclusive groups based on the relationship of the sex partner s : those who reported having only a steady partner i. Peerson anal intercourse at last sexual encounter was ificantly less likely with HIV-negative partners and partners of unknown serostatus than with HIV-positive partners Table 2.
Editorial Note:. Among sexually active MSM, anal sex was less common than oral sex.
Insertive anal intercourse was ificantly less likely with HIV-negative partners or unknown serostatus partners, compared with HIV-positive partners. Condom use for insertive anal intercourse was ificantly higher dex HIV-negative partners than with HIV-positive partners. Abstinence or sexual behaviors with a lower risk for transmitting HIV e.
The assumption by HIV-positive MSM that partners of unknown serostatus are seroconcordant might be inaccurate, resulting in high-risk behavior with partners who are HIV negative. Recent outbreaks of sexually transmitted diseases STDs among MSM, including many who were HIV positive 6indicate a possible resurgence of high-risk sexual behavior in this population.
One key strategy is to prevent new HIV infections by helping persons with HIV and their partners reduce risk behavior and maintain behavior change. Current guidelines recommend routine provider-delivered prevention messages and STD screening for persons who are HIV unonown 8. For those persons who have difficulty initiating and sustaining safer behaviors e.
The findings in this report are subject to at least four limitations. Second, data on sexual behaviors were self-reported and persn to recall and desirability biases.
No assessment was conducted of how participants determined the serostatus of their most recent male sex partner or whether the participants had disclosed their own HIV-positive status to their sex partners. Third, the analysis was limited to UIAI with male partners and did not examine differences in receptive anal intercourse or oral sex behaviors with a lower per-episode risk for transmitting HIV [ 2 ] by partner type or serostatus.
Peraon, behavioral data were available for only the most recent sexual encounter with the most recent partner and did not include information about motivations for behavior e. Sexual behaviors and risk-reduction strategies of HIV-positive MSM are complex and dependent on many factors, including partner relationship and perceived serostatus. To stop HIV transmission, public health authorities and health-care providers must provide effective HIV-prevention activities to those who continue to demonstrate risk behaviors.
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Per-contact risk of human immunodeficiency virus transmission between male sexual partners. Am J Epidemiol ; Differences in sexual behavior among HIV discordant and concordant gay men in primary relationships. Am J Public Unkhown ; Public Health Rep ; Suppl 1 Outbreak of syphilis among men who have sex with menSouthern California, MMWR ; MMWR ;52 No. Advancing HIV prevention: interim guidance for selected interventions Am J Prev Persoh ; Table 1 Return to top.
Table 2 Return to top.