HIV: seroconversion tied to reduced risky behavior among MSM

  • Zhu W & al.
  • AIDS
  • 27 Jan 2019

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Improved treatment access and use lead to reduced risk engagement after HIV seroconversion in men who have sex with men (MSM).

Why this matters

  • Continued investment in HIV care linkage/care continuum is essential to reduce specific risky behavior in HIV-infected persons generally, and in MSM specifically.

Key results

  • 558 MSM seroconversions.
  • HIV seroconversion associated with reduced odds of risky behavior, including: 1) subsequent engagement of sex with >2 partners (aOR, 0.371; 95% CI, 0.263-0.523), 2) insertive anal sex with >2 partners (aOR, 0.360; 95% CI, 0.219-0.591), 3) heavy drinking (aOR, 0.704; 95% CI, 0.508-0.977).
  • Post-1996 highly active antiretroviral therapy (HAART) seroconversions linked to further reduced odds of insertive anal sex with >2 partners (aOR, 0.219; 95% CI, 0.121-0.398) vs pre-1996 (aOR, 0.411; 95% CI, 0.241-0.703).
  • Post-HIV treatment seroconversion associated with further reduced odds of any sex with >2 partners (aOR, 0.239; 95% CI, 0.157-0.364) in post- vs pre-1996 (aOR, 0.392; 95% CI, 0.276-0.557).

Study design

  • Prospective cohort evaluating the association of HIV seroconversion, treatment with subsequent health behaviors during US HAART expansion.
  • Funding: National Institute on Drug Abuse.

Limitations

  • Racial/ethnic minority under-representation.
  • Data precede "treatment as prevention."
  • Reporting bias, subjective responses.
  • No comparison of long-term vs newly infected.

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