HIV-Positive Men Sexually Active with Women: Sexual Behaviors and Sexual Risks

Aidala, Angela A.; Lee, Gunjeong; Howard, Joyce Moon; Cabán, María; Abramson, David M.; Messeri, Peter

doi:10.1007/s11524-006-9074-1

Cited by 24 publications

(21 citation statements)

References 54 publications

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“…There is evidence that HIVpositive Black MSW may have high rates of unprotected sex. A recent study found that 38% of HIV-positive Black MSW reported having unprotected sex with female partners (Aidala et al, 2006). Similar findings have been observed in other studies (Buchacz et al, 2001;Purcell et al, 2006).…”

Section: Introductionsupporting

confidence: 80%

Sexual Risk Behaviors of HIV-Positive, HIV-Negative, and Serostatus-Unknown Black Men Who Have Sex with Men and Women

et al. 2008

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Black men who have sex with men and women (MSMW) are at high risk for HIV infection and transmission. This study compared the sexual risk behaviors of Black MSMW who self-reported being HIV-positive with those who reported being HIV-negative and those who did not know their HIV status. Respondent-driven sampling (RDS) was used to recruit 1,154 Black MSM in Philadelphia and New York who completed an audio computer-assisted self-interview (ACASI). Of these men, 212 had engaged in anal sex with male partners and vaginal or anal sex with female partners in the past 3 months. A quarter (23.6%; n = 50) of MSMW self-reported testing positive for HIV at their last test, 59.4% (n = 126) reported testing negative for HIV at their last test, and 17.0% (n = 36) reported never having an HIV test. Multivariate logistic regression analysis revealed that HIV-positive MSMW were much less likely than HIV-negative men and never-tested men to have engaged in unprotected intercourse with main male and main female partners perceived to be HIV-negative or of unknown serostatus. However, HIV-positive men were equally as likely as HIV-negative men to have unprotected intercourse with non-main male and non-main female partners perceived as HIV-negative or of unknown serostatus. Our findings indicate that some HIV-positive MSMW engage in unprotected sex that places female and male partners at risk for HIV infection. However, MSMW who have never taken an HIV test, or who have not been recently tested, may be a greater source of HIV transmission to their female and male partners.

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Section: Introductionsupporting

confidence: 80%

Sexual Risk Behaviors of HIV-Positive, HIV-Negative, and Serostatus-Unknown Black Men Who Have Sex with Men and Women

et al. 2008

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“…Less is known about unsafe sex among HIV-positive men who have sex with women (MSW). Some variables that have been found as associated factors are to be in a stable relationship, to be young, to exchange sex for money, to have multiple sexual partners, serosorting, to be on cART for more than 6 months, and to have an undetectable viral load (Aidala et al, 2006;Golin et al, 2009;Seng et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Unprotected Sexual Practices Among Men Who Have Sex with Women and Men Who Have Sex with Men Living with HIV/AIDS in Rio de Janeiro

et al. 2014

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Combined antiretroviral therapy is now acknowledged for preventing new HIV infections, besides decreasing mortality and morbidity. However, in many Latin America countries the epidemic is still driven by unprotected sexual intercourse. This study aims to describe sexual practices related to HIV/STD and to evaluate factors associated to unprotected sex among men who have sex with women (MSW) and men who have sex with men (MSM) under care at a reference center for HIV in Rio de Janeiro, Brazil. A cross-sectional study, nested in a Brazilian clinical cohort, evaluated the sexual practices of 404 sexually active HIV-positive MSW and men who have MSM. Approximately 30 % of them reported unprotected sexual practices during the 6 months prior to the interview. Most frequent risky practices reported were unprotected vaginal sex among MSW and unprotected receptive anal sex among MSM. Factors increasing the chance of unprotected sexual practices among MSW were the partner's desire of becoming pregnant (OR 2.81; CI 95 %: 1.36-5.95). To have received comments about excessive consumption of alcohol (OR 2.43; CI 95 %: 1.01-5.83), illicit drug use (OR 4.41; CI 95 %: 1.75-11.60) and lived in marital situation (OR 2.10; CI 95 %: 1.09-4.08) were significantly associated with unsafe sexual practices among MSM. The results highlight that health care of men living with HIV, as well as the prevention strategies, must consider the particularities of sexual behavior practiced by people who differ in sexual orientation.

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“…In regions as diverse as sub-Saharan Africa, North and South America, East Asia, the Caribbean and Europe, between 20% and 60% of sexually active serodiscordant couples have been found to practise unprotected vaginal and anal sex (Skurnick et al 1998, Van der Straten et al 1998, Buchacz et al 2001, Aidala et al 2006, Milam et al 2006, Stevens and Galvao 2007, Bradley et al 2008, Hernando et al 2009, Orengo-Aguayo and Pérez-Jiménez 2009, Reis and Gir 2009, Beyeza-Kashesya et al 2010, NIMH Multisite HIV/STD Prevention Trial for African American Couples Group 2010, Lau et al 2012). According to recent data from India, only 6% of serodiscordant couples used condoms consistently (Saggurti andMalviya 2009, UNAIDS 2009), a figure that raises the question of whether unprotected sex might be underreported by couples in other regions due to perceived social unacceptability or, as a study from Uganda suggested, due to negative attitudes among health workers (BeyezaKashesya et al 2009).…”

Section: Introductionmentioning

confidence: 99%

Notes on the concepts of ‘serodiscordance’ and ‘risk’ in couples with mixed HIV status

Persson

2013

Global Public Health

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Serodiscordant primary relationships, in which one partner is HIV-positive and the other is HIV-negative, are increasingly recognised as a key context for the transmission of HIV globally. Yet insights into the dynamics of serodiscordance remain relatively limited. I argue that to understand what makes serodiscordant couples engage in sexual practices that increase the chance of transmission, we need to examine what HIV 'risk' actually means in different cultures and contexts. A 'socially situated' approach to HIV risk moves beyond its scientific conceptualisation as an objective 'fact', revealing a diversity of perceptions and competing risks. It also reveals that couples do not necessarily perceive their mixed HIV status in terms of 'difference', a common assumption that predetermines serodiscordance and thereby obscures its many and complex enactments. I draw on examples from the social research literature to illustrate how serodiscordance is shaped in different ways by local practices, priorities, and meanings. I argue that it is within these lived contexts that perceptions and negotiations of 'risk' arise and, thus, where couples' sexual practices need to be situated and understood. Such insights are timely as HIV research and prevention grapple with emerging scientific data that challenge traditional understandings about HIV transmission risk.

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HIV-Positive Men Sexually Active with Women: Sexual Behaviors and Sexual Risks

Cited by 24 publications

References 54 publications

Sexual Risk Behaviors of HIV-Positive, HIV-Negative, and Serostatus-Unknown Black Men Who Have Sex with Men and Women

Sexual Risk Behaviors of HIV-Positive, HIV-Negative, and Serostatus-Unknown Black Men Who Have Sex with Men and Women

Unprotected Sexual Practices Among Men Who Have Sex with Women and Men Who Have Sex with Men Living with HIV/AIDS in Rio de Janeiro

Notes on the concepts of ‘serodiscordance’ and ‘risk’ in couples with mixed HIV status

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