CDC: Unsafe Sex Common for HIV+ Men
After HIV Infection, 35% of Men Who Have Sex with Men Continue Unsafe Sex
Dec. 3, 2007 -- Even after learning they have HIV,
more than 35% men who have sex with men continue to have unsafe sex.
The finding, reported at the CDC's 2007 National HIV Prevention Conference,
points to a big hole in what CDC AIDS chief Kevin Fenton, MD, PhD, calls
"the key element of our HIV prevention strategy" -- HIV testing.
"Research shows that those who do not know they are infected are more
likely to engage in HIV risk behavior," Fenton said at a conference news
briefing, noting that 20% of HIV-infected Americans don't know they're carrying
the AIDS virus.
Nearly two-thirds of men who have sex with men -- MSM -- do change their
behavior. But as researchers finally begin to get a closer focus on the exact
risk behaviors of HIV-positive men, troubling findings are emerging.
"Recent data suggest only one in five MSM have been reached by intensive
HIV programs. This is 26 years into the epidemic, so we do have some way to go
in targeting preventions," Fenton said.
"The scale of HIV prevention efforts is not at the critical mass to make
the impact that is needed," Robert Janssen, MD, director of the CDC's
division of HIV/AIDS prevention, said at the news conference. "My
understanding is that state and federal budgets [for preventing sexually
transmitted diseases] are stable, which means they are eroding over time. What
we can do is provide the best data on the gaps that need to be
That gap became apparent in several conference reports highlighted at the
35% of HIV+ MSM Have Unsafe Sex
Fenton pointed to a study by CDC researcher Nicole Crepaz, PhD and
colleagues, which analyzed data from 27 studies including more than 10,000 MSM
who knew they carried HIV.
More than one in three of these men -- 35% -- reported recent unsafe sex
(anal or vaginal intercourse without a condom).
That's very close to the 37% of Boston-area HIV positive MSM who reported
unprotected anal intercourse in a conference report by Kenneth Mayer, MD,
medical director of Boston's Fenway Community Health.
This behavior was not entirely irresponsible. More than 30% of these men in
the Crepaz study and more than 41% in the Mayer study had unprotected sex only
with partners already infected with HIV.
This practice, called serosorting, is not truly safe. While it does prevent
infection of uninfected partners, the practice spreads sexually transmitted
diseases such as syphilis and gonorrhea. And
even though a person already has HIV, that person can still catch a second,
potentially more dangerous HIV strain.
One in 10 HIV-positive men in the Crepaz study and 23% of the HIV-positive
men in the Mayer study reported unsafe sex with partners they knew to be
HIV-negative. This suggests that men who know they carry HIV are less likely to
have unprotected sex with uninfected partners if these partners have had a
recent HIV test.