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HIV & AIDS Health Center

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CDC: Unsafe Sex Common for HIV+ Men

After HIV Infection, 35% of Men Who Have Sex with Men Continue Unsafe Sex

35% of HIV+ MSM Have Unsafe Sex continued...

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.

On the other hand, men seem to behave badly with men they meet on the Internet than they do when they meet at bars or gay-oriented events. Nearly two-thirds of MSM recruited online reported recent unsafe sex in the Crepaz study.

And the Mayer team found that men who reported substance use -- particularly methamphetamines -- were three times more likely to have a sexually transmitted disease (syphilis in nearly 80% of cases).

"This study really underscores the continued need for positive protection methods for men," Fenton said.

Fenton also called attention to a troubling study by CDC researcher Kate Buchacz, PhD, MPH, and colleagues.

The Buchacz study showed that half of MSM diagnosed with syphilis at STD clinics in three major cities -- Atlanta, San Francisco, and Los Angeles -- were also infected with HIV.

Each year, studies suggest, 3% to 4% of U.S. MSM get HIV. But Buchacz and colleagues found that more than 10% of men with syphilis infections had recent HIV infections, too.

"Syphilis in the U.S. is overwhelmingly concentrated in MSM," Fenton said. "This demonstrates the need for routine HIV testing and investigation of HIV-positive men for syphilis infection."

African-American MSM: Surprising New Data

The U.S. HIV epidemic first appeared among MSM -- and almost half of U.S. HIV infections are among MSM.

But America's HIV epidemic is vastly worse for African Americans than for any other racial or ethnic group. Half of U.S. HIV infections are among African Americans. And African-American men are seven times more likely to have HIV than white men are.

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