If I told you I had a secret way to get gay guys to stop having unprotected sex, and put down the meth long enough to realize the half dozen guys screwing them weren’t wearing condoms, would you be thrilled? How about if I told you the super secret way is to get them infected with HIV?
In the short term, learning you’re HIV-positive is enough to get you to cut down on the number of guys you’re having sex with, new findings published in the Journal of Acquired Immune Deficiency Syndromes claim. Looking at 193 men recently infected with HIV, researchers learned:
There was a reduction in the number of reported sex partners, and in the first few months after diagnosis there was a reduction in unprotected sex with HIV-negative partners or men of unknown HIV status. Rates of reported methamphetamine use fell, but still remained high. There was no evidence that individuals were using viral load to guide their decisions about unprotected sex.
“Our findings demonstrate how sexual behaviours, partnership status, substance abuse and partner choices of MSM [men who have sex with men] with recent HIV infection changed during the first year following diagnosis,” write the investigators. Gay and other men who have sex with men continue to be a main focus of the HIV epidemic in industrialised countries such as the US. Recent research suggests that between 25 and 50% of all new infections originate in individuals who have been recently infected with the virus.
[...] At baseline, the men reported a mean of nine sex partners in the previous three months. This fell to a mean of seven partners in the three months after their diagnosis, and there was a further slight fall at twelve months (mean, six partners).
Except once the novelty of being infected wears off, it seems men who have sex with men (MSM) return to their same old habits. And sometimes go at it ever harder.
The proportion of men who reported a main partner increased from 20% at baseline to 48% at the end of the study. This increase was significant (p < 0.001). Almost half (46%) of men reported unprotected sex with a recent partner at the beginning of the study. This fell to 39% after nine months, but then increased sharply to 57% at the end of the study. There was some evidence that men were serosorting, At baseline, 14% reported having a partner who was HIV-positive, and this increased to 33% at month three and 39% at the end of the study. The proportion of men reporting recent unprotected sex with an HIV-negative partner, or man of unknown status, fell from 42% at baseline to 23% at month nine. However, the proportion increased to 50% at month twelve.
And what about the drugs?
Methamphetamine use was widespread. At baseline, 30% reported using the drug during their last sexual encounter. This fell to 11% at month three and remained steady for the rest of the study. However, over the twelve months of the study, the proportion of methamphetamine users reporting risky sex increased significantly (p = 0.05).
So: In the immediate, HIV is an effective deterrent against unprotected sex, which of course protects other people but does little for the HIV health of the subject (I mean, he’s already got the virus). But once men come to terms with their poz status, it’s back to tricks. Wonderful.