AI Article Synopsis

  • The study aimed to identify and measure risk factors for HIV infection among gay men who are undergoing repeat testing at sexual health clinics.
  • Researchers conducted an unmatched case-control study in the UK, comparing 75 men who recently tested positive for HIV with 157 men who tested negative.
  • Key findings revealed that unprotected receptive anal intercourse (URAI) with partners thought to be HIV negative was a major risk factor, with increased risks linked to using nitrite inhalants and having multiple partners; it also highlighted the significant risk associated with unprotected insertive anal intercourse (UIAI).

Article Abstract

Objectives: To detect and quantify current risk factors for HIV seroconversion among gay men seeking repeat tests at sexual health clinics.

Design: Unmatched case control study conducted in London, Brighton and Manchester, UK.

Methods: 75 cases (recent HIV positive test following a negative test within the past 2 years) and 157 controls (recent HIV negative test following a previous negative test within the past 2 years) completed a computer-assisted self interview focused on sexual behaviour and lifestyle between HIV tests.

Results: Cases and controls were similar in socio-demographics, years since commencing sex with men, lifetime number of HIV tests, reasons for seeking their previous HIV tests and the interval between last HIV tests (mean = 10.5 months). Risk factors between tests included unprotected receptive anal intercourse (URAI) with partners not believed to be HIV negative (adjusted odds ratio (AOR) and 95% confidence interval 4.1, 1.8 to 9.3), where increased risk was associated with concomitant use of nitrite inhalants, receiving ejaculate and increasing numbers of partners. Independent risk was also detected for unprotected insertive anal intercourse (UIAI) with more than one man (AOR 2.7, 1.3 to 5.5) and use of nitrite inhalants (AOR 2.4, 1.1 to 5.2).

Conclusions: HIV serodiscordant unprotected anal intercourse remains the primary context for HIV transmission among gay men, with increased risk associated with being the receptive partner, receiving ejaculate and use of nitrite inhalants. Although the HIV transmission risk of URAI is widely acknowledged, this study highlights the risk of UIAI and that nitrite inhalants may be an important facilitator of transmission when HIV exposure occurs.

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http://dx.doi.org/10.1136/sti.2007.027946DOI Listing

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