Gay men in Sydney who only have unprotected anal intercourse as part of a risk reduction strategy such as serosorting or negotiated safety have a considerably lower risk of acquiring HIV than men who have unprotected sex in other ways, report Australian researchers in the January 14th issue of AIDS.
Men who have unprotected anal intercourse only as the insertive partner, and those who ensure that their partner withdraws before ejaculation, also had a lower risk of acquiring HIV than men who don't employ any form of risk reduction strategy when they have unprotected anal intercourse.
Taken together, men using any of these practices were three times more likely to acquire HIV than men who had no unprotected anal intercourse (UAI). However men who practiced UAI without any of these safeguards were almost eleven times more likely than men having no UAI to acquire HIV.
Moreover, withdrawal before ejaculation was the riskiest practice studied. It was associated with a five fold increase in the risk of infection (compared to no UAI).
These strategies have been used by gay men for many years and some scientists consider them to be biologically plausible, but until now there has been limited evidence on their effectiveness in the real world. One important study came in 2007 when Fengyi Jin reported that a third of Australian gay seroconverters had tried to employ a risk reduction strategy.
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Tuesday, January 20, 2009
Risk reduction strategies are safer for Sydney gay men than other unprotected sex practices - but less safe than consistent condom use
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