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Some MSM Think Meds Prevent HIV Transmission
by GayHealth Staff

Gay men may be more likely to have unsafe sex with HIV-positive partners who take HIV medications as opposed to those who donít, according to research.

"There were differences in the way people perceived risk of infection, and these differences can definitely lead to risky behavior," lead author of the study Dr. Troy P. Suarez, director of scientific services at MediSolutions, a New York City medical education company, told Reuters Health.
Viral loads often "blip" up -- even in people who are faithfully taking their medication and have steadily undetectable readings.
Researchers surveyed 472 HIV-negative men at a gay pride festival. Participants were asked how risky they think different sexual behaviors are including unprotected sex with men who were either HIV positive and taking antiviral medications with undetectable viral loads, or HIV positive and not taking medications. They were also asked about sex with HIV negative men and men whose HIV status was unknown.

Men were likely to say that unprotected anal sex with a man who was taking antiviral medications was less risky than sex with a man with HIV who was not taking antiviral medications. The findings were published in the Journal of Acquired Immune Deficiency Syndromes.

A similar study published in the November issue of the Annals of Behavioral Medicine found MSM more likely to have unprotected anal sex if they think antiviral medications reduce risk of HIV.

Researchers from the Arizona State University analyzed the responses of 575 gay and bisexual men from Phoenix, Arizona. According to the study authors, the transmission perceptions, "appear to be central to understanding the HIV-related sexual risk behavior of gay and bisexual men."

Gay and bisexual men who thought antiviral medications reduced the risk of HIV transmission were 30 percent more likely to have unprotected anal casual sex. They were also less likely to report the intention of using condoms for receptive anal sex. In addition, men with HIV who believed this were more than twice as likely as their peers to engage in unprotected insertive anal sex.

"There is no doubt that a lower viral load corresponds to less risk. But we also know that viral loads often "blip" up -- even in people who are faithfully taking their medication and have steadily undetectable readings," said Susan C. Ball, M.D., M.P.H., assistant director of the Birnbaum Unit HIV Care Center at New York Presbyterian Hospital, in November. "Out of the blue they will have a low but detectable viral load and then be undetectable once again." The problem is you can't ever know when a "blip" is going to occur and this should be of concern when one is thinking of having unsafe sex, she added.

Unsafe receptive sex has the highest incidences of viral transmission, explained Dr. Ball. "No doctor would counsel someone and say that unprotected sex is safe. I tell patients that it only takes one virus. In people having unsafe sex with someone who is on medication, that one virus may be a resistant virus and while HIV is no fun either way you put it, having a resistant virus makes finding an effective regimen all the more difficult."

Updated: Wednesday, January 16th 2002


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