Behavior change following HIV diagnosis: findings from a Cohort of Los Angeles MSM

ABSTRACT

The effect of an HIV diagnosis on subsequent behavior of men who have sex with men (MSM) remains unclear. From 2009 to 2012 the NIDA funded Metromates Study enrolled and followed for one year MSM seeking testing for HIV in Los Angeles, assessing those with new HIV diagnoses for acute/recent HIV infection. Behavioral data were collected via Computer-Assisted Self-Interview from 321 men of whom 125 were classified as recently HIV infected, 91 as not recently HIV infected, and 105 as HIV-negative. Differences over time between those with recent HIV infection, not recent HIV infection, and no HIV were evaluated using bivariate and multivariable analyses for repeat measures to assess associations between HIV group, behaviors and condomless receptive (CRAI), intersertive (CIAI), or any condomless anal intercourse (CAI). Participants were mostly young (59% < 30 years of age) and minority. Median number of partners reported in past year dropped significantly over time among recently infected MSM (10 to 5) and HIV negative men (5 to 3) but not for not recently HIV infected. No changes comparing baseline to follow-up were noted in reports of CAI within each HIV-group. Based on GEE multivariable analyses adjusting for age, and race/ethnicity after HIV testing recently HIV infected and not recently HIV infected men practiced more CAI within serodiscordant partnerships than HIV negative MSM: more CRAI than the HIV negatives (AOR =  4.90; 95% CI 1.80–13.29 and AOR = 5.01; 95% CI 1.77–14.16 among recently infected and not recently infected, respectively) but only more CIAI among not recently infected (AOR 3.48; 95% CI 1.31–9.24) when compared to HIV negatives. For MSM seeking HIV testing in Los Angeles at that time, there was little indication of behavior change following HIV diagnosis and continued CAI, suggesting that without rapid linkage to care and viral suppression significant transmissions may have been ongoing.

KEYWORDS:

• HIV diagnosis
• acute HIV infection
• behavior change and HIV diagnosis
• HIV transmission behaviors

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Main partner was defined for participants in the questionnaire as “Someone who is your primary and most important sexual partner such as your boyfriend/ girlfriend or wife/husband or lover.

Additional information

Funding

This work was supported by Division of Intramural Research, National Institute of Allergy and Infectious Diseases [grant number 5P30AI028697]; National Institute on Drug Abuse [grant number DA022116-01A1] [grant number U01DA036267]; National Institute of Drug Abuse [grant number U01DA036267].