Settings, Sexual Practices, and Personal HIV Protection Strategies: The Circumstances of Recent HIV Infections in Switzerland

Abstract

The authors investigated the circumstances of recent HIV infections in Switzerland. Their aim was to identify the interactions between individuals’ personal HIV protection strategies, their actual risk behavior, and situational factors during the high-risk event. Semi-structured interviews were conducted with 32 recently infected persons aged 21–64. Data analysis followed the principles of Grounded Theory. Interviews revealed that respondents adopted the safer sex strategy, risk reduction strategies, a priori ineffective HIV protection strategies, and alternating HIV protection strategies. Some, however, adopted no explicit protection strategy. Risk reduction strategies mirrored discourses circulating within men who have sex with men subcultures as well as messages about noninfectiousness while on treatment. Safer sex had failed due to situational or relational factors. In the case of the other strategies, infections resulted from the risk inherent in these strategies. Results show the influence of discourses about risk reduction strategies and noninfectiousness under antiretroviral treatment on personal HIV protection strategies.

KEYWORDS:

• HIV-related risk behaviors
• sexual risk-taking
• HIV prevention
• qualitative research
• Europe

ACKNOWLEDGMENTS

First, we thank the interviewees for participating in this study and for disclosing their personal HIV protection strategies and paths to HIV infection. We gratefully acknowledge the contributions of the Swiss confirming laboratories and the physicians involved in the recruitment of survey participants. Our thanks go to Claudia Ballerini, Daniel Goldberg, Flavia Juri, Eveline Odermatt, and Andreas Pfister for assistance with interviewing, transcription, and research. We thank Matthias Wentzlaff-Eggebert and Mark Kyburz for editing and copyediting this manuscript. Finally, we thank the Federal Office of Public Health, Berne, Switzerland, for its financial assistance.