Men who have sex with men (MSM) diagnosed in the acute phase of HIV infection have an increased number of recent sexual partners and more than sex without condoms among MSM diagnosed with chronic HIV infection, according to research published in the onlineJournal of Infectious Diseases. The study was conducted in Los Angeles. Men with acute HIV infection have twice the recent sexual partners and were also more likely to have sex without condom insertive, receptive and anal sex than men with a longer time of infection.
"Our data show an increased risk behaviors among MSM with acute infection," comment the researchers.
Viral load is therefore potential power infectivity because it is especially high in the acute phase of HIV infection.
But an article published in an earlier issue of the journal found that acute infection and early stages of HIV infection are short (three seven weeks, respectively)
and do not require special interventions to control the HIV epidemic in most settings.
Researchers in Los Angeles were convinced by this statement. Therefore designed an analytical study of sexual risk MSM recently diagnosed with HIV behavior between 2011 and 2015 in LA LGBT Center.
A total of 912 MSM were newly diagnosed with HIV during the study period. Of these, 145 (16%) had acute infection (defined as a test for the nucleic acid amplification of HIV - NAAT rule - but a text negative HIV antibody). The other 767 MSM had no acute infection.
Newly diagnosed provided information about their sexual activity in the three months prior to their diagnosis, including total number of sexual partners and occurrence of anal sex without a condom.
MSM with acute infection had twice the number of sexual partners in the last thirty days (average 4,2 against a median of 2) and three months (mean 9,9 and median 4) before their diagnosis, compared to men with chronic infection ( average 2.4, median, 4, three months = 5.3 average, median, 2; p <0,001).
Moreover, in the three months prior to diagnosis, unprotected receptive anal sex was more common among men with acute infection (65%) than men with chronic infection (56%, p <0,05). Men with acute infection were also reported more cases of insertive anal sex without a condom in this period of three months (vs 55 50%).
"In our cohort MSM demonstrated that acute HIV infection have almost 2 times the number of sexual partners during the last thirty days and 3 months when viremia is the highest. In addition, the men are more likely to have intercourse without protection receptive and insertive anal intercourse, the researchers concluded. "They argue that there is an urgent need to promote actions aimed at MSM to diagnose acute infections, even at a higher cost to reach them with interventions and early treatment to halt the onward transmission of HIV."
Published: 28 2016 in April Aidsmap
reviewed by Bob Volpe
J Davey et al.Sexual behavior in the acute phase of HIV infection among men who have sex with men in Los Angeles, California. J infect Dis. online edition, 2016
Suthar AB et al.acute and programmatic implications early HIV infection. J infect Dis, 212: 1351-