Men who have sex with men (MSM) diagnosed in the acute phase of HIV infection have a higher number of recent sexual partners and more than uninhibited sex among MSM with a diagnosis of chronic HIV infection, according to research published in the issue online Journal of Infectious Diseases. The study was conducted in Los Angeles. Men with acute HIV infection have twice as many recent sexual partners and have also been more susceptible to sex without an insertive, receptive condom and anal sex than men with a longer time of infection.
"Our data demonstrate increased risk behaviors among MSM with acute infection," the researchers said.
Viral load is therefore potentially infectious, as it is especially high in the acute phase of HIV infection.
But an article published in an earlier issue of the journal concluded that acute infection and early stages of HIV infection are short-lived (three and 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. We therefore designed an analysis study of the risky sexual behavior of newly diagnosed MSM with HIV between 2011 and 2015 at the LGBT LA Center.
A total of 912 MSM were recently diagnosed with HIV during the study period. Of these, 145 (16%) had acute infection (defined as a test for HIV nucleic acid amplification - NASC rule - but a text of HIV-negative antibodies). The other 767 MSM had no acute infection.
The newly diagnosed individuals 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.
Acutely infected MSM had twice the number of sexual partners in the last 30 days (mean 4,2 vs median 2) and 3 months (mean 9,9 and median 4) prior to their diagnosis compared to men with chronic infection ( mean, 2.4, median, 4, three months = 5.3 mean, median, 2, p <0,001).
In addition, within three months before 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 also had reported more cases of anal insertive sex without condom in this period of three months (55 vs. 50%).
"In our cohort we have shown that MSM with acute HIV infection have almost 2 times the number of sexual partners in the last 30 days and 3 months when viremia is the highest. In addition, those men are more likely to have unprotected and receptive intercourse in anal intercourse, the researchers conclude. "They argue that there is an urgent need to encourage actions directed at MSM to diagnose acute infections, even at a higher cost to reach them, with interventions and early treatment to curb subsequent HIV transmission."
Posted in: 28 April 2016 in Aidsmap
reviewed by Bob Volpe
Davey J 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. Implications of acute and programmatic early HIV infection. J infect Dis, 212: 1351-