Di Ciaccio M., Sagaon Teyssier Luis, Mimi M., Suzan-Monti M., Protiere C., Castro D. R., Meyer L., Tremblay C., Chidiac C., Capitant C., Preau M., Molina J. M., Spire B., ANRS IPERGAY Study Group. (2020). What are the situational and behavioral factors associated with condomless anal sex without pre-exposure prophylaxis in MSM ? [+ Erratum 2021, vol. 35, no 1, p. 163]. AIDS, 34 (9), p. 1367-1375 [+ Erratum 2021, vol. 35, no 1, p. 163]. ISSN 0269-9370.
Titre du document
What are the situational and behavioral factors associated with condomless anal sex without pre-exposure prophylaxis in MSM ? [+ Erratum 2021, vol. 35, no 1, p. 163]
Année de publication
2020
Auteurs
Di Ciaccio M., Sagaon Teyssier Luis, Mimi M., Suzan-Monti M., Protiere C., Castro D. R., Meyer L., Tremblay C., Chidiac C., Capitant C., Preau M., Molina J. M., Spire B., ANRS IPERGAY Study Group
Source
AIDS, 2020,
34 (9), p. 1367-1375 [+ Erratum 2021, vol. 35, no 1, p. 163] ISSN 0269-9370
Objective: This study aimed to identify situational and behavioral factors associated with condomless anal sex without on-demand PrEP in the open-label extension (OLE) study of the ANRS-IPERGAY trial. Methods: Univariable and multivariable modified Poisson regressions with a generalized estimating equation (GEE) were used. The attributable risk percentage for each explanatory variable and for condomless anal sex without PrEP was calculated. Results: In the OLE, 19% of anal intercourses were unprotected (i.e. no PrEP or condom). Of these, 85% were attributable to sexual intercourse with main partners and 47% with HIV-negative partners. The following factors were positively associated with condomless anal sex without PrEP: a depressive episode in the previous 12 months [aR (95% CI),P-value: 1.49 (1.02--2.17), 0.039], a higher number of sexual intercourses during the previous 4 weeks [1.01 [1.002--1.02], 0.014], and sexual intercourses under the influence of alcohol [1.45 (1.10--1.92), 0.008]. By contrast, condomless anal sex without PrEP was less frequent during sexual intercourses with known casual, unknown casual and multiple partners [0.20 (0.14--0.30), <0.001; 0.10 (0.05--0.20), <0.001; 0.11 (0.05--0.29), <0.001, respectively], as well as with HIV+ partners with an undetectable viral load and HIV+ partners with a detectable/unknown viral load or unknown serology status [0.57 (0.38--0.86), 0.007; 0.52 (0.32--0.87), 0.012, respectively]. Conclusion: Choosing to have condomless anal sex without PrEP depends primarily on the sexual partner's characteristics (level of intimacy, serological status). This reflects a form of rationality in HIV risk management. However, our results raise questions about the true efficacy of managing HIV risk using this approach.
Plan de classement
Entomologie médicale / Parasitologie / Virologie [052]
;
Santé : aspects socioculturels, économiques et politiques [056]
Description Géographique
FRANCE ; CANADA
Localisation
Fonds IRD [F B010079322]
Identifiant IRD
fdi:010079322
