Di Ciaccio M. auteur aut IRD Sagaon Teyssier Luis auteur aut IRD Mimi M. auteur aut IRD Suzan-Monti M. auteur aut IRD Protiere C. auteur aut IRD Castro D. R. auteur aut IRD Meyer L. auteur aut IRD Tremblay C. auteur aut IRD Chidiac C. auteur aut IRD Capitant C. auteur aut IRD Preau M. auteur aut IRD Molina J. M. auteur aut IRD Spire B. auteur aut IRD ANRS IPERGAY Study Group auteur aut IRD text journalArticle eng text/pdf born digital access 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. specialized ANRS-IPERGAY condom MSM on-demand pre-exposure prophylaxis unprotected anal intercourse FRANCE CANADA 052 056 34 9 1367-1375 [+ Erratum 2021, vol. 35, no 1, p. 163] 2020 0269-9370 https://www.documentation.ird.fr/hor/fdi:010079322 10.1097/qad.0000000000002542 0269-9370 [F B010079322] https://www.documentation.ird.fr/hor/fdi:010079322 https://www.documentation.ird.fr/intranet/publi/2020/08/010079322.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2020-09-17 2025-02-24 fdi:010079322 fre