Antiretroviral therapy (ART)
improves the health of people living with HIV and can reduce infectiousness,
preventing HIV transmission. The potential preventive benefits of ART are
undermined by beliefs that it is safe to have condomless sex when viral load is
below levels of detection (infectiousness beliefs and risk perceptions).
In
this study, we hypothesized that infectiousness beliefs and HIV transmission
risk perceptions would prospectively predict people living with HIV engaging in
more condomless sex with HIV-negative and unknown HIV status sex partners.
Sexually active HIV-positive men (n = 538, 76 %) and women
(n = 166, 24 %) completed computerized interviews of sexually
transmitted infection (STI) symptoms and diagnoses, unannounced pill counts for
medication adherence, medical chart-abstracted HIV viral load, and 28 daily
cell-phone-delivered prospective sexual behavior assessments.
Results showed
that a total of 313 (44 %) participants had engaged in condomless sex with
HIV-negative/unknown status sex partners, and these individuals demonstrated
higher rates of STI symptoms and diagnoses. Two-thirds of participants who had
condomless sex with HIV-negative/unknown status partners had not disclosed
their HIV status. Multivariable logistic regression models showed that beliefs
regarding viral load and HIV infectiousness and perceptions of lower risk of
HIV transmission resulting from HIV viral suppression predicted condomless sex
with potentially uninfected partners over and above sex behaviors with HIV-positive
partners and STI symptoms/diagnoses.
Interventions that address HIV status
disclosure and aggressively treat STI in sexually active people living with HIV
should routinely accompany the use of HIV treatments as prevention.
Purchase full article at: http://goo.gl/RMZPgv
By:
- 1Department of Psychology, University of Connecticut, 406 Babbidge Road, Storrs, CT, 06269, USA, seth.k@uconn.edu.
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