Sophia A. Hussen, MD, MPH, Carlos del Rio, MD reviewing Wilson PA et al. JAMA Pediatr 2015 Dec 7.

Rates of HIV viral suppression were low and condomless anal intercourse was frequent in a sample of clinic-engaged young men who have sex with men.

In the U.S., the subpopulation of young men who have sex with men (YMSM) is the only group in which HIV incidence continues to increase. Existing evidence indicates that HIV-infected YMSM are frequently not virally suppressed and that they continue to engage in risky sexual behavior such as condomless anal intercourse (CAI). However, the prevalence of these behaviors and their psychosocial correlates remain understudied.

Now, researchers have conducted a cross-sectional analysis of HIV-infected YMSM aged 15 to 26 years, all of whom were linked to care at one of 20 clinical sites affiliated with the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). Of the 991 YMSM who met inclusion criteria, 668 (69.4%) had a detectable HIV-1 viral load (>200 copies/mL). Compared with the YMSM with undetectable viral loads, those with detectable viremia were more likely to be older, to have a history of incarceration, to be unemployed, to endorse symptoms of depression and anxiety, and to report CAI and serodiscordant CAI. Transgender identity and black race were associated with lower rates of CAI; disclosure of status to sex partners and substance abuse were positively associated with CAI.

Citation(s):

Wilson PA et al. Sexual risk behavior among virologically detectable human immunodeficiency virus–infected young men who have sex with men. JAMA Pediatr 2015 Dec 7; [e-pub].

JWatch