Golden, M.
R., Brewer, D. D., Kurth, A. E., Holmes, K. K., & Handsfield, H. H.
(2004).
Importance of sex partner HIV status in
HIV risk assessment among men who have sex with men. Journal of Acquired Immune
Deficiency Syndromes, 36, 734-742.
Clinical HIV risk assessments have not
typically integrated questions
about sex partners' HIV status with questions about condom use and type
of sex. Since 2001, we have asked all men who have sex with men (MSM)
evaluated in an urban sexually transmitted disease (STD) clinic how
often in the preceding 12 months they used condoms for anal sex with
partners who were HIV-positive, HIV-negative, and of unknown HIV
status. Overall, MSM displayed a pattern of assortative mixing by HIV
status, particularly for unprotected anal intercourse (UAI).
Nevertheless, 433 (27%) of 1580 MSM who denied knowing they were
HIV-positive and 93 (43%) of 217 HIV-positive MSM reported having UAI
with a partner of opposite or unknown HIV status. Among men who denied
previously knowing they were HIV-positive, 24 (9.6%) of 251 MSM who
reported having UAI with an HIV-positive partner or partner of unknown
HIV status compared with 11 (1.7%) of 620 MSM who denied such exposure
tested HIV-positive (odds ratio = 5.8, 95% confidence interval:
2.8-12.1). UAI with an HIV-positive partner or partner with unknown HIV
status was 69% sensitive and 73% specific in identifying men with
previously undiagnosed HIV infection; UAI regardless of partner HIV
status was 80% sensitive but only 45% specific. The positive predictive
value was highest for risk assessments that included partner HIV
status. Integrating questions about anal sex partner HIV status and
condom use identifies MSM at greatest risk for HIV acquisition and
transmission. These risk criteria might be effectively used to triage
MSM into more intensive prevention interventions.
To request
immediate delivery of this article
(pdf in zip archive, 70 KB) by email
attachment,
put
your name and email address in the blanks below and click the "Please
send me this article" button. We
keep your information confidential. We do not sell, trade, or
exchange mailing lists with any organization, and we will not contact
you unless you ask to be contacted.
|
