TORONTO — Men who have sex with men are engaging in unsafe sex under the false belief that highly active antiretroviral therapy will protect them from transmitting or getting infected with HIV, according to a poster presented at the 16th International AIDS Conference.
Men who were positive for HIV and who were taking highly active antiretroviral therapy admitted in a questionnaire that they believed that their HIV medications made it much harder to transmit the virus and were more likely to have unprotected sex with men who were not HIV positive, said Trevor A. Hart, Ph.D., of the department of psychology at York University, Toronto.
Similarly, men who were negative for HIV were much more likely to have unprotected sex with HIV-positive partners who were taking HAART because of their optimistic beliefs about the therapy.
In addition to the belief that HIV is harder to transmit sexually because of HAART, the men were more likely to believe that HIV is a less-serious disease because of HAART, Dr. Hart said.
He and his colleagues examined the relation between HAART beliefs and risky sexual behaviors among 554 men who have sex with men who were recruited for the study from the 2005 Toronto Gay Pride Festival.
It is true that HIV medications reduce viral load and improve individuals' health, but if people are having more unprotected sex as a result, their risk of transmitting or getting the infection still is increased, Dr. Hart said in an interview.
“We need to pass on the message that, even though the medications are quite useful, they don't make HIV into a pleasant disease to have, and they do not ensure that you can't ever get HIV. True, there is some reduction of risk, but if you then go and compensate by having risky sex, that really won't be helpful.” Getting this message across is important for protecting gay and bisexual patients, he said.
Similar concerns about the dangers of HIV transmission and reinfection also were voiced by Julie Overbaugh, Ph.D., of the human biology division at the Fred Hutchinson Cancer Research Center, Seattle.
Speaking about “serosorting”—a practice in which HIV-positive individuals seek out sexual partners with the same HIV status—Dr. Overbaugh said evidence is emerging about the danger of reinfection from this practice.
“In the case of patients who continue to engage in a lot of high-risk behavior with other HIV partners, there should be a little caution that they may be getting reinfected. At this point, there are very little data, but [the patients] should be told that their chance of getting reinfected is there, and that it could have clinical consequences,” she said.
Although HAART may be somewhat protective against being reinfected, there is still a danger, she added.
In a survey, men who have sex with men said they believed HIV was a less serious disease because of HAART. DR. HART