Strategies to prevent HIV transmission among Australian gay male serodiscordant couples

Stream: HIV: Emerging strategies in prevention among MSM
Date: Friday, 1 April 2016
Time: 2.00 pm – 3.45 pm


Introduction: There are few data on the strategies used by gay male serodiscordant couples (GM-SDC) to prevent HIV transmission.

Methods: Opposites Attract is an ongoing cohort study of GM-SDC. At baseline, HIV-positive partners (HPP) had viral load (VL) tested; HIV-negative partners (HNP) reported the previous three months’ sexual behaviour and perception of the HPP’s last VL test.

Results: By October 2015, 148 couples were enrolled. At baseline, 90.5% of HPPs were on treatment and 87.8% had undetectable VL (UVL); 78.4% of HNPs perceived their partners to have UVL. In the previous three months, two-thirds of couples had condomless anal intercourse (CLAI): 61.5%, 40.5%, and 20.3% of HNPs reported insertive CLAI, receptive CLAI with withdrawal, and receptive CLAI with ejaculation respectively. Four HNPs took daily PrEP. The most common HIV prevention strategy within couples was relying on UVL only (56.1%), followed by consistent condom use (29.7%). Three out of the four HNPs taking PrEP perceived their HPPs to have UVL. Of the 14 HNPs who perceived their HPP to have detectable viral load, four engaged only in insertive CLAI (strategic positioning), while 10 (6.8% of all HNPs) had some receptive CLAI. The total number of receptive CLAI acts with detectable perceived VL and without PrEP was 127: 118 without and 9 with ejaculation.

Conclusions: Couples most commonly relied on UVL and condom use to prevent HIV transmission, while about 7% did not use any clear risk reduction strategies. However, within these, the absolute number of high-risk CLAI acts was very low.


Benjamin Bavinton (Presenter), The Kirby Institute
Ben has worked in the field of HIV prevention, research and policy for over 10 years both in Australia and internationally. He is currently the Project Leader of the Opposites Attract Study, an international, multi-site cohort study of HIV transmission and HIV treatments in gay male serodiscordant relationships.

Garrett Prestage, The Kirby Institute; Australian Research Centre in Sex, Health and Society

Iryna Zablotska, The Kirby Institute

Fengyi Jin, The Kirby Institute

Andrew Grulich, The Kirby Institute