November 27, 2013
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MSM with known HIV status lowered sexual risk through safer sex practices

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Sexual risk is significantly lower among men who have sex with men who know their HIV status, according to a report in MMWR.

In 2011, 33% of MSM with HIV who were unaware of their infection reported having unprotected, discordant anal sex vs. 13% of MSM with HIV who were aware of their infection.

“These findings are a stark reminder that we cannot afford to undervalue HIV testing,” Jonathan Mermin, MD, MPH, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in a press release. “Getting an HIV test at least once a year is essential for gay and bisexual men. Only when a man knows his status can he make the best prevention choices for himself and his partners.”

Jonathan Mermin, MD, MPH 

Jonathan Mermin

Researchers from the CDC used data from the National HIV Surveillance System (NHSS) and from the National HIV Behavioral Surveillance System (NHBS) to estimate HIV diagnoses, the incidence of unprotected anal sex and unprotected discordant anal sex in the past 12 months in 2005, 2008 and 2011, and HIV testing history among MSM.

Overall, the number of MSM reporting unprotected anal sex at least once in the past 12 months increased from 48% in 2005 to 57% in 2011. In 2008 and in 2011, 13% reported engaging in unprotected discordant anal sex. In 2011, 33% of MSM who were HIV-positive but unaware reported having unprotected discordant anal sex at their latest sex. This is more than twice as high as the 13% of MSM who were HIV-positive but aware and the 12% of HIV-negative MSM.

Only 67% of MSM who were HIV-negative or who had unknown status had an HIV test within the past 12 months. Among men tested within the past 3 months, 4% were HIV-positive but unaware of their infection. For those tested within the past 4 to 6 months, 5% were HIV-positive but unaware, and for those tested within the past 12 months, 7% were HIV-positive but unaware.

Thomas R. Frieden, MD, MPH 

Thomas Frieden

“While we remain concerned about potentially increasing levels of sexual risk, it is encouraging to see that risk is substantially lower in those who know they have HIV,” CDC Director Thomas Frieden, MD, MPH, said in a press release. “HIV testing remains one of our most powerful tools to reverse the epidemic. Everyone should know their HIV status.”

Disclosure: The researchers, Mermin and Frieden report no relevant financial disclosures.