Day 2: Risk reducing strategies

Background

·         Gay and bisexual men’s sexual practices have evolved throughout the HIV Epidemic

·         Protective strategies (e.g. condoms) have often been community led/ generated

·         Every technological innovation in HIV testing, treatment and prevention has prompted shifts in practice

·         Australian GBM’s practices have been monitored by the Gay Community Periodic Surveys since 1996

·         What follows is a review of trends in selected practices since 2000

( national;unadjusted;7 states / territories, > 6000 participants per year; only NSW & VIC in 2017 )

Findings

Overall, partner numbers have declined over time, except in 2016 – 2017

Majority of men in relationship have condomless sex with their regular partners. This became more common after 2010 which is around 60 % in 2017 

Regarding HIV status, 30- 40 % of HIV Negative partners with similar status while both partners positive observed just under 10 %

HIV negative relationship more common after 2010

Condom use was primary prevention strategy, with casual partners and Anal sex has become gradually more common with casual partners.

Risk reducing strategies frequently used during condomless sex with casual partners

-          HIV positive men who had CAIC  ( Condomless Anal Intercourse ); 2011 – 2017 counted Undectable viral load 80 % whose partners are on PrEP around 40 %

-          HIV Negative men who had CAIC represented around 50 % whose partners on PrEP approx. 40 %

Summary

·         Up until recently, Gay / Bi men were reporting fewer male sex partners over time

·         Since 2000, condomless sex has become more common

-          First emphasising serosorting ( matching HIV status )

-          Now harnessing PrEP and treatment as prevention

·         In the last 5 years,

-          HIV positive men have switched from serosorting to undetectable viral load as their primary strategy during condomless sex with casual partners

-          HIV negative men have rapidly embraced PrEP and many continue to serosort

·         The vast majority of GBM continue to minimise HIV transmission risk, using an increased range of strategies