Nav: Home

Study suggests many gay and bisexual men are skeptical, but attitudes are on the rise

January 11, 2018

Dr. Jonathon Rendina (@ProfRendina), an Assistant Professor at Hunter College and Director of Quantitative Methods at Hunter's Center for HIV Educational Studies & Training (CHEST; @CHESTNYC), and Dr. Jeffrey Parsons (@DrJeffParsons), Distinguished Professor at Hunter and Director of CHEST, have published a new paper in the Journal of the International AIDS Society focused on gay and bisexual men's perceptions of the HIV treatment-as-prevention message, "Undetectable = Untransmittable." Numerous well-controlled trials have recently demonstrated that there is effectively no risk of HIV transmission during sex with a partner who has a sustained, undetectable viral load. This notion, that HIV treatment can lead to HIV prevention, has been captured with the #UequalsU slogan popularized by Bruce Richman (@BR999) and the Prevention Access Campaign, of which he is Executive Director, and has gained growing popularity and endorsements, including the U.S. Centers for Disease Control and Prevention (CDC). The Hunter CHEST study sought to examine how accurate gay and bisexual men perceive this message to be by surveying more than 12,000 men across the United States in the summer of 2017.

"Some studies have examined beliefs about treatment-as-prevention generally, though they have largely been done outside of the U.S. and weren't focused on any specific message," said Dr. Rendina, lead author of the paper. Overall, the message was perceived to be accurate by 70% of men who were HIV-positive and 36% of men who were HIV-negative or unsure of their HIV status--though there is some room for improvement, these rates suggest there have been increases since earlier studies. "We found that HIV-negative and unknown guys were more likely to believe the message was accurate if they got tested for HIV more regularly and if they were taking pre-exposure prophylaxis (PrEP), suggesting these prevention services may be a great way to gain a captive audience to provide more information about treatment-as-prevention."

In addition to promoting HIV knowledge, one goal of the message is to help reduce HIV stigma. Mr. Richman noted, "This study underscores the great need for further targeted educational and dissemination strategies and provides data that will be immensely valuable as we work with our partners to scale up campaigns to prevent new transmissions and reduce HIV stigma." Among HIV-positive men, reporting a detectable viral load was associated with believing the message was less accurate. Dr. Rendina added, "What we may be seeing is that some guys who aren't able to maintain a sustained undetectable viral load either have lower levels of knowledge potentially due to being less well-retained in care or that they may feel left out of the message and concerned it will lead to additional stigma placed on them." He continued, "There is great promise for the message to reduce HIV stigma, but at the same we need to make sure we don't end up marginalizing or stigmatizing those who struggle with keeping their viral loads undetectable."

Among men with and without HIV, believing the message was more accurate was associated with having had condomless anal sex with a partner of a different HIV status. Dr. Parsons noted, "This suggests that men who understand the scientific evidence, now endorsed by the CDC, that Undetectable = Untransmittable feel more comfortable having condomless sex when a positive partner is virally suppressed. Because they know that treatment-as prevention is effective--as with other forms of biomedical prevention, like PrEP, it's giving men more options regarding their sexual health that emphasize autonomy and sexual pleasure. The message of 'use a condom every time' is now outdated and limiting." Strategies such as regular viral load monitoring, efforts to maintain medication adherence, routine screening for sexually transmitted infections, better access to PrEP, and promoting communication about biomedical prevention with sexual partners can be helpful in conjunction with treatment-as-prevention to continue curbing the HIV epidemic and averting new epidemics among other sexually transmitted infections.
-end-
About the study: The results of the study, entitled, "Factors associated with perceived accuracy of the Undetectable = Untransmittable slogan among men who have sex with men: Implications for messaging scale-up and implementation" (doi: 10.1002/jia2.25055) by H. Jonathon Rendina and Jeffrey T. Parsons will be published in an upcoming issue of JIAS. The study was conducted in part with funding from the National Institute on Drug Abuse (K01-DA039030, PI: H. Jonathon Rendina; R25-DA031608, PI: Celia B. Fisher) as well as with funding provided by Hunter College, CUNY. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Fordham HIV Prevention Research Ethics Training Institute, or Hunter College, CUNY.

CHEST's mission is to conduct research to identify and promote strategies that prevent the spread of HIV and improve the lives of people living with HIV. We have been advocating for and working with the LGBT community since 1996.

The City University of New York is the nation's leading urban public university. Founded in New York City in 1847, the University comprises 24 institutions: 11 senior colleges, seven community colleges, and additional professional schools. The University serves nearly 275,000 degree-credit students and 218,083 adult, continuing and professional education students.

For more information, please contact Shante Booker (shante.booker@cuny.edu) or visit http://www.cuny.edu/research

The City University of New York

Related Hiv Articles:

Defective HIV proviruses reduce effective immune system response, interfere with HIV cure
A new study finds defective HIV proviruses, long thought to be harmless, produce viral proteins and distract the immune system from killing intact proviruses needed to reduce the HIV reservoir and cure HIV.
1 in 7 people living with HIV in the EU/EEA are not aware of their HIV status
Almost 30,000 newly diagnosed HIV infections were reported by the 31 European Union and European Economic Area (EU/EEA) countries in 2015, according to data published today by ECDC and the WHO Regional Office for Europe.
Smoking may shorten the lifespan of people living with HIV more than HIV itself
A new study led by researchers at Massachusetts General Hospital finds that cigarette smoking substantially reduces the lifespan of people living with HIV in the US, potentially even more than HIV itself.
For smokers with HIV, smoking may now be more harmful than HIV itself
HIV-positive individuals who smoke cigarettes may be more likely to die from smoking-related disease than the infection itself, according to a new study published in the Journal of Infectious Diseases.
Patients diagnosed late with HIV infection are more likely to transmit HIV to others
An estimated 1.2 million people live with HIV in the United States, with nearly 13 percent being unaware of their infection.
The Lancet HIV: New HIV infections stagnating at 2.5 million a year worldwide
A major new analysis from the Global Burden of Disease 2015 study, published today in The Lancet HIV journal, reveals that although deaths from HIV/AIDS have been steadily declining from a peak in 2005, 2.5 million people worldwide became newly infected with HIV in 2015, a number that hasn't changed substantially in the past 10 years.
NIH scientists discover that defective HIV DNA can encode HIV-related proteins
Investigators from the National Institutes of Health have discovered that cells from HIV-infected people whose virus is suppressed with treatment harbor defective HIV DNA that can nevertheless be transcribed into a template for producing HIV-related proteins.
Study examines risk of HIV transmission from condomless sex with virologically suppressed HIV infection
Among nearly 900 serodifferent (one partner is HIV-positive, one is HIV-negative) heterosexual and men who have sex with men couples in which the HIV-positive partner was using suppressive antiretroviral therapy and who reported condomless sex, during a median follow-up of 1.3 years per couple, there were no documented cases of within-couple HIV transmission, according to a study appearing in the July 12 issue of JAMA, an HIV/AIDS theme issue.
HIV vaccine design should adapt as HIV virus mutates
Researchers from UAB, Emory and Microsoft demonstrate that HIV has evolved to be pre-adapted to the immune response, worsening clinical outcomes in newly infected patients.
Charlie Sheen's HIV disclosure may reinvigorate awareness, prevention of HIV
Actor Charlie Sheen's public disclosure in November 2015 that he has the human immunodeficiency virus (HIV) corresponded with the greatest number of HIV-related Google searches ever recorded in the United States, according to an article published online by JAMA Internal Medicine.

Related Hiv Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Setbacks
Failure can feel lonely and final. But can we learn from failure, even reframe it, to feel more like a temporary setback? This hour, TED speakers on changing a crushing defeat into a stepping stone. Guests include entrepreneur Leticia Gasca, psychology professor Alison Ledgerwood, astronomer Phil Plait, former professional athlete Charly Haversat, and UPS training manager Jon Bowers.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".