Ascertaining knowledge of partner HIV status and its association with HIV risk behavior

The purpose of this study was to understand strategies used by men who have sex with men (MSM) to determine the serostatus of their sexual partners, and what relationship such strategies have with unprotected anal intercourse (UAI). Data were collected as baseline measures for a randomized controlled trial of an online HIV prevention intervention. 644 MSM completed demographic and UAI partner (past 3 months) measures. Participants were categorized according to whether they used 1, 2, or 3-4 of the following strategies to ascertain their sexual partner's HIV status: Checking the online profile(s), Asking before sex, Talking after sex, Guessing. The average age of participants was 34 years, and most self-reported as white (69%), college educated (92% some college), and living in or near a large city (67%). The average number of UAI partners was 5. Thirty-two percent of men endorsed guessing as a strategy, and 45% used all 4 strategies to ascertain their partners' HIV status. Men who used 2 strategies reported more UAI partners (Mdn=4; Incidence-Rate Ratio=1.4; 95%CI=1.06-1.94) than those using 1 (Mdn=2) or 3-4 strategies (Mdn=3), and were more likely to live in downtown areas and have higher comfort with their sexual orientation. A high percentage of Latino and Bi/Multi-racial participants used 3-4 strategies. The finding that nearly one-third of participants guessed their partner's HIV status represents a critical prevention challenge. Having a limited number of strategies for ascertaining partner HIV status may reflect a tendency to avoid sharing HIV status information, resulting in increased risk behavior.