Unprotected anal intercourse among HIV-positive men who have a steady male sex partner with negative or unknown HIV serostatus

OBJECTIVES: We sought to determine the prevalence and predictors of unprotected anal intercourse (UAI) among HIV-positive men who have a single steady male partner with negative or unknown HIV serostatus. METHODS: We analyzed behavioral surveillance data from HIV-positive men who have sex with men (MSM) interviewed in 12 states between 1995 and 2000. RESULTS: Of 970 HIV-positive MSM who had a single steady male sex partner with negative or unknown serostatus, 278 (29%) reported UAI during the previous year. In a subset of 674 men who were aware of their infection, 144 (21%) had UAI. Among the men who were aware of their infection, factors found to be predictive of UAI in multivariate modeling were heterosexual self-identification, crack cocaine use, no education beyond high school, and a partner with unknown serostatus. CONCLUSIONS: Even after learning of their infection, one fifth of HIV-positive MSM who had a single steady male partner with negative or unknown serostatus engaged in UAI, underscoring the need to expand HIV prevention interventions among these men.