HIV-positive gay men are using viral load test results to gauge their perceived risks of passing the virus along to others and adjusting their sexual behavior based on those perceptions, according to two studies presented at the U.S. National HIV Prevention Conference in Atlanta. A study of San Francisco HIV-negative and HIV-positive men shows one third had discussed viral load data with a partner of a different serostatus before determining which sexual acts to engage in. HIV-positive gay and bisexual men, particularly African-Americans, were more likely to base sexual decisions on viral load information than were HIV-negative men, according to the study.
A study conducted by Boston's Fenway Community Health Center shows that about 64% of HIV-positive gay men surveyed have unfounded beliefs that a low or undetectable blood-based viral load diminishes their chances of infecting sex partners; 3% believe it completely eliminates transmission risks. The study also shows that many HIV-positive gay men are opting to engage in only oral sex or be the receptive'rather than the insertive'partner during anal sex to reduce their chances of transmitting the virus.
The researchers warn that although the virus may be at very low or undetectable levels in the bloodstream, it can be present at a higher percentage'even at infectious levels'in semen and rectal secretions, causing sexual decision making based on viral load measurements to be very risky. It's also possible for viral levels to climb considerably, they say, in the period between viral load tests.