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AIDS drugs haven't changed HIV risk with anal sex

The introduction of effective drugs against HIV, the virus that causes AIDS, has not changed homosexual men's risk of contracting the virus during a single act of anal sex, new research from Australia shows.

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The introduction of effective drugs against HIV, the virus that causes AIDS, has not changed homosexual men's risk of contracting the virus during a single act of anal sex, new research from Australia shows.

To estimate the risk of contracting HIV for each instance of unprotected anal sex, the researchers enrolled 1,427 Australian men who reported having had sex with another man at least once in the past five years between June 2001 and December 2004. The participants were interviewed about their sexual behavior every six months, and tested for HIV every year until June 2007. During follow-up, 53 men contracted HIV.

The riskiest type of sexual activity was receptive anal sex with ejaculation into the rectum; each such act carried a 1.43 percent risk of contracting HIV. If a man's partner withdrew before ejaculation, the risk dropped to 0.65 percent. Circumcised men had a 0.11 percent risk of contracting HIV for every insertive sex act, while the risk for circumcised men was 0.62 percent.

The findings are very similar to a US study done in the early 1990s, which found an 0.82 percent risk of contracting HIV for every instance of receptive anal sex (whether or not withdrawal occurred).

The researchers conclude that the findings apply to the population of gay men as a whole; caution should be exercised before interpreting the results at the level of individual men. Genes and other biological factors can influence the risk of both transmitting and contracting the virus. For example, it was noted that 12 of the men in the above study contracted HIV after having unprotected anal sex less than 10 times, while there were six study participants who didn't contract the virus even though they had extremely large numbers of receptive anal sex episodes with HIV-positive partners.

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