382P
IS INCREASED ARGUING AMONG MEN IN PRIMARY PARTNERSHIPS A FACTOR IN UNPROTECTED SEX? RESULTS FROM THE POLARIS STUDY
AM Anonychuk1, L Calzavara2, T Myers2, J Raboud1, A Burchell1
¹HIV Social, Behavioural and Epidemiological Studies Unit, Faculty of Medicine, University of Toronto; 2HIV Social, Behavioural and Epidemiological Studies Unit, Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario
Objectives: To examine the association between relationship stressors and high-risk sex among gay men in primary relationships.
Methods: Stressful life events, behavioural and health information were obtained from HIV-positive and HIV-negative men participating in a longitudinal study. A previous analysis of 208 men with multiple regular partners has been undertaken. This exploratory analysis focuses on a sub-sample of 69 men who had one primary partner for two consecutive interviews (12-month period). Logistic regression models were used to determine the association between stressful relationship events and unprotected anal intercourse (UAI).
Results: 35% (24/69) were HIV-discordant with their primary partners, 48% also had casual sex partners and a further 21% had UAI with these casual partners. 51% (35/69) had UAI with their primary partners, including 3 (8.6%) HIV-discordant couples. The most commonly experienced stressful relationship event was "increased arguments with a partner" (27.5%). These couples also experienced other stressors including financial crises, substance use problems, physical violence and diagnosis of serious illness. After controlling for demographic and other factors known to be associated with UAI, the only independent risk factor for UAI was having increased arguments (ORadj=3.9, 95% CI: 1.2–12.4, p=0.02).
Conclusions: Very little is known about the impact of life events on high-risk sexual behaviour in gay men. This study found that couples who experience relationship stress are more likely to engage in UAI with their primary partners, and therefore may be potentially at risk for HIV transmission. Although 65% of couples were not HIV-discordant, many also had UAI with casual partners, thus increasing the risk of infection and transmission to their partner. The results of this study show important directions for future research and a necessity to understand and incorporate psychosocial factors into current prevention and educational initiatives in order to reduce HIV-risk behaviour.