Publications & Reports

Undetectable viral load and the decision to engage in unprotected anal intercourse among HIV-positive MSM.

Wijnand Van Den Boom, Ineke G Stolte, Robert Witlox, Theo Sandfort, Maria Prins, Udi Davidovich
Cluster Infectious Diseases, Department of Research, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands.


We investigated how often HIV-positive MSM (n = 177) decide to engage in unprotected anal intercourse (UAI) because they have an undetectable viral load (UVL). We found that 20-57% of the UAI acts were related to having UVL, varying by partner type and partner HIV status. Among HIV-concordant partners, consideration of UVL before engaging in UAI was more prevalent with sex buddies (55%) than with casual partners (20%), although marginally significant (p = 0.051). Among HIV-discordant partners, no significant difference was found in the frequency of UVL considerations before engaging in UAI: 40% with sex buddies versus 57% with casual partners. Interestingly, while the decision to engage in UAI based on UVL was frequently discussed with HIV-concordant partners (>91%), it was only discussed with HIV-discordant partners in 13-25% of the UAI cases (according to partner type), suggesting that the decision was mostly unilateral.


  • Journal: AIDS and Behavior
  • Published: 01/07/2013
  • Volume: 17
  • Issue: 6
  • Pagination: 2136-2142