Australian HIV-negative gay men express far more confidence in pre-exposure prophylaxis (PrEP) than an undetectable viral load in preventing HIV, with only 18% agreeing that “a person with an undetectable viral load cannot pass on HIV” and 6% feeling comfortable having condomless sex with an HIV-positive partner who had an undetectable viral load, according to a pair of articles recently published in Sexually Transmitted Infections and AIDS & Behavior.
Confidence in the efficacy of PrEP was much higher.
Researchers from the Burnet Institute conducted an online survey with gay and bisexual men living in Melbourne and other parts of the state of Victoria. It included a series of questions to gauge men’s knowledge of and attitudes towards condoms, an undetectable viral load and PrEP.
Australia has a long history of promoting condom use and regular HIV testing in gay men. More recently, there has also been high-profile support for treatment as prevention and PrEP. Around the time the survey was conducted in August and September 2016, a PrEP demonstration project was scaling up in Victoria. Several Australian campaigns promoting the benefits of HIV treatment had already been run, but the international "Undetectable = Untransmittable" campaign had not yet taken off.
Half the survey participants were between the ages of 25 and 40; most identified as gay; and 20% were born outside Australia. A third reported condomless sex with a casual partner in the past six months, and half with a regular partner.
The survey was completed by 844 people, but men with diagnosed HIV were excluded from the following analyses. The data on comfort having condomless sex come from 771 HIV-negative or untested men, including 83 PrEP users (12% of the men). The data on perceptions of effectiveness come from a smaller group of 462 survey respondents who answered all relevant questions and were not using PrEP. (The researchers did not report on responses from PrEP users for these questions.)