When men who have sex with men (MSM) cite a desire for intimacy as a reason they don't use condoms with a main partner there is a greater chance they'll be interested in taking Truvada as pre-exposure prophylaxis (PrEP). Publishing their findings in the Annals of Behavioral Medicine, researchers conducted a cross-sectional study in which they interviewed 164 HIV-negative MSM in New York City who were in steady relationships (13.4 percent said they were partnered with a transgender woman; the rest were with other men) and who had had sex without a condom at least once during the previous 30 days. The interviews were conducted between January 2012 and October 2013.

Other research has suggested that between one-third and just over two-thirds of MSM acquire HIV from a steady partner. One of the reasons for this appears to be that men's desire to express intimacy influences their choice not to use a condom with their partner. This can open a window for transmission if they have not been tested, if they were recently tested but are still in the test's “window period” when false negatives are likely, or if one partner is knowingly HIV positive but does not share this information.

This new study found that citing a desire for intimacy as a reason for not using condoms with a primary partner was associated with a 55 percent increase in the odds of being willing to use PrEP. The researchers found no such link in a comparison group of MSM not in relationships.

Other factors that were associated with interest in PrEP among the MSM in relationships included being older, having a higher perception of personal HIV risk, having sex—with or without a condom—outside of the relationship, and having less than a bachelor's degree. But after controlling for various factors, the researchers found that the factors that most strongly predicted PrEP interest among this group were the intimacy desire, a low education level and, to a lesser extent, being older.

“For people who are disseminating PrEP or talking to patients about PrEP, I think it's important to think about their relationships,” Kristi Gamarel, PhD, a psychiatry and human behavior postdoctoral researcher in the Warren Alpert Medical School of Brown University, said in a release. “Something that's being supported and endorsed right now by the World Health Organization is couples voluntary testing and counseling. That may be a way to disseminate PrEP and to allow couples to have a discussion about whether PrEP is good for their relationship and how they can support each other using PrEP.”

To read the press release, click here.

To read the study abstract, click here.