AIDS 2014A new study of Australian gay and bisexual men illustrates how men are using multiple behavioral methods to reduce HIV risk, underlining the fact that “safer sex” is not a simple binary consideration between whether or not condoms are used, aidsmap reports. Researchers conducted a pair of large cross-sectional community surveys of 15,615 Aussie gay and bisexual men in 2011 and 2012. They presented their findings at the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia.

This analysis did not include the 38 percent of respondents who reported no casual partners, regardless of their condom use. (Ignoring that group, however, may be a key oversight on the researchers' part, considering that studies have suggested that between one and two thirds of new HIV cases among gay and bi men are transmitting between primary partnerships.) Twenty-eight percent of the men said they always used condoms with casual partners, and 13 percent said they had not recently engaged in anal sex.

The study focused on the 21 percent who said they had engaged in condomless anal intercourse with at least one casual partner during the past year. The researchers analyzed the men's use of various risk reduction strategies, including condoms, serosorting (attempting to have sex only with men of the same HIV status), strategic positioning (attempting to have HIV-positive partners be the bottom, or receptive, partner), and withdrawing before ejaculation during intercourse.

Among the HIV-positive men who didn't always use condoms with casual partners, 60 percent serosorted, 22 percent “often used condoms,” 17 percent engaged in strategic positioning and 22 percent practiced withdrawal. (The study did not report on whether men where factoring in their viral load when making decisions about risk reduction strategies.)

Among the HIV-negative men not always using condoms with casual partners, 44 percent serosorted, 41 percent used condoms most of the time, 24 percent engaged in strategic positioning and 22 percent practiced withdrawal.

Three out of four of the men reported they used more than one strategy, most commonly a pair of serosorting and condoms.

To read the aidsmap story, click here.

To read the conference abstract, click here.