EXTRAMARITAL SEX - IS THERE AN INCREASED RISK FOR HIV TRANSMISSION - A STUDY OF MALE COUPLES OF MIXED HIV STATUS

This report describes the sexual behavior with ''extramarital'' partne rs of men who are in committed relationships with men of opposite HIV status. We examined the rates of unprotected anal sex with outside par tners and compared these rates with the prevalence of such activity wi thin the couple, during the year prior to the assessment. Seventy-five couples were interviewed, of whom 50 (67%) reported sex outside of th e primary relationship by one or both members of the couple. Rates of unprotected anal sex with one-night stands and ''other'' partners were 25% and 33%, respectively among men who engaged in anal sex with such partners. In contrast, 54% of the men who engaged in anal sex with th eir primary partner did not always use condoms. Data from men who enga ged in anal sex with both their primary partner and one-night stand(s) revealed that condoms were used less frequently within the primary re lationship when the HIV negative men were the insertive partner; other wise the rates of unprotected anal sex were similar. Approximately 75% of HIV negative men who engaged in receptive anal sex always used con doms, and a similar proportion of HIV positive men always used condoms during insertive anal sex, regardless of partner type. The vast major ity of unprotected anal sex occurred without ejaculation inside the re ctum. Unprotected oral sex was highly prevalent regardless of partner type. Implications for public health policy and primary prevention res earch are discussed.