Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men

The availability of improved HIV treatments may prompt reduced concern abou t HIV and sexual risk. Gay and bisexual men (N = 554, 17% HIV-positive) com pleted measures of treatment attitudes, sexual risk, and assumptions regard ing the infectiousness of sexual partners. A substantial minority reported reduced HIV concern related to treatment advances. Reduced HN concern was a n independent predictor of sexual risk, particularly among HIV-positive men . In response to hypothetical scenarios describing sex with an HIV-positive partner, participants rated the risk of unprotected sex to be lower if the partner was taking combination treatments and had an undetectable viral lo ad, relative to scenarios with a seropositive partner not taking combinatio n treatments. Prevention efforts must address attitudinal shifts prompted b y recent treatment successes, stressing the continued importance of safer s ex, and that an undetectable viral load does not eliminate infection risks.