Unsafe Sex With Casual Partners and Quality of Life Among HIV-Infected Gay Men

International audienceIntroduction: The introduction of highly active antiretroviraltherapy has relaunched the debate on risky sexual behavior amongHIV-infected gay men. It was proposed to study the influences oflifestyle characteristics and health-related quality of life (HRQL) onunsafe sex with casual partners in a representative sample of HIVinfectedgay men.Methods: In 2003, a national survey based on face-to-face interviewswas conducted among a representative sample of patients selected in arandom stratified sample of 102 French hospital departmentsdelivering HIV care. The patients selected for this analysis weregay men who reported having had sex with casual partners during theprevious 12 months. Unsafe sex was defined as at least 1 episode ofanal sexual intercourse without a condom with a casual partner duringthe previous 12 months. Health-related quality of life was assessedusing the SF-36 Scale. Patients who declared that they had engaged inunsafe sex were compared with those who declared that they had notdone so, using the W2 test and logistic regressions.Results: Among the 1117 gay men who participated in the study, 607declared having had casual partners during the previous 12 months,and 140 (20%) of this latter group had engaged in unsafe sex. Poormental HRQL was encountered in 68% of the patients and found to beindependently associated with unsafe sex, even after multiple adjustmentfor number of partners, occurrences of binge drinking, use ofanxiolytics, use of the Internet, and use of outdoor and commercialvenues for sexual encounters.Conclusions: Risky sexual behavior with casual partners is frequentamong HIV-infected gay men. In addition to other well-knownfactors, behavior of this kind was found in this study to be related topoor mental HRQL. A more comprehensive approach to care designedto improve mental quality of life might therefore make formore effective secondary prevention