Is HIV Testing Motivating Men Who Have Sex With Men To Forego Condoms?

A new report from the Centers for Disease Control and Prevention finds that men who have sex with men (MSM) are having increasingly more unprotected sex. The rate of men having unprotected anal sex rose nearly 20 percent from 2005 to 2011. Those who did not know their status were more likely to have unprotected sex, but the emphasis that has been placed on HIV testing as a means of behavior may be motivating this behavior. MSM are still more severely impacted by HIV infection than any other group in the country.

The study found that even being tested once for HIV was associated with taking fewer risks — regardless of the results of the test. However, a third of the men who were interviewed had not been tested in the past year. One of the leading hypotheses for the increase in unprotected sex is that more men are “serosorting,” which means that men who are HIV-negative try to only have sex with other men that are uninfected. If most of the men having unprotected sex haven’t actually been tested, however, this suggests that serosorting is actually backfiring.

Another factor that might be inhibiting the potential benefits of testing is the many laws that continue to criminalize the transmission of HIV or even the nondisclosure of an individual’s status even when protection is used. Several studies have found that these outdated laws, most of which were passed before much of the modern research was conducted on the virus, actually discourage men from getting tested. The men in the studies believe they won’t be culpable for punishment of possible transmission if they remain ignorant of their own status. The Presidential AIDS Council has recommended repealing these laws, but not only do individuals continue to be prosecuted under them, but some states are still proposing them, including Maryland in 2012 and Arizona this year.

Condoms remain the only effective way of actually preventing the transmission of HIV, regardless of how prevalent testing ever becomes. It’s estimated that only 5 percent of men around the world use condoms when they have sex because condoms are associated with less pleasure. The Bill & Melinda Gates Foundation has been working to design a new condom and recently announced 11 finalists after over 800 ideas were submitted. These innovations will hopefully improve how pleasurable using condoms is so that pleasure and safety are no longer treated like mutually exclusive ideals when it comes to having sex.