Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA.
Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA.
J Int AIDS Soc. 2018 Jan;21(1). doi: 10.1002/jia2.25055.
Recent research has shown high efficacy of HIV treatment for reducing the risk of HIV transmission to sexual partners. As the efficacy of treatment as prevention (TasP) has proliferated, a new messaging campaign, Undetectable = Untransmittable, has been gaining popularity. The purpose of this paper was to assess factors associated with the perceived accuracy of this TasP messaging strategy among a large and diverse sample of gay, bisexual, and other men who have sex with men (GBMSM) in order to inform subsequent efforts at large-scale and implementation of the HIV prevention message.
We conducted a nationwide survey of GBMSM in the U.S. recruited from an online social networking site and a mobile sexual networking app. We analysed data from 12,222 GBMSM separately by HIV status to examine sociodemographic and behavioural factors associated with ratings of the accuracy of the Undetectable = Untransmittable message, which included the option to indicate not understanding what "undetectable" meant.
Among HIV-negative and unknown men, multivariable linear regression indicated that being on pre-exposure prophylaxis (PrEP), identifying as gay or queer (versus bisexual or straight), recent serodiscordant condomless anal sex (CAS), testing every six months or more often, less concern about sexually transmitted infection (STI) infection, and lower perceived risk of HIV infection were the factors with the largest independent effect on rating the Undetectable = Untransmittable statement as more accurate. Fewer factors emerged as associated with accuracy ratings among HIV-positive participants-reporting an undetectable viral load, a lifetime acquired immune deficiency syndrome (AIDS) diagnosis, and lower concern about STI infection were the factors most strongly associated with rating the statement as more accurate.
The findings of the current study highlight variability in the perceived accuracy of the Undetectable = Untransmittable message, suggesting potential subgroups who might benefit from targeted educational campaigns, perhaps broadcast utilizing sexual networking apps. Numerous factors, particularly among HIV-negative and unknown GBMSM, were associated with rating the message as more accurate. In particular, being on PrEP and testing regularly were two of the variables most strongly associated with higher accuracy ratings among HIV-negative GBMSM, suggesting HIV prevention services as potential points of intervention for increasing HIV knowledge and decreasing HIV stigma.
最近的研究表明，艾滋病毒治疗的疗效很高，可以降低性伴侣感染艾滋病毒的风险。随着治疗即预防（TasP）的疗效不断普及，一项新的宣传活动“检测不到=不传播”（Undetectable = Untransmittable）越来越受欢迎。本文旨在评估在大量不同的男同性恋、双性恋和其他与男性发生性关系的男性（GBMSM）群体中，这种 TasP 信息策略的感知准确性相关的因素，以便为随后的大规模努力和实施 HIV 预防信息提供信息。
我们对美国的 GBMSM 进行了一项全国性的调查，这些参与者是从一个在线社交网络网站和一个移动性网络应用程序招募而来的。我们分别对 HIV 阳性和阴性的 GBMSM 进行了数据分析，以研究与不可检测即不可传播信息准确性相关的社会人口学和行为因素，其中包括表示不理解“不可检测”含义的选项。
在 HIV 阴性和未知的男性中，多变量线性回归表明，使用暴露前预防（PrEP）、认同同性恋或酷儿（而不是双性恋或异性恋）、最近的血清不一致无保护肛交（CAS）、每六个月或更频繁地进行检测、较少关注性传播感染（STI）感染，以及较低的 HIV 感染风险感知是对不可检测即不可传播声明评价更准确的最大独立影响因素。在 HIV 阳性参与者中，与准确性评价相关的因素较少，报告不可检测的病毒载量、终身获得性免疫缺陷综合征（AIDS）诊断以及较低的 STI 感染关注是与评价该声明更准确最相关的因素。
当前研究的结果强调了不可检测即不可传播信息的感知准确性存在差异，这表明可能有一些特定的亚组需要有针对性的教育宣传活动，也许可以利用性网络应用程序进行广播。许多因素，特别是在 HIV 阴性和未知的 GBMSM 中，与评价该信息更准确相关。特别是，使用 PrEP 和定期检测是与 HIV 阴性 GBMSM 中更高准确性评分最相关的两个变量之一，这表明 HIV 预防服务可能是增加 HIV 知识和减少 HIV 耻辱感的潜在干预点。
