Researchers set out to evaluate whether changes in the use of condoms reflected increased adoption of serosorting (having sex only with those of similar HIV status) or biomedical preventions like antiretroviral treatment. Their report, published in May in the journal AIDS, concluded that condomless sex continues to increase among men who have sex with men, but “the trends are not explained by serosorting or ART.”
The scientists reviewed data gathered by the National HIV Behavioral Surveillance Survey, which was conducted in up to 21 cities in 2005, 2008, 2011, and 2014. The survey asked more than a thousand men whether they used a condom with their latest anal sex partner.
They found that declines in condom usage were seen across the board among men, whether or not their sexual partners were of the same HIV status and regardless of whether they knew their partners’ HIV status. This led researchers to conclude that the lack of condom use cannot be explained by serosorting.
In the near-decade between 2005 and 2014, the number of HIV-negative gay and bisexual men who reported having sex without a condom rose from 29% to 41%.
As Website NAM Aidsmap points out, “Condom use began to fall long before PrEP became available.
In the surveillance survey, PrEP usage was reported by 0.5% of the gay and bi men in 2011. That number rose to only 3.5% of men in 2014, making it highly unlikely that the HIV prevention protocol played a significant role in the decline of condom use.