Characteristics of Agreements to have Condomless Anal Intercourse in the Presence of an Undetectable Viral Load Among HIV Serodiscordant Male Couples in Australia, Brazil and Thailand

James Gray, Garrett Prestage, Fengyi Jin, Nittaya Phanuphak, Ruth K. Friedman, Christopher K. Fairley, Anthony Kelleher, David Templeton, Iryna Zablotska-Manos, Jennifer Hoy, Anna McNulty, Catherine Pell, Andrew Grulich, Benjamin Bavinton, Opposites Attract Study Group

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2 Citations (Scopus)


The use of undetectable viral load (VL) to negotiate condomless anal intercourse (CLAI) in HIV serodiscordant male relationships has become more common as more data regarding the effectiveness of antiretroviral treatments for the prevention of HIV transmission has been described. We examined viral load agreements (VLAs) for condomless sex in the presence of an undetectable VL in 343 HIV serodiscordant male couples in Australia, Brazil and Thailand. Factors associated with having a VLA included having agreements for the HIV-positive partner to report his VL result (p < 0.001), agreeing that VL affects agreements about sexual practice (p < 0.001), the HIV-negative partner’s perception of his partner’s undetectable VL (p < 0.001), the couple’s belief in the efficacy of undetectable VL in preventing HIV transmission (p < 0.001), and the couple engaging in CLAI with each other (p < 0.001). Over time, these agreements became more common although 49.3% of couples in the sample never had a viral load agreement. As these agreements become more common, further education is required to support male couples in using them safely.

Original languageEnglish
Pages (from-to)3944-3954
Number of pages11
JournalAIDS and Behavior
Issue number12
Publication statusPublished - Dec 2021


  • Gay men
  • HIV prevention
  • Homosexual
  • Men who have sex with men
  • Risk reduction strategies
  • Serodiscordant couples
  • Sexual behavior

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