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Presentation by Ford Hickson, from Sigma Research, London, at the 2010 AFAO HIV Educators Conference.
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What’s the point of HIV prevention? Ford HicksonSigma Research, United Kingdom
Tackling Stigma: Pride, Prejudice and PreventionAustralian Federation of AIDS Organisations’ HIV Educators ConferenceSydney, June 2010.
Amount of riskNo risk Much risk
0
20
40
60
80
100Population risk profile
Amount of riskNo UAI last 12 mths UAI in last 12 mths
0
20
40
60
80
100Population risk profile (UK GMSS 1998)
Amount of riskNo UAI last 12 mths UAI in last 12 mths
0
20
40
60
80
100Population risk profile (UK GMSS 2008)
Amount of risk (UAI & Condom Failure)No UAI or CF
Thought neg onlyUnknown not pos
Known pos
0
20
40
60
80
100Population risk profile (Sydney HIM Study 2001-4)
O.3% O.7% 1.5% 5.3%
Jin et al. (2009) AIDS, 23: 243–252.
Annual HIV incidence
% of new infections
28%28%30%15%
Amount of risk (UAI & condom failure)No UAI
Negotiated safetyOther thought neg only
Unknown not posKnown pos
0
20
40
60
80
100Population risk profile (Sydney HIM Study 2001-4)
Jin et al. (2009) AIDS, 23: 243–252.
Amount of risk (UAI & condom failure)No AI
PAI onlyNegotiated safety
Other thought negUnknown not pos
Known pos
0
20
40
60
80
100Population risk profile (Sydney HIM Study 2001-4)
Jin et al. (2009) AIDS, 23: 243–252 and personal communication.
Contribution to population HIV risk
Prop
ortio
n of
pop
ulati
on
open relationships →
ejaculation into the body →using poppers →
anal intercourse →
← STI/HIV test & treat
← disclosure & negotiation
← condoms and lubricant
← PEP taking
0.5%0.4% 0.6%
have new sex partners → ← decline, defer or date new partners
deferring screening & treatment →
← monogamy
silence (or lies) →
no condoms →
← non-penetrative sex
not seeking PEP →
← withdrawal before ejaculation← not using poppers
The best sex?
• Unconfident of already having an STI• Immediate sex with a new partner• Silent sex• Open relationships• Anal intercourse• Bareback• Ejaculating into the body• Using poppers• Not seeking PEP
The best sex?
• Confident of not having an STI• No sex, deferred sex or pre-dated sex• Disclosed and discussed sex• Monogamous relationships• Without intercourse• With condoms• Ejaculating outside the body• Not using poppers• Seeking PEP afterwards
The best sex with least harm?
Confident or Unconfident of passing on an STI?Declined or deferred or Sex now with new partner?
Disclosed and discussed or Silent?Monogamous or Open relationships?Non-penetrative or Anal intercourse?
Condom or Bareback?Ejaculation in the body or Outside the body?
No poppers or Poppers?PEP or No PEP?
