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CTNPT 013: Sexual health and HIV-risk management in MSM

The impact of in-clinic follow-up with a sexologist on the sexual health of HIV-serodiscordant MSM couples.

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About the study

The main goal of this 24-week (6-month) study is to see how effective sessions with a sexologist (a therapist specialized in human sexuality) are in improving sexual health and reducing HIV transmission risk in couples of men who have sex with men (MSM) with one HIV-positive partner. The sexologist will discuss a range of sexual health issues adapted to each couple with the goal of helping them build skills to both increase their sexual health and decrease their HIV risk behaviours.

About the disease/condition

While HIV treatments have lowered the death rate of AIDS-related illnesses, HIV infection rates have continued to increase. This tells us that we need new approaches to HIV prevention. An approach that includes all aspects of sexual health could help reduce transmission rates. Sexual problems are common for HIV-positive individuals and often these problems are not discussed with a doctor. Even if a doctor is told of sexual problems by a patient who is HIV-positive, they may not have enough training in the area to help.

Studies have shown that antiretroviral therapy can prevent the transmission of HIV in heterosexual couples, but it is not known if the therapy works the same way for MSM or if MSM include this information in their decision-making when it comes to sex.

Study Approach

This study involves a mix of couples-based and one-on-one sessions with a sexologist, filling out questionnaires, interviews on topics related to sexual health as well as the collection of medical information. Blood will also be drawn to test for HIV during the study visits (in the amount of 7 mL per test), if there is no record of an HIV test result that is 1 month old or less. For HIV testing, participants will receive counselling before testing and when test results are received.

If eligible to participate, between the screening and baseline visit each couple will meet with the sexologist to help plan the upcoming sessions. Each session with the sexologist will be about one hour long.

These sessions will be adapted to the specific sexual health needs of each couple. They will help couples manage HIV-transmission risk (e.g., tailored risk-reduction strategies), take a sex-positive and multidimensional approach to sexual health, and aim to build skills.

The study outcomes that will be measured include sexual function, satisfaction, and communication, relationship satisfaction, and measures of HIV transmission risk like treatment adherence and viral load.

Eligibility criteria

Inclusion Criteria:

  • 18 years of age or older
  • Each member of the couple is a gay man, MSM or a transsexual man (self-identified man) who has sex with men
  • Both members consider that they are part of a couple or otherwise enduring primary sexual relationship
  • Both report that they have been together for at least 3 months
  • Both expect to remain a couple for the next 6 months
  • Only one partner is known by both members of the couple to be HIV-positive
  • The HIV-positive partner has known his status for at least 3 months before study entry and is currently receiving care at one of the participating HIV clinics

Exclusion Criteria:

  • Serious mental illness that prevents effective interviewing (accommodation will be made for HIV-related cognitive deficits and illnesses)
  • Either partner has plans to relocate to an unreasonable distance from the study site
  • Either partner is currently using the services of a sex therapist/sexologist
  • Severe psychological, physical or sexual abuse in the current or a past relationship has taken place in the previous year (e.g., significant enough to require medical, psychological, and/or legal intervention)
  • HIV testing finds the presumed ‘negative’ partner to be HIV-positive

Participating sites

Ontario

Dr. Paul MacPherson
Immunodeficiency Clinic, The Ottawa Hospital General Campus, Ottawa

Dr. Mona Loutfy
Maple Leaf Medical Clinic, Toronto

Quebec

Dr. Bertrand Lebouché, Dr. Jean-Pierre Routy
Chronic Viral Illness Service (CVIS), McGill University Health Centre, Montreal

Dr. Réjean Thomas
Clinique médicale L’Actuel, Montreal

Additional Information

If you would like more information on this clinical study, please refer to a participating site.

Principal Investigator:

Bertrand Lebouché MD, PhD
(514) 934-1934 extension 32600

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