Skip to main content
Top
Published in: AIDS and Behavior 5/2007

01-09-2007 | Original paper

Beliefs about Personal and Partner Responsibility among HIV-Seropositive Men Who Have Sex with Men: Measurement and Association with Transmission Risk Behavior

Authors: Richard J. Wolitski, Stephen A. Flores, Ann O’Leary, David S. Bimbi, Cynthia A. Gómez

Published in: AIDS and Behavior | Issue 5/2007

Login to get access

Abstract

Beliefs of people living with HIV about their own responsibility for preventing HIV transmission (personal responsibility) and their sex partners’ responsibility for protecting themselves (partner responsibility) are poorly understood. A sample of 1163 HIV-seropositive men who have sex with men (MSM; 55% men of color) completed an A-CASI assessment of sexual behavior and psychosocial measures. A two-dimensional model that represents four orientations toward responsibility was tested: (1) self—high personal and low partner responsibility, (2) other—low personal and high partner responsibility, (3) shared—high personal and high partner responsibility, and (4) diminished—low personal and low partner responsibility. As predicted, the self-responsibility group demonstrated the lowest risk of HIV transmission; the other responsibility group had the highest risk. Intermediate risk was observed in the shared and diminished responsibility groups. Implications for future research and HIV prevention efforts are discussed.
Literature
go back to reference Bandura, A. (2002). Selective moral disengagement in the exercise of moral agency. Journal of Moral Education, 31, 101–119.CrossRef Bandura, A. (2002). Selective moral disengagement in the exercise of moral agency. Journal of Moral Education, 31, 101–119.CrossRef
go back to reference Bandura, A., Barbaranelli, C., Caprara, G. V., & Pastorelli, C. (1996). Mechanisms of moral disengagement in the exercise of moral agency. Journal of Personality and Social Psychology, 71, 364–374.CrossRef Bandura, A., Barbaranelli, C., Caprara, G. V., & Pastorelli, C. (1996). Mechanisms of moral disengagement in the exercise of moral agency. Journal of Personality and Social Psychology, 71, 364–374.CrossRef
go back to reference Bogart, L. M., Collins, R. L., Kanouse, D. E., Cunningham, W., Beckman, R., Golinelli, D., & Bird, C. E. (2006). Patterns and correlates of deliberate abstinence among men and women with HIV/AIDS. American Journal of Public Health, 96, 1078–1084.PubMedCrossRef Bogart, L. M., Collins, R. L., Kanouse, D. E., Cunningham, W., Beckman, R., Golinelli, D., & Bird, C. E. (2006). Patterns and correlates of deliberate abstinence among men and women with HIV/AIDS. American Journal of Public Health, 96, 1078–1084.PubMedCrossRef
go back to reference Centers for Disease Control and Prevention (2003). Advancing HIV prevention: New strategies for a changing epidemic–United States, 2003. MMWR, 52, 329–332. Centers for Disease Control and Prevention (2003). Advancing HIV prevention: New strategies for a changing epidemic–United States, 2003. MMWR, 52, 329–332.
go back to reference Crepaz, N., Lyles, C. M., Wolitski, R. J., Passin, W. F., Rama, S. M., Herbst, J. H., Purcell, D. W., Malow, R. M., & Stall, R. (2006). Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials. AIDS, 20, 143–157.PubMedCrossRef Crepaz, N., Lyles, C. M., Wolitski, R. J., Passin, W. F., Rama, S. M., Herbst, J. H., Purcell, D. W., Malow, R. M., & Stall, R. (2006). Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials. AIDS, 20, 143–157.PubMedCrossRef
go back to reference Crepaz, N., & Marks, G. (2002). Towards an understanding of sexual risk behavior in people living with HIV: A review of social, psychological, and medical findings. AIDS, 16, 135–149.PubMedCrossRef Crepaz, N., & Marks, G. (2002). Towards an understanding of sexual risk behavior in people living with HIV: A review of social, psychological, and medical findings. AIDS, 16, 135–149.PubMedCrossRef
go back to reference Crosby, G. M. (1998, June). Whose responsibility is it to stop the spread of HIV—Is it mine, is it his, is it ours? Paper presented at the XII International Conference on AIDS, Geneva, Switzerland. Crosby, G. M. (1998, June). Whose responsibility is it to stop the spread of HIV—Is it mine, is it his, is it ours? Paper presented at the XII International Conference on AIDS, Geneva, Switzerland.
go back to reference Crowne, D., & Marlowe, D. (1964). The approval motive. New York: Wiley. Crowne, D., & Marlowe, D. (1964). The approval motive. New York: Wiley.
go back to reference Davis, M. D. M., Hart, G., Imrie, J., Davidson, O., Williams, I., & Stephenson, J. (2002). ‘HIV is HIV to me’: The meanings of treatment, viral load and reinfection for gay men living with HIV. Health, Risk and Society, 4, 31–43.CrossRef Davis, M. D. M., Hart, G., Imrie, J., Davidson, O., Williams, I., & Stephenson, J. (2002). ‘HIV is HIV to me’: The meanings of treatment, viral load and reinfection for gay men living with HIV. Health, Risk and Society, 4, 31–43.CrossRef
go back to reference DiFranceisco, W., McAuliffe, T. L., & Sikkema, K. J. (1998). Influences of survey instrument format and social desirability on the reliability of self-reported high-risk sexual behavior. AIDS and Behavior, 2, 329–337.CrossRef DiFranceisco, W., McAuliffe, T. L., & Sikkema, K. J. (1998). Influences of survey instrument format and social desirability on the reliability of self-reported high-risk sexual behavior. AIDS and Behavior, 2, 329–337.CrossRef
go back to reference Duru, O. K., Collins, R. L., Ciccarone, D. H., Morton, S. C., Stall, R., Beckman, R., Miu, A., & Kanouse, D. E. (2006). Correlates of sex without serostatus disclosure among a national probability sample of HIV patients. AIDS and Behavior, 10, 495–507.PubMedCrossRef Duru, O. K., Collins, R. L., Ciccarone, D. H., Morton, S. C., Stall, R., Beckman, R., Miu, A., & Kanouse, D. E. (2006). Correlates of sex without serostatus disclosure among a national probability sample of HIV patients. AIDS and Behavior, 10, 495–507.PubMedCrossRef
go back to reference Flowers, P., Duncan, B., & Frankis, J. (2000). Community, responsibility and culpability: HIV risk-management amongst Scottish gay men. Journal of Community and Applied Social Psychology, 10, 285–300.CrossRef Flowers, P., Duncan, B., & Frankis, J. (2000). Community, responsibility and culpability: HIV risk-management amongst Scottish gay men. Journal of Community and Applied Social Psychology, 10, 285–300.CrossRef
go back to reference Gold, R. S., Skinner, M. J., & Ross, M. (1994). Unprotected anal intercourse in HIV-infected and non-HIV-infected gay men. Journal of Sex Research, 31, 59–77.CrossRef Gold, R. S., Skinner, M. J., & Ross, M. (1994). Unprotected anal intercourse in HIV-infected and non-HIV-infected gay men. Journal of Sex Research, 31, 59–77.CrossRef
go back to reference Hart, T. A., Wolitski, R. J., Purcell, D. W., Parsons, J. T., Gómez, C. A., & the SUMS Study Team. (2005). Partner awareness of the serostatus of HIV-positive men who have sex with men: Impact on unprotected sexual behavior. AIDS and Behavior, 9, 155–166. Hart, T. A., Wolitski, R. J., Purcell, D. W., Parsons, J. T., Gómez, C. A., & the SUMS Study Team. (2005). Partner awareness of the serostatus of HIV-positive men who have sex with men: Impact on unprotected sexual behavior. AIDS and Behavior, 9, 155–166.
go back to reference Hong, D. S., Goldstein, R. B., Rotheram-Borus, M. J., Wong, F. L., Gore-Felton, C., & the NIMH Health Living Trial Group. (2006). Perceived partner serostatus, attribution of responsibility for prevention of HIV transmission, and sexual risk behavior with “main” partner among adults living with HIV. AIDS Education and Prevention, 18, 150–162. Hong, D. S., Goldstein, R. B., Rotheram-Borus, M. J., Wong, F. L., Gore-Felton, C., & the NIMH Health Living Trial Group. (2006). Perceived partner serostatus, attribution of responsibility for prevention of HIV transmission, and sexual risk behavior with “main” partner among adults living with HIV. AIDS Education and Prevention, 18, 150–162.
go back to reference Janssen, R. S., Holtgrave, D. R., Valdiserri, R. O., Shepherd, M., Gayle, H. D., & DeCock, K. M. (2001). The serostatus approach to fighting the HIV epidemic: Prevention strategies for infected individuals. American Journal of Public Health, 91, 1019–1024.PubMedCrossRef Janssen, R. S., Holtgrave, D. R., Valdiserri, R. O., Shepherd, M., Gayle, H. D., & DeCock, K. M. (2001). The serostatus approach to fighting the HIV epidemic: Prevention strategies for infected individuals. American Journal of Public Health, 91, 1019–1024.PubMedCrossRef
go back to reference Johnson, B. T., Carey, M. P., Chaudoir, S. R., & Reid, A. E. (2006). Sexual risk reduction for persons living with HIV: Research synthesis of randomized controlled trials, 1993 to 2004. Journal of Acquired Immune Deficiency Syndromes, 41, 642–650.PubMedCrossRef Johnson, B. T., Carey, M. P., Chaudoir, S. R., & Reid, A. E. (2006). Sexual risk reduction for persons living with HIV: Research synthesis of randomized controlled trials, 1993 to 2004. Journal of Acquired Immune Deficiency Syndromes, 41, 642–650.PubMedCrossRef
go back to reference Kalichman, S. C. (2000). HIV transmission risk behaviors of men and women living with HIV-AIDS: Prevalence, predictors, and emerging clinical interventions. Clinical Psychology: Science and Practice, 7, 32–47.CrossRef Kalichman, S. C. (2000). HIV transmission risk behaviors of men and women living with HIV-AIDS: Prevalence, predictors, and emerging clinical interventions. Clinical Psychology: Science and Practice, 7, 32–47.CrossRef
go back to reference Kalichman, S. C. (Ed.), (2005). Positive prevention: Reducing HIV transmission among people living with HIV/AIDS. New York, NY: Kluwer Academic/Plenum Publishers. Kalichman, S. C. (Ed.), (2005). Positive prevention: Reducing HIV transmission among people living with HIV/AIDS. New York, NY: Kluwer Academic/Plenum Publishers.
go back to reference Kok, G. (1999). Targeted prevention for people with HIV/AIDS: Feasible and desirable? Patient Education and Counseling, 36, 239–246.PubMedCrossRef Kok, G. (1999). Targeted prevention for people with HIV/AIDS: Feasible and desirable? Patient Education and Counseling, 36, 239–246.PubMedCrossRef
go back to reference Marks, B., Burris, & Peterman, T. A. (1999). Reducing sexual transmission of HIV from those who know they are infected: The need for personal and collective responsibility. AIDS, 13, 297–306.PubMedCrossRef Marks, B., Burris, & Peterman, T. A. (1999). Reducing sexual transmission of HIV from those who know they are infected: The need for personal and collective responsibility. AIDS, 13, 297–306.PubMedCrossRef
go back to reference Marks, G., Crepaz, N., & Janssen, R. S. (2006). Estimating sexual transmission of HIV from persons aware and unaware they are infected with the virus in the United States. AIDS, 20, 1447–1450.PubMedCrossRef Marks, G., Crepaz, N., & Janssen, R. S. (2006). Estimating sexual transmission of HIV from persons aware and unaware they are infected with the virus in the United States. AIDS, 20, 1447–1450.PubMedCrossRef
go back to reference Nimmons, D., & Folkman, S. (1999). Other-sensitive motivation for safer sex among gay men: Expanding paradigms for HIV prevention. AIDS and Behavior, 3, 313–324.CrossRef Nimmons, D., & Folkman, S. (1999). Other-sensitive motivation for safer sex among gay men: Expanding paradigms for HIV prevention. AIDS and Behavior, 3, 313–324.CrossRef
go back to reference O’Leary, A., Hoff, C. C., Purcell, D. W., Gómez, C. A., Parsons, J. T., Hardnett, F., & Lyles, C. M. (2005). What happened in the SUMIT trial? Mediation and behavior change. AIDS, 19(Suppl 1), S111–S122.PubMedCrossRef O’Leary, A., Hoff, C. C., Purcell, D. W., Gómez, C. A., Parsons, J. T., Hardnett, F., & Lyles, C. M. (2005). What happened in the SUMIT trial? Mediation and behavior change. AIDS, 19(Suppl 1), S111–S122.PubMedCrossRef
go back to reference O’Leary, A., Wolitski, R. J., Remien, R. H., Woods, W., Parsons, J. T., Moss, S., & Lyles, C. (2005). Psychosocial correlates of transmission risk behavior among HIV-seropositive gay and bisexual men. AIDS, 19(Suppl 1), S67–S75.PubMed O’Leary, A., Wolitski, R. J., Remien, R. H., Woods, W., Parsons, J. T., Moss, S., & Lyles, C. (2005). Psychosocial correlates of transmission risk behavior among HIV-seropositive gay and bisexual men. AIDS, 19(Suppl 1), S67–S75.PubMed
go back to reference Ostrow D. G., McKirnan D., Klein C., & DiFranceisco, W. (1999). Patterns and correlates of risky behavior among HIV+ gay men: Are they really different from HIV-men? AIDS and Behavior, 3, 99–110.CrossRef Ostrow D. G., McKirnan D., Klein C., & DiFranceisco, W. (1999). Patterns and correlates of risky behavior among HIV+ gay men: Are they really different from HIV-men? AIDS and Behavior, 3, 99–110.CrossRef
go back to reference Parsons, J. T., Halkitis, P. N., Wolitski, R. J., Gómez, C. A., & the Seropositive Urban Men’s Study (SUMS) Team. (2003). Correlates of sexual risk behavior among HIV+ men who have sex with men. AIDS Education and Prevention, 15, 383–400. Parsons, J. T., Halkitis, P. N., Wolitski, R. J., Gómez, C. A., & the Seropositive Urban Men’s Study (SUMS) Team. (2003). Correlates of sexual risk behavior among HIV+ men who have sex with men. AIDS Education and Prevention, 15, 383–400.
go back to reference Reynolds, W. M. (1992). Development of reliable and valid short forms of the Marlowe–Crowne social desirability scale. Journal of Clinical Psychology, 38, 119–125.CrossRef Reynolds, W. M. (1992). Development of reliable and valid short forms of the Marlowe–Crowne social desirability scale. Journal of Clinical Psychology, 38, 119–125.CrossRef
go back to reference Rhodes, T., & Cusick, L. (2002). Accounting for unprotected sex: Stories of agency and acceptability. Social Science and Medicine, 55, 211–226.PubMedCrossRef Rhodes, T., & Cusick, L. (2002). Accounting for unprotected sex: Stories of agency and acceptability. Social Science and Medicine, 55, 211–226.PubMedCrossRef
go back to reference Ryan, R., Downey, L., Fisher, D., & Krutch, B. (2003, July). Responsibility and reduced sexual risk-taking among HIV+ MSM. Paper presented at the 2003 National HIV Prevention Conference, Atlanta, GA. Ryan, R., Downey, L., Fisher, D., & Krutch, B. (2003, July). Responsibility and reduced sexual risk-taking among HIV+ MSM. Paper presented at the 2003 National HIV Prevention Conference, Atlanta, GA.
go back to reference Schiltz, M. A., & Sandfort, T. G. (2000). HIV-positive people, risk and sexual behaviour. Social Science and Medicine, 50, 1571–1588.PubMedCrossRef Schiltz, M. A., & Sandfort, T. G. (2000). HIV-positive people, risk and sexual behaviour. Social Science and Medicine, 50, 1571–1588.PubMedCrossRef
go back to reference Schwartz, D. J., & Bailey, C. J. (2005). Between the sheets and between the ears: Sexual practices and risk beliefs of HIV-positive gay and bisexual men. In P. Halkitis, C. Gómez, & R. J. Wolitski (Eds.) HIV + Sex: The psychological and interpersonal dynamics of HIV-seropositive gay and bisexual men’s relationships (pp. 55–72). Washington, DC: American Psychological Association. Schwartz, D. J., & Bailey, C. J. (2005). Between the sheets and between the ears: Sexual practices and risk beliefs of HIV-positive gay and bisexual men. In P. Halkitis, C. Gómez, & R. J. Wolitski (Eds.) HIV + Sex: The psychological and interpersonal dynamics of HIV-seropositive gay and bisexual men’s relationships (pp. 55–72). Washington, DC: American Psychological Association.
go back to reference Serovich, J. M., & Mosack, K. E. (2003). Reasons for HIV disclosure or nondisclosure to casual sex partners. AIDS Education and Prevention, 15, 70–80.PubMedCrossRef Serovich, J. M., & Mosack, K. E. (2003). Reasons for HIV disclosure or nondisclosure to casual sex partners. AIDS Education and Prevention, 15, 70–80.PubMedCrossRef
go back to reference Suarez, T., & Miller, J. (2001). Negotiating risks in context: A perspective on unprotected anal intercourse and barebacking among men who have sex with men. Archives of Sexual Behavior, 30, 287–300.PubMedCrossRef Suarez, T., & Miller, J. (2001). Negotiating risks in context: A perspective on unprotected anal intercourse and barebacking among men who have sex with men. Archives of Sexual Behavior, 30, 287–300.PubMedCrossRef
go back to reference van Kesteren, N. M. C., Hospers, H. J., Kok, G., & van Emplen, P. (2005). Sexuality and sexual risk behavior in HIV-positive men who have sex with men. Qualitative Health Research, 15, 145–168.PubMedCrossRef van Kesteren, N. M. C., Hospers, H. J., Kok, G., & van Emplen, P. (2005). Sexuality and sexual risk behavior in HIV-positive men who have sex with men. Qualitative Health Research, 15, 145–168.PubMedCrossRef
go back to reference Wolitski, R. J., Bailey, C., O’Leary, A., Gómez, C. A., Parsons, J. T., & the Seropositive Urban Men’s Study Group. (2003). Self-perceived responsibility of HIV-seropositive men for preventing HIV transmission to sex partners. AIDS and Behavior, 7, 363–372. Wolitski, R. J., Bailey, C., O’Leary, A., Gómez, C. A., Parsons, J. T., & the Seropositive Urban Men’s Study Group. (2003). Self-perceived responsibility of HIV-seropositive men for preventing HIV transmission to sex partners. AIDS and Behavior, 7, 363–372.
go back to reference Wolitski, R. J., Gómez, C. A., Parsons, J., Ambrose, T., & Remien, R. (1998, June). HIV-seropositive men’s perceived responsibility for preventing transmission of HIV to others. Paper presented at the XII International Conference on AIDS, Geneva, Switzerland. Wolitski, R. J., Gómez, C. A., Parsons, J., Ambrose, T., & Remien, R. (1998, June). HIV-seropositive men’s perceived responsibility for preventing transmission of HIV to others. Paper presented at the XII International Conference on AIDS, Geneva, Switzerland.
go back to reference Wolitski, R. J., Parsons, J. T., & Gómez, C. A. (2004). Prevention with HIV-seropositive gay and bisexual men: Lessons learned from the Seropositive Urban Men’s Study (SUMS) and the Seropositive Urban Men’s Intervention Trial (SUMIT). Journal of Acquired Immunodeficiency Syndromes, 37(Suppl 2), S101–S109.CrossRef Wolitski, R. J., Parsons, J. T., & Gómez, C. A. (2004). Prevention with HIV-seropositive gay and bisexual men: Lessons learned from the Seropositive Urban Men’s Study (SUMS) and the Seropositive Urban Men’s Intervention Trial (SUMIT). Journal of Acquired Immunodeficiency Syndromes, 37(Suppl 2), S101–S109.CrossRef
go back to reference Wolitski, R. J., Parsons, J. T., Gómez, C. A., Purcell, D. W., Hoff, C. C., Halkitis, P. N., & the SUMIT Study Group. (2005). Prevention with gay and bisexual men living with HIV: Rationale and methods of the Seropositive Urban Men’s Intervention Trial (SUMIT). AIDS, 19(Suppl 1), S1–S11. Wolitski, R. J., Parsons, J. T., Gómez, C. A., Purcell, D. W., Hoff, C. C., Halkitis, P. N., & the SUMIT Study Group. (2005). Prevention with gay and bisexual men living with HIV: Rationale and methods of the Seropositive Urban Men’s Intervention Trial (SUMIT). AIDS, 19(Suppl 1), S1–S11.
go back to reference Wolitski, R. J., & Zhang, J. (in press). Understanding and motivating condom use among at-risk and HIV-seropositive persons: A review and demonstration of the applicability of the Theories of Reasoned Action and Planned Behavior. In I. Ajzen, R Hornik, D. Albarracín (eds.), Prediction and Change of Behavior: Applying a Reasoned Action Approach. Mahwah, NJ: Lawrence Erlbaum. Wolitski, R. J., & Zhang, J. (in press). Understanding and motivating condom use among at-risk and HIV-seropositive persons: A review and demonstration of the applicability of the Theories of Reasoned Action and Planned Behavior. In I. Ajzen, R Hornik, D. Albarracín (eds.), Prediction and Change of Behavior: Applying a Reasoned Action Approach. Mahwah, NJ: Lawrence Erlbaum.
Metadata
Title
Beliefs about Personal and Partner Responsibility among HIV-Seropositive Men Who Have Sex with Men: Measurement and Association with Transmission Risk Behavior
Authors
Richard J. Wolitski
Stephen A. Flores
Ann O’Leary
David S. Bimbi
Cynthia A. Gómez
Publication date
01-09-2007
Publisher
Springer US
Published in
AIDS and Behavior / Issue 5/2007
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-006-9183-6

Other articles of this Issue 5/2007

AIDS and Behavior 5/2007 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.