Skip to main content
Top
Published in: AIDS and Behavior 4/2013

01-05-2013 | Original Paper

Sexual Risk Behavior and Risk Reduction Beliefs Among HIV-Positive Young Men Who have Sex with Men

Authors: Douglas Bruce, Gary W. Harper, Katie Suleta, The Adolescent Medicine Trials Network for HIV/AIDS Interventions

Published in: AIDS and Behavior | Issue 4/2013

Login to get access

Abstract

With young men who have sex with men (YMSM) continuing to be disproportionately affected by the HIV/AIDS epidemic in the U.S., secondary prevention efforts with this population take on increasing significance. We surveyed 200 HIV-positive YMSM (ages 16–24, 66% Black, 18% Latino, 7% White, 7% Multiracial/Other) recruited from 14 HIV primary care sites to examine associations of unprotected anal intercourse (UAI) and partner HIV status with endorsement of serosorting, sexual positioning, and viral load beliefs. Proportions of participants engaging in UAI one or more times during the past three months were consistent across type of UAI (insertive or receptive) and partner status. Belief that an undetectable viral load reduces infectiousness was significantly associated with insertive UAI (p < .05) and receptive UAI (p < .05) with HIV-negative or unknown status partners and receptive UAI with HIV-positive partners (p < .01). Endorsement of belief in serosorting was significantly associated with receptive UAI (p < .01) and insertive UAI (p < .05) with HIV-positive male partners. Implications for sexual behavior and risk reduction beliefs in this population are discussed.
Literature
1.
go back to reference Centers for Disease Control and Prevention. HIV surveillance report 2008, vol 20. 2010. Centers for Disease Control and Prevention. HIV surveillance report 2008, vol 20. 2010.
2.
go back to reference Centers for Disease Control and Prevention. Subpopulation estimates from the HIV incidence surveillance system—United States, 2006. MMWR. 2008;57:985–9. Centers for Disease Control and Prevention. Subpopulation estimates from the HIV incidence surveillance system—United States, 2006. MMWR. 2008;57:985–9.
3.
go back to reference Fernyak SE, Page-Shafer K, Kellogg TA, McFarland W, Katz MH. Risk behaviors and HIV incidence among repeat testers at publicly funded HIV testing sites in San Francisco. J Acquir Immune Defic Syndr. 2002;31(1):63–70.PubMedCrossRef Fernyak SE, Page-Shafer K, Kellogg TA, McFarland W, Katz MH. Risk behaviors and HIV incidence among repeat testers at publicly funded HIV testing sites in San Francisco. J Acquir Immune Defic Syndr. 2002;31(1):63–70.PubMedCrossRef
4.
go back to reference Jin F, Jansson J, Law M, et al. Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS. 2010;24:907–13.PubMedCrossRef Jin F, Jansson J, Law M, et al. Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS. 2010;24:907–13.PubMedCrossRef
5.
go back to reference Eaton LA, Kalichman SC, O’Donnell DA, Karchner WD. A strategy for selecting sexual partners believed to pose little/no risks for HIV: serosorting and its implications for HIV transmission. AIDS Care. 2009;21(1):1279–88.PubMedCrossRef Eaton LA, Kalichman SC, O’Donnell DA, Karchner WD. A strategy for selecting sexual partners believed to pose little/no risks for HIV: serosorting and its implications for HIV transmission. AIDS Care. 2009;21(1):1279–88.PubMedCrossRef
6.
go back to reference Jin F, Crawford J, Prestage GP, et al. Unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men. AIDS. 2009;23(2):243–52.PubMedCrossRef Jin F, Crawford J, Prestage GP, et al. Unprotected anal intercourse, risk reduction behaviours, and subsequent HIV infection in a cohort of homosexual men. AIDS. 2009;23(2):243–52.PubMedCrossRef
7.
go back to reference Kippax S, Noble J, Prestage G, et al. Sexual negotiation in the AIDS era: negotiated safety revisited. AIDS. 1997;11(2):191–7.PubMedCrossRef Kippax S, Noble J, Prestage G, et al. Sexual negotiation in the AIDS era: negotiated safety revisited. AIDS. 1997;11(2):191–7.PubMedCrossRef
8.
go back to reference Vernazza P, Hirschel B, Bernasconi E, Flepp M. Les personnes seropositives ne souffrant d’aucune autre MST et suivant un traitment antiretroviral efficie ne transmettent pas le VIH par voie sexuelle. Bull Meds Suisses. 2008;89:165–9. Vernazza P, Hirschel B, Bernasconi E, Flepp M. Les personnes seropositives ne souffrant d’aucune autre MST et suivant un traitment antiretroviral efficie ne transmettent pas le VIH par voie sexuelle. Bull Meds Suisses. 2008;89:165–9.
9.
go back to reference Wilson DP, Law MG, Grulich AE, Cooper DA, Kaldor JM. Relation between HIV viral load and infectiousness: a model-based analysis. Lancet. 2008;372(9635):314–20.PubMedCrossRef Wilson DP, Law MG, Grulich AE, Cooper DA, Kaldor JM. Relation between HIV viral load and infectiousness: a model-based analysis. Lancet. 2008;372(9635):314–20.PubMedCrossRef
10.
go back to reference Crepaz N, Hart T, Marks G. Highly active antiretroviral therapy and sexual risk behavior. JAMA. 2004;292(2):224–36.PubMedCrossRef Crepaz N, Hart T, Marks G. Highly active antiretroviral therapy and sexual risk behavior. JAMA. 2004;292(2):224–36.PubMedCrossRef
11.
go back to reference Crepaz N, Marks G, Liau A, et al. Prevalence of unprotected anal intercourse among HIV-diagnosed MSM in the United States: a meta-analysis. AIDS. 2009;23(13):1617–29.PubMedCrossRef Crepaz N, Marks G, Liau A, et al. Prevalence of unprotected anal intercourse among HIV-diagnosed MSM in the United States: a meta-analysis. AIDS. 2009;23(13):1617–29.PubMedCrossRef
12.
go back to reference Kalichman SC. HIV transmission risk behaviors of men and women living with HIV-AIDS: prevalence, predictors, and emerging clinical interventions. Clin Psych. 2000;7(1):32–47. Kalichman SC. HIV transmission risk behaviors of men and women living with HIV-AIDS: prevalence, predictors, and emerging clinical interventions. Clin Psych. 2000;7(1):32–47.
13.
go back to reference Van Kesteren NMC, Hospers HJ, Kok G. Sexual risk behavior among HIV-positive men who have sex with men: a literature review. Patient Educ Couns. 2007;65(1):5–20.PubMedCrossRef Van Kesteren NMC, Hospers HJ, Kok G. Sexual risk behavior among HIV-positive men who have sex with men: a literature review. Patient Educ Couns. 2007;65(1):5–20.PubMedCrossRef
14.
go back to reference Truong HH, Kellogg T, Klausner JD, et al. Increases in sexually transmitted infections and sexual risk behavior without a concurrent increase in HIV incidence among men who have sex with men in San Francisco: a suggestion of HIV serosorting? Sex Transm Infect. 2006;82:461–6.PubMedCrossRef Truong HH, Kellogg T, Klausner JD, et al. Increases in sexually transmitted infections and sexual risk behavior without a concurrent increase in HIV incidence among men who have sex with men in San Francisco: a suggestion of HIV serosorting? Sex Transm Infect. 2006;82:461–6.PubMedCrossRef
15.
go back to reference Dougan S, Evans B, Elford J. Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Sex Transm Dis. 2009;34(10):783–90. Dougan S, Evans B, Elford J. Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Sex Transm Dis. 2009;34(10):783–90.
16.
go back to reference Eaton LA, West TV, Kenny DA, Kalichman SC. HIV transmission risk among HIV seroconcordant and serodiscordant couples: dyadic processes of partner selection. AIDS Behav. 2009;13(2):185–95.PubMedCrossRef Eaton LA, West TV, Kenny DA, Kalichman SC. HIV transmission risk among HIV seroconcordant and serodiscordant couples: dyadic processes of partner selection. AIDS Behav. 2009;13(2):185–95.PubMedCrossRef
17.
go back to reference Rosengarten M, Race K, Kippax S. Touch wood, everything will be OK: gay men’s understandings of clinical markers in sexual practice. Sydney: National Centre in HIV Social Research, UNSW; 2000. Rosengarten M, Race K, Kippax S. Touch wood, everything will be OK: gay men’s understandings of clinical markers in sexual practice. Sydney: National Centre in HIV Social Research, UNSW; 2000.
18.
go back to reference Van de Van P, Kippax S, Crawford J, et al. In a minority of gay men, sexual risk practice indicates strategic positioning for perceived risk reduction rather than unbridled sex. AIDS Care. 2002;14:471–80. Van de Van P, Kippax S, Crawford J, et al. In a minority of gay men, sexual risk practice indicates strategic positioning for perceived risk reduction rather than unbridled sex. AIDS Care. 2002;14:471–80.
19.
go back to reference Elford J, Bolding G, Sherr L. High-risk sexual behaviour increases among London gay men between 1998 and 2001: what is the role of HIV optimism? AIDS. 2002;16(11):1537–44.PubMedCrossRef Elford J, Bolding G, Sherr L. High-risk sexual behaviour increases among London gay men between 1998 and 2001: what is the role of HIV optimism? AIDS. 2002;16(11):1537–44.PubMedCrossRef
20.
go back to reference Chen SY, Gibson S, Katz MH, et al. Continuing increases in sexual risk behavior and sexually transmitted diseases among men who have sex with men: San Francisco, CA, 1999–2001. Am J Public Health. 2002;92(9):1387–8.PubMedCrossRef Chen SY, Gibson S, Katz MH, et al. Continuing increases in sexual risk behavior and sexually transmitted diseases among men who have sex with men: San Francisco, CA, 1999–2001. Am J Public Health. 2002;92(9):1387–8.PubMedCrossRef
21.
go back to reference Kalichman SC, Eaton L, White D, et al. Beliefs about treatments for HIV/AIDS and sexual risk behaviors among men who have sex with men, 1997–2006. J Behav Med. 2007;30(6):497–503.PubMedCrossRef Kalichman SC, Eaton L, White D, et al. Beliefs about treatments for HIV/AIDS and sexual risk behaviors among men who have sex with men, 1997–2006. J Behav Med. 2007;30(6):497–503.PubMedCrossRef
22.
go back to reference Prestage G, Mao L, Kippax S, et al. Use of viral load to negotiate condom use among gay men in Sydney, Australia. AIDS Behav. 2009;13(4):645–51.PubMedCrossRef Prestage G, Mao L, Kippax S, et al. Use of viral load to negotiate condom use among gay men in Sydney, Australia. AIDS Behav. 2009;13(4):645–51.PubMedCrossRef
23.
go back to reference Magnus M, Jones K, Phillips G, et al. Characteristics associated with retention among African American and Latino adolescent HIV-positive men: results from the outreach, care, and prevention to engage HIV-seropositive young MSM of color special project of national significance initiative. J Acquir Immune Defic Syndr. 2010;53(4):529–36.PubMedCrossRef Magnus M, Jones K, Phillips G, et al. Characteristics associated with retention among African American and Latino adolescent HIV-positive men: results from the outreach, care, and prevention to engage HIV-seropositive young MSM of color special project of national significance initiative. J Acquir Immune Defic Syndr. 2010;53(4):529–36.PubMedCrossRef
25.
go back to reference Comulada WS, Swendeman DT, Rotheram-Borus MJ, Mattes KM, Weiss RE. Use of HAART among young people living with HIV. Am J Health Behav. 2003;27(4):389–400.PubMedCrossRef Comulada WS, Swendeman DT, Rotheram-Borus MJ, Mattes KM, Weiss RE. Use of HAART among young people living with HIV. Am J Health Behav. 2003;27(4):389–400.PubMedCrossRef
26.
go back to reference Hightow-Weidman LB, Jones K, Phillips G, Wohl A, Giordano TP, The YMSM of Color SPNS Initiative Study Group. Baseline clinical characteristics, antiretroviral therapy use, and viral load suppression among HIV-positive young men of color who have sex with men. AIDS Patient Care STDs. 2011;25(suppl 1):S9–14. doi:10.1089/apc.2011.9881.PubMedCrossRef Hightow-Weidman LB, Jones K, Phillips G, Wohl A, Giordano TP, The YMSM of Color SPNS Initiative Study Group. Baseline clinical characteristics, antiretroviral therapy use, and viral load suppression among HIV-positive young men of color who have sex with men. AIDS Patient Care STDs. 2011;25(suppl 1):S9–14. doi:10.​1089/​apc.​2011.​9881.PubMedCrossRef
27.
go back to reference Fleming PF, Wortley PM, Karon JM, DeCock KM, Janssen RS. Tracking the HIV epidemic: current issues, future challenges. Am J Public Health. 2000;90:1037–41.PubMedCrossRef Fleming PF, Wortley PM, Karon JM, DeCock KM, Janssen RS. Tracking the HIV epidemic: current issues, future challenges. Am J Public Health. 2000;90:1037–41.PubMedCrossRef
28.
go back to reference Granich R, Crowley S, Vitoria M, et al. Highly active antiretroviral treatment as prevention of HIV transmission: review of scientific evidence and update. Curr Opin HIV AIDS. 2010;5(4):298–304.PubMedCrossRef Granich R, Crowley S, Vitoria M, et al. Highly active antiretroviral treatment as prevention of HIV transmission: review of scientific evidence and update. Curr Opin HIV AIDS. 2010;5(4):298–304.PubMedCrossRef
29.
go back to reference Grant RM, Lama JR, Anderson PL, et al. Pre-exposure chemoprophylaxis for HIV prevention men who have sex with men. N Eng J Med. 2010;363:2587–99.CrossRef Grant RM, Lama JR, Anderson PL, et al. Pre-exposure chemoprophylaxis for HIV prevention men who have sex with men. N Eng J Med. 2010;363:2587–99.CrossRef
30.
go back to reference Zablotska IB, Imrie J, Prestage G, et al. Gay men’s current practice of HIV seroconcordant unprotected anal intercourse: serosorting or seroguessing? AIDS Care. 2009;21(4):501–10.PubMedCrossRef Zablotska IB, Imrie J, Prestage G, et al. Gay men’s current practice of HIV seroconcordant unprotected anal intercourse: serosorting or seroguessing? AIDS Care. 2009;21(4):501–10.PubMedCrossRef
31.
go back to reference Wiener LS, Battles HB. Untangling the web: a close look at diagnosis disclosure among HIV-infected adolescents. J Adolesc Health. 2006;38(3):307–9.PubMedCrossRef Wiener LS, Battles HB. Untangling the web: a close look at diagnosis disclosure among HIV-infected adolescents. J Adolesc Health. 2006;38(3):307–9.PubMedCrossRef
32.
go back to reference Carballo-Diéguez A, Miner M, Dolezal C, Rosser BRS, Jacoby S. Sexual negotiation, HIV-status disclosure, and sexual risk behavior among Latino men who use the internet to seek sex with other men. Arch Sex Behav. 2004;35(4):473–81.CrossRef Carballo-Diéguez A, Miner M, Dolezal C, Rosser BRS, Jacoby S. Sexual negotiation, HIV-status disclosure, and sexual risk behavior among Latino men who use the internet to seek sex with other men. Arch Sex Behav. 2004;35(4):473–81.CrossRef
33.
go back to reference Sullivan KM. Male self-disclosure of HIV-positive serostatus to sex partners: a review of the literature. JANAC. 2005;16(6):33–47.PubMedCrossRef Sullivan KM. Male self-disclosure of HIV-positive serostatus to sex partners: a review of the literature. JANAC. 2005;16(6):33–47.PubMedCrossRef
34.
go back to reference Danta M, Brown D, Bhagani S, et al. Recent epidemic of acute hepatitis C virus in HIV-positive men who have sex with men linked to high-risk sexual behaviours. AIDS. 2007;21(8):983–91.PubMedCrossRef Danta M, Brown D, Bhagani S, et al. Recent epidemic of acute hepatitis C virus in HIV-positive men who have sex with men linked to high-risk sexual behaviours. AIDS. 2007;21(8):983–91.PubMedCrossRef
35.
go back to reference Rauch A, Martin M, Weber R, et al. Unsafe sex and increased incidence of hepatitis C virus infection among HIV-infected men who have ex with men: the Swiss HIV cohort study. Clin Infect Dis. 2005;41(3):395–402.PubMedCrossRef Rauch A, Martin M, Weber R, et al. Unsafe sex and increased incidence of hepatitis C virus infection among HIV-infected men who have ex with men: the Swiss HIV cohort study. Clin Infect Dis. 2005;41(3):395–402.PubMedCrossRef
36.
go back to reference Van der Helm JJ, Prins M, del Amo J, et al. The hepatitis C epidemic among HIV-positive MSM: incidence estimates from 1990 to 2007. AIDS. 2011;25(8):1083–91.PubMedCrossRef Van der Helm JJ, Prins M, del Amo J, et al. The hepatitis C epidemic among HIV-positive MSM: incidence estimates from 1990 to 2007. AIDS. 2011;25(8):1083–91.PubMedCrossRef
37.
go back to reference Kim JH, Psevdos G, Suh J, Sharp VL. Co-infection of hepatitis B and hepatitis C virus in human immunodeficiency virus-infected patients in New York city, United States. World J Gastroenterol. 2008;14(43):6689–93.PubMedCrossRef Kim JH, Psevdos G, Suh J, Sharp VL. Co-infection of hepatitis B and hepatitis C virus in human immunodeficiency virus-infected patients in New York city, United States. World J Gastroenterol. 2008;14(43):6689–93.PubMedCrossRef
38.
go back to reference Myers T, Allman D, Xu K, et al. The prevalence and correlates of hepatitis C virus (HCV) infection and HCV–HIV co-infection in a community sample of gay and bisexual men. Int J Infect Dis. 2009;13(6):730–9.PubMedCrossRef Myers T, Allman D, Xu K, et al. The prevalence and correlates of hepatitis C virus (HCV) infection and HCV–HIV co-infection in a community sample of gay and bisexual men. Int J Infect Dis. 2009;13(6):730–9.PubMedCrossRef
39.
go back to reference Matthews GV, Pham ST, Hellard M, et al. Patterns and characteristics of hepatitis C transmission clusters among HIV-positive and HIV-negative individuals in the Australian trial in acute hepatitis C. Clin Infect Dis. 2011;52(6):803–11.PubMedCrossRef Matthews GV, Pham ST, Hellard M, et al. Patterns and characteristics of hepatitis C transmission clusters among HIV-positive and HIV-negative individuals in the Australian trial in acute hepatitis C. Clin Infect Dis. 2011;52(6):803–11.PubMedCrossRef
40.
go back to reference Centers for Disease Control and Prevention. Sexual transmission of hepatitis C virus among HIV-infected men who have sex with men: New York City, 2005–2010. MMWR. 2011;60(28):945–50. Centers for Disease Control and Prevention. Sexual transmission of hepatitis C virus among HIV-infected men who have sex with men: New York City, 2005–2010. MMWR. 2011;60(28):945–50.
42.
43.
go back to reference Parsons JT, Scrimshaw EW, Wolitski RJ, et al. Sexual harm reduction practices of HIV-seropositive gay and bisexual men: serosorting, strategic positioning, and withdrawal before ejaculation. AIDS. 2005;19(S1):S13–25.PubMedCrossRef Parsons JT, Scrimshaw EW, Wolitski RJ, et al. Sexual harm reduction practices of HIV-seropositive gay and bisexual men: serosorting, strategic positioning, and withdrawal before ejaculation. AIDS. 2005;19(S1):S13–25.PubMedCrossRef
Metadata
Title
Sexual Risk Behavior and Risk Reduction Beliefs Among HIV-Positive Young Men Who have Sex with Men
Authors
Douglas Bruce
Gary W. Harper
Katie Suleta
The Adolescent Medicine Trials Network for HIV/AIDS Interventions
Publication date
01-05-2013
Publisher
Springer US
Published in
AIDS and Behavior / Issue 4/2013
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-012-0155-8

Other articles of this Issue 4/2013

AIDS and Behavior 4/2013 Go to the issue
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 discuss last year's major advances in heart failure and cardiomyopathies.