HIV-infected men who have sex with men who engage in very high levels of transmission risk behaviors: Establishing a context for novel prevention interventions

Abstract

Men who have sex with men (MSM) comprise the largest risk group of individuals living with HIV in the USA and have the highest rates of new infections. A minority of HIV-infected MSM engage in unprotected anal intercourse after learning about their infection, potentially transmitting the virus to others. The current study sought to generate self-generated descriptive themes, from a group of HIV-infected MSM who reported high rates of sexual transmission risk behavior that may be relevant for understanding sexual risk in this group. Five descriptive themes emerged during content analysis: (a) serostatus attribution, (b) assumption of sexual partner’s responsibility for safer sex, (c) sexual sensation seeking, (d) ongoing substance use, and (e) dissatisfaction with current relationships. Traditional HIV transmission risk reduction interventions that have been known to have only modest effects should be augmented by developing HIV prevention strategies for this subgroup of MSM to address these salient themes.

Keywords:

• HIV infection
• MSM
• gay and bisexual men
• HIV prevention
• risky sexual behavior

Acknowledgments

This study was supported by a series of feasibility grant awards by Harvard University Center for AIDS Research: (P30-AI 060354 – National Institute of Health /NIAID) Characteristics of HIV-infected MSM who Report Very High Rates of Sexual Transmission Risk (PI: of CFAR Walker, B; PI of development award O’Cleirigh, C) and HIV Prevention Intervention Development in Very High Risk MSM (PI: O’Cleirigh, C).