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Abstract #150012

Karyn K. Heavner, MSPH¹, Benjamin Shaw, PhD², Haven Battles, PhD³, Kristi McClamroch, PhD¹, James Tesoriero, PhD⁴, and Guthrie S. Birkhead, MD, MPH⁵. (1) Department of Epidemiology and Biostatistics, University at Albany, School of Public Health, One University Place, Rensselaer, NY 12144, 518-402-6809, karynkh@aol.com, (2) Department of Health Policy, Management and Behavior, University at Albany, School of Public Health, One University Place, Rensselaer, NY 12144, (3) AIDS Institute, Office of Program Evaluation and Research, New York State Department of Health, Riverview Center, 150 Broadway, Suite 516, Menands, NY 12204, (4) New York State Department of Health AIDS Institute, State of New York Department of Health, Riverview Center, 5th floor, 150 Broadway, Menands, NY 12204, (5) Deputy Commissioner, Office of Public Health, NYS Department of Health, Corning Tower, 14th floor, ESP, Albany, NY 12237

Background/Objectives: HIV prevention fatigue (weariness of monitoring/maintaining safer behaviors to prevent transmission) has been proposed but rarely studied as an explanation for the recent resurgence in MSM's high-risk sexual behavior. This study describes prevention fatigue among MSM, its association with high-risk behavior and the consequent challenges for HIV prevention.

Methods: A venue-based sample of MSM in Upstate New York was studied (n=635). Fatigue was measured by the mean score (1-4=no-high fatigue) and agreement with four statements: “you take risks because you are tired of being careful;” “you often tune out HIV messages” “you are burned out about HIV;” and “people are less careful because they are tired of being safe.” The relationships between fatigue, sociodemographics, and high-risk behaviors were assessed using linear and poisson regression.

Results: The mean fatigue score was 2.2 (SD=0.8). Black MSM had lower fatigue than whites (p=0.0003) after adjusting for enrollment venue, age, education, HIV status and sexual orientation. MSM with high fatigue were more likely to have higher overall risk (adjusted prevalence risk ratio (aPRR)=1.1, 95% CI: 1.0-1.3), UAI (aPRR =1.2, CI: 1.0-1.4), and 6+ partners (aPRR=1.2, CI: 1.0-1.5). In the multivariable analysis, tuning out HIV messages and risk taking because “you are tired of being careful” were more strongly associated with HIV risk than the other statements.

Conclusions: Prevention fatigue presents a relatively new challenge for safer sex promotion among MSM. Innovative interventions are needed for MSM who tune out HIV prevention messages and to reinforce the importance of lifelong adoption of safer behaviors.

Learning Objectives:

• Define HIV prevention fatigue;
• Describe the prevalence of HIV prevention fatigue among MSM;
• Describe the relationships between HIV prevention fatigue and HIV risk behaviors among MSM; and
• Identify challenges to delivering effective HIV prevention interventions posed by HIV prevention fatigue.

Keywords: HIV Risk Behavior, Prevention

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.