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Abstract #152837

Monique A. Tello, MD, Division of General Internal Medicine, Johns Hopkins Medical Institutions, 1830 East Monument Street, Room 8012, Baltimore, MD 21231, 410-614-6441, mtello3@jhmi.edu, Hsin-Chieh Yeh, PhD, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Public Health, Suite 2600, 2024 East Monument Street, Baltimore, MD 21205, Shilpa N. Patel, MPH, School of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Road, CB 7030, Chapel Hill, NC 27599, Carol E. Golin, MD, MPH, Cecil G. Sheps Center for Health Services and Research, 725 Airport Road CB7590, Chapel Hill, NC 27599, and Emily Erbelding, MD, MPH, Division of Infectious Disease, Johns Hopkins Medical Institutions, MLF Tower 4000, 4940 Eastern Ave, Baltimore, MD 21224.

BACKGROUND: Coping self-efficacy has been associated with risky sexual behavior among HIV-positive men who have sex with men (MSM). Few studies have evaluated this relationship among clinic-based populations, or among men who have sex with women (MSW). METHODS: We conducted an analysis of survey data from 594 HIV-positive men receiving care at one of two clinic sites between 5/04 to 10/06. Coping self-efficacy was measured using a 9-item 7-point scale adapted from a previously validated scale. We compared means of total coping self-efficacy scores across protected vs. unprotected vaginal or anal sex with HIV-negative or unknown status partners, stratified by MSW and MSM. Multivariate logistic regression was performed to adjust for confounding variables. RESULTS: Coping self-efficacy was not associated with any HIV transmission risk behaviors for MSW. However, low coping self-efficacy was associated with receptive anal sex (N=110, unprotected mean(sd)= 44(11), protected=49(9), p=0.008) and insertive anal sex (N= 82, unprotected mean(sd)= 39(13), protected=50(10), p=0.0001) for MSM. Multivariate logistic regression models adjusting for ethnicity, education level, income, age, relationship status, and illicit substance use showed that every 1 SD increase in coping self-efficacy was associated with a decreased likelihood of engaging receptive anal sex (OR=0.56, 95% CI: 0.34-0.92) and insertive anal sex (OR=0.38, 95% CI: 0.21-0.70). CONCLUSIONS: Coping self-efficacy is associated with HIV sexual transmission risk behavior, though it may be more important for MSM than for other risk groups. Clinic-based behavioral interventions should target coping self-efficacy, particularly among MSM.

Learning Objectives:

• Define coping self-efficacy
• Recognize the association between coping self-efficacy and HIV transmission risk sexual behavior
• Understand the rationale for applying HIV prevention behavioral interventions targeting coping self-efficacy

Keywords: HIV Risk Behavior, HIV/AIDS

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.