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182459 Use of a structured sex diary to explore situational factors impacting HIV transmission risk episodes among HIV+ MSM

Monday, October 27, 2008

Patrick A. Wilson, PhD , Mailman School of Public Health, Columbia University, New York, NY
Stephanie H. Cook, BA , Department of Sociomedical Science, Columbia University, New York, NY
Jermel McGaskey , Mailman School of Public Health, Columbia University, New York, NY
Matthew S. Rowe, MPH , HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University, New York, NY
Background: HIV+ men who have sex with men (MSM) represent the largest group of people living with HIV/AIDS in the U.S. It is important to understand sexual risk-taking behaviors that may be linked to poor health outcomes among these men and their partners. Models of HIV risk behavior that focus solely on personal factors have been demonstrated to be ineffective at explaining risk behavior. Rather, in order to fully understand sexual risk taking, it is important to examine the factors linked to high-risk sexual situations, and not solely the factors linked to potentially high-risk persons.

Methods: An ethnically diverse sample of 100 HIV+ MSM completed an 8-week structured sex diary that collected detailed information on recent sexual encounters. In total, information on over 250 sexual encounters was collected and analyzed. Random effects regression analysis was used to examine situational factors that were related to high HIV transmission risk sexual encounters.

Results: Analyses revealed that substance use by a sex partner, heightened feelings of emotional and sexual attraction toward a partner, discussions about HIV and condom use, and depressed affect were each associated with high HIV transmission risk episodes. Substance use during sexual encounters behavior frequently co-occurred with unprotected sex. Likewise, substance use was more likely to occur in episodes with HIV+ partners.

Conclusions: Situational factors play an important role in sexual risk-taking among HIV+ MSM. Researchers should place a greater focus on behaviors and characteristics of sex partners in order to comprehensively understand sexual risk-taking among HIV+ MSM.

Learning Objectives:
1. Define the role the situational factors in understanding sexual risk-taking behaviors. 2. Identify situational factors that should be considered in developing interventions for HIV+ MSM. 3. Recognize the importance of understanding behaviors and characteristics of sex partners in order to effectively intervene with HIV+ MSM.

Keywords: HIV Risk Behavior, Sexual Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: PI of the study described in the abstract.
Any relevant financial relationships? No

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.

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