Objective: To determine if attitudes towards HAART are associated with unprotected anal sex among HIV- and HIV+ gay men. Methods: Gay men enrolled in a prospective multicenter study underwent semi-annual surveys and laboratory assays. In 1999, men completed a survey on attitudes towards HAART (e.g., "Because of HAART, I am less concerned about becoming HIV+ or infecting someone"). Logistic regression was used to determine whether scores on 6 attitudinal sub-scales were associated with unprotected receptive anal sex (RAS) and insertive anal sex (IAS) in the prior 6 months. Results: Of 548 men (219 HIV- and 329 HIV+) reporting anal sex, mean age was 45; 83% were Caucasian. Relative to HIV+ men, HIV- men reported more male sex partners (median: 5 vs. 4, p=0.03). There were no significant differences for unprotected RAS and IAS by HIV-serostatus (approx. 50%). Among HIV- men, those agreeing that HAART lessened their concern about becoming HIV+ were more likely to report unprotected RAS (AdjOR=2.6; 95% CI: 1.1-6.4). Among HIV+ men, those agreeing that HAART reduced concern about infecting someone were more likely to report unprotected IAS (AdjOR=8.8; 95% CI: 3.3-23.9) and RAS (AdjOR=3.5; 95% CI=1.4-8.5). HIV "burnout" (e.g., "tired of always having safer sex") was independently associated with a four-fold increased odds of IAS and RAS among HIV+ men (p<0.001). Conclusions: Decreased concern about HIV transmission due to HAART was associated with sexual risk taking among HIV- and HIV+ men. Prevention programs should take into account underlying reasons for unprotected sex in the era of HAART.
Learning Objectives: - To identify barriers to safer sex among gay men. - To understand how the advent of HIV antiretroviral Therapies has influenced gay mens' attitudes towards safer sex
Keywords: HIV/AIDS, Antiretroviral Combination Therapy
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.