3044.0: Monday, November 13, 2000 - 12:30 PM

Abstract #9840

Attitudes Towards Highly Active Antiretroviral Therapy (HAART) Predict Sexual Risk-taking among HIV-Infected and Uninfected Gay Men in the Multicenter AIDS Cohort Study (MACS)

David Ostrow, MD, PhD1, K. Fox, MSc2, J.S. Chmiel, PhD3, A. Silvestre, PhD4, B.R. Vissher, PhD5, P. Vanable, PhD6, L.P. Jacobson, PhD2, and S.A. Strathdee, PhD2. (1) Howard Brown Health Center, Loyola University, 4334 N. Hazel Street, Rm 106, Chicago, IL 60613, 773-525-0246, dostrow@interaccess.com, (2) Department of Epidemiology, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, (3) Department of Prevention Medicine, Northwestern University Medical School, Biometry Section, Suite 1104, Chicago, IL 60611, (4) Pitt Men's Study, University of Pittsburgh, P.O. Box 7319, Pittsburgh, PA 15213, (5) Department of Epidemiology, UCLA School of Public Health, Center for the Health Sciences, Room 71-269A/Box 951772, Los Angeles, CA 90095-1772, (6) Syracuse University, 430 Huntington Hall, Syracuse, NY 13244

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.

The 128th Annual Meeting of APHA