The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68179

Robert J Guzman, MPH¹, Grant Colfax, MD², Gordon Mansergh, PhD³, Gary Marks, PhD⁴, Sarah Wheeler, MPH¹, Melissa Rader, MPH⁵, and Susan Buchbinder, MD². (1) HIV Research Section, San Francisco Department of Public Health, 25 Van Ness, Suite 500, San Francisco, CA 94102, 415 554 4243, robert.guzman@sfdph.org, (2) AIDS Office, San Francisco Department of Public Health, 25 Van Ness, Suite 500, San Francisco, CA 94102, (3) DHAP, Prevention Research Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop E-37, Atlanta, GA 30333, (4) DHAP, Epidemiology, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop E-45, Atlanta, GA 30333, (5) Division of HIV/AIDS Prevention - Epidemiology Branch, CDC, 1600 Clifton Road, Mailstop E45, Atlanta, GA 30342

Background: Optimistic beliefs about treatment advances and the potential for reduced infectivity associated with undetectable HIV viral loads (UVL) have been linked to high-risk behavior among MSM. Little is known about demographic and behavioral factors associated with such optimism. Methods: 533 MSM (31% white, 28% African American, 28% Latino) were asked questions measuring HIV-related optimism (e.g. “knowing about improved treatments has caused me to have more unprotected sex”). Factors associated with optimism were determined using multivariate logistic regression models controlling for age, education, income, race, and HIV serostatus. Results: Compared to younger men, men over 30 (adjusted odds ratio [OR]=2.3; 95% confidence interval [CI]=1.1, 4.8), African-American men (OR=2.5; 95% CI=1.1, 5.5) vs. white men, and Viagra users (OR=2.7; 95% CI = 1.1,7.1) were more likely to state that improved treatments caused them to have more unprotected sex, while men with > college degrees vs. < high school were less likely (OR=0.4; 95% CI=0.2, 1.0) . Belief that UVL reduces transmission was higher among those earning > $40,000/year (OR=2.3; 95% CI=1.2, 4.6) vs. < $10,000, those with > college degrees (OR=2.1; 95% CI=1.1, 3.7) vs. < high school, and those with knowledge of Post-Exposure Prophylaxis (OR=1.7; 95% CI=1.1, 2.6), but was lower among men recently receiving health care (OR=0.5; 95% CI=0.3, 0.9). Conclusions: HIV optimism varies by socioeconomic, demographic, and behavioral factors. These findings are useful in designing/targeting interventions for MSM subpopulations to temper and reduce risk behavior due to optimism. Health care settings may be effective venues for such interventions.

Learning Objectives:

• 1. Identify at least three demographic, socioeconomic, and behavioral factors associated with HIV-related optimism among men who have sex with men (MSM).
• 2. Integrate information regarding predictors of HIV-related optimism into health promotion efforts for MSM.
• 3. Appropriately target subpopulations of MSM with specific messages which temper HIV-related optimism and encourage risk behavior reduction.

Keywords: HIV Interventions, Gay Men

Presenting author's disclosure statement:
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.