Attitudes toward the criminalization of HIV transmission in a sample of men who have sex with men (MSM) in the United States (US)

Background:

Although the degree to which criminalization of HIV transmission (CHT) laws undermine prevention efforts continues to be debated, relatively little is known of the attitudes that persons at high risk for HIV and other sexually transmitted infections (STIs) in the US hold about such laws.

Methods:

MSM (n=1,725) were recruited on 2 sex-seeking websites to complete a 70-minute online survey during a 3.5 month period in 2008. Inclusion criteria were male, ≥18 years old, English-speaking, living in the US, and having sex with another man. Participants who completed the survey received $30.

Results:

Participants were primarily 21-40 years old (65%), HIV-negative (86%), white (76%), and college educated (52%). Most identified as gay (86%) and “very comfortable” with their sexual orientation. Fifty-eight percent believed they lived in a state whose people were somewhat/very gay accepting, and 63% reported no unprotected anal intercourse (UAI) partners in the past 3 months. Multivariate analysis showed that men who identified as HIV-positive (OR=0.33), had higher levels of education (ORs=0.64-0.42), perceived people in their state to be somewhat or very accepting (OR=.75), reported 2 or more UAI partners (OR=0.72), and had lower perceived responsibility toward not infecting their online partners with HIV/STIs (OR=0.75) held more unfavorable attitudes toward CHT. Non-gay identity was associated with more favorable CHT attitudes (OR=1.54).

Conclusions:

MSM at greatest risk for HIV/STIs and vulnerable populations (e.g., HIV-positive persons) have the least favorable attitudes toward CHT. The association between perceived acceptance of state residents and attitudes toward CHT deserves further attention.