Self-perceived HIV risk in HIV-negative men who have sex with men (MSM) and who use the Internet to find partners for unprotected sex

BACKGROUND: HIV-negative MSM, particularly those who bareback, are at high risk for acquiring HIV. This study examines HIV risk perceptions among HIV-negative MSM using the Internet to find partners for unsafe sex. METHODS: In 2008 and 2009, 332 American MSM were sampled randomly from 16 websites. All used the Internet to search for unprotected sex partners. Interviews were conducted by telephone and lasted 1-2 hours. RESULTS: Half of the participants said that they had "zero chance" (8%) or "only a slight chance" (43%) of seroconverting. Men's estimations of their chances of becoming HIV-positive did not correspond with (1) the amount of unprotected sex they had, (2) percentage of sex acts that entailed internal ejaculation, (3) desired HIV serostatus of their sex partners, or (4) number of recent sex partners they reported. Multivariate analysis revealed four factors associated with a greater perception of HIV acquisition risk: (1) identifying as a sexual "bottom," (2) recently having sex while under the influence of illegal drugs, (3) more frequent use of bareback-focused websites to find partners, and (4) younger age. CONCLUSIONS: Although all of this study's participants were at great risk for acquiring HIV due to their efforts to meet men online for unprotected sex, most considered their chances of becoming HIV-positive to be minimal. This risk perception needs to be altered to be more realistic. Previous studies have shown that an increased perception of vulnerability to HIV often leads to a reduction in risky practices.