Sexual Risk Behavior and Secondary Prevention Beliefs among Young HIV-Positive Gay and Bisexual Men

Background: Given the escalating numbers of young gay and bisexual men (YGBM) living with HIVAIDS, secondary prevention beliefs and practices (including serosorting, sexual positioning, and beliefs about viral load and infectiousness) among this population take on increasing significance.

Methods: 200 HIV-positive YGBM (ages 16-24, 66% Black, 18% Latino, 7% White, 7% Multiracial/Other) were recruited from 14 HIV primary care sites in the U.S. We used logistic regression models to examine associations of unprotected anal intercourse (UAI) and partner HIV status with a range of attitudinal and behavioral variables.

Results: Proportions of participants engaging in UAI one or more times during the past three months were consistent across type of act and partner status: 20% insertive UAI and 22% receptive UAI with HIV-negative/unknown partners, 22% insertive UAI and 21% receptive UAI with HIV-positive partners. Viral load beliefs were significantly associated with insertive UAI with HIV-negative male partners (β=.88, p<.05). Sexual positioning beliefs were significantly associated with receptive UAI with HIV-negative men (β=1.00, p<.05). Serosorting beliefs were significantly associated with receptive UAI (β=1.45, p<.01) and insertive UAI (β=1.12, p<.05) with HIV-positive male partners. Failure to use a condom after drinking alcohol was significantly associated with insertive UAI (β=1.98, p<.001) and receptive UAI with HIV-negative men (β=1.77, p<.01).

Conclusions: In this sample, different secondary prevention beliefs were associated with UAI with different types of partners. Secondary prevention efforts with this population should address serosorting, sexual positioning, and viral load beliefs when assessing risk reduction practices.