Associations between sexual risk behavior and religious/spiritual coping by HIV status within race/ethnicity, in a diverse sample of men who have sex with men

Background: MSM continue to have the highest incidence of HIV in the US. Research in other populations suggests that religion is associated with less sexual risk; however, such research is lacking among MSM. This study examined religious/spiritual coping and sexual risk behavior among MSM.

Methods: Data were from baseline assessments of a randomized trial with substance-using MSM in four US cities. We examined the association between two religious coping variables and HIV-discordant unprotected anal sex (DUA) with most recent casual partner.

Results: Of 1208 participants, 38% were white, 32% black, 18% Latino, and 11% other race/ethnicity; half were HIV-positive. 62% reported some comfort in religion/spirituality, and 66% reported some praying/meditation. Among HIV-negative black MSM (n=114), receptive DUA was inversely associated with finding comfort in religion/spirituality (OR=0.20,CI=0.05-0.98). Among HIV-positive black men (n=277), insertive DUA was positively associated with some praying/meditation (OR=4.88, CI=1.05-22.60). Among HIV-positive Latino MSM (n=99), insertive DUA was inversely associated with some praying/meditation (OR=0.21,CI=0.05-0.93). There were no other significant associations by HIV-status and race/ethnicity.

Conclusions: We found mixed results for sexual risk behavior and religious/spiritual coping among black MSM relative to other MSM. Results for black HIV-negative MSM and Latino HIV-positive MSM supported existing research suggesting religious/spiritual coping correlates with less risk behavior. Results for black HIV-positive MSM contradicted this suggesting increased risk behavior correlates with prayer/meditation. More research is needed with diverse MSM to confirm these results, including the underlying nature of these links. The findings have implications for novel interventions to reduce risk behavior of minority MSM.