Attitudes toward the impact of HIV treatment on transmission risk among newly HIV-diagnosed men who have sex with men in New York City

Background: Attitudes toward the impact of HIV treatment on transmission risk have been linked to sexual risk behavior among men who have sex with men (MSM). This study examined attitudes among newly HIV-diagnosed MSM, the relationship between attitudes and unprotected anal intercourse (UAI), and factors associated with risky attitudes. Methods: 102 newly HIV-diagnosed MSM were recruited from a New York City community health center. A 13-item measure assessed attitudes: e.g. “The new AIDS combination drugs make me less anxious about unprotected sex,” responses from 0 (strongly disagree) to 4 (strongly agree) (α=0.88). Participants reported UAI occasions during the 3 months following diagnosis via timeline follow-back interview. Demographics, mental health, substance use, and antiretroviral use were assessed by computerized interview. Negative binomial regression examined the relationship between attitudes and UAI. Linear regression tested factors associated with attitudes. Results: Participants were young (mean age=32.3(SD=8.8)), diverse (37% White, 30% Hispanic/Latino, 17% Black/African-American), and well-educated (50% with Bachelor's). Mean attitudes score was 1.1(SD=0.8); 70% agreed with at least one item. 54% reported UAI, averaging 17.8(SD=24.4) occasions. UAI was associated with attitudes (B=0.274, p<.01). Attitudes were associated with age, White ethnicity, college education, depressive symptoms, and drug problems. In the multivariate model, only education related to attitudes (B=0.218, p<.05). Conclusions: This sample of newly-diagnosed MSM endorsed low levels of risky attitudes, but higher education predicted riskier attitudes. Risky attitudes were associated with UAI, which may reflect a trend toward risk compensation in this sample. Research should examine risky attitudes as time since diagnosis increases.