Young men who have sex with men report low levels of HIV prevention fatigue and HIV treatment optimism

BACKGROUND: It has been hypothesized that HIV prevention fatigue, or the sense that HIV prevention messages and behaviors have become tiresome, and optimism about available treatments for HIV (i.e., HIV treatment optimism) are important drivers of the increasing HIV diagnosis rate among men who have sex with men (MSM). Yet empirical evidence of these phenomena are lacking among young MSM (YMSM), who are at disproportionately high risk for HIV.

METHODS: As part of a longitudinal study, a group of 352 racially- and ethnically-diverse YMSM (mean age = 19.9 years) completed measures of HIV prevention fatigue, treatment optimism, HIV risk behaviors, HIV-related knowledge, and likelihood of using PrEP at two timepoints 18 months apart. 

RESULTS: Overall, YMSM reported low levels of HIV prevention fatigue and treatment optimism, which both decreased significantly over 18 months. Consistent with past studies, bivariate analyses showed that greater prevention fatigue was associated with HIV risk behaviors and HIV-positive serostatus. Multivariate analyses revealed that significant predictors of prevention fatigue included longer time since sexual debut and using drugs or alcohol before sex. Treatment optimism was predicted by number of condomless sex partners.

CONCLUSIONS: Results are inconsistent with the hypothesis of high levels of prevention fatigue in YMSM and suggest that YMSM remain receptive to HIV prevention messages. However, as prevention fatigue may increase for YMSM who have been sexually active for longer periods of time, closer attention to the design of HIV prevention interventions may help attenuate fatigue and ensure that messages remain compelling for YMSM.