Correlates of Perceived HIV Prevalence and Associations With HIV Testing Behavior Among Men Who Have Sex With Men in the United States

Abstract

As the rate of HIV infection continues to rise among men who have sex with men (MSM) in the United States, a focus of current prevention efforts is to encourage frequent HIV testing. Although levels of lifetime testing are high, low levels of routine testing among MSM are concerning. Using data from an online sample of 768 MSM, this article explores how perceptions of HIV prevalence are associated with HIV testing behavior. Ordinal logistic regression models were fitted to examine correlates of perceived prevalence, and binary logistic regression models were fitted to assess associations between perceived prevalence and HIV testing. The results indicate that perceptions of higher prevalence among more proximal reference groups such as friends and sex partners are associated with greater odds of HIV testing. Perceptions of HIV prevalence were nonuniform across the sample; these variations point to groups to target with strategic messaging and interventions to increase HIV testing among MSM.

Birth Cohort Variations Across Functional Knowledge of HIV Prevention Strategies, Perceived Risk, and HIV-Associated Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States

“…Non-Hispanic non-White and Hispanic participants were substantially more concerned, similar to published research with these demographic subgroups ( MacKellar et al, 2007 ). Risk appraisal is a complex analytical and emotional assessment process ( Slovic, Finucane, Peters, & MacGregor, 2004 ), which includes a personal evaluation of the prevalence of HIV within one’s community ( White & Stephenson, 2016 ). This result should be interpreted with caution due to the relative underrepresentation of racial and ethnic minority GBMSM, an unfortunate reality plaguing Web-based studies ( Sullivan et al, 2011 ).…”

“…Advances in antiretroviral medications over the past two decades have been hypothesized to contribute to the emergence of “treatment optimism” ( Huebner, Rebchook, & Kegeles, 2004 ; Sullivan, Drake, & Sanchez, 2007 ), described as “feeling less concerned about acquiring HIV because of medications that can reduce HIV-related mortality and morbidity” ( Schwarcz et al, 2007 ). Lower risk perceptions have in turn been associated with a greater engagement in risky sexual behaviors like CAS ( Ostrow et al, 2002 ; Paz-Bailey et al, 2016 ), and a reduction in preventive behaviors like HIV testing ( CDC, 2016b ; White & Stephenson, 2016 ). Researchers have also raised concerns about “HIV prevention fatigue” among GBMSM, a viewpoint that messages, programs, or services have become monotonous over the years ( Stockman et al, 2004 ).…”

Dyadic Reporting of Intimate Partner Violence Among Male Couples in Three U.S. Cities

“…IPV is a complex health risk that is affected by myriad individual and demographic characteristics in tandem with partner attributes and relationship quality factors. Studies of IPV among same-sex male couples have generally ignored dyadic factors and examined IPV as a factor associated with sexual risk-taking behaviors and drug use ( Chakravarty, Hoff, Neilands, & Darbes, 2012 ; Davis et al, 2015 ; Feldman et al., 2008 ; Stall et al, 2003 ; Stephenson, de Voux, & Sullivan, 2011 ; Stults et al, 2015 ; White & Stephenson, 2016 ) rather than taking a broader scope to examine factors that affect the risk for IPV. The few studies that have incorporated dyadic data are based on reports from only one partner ( Stephenson, Rentsch et al, 2011 ; Stephenson et al, 2013 ).…”

HIV Prioritization and Risk Perception Among an Online Sample of Men Who Have Sex With Men in the United States

“…Perception of HIV risk has been identified as one factor associated with sexual and HIV testing behavior among MSM. Underestimation of HIV risk has been reported as a significant predictor of both CAS and underutilization of HIV testing ( Golub & Gamarel, 2013 ; Stephenson, White, Darbes, Hoff, & Sullivan, 2015 ; White & Stephenson, 2016 ). HIV risk perception, particularly among young MSM, may be declining, partly due to “treatment optimism,” the awareness that antiretroviral treatments are highly effective in reducing HIV viremia ( Huebner, Rebchook, & Kegeles, 2004 ), along with the introduction of pre-exposure prophylaxis (PrEP), the use of antiretroviral medications among HIV to lower risk of HIV infection ( Chen, 2013 ; Kalichman et al, 2017 ).…”