Sexual Decision-Making in HIV-Positive Men Who Have Sex with Men: How Moral Concerns and Sexual Motives Guide Intended Condom Use with Steady and Casual Sex Partners

Abstract

Determinants of intended condom use with steady and casual sex partners were examined among Dutch HIVpositive men who have sex with men (MSM) (N = 296). Given the proposition that safer sex behavior among HIVpositive people is a form of prosocial behavior, the present study extended the general framework of the Theory of Planned Behavior with Schwartz's norm-activation theory and tested the assumption that personal norms would mediate the effects of other psychosocial factors on intended condom use for anal sex. In addition, it was hypothesized that, depending on the context in which sex occurs, specific motives for unprotected anal sex may have a negative influence on intended condom use and, as such, undermine a prosocial tendency to practice safer sex. Therefore, we also investigated the influence of sexual motives for unprotected anal sex on intended condom use with steady and casual sex partners. Results indicated that the Theory of Planned Behavior adequately predicted condom use intentions (for

Differential HIV Risk Behavior among Men who have Sex with Men Seeking Health-Related Mobile Van Services at Diverse Gay-Specific Venues

“…The reasons driving resurgent risky behavior among MSM are complicated and multi-faceted, and may include a combination of psychological person-level factors (e.g., self-esteem, communication skills, self-perception of risk, self-efficacy for adopting safer sexual behaviors) (Eaton et al 2007;Elwood et al 2003;MacKellar et al 2007;Morin et al 2005;O'Leary et al 2007;Stall et al 2000;Van Kesteren et al 2007), community level factors (e.g., condom use norms, sexual identity, social support, HIV treatment optimism, prevention fatigue) (Crepaz et al 2004;Klitzman et al 2007;Kok et al 2007;Ostrow et al 2008;Stall et al 2000;Strathdee et al 1998;Sullivan et al 2007;Wolitski et al 2006), and societal variables (e.g., stigma, racism, poverty) (Bingham et al 2003;Centers for Disease Control and Prevention 2003;Easterbrook et al 1993;Harawa et al 2004;O'Leary et al 2007;Preston et al 2007). Future research might benefit from examining the role of other psychological person-level factors (e.g., identity, impulsivity, or temptation of unsafe sex), as well as contextual-level factors (e.g., geography, neighborhood composition) (Mills et al 2001), which may importantly interact with venue to determine risk (Grov et al 2007).…”

Relationship Characteristics Associated with Sexual Risk Behavior Among MSM in Committed Relationships

“…Yet few models exist that MSM couples may use to navigate the disclosure of breaks when they happen. 13,21,[30][31][32][33] In addition, Interdependence Theory posits that men prioritize the needs of their relationship over their personal health when making decisions-which could make negotiation and/or disclosure of broken agreements even more difficult. 34,35 These complexities between individual and partner-level priorities highlight the need to examine the influence of relationship dynamics on sexual risk behavior in MSM couples.…”

Less decrease in risk behaviour from pre-HIV to post-HIV seroconversion among MSM in the combination antiretroviral therapy era compared with the pre-combination antiretroviral therapy era

“…This suggests that a substantial group of HIV-positive MSM who are aware of their diagnosis are not effectively reducing their sexual risk behaviour [12][13][14]. Some studies have indicated that MSM diagnosed with HIV decrease their sexual risk behaviour immediately after becoming aware of their HIV-positive status [15][16][17]. However, these studies either did not compare trends in sexual behaviour before and after HIV diagnosis over a long calendar period or relied on qualitative data only.…”