Sexuality and Sexual Risk Behavior in HIV-Positive Men Who Have Sex With Men

Abstract

The purpose of this study was to examine the psychological processes pertaining to sexuality and sexual risk behavior among HIV-positive men who have sex with men (MSM). The authors analyzed transcripts of 30 semistructured interviews. Findings suggest that sexual problems in HIV-positive MSM might be primarily caused by the perceived risk of transmitting HIV to others. Furthermore, safer sexual behavior seems to be related to feelings of personal responsibility for safer sex. This study illustrates that although some men might have a clear notion of personal responsibility for safer sex, contextual factors can influence whether behavior is consistent with their norms of personal responsibility. The implications of the study are discussed for the practice of HIV prevention for HIV-positive MSM.

Beliefs about Personal and Partner Responsibility among HIV-Seropositive Men Who Have Sex with Men: Measurement and Association with Transmission Risk Behavior

“…This finding is consistent with earlier observations from qualitative studies of HIVseropositive MSM in the United States and Europe (van Kesteren et al, 2005;Wolitski et al, 2003). Further, high levels of personal responsibility were observed within various demographic subgroups of HIV-seropositive MSM.…”

Prevalence of Sexually Acquired Antiretroviral Drug Resistance in a Community Sample of HIV-Positive Men Who Have Sex with Men in New York City

“…Early prevention efforts among MSM focused on primary prevention, primarily targeting HIV-negative or presumed HIV negative MSM. 1 More recently, increased attention has been given to secondary prevention among at-risk MSM, including broader participation in voluntary testing and early enrollment in antiretroviral care. Suppressing viral load reduces risk for opportunistic infection at an individual level and may also contribute to reduction in the incidence at a community level.…”

“…6,7 Estimates of the prevalence of drug-resistant HIV range from 5% to 17% among newly diagnosed and/or treatment-naïve individuals. [8][9][10][11][12][13] Higher rates have been found among individuals with comorbid use of illicit drugs (particularly methamphetamine), notably a group with high rates of unprotected anal intercourse and high numbers of 1 National Development and Research Institutes, Inc., New York, New York. concurrent sexual partners.…”

Formation of Personal HIV Disclosure Policies among HIV-Positive Men Who Have Sex with Men

“…46,47 A variety of interpersonal and contextual factors have been associated with disclosure in sexual situations, including partner characteristics and behaviors, beliefs about viral load, and setting. [48][49][50] For example, in a qualitative study of MSM with recent sexually transmitted infections in Los Angeles, California, and Seattle, Washington, 51 participants tended to be more likely to disclose to sex partners if they had feelings for the other person, felt responsible for sex partners, or feared arrest. They were less likely to disclose if they minimized the importance of sex, believed having a low viral load reduced transmission likelihood, or feared rejection.…”

“…54 HIV-positive persons, including MSM, may resolve to disclose their serostatus to sexual partners for emotional release, to educate others or out of a sense of obligation to 532 RUTLEDGE others, 51,57 but contextual factors may conflict with a personal sense of responsibility. 48 For example, HIV-positive MSM may disclose more often than HIV-negative MSM to absolve themselves of responsibility for safer sex or to facilitate unprotected sex. 16 In addition, responsibility for discussing serostatus has been modeled to have four orientations among HIV-positive MSM that include dimensions of responsibility for self as well as responsibility for the sexual partner.…”