Skip to main content
SpringerLink
Log in

Perceived HIV Prevalence Accuracy and Sexual Risk Behavior Among Gay, Bisexual, and Other Men Who Have Sex with Men in the United States

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Interventions that promote HIV prevention and reduce sexual risk-taking among men who have sex with men (MSM) are needed. Decisions surrounding sexual behavior and prevention are in part shaped by how individuals gauge HIV risk, which may be influenced by perceptions of local HIV prevalence. Using an online sample of self-reported HIV-negative adult MSM (n = 1477, mean age = 45) recruited in 2015, we examine associations between accuracy of perceived local HIV prevalence and self-reported condomless anal sex (CAS) and HIV testing. Men who perceived their local HIV prevalence to be higher than actual were more likely to be recently HIV tested and less likely to engage in CAS. Men who estimated their local prevalence to be lower than actual were more likely to engage in CAS and less likely to have recently tested for HIV. Results suggest that how accurately MSM understand their HIV environment may contribute to prevention decisions.

Resumen

Intervenciones que promueven la prevención de VIH y reducen los comportamientos sexuales de riesgo entre hombres que tienen sexo con hombres (HSH) son necesarias. Las decisiones sobre el comportamiento sexual y de prevención están en parte determinadas por como los individuos miden el riesgo de VIH, el cual está influenciado por la percepción de la prevalencia local de VIH. Utilizando una muestra en línea de HSH adultos, auto-reportados como VIH negativos (n = 1477, edad promedio = 45) y reclutados en el 2015, se examinó las asociaciones entre la percepción exacta de la prevalencia local de VIH y el auto-reporte del sexo anal sin preservativo, así también como la prueba de VIH. Los hombres que percibieron que la prevalencia local de VIH era más alta que la actual eran más probables de haber recibido una prueba de VIH recientemente y eran menos probables de tener conductas de sexo anal sin protección. Los hombres quienes estimaron que la prevalencia local de VIH era más baja que la actual, eran más probables de tener conductas de sexo anal sin protección y menos probable de haber recibido un test de VIH. Estos resultados sugieren que la precisión en que los HSH perciben su entorno de VIH pueden contribuir a tomar decisiones de prevención.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Johnson AS, Hall HI, Hu X, Lansky A, Holtgrave DR, Mermin J. Trends in diagnoses of HIV infection in the United States, 2002–2011. JAMA. 2014;312(4):432–4.

    Article  PubMed  CAS  Google Scholar 

  2. Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2014. HIV Surveillance Report; 2015. p. 26.

  3. Frieden TR, Foti KE, Mermin J. Applying public health principles to the HIV epidemic–how are we doing? N Engl J Med. 2015;373(23):2281–7.

    Article  PubMed  CAS  Google Scholar 

  4. Purcell DW, Johnson CH, Lansky A, et al. Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS J. 2012;6:98–107.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2013. HIV Surveillance Report; 2015. p. 25.

  6. Hess K, Hu X, Lansky A, Mermin J, Hall I. Estimating the lifetime risk of a diagnosis of HIV infection in the United States. Presented at the Conference on Retroviruses and Opportunistic Infections. Boston; 2016 [abstract 52].

  7. White House Office of National AIDS Policy. National HIV/AIDS strategy for the United States: updated to 2020. Available at: https://www.aids.gov/federal-resources/national-hiv-aids-strategy/nhas-update.pdf, 2015.

  8. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. U.S. Public Health Service. Pre-exposure prophylaxis for the prevention of HIV in the United States-2014: a clinical practice guideline. Available at: http://www.cdc.gov/hiv/pdf/prepguidelines2014.pdf, 2014.

  10. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Centers for Disease Control and Prevention. HIV infection risk, prevention, and testing among men who have sex with men: national HIV behavioral surveillance 20 U.S. cities, 2014. HIV Surveillance Report Special Report. 2015;15:1–32.

  12. Centers for Disease Control and Prevention. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. Morb Mortal Wkly Rep. 2006;55(14):1–17.

    Google Scholar 

  13. Centers for Disease Control and Prevention. HIV testing and risk behaviors among gay, bisexual, and other men who have sex with men—United States. Morb Mortal Wkly Rep. 2013;62(47):958–62.

    Google Scholar 

  14. Janz NK, Becker MH. The health belief model: a decade later. Health Educ Quart. 1984;11(1):1–47.

    Article  CAS  Google Scholar 

  15. Catania J, Kegeles S, Coates T. Towards an understanding of risk behavior: an AIDS risk reduction model (ARRM). Health Educ Quart. 1990;17(1):53–72.

    Article  CAS  Google Scholar 

  16. Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice-Hall; 1986.

    Google Scholar 

  17. Lacefield K, Negy C, Schrader RM, Kuhlman C. Comparing psychosocial correlates of condomless anal sex in HIV-diagnosed and HIV-nondiagnosed men who have sex with men: a series of meta-analyses of studies from 1993 to 2013. LGBT Health. 2015;2(3):200–20.

    Article  PubMed  Google Scholar 

  18. Tillman JL, Mark HD. HIV and STI testing in older adults: an integrative review. J Clin Nurs. 2015;24(15–16):2074–95.

    Article  PubMed  Google Scholar 

  19. Grover KW, Miller CT. Effects of mortality salience and perceived vulnerability on HIV testing intentions and behaviour. Psychol Health. 2014;29(4):475–90.

    Article  PubMed  Google Scholar 

  20. Natan MB, Kutygaro R. Predictors of women’s intentions to be screened for HIV during pregnancy. J Assoc Nurs AIDS Care. 2015;26(5):673–9.

    Article  Google Scholar 

  21. Napper L, Fisher D. Measuring perceived susceptibility, perceived vulnerability and perceived risk of HIV infection. In: Lavino J, Neumann R, editors. Psychology of risk perception. New York: Nova Science Publishers; 2010.

    Google Scholar 

  22. Slovic P, Finucane ML, Peters E, MacGregor DG. Risk as analysis and risk as feelings: some thoughts about affect, reason, risk, and rationality. Risk Anal. 2004;24(2):311–22.

    Article  PubMed  Google Scholar 

  23. Napper LE, Fisher DG, Reynolds GL. Development of the perceived risk of HIV scale. AIDS Behav. 2012;16(4):1075–83.

    Article  PubMed  Google Scholar 

  24. Chao LW, Gow J, Akintola O, Pauly M. Perceptions of community HIV prevalence, own HIV infection, and condom use among teachers in KwaZulu-Natal, South Africa. AIDS Behav. 2007;11(3):453–62.

    Article  PubMed  Google Scholar 

  25. Eaton L, Kalichman S, Cain D, et al. Perceived prevalence and risks for human papillomavirus (HPV) infection among women who have sex with women. J Womens Health (Larchmt). 2008;17(1):75–83.

    Article  Google Scholar 

  26. Kalichman SC, Cain D. Perceptions of local HIV/AIDS prevalence and risks for HIV/AIDS and other sexually transmitted infections: preliminary study of intuitive epidemiology. Ann Behav Med. 2005;29(2):100–5.

    Article  PubMed  Google Scholar 

  27. Kalichman S, Simbayi L, Cain D, Jooste S. Perceived HIV/AIDS Prevalence, Burden, and Risk, Cape Town, South Africa. Am J Health Behav. 2008;32(6):693–700.

    Article  PubMed  Google Scholar 

  28. White D, Stephenson R. Correlates of Perceived HIV prevalence and associations with HIV testing behavior among men who have sex with men in the United States. Am J Mens Health. 2014;10(2):90–9.

    Article  PubMed  Google Scholar 

  29. Hoff CC, Beougher SC. Sexual agreements among gay male couples. Arch Sex Behav. 2010;39(2):774–87.

    Article  PubMed  Google Scholar 

  30. Parsons JT, Starks TJ, DuBois S, Grov C, Golub SA. Alternatives to monogamy among gay male couples in a community survey: implications for mental health and sexual risk. Arch Sex Behav. 2013;42(2):303–12.

    Article  PubMed  Google Scholar 

  31. StataCorp. Stata Statistical Software: Release 14. College Station: StataCorp LP. 2015.

  32. Perloff LS. Social comparison and illusions of invulnerability to negative life events. In: Snyder CR, Ford CE, editors. Coping with negative life events: clinical and social psychological perspectives. New York: Springer Science + Business Media; 1987.

    Google Scholar 

  33. Weinstein ND. Why it won’t happen to me: perceptions of risk factors and susceptibility. Health Psychol. 1984;3(5):431–57.

    Article  PubMed  CAS  Google Scholar 

  34. Lombardo AP. Anatomy of fear: Mead’s theory of the past and the experience of the HIV/AIDS “worried well”. Symb Interact. 2004;27(4):531–48.

    Article  Google Scholar 

  35. Fisher JD, DelGado BP, Melchreit R, Spurlock-McLendon J. The dynamics of repeat HIV testing, and interventions for repeat HIV testers. AIDS Behav. 2002;6(2):183–91.

    Article  Google Scholar 

  36. Suarez T, Miller J. Negotiating risks in context: a perspective on unprotected anal intercourse and barebacking among men who have sex with men—where do we go from here? Arch Sex Behav. 2001;30(3):287–300.

    Article  PubMed  CAS  Google Scholar 

  37. Adam BD, Husbands W, Murray J, Maxwell J. AIDS optimism, condom fatigue, or self-esteem? Explaining unsafe sex among gay and bisexual men. J Sex Res. 2005;42(3):238–48.

    Article  PubMed  Google Scholar 

  38. Mustanski BS, Newcomb ME, Du Bois SN, Garcia SC, Grov C. HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions. J Sex Res. 2011;48(2–3):218–53.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Castel AD, Befus M, Willis S, et al. Use of the community viral load as a population-based biomarker of HIV burden. AIDS. 2012;26(3):345–53.

    Article  PubMed  Google Scholar 

  40. Das M, Chu PL, Santos GM, et al. Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco. PLoS ONE. 2010;5(6):e11068.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  41. Montaner JS, Lima VD, Barrios R, et al. Association of highly active antiretroviral therapy coverage, population viral load, and yearly new HIV diagnoses in British Columbia, Canada: a population-based study. Lancet. 2010;376(9740):532–9.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Health Behavior and Biological Sciences, School of Nursing and the Center for Sexuality and Health Disparities, University of Michigan, 400 North Ingalls, Ann Arbor, MI, USA

    Stephen Sullivan & Rob Stephenson

Authors
  1. Stephen Sullivan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rob Stephenson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephen Sullivan.

Ethics declarations

Conflict of interest

The authors declare they have no conflicts of interest to disclose.

Ethical Approval

All procedures performed in our study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sullivan, S., Stephenson, R. Perceived HIV Prevalence Accuracy and Sexual Risk Behavior Among Gay, Bisexual, and Other Men Who Have Sex with Men in the United States. AIDS Behav 22, 1849–1857 (2018). https://doi.org/10.1007/s10461-017-1789-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-017-1789-3

Keywords

Search

Navigation