AIDS and Behavior

, Volume 22, Issue 6, pp 1932–1943 | Cite as

Accuracy of HIV Risk Perceptions Among Episodic Substance-Using Men Who Have Sex with Men

  • Grace (Chela) Hall
  • Linda J. Koenig
  • Simone C. Gray
  • Jeffrey H. Herbst
  • Tim Matheson
  • Phillip Coffin
  • Jerris Raiford
Original Paper


Using the HIV Incident Risk Index for men who have sex with men—an objective and validated measure of risk for HIV acquisition, and self-perceptions of belief and worry about acquiring HIV, we identified individuals who underestimated substantial risk for HIV. Data from a racially/ethnically diverse cohort of 324 HIV-negative episodic substance-using men who have sex with men (SUMSM) enrolled in a behavioral risk reduction intervention (2010–2012) were analyzed. Two hundred and fourteen (66%) SUMSM at substantial risk for HIV were identified, of whom 147 (69%, or 45% of the total sample) underestimated their risk. In multivariable regression analyses, compared to others in the cohort, SUMSM who underestimated their substantial risk were more likely to report: a recent sexually transmitted infection diagnosis, experiencing greater social isolation, and exchanging sex for drugs, money, or other goods. An objective risk screener can be valuable to providers in identifying and discussing with SUMSM factors associated with substantial HIV risk, particularly those who may not recognize their risk.


MSM Substance-using Perceptions of risk HIV Risk 


Este estudio utilizó el índice de riesgo de incidentes de VIH para hombres que tienen sexo con hombres (HIRI-HSH)—una medida objetiva y validada de riesgo para la adquisición del VIH–y autopercepción de creencia y preocupación de contraer el VIH para identificar individuos que subestimaron su riesgo substancial para el VIH. Se analizaron los datos de un cohorte de diversidad racial/étnica de 324 HSH, VIH-negativos usadores de sustancias de forma episódica (por sus siglas en inglés, SUMSM) inscritos en una intervención de reducción de riesgo del comportamiento (2010-2012). Dos ciento catorce (66%) se identificaron SUMSM con substancial riesgo de VIH, de los cuales 147 (69% o 45% de la muestra total) subestima el riesgo. En el análisis multivariado de regresión, en comparación con el resto del cohorte, los SUMSM más propensos fueron los que subestimaron su riesgo sustancial: una reciente transmisión diagnóstico de infección, experimentando mayor aislamiento social y el intercambio de sexo por drogas, dinero ni otros cosas. La medida objetiva de riesgo para la adquisición de VIH, puede ser una herramienta valiosa para ayudar a los proveedores identificar e iniciar conversaciones con SUMSM sobre los factores importantes asociados con riesgo de VIH, particularmente para aquellos que no pueden reconocer conductas de riesgo.



The study was supported by the Centers for Disease Control and Prevention under cooperative agreement UR6PS000684 to Public Health Foundation Enterprises, City of Industry, California. We acknowledge all of the study participants who volunteered for this Project, Project ECHO facilitators and staff (Milo-Glen Santos, Erin Antunez, Reggie Gage, Alic Shook, Rand Dadasovich, Shannon Huffaker, Deirdre Santos and Kelly R. Knight), the recruitment coordinator, John Farley, and field recruitment team. The first author would also like to acknowledge Dr. Donna McCree and the ORISE Communities of Color Fellowship Program and colleagues Iddrisu Abdallah and Jeffry S. Becasen for their support.

Compliance with Ethical Standards


The study was supported by the Centers for Disease Control and Prevention under cooperative agreement UR6PS000684.

Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Centers for Disease Control and Prevention and the University of California San Francisco (UCSF) committee on Human Research and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

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


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Copyright information

© Springer Science+Business Media, LLC (outside the USA) 2017

Authors and Affiliations

  1. 1.Division of HIV/AIDS PreventionCenters for Disease Control and Prevention (CDC)AtlantaUSA
  2. 2.Public Health Foundation Enterprises (San Francisco Department of Public Health AIDS Office)San FranciscoUSA
  3. 3.San Francisco Department of Public Health, Division of HIV/AIDSUniversity of California San FranciscoSan FranciscoUSA
  4. 4.Division of Violence PreventionCDCAtlantaUSA

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