Sexually Transmitted Diseases

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Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e31820d5a77
Original Study

HIV/AIDS Complacency and HIV Infection Among Young Men Who Have Sex With Men, and the Race-Specific Influence of Underlying HAART Beliefs

MacKellar, Duncan A. DrPH, MA, MPH*; Hou, Su-I DrPH†; Whalen, Christopher C. MD†; Samuelsen, Karen PhD‡; Valleroy, Linda A. PhD*; Secura, Gina M. PhD, MPH*; Behel, Stephanie MPH*; Bingham, Trista PhD, MPH§; Celentano, David D. ScD¶; Koblin, Beryl A. PhD∥; LaLota, Marlene MPH**; Shehan, Douglas BA††; Thiede, Hanne DVM, MPH‡‡; Torian, Lucia V. PhD§§; for the Young Men's Survey Study Group

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Abstract

Background: Among men who have sex with men (MSM) in the United States, the influence of HIV/AIDS complacency and beliefs about the efficacy of highly active antiretroviral therapy (HAART) on HIV-infection risk is unknown.

Methods: We analyzed data from a 1998–2000 cross-sectional 6-city survey of 1575 MSM aged 23 to 29 years who had never tested for HIV or had last tested HIV-negative to assess these plausible influences overall and by race/ethnicity.

Findings: Measured as strong endorsement for reduced HIV/AIDS concern due to HAART, HIV/AIDS complacency was associated with reporting ≥10 male sex partners (odds ratio [OR], 2.94; 95% confidence interval [CI], 2.12–4.07), unprotected anal intercourse with an HIV-positive or HIV-unknown-status male partner (OR, 2.06; 95% CI, 1.51–2.81), and testing HIV-positive (adjusted OR [AOR], 2.35; 95% CI, 1.38–3.98). Strong endorsement of the belief that HAART mitigates HIV/AIDS severity was more prevalent among black (21.8%) and Hispanic (21.3%) than white (9.6%) MSM (P < 0.001), and was more strongly associated with testing HIV-positive among black (AOR, 4.65; 95% CI, 1.97–10.99) and Hispanic (AOR, 4.12; 95% CI, 1.58–10.70) than white (AOR, 1.62; 95% CI, 0.64–4.11) MSM.

Conclusions: Young MSM who are complacent about HIV/AIDS because of HAART may be more likely to engage in risk behavior and acquire HIV. Programs that target HIV/AIDS complacency as a means to reduce HIV incidence among young MSM should consider that both the prevalence of strong HAART-efficacy beliefs and the effects of these beliefs on HIV-infection risk might differ considerably by race/ethnicity.

© Copyright 2011 American Sexually Transmitted Diseases Association

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