Attitudes towards highly active antiretroviral therapy are associated with sexual risk taking among HIV-infected and uninfected homosexual men

David E. Ostrow, Kelly J. Fox, Joan S. Chmiel, Anthony Silvestre, Barbara R. Visscher, Peter A. Vanable, Lisa Paula Jacobson, Steffanie A. Strathdee

Research output: Contribution to journalArticle

Abstract

Objective: To determine whether attitudes towards highly active antiretroviral therapy (HAART) are associated with unprotected anal sex among sexually active homosexual men. Design: Cross-sectional study nested within an ongoing prospective cohort study. Setting: Multicenter AIDS Cohort Study, from April through September 1999. Participants: Five-hundred and forty-seven homosexual men reporting anal sex (218 HIV-negative and 329 HIV-positive) during study interviews in 1999, including a 20-item validated scale on attitudes toward HAART and HIV risk behaviors (e.g., 'Because of HAART, I am less concerned about becoming HIV-infected or infecting someone'), and safer sex fatigue (e.g., 'I am tired of always having safer sex'). Main outcome measures: Self-reported unprotected receptive anal sex (RAS) and insertive anal sex (IAS) in the prior 6 months. Results: More than 50% of HIV-negative and HIV-positive men who reported having anal sex also reported recent unprotected RAS and/or IAS. HIV-negative men who most agreed that HAART reduced concern about becoming infected were more likely to report unprotected RAS compared to other HIV-negative men [adjusted odds ratio (AOR), 3.31; 95% confidence interval (CI), 1.27-8.62]. Moreover, HIV-positive men with greatest reduced concern due to HAART or safer sex fatigue were more likely to report unprotected IAS (AOR, 6.05; 95% CI, 2.24-16.63 and AOR, 4.57; 95% CI, 1.70-12.24, respectively) compared to other HIV-positive men. Conclusions: Among sexually active homosexual men, lessened concern about HIV transmission due to HAART was strongly associated with sexual risk taking, as was safer sex fatigue among HIV-positive men. Prevention programs should take into account underlying attitudes for unprotected sex in the era of HAART among both HIV-infected and uninfected men.

Original languageEnglish (US)
Pages (from-to)775-780
Number of pages6
JournalAIDS
Volume16
Issue number5
DOIs
StatePublished - Mar 29 2002

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Highly Active Antiretroviral Therapy
Risk-Taking
HIV
Sexual Behavior
Safe Sex
Fatigue
Unsafe Sex
Odds Ratio
Confidence Intervals
Sexual Minorities
Cohort Studies
Acquired Immunodeficiency Syndrome
Cross-Sectional Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Ostrow, D. E., Fox, K. J., Chmiel, J. S., Silvestre, A., Visscher, B. R., Vanable, P. A., ... Strathdee, S. A. (2002). Attitudes towards highly active antiretroviral therapy are associated with sexual risk taking among HIV-infected and uninfected homosexual men. AIDS, 16(5), 775-780. https://doi.org/10.1097/00002030-200203290-00013

Attitudes towards highly active antiretroviral therapy are associated with sexual risk taking among HIV-infected and uninfected homosexual men. / Ostrow, David E.; Fox, Kelly J.; Chmiel, Joan S.; Silvestre, Anthony; Visscher, Barbara R.; Vanable, Peter A.; Jacobson, Lisa Paula; Strathdee, Steffanie A.

In: AIDS, Vol. 16, No. 5, 29.03.2002, p. 775-780.

Research output: Contribution to journalArticle

Ostrow, David E. ; Fox, Kelly J. ; Chmiel, Joan S. ; Silvestre, Anthony ; Visscher, Barbara R. ; Vanable, Peter A. ; Jacobson, Lisa Paula ; Strathdee, Steffanie A. / Attitudes towards highly active antiretroviral therapy are associated with sexual risk taking among HIV-infected and uninfected homosexual men. In: AIDS. 2002 ; Vol. 16, No. 5. pp. 775-780.
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abstract = "Objective: To determine whether attitudes towards highly active antiretroviral therapy (HAART) are associated with unprotected anal sex among sexually active homosexual men. Design: Cross-sectional study nested within an ongoing prospective cohort study. Setting: Multicenter AIDS Cohort Study, from April through September 1999. Participants: Five-hundred and forty-seven homosexual men reporting anal sex (218 HIV-negative and 329 HIV-positive) during study interviews in 1999, including a 20-item validated scale on attitudes toward HAART and HIV risk behaviors (e.g., 'Because of HAART, I am less concerned about becoming HIV-infected or infecting someone'), and safer sex fatigue (e.g., 'I am tired of always having safer sex'). Main outcome measures: Self-reported unprotected receptive anal sex (RAS) and insertive anal sex (IAS) in the prior 6 months. Results: More than 50{\%} of HIV-negative and HIV-positive men who reported having anal sex also reported recent unprotected RAS and/or IAS. HIV-negative men who most agreed that HAART reduced concern about becoming infected were more likely to report unprotected RAS compared to other HIV-negative men [adjusted odds ratio (AOR), 3.31; 95{\%} confidence interval (CI), 1.27-8.62]. Moreover, HIV-positive men with greatest reduced concern due to HAART or safer sex fatigue were more likely to report unprotected IAS (AOR, 6.05; 95{\%} CI, 2.24-16.63 and AOR, 4.57; 95{\%} CI, 1.70-12.24, respectively) compared to other HIV-positive men. Conclusions: Among sexually active homosexual men, lessened concern about HIV transmission due to HAART was strongly associated with sexual risk taking, as was safer sex fatigue among HIV-positive men. Prevention programs should take into account underlying attitudes for unprotected sex in the era of HAART among both HIV-infected and uninfected men.",
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AU - Ostrow, David E.

AU - Fox, Kelly J.

AU - Chmiel, Joan S.

AU - Silvestre, Anthony

AU - Visscher, Barbara R.

AU - Vanable, Peter A.

AU - Jacobson, Lisa Paula

AU - Strathdee, Steffanie A.

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N2 - Objective: To determine whether attitudes towards highly active antiretroviral therapy (HAART) are associated with unprotected anal sex among sexually active homosexual men. Design: Cross-sectional study nested within an ongoing prospective cohort study. Setting: Multicenter AIDS Cohort Study, from April through September 1999. Participants: Five-hundred and forty-seven homosexual men reporting anal sex (218 HIV-negative and 329 HIV-positive) during study interviews in 1999, including a 20-item validated scale on attitudes toward HAART and HIV risk behaviors (e.g., 'Because of HAART, I am less concerned about becoming HIV-infected or infecting someone'), and safer sex fatigue (e.g., 'I am tired of always having safer sex'). Main outcome measures: Self-reported unprotected receptive anal sex (RAS) and insertive anal sex (IAS) in the prior 6 months. Results: More than 50% of HIV-negative and HIV-positive men who reported having anal sex also reported recent unprotected RAS and/or IAS. HIV-negative men who most agreed that HAART reduced concern about becoming infected were more likely to report unprotected RAS compared to other HIV-negative men [adjusted odds ratio (AOR), 3.31; 95% confidence interval (CI), 1.27-8.62]. Moreover, HIV-positive men with greatest reduced concern due to HAART or safer sex fatigue were more likely to report unprotected IAS (AOR, 6.05; 95% CI, 2.24-16.63 and AOR, 4.57; 95% CI, 1.70-12.24, respectively) compared to other HIV-positive men. Conclusions: Among sexually active homosexual men, lessened concern about HIV transmission due to HAART was strongly associated with sexual risk taking, as was safer sex fatigue among HIV-positive men. Prevention programs should take into account underlying attitudes for unprotected sex in the era of HAART among both HIV-infected and uninfected men.

AB - Objective: To determine whether attitudes towards highly active antiretroviral therapy (HAART) are associated with unprotected anal sex among sexually active homosexual men. Design: Cross-sectional study nested within an ongoing prospective cohort study. Setting: Multicenter AIDS Cohort Study, from April through September 1999. Participants: Five-hundred and forty-seven homosexual men reporting anal sex (218 HIV-negative and 329 HIV-positive) during study interviews in 1999, including a 20-item validated scale on attitudes toward HAART and HIV risk behaviors (e.g., 'Because of HAART, I am less concerned about becoming HIV-infected or infecting someone'), and safer sex fatigue (e.g., 'I am tired of always having safer sex'). Main outcome measures: Self-reported unprotected receptive anal sex (RAS) and insertive anal sex (IAS) in the prior 6 months. Results: More than 50% of HIV-negative and HIV-positive men who reported having anal sex also reported recent unprotected RAS and/or IAS. HIV-negative men who most agreed that HAART reduced concern about becoming infected were more likely to report unprotected RAS compared to other HIV-negative men [adjusted odds ratio (AOR), 3.31; 95% confidence interval (CI), 1.27-8.62]. Moreover, HIV-positive men with greatest reduced concern due to HAART or safer sex fatigue were more likely to report unprotected IAS (AOR, 6.05; 95% CI, 2.24-16.63 and AOR, 4.57; 95% CI, 1.70-12.24, respectively) compared to other HIV-positive men. Conclusions: Among sexually active homosexual men, lessened concern about HIV transmission due to HAART was strongly associated with sexual risk taking, as was safer sex fatigue among HIV-positive men. Prevention programs should take into account underlying attitudes for unprotected sex in the era of HAART among both HIV-infected and uninfected men.

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