Personality traits and adaptive HIV disease management: Relationships with engagement in care and condomless anal intercourse among highly sexually active sexual minority men living with HIV

Purpose: The purpose of this study was to identify systematic relationships between personality domains and engagement in HIV care and secondary HIV prevention among sexual minority men living with HIV. Methods: This cross-sectional study examined the relationships between general personality traits of the Five-Factor Model of personality (e.g., Neuroticism and Conscientiousness) and engagement in medical care and condomless anal intercourse among a sample of highly sexually active sexual minority men living with HIV (N = 60). Results: Conscientiousness (B =-0.01, P < 0.05), Openness (B =-0.03, P < 0.05), and Extraversion (B =-0.03, P < 0.001) were each associated with engaging in fewer episodes of condomless anal intercourse and Conscientiousness alone was significantly related to having fewer sexual partners (B =-0.04, P < 0.001). Conscientiousness (odds ratio [OR] = 1.07, confidence interval [CI]: 1.01-1.13) and Extraversion (OR = 1.13, CI: 1.04-1.22) were both associated significantly with prevention service use. Conscientiousness alone was related to engagement in HIV medical case management (B =-0.11, P < 0.05), whereas both Conscientiousness (B = 0.41, P < 0.0001) and Neuroticism (B =-0.64, P < 0.001) were associated with perceived health. Furthermore, compared with the normative sample for the NEO-Personality Inventory-Revised, men in our sample scored significantly higher on Neuroticism and significantly lower on Conscientiousness (Ps < 0.05). Conclusion: These findings suggest that enduring individual differences may account, in part, for some of the high levels of condomless anal intercourse reported by this group, as well as engagement in and use of prevention services. We suggest strategies for engaging this group in secondary HIV prevention programs and initiatives.