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. 2003 Apr;79(2):142–146. doi: 10.1136/sti.79.2.142

Psychosocial predictors of HIV/STI risk behaviours in a sample of homosexual men

A Beck 1, I McNally 1, J Petrak 1
PMCID: PMC1744640  PMID: 12690138

Abstract

Objectives: To determine the prevalence of STI/HIV risk behaviours in a sample of homosexual men and investigate the psychosocial and cognitive variables associated with these behaviours.

Method: A sample of 123 users of a homosexual men's sexual health clinic completed a questionnaire which included demographic information, psychometric measures, history of sexual risk behaviour, and history of non-consensual sex (NCS).

Results: High rates of sexual risk were found in this sample behaviour (36% of men had risky sex in the previous month) despite using a narrower definition than other recent studies. Comparable rates of non-consensual sex were found in this sample (26% of the sample had experienced NCS); however, this variable was not directly linked to increased risk behaviour. Depression and cognitions associated with controllability or predictability of risk were associated with increased HIV/STI risk behaviour.

Conclusions: Clinical measures of depression are associated with risk behaviour in this sample as are cognitions about the uncontrollability of risk and reducing chances of exposure to HIV by insertive sexual practices and fidelity. Demographic variables, a history of non-consensual sex and depression are not predictors of risk behaviour when sexual risk cognitions are used to predict unsafe sexual practices indicating that cognitions are foremost in driving risk behaviours, demographic variables, and the NCS history of the subject. Given the considerable costs of providing medical care to patients with HIV it is likely that even modest reductions in rates of HIV infection through proactive psychological interventions to modify erroneous cognitions will prove highly cost effective.

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Selected References

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  1. Bartholow B. N., Doll L. S., Joy D., Douglas J. M., Jr, Bolan G., Harrison J. S., Moss P. M., McKirnan D. Emotional, behavioral, and HIV risks associated with sexual abuse among adult homosexual and bisexual men. Child Abuse Negl. 1994 Sep;18(9):747–761. doi: 10.1016/0145-2134(94)00042-5. [DOI] [PubMed] [Google Scholar]
  2. Cunningham R. M., Stiffman A. R., Doré P., Earls F. The association of physical and sexual abuse with HIV risk behaviors in adolescence and young adulthood: implications for public health. Child Abuse Negl. 1994 Mar;18(3):233–245. doi: 10.1016/0145-2134(94)90108-2. [DOI] [PubMed] [Google Scholar]
  3. Ekstrand M. L., Stall R. D., Paul J. P., Osmond D. H., Coates T. J. Gay men report high rates of unprotected anal sex with partners of unknown or discordant HIV status. AIDS. 1999 Aug 20;13(12):1525–1533. doi: 10.1097/00002030-199908200-00013. [DOI] [PubMed] [Google Scholar]
  4. Gold R. S., Skinner M. J. Situational factors and thought processes associated with unprotected intercourse in young gay men. AIDS. 1992 Sep;6(9):1021–1030. doi: 10.1097/00002030-199209000-00017. [DOI] [PubMed] [Google Scholar]
  5. Hart G. J., Flowers P., Der G. J., Frankis J. S. Homosexual men's HIV related sexual risk behaviour in Scotland. Sex Transm Infect. 1999 Aug;75(4):242–246. doi: 10.1136/sti.75.4.242. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hays R. B., Paul J., Ekstrand M., Kegeles S. M., Stall R., Coates T. J. Actual versus perceived HIV status, sexual behaviors and predictors of unprotected sex among young gay and bisexual men who identify as HIV-negative, HIV-positive and untested. AIDS. 1997 Oct;11(12):1495–1502. doi: 10.1097/00002030-199712000-00014. [DOI] [PubMed] [Google Scholar]
  7. Hickson F. C., Davies P. M., Hunt A. J., Weatherburn P., McManus T. J., Coxon A. P. Gay men as victims of nonconsensual sex. Arch Sex Behav. 1994 Jun;23(3):281–294. doi: 10.1007/BF01541564. [DOI] [PubMed] [Google Scholar]
  8. Kalichman S. C., Kelly J. A., Morgan M., Rompa D. Fatalism, current life satisfaction, and risk for HIV infection among gay and bisexual men. J Consult Clin Psychol. 1997 Aug;65(4):542–546. [PubMed] [Google Scholar]
  9. Kippax S., Campbell D., Van de Ven P., Crawford J., Prestage G., Knox S., Culpin A., Kaldor J., Kinder P. Cultures of sexual adventurism as markers of HIV seroconversion: a case control study in a cohort of Sydney gay men. AIDS Care. 1998 Dec;10(6):677–688. doi: 10.1080/09540129848307. [DOI] [PubMed] [Google Scholar]
  10. Shah D., Thornton S., Burgess A. P. Sexual Risk Cognitions Questionnaire: a reliability and validity study. AIDS Care. 1997 Aug;9(4):471–480. doi: 10.1080/00222937500770361. [DOI] [PubMed] [Google Scholar]
  11. Strathdee S. A., Hogg R. S., Martindale S. L., Cornelisse P. G., Craib K. J., Montaner J. S., O'Shaughnessy M. V., Schechter M. T. Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Sep 1;19(1):61–66. doi: 10.1097/00042560-199809010-00010. [DOI] [PubMed] [Google Scholar]
  12. Waldner-Haugrud L. K., Gratch L. V. Sexual coercion in gay/lesbian relationships: descriptives and gender differences. Violence Vict. 1997 Spring;12(1):87–98. [PubMed] [Google Scholar]
  13. Weatherburn P., Hunt A. J., Davies P. M., Coxon A. P., McManus T. J. Condom use in a large cohort of homosexually active men in England and Wales. AIDS Care. 1991;3(1):31–41. doi: 10.1080/09540129108253045. [DOI] [PubMed] [Google Scholar]
  14. Weinhardt L. S., Forsyth A. D., Carey M. P., Jaworski B. C., Durant L. E. Reliability and validity of self-report measures of HIV-related sexual behavior: progress since 1990 and recommendations for research and practice. Arch Sex Behav. 1998 Apr;27(2):155–180. doi: 10.1023/a:1018682530519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Zierler S., Feingold L., Laufer D., Velentgas P., Kantrowitz-Gordon I., Mayer K. Adult survivors of childhood sexual abuse and subsequent risk of HIV infection. Am J Public Health. 1991 May;81(5):572–575. doi: 10.2105/ajph.81.5.572. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]

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