Prevalence and Predictors of Conscious Risk Behavior Among San Franciscan Men who have Sex with Men

• Published in: AIDS and behavior Vol. 17; no. 4; pp. 1338 - 1343
• Main Authors: Chen, Yea-Hung, Raymond, H. Fisher, Grasso, Michael, Nguyen, Binh, Robertson, Tyler, McFarland, Willi
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.05.2013; Springer Nature B.V
• Subjects: Adult; African Americans - statistics & numerical data; Age Distribution; Black White Differences; Black White Relations; Candidates; Drug Abuse; Employment; European Continental Ancestry Group - statistics & numerical data; Gays & lesbians; Health Psychology; Hispanic Americans; Hispanic Americans - statistics & numerical data; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Seronegativity; HIV Seropositivity - epidemiology; Homosexuality; Homosexuality, Male - psychology; Homosexuality, Male - statistics & numerical data; Human immunodeficiency virus; Humans; Infectious Diseases; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Men; Methamphetamine; Middle Aged; Original Paper; Partnerships; Prevalence; Prophylaxis; Public Health; Race; Risk; Risk Factors; Risk taking; San Francisco - epidemiology; Self Report; Sexual behavior; Sexually transmitted diseases; Socioeconomic Factors; STD; Surveys and Questionnaires; Unsafe Sex - statistics & numerical data; San Francisco; United States > US; San Francisco California; San Francisco; Risk behavior; Unprotected intercourse; Men who have sex with men
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-012-0169-2

We estimated the prevalence of conscious risk, specifically defined as unprotected anal intercourse with an HIV-serodiscordant partner, and identified individual-level and partnership-level predictors of this behavior. Conscious risk was estimated to be practiced by 4.8% of HIV-negative MSM and 15.7% of HIV-positive MSM over a six-month period ( p  < 0.01). Among HIV-negative MSM, episodes of conscious risk were estimated to be more frequent among individuals between the ages of 18 and 24 (compared to those 55 years of age or older), among African Americans and Whites (compared to Latinos and Asians), individuals earning less than 10,000 dollars per year (compared to those earning 50,000 and 70,000 dollars per year), and among users of methamphetamine, downers, pain killers, and amyl nitrate (poppers). Among HIV-positive MSM, episodes of conscious risk were more frequent among Whites and Asians (compared to those of “other” races, i.e., those of mixed race, or those who did not exclusively self-report as White, Black, Latino, or Asian), those with full-time employment (as opposed to those with part-time employment), those earning between 30,000 and 50,000 dollars per year or 70,000 dollars per year or greater (compared to those earning under 10,000 dollars per year), and recent users of poppers. Conscious risk was more frequently reported in partnerships with large age gaps and in main partnerships (as opposed to casual or exchange partnerships). Individuals at high risk for conscious risk may be ideal candidates for pre-exposure prophylaxis (PrEP).