Beck A, McNally I, Petrak J
Clinical Psychology Services, The Ambrose King Centre, Royal London Hospital, Whitechapel, London E1 1BB, UK.
Sex Transm Infect. 2003 Apr;79(2):142-6. doi: 10.1136/sti.79.2.142.
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.
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).
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.
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.
确定男同性恋者样本中性传播感染/艾滋病毒风险行为的流行率，并调查与这些行为相关的社会心理和认知变量。
123名男同性恋者性健康诊所的使用者完成了一份问卷，其中包括人口统计学信息、心理测量指标、性风险行为史和非自愿性行为史（NCS）。
尽管采用了比其他近期研究更狭义的定义，但在该样本中仍发现了高比例的性风险行为（36%的男性在上个月有危险性行为）。该样本中发现的非自愿性行为比例相当（26%的样本经历过NCS）；然而，这一变量与增加的风险行为没有直接联系。与风险的可控性或可预测性相关的抑郁和认知与增加的艾滋病毒/性传播感染风险行为有关。
在该样本中，抑郁的临床指标与风险行为相关，对风险不可控性的认知以及通过插入式性行为和忠诚来降低感染艾滋病毒的几率也与风险行为相关。当用性风险认知来预测不安全的性行为时，人口统计学变量、非自愿性行为史和抑郁并不是风险行为的预测因素，这表明认知在驱动风险行为、人口统计学变量和受试者的NCS史方面最为重要。鉴于为艾滋病毒患者提供医疗护理的成本相当高，通过积极的心理干预来改变错误认知，即使艾滋病毒感染率有适度降低也可能证明具有很高的成本效益。
