Levy Matthew E, Phillips Gregory, Magnus Manya, Kuo Irene, Beauchamp Geetha, Emel Lynda, Hucks-Ortiz Christopher, Hamilton Erica L, Wilton Leo, Chen Iris, Mannheimer Sharon, Tieu Hong-Van, Scott Hyman, Fields Sheldon D, Del Rio Carlos, Shoptaw Steven, Mayer Kenneth
Department of Epidemiology and Biostatistics, Milken Institute School of Public Health at the George Washington University, 950 New Hampshire Ave NW, 5th Floor, Washington, DC, USA.
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
AIDS Behav. 2017 Oct;21(10):2958-2972. doi: 10.1007/s10461-017-1756-z.
Little is known about HIV treatment optimism and risk behaviors among Black men who have sex with men (BMSM). Using longitudinal data from BMSM in the HPTN 061 study, we examined participants' self-reported comfort with having condomless sex due to optimistic beliefs regarding HIV treatment. We assessed correlates of treatment optimism and its association with subsequent risk behaviors for HIV acquisition or transmission using multivariable logistic regression with generalized estimating equations. Independent correlates of treatment optimism included age ≥35 years, annual household income <$20,000, depressive symptoms, high HIV conspiracy beliefs, problematic alcohol use, and previous HIV diagnosis. Treatment optimism was independently associated with subsequent condomless anal sex with a male partner of serodiscordant/unknown HIV status among HIV-infected men, but this association was not statistically significant among HIV-uninfected men. HIV providers should engage men in counseling conversations to assess and minimize willingness to have condomless sex that is rooted in optimistic treatment beliefs without knowledge of viral suppression.
对于男男性行为的黑人（BMSM）群体中，人们对艾滋病治疗的乐观态度及其风险行为知之甚少。利用HPTN 061研究中BMSM的纵向数据，我们研究了参与者因对艾滋病治疗持乐观信念而自我报告的无保护性行为舒适度。我们使用广义估计方程的多变量逻辑回归评估了治疗乐观态度的相关因素及其与后续感染或传播艾滋病风险行为的关联。治疗乐观态度的独立相关因素包括年龄≥35岁、家庭年收入<$20,000、抑郁症状、高艾滋病阴谋论信念、有问题的饮酒行为以及先前的艾滋病诊断。治疗乐观态度与感染艾滋病的男性随后与血清学不一致/艾滋病病毒状况未知的男性伴侣进行无保护肛交独立相关，但在未感染艾滋病的男性中，这种关联在统计学上并不显著。艾滋病服务提供者应与男性进行咨询谈话，以评估并尽量减少因乐观的治疗信念而在不了解病毒抑制情况时进行无保护性行为意愿。
