RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA.
Health Promotion and Disease Prevention, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
AIDS Behav. 2018 May;22(5):1699-1712. doi: 10.1007/s10461-017-1790-x.
Despite the high incidence of HIV among young Black MSM in the United States and engagement in high risk behaviors, many men in this group avoid infection. This suggests that some men may engage in systematic risk reduction behaviors when not always using condoms or abstaining from substances. Using a "positive deviance" framework, we conducted qualitative interviews with HIV-negative, Black MSM between 25 and 35 who reported unprotected anal sex and drug use in the past six months or current heavy drinking (N = 29) to discover behaviors that could facilitate remaining HIV-uninfected. Findings showed that MSM who remain HIV negative despite continuing to engage in high-risk behaviors may be engaging in adaptive risk reduction behaviors that, through successive decisions and advance planning along the timeline to a sexual event, could lead to increased condom use, avoidance or delay of a risky sexual event, or reduction of HIV positive partners.
尽管美国年轻的黑人男男性行为者（MSM）中 HIV 的发病率很高，且他们存在高危行为，但该群体中的许多男性还是避免了感染。这表明，当这些男性并非总是使用安全套或避免使用物质时，他们可能会采取系统的降低风险行为。我们采用“积极偏差”框架，对 25 至 35 岁之间的 HIV 阴性黑人 MSM 进行了定性访谈，这些男性在过去六个月报告了无保护的肛交和药物使用，或目前有重度饮酒行为（N=29），以发现可能有助于保持 HIV 阴性的行为。研究结果表明，尽管继续从事高危行为，但 HIV 仍呈阴性的 MSM 可能正在采取适应性的降低风险行为，通过在性事件时间线上的连续决策和提前计划，这些行为可能会增加使用安全套、避免或延迟高危性行为，或减少 HIV 阳性伴侣。
