AIDS risk reduction recommendations and sexual behavior patterns among gay men: a multifactorial categorical approach to assessing change.

A sample of 745 New York City gay men, aged 20-65, were interviewed in 1985 as part of a longitudinal effort to determine the behavioral, psychological, and social impact of the AIDS epidemic on the non-ill but at-risk community. Detailed sexual behavior histories were taken for the year prior to the interview (1984-1985) and the year prior to when respondents first heard about AIDS (mode = July 1981). Parallel questions were asked for each annual time period allowing pre-AIDS/post-AIDS comparisons to be conducted. A multifactorial index of sexual behavior was constructed from three categorical variables: number of different sexual partners, (0, 1, and 2 or more); engaging in sexual contact outside a private home, (0, vs. 1); and engaging in sexual acts considered to be of higher risk for exposure to disease pathogens (0 vs. 1). These three factors, representing aspects of sexual behavior targeted for change by authors of risk reduction educational materials, were combined to form a seven-level typological index of sexual behavior. Analyses are based on comparisons between pre- and post-AIDS time periods on this index. Results indicate that both substantial change and substantial lack of change have occurred in gay male sexual behavior patterns, when sexual behavior measures are scaled to reflect complete abstinence from a particular type of sexual activity, as they are here. Results are discussed in light of previously reported findings on sexual behavior changes and the ambiguity surrounding the question of how much change is needed for significant risk reduction of AIDS.