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Are HIV-Negative Men Who Have Sex with Men and Who Bareback Concerned About HIV Infection? Implications for HIV Risk Reduction Interventions

Abstract

The emergence of barebacking (intentional unprotected anal intercourse in situations where there is risk of HIV infection) among men who have sex with men (MSM) has been partially attributed to a decrease in HIV-related concerns due to improved anti-retroviral treatment. It is important to understand the level of concern these men have regarding HIV infection because it can affect their interest in risk reduction behaviors as well as their possible engagement in risk reduction interventions. As part of a study on MSM who use the Internet to seek sexual partners, 89 ethnic and racially diverse men who reported never having an HIV-positive test result completed an in-depth qualitative interview and a computer-based quantitative assessment. Of the 82 men who were asked about concerns of HIV infection during the qualitative interviews, 30 expressed “significant concern” about acquiring HIV, 42 expressed “moderate concern,” and 10 expressed “minimal concern.” Themes that emerged across the different levels of concern were their perceptions of the severity of HIV infection, having friends who were HIV positive, and their own vulnerability to HIV infection. However, these themes differed depending on the level of concern. Among the most frequently mentioned approaches to decrease risk of HIV infection, participants mentioned avoiding HIV-positive sex partners, limiting the number of partners with whom they barebacked, and not allowing partners to ejaculate inside their rectum. Findings suggest that many MSM who bareback would be amenable to HIV prevention efforts that do not depend solely on condom use.

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Acknowledgments

This research was supported by a grant (R01 MH69333; PI: Alex Carballo-Diéguez, Ph.D.) from the United States National Institute of Mental Health (NIMH) and by a center NIMH grant (P30-MH43520; PI: Anke A. Ehrhardt, Ph.D.) to the HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIMH or the NIH.

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Correspondence to Iván C. Balán.

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Balán, I.C., Carballo-Diéguez, A., Ventuneac, A. et al. Are HIV-Negative Men Who Have Sex with Men and Who Bareback Concerned About HIV Infection? Implications for HIV Risk Reduction Interventions. Arch Sex Behav 42, 279–289 (2013). https://doi.org/10.1007/s10508-011-9886-2

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Keywords

  • Gay men
  • HIV prevention
  • HIV concerns
  • HIV optimism
  • Raw sex
  • Barebacking