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HIV Prevention for Gay and Bisexual Men in Metropolitan Cities

  • Chapter
Preventing AIDS

Part of the book series: AIDS Prevention and Mental Health ((APMH))

Abstract

The acquired immunodeficiency syndrome (AIDS) epidemic continues to exert a profound toll on urban gay men. As of the end of 1992, more than 150,000 cases of AIDS had been reported in the United States among men who have had sex with other men (Centers for Disease Control, 1993). It is estimated that by the end of 1993, between 240,000 and 280,000 homosexual and bisexual men will have developed AIDS, with between 30,000 and 50,000 men developing AIDS during 1993 alone (Centers for Disease Control, 1990). The majority of U.S. gay and bisexual men with human immunodeficiency virus (HIV) or AIDS reside in major metropolitan areas (Centers for Disease Control, 1993). The National Academy of Sciences Commission on AIDS has predicted that AIDS will “settle in” to gay and minority communities; thus the need for effective preventive interventions for those communities is tremendous. In this chapter, we review the prevalence and predictors of HIV infection and HIV risk behavior among urban gay men, discuss preventive interventions that have been used to reduce HIV risk-taking among urban gay men, highlight strengths and limitations of the existing literature, and present suggestions for future research.

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References

  • Adib, S. M., Joseph, J. G., Ostrow, D. G., & James, S. A. (1991). Predictors of relapse in sexual practices among homosexual men. AIDS Education & Prevention, 3, 293–304.

    CAS  Google Scholar 

  • Ames, L. J., & Beeker, C. (1990). Gay men in small cities: How risky are they? Paper presented at 6th International Conference on AIDS, San Francisco.

    Google Scholar 

  • Aspinwall, L. G., Kemeny, M. E., Taylor, S. E., Schneider, S. G., & Dudley, J. P. (1991). Psychosocial predictors of gay men’s AIDS risk reduction behavior. Health Psychology, 10, 432–444.

    Article  PubMed  CAS  Google Scholar 

  • Becker, M. H., & Joseph, J. G. (1988). AIDS and behavioral change to reduce risk: A review. American Journal of Public Health, 78, 394–410.

    Article  PubMed  CAS  Google Scholar 

  • Calabrese, L. H., Harris, B., & Easley, K. (1987). Analysis of variables impacting on safe sexual behavior among homosexual men in an area of low incidence for AIDS. Paper presented at 3rd International Conference on AIDS, Washington, DC.

    Google Scholar 

  • Catania, J. A., Coates, T. J., Kegeles, S. M., Ekstrand, M., & Guydish, J. (1988). Implications of the AIDS risk reduction model for the gay community: The importance of perceived sexual enjoyment and help-seeking behaviors. In V. Mays, G. Albee, J. Jones, J. Schneider (Eds.), Psychological approaches to the prevention of AIDS (pp. 242–261). Beverly Hills: Sage.

    Google Scholar 

  • Catania, J. A., Coates, T. J., Stall, R., Bye, L., Kegeles, S. M., Capell, F., Henne, J., McKusick, L., Morin, S., Turner, H., & Pollack, L. (1991). Changes in condom use among homosexual men in San Francisco. Health Psychology, 10, 190–199.

    Article  PubMed  CAS  Google Scholar 

  • Catania, J. A., Gibson, D., Chitwood, D., & Coates, T. J. (1990). Methodological problems in AIDS behavioral research. Psychological Bulletin, 108, 339–362.

    Article  PubMed  CAS  Google Scholar 

  • Catania, J. A., Kegeles, S. M., & Coates, T. J. (1990). Toward an understanding of risk behavior: An AIDS risk reduction model. Health Education Quarterly, 17, 53–72.

    Article  PubMed  CAS  Google Scholar 

  • Centers for Disease Control and Prevention (1993). HIV/AIDS Surveillance: Year-End Edition. Washington, DC: U.S. Public Health Service.

    Google Scholar 

  • Centers for Disease Control (1990). Estimates of HIV prevalence and projected AIDS cases: Summary of workshop, October 31–November 1, 1989. Morbidity and Mortality Weekly Report, 39, 10–119.

    Google Scholar 

  • Coates, T. J. (1990). Strategies for modifying sexual behavior for primary and secondary prevention of HIV disease. Journal of Consulting & Clinical Psychology, 58, 57–69.

    Article  CAS  Google Scholar 

  • Coates, T. J., Stall, R. D., Catania, J. A., & Kegeles, S. M. (1988). Behavioral factors in the spread of HIV infection. AIDS, 2(suppl. 1), 239–246.

    Article  Google Scholar 

  • Cochran, S. D., Mays, V. M., Ciarletta, J., Caruso, C., & Mallon, D. (1992). Efficacy of the theory of reasoned action in predicting AIDS-related sexual risk reduction among gay men. Journal of Applied Social Psychology, 22, 1481–1501.

    Google Scholar 

  • Curran, J. W., Jaffe, H. W., Hardy, A. M., Morgan, W. M., Selik, R. M., & Dondero, T. J. (1988). Epidemiology of HIV infection and AIDS in the United States. Science, 239, 610–616.

    Article  PubMed  CAS  Google Scholar 

  • Doll, L. S., Byers, R. H., Bolan, G., Douglas, J. M., Moss, P. M., Weiler, P. D., Joy, D., Bartholow, B. N., & Harrison, J. S. (1991). Homosexual men who engage in high-risk sexual behavior: A multi-center comparison. Sexually Transmitted Diseases, 18, 170–175.

    Article  PubMed  CAS  Google Scholar 

  • Doll, L. S., Peterson, L. R., White, C. R., Johnson, E. S., Ward, J. W., & The Blood Donor Study Group (1991). Homosexually and nonhomosexually identified men who have sex with men: A behavioral comparison. Journal of Sex Research, 29, 1–14.

    Article  Google Scholar 

  • Ekstrand, M. L., & Coates, T. J. (1990). Maintenance of safer sexual behaviors and predictors of risky sex: The San Francisco Men’s Health Study. American Journal of Public Health, 80, 973–977.

    Article  PubMed  CAS  Google Scholar 

  • Emmons, C., Joseph, J. G., Kessler, R. C., Wortman, D. B., Montgomery, S. B., & Ostrow, D. G. (1986). Psychological predictors of reported behavior change in homosexual men at risk for AIDS. Health Education Quarterly, 13, 331–345.

    Article  PubMed  CAS  Google Scholar 

  • Exner, T. M., Meyer-Bahlburg, H. F., & Ehrhardt, A. A. (1992). Sexual self control as a mediator of high risk sexual behavior in a New York City cohort of HIV+ and HIV-gay men. The Journal of Sex Research, 29, 389–406.

    Article  Google Scholar 

  • Flowers, J. V., Booraem, C., Miller, T. E., Iverson, A. E., Copeland, J., & Furtado, K. (1991). Comparison of the results of a standardized AIDS prevention program in three geographic locations. AIDS Education & Prevention, 3, 189–196.

    CAS  Google Scholar 

  • Folkman, S., Chesney, M. C., Pollack, L., & Phillips, C. (1992). Stress, coping and high risk sexual behavior. Health Psychology, 11, 218–222.

    Article  PubMed  CAS  Google Scholar 

  • Fox, R., Odaka, N. J., Brookmeyer, R., & Polk, B. F. (1987). Effect of HIV antibody disclosure on subsequent sexual activity in homosexual men. AIDS, 1, 241–246.

    PubMed  CAS  Google Scholar 

  • Hansfield, H. H. (1985). Decreasing incidence of gonorrhea in homosexually active men—minimal effect of risk of AIDS. Western Journal of Medicine, 143, 469–470.

    Google Scholar 

  • Hays, R. B., Catania, J. A., McKusick, L., & Coates, T. J. (1990). Help-seeking for AIDS-related concerns: A comparison of gay men with various HIV diagnoses. American Journal of Community Psychology, 18, 743–755.

    Article  PubMed  CAS  Google Scholar 

  • Hays, R. B., Kegeles, S. M., & Coates, T. J. (1990). High HIV risk taking among young gay men. AIDS, 4, 901–907.

    Article  PubMed  CAS  Google Scholar 

  • Hays, R. B., Kegeles, S. M., & Coates, T. J. (1991). Understanding the high rates of HIV risktaking among young gay and bisexual men: The young men’s survey. Paper presented at the 7th International Conference on AIDS, Florence, Italy.

    Google Scholar 

  • Hays, R. B., Kegeles, S. M., & Coates, T. J. (1992). Changes in peer norms and sexual enjoyment predict changes in sexual risk-taking among young gay men. Paper presented at 8th International Conference on AIDS, Amsterdam, The Netherlands.

    Google Scholar 

  • Higgins, D. L., Galavotti, C., O’Reilly, K. R., Schnell, D. J., Moore, M., Rugg, D. L., & Johnson, R. (1991). Evidence for the effects of HIV antibody counseling and testing on risk behaviors. Journal of the American Medical Association, 266, 2419–2428.

    Article  PubMed  CAS  Google Scholar 

  • Honnen, T. J., & Kleinke, C. L. (1990). Prompting bar patrons with signs to take free condoms. Journal of Applied Behavioral Analysis, 23, 215–217.

    Article  CAS  Google Scholar 

  • Joseph, J. G., Montgomery, S. B., Emmons, C., Kiracht, J. P., Kessler, R. C., Ostrow, D. G., Wortman, C. B., & O’Brien, K. (1987). Perceived Risk of AIDS: Assessing the behavioral and psychosocial consequences in a cohort of gay men. Journal of Applied Social Psychology, 17, 231–250.

    Article  Google Scholar 

  • Joseph, K. M., Adib, S. M., Joseph, J. G., & Tal, M. (1991). Gay identity and risky sexual behavior related to the AIDS threat. Journal of Community Health, 16, 287–297.

    Article  PubMed  CAS  Google Scholar 

  • Kegeles, S. M., Hays, R. B., & Coates, T. J. (1993, June). A community-level risk reduction intervention for young gay and bisexual men. Paper presented at 8th International Conference on AIDS, Amsterdam.

    Google Scholar 

  • Kelly, J. A., St. Lawrence, J. S., Brasfield, T. L., Stevenson, Y. L., Diaz, Y. Y., & Hauth, A. C. (1990). AIDS risk behavior patterns among gay men in small southern cities. American Journal of Public Health, 80, 416–418.

    Article  PubMed  CAS  Google Scholar 

  • Kelly, J. A., St. Lawrence, J. S., Hood, H. V., & Brasfield, T. L. (1989). Behavioral intervention to reduce AIDS risk activities. Journal of Consulting & Clinical Psychology, 57, 60–67.

    Article  CAS  Google Scholar 

  • Kelly, J. A., St. Lawrence, J. S., Betts, R., Brasfield, T. L., & Hood, H. V. (1990). A skills-training group intervention model to assist persons in reducing risk behaviors for HIV infection. AIDS Education & Prevention, 2, 24–35.

    CAS  Google Scholar 

  • Kingsley, L. A., Bacella, H., Zhou, S. Y. J., Rinaldo, C., Chmiel, J., Detels, R., Saah, A., Van Raden, M., Ho, M., Armstrong, J., & Mernoz, A. (1990, June). Temporal trends in HIV seroconversion: A report from the Multicenter AIDS Cohort Study (MACS). Paper presented at the 6th International Conference on AIDS, San Francisco.

    Google Scholar 

  • Levine, M. (1992). The life and death of gay clones. In G. Herdt (Ed.), Gay culture in America: Essays from the field (pp. 68–86). Boston: Beacon Press.

    Google Scholar 

  • Leviton, L. C., Valdiserri, R. O., Lyter, D. W., Callahan, C. M., Kingsley, L. A., Huggins, J., & Rinaldo, C. R. (1990). Preventing HIV infection in gay and bisexual men: Experimental evaluation of attitude change from two risk reduction interventions. AIDS Education & Prevention, 2, 95–108.

    CAS  Google Scholar 

  • Martin, J. L., Garcia, M. A., & Beatrice, S. T. (1989a). Sexual behavior changes and HIV antibody in a cohort of New York City gay men. American Journal of Public Health, 79, 501–503.

    Article  PubMed  CAS  Google Scholar 

  • Martin, L., Dean, L., Garcia, M., & Hall, W. (1989b). The impact of AIDS on a gay community: Changes in sexual behavior, substance use and mental health. American Journal of Community Psychology, 17, 269–293.

    Article  PubMed  CAS  Google Scholar 

  • McCusker, J., Stoddard, A. M., Mayer, K. H., Zapka, J., Morrison, C., & Saltzman, S. P. (1988). Effects of HIV antibody test knowledge on subsequent sexual behaviors in a cohort of homosexually active men. American Journal of Public Health, 78, 462–467.

    Article  PubMed  CAS  Google Scholar 

  • McCusker, J., Stoddard, A. M., Zapka, J. G., Zorn, M., & Mayer, K. H. (1989). Predictors of AIDS-preventive behavior among homosexually active men: A longitudinal study. AIDS, 3, 443–448.

    Article  PubMed  CAS  Google Scholar 

  • McCusker, J., Westenhouse, J., Stoddard, A. M., Zapka, J. G., Zorn, M. W., & Mayer, K. H. (1990). Use of drugs and alcohol by homosexually active men in relation to sexual practices. Journal of Acquired Immune Deficiency Syndromes, 3, 729–736.

    PubMed  CAS  Google Scholar 

  • McKusick, L., Coates, T. J., Morin, S., Pollack, L., & Hoff, C. (1990). Longitudinal predictors of reductions in unprotected anal intercourse among gay men in San Francisco: The AIDS Behavioral Research Project. American Journal of Public Health, 80, 1–8.

    Article  Google Scholar 

  • McKusick, L., Horstman, W., & Coates, T. J. (1985). AIDS and sexual behavior reported by gay men in San Francisco. American Journal of Public Health, 75, 493–496.

    Article  PubMed  CAS  Google Scholar 

  • McKusick, L., Wiley, J., Coates, T. J., Stall, R., Saika, G., Morin, S., Charles, K., Horstman, W., & Conant, M. (1985). Reported changes in the sexual behavior of men at risk for AIDS, San Francisco, 1982–1984: The AIDS Behavioral Research Project. Public Health Reports, 100, 622–629.

    PubMed  CAS  Google Scholar 

  • Miller, T. E., Booraem, C., Flowers, J. V., & Iverson, A. E. (1990). Changes in knowledge, attitudes, and behavior as a result of a community-based AIDS prevention program. AIDS Education & Prevention, 2, 12–23.

    CAS  Google Scholar 

  • National Research Council (1993). The social impact of AIDS in the United States. Washington, DC: National Academy Press.

    Google Scholar 

  • Osmond, D. H., Page, K., Wiley, J., Garrett, K., Sheppard, H. W., Moss, A. R., Schrager, L., & Winkelstein, W. (1993, June). Human immunodeficiency virus infection in homosexual/bisexual men, ages 18–29. The San Francisco Young Men’s Health Study. Paper presented at the 9th International AIDS Conference, Berlin, Germany.

    Google Scholar 

  • Peterson, J., Coates, T., Catania, J., Hilliard, B., Middleton, L., & Hearst, N. (in press). Helpseeking for AIDS high risk behavior. AIDS Education and Prevention.

    Google Scholar 

  • Peterson, J. L., Coates, T. J., Catania, J. A., Middleton, L., Hilliard, B., & Hearst, N. (1992). High-risk sexual behavior and condom use among gay and bisexual African American men. American Journal of Public Health, 82, 1490–1494.

    Article  PubMed  CAS  Google Scholar 

  • Peterson, J. L. & Marin, G. (1988). Issues in the prevention of AIDS among Black and Hispanic men. American Psychologist, 43, 871–877.

    Article  PubMed  CAS  Google Scholar 

  • Roffman, R. A., Gordon, J. R., Beadnell, B. A., Stern, M., Craver, J. N., Douglass, F., & Simpson, D. (1989, November). Reaching gay and bisexual men who continue to engage in unsafe sexual activity: A comparison of subjects recruited for in-person or telephone counseling formats. Paper presented at the 23rd Annual Convention of the Association for Advancement of Behavior Therapy, Washington, D.C.

    Google Scholar 

  • Rogers, E. M. (1983). Diffusion of innovations (3rd Ed.). New York: Free Press.

    Google Scholar 

  • Ruefli, T., Yu, O., & Barton, J. (1992). Sexual risk-taking in smaller cities: The case of Buffalo, New York. The Journal of Sex Research, 29, 95–108.

    Article  Google Scholar 

  • Samuel, M., & Winkelstein, W. Jr. (1987). Prevalence of human immunodeficiency virus infection in ethnic minority homosexual/bisexual men. Journal of the American Medical Association, 257, 1901–1902.

    Article  PubMed  CAS  Google Scholar 

  • San Francisco Department of Public Health (1989). Continued seroconversion for HIV antibody among homosexual and bisexual men. San Francisco Epidemiology Bulletin, 5, 35–37.

    Google Scholar 

  • Schechter, M. T. (1988). Patterns of sexual behavior and condom use in a cohort of homosexual men. American Journal of Homosexual Men, 78, 1535–1538.

    CAS  Google Scholar 

  • Shernoff, M., & Bloom, D. J. (1991). Designing effective AIDS prevention workshops for gay and bisexual men. AIDS Education & Prevention, 3, 31–46.

    CAS  Google Scholar 

  • Siegel, K., Mesagno, F. P., Chen, J. Y., & Christ, G. (1989). Factors distinguishing homosexual males practicing risky and safer sex. Social Science & Medicine, 28, 561–569.

    Article  CAS  Google Scholar 

  • Silvestre, A. J., Lyter, D. W., Valdiserri, R. O., Huggins, J., & Rinaldo, C. R. (1989). Factors related to seroconversion among homo-and bisexual men after attending a risk-reduction educational session. AIDS, 3, 647–650.

    Article  PubMed  CAS  Google Scholar 

  • Smucny, J., Horn, D., Ellner, J. J., Carey, J. T., Houser, H. B., Calabrese, L. H., Edmonds, K., Bowerfind, E., Proffitt, M., Yen-Lieberman, B., Rehm, S., Wilson, T. R., & Lederman, M. M. (1992). Risk factors for HIV infection in homosexual men: The Cleveland Men’s Study of Risks in a Low-Prevalence Area. Cleveland Clinic Journal of Medicine, 59, 573–580.

    PubMed  CAS  Google Scholar 

  • St. Lawrence, J. S., Hood, H. V., Brasfield, T., & Kelly, J. A. (1989). Risk knowledge and risk behavior among gay men in high vs. low AIDS prevalence areas. Public Health Reports, 104, 391–396.

    PubMed  CAS  Google Scholar 

  • Stall, R., Barrett, D., Bye, L., Catania, J., Frutchey, C., Henne, J., Lemp, G., & Paul, J. (1992). A comparison of younger and older gay men’s HIV risk-taking behaviors: The Communication Technologies 1989 Cross-Sectional Survey. Journal of Acquired Immune Deficiency Syndromes, 5, 682–687.

    PubMed  CAS  Google Scholar 

  • Stall, R. D., Coates, T. J., & Hoff, C. C. (1988). Behavioral risk reduction for HIV infection among gay and bisexual men: A comparison of published results from the United States. American Psychologist, 43, 859–864.

    Article  PubMed  Google Scholar 

  • Stall, R. D., Ekstrand, M., Hoff, C., Paul, J., Catania, J., & Coates, T. (1993, June). Early interventions for HIV infection among gay men in two secondary AIDS epicenters. Paper presented at 9th International Conference on AIDS, Berlin.

    Google Scholar 

  • Stall, R. D., McKusick, L., Wiley, J., Coates, T., & Ostrow, D. (1986). Alcohol and drug use during sexual activity and compliance with safe sex guidelines for AIDS: The AIDS Behavioral Research Project. Health Education Quarterly, 13, 359–371.

    Article  PubMed  CAS  Google Scholar 

  • Valdiserri, R. O., Lyter, D. W., Kingsley, L. A., Leviton, L. C., Schofield, J. W., Huggins, J., Ho, M., & Rinaldo, C. R. (1987). The effect of group education on improving attitudes about AIDS risk reduction. New York State Journal of Medicine, 87, 272–278.

    PubMed  CAS  Google Scholar 

  • Valdiserri, R. CL, Lyter, D., Leviton, L. C., Callahan, C. M., Kingsley, L. A., & Rinaldo, C. R. (1988). Variables influencing condom use in a cohort of gay and bisexual men. American Journal of Public Health, 78, 801–805.

    Article  PubMed  CAS  Google Scholar 

  • Valdiserri, R. O., Lyter, D. W., Leviton, L. C., Callahan, C. M., Kingsley, L. A., & Rinaldo, C. R. (1989). AIDS prevention in homosexual and bisexual men: Results of a randomized trial evaluating two risk reduction interventions. AIDS, 3, 21–26.

    PubMed  CAS  Google Scholar 

  • Van Raden, M., Kaslow, R., & Kingsley, L. (1988). Incidence and nonsexual risk factors for recent HIV infection in homosexual men. Paper presented at the 4th International Conference on AIDS, Stockholm.

    Google Scholar 

  • Winkelstein, W. (1988). The San Francisco Men’s Health Study: Continued decline in HIV seroconversion rates among homosexual/bisexual men. American Journal of Public Health, 78, 1472–1474.

    Article  PubMed  Google Scholar 

  • Winkelstein, W., Samuel, M., & Padian, N. (1987). The San Francisco Men’s Health Study, III: Reduction in human immunodeficiency virus transmission among homosexual/bisexual men, 1982–86. American Journal of Public Health, 77, 685–689.

    Article  PubMed  Google Scholar 

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Hays, R.B., Peterson, J.L. (1994). HIV Prevention for Gay and Bisexual Men in Metropolitan Cities. In: DiClemente, R.J., Peterson, J.L. (eds) Preventing AIDS. AIDS Prevention and Mental Health. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1193-3_14

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