Gay and bisexual men were more likely to have unprotected sex with casual partners if they believed that HIV/AIDS treatments -- generally referred to as highly active anti-retroviral therapy, or HAART for short -- reduced the likelihood of the transmission of HIV, the virus that causes AIDS, the study published in the November issue of Annals of Behavioral Medicine shows.
“Among both HIV-positive and HIV-negative men, those who believed in HAART’s ability to prevent the transmission of HIV reported somewhat weaker intentions to use condoms … . Transmission-prevention beliefs appear to be central to understanding the HIV-related sexual risk behavior of gay and bisexual men,” say authors David M. Huebner, M.A., and Mary A. Gerend, M.A., of Arizona State University.
Research into whether treatments reduce the risk of transmission are ongoing. Although, the reduced viral loads seen with these therapies seem to suggest that the risk would be lower, this conclusion is still controversial in the scientific community.
Huebner and Gerend note that even if treatment does reduce risk, the risk of transmission is still there.
In addition to the paper's primary findings, preliminary evidence suggested that “Men who have risky sex perceive themselves to be more susceptible to HIV as a result and help assuage the anxiety this may produce by believing that HAART helps prevent HIV transmission,” according to the authors.
"Because HIV/AIDS is no longer an assured death sentence, new issues in disease management have arisen -- cost and adherence," says Jessie C. Gruman, Ph.D., executive director of the Center for the Advancement of Health. "The success of new treatments presents an additional challenge, helping patients keep from returning to risky behaviors that could spread the disease anew."
The study included survey responses from 575 gay and bisexual men. Ninety-three identified themselves as HIV-positive, 379 said they were HIV-negative and 103 had never been tested. Respondents filled out a mail-in survey that was strategically placed throughout the Phoenix metropolitan area.
Many men in the study also subscribed to other beliefs about current HIV/AIDS treatments, such as that the treatments improve the health of HIV-infected patients and that they are complicated to take and are not completely effective. However, these beliefs were not associated with engaging in increased or decreased unprotected sex.
Even if future research does show that HAART reduces transmission risk, behavioral interventions that target these men will need to aid them in “realistically evaluating whether the potential protection afforded by HAART truly warrants abandoning more traditional risk reduction approaches, such as consistent condom use.”
The study was supported in part with funding from a National Science Foundation Graduate Fellowship award.
Annals of Behavioral Medicine is the official peer-reviewed publication of The Society of Behavioral Medicine. For information about the journal, contact Robert Kaplan, Ph.D., (858) 534-6058.
For more background on the issue of safe sex among people with HIV/AID, please see Adherence for Life: Managing HIV/AIDS from the "Facts of Life" issue briefings produced by the Health Behavior News Service. http://www.cfah.org/factsoflife/vol5no8.cfm
Posted by the Center for the Advancement of Health Annals of Behavioral Medicine
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