AEGiS-14IAC: Why HIV infections have increased among men who have sex with men and what to do about it.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Why HIV infections have increased among men who have sex with men and what to do about it.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. D11078)

Morin SF, Harcourt J, Vernon K, Volk J, Riess T, Neilands T, McLaughlin M, Coates TJ
UCSF AIDS Research Institute, San Francisco, United States

BACKGROUND: A resurgence of sexual risk taking, STDs and HIV incidence have been reported among men who have sex with men (MSM) in several countries. We designed this study to determine the reasons behind the increase in new HIV infections and to define prevention messages that might reduce risk in this population.

METHODS: We conducted 6 focus groups with 55 MSM recruited from different neighborhoods in San Francisco. We asked participants to define the factors leading to increased risk taking and new infections. The first four groups identified major themes, while the last two groups validated and confirmed the findings and pilot tested potential prevention messages. Participants in these last 2 groups ranked 19 potential messages, and Friedman tests were used to test for significance differences among 5 prevention themes. Themes were identified in transcripts of the focus groups by independent coders and entered into Ethnograph software; average rank was assigned to prevention messages assigned by participants.

RESULTS: HIV risk taking and transmission have increased because 1) HIV is not perceived as the threat it once was due to more effective therapies; 2) MSM communicate less about HIV, and social support for risk reduction has decreased; and 3) community norms have shifted such that unsafe sex is more acceptable. The messages most likely to motivate risk reduction encouraged individuals to seek social support from friends; the themes ranked least likely to succeed were those that reinforced existing safer sex messages.

CONCLUSIONS: HIV is not as threatening as it once was, and the MSM community has shifted away from the safer sex norm. Prevention messages need to emphasize talking to friends and the negative consequences of HIV disease.

Keywords: AEGIS, HIV Infections, Safe Sex, Risk-Taking, Coitus, Incidence, HIV Seropositivity, Communication, Social Support, Interpersonal Relations, Focus Groups, San Francisco, Human, Male

020707
D11078