Psychosocial predictors of risky sexual behaviors in African American men: implications for prevention.

Psychosocial predictors of sexual risk taking were investigated in a community sample of 502 HIV-positive and HIV-negative African American men enrolled in the African American Health Project. Poisson regression analyses were used to estimate the relative contributions of psychosocial risk and protective factors in predicting sexual risk as measured by a sexual risk behavior index. HIV-negative men, men who have sex with men and women (MSM/W), and men who have sex with men (MSM) engaged in more high-risk sexual behaviors than heterosexuals and HIV-positive men, but men who were HIV-positive carried a heavier burden of psychosocial risk factors. High psychological distress, being HIV-negative, older age, low socioeconomic status (SES), and being an MSM/W were the best predictors of sexual risk. HIV serostatus and sexual orientation differences were obtained, with high psychological distress being the most consistent predictor regardless of serostatus or sexual orientation. Results confirm previous findings of riskier sexual lifestyle among MSM/W, men with low SES, and men who are experiencing significant psychological distress.