Correlates of sexual risk behaviors among HIV-positive men who have sex with men.

This study examines correlates of unprotected sexual risk practices of an ethnically diverse sample of HIV-seropositive men who have sex with men (MSM) from the New York City and San Francisco metropolitan areas. Participants completed a self-report survey that assessed sexual risk behaviors and potential correlates. A total of 367 men reported sex with a casual male partner in the previous 3 months. Participants were divided into three groups based on level of HIV-transmission risk with HIV negative or unknown-status partners: no unprotected anal sex (58.9%), unprotected receptive anal sex only (14.2%), and unprotected insertive anal sex (22.6%). Multivariate logistic regression analyses indicated that men reporting unprotected anal insertive sex perceived less responsibility to protect their partners from HIV. Men reporting no unprotected anal sex also reported less use of nitrate inhalants, lower temptation for unsafe sex, and fewer HIV-negative and unknown-status partners. Men reporting unprotected receptive anal sex were less anxious than the other two groups but also reported greater depression than those not reporting unprotected anal sex and greater loneliness than those reporting unprotected anal insertive sex. Implications for interventions with HIV-positive MSM are presented.