Situational, partner, and contextual factors associated with level of risk at most recent intercourse among Black men who have sex with men.

African American men who have sex with men (MSM) in the United States bear a disproportionate burden of HIV infection and disease incidence. 178 Black MSM provided detailed situational information concerning their most recent act of anal intercourse (AI) with a male partner including condom use, partner characteristics, serostatus disclosure, and substance use. Participants completed scales assessing AIDS-related as well as broader contextual domains. Most recent AI acts occurred with same-race partners outside of main relationships. Over one-third of AI acts were unprotected, and almost half of the unprotected acts were not between known HIV-concordant partners. Nearly half of men reported substance use before sex. In a multiple regression analysis, unprotected AI with a partner not known to be concordant was predicted by low risk reduction intentions and indicators of a casual relationship. The findings highlight issues and partner contexts associated with risk for contracting HIV infection among Black MSM.