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Using a "Positive Deviance" Framework to Discover Adaptive Risk Reduction Behaviors Among High-Risk HIV Negative
A J Ober1, D T Dangerfield2, S Shoptaw3
1RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA. ober@rand.org.
AIDS and Behavior
|May 15, 2017
Summary
Young Black men who have sex with men (MSM) may use adaptive risk reduction strategies to avoid HIV infection, even without consistent condom use or abstinence. These proactive behaviors help reduce risk during sexual encounters.
Area of Science:
- Public Health
- Behavioral Science
- Epidemiology
Background:
- High HIV incidence among young Black men who have sex with men (MSM) in the US.
- Many MSM in this demographic avoid HIV infection despite high-risk behaviors, suggesting unobserved protective factors.
Purpose of the Study:
- To explore adaptive risk reduction behaviors used by HIV-negative young Black MSM.
- To identify strategies facilitating HIV avoidance in this population.
Main Methods:
- Qualitative interviews using a "positive deviance" framework.
- Participants: 29 HIV-negative Black MSM (aged 25-35) reporting recent unprotected anal sex, drug use, or heavy drinking.
Main Results:
- Participants employed systematic, planned risk reduction strategies.
- Behaviors included increased condom use, avoiding/delaying risky sexual events, and seeking partners with lower HIV risk.
Conclusions:
- HIV-negative young Black MSM may utilize sophisticated, adaptive risk reduction tactics.
- These behaviors, often planned in advance, contribute to remaining uninfected despite ongoing high-risk activities.
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