Psychosocial predictors of high-risk sexual behavior among HIV-negative homosexual men

Despite general awareness that human immunodeficiency virus (HIV) is transmitted sexually, people continue to engage in high-risk behavior. As part of a larger HIV project, the Coping in Health and Illness Project (CHIP), we studied the association of psychosocial factors with sexual risk taking behaviors in 53 HIV-negative gay men residing in a HIV non-epicenter. Risk behavior was measured on a 3-point scale, taking into account condom use, number of sexual partners, and type of sexual activity. Independent variables included mood, coping, history of substance dependence, social support, and acceptance of sexual orientation. Sixty percent of the subjects practiced lower-risk, 17.3% practiced moderate-risk, and 23.1% practiced high-risk behavior. We found that risk behavior was positively correlated with optimism (Life Orientation Test) (OR = 2.7; 95% CI = 1.3-5.5), anger (POMS) (OR = 2.6; 95% CI = 1.2-5.7), and negatively related to emotional control (Courtauld) (OR = 0.5; 95% CI = 0.3-1.0), and gay self-acceptance (OR = 0.35; 95% CI = 0.2-0.8). Further study is needed to determine if sexual risk-taking behavior in HIV-negative gay men will be reduced by enhancing gay self-esteem, increased understanding and adaptive use of anger, and modifying overly optimistic attitudes to increase realism.