Skip to main content
Log in

The relation between beliefs about drug treatments for HIV and sexual risk behavior in gay and bisexual men

  • Published:
Annals of Behavioral Medicine

Abstract

This study examined the relation between gay and bisexual men’s (N = 575) beliefs about highly active antiretroviral therapy (HAART) and other HIV-related beliefs, intentions, and risk behaviors. Confirmatory factor analysis verified three belief factors: the extent to which HAART improves health among HIV-infected individuals, decreases the risk of HIV transmission, and is complicated and of limited efficacy. Men who endorsed the belief that HAART decreases HIV transmission risk expressed lower intentions to use condoms for anal sex and were more likely to have engaged in unprotected anal intercourse with a casual partner. HIV-negative men who believed that HAART decreases transmission risk also perceived themselves to be more susceptible to HIV infection. Statistical evidence indicated that perceptions of susceptibility partially mediate the relation between sexual risk behavior and beliefs about HAART, suggesting that beliefs may result from, rather than cause, increased risk behavior.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Shindle K: Barebacking? Brainless.The Advocate. 1998,Feb 8:9.

  2. Signorile M: Bareback and restless.Out. 1997,July:36–37.

  3. Collier AC, Coombs RW, Schoenfeld DA, et al.: Treatment of human immunodeficiency virus infection with sasquinavir, zidovudine, and zalcitabine.New England Journal of Medicine. 1996,334:1011–1017.

    Article  PubMed  CAS  Google Scholar 

  4. Deeks SG, Smith M, Holodniy M, Kahn JO: HIV-1 protease in-hibitors: A review for clinicians.Journal of the American Medical Association. 1997,276:146–154.

    Google Scholar 

  5. McDonald CK, Kuritzkes DR: Human immunodeficiency virus type 1 protease inhibitors.Archives of Internal Medicine. 1997,157:951–959.

    Article  PubMed  CAS  Google Scholar 

  6. Anderson DJ, O’Brien TR, Politch JA, et al.: Effects of disease stage and zidovudine therapy on the detection of human immunodeficiency virus type 1 in semen.Journal of the American Medical Association. 1992,267:2769–2774.

    Article  PubMed  CAS  Google Scholar 

  7. Dornadula G, Zhang H, VanUitert B, et al.: Residual HIV-1 RNA in blood plasma of patients taking suppressive highly active antiretroviral therapy.Journal of the American Medical Association. 1999,282:1627–1632.

    Article  PubMed  CAS  Google Scholar 

  8. Rasheed S, Li Z, Xu D, Kovacs A: Presence of cell-free human immunodeficiency virus in cervicovaginal secretions is independent of viral load in the blood of human immunodeficiency virus-infected women.American Journal of Obstetrics and Gynecology. 1996,175:122–130.

    Article  PubMed  CAS  Google Scholar 

  9. Royce RA, Sena A, Cates W, Cohen MS: Sexual transmission of HIV.New England Journal of Medicine. 1997,336:1072–1078.

    Article  PubMed  CAS  Google Scholar 

  10. Vernazza PL, Gilliam BL, Dyer J, et al.: Quantification of HIV in semen: Correlation with antiviral treatment and immune status.AIDS. 1997,11:987–993.

    Article  PubMed  CAS  Google Scholar 

  11. Cardo DM, Culver DH, Ciesielski CA, et al.: A case-control study of HIV seroconversion in health care workers after percutaneous exposure.New England Journal of Medicine. 1997,337:1485–1490.

    Article  PubMed  CAS  Google Scholar 

  12. Katz M, Gerberding JL: Postexposure treatment of people exposed to the human immunodeficiency virus through sexual contact or injection-drug use.New England Journal of Medicine. 1997,336:1097–1100.

    Article  PubMed  CAS  Google Scholar 

  13. Carpenter CC, Fischl MA, Hammer SM, et al.: Antiretroviral therapy for HIV infection in 1997: Updated recommendations of the International AIDS Society-USA Panel.Journal of the American Medical Association. 1997,277:1962–1969.

    Article  PubMed  CAS  Google Scholar 

  14. Haubrich RH, Little SJ, Currier JS, et al.: The value of patient-reported adherence to antiretroviral therapy in predicting virologic and immunologic response.AIDS. 1999,13:1099–1107.

    Article  PubMed  CAS  Google Scholar 

  15. Lucas GM, Chaisson RE, Moore RD: Highly active antiretroviral therapy in a large urban clinic: risk factors for virologic failure and adverse drug reactions.Annals of Internal Medicine. 1999,131:81–87.

    PubMed  CAS  Google Scholar 

  16. Becker MH: The health belief model and personal health behavior.Health Education Monographs. 1974,2:324–508.

    Google Scholar 

  17. Rogers RW: A protection motivation theory of fear appeals and attitude change.Journal of Psychology. 1975,91:93–114.

    Google Scholar 

  18. Weinstein ND: The precaution adoption process.Health Psychology. 1988, 7:355–386.

    Article  PubMed  CAS  Google Scholar 

  19. Catania JA, Kegeles SM, Coates TJ: Towards an understanding of risk behavior: An AIDS risk reduction model (ARRM).Health Education Quarterly. 1990,17:53–72.

    PubMed  CAS  Google Scholar 

  20. Fisher JD, Fisher WA: Changing AIDS-risk behavior.Psychological Bulletin. 1992,111:455–474.

    Article  PubMed  CAS  Google Scholar 

  21. Dilley JW, Woods WJ, McFarland W: Are advances in treat-ment changing views about high-risk sex?New England Journal of Medicine. 1997,337:501–502.

    Article  PubMed  CAS  Google Scholar 

  22. Kelly JA, Hoffmann RG, Rompa D, Gray M: Protease inhibitor combination therapies and perceptions of gay men regarding AIDS severity and the need to maintain safer sex.AIDS. 1998,12:F91-F95.

    Article  PubMed  CAS  Google Scholar 

  23. Vanable PA, Ostrow DG, McKirnan DJ, Taywaditep KJ, Hope B: Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men.Health Psychology. 2000, 19:134–145.

    Article  PubMed  CAS  Google Scholar 

  24. Van de Ven P, Crawford J, Kippax S, Knox S, Prestage G: A scale of optimism-scepticism in the context of HIV treatments.AIDS-Care. 2000,12:171–176.

    Article  PubMed  Google Scholar 

  25. Perloff RM: Defining and measuring attitude.The Dynamics of Persuasion. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 1993, 25–49.

    Google Scholar 

  26. Ajzen I, Fishbein M:Understanding Attitudes and Predicting Social Behavior. Englewood Cliffs, NJ: Prentice Hall, 1980.

    Google Scholar 

  27. Ajzen I, Madden TJ: Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control.Journal of Experimental Social Psychology. 1986,22:453–474.

    Article  Google Scholar 

  28. Fishbein M, Ajzen I:Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Reading, MA: Addison-Wesley, 1975.

    Google Scholar 

  29. Kalichman SC, Nachimson D, Cherry C, Williams E: AIDS treatment advances and behavioral prevention setbacks: Preliminary assessment of reduced perceived threat of HIV-AIDS.Health Psychology. 1998,17:546–550.

    Article  PubMed  CAS  Google Scholar 

  30. Joseph JG, Montgomery SB, Emmons C, et al.: Perceived risk of AIDS: Assessing the behavioral and psychological consequences in a cohort of gay men.Journal of Applied Social Psychology. 1987, 17:231–250.

    Article  Google Scholar 

  31. Emmons C, Joseph JG, Kessler RC, et al.: Psychosocial predictors of reported behavior change in homosexual men at risk for AIDS.Health Education Quarterly. 1986,13:331–345.

    PubMed  CAS  Google Scholar 

  32. Aspinwall LG, Kemeny ME, Taylor SE, Schneider SG, Dudley JP: Psychosocial predictors of gay men’s AIDS risk-reduction behavior.Health Psychology. 1991,10:432–444.

    Article  PubMed  CAS  Google Scholar 

  33. Bryan AD, Aiken LS, West SG: Young women’s condom use: The influence of acceptance of sexuality, control over the sexual encounter, and perceived susceptibility to common STDs.Health Psychology. 1997,16:468–479.

    Article  PubMed  CAS  Google Scholar 

  34. Gerrard M, Gibbons FX, Bushman BJ: Relation between perceived vulnerability to HIV and precautionary sexual behavior. Psychological Bulletin. 1996,19:390–409.

    Article  Google Scholar 

  35. Kowalewski MR, Henson KD, Longshore D: Rethinking perceived risk and health behavior: A critical review of HIV prevention research.Health Education & Behavior. 1997,24:313–325.

    Article  CAS  Google Scholar 

  36. Sanderson CA, Jemmott JB: Moderation and mediation of HIV-prevention interventions: Relationship status, intentions and condom use among college students.Journal of Applied Social Psychology. 1996,26:2076–2099.

    Article  Google Scholar 

  37. Morrison DM, Rogers Gillmore M, Baker SA: Determinants of condom use among high-risk adults: A test of the theory of reasoned action.Journal of Applied Social Psychology. 1995,25:651–676.

    Article  Google Scholar 

  38. de Wit JBF, van Griensven GJP, Kok G, Sandfort TGM: Why do homosexual men relapse into unsafe sex? Predictors of resumption of unprotected anogenital intercourse with casual partners.AIDS. 1993,7:1113–1118.

    Article  PubMed  Google Scholar 

  39. Sheeran P, Orbell S: Do intentions predict condom use? Meta-analysis and examination of six moderator variables.British Journal of Social Psychology. 1998,37:231–250.

    PubMed  Google Scholar 

  40. Kauth MR, St. Lawrence JS, Kelly JA: Reliability of retrospective assessments of sexual HIV risk behavior: A comparison of biweekly, 3-month, and 12-month self-reports.AIDS Education and Prevention. 1991,3:207–214.

    PubMed  CAS  Google Scholar 

  41. Bentler PM:EQS for Unix. Version 5.1. [Computer software]. Encino, CA: Mulitvariate Software, Inc., 1995.

    Google Scholar 

  42. Aiken LS, West SG:Multiple Regression: Testing and Interpreting Interactions. Newbury Park, CA: Sage, 1991.

    Google Scholar 

  43. Hosmer DW, Lemeshow S:Applied Logistic Regression. New York: Wiley, 1989.

    Google Scholar 

  44. Bentler PM: Comparative fit indices in structural models.Psychological Bulletin. 1990,107:238–246.

    Article  PubMed  CAS  Google Scholar 

  45. Steiger JH: Some additional thoughts on components, factors, and factor indeterminancy.Multivariate Behavioral Research. 1990,25:41–45.

    Article  Google Scholar 

  46. Barron RM, Kenny DA: The moderator-mediator distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality and Social Psychology. 1986,51:1173–1182.

    Article  Google Scholar 

  47. Sobel ME: Asymptotic confidence intervals for indirect effects in structural equations.Sociological Methodology. 1982,12:290–312.

    Article  Google Scholar 

  48. Elford J, Bolding G, Maguire M, Sherr L: Combination therapies for HIV and sexual risk behavior among gay men.Journal of Acquired Immunodeficiency Syndrome. 2000,23:266–271.

    CAS  Google Scholar 

  49. Remien RH, Wagner G, Carballo-Diéguez A, Dolezal C: Who may be engaging in high-risk sex due to medical treatment advances?AIDS. 1998,12:1560–1561.

    Article  PubMed  CAS  Google Scholar 

  50. Siegel K, Mesagno FP, Chen JY, Christ G: Factors distinguishing homosexual males practicing risky and safer sex.Social Science and Medicine. 1989,28:561–569.

    Article  PubMed  CAS  Google Scholar 

  51. Hays RB, Kegeles SM, Coates TJ: High HIV risk-taking among young gay men.AIDS. 1990,4:901–907.

    Article  PubMed  CAS  Google Scholar 

  52. Kelly JA, St. Lawrence JS, Hood HV, Brasfield TL: Behavioral intervention to reduce AIDS risk activities.Journal of Consulting and Clinical Psychology. 1989,57:60–67.

    Article  PubMed  CAS  Google Scholar 

  53. Cohen J, Cohen P:Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences (2nd Ed.). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 1983.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David M. Huebner M.A..

Additional information

This material is based on work supported in part under a National Science Foundation Graduate Fellowship awarded to Mary Gerend. Computing resources were donated by David P. MacKinnon’s Research in Prevention Laboratory.

We thank Mary C. Davis and Leona S. Aiken for their helpful comments on earlier versions of this article. We are indebted to Sam VanLeeuwen and the other staff and volunteers at Project LifeGuard, Phoenix, for their cooperation and assistance in this research. Thanks also to Melissa Marlowe for her assistance with data management.

About this article

Cite this article

Huebner, D.M., Gerend, M.A. The relation between beliefs about drug treatments for HIV and sexual risk behavior in gay and bisexual men. ann. behav. med. 23, 304–312 (2001). https://doi.org/10.1207/S15324796ABM2304_10

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1207/S15324796ABM2304_10

Keywords

Navigation