title: Incidence of sexually transmitted diseases and HIV infection in men who have sex with men related to knowledge, perceived susceptibility, and perceived severity of sexually transmitted diseases and HIV infection: Dutch MSM-Cohort Study.
abstract: BACKGROUND
  This longitudinal study was conducted to investigate whether knowledge, perceived susceptibility, and perceived severity of HIV infection and sexually transmitted diseases (STDs) are associated with the incidence of STDs and new HIV infections among men who have sex with men (MSM).
  
  
  METHODS
  A 3-year cohort study was conducted among 190 HIV-negative MSM. Data were collected on the incidence of STDs and new HIV infections, as well as on knowledge and perceived susceptibility to and perceived severity of HIV infection and STDs. Knowledge and perceptions were assessed in self-administered questionnaires.
  
  
  RESULTS
  In the course of the 3-year study, six MSM (3.2%) HIV-seroconverted and 78 (41.1%) participants were diagnosed with at least one STD. MSM seemed to be better informed about HIV infection compared with STDs, and HIV infection was perceived as more severe than other STDs. In multivariable analyses, low perceived severity of HIV infection significantly (P = 0.025) predicted increased likelihood of infection with STDs or HIV, and the practice of anal intercourse was (marginally) associated with an increased risk of acquiring STDs or HIV (P = 0.052).
  
  
  CONCLUSIONS
  A high perceived severity of HIV infection seems to induce sexual behavior that protects against STDs and HIV infection. More research is needed to establish the specific behaviors by which perceived severity of STDs/HIV influences the incidence of STDs and HIV.
authors.affiliation: Department of Dermatology and Venereology, Erasmus MC, Rotterdam, The Netherlands. e.vandersnoek@erasmusmc.nl
authors.forename: Eric M
authors.initials: EM
authors.lastname: van der Snoek
authors.forename: John B F
authors.initials: JB
authors.lastname: de Wit
authors.forename: Hannelore M
authors.initials: HM
authors.lastname: Götz
authors.forename: Paul G H
authors.initials: PG
authors.lastname: Mulder
authors.forename: Martino H A
authors.initials: MH
authors.lastname: Neumann
authors.forename: Willem I
authors.initials: WI
authors.lastname: van der Meijden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D021841:Safe Sex; D012720:Severity of Illness Index; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D011795:Surveys and Questionnaires