title: Unsafe sexual behavior and correlates of risk in a probability sample of men who have sex with men in the era of highly active antiretroviral therapy.
abstract: OBJECTIVE
  To assess the levels and correlates of potential exposure to and transmission of HIV in a contemporary, community-based probability sample of men who have sex with men (MSM).
  
  
  METHODS
  In 2003, 311 sexually active MSM participated in a random-digit dial telephone survey in Seattle neighborhoods with a high prevalence of MSM. The primary outcomes were potential exposure to and transmission of HIV, defined as unprotected anal intercourse with a man of opposite or unknown HIV status in the preceding 12 months.
  
  
  RESULTS
  Fourteen percent of respondents reported being HIV-positive, 77% reported being HIV-negative, and 8% had not been tested. Of 241 HIV-negative MSM, 25 (10%; 95% confidence interval [CI], 7-15%) were potentially exposed to HIV; among 45 HIV-positive MSM, 14 (31%; 95% CI, 20-46%) were potential HIV-transmitters. Among HIV-negative men, the strongest bivariate correlates of potential exposure to HIV were recent bacterial sexually transmitted disease (odds ratio [OR], 5.8), number of recent male sexual partners (OR, 1.01 per partner), recent sex at a bathhouse (OR, 9.1), and recent use of sildenafil (OR, 4.4), amyl nitrite (OR, 6.2), and methamphetamine (OR, 8.0). Among HIV-infected men, the strongest correlates of potential HIV transmission were recent use of amyl nitrite (OR, 3.1), number of recent male sex partners (OR, 1.07 per partner), and having a male spouse or domestic partner (OR, 0.3).
  
  
  CONCLUSIONS
  Most MSM knew their HIV status and adopted safer sexual behaviors to reduce their risk of HIV acquisition or transmission. However, 10% of HIV-negative MSM and 31% of HIV-positive MSM recently engaged in behaviors that placed them at high risk for acquiring or transmitting HIV.
authors.affiliation: Department of Medicine and the Center for AIDS and STD, University of Washington, and Public Health-Seattle & King County, Seattle, Washington 98115, USA. www.interscientific.net/contact.html
authors.forename: Devon D
authors.initials: DD
authors.lastname: Brewer
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Golden
authors.forename: H Hunter
authors.initials: HH
authors.lastname: Handsfield
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires; D047568:Unsafe Sex; D014861:Washington / Q000453:epidemiology