title: Sexual risk behavior among HIV-positive men who have sex with men: a literature review.
abstract: OBJECTIVE
  To review research on sexual risk behavior among HIV-positive men who have sex with men (MSM) after the year 2000.
  
  
  METHODS
  The review included 53 published studies that reported on unprotected anal intercourse (UAI) in cross-sectional and longitudinal surveys of HIV-positive MSM and MSM of mixed HIV status.
  
  
  RESULTS
  The findings indicate high levels of UAI among HIV-positive MSM, particularly with HIV-negative or HIV status unknown partners. In studies of MSM of mixed HIV status, we found that the rate of UAI among HIV-positive MSM was much higher than that of HIV-negative MSM. Furthermore, the prevalence of UAI among HIV-positive MSM has increased in recent years.
  
  
  CONCLUSIONS
  Although studies indicate that HIV-positive MSM have adopted risk reduction strategies, roughly two in five HIV-positive MSM continue to engage in UAI, which represents a risk for continued HIV and STI (sexually transmitted infection) transmission.
  
  
  CONCLUSIONS
  Prevention efforts targeting HIV-positive MSM to assist them in adopting and maintaining safer sexual behaviors need to be intensified.
authors.affiliation: Center for Research on HIV/AIDS Prevention and Education (Reshape), Department of Experimental Psychology, Maastricht University, The Netherlands. n.vankesteren@psychology.unimaas.nl
authors.forename: Nicole M C
authors.initials: NM
authors.lastname: van Kesteren
authors.forename: Harm J
authors.initials: HJ
authors.lastname: Hospers
authors.forename: Gerjo
authors.initials: G
authors.lastname: Kok
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D006679:HIV Seropositivity / Q000523:psychology* / Q000635:transmission; D040261:Harm Reduction; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011322:Primary Prevention; D012107:Research Design; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012747:Sexual Partners; D047568:Unsafe Sex / Q000517:prevention & control / Q000523:psychology*