A plausible causal model of HAART-efficacy beliefs, HIV/AIDS complacency, and HIV-acquisition risk behavior among young men who have sex with men.
Despite considerable research, the causal relationship remains unclear between HIV/AIDS complacency, measured as reduced HIV/AIDS concern because of highly active antiretroviral therapy (HAART), and HIV risk behavior. Understanding the directionality and underpinnings of this relationship is critical for programs that target HIV/AIDS complacency as a means to reduce HIV incidence among men who have sex with men (MSM). This report uses structural equation modeling to evaluate a theory-based, HIV/AIDS complacency model on 1,593 MSM who participated in a venue-based, cross-sectional survey in six U.S. cities, 1998-2000. Demonstrating adequate fit and stability across geographic samples, the model explained 15.0% of the variance in HIV-acquisition behavior among young MSM. Analyses that evaluated alternative models and models stratified by perceived risk for HIV infection suggest that HIV/AIDS complacency increases acquisition behavior by mediating the effects of two underlying HAART-efficacy beliefs. New research is needed to assess model effects on current acquisition risk behavior, and thus help inform prevention programs designed to reduce HIV/AIDS complacency and HIV incidence among young MSM.
Mackellar
Duncan A
DA
Division of HIV/AIDS Prevention-Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. dym4@cdc.gov
Hou
Su-I
SI
Whalen
Christopher C
CC
Samuelsen
Karen
K
Valleroy
Linda A
LA
Secura
Gina M
GM
Behel
Stephanie
S
Bingham
Trista
T
Celentano
David D
DD
Koblin
Beryl A
BA
LaLota
Marlene
M
Shehan
Douglas
D
Thiede
Hanne
H
Torian
Lucia V
LV
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D012306:Risk; D012309:Risk-Taking; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult