title: HIV/AIDS complacency and HIV infection among young men who have sex with men, and the race-specific influence of underlying HAART beliefs.
abstract: BACKGROUND
  Among men who have sex with men (MSM) in the United States, the influence of HIV/AIDS complacency and beliefs about the efficacy of highly active antiretroviral therapy (HAART) on HIV-infection risk is unknown.
  
  
  METHODS
  We analyzed data from a 1998-2000 cross-sectional 6-city survey of 1575 MSM aged 23 to 29 years who had never tested for HIV or had last tested HIV-negative to assess these plausible influences overall and by race/ethnicity.
  
  
  RESULTS
  Measured as strong endorsement for reduced HIV/AIDS concern due to HAART, HIV/AIDS complacency was associated with reporting ≥10 male sex partners (odds ratio [OR], 2.94; 95% confidence interval [CI], 2.12-4.07), unprotected anal intercourse with an HIV-positive or HIV-unknown-status male partner (OR, 2.06; 95% CI, 1.51-2.81), and testing HIV-positive (adjusted OR [AOR], 2.35; 95% CI, 1.38-3.98). Strong endorsement of the belief that HAART mitigates HIV/AIDS severity was more prevalent among black (21.8%) and Hispanic (21.3%) than white (9.6%) MSM (P < 0.001), and was more strongly associated with testing HIV-positive among black (AOR, 4.65; 95% CI, 1.97-10.99) and Hispanic (AOR, 4.12; 95% CI, 1.58-10.70) than white (AOR, 1.62; 95% CI, 0.64-4.11) MSM.
  
  
  CONCLUSIONS
  Young MSM who are complacent about HIV/AIDS because of HAART may be more likely to engage in risk behavior and acquire HIV. Programs that target HIV/AIDS complacency as a means to reduce HIV incidence among young MSM should consider that both the prevalence of strong HAART-efficacy beliefs and the effects of these beliefs on HIV-infection risk might differ considerably by race/ethnicity.
authors.affiliation: 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
authors.forename: Duncan A
authors.initials: DA
authors.lastname: MacKellar
authors.forename: Su-I
authors.initials: SI
authors.lastname: Hou
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Whalen
authors.forename: Karen
authors.initials: K
authors.lastname: Samuelsen
authors.forename: Linda A
authors.initials: LA
authors.lastname: Valleroy
authors.forename: Gina M
authors.initials: GM
authors.lastname: Secura
authors.forename: Stephanie
authors.initials: S
authors.lastname: Behel
authors.forename: Trista
authors.initials: T
authors.lastname: Bingham
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
authors.forename: Beryl A
authors.initials: BA
authors.lastname: Koblin
authors.forename: Marlene
authors.initials: M
authors.lastname: LaLota
authors.forename: Douglas
authors.initials: D
authors.lastname: Shehan
authors.forename: Hanne
authors.initials: H
authors.lastname: Thiede
authors.forename: Lucia V
authors.initials: LV
authors.lastname: Torian
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012309:Risk-Taking; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex / Q000523:psychology; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult