title: Prevalence and predictors of conscious risk behavior among San Franciscan men who have sex with men.
abstract: We estimated the prevalence of conscious risk, specifically defined as unprotected anal intercourse with an HIV-serodiscordant partner, and identified individual-level and partnership-level predictors of this behavior. Conscious risk was estimated to be practiced by 4.8% of HIV-negative MSM and 15.7% of HIV-positive MSM over a six-month period (p < 0.01). Among HIV-negative MSM, episodes of conscious risk were estimated to be more frequent among individuals between the ages of 18 and 24 (compared to those 55 years of age or older), among African Americans and Whites (compared to Latinos and Asians), individuals earning less than 10,000 dollars per year (compared to those earning 50,000 and 70,000 dollars per year), and among users of methamphetamine, downers, pain killers, and amyl nitrate (poppers). Among HIV-positive MSM, episodes of conscious risk were more frequent among Whites and Asians (compared to those of "other" races, i.e., those of mixed race, or those who did not exclusively self-report as White, Black, Latino, or Asian), those with full-time employment (as opposed to those with part-time employment), those earning between 30,000 and 50,000 dollars per year or 70,000 dollars per year or greater (compared to those earning under 10,000 dollars per year), and recent users of poppers. Conscious risk was more frequently reported in partnerships with large age gaps and in main partnerships (as opposed to casual or exchange partnerships). Individuals at high risk for conscious risk may be ideal candidates for pre-exposure prophylaxis (PrEP).
authors.affiliation: AIDS Office, San Francisco Department of Public Health, 25 Van Ness Ave. Ste 500, San Francisco, CA 94102-6033, USA.
authors.forename: Yea-Hung
authors.initials: YH
authors.lastname: Chen
authors.forename: H Fisher
authors.initials: HF
authors.lastname: Raymond
authors.forename: Michael
authors.initials: M
authors.lastname: Grasso
authors.forename: Binh
authors.initials: B
authors.lastname: Nguyen
authors.forename: Tyler
authors.initials: T
authors.lastname: Robertson
authors.forename: Willi
authors.initials: W
authors.lastname: McFarland
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000453:epidemiology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data