title: A cautionary tale: risk reduction strategies among urban American Indian/Alaska Native men who have sex with men.
abstract: American Indian and Alaska Native (AIAN) men who have sex with men (MSM) are considered particularly high risk for HIV transmission and acquisition. In a multi-site cross-sectional survey, 174 AIAN men reported having sex with a man in the past 12 months. We describe harm reduction strategies and sexual behavior by HIV serostatus and seroconcordant partnerships. About half (51.3%) of the respondents reported no anal sex or 100% condom use and 8% were in seroconcordant monogamous partnership. Of the 65 men who reported any sero-adaptive strategy (e.g., 100% seroconcordant partnership, strategic positioning or engaging in any strategy half or most of the time), only 35 (54.7%) disclosed their serostatus to their partners and 27 (41.5%) tested for HIV in the past 3 months. Public health messages directed towards AIAN MSM should continue to encourage risk reduction practices, including condom use and sero-adaptive behaviors. However, messages should emphasize the importance of HIV testing and HIV serostatus disclosure when relying solely on sero-adaptive practices.
authors: Indigenous Wellness Research Institute, University of Washington, Seattle, WA 98105, USA. pearsonc@uw.edu
authors: Cynthia R
authors: CR
authors: Pearson
authors: Karina L
authors: KL
authors: Walters
authors: Jane M
authors: JM
authors: Simoni
authors: Ramona
authors: R
authors: Beltran
authors: Kimberly M
authors: KM
authors: Nelson
mesh_terms: D000293:Adolescent; D000328:Adult; D000413:Alaska; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D018023:HIV Seronegativity; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012747:Sexual Partners; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D047568:Unsafe Sex / Q000706:statistics & numerical data; D014505:Urban Population; D055815:Young Adult
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