title: Risk patterns preceding diagnosis among newly HIV-diagnosed men who have sex with men in New York City.
abstract: Men who have sex with men (MSM) are at high risk for contracting and transmitting HIV. They are increasingly encouraged to get tested, but understanding of the interplay between HIV testing and risk behavior is limited. One hundred fifty newly HIV-diagnosed (within past 3 months) MSM were recruited from a community clinic in New York City. Participants completed an interview assessing sexual behavior and substance use during the 3 months pre-diagnosis, current depressive symptoms, and prior HIV testing. HIV-related health characteristics at diagnosis were abstracted from medical records. Analyses examined factors associated with unprotected anal intercourse (UAI) in the 3 months pre-diagnosis, and with a negative HIV test in the 12 months pre-diagnosis. The sample was young (mean age=32.5, SD=8.8), ethnically diverse (62% racial/ethnic minority), low-income (71%≤$30,000/year), and educated (48% college/advanced degree). Most (95%) had a prior negative HIV test, 55% within the last 12 months. Significant risk behavior was reported, with 79% reporting UAI. UAI was associated with recent testing and use of substances during sexual behavior. Recent testing was associated with being employed/a student, having had UAI, and higher CD4 count. Implications for future research addressing perceived HIV risk, HIV testing utilization, and risk behavior are discussed.
authors.affiliation: Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA. anya.drabkin@duke.edu
authors.forename: Anya S
authors.initials: AS
authors.lastname: Drabkin
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Sikkema
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Wilson
authors.forename: Christina S
authors.initials: CS
authors.lastname: Meade
authors.forename: Nathan B
authors.initials: NB
authors.lastname: Hansen
authors.forename: Allyson
authors.initials: A
authors.lastname: DeLorenzo
authors.forename: Arlene
authors.initials: A
authors.lastname: Kochman
authors.forename: Jessica C
authors.initials: JC
authors.lastname: MacFarlane
authors.forename: Melissa H
authors.initials: MH
authors.lastname: Watt
authors.forename: Frances M
authors.initials: FM
authors.lastname: Aunon
authors.forename: Krista W
authors.initials: KW
authors.lastname: Ranby
authors.forename: Gal
authors.initials: G
authors.lastname: Mayer
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D017280:Condoms / Q000706:statistics & numerical data; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015438:Health Behavior; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening; D009519:New York City / Q000453:epidemiology; D011159:Population Surveillance; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data*; D019562:Viral Load; D055815:Young Adult