Tensions between the epidemiology and psychology of HIV risk: implications for pre-exposure prophylaxis.
This study focuses on psychological differences in risk-taking patterns and their association with risk compensation motivations in the context of pre-exposure prophylaxis (PrEP). Participants were 257 HIV-negative MSM and transgender women recruited in New York City. The majority of participants (89.5 %, n = 230), could be classified as either: Intimates (40 %), who report unprotected anal intercourse (UAI) only with a main partner believed to be HIV-negative; Trusters (34 %), who engaged in UAI only with casual partners believed to be HIV-negative; and Gamblers (26 %) who report UAI with partners of unknown serostatus. Partner-based classifications were better predictors of HIV risk perception and other traditional correlates of risk-taking (e.g. impulsivity, sexual compulsivity) than rates of UAI. The three groups differed significantly in PrEP-related risk compensation motivations: sexual pleasure (Gamblers), intimacy (Trusters) and partner pressure (Intimates). These data underscore the importance of focusing the psychological dynamics of risk perception and sexual decision-making.
Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Avenue, New York, NY, 10065, USA, sarit.golub@hunter.cuny.edu.
Sarit A
SA
Golub
D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D009519:New York City / Q000453:epidemiology; D065129:Pre-Exposure Prophylaxis; D011569:Psychiatric Status Rating Scales; D012309:Risk-Taking; D012747:Sexual Partners; D063106:Transgender Persons / Q000523:psychology*; D055815:Young Adult