title: A Longitudinal Analysis of Treatment Optimism and HIV Acquisition and Transmission Risk Behaviors Among Black Men Who Have Sex with Men in HPTN 061.
abstract: Little is known about HIV treatment optimism and risk behaviors among Black men who have sex with men (BMSM). Using longitudinal data from BMSM in the HPTN 061 study, we examined participants' self-reported comfort with having condomless sex due to optimistic beliefs regarding HIV treatment. We assessed correlates of treatment optimism and its association with subsequent risk behaviors for HIV acquisition or transmission using multivariable logistic regression with generalized estimating equations. Independent correlates of treatment optimism included age ≥35 years, annual household income <$20,000, depressive symptoms, high HIV conspiracy beliefs, problematic alcohol use, and previous HIV diagnosis. Treatment optimism was independently associated with subsequent condomless anal sex with a male partner of serodiscordant/unknown HIV status among HIV-infected men, but this association was not statistically significant among HIV-uninfected men. HIV providers should engage men in counseling conversations to assess and minimize willingness to have condomless sex that is rooted in optimistic treatment beliefs without knowledge of viral suppression.
authors.affiliation: Department of Epidemiology and Biostatistics, Milken Institute School of Public Health at the George Washington University, 950 New Hampshire Ave NW, 5th Floor, Washington, DC, USA. mattelevy@gwu.edu.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Levy
authors.affiliation: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Phillips
authors.affiliation: Department of Epidemiology and Biostatistics, Milken Institute School of Public Health at the George Washington University, 950 New Hampshire Ave NW, 5th Floor, Washington, DC, USA.
authors.forename: Manya
authors.initials: M
authors.lastname: Magnus
authors.affiliation: Department of Epidemiology and Biostatistics, Milken Institute School of Public Health at the George Washington University, 950 New Hampshire Ave NW, 5th Floor, Washington, DC, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Kuo
authors.affiliation: Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Geetha
authors.initials: G
authors.lastname: Beauchamp
authors.affiliation: Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Lynda
authors.initials: L
authors.lastname: Emel
authors.affiliation: Division of HIV Prevention and Care, John Wesley Community Health Institute, Los Angeles, CA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hucks-Ortiz
authors.affiliation: Science Facilitation Department, FHI 360, Durham, NC, USA.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Hamilton
authors.affiliation: Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA.|Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa.
authors.forename: Leo
authors.initials: L
authors.lastname: Wilton
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Iris
authors.initials: I
authors.lastname: Chen
authors.affiliation: Department of Medicine, Harlem Hospital and Columbia University Medical Center, New York, NY, USA.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Mannheimer
authors.affiliation: Laboratory of Infectious Disease Prevention, New York Blood Center, New York, NY, USA.|Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, USA.
authors.forename: Hong-Van
authors.initials: HV
authors.lastname: Tieu
authors.affiliation: Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA.
authors.forename: Hyman
authors.initials: H
authors.lastname: Scott
authors.affiliation: Nicole Weirtheim College of Nursing and Health Sciences, Florida International University, Miami, FL, USA.
authors.forename: Sheldon D
authors.initials: SD
authors.lastname: Fields
authors.affiliation: Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA.|Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Del Rio
authors.affiliation: Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Shoptaw
authors.affiliation: Fenway Health, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mayer
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000367:Age Factors; D017280:Condoms / Q000706:statistics & numerical data; D003863:Depression / Q000523:psychology; D015658:HIV Infections / Q000188:drug therapy / Q000208:ethnology / Q000523:psychology* / Q000635:transmission; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012747:Sexual Partners; D012959:Socioeconomic Factors
keywords: Black men who have sex with men; Condom use; HIV; Sexual risk behaviors; Treatment optimism