The authors noted that while measures of HIV treatment optimism were developed in response to increased risk behavior among gay men, they were limited in their capacity to help understand gay men's risk behavior. The team's study explored current beliefs about HIV health and transmission, and sexual desire and risk behavior, in an online survey of 2,306 gay men in Australia.
The survey included free text components. The researchers conducted 40 qualitative interviews to assess how men's decisions about risk behavior are affected by their beliefs. Principal components factor analysis on the survey's optimism belief items was conducted; thematic analysis of the qualitative material was used to interrogate the concepts underpinning these beliefs.
Two measures of HIV optimism were identified: Health Optimism (a=0.791) and Transmission Optimism (a=0.795). Multivariate analysis showed unprotected anal intercourse with casual partners was only associated with HIV transmission optimism, regardless of HIV serostatus (P<0.001). Through qualitative data, the researchers identified four themes in how men think about HIV: "concerned," "unconcerned," "fearful" and "irrelevant." Each theme interpellates the two optimism measures.
"HIV optimism remains a useful indicator of gay men's likelihood to take risk, but technical knowledge, experience, desire and attitudes to risk may all affect how people respond and often in multiple, sometimes contradictory, directions," the authors concluded. "Men's beliefs about HIV transmission risk in particular may reflect willingness to pursue pleasure over risk, or, alternatively, morbid fear of any risk. Measures of HIV optimism should be complemented by analysis of the complexities of individuals' assessments of both risk and pleasure in specific sexual contexts."
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This article was provided by CDC National Prevention Information Network.
It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.