ATLANTAA survey of homosexual men in California suggests that
the more strongly a man believes in the effectiveness of HIV drug
regimens to prolong life and prevent transmission to partners, the
more likely he may be to engage in unsafe sex.
Weve heard rumors about increases in unprotected sex, but
this is the first actual data that show increases in risky behavior,
such as having more sexual partners, as a result of this sort of
optimism, Sheila Murphy, a psychologist at the University of
Southern California and one of the study authors, said at the
National HIV Prevention Conference.
The researchers surveyed 410 homosexual men in West Hollywood,
California, who said they were aware of the use of protease inhibitor
combination regimens in suppressing HIV infection. The men were then
asked about their confidence in the ability of the protease
inhibitors to control HIV infection.
Of the 346 men who were HIV negative, those who believed the drugs
were effective said they used condoms about 74% of the time during
anal sex. In contrast, those who had less confidence in the drugs
said they used condoms 85% of the time.
Similarly, of the 64 men who were HIV positive, those who were
optimistic about the drugs said they used condoms 66% of the time vs
85% condom use among those who were less confident.
Furthermore, fewer of the optimistic men said they were monogamous.
Among HIV-infected respondents, 35% of the optimists said they had
only one partner vs 43% of the less optimistic men. Among the
HIV-negative men surveyed, 50% of the more optimistic men vs 59% of
the less optimistic men said they were in a monogamous relationship.
An increase in unsafe sex practices, whether due to this optimism
about drug treatments or other causes, appears to be behind a recent
resurgence in sexually transmitted disease among homosexual men in
King County, Washington. Hunter H. Handsfield, MD, of Public
Health-Seattle, reported that cases of infectious syphilis rose from
0 in 1996 to 46 in the first 6 months of 1999. The proportion of
cases in homosexual men increased from 21% in 1997 to 85% in
1998/1999. Of 63 homosexual men with syphilis who gave data on sex
partners, 50 (79%) reported at least one anonymous partner.