'Safer Sex Fatigue,' Confidence in HIV Treatment Lead to Risky Sex Behavior
Originally published by Reuters Health, April 23, 2002
NEW YORK (Reuters Health) — Impatience with safer sex practices and a decreased concern about HIV transmission in the era of highly active antiretroviral therapy are associated with unprotected anal sex among homosexual men in the US.
In 1999, Dr. Steffanie A. Strathdee, of The Johns Hopkins University in Baltimore, and colleagues surveyed homosexual men enrolled in the Multicenter AIDS Cohort Study who reported having engaged in anal sex within the previous 6 months. Of this group, 218 were HIV-seronegative and 329 were seropositive.
According to the authors' report in the March 29th issue of AIDS, HIV-positive men who scored in the upper quartile for less concern about infecting another person because of HAART were six times more likely than those in the lowest quartile to have engaged in unprotected insertive anal sex. The risk was nearly five times higher for those reporting "safer sex fatigue," i.e. they agreed with the statement 'I am tired of always having safer sex.'
Similar associations were found for HIV-uninfected men and their risk of engaging in unprotected receptive anal sex.
"A message of complacency has arisen in the gay community and the general population," Dr. Strathdee told Reuters Health. "We've been telling gay men for the last 2 decades that they need to use a condom each time they have sex, so any kind of suggestion that this is not so important anymore, provides justification for people who want to relax and experience the sexual liberation of the 1970s."
She added that pharmaceutical companies need to be "responsible" and not run ads in which models appear to be "the picture of health." Instead, she said, the companies should continue to reinforce the message that HIV is ultimately fatal.
"What is concerning is that these are men in major urban areas who have so far survived the AIDS epidemic, but despite all that they've seen, they are having unprotected sex," Dr. Strathdee pointed out. "So what is going on in suburban and rural America and among young men and men of color who are at very high risk? We need to revamp the prevention paradigm."
