The research, published in the June issue of the American
Journal of Public Health, concludes that these are among many different combinations of behavioral
factors that may be linked to risky sex among gay men.
The two behaviors that proved the most likely predictors
of risky sexual behavior — noninjection
drug use and enjoyment of unprotected receptive anal sex — accounted
for risky sex in only one-third of the men, according to Margaret A. Chesney,
Ph.D., who conducted the study while at the University of California, San
Francisco.
The wide variety in risk-related behaviors suggests that one-on-one counseling,
tailored to the particular behaviors practiced by each man, might be useful
in preventing new HIV infections, the researchers say.
The data reported by Chesney and colleagues come from a study, still in progress,
called EXPLORE, the first randomized clinical trial examining whether behavioral
counseling might help reduce the rates of HIV infection in the United States.
Men participating in the trial are randomly assigned to receive either 10
one-on-one counseling sessions along with HIV testing every six months or only
standard testing and counseling every six months.
The personalized counseling sessions begin by determining
which of an individual’s
behaviors may be likely to lead to risky sexual behavior, followed by more
tailored sessions that address these specific behaviors. For instance, men
who report having poor communication skills may receiving coaching on how
to discuss their HIV status with their partners.
The men enrolled in the study are at “high risk” of
HIV infection, according to Beryl Koblin, Ph.D., of the New York Blood
Center and colleagues.
Koblin and colleagues report that alcohol and drug use, multiple partners
or one primary partner are all associated with unprotected sex among the
men
The results of the trial will be available in 2004. The study was supported
by the National Institute of Allergy and Infectious Diseases, the National
Institute of Mental Health and the National Institute on Alcohol Abuse and
Alcoholism.
